FSAI Publishes First Healthy Eating Recommendations for 1-5 Year-Olds

Monday, 22 June 2020

The Food Safety Authority of Ireland (FSAI) published a report today outlining food based dietary guideline recommendations for 1 to 5 year-old children living in Ireland. The latest Irish research on the dietary habits of this age group was used by the FSAI’s Scientific Committee to develop these guidelines, which reflect international best practice on young child feeding in an Irish context. It is the first time a national scientific report addresses the nutritional needs of toddlers and pre-school children living in Ireland. These guidelines cover the gap in Irish scientific dietary recommendations for the post-infancy period – a phase that starts on their 1st birthday and ends at age 5 years, when the general population healthy eating recommendations begin to apply.

According to Dr Pamela Byrne, CEO, FSAI, children in this age group are at a development stage, where their increasing wish is to make their own decisions about what they eat, and this can be challenging.

    “We know that dietary habits which can last for a lifetime are formed during this critical phase. We live in an age where there are so many confusing messages and information about food and nutrition, and today’s parents and guardians are facing more challenges than ever to ensure their children are getting the right diet to support their healthy development. Also, many children in this age group develop a preference for sweet, salty and energy-dense foods, which can be difficult for parents and guardians to manage,” said Dr Byrne.

    “The recommendations in this report from the FSAI’s Scientific Committee will be the scientific evidence-base provided to the Department of Health, to inform the future national food-based dietary guidelines that will empower parents, guardians and health professionals in Ireland to best support this essential stage in a child’s development,” concluded Dr Byrne.

According to Ms. Ita Saul, Chair of the FSAI Working Group which prepared the report, the period from 1 to 5 years of age is an exciting and challenging time of transition from a predominantly milk-based diet at the end of infancy.

    “Toddlers and preschoolers have very high nutritional requirements relative to their size, so there is a real need to focus on the quality of food rather than quantity. The innovative process of using children’s growth chart percentiles as a basis for these dietary recommendations now enables healthcare workers involved in assessing young children’s growth, to identify those at nutritional risk and provide specific advice on fortified foods or supplements.”

Key recommendations from the report include:

  • Milk is a key food, with a daily intake of 550ml of cow’s milk, or equivalent amounts of yoghurt or cheese, is recommended.
  • Water and milk are the only drinks recommended for this age group. Sugar-containing and acidic drinks should be limited and, if consumed at all, should be kept to mealtimes.
  • Parents and guardians are warned against using some beverages such as almond ‘milk’, coconut ‘milk’ and rice ‘milk’, as milk substitutes as these are nutritionally inadequate. If a plant-based beverage is required to replace cow’s milk, a soya ‘milk’, can be used, provided it is fortified with nutrients, particularly calcium.
  • A portion of vegetables should always be included at the main meal, together with the number of small portions of salad, vegetables or fruit that match the age of the child, for example two small portions for a two year old, four small portions for a four year old (the portion size given should fit into the child’s hand so that smaller children are given less and bigger children more).
  • Lean red meat (about 30g) is recommended three days a week for iron and other essential minerals in addition to protein. On other days, red meat can be replaced with poultry, fish, eggs, beans or lentils which also provide iron, as well protein and minerals. Smooth nut butters also provide protein.
  • A combination of both white and wholemeal breads, cereals, potatoes, pastas and rice will provide adequate fibre and are important sources of calories.
  • Foods high in fat, high in sugar or salt such as confectionery, cakes, crisps, biscuits and sugar-coated breakfast cereals are not recommended. There is very little room for such foods in a 1 to 5 year-old’s diet, so such foods either overwhelm the child’s capacity for nutritious foods or provide additional calories that lead to the development of overweight or obesity.
  • Fats, spreads and oils should be used minimally.
  • During the extended winter months – from Hallowe’en to St Patrick’s day, all children aged 1 to 5 years need to be given a low-dose (5 µg) vitamin D-only supplement to make up for lack of skin synthesis of this vitamin from sunlight.
  • Young children aged 1 to 3 years, who are naturally small (25th percentile or less on growth charts) need extra iron, which can be taken as an iron-fortified full-fat milk, or a low-dose iron supplement.
  • Encouraging acceptance of the wide range of flavours and textures naturally found in the food people need for healthy eating throughout life is important at this young life stage. Fostering a tolerance to ‘try’ an expanding variety of vegetables, salads, fruits, meat, fish and wholemeal cereals helps children develop a taste for nutritious foods. To assist this, small amounts of sugar can be used e.g. in stewed fruit, milk puddings, in jam on wholemeal bread or as a small portion of ice cream on fruit etc.
  • If a key food group is excluded from a child’s diet because a food allergy is suspected without proper indication or appropriate professional advice being sought, the growth and development of a child can be compromised.
Scientific Recommendations for Food-Based Dietary Guidelines for 1-5 Year-Olds in Ireland

 -ENDS-

Additional information:

These recommendations were developed by the FSAI’s Scientific Committee by modeling over 2,500 daily meal patterns made up of foods commonly eaten by 1 to 5-year old children in Ireland (consumed by more than 10% of children in the Irish National Pre-School Nutrition Survey). Vegetarian patterns were also modeled. Data from a questionnaire and a focused discussion involving paediatric and community dietitians working specifically with this age group provided additional information.

An innovative approach to modeling included consideration of five growth chart percentile levels to ensure the wide range of healthy body sizes in children aged 1 to 5 years were represented. This enabled the linking of growth percentile levels to nutritional risk so that specific recommendations on fortified food or supplements are targeted towards vulnerable children. This enables the wide range of healthcare workers involved in assessing growth to provide such advice where required. The report includes additional relevant recommendations developed for children with special needs.

Dietary intake targets were identified for energy, macronutrients (protein, carbohydrate, sugar, dietary fibre, fat, saturated fat, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)) and six key micronutrients (vitamin A, vitamin D, calcium, iron, iodine and zinc). The dietary modelling was informed by healthy eating principles and considered girls and boys at five percentiles based on World Health Organization growth charts for six age groups (1 year, 1.5 years, 2 years, 3 years, 4 years and 5 years).

Members of Healthy Eating Guidelines for Toddlers and Pre-schoolers Working Group who developed this report for the FSAI’s Scientific Committee, included those with expertise in paediatric dietetics, nutrition, physical development and activity, behavioural and cognitive development, and dental health.