Monday, April 21, 2008

When Good Intentions Have Unintended Consequences

Unlike adults, children - especially those under five - are quite unique in their requirements for calories and nutrients each day. That is because they're on a trajectory of growth that requires significant calories, making it is next to impossible to estimate accurately their energy needs by any formula that applies to adults.

Yet this fact doesn't stop the well-intentioned from taking the standard dietary recommendations for adults and simply downsizing portions, in the assumption that smaller portions of the same foods recommended for adults will translate to adequate nutrition for children.

Back in January 2007, I wrote about a study in Sweden that found children fed a diet low in fat were found to have a higher incidence of insulin resistance, significant nutritional deficiencies, and weighed more with higher BMI's than children fed a diet higher in fat.

As I noted in that post, "In previous generations the focus was mainly on getting and providing enough food to meet these energy needs; today we've modified our view and extrapolated our notions about a "healthy diet" - carbohydrate-rich, low-fat - to our children. Not a day goes by that there isn't an article or segment in the news that we need to feed our kids less fat and more "good" carbohydrates."

Also in January of last year, I shared with readers a day in the life of my son by posting pictures of the foods he consumed throughout the day, along with how his menu stacked up for nutrients and calories, along with how his eating differed from the sample menu offered by the American Academy of Pediatrics (AAP) as an example of "healthy eating" for children.

In that post I noted, "the menu [from the AAP] fails to provide adequate intake of Vitamin E, Vitamin K, Copper, Selenium, Potassium and omega-3 fatty acids" for a toddler.

I also wrote, "We seriously need to start re-thinking our dietary recommendations for children; right now our dietary recommendations and policy are failing them because our phobias about dietary fats have seeped into their lives as we've modified their diet to limit fat and include an abundance of carbohydrate-rich foods that does not, at the end of the day, have the desired effect."

The desired effect these days is prevention of childhood obesity and rather than truly look at how children are eating, the experts continue to downsize adult dietary recommendations and assume they'll meet the requirements of children. The worst of the assumptions is that if parents feed their children a downsized adult diet, with a variety of foods while limiting dietary fats, their children will learn good eating habits and avoid obesity.

While I was away on vacation, I read the disturbing findings reported in the Observer - a survey of nursery preschools in the UK found that 70% are feeding children inadequate calories each day because they're feeding them too many fruits and vegetables in an attempt to make sure they're eating enough fiber!

As Sarah Almond, a pediatric dietitian, noted, "We expected the study to show nurseries were serving children food that was too high in calories, fat, saturated fat and salt, and low in vegetables and fruit. Instead, we found that the majority of nurseries had gone to the other extreme and appeared to be providing food that was too low in calories, fat and saturated fat and too high in fruit and vegetables."


"Because a significant number of children attend nurseries from 7am until 7pm, the food and nutrition they receive there are key to their health," said Almond. "Nurseries are applying requirements of healthy eating for school-age children and adults to the one-to-four age group, who have entirely different requirements."

These findings speak volumes about the unintended consequences of good intentions that are based on dogma and assumptions rather than hard data. And when hard data points to the opposite of the assumptions and dogma, it's ignored.

In our desire to prevent childhood obesity, we're missing the forest for the trees and ignoring the critical requirement they have for both energy and nutrients to grow properly. It is easy to assume that a child under five doesn't need a lot of calories, especially when we think about how many we need as adults. If we believe the average adult needs about 2000-calories a day, then that tiny little kid should only need a fraction of what we need since they are much shorter and weigh a lot less, right?


Check out the Energy Calculator online, created by the USDA/ARS Children's Nutrition Research Center, designed to help parents and caregivers estimate calorie needs for children.

If you input the numbers for an average three year old boy (38", 32-pounds and active 1-hour or more a day) you'll learn he needs 1710-calories a day on average!

What do you feed a three-year old boy to meet his energy requirements and nutritional needs? I can tell you this - it's not a low-fat diet!


  1. Funny, I just posted about kids diets!

    It pains me to think that school menus are in some cases being legislated to contain certain nutrients - fibre, etc - and to disclude certain things - fat, mainly. I am all for getting rid of the junk and the sugar, but replacing them with grains and low fat milk is nowhere near an improvement.

    The calorie requirements were eye-opening! Wow. How many people are aware of this? Shouldn't anyone who takes care of children know this? I shudder to think at what will happen to these obese kids who are being put on low calorie diets - they're being set up for a lifelong struggle.

  2. It is also scary to hear that, "a significant number of children attend nurseries from 7am until 7pm." Yikes! Why even have kids if they are in daycare for their entire day. Who is the "parent" here?

  3. Anonymous12:12 PM

    The three favorite food items of my son (3 and half) are (in this order), mascarpone, creamed coconut and butter. He loves to take a spoon of mascarpone (an italian cream-chees with 44% fat). He eats creamed coconut (70% fat) like candy. For the butter he can eat it directly without bread or something, even I can not do it.
    The quantities are not big, but it is something he really likes.

    The funny part is, that I never ever forced him to eat it, he tried it himself and loved it.


  4. That's tragic, because it amounts to a lab-rat study on a national level, using kids as the experimental animals, and we may not even know all these consequences until several generations later.

    I also suspect that real effects that might for example slow growth, may be invisibly mitigated by other effects that have the reverse effect, eg the hormones in food. How long would it take us to realize that if you malnutrition and undercalorie and overgrain a child, it would stunt their growth and development a little, when we have hormones that accelerate growth and development?

    I suspect there is another reason day care centers feed the children so much fruit: because it is a helluva lot easier to say "here, have a banana" than to actually plan, prepare and cook something, which is messier, and then clean up after, for a bunch of kids. Given the choice between a grilled chicken breast (low-fat but good on protein and nutrients) vs. a pear and carrot sticks, guess which one is both cheapier and easier. The "we're avoiding feeding high-fat" is to me, probably secondary and merely very convenient.