For many of us with busy lives, feeding the family something is a victory, let alone a home-cooked, balanced meal! And even more so when it comes to early morning breakfasts and rushed lunch boxes. Nowhere can we see the effects more acutely than in our kids – the pressure they feel at school, the difficulties with focus and concentration, and the rising levels of obesity. So many of the stressors in our lives are beyond our control, but there’s one where small victories can make a big impact – what we eat, and what we feed our children.
What you will learn
- Whole food over fast food
- Low GI over High GI
- Include protein in every meal
- Have meals as a family, at least once a day
- Model the behaviour you want to see
- Change happens over time
- Allergies and intolerances
- Breakfast and lunch ideas
Growing a healthy brain and body
We all want our kids to do well at school and in life. Cognitive functioning is central to academic achievement and encompasses the area of executive functioning, as it relates to the ability to make and achieve goals, attention and planning, working memory and impulse control. These skills develop along with the changes and development of the brain throughout childhood and adolescence, and research shows that there is a positive correlation between healthy eating and executive functioning.
Central to our children’s mental and physical development is the food they eat. The simplest comparison we can draw to how our bodies function in relation to the fuel we consume is perhaps the car. For a car to run efficiently, it needs a number of things, most importantly clean fuel, oil and water. If any of those is missing or somehow dirty, we can expect trouble. Our bodies are not much different. If we fail to feed it the right nutrients we will have less than optimal results, especially in growing brains and bodies.
But what are the right nutrients? What is ‘healthy’? None of us were really taught at school what a balanced diet looks like and that’s not to mention the political games that take place in the nutrition and health field. Fat and eggs are bad, right … and low fat milk and corn flakes are good? Yikes!
The easiest way to demystify the healthy food debacle is to always take food back to its most natural form. The slogan ‘whole foods’ helps, I would add, ‘unprocessed’ to whole foods … From a research perspective, a healthy eating pattern can be described as one that includes fruit, vegetables, legumes, whole grains, eggs, fish and certain types of meat, whereas unhealthy patterns consist of processed meats, processed grains, sugar-sweetened beverages, fried and refined food, and take-aways. Clean fuel vs dirty fuel – an optimally functioning body and mind vs one spluttering and spurting down the road.
Proper nutrition has far reaching effects for our children, from neurodevelopment to musculoskeletal growth, immunity and cardiorespiratory fitness. Let’s get into the nuts and bolts …
The main players
Now that we’re all on the whole-foods bus, let’s look at the composition of the meal. The body’s glycemic response (the effect of a meal on blood sugar levels) is central to energy production and also cognitive functioning. Have you ever had a meal and needed to go for a nap a short while after? That would have been a spike and subsequent drop in your blood sugar levels. The aim of the game is to have few or no spikes and drops and to aim for gentle undulations. We can achieve this by composing a balanced meal with the right proportions of carbohydrates, proteins and fats. This graph shows the effect of these three macro nutrients on blood glucose levels.
Carbohydrates
Not all carbs are created equal – there are differences in how simple carbohydrates and complex carbohydrates affect blood glucose levels. As you can see in the graph below, there’s a substantial spike and subsequent crash in consuming simple carbohydrate foods like white bread, potato and soft drinks, with a far more even response from something like lentils, a complex carbohydrate that also contains protein and fibre.
One way to think about carbohydrates is according to the glycemic index, a useful tool to assess the effect of a carbohydrate on blood glucose levels. Always aim for the lower GI foods, and combine them with healthy proteins and fats to even out the curve.
- Low GI: Green vegetables, most fruits, raw carrots, kidney beans, chickpeas, most nuts, lentils, milk, yoghurt, maas
- Medium GI: Sweet corn, bananas, raw pineapple, watermelon, raisins, cherries, whole cooked oats, and multigrain, whole-grain wheat or rye bread, cooled mielie/putu-pap
- High GI: White rice, white bread and potatoes, hot mielie/putu-pap, most commercial cereals, instant oats
Protein
Protein is an important nutrient for growth and development. Proteins are comprised of building blocks called amino acids, vital for muscle growth and repair, healthy bones and synthesis of hormones and enzymes. Some animo acids are considered essential – meaning the body cannot make them and must be consumed from external sources. Protein deficiency has far reaching consequences and can lead to stunted growth, a compromised immune system and muscle and bone loss. You can see why protein is so important in a growing body and mind!
The exact amount of protein is however something scientists haven’t agreed on, mostly because more research is required. Practically we can aim for a protein serving the size of the child’s palm. Of course, the need will be greater in children who are more active, as there are greater metabolic demands. Good sources of protein include meat, chicken, fish, legumes, beans and soy products and also dairy, which comes with a healthy dose of fat. Bear in mind that each of these contain a different proportion of actual protein amino acids and portions will need to be adjusted accordingly.
Fat
Gone are the days where we consider fat in and of itself is as the enemy. It depends very much on what kind of fat and how the food is prepared. Trans fats found in take-aways, baked goods and deep fried foods is certainly undesirable and will lead to weight gain and poor long term health outcomes. Fats found in unprocessed whole foods contribute positively to the nutrient requirements of our children. In fact, the greatest danger of severely limiting the fats in a child’s diet is a deficiency in some key minerals and vitamins and an increase in sugar consumption. This has a detrimental effect on their development with negative effects on health outcomes in adult life. Healthy fats are in foods like nuts, full fat dairy, some meat, olive oil and avocados.
Water
The current literature suggests that children globally have insufficient water intake. Adequate hydration is essential for survival, and children are even more sensitive to adequate water intake than adults because their body surface area to body mass ratio is higher. Even mild dehydration can lead to diminished cognitive performance while severe dehydration affects the nervous system, thermoregulation and cognitive and physical development. Adequate water intake for children ages 4-8 is 1,2 litres a day and for 9 years and older it is 1,5 litres a day. Of course increased physical activity and temperature fluctuations will also affect the amount of water needed.
Now to put it all together … Harvard has adjusted its recommendations over the years and the current plate looks something like this. The plate is appropriate for children, but no caffeinated drinks.
I can already see you jumping up and down – how on earth are we going to get all those vegetables into our kids?! Especially at lunch time! I get it … this is the plate we are aiming for for a healthy, balanced family meal, usually at supper time, eaten around the table, and catching up on the day’s events. More on the details next.
Get them off to a good start – what the research says
It’s for good reason that breakfast is known as the most important meal of the day, especially for the youngins. Skipping breakfast (usually due to getting up late) causes a deficit in energy intake and protein consumption for the day, leading to potential malnutrition, as many of these kids never make up that deficit later in the day. They simply never have enough fuel in the tank to meet their ever growing demands.
So having breakfast is better than not having breakfast, but what about the composition of the meal? Children and adolescents given a low GI breakfast have greater cognitive performance than those who have a high GI breakfast or those who skipped breakfast altogether, much like children who have oats vs those having ready-to-eat cereal – glycemic index and fibre content of the meal make a difference. Memory and attention is a specific area of cognitive performance that does well given low GI breakfasts.
Taking it a step further and including a decent amount of protein in the breakfast further improves the GI of the meal, increases satiety, subsequent food intake and diet induced thermogenesis (the body’s ability to burn energy) – better energy balance means greater concentration and more stable moods. Egg-based breakfasts are great for this!
Now that we have them off to a good start, what do we include in their lunch boxes? The principles remain the same for all meals. Carbohydrates are important for busy, energy hungry bodies and minds, but it must be accompanied by a healthy protein and some fat. For lunches and suppers it is easier to incorporate veggies. There are some examples of nutrient dense breakfasts and interesting lunch box ideas at the end of this article.
But how?
We’ve all seen how powerful modelling can be, sometimes to our embarrassment. Remember the kid imitating a parent smoking, or driving a car, or repeating some choice phrase … I know you too have many of your own examples! The point is, it’s an incredibly powerful tool, and there’s no quicker way to see behaviour change in our children than when we model that behaviour to them. This can be in the way that partners speak to one another, how much time we spend on our phones and yes, in what and how we eat.
When we involve children in the cooking process they are far more likely to eat the protein and vegetables (not just the carbs), leading to better nutritional outcomes. It also gives them a greater feeling of positivity and autonomy in the process.
In addition to preparing meals together, there is a significant correlation between the frequency of meals eaten together and positive nutritional outcomes for children. Having those meals together, at a table and not in front of the TV has a further positive nutritional impact, leading to better brain and body development. Meals eaten together provide bonding time for families, and slowly but surely builds a lifetime of healthy habits. A game we play every evening is “best, worse, what you learnt and what you are grateful for” (we need to work on a catchier title!). At times it’s met with a grunt, but I think the importance is more in the asking than in the answer.
Availability of food dictates what our children eat – having healthy, nutrient dense foods in the house will mean that they are more likely to eat those and also, when junk food isn’t readily available, they’ll eat less of it. It sounds obvious, but sometimes it needs spelling out.
This is the long game, don’t pressurise your child into eating specific foods, it all too often backfires and causes negative associations with food that you hope for them to find appealing. Model the behaviour you wish to see and praise them when they take a step in the right direction, no matter how small that step is.
Rome wasn’t built in a day
These are habits that take time to build, so don’t expect overnight miracles – for you or your child. Introduce small changes, one at a time. It will give you time to wrap your head around everything, and your child time to wrap their taste buds around new flavours and textures. The changes we see in our patients after dietary interventions are oftentimes mind-blowing. It includes improvements in immune health, better focus and concentration, consistent energy throughout the day and more stable moods.
What to look out for
Sometimes we can be feeding our children all the ‘healthy’ foods we mentioned before, but things are still just not 100%. At times like this it’s pertinent to consider food allergies and intolerances. The symptoms can be anything from persistent a snotty nose, rashes, energy slumps and trouble with concentrating (consider what your child is eating before considering ADD medication). Here we would consider food allergies and intolerances.
A food allergy is usually an immediate reaction to a food, mediated by IgE antibodies. Most people are familiar with these in the context of peanuts, shellfish or bee allergies. It may also be wheat, milk eggs or soy, the big ones we test for. Or even an inhaled allergen. The reactions can be mild but persistent and it’s often the first thing we test for. Allergies are for life and avoidance of the food will be necessary. For inhaled allergens, such as grasses, pollens and animal dander we have a few more tricks up our sleeve.
Food intolerances are a bit more nuanced and are mediated by IgG antibodies.The response time is more often delayed and can be up to 72 hours, making it hard to pinpoint what the problem is. The tests we use cover anything from 90 to 300 foods. Most intolerances are not life-long or life-threatening and can be managed. We guide our patients through the process of healing their guts and often find a complete resolution of the symptoms they were struggling with.
And now the moment you’ve been waiting for …
Recipe ideas
We’ve given you all the research on why eating well will benefit your child, but what is the point of technical information without some good examples? Here are some of our favourite ideas for healthy and easy breakfast and lunch meals. It’s by no means exhaustive but will give you a good idea of what’s possible. For supper, follow the basic guideline of the Harvard Healthy Eating Plate. Adults often don’t need as many carbs as children and it’s possible that within that framework you can cater for everyone’s needs without cooking multiple meals. See our blog post on Low-carb eating for a simple breakdown of what that would look like.
The name of the game is planning, and we can’t stress enough how important this is! And if you get the kids to help you’ll have more buy-in, fewer moans and better compliance. You may even have a ton of fun together. One of our friends is a working mom with a crazy schedule and she’s gone so far as to give her older girls a weekly budget and when they do the weekly family shop. They load the basket with their own breakfast and lunch goodies, and in the week, they prepare it themselves. Of course under supervision and once they know what foods are best, but it works like a charm.
Breakfast Ideas
- Protein rich pancakes
- Sourdough French Toast with a protein topping
- Cooked oats with added nuts or nut butter and berries for some sweetness
- Egg on wholewheat toast
- Egg muffins – these are great for freezing and reheating on the day
- Nut and seed based muesli with full cream or coconut yoghurt and berries
All of these will do them a lot more good than any packaged instant breakfast.
Lunchbox ideas
Lunch boxes can be assembled from a few of these individual components. Remember that the goal is to include a protein and healthy fat alongside the carb of choice.
Proteins
- Chicken schnitzel
- Fish fingers
- Tuna, fresh or tinned
- Smoked trout or salmon
- Tinned mackrel
- Chicken breast
- Chicken, beef or veggie burger
- Droewors or biltong
- Sausages (not heavily processed)
Fats
- Nut butters
- Avocado
- Mayonaise
- Full fat cheese
- Full fat yoghurt
Carbohydrates
- Sourdough bread
- Wholewheat, seed and nut loaf
- Pita breads
- Rice crackers
- Pasta
- Selection of fresh veggies, crinkle cut for fun!
- Fruit
No sweets or fizzy drinks!
If you need any more advice or are concerned that your child may have an underlying allergy or intolerance, please get in touch with us.