STANFORD, CALIF. — In the ideologic tug-of-war among nutritionists about how best to help obese children, the 2005 federal dietary guidelines pull for controlling children's consumption of calories.
“We emphasize that modest reductions in energy intake are appropriate” to reduce the body mass index and the rate of weight gain while allowing continued growth and development, Janet C. King, Ph.D., said at a conference on perinatal and pediatric nutrition. Dr. King chaired the scientific advisory committee for the 2005 Dietary Guidelines for Americans, produced by the U.S. Department of Health and Human Services and the Department of Agriculture.
Another speaker at the conference, nationally known children's nutritionist Ellyn Satter, argued that restricting food from children backfires by disrupting their own internal regulators for healthy feeding. She called for better attention to feeding dynamics and education of parents.
The recommendation regarding overweight children is 1 of 18 recommendations for special subgroups of the population presented in the document. Others that address physical activity recommend that children and adolescents engage in at least 60 minutes of physical activity per day on a minimum of 5 days each week. “Very, very, very few children are reaching this standard,” said Dr. King, professor emeritus of nutrition at the University of California, Berkeley, and UC Davis.
Children and adolescents earned a special recommendation under the heading, “Choose fats wisely for good health.” The advisory committee felt that the recommendation that adults obtain 20%–35% of energy from fat in the diet was inappropriate for younger people. For children aged 2–3 years, fat should comprise 30%–35% of energy intake. For those aged 4–18 years, total fat should comprise 25%–35% of the diet, she said. Most fats should come from polyunsaturated and monounsaturated fatty acids, contained in foods such as fish, nuts, and vegetable oils.
Below the lower end of the desired fat content ranges, it's difficult to meet the recommended intakes of helpful fatty acids and vitamin E in each age group, Dr. King noted at the conference, jointly sponsored by Symposia Medicus and Stanford University. When diets contain more than 35% fat, the intake of saturated fat increases to levels that create a risk for chronic disease, evidence suggests.
Children and adolescents also need to “choose carbohydrates wisely” to make sure they get high-fiber foods that contribute 14 g of fiber per 1,000 calories and avoid excessive calories from added sugar, she said. “Children can become constipated just like adults due to a lack of fiber in their diets.”
A children's version of the signature graphic representation of the guidelines—MyPyramid.gov—soon will be released. Dr. King said the government has no plans to create a version of MyPyramid.gov for another deserving subpopulation: pregnant and lactating women. “I was very disappointed to hear that,” she said.
Women and teens of childbearing age who might become pregnant should eat iron-rich foods or iron-fortified foods and consume these with an enhancer of iron absorption, such as foods rich in vitamin C, according to one special recommendation. In addition, these women and pregnant women in the first trimester should consume at least 400 mcg/day of synthetic folic acid.
As for controlling calories, pregnant women need to eat enough for appropriate weight gain, but moderate weight reduction in breast-feeding women is safe and does not compromise the weight gain of the infant.
Regular or acute exercise will not harm a breast-feeding mother's ability to breast-feed successfully, according to the guidelines. Pregnant women should engage in at least 30 minutes of moderate-intensity physical activity on 5 or more days each week unless there's a medical or obstetric complication that would limit the safety of activity.