What the @#$! do I feed my child?

A blackboard used by Albert Einstein in a 1931 lecture in Oxford. Source: Creative Commons

I find maths and science quite soothing. There is something beautiful about straight numbers and clear cut conclusions. You must have already picked up on my love of graphs and diagrams. They got me through med school.

However, once you finish a beautifully straightforward equation or reach a perfectly logical conclusion using an algorithm you hit a little snag. How do you translate all these numbers to real life?

In the last few weeks I have read somewhere around 30+ journal articles on child metabolism alone. The numbers are simple, the graphs are straightforward but as we very well know the applications to child nutrition can be vastly different. For all the parents out there the only biochemical pathway they are likely to be interested in is the one between the fridge and the pantry.

Here is a short summary of my last few slightly dry posts on child metabolism (on conventional advice, BMRmalnutrition and catch up growth) and MY conclusions.

1. Children grow. Therefore children are not in “energy balance” in simple terms. The energy cost of growth is high including both the energy density plus quality nutrients to ensure lean body mass increase.

2. Energy quantity (calories) is important but ultimately you cannot build muscle and bone with broccoli or worse, orange cordial. The quality of nutrients needs to be concentrated to provide more bang for your buck: high nutrient density in a small volume fit for a small stomach.

3. Children regulate their energy needs with their appetite. No calorie calculators required. When the nutrient quality has been addressed the appetite will take care of the rest. If they are hungry they will eat.

4.  Babies, infants and children have less reserves to cope with malnutrition. Even a minor infection may potentially result in muscle loss.

5. Point 4 makes it obvious that it’s not a good idea to put children (=growing bodies) on calorie restricted diets for weight loss.

6. A decrease in activity is a pretty good marker for malnutrition especially for small children. This should give some worried-well parents some confidence, especially where breastfed babies are concerned. If you baby is happy and active it is likely that they are getting enough energy.

7. When children recover from even a minor infection their energy requirements are 4-5 times what they were before. They are going to be very hungry. Feed them. A lot.

8.The period of catch up growth during recovery puts children in a slightly vulnerable metabolic state. They seem more likely to develop insulin resistance (in skeletal muscle), sensitivity to glucose and store abdominal fat.

9. Point 8 makes you think that the post-recovery window is crucial for providing good nutrition for longer term gains. Maybe it is not a good time to provide sweet treats or let children laze around. My thoughts go towards fatty chewable chunks of meat and providing plenty of opportunities for spontaneous activity.

10. My personal way of identifying junk food: if a child is willing to have it after a steak dinner it’s junk. Nobody makes room for more meat or pumpkin when they are stuffed. But there is always stomach space to be found when lollies, cakes, milkshakes and ice-cream are on offer.

The diet recommended by our health authorities always confuses me. I assume (perhaps naively) that they read the same studies and they study the same physiology books. I’m stumped at how they arrive at their conclusions. Today Cancer Council NSW, backed by the Obesity Policy Coalition and the Parent’s Jury, announced the latest villains in the child obesity epidemic: Toucan Sam

and the Paddle Pop lion:

The research by Cancer Council NSW and the University of Sydney found  that 74% of supermarket products adorned with bright cartoon packaging are not up to our healthy nutritional standards. The specific complaints were high-sugar, high-salt and high fat. Apparently the adorable visages of cartoon characters and chiseled jaws of our sporting heroes are just too much for the little kiddies (and their parents) to resist.

“Although stopping short of calling for plain packaging (???) Cancer Council nutritionist Kathy Chapman said regulations around the marketing of foods to children were urgently needed.”

Deep breath. I am not defending sugary cereals. (Not entirely sure how the high-fat monster has slipped into the discussion since the foods in question are mostly low in fat to the point of deficiency. But that’s another matter). In fact, I’m happy to wear a t-shirt: “Friends don’t let friends eat cereal”.  I am more concerned about the whiff of a new scare campaign and propaganda. Plus, when it comes to my own child, I’m the one with a wallet, sorry kiddo.

The second issue is that we rely on these guys for their interpretation of science to tell us which foods are healthy and which are not. I hope we all agree that Froot-Loops are not exactly health food. Nobody buys those because they think that the multiple colours are indicative of the high antioxidant and phytonutrient content. On the other hand Kathy Chapman “welcomes cricketers fronting Weet-Bix” presumably because she thinks that this brand of bland cardboard-like blocks of processed wheat is a healthy alternative. Never mind that most children cover it with malt, sugar, fruit and honey just to make it palatable.

And because the University of Sydney (the home of GI) is involved in this story I’ll throw in a GI reference:

Froot-Loops 69
Weet-Bix 69


P.S. I have a very special guest post coming up for you next time. The guest is currently in the middle of the creative process and I am not sure how long before we see the final result. But I know it is going to be something.