Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2 –18 years) A background paper Citation: Ministry of Health. 2012. Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2–18 years): A background paper. Partial revision February 2015. Wellington: Ministry of Health. Published in July 2012 Partial revision February 2015 (minor editorial changes) by the Ministry of Health PO Box 5013, Wellington 6145, New Zealand ISBN 978-0-478-44482-7 (print) ISBN 978-0-478-44483-4 (online) HP 5480 This document is available at www.health.govt.nz This work is licensed under the Creative Commons Attribution 4.0 International licence. In essence, you are free to: share ie, copy and redistribute the material in any medium or format; adapt ie, remix, transform and build upon the material. You must give appropriate credit, provide a link to the licence and indicate if changes were made. Foreword The health and wellbeing of our children and young people are extremely important, not only for their lives now, but also for their futures and ultimately for the future of New Zealand. Good nutrition and adequate physical activity are key contributors to both health and development. The Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2–18 Years): A background paper (2012) provides the information to educate and encourage children, young people and their families or whānau to follow healthy lifestyles. This population health document aims to promote health while also preventing obesity and diet-related chronic diseases. These Guidelines have been developed from the update and amalgamation of the Food and Nutrition Guidelines for Healthy Children (Aged 2–12 years): A background paper (1997) and the Food and Nutrition Guidelines for Healthy Adolescents: A background paper (1998). They aim to provide up-to-date, evidence-informed advice and technical information for health practitioners working with children and young people (aged 2 –18 years). These practitioners include nurses, dietitians, doctors, nutritionists, health promoters and educators. In recognition of the many factors that influence the food choices of children and young people, some new topics have been included. For example, new sections outline considerations for selected population subgroups, the influence of environmental factors on food choice, and related topics such as physical activity and oral health. Dr Don Mackie Chief Medical Officer Clinical Leadership, Protection and Regulation Business Unit Ministry of Health Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2–18 years): A background paper iii Acknowledgements The development of the Food and Nutrition Guidelines for Children and Young People (Aged 2 –18 Years): A background paper has involved a number of stages. The final document is the result of input that many individuals and organisations have provided throughout this process. Initially the following stakeholders provided feedback on the proposed structure and content of the background paper: Dietitians New Zealand, the Paediatric Society of New Zealand, Public Health Nurses, Plunket, the Home Economics & Technology Teachers’ Association of New Zealand, Te Hotu Manawa Māori, the Pacific Island Food and Nutrition Advisory Group (PIFNAG), the Asian Health Foundation and the Health Sponsorship Council. The Clinical Trials Research Unit at the University of Auckland prepared the initial draft of the Food and Nutrition Guidelines for Children and Young People: A background paper for the Ministry of Health during 2009 and early 2010. Maria Turley wrote the draft background paper, with technical advice and input from Dr Cliona Ni Mhurchu, Delvina Gorton, Helen Eyles and Dr Andrew Jull. The initial draft then underwent external peer review by Dr Clare Wall, Kate Sladden, Kathy Hamilton, Eruera Maxted (Part 9 on Māori), PIFNAG (Part 10 on Pacific peoples), Geeta Gala (Part 11 on Asian and ‘Other’ peoples) and the Ministry of Agriculture and Forestry (topics related to food safety). Further development of the document by the Nutrition and Physical Activity Policy Team at the Ministry of Health produced the Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2–18 Years): A background paper – draft for consultation, which was published in October 2010. During the public consultation 44 submissions were received from individuals and organisations representing the public and personal health sector, industry, non-governmental organisations, academic and research sector, education and training sector and Crown agencies. Comments and recommendations (including some additional references) from the submissions were considered and further specialist input was sought to produce the final document. Tammy Kaiwai, Soana Muimuiheata and Pratibha Balu provided specialist input to the meal plans in Appendix 5. Jenny Heyward, Rhonda Ackroyd and Dr Jan Sinclair reviewed the allergy section in Part 12. Te Hotu Manawa Māori provided information for Part 9: Considerations for Tamariki and Rangatahi Māori and Their Whānau. The Ministry of Health is grateful to all who contributed to this document, including those who made submissions during the public consultation process. iv Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2–18 years): A background paper Contents Foreword ...............................................................................................................................iii Acknowledgements .............................................................................................................. iv Introduction ...........................................................................................................................1 Part 1: New Zealand Food and Nutrition Guidelines ........................................................... 6 1.1 The New Zealand Food and Nutrition Guideline Statements, including physical activity ............................................................................................................. 6 1.2 Food groups and recommended serving sizes ...............................................................7 1.3 Summary of food groups, serving sizes and recommended intakes ............................ 9 Part 2: Meal patterns of New Zealand children and young people .....................................14 Summary ............................................................................................................................14 2.1 Breakfast ........................................................................................................................15 2.2 Lunch ............................................................................................................................16 2.3 Dinner ........................................................................................................................... 17 2.4 Snacks ............................................................................................................................ 17 2.5 High fat, sugar and salt foods .......................................................................................18 Part 3: Growth and body size .............................................................................................. 20 Summary ........................................................................................................................... 20 3.1 Growth ...........................................................................................................................21 3.2 Body size .......................................................................................................................25 3.3 Obesity.......................................................................................................................... 26 3.4 Underweight ................................................................................................................ 30 Part 4: Energy and nutrients ................................................................................................31 4.1 Introduction ..................................................................................................................31 4.2 Energy ...........................................................................................................................33 4.3 Carbohydrate ................................................................................................................35 4.4 Dietary fibre ..................................................................................................................37 4.5 Fat .................................................................................................................................40 4.6 Protein .......................................................................................................................... 46 4.7 Vitamin A ..................................................................................................................... 48 4.8 Folate............................................................................................................................ 50 4.9 Vitamin D ......................................................................................................................52 4.10 Calcium ...................................................................................................................... 56 4.11 Iodine .........................................................................................................................