How Can I Make My Child’s Diet as Sugar-Free/Low in Sugar as Possible?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Renowned scientists such as Robert Lustig, a pediatrician and professor for neuroendocrinology at the University of California in San Francisco, have spent much time addressing the subject of sugar. In his book “Fat Chance. Beating the Odds against Sugar, Processed Food, Obesity, and Disease” he discusses the scientific aspects of sugar consumption by children and adolescents, describes connections between sugar consumption and overweight, and explains scientifically based facts.

Yet how dangerous is sugar really? Should we make our children’s diets as low-sugar as possible or even sugar-free? Is sugar as dangerous as alcohol or nicotine? How much sugar is even healthy? We answer the five most important questions about sugar in children’s diets.

 

Photo: Nadja Lenherr

Photo: Nadja Lenherr

 

How soon can my child eat sugar and how much?

Up to the age of six months, an infant should not have any free sugar at all. Up to the age of twelve months, foods with added sugar should also be avoided, whenever possible. It should be ensured that only 10% of the daily total energy supply comes from free sugar.

Is there evidence that the consumption of sweetened foods leads to increased restlessness or activity?

No, at present there are not enough data to make reliable statements. The studies are to some extent contradictory. However, many parents of children with attention deficit/hyperactivity disorder (ADHD) report that they see a clearly positive effect when their children consume less sugar.

Is the consumption of small amounts of sweets necessarily unhealthy?

No, small amounts in moderation are allowed to have a place in a balanced, healthy, varied diet.

Are fruit juices good for my child?

Adults may consume one serving of fruit per day in the form of unsweetened fruit juice; this corresponds to approximately 120 g fruit or 2 dl.

The American Academy of Pediatrics recommends a maximum of 110 ml unsweetened fruit juice per day for children aged one to three years and 110 to 170 ml unsweetened fruit juice per day for children aged four to six years. The recommendation is clear: “Eat fruit, don’t drink it.”

Is honey healthier than sugar?

Yes, honey is healthier than sugar.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George MarxAndrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

Where and How Can I Cut Down on Sugar in Daily Life?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Most people consume sugar every day without being aware of it – since it is found not only in sweets but also in sauces, sweetened drinks and fruit juices, ketchup or frozen pizza. There are more and more artificial sweeteners, light products and sugar alternatives – yet nonetheless, sugar consumption has steadily increased in recent years. The World Health Organization (WHO) is urgently calling for a change to the addition of sugar in food and research is investigating the question of the perfect, calorie-free sugar substitute, a super sugar, which is equivalent to the original but safe.

 

Photo: Nadja Lenherr

Photo: Nadja Lenherr

Sugar Reduction in Beverages

(1 sugar cube = 4 g sugar)

QuantityProductSugarAlternative tip
100 mlUnsweetened fruit juice12 gMix 1:2 or 1:3 with water
→ 50–70% less sugar
100 mlFruit juice spritzer, unsweetened, 60% juice/40% water7.2 gMix 1:2 with water
→ 50% less sugar
100 mlFruit nectar10 gMix 1:2 with water
→ 50% less sugar
100 mlSweetened drinks, soft drinks9.5 gMix 1:2 with water
→ 50% less sugar
100 mlSweetened iced tea7.5 g500 ml tea, lemon juice, 1 tbsp. honey, 2 tbsp. apple juice, chill
→ 70% less sugar or
Mix 1:2 with water
→ 50% less sugar
100 mlSyrup, diluted 1:512 gFlavor water with fresh mint or lemon balm leaves and a few squeezes of fresh lemon or orange juice
→ 100% less sugar

 

Sugar Reduction in Breakfast Foods

QuantityProductSugarAlternative tip
100 gPreserves, jelly60 gHomemade preserves with gelling agent
2 parts fruit + 1 part sugar
→ 50% less sugar
100 gBreakfast cereals for children10–60 gThere are products with less sugar that also taste good!
100 gFruit muesli10–25 gMake muesli yourself with sunflower seeds, coconut chips, flaxseed, oat flakes, spelt flakes, cornflakes without sugar
→ 80% less sugar
100 gChocolate nut spread50–60 gHomemade chocolate nut spread
→ 70–80% less sugar

 

Sugar Reduction in Dairy Products

QuantityProductSugarAlternative tip
100 gFruit yoghurt9–18 gMix with an equal amount of plain yoghurt
→ 40% less sugar or
Make fruit yoghurt yourself with 2 parts plain yoghurt + 1 part pureed seasonal fruit
→ 50–70% less sugar
100 gChocolate milk10 gMix with an equal amount of milk
→ 30% less sugar or
Make your own chocolate milk with 180 ml milk, 2 tsp. pure cocoa powder, 1 tsp. sugar
→ approx. 30% less sugar

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George MarxAndrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

How Healthy Is a Vegetarian/Vegan Diet?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

More and more people are deciding to follow a vegetarian or vegan diet. In addition, more and more children are fed a vegan diet. More women and girls are vegetarian than men and boys.

Vegetarianism has a long history. The vegan/vegetarian movement is not a modern phenomenon. It has been with people for several centuries already. The Greek Orphics who lived around 600 BC are considered to be the first historically documented followers of vegetarianism. Their avoidance of meat was religious and philosophical in nature. The first vegetarian organizations have been around since the 18th century.

Vegetarianism primarily involves avoidance of meat. Some decades ago, veganism – which argued against the use of all animal products – came into play. This was initially referred to as high vegetarianism and later as “vegan” which is composed from the first and last letters of the term “vegetarian”.

The number of publications which emphasize the health benefits of a vegetarian or vegan diet is continually increasing. By now there are indications that a meat-free diet can reduce the risk of suffering from cardiovascular diseases. These people are also generally thinner, which is also due to the fact that they have a healthier lifestyle: They get more exercise, smoke less, and drink less alcohol. The data are less clear in the case of children, because there are only very few studies on the effect of a meat-free diet at this age. It could be shown only that children on a vegan diet are somewhat thinner and also smaller. Whether vegetarians or vegans have a survival advantage as compared to meat-eaters is still a component of research.

Pediatricians are referring more and more children to the gastroenterologist since their parents are convinced that a meat-free diet is healthier for their children. They feed their children either a vegetarian or vegan diet. While children on a vegetarian diet do not have health risks and undernourishment or malnutrition (with the exception of iron deficiency) is rare, caring for children on a vegan diet is often a challenge. Here there is a significant risk of malnutrition. Serious consequences may result, either through an iron, zinc or vitamin B12 deficiency. Regular blood tests to check these values and optimal nutrition counselling are essential.

A particularly important group in whom it is very “trendy” to follow a vegan diet are adolescent girls, either for ethical reasons for animal protection, for ecological/social considerations, or from the desire to be thin and healthy. Medical check-ups are particularly important for these adolescents since they are in a phase of growth and development in which they are particularly susceptible to disorders.

 

Photo: Nadja Lenherr

Photo: Nadja Lenherr

 

Is a vegan diet harmful for children?

No, it is not harmful in principle. Attention must be paid to the vitamin B2, vitamin B12, vitamin D, iron, zinc, iodine, calcium, long-chain fatty acids and the protein profile of the diet. Vitamin B12 must be supplemented in order to prevent serious complications of the nerve cells and blood count. Regular check-ups by the pediatrician and nutrition counselling are strongly recommended. A vegan diet is generally not recommended for infants and small children.

Can one engage in competitive sports on a vegan diet?

Yes, this is possible. Particularly close attention must be paid to the above-mentioned nutrients and minerals.

Does my child have to eat meat?

No. Children do not have to eat meat. The critical trace element iron can also be supplied through other foods such as eggs, fish, dark-green leafy vegetables (Brussels sprouts, chard, kale, spinach), nuts, seeds, grains and legumes (lentils, chickpeas, beans, lupin and soy).

Does my child need meat?

No, not necessarily. A child on a vegetarian diet can also obtain adequate nutrients and iron even without meat by consuming dairy products, eggs and legumes (such as lentils). Anyone who follows a vegan diet, however, must take a vitamin B12 supplement to avoid a deficiency.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George MarxAndrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

What Are the Tasks of the Microbiome?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Buzzwords such as microbiome, gut-brain axis, superfood, or stool transplantation are talked about nowadays by laypersons and scientists. What do they mean and what influence does our children’s diet have on the diversity of the microbiome? And what does this mean in connection with the development of chronic diseases?

The human gastrointestinal tract contains 100,000,000,000,000,000 microorganisms which are referred to in their entirety as the microbiome. This number is even ten to a hundred times greater than that of all human cells. More than 90% of the cells we carry in us are of microbial origin.

Nowadays we know that the microbiome is responsible for numerous vital processes in humans. Millions of dollars are being put into researching gut microorganisms. Projects such as “The Human Microbiome Project” in the USA and “MyNewGut” in Europe are intended to expand the knowledge about the human microbiome. Many diseases, such as autoimmune diseases (diabetes mellitus type 1, chronic inflammatory bowel disease, celiac disease), obesity, diabetes mellitus type 2, irritable bowel syndrome, asthma, allergies, autism, and depression are associated with a disruption in the balance of these microorganisms. By now there are good indications that the origin of these diseases can be found in the microbiome.

Apart from the utilization of food consumed, many other important functions have been ascribed to the gut microbiome, such as the formation of crucial vitamins, for example, vitamin B12, B1, B2, B6 and K, or the production of short-chain fatty acids (acetic acid, butyric acid, and propionic acid) which serve as an energy source for the gut mucosal cells (“power for the gut”). Components of the gut microbiome such as acetic acid and butyric acid, tryptophan (an amino acid) and other messengers (neurotransmitters) which develop as metabolic products of the gut bacteria interact not only with the immune system but also with the nerve cells and are thus in constant contact with the entire nervous system and the brain.

This is referred to as the gut-brain axis. It is therefore understandable that changes to the gut microbiome could be connected to the development of the aforementioned diseases.

Tasks of the Microbiome in Brief

  • Digestion of certain food components
  • Energy production through the breakdown of undigestible carbohydrates
  • Support of the absorption of micronutrients
  • pH maintenance (acid-base balance)
  • Maintenance of healthy gut mucosa
  • Metabolism of drugs
  • Neutralization of carcinogenic components
  • Synthetization of B vitamins and some fat-soluble vitamins
  • Influence of the body’s own immune system

 

Photo: Nadja Lenherr

Photo: Nadja Lenherr

 

Is it true that children born spontaneously have different gut bacteria than children born via Cesarean section?

Yes, this is true. When the newborn passes through the birth canal, it picks up bacteria from the birth canal and gut of the mother. These are the first microbes to colonize the infant’s gut.

Can my child’s gut flora be permanently damaged as a result of an antibiotic treatment?

It is a fact that repeated antibiotic treatments change the microbiome and this can have an influence on the development of chronic diseases. However, a single antibiotic treatment is not enough to change the composition in the long term.

Is yoghurt which contains bifidobacteria or LC1 bacteria (probiotic yoghurt) better for our children’s health than other yoghurt?

The degree to which this probiotic yoghurt is superior to the effect of regular yoghurt is disputed. This is because the lactic acid bacteria found in regular yoghurt also have a positive effect on gut flora. The bacteria contained in probiotic yoghurt are said to be more resistant, however, and thus greater numbers survive in the gastrointestinal tract.

Can I give my child probiotics to prevent allergies?

The results of various studies with probiotics as allergy prophylaxis have been contradictory to date. In general, only the influence on atopic eczema was investigated and only a few studies focused on the influence on other allergies. If there is a high familial risk of allergies, certain probiotics for pregnant and breastfeeding women and newborns appear to help prevent atopic eczema. Lactobacillus rhamnosus GG and Bifidobacterium lactis are promising probiotic microbes in this regard.

Everyone’s talking about superfood, but what exactly is that?

Superfood is a marketing term which describes foods with certain health benefits. This term is not defined scientifically but the effect of certain foods which are also referred to as superfoods is often scientifically proven. Superfoods include products such as goji berries, acai berries, aronia berries, chia seeds, hemp seeds, spirulina algae, chlorella algae, but also raw cocoa, ginger, pomegranates, maca or acerola cherries.

The positive effects on health are extremely varied. It is certain that these superfoods have a positive effect on the condition of the microbiome; they are thus microbiome-friendly. Likewise, they have high levels of vitamins, minerals, antioxidants, and fiber to varying degrees. Some of them also have a high proportion of essential amino acids.

However, many of the active substances found in superfoods are also present in more conventional foods. For example, the nutrients contained in chia seeds (which come, for example, from South America) are by all means also found in flaxseed (which grow in Europe). Ecological and financial considerations should always be taken into account.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George MarxAndrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

The Most Important Questions about Milk Consumption

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Nearly every one of us grew up with it and was supposed to drink a lot of it in order to grow up as big and strong as possible. For many decades, milk has been considered to be a healthy, natural product and advertised as such not only by the dairy industry. Many nutritional scientists recommend the daily consumption of milk and dairy products. The variety of nutrients found in milk and products made from it is impressive.

Nowadays, milk and dairy products are among the most controversial foods. Consumers, especially parents of young children, are increasingly unsure. Whom should we believe? Is milk good for you or bad for you?

In this article, we answer the most important questions about milk, the consumption of milk and dairy products, as well as milk alternatives.

 

Photo: Nadja Lenherr

Photo: Nadja Lenherr

 

My children refuse all milk. What should I do?

This is not a problem. Other dairy products, such as yoghurt, cheese and quark, can easily meet the need for calcium. Calcium-enriched alternative drinks, such as almond or oat milk, can also be used.

Does the consumption of milk and dairy products increase mucus formation in the respiratory tract or digestive tract?

The mucus production theory is a myth. Milk, when it mixes with saliva in the mouth, does indeed feel rather similar to the consistency of mucus, however mucus formation is not stimulated by the consumption of milk. There is no scientifically based proof of this.

Does the quality of the milk suffer as a result of being processed? Is UHT milk worse than regularly pasteurized milk?

The UHT process (ultra-high temperature) is very similar to pasteurization and high-temperature pasteurization. However, the milk is preserved at significantly higher temperatures. It is heated for a few seconds to 135 to 150 °C and immediately cooled. Thereafter the milk is germ-free and can be kept for eight to twelve weeks.

The UHT process results in somewhat higher vitamin losses than in the case of pasteurization (see table on losses due to preservation and boiling below). Overall, preservation has only minor effects on the vitamin content of the milk.

MethodB1, in %B6, in %B12, in %Folic acid, in %Vitamin C, in %
Pasteurization0–50–5<10<1010–25
UHT0–20<105–105–205–30
Boiling10–2010201515–30
Source: Renner E: Milch und Milchprodukte in der Ernährung des Menschen, ed 4. München, Volkswirtschaftlicher Verlag, 1982.

 

How much milk should my child drink?

Between 300 and 500 ml per day, depending on age.

Is cow’s milk suitable for children at all?

Yes, cow’s milk is suitable and because of its nutrient composition, it makes an important contribution to a healthy diet.

Is organic milk better?

Organic milk has a better ratio of omega-6 to omega-3 fatty acids. The omega-3 fatty acid proportion, which is considered to be health-promoting, is higher because the cows are fed grass and herbs.

Dairy products, like many foods, are also contaminated with hormone and pesticide residues. The risk of this is lower in the case of milk from organic farmers.

By contrast, the calcium, vitamin and trace element content is the same.

Are soy or almond milks a complete substitute for cow’s milk?

No. Soy and almond milks are among what are known as milk alternatives, along with coconut, rice, hemp and oat milks. With regard to vitamins and minerals, none of the natural products listed can compete with a mammal milk. In addition to cow’s milk, these also include other animal milks, such as goat’s and sheep’s milk. The nutrient profile of these mammal milks is unique. Milk contains various vitamins and is rich in protein and minerals. Sugar and other sweeteners are additionally added to some milk alternatives and for this reason, the ingredients list should be examined carefully.

In children who do not tolerate cow’s milk products due to lactose intolerance or an allergy to cow’s milk protein, alternative milks are appropriate if they are enriched with calcium.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George MarxAndrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

Which Sugar Alternatives Are Available?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Headlines such as “Sugar – a drug”, “Is Sugar a Toxin?” or “Fight the Sugar Bombs” follow us at every turn. Sugar is a treat which has an addictive nature. Here we present possible alternatives to sugar.

Natural Sweetness

As an alternative to table sugar, there is a large selection of other sweeteners such as honey, agave syrup/juice concentrate, maple syrup, date syrup, cane or coconut blossom sugar, rice syrup or apple and pear juice concentrate, among others. They contain natural sweetness and in terms of sweetening ability, they are similar to sugar or somewhat sweeter. With regard to the energy content, they are comparable to sugar and therefore only a limited alternative to sugar. Attention should be paid to fair-trade, organic products.

Honey

Honey is a liquid or creamy to solid substance which consists primarily of fructose and glucose. Honey also contains trace amounts of other types of sugar, proteins, enzymes and vitamins. The color of honey varies from yellow to brown. The taste depends on the flower nectar collected. The sweetening ability is indicated with a factor of 1.2 in comparison to table sugar, and thus a smaller amount is needed to obtain the same sweetening ability. When purchasing, attention should be paid to fair trade and – even better – regional honey.

Sweetening beverages with honey or coating the nipples with honey before breastfeeding has long been considered obsolete, since the bacteria or spores in unprocessed honey can damage the infant’s gastrointestinal tract which is still immature. For this reason, honey should not be given to children until after the first birthday. There is no longer any risk in this regard in older children and adults. Honey contains many anti-inflammatory enzymes, which is why the effect appears to have a certain value in flu-like (viral) infections.

Sugar Substitutes

Sugar substitutes, also known as sugar alcohols, have a somewhat lower sweetening ability than table sugar. They belong to the group of food additives and have 2.4 kcal per 100 g. Sugar substitutes are easy to identify. Their names end in “ol” (erythritol, isomaltitol, lactitol, maltitol, mannitol, sorbitol, xylitol). Fructose, which is also a sugar substitute, is an exception to this nomenclature.

Sugar substitutes are obtained synthetically from starches (such as fungi, algae, rowan berries, birch and beech bark, etc.) and from various types of sugars. Their taste, volume and consistency are very similar to that of sugar. With the exception of maltitol, sugar substitutes are metabolized without insulin and only partially absorbed in the gastrointestinal tract. If excessive quantities are consumed, they can cause discomfort such as bloating and diarrhea. In children, this discomfort occurs often after only small amounts have been consumed. Sugar substitutes are found most frequently in chewing gum, candies and sweets.

Table. Sugar substitutes and their characteristics

Name/E numberSweetening abilityPotential to cause cavities
Xylitol (E 967)100No
Erythritol (E 968)70No
Maltitol (E 965)90No
Maltitol syrup (E 965)80No
Sorbitol (E 420)60Yes
Isomalt/isomaltitol (E 953)40No
Lactitol (E 966)30–40No
Mannitol (E 421)30–40Yes
Fructose100–180Yes

Fruit Sugar (Fructose)

Fructose exists in nature primarily in fruits, some vegetables, and honey. It is a simple sugar, tastes sweet, is odorless and colorless, and its sweetening ability is somewhat higher than that of table sugar. Fructose constitutes half of table sugar. In most cases, fructose is consumed in the form of table sugar.

Fructose and fructose syrup are regularly used in the food industry. Fructose is added to many sweet drinks as a sweetener, particularly in the US. Excessive consumption of fructose can cause abdominal pain, bloating, and diarrhea. Fructose is by definition a sugar substitute.

Photo: Nadja Lenherr

Photo: Nadja Lenherr

Sweeteners

Sweeteners are also food additives. They are synthetically manufactured and have a powerful sweetening ability which is up to 13,000 times higher than that of table sugar. They have practically no calories and do not harm the teeth. They are not carbohydrates and do not require insulin for metabolization. Most sweeteners are absorbed in the intestine, not metabolized, and eliminated with the urine. The most common approved sweeteners are neotame, saccharine, steviol glycosides, sucralose, thaumatin, acesulfame K, aspartame, cyclamate and neohesperidin. Because of the frequent aftertaste or flavor of sweeteners, the food industry combines sweeteners with one another.

Sweeteners are found most often in beverages, desserts, chewing gum and milk products. Since possible health risks of artificial sweeteners have been discussed for years, there are maximum permissible daily doses in the EU which are based on the ADI (= acceptable daily intake) value. The amount of sweeteners (aspartame, cyclamate, saccharine) is indicated in milligrams per kilogram body weight. The permitted daily dose of aspartame is 40 mg/kg body weight; for cyclamate it is 7 mg/kg body weight and for saccharine, 5 mg/kg body weight. The maximum daily dose of artificial sweeteners is quickly reached in children. In a child weighing 15 kg, the daily dose is already exceeded with 4 dl of a beverage sweetened with cyclamate.

It has not been able to be demonstrated to date that sweeteners lead to a reduction in or a stabilization of body weight. It has also not been able to be shown that it helps reduce cravings, as is frequently postulated. As a general rule, sugar substitutes and sweeteners are not recommended for children.

Stevia/Steviol Glycoside

In recent years, this wonder plant has attracted a great deal of attention. Stevia, also known as sweetleaf, is a South American perennial which has been used for centuries for sweetening or as a medicinal plant. Its leaves are 30 to 45 times sweeter than table sugar. The safety of the stevia plant with regard to health has not been fully proven and for this reason, stevia leaves may not be marketed in the EU as a food or for sweetening foods. However, it is used in the form of steviol glycosides. These sweeteners are extracted from the stevia plant and are about 300 to 400 times sweeter than table sugar. They have been declared safe and have been approved by the European Food Safety Authority (EFSA).

Conclusion: ‘Less Is More’

Aim for a balanced, varied diet. Sugar or other natural sweeteners should be deliberately reduced. When possible, sugar substitutes and artificial sweeteners should be avoided. Ensure proper dental hygiene.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George Marx, Andrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

How Important Is Proper Vitamin Intake for My Child?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Vitamins are vital for life and are involved in various metabolic processes in the body. Vitamins are known as essential nutritional components; i.e., our body cannot produce them itself. We answer the most important questions about vitamin intake in children.

Functions

Vitamins have various functions in the conversion, composition and breakdown of nutrients for energy production and are involved in cell growth, vision, bone metabolism and blood clotting. They have an antioxidant effect.

They are categorized into fat-soluble and water-soluble vitamins:

  • Fat-soluble vitamins: These are the vitamins A, D, E and K. Fat-soluble vitamins are stored in fat tissue. An excessively high intake can result in an overdose, which in turn can have serious adverse effects.
  • Water-soluble vitamins: These are the vitamins B1, B2, B6, B12 and C, folic acid, niacin, pantothenic acid and biotin. The water-soluble vitamins are eliminated by the kidneys. An overdose is virtually impossible.

Requirement

The average daily requirement depends on age and gender. A varied, balanced diet covers the vitamin requirement (with the exception of vitamin D).

Photo: Nadja Lenherr

It’s very clear that vitamins are important. Without them, serious signs of deficiency can develop. So does this mean: The more vitamins, the better?

Many studies prove: Even if additional vitamins are taken, for example, in the form of tablets or powders, a person is not healthier as a result. Certain vitamins can even be harmful if too much is taken, for example, vitamins A, D, E and K. These are known as fat-soluble vitamins which are stored in the fat tissue and liver.

Do organic products have more vitamins?

Putting an organic product in the shopping basket immediately makes a person feel a little better. Yet this feeling cannot be scientifically substantiated: Cucumbers and turnips from the organic rack do not contain more vitamins than regular supermarket vegetables. This was shown by a meta-study by the British Food Standards Agency from 2009.

Even the stubborn suspicion that everything was better in the past and that vegetables would have had more vitamins and minerals 50 years ago than today has been refuted. But: Organic products at least contain fewer harmful substances. The level of pesticide contamination of organically cultivated produce is about 100 times lower than that of regular food.

Where are there more vitamins? In vegetables from the farmer’s market or in the “summer vegetables” package from the freezer?

Those who are fans of freezers actually make healthier purchases in general, unless the vegetables go directly from one’s own garden to the table, in which case they can compete with frozen foods. However, if broccoli or carrots are stored for several days in the market stall, on the supermarket shelf and then at home, they lose a considerable amount of vitamins. For example, the vitamin C content of spinach goes to nearly zero. Even locally grown fruit contain their full nutritional value almost only in summer and early autumn. Conversely, spinach, when frozen at minus 18 °C, still has 85% of its original vitamin C content after four months. Since the vegetables are flash-frozen shortly after harvest and packaged in opaque, air-tight bags, the nutrients are better preserved.

Is lettuce high in vitamins and fiber?

Lettuce is considered to be synonymous with a healthy diet and immediately makes one feel good. But wrongly so: Lettuce is one of the most overvalued foods. Lettuce is more than 95% water and has low nutritional value, little fiber, and few vitamins. Vitamins should be obtained in the form of vegetables and fruits.

Is it true that lemons contain the most vitamin C?

They are not exactly low in vitamin C, but the honor goes to other fruits. Lemons contain about 52 mg ascorbic acid (per 100 g). Even broccoli, with over 115 mg per 100 g, is far superior to lemons in terms of vitamin C content. Kiwi, with 71 g per 100 g, is also rich in vitamin C.

Can I use vitamin pills to protect my child from diseases?

Our body needs vitamins and minerals, but not from a jar. They do not work like original vitamins in foods. It is not yet known why this is the case. An apple alone contains about 1,000 substances – presumably the body needs an interaction of various substances.

The products in capsules and powders can even be harmful. Supplementation is recommended only for deficiencies which have actually been proven and then in a targeted manner with the missing substance. However, this should be discussed with the doctor or nutrition specialist.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George Marx, Andrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

What Are the Effects of Sugar on Health?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

An unbalanced diet with a high proportion of added sugar jeopardizes our health and increases the risk of overweight, type 2 diabetes, and cardiovascular diseases. Yet sugar alone is not to blame. It comes down to overall eating habits and personal lifestyle. A balance between energy intake and energy consumption yields a normal weight. If the balance of energy is not in equilibrium and is combined with inadequate everyday physical activity, the risk of overweight as well as other diseases increases.

How Is Sugar Addictive?

Eating sweet foods does not need to be learned. We love sugar. The preference for the sweet taste is innate in humans and even breast milk tastes slightly sweet. It is assumed that the imprinting of taste perceptions already takes place in the womb. Abstaining from sugar does not trigger any physical withdrawal symptoms and, unlike drugs, food – and thus the consumption of carbohydrates – is necessary for life. After consuming sugar, a reward system in the brain is activated and it provokes a pleasant feeling via the neurotransmitters serotonin and dopamine. This increases the motivation to repeat this feeling – a useful mechanism from the early days of mankind when the consumption of rare sweet foods was necessary for survival. In overweight persons, the reward area of the brain additionally appears to react more strongly to pictures of sweet foods than in the case of persons of normal weight. The consumption of foods containing sugar causes the blood glucose level to increase rapidly; however, it also quickly decreases once again. Hunger returns. If sugar is then eaten again, a vicious cycle easily begins.

The penchant for sweet foods is not just related to biochemical processes in the body but is also associated with learned behavior. Starting in childhood, sweets are often used as a reward, comfort, or gift. In young children in particular, a restrained, conscious approach to sugary foods should be taken. Many foods promoted and developed especially for children are not particularly tailored to children’s nutritional needs but often contain a lot of sugar and fat. Taste preferences are critically shaped from an early age by eating habits. If children regularly eat too much sugar, they become accustomed to the sweet taste. The stimulus threshold for sweet foods increases. It is recommended to take a look at the list of ingredients and nutrition chart. And it is worth it to set a good example. It may help to initially observe yourself to identify the situations in which you automatically reach for sweet foods. Is it from frustration, stress, sadness, boredom, or as a reward? Are there alternatives? Other experiences perceived as pleasant also lead to a release of serotonin or dopamine.

Photo: Nadja Lenherr

How Much Sugar Is Healthy? The Experts’ Current Nutritional Recommendations

In 2015, the WHO issued guidelines on sugar consumption for adults and children, with the following recommendations: The daily intake of free sugar should be limited to <10% of the total energy intake. This recommendation is based on an analysis of the scientific evidence which shows that adults with a low sugar intake have a lower body weight, that weight increases as sugar intake increases, that the consumption of sugar-sweetened beverages by children is positively correlated with overweight, and that there is a connection between an increased intake of free sugar (>10% of total energy) and the frequency of cavities. It would be advisable to aim for a daily intake of free sugar of a maximum of 5% of total energy.

“Free sugar” refers to monosaccharides (such as glucose and fructose) and disaccharides (such as table sugar = sucrose) which are added to foods by manufacturers, cooks or consumers, as well as sugars inherently present in honey, syrup, fruit juices and fruit juice concentrates. The WHO guideline does not refer to sugars occurring naturally in fresh fruit and vegetables as well as in milk, since there are no indications that their intake leads to adverse health effects.

What Does This Mean in Practical Terms?

For an adult who consumes an average of 2,000 kcal per day, 10% of the total energy would be 200 kcal which may be consumed in the form of free sugar. This corresponds to approximately 50 g sugar = approx. 12.5 sugar cubes per day. For a child aged one to two years who consumes 1,100 kcal per day, 10% of the total energy would be 110 kcal which may be consumed in the form of free sugar. This corresponds to approximately 30 g sugar = 7.5 sugar cubes per day.

Conclusion

  • In everyday life, use sugar consciously and properly measured.
  • Any sweetness should preferably be natural.
  • Visualize the amount of sugar: 1 sugar cube = 4 g sugar (average).
  • Enjoy sugary foods such as desserts or chocolates as a special treat, in moderation.
  • There are endless possibilities for being creative in reducing sugar in recipes.
  • Mix sugary foods with unsweetened foods (such as fruit juice with water or fruit yoghurt with plain yoghurt).
  • Read the list of ingredients and nutritional chart on the product; ingredients are listed in decreasing order by quantity; pay attention to the “of which are sugar” quantity.
  • Sugar has many names and hides in the list of ingredients.
  • Avoid sugar substitutes and artificial sweeteners.
  • When buying sugar and sugar alternatives, consider the origin, cultivation method and social sustainability.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George Marx, Andrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

How Useful Is a Gluten-Free Diet?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Whether due to abdominal pain, diarrhea, constipation, bloating, nausea or headache: More and more people are adopting a gluten-free diet. They think they have found the culprit. However, by no means all of them have a medical problem which is caused by gluten. Nearly 30% of Americans are interested in reducing their gluten consumption, and this number is steadily growing. Following a gluten-free diet has become a trend – whether to lose weight or to ostensibly have a healthier diet, to achieve better skin or increased performance.

Photo: Nadja Lenherr

A distinction is primarily made between three different gluten diseases which are medically established: These are celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS). The symptoms are similar to some extent and are shown in the following table. The timing for the introduction of foods containing gluten into infants’ diets should be in the first twelve months; however, this has no effect on the development of celiac disease, not even in patients at risk.

‘Gluten-free – not for everybody!’ A gluten-free diet without a medical diagnosis is not recommended. There is no scientific proof that gluten-free food without a medical diagnosis is healthy. In the case of a long-term gluten-free diet, it is necessary to monitor folic acid, vitamin B12, vitamin D, iron, zinc, magnesium, selenium and calcium.

Patients with celiac disease, non-celiac gluten sensitivity or wheat allergy need comprehensive support and counselling by an experienced interdisciplinary team with a physician and a nutrition expert with experience in allergology/gastroenterology.

 Celiac diseaseWheat allergyGluten sensitivity
Onset of the initial symptoms after consuming gluten or wheatWeeks to yearsMinutes to hoursHours to days
Cause (pathogenesis)AutoimmuneAllergic immune reactionUnclear/immunological?
HLA DQ2/DQ8*PositiveNegativeNegative
AutoantibodiesYesNo, positive wheat IgENo
Villi damageYesNoNo
SymptomsGastrointestinal tract (intestinal) and outside of the gastrointestinal tract (extraintestinal)Intestinal/extraintestinalIntestinal/extraintestinal
ComplicationsLong-term complications can be expected if diet is not adhered to (osteoporosis, increased risk of colon cancer, malnutrition)No long-term complications to be expected, acute allergic reaction (anaphylaxis) possibleNo long-term complications to be expected
*HLA DQ2 and HLA DQ8 are genetic components which are associated with the development of celiac disease. This molecular genetic measurement in the blood is used primarily for a diagnosis by exclusion of celiac disease.

What happens if I follow a gluten-free diet and do not have celiac disease or gluten sensitivity (NCGS)?

If one’s nutrition is balanced otherwise, then a gluten-free diet is not harmful. However, the diet of patients who eat gluten-free is often not balanced and for this reason, they tend to develop malnutrition or nutritional deficiencies. These patients must receive proper support from a doctor or dietitian.

Do oats contain gluten?

Oats as such are gluten-free since they are not related to other grain varieties which contain gluten. Nonetheless they are often contaminated and thus not guaranteed to be gluten-free. We therefore recommend using gluten-free oats bought from a health food store.

Is wheat sensitivity the same as gluten sensitivity?

No, it is not the same thing, although the symptoms in both diseases can be very similar. Abdominal pain, discomfort and bloating are also the primary symptoms in cases of wheat sensitivity, but these patients also often have headaches and nausea.

If I have a wheat allergy, can I simply buy gluten-free products?

No.

When is it necessary to seek nutrition counselling for celiac disease?

Upon diagnosis, during the annual check-up (if the antibodies in the blood remain elevated), upon entry into kindergarten or school, prior to a planned pregnancy, and if there are additional diseases, such as diabetes mellitus or thyroid diseases, and when parents of children with celiac disease have concerns.

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George Marx, Andrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

Why Is Dietary Calcium so Important for Children?

In their book “Kinderernährung – Expertenwissen für den Alltag” (German only), Swiss nutrition experts Dr George Marx and Andrea Mathis give a comprehensive overview of the wide-ranging and often controversial topic of child nutrition. We translated a selection of their insights and publish their findings on this blog to make them available to a wider audience. Please find the links to further posts of this series at the end of this contribution.

Calcium is an important mineral that in our body is found mostly fixated in our skeletal bones. Quantitatively, it is the most abundant mineral, and it plays an important role in blood coagulation (clotting) and in the activation of various enzymes and hormones in the body. It is also important for the formation, growth and regeneration of bones and teeth. In order for calcium to be optimally absorbed and incorporated into the bones, vitamin D is required. Bone metabolism constitutes a constant process of building up, breaking down and remodeling.

Milk and dairy products are good sources of calcium and should be fixtures in a healthy diet. Mineral water with more than 30 mg of calcium per 100 ml is also a good source of calcium. Here its bioavailability is about the same as in milk.
It is difficult – but possible with sufficient nutritional expertise – to meet calcium requirements without milk and dairy products.
As a matter of principle, a balanced healthy diet is of great importance. Use of medicinal products or substitutes should be avoided as much as possible, as most things can be optimized directly with the help of nutrition and common sense. In addition, it is important to pay attention to the topic of ‘exercise’ in the whole complex of bone development.

Calcium

Photo: Nadja Lenherr

What is a good source of calcium if you cannot or do not want to have dairy products?

Calcium-rich vegetables such as broccoli, all types of round cabbage (e.g. red cabbage, savoy cabbage), green cabbage, Chinese cabbage, pak choi, kai choi, choi sum, algae (Asian), calcium-rich mineral water, calcium-enriched alternative drinks such as rice, oat, soy, almond and spelt drinks, or convenience products (ready-to-eat and ready-to-serve foods) with added calcium. Convenience products are not intended to serve as regular sources of calcium. They often contain hidden fat or sugar. It is important to consider possible effects on weight gain.

Is calcium bioavailability (readiness for absorption) higher in calcium-rich vegetables than it is in products made from cow milk?

Calcium bioavailability in the above-mentioned vegetables is very high. For example, in broccoli it is about 60%, in pak choi 50%, and in kale 49%. Spinach, chard and rhubarb have a calcium bioavailability of only 5 to 8%. The bioavailability of milk calcium, by contrast, is 30%. This means that 30% of the calcium contained in the milk will be absorbed; the rest is lost.

Can vitamin D positively influence the calcium balance?

Those who do not have a sufficient supply of vitamin D may suffer calcium deficiency despite optimum calcium supply, because only in the presence of vitamin D can calcium be absorbed from the intestine. Vitamin D is the so-called sun vitamin, which is formed in the skin with the help of UV irradiation. Only a small portion of the required vitamin D is supplied with food. Vitamin K2 also seems to play an important role in calcium metabolism.

Are there any calcium uptake inhibitors?

Yes. These include: Caffeine* (in coffee and tea, also iced tea), oxalic acid (in rhubarb, spinach, chard, purslane, cocoa), phytic acid (e.g. in cereals, pulses), alcohol*. A diet high in protein also inhibits calcium absorption in the intestine.
(*Caffeine and alcohol are mentioned for completeness only. Of course they do not belong into children’s diet.)

 

Please feel free to download this tasty, healthy and easy-to-prepare recipe which will soon be a favorite of your children!

Please check out the other posts of our series here:

 

Source:
Dr. med. George Marx, Andrea Mathis, BSc in Nutrition and Dietetics
Kinderernährung – Expertenwissen für den Alltag

Dr George Marx

Dr. med. George Marx grew up in Venezuela, studied at the Medical University of Basel, and obtained his doctorate there. He completed his training as a specialist in pediatric and adolescent medicine at the University Children’s Hospital in Basel. His further specialization in pediatric gastroenterology, hepatology and nutrition took place at the University of Montreal, Canada. Since 2002 he has been the Head of Pediatric Gastroenterology and Nutrition at the Children’s Hospital of Eastern Switzerland  in St. Gallen. Additionally he works as a consultant in the pediatric department at the Triemlispital in Zurich. His sense of humor makes him very popular with his patients, big and small. In his free time, he likes to do sports so that he can pursue his second hobby, eating with pleasure, without a guilty conscience.

Photo: Nadja Lenherr

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