April 2016 Issue

Infant/Toddler Nutrition: Snacking in Young Children
By Sharon Palmer, RDN
Today's Dietitian
Vol. 18 No. 4 P. 8

Help clients get it right.

Here a snack, there a snack, everywhere a snack!

It seems like parents of 1- to 4-year-olds don't dare leave the house without a battery of snacks on hand, from fish crackers and breakfast cereal in baggies at the park play date to mini pretzels in the car seat on a trip to see Grandma. What was once perceived as a "spoiler of appetites" has now become mainstream eating behavior for young children. In fact, studies document that American children are snacking more now than ever and in greater quantities than ever before. For children aged 2 to 12, an estimated 30% of daily calories are consumed in the form of sweet and salty snacks, and up to 40% of total daily calories are consumed in snacks when sugar-sweetened beverages are included.1

So what's the problem with all of this snacking? As you may suspect, it's been linked with childhood obesity. Research suggests that greater snacking frequency of energy-dense foods, such as cookies, chips, and sweets, is linked with increased risk of excessive weight gain in childhood. Nearly 1 in 3 American children already are overweight or obese by the time they enter elementary school.1

As any parent of a young child knows, there are many reasons to dole out snacks. Right or wrong, parents report several diverse rationales for offering their children snacks, such as growth promotion, satisfying hunger, keeping kids quiet, celebrating events and holidays, and rewarding behavior and achievements.1

Smart Snacking
Does this mean parents must throw out the baby (snacking) with the bathwater? The answer is a resounding "no!" According to the American Academy of Pediatrics (AAP), snacks can make up an important part of early childhood nutrition and are an opportunity to encourage healthful eating. Because young children have small stomachs, they may not be able to eat enough at meals to meet their nutrient needs, thus a pattern of three meals with two to three healthful snacks each day may help them meet their needs.2

The crux of the matter lies in helping parents make wise snacking choices for their young children, instead of simply tasty foods that fill the stomach and please the palate. When snacks become such a large part of the overall diet, they need to count by contributing to the foods children need over the course of the day, such as lean proteins, whole grains, fruits, vegetables, and dairy products. MyPlate (choosemyplate.gov) serves as an excellent resource for establishing the correct serving sizes among these important food groups based on age group.

In fact, purposeful, healthful snacking can mean a more balanced calorie intake for young children, thus avoiding excessive weight gain. A study published in Pediatrics found that when children were offered a healthful snack (cheese and vegetables) and instructed to eat freely while watching a 45-minute cartoon, they ate 72% fewer calories compared with the group given potato chips.3

Beverage choice is of particular significance for creating healthful snacking patterns for young children. The AAP encourages healthful beverage choices, such as milk and water, as go-to options, and even states that fruit juice may be a source of unnecessary calories in a child's diet and potentially harmful to teeth. If parents choose to offer fruit juice, it should be limited to 4 to 6 oz per day.4

Tips to Guide Smart Snacking Behavior Among Young Children
How do dietitians help parents encourage healthful snacking habits among their young children? The following are some RD-approved tips from our experts.

• Get in touch with hunger cues. "The No. 1 thing I tell my clients is that kids are really great at understanding their own hunger and satiety cues. Remember, they decide how much they will eat and, sometimes, when they will eat. You decide what they will eat. That way they learn to honor their hunger and satiety cues instead of override them, like so many of us adults have learned to do," says Kelli Shallal, MPH, RD, CPT, a nutrition counseling and communications specialist in Phoenix.

• Balance nutrients in snacks. "Parents don't realize that, like with adults, it's important to balance the nutrients in the snack. Kids' snack choices tend to be super carb rich, such as cheesy crackers, chips, pretzels, or fruit snacks—there's minimal nutrition and lots of empty calories. I recommend making sure each snack contains a source of protein and produce, like apples and peanut butter or carrots and hummus. This will be satisfying, nutrient and fiber rich, and provide a source of sustained energy," says Lauren Harris-Pincus, MS, RDN, a nutrition therapist and consultant, and owner of Nutrition Starring YOU, LLC, in the greater New York City area.

• Keep portion sizes reasonable. "Allowing too many snacks or large-portioned snacks can cause kids to not eat as much at mealtime. Offering one small-portioned snack between meals may help improve their appetite and eating behaviors at mealtime," says Lauren Sharifi, RD, LDN, blogger at Bite of Health Nutrition.

• Fit in whole, nutrient-rich foods. "Young children are often picky eaters, and getting them to eat a well-rounded diet at meal time can be difficult. Snacks can be a way to fit in those foods, specifically fruits, vegetables, whole grains, and dairy," Sharifi says.

• Make healthful snacks easy and delicious. "Provide young children with healthful choices that are tasty and easy to eat. For example, cut up fruit, portion it into sandwich bags, and keep it in the refrigerator. Make granola or flax 'power bites' to keep where the kids can easily access them when they're hungry. Keep bottles of water and healthful snacks in the car for when you drive to activities and events," says Kim Melton, RDN, nutrition consultant at Nutrition Pro Consulting, a nutrition consulting and resources business.

• Put a time limit on snacking. "Adults need to remind children that a snack is not a meal and put a time limit on snacks. Keep snack time to 10 to 15 minutes. Most younger children don't recognize when they're full and will continue to eat as long as food is available," says Jessica Fishman Levinson, MS, RDN, CDN, founder of Nutritioulicious, a nutrition communications and consulting business in New York City.

• Nix snacks too close to mealtimes. "When parents talk to me about their child not eating a good dinner, my first question to them is what was the last thing they ate and when did they eat it. Knowing what a suitable snack is before mealtime often staves off a poorly eaten dinner and a negative dinner experience. Vegetables, fruit, and water an hour or so before dinner is perfectly fine. It's also okay to say, 'No snacks right now; we are eating in 15 minutes,'" says Robin Plotkin, RDN, LD, a culinary and nutrition communications expert and blogger.

— Sharon Palmer, RDN, is the author of Plant-Powered for Life, nutrition editor for Today's Dietitian, blogger at The Plant-Powered Blog, and mother of two in Los Angeles.

References
1. Blaine RE, Fisher JO, Taveras EM, et al. Reasons low-income parents offer snacks to children: how feeding rationale influences snack frequency and adherence to dietary recommendations. Nutrients. 2015;7(7):5982-5999.

2. Making sure your child is eating enough. American Academy of Pediatrics website. https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Making-Sure-Your-Child-is-Eating-Enough.aspx. Updated November 21, 2015. Accessed February 20, 2016.

3. Wansink B, Shimizu M, Brumberg A. Association of nutrient-dense snack combinations with calories and vegetable intake. Pediatrics. 2013;131(1):22-29.

4. Food and feeding: toddler 1-3 years. American Academy of Pediatrics website. https://www.healthychildren.org/English/healthy-living/growing-healthy/Pages/toddler-food-and-feeding.aspx#none. Accessed February 20, 2016.

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SMART SNACKS TO THE RESCUE
Refer to this list of healthful snack suggestions appropriate for children aged 1 to 4:
• Sliced apples, bananas, or nectarines with soft cheese cubes
• Orange sections or strawberries with cottage cheese
• Raisins with dry cereal
• Mini whole-wheat bagel with thinly spread almond butter
• Carrots or green beans (cooked for younger children—texture tolerance varies according to development and age) with hummus
• Plain yogurt mixed with chopped peaches or cherries
• Smoothie blended with milk (or fortified soymilk), vegetables, and fruit
• Whole grain bread with thinly spread peanut butter
• Whole grain crackers with tuna
• Quesadilla with whole grain tortilla and melted cheese
• Blueberry whole grain muffin with milk (or fortified soymilk)
• Banana nut bread spread with cashew butter

— SP

Recipe

Pretty as Pink Beet Hummus

Makes 12 1/4-cup servings

Ingredients
1 15-oz can cannellini or white beans, rinsed, and drained
1 cup chopped, cooked beets, drained
1 large clove garlic, minced
1 small lemon, juiced
11/2 T tahini
1 T extra-virgin olive oil
Salt and pepper, as desired (optional)
Fresh mint for garnish (optional)

Directions
1. Add beans, beets, garlic, lemon juice, tahini, and olive oil to a blender container and blend until smooth.

2. Season as desired.

3. Pour into a serving container and garnish with fresh mint, as desired.

4. Chill until serving time.

Note: Serve with vegetables appropriate for the development of the child's age group.

Nutrient Analysis per serving:
Calories: 68; Total fat: 2 g; Sat fat: 0 g; Trans fat: 0 g; Cholesterol: 0 mg; Sodium: 14 mg; Total carbohydrate: 10 g; Dietary fiber: 2 g; Sugar: 1 g; Protein: 3 g