Category: Position Statements

The Infant and Toddler Forum (ITF) welcomes the government’s announcement today to reduce sugar content in food and drink by 20%, and to introduce a sugar levy.

Judy More, paediatric dietitian and ITF member, said: “Sugary food and drinks can have a detrimental effect on children’s health. When eaten too frequently they cause tooth decay and add excess calories increasing the likelihood of overweight and obesity.  Young children naturally like sweet food and drinks but it is a parent’s responsibility to offer children a balanced diet with a limit on sugary food and drinks. Reducing sugar intake by cutting out sugary drinks is an easy way to do this. We welcome any development that supports parents to better manage sugar consumption in their young children’s diets, makes them aware of the importance of doing so, and helps them put this into action. Continue reading →

Whilst, recent research questions the use of multivitamin supplementation during pregnancy, the Infant & Toddler Forum maintain that the most important advice to give mothers-to-be is to take a daily supplement of 10µg vitamin D throughout pregnancy and 400µg folic acid up until at least the 12th week of pregnancy. Continue reading →

The latest statistics from the National Child Measurement Programme, show that over a fifth of pre-school children were still found to be overweight or obese. And by the time they reach 11 years old this figure is over 33%. Despite the slight decrease year on year, it’s still a concern that children are becoming overweight at such a young age. Continue reading →

The Infant & Toddler Forum (ITF) supports the advice of Professor John Ashton, the president of the UK Faculty of Public Health that all parents should be offered state-funded classes on how to bring up their children in an attempt to tackle rising levels of child obesity, mental distress and underachievement. He called for more parenting programmes and telephone helplines and said schools should introduce daily meditation sessions.

Judy More, paediatric dietitian and ITF member, said: “It’s now well accepted that what happens during the very early years  of life  (starting in the womb) has lifelong effects on certain aspects of health and well-being. It is clear that we do need to act earlier to ensure every child gets the best start in life. Education is paramount to achieving this. Our latest report  Early Nutrition for Later Health: Time to Act Earlier, not only echoes this call for education but highlights the need to take a life course approach to health and wellbeing starting before pregnancy  – at preconception and continuing throughout the very early years to encourage healthy family  lifestyles. Families need consistent, simple, advice to get back on the right track if we are going to halt the obesity epidemic.”

The Infant & Toddler Forum (ITF) supports the recent advice from the Chief Executive of Public Health England, Duncan Selbie, who has said that parents should consider giving children smaller plates at meal times to reduce the amount of food they eat.

In an interview with The Daily Telegraph, Mr Selbie said that he wanted to help families make better choices with simple, practical steps such as exercising together or giving smaller plates to children.

Judy More, paediatric dietitian and member of the ITF, commented: “It is clear that families need more support to make better choices. For example, research carried out by the ITF, showed that 77 per cent of parents have never received clear advice about toddler portion sizesⁱ and only 16 per cent of parents answered a question on toddler portion sizes correctly.ⁱⁱ

“The number of calories toddlers need varies depending on their size and how active they are. When parents have no clear, accessible guidance on what sized portion to offer their child they serve toddlers whatever food and portion sizes they consider suitable. Large portion sizes, particularly of energy-dense foods, are one of the key contributing factors to obesity in children. Parents/carers may also exacerbate the problem by insisting their toddlers eat more food when they have clearly indicated they have had enough.”

The ITF offers evidence-based resources and tools to support families such as the award-winning Portion Sizes for Children 1-4 Years Factsheet and the Tot It Up app.

The Factsheet is a practical, visual guide on how much food and drink to offer. It aims to reassure parents on recommended portion size ranges and allowing toddlers to eat to their appetite.

The Tot It Up app provides a personal analysis of a toddler’s daily – or more importantly, weekly – food intake compared against current recommendations. Parents and carers can input details of what meals, snacks and drinks a toddler has consumed, as well as the amount of physical activity he or she has done, to receive a personalised analysis with advice on improving diet and physical activity.

References

i. Who’s feeding your toddler?’ OnePoll on behalf of the Infant & Toddler Forum, 2010

ii. Online poll by the ITF in 2010 asked “How many table spoons of baked beans in tomato sauce is about the right amount to offer to a toddler?” Responses as of 12 October 2011. Out of 62 respondents, 10 gave the correct answer.

The Infant and Toddler Forum (ITF) welcomes the new Scientific Advisory Committee on Nutrition (SACN) draft recommendations on Carbohydrates and Health for public consultation, and Public Health England’s (PHE) report Sugar reduction: Responding to the Challenge, both published this week in an attempt to halt the UK’s looming obesity crisis by reducing our sugar intake.

Recommendations include for the population to halve the consumption of free sugars to around 5% of daily dietary energy intake; and to minimise consumption of sugar-sweetened beverages (e.g. fizzy drinks, squash) by both children and adults.

PHE is calling on charities, non-governmental organisations, academics, businesses, retailers and consumers to work together to reduce the amount of sugar we eat as a nation. Both reports have generated a huge media response around sugar and obesity but it’s also important to remember that all drinks sweetened with sugar, or naturally sweet with fruit sugar (e.g. fruit juices) cause dental decay. Over 27% of 5 year olds have tooth decay according to the National Dental Epidemiology Programme for England, with children on average having between 3 and 4 teeth affected by decay.

Judy More, paediatric dietitian and member of the Infant & Toddler Forum comments: “In amongst this explosion of media interest, parents need practical advice and information. Toddlers should be offered 6-8 drinks per day; one drink with each meal and snack. Water is a good choice because it contains no sugar or acid and will not damage the teeth. All sweet foods and, if offered, sweet drinks should be limited to mealtimes and to no more than one snack a day. Sweet and acidic drinks, including squashes and fruit juices, can damage the teeth and are not a necessary source of vitamin C, which is provided by fruit and vegetables. If fruit juice is offered to toddlers, it should be well diluted – one part juice to about six to ten parts water.”

For more practical advice and information, from the ITF please see the Meals Snacks and Drinks Factsheet for healthcare professionals and Guidance and Tips sheet for parents.

References

1. National Dental Epidemiology Programme for England, oral health survey of 5 year old children 2012’ study on the prevalence and severity of dental decay

New research from NatCen Social Research, highlights that healthy behaviours including eating more fruit and vegetables in adults and enjoying physical activity in seven year olds are factors associated with higher wellbeing.

The Infant & Toddler Forum (ITF) are delighted that this new research supports their commitment to taking a life course approach to nutrition and health, highlighting the early years (pregnancy to preschool) as a key time to teach healthy lifestyles. Establishing positive health behaviours at an early age may lead to healthier outcomes in later life, such as a normal BMI and fewer chronic health conditions, which in turn contribute to higher wellbeing at that life stage.

The study, funded by the Department of Health, revealed that seven year old children who said that they like PE ‘a lot’ had much higher odds of happiness than children who said that they like it ‘a little’ or ‘not at all’. Children who watch some television – but who watch a very limited amount (less than one hour per week day) – were found to worry the least.

Enjoyment of PE lessons was positively associated with child wellbeing however the relationship between health behaviours and children’s subjective wellbeing is likely to be more complex and longer term. It was found that being happier and lacking worry does not mean never having sweets, snacks and television. In fact, there was some indication in the results that higher wellbeing was more likely when these were enjoyed in moderation. For example, wellbeing was lower among children who never watched television and among those who watched it the most, and higher among those who watched television, but for less than an hour a day.

Judy More, paediatric dietitian and member of the Infant & Toddler Forum comments: “The research shows that in general young children who enjoy time with their parents, like physical activity, and eat in family meals, are happier and worry less. A few simple tips for parents are therefore: eating together as a family and making mealtimes relaxed, happy occasions; limiting TV and other screen time like computers to just 1 hour a day; keeping their toddlers active for at least 3 hours every day and helping them to develop their physical activity skills so that they are competent and can keep up with their peer group when they get to school. All activity counts towards the three hours for toddlers including active play and games inside or outside, walking, running and dancing.”

For practical advice on developing a positive approach to health, growth and development in the early years visit the ITF’s Ten Steps for Healthy Toddlers and the Physical Activity and Active Play Factsheet

The ITF have launched the Tot It Up app to track whether your toddlers are getting a good balance of food and activity

References

NatCen Social Research. Predicting Wellbeing. 2014. Available at: http://www.natcen.ac.uk/media/205352/predictors-of-wellbeing.pdf

The Infant & Toddler Forum (ITF) welcomes new research from a University College London (UCL) study, linking an increased intake of fruit and vegetables to a lower chance of death from cancer, heart disease or stroke, suggesting that eating more than the government recommended “five a day” may have additional health benefits.

The research, published in the Journal of Epidemiology and Community Health, found that eating seven or more portions of fruit and vegetables a day was associated with a 25% lower risk of cancer and 31% lower risk of heart disease or stroke.

In the UK we struggle to eat the recommended five a day, but it’s never too early to start promoting healthy eating habits and a critical window of opportunity is in a child’s earliest years.

Judy More, paediatric dietician and ITF member said: “Although this research focused on adults, offering children fruit and vegetables at all meals and some snacks teaches them that eating fruits and vegetables is normal – a message for them to retain as they become adults. Learning to like vegetables and fruit in their early years can take time; some toddlers need to be offered a new food up to 10 – 14 times before they will be brave enough to try tasting it. Toddlers often prefer the flavour of vegetables that have been stir fried, roasted or baked rather than steamed or boiled. Key tips to help parents teach their young children healthy eating habits include: eating together as a family and making mealtimes relaxed, happy occasions; eating the foods that you would like your toddler to eat and rewarding your toddler with your attention when he or she eats well or tries something new. Young children have good and bad days when it comes to eating and it is best to focus on their intake over a week rather than one day.”

You can track the amounts of different foods your toddlers are eating, using the ITF’s newly launched food calculator app, Tot It Up. The app gives practical advice based on the ITF’s award winning Portion Size Recommendations for 1-4 year olds.

References

Oyebode, O. et al. Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data.Journal of Epidemiology and Community Health,31 March 2014. Available at: http://jech.bmj.com/content/early/2014/03/03/jech-2013-203500.full

The Infant & Toddler Forum (ITF) welcomes new research published this week in Paediatricsi that establishes a direct, positive association between physical activity in four year old children and their mothers – the more activity the mother did, the more active the child. In addition, another study from the University College London, published in International Journal of Obesityii highlighted that toddlers that received less than ten hours sleep ate 10% more calories than those who slept for longer, which put this group at a greater risk of obesity.

This new evidence supports the ITF’s Ten Steps for Healthy Toddlers programme which encourages toddlers to engage in 3 hours of physical activity and 12 hours of sleep per day and highlights the important role parents have to play in developing healthy habits early on in life.

Judy More, paediatric dietician and ITF member said: “Whilst good nutrition will go a long way to optimising health, growth and development in young children, parents and health professionals must not underestimate the importance of activity and sleep too. Encouraging active play, active lifestyles and regular sleep patterns is critical for physical and mental health and development. Physical activity in the toddler years is vital for developing the physical skills, coordination and confidence to ensure enjoyment and participation in sport throughout their school life thus reducing the likelihood of obesity and the risks of developing heart disease and diabetes later in life.”

Celebrating its ten year anniversary, the ITF is taking a life course approach to nutrition and health, exploring the early connection through pregnancy, infancy and toddlerhood. Our aim is to support and empower families to make healthy lifestyle choices by delivering clear, practical advice on those critical early windows of opportunity to provide children with the best start in life.

References

i. Activity Levels in Mothers and Their Preschool Children, Pediatrics, 24th March 2014. Available at http://pediatrics.aappublications.org/content/early/2014/03/19/peds.2013-3153.abstract?sid=6c1dbbed-4a4b-4d7f-8824-f138ff090f30 Last accessed 26.03.14

ii. International Journal of Obesity, http://www.nature.com/ijo/index.html Last accessed 26.03.14

The Infant & Toddler Forum (ITF) responds to research results from a new survey commissioned by Vouchercloud – showing that only one in five children eats vegetables every day, and that one in ten totally refuses to eat vegetables – by offering simple, practical advice for parents, carers and healthcare professionals on food and feeding.

The study polled 1,912 parents with children aged 10 or under and the results are not surprising because children prefer familiar foods and parents tend to offer those foods that they know their children will eat. Children need to be encouraged to try new foods and it is best to begin healthy eating habits early because babies are usually happy to try new tastes during weaning. Attitudes to food change in the second year and fussy toddlers may refuse vegetables.

Parents’ best strategy at this time is to role model by eating with their children and eating the vegetables they want their children to eat. As children grow older it is really important to keep this up and to offer vegetables at both the midday and evening meals because taste preferences and eating habits influence health.

Judy More, paediatric dietitian and ITF member said: “Young children need nutritious food for their rapid growth and development, but prefer familiar foods and also have good and bad days when it comes to eating. Some toddlers need to be offered a new food up to 10 – 14 times before they will be brave enough to try tasting it. An emphasis on developing healthy eating habits early in life and nutritional guidance for the early years should be a key public health strategy. We need to, not only prevent childhood dietary deficiencies, but also prevent children becoming overweight and obese because many of them will remain so as adults with the associated risk of developing chronic conditions such as heart disease and diabetes.”

Celebrating its ten year anniversary, the ITF is taking a life course approach to nutrition and health, exploring the early connection through pregnancy, infancy and toddlerhood. Our aim is to support and empower families to make healthy lifestyle choices by delivering clear, practical advice on those critical early windows of opportunity to provide children with the best start in life.

Notes to editors

Childhood overweight and obesity remains at about 30% and this level shows no signs of declining.

i. Health and Social Care Information Centre, Lifestyles Statistics. Statistics on Obesity, Physical Activity and Diet: England, 2013, London.
Available at http://www.hscic.gov.uk/catalogue/PUB10364/obes-phys-acti-diet-eng-2013-rep.pdf Last accessed 21.02.14

Infant & Toddler Forum supports National Obesity Awareness Week, 13th – 19th January

This week is National Obesity Awareness Week 2014. The Infant & Toddler Forum (ITF) is delighted to support this initiative and encourage families to make a new start in 2014 with healthier lifestyle choices.

We know what happens to children in their earliest years is key to health outcomes in adult life. We also know that making lifestyle changes can be a challenge. The Forum encourage a step wise approach to health and wellbeing placing the emphasis on simple, practical advice so that families can take small steps towards better health that are impossible not to achieve.

The ITF’s award-winning Ten Steps for Healthy Toddlers programme provides families with simple, practical tips that help promote good habits for health, growth and development.
ITF is an independent, multi-disciplinary group of experts from paediatrics, neonatology, health visiting, dietetics and child psychology, specialising in early-years nutrition and development. To speak to a member of the ITF for comment on the issues discussed during National Obesity

Awareness Week, contact Neil Hardman on 0208 9716419 or email nhardman@saycomms.co.uk

The ITF is supported by an unrestricted educational grant from Danone Baby Nutrition. However its views are independent of Danone Baby Nutrition and its commercial interests, and its outputs are the intellectual property of the Forum members with whom copyright rests.