Snack Swap Series: Fruity Snacks
Depending on the ingredients, these can provide some fiber, vitamins and minerals, but many are just candy in disguise! Fruit leathers are a better bet, but can contain high concentrations of pesticides(1), so choose organic where possible. Look for ones made from whole fruit (not concentrates) and free from additives.
To give the numbers below some context, the American Academy of Pediatrics recommends limiting kids' (aged 2-18 years) added sugar intake to no more than 25 grams per day (~6 tsp). In the UK these recommendations are broken down by age, with 4-6 year olds limited to 19 g per day, and 7-10 year olds having no more than 24g per day. The UK guidelines indicated that babies and toddlers (under 4 years old) should avoid added sugars altogether, while the US suggests none for those under 2 years old.
If made from real fruit, the sugar in the items below is not considered 'added', but the use of fruit juice concentrates in some products is a grey area - the FDA does consider this 'added sugar' in most cases.
Snack Swap Series: Granola Bars
A few clients have recently asked me for my favorite brands of various kids’ snacks, so I thought I’d put together a few lists for you all. A short rationale is included for those who want to know why, and also to help you make your own choice at the store, because this list is by no means exhaustive. For those of you who don’t have the time, I’ve color-coded the brands so you can simply skip ahead and get on with your day - green are your best bets!
Let’s start with a reminder that the primary reasons we feed our kids are 1) to provide fuel to get them through the day, and 2) to provide adequate nutrients for them to grow and develop well over time. They have little stomachs (about the size of their fist) and short attention spans, so we can expect them to need refueling every couple of hours, typically with three meals and two snack times over the course of a day.
Ideally, snack time would be a nutrient-dense mini-meal, with a balance of carbs (for energy) protein (for growth) and fats (for brain development). And, ideally, these would be from minimally processed whole food sources: whole grains, fruits and vegetables for the carbs, and nuts, seeds, beans, cheese, yogurt and eggs for the fats/proteins. The reason for this is that minimally processed foods contain the most fiber, water, vitamins and minerals, and this is what our children’s bodies need to operate and develop optimally. Processed foods tend to strip these things out and replace them with sugar, salt, and artificial additives.
A simple whole food snacking plan is to offer a fresh fruit or vegetable at every snack, paired with a protein source and/or whole grain. For example, carrots and hummus, apple slices and cheese, celery sticks with peanut butter, yogurt and berries, chia pudding and mango, almonds and a piece of fruit, 100% wholewheat toast with nut/seed butter and a clementine, and so on - the combinations are endless! This is also much more cost-effective than packaged snacks.
Providing these types of snacks is easier at home; when we are packing snacks for school or outings, it isn’t as easy to offer these foods. Enter packaged snacks! Every kid’s favorite way to fuel up, and a welcome shortcut for most parents. However, as parents, we still want to find that balance between convenience and nutrition, and it’s a minefield out there. So, without further ado, I will offer my suggestions in each of the main snacking categories, to help you navigate the sugar traps, sodium bombs, and artificial additives!
Image by Silvia from Pixabay
Granola bars (AKA cereal bars, chewy bars) can be a good source of whole grains, fiber and some micronutrients - watch for added sugar and artificial ingredients. Brands with nuts, seeds and a variety of grains will provide more fiber, protein and minerals. Look for less than 25% sugar by weight, 3+ grams of fiber, and 3+ grams of protein per bar. Smaller (24g) bars are a good size for preschoolers; bigger kids might need a bigger bar, or a second snack item to keep them going.
Kelloggs Nutrigrain bars: 37g bar, 13g sugar (35% by weight), 1g fiber, 2g protein. Over 40 ingredients, around seven of which are sugar under different names, and GMO corn syrup and soy. Highly processed; synthetic vitamins and minerals added.
Quaker Chewy bars: 24g bar, 7g sugar (29% by weight), 1g fiber, 1g protein. Contains 40+ ingredients, GMO corn syrup and soy, artificial flavors and preservatives.
Trader Joe’s chewy chocolate chip bar: 24g bar, 8 grams of sugar (33% by weight), 1g fiber, 2g protein. Lots of ingredients, many of which are sugar sources, but all are organic. Smaller bar is a good size for smaller kiddos.
CLIF Kid Z bars: 36g bar, total of 10g sugar (28% by weight), 2g fiber, 2g protein. More processed ingredients than some other options, lots of different sugar sources, but organic/non-GMO and no corn syrup.
Nature Valley Crunchy Oats & Honey: 42g bar, 11g sugar (26% by weight), 2g fiber, 1g protein. 10 relatively simple ingredients, three of which are sugar; does contain GM soy. Bigger bar, better for bigger kids.
Made Good granola bars: 24 bar, 6 grams of sugar (20% by weight), 1-2g fiber, 2g protein depending on which flavor. Quite a few ingredients, but they include a vegetable extract blend which contributes some natural food sources of vitamins and minerals. Good for little kids due to smaller size.
Kind Healthy Grains: 35g bar, 6-8g of sugar (~20% by weight), 2-3g of fiber, and 2-3g of protein, depending on the flavor. This bar has recognizable ‘real food’ ingredients (although there are 20 of them, and 5 are different sugar sources). Mixture of whole grains (buckwheat, amaranth, quinoa, millet, oats, rice) contribute some micronutrients and diversity.
88 Acres seed bar: 45g bar, 7-10g sugar (~18% by weight), 3g fiber, 5-7g protein, depending on flavor. Double the weight of some other bars, but more nutrients with less sugar proportionately (AKA more nutrient dense). Lots of micronutrient-rich seeds add important minerals. A more substantive option, good for bigger kids (and adults).
Kind Nut bars: 40g bar, 5-9g sugar (12-22% by weight), 3-7g fiber, 4-6g protein. Whole nuts, and a fairly short list of simple ingredients. Packed with fiber and protein. Substantive enough to keep bigger kids full (and also sold as ‘minis’ for smaller kids). Non-GMO, and a good source of healthy fats.
Health Warrior Chia bars: 25g bar, 3g sugar (12% by weight), 4-5g fiber, 3g protein. Packs a nutritional punch for a smaller bar and the lowest in sugar. Made with nuts, seeds and whole grains; rich in essential fatty acids, as well as the fiber and protein, and non-GMO.
Easy homemade option: trail mix
Trail mix is essentially a deconstructed granola bar. Consider mixing together some nuts, seeds, and unsweetened dried fruits (and perhaps a sprinkle of dark chocolate chips) for a DIY trail mix: you can make a batch in minutes and portion it out into mini reusable snack pots for grab-and-go convenience.
Try this combo:1 cup of almonds, 2/3 cup of dried unsweetened cherries, 1/2 cup of pumpkin seeds, and 1/3 cup of semisweet chocolate chips in a large bowl. This is much more cost effective than buying bars, as well as more nutritious! A 1/4 cup serving (35g) of the trail mix above has 7g of sugar (20% by weight), 3g of fiber, and 5g of protein, plus offers a spectrum of minerals like iron, calcium, copper, zinc and magnesium.
As many of us prepare to send our children back to school and with Covid-19 showing no sign of abating, I’m getting requests for tips on how to keep kids’ immune systems in good shape this fall. The good news is, kids are probably less likely than usual to get the standard sniffles this semester due to enhanced cleaning protocols, social distancing, and masking measures in place to prevent the spread of Covid-19. However, their immune systems may be a little out of practice after a year and a half of relatively sterile living (e.g. limited contact with peers and endless hand sanitizing). Thankfully, kids are at very low risk of serious illness from SARS-CoV2, and masked exposure would reduce the viral load, which may mean a milder or asymptomatic case (1).
Aside from these external prevention strategies there are a few key nutrients that support healthy immune defenses and may offer an additional layer of protection (to be clear, I am not claiming that diet and supplements can prevent or cure Covid-19!). Most of these nutrients can be obtained from food, but if some are in limited supply in your child’s diet due to allergies, dietary restrictions or picky eating, you might consider supplementing.
#1: Vitamin D
Vitamin D is a key player in regulating immunity and inflammation. During the pandemic a lot of research has looked vitamin D status and the risk of catching Covid-19, as well as links to outcomes of the virus: one study found that those with vitamin D deficiency were 70% more likely to test positive for Covid-19 than those with adequate D status (2), while another found that patients hospitalized with Covid-19 were significantly more likely to be deficient in vitamin D than controls (3). Vitamin D deficiency is widespread, with approximately half the population having inadequate levels - those who are obese, have darker skin tones, and the elderly are at even greater risk (these groups are also hardest hit by Covid-19).
Children tend to have higher levels of vitamin D (perhaps because they spend more time in the sun), but 10% of children are still estimated to be deficient (<15 ng/ml), and these rates are even higher among kids in the aforementioned high risk categories. On top of this, a further 60% of children may have suboptimal levels (≤20 ng/ml; 4), putting them at risk for deficiency. Older infants and toddlers who are breastfed may also be at higher risk of deficiency due to low vitamin D levels in breastmilk (this can be rectified with maternal supplementation). Your pediatrician can test for vitamin D levels; some experts at Hopkins believe this should be routine for at-risk groups (5).
All children aged 1-18 years old need at least 600 IU (15 mcg) per day to maintain adequate levels; the Endocrine Society suggests that up to 1000 IU (25 mcg) may actually be needed for certain subgroups. As you probably know, the main source of vitamin D is the sun - our skin makes it when exposed to sunlight. Ten to fifteen minutes of sun on the arms and legs a few times per week is typically adequate for light-skinned individuals to get enough vitamin D, but those with darker skin tones may need double the exposure. Also, if you live in the Northern states, there’s not enough sun outside of the summer months to synthesize vitamin D (and if you routinely apply sunscreen to your child in the summer, it’s going to be limited then too).
As for food sources, oily fish is the best source of vitamin D3 (3 oz of salmon = 570 IU), and a little bit can be found in egg yolks (I large egg = 45 IU) and cheese (1 oz cheddar = 12 IU). Plant sources like mushrooms contain D2, an inferior form that the body has to convert (1/4 cup white mushrooms = 180 IU). Most milks in the US have added vitamin D (1 cup = 100-140 IU), which is where most kids are going to be getting it from, but check that it’s D3, not D2. Also know that vitamin D needs fat to be absorbed, which means that whole milk is going to be a better source for your child than fat-free milk.
Vitamin D is one nutrient that should probably be supplemented for most kids due to low availability from food and limited exposure to sun as we head into fall and winter. Look for a supplement that contains D3, in an oil (drops like this from Carlson Labs are good for kids); give 400-800 IU per day for maintaining levels (more if the child is deficient).
Zinc is a mineral and an immunity all-star; low zinc status puts us at greater risk for various infectious diseases. A recent study found a significant link between patients’ zinc levels on admission to hospital with Covid-19 and disease outcomes, concluding that low zinc was a risk factor for greater severity and higher mortality (6). Zinc deficiency can present as a loss of sense of smell and taste, which is also recognized as a symptom of Covid-19 infection. This makes physiological sense: when we catch a virus our zinc levels drop in the acute phase, as the body uses it to fight the infection (7). Preventive zinc supplementation has been shown to reduce the incidence of infectious diseases like pneumonia and diarrhea in children in developing countries (8), and maintaining adequate levels of zinc is important for optimal immune function.
Your child needs different amounts depending on their age group:
Most kids in the US get adequate zinc from food. The best sources are protein foods like meat and seafood, nuts, beans, and dairy products, which the majority of US children eat plenty of. Good animal-based sources are beef (3 oz = 7 mg), crab (3 oz, cooked = 6.5 mg), and chicken (3 oz, dark meat = 2.5 mg). Dairy sources include Swiss cheese (1 oz = 1.2 mg), milk (1 cup = 1 mg) and yogurt (1/2 cup = 0.8 mg). Top plant-based options are baked beans (1/2 cup = 3 mg), pumpkin seeds (1 oz = 2.2 mg), cashews (1 oz = 1.6 mg) and oatmeal (1/2 cup = 1 mg).
If you have a particularly picky eater, or a vegetarian or vegan child, you may want to consider a supplement. Look for something that offers at least half of the recommended daily allowance for your child’s age group (above). I don’t recommend supplementing with more than the RDA or for extended periods - this can upset the balance of other minerals like iron and copper.
#3: Vitamin C
Vitamin C is a water-soluble vitamin and a powerful antioxidant; it is important to get enough for healthy immune function. There is some evidence (9) that it may reduce the severity of colds and other upper respiratory infections slightly when taken preventively (it doesn’t seem to stop people from getting colds, but they’re less serious when they do). However, there isn't strong evidence supporting ongoing preventive supplementation with vitamin C, and it hasn’t really lived up to it’s promise against Covid-19 (10).
How much your child needs depends on their age group:
These are the minimums needed to prevent scurvy, not necessarily the amount needed for optimal functioning, so getting more is definitely not a problem! The majority of kids in the US get adequate vitamin C from foods - fruits and vegetables are the best sources. Whole fruits are better than juice, and raw fruits and veggies have more vitamin C than cooked (because some is destroyed in the cooking process). Vitamin C can be found in oranges (1 medium = 70 mg), kiwi (1 medium = 64 mg) and strawberries (1/2 cup = 49 mg), plus vegetables like bell peppers (1/4 cup = 47 mg), broccoli (1/4 cup = 25 mg), Brussels sprouts (1/4 cup = 25 mg) and cauliflower (1/4 cup = 13 mg).
Looking at these numbers you can see that most kids will be meeting the minimums, but picky eaters who don’t get enough fresh produce each day might be at risk for vitamin C deficiency (and other vitamins and minerals too). Supplements may be helpful while working on improving dietary diversity; you can safely go from the RDA up to 250 mg. Vitamin C is water soluble so supplementing is low risk - the worst-case scenario is looser stools if an excess is consumed.
These fatty acids are essential and have a regulatory effect on the immune system, bringing it back into balance: most of the fats in the Western diet are inflammatory (omega-6s), while the omega-3s are anti-inflammatory. Both are important, but most people are getting way too much of the former and not enough of the latter. Omega-3s up-regulate the activity of neutrophils (our first line of defense against pathogens), help activate T cells, and can modulate cytokine responses (11). Whether or not they’re useful in the fight against respiratory diseases is unclear, but they’re important for general health and have few downsides.
The omega-3 fatty acids (EPA and DHA) can only be found in oily fish (e.g. salmon, mackerel, rainbow trout, sardines and tuna), while their less-potent precursors (ALA) are found in nuts and seeds (e.g. flax, chia, walnuts). Most children get adequate ALA but very little DHA, because most kids aren’t eating fish on a regular basis! If this is true for your child, consider a high-quality supplement with at least 200-300 mg of DHA/EPA per serving from low mercury fish. Nordic Naturals are a reliable brand with all different options for kids including liquids, gummies and chewable soft gels.
These friendly microbes also play a role in our immune health, and may reduce the risk of respiratory diseases (12). Particular strains of interest include Lactobacillus species L. planetarium, L. paracasei and L. reuteri. Research in this area is ongoing, but there are general health benefits and no known drawbacks to getting more good bacteria into our kids’ lives, especially in the fight against pathogenic microbes.
Common food sources are yogurt, kefir, pickles (truly pickled, not in brine or vinegar), kombucha and kimchi. If your child doesn’t enjoy many of these foods, consider a probiotic supplement with a few different strains, especially if they have a history of antibiotic use.
Last but not least: SLEEP!
Kids need to be getting adequate sleep in order for their immune systems to function optimally (we all do). As they get back into the school routine, make sure they’re getting enough for their age group:
To wrap up: offer your child plenty of fresh fruits and vegetables, a variety of protein foods (animal- and plant-based) and include fish a couple of times per week. If they drink milk, make sure it’s fortified with D3 and not fat-free. If you need to plug some dietary gaps, supplements can help. Round off with a healthy dose of sunshine, fresh air, and plenty of rest. Here’s to a healthy and happy school year!
The information in the previous article is all well and good, you know WHAT children need to be eating, but HOW do you get your kids to eat more of things they need? In my experience, a few things are key: exposure, small switches, structured choices, getting kids involved, and a no-pressure approach.
I am often asked what to feed kids and how to get them to eat more healthful foods. Some kids are super picky eaters from the get-go, while others have just got used to having a certain set of options every night and aren’t really willing to stray beyond those. In other families, kids are fairly open to new flavors and parents simply want ideas for kid-friendly foods, while others need guidance on providing a more balanced diet. So, there’s a what and a how of feeding children, and I’ll address both. In this article I’ll start with what to feed kids to help them grow and thrive, and in the next part I’ll talk about how.
Six types foods and nutrients are consistently lacking in kids' diets, two nutrients that you might be mindful of are usually adequate, and two more are often excessive (and hidden everywhere). Here's a quick run down!
Hi, I'm Amy. I'm a nutritionist in the DC area, working with clients of all ages, focusing on prenatal and pediatrics. I'm all about straightforward, evidence-based health & wellness advice - because life/parenting in the modern world is complicated enough!