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The health of our children

Children's health is probably more important than for any other age group. For a start, we are responsible for them: they have no concept of their own health or what health means. They have no understanding of its importance. Children can be an easier group to over-look because they will eat and drink what they are given and adopt a lifestyle they will not realise is unhealthy. Good parenting and feeding of children is paramount because the unhealthy child carries the legacy of poor care into adulthood.

A hundred years ago the problems were rooted in lack of fresh food or poverty. Some children were wracked with rickets (soft bones), deformities, poor eyesight or stunted growth. After the Second World War, rationing gave way to an abundance of fresh food. People were healthier and weight problems were almost unknown.

Sixty years on, the situation has reverted to a different kind of poor health. With an over-abundance of food and mass production, the diseases now are of over, rather than under-feeding. Constipation, debilitating bodyfat and diabetes, although still uncommon, are becoming more frequent in childhood. Indeed, anybody who saw the recent Channel 4 series Jamie's school Dinners with chef Jamie Oliver, will have been shocked at the problems uncovered by this expose of some children's school meals. Junk food, highly-processed food, additive-laden food, were the basis of the daily diet in some schools. This diet can lead to children's lack of bowel activity and under nourishment as a result.

How children's eating habits affect the digestive system

The digestive system is one of the most important systems of the body. Food is our fuel and our internal system is like an engine room; processing, extracting nutrients, feeding storing and eventually, excreting. The process of input and output needs to run in an efficient and regular way for optimum health and wellbeing.
Eating habits determine how effectively a child's system works and irregular feeding times, eating under stress, eating stodgy food with little bulk; dehydration and lack of exercise all serve to slow down the internal system.

Therefore one of the most important areas of a child's development is his/her eating routine. Here are some points:

• Regular bowel habits make a child feel secure. It is embarrassing to ask for the loo where you are not comfortable.
• The body likes routine. If your child has breakfast, lunch and a later meal at approximately the same times each day, they will soon get into the habit of opening their bowels at the same time every day.
• Never fit in mealtimes to your life. Decide on mealtimes and fit your life around them. They are like pit stops or filling a car with fuel so you can carry on the next leg of your day's journey.

How children get constipated.

• Does your child eat a lot of processed junk food? Crisps, chips, burgers, pizza, white bread. Meals like these are eaten several times a day by many of our children and they can cause constipation. Without fibre to bulk up the waste and ease the waste through, the system can get clogged and painful inflamed pockets can appear in the gut as the intestines try to find something to 'grab on to' to propel the food along. In children, this can result in constipation.
• Does your child drink enough water? Does he/she eat enough food with a high water content, such a fruit and vegetables which can be up to 90% water? A 'dry' diet of biscuits, crisps and sweets slows down the passage of food through the gut, which can lead to constipation.
• Does your child eat too little? Faddy children will go for hours without food rather than eat something they hate. This means the stomach empties slowly and can lead to a feeling of bloating and fullness after meals which in itself can become another problem!

Preventing constipation in children

1. Get a meal routine going. Your child can then get into the habit of emptying their bowels at the same time every day, hopefully after breakfast, at home.
2. Cook fresh food at home whenever possible. Add at least two vegetables or a salad or serve vegetable soups, pasta with fresh vegetables or vegetable curries for vital dietary fibre. This adds bulk which eases food through the gut in a natural way

However, children are not simply small adults. Their overriding need is for energy and too much fibre fills them up and affects their ability to absorb nutrients like calcium from food. This can affect growth. Introduce fibre gradually to babies and toddlers as you would in any process of weaning, with simple fruit purees, peeled fruit, sieved or mashed vegetables and never serve bran or large amounts of wholemeal foods to very young children as this type of insoluble fibre passes through the system whole and is a little too drastic for them. Gradually allow peels and skins into the diet by the time a child is school age, as these are the most fibrous parts of the fruits. However, it is worth pointing out that babies and toddlers are rarely constipated.

School age or nursery children over the age of four are the more likely to become constipated, as a child is away from the comfort and security of home. Eating strange food and going to unfamiliar toilets, causes anxiety and can lead to constipation. A little judicious care with small amounts of high-fibre food such as porridge, muesli with dried fruits and bananas should soon restore the situation to a smoothly working bowel.

As soon as your child has a regular and satisfactory bowel habit, make sure each meal has some soluble fibre. This type of fibre binds to waste matter to eliminate it from the body gently as opposed to insoluble fibre which acts as a 'scrubbing brush' for the system. Insoluble fibre, as found in strawberries, nuts and bran cereals should be served in small amounts; for example six strawberries or a handful of nuts - do not allow them to forage at will!

 

1. Combine fibre. Wheat bran, whole grains and dried fruit are examples of foods that have both types of fibre.
2. Always pack a small bottle of water for your child even if you fill it from the tap - fortunately, water is fashionable!
3. Even if a child is faddy and will not eat much, keep them active and well hydrated. Activity contributes to healthy bowels just as much as the right diet.
4. Do not allow too much meat. Proteins are quite heavy and 'binding' for any child, and it is better to take protein in the form of fish or cheese, yoghurt and nuts.
5. Pack dried fruit instead of sweets or chocolate bars when making school lunch boxes. This provides the necessary sweetness with added fibre.

This depends on the age of the child and when he or she goes to bed. Ideally, they should have three 'main' meals a day and snacks only if hungry. Example of good snack foods are fruit, raw vegetables or home-made biscuits or oat flapjacks - bought ones can contain a lot more fat than is necessary. Occasionally you could try vegetable crisps: these are beetroot parsnip and sweet potato and contain enough dietary fibre to make them a good accompaniment to meals - try not to have them as snacks, however.

Providing healthy meals to prevent constipation

**Give a child a soluble fibre breakfast such as porridge, muesli or granary bread
**Offer a bowl of salad or stir-fried vegetables with every meal. Make sure you never treat fruit and vegetables as something to be endured in order to get the more enjoyable foods. Eat them as a matter of course and in the case of slightly older girls emphasise the beauty benefits!
**Have fruit salad for dessert and a bowl of fruit on the table at all times. Make sure that sweet puddings or chocolates are not part of an everyday diet. If necessary, explain that you are doing things differently and sweets can be full of additives and can ruin their teeth. **If you have trouble getting children to eat vegetables, try

• Vegetable pizza
• Vegetable soup
• Chilli con carne with rice and kidney beans
• Spaghetti Bolognese with whole-wheat pasta and a sauce including peppers and onions
• Spanish omelettes
• Home-made chips using unpeeled potatoes - the skins are high fibre

How to help your child avoid constipation when away from home

Forcing them to eat a certain way just will not work; they need to understand why they must eat more healthily. It is not so different from vegetarian parents who expect their child to ask for non-meat options for reasons of belief rather than 'because they must'. Packing wonderful healthy lunches is useless if your child throws it in the bin because they either don't believe in healthy food or do not understand why they should be doing it. Get them on your side. Be enthusiastic about the merits of being healthy on the inside.

Otherwise always train children to ask for:

1. side salads or vegetables like peas with all main meals
2. cereal for breakfast instead of white toast
3. a glass of water with and between meals
4. a bottle of water always to hand
5. an apple or banana in case of hunger
6. brown bread instead of white
7. dried fruit instead of sweets

Check out Monica's next article on Low carb diets and Constipation »

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