Today’s contributing article is by a member of Kensington Mums Maya Aboukhater, who is a registered dietitian with special interest in mothers and children, diabetes and weight management. She explains the importance of good nutrition and active lifestyle in order to have a healthy start to the new school year. She currently works in two private hospitals and sees private patients as well. During the last ten years, Maya has worked at Great Ormond Street Hospital for Children, BUPA Cromwell Hospital and The Portland Hospital for Women and Children.
As a working Kensington Mum living in London and mother of two boys, she discusses:
- How can we keep our kids stay active while we are keen to help them have a successful year at school?
- The vitamins and minerals we or our kids tend to be deficient in especially during the winter months.
- How we can assess whether we or our kids are deficient?
- Where can we find the vitamins and minerals from?
How can we keep our kids active while we are keen to help them have a successful year at school?
With all the pressure of school and homework, it is very important for kids to keep active once back to school. Research suggests a strong link between movement, learning and attention. Toddlers and pre-schoolers should be doing at least 3 hours of physical activity through the day. This may include going to the park, running, jumping, climbing or visiting a soft area. Kids by the age of five should have at least 60 (or more) minutes of physical activity each day and exercises for strengthening muscles 3 times per week. Keeping kids active can be achieved by walking to and from school and as much as possible. Strengthening exercises can include swimming, football or tennis. Screen time should be limited to spend 1-2 hours maximum.
The vitamins and minerals we/our kids tend to be deficient in especially during the winter months.
A vitamin is something that helps our body function – a ‘nutrient’ – that we cannot make in our body. In order to assess whether we are deficient in vitamins or minerals during the winter months, it is important to check whether you have an acute or chronic illness, injury or surgery as this can have considerable impact on your nutritional status. This can be directly the result of the injury or indirectly because of the effects of your food intake. It might be also worth checking whether the medication you maybe taking can affect your nutrient intake and absorption. There are other factors that also affect your nutritional status including age, gender, weight, height, waist circumference and ethnicity. In addition, environment, shopping habits and cooking facilities plays an important role. Examples of increased nutrient losses include vomiting, diarrhoea or bleeding. Difficulties in self feeding, chewing or maintaining food in the mouth also increase nutrient losses.
Examples of physical signs of nutritional problems:
If your hair is thin, sparse, or colour has changed, your body may be deficient in protein, energy, zinc and copper.
If your skin is dry, flaky or bruising, your body may be deficient in essential fatty acids, B vitamins, Vitamin A and Vitamin C.
If your eyes are pale, your body may be deficient in iron and Vitamin A.
If your tongue colour changes, your body may be deficient in B Vitamins.
If the enamel of your teeth is molting, you may be having an excess of Fluoride.
If your gums are spongy or bleeds easily, your body may be deficient in Vitamin C.
If your thyroid is enlarged, your body may be deficient in Iodine.
If your nails have spoon shape, your body may be deficient in iron, zinc and copper.
If your muscles are wasted, your body may be deficient in protein, energy and zinc.
If you can see the beading of your ribs, your body may be deficient in Vitamin D.
How do you assess whether you are eating the right food for you?
Dietitians usually consider food and fluid intake during the last 24 hour. We discuss your usual meal pattern and food choice with your overall dietary balance. The duration and the severity of any change in appetite and oral intake are considered. People mostly underestimate the impact of social conditions, isolation, lack of knowledge of the carer of the child, alcoholism, financial difficulties, bereavement especially if your partner used to organise meals.
Are you still not sure whether you are deficient in any vitamins or minerals?
Asking your doctor to have a blood test provides you with objective results. This can help determine the status of specific nutrients in your body. This can include Vitamin B12 if you are vegetarian or iron deficient or if you suffer from heavy bleeding especially for women. As with adults, assessing the nutritional status of infant, child or adolescent is vital prior to developing an appropriate nutritional care plan. Children have changing needs as they grow and develop. Other factors to consider depending on the age of the children are: feeding behaviours, growth evaluation, family viewpoint regarding nutrition, feeding habits and mothers’ nutritional status when breastfeeding. It is very important to check whether your child is at risk of malnutrition as this not only affect their growth but also their immune function to fight diseases.
Where can we find the vitamins and minerals from?
One vitamin that we tend to be deficient in especially in winter is Vitamin D. According to the British Dietetic Association, ‘vitamin D’ is sometimes called the ‘sunshine vitamin’ and our bodies make vitamin D from sunlight during the spring and summer.
During October to March, most people get vitamin D deficient. At other times of the year, it is recommended to eat foods that contain vitamin D, such as:
• most margarines
• fortified brands of soya milks, yogurts and desserts – check the label
• fortified breakfast cereals – check the label
• dried skimmed milk
• fortified yoghurts
Additional supplements are recommended for pregnant and breastfeeding women, children under five-years-old, people aged over 65 years and people who are not exposed to much sun subject to doctor or a health professional advice. The Department of Health recommends that all children aged six month to five years are given vitamin supplements containing A,C and D every day. If mothers are breastfeeding, babies should get daily Vitamin D from birth. If your child is drinking more than 500ml of infant formula, vitamin supplements should not be given because the formula is fortified.
Another vitamin that is important especially if you are vegan is Vitamin B12. Eggs and dairy foods contain Vitamin B12. Vegans should include fortified foods containing Vitamin B12 (check the label):
• yeast extract
• soya milk, yoghurts and desserts
• breakfast cereals
• certain brands of rice drinks and oat drinks.
A mineral that our body tends to be deficient in especially for women is iron. Red meat is the most easily absorbed source of iron, but various plant foods also contribute:
• fortified breakfast cereals
• dried fruit
• leafy green vegetables
• sesame seeds
• wholemeal bread
In order to help your body absorb iron from plant foods, you can include a source of vitamin C with your meal (e.g. vegetables, fruit or a glass of fruit juice).
Calcium is another important mineral that is important to grow and stay healthy especially around menopause for women.
Dairy foods are rich in calcium. If you’re not eating these, include plenty of the following:
• calcium-fortified foods e.g. soya milk, yoghurts and puddings; rice/oat drinks; and fruit juice
• green leafy vegetables, especially kale and pakchoi, but not spinach. Although spinach contains calcium it is bound to a compound called oxalate. This greatly reduces it absorption making it a poor source of unusable calcium.
• brown/white bread
• sesame seeds/ tahini
• dried fruit e.g. apricots and figs.
if you eat a lot of wholegrains and beans, this can reduce your zinc absorption. Eat fermented soya such as tempeh and miso; beans (soak dried beans then rinse before cooking to increase zinc absorption); wholegrains; nuts; seeds and some fortified breakfast cereals. If you don’t eat meat or fish, you can include some nuts into your diet, especially Brazil nuts which include selenium.
Iodine is another important mineral that help your body make thyroid hormones. Good sources of iodine includes sea fish or shellfish. If you’re a vegan include small amounts of iodised salt or sea vegetables for your iodine. Extra care is needed during pregnancy, breastfeeding, weaning and in childhood to make sure that all nutritional needs are met.
Most people get all the nutrients they need by having a varied and balanced diet, although some few people may need to add extra supplements. Be wary of fad or detox diets as there is no magic solution to losing weight very quickly. Very restrictive diets can potentially lead to long term deficiencies. If you are not sure if you/your child are meeting your nutritional requirements, I suggest speaking to a dietitian.