No matter what your dietary preferences are or how you choose to feed your kiddos, there are a few essential nutrients that all parents need to have on their radar.
It doesn’t mean you need to be neurotic about whether or not your child is getting adequate amounts of these vitamins and minerals- because parenthood gives us enough to obsess over- but it’s a good idea to have them on your radar. In many cases, a varied diet focusing on lean proteins, occasional servings of fish, whole grains, healthy fats and plenty of fruits and vegetables will help prevent most deficiencies.
A diet high in processed and convenience foods, however, can lead to deficiencies. Highly processed convenience foods are often stripped of their vitamins and minerals and have a high ratio of calories to nutrients so kids get more calories than they need but no enough of the nutrients they need.
You already talk to your pediatrician about medications, concerns and symptoms. Nutrient deficiencies can be at the root of many conditions, so talk to your pediatrician about your child’s diet as well. Get a referral for a pediatric dietitian if necessary.
Starting your kids off with a wide variety of whole foods, including plenty of fruits and vegetables, and encouraging them to try new things will go a long way towards keeping them healthy now and into adulthood (for more see “how to avoid picky eaters)”
One exception to that rule? Vitamin D. It’s notoriously hard to get in the diet, and most of us are deficient or at risk of deficiency.
Vitamin D
Yes, you can get it from the sun.
But, with screen time in kids increasing, kids are going outside and getting sunshine less.
Additionally, it takes 15-20 minutes a day, in the heat of the day, in full sun, without sunscreen. If your kids are going out between 10 am and 4 pm, I bet you’ve slathered them in sunscreen (and rightfully so!). And from November to March, the sun isn’t strong enough to provide adequate amounts of vitamin D unless we live south of 37 degrees latitude. That’s anything south of Los Angeles, the southern tip of Nevada, the states of Utah, Colorado, Kansas and Missouri and the northern borders of Tennessee and North Carolina.
And the 15-20 minutes of sun a day? That’s only if you’re fair-skinned. If you’re darker-skinned, you may need longer in the sun. Research on vitamin D needs in those with darker skin is evolving; darker-skinned folks may not need as much vitamin D, and they may need a different measurement standard.
So, what is a person to do?
Food sources of vitamin D include fortified milk and plant-based dairy alternatives, fortified cereals and juices and fortified margarine/spreads. Egg yolks, liver and cheese, provide a small amount of vitamin D. Mushrooms can be a source of vitamin D, you can buy mushrooms that have been grown under UV light or put regular mushrooms out in the sun where they can convert the UV into vitamin D.
Some foods contain vitamin D, but, honestly, this one is best to supplement to ensure your kiddo is getting enough.
Why is vitamin D important?
Vitamin D is essential for proper bone growth. Sure, calcium gets all the glory there, but vitamin D helps the body absorb calcium and get it to the bones where it needs to be. Rickets, a softening of the bones leading to bowed legs in kids, is a consequence of inadequate vitamin D Although we tend to think of rickets as a thing of the past, cases are rising again.
But it doesn’t just end with bone health.
Vitamin D is a crucial factor in immunity and building a robust immune system. A deficiency increases your kiddo’s risk of viral and bacterial infections (something most kids don’t need any help with, thank you very much!), and increases inflammation.
Even breastfeeding infants need vitamin D (LINK TO BREASTFEEDING AGES AND STAGES) though they can get some through breast milk if mom has adequate amounts. Formulas usually contain sufficient vitamin D.
How much should kids get each day?
The National Institutes of Health recommend that babies up to one year of age should get at least 400 IU of vitamin D3 per day. Everyone 1 year of age and older should get at least 600 IU of vitamin D3 each day. Vitamin D3 is better absorbed, so although both vitamin D2 and vitamin D3 are available, opt for the D3. Take any vitamin D supplements with meals. Vitamin D is a fat-soluble vitamin, which means it needs fat to be absorbed.
Pro Tip: look for a vitamin D supplement that also has vitamin K2 for ultimate bone health. While vitamin D helps get calcium where it needs to go, vitamin K2 helps it stick to the bone.
Signs & Symptoms of a Deficiency
Signs and symptoms of a vitamin D deficiency can be vague but include fatigue, muscle weakness or cramps, bone pain and fractures and even impaired growth.
There are a few minerals to keep on your radar as well. In most cases, you won’t need to supplement these minerals, but it wouldn’t hurt to make sure your kids are getting plenty of foods that contain these minerals.
First up on our list:
Iron.
Why do we care about iron?
Iron helps the body transport oxygen. Muscles store and are able to use oxygen thanks to iron.
Iron deficiency is the most prevalent form of nutritional anemia. Inadequate dietary intake of iron, high intake of fiber from cereal and legumes, low birth weight and infections can all contribute to iron-deficient anemia.
It’s not just anemia. Iron deficiency can also contribute to delayed brain maturation and reduced cognitive development, including reduced motor development and language development.
Although there are many symptoms of iron deficiency, one common hallmark sign of a deficiency is known as pica.
Pica is the desire to eat odd things- laundry detergent, ice, paint, dirt, etc.
Who is at risk for an iron deficiency?
It depends- everyone from newborns to older kids can be at risk.
If mama has adequate iron intake during pregnancy, babies build up their stores while in utero. These stores last them until four to six months, which works out just about ideally since this is about the time babies start eating solids and can replenish those stores.
One baby starts eating solids, 90% of their iron intake should come from food. Breast milk only supplies around 10% of what they need. Once baby stops breastfeeding, foods must meet 100% of their iron needs.
If kids get a varied diet and eat meat, they’re less likely to end up with iron-deficient anemia. However, once they hit puberty and start menstruating, teen girls are at an increased risk of iron deficiency as they lose iron each month.
Signs & Symptoms of a Deficiency
Signs and symptoms of iron deficiency include pale skin, cold hands and feet, fatigue, slow growth, frequent infections and poor appetite.
Where do kids get iron?
At first, infants may get their iron from fortified foods like rice cereal or fortified formula. As their palates expand, kids should be eating plenty of foods that are rich in bioavailable iron, like meat, seafood and poultry.
Iron comes in two forms: heme and non-heme. Heme iron comes from animal products and is the most bioavailable form of iron. Non-heme iron is found in plant foods and is less bioavailable, so kids need more. (See “vegetarian diets” for more information on non-meat sources of iron).
It’s essential to keep in mind that cow’s milk is a poor source of iron. What’s worse, cow’s milk is a rich source of calcium. Calcium and iron compete for absorption in the body. Too much cow’s milk can prevent the iron in foods from being absorbed and lead to low iron levels, so it should not be baby’s main beverage until at least 12 months of age.
Speaking of calcium…
Calcium
Calcium is a mineral of concern when it comes to bone and tooth health, but it’s also crucial in maintaining blood vessel health, muscle function, nerve transmission and hormones.
To reap the benefits of calcium the body must also have adequate vitamin D, magnesium, sodium and potassium on board.
Bones are always under construction, especially in kids. Bone is continuously being broken down and rebuilt and calcium is deposited into bones continually. In kids, bone growth outweighs bone breakdown, especially during growth spurts.
Once they hit adulthood, bone breakdown outweighs new bone growth, so it’s vital to build up plenty of strong bone reserves while they can. The more bone kids can build up when they’re young, the more likely they are to have strong, healthy bones throughout their lives.
Between the ages of 10-20, our bodies work hard to build strong, dense bones; we build up most of our bone density and strength during these years, and this is especially true for girls. These early years set the stage for bone health for life, so they are crucial.
Calcium is a critical factor in bone building, but so is weight-bearing exercise. Essentially this means any activity that continuously puts pressure on the bones and forces them to work against gravity- things like running, weight lifting, gymnastics, tennis, jumping and dancing. Exercises like swimming, which take weight and pressure off the bones, don’t build up bones.
Unfortunately, most kids are not getting adequate calcium.
Younger kids, those ages 1-2 years, are most likely to get adequate amounts of calcium, but even then many fall short. As kids get older, the risk of deficiency increases.
Teenage girls are most at risk as pressure to look a certain way mounts, but adolescent boys don’t fare much better. Drinking soda or juice instead of milk also puts kids at a high risk of inadequate calcium.
Calcium is a mineral that we can get in adequate amounts if we follow a varied and diverse diet. A variety of foods contain calcium, and many more have it added. Three servings of dairy, especially milk, and fortified plant-based dairy alternatives and juices provide the calcium needed in a day. Other good sources of calcium include broccoli, cabbage, collard greens, bok choy, turnip greens, kale, fortified soy products (tofu, tempeh, milk) and cereals, dried figs, almonds and tahini.
Iodine
Next up on our list of minerals of concern: Iodine.
Iodine deficiency was common back in the day, but with the introduction of iodized salt, incidence went way down. Why salt? Because everyone uses it.
However, now we’re using Himalayan pink salt and sea salt and smoked salt and a million other fancy salts… What we’re not using is iodized salt, and incidences of iodine deficiency are on the rise again.
Iodine is a key mineral for the immune system and thyroid health. Thyroid hormones regulate growth, metabolism and protein synthesis as well as a whole host of other essential functions.
Where do kids get iodine?
Breast and formula-fed infants get adequate amounts as iodine is generally present in sufficient amounts in breast milk and formula.
Older kids get iodine from dairy, eggs, and grains. Seaweed, like nori, is a good source of iodine, and, of course, iodized salt is a great source as well.
Signs & Symptoms of a Deficiency
Unfortunately, the symptoms of an iodine deficiency can be maddeningly non-specific and hard to nail down; things like feeling cold or tired, being constipated, or gaining weight can all be symptoms of iodine deficiency. When an iodine deficiency becomes extreme, goiters can appear.
Who is at risk for a deficiency?
Kids on restrictive diets are most at risk, especially during the first three years of life when so much growth happens. If your child is gluten-free, vegan, or on a low salt diet, you may want to have their levels checked. But don’t worry, you’ll know if you’re playing catchup from the beginning; all newborns are screened for iodine deficiency at birth.
But there is good news: getting a varied diet and using iodized salt can help prevent iodine deficiency. Iodine is an easy mineral to get in an adequate amount but one that should be on your radar nonetheless.
Omega-3 Fatty Acids
Finally, we have Omega-3 fatty acids.
Omega-3 fatty acids are essential fatty acids, meaning our bodies cannot make them, so we must get them from our food. There are three kinds of dietary omega-3 fats: DHA, EPA and ALA. DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) play a vital role in immune, cognitive and retina development in children and help reduce inflammation.
Infants don’t often have to worry about their omega-3 intake as both breast milk and formula provide preformed omega-3s.
The gold standard and best source of omega-3 fat are preformed DHA and EPA. These are found mostly in animal products. The best sources are fatty fish like salmon, sardines, herring, tuna and mackerel and fish oil, but less fatty fish like trout, cod and tilapia, eggs and free-range beef have it in small quantities as well.
Fish don’t make their own omega-3 fatty acids. Instead, they get it from their diets by eating the algae that make it. Because the algae make both EPA and DHA, they’re a good vegetarian source of omega-3’s.
The second type of omega-3 is a precursor called alpha-linolenic acid (ALA). The body can convert ALA into EPA and then DHA, but even under perfect conditions, the conversion rate is low (estimates put it at around 15%). Often touted for their omega-3 content, walnuts, soybeans/tofu, flax, hemp and chia seeds and canola oil don’t contain DHA or EPA, but instead, contain the precursor ALA. However, ALA and the foods that contain it, have a plethora of other health benefits, so don’t skip it.
Aim to get ALA daily, and serve kids fatty fish 2-3 times per week preferrably not in fish stick form too often) to meet the omega-3 recommendations.
There are enough things to worry about when it comes to your kids, whether or not they’re getting enough of a certain vitamin, mineral or fat, shouldn’t be one of them. Fortunately, with a little planning, you can help them avoid vitamin and mineral deficiencies that can impact their growth and long term health.
Ensure they have a balanced diet with a variety of veggies and protein sources (meat, eggs, poultry, fish and legumes) while avoiding too many processed foods and your kids will likely not have to worry about vitamin and mineral deficiencies.
One less thing to worry about!