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Posted Jun 09 2009 11:34pm
Recommendations for healthy Childhood dieting  should be age-specific and flexible enough to accommodate family and ethnic food preferences . In toddlers, limiting sweetened beverages is usually the most useful initial strategy. accoriding to The American Academy of Pediatrics (AAP) recommendation for childhood dieting, a maximum intake of 4–6 oz of fruit juice/day for children ages 1–6 yr and 8–12 oz for 7–18 yr olds. Other simple interventions include changing to skim milk in children older than the age of 2 yr and assuring exposure to a wide variety of foods, including less calorie-dense food choices and limitation of between-meal snacking. For preschool-aged children, sweetened beverages should be limited and parents should continue to offer healthy foods. The parents should be educated about approaches to dealing with food refusals as diets are modified. It often requires more than 10 repeated exposures to a new food before a child will regularly accept it as part of the regular diet. As children reach school age, busy schedules and exposure to food advertisements often increase fast food intake. Education regarding meal planning and the value of family mealtimes in maintaining family structures can decrease the number of meals eaten away from home. Including children in meal choices and food preparation helps them to learn healthy eating patterns. Adolescents also fall victim to busy schedules, and given their increasing independence, they are more likely to develop unhealthy eating patterns, such as skipping meals and following fad diets. Encouraging children to eat breakfast, decreasing their intake of sweetened beverages, and teaching them the principles of balanced nutrition (eating from all food groups) are useful strategies for the overweight adolescent.

In childhood dieting programme the more severe dietary restriction should be used only in a supervised program. Some centers have reported success with specific dietary interventions, such as a protein-sparing modified fast, which is usually managed in an inpatient setting or in a closely supervised outpatient clinic. An extremely low-calorie diet (≈800 kcal/24 hr) is used for children with severe obesity needing rapid weight loss. Low-carbohydrate or controlled-carbohydrate diets show superior weight loss compared with low-fat diets in adolescents. Adult studies show similar weight loss between this approach and other diets, so the benefit is uncertain. Nutrition plans based on the glycemic index of foods has shown great promise in overweight children. The glycemic index is based on the insulin response to a carbohydrate, with simple carbohydrates having a higher, and therefore less desirable, glycemic index compared with complex carbohydrates, such as non-starchy vegetables and whole grains. Multidisciplinary teams and dietitians usually focus on identifying problem areas in a child's and family's regular diet and then teach them about healthier alternatives and eating patterns. This approach creates sustainable, lifelong change, which is more useful than restrictive diets, which are usually not maintained, with resultant weight gain. A successful approach used in preschool and preadolescent children is the traffic light or stoplight diet. Foods are grouped by nutrient and caloric density, with the color indicating the frequency of recommended consumption . It is designed to limit calories, yet achieve good nutrient balance and is easily adaptable to fit particular ethnicities and nutrition plans, such as low-carbohydrate or glycemic index diets.
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