Healthy Eating and Nutrition for Children

Good nutrition in early childhood does more than fuel growth. It shapes the architecture of the developing brain, supports the immune system, establishes metabolic patterns that affect health for decades and (perhaps most enduringly) forms the eating habits and food preferences that children will carry into adult life. The diet a child receives in their first five years is among the most significant determinants of their long-term health outcomes, and the attitudes towards food they develop in childhood are among the hardest to change later.

This is why nutrition is not simply a parenting preference but a public health priority. Data from the National Diet and Nutrition Survey consistently shows that children in England eat too much sugar, too much salt and too little fruit, vegetables, fibre and oily fish relative to recommended levels. Childhood obesity rates, while subject to some methodological debate, have remained stubbornly high for two decades. The consequences (cardiovascular disease, type 2 diabetes, mental health problems) are both personal and societal in scale.

The Eatwell Guide: The Framework for a Balanced Diet

The UK Eatwell Guide, published by Public Health England (now the UK Health Security Agency), provides the primary framework for a balanced diet for most children over the age of two. It divides food into five main groups and recommends the relative proportions in which each should appear in the diet:

• Fruit and vegetables: Should make up over a third of the diet. Five-a-day is the minimum recommendation; evidence suggests higher intakes are associated with better health outcomes
• Starchy carbohydrates: Bread, pasta, rice, potatoes – should also make up about a third. Wholegrain versions are preferable for older children
• Proteins: Beans, pulses, fish, eggs and meat – should be eaten in moderate portions. Two portions of fish per week, including one oily fish, is recommended
• Dairy: Lower-fat versions for older children and adults, but full-fat dairy is recommended for children under two
• Oils and spreads: In small amounts; unsaturated fats preferred

Foods high in fat, salt and sugar (biscuits, cakes, sweets, crisps, sugary drinks) are not part of any food group and should be consumed sparingly. They are not “treats” in a morally loaded sense, but their nutritional value is low and their effects on dental health, weight and blood sugar are well-documented.

Sugar: Understanding the Limits

Free sugars (all sugars added to food and drink, plus sugars naturally present in honey, syrups, fruit juice and smoothies (but not sugars in whole fruit, vegetables and milk)) are the primary dietary concern in relation to children’s health. SACN (the Scientific Advisory Committee on Nutrition) recommends that free sugars should not exceed 5% of total energy intake. In practical terms, this translates to: no more than 19g per day for children aged 4–6; no more than 24g for ages 7–10; and no more than 30g for ages 11 and over. Children under 4 should have as little free sugar as possible.

The most significant source of free sugars in children’s diets is sugary drinks (fizzy drinks, squash, fruit juice and smoothies. A single 330ml can of cola contains approximately 35g of free sugar) nearly double the recommended daily maximum for a 4–6-year-old. Fruit juice, widely assumed to be healthy, contains around 20–25g of free sugar per 200ml glass – the same as a fizzy drink. The recommendation for fruit juice is no more than 150ml per day, drunk with meals. Water and full-fat milk (for under-5s) or lower-fat milk (for older children) are the recommended daily drinks.

Breakfast and School Performance

The relationship between breakfast and academic performance is one of the most consistently replicated findings in nutritional epidemiology. Children who eat breakfast regularly show better concentration, memory, problem-solving ability and behaviour at school compared to those who skip it. Breakfast skipping is more prevalent among children from lower-income households, which compounds the educational disadvantage already associated with poverty. Free school breakfasts and universal infant free school meals both have evidence of positive impact on attainment.

What children eat for breakfast matters as much as whether they eat it. A high-sugar breakfast (sugary cereal, white toast with jam, fruit juice) produces a rapid rise and fall in blood glucose that is associated with subsequent fatigue, poor concentration and increased appetite. A breakfast rich in protein and complex carbohydrates (porridge, eggs, wholegrain bread, yogurt) produces a more gradual, sustained rise in blood glucose and is associated with better sustained attention through the morning.

Fussy Eating: Normal Development or Cause for Concern?

Fussy or selective eating (the refusal to eat certain foods, often extending to entire food groups or textures) is one of the most common concerns raised by parents of toddlers and pre-school children. It is helpful to understand that a degree of food neophobia (fear of new foods) and preference for familiar foods is developmentally normal in children aged roughly 18 months to 5 years. From an evolutionary perspective, caution about unfamiliar foods at an age when children are mobile but not yet well-supervised makes adaptive sense.

Most children who are fussy eaters at two or three will, with patient, low-pressure exposure, expand their dietary range as they get older. The approaches with the best evidence base are:

• consistent exposure to refused foods without pressure to eat them
• eating together as a family
• modelling positive attitudes to a variety of foods
• avoiding short-order cooking (making separate meals for the fussy child)
• not using food as a reward or punishment. Fussy eating becomes a medical concern when a child’s intake is so restricted that it is affecting their growth, nutritional status or social functioning, at which point referral to a paediatric dietitian or a feeding specialist may be appropriate

Nutrition in Childcare Settings

Registered childcare settings that provide meals and snacks must ensure these are healthy and nutritious. The School Food Standards (which apply to maintained schools) do not legally apply to early years settings, but providers should follow the Eat Better, Start Better voluntary guidance, which provides detailed practical advice on meal planning, snack provision and the nutritional needs of children in childcare. Settings should have a food policy that parents can access, should be transparent about what children eat during the day and should alert parents to the introduction of any new foods where allergies are a concern.

Water should be freely available throughout the day. Snacks should prioritise fruit, vegetables and dairy rather than processed snack foods. Settings should ensure that children who bring packed lunches from home are not consuming foods that are significantly less healthy than those provided by the setting – some settings ask parents to follow guidelines on packed lunch contents. Mealtimes in early years settings should be social, unhurried occasions that model positive attitudes to food and eating together.

For related guidance, see also our articles on health requirements under the EYFS, SEND and children with additional health needs, play-based learning and quality childcare provision.