I'm confused about whether I should be giving my children full-fat, semi-skimmed or fully skimmed milk. My children are 18 months, 4 and 7 years old. Help!

    I can understand your confusion because, officially, your children are all advised to have different types of milk, which is a bit of a nuisance for you as your fridge will be full of bottles or cartons. My advice, and it's backed by the Food Standards Agency, is that your toddler should have full-fat milk up until two years of age. From then until they are 5, children should stick with semi-skimmed and, once they are over 5, you can give them fully skimmed.

    The reasoning behind these gradual steps is that before they are two years of age, toddlers do not tend to eat large quantities of food at one go. So, while you need to give them a healthy, balanced mix of foods including protein (meat, fish, eggs, milk and cheese or tofu, for instance), carbohydrates (bread, pasta, rice, potatoes, breakfast cereals) and fruits and vegetables, they need to be the “normal” versions that ensure sufficient calories and all the important nutrients are consumed.

    Over two years old, children's tummies are getting more able to cope with slightly larger meals and snacks, allowing the introduction of lower-fat versions of dairy foods such as semi-skimmed milk. This step begins gradually to cut the amount of saturated fats eaten, a need highlighted in a new Food Standards Agency campaign to encourage us to eat less of these animal-based fats that raise cholesterol.

    By the age of 5, fully skimmed milk is allowed to further cut saturated fats with the assumption that all nutrient and energy needs can be met through eating sufficient amounts of other healthy foods.

    While we are at it, it is worth looking at other food groups that can give parents concern regarding children. When it comes to fruits and vegetables, from the age of 1 children should be building up to five portions a day, remembering that one portion is roughly the amount that they can hold in their hand. This may for instance be only two grapes, a few carrot batons or smallish slices of apple. Given that little hands grow, portion sizes grow too as they get older.

    High-fibre foods are an interesting topic. While nobody would advocate sprinkling bran on to toddlers' and children's foods, the British Dietetic Association Paediatric Group does say that wholegrain foods are acceptable from the age of 1. In other words, wholemeal bread, brown rice and pasta can be gradually introduced.

    As for what we need to avoid, toddlers should not be given undercooked or raw eggs, to avoid the risk of salmonella - but note the British Heart Foundation's recent advice that eggs no longer need to be limited for fear of cholesterol.

    Whole or chopped nuts are not advised until the age of 5 to avoid the risk of choking. It's best to avoid shark, swordfish and marlin as they contain relatively high levels of mercury that may affect a developing nervous system. Added salt and processed foods should be kept to a minimum in a child's diet, as should sugary foods and drinks.

    Other healthier options for children

    If wholegrain foods are not palatable for your children, try things such as mixing white and brown rice, and bread such as Kingsmill 50/50, which looks white but contains 50 per cent wholemeal flour. Switching to lower fat milk from the age of two, and fully skimmed from five is especially good for girls. According to the Institute of Medicine of the National Academies in America it will reduce exposure to dietary pollutants that are carried in animal fats.

    我不知道我該給我的孩子們全脂牛奶,半脫脂牛奶,還是完全脫脂的牛奶。我的孩子們分別為 18 個月、4 歲和 7 歲。幫幫我!
　　
    我能理解你的困惑,因為正式告知你的孩子們全都要喝不同類型的牛奶,是有點讓你麻煩的事,會使你的冰箱會裝滿瓶子或紙盒。我的建議——它是食品標準局所支持的——是:你蹣跚學步的孩子應該喝全脂的牛奶,直到長到兩歲的年齡。從那時到他們 5 歲的時候,孩子們應該堅持喝半脫脂的牛奶,一旦超過 5 歲,你可以給他們全脫脂的牛奶。
　　
    在這些循序漸進步驟的背后的理由是,在兩歲之前,蹣跚學步的孩子們不趨向于一口氣吃大量的食物。所以,當你需要給他們健康的、營養(yǎng)均衡的食物混合物,包括蛋白質(比如肉、魚、蛋、牛奶、奶酪或豆腐)、碳水化合物(面包、面條、米飯、土豆、早餐谷物片)、水果和蔬菜的時候,它們必須是“正常”的型式,以確保消耗足夠的卡路里和全部重要的營養(yǎng)成分。
　　
    兩歲以上兒童的胃變得愈來愈能夠應付稍大的食品和點心,允許引入低脂肪型式的的乳制品,如半脫脂的牛奶。這一步驟開始逐漸減少食入的飽和脂肪量。在食品標準局進行的一項新的活動中強調需要鼓勵我們少吃這些升高膽固醇的動物基脂肪。
　　
    在 5 歲的時候,允許使用完全脫脂的牛奶,以進一步削減飽和脂肪,假定全部的營養(yǎng)和能量需求可以通過吃足夠數(shù)量的其它健康食品來滿足的話。
　　
    我們談到這時,值得看一看其它的食物組,可以提供給關心孩子的家長們。對于水果和蔬菜來說,從年齡 1 歲的兒童就應該增加到一天五份,記住一份大致是他們能夠在他們的手中抓住的量。例如這可能是只是兩粒葡萄,幾小截胡蘿卜,或者小片的蘋果。如果那雙小手長大,份量也隨著他們年齡的增長而加大。
　　
    高纖維食品是一個很有意思的話題。雖然沒有人會主張將麩皮撒到幼兒和兒童的食品上,英國飲食協(xié)會兒童組確實說過,從 1 歲兒童開始,可以接受全粒食物。換句話說,可以逐步引入全麥面包、糙米和面食。
　　
    至于需要我們避免的事情是,不應該給蹣跚學步的孩子們未煮熟的或者生的雞蛋,以避免沙門氏菌的風險——但是值得注意,英國心臟基金會最近報道,不再需要因為恐懼膽固醇而限制蛋品。
　　
    不建議五歲以前的孩子食用整個的或者劈開的的堅果,以避免發(fā)生窒息。最好是避免鯊魚、旗魚和馬林魚,因為它們含有相當數(shù)量的汞,可能影響神經系統(tǒng)的發(fā)育。在兒童的飲食中應該盡量少用加鹽的和加工的食品,而應該是含糖的食物和飲料。
　　
    為孩子們更加健康的其它選擇
　　
    如果對于你的孩子們全粒食物不好吃,嘗試一些東西,例如混合的白米和糙米,以及像 Kingsmill 50/50 那樣的面包,它看起來是白色的,但是含有 50% 的全麥面粉。從兩歲起改用低脂牛奶,從五歲起食用完全脫脂的牛奶尤其適合于女孩子。按照美國國家醫(yī)學研究所的說法,它將減少接觸動物油脂中的食物污染物。