As children get older, they have an increasing amount of freedom over food choice and often eat outside the home. Outside factors - such as peer pressure and advertising - also start to play their part.

Nutritional considerations

Although growth is slower than in infancy or early childhood, school-aged children still have high nutritional needs, but fairly small appetites. Therefore, it's crucial that all meals and snacks are nutrient-dense.

A recent Government report provided detailed information on the nutritional intakes of young people aged four to 18 years. The findings of this survey offer the first real insight into the health of young people in more than 17 years.

While nutrient intakes were surprisingly robust, there are a number of areas of concern identified by the findings. With falling activity levels and increasing levels of obesity already a concern in young people and adults alike, this survey highlights that physical activity levels are a major issue in the age groups studied too.

The link between diet and health has long been established, and the behaviour of our children during the crucial years of development set a pattern for a future of ill health if measures are't in place to counteract these problems. Issues of particular concern include:

Energy
A healthy growing child needs lots of energy, which must be supplied by the diet. Over the years, energy intakes have declined in children. However, as activity levels have also fallen, this isn't thought to be a problem. In fact, there are an increasing number of children who are overweight or obese.

Encourage your child to be as active as possible and make sure their diet supplies enough energy through frequent meals and snacks based on the main food groups.

If your child is putting on too much weight, don't make too much of an issue of this - instead, encourage physical activity in whatever form (football, netball, walking the dog, cycling, swimming, etc). Also, base meals and snacks on the four main food groups, with limited fatty and sugary snacks. Even if a child is overweight, they still need a nutrient-packed diet providing essential building blocks for growth and development.

Iron
Iron is a mineral that helps to keep red blood cells healthy. Insufficient iron can lead to iron-deficiency anaemia, which is particularly common among young girls. Good sources of iron include red meat, liver, egg yolk, corned beef, fortified breakfast cereals, beans and pulses. To help adsorb the iron more effectively, combine with vitamin C-rich foods such as citrus fruits, fruit juice, tomatoes and green leafy vegetables.

Calcium
The mineral calcium is important for healthy bone development. Good sources include dairy products - milk, cheese, yoghurt and fromage frais - fortified orange juice, green leafy vegetables, cereals, sesame seeds and tofu. Your child should ideally have one pint (500 to 600 ml) of semi-skimmed (or skimmed if the diet has sufficient energy) milk per day.

Folate
Folate is important for growth, but intakes appear to be quite low in some children, especially those that skip breakfast - fortified breakfast cereal are a good source of this important vitamin. Other sources include breads, green leafy vegetables and pulses.

Foods to choose
Regular meals and snacks are important, as is variety; burgers and chips can be fine occasionally, but not for every meal! Make sure your child has a variety of foods based on the main food groups:

School meals

School meals used to be subject to strict regulation to provide a minimum nutritional standard, but this was abolished in 1980. However, plans are afoot to reintroduce legislation as concerns have been expressed over the nutritional adequacy of school meals and the diets of schoolchildren in general.

The new guidelines will introduce and enforce healthy menus, cooking methods and nutritional standards. The proposed requirements recommend that children should have the chance to have an item from the four main food groups. If foods containing fat and sugar are available, they should form no more than 10 per cent of the total food offered in a week.

The guidelines are warmly welcomed by dietitians and health professionals and should be introduced to school nationwide in the future. In the meantime, it's important that your child makes the right choices for school lunch rather than having chips and cakes every day. Encourage your child to:

• Always choose a protein. This may be meat, fish, eggs, cheese or beans, but not pies, pasties, sausages or burgers every day as these are very high in fat.
  
• Choose at least one starchy food - bread, jacket potatoes, boiled potatoes, rice or pasta.
• Chips can be eaten occasionally, but they are too high in fat to be eaten every day.
  
• At least one portion of vegetables - raw, cooked or as part of a salad.
  
• A piece of fruit - fresh, dried or juiced.

National School Fruit Scheme
In November 2000, the Department of Health launched the National School Fruit Scheme. The rationale behind this is to provide fruit to all schoolchildren, or around two million children, by the end of 2004. The scheme will initially focus on four- to six-year-olds. The scheme will initially focus on four- to six-year-olds. This follows a Government survey which found that while it's recommended that children eat at least five portions of fruit and vegetables a day, on average they eat just two.

Children's consumption of fruit has fallen since 1983, when the intake was three portions a day. The survey also found that one in five children ate no fruit in a week - quite alarming statistics.

The Healthy Schools Campaign
This Government scheme was launched in October 1999. The philosophy emphasises the holistic approach to health, where, for example, classroom teaching about healthy eating is supported by the foods offered in vending machines, tuck shops and the school cafeteria. Participating schools have been supported by resources and initiatives, such as Wired for Health, a website providing health information. Ask if your child's school has joined the scheme; if not, ask teachers if there are any plans to join.

Ideas for packed lunches
Many children take packed lunches to school. There are lots of different types of bread around, which can add variety to sandwiches. Try pitta bread, chappatis, crusty rolls, muffins or bagels with one of these healthy fillings:

• peanut butter and banana
  
• chicken with a low-fat dressing and salad
  
• cheese and pickle
  
• bacon, lettuce and tomato
  
• tuna and tomato
  
• salmon and cucumber
  
• hummus and salad

Other suitable items for lunch include: fruit, both fresh or dried; cheese cubes; a pot of yoghurt or a yoghurt drink; cheese dip with breadsticks; sticks of vegetables or cherry tomatoes; a small pot of potato salad; nuts; coleslaw; hard-boiled egg; fruit juice or soup in a flask. Crisps and other savoury snacks, chocolate or muesli bars can be added as an occasional treat.

Healthy snacks

• breakfast cereal and milk
  
• crunchy muesli and yoghurt
  
• toasted crumpet or teacake
  
• fresh fruit
  
• low-fat yoghurt or fromage frais
  
• nuts, seeds or dried fruit
  
• a small carton of milk
  
• fruit smoothes
  
• cheese and crackers or oatcakes
  
• a slice of fruit loaf or malt loaf
  

Key points

• Important nutrients for this age include iron, calcium, vitamin C and folate.
  
• Children of this age should have regular meals and snacks and a variety of foods from the four food groups.
  
• Encourage your child to have healthy nutritious snacks rather than lots of fatty and sugary foods and drinks.
  
• School meals and packed lunches are an important contribution to the day's nutritional intake.
• Make sure that your child makes the right choices at school, or provide a healthy packed lunch as an alternative.
  
• Encourage your child to be active. Coupled with a healthy diet, this will provide the foundations to good health, in the short term and in the future.