Appendix 2 Menu planning
The nutrient guidance for protein is for a meal to provide 30% of the daily RNI ( Appendix 1, Table 1) and a meal and a snack combination to provide 40% of the RNI ( Appendix 1, Table 2). When designing a menu, the protein content will usually work out higher than this, which is in line with eating patterns in the UK population and helps to provide sufficient iron and zinc in the diet.
The UK Reference Nutrient Intake ( RNI) for vitamin D for children aged 6 months to 3 years is 7 µg per day. 23 For children 4 years and older there is no RNI because it is assumed that the action of sunlight on the skin will ensure that sufficient vitamin D is available. Vitamin D status in pre-school children varies depending on the season of the year and a dietary supply of vitamin D is important to maintain vitamin D status during autumn, winter and spring in Scotland. 28,27 Vitamin D is also available from body stores. However, adequate body stores of vitamin D depend on regular exposure of the skin to sunlight during the summer months.
The children most at risk of low vitamin D status and deficiency are those living in northern latitudes (which includes Scotland) where there is inadequate sunlight for much of the year. In particular children with darker skin pigmentation, e.g. from Asian, Middle Eastern, African and Eastern European families, living in Scotland. 28 This is because there is less synthesis of the bioactive form of vitamin D through the action of sunlight on darker skin.
Based on current dietary choices, achieving the dietary RNI of 7 µg per day (1 to 3 years old only) is unlikely without supplementation. Therefore, routine vitamin D supplementation is recommended for all children over 1 year of age and should be continued until 5 years unless the diet is diverse and plentiful. 26,27
The nutrient guidance for iron is for a meal to provide 30% of the RNI and for a meal and snack combination to provide 40% of the RNI. Children between the ages of 1 and 5 years have high iron requirements because of their rapid growth and the need to build up iron stores. A high proportion of pre-school children in the UK have less than adequate iron intakes and iron deficiency anaemia is common in this age group. 30,31 Iron deficiency can have lasting effects on health and development. 32 Therefore, we need to improve the iron status of young children through adequate dietary intake.
In practice, achieving adequate iron intake is not easy and requires careful menu planning to ensure that iron-rich foods are included on a regular basis. 33 Red meats are the richest and most easily absorbed source of iron, however breakfast cereals fortified with iron are also an important source of iron for children. The formal childcare setting is an excellent opportunity to boost overall iron intakes by encouraging healthy eating.
The nutrient guidance for sodium is for a meal to provide a maximum of 30% of the daily SACN34 recommendation (for age group 1 to 5 years) and the combination of a meal and snack to provide a maximum of 40%. The sample menus given in this document do not meet the nutrient guidance for sodium. This is because the majority of the sodium in the diet is found in processed food and also in bread. Although this may eventually be partly addressed by a decrease in the sodium content of processed foods and breads, caterers can reduce salt intake by choosing low-salt foods and reducing the salt used in cooking, e.g. making sauces from base ingredients, not adding salt to sauces and homemade soups, choosing low salt varieties of tinned foods. Work is already under way with partners in the food industry to reduce the salt content of processed foods and this will eventually help to reduce the sodium content of processed foods used in public sector catering. 35 For further information and ideas on reducing sodium intake see the Food Standards Agency website. 36