Schwartz Sally, Benuck Irwin
Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Avenue, Chicago, IL 60611, USA.
Pediatr Ann. 2013 Sep;42(9):181-3. doi: 10.3928/00904481-20130823-09.
Nutritional challenges for toddlers are common because their eating behaviors are inconsistent; they may eat more or less than requirements meal to meal and day to day. To help reduce parental stress, it's essential to discuss with parents/caregivers their expectations on how and what they think their toddler should be eating. It is important to remember that toddlers are not little adults; portion sizes are often distorted (too large), and portions should reflect the individual child's age and development. Parents/caregivers can help with new food acceptance by modeling good mealtime behaviors such as limiting high-energy, low-nutritional food and drinks, eating healthy foods along with their children together at the table with the television shut off, and eating appropriate portion sizes. Pediatricians should inform concerned parents/caregivers that toddlers commonly do not accept new foods; foods may need to be introduced repeatedly, up to 10 to 15 times before a child will eat them. To adhere to National Heart, Lung, and Blood Institute (NHLBI) guidelines, parents and caregivers should focus on providing balanced meals that offer a variety of foods, with at least three to four food groups for meals and one to two food groups for snacks, always including familiar foods along with new foods. It is important to reassure families that adherence to NHLBI guidelines for toddlers may be difficult at first, but with the proper education, planning ahead for meal/snack times, and education of all providers caring for the toddler (including nannies, daycares, and family members), it can be done successfully. Improving the nutrition and health of their young toddler will help prevent risk factors for the development of cardiovascular disease.
幼儿面临的营养挑战很常见，因为他们的饮食行为不稳定；每餐之间以及每天的进食量可能多于或少于需求。为了帮助减轻家长的压力，与家长/照顾者讨论他们对幼儿饮食方式和内容的期望至关重要。要记住，幼儿不是小大人；食物分量常常被夸大（过大），分量应该根据孩子的年龄和发育情况而定。家长/照顾者可以通过树立良好的用餐行为来帮助孩子接受新食物，比如限制高能量、低营养的食物和饮料，关掉电视，与孩子一起在餐桌上吃健康食品，以及食用合适的分量。儿科医生应该告知忧心的家长/照顾者，幼儿通常不接受新食物；在孩子愿意吃之前，食物可能需要反复介绍10到15次。为了遵循美国国立心肺血液研究所（NHLBI）的指导方针，家长和照顾者应该注重提供均衡的膳食，包含各种食物，每餐至少有三到四个食物类别，零食有一到两个食物类别，始终包括熟悉的食物和新食物。重要的是要让家庭放心，一开始遵循NHLBI针对幼儿的指导方针可能会很困难，但通过适当的教育、提前规划用餐/零食时间，以及对所有照顾幼儿的人员（包括保姆、日托中心和家庭成员）进行教育，是可以成功做到的。改善幼儿的营养和健康状况将有助于预防心血管疾病发展的风险因素。
