Parents should keep tabs on child's fat intake

My cute patient was a solid fellow. He had just turned 1 and his parents were wondering if there were any new dietary rules they had to follow now that he was a toddler. I let them know that other than chokable items, there were not a lot of food restrictions.

A few days later, another youngster came in for a 2-year-old checkup, accompanied by his petite, under 5-foot mother. Mom was a bit worried about her boy's weight, but after reviewing the growth chart, I assured her that since he was growing steadily on the 20th percentile, I had no concerns.

So which parents got the mini-lecture about watching fat intake? It turned out to be the mother of the little 2-year-old. Not because she was doing anything wrong, but simply because after the age of 2, young children start to be treated much like older kids and adults. At this point in development, nutritional advice really focuses on promoting future heart health.

I informed this mom that she could begin some dietary fat restriction, despite her boy's slender physique. Specifically, I asked her to switch the boy from whole milk to the skim or 1-percent versions, which still provide a good source of calcium and vitamin D but with less of the calories and fat.

On the other hand, since little infants and younger toddlers still need extra fat for growth and proper brain development, I told the parents of the now 1-year-old that they did not have to go out of their way to restrict their boy's dietary fat. We did, however, go over examples of desirable “healthy fat” (think avocados and whole milk) vs. the abundantly available “bad fat” options (such as greasy fries and candy bars).

In more unusual cases, such as with a truly obese toddler, pediatricians may instruct parents to be more restrictive with fat calories by introducing low-fat milk at an earlier age. On the opposite extreme, a 3-year-old with poor weight gain and a diagnosis of failure-to-thrive might require a higher-fat diet featuring the addition of certain oils and extra healthy fats to his meals.

Despite the negative press, fat is not all bad. We humans do need some fat in our diets with daily dietary fat requirements changing as we age. The American Heart Association recommends that 1- to 2-year-olds consume 30 percent to 40 percent of their nutrients as fat; 2- to 3-year-olds, 30 percent to 35 percent; older children and teens, 25 percent to 35 percent; and adults 19 years and older, 20 percent to 35 percent of their total calories as fat.

Experts at the USDA advise individuals to keep saturated fats to less than 10 percent of their total caloric intake since higher saturated fat intake is associated with the development of higher levels of LDL or “bad” cholesterol. Saturated fats, which include solid fats such as butter and lard, should be replaced with products high in the monounsaturated (olive, canola and safflower oils) and polyunsaturated (soybean, corn and cottonseed oils) fatty acids.

The department also notes that trans-fatty acids, found in partially hydrogenated oils, are not an essential part of our diet. Trans-fat consumption should always be kept to a minimum, due to its recognized link with an increased risk of heart disease.

• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.