Patient EducationHealth and Nutrition: The Importance of Fat in aChild’s Diet

Jeannine Baumgartner, Ph.D. in Nutrition

Fats form an essential part of a child’s diet, however, it is not solely the amount of

fat that requires attention, equally or even more important is the quality (type) of

fat a child consumes.

Traditionally, fats have been considered mainly as a source of energy, and got a

bad reputation for causing obesity and coronary heart disease. Even though

energy supplied from fat is necessary for a child’s normal growth and physical

activity, fats are more than just a convenient source of energy. Dietary fats carry

fat-soluble vitamins (e.g. vitamins A, D, E and K) from the food into the body, and

some specific dietary fats are of critical importance for a child’s physical health as

well as the development and function of the brain and eyes .

Types of Fatty Acids

Most dietary fats and oils contain a mixture of three types of fatty acids: saturated,

monounsaturated and polyunsaturated fatty acids. Fats high in saturated fatty

acids, such as animal fat (e.g. visible fat on meat, butter, dairy cream) and certain

plant oils (e.g. coconut oil, palm oil, palm kernel oil), are often referred to as ‘hard’

fats, because they are solid at room temperature. Saturated fatty acids are present

in all dietary fats and oils in different quantities. Humans have no nutritional need

for saturated fats because the human body can produce them. Furthermore, a

high dietary intake of saturated fats might impact a person’s cholesterol health and

increase the risk for cardiovascular disease .

Monounsaturated fatty acids found in olive oil, canola oil, avocados, nuts and meat

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can also be produced by the human body. Nevertheless, they are usually regarded

as ‘healthy’ fats as several studies have found beneficial effects of dietary

monounsaturated fats on blood lipids when replacing saturated fats.

Polyunsaturated fatty acids can be categorized into two families, the omega-3 and

the omega-6 fatty acids (also known as n-3 and n-6 fatty acids). The parent fatty

acids of these families, alpha-linolenic acid (omega-3 family) and linoleic acid

(omega-6 family) cannot be made by the human body and must be provided by the

diet. Therefore, they are called “essential” fatty acids. Dietary sources of alpha-

linolenic acid include green leafy vegetables, flaxseed oil, canola oil, soybean oil

and walnuts. Linoleic acid is present in many vegetable oils, and found in high

quantities in safflower oil, sunflower oil, poppy seed oil, grape seed oil and maize

oil. The essential parent fatty acids alpha-linolenic acid and linoleic acid can be

converted by the body into longer chain versions, such as eicosapentaenoic acid

(EPA, omega-3 family), docosahexaenoic acid (DHA, omega-3 family) and

arachidonic acid (ARA, omega-6 family). However, it was shown that this

conversion is not very efficient in humans . EPA and DHA are found mainly in

(fatty) fish (e.g. pilchards, mackerel, salmon, sardines, snoek), while ARA can be

found in all types of meat, eggs and dairy products including milk, cream, butter,

cheese and yoghurt. Omega-6 fatty acids are less likely to be lacking from a child’s

diet, thus more attention is required to increase the dietary intake of omega-3 fatty

acids, particularly of EPA and DHA.

The Role of Omega-3 and Omega-6

When ignoring its water content, the human brain consists of 60% fat. DHA and

ARA are the most abundant types of fat found in this crucial organ. DHA and ARA

are needed to maintain the brain’s structure and function. Thus, it comes as no

surprise that a good supply of these fatty acids during early life is essential, as the

brain is developing and maturing until young adulthood . There is growing

evidence that cognitive performance (such as learning, memory and problem-

solving) and behaviour in children can be enhanced by the provision of omega-3

fatty acids through breast milk and omega-3 fatty acid-rich foods during early life

. In fact, breast milk provides all the essential fatty acids, as well as their longer

chain products ARA and DHA7, and is considered to be the optimal method for

infant feeding. However, the concentration of these important fatty acids in breast

milk is influenced by the mother’s diet. Thus, it is important that breast-feeding

mothers adhere to a healthy diet rich in omega-3 and omega-6 fatty acids. Once

the transition to solid foods occurs, the omega-3 fatty acid intake, particularly of

DHA, usually drops dramatically . This is of concern, considering that several

studies have shown that children with low dietary DHA intake performed worse in

tasks that measure brain development .

The eye is another important organ that is dependent on omega-3 fatty acids. 30-

50% of the retina of the eye (the part that receives light signals) is made from the

omega-3 fatty acid DHA. Several studies have shown that infants who were breast-

fed or received formula supplemented with DHA and ARA had better clearness of

vision than infants that received formula without added DHA and ARA .

Besides its critical role in visual and brain development, omega-3 fatty acids may

also be useful in supporting the child’s immune system and heart health . Omega-

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3 fatty acids, especially EPA, have anti-inflammatory properties . Recent studies

suggest that the provision of EPA and DHA to infants, toddlers and children

reduces the incidence and the duration of illness , and protects them against

allergies and eczema . Unfavourable blood lipids and high blood pressure are

now also observed in young children . It has been suggested that early intake

of DHA and ARA may reduce the risk for cardiovascular disease later in life .

Fat Intake of South African Children

According to the latest available information on the food intake of South African

children, the average amount of fat consumed is not exceeding the recommended

30–35% of energy for children older than six months of age . However, the

quality (type) of fat in the diet of South African children requires attention. The

three most popular food groups that supply fats consumed by South African

children one to five and six to nine years are milk, meat and vegetable fats and

oils . Full cream milk is the major food item consumed by both age categories,

followed by brick margarine and chicken meat. Also, salty snacks, confectionary

products (e.g. cookies, cakes and tart), and non-dairy creamers are among the top

ten food items that contribute to fat intake in South African children, most of which

contain high amounts of saturated fatty acids and often also contain trans-fats.

Trans-fats have many health risks and are produced during manufacturing when

liquid oils are converted to more solid oils (e.g. brick margarines, shortenings).

Furthermore, South African children are increasingly exposed to fast foods ,

which are generally high in total fat and saturated fatty acids.

In order to improve the quality of fat intake in South African children, processed

foods (e.g. polony, viennas, pies, etc.) and fast foods should be avoided or eaten

infrequently. Soft tub margarines that contain polyunsaturated fatty acids,

preferentially high in omega-3 fatty acids, and that are labelled as “trans-fat free”

should be chosen over hard brick margarines and butter. Vegetable oils rich in

polyunsaturated fatty acids rather than hard fats should be chosen for food

preparation. However, not all oils should be used for frying and deep frying of

foods, because they can produce compounds detrimental to one’s health when

heated to high temperatures. Most suitable for frying are canola oil, olive oil (but

avoid Extra Virgin) and sunflower oil. Furthermore, frying oils should be replaced

after each use. Nevertheless, the amount of fried foods in a child’s diet should be

limited. In order to increase the intake of EPA and DHA, it is advised that children

eat two portions of fatty fish per week. Therefore, it is recommended to introduce

fish early into the diet of children to ensure that fish is consumed on a regular

basis throughout life.

In summary, fat plays an important role in a child’s diet. Fat is not only a source of

energy but is crucial for the development of the brain and eyes, as well as a

healthy heart and immune system. Therefore, not only the amount but also the

type of fat in a child’s diet is critical to ensure proper development and good

health.

References

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