I'm confused about whether I should be giving my children full-fat, semi-skimmed or fully skimmed milk. My children are 18 months, 4 and 7 years old. Help!

I can understand your confusion because, officially, your children are all advised to have different types of milk, which is a bit of a nuisance for you as your fridge will be full of bottles or cartons. My advice, and it's backed by the Food Standards Agency, is that your toddler should have full-fat milk up until two years of age. From then until they are 5, children should stick with semi-skimmed and, once they are over 5, you can give them fully skimmed.

The reasoning behind these gradual steps is that before they are two years of age, toddlers do not tend to eat large quantities of food at one go. So, while you need to give them a healthy, balanced mix of foods including protein (meat, fish, eggs, milk and cheese or tofu, for instance), carbohydrates (bread, pasta, rice, potatoes, breakfast cereals) and fruits and vegetables, they need to be the “normal” versions that ensure sufficient calories and all the important nutrients are consumed.

Over two years old, children's tummies are getting more able to cope with slightly larger meals and snacks, allowing the introduction of lower-fat versions of dairy foods such as semi-skimmed milk. This step begins gradually to cut the amount of saturated fats eaten, a need highlighted in a new Food Standards Agency campaign to encourage us to eat less of these animal-based fats that raise cholesterol.

By the age of 5, fully skimmed milk is allowed to further cut saturated fats with the assumption that all nutrient and energy needs can be met through eating sufficient amounts of other healthy foods.

While we are at it, it is worth looking at other food groups that can give parents concern regarding children. When it comes to fruits and vegetables, from the age of 1 children should be building up to five portions a day, remembering that one portion is roughly the amount that they can hold in their hand. This may for instance be only two grapes, a few carrot batons or smallish slices of apple. Given that little hands grow, portion sizes grow too as they get older.

High-fibre foods are an interesting topic. While nobody would advocate sprinkling bran on to toddlers' and children's foods, the British Dietetic Association Paediatric Group does say that wholegrain foods are acceptable from the age of 1. In other words, wholemeal bread, brown rice and pasta can be gradually introduced.

As for what we need to avoid, toddlers should not be given undercooked or raw eggs, to avoid the risk of salmonella - but note the British Heart Foundation's recent advice that eggs no longer need to be limited for fear of cholesterol.

Whole or chopped nuts are not advised until the age of 5 to avoid the risk of choking. It's best to avoid shark, swordfish and marlin as they contain relatively high levels of mercury that may affect a developing nervous system. Added salt and processed foods should be kept to a minimum in a child's diet, as should sugary foods and drinks.

Other healthier options for children

If wholegrain foods are not palatable for your children, try things such as mixing white and brown rice, and bread such as Kingsmill 50/50, which looks white but contains 50 per cent wholemeal flour. Switching to lower fat milk from the age of two, and fully skimmed from five is especially good for girls. According to the Institute of Medicine of the National Academies in America it will reduce exposure to dietary pollutants that are carried in animal fats.

我不知道我该给我的孩子们全脂牛奶,半脱脂牛奶,还是完全脱脂的牛奶。我的孩子们分别为 18 个月、4 岁和 7 岁。帮帮我!

我能理解你的困惑,因为正式告知你的孩子们全都要喝不同类型的牛奶,是有点让你麻烦的事,会使你的冰箱会装满瓶子或纸盒。我的建议——它是食品标准局所支持的——是:你蹒跚学步的孩子应该喝全脂的牛奶,直到长到两岁的年龄。从那时到他们 5 岁的时候,孩子们应该坚持喝半脱脂的牛奶,一旦超过 5 岁,你可以给他们全脱脂的牛奶。

在这些循序渐进步骤的背后的理由是,在两岁之前,蹒跚学步的孩子们不趋向于一口气吃大量的食物。所以,当你需要给他们健康的、营养均衡的食物混合物,包括蛋白质(比如肉、鱼、蛋、牛奶、奶酪或豆腐)、碳水化合物(面包、面条、米饭、土豆、早餐谷物片)、水果和蔬菜的时候,它们必须是“正常”的型式,以确保消耗足够的卡路里和全部重要的营养成分。

两岁以上儿童的胃变得愈来愈能够应付稍大的食品和点心,允许引入低脂肪型式的的乳制品,如半脱脂的牛奶。这一步骤开始逐渐减少食入的饱和脂肪量。在食品标准局进行的一项新的活动中强调需要鼓励我们少吃这些升高胆固醇的动物基脂肪。

在 5 岁的时候,允许使用完全脱脂的牛奶,以进一步削减饱和脂肪,假定全部的营养和能量需求可以通过吃足够数量的其它健康食品来满足的话。

我们谈到这时,值得看一看其它的食物组,可以提供给关心孩子的家长们。对于水果和蔬菜来说,从年龄 1 岁的儿童就应该增加到一天五份,记住一份大致是他们能够在他们的手中抓住的量。例如这可能是只是两粒葡萄,几小截胡萝卜,或者小片的苹果。如果那双小手长大,份量也随着他们年龄的增长而加大。

高纤维食品是一个很有意思的话题。虽然没有人会主张将麸皮撒到幼儿和儿童的食品上,英国饮食协会儿童组确实说过,从 1 岁儿童开始,可以接受全粒食物。换句话说,可以逐步引入全麦面包、糙米和面食。

至于需要我们避免的事情是,不应该给蹒跚学步的孩子们未煮熟的或者生的鸡蛋,以避免沙门氏菌的风险——但是值得注意,英国心脏基金会最近报道,不再需要因为恐惧胆固醇而限制蛋品。

不建议五岁以前的孩子食用整个的或者劈开的的坚果,以避免发生窒息。最好是避免鲨鱼、旗鱼和马林鱼,因为它们含有相当数量的汞,可能影响神经系统的发育。在儿童的饮食中应该尽量少用加盐的和加工的食品,而应该是含糖的食物和饮料。

为孩子们更加健康的其它选择

如果对于你的孩子们全粒食物不好吃,尝试一些东西,例如混合的白米和糙米,以及像 Kingsmill 50/50 那样的面包,它看起来是白色的,但是含有 50% 的全麦面粉。从两岁起改用低脂牛奶,从五岁起食用完全脱脂的牛奶尤其适合于女孩子。按照美国国家医学研究所的说法,它将减少接触动物油脂中的食物污染物。