Plate shows portion division for a balanced meal.
RECENTLY, a six-year-old foreign girl, who lives in an oil palm plantation, visited the hospital after a week of severe diarrhoea and vomiting. She was so sick that she had to be admitted to the intensive care unit. Since the start of the Movement Control Order (MCO), children with the same illness, who used to come in batches daily, have disappeared, which I assume is due to safer home-cooked meals, compared to outside food. Nevertheless, please let us share some information, for those parents who are still learning to prepare meals at home.
Eating a healthy diet is essential for everyone because it affects our body’s ability to prevent, fight, and recover from diseases. Balanced nutrition can also reduce the risk of developing other health problems, including obesity, heart disease, diabetes, and some cancers in future. Currently, there are no known foods or any dietary supplements that can directly prevent or cure us of Covid-19 infection!
What are healthy diets for children?
1. Breastfeeding
Breastfeeding is the only known protective mechanism that will protect babies and toddlers from infection. The World Health Organisation recommends breastfeeding exclusively from birth to six months of age. Thereafter, infants should receive a varied diet, while continuing to be breastfed until two years of age. We should avoid food that may cause choking until four years old (nuts, sweets, whole grapes/longan, etc.).
2. A mixed variety of colourful food
Besides the carbohydrate supplied in rice, grains, and noodles (wheat), children should have protein-rich legumes such as bean sprouts, beans, and crushed peanuts, as well as eggs and fresh milk.
Meat and fish are also essential sources of protein for children to grow and develop.
To make the meals colourful, vegetables and fresh fruits (not those canned with syrup) are vital.
Generally, children should take a maximum of a quarter of a plateful of carbohydrate-rich food, with half the plate filled with the fruits and vegetables, while the remaining quarter will consist of meat or fish.
Choose fresh fruits, non-cream crackers, fresh milk for snacks in between the main meals.
No supper.
3. Cut back on the sugar
Aside from fresh milk, no other drink is better than plain (and boiled) water – children do not need the flavoured chocolate drink, syrup, soft drinks, sports/energy drinks, etc.
There is no need to prepare specially treated water (eg ionised, oxygenated, purified), other than boiled tap water.
Condensed milk contains 54 grams of sugar per 100ml (about 13 teaspoonfuls of sugar) and very minimum (8 grams per 100ml) amount of protein – they are useless for children.
Fruit juices, unless freshly extracted, often contain a high amount of refined sugar (better to eat fruits fresh).
Reduce intake of desserts, cakes, chocolate.
4. Reduce salt intake
Young children need about 3 to 5 grams of salt (nearly half to a teaspoon) daily (infants need less than 1 gram).
Use salt sparingly and reduce the use of salty sauces and condiments (eg soy sauce, stock, or fish sauce).
Canned or dried food (salted vegetables, salted fish, or salted eggs, and pickles), frozen packed food (meat pies, dim sum, pizza), fast food, and processed meats (ham, nuggets, fishballs, sausages) contain a high amount of salt, take less of them, and do not add extra salt if you do.
5. Take moderate amounts of fats and oils
Choose white meat like poultry and fish, which are generally lower in fat than red meat; trim the meat of visible fat.
Full cream milk is good for young children (formula powder is unnecessary), although low-fat milk and dairy products are preferable for those who are obese (and their adult parents).
Replace butter and lard with healthier fats like olive, soy, sunflower, or corn oil when preparing the meals.
Coconut milk (santan), which contains a lot of fat and calories, is used in making food such as nasi lemak, curry, and laksa. It is best to limit its consumption.
When cooking, try steaming or boiling.
Avoid processed, roasted, and fried foods (fries, grilled meat, banana fritters) that contain industrially-produced trans-fat.
6. Do not learn new (drinking) habits during MCO
Alcohol, tea, coffee, and smoking are not part of a healthy diet; neither do they prevent anyone from Covid-19 infection. While tea can be acceptable in older children, alcohol and coffee do affect children’s health. Smoking is detrimental to health in life.
7. Supplements are unnecessary
When a child (and adult) eats a well-balanced diet and avoids alcohol, there is no need to take supplements, herbs, or traditional medicine, despite the many claims on social media. None of these practices have been proven to prevent any infection.
Do not give young children these ‘healthy’ products, because their immature kidneys and liver cannot handle them.
Do not buy any medication or supplements online or through social networks.
Before giving to older children, do check the label for Ministry of Health approval, and best consult a pharmacist or doctor.
How to handle and prepare food
Avoid eating raw food (except vegetables and fruits).
Clean raw food (including vegetables and fruits) thoroughly with clean water before cooking.
Do not mix raw and cooked food.
Cook meat and fish thoroughly (if uncooked, they contain many germs that can cause diarrhoea and vomiting, and worse, bacteria in the blood).
Eat freshly cooked meals (hence, home cooking is always superior to takeaway food).
Keep food at safe temperatures, do not consume leftover foods left overnight at room temperature.
Shopping for raw food
It’s best to order food delivered from the supermarket.
Do not bring children shopping with you (instead, ask the children to assist you at home when preparing meals).
Keep to physical distancing – stay at least one metre apart from people when queuing or during shopping.
If possible, clean handles, and wash hands frequently.
Learn from the elderly and those who are experienced, how to pick fresh meat and fish.
Always check for the expiry date before you buy.
Wash raw foods before putting them in the fridge.
Good practice for refrigerators includes avoiding opening the door too frequently, and deciding what you wish to take out before you open the door.
Building up immunity is essential in preventing illness, and having a well-balanced and healthy diet (with exercise) can achieve that. One would think food preparation at home is difficult, and cannot wait to opt for eating out as soon as the MCO is lifted.
We want to reassure you, while it is hard to maintain safe eating at home, it is still much easier compared to what you feed your children with from outside your house. You eat what you prepare safely for your children and your family.
For others, it is up to the honesty of the food seller and the authority who monitors them. Keep it up, and you can survive by eating safely at home with your children.
Prof Dr Toh Teck Hock is consultant paediatrician and adjunct professor for the Faculty of Medicine, Segi University, Sibu, Sarawak; while Aaron Toh Aw Zien is a Year 1 medical student at the Institute of Medical and Biomedical Education, St George’s University of London.