Archive for Nutrition Bites

17 May 2018

Eight ways to make healthy normal

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  1. Have a fruit bowl permanently available – full and sporting ripe and fresh fruit.
  2. Don’t allow chocolate, sweets, cakes, crisps and other junk foods to become everyday foods. Just get them in for special occasions only.
  3. Encourage them to drink water and enjoy it, by serving water with every meal. Put water in a jug with some ice and have nice glasses/beakers to make it more appealing.
  4. Make sure every meal comes with at least one sort of veggie or salad accompaniment. Don’t make it unusual for a vegetable to turn up on their plates!
  5. Have a think about your cooking and see about ways you could reduce the fat, salt or sugar content of your meals.
  6. Help children build on their knowledge of healthy eating by talking about what a balanced meal is. The 5-a-day message is obvious, but discuss other aspects of healthy eating too (for ideas, see my other blog posts).
  7. Aim to make healthy alternatives to favourite ‘junk’ food. Have a home-made-takeaway night and make your own version of pizza, burgers or Chinese – with a healthy twist of course.
  8. Offer some choice, but within a healthy range. Children like to feel in control without realising you’re influencing what they eat.

Hayley Kuter

Paediatric Dietitian

02 Apr 2018

Measuring children – not as easy as it sounds!

No Comments Nutrition Bites

As a specialist paediatric dietitian, I am committed to ongoing professional development (‘CPD’) and that’s part of the reason why I’m so involved in research – either through editing scientific papers, being part of research projects, or analysing medical research papers for the latest evidence (usually accompanied by a mug of tea!).

An area that I don’t feel receives the attention it deserves is in childhood measurement. Parents are frequently encouraged to have their babies and children weighed and measured…and yet how accurate are these measurements? Are scales and length measures regularly calibrated and serviced? Does the health professional undertaking the measurements receive regular training and can they be certain of their technical error of measurement (we’re all human afterall).

I have recently been involved in a training program to teach professionals some of the basics of measuring children, and I’ve also been involved in a research project investigating measuring children with special needs – here’s a link to my recent publication:

As parents, I would encourage you to:

  • ask at your clinic to have your infant/child measured in length as well as weight
  • question unusual measurements (it’s good practice to take two repeat measurements)
  • rely on serial measurements (trends) rather than one-offs
  • try to make sure weighing/measuring conditions are the same each time eg clothes/nappy off, same time of the day, after voiding etc.

And lastly, don’t be afraid to ask questions about the measurements you’re given!

Hayley Kuter

Paediatric Dietitian


23 Nov 2017

Fibre for children

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Dietitians are always looking for new evidence and over the past few weeks in my spare time I’ve been busy researching the science behind dietary fibre for children. I wrote an article in a professional magazine and gave a talk to paediatric dietitians about the benefits of including fibre in children’s diets.

So here’s a quick summary:

What is dietary fibre? It’s any carbohydrate that is not digested or absorbed in the small intestine, and will undergo fermentation in the large intestine. Examples include: fruit and veg, wholegrains, lentils, nuts, healthy cereals.

What’s the point of eating fibre if it’s poorly digested? Fibre has some amazing properties that can assist in keeping normal healthy bowels and general health overall. Fibre in food can thicken the contents of the bowel and mean it’s easier to pass normal stools. Fibre acts as a fuel for healthy gut bacteria and so can help prevent nasty gastro bugs from taking over.

Who can benefit from fibre? Just about everyone can improve their diets to include more fibre. People who are constipated or even have very loose stools can benefit. Research is linking some allergies to the health of the gut bacteria.

Is fibre safe for children? Like any nutrition advice, a healthy balance is the best way to approach fibre for children. Too much fibre is not a good thing, but fibre can be included in children’s diets as they are weaned, and by the time they are two, fibre intakes should be as follows:

2-5 years: 15 grams per day

5-11 years: 20 grams per day

11-16 years: 25 grams per day

17+ years: 30 grams per day

Children need to learn from an early age that fibre is a part of everyday foods and including high fibre foods (such as wholemeal bread) every now and then as part of a healthy eating pattern that will hopefully last a lifetime.

Hayley Kuter

Paediatric Dietitian

28 Jun 2017

Children with Life-Limiting Conditions

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Last week I was invited to speak to a group of health professionals who do the amazing job of looking after babies on Neonatal Units across the north west. My topic was ‘nutrition in paediatric palliative care’ – not everyone’s favourite subject but something that does require careful thought and understanding.

In my research for the presentation, I discovered that there are over 49,000 children in the UK living with a life-limiting or life-threatening condition. A recent survey found that 35% of us know someone who has or has had a child with a life-limiting condition.

The charity “Together for Short Lives” is an incredible charity that provides information and support for children, parents, families and health professionals. If you’re interested, I really recommend taking a look at their website (or even getting involved with some of their fundraising activities)…

Hayley Kuter

Paediatric Dietitian

08 May 2017

Eco Eating

No Comments Nutrition Bites

One of the little pamphlets that arrived in one of my professional newsletters this week was about eating a diet with a low environmental impact. The authors state that sustainable diets are those which contribute to food and nutrition security and to healthy life for present and future generations. Basically, a healthy diet and an ecologically friendly diet has quite a lot in common:

“Eat greener, not too much, and be active” is the take-home message.

So….putting this into practice it means less processed/junk food and more fruit, veg, and grains. Furthermore, reducing food waste and packaging where possible.

I also like this website that is part of a movement towards less plastic:

Hayley Kuter

Paediatric Dietitian


05 Jan 2017

Bone Mass and Activity

No Comments Nutrition Bites, Sports Nutrition

The prevalence of osteoporosis is increasing in modern society. Fragile bones make life difficult and painful. We know that our adult bone mass was determined during childhood. Read more

03 Aug 2014

Caffeinated Kids?

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We may not like to admit it, but most of us are probably not able to get through a single day without a hit of caffeine. Tea, coffee, soft-drinks, energy drinks and even some medicines all contain this addictive drug.

Caffeine’s benefits have been known throughout the world for many years: by blocking the neurotransmitter adenosine, which tells the brain when we are tired, caffeine reduces feelings of fatigue. There are so many occasions when the world’s favourite drug can be put to good use: as a morning wake-up, to help with a hang-over or after a late night, to stay alert for an afternoon meeting, for sports performance or even a long drive.

But like any drug, caffeine also has a few down-sides. It has a half-life of around 5 hours, which means the stimulating effects of an after-dinner percolation will still be in full force until the early hours of the morning. It can also induce panic attacks and anxiety in those susceptible. What I find worrying, is that the caffeine in soft-drinks and medicines is almost certainly from synthetic caffeine made in chemical labs in China and the like. Regulating the quality and safety of these is incredibly difficult. What’s more – labelling laws at the moment don’t insist that caffeine levels are fully declared on drink bottles so we really haven’t got a clue as to how much we (or our children) are consuming.

As for children; my advice is to not let children have any caffeine at all. Just in case you think I’m being a little over cautious, here is a quote from a report in 2011 on caffeine from the American Academy of Pediatrics: “Rigorous review and analysis of the literature reveal that caffeine and other stimulating substances contained in energy drinks have no place in the diet of children and adolescents.”   

Hayley Kuter
Paediatric Dietitian
20 Jul 2014

Bottled water for infants

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The summer holiday season is upon us, and I am often asked about using bottled water to make up infant formulas when abroad.

There are three different sources of water: tap water – contains chloride and fluoride with all other minerals removed during the treatment process, bottled water – which is expected to conform to the same standards as the public water supply, and thirdly natural mineral/spring water. Mineral or spring waters may contain higher amounts of solutes including nitrate, sodium, fluoride and sulphate. Waters with high mineral contents are unsuitable for infants and young children.

Recommendations for using water abroad:

1. Use tap water which has been boiled once and allowed to cool to between 70-80 degrees Celsius before adding infant formula. In countries where the tap water quality cannot be guaranteed, bottled water can be used an alternative.

2. Use bottled water which conforms to the UK Dept of Health guidelines: (maximum amounts) sodium: 200mg/litre, nitrate: 100mg/litre, nitrite: 3mg/litre, sulphate: 500mg/litre.

3. Avoid using all water in bottles labelled ‘natural mineral water’ or ‘spring water’.

And happy holidays!

Hayley Kuter
Paediatric Dietitian 




15 Jul 2014

Vitamin D Calculator

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Many of my friends and colleagues know that I’m very interested in Vitamin D. I attended a professional update on Vitamin D in London last week and was excited to see a couple of new developments: a vitamin D supplement that comes in a mouth spray (tablets can be hard to swallow especially for children) and also an online vitamin D calculator. Dr Benjamin Jacobs has helped develop the online tool as part of the Vitamin D Mission. The website is worth checking out: Vitamin D Mission – especially the calculator and the printable posters that I will try putting in some of the schools and nurseries I work with.

As for the mouth-spray supplement: I’m pretty sure kids are going to love it. Made by BetterYou.


Hayley Kuter
Paediatric Dietitian


24 Oct 2013

Vitamin D – vital for winter!

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It’s that time of year again – leaves are falling, days are getting shorter, summer holidays now long forgotten….and our vitamin D levels are about to plummet.

If there’s one vitamin I recommend for all children, it’s vitamin D.

We know that British toddlers receive less than 30% of the recommended amount of daily vitamin D from food – the rest must come from exposure to sunshine in the summer. In the winter, sunshine levels in Britain just aren’t strong enough for our bodies to synthesise any vitamin D, so for children 6 months to school age (some would say beyond) a vitamin D supplement is a must.

Vitamin D is crucially important for strong bones, growth, muscle development and the immune system. Vitamin D has also been implicated in other serious medical conditions such as type 1 diabetes, hypertension, cancers, multiple sclerosis (MS) and the autistic spectrum disorder (ASD). Severe vitamin D deficiency in children results in bone softening or “rickets”.

Vitamin D drops can be found in your local supermarket or pharmacy, or some NHS clinics supply the drops too. I remind parents to keep the bottle on their kitchen top or in a place where they won’t forget to give their children their daily dose. Vitamin D should be given all year round – not just in winter. Let’s face it – the amount of sunshine in the British summer is sometimes variable and often outside play is difficult.

Hayley Kuter
Paediatric Dietitian
12 Jul 2013

Eat food. Mostly plants. Not too much.

No Comments Nutrition Bites

As a dietitian, I usually steer well clear of popular diet books, the latest diet fads or celebrity weight-loss plans. You might think this is akin to burying my head in the sand – but I really dislike spending any time thinking about diet crazes and worry about how certain foods or nutrients are the flavour of the moment one minute…then blacklisted the next. Carbs were once good, then they were out and protein was in, then superfoods found a place, now calorie counting is back – it really is all pretty ridiculous.

Finally though, I’ve found a book (and let’s not call it a ‘diet book’) that almost exactly outlines my own diet and nutrition thinking. Michael Pollan is an American journalist and has written a neat little book called “Food Rules”. (I’m not going to put any links in here, as I really and truly am not trying to sell it). His wisdom is summarised by the three sentence rule: eat food (as in real food – no imitations, chemical-laden, processed crap), mostly plants (yes of course fruit, veg and wholegrains get the thumbs up) and not too much (easier said than done, but some helpful reminders all the same). Expanding on this – in 64 ‘rules’ he forms the basis for every eaters’ life-long dietary guidelines for surviving the Western diet. Examples include: “avoid food products containing ingredients that no ordinary human would keep in the food pantry”, “avoid foods you see advertised on television”, and “treat treats and treats”. The advice is written in a light-hearted way; yet following it is a simple way to navigate the labyrinth of diet programmes, advertising, government policies etc and just have a sensible healthy diet.

If there’s one food book to have handy for your supermarket shop – I certainly recommend “Food Rules”. I can’t say following it will be easy, but then diets aren’t supposed to be easy are they?!


Hayley Kuter – paediatric dietitian


26 Feb 2013

Learning to like vegetables – should we disguise the taste?

No Comments Fussy Eaters, Nutrition Bites

Not enough vegetables are eaten by children. We know that from thousands of studies across the western world, and it’s evident from our rising problems with obesity in this country. Vegetables are low in energy and dense in nutrients – which makes them a very important part of children’s diets.

The main trouble is actually getting a child to like vegetables and to eat them.

The European project ‘HabEat’ has studied different methods of making children like vegetables – without force, bribery, or punishments! The three ways they researched were:

1. Repeated exposure to the vegetable – at least 8-10 tastes

2. Adding a flavour (sweet or savoury) to the vegetable

3. Adding energy (eg ketchup) to the vegetable

Overall, the results showed that the technique of repeated exposure is the most effective for increasing vegetable consumption in children of pre-school age, especially since this means not adding ingredients which are not in line with public health recommendations (sugar, salt, sauces, etc).

Interestingly, adding energy (eg ketchup) showed no positive results in the consumption of vegetables in the long term.


Hayley Kuter

Paediatric Dietitian

07 Sep 2012

We can’t all be Olympians but…

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With the 2012 Summer Olympics and Paralympics now drawn to a close, we can reflect on both the success of these amazing sporting events and some of the controversy that surrounded the games beforehand; from the amount of money spent, to the sponsors being purveyors of high calorie junk food and drinks companies (I’m not going to name them here to avoid further advertising!).  Hopefully now that the games are over, we will all feel inspired to leave our sofas and particpate in some sporting activities ourselves. The Lancet  has published studies to show that inactivity is a risk factor comparable to smoking or obesity.  Further studies have shown that cutting down on tv time can increase our life expectancy by 1.4 years, and that restricting the amount of time someone spends sitting down to less than 3 hours per day could increase life expectancy by 2 years. Obviously our sporting heros are highly trained, committed, talented and competitive – but perhaps we could be inspired on some level to do a bit more exercise – not just for the sake of our waistlines but for the prevention of many other diseases and of course that ‘feel good factor’. Happy moving!


Hayley Kuter
Paediatric Dietitian
Blossom Consulting Ltd
22 Jul 2012

Table manners at all-time low

No Comments Fussy Eaters, Nutrition Bites

Texting whilst at the dinner table, not washing hands before a meal, and scoffing food in a hurry are all examples of the table manners in decline as found by a survey at the recent Birmingham Food Fest (July 13-19). The tradition of eating as a family, and savouring the meal in front of us has become rare – with our busy lives, social media and other distractions taking over.
As a paediatric dietitian, I often see families who don’t manage to eat meals together, or allow the tv on, games and other distractions to take over from the main event. Does this affect nutrition? Of course!
Food is such an important part of family life, and of nutrition too – and this survey perhaps highlights the need for back-to-basics approach to mealtimes and eating. The Birmingham Food Fest website offers a guide to table etiquette: Good Etiquette Guide
– perhaps a good start to re-establishing values that seem to have been dropped.

Hayley Kuter
Paediatric Dietitian
Blossom Consulting Ltd
09 May 2012

Mild dehydration found to impair children’s cognitive function

No Comments Nutrition Bites

Children are at much more risk of dehydration than adults – due to their higher surface-to-mass ratio. I often wonder how it is possible for children to achieve their daily fluid requirements without taking a drink bottle to school as one drink at lunch in the school cafeteria cannot surely be enough. An interesting study of a group of school children (aged 11-12 years) in Manchester proved that encouraging children to drink adequate amounts had benefits on cognitive function, mood, feelings of calmness and feelings of ‘interest’ at school.

Here is the recommended amounts children should be drinking daily:

Age Girls / Boys
4-8 1120ml/day // 1120ml/day
9-13 1330ml/day // 1470ml/day
14+ 1400ml/day // 1750ml/day

The study in question found that sending children to school with a bottle of drinking water increased their water intake by at least 500ml or two cups per day. The benefits were significant.

Children frequently prefer sweetened drinks, but even this study found that children reported they developed a ‘taste for water’ during the 14 day trial.

05 Mar 2012

Research shows children who eat well are happier

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New research show that teenagers who eat a healthier diet and exercise regularly are happier than their peers. The Institute for Social and Economic Research at the University of Essex has shown that:
– higher consumption of fruit and vegetables, and lower intake of crisps, sweets and fizzy drinks were associated with greater happiness.
– the more hours of sport or physical activity teenagers do per week, the happier they are
– between the ages of 13 and 15, teenagers diets typically become less healthy and participation in exercise decreases, as they gain more autonomy over lifestyle choices.
– only 11% of 13-15 year olds reported reaching 5-a-day, and even in 10-12 year olds, only 20% reported reaching their daily fruit and vegetable targets.

25 Jan 2012

Generation Smoothie

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I know I’ve mentioned smoothies previously, but here is another article to back me up: a dentist warning parents about the effects of smoothies on children’s teeth…

healthy smoothies not so innocent

Hayley Kuter
Paediatric Dietitian
Blossom Consulting Ltd
25 Jan 2012

Children’s breakfast cereals

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I’ve just completed some work analysing 50 breakfast cereals. Breakfast is considered to be one of the most important meals of the day. Children particularly, perform better academically, socially and physically when they eat a breakfast. Breakfast cereals are a great choice – but during my research I was shocked by the poor quality of cereals aimed at children.

Of the 14 cereals I looked at, only 1 was not high in sugar. Many were high in salt – even for adult standards. I would encourage parents to choose breakfast cereals wisely for their children. If it means foregoing a cereal box with a cartoon on it, so be it. If you introduce a chocolate cereal from the beginning, it is very difficult to change little taste buds onto a wholesome cereal. Ignore the ‘children’s cereals’ section of the supermarket and head for the nutritious wholegrain options and give your children the best start possible!

Here are some links to media coverage of my report…

20 Oct 2011

New! Portion size guidance for toddlers

No Comments Nutrition Bites, Weaning

Anyone who has tried to feed a toddler knows that how much they eat will vary from day to day and week to week. This is perfectly normal, but sometimes it would be helpful to know whether your expectations are realistic.

The Infant and Toddler Forum have published evidence-based guidance on healthy portion sizes that meet UK Estimated Average Requirements for energy (EAR) and Reference Nutrient Intakes (RNIs) for toddlers. It can help ensure your child receives the best nutrition possible at a really crucial time in their development. The portion size models can be downloaded for free here:

10 Aug 2011


No Comments Nutrition Bites

News reports this week of the high salt diet that most UK babies consume were slightly inflated. “Seventy percent of 8-month-olds consume too much salt, UK study shows” was the headline from one news report. The study quoted was actually from a study of children born in 1991-1992, and although the cohort was large – almost 1,200 participants, and yes 70% of these babies did consume over 0.4g sodium (1g salt) per day….this ‘news’ is nearly 20 years old!

So is salt still an issue now and can we learn anything from this study? Read more