nutrition and oral health

ISBN 9780905453316
90000 >
9 780905 453316
The Department of Public Health
NHS Lanarkshire
14 Beckford Street
Telephone: 01698 206335
Fax: 01698 424316
© Lanarkshire NHS Board
Published March 2011
We encourage the use by others of information and
data contained in this publication. Brief extracts
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acknowledged. Proposals for reproduction of large
extracts should be sent to the address above.
ISBN 978–0–905453–31–6
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Policy Context
Eating Well
Special Diets
Developing a Healthy Eating Policy
Food Safety and Hygiene
10 Making the Most of Mealtimes
Common Festivals and Religious Celebrations
12 Activities for Common Festivals and Religious Celebrations
13 Food for Parties and Special Celebrations
14 Healthy Food Activities
15 Happy Healthy Smiles
16 On the Move
Supporting Curriculum for Excellence
18 Working in Partnership
19 Parent Prompts
20 Resources
21 Useful Contacts & Further Reading
22 Bibliography
23 Appendices
Contents 1
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The nutrition and oral health of children and young people is fundamental to their
physical, mental, social and educational development and wellbeing.
In the last decade, we have seen the publication of national policy documents such as:
• The Regulation of Care (Scotland) Act 2001,
• National Care Standards (2005),
• An Action Plan for Improving Oral Health and Modernising NHS Dental Services in
Scotland (2005),
• Nutritional Guidance for Early Years (2006),
• The passing of the Schools (Health Promotion and Nutrition) (Scotland) Act 2007 in
the Scottish Parliament,
• The development of Childsmile a national oral health improvement programme for
• Achieving Our Potential (2008),
• Equally Well Implementation Plan (2008),
• Early Years Framework (2008), and
• Curriculum for Excellence (2009).
In 2007, a multi-agency and multi-disciplinary steering group comprising staff from key
agencies across Lanarkshire convened to examine access to resources and training in
nutrition and oral health for childcare providers. Following the updating of the Nutrition
and Oral Health Pack – Strategy into Practice in the Early Years, the group prioritised the
development of a similar resource for staff working with children and young people
aged between 5–14 years and in out of school care (OSC) services.
This finished resource complements the Nutrition and Oral Health Pack - Strategy into
Practice in the Early Years edition and contains updated factual information on a range
of issues relating to healthy eating and oral health, and provides practical advice for
incorporating food into the informal curriculum and OSC activities.
Thank you to all who were involved in the development of this resource and to the
group who developed and updated the Nutrition and Oral Health Pack – Strategy into
Practice in the Early Years, on which this resource is based. Thank you to the OSC
services who provided photographs.
2 Preface/Acknowledgements
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This resource will support childcare services to become health promoting by providing
guidance on good nutrition and oral health and enable services to incorporate the
health messages outlined in this resource into daily activities. It is intended that this
resource will complement existing work, support the development of future activities
and link activities with the National Care Standards (2005) and Curriculum for
Excellence (2009).
As health and wellbeing is now the responsibility of all within the learning community
(Learning and Teaching Scotland, 2009), the information presented is in a format that
can easily be shared with all staff members, parents, carers and children.
National Care Standards (2005)
This resource will support OSC services to achieve the following National Care
• National Care Standard 3: Health and Wellbeing
ᔜ 3.3 Opportunities to learn about healthy lifestyles and relationships.
ᔜ 3.4 Access to a well balanced and healthy diet.
ᔜ 3.5 Regular access to fresh air and energetic play.
• National Care Standard 4: Engaging with Children
ᔜ 4.3 Build confidence, extend learning and encourage and value contributions.
• National Care Standard 9: Involving the Community.
This resource contains a range of information including eating well, food safety and
hygiene, oral health, developing food skills, and ideas for healthy snacks and special
occasions. This resource can support the development of nutrition and oral health
policies within your own service.
Curriculum for Excellence is also introduced in Chapter 17. This chapter outlines how
OSC services can link their activities to the national curriculum.
Strategy into Practice for Childcare Providers
Introduction 3
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National Policy Context
Let’s Make Scotland More Active – A Strategy for Physical Activity (2003)
Let’s Make Scotland More Active sets out a variety of actions to encourage and enable
children and adults to take part in regular physical activity.
National Care Standards (2005)
The Regulation of Care (Scotland) Act 2001 was introduced to ensure a greater
standard of care provision and requires certain care services to be regulated. Those
providing care services to children are regulated by the Care Commission against a set
of National Care Standards. These set out the quality of care that care services should
An Action Plan for Improving Oral Health and Modernising NHS Dental Services in
Scotland (2005)
The Dental Action Plan saw the beginning of Childsmile. Childsmile is a national
programme designed to improve the oral and general health of children in Scotland,
and reduce inequalities, both in dental health and access to dental services.
Nutritional Guidance for Early Years (2006)
Nutritional Guidance for Early Years: food choices for children aged 1–5 years in
early education and childcare settings is a national guidance document which
provides support to meet the standard outlined in National Care Standard 3.
Although aimed at children in early years and the childcare setting, this document
contains useful information and ideas for snacks that should be continued beyond the
age of five years old.
Schools (Health Promotion and Nutrition) (Scotland) Act 2007
The Scottish Government introduced legislation to help schools become health
promoting establishments, which includes serving healthy food and drinks to pupils.
The legislation ensures that food and drink served in school premises complies with
national nutritional standards. OSC services operating in school premises should adhere
to this legislation.
Equally Well Implementation Plan (2008)
The Ministerial Task Force on Health Inequalities published the Equally Well
Implementation Plan in December 2008 to ensure that improvements in health are seen
across the whole population and are shared more equally between rich and poor and
across both urban and rural settings. The plan brings local and national action together
across four key priority areas and calls on public sector resources to address health
inequalities in an upstream manner through early intervention and prevention.
Achieving Our Potential - A framework to tackle poverty and income inequality in
Scotland (2008)
This framework for tackling poverty and income inequality fits with other Scottish
Government policies. The framework recognises that having the best possible start in
life, a good education, good health and enough money can all help make society more
equal. The framework aims, through a variety of policy documents and working with all
4 Policy Context
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parts of society, to tackle the causes of poverty and make lasting improvement to the
lives of those in poverty.
Early Years Framework (2008)
The Early Years Framework sets out to improve the future outcomes of our youngest
children. The Framework emphasises the importance of providing children with the best
start in life by maximising positive opportunities, reducing poverty and health
inequalities, and focusing on prevention and early intervention. The role of parents and
the wider community are key to providing supportive and nurturing environments for
children, as is the availability and accessibility of high quality services, where these are
Curriculum for Excellence (2009)
Curriculum for Excellence provides a
framework for learning and teaching
which promotes successful learners,
confident individuals, responsible
citizens and effective contributors. It
takes a holistic approach to health and
wellbeing, which includes experiences
and outcomes for children around
food and nutrition. Health and
wellbeing is the responsibility of all in
the learning community, including
OSC services.
Aiming High Scotland (2009)
Aiming High Scotland is the national
quality assurance scheme for OSC
services in Scotland and is delivered by
the Scottish Out of School Care
Network (SOSCN). Aiming High
Scotland ensures services are
committed to promoting and
supporting the United Nations
Convention on the Rights of the Child
by creating a child centred service
which supports the development of
physical and emotional health and wellbeing of school-aged children within a caring
Local Policy and Activity
NHS Lanarkshire Breastfeeding Policy
The overall aim of the NHS Lanarkshire Breastfeeding Policy is to ensure that all
mothers have the right to make a fully informed choice as to how they feed and care for
their babies. It encourages and enables health care staff to create an environment
where more women choose to breastfeed and are supported to breastfeed exclusively
for the first six months and beyond. The policy supports breastfeeding in all public areas
of NHS Lanarkshire and partner premises.
Strategy into Practice for Childcare Providers
Policy Context 5
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Health Promoting School Award Scheme
A Health Promoting School is one in which all members of the school community work
together to provide children with integrated and positive experiences that promote and
protect their health. Many OSC services operate on the premises of schools that are
health promoting. Positive health promotion messages should therefore be consistent,
continually cascaded, implemented and reinforced to children by education staff and
OSC staff. As a result, a whole establishment approach to raising the profile of health is
promoted by way of the Health Promoting School Award Scheme.
Health and Wellbeing Portfolio
This portfolio enables all education establishments who participated in the Health
Promoting School Award Scheme to embed the Health and Wellbeing experiences and
outcomes into the curriculum. It also provides a framework for maintaining Health
Promoting School status and monitors compliance with the Schools (Health Promotion
and Nutrition) (Scotland) Act 2007. It reflects that health is now the responsibility of all
and should sit within the school’s normal planning cycle.
Lanarkshire’s Childrens Healthy Weight Strategy
This strategy has been developed to address the increasing levels of childhood obesity in
Lanarkshire. The strategy targets children from birth to eleven years of age and aims to
determine the actions and progress required to reduce the high prevalence of obesity in
children. The focus of activity is in four key areas: antenatal/postnatal, early years,
primary school aged children, and community treatment programmes.
North Lanarkshire Council Diet and Nutrition Policy
North Lanarkshire Council Diet and Nutrition Policy (2008–2012) has been developed
with the whole of the North Lanarkshire population in mind. In addition, specific
commitments have been made in the following areas: breastfeeding mothers, children
and young people, older adults, individuals requiring special diets, communities, and
individuals and families who are temporarily accommodated. The policy also commits to
improving food provision for employees, as well as raising awareness of and promoting
healthy eating to staff and customers.
Hungry for Health
North Lanarkshire Council, in partnership with Focus on Food, has developed a food
and health curriculum pack for nurseries and schools - Hungry for Health. This pack
raises awareness among children regarding the importance of positive dietary habits,
and focuses on nutrition and health. This resource also aims to encourage the
development of food preparation and cookery skills in children from a young age.
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Research shows that children who are breastfed have a better nutritional start in life.
Breast milk is superior to formula milk as it contains anti-infective properties and
antibodies that boost the immune system and protect babies from infection. Evidence
also shows that breastfeeding offers protection from a range of childhood infections,
reduces hospital admissions in the first year of life and continues to give added
protection into the teenage years. The protective effect of breastfeeding is dose related
i.e. the longer and more exclusive the breastfeeding is, the greater the protection.
When a child is exclusively breastfed it is given only breastmilk and nothing else, not
even water.
Babies who are exclusively breastfed are:
• protected against diarrhoea, gastro-enteritis and tummy upsets,
• protected against chest infections and wheezing,
• protected against ear infections,
• protected against colds, flu and sore throats,
• less likely to have eczema and other allergies,
• less likely to develop diabetes, and
• more likely to have prolonged natural immunity to mumps, measles, polio and other
Breastfeeding is good for mothers too; breastfeeding mothers have a reduced risk of
breast cancer, ovarian cancer and breastfeeding aids an earlier return to pre-pregnancy
Despite the growing evidence for the health benefits of breastfeeding, fewer children in
Lanarkshire are breastfed compared with other areas in Scotland. To ensure that more
children and women experience the full benefits of breastfeeding, a number of local
partnership initiatives are in place to encourage and support more mothers to choose
Childcare providers can support women to continue breastfeeding by ensuring parents
or staff members are welcomed and supported to breastfeed within the establishment
and appropriate facilities to store expressed breast milk are provided.
If necessary, expressed breast milk can be stored for up to five days in the fridge. Bottles
should be clearly labelled with the child’s name and date. Any unused milk should be
discarded after five days. If you require further clarification or advice contact your local
environmental health officer within your local authority.
OSC can participate in Lanarkshire’s Breastfeeding Friendly Campaign. The aim of the
campaign is to support a woman’s right to breastfeed whenever and wherever she
chooses. The campaign rewards organisations that welcome breastfeeding on their
premises. To find out more about the campaign, log on to
Strategy into Practice for Childcare Providers
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Children and young people need the right balance of food and nutrients to help them
grow and develop. A healthy diet can positively influence children and young people’s
current and future health; reducing the risk of diet-related diseases and conditions such
as overweight and obesity, diabetes and dental decay. Healthy eating does not mean
denying children and young people the foods they enjoy. It is the balance and variety of
food in the diet that is important.
The eatwell plate below shows the types and proportions of food needed to make up a
healthy, well balanced diet.
Each day children and young people should be encouraged to eat a variety of foods
from the four main food groups:
1. Fruit and vegetables
Fruit and vegetables are good sources of a wide range of vitamins, especially A, C and
folate. Children and young people should eat at least five portions each day (see
Appendix 1 for more information on portion sizes). Children and young people should
eat as wide a variety as possible; fresh, frozen, dried and canned (in own juice) varieties
are equally nutritious and all count towards the five-a-day recommendation. Fresh fruit
and vegetable juice also counts as a portion, but only once each day, no matter how
much is consumed. Smoothies can count as two of the five-a-day but only if they
contain 150 ml of fresh fruit juice and 80 g of crushed fruit or vegetable pulp.
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A long list of fruit and vegetables includes grapes, cherries, melons, pears, kiwi fruits,
bananas, pineapples, oranges, strawberries, apples, peaches, plums, nectarines,
sweetcorn, broccoli, peas, beans, cabbage, spinach, mushrooms, lettuce, parsnip,
cauliflower - the list goes on and on!
2. Bread, rice, potatoes, pasta and other starchy foods
This food group includes all types of bread and rolls (such as white, brown, wholemeal,
granary), pitta, baps and bagels, potatoes, pasta, rice and breakfast cereals. These
foods are good sources of starchy carbohydrate which supply energy. They are packed
with vitamins like thiamin, riboflavin, niacin and folate, and also provide fibre. Children
and young people should have an item from this food group at every meal.
3. Milk and dairy foods
Milk and dairy foods (such as yoghurt, cheese and fromage frais) are good sources of
protein and calcium, which is needed for the development of strong bones and teeth.
Choose lower fat milk, yoghurt and cheese, such as edam, mozzarella, cottage or
reduced fat cheddar. Plain semi-skimmed or skimmed milk should be encouraged as a
drink and for use in meals. Children will not be missing out on calcium by moving from
whole milk to semi-skimmed or skimmed milk (after the age of five), in fact semiskimmed and skimmed milk have more calcium than whole-milk and contain less fat.
Children and young people should have three foods from this food group each day.
4. Meat, fish, eggs, beans and other non-dairy sources of protein
This food group includes beef, lamb, pork, chicken, turkey, fish, eggs, pulses (such as
beans, peas and lentils) and soya products. These foods are all good sources of protein
and iron, therefore essential for growing children and adolescents. Children and young
people should have two to three foods from this group each day.
The fifth food group shown in the eatwell plate is foods and drinks high in fat and/or
sugar. Research tells us that children and young people in Scotland are consuming too
many foods and drinks high in fat, saturated fat, salt and sugar. Therefore, children and
young people need to consume these foods and drinks less frequently to prevent dietrelated diseases and conditions.
Foods containing fat
Fat is a good source of energy and provides essential fatty acids that the body cannot
make itself. Fat in our diet helps the body to absorb some vitamins. However, eating too
much fat can lead to weight gain; and eating a diet high in saturated fat can raise levels
of blood cholesterol, which increases the risk of heart disease.
It is important to try to eat less fat and choose foods which are rich in unsaturated fats
instead of saturated fats. Foods that contain a lot of fat include: butter, margarine and
oil; cream and ice-cream; pastries, cakes and biscuits; fatty cuts of meat and meat
products (such as pies and sausages); some savoury snacks (such as crisps); chocolate;
fried foods and some ready-made meals. Foods that contain unsaturated fats include
oily fish, avocados, nuts and seeds, sunflower and olive oils.
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Foods containing sugar
Foods such as cakes, sweets, chocolate, biscuits and sugary drinks are high in sugar.
They are low in nutritional value because they do not contain nutrients such as vitamins
or minerals and are high in calories. These foods need not be avoided completely, but
when they are given, they should be offered occasionally after mealtimes rather than
between meals to avoid tooth decay (tooth decay is discussed in more detail later).
Foods containing salt
Some salt (or sodium chloride) is necessary in everyone’s diet, but too much can be
harmful. A high salt intake is linked with high blood pressure and increases the risk of
stroke later in life. If children become accustomed to a high amount of salt from an
early age they will develop a taste for it, making it difficult to change. Children aged four
to six years should have no more than three grams of salt a day; seven to ten year olds
no more than five grams a day and children and young people aged eleven years and
over, no more than six grams a day.
Convenience foods (such as canned products, ready-made meals and sauces) are often
high in salt. Savoury snacks (like crisps and corn snacks) should be limited to no more
than two or three times per week as these are salty and high in fat. Smoked foods like
smoked bacon, fish and cheese are high in salt so try not to have more than one of
these foods per day. Children and young people get enough salt from the amount that is
naturally present in food so avoid adding it during cooking or at the table. When
reading food labels look out for ‘sodium’ and ‘monosodium glutamate’. Products
containing these are likely to be high in salt.
Vitamins are necessary in our diet for a variety of functions: to maintain healthy skin,
hair, bones and teeth; maintain the immune system and offer protection against chronic
diseases such as heart disease and cancers.
Vitamins are split into two groups: fat-soluble and water-soluble. Fat-soluble vitamins
are vitamins A, D, E and K - these can be stored by the body. Water-soluble vitamins are
B vitamins (including thiamin, riboflavin, niacin, B6 and B12), folate and vitamin C these cannot be stored by the body so a daily intake of these is important.
Appendix 2 lists the main functions and food sources of key vitamins and minerals.
Like vitamins, minerals are required in our diet for a range of functions: to develop
strong teeth and bones; to maintain healthy blood; to help breakdown carbohydrate
and fat and for a healthy immune system. There are a number of important minerals,
but for children and young people the key minerals are iron, calcium and zinc.
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Iron is involved in the formation of red blood cells which carry oxygen around the body.
A deficiency of iron in the diet leads to anaemia. Anaemia is common in children and
young people, particularly adolescent females due to the onset of menstruation.
Children with anaemia may appear pale, tired and lethargic and have a poor appetite.
Prevention of iron deficiency is important as it affects intellectual achievement and is
linked to poorer development and health overall.
There are two forms of iron: haem iron and non-haem iron. Haem iron is easier for our
bodies to absorb and is found in meat and meat products such as red meat (e.g. beef
and lamb), chicken, turkey and some fish such as sardines. Liver, in particular, is a rich
source of iron. Non-haem iron is harder for our bodies to absorb than haem iron. Nonhaem iron is found in plant foods such as pulses (e.g. peas, beans and lentils), dark
green vegetables, dried fruit (e.g. apricots and raisins), fortified breakfast cereals, bread
and eggs.
Vitamin C helps the body absorb iron so encourage children and young people to have
a glass of fresh fruit juice (such as orange or apple), vegetables or some fruit with a
meal. Tannin, found in tea and coffee, hinders the absorption of iron so these should be
avoided or, if given, only offered between meals and without sugar.
The main function of calcium is to form and maintain strong bones and teeth as well as
to build muscle and maintain the nervous system. Often older children, particularly
teenagers, have a worryingly low calcium intake. This is likely to lead to problems later
in life with osteoporosis, or thinning of the bones, which can be very debilitating.
Children and young people should be encouraged to eat foods rich in calcium such as
milk and milk products (e.g. yoghurt, cheese and fromage frais), sardines, pilchards,
pulses, eggs, spinach and dried fruits.
Zinc plays a part in a variety of functions including the breakdown of protein, fat and
carbohydrate, wound healing, and maintaining the nervous and immune systems.
Children and young people should be encouraged to eat rich sources of zinc including
milk and milk products, meat, eggs, pulses and wholegrain cereals.
Strategy into Practice for Childcare Providers
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Occasionally childcare providers may have to cater for children and young people who
require a special diet. A number of common special dietary needs are detailed below. In
all instances, staff should consult with the child and their parents/carers; no assumptions
should ever be made about an individual’s food choice.
Vegetarian diets
By excluding meat and animal products from the diet, consideration has to be given to
alternative sources of key nutrients such as protein, iron, calcium and some vitamins.
Staff should ask the parents of vegetarian children and young people for information on
the foods that the child should/should not be given. For example, some vegetarians will
eat eggs or fish while others will not. It should not be assumed that all vegetarians follow
the same diet or exclude the same foods.
Some people exclude animal products completely and follow a vegan diet. To ensure an
adequate protein intake, food such as milk, cheese, fish and eggs should be included.
However, if these are not eaten then pulses such as chickpeas, beans (butter, haricot,
broad, pinto) and lentils are good sources of protein. Similarly for calcium, milk and
dairy products are the best sources although spinach, pulses, dried fruit, oranges, white
bread and tofu are good alternatives. Non-meat sources of iron must be included in a
vegetarian diet on a daily basis to prevent anaemia (see previous section on iron).
Remember that vitamin C helps the body absorb iron so include fruits, vegetables or
fruit juices with meals.
Children and young people with special dietary requirements
Fortunately, very few children require a restricted diet and, often, any restriction may
only be for a short period of time. Children and young people with special dietary
requirements should be under the supervision of a registered dietitian or other health
professional. Parents or carers should provide staff with a copy of any relevant dietary
information specific to their child. In some cases it may be necessary to request that
parents or carers provide specific food items such as milk, snacks or packed lunches.
Some of the more common conditions that staff may encounter in children in their care
are outlined below.
Coeliac disease
This is a condition where gluten (protein found in wheat) is not tolerated by the digestive
system. Here, the child would need to avoid all foods containing wheat, rye, barley and
oats. These may be contained in foods such as biscuits, puddings, cakes, soups, and
some canned and packet foods. Parents should be able to provide a comprehensive list
of fresh, canned and packet foods that are gluten free. Further information can be
obtained from Coeliac UK (see Useful Contacts and Further Reading section for details).
Food allergy
Food allergy involves an adverse response of the immune system and affects fewer than
two percent of children in the UK. The effects of an allergic response can be minor,
although in some cases, can cause a severe reaction or even be life-threatening.
Research shows that many people perceive they have a food allergy when in fact it is
food intolerance.
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Food intolerance
Intolerance to a number of foods, or a specific food, can result in a range of symptoms
from wheezing to gastrointestinal upset or discomfort. In all cases of suspected food
allergy or intolerance, parents should seek medical advice for accurate diagnosis and
future dietary management. It could be harmful for parents to exclude foods from their
child’s diet without proper advice, as this could lead to malnutrition and be
unnecessarily restrictive.
Foods which can result in an adverse reaction caused by allergy or intolerance described
above are: hen’s eggs, cow’s milk, fish, shellfish, soya beans, wheat (gluten), peanuts,
some other types of nuts and products containing any of these foods.
Diabetes is a condition where the hormone insulin is not produced, resulting in the
body’s inability to control blood sugars. Children and young people with diabetes may
require two or three injections of insulin daily. A healthy and varied diet should be
encouraged. The timing and frequency of meals and snacks is crucial to ensure good
control of blood sugars. A regular intake of carbohydrate (bread, fruit, crackers), usually
every two hours or so, will ensure a steady blood sugar level.
If children and young people with diabetes miss a snack or a meal, are unwell, or are
more active than usual, this can increase their need for foods containing carbohydrate.
At these times, they may need extra snacks containing carbohydrate to prevent
hypoglycaemia (low blood sugar level). Hypoglycaemia (a ‘hypo’) can present in
different ways for different children. Staff should ask parents or carers for information on
recognising symptoms in their child and the appropriate action that should be taken.
Generally, if a child is hypoglycaemic, they require sugar, glucose or a sugary drink
quickly, followed by a more substantial snack or meal. For general information on
diabetes, staff can contact Diabetes UK in Scotland (see Useful Contacts and Further
Reading section for details).
Children and young people with additional support needs
Some children and young people, with additional support needs, may not be able to
chew, eat and enjoy a wide range of foods and textures. Working with parents to ensure
meals and snacks are of an appropriate texture and consistency is essential. This may
involve input from a range of professionals, including a registered dietitian, speech and
language therapist, occupational therapist or physiotherapist. Children and young
people may require foods modified in consistency, specialised feeding equipment, safe
seating and positioning for eating or a high level of one-to-one support to eat and drink.
If a parent expresses concern over their child’s eating or drinking, staff should suggest
that they contact their health visitor/public health nurse, or an appropriate health
professional for further advice.
Children and young people with chronic illness may require regular, frequent medication
and therefore should be under the continuing care of a dentist. As with all children,
parents should be encouraged to request sugar-free medicines and pay attention to
maintaining good oral hygiene.
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There may be instances where childcare providers cater for children and young people
on the autistic spectrum. Some children with autism have particular issues relating to
food and will only eat a limited variety. Childcare providers should ensure that children
with autism are provided with food that they will eat, whilst making every effort to
encourage them to consume healthy snacks and drinks.
Religious and cultural diets
Many families have religious and cultural beliefs which influence the food they eat.
People of Muslim faith are only permitted to eat foods that have been slaughtered in the
correct Islamic way (Halal). Meat from pigs and other meat-eating animals is strictly
forbidden. Fish, eggs and dairy foods are permitted; however, cheese should not contain
animal rennet. Muslims will avoid food items thought to contain lard or fat from animals
not slaughtered in the correct way (for example, cakes, biscuits and pastries). Alcohol is
also forbidden.
People of Jewish faith will only eat meat which is Kosher (a Jewish slaughter method
which allows as much blood as possible to be drained from the meat before preparation
and cooking). Only meat from cloven hoof animals may be eaten (beef and lamb);
meat from pigs is strictly forbidden. Most Jewish people will eat eggs and fish, however,
only fish with fins and scales are permitted. Meat and milk foods must be kept apart
when cooking and eating, some Jewish people will usually wait three hours between
eating these types of foods. Cooking and eating utensils for milk and meat are kept
Most people of Hindu faith are vegetarian and many (especially women) avoid eggs.
The cow is sacred and even Hindus who are non-vegetarians will not eat beef. Nonvegetarian Hindus will eat lamb, pork, chicken and some fish. Staple foods include
baked cereal products (chapattis and breads), rice, pulses, milk, yoghurt and cheese
(made without animal rennet). Lard and other carcass-derived fats are strictly forbidden.
Ask the parent or carer for specific advice if you have children or young people within
your service who have specific religious and/or cultural dietary requirements.
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A healthy eating policy is a method of ensuring that everyone is clear about the healthy
eating messages that the childcare provider aims to promote. It can be used to provide
information to both staff and parents and it should be written in agreement with
parents, carers and children and young people. It allows staff to clearly state what their
approach to food and nutrition will be, and creates the opportunity for food and oral
health issues to be discussed and agreed with parents, carers and children and young
people. The policy should be given out to parents and carers, and can be updated as
new information becomes available.
This section provides the sort of information you may wish to consider when developing
a policy.
Support offered to breastfeeding women (parents and staff)
You may wish to identify an area where women (parents or staff) can breastfeed their
baby or express breast milk comfortably. All staff should be aware that the establishment
welcomes breastfeeding mothers and that breastfeeding is seen as the healthiest way to
feed a baby for both the mother and her child.
Types of food provided as snacks
Healthy food items will be offered e.g. fruit and vegetables and food items low in fat,
salt and sugar.
You could explain who will shop for and prepare snacks and how decisions about food
provision are made e.g. food labels are checked, food preferences are considered, and
children and young people are involved in food preparation and choosing healthy
Types of drinks provided
Plain, still drinking water will be available at all times. Plain semi-skimmed or skimmed
milk and plain still water will be the only drinks offered between meals. Fresh fruit juice
and sugar-free squashes may be offered at mealtimes. Sugary, fizzy drinks will not be
Types of restaurants
for outings
Carefully consider
any venue when
taking children and
young people out to
eat. The venue
should reflect the
principles of the
healthy eating policy
and cater to children
and young people
with special dietary
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Communication and dissemination of the policy
You may wish to give a copy of the policy to all staff, parents and carers, and then to all
new staff, parents and carers thereafter. The policy should contain a list of the snacks
and drinks that will be provided by the service and which foods and drinks children will
be discouraged from bringing to the service with them.
Feedback from staff, parents and carers should be encouraged and any changes to the
policy could be posted on the notice board or communicated via a newsletter.
How you will encourage good eating habits in children
This section could include, for example, that:
• Staff will encourage children to enjoy sitting with others to eat and drink; supporting
good table manners and social interaction.
• Staff will exhibit good eating habits in order to be positive role models.
• Children and young people will be encouraged to participate in games and activities
related to food and health to instil an interest in food and nutrition.
What you will do if a child does not eat
Children and young people who do not eat the snacks provided should not be forced to
do so and will be offered a suitable alternative e.g. fruit, yoghurt, plain crackers and
cheese or toast.
Include that regular, informal contact with parents and carers will take place to let them
know how their child has been eating at the service and make them aware of any
Advice you will give to parents about providing food
Parents and carers should not give children sweets, chocolate or sugary drinks to bring
to the service; healthy snacks and drinks will be provided.
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Participation in food preparation is a valuable learning experience for children and
young people, providing a great opportunity to reinforce basic personal and food
hygiene procedures. It is essential that children who are involved in the preparation of
snacks are always closely supervised.
The Elementary Food Hygiene Certificate
The Elementary Food Hygiene Certificate is required for the level of food preparation
discussed in this pack and we strongly recommend that at least one member of staff
involved in food or snack production completes the course.
A number of colleges in North Lanarkshire run the Royal Environmental Health Institute
of Scotland (REHIS) Elementary Food Hygiene course. Staff should contact Coatbridge,
Cumbernauld or Motherwell colleges directly.
Staff in South Lanarkshire should contact the environmental health department within
the local authority for further information on the REHIS Elementary Food Hygiene
We recognise that the majority of establishments will not provide lunches and will only
handle a limited range of snack foods. However, it is intended that the information
below can be shared with parents, as it gives advice on the appropriate handling of high
risk foods such as raw meat and poultry.
If your service is responsible for providing lunches or cooked meals we recommend that
you consult with your local environmental health officer for advice on food hygiene
training, registration and risk assessment. Depending on the type of foods you prepare
in your service, you may be required to complete a food registration form. You should
contact your environmental health officer in your local authority for advice on whether
this is necessary for your service.
Safe Food Preparation
• Always wash hands thoroughly with warm running water and a bactericidal liquid or
clean soap in a wash hand basin or nominated sink, and dry using disposable towels.
Do this before preparation of food, between preparation of raw meat, vegetables or
fresh shelled eggs, after going to the toilet, blowing your nose, changing nappies,
handling waste or handling pets.
• Make sure food is kept at safe temperatures: for hot food this is above 63 °C, for cold
food this is below 5 °C.
• Do not use unpasteurised milk or milk-based products such as goat’s cheese.
• Fresh shelled eggs should be used with caution within OSC services and often, dried
or pasteurised eggs are recommended as a suitable alternative. Seek advice from
your local authority.
• Wash all fruit and vegetables thoroughly before eating. Take extra care when washing
vegetables, especially if eating raw. Always use a clean chopping board and knife.
Vegetables for young children should be washed and peeled.
• Wash the sink with a bactericidal detergent before and after any use, after cleaning
vegetables or food preparation. Separate sinks should be used for food preparation
and other activities e.g. washing paint brushes.
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• Wash dishes, cutlery, worktops, equipment and tabletops with hot water and a
bactericidal detergent and rinse in designated sinks, preferably twin sinks, or use a
dishwasher if available.
• Separate chopping boards and knives, preferably colour coded, should be used for
ready to eat foods and vegetables and for the preparation of fruit.
• Change cloths or sponges often. Always disinfect worktops and tabletops before and
after food preparation. Wipe the tops of cans before opening them.
• Bring milk indoors as quickly as possible and place in the fridge. Any damaged
cartons should be discarded. Provide a covered holder for any deliveries of food to
avoid contamination from birds.
• Take off jewellery such as rings or bracelets before preparing food to avoid germs
getting into food.
• Always cover cuts or sores with a blue waterproof dressing.
• If a member of staff is unwell they should not handle food, especially if they have
been sick or have diarrhoea. Report any such illness to the supervisor, who should
exclude the member of staff from any work that involves food exposure until they are
asymptomatic for at least 48 hours.
• Clean protective clothing should be worn when preparing food.
• Never smoke when handling food.
• Ensure long hair is tied back.
• Perishable foods such as meat and poultry will be labelled with a ‘use by’ date and
should not be kept beyond this date. Foods that can be kept for longer such as bread
will be labelled with a ‘best before’ date. When this date runs out it does not mean
that the food is dangerous but it may no longer be at its best. So, to enjoy food at its
best, use it before the ‘best before’ date (see Appendix 3 for further information).
• Always store food in accordance with the labelling instructions.
• The fridge should be cleaned with a bactericidal spray and defrosted following the
manufacturer’s instructions. The fridge should be fitted with a thermometer. The
fridge should be capable of storing perishable foods at a temperature of between 0 °C
and 5 °C. Adhere to any recommended storage temperatures marked on food labels
and check and record temperatures of chilled foods regularly and of fridges daily.
• Do not overload the fridge as this will increase the temperature.
• Part-used canned food should be transferred to an airtight container and stored in the
• Raw meat and fish should be kept covered at the bottom of the fridge.
• Raw and cooked food should be stored and prepared separately.
• Packed lunch boxes should be refrigerated if possible. If not, they should always be
stored in a cool place with a cool pack inside. Ensure the child’s name is clearly
marked on the lunch box.
• Do not use any leftover food.
• Insulated cool boxes, or a cool box with cool packs, should be used for carrying food
when taking children on trips or outings.
• Ready to eat foods such as cooked meats, dairy products and pasta dishes provided
by parents and intended to be shared by children should not be accepted as it is not
possible to verify the conditions under which the food has been prepared and stored.
However, foods brought in for snacks such as fruits, vegetables, bread and rolls are
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Staff and parents/carers play an important part in the development of a healthy lifestyle
for children and young people. Young children depend on carers to make healthy
choices for them. As they grow older, children develop independence and can start to
make their own choices so it is essential that they receive healthy and consistent
messages early in life.
• Make mealtimes sociable. Sit with children as a group during meals or snacks, it’s a
nice time to chat and talk about likes and dislikes.
• Children will imitate important people in their life and this applies to eating and
drinking habits. Be a good role model.
• Make mealtimes relaxed and calm by avoiding distractions such as television and
• Encourage children and young people to try all the food offered to them; they will
develop new tastes as they experiment and will get a more balanced diet if they eat a
variety of foods.
• Encourage good table manners as it will lead to pleasant mealtimes and develop selfesteem.
• Be patient. Children need repeated exposure to an unfamiliar food in order to learn to
accept it and eat it. If an unfamiliar food is refused use gentle encouragement but do
not force a child to eat. If, after encouragement, the food is still refused, take the food
away without comment or fuss – it can be offered again at a later date.
• Involve children and young people in choosing and preparing snacks; this may help
develop their interest in different foods.
• Present food in a variety of ways, for example, offer vegetables raw instead of cooked,
cut vegetables into different shapes e.g. carrot sticks or cubes instead of circles.
• Avoid using food as rewards. For example, withholding a dessert until all the
vegetables are eaten may establish a preference for the dessert and a dislike of
• Praise children and young people when they try new foods.
• Whilst encouraging children and young people to enjoy all food, remember they will
have their own likes and dislikes, so respect individual preferences.
Breakfast is a very important meal. Children and young people should be encouraged to
develop the habit of having breakfast every morning. Breakfast provides us with the
energy we need to start the day, as well as essential vitamins and minerals. Eating
breakfast can help with weight control as people who eat breakfast are less likely to
snack on high fat and high sugar foods later in the morning.
Breakfast should be based on starchy foods such as breakfast cereal and bread. Some
healthy breakfast ideas are provided below:
• Choose low sugar breakfast cereals, and preferably those which contain wholegrain.
Some examples of low–medium sugar cereals include: cornflakes, Rice Krispies,
Weetabix, Shreddies or porridge. Serve cereals with semi-skimmed or skimmed milk.
Try adding some fruit as a topping e.g. chopped banana, grapes, berries or raisins.
Do not add sugar.
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• Make toast with wholemeal, granary or brown bread as these are higher in fibre. Use
a small amount of polyunsaturated spread or try topping with jam, marmalade,
banana, or soft-cheese. For a change, try toasting a bread roll, English muffin, bagel
or fruit bread.
• Always have some fruit at breakfast time; fresh, frozen, canned (in juice not syrup) or
dried all count towards the five portions of fruit and vegetables recommended each
day. Wash down breakfast with some fruit juice; this will count as one of the fruit and
vegetable portions and contains vitamin C which will help the body to absorb iron.
• Porridge oats contain vitamins, minerals and fibre. Make porridge with semi-skimmed
or skimmed milk, or water. Try not to add sugar or salt, but top with fruit instead.
• Eggs are versatile at breakfast time and can be boiled, poached or scrambled. Try
adding some mushrooms or grilled tomatoes.
• Try low fat natural yoghurt with added fresh, canned or dried fruit.
Drinks and snacks
Snacks and drinks should be low in fat, sugar and salt and contain fruit and/or
vegetables where possible. Some examples of healthier snacks and drinks which may be
provided are given below. However, remember plain milk and water are the only safe
drinks for teeth.
• Plain water (still or sparkling not flavoured).
• Semi-skimmed, skimmed or other lower fat milks.
• Pure, unsweetened/unsalted fruit/vegetable juices.
• Water and pure fruit juice combinations (one part water to one part juice).
• Sugar-free fruit squash (diluted one part juice to at least eight parts water).
• Flavoured milk and drinking yoghurts which are lower in fat and sugar (e.g. contain
no more than 1.8 g total fat/100 ml, no more than 10 g total sugars/100 ml and no
more than 20 g total sugars/portion size).
• A variety of fresh fruit, including, apples, satsumas, pears, grapes, bananas,
strawberries, peaches, plums, kiwi fruits, melon, pineapple and cherry tomatoes (fruit
prepared into small cubes or slices may encourage consumption).
• Raw vegetables, including, carrots, cucumber, peppers, celery and courgette.
• Lower fat yoghurt or fromage frais (plain or fruit).
• Toast (including wholemeal, granary or brown varieties) with a small amount of
polyunsaturated spread.
• Small sandwiches and filled rolls (with cheese, salad, tuna, thin slices of meat or
• Plain, cheese or potato scones, pancakes, crumpets, breadsticks, crackers, oatcakes
or rice cakes (may be served with a small amount of polyunsaturated spread or soft
• Fruit or yoghurt loaf, plain or fruit muffins.
• Low sugar breakfast cereal.
• Plain popcorn.
• Small servings of homemade pizza.
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Many of the ‘treats’ given to children and young people can be high in fat, sugar and
salt. A treat might be confectionery (chocolate/sweets), biscuits, cakes, doughnuts, icecream, crisps and savoury snacks and fizzy juice. However, these types of foods and
drinks should be kept to a minimum. Treats which are high in sugar should be eaten
only at mealtimes to avoid tooth decay. Consider the appropriateness of the treat (size
and frequency) in line with your healthy eating policy when offering them. Treats should
be given occasionally rather than daily. When providing treats, think about the portion
size given e.g. a mini-sized chocolate bar or only one biscuit is sufficient for children.
For more information on portion sizes see Appendix 1: Portion Sizes.
Eating out
Childcare, including OSC, services will often find themselves out and about during after
school sessions and school holidays. Just as being out and about is seen as the norm, so
should the healthy eating policy and practices that have been embedded.
Consider the following when planning to eat out:
• Ensure that all medically prescribed diets, allergies and any religious and cultural
specifications are appropriately considered in the planning and preparation of foods
and eating out (as per the guidance within this resource).
• Take snacks with you that have been prepared in advance (on site), do not require
refrigeration and can be contained as individual portions.
• Even when going on special outings, ensure that the healthy eating policy and
practice is communicated to parents in advance if they are providing snacks or
packed lunches.
• Ensure that all consumables are stored at the correct temperature (as per the
guidance within this pack).
• The purchase of snacks and/or lunches from food retailers or restaurants should be
considered at the planning stage and options considered in line with the healthy
eating policy.
• If opting to purchase snacks and/or lunches from food retailers or restaurants, ensure
that such purchases follow the healthy eating policy and practices.
Be aware that some of the food choices on offer at some venues will be attractive to
children and could be seen as a treat or a quick, easy option. Visiting venues that offer
unhealthy choices will reduce the impact of your efforts to maintain the healthy eating
policy and deliver consistent messages to both children and parents.
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Different festivals are celebrated throughout the year. Some of these originate from
religious beliefs, while others are based on events from history. The celebration of
festivals is often a child’s first introduction to understanding and appreciating the beliefs
of children from other cultures. They can begin to learn to appreciate, respect and value
the beliefs of their peers.
‘Festival’ derives from ‘feast’ and often a feast can be a delightful introduction to
multicultural awareness. Services should invite parents/carers from different cultural
backgrounds to contribute to an activity involving their own culture, for example, a
baking activity.
Dates of festivals often change from year to year and it would be impossible to
celebrate them all, so be selective and decide which ones are appropriate to your own
service taking into account the needs of the children and their parents. Remember, it is
still a good idea to celebrate a cultural event that may not be represented among the
children, as this may be the only occasion they have to learn about this particular
1st New Year’s Day
6th Epiphany: Three Kings Day (Christian)
7th Rastafarian New Year
25th Burns Night
Chinese New Year (occasionally late January)
3rd Japanese Bean Scattering
14th St Valentine’s Day
Shrove Tuesday (Pancake Day) 40 days before Easter (Christian)
Mardi Gras (same day as Shrove Tuesday)
Jewish New Year for Trees
Chinese Lantern Festival
1st St David’s Day
17th St Patrick’s Day
Purim (Jewish)
Baha’i New Year
Holi (Hindu Festival of Love)
Late March/ Early April
Mothering Sunday
Easter (Christian)
13th April Baisakhi (Sikh New Year)
23rd St George’s Day
Passover (Jewish Festival of Pesach)
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1st May Day
5th Children’s Day (Japanese)
Wesak Buddhist festival, first day of full moon in May
Late May/Early June
Shavuot: Jewish Festival of Weeks
Tuan Yang Chieh: Chinese Dragon Boat Festival
Father’s Day
O’bon (Japanese Buddhist festival)
28th Ganesh-Chaturthi (Hindu)
Raksha Bandhan: Indian celebration of brother or sisterly love
Jewish New Year: Rosh Hashanah
Chinese Moon Festival
Late September/Early October
Sukkot (Jewish)
Yom Kippur: Day of Atonement
Harvest Festival
31st Halloween
Mid October – Mid November
Diwali (Sikh/Hindu Festival of Lights)
5th Guy Fawkes Night
Thanksgiving (American)
30th St Andrew’s Day
6th St Nicholas (European)
Hanukkah (Jewish Festival of Lights)
25th Christmas Day (Christian)
26th Boxing Day (Christian)
Festivals such as Eid-Ul-Fitr Islamic festival of fast breaking linked to Ramadan, occur at
a different time each year. Parents will be able to advise of these dates or contact
Education Resources in your local authority for a current calendar of festivals.
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Chinese New Year
The Chinese New Year is seen as a time to celebrate the end of winter. It is a very
colourful occasion and a time when Chinese people traditionally right their wrongs,
discard negative thoughts, words and deeds and wish each other good luck for the
coming year. It is a very important time for the family. At Chinese New Year, some
Chinese people honour the ancient Chinese customs. Children and young people could
look at the Chinese zodiac calendar and find out which Chinese animal symbol
represents their birth year.
Chinese foods are readily available from supermarkets. Suitable snack foods might
include water chestnuts, beansprouts, lychees, cooked noodles, dates and mandarin
oranges. Children love to experiment with chopsticks but this can become quite a messy
The traditional Chinese New Year cake is ‘Nian Gao’. The children and young people
could help to make this. This is a very sweet cake, serve small slices and keep for after a
meal if possible.
Nian Gao
• 500 g brown sugar
• 500 g glutinous rice flour
1 Boil 1 litre water in a small pan, add sugar and mix well until it becomes syrupy.
2 Pour the rice flour into a bowl, add the syrup a little at a time, stirring the mixture until
3 Pour the mixture into a 15 cm round cake tin.
4 Boil plenty of water in a large pot, place the cake tin on a steaming rack, cover and
steam for an hour until cooked.
5 Cut into slices and eat hot or cold.
Other healthier recipes include Ginger and Spring Onion Noodles. There are a variety of
types of soy sauce including low sodium and those that are suitable for children and
young people with special dietary requirements.
Ginger and Spring Onion Noodles
• 2 spring onions
• Small piece of fresh root ginger (about 2 cm)
• 130 g medium dried egg noodles
• 1 tbsp soy sauce
1 Chop the spring onions finely, removing the tips and bottom of the white bulb.
2 Peel the ginger and finely chop or grate.
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3 Bring a pan of water to the boil, add the noodles and cook as per packet instructions
until they begin to go soft.
4 Drain the noodles, add the spring onions, ginger and soy sauce.
Chinese Dragon Boat Festival
The Dragon Boat Festival is celebrated by racing boats which have been decorated in
the shape of dragons and eating ‘Tzung Tzu’ (rice dumplings). The boat races represent
attempts to rescue the patriotic poet Chu Yuan who drowned on the fifth day of the fifth
lunar month in 277 B.C. Chinese citizens raced to save the poet and pounded drums
and threw bamboo leaves filled with cooked rice into the water. They drummed the
drums to scare the fish away and threw rice to ensure that the fish did not eat the poet,
but the rice instead. The Dragon Boat Festival is a lunar holiday, occurring on the fifth
day of the fifth lunar month.
Some Chinese people will hang herbs on the front door and drink nutritious drinks, all to
protect themselves from evil and disease.
To celebrate the Dragon Boat Festival, you can buy rice dumplings and steam them
within the service. Other activities include:
• Drawing/making dragons and dragon heads.
• Create dragon boats; create a large boat that the children can decorate or make and
decorate small dragon boats from plastic containers.
Chinese Moon Festival
The Chinese Moon Festival celebrates the harvest season and is held on the 15th day of
the eighth month in the Chinese calendar, which is usually around late September or
early October. Chinese families traditionally gather on this day to admire the moon and
eat mooncakes and pomelos under the moon as a family. There are many different
varieties of mooncake (a baked pastry), while a pomelo is a citrus fruit similar to a
grapefruit and sometimes known as a Chinese grapefruit. Other additional activities that
traditionally accompany the Moon Festival include carrying lanterns and dancing
Dragon Dances.
To celebrate this festival, children could make and decorate lanterns using the
traditional gold and red Chinese colours, try out exotic fruits in fruit tasting, make a
dragon kite or dance a Dragon Dance to traditional Chinese music.
Making a Dragon
Each child should decorate a paper plate. String the plates (maximum of 5) together
with knotted string.
• Ball of string
• Paper plates (one per person)
• Paper and glue
• Coloured streamers
• Glitter
• Paints/crayons/coloured pencils and pens
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1 Ask the children to think about what a dragon would look like. What colours would
they be? Would they be fierce or friendly? Discuss.
2 Hand each child a paper plate, suggest or ask for a volunteer to design the dragon
head, while the rest of the children should decorate the body.
3 When they are finished, help them to thread the paper plates together to form a
dragon. They should be joined horizontally at three different points on the outside rim
of each paper plate to form a tube like shape. Tie the three strings together at the
head and tail end of the dragon.
Shrove Tuesday
Shrove Tuesday or ‘Pancake’ day, is the day before Ash Wednesday and marks the start
of Lent, a Christian celebration. The period of Lent, which leads up to Easter is a time
when Christians used to abstain from meat, fat, eggs and dairy products. Shrove
Tuesday was traditionally a time when people used up all the ingredients from their store
cupboards and making pancakes became a popular way of doing this. Pancakes can be
made with many tasty fillings. A basic recipe would be:
• 100 g flour
• Pinch of salt
• 1 egg (or dried egg equivalent)
• 300 ml milk
• Olive oil
1 Sieve flour and salt into bowl.
2 Make a well in the centre and add the egg.
3 Add the milk a little at a time, mixing with a wooden spoon, drawing in all the flour.
4 Beat the batter mixture until smooth.
5 Heat a little olive oil in a heavy-based frying pan until hot. Pour batter into the pan
until the base of the pan has a thin even covering of batter.
6 Place over a moderate heat and cook until the bottom side of the pancake is golden
7 Carefully turn the pancake to cook the other side.
Try fillings such as cheese, tomatoes, mushrooms or other vegetables.
Mardi Gras
Mardi Gras is held on the same day as Shrove Tuesday and is French for ‘Fat Tuesday’.
Again, it refers to using up the foods that would be abstained during Lent which starts
on Ash Wednesday. Popular customs include wearing masks and costumes, taking part
in parades and dancing.
A traditional cake made and eaten at Mardi Gras is the King Cake. This is a type of
sweet bread with an almond filling and is frequently coloured yellow, purple and green,
the colours of Mardi Gras. Other Mardi Gras recipes are Cajun-spiced and include rice
and beans for example jambalaya and gumbo. The following recipe is Red Bean and
Rice Salad and provides eight child portions.
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Red Bean and Rice Salad
• 400 g brown rice
• 1 x 400 g can kidney beans (rinsed and drained)
• 150 g green pepper (finely chopped)
• 100 g mango or peaches (peeled and cubed)
• 1 large red onion (finely chopped)
• 100 g tomatoes (finely chopped)
1 Cook the rice as per packet instructions.
2 In a large bowl, combine the ingredients.
This Muslim festival means ‘festival of fast breaking and happiness forever’ and marks
the end of the fast during Ramadan. During this festival, Muslims fast through daylight
hours by not eating or drinking anything at all. During this period of fasting Muslims are
preparing themselves to face the difficulties of life which lie ahead and the regime is
followed by rich and poor alike. This enforces an important rule of Islam – to give to
charity, ‘Zakat’. A traditional Eid dish is Wedhmi. This can be simply made by the
children with some help from an adult. This is a sweet cake, serve small slices and keep
for after a meal if possible.
Ingredients for pastry
• 100 g plain flour
• Pinch of salt
• 100 g butter or margarine
• Small bowl of water (1–2 tbsp would be plenty)
Ingredients for the filling
• 200 g desiccated coconut (soak in water for 30 minutes)
• 4 tbsp sugar
• ½ tsp cardamom seeds
• ½ tsp cinnamon powder
• Sunflower oil
To make pastry: mix flour and salt, rub in butter or margarine, add water and mix until
stiff dough is formed.
To make the filling
1 In a bowl, mix the soaked desiccated coconut, sugar, cardamom seeds and cinnamon
2 Melt a little oil in a saucepan and gently shallow fry the ingredients.
3 Divide the dough into fairly large pieces, roll out, fill with the coconut mixture and
deep fry in oil.
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Holi is an Indian spring festival when thanks are given for a good harvest. Since India is
mainly an agricultural society it is essential to most Indian families that they have a good
harvest. As well as a religious and social occasion, Holi has cleansing elements too.
People in India traditionally ‘spring clean’ at this time.
At Holi, the coconut is thrown on bonfires to symbolise triumph over evil. As a result
coconuts often feature in religious ceremonies. Children could be given the opportunity
to investigate a coconut and be told about its uses. They could taste some of the juice
and flesh and decorate whole coconuts for display. Sweets are traditionally eaten at
Asian festivals and a popular sweet at Holi is Gulab Jaman, although it is high in fat and
sugar. Here is a healthier alternative. The children could help to prepare this.
Carrot Pudding
• 400 g carrots (grated)
• 1.2 litres semi-skimmed milk
• 4 tbsp sugar
• 4 tbsp basmati rice
1 Mix all the ingredients together in a pan and bring to the boil.
2 Simmer for 20 minutes or until the mixture becomes a ‘pudding’ consistency.
3 Top with raisins or almonds if desired.
The Christian festival of Easter is traditionally a time for Easter eggs, but there are other
foods which have come to symbolise Easter. There are many variations on the ‘bird’s
nest’, including melted chocolate through shredded wheat topped with mini chocolate
eggs, but perhaps a healthier option would be this recipe:
Easter ‘bird’s nest’
• Raw carrot (grated)
• Cherry tomatoes
• Lemon juice
• Raisins or sultanas
• Grapes
• Button mushrooms
1 Soak raw carrot in lemon juice for a couple of minutes and shape into a nest.
2 Use other ingredients to represent the eggs in the nest.
Hot cross buns are also traditionally eaten at this time of year.
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Baisakhi, the Sikh New Year, was originally a harvest festival in the Punjab region of
India. This festival celebrated the founding of the Sikh community, the Khalsa, in 1699
by the 10th Sikh Guru, Guru Gobind Singh. It also marks the beginning of a new solar
year, and new harvest season. Many recipes to celebrate Baisakhi can be hot and spicy
so try the following Mango Lassi instead or learn the bhangra dance.
Mango Lassi
• 200 ml whole milk
• 400 ml natural unsweetened yoghurt
• 400 ml mango pulp
• 4 tsp caster sugar
Blend the ingredients together and serve with ice.
This is a time for the pumpkin – for making lanterns or for pumpkin soup or pumpkin
pie. There are many recipes around for each, but here is a very simple one for Pumpkin
Pumpkin Soup
• 1 pumpkin (approx. 1.4 kg)
• 2 small onions
• 100 ml vegetable stock
• 3 tbsp flour
• 500 ml milk
• A little cheese (grated)
• ½ –1 small carton of cream
• 1 tbsp sunflower oil
1 Lightly fry pumpkin and onions in oil for 5 minutes – do not colour.
2 Add stock, cover and simmer for an hour or until vegetables are soft, adding extra
water as necessary.
3 Sieve or puree soup and return to pan.
4 Blend flour with a little of the milk to a smooth cream.
5 Add the rest of the milk to the soup and reheat.
6.Stir a little of the soup into the blended flour and milk and return this mixture to
the pan.
7 Bring to the boil, stirring until it thickens and cook for a further 2–3 minutes.
8 Stir in cheese, cream and season.
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Diwali, also known as the Festival of Lights, is a five day festival celebrated across the
world by Hindus and Sikhs. Traditionally during Diwali, people light small clay lamps
(Diya) to signify a triumph of good over evil. In many countries, Diwali is an official
holiday. Diwali celebrants wear new clothes, send greeting cards and share special foods
with their family and friends. Traditional foods include Dhokla (similar to pakora), but
Dhokla may be too complicated to make within the premises. Other activities could
include learning the Dandia Raas or Garba, which are traditional dances, or children
could make Diwali greeting cards.
Thanksgiving is celebrated in the United States of America on the fourth Thursday in
November. Thanksgiving was first celebrated in 1621, but has been an annual
celebration since 1863, to thank God for helping the Pilgrims of Plymouth Colony
survive the brutal winter in Massachusetts in December 1620. At the first Thanksgiving
feast, the pilgrims ate food they grew and harvested themselves – turkey, pumpkins,
corn, sweet potatoes and cranberries. The following is a fun and fruity activity for all
children to celebrate Thanksgiving.
Fruit Cockerel/Turkey
• Pear (for head)
• Melon (for body)
• Red, yellow, orange peppers (for snood,
feet and side feathers)
• Raisins (for eyes)
• Cubed fruit such as pineapple, apple,
peach/nectarine, plum and grapes (for
tail feathers)
• Bamboo skewers
• Toothpicks
1 Stabilise the melon body by cutting a
shallow slice off the rind to form a flat
base. Using a toothpick, attach a pear
head to the melon. Decorate the pear to
resemble a turkey face.
2 Use the red pepper to form the
cockerel’s comb.
3 Cut red pepper feet and set them in
4 For tail feathers, allow the children to decorate the skewers with cubed fruit. An adult
should then insert the skewers into the melon and pin the side feathers, made of
peppers, in place with toothpicks.
This activity and other fruit animal activities will require adult supervision. However, fruit
animals are easy and fun to make and can be used as an activity to celebrate many
festivals – all you need is a little imagination.
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Another harvest recipe is Lentil and Vegetable Stew.
Lentil and Vegetable Stew
• 200 g lentils
• 2 potatoes (diced)
• 3 courgettes (sliced)
• 2 leeks (trimmed and sliced)
• 1 stalk celery (sliced)
• Juice of 1 lemon
• 1 onion (finely diced)
• Olive oil for frying
• 2 cloves garlic (finely chopped)
• 2 tbsp chopped parsley
1 Cook the lentils as per packet instructions.
2 Add the potatoes, courgettes, leeks and celery. Simmer until vegetables are tender.
3 Fry the onion and garlic, add to the rest of vegetables.
4 Add the lemon juice and parsley, simmer for a few moments and serve with rice or
crusty bread.
St Andrew’s Day
St Andrew is the Patron Saint of Scotland as well as Ukraine, Russia and Romania. He
was a fisherman who became one of the 12 disciples. St Andrew's Day is celebrated
by Scots around the world on the 30th November. For more informaation on the story of
St Andrew visit Stovies and
Scotch broth are two examples of Scottish recipes that could be made to celebrate
St Andrew’s Day.
• 6 large baking potatoes (peeled and cubed to 2.5 cm/1 inch)
• 240 ml meat stock
• 25 g butter
• 1 large onion (roughly chopped)
• 350 g cooked lamb (diced)
1 Place the potatoes and stock in a saucepan, bring to the boil, then reduce heat,
partially cover and simmer for 25–30 minutes or until the potatoes are tender.
2 Meanwhile, melt butter in a frying pan over medium high heat. Add the onion and
sauté gently until soft and transparent.
3 When potatoes are cooked, add the cooked onions and lamb. Mix well and continue
to cook for 10 minutes, or until thoroughly heated through. Serve hot.
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Scotch Broth
• 25 g pearl barley
• 1.2 litres lamb stock
• 75 g leeks, sliced
• 225 g carrot, diced
• 225 g turnip, diced
• 50 g cabbage, shredded
1 Place the barley in a pan of cold water, bring to the boil then drain.
2 Return the barley to the pan together with the stock. Bring to the boil then simmer for
1 hour.
3 Add the leeks, carrot and turnip and continue to simmer for a further hour. After this
time, add the cabbage and cook for a further 20 minutes. Serve hot.
This is probably the most celebrated time in many childcare settings and there are
literally hundreds of food ideas. The children could make mincemeat pies using readymade pastry. They could also make biscuits in Christmas shapes. A very simple recipe
for Oatmeal Biscuits is:
Oatmeal Biscuits
• 100 g sunflower margarine
• 50 g caster sugar
• 100 g porridge oats
• 100 g plain wheat flour
1 Cream the margarine and sugar. Add the porridge oats and flour.
2 Roll the mixture into small balls and flatten slightly.
3 Put in oven at 180 °C/350 °F/Gas 5 for 15 minutes.
These biscuits could be eaten after a meal or sent home with the children.
Winter Fruit Salad
A Winter Fruit Salad is a delicious, quick and easy snack for the children to make.
• 6 tangerines
• 4 ripe pears
• 3 bananas
Squeeze the juice and flesh from the tangerines. Chop the pears and bananas into the
juice and mix together.
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Food for parties
A party is a time of great excitement and is the celebration of a happy occasion.
Services often include parties and special celebrations in the activities planned for the
children and young people. When planning for such activities and considering food
options, the healthy eating policy should be maintained. The quality of food at a party
should be as high as it would normally be at any other time.
As per the healthy eating policy, include children and young people in the planning of
the activities, this promotes ownership. Staff should use this opportunity to encourage
children and young people to continue to follow the healthy eating patterns already in
place. When their suggestions do not fit with the healthy eating policy, do not focus
discussion on not being able to have certain foods but rather offer enticing alternatives.
Always ensure that all medically prescribed diets, allergies and any cultural or religious
specifications are appropriately considered in the planning and preparation of foods (as
per the guidance within this pack).
If parents and carers are being asked to contribute donations of food for the party or
special celebration, produce a list of required items and ask them to indicate what they
will donate; share with parents that the children and young people have been involved
in the planning and have come up with the list. Remember ready to eat foods such as
cooked meats, dairy products and pasta dishes provided by parents and intended to be
shared should not be accepted as it is not possible to verify the conditions under which
the food was prepared or stored.
To ensure that the points above on medically prescribed diets, allergies and any religious
or cultural specifications are appropriately considered, all donations must be shop
bought (not homemade) in the original packaging that details full ingredients. As
parents could be purchasing and transporting items over a period of time do not include
items of food that cannot be stored safely at room temperature.
It is important to explain to parents that the service has adopted a healthy eating policy.
Instead of sweets, encourage parents to send fruit treats in for the children.
Remember it is important that the special occasion should look special. Use visual tricks
and keep to the healthy ingredients. Use strips of coloured crepe paper, streamers and
fancy drinking straws. Children could design their own placemats in advance. Food can
be attractively presented with colours matching paper plates.
Birthdays are often celebrated in OSC services, which means that in a large service,
there could be several birthdays in one week. Traditionally parents may provide a
birthday cake for their child to share. Many cakes are high in sugar and fat. As a
healthier alternative, staff could arrange for the child celebrating a birthday to take a
small cake home. Birthdays can be celebrated in other (age appropriate) ways, for
example, receiving a card, playing party games, organising a disco.
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There are many healthy foods available from shops that are ideal for parties. Instead of
traditional party foods that are high in fat and sugar, offer these healthy options.
• Wholemeal, granary or multigrain bread
• Malted, brown or white bread
• Bagels, muffins or croissants
• Tortilla wraps or pitta pockets
• Crusty bread with sesame or poppy seeds
• Finger rolls or baps
Sandwich Fillings
Make interesting sandwiches using bread cut into various shapes. Try different fillings.
Here are a few suggestions:
• Canned fish such as tuna, mackerel, pilchards and sardines
• Grated cheese with cucumber or pickle
• Roast beef and tomato slices
• Cottage or cream cheese with pineapple
• Thinly sliced ham and mustard
• Hummus with grated carrot
• Wafer thin turkey and coleslaw
• Mashed banana
• Chopped chicken in low fat mayonnaise with mango or celery
Finger Foods
Children love finger foods, try these served with healthy dips:
• Breadsticks
• Pitta bread strips
• Cheese sticks
• Carrot batons
• Celery sticks
• Courgette sticks
• Cucumber sticks
• Pepper batons
Accompanying dips could include:
• Fish paté – this is quick and easy, just mix some mackerel or tuna with some cottage
cheese, cream cheese or low fat natural yoghurt
• Reduced fat soft cheese
• Cooked carrot mashed with orange juice
• Avocado
• Low fat mayonnaise mixed with a little tomato ketchup
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Sweet Dishes
• Banana bread or carrot cake (some cakes contain nuts, which may cause an adverse
reaction in a small number of children)
• Frozen yoghurt lollipops (freeze yoghurt with fruit in plastic cups with a spatula in each
• Dried fruit or dried fruit salad
• Serve a fruit salad
• Sugar free jellies, frozen bananas on a stick, melon balls
• Fruit kebabs
Party time may be a time when you decide to offer drinks other than milk or water.
Choose from:
• No added sugar diluted fruit juice – orange, apple, grapefruit, pineapple or mixed
• Punch (diluted concentrated pear juice with fresh lemon – gives a lemonade-like
• Fruit smoothies, using fruit in natural juices (e.g. canned peaches or pears) or fresh
fruit in season (such as raspberries or strawberries)
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Preparing healthy food is a great way to involve children and young people in healthy
eating. Involving them in choosing and preparing snacks will help develop their interest
in different foods.
The following section has some healthy recipes that can be used as food activities in
childcare services. Some involve cooking while others are ideas for cold dishes, such as
simple salads, recognising that kitchen provision differs between services. The recipes
below have been adapted from the Hungry for Health pack developed by the Focus on
Food Campaign in partnership with North Lanarkshire Council.
Apple, Orange and Celery Salad
(Serves 4)
• 1 red-skinned eating apple e.g. Pink Lady
• 1 green-skinned eating apple e.g. Granny Smith
• 3 celery sticks (washed)
• 1 spring onion
• Juice of 1 lemon
• 1 large orange or 2 satsumas or tangerines
• 2 tbsp salad cream
1 Cut the apples in half from stalk to base. Use a melon baller to scoop out the cores.
Slice the apple thinly or cut into cubes, and put it into the mixing bowl with half the
juice of the lemon.
2 Cut the celery in 1 cm pieces. Divide the orange or satsumas into segments, and cut
the large segments into pieces. Slice the onion, if using. Add the segments and the
onion to the mixing bowl.
3 In the small bowl, combine the salad cream and the remaining lemon juice. Mix well
and pour the mixture over the apple, orange and celery. Toss lightly to coat.
4 Pile into a serving bowl.
Tomato and Basil Salad
(Serves 4–6)
• 6 tomatoes (cut into wedges)
• 50 g black olives (pitted and sliced)
• 1 medium red onion (peeled and thinly sliced)
• Fresh basil leaves
For the dressing
• 4 tbsp fresh basil leaves
• 1 garlic clove (crushed)
• 2 tbsp Parmesan cheese (freshly grated)
• 4 tbsp olive oil
• 2 tbsp lemon juice
• Freshly ground black pepper
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1 Arrange all the prepared salad ingredients in a large bowl or on a large plate.
2 To make the dressing, whisk the basil leaves, garlic, Parmesan cheese, olive oil, lemon
juice and pepper in a small bowl until well blended.
3 Pour the dressing over the salad ingredients.
Kaleidoscope Couscous
(Serves 4–6)
• 200 g couscous
• 250 ml boiling water
• Ground black pepper, to taste
• ¼ red pepper (deseeded and chopped)
• ¼ green pepper (deseeded and chopped)
• ¼ yellow or orange pepper (deseeded and chopped)
• 4 spring onions (finely sliced)
• 4 tbsp sweetcorn niblets (canned)
• 3–4 cherry tomatoes (quartered)
• 1 tbsp mint (finely chopped)
• 1 tbsp olive oil
1 Place the couscous in a mixing bowl. Pour the boiling water onto the couscous and
quickly stir the couscous with a fork. Season with pepper. Cover the bowl with a plate
and set it aside for 10–15 minutes.
2 Remove the plate. Using the fork, separate the grains and allow the couscous to cool.
3 When the couscous is cold, stir in the olive oil, the prepared vegetables and the mint
and spoon into a serving bowl.
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Big Snack Bruschetta (or French Bread Pizza)
(Serves 2–4)
Bruschetta is a toasted bread snack. Crusty bread is toasted and flavoured with garlic,
drizzled with olive oil and piled with tomato.
• 1 slice of ciabatta or French bread
• 1 garlic clove (sliced in half)
• 1 dessertspoon olive oil
• 1 or 2 tomatoes (finely chopped)
• 25 g cheese (grated)
• Fresh basil leaves to garnish (optional)
Choose from one or two of the ingredients below to add to the tomato topping:
• 1 tbsp green or red pepper (finely chopped)
• 1 tbsp canned sweetcorn
• 1 tbsp cooked ham (finely chopped)
• 1 tbsp pitted olives (sliced)
• 1 spring onion (trimmed and finely chopped)
1 Lightly toast the bread on both sides. Rub both sides of the bread with the garlic clove
halves and then place the slices of bread on the baking tray.
2 Heat the oven to 200 ºC/400 ºF/Gas 6.
3 With a teaspoon, drizzle a little olive oil on to the bread.
4 Arrange the chopped tomato and one or two of the optional ingredients on top of the
bread. Sprinkle with cheese.
Honeyed Vegetable Kebabs
(Serves 6)
For the kebabs
• 12 small new potatoes (boiled and cooled)
• 2 courgettes (thickly sliced)
• 1 red pepper (deseeded and cut into squares)
• 1 yellow pepper (deseeded and cut into squares)
• 1 red onion (peeled, quartered and split into layers)
For the marinade
• 2 tbsp olive oil
• 2 tbsp clear honey
• 1 garlic clove (peeled and crushed)
• Juice and zest of 1 lemon
• 1 tbsp whole grain mustard
• Freshly ground black pepper
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For herb dressing
• 5 tbsp mixture of fresh chopped mint, coriander and basil
• 200 ml crème fraìche
To serve
• 6 pitta breads
• 6 tablespoons grated Parmesan cheese
1 Whisk the marinade ingredients together in a mixing bowl. Prepare the vegetables
and add them to the marinade and toss them gently to coat.
2 Carefully thread the vegetables on to the skewers, reserving the remaining marinade.
3 Split the pitta breads, brush the inside surfaces with the remaining marinade and
sprinkle with Parmesan cheese.
4 Cook the kebabs either over hot barbecue coals, under the grill or bake at 200 ºC/
400 ºF/Gas 6 until they are evenly golden. Meanwhile, lightly toast the pittas on both
sides on the edge of the barbecue or under the grill
5 To make the dressing, stir the herbs into the crème fraîche. Cover and refrigerate.
6 Remove the vegetables from the skewers and gently spoon them into the pittas. Serve
the kebabs with a generous helping of herb dressing spooned over the top.
Tuscan Tomato Soup with Beans
(Serves 4–6)
• 2 tbsp olive oil
• 1 onion (finely chopped)
• 2 celery sticks (chopped)
• 2 cloves garlic (finely chopped)
• 1 litre vegetable or chicken stock
• 2 x 410 g can cannellini beans (drained and rinsed)
• 1 x 400 g can chopped tomatoes
• 2 tbsp chopped parsley
• Ground black pepper
1 Heat the oil in a large pan, then add the onion and celery and fry for 5-7 minutes
until they have softened.
2 Add the garlic and stock and bring to the boil.
3 Add the beans, tomatoes and seasoning. Simmer for 15 minutes or until the
vegetables are tender.
4 Add the parsley and serve piping hot with warm crusty bread.
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Cheesy Seedy Stuffed Courgettes
(Serves 6)
• 2 tbsp sunflower oil
• 2 onions (sliced)
• 3 courgettes (trimmed and halved lengthways)
• 100 g Feta cheese (crumbled)
• 3 tsp sunflower seeds (roughly chopped)
• 3 tbsp fresh parsley (roughly chopped)
• 3 tbsp Cheddar cheese (grated)
1 Pre-heat the oven to 200 ºC/400 ºF/Gas 6.
2 Place the oil in a frying pan and when warm, add sliced onions. Stir then cover with a
lid to sweat for 8–10 minutes or until softened. Allow to cool.
3 Meanwhile, place the courgettes in a pan of boiling water to cook for 3 minutes.
Remove from the pan and place in cold water to refresh. Drain the courgettes.
4 Using a spoon, carefully scoop out the seeds to form a boat shape. Place the
courgette flesh and seeds in a bowl with the chopped onions, add the chopped
sunflower seeds and mix. Add some of the mixture to the cavity. Sprinkle over the
crumbled Feta.
5 In a clean bowl mix the grated Cheddar cheese and parsley. Sprinkle it over each filled
courgette half.
6 Bake for 12–15 minutes until the cheese has melted and the tops are golden-brown.
7 Serve with a fresh salad.
Sunset Pasta Salad
• 100 g small dried pasta shapes
• 3 tbsp sunflower oil
• 1 dessertspoon red or white wine vinegar
• 1 dessertspoon tomato ketchup
• 1 small carrot (peeled and grated)
• ½ red pepper (deseeded, sliced and diced)
• ½ small cucumber (cut into sticks and diced)
• 6 cherry tomatoes (quartered)
• 100 g Cheddar cheese (diced)
1 Cook the pasta in fast-boiling water until just tender
but with ‘bite’ (al dente). Mix the oil, ketchup and
vinegar in a bowl.
2 Prepare the vegetables and add them all, except the tomatoes, to the sunflower oil,
ketchup and vinegar. Add the cheese and toss the ingredients together.
3 Drain the pasta and plunge it into cold water. Drain it again and pat dry with
kitchen roll.
4 Add the pasta to the vegetable and cheese mixture, and stir to combine.
5 Turn the pasta into a serving dish and decorate with the quartered cherry tomatoes.
Serve immediately.
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Oat and Apple ‘Puffins’
• 50 g medium oats
• 100 g white self-raising flour
• 100 g wholemeal self-raising flour
• 1 tsp baking powder
• 1 tsp ground cinnamon
• 50 g light brown sugar
• 3 eating apples (cored and grated)
• 50 g sultanas (or stoned dates - chopped)
• 50 g butter (melted)
• 150 ml fromage frais
• 150 ml whole (full-fat) milk
• 1 medium-sized egg
• 45 ml runny honey
• Extra oatmeal or rolled porridge oats for sprinkling
1 Heat the oven to 200 ºC/400 ºF/Gas 6. Put all the dry ingredients, including the
sultanas, into a mixing bowl and stir to combine them.
2 In a separate bowl, thoroughly mix the grated apple, melted butter, fromage frais,
milk, honey and egg with a fork.
3 Make a well in the dry ingredients. Pour all the liquid into the well and quickly and
lightly mix until all the ingredients are just combined (do not over mix or the cooked
muffins will go hard).
4 Use a dessertspoon to fill the muffin cases. Sprinkle each ‘puffin’ with a little extra
oatmeal or rolled (porridge) oats. Bake in the oven for 15–20 minutes until well-risen,
golden-brown and firm to the touch.
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Oral health is an important part of health and wellbeing. It is essential to general health
because it enables people to eat, speak, smile and socialise without pain, discomfort or
embarrassment. The messages found in this section should be incorporated where
possible when developing policies, designing activities, or delivering awareness sessions.
Tooth decay is the most common childhood disease, but it is also largely preventable.
In 2009, 43% of primary seven children in Lanarkshire had experienced tooth decay
(Merrett et al 2009).
Although tooth decay can affect any child, those in the following groups are most likely
to be affected:
• Children living in more deprived areas
• Children from low income families
• Children from ethnic minority backgrounds
In Lanarkshire, approximately 1100 children every year receive a general anaesthetic
(gas) for tooth extraction. Tooth decay is the single most common reason for admitting
a child to hospital in Lanarkshire for a general anaesthetic. As general anaesthetics
carry some degree of risk, it is extremely important to try to reduce the numbers of
children receiving them.
Why do teeth decay?
Tooth decay occurs because sugars from the diet mix with plaque bacteria (plaque is a
sticky substance on the surface of the teeth) to form an acid. This rots the tooth surface.
If sugar is eaten often during the day, a greater amount of acid is produced and the
tooth will decay. The tooth will have to be checked by a dentist who will decide whether
to fill the cavity or remove the decayed tooth (frequently under general anaesthetic in
Prevention of tooth decay
1. Reduce the amount and frequency of sugary foods and drinks consumed and, if
possible, restrict to mealtimes only
Foods and drinks containing sugar should be consumed on no more than four occasions
in one day. If sugary foods and drinks are kept to mealtimes, the time the teeth are
exposed to an acid attack is reduced. The best advice is to reduce the amount of sugar
consumed and the frequency of sugar intakes and limit sugar-containing foods and
drinks to mealtimes. Mealtimes are regarded as the safest time to consume sugary
foods and drinks because the increased amount of saliva in the mouth at this time
quickly neutralises the acid produced by plaque.
When children are snacking between meals, ensure these snacks are healthy and tooth
friendly (see earlier section on drinks and snacks). Plain milk and water are the only safe
drinks for teeth, and therefore the only drinks that should be given between meals. Due
to the sugar content and acidity levels, fruit juice and fruit smoothies can harm teeth
and therefore are best kept to mealtimes.
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Parents should be advised to look out for the hidden sugars in foods and drinks. Sugar
can be found in many foods under a variety of names. The most common added sugars
are sucrose, glucose, maltose and fructose. In fact, many sugars end with –ose. Look for
them on the ingredients list.
2. Brush teeth for at least two minutes twice a day with fluoride toothpaste
It is recommended that teeth should be brushed as soon as the first tooth appears in the
mouth, using a soft baby toothbrush and a smear of fluoride toothpaste. For children
older than three years a pea-sized amount of toothpaste containing not less than 1000
ppm (parts per million) fluoride should be used. For children older than seven years, a
pea-sized amount of toothpaste containing between 1350–1500 ppm (parts per million)
fluoride should be used. Regular brushing in the morning and last thing at night is a
good habit to establish from an early age. There is no need to use water during and
after brushing. Spit out the extra toothpaste but don’t rinse the mouth – ‘spit, don’t
rinse’. Always check the toothpaste contains an appropriate concentration of fluoride.
Fluoride helps to strengthen the outer layer of the tooth (enamel) and make it more
resistant to acid. It also helps to repair the tooth surface, but this will only work if the
cavity or hole in the tooth is very small. It is important that parents/carers help children
to brush their teeth until the child reaches the age of seven. Until then, most children
are not able to brush properly.
3. Register with a dentist and attend regularly for check-ups
It is important to promote regular dental visits from an early age.
Regular dental visits ensure that:
• parents receive appropriate advice on healthy eating,
• any signs of dental disease are recognised early, and
• the child gets used to visiting the dental surgery.
The best way to find a new dentist is to go to one that is recommended by a friend,
neighbour or a member of your family. A list of local dentists can be found in the Yellow
Pages, or via NHS Lanarkshire website:
Alternatively, you can contact the NHS Lanarkshire General Enquiry Line on 08453 130
130 for help to locate a NHS dentist in your local area.
Children and young people needing regular medicines should be under the regular care
of a dentist, who will offer preventive advice and treatments as necessary. Parents/carers
should always request a sugar-free type. Almost all medicines supplied today are
available in a sugar-free form. Children and young people on long-term medication who
are prescribed medicines with sugar in them can suffer very high levels of tooth decay.
Using a narrow straw can minimise the damage to teeth.
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The importance of physical activity in children and young people
There’s more to healthy living than food! It is important that healthy eating and active
living are promoted. Research indicates that active children and young people are more
likely to become active adults.
Young children are naturally active and enjoy physical activity through play; this
enthusiasm needs to be encouraged.
Physical activity is paramount for healthy growth. Research suggests it helps prevent
weight gain, promotes positive mental health and helps support social development. It is
essential to embed positive attitudes, skills and behaviours for lifelong physical activity
and health. Many children and young people are spending more and more of their time
in less active pursuits such as watching TV or playing computer and video games. These
particular pastimes can contribute to the development of childhood and adult obesity,
associated heart disease, teenage and adult depression and diabetes.
The UK Physical Activity Guidelines are currently being reviewed and although the
recommendations from the Physical Activity Task Force in Let’s Make Scotland More
Active (2003) are still relevant, the new guidelines Making the Case for UK Physical
Activity Guidelines (2009) are expected to go further by differentiating the appropriate
amount and type of physical activity for different age groups: infants, pre-school
children, children and young people. The recommendations for children and young
people are outlined below. See the Nutrition and Oral Health - Strategy into Practice in
the Early Years resource for information on infants and pre-school children.
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Children and Young People
Children and young people should be participating in daily physical activity. The activity
should be of at least moderate intensity and children and young people should
accumulate at least 60 minutes of activity on most days of the week. As part of this daily
activity, vigorous intensity activity should take place at least three times per week. In
addition, it is recommended that activity promoting muscle and bone development and
flexibility is done at least three times a week. Any whole body, weight bearing activity will
help muscle and bone development and flexibility. Examples include sports, games, play,
dance and gymnastics. Any activity above these recommendations, up to several hours
per day, brings even greater health benefit to participants.
If children and young people are particularly inactive, a progressive increase in activity
to eventually meet these recommendations is appropriate, starting at 30 minutes
per day.
Sedentary behaviours should be discouraged. The amount of time on sedentary
activities such as time spent watching TV or playing video games should be limited to no
longer than one hour at a time.
Encouraging Physical Activity
There are a range of activities involving exercise, sports, outdoor activities, games, play
and dance that can be implemented to enhance and encourage natural physical activity
as part of a daily routine.
Playing with peers or walking with an adult to school or the shops are examples of
integrating physical activity into everyday life. Being active is important and can be as
simple as playing rounders, basketball, dodgeball, football, netball, relay, tig, dancing,
playing with a frisbee, parachute games or taking part in treasure hunts and nature
trails. Other simple ways a group can be active together include cycling, swimming,
trampolining, ice skating, gardening or flying a kite.
Curriculum for Excellence
As part of Curriculum for Excellence (CfE), schools are expected to work towards
providing two hours of good quality physical education for each child every week. The
Concordat with local government means that authorities and schools can decide the
best way of achieving the experiences and outcomes in a way that meets local needs
and circumstances.
OSC services can ensure that children and young people are more active by
contributing to the amount of physical activity they participate in daily, helping to
accumulate at least 60 minutes of activity. Active Schools and Active Schools Coordinators can support any non-curricular physical activity and this includes activities
carried out in OSC.
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Curriculum for Excellence
Curriculum for Excellence (CfE) provides a framework for education for children and
young people from 3-18 years old. The role of OSC services is to support the child’s
learning and this can be achieved by complementing the learning within the school
This resource is designed to help staff support the child’s learning through a number of
experiences and outcomes within the curriculum. It aims to contribute to the
development of children and young people as successful learners, confident individuals,
responsible citizens and effective contributors: the four capacities of CfE. In order to
achieve these capacities, Learning and Teaching Scotland has established seven
principles of curriculum design: Challenge and Enjoyment; Breadth; Progression; Depth;
Personalisation and Choice; Coherence; and Relevance.
The following diagram shows the capacities and the linked overarching aims from the
Health and Wellbeing indicators.
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Capacities of the Curriculum
successful learners
confident individuals
> enthusiasm and motivation for learning
> determination to reach high standards of
> openness to new thinking and ideas
> self-respect
> a sense of physical, mental and emotional
> secure values and beliefs
> ambition
and able to
> use literacy, communication and numeracy skills
> use technology for learning
> think creatively and independently
> learn independently and as part of a group
> make reasoned evaluations
> link and apply different kinds of learning in new
and able to
> relate to others and manage themselves
> pursue a healthy and active lifestyle
> be self-aware
> develop and communicate their own beliefs
and view of the world
> live as independently as they can
> assess risk and take informed decisions
> achieve success in different areas of activity
To enable all young people to become:
responsible citizens
effective contributors
> an enterprising attitude
> resilience
> self-reliance
> respect for others
> commitment to participate responsibly in
political, economic, social and cultural life
and able to
> communicate in different ways and in different
> work in partnership and in teams
> take the initiative and lead
> apply critical thinking in new contexts
> create and develop
> solve problems
and able to
> develop knowledge and understanding of the
world and Scotland’s place in it
> understand different beliefs and cultures
> make informed choices and decisions
> evaluate environmental, scientific and
technological issues
> develop informed, ethical views of complex
Health and Wellbeing is only one of the curriculum areas within CfE. However,
establishments will have the freedom to address Health and Wellbeing within the other
seven curriculum areas. These are: Sciences, Languages, Numeracy and Mathematics,
Expressive Arts, Social Studies, Technologies, and Religious and Moral Education.
The suggested learning contexts on the following pages highlight the cross-curricular
links that could be explored under each of the eight curriculum areas. Each
demonstrates several of the Health and Wellbeing experiences and outcomes from one
of the five levels (Early, First, Second, Third and Fourth and Senior Phase) and under the
following three broad headings of Physical Play, Nutrition and Oral Health. Although
these activities have been linked to only one of the levels, all can be linked to the
curriculum across the five levels. For more information on the CfE, go to the Learning
and Teaching Scotland website.
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Suggested Learning Context (Early Years Level): Physical Play
Area of Curriculum
Health and Wellbeing
Area of Curriculum
Numeracy and Mathematics
CfE Experience(s)/Outcome(s)
In everyday activity and play, I explore and
make choices to develop my learning and
interests. I am encouraged to use and
share my experiences.
HWB 0-19a
I am developing my movement skills
through practice and energetic play.
HWB 0-22a
I am enjoying daily opportunities to
participate in different kinds of energetic
play, both outdoors and indoors.
HWB 0-25a
CfE Experience(s)/Outcome(s)
I am aware of how routines and events in
my world link with times and seasons, and
have explored ways to record and display
these using clocks, calendars and other
MNU 0-10a
In movement, games, and using
technology I can use simple directions and
describe positions.
MNU 0-17a
Area of Curriculum
Languages (Literacy and English)
Area of Curriculum
Social Studies
CfE Experience(s)/Outcome(s)
I listen or watch for useful or interesting
information and I use this to make
choices or learn new things.
LIT 0-04a
As I listen and take part in conversations
and discussions, I discover new words and
phrases which I use to help me express
my ideas, thoughts and feelings.
LIT 0-10a
CfE Experience(s)/Outcome(s)
I make decisions and take responsibility in
my everyday experiences and play,
showing consideration for others.
SOC 0-17a
Within my everyday experiences and play,
I make choices about where I work, how I
work and who I work with.
SOC 0-18a
Suggested Activities:
Walking, running, rounders, basketball, netball, dodgeball, football, relay games, rip tig,
tunnel tig, high five tig, topsy turvey (cones), fitness circuits, Streetdance, Hip Hop, Glee
club (drama, dance and singing), scavenger hunts, parachute games, playground
games, obstacle courses, orienteering, nature trails, circus skills, Zumba, walk to service
and visits to local park/shops/library.
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Suggested Learning Context (First Level): Preparing a Healthy Snack
Area of Curriculum
Health and Wellbeing
Area of Curriculum
Numeracy and Mathematics
CfE Experience(s)/Outcome(s)
By investigating the range of foods
available I can discuss how they
contribute to a healthy diet.
HWB 1-30a
I experience a sense of enjoyment and
achievement when preparing simple
healthy foods and drinks.
HWB 1-30b
CfE Experience(s)/Outcome(s)
Through exploring how groups of items
can be shared equally, I can find a
fraction of an amount by applying my
knowledge of division.
MNU 1-07b
I can estimate how long or heavy an
object is, or what amount it holds, using
everyday things as a guide, then measure
or weigh it using appropriate instruments
and units.
MNU 1-11a
Area of Curriculum
Languages (Literacy and English)
Area of Curriculum
Social Studies
CfE Experience(s)/Outcome(s)
When I engage with others, I know when
and how to listen, when to talk, how
much to say, when to ask questions and
how to respond with respect.
LIT 1-02a
As I listen or watch, I can identify and
discuss the purpose, key words and main
ideas of the text, and use this information
for a specific purpose.
LIT 1-04a
CfE Experience(s)/Outcome(s)
I have participated in decision making and
have considered the different options
available in order to make decisions.
SOC 1-18a
I have developed an understanding of the
importance of local organisations in
providing for the needs of my local
SOC 1-20a
Suggested Activities:
Try the healthy eating activities in the pack, menu design, hygiene discussion and
practice in preparing snacks, run a healthy tuck shop, source and use a local food coop, become a Fair Trade service, shop in local shops for snacks, use ICT to shop online,
think about the advertising and marketing of food and drink to children and young
Strategy into Practice for Childcare Providers
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Suggested Learning Context (Second Level): Drama - visit to the dentist
Area of Curriculum
Health and Wellbeing
Area of Curriculum
CfE Experience(s)/Outcome(s)
I am developing my understanding of the
human body and can use this knowledge
to maintain and improve my wellbeing
and health.
HWB 2-15a
By applying my knowledge and
understanding of current healthy eating
advice I can contribute to a healthy eating
HWB 2-30a
CfE Experience(s)/Outcome(s)
By investigating some body systems and
potential problems which they may
develop, I can make informed decisions to
help me to maintain my health and
SCN 2-12a
I have contributed to investigations into
the role of microorganisms in producing
and breaking down some materials.
SCN 2-13a
Area of Curriculum
Languages (Literacy and English)
Area of Curriculum
Expressive Arts
CfE Experience(s)/Outcome(s)
When I engage with others, I can respond
in ways appropriate to my role, show that
I value others’ contributions and use these
to build on thinking.
LIT 2-02a
When listening and talking with others for
different purposes, I can share
information, experiences and opinions;
explain processes and ideas; identify
issues raised and summarise main points
or findings; clarify points by asking
questions or by asking others to say more.
LIT 2-09a
CfE Experience(s)/Outcome(s)
I have experienced the energy and
excitement of presenting/performing for
audiences and being part of an audience
for other people’s presentations/
EXA 2-01a
I have created and presented scripted or
improvised drama, beginning to take
account of audience and atmosphere.
EXA 2-14a
Suggested Activities:
Role play - use of ICT to book/cancel appointments, develop letters to patients,
appointment cards, opening/closing times. Develop and design posters on healthy
foods/unhealthy foods. Children to carry out survey on what foods/drinks they eat and
drink and what foods they don’t and why, or who has had treatment at the dentist, what
sort of treatment and how it made them feel.Plan activities during National Smile Month.
50 Supporting Curriculum for Excellence
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Working with parents and carers
Parents and carers are the prime educators of their children, however, school and OSC
provides an extension to the child’s home life. This is a very important factor to
remember when promoting healthy habits within the service. Working with parents/
carers, other agencies and children in identifying needs and support is key to a
successful partnership. The unique relationship staff have developed with children
and parents provides a good foundation for the promotion of healthy choices.
Working in partnership with parents can be achieved in many ways and below are a
few suggestions.
Parents can help with snacks, packed lunches for outings and promoting healthy
messages. Work with parents to take healthy snack messages home and ask them for
their feedback.
Parent enrolment session
Healthy choice displays, pre-entry information including personal dietary information.
Parent evenings/open days
Consider parent activities that would increase awareness of healthy habits and children’s
self-help skills.
Parent workshops
Consider parent workshops focusing on establishing healthy habits.
Parent newsletters and leaflets
Sharing information on healthy choices (using leaflets or the parent prompts provided
within this pack).
Promotional events
National Smile Month to promote good oral health habits; Farmhouse Breakfast Week
to raise awareness of the importance of a healthy breakfast; or develop your own focus,
for example, low salt week; fruity Friday; or exotic fruit week.
Snack menu
Displayed for parents to view, ask for feedback from parents and children.
Display boards
Use to display health promotion materials or showcase health promotion events or
Fundraising opportunities
Encourage parents to continue to promote the positive health messages embedded in
the service.
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This section contains four ‘Parent Prompt’ leaflets:
Helpful Hints for Healthy Habits – Ideas for Healthy Lunchboxes
Helpful Hints for Healthy Habits – Happy Healthy Smiles
Helpful Hints for Healthy Habits – Hygiene and Handwashing
Helpful Hints for Healthy Habits – A Healthy Diet
The leaflets can be photocopied and given to parents.
52 Parent Prompts
Nutriton and Oral Health
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Strategy into Practice for Childcare Providers
Helpful Hints For Healthy Habits
Ideas for Healthy Lunchboxes
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It’s easy to get stuck in a rut with lunchboxes,
especially if children insist on having the same
sandwich filling day after day. Changing a few items
in a lunchbox over the course of a week can help to
provide a range of important nutrients and encourage
children to try new foods.
With a little careful planning, a healthy lunchbox can
be prepared in just a few minutes. Don’t forget that
the contents of a lunchbox have to survive until the
middle of the day or even after school and by that
time it may have been dropped a few times! There are
many novelty lunchboxes and bags to choose from,
but remember a plain plastic box with a cool pack
does the job just as well.
• Sandwiches are an easy choice for a packed lunch.
To give a little variety, try different breads and rolls
such as wholemeal, granary, poppy seed, sesame
seed, pitta bread, bagels and baps. Try some
breadsticks or crackers too.
• For sandwich fillings, include ham, turkey,
chicken, fish, egg, banana, Edam, mozzarella or
cottage cheese. Add plenty of salad, but avoid too
much mayonnaise or salad cream, as these are
high in fat.
• Homemade pasta and rice salads are ideal for
packed lunches.
• Include some chopped raw vegetables such as
carrots, cucumber, peppers or cherry tomatoes.
• An apple every day can soon become boring so
include a variety of fruit. Choose fruits that are in
season as this will be more economical. Include a
pot of fruit salad as a change to a whole fruit. Try
some dried fruit such as raisins, sultanas, mango or
• For a dessert include milk-based puddings such as
yoghurt, fromage frais or a small pot of custard or
• Choose fruit scones, pancakes or fruit loaf as
healthier alternatives to sweets and chocolate.
Please see your copy of the Healthy Eating Policy
for more information.
• For a drink include semi-skimmed or skimmed milk
or water. Small cartons of pure fruit juice are easy to
transport but remember this should be consumed at
mealtimes only. Fruit squash (sugar-free) should be
diluted one part juice to at least eight parts water.
Fizzy drinks, diet varieties or otherwise, are not
suitable for children’s lunchboxes.
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Strategy into Practice for Childcare Providers
Helpful Hints For Healthy Habits
Happy Healthy Smiles
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Snacks and Drinks
When the child wants to eat,
Try not to give them food that’s sweet;
It’s better to give instead
Vegetables, crackers, fruit or bread.
Keep puddings and sweets
as mealtime treats;
If used as a snack,
they will turn teeth black.
When they’re dry and want a drink
Don’t give juice, please stop and think,
Child or young person, son or daughter
It’s best to stick to milk or water.
For happy, healthy smiles remember to:
• Use a pea-sized amount of fluoride toothpaste for
children over three years, ensuring the toothpaste
contains no less than 1000 ppm (parts per million)
fluoride. For children over seven years old use a
toothpaste with 1350–1500 ppm fluoride. Gently
scrub each tooth thoroughly using a brush with a
small head and soft to medium bristles. Spit, don’t
rinse afterwards. This gives the fluoride time to
• Register your child with a dentist as soon as possible
and attend at least twice a year or as recommended
by your dental health professional.
• Try to reduce the amount and frequency of sugar
intake. Foods and drinks containing sugars should
be limited between meals, as should acidic drinks
such as diet juices, fruit juices and smoothies.
Where possible, keep sugary foods and drinks to
Childsmile is a national programme, funded by the
Scottish Government, designed to improve the dental
health of children in Scotland. Further information on
Childsmile and keeping teeth healthy is available on
the Childsmile website.
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Strategy into Practice for Childcare Providers
Helpful Hints For Healthy Habits
Hygiene and
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Parent Prompts 57
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Wash your hands with soap and water
Every single day,
Before you eat your food
Or when you’ve just been out to play.
Wash your hands with soap and water
Every chance you get,
If you’ve just used the toilet
Or touched or clapped your pets.
Don’t forget to wash your hands
If you should cough or sneeze,
‘Cause soap and water on your hands
Will help to stop disease.
Children learn by watching the adults around them.
They will do what you do. Adults can set a good
example by washing their hands.
Remember always wash your hands:
• after going to the toilet or changing nappies,
• after touching pets or handling rubbish, and
• before preparing food or sitting down to eat.
Frequent hand washing is one of the single most
important things we can do to help to reduce the
spread of infections and prevent ill health. For
example, good hand hygiene in children will help to
prevent the spread of common communicable
infections such as colds and tummy bugs.
For more information on hygiene and handwashing
visit and click on
‘Hand Hygiene and You’ or look for the ‘Children’s
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Helpful Hints For Healthy Habits
A Healthy Diet
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Healthy eating doesn’t mean missing out all the foods we enjoy.
It is the balance of foods in our diet that is the most important thing.
Encourage your child to eat as wide a range of foods as possible.
The eatwell plate shows how much of what you eat should come
from each food group below. This includes everything you eat during
the day, including snacks.
Fruit and vegetables – eat plenty
• Fruit and vegetables should make up about a third of the food you
eat each day. You can choose from fresh, frozen, canned or juiced.
• Eat at least five portions of a variety of fruit and vegetables every
day. If you eat one or two portions with each meal and have the
occasional fruit snack it is easy to eat five-a-day.
Bread, rice, potatoes, pasta and other starchy foods – eat plenty
• Starchy foods should make up about a third of the food you eat.
• Choose wholemeal or wholegrain varieties when you can.
• Good sources of starchy food include all sorts of bread (including
wholemeal, granary, brown, seeded, chapattis, pitta bread, bagels,
roti and tortillas), rice, cereals, potatoes and pasta.
• Potatoes also count as a starchy food rather than a vegetable
• Children and young people should have an item from this group at
every meal.
Milk and dairy foods – eat some
• Milk and dairy products (cheese, yoghurt, fromage frais) are an
important part of the diet. They are a good source of energy and
protein and contain a wide variety of vitamins and minerals,
particularly calcium, which is necessary to help build healthy bones
and teeth.
• After the age of five years, choose lower fat alternatives whenever
• Some flavoured and malted milk drink products and shakes tend
to contain added sugar, which is bad for teeth.
• Children and young people should have three foods from this
group per day.
Meat, fish, eggs, beans and other non-dairy sources of protein –
eat some
• Choose lean cuts of meat and remove visible fat from meat.
Processed meat products should be eaten sparingly as these are
high in fat, e.g. sausages, Scotch pies.
• Aim for at least two portions of fish a week, including a portion of
oily fish (such as salmon, mackerel, sardines, trout and herring).
• Eggs, pulses, nuts and seeds are all good sources of protein and
very easy to prepare.
• Children and young people should have two to three foods from
this group per day.
Foods and drinks high in fat and/or sugar – eat less
• Eat just a small amount and try to choose options that are lower in
fat, salt and sugar when you can.
• Cut down on added sugars which can be found in fizzy drinks,
juice drinks, sweets, cakes and jam. If you must include them,
have them at mealtimes only.
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NHS Lanarkshire has a well-stocked health improvement library for use by anyone who
lives, studies or works in the Lanarkshire area. The library provides a full lending service
of books, videos, DVDs, activity packs, puppets, toys, jigsaws, teaching packs and
equipment on all aspects of health education and health promotion including nutrition
and oral health. In addition, a range of leaflets and posters are also available to order
free of charge. Please note that orders take up to 10 working days for completion.
For a comprehensive list of resources, further information or to check availability please
contact the Health Improvement Library (opening hours Mon–Fri 9am–5pm).
Health Improvement Library
Law House
Airdrie Road
Tel: 01698 377600
Strategy into Practice for Childcare Providers
Resources 61
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Local Contacts
Childcare Information Service (SLC)
SLC Education Resource Service
Floor 5
Almada Street
Tel: 01698 454 102
Environmental Services Department
Atholl House
Churchill Avenue
East Kilbride
G74 1LU
Tel: 0845 740 6080
Environmental Services Department
Food Safety Section
Fleming House
2 Tryst Road
G67 1JW
Tel: 01236 616 469
Family Information Service (NLC)
Kildonan Street
Tel: 01236 812 281
Head of Oral Health Education
Salaried Primary Care Dental Services
NHS Lanarkshire
Blantyre Health Centre
64 Victoria Street
G72 0BS
Tel: 01698 727 861
Lanarkshire Community Food and
Health Partnership
Unit 7, Strathclyde Business Park
391 Langmuir Road
G69 7TU
Tel: 0141 771 9043
National Contacts
British Dental Health Foundation
Smile House
2 East Union Street
CV22 6AJ
Tel: 01788 539 793
British Heart Foundation Scotland
Ocean Point One
94 Ocean Drive
Tel: 0131 555 5891
British Dietetic Association
5th Floor, Charles House
148/9 Great Charles Street
B3 3HT
Tel: 0121 200 8080
British Nutrition Foundation
High Holborn House
52–54 High Holborn
Tel: 020 7404 6504
62 Useful Contacts and Further Reading
Nutriton and Oral Health
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Caroline Walker Trust
22 Kindersley Way
Abotts Langley
Tel: 01923 445 374
Coeliac UK
1 Saint Colme Street
Tel: 0131 220 8342
The Dairy Council
93 Baker Street
Tel: 020 7467 2629
Learning and Teaching Scotland
The Optima
58 Robertson Street
G2 8DU
Tel: 08700 100 297
NHS Health Scotland
Woodburn House
Canaan Lane
EH10 4SG
Tel: 0131 536 5500
Scottish Food and Drink Federation
4a Torphichen Street
Tel: 0131 229 9415
Diabetes UK Scotland
The Venlaw
349 Bath Street
G2 4AA
Tel: 0141 245 6380
Food Standards Agency Scotland
6th Floor, St Magnus House
25 Guild Street
AB11 6NJ
Tel: 01224 285 100
Strategy into Practice for Childcare Providers
Useful Contacts and Further Reading 63
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Crawley, H. (2006) Eating well for under-5s in child care. 2nd ed. St Austell: The
Caroline Walker Trust.
Fife Council Education Service and NHS Fife (1999) Play@home. Fife: Fife
Food Standards Agency Scotland and Scottish Executive (2006) Catering for
Health: A guide for teaching healthier catering practices. Aberdeen: Food
Standards Agency Scotland.
Health Education Board for Scotland and Edinburgh Community Food Initiative (1999)
Just for Starters. Edinburgh: HEBS.
Karmel, A. (2001) Superfoods for Babies and Children. London: Ebury Press.
Learning and Teaching Scotland (2009) A Curriculum for Excellence. Glasgow: Learning
and Teaching Scotland.
Making the case for UK Physical Activity Guidelines for Early Years:
Recommendations and draft summary statements based on the current evidence
Merrett, MCW, Conway, DI, Goold, S, Jones, CM, McCall, DR, McMahon, AD,
Macpherson, LMD, Pitts, NB. (2009) National Dental Inspection Programme of
Scotland: Report of the 2009 Survey of P7 Children. Dundee: Scottish Dental
Epidemiological Co-ordinating Committee.
NHS Health Scotland (2006) Hassle Free Food. Edinburgh: NHS Health Scotland.
NHS Health Scotland (2008) Fun First Foods: An easy guide to introducing solid foods.
Edinburgh: NHS Health Scotland.
North Lanarkshire Council (2006) Hungry for Health. Improving the Health of Young
People. Coatbridge: North Lanarkshire Council.
North Lanarkshire Council (2008) North Lanarkshire Council Diet and Nutrition Policy
2008–2012. Coatbridge: North Lanarkshire Council.
Scottish Dental Clinical Effectiveness Programme (2010) Prevention and Management
of Dental Caries in Children. Dental Clinical Guidance. Dundee: Scottish Dental Clinical
Effectiveness Programme.
Scottish Executive (2002) Hungry for Success – A whole school approach to school
meals in Scotland. Edinburgh: Scottish Executive.
Scottish Executive (2003) Let’s Make Scotland More Active: A strategy for physical
activity. Edinburgh: Scottish Executive.
64 Bibliography
Nutriton and Oral Health
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Scottish Executive (2005) An Action Plan for Improving Oral Health and
Modernising NHS Dental Services in Scotland. Edinburgh: Scottish Executive.
Scottish Executive (2006) Nutritional Guidance for Early Years: food choices for children
aged 1-5 years in early education and childcare settings. Edinburgh: Scottish Executive.
Scottish Government (2001) Regulation of Care (Scotland) Act 2001. Edinburgh:TSO.
Scottish Government (2005) National Care Standards: Early education and
childcare up to the age of 16. Edinburgh: Scottish Government.
Scottish Government (2007) Schools (Health Promotion and Nutrition) (Scotland) Act
2007. Edinburgh: TSO.
Scottish Government (2008) Achieving Our Potential: A framework to tackle poverty and
income equality in Scotland. Edinburgh: Scottish Government.
Scottish Government (2008) Equally Well Implementation Plan. Edinburgh: Scottish
Scottish Government (2008) The Early Years Framework. Edinburgh: Scottish
Scottish Government (2009) Scottish Health Survey 2008. Edinburgh: Scottish
Scottish Government (2010) Scottish Health Survey 2009. Edinburgh: Scottish
Scottish Office (1996) Eating for Health: A Diet Action Plan for Scotland.
Edinburgh: TSO.
Scottish Office (1999) Towards a Healthier Scotland. Edinburgh: TSO.
Timperley, C. (1997) Baby and Child Vegetarian Recipes. London: Ebury Press.
Strategy into Practice for Childcare Providers
Bibliography 65
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Appendix 1: Portion Sizes
Childcare providers will be catering for children and young people of varying ages and
stages. Children’s energy requirements, nutritional needs and appetites are dependant
on a number of factors, including age, gender and activity levels.
Children should be encouraged to fill up on healthier snacks when they are hungry, for
example, starchy foods (which are naturally low in fat) and fruits and vegetables.
However, staff should not allow children to overeat. Foods high in fat, sugar and salt
e.g. cakes, biscuits, confectionery and crisps should be eaten sparingly and children
should always be encouraged to be as physically active as possible. The table below
provides a guide to portion sizes for children and young people.
Fruit and vegetables
Portion size
5–11 year olds
Portion size
12–18 year olds
Large fruit e.g. melon, pineapple
Half-one slice
One slice
Medium-size fruit e.g. apples, pears,
oranges, bananas, peaches
Half-one fruit
One fruit
Small-size fruit e.g. satsumas,
tangerines, kiwis, plums, apricots
One-two fruits
Two fruits
Very small fruits e.g. grapes,
strawberries, raspberries, blackberries,
blueberries, cherries
Half-one cup
One cup
Dried fruit e.g. raisins, sultanas, apricots Half-one heaped tbsp
One heaped tbsp
Fresh fruit salad, fruit canned in juice,
stewed fruit
Two-three heaped tbsp Three heaped tbsp
Half a dessert bowl
Raw vegetables e.g. cherry tomatoes,
cucumber, peppers, carrots
Two-three heaped tbsp Three heaped tbsp
Fruit juice (counts as a maximum of one 150 ml glass
portion a day, however much you drink)
One dessert bowl
150 ml glass
Adapted from Hungry for Success: A whole school approach to school meals in Scotland (2002)
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Other foods
Portion size
5–11 year olds
Portion size
12–18 year olds
Small pot (100–125 g)
Small pot (125–150 g)
One-two slices
Two slices
Homemade soup
170–220 g
(Only half-one slice of bread
should be served as an
accompaniment to soup)
300 g
(Only one-two slices of bread
should be served as an
accompaniment to soup)
Homemade pizza
Half-one slice
One-two slices
Breakfast cereal
Half-three quarters full bowl
(30–40 g)
Half-three quarters full bowl
(35–45 g)
Plain popcorn
One small packet (25 g)
One small packet (25 g)
Lower fat crisps
One small packet (25 g)
One small packet (25 g)
Pasta (cooked weight)
80–120 g
180 g
Jacket potatoes
120–170 g
250 g
70–100 g
150 g
Bread: sliced, rolls,
French stick
45–65 g
100 g
Drinking milk
200 ml
300 ml
Cheese (served in a
salad, baked potato,
sandwich or with
30–40 g
50 g
Scotch pies, bridies,
sausage rolls, Cornish
pasty, encased meat
pastry pies, quiche,
cold pork pie (e.g.
Melton Mowbray)
80 g
110 g
Breaded or battered
shaped chicken and
turkey products, e.g.
nuggets, goujons,
60–80 g
120 g
80–120 g
160 g
Cakes, muffins,
sponges, fairy cakes,
scones, sponge
puddings, doughnuts,
cookies, tray-bakes
40–50 g
65 g
Ice cream
60–80 g
100 g
Adapted from Hungry for Success: A whole school approach to school meals in Scotland (2002)
Strategy into Practice for Childcare Providers
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Appendix 2: Function and Sources of Key Vitamins and Minerals
Adapted From ‘Catering for Health: A guide for teaching healthier catering practices’
Food Standards Agency Scotland & Scottish Executive (2006)
Maintains and repairs tissues,
needed for growth & development. Essential for immune system & vision
As retinol (pre-formed vitamin A) milk,
fortified margarines, cheese, egg, liver,
oily fish (pilchards, sardines, herrings,
As carotene (converted to vitamin A by
the body) carrots, tomatoes, green leafy
vegetables, peppers, mango, apricots,
Essential for bones & teeth, promotes absorption of calcium from
Fortified margarines & spreads, oily fish,
fortified breakfast cereals
Antioxidant vitamin which helps
prevent damage to cells
Green leafy vegetables, margarine,
whole grain cereals, eggs
Essential for blood clotting
Dark green vegetables especially cabbage, Brussels sprouts & spinach
B1 (thiamin)
Involved in release of energy from
carbohydrates & fat, needed for
brain & nerve function
Potatoes, bread, fortified breakfast cereals, milk, diary products, meat & poultry
B2 (riboflavin)
Involved in release of energy from
carbohydrate, fat & protein,
needed for growth
Milk & dairy products, liver, fortified
breakfast cereals, meat & poultry
B3 (niacin)
Same as B2
Meat & poultry, fortified breakfast cereals, fish, potatoes
B6 (pyridoxine)
Protein metabolism, formation of
healthy blood & nervous system
Meat, milk, potatoes, fortified breakfast
Production of red blood cells, involved in nervous system
Meat, milk, dairy products, fish, eggs,
fortified breakfast cereals, yeast extract
Production of red blood cells, reduces risk of neural tube defects
e.g. spina bifida in early pregnancy
Green leafy vegetables especially
Brussels sprouts, spinach, green beans,
potatoes, oranges, melon
Helps wound healing & iron absorption, needed for formation of
bones, muscle & blood vessels,
antioxidant vitamin
Fruits especially citrus fruit – oranges,
blackcurrants, strawberries, green vegetables, potatoes
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Appendix 3: Food Labelling
Food labels now contain a vast amount of information relating to food safety and
nutrition, which can be confusing to some consumers. The information below aims to
make reading food labels easier for staff, parents and carers.
Use by
‘Use by’ dates are usually found on perishable foods, which tend to go off quickly, such
as milk, soft cheese, yoghurt, ready-prepared salads and meat and poultry. Generally,
food with a ‘use by’ date should be kept in the fridge. Do not use any food or drink after
the end of the ‘use by’ date shown on the label. Even if it looks and smells fine, it may
be harmful and cause food poisoning.
Best before
Foods with a ‘best before’ date tend to last for longer, for example, canned, frozen or
dried foods. It should be safe to eat food after the ‘best before’ date has passed;
however, the food will no longer be at its best and may have lost some of its flavour or
Eggs should not be used after the ‘best before’ date because they can contain
salmonella bacteria which may start to multiply after the ‘best before’ date.
Storage instructions
It is important to follow the storage instructions shown on the label, as this will ensure
that the food lasts until the ‘use by’ date. This may include terms such as ‘keep
Preparation and cooking instructions
To enjoy food and avoid food poisoning, it is important to follow the preparation and
cooking instructions which are shown on the label. This will ensure food is cooked
thoroughly and any harmful bacteria are killed. This may include instructions such as
defrosting times.
Ingredients list
All of the ingredients present in a food or drink will be listed in descending order (by
weight) with the biggest ingredient first.
Nutrition information panel
The nutrition information panel will display information about the nutritional value of
the product. Some labels provide information on four key areas – energy, protein,
carbohydrate and fat. Other labels provide more information and include – energy,
protein, carbohydrate, (of which is sugar), fat, (of which is saturated fat), fibre and
sodium (salt). Nutrients will be given per 100 g and often per pack size too. If you want
to compare two similar products, compare the nutrient values per 100 g.
Criteria to allow consumers to more easily identify products which are high or low in a
particular nutrient has been developed. This is a useful guide for consumers and is set
out below:
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High (per 100 g)
20 g of fat or more
5 g of saturated fat or more
15 g of sugar or more
0.6 g of sodium or more (1.5 g salt)
Low (per 100 g)
3 g of fat or less
1.5 g of saturated fat or less
5 g of sugar or less
0.1 g of sodium or less (0.3 g salt)
If quantities fall between these figures, then this would be a moderate amount.
Hidden sugars
Parents should be advised to look out for the hidden sugars in foods and drinks. The
common ones are sucrose (refined from beet and cane), glucose, maltose (from many
foods) and fructose (from fruit).
The following sugars are added to some foods and drinks during processing and have
the potential to cause tooth decay:
Dextrose; maltose; invert sugar; hydrolysed starch; glucose; sucrose; lactose; fructose;
glucose syrup.
Also, look out for the following products, which are basically a mixture of sugars:
Brown sugar; treacle; maple & golden syrup; honey.
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Appendix 4: Food Additives
A food additive is a substance which has been intentionally added to food for a specific
function, for example, to preserve, flavour or colour the food. All food additives (natural
and artificial) go through rigorous safety testing to ensure they are both necessary and
safe, and must comply with European Union legislation. A food additive which has been
approved for use in the European Union will have an E number. Most food additives
must be included either by name or by E number in the ingredients list on the food
Some people can have an adverse reaction to certain additives, just as some people
react to certain types of food. People who react to additives are likely to have asthma or
other allergies already. Reactions to additives can bring on an asthma attack or cause
urticaria (nettle rash).
The types of additives most likely to be found in food are listed below.
Antioxidants make food last longer by stopping fats, oils and certain vitamins from
combining with oxygen in the air, and becoming rancid. Vitamin C (ascorbic acid or
E300) is one of the most common antioxidants used in food.
Preservatives stop food going off, resulting in a longer shelf-life. Sulphur dioxide, nitrite
and nitrate are examples of preservatives, along with more traditional types, such as
sugar, salt and vinegar.
Colours are used to replace the natural colour lost during food processing and storage,
or to make food products a consistent colour. Some people think this makes food more
attractive. Certain combinations of some artificial food colours have been linked to a
negative effect on children’s behaviour: sunset yellow (E110), quinoline yellow (E104),
carmoisine (E122), allura red (E129), tartrazine (E102), and ponceau 4R (E124). These
colours are used in soft drinks, sweets and ice-cream. If a child shows signs of
hyperactivity or Attention Deficit Hyperactivity Disorder (ADHD), these additives should
be avoided as this may help improve behaviour.
Emulsifiers and Stabilisers
Emulsifiers and stabilisers give food a consistent texture and are used in foods, including
low fat spreads. Emulsifiers help mix ingredients together that would normally separate,
such as oil and water. Stabilisers help stop these ingredients from separating again.
Flavour Enhancers and Flavourings
Flavour enhancers are used to bring out the flavour in food. An example of a flavour
enhancer would be monosodium glutamate (MSG or E621) which is added to processed
foods like sauces, soups and sausages. Flavourings are added to a wide range of foods
in small amounts, to give a particular taste or smell. Flavourings do not have E numbers
but an ingredients list will say if flavourings have been used.
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Sweeteners are often used instead of sugar as they are lower in calories and safer for
teeth. Sweeteners are commonly found in fizzy drinks, yoghurt and chewing gum.
Intense sweeteners are many times sweeter than sugar and are therefore only required
in very small amounts: aspartame (E951), saccharin (E954) and acesulfame-K (E950).
Bulk sweeteners, such as sorbitol (E420), have about the same sweetness as sugar and
are therefore used in similar amounts to sugar.
72 Appendices
Nutriton and Oral Health
The Department of Public Health
NHS Lanarkshire
14 Beckford Street
Telephone: 01698 206335
Fax: 01698 424316
© Lanarkshire NHS Board
Published March 2011
We encourage the use by others of information and
data contained in this publication. Brief extracts
may be reproduced provided the source is fully
acknowledged. Proposals for reproduction of large
extracts should be sent to the address above.
ISBN 978–0–905453–31–6
ISBN 9780905453316
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