The optimisation of skeletal health during the life cycle is critical, especially if we are to reduce the continuing rise in osteoporosis -1 in 2 women and 1 in 5 men over the age of 50 years will suffer an osteoporotic fracture. The foundations of adult bone health are laid down in the early years; therefore, optimisation of bone health in the young is fundamental. Although genetics play a major role, accounting for 70-75% of bone strength, other lifestyle and nutrition factors are known to be highly influential. Calcium (Ca) and vitamin D play critical roles in bone mineralisation as well as generally being key nutrients in health. All living cells require Ca to survive, with the majority (99%) of Ca being found in bones and teeth and the remainder in soft tissues and body fluids. Vitamin D is the generic term for two molecules: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). The former is derived by ultraviolet (UV) irradiation of ergosterol, which is distributed in plants and fungi. The latter is formed from the effect of UV irradiation on the skin. The principal role of vitamin D is to support the serum Ca concentration within narrow limits. Vitamin D is crucial for maximising gut absorption of calcium via vitamin D dependent Ca receptors. It is estimated that adequate vitamin D status increases Ca absorption to 30-40% of intake compared with only 10-15% absorption without adequate vitamin D. Intakes of Ca are a concern among certain groups of the population, for example a high proportion (>12%) of teenage boys and girls fail to meet the lower reference nutrient intake for Ca. For vitamin D, there are no dietary reference values for the age group 4-64 years as it is considered that UV exposure provides sufficient quantities of vitamin D, but there is now mounting evidence of widespread vitamin D insufficiency in the population. Weight-bearing physical activity is beneficial to the skeleton but clarification is needed of the exact type, intensity and duration required for optimal bone mass. The role of othermicronutrients on bone metabolism remains to be fully quantified. This review investigates the current evidence of the impact of dietary and lifestyle factors on bone health, with specific reference to children and adolescents and with a focus on vitamin D, Ca and weight-bearing exercise. © 2007 The Authors; Journal compilation © 2007 British Nutrition Foundation

These practical food portion size ranges could be used both in early years settings and in advice to parents. The food plan emphasises the need to include a variety of nutrient-dense foods if a balanced diet is to be achieved for preschool children.

Summary  The toddler years (12–36 months) are a period of changing nutritional requirements and food intake. As a time of considerable growth and development, they are crucial not only to the health of the toddler, but also to his or her later health. Toddlers need a relatively energy‐dense diet to meet their needs for growth and activity, but also adequate micronutrients to guard against iron deficiency, rickets and growth faltering. Healthy eating habits in toddlerhood can be the basis for lifelong healthy eating, including the prevention of obesity, diabetes and dental caries. Parents and carers need clear and consistent advice, and healthcare professionals need access to evidence‐based information and best practice in order to support them.

Optimal nutritional intake is essential for protecting the health of adults and children. A balanced diet that provides sufficient energy and essential nutrients is vital for supporting metabolism and daily activity. Children have higher energy and nutrient requirements than adults in relation to their body size as a result of the extra demands of growth and development. 1 However, excessive energy intake is associated with an increased risk of overweight/ obesity. This is a major public health concern because being overweight or obese in childhood increases the risk of disease in the short-and long-term. Children who are overweight are at increased risk of potentially life-threatening illnesses such as asthma and sleep apnoea. 2,3 Affected children have lower self-esteem and suffer more

Summary To address the lack of guidance in feeding toddlers, the Infant and Toddler Forum has launched a factsheet providing evidence‐based portion size ranges of a wide variety of foods. They can be used to limit excess energy intakes in toddlers (aged 1–3 years) and to reassure parents who worry that their toddlers do not eat enough.