子ど もの食と栄養

子どもの食と栄養
編集・執筆

子どもの保健児玉浩子

相談援助
保育相談支援

執筆

小橋 明子

◉

改訂第 2 版

編著◉渡辺 博

帝京平成大学本体 2,100 円＋税◉

ISBN978-4-521-73488-0

太田百合子 風見公子
小林陽子 藤澤由美子

著◉ 笠師 千恵

本体 2,500 円＋税
ISBN978-4-521-73956-4

児玉浩子

編集・執筆 ◉

子どもの保健演習
編著◉大西 文子

本体 2,100 円＋税
ISBN978-4-521-73677-8

中山書店

食と栄養_カバー.indd 1

14/07/08 10:10

序
乳幼児期は人生の始まりの時期です．心身の発達に最も重要な時期で，健全な心身の発達に，適切な栄養は必要不可欠です．保育所利用児童は，起きている時間の大半を保育所で過ごします．したがって，保育における “ 食べ物の提供 ” と “ 食育 ” は保育の根源にかかわる最重要課題です．本書は，保育を学ぶ方々や保育士・幼稚園教諭を対象に，「子どもの食と栄養」について，重要なことを楽しく学べるように，わかりやすくまとめました．執筆者は，実際，保育士養成課程の「子どもの食と栄養」を担当している教員や食育を実践している医師・管理栄養士です．
本書の特徴は，保育士・幼稚園教諭が知っておくべきことと，子どもたちの食育に役立つことを 2 本柱にしたことです．知っておくべきこととしては，保育士養成課程の教育カリ
キュラム「子どもの食と栄養」の項目に対応した内容になっています．また，皆でディスカッションしたり，考えたりできるテーマも提示しました．ディスカッションして食に対する理解をさらに深めていただきたいと願っています．さらに，食育に役立つことを念頭に，季節の食事，伝統的な食，食事マナー，食の常識などを随所に盛り込みました．これらは，この本を読まれる方や乳幼児の保護者にもぜひ知っていただきたいと思っています．食に関する教養を身につけることができます．また，本書を読まれると，子どもや保護者に伝えたいこと，“ なぜバランスよく食べなくてはいけないの？” “ なぜ食事の前に手を洗うの？” “ なぜよく噛まないといけないの？” “ 元気・力の源は？” など食育に欠かせないテーマを理解することができます．それらを基に，各自で工夫して食育をしていただければ幸いです．食育を通して，子どもたちに健全な身体と暖かい心が培われることを願っています．
保育所利用児童の数は，毎年数万人ずつ増加し，2014 年 4 月現在，2,219,581 人と非常に多くなっています．このような多くの乳幼児の保育を担う保育士の役割はとても重要で，保育士は非常にやりがいのある仕事です．本書は，保育士を目指している方のみならず，保育士，認定こども園の教諭，幼稚園教諭の方など，子どもの「食」に携わる多くの方々にも役立てていただける内容にしたつもりです．今後，さらに皆様に役立つように改訂したいと思っています．本書を読まれて，本書に対するご意見などをいただければありがたいです．
2014 年 6 月

帝京平成大学
健康メディカル学部 健康栄養学科 教授

児玉浩子iii目次
第1章

子どもの健康と食生活

1 乳幼児の食生活の現状─ 2005（平成 17）年度乳幼児栄養調査から····································

2

2 乳幼児の栄養アセスメント············································································································

6

3 朝食欠食の問題と対応····················································································································· 10
4 偏食の弊害と対応······························································································································· 14
5 噛まない子の問題と対応················································································································· 16
6 孤食の弊害と対応······························································································································· 20
7 世界の子どもたちの食生活············································································································ 22

第2章

栄養・食に関する基本的知識

1 消化吸収の仕組み······························································································································· 26
2 栄養の基礎知識···································································································································· 28
3 たんぱく質の代謝と栄養学的意義····························································································· 30
4 糖質の代謝と栄養学的意義············································································································ 32
5 脂質の代謝と栄養学的意義············································································································ 34
6 ビタミンの代謝と栄養学的意義·································································································· 36
7 ミネラルの代謝と栄養学的意義·································································································· 38
8 食物繊維と水分···································································································································· 40
9 日本人の食事摂取基準の意義と活用························································································ 42
10 妊婦・授乳婦の食事摂取基準······································································································· 44
11 乳幼児の食事摂取基準····················································································································· 46
12 学童・思春期の食事摂取基準······································································································· 47v

目次

第3章

子どもの発育・発達と栄養・食生活

1 授乳・離乳の支援ガイド················································································································· 50
2 乳幼児の咀嚼機能の発達と食事提供························································································ 52
3 乳幼児の味覚機能の発達と食事提供························································································ 54
4 乳幼児の消化吸収機能の発達と食事提供·············································································· 58
5 乳児期栄養a．乳汁栄養···················································································································

62

b．離乳食期栄養···········································································································

69

6 幼児期栄養·············································································································································· 74
7 学童・思春期の栄養·························································································································· 80

第4章

食育の基本と実践

1 食育基本法の概要······························································································································· 88
2 食育推進基本計画の概要················································································································· 90
3 保育所における食育の推進············································································································ 94
4 保育所における食育推進の計画・実施・評価···································································· 96
5 学校給食の現状···································································································································· 104
6 栄養教諭··················································································································································· 106

第5章

児童福祉施設や家庭における食と栄養

1 児童福祉施設における食に関する指針··················································································· 110
2 児童福祉施設と給食の役割············································································································ 111
3 児童福祉施設での食事の提供で注意すべき点···································································· 112
4 保育所における食に関する保護者支援··················································································· 114
5 食に関する地域との連携················································································································· 115vi

目次第6章

食の安全

1 感染症と食中毒の違い····················································································································· 118
2 食中毒の発生状況と予防策············································································································ 124
3 施設における衛生管理····················································································································· 130

第7章

特別な配慮を要する子どもの食と栄養

1 食物アレルギー···································································································································· 136
2 発熱····························································································································································· 139
3 体調不良··················································································································································· 140
4 急性胃腸炎·············································································································································· 142
5 肥満····························································································································································· 144
6 便秘····························································································································································· 146
7 やせ····························································································································································· 148
8 鉄欠乏性貧血········································································································································· 149
9 障害（碍）児·············································································································································· 150·

付録 ···························153

コラム

知っておきたい食のお話

索引 ···························169

JAS マークって何？·································································································································

9

大人の朝食欠食問題···································································································································

13

食事の基本は箸の使い方から···············································································································

19

和食の献立と配膳の基本·························································································································

24

賞味期限と消費期限の違い····················································································································

48

丈夫な歯で食事を楽しもう····················································································································

61

日本の年間行事食········································································································································

86

新年を祝うおせち料理······························································································································89

節分は春を迎えるための厄払い··········································································································

93

給食にも取り入れられている郷土料理···························································································· 105
ひな祭りと祝いの料理······························································································································ 108
子どもの日と祝いの料理························································································································· 116
日本の食に欠かせない大豆···················································································································· 134vii

執筆者一覧（五十音順）［編集・執筆］

児玉浩子····································································································· 2 章 1 〜 8，7 章 1 〜 5

帝京平成大学 健康メディカル学部 健康栄養学科 教授［執筆］

太田百合子·············································································· 3 章 5b 〜 6，5 章，7 章 6 〜 9
国立総合児童センター こどもの城 技術主任

風見公子······················································································· 1 章，3 章 1 〜 2・4 〜 5a

人間総合科学大学 人間科学部 健康栄養学科 准教授

小林

陽子························································································· 3 章 3，4 章 1 〜 4，6 章

帝京平成大学 健康メディカル学部 健康栄養学科 准教授

藤澤由美子··········································································· 2 章 9 〜 12，3 章 7，4 章 5 〜 6
和洋女子大学 家政学群 健康栄養学類 教授

viii

食事の基本は箸の使い方から家族で食事をする機会の減少からか，基本中の基本である箸の使い方が上手く身につけられていない子どもの姿がみかけられる．日本の食卓における礼儀作法や美意識を知ることは，人間性を育むという点でも大きな影響力をもつ．正しい使い方を指導して，マナーを守り，食事の時間をより楽しいものにしよう．

正しい箸の持ち方

上の箸は親指，人差し指，中指で軽く持つ鉛筆を持つようなイメージで少しはみ出す
箸先をそろえる下の箸は親指の根元でしっかりと固定

薬指の第一関節の少し下にあてる

してはいけない箸使い

迷い箸

寄せ箸

刺し箸

探り箸

どの料理を取るか迷って，あちこち動かす

箸で器を寄せる

箸を突き刺して食べる

箸で料理をかき回して，好きな物を取ろうとする

指し箸

立て箸

箸渡し

ねぶり箸

食事中に人を箸で指す

仏事のように，ご飯に箸を突き刺して立てる

箸と箸とで料理を受け渡す

箸についたものをなめる

19

第2章

section

栄養・食に関する基本的知識

7

ミネラルの代謝と栄養学的意義• ミネラルは無機質ともいわれる．
• 日本人食事摂取基準 2015 年版では，体内に多く存在するミネラルを多量ミネラ
ルとし，ナトリウム，カリウム，カルシウム，リン，マグネシウムが示されている．体内に微量しか存在しないミネラルを微量ミネラルといい，鉄，亜鉛，銅，セレン，ヨウ素，マンガンなどがある．
• ミネラルは体内で作ることができないので，必須の栄養素である（❶）．
▶▶不足すると欠乏症，過剰摂取で過剰症が発症する．

• 現代の幼児は，カルシウムと鉄が不足しがちである．カルシウムや鉄の多い食事を心がける（❷，❸）．しかし，サプリメントで過剰に摂取すると，過剰症になる危険性がある．
• カリウムは，ナトリウムの排泄を促し，将来の生活習慣病の予防になる．積極的に摂取を心がける．
＊1
食塩や醤油に含まれる．

• ナトリウム＊1 のとりすぎは，将来，高血圧の原因になる．幼児期から薄味に慣れさせるのが大切である．

❶ 主なミネラルの働き，欠乏症など，多く含まれる食品
働き含まれる食品

体液の浸透圧の調節

通常，欠乏はない

食塩，醤油

カリウム
（K）

体液の浸透圧の調節
ナトリウムの排泄やや不足気味である

果物（バナナなど），いも類，大豆，海藻

クロール
（Cl）

浸透圧の調節，胃液酸性の保持

通常，欠乏はない

食塩，醤油

カルシウム
（Ca）

骨や歯の成分，体内の 99％は骨・欠乏症：骨粗しょう症，易骨折，く 牛乳・乳製品，小骨含有小魚，大歯に存在，神経伝達機構・インスリる病，しびれ，筋力低下
豆製品
ン分泌に関与リン（P）

骨や歯の成分，エネルギー代謝，ビ通常，欠乏はない
タミン B 類の働きを補佐

マグネシウム（Mg） 骨の成分，筋肉の糖代謝38

現状・欠乏症など

ナトリウム（Na）

穀類，肉，卵，牛乳・乳製品，食品添加物

通常，欠乏はない
種実（ゴマ，アーモンド），魚介類，欠乏症：脱力感，イライラ，不整脈 緑黄野菜，大豆

鉄（Fe）

酸素の全身への運搬
血色素の成分

欠乏症：貧血（顔色が悪い，疲れや 豚・鶏のレバー，牛ひれ肉，アサリ，すい，元気がない），スプーン爪シジミ

亜鉛（Zn）

体内に 300 以上ある亜鉛酵素の欠乏症：皮膚炎，体重増加不良，牡蠣，ココア，チョコレート，プロセ
成分，核酸代謝・蛋白合成に不可
低身長，味覚異常
スチーズ，味噌，しいたけ欠

ヨウ素（I）

甲状腺ホルモンの成分

通常，欠乏はない．過剰摂取に注
海草類（こんぶ，わかめ，のり，ひじ意が必要，不足・過剰で甲状腺機き）
能低下，甲状腺腫

7 ミネラルの代謝と栄養学的意義❷ カルシウムを多く含む食品（1 回の食事量）
分量（ｇ）

目安量

カルシウム量（mg）

牛乳

200

1 カップ

220

ヨーグルト

100

約 1/2 カップ

120

しらす干し

15

大さじ３32豆腐100

1/3 丁120

小松菜

30

1株51

❸ 鉄を多く含む食品（1 回の食事量）
分量（ｇ）

目安量

鉄量（mg）

レバー（豚）

30

1/2 切れ3.9（鶏）

30

1/2 切れ（焼鳥 1 本）

2.7

鶏卵

70

1個

0.9

豚肉
（赤身）

70

１切れ

0.6

牛肉
（赤身）

70

１切れ

1.9

アサリ
（可食部）

50

12 〜 13 個

1.9

ほうれん草

60

おひたし小鉢 1 杯

1.2

小松菜

60

おひたし小鉢 1 杯

1.8

ひじき

7

煮物小鉢１杯

3.9

カルシウム

健康な骨や歯をつくる

鉄

神経のいらだちを抑え，精神を安定させる

体温を維持する体の各器官に酸素を運ぶ

集中力の低下，疲労，貧血などを防ぐ

心臓を規則的に正しく活動させ，筋肉をスムーズに収縮させる

病気に対する抵抗力をつける

カルシウムが多く含まれている食品
豆腐

牛乳

しらす干し

鉄が多く含まれている食品
ひじき

レバー

牛肉（赤身）

アサリ

39

第3 章 子どもの発育・発達と栄養・食生活

日本の年間行事食
一年を通してさまざまな行事があり，その際には，健康や幸せを祈る特別な食品が食べられる．四季折々の食材が取り入れられた行事食にはどのようなものがあるだろう．調べてみよう．

おせち

かぼちゃ

七草がゆ
年越しそば
千歳飴
菱餅

おしるこ

赤飯

炒り豆

亥の子餅
ぼた餅

おはぎ

12 1

月

月見団子

11109827 6 5
うなぎ

34

ひなあられ

花見団子
柏餅

栗ごはん

ちまき

黒ごま粥
あられ

そうめん

86

新年を祝うおせち料理
おせちは漢字で書くと「御節」，これは暦の節句を示した言葉であり，そのとき食べられる祝いの料理がおせち料理とよばれていた．節句にはほかにも桃の節句などがあるが，正月は特に重要な節句であることから，後に正月料理のことをおせち料理とよぶようになったとされる．1 年の食の始まりにはさまざまな願いが込められているので，その由来も知っておこう．

縁起物が詰まった重箱
めでたいことを重ねるという意味から，おせち料理は重箱に詰められる．現代で一般的なのは三段重や二段重で，それぞれの重箱に詰められる献立はそれぞれ決まりがあり，新たな年の幸せを願う縁起物がそろう．いずれも日持ちする献立となっているが，正月三が日は炊事をする女性を休ませる，また正月には台所を騒がせず，静かに年神様を迎えるため，といった理由があるといわれている．海の幸や山の幸を用いた伝統的な和食は，華やかさだけではなく栄養面も優れている．
黒豆
まめ（健康）に暮らせるように

田作り・・・・・・・・・・・・・・・

田を作る，豊作を願って数の子
子孫繁栄を願って・・・・・・・・・・・・

海老
腰が曲がるまで長生きできるようにと願ってなます・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・・
・・・・・・・
・・・・・・

栗きんとん

漢字では「栗金団」，
金運と繁栄を願って祝いの水引をイメージしたもの

かまぼこ
縁起がよいとされる紅白のもの

・・・
・・・
伊達巻
・・・
・ 「伊達」とは華やかなこのほかの料理の意
味も調べてみよう！

様を例えた言葉
また，形が巻物を表しており，「学問，習い 事 」が 成 就 す る よ
うにとの意味もある

89