Does Food Intake of Australian Toddlers 12–24 Months Align with Recommendations: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

Abstract

(1) Background: Food-based dietary guidelines promote population health and well-being through dietary patterns that reduce chronic disease risk while providing adequate energy and nutrients. In Australia, recommended dietary patterns based on servings per day from the five food groups—fruits, vegetables, cereals and grains, meats and alternatives, and dairy—have been developed for toddlers 1–2 years of age. However, no study has assessed the intake of the five food groups in this age group nationally. (2) Aim: To compare daily servings and the percentage of energy from the five food groups and discretionary foods in toddlers 1–2 years old to the Australian Dietary Guidelines. (3) Methods: Dietary intake was assessed using a one-day food record for 475 toddlers. (4) Results: Apart from fruit and dairy, servings of the five food groups were below the recommendations. Two-thirds of toddlers did not consume enough vegetables, and only 10% consumed the recommended number of servings for cereals and grains. On average, toddlers consumed only half the recommended servings of meat and alternatives. Nearly all toddlers (89%) consumed discretionary foods, which accounted for ~12% of total energy. Forty-five percent of toddlers received breastmilk. On average, breastfed toddlers consumed fewer servings from the five food groups than non-breastfed toddlers. Dairy contributed 20% of daily energy in all toddlers; however, this food group accounted for 13% in breastfed and 32% in non-breastfed toddlers on the day of the food record. (4) Conclusions: Compared to the recommendations, alignment with the servings of the five food group foods was not achieved by most toddlers, except for fruit and dairy. Discretionary foods may have displaced nutritious family foods. Consistent with Australian Infant Feeding Guidelines, many toddlers in this study continued to receive breastmilk but the recommended dietary patterns do not include breastmilk. Dietary modeling, including breastmilk as the primary milk source, is urgently needed, along with practical advice on incorporating breastmilk in a toddler’s diet while optimizing food consumption.

The Australian Feeding Infants and Toddlers Study (OzFITS) 2021: Highlights and Future Directions

“…OzFITS 2021 is the first study to compare the dietary intakes of Australian toddlers to the recommended servings of all five food groups (fruits, vegetables, dairy cereals and grains, and meat and meat alternatives) [ 16 ]. We found a mismatch between the number of recommended servings from each food group and the dietary intake of toddlers in our study [ 15 , 17 ]. Toddlers consumed twice as many fruit servings as recommended, and nearly all toddlers consumed discretionary foods, despite no allowance for these foods.…”

Feeding Infants and Toddlers Studies (FITS) Provide Valuable Information for Setting Dietary Guidelines

“…The FITS studies that have been completed and published are shown in Table 1 [ 5 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. These studies have been ongoing, and since 2002, there have been seven countries having published results, including the OzFITS studies now published in this Special Issue [ 4 , 5 , 6 , 7 , 8 ]. With each survey this is an opportunity to improve or modify the methodology yet stay consistent with a common analysis approach in more recent FITS such as those in Australia, China, Mexico, the Philippines, Russia, and the United States [ 3 , 4 ].…”

“…As shown in Table 1 , OzFITS is the latest FITS, and results are provided in four papers in this Special Issue [ 5 , 6 , 7 , 8 ] with a concluding paper [ 9 ]. These researchers indicated that national nutrition surveys conducted in Australia over the past 30 years had not included sampling of children under 2 years of age [ 5 ].…”

“…Its design [ 5 ] is similar to other FITS conducted elsewhere [ 3 ]. The data it provides include the following: Breastfeeding and early feeding practices [ 6 ]; Usual nutrient intake distribution and prevalence of inadequacy [ 7 ]; Food intake of Australian toddlers 12–24 months compared to recommendations [ 8 ]. …”

“…In this Introduction to the Special Issue entitled “Australian Feeding Infant and Toddler Study 2021”, we provide the background to Feeding Infants and Toddlers Studies (FITS) which have, in the past two decades, provided much-needed data on early childhood nutrition that can lead to development of dietary guidelines specific for the first two years of life [ 3 , 4 ]. Appreciating the role FITS can play puts into context the findings of the most recent FITS conducted in Australia, called OzFITS [ 5 , 6 , 7 , 8 , 9 ]. Our purpose is to position OzFITS as a necessary and important step for healthcare professionals in Australia to have for developing dietary guidelines and nutrition education resources for its young children.…”