Food Sources of Total Energy and Nutrients among U.S. Infants and Toddlers: National Health and Nutrition Examination Survey 2005–2012

Abstract

Understanding the dietary intakes of infants and toddlers is important because early life nutrition influences future health outcomes. The aim of this study was to determine the dietary sources of total energy and 16 nutrients in a nationally representative sample of U.S. infants and toddlers aged 0–24 months. Data from the 2005–2012 National Health and Nutrition Examination Survey were analyzed. Dietary intake was assessed in 2740 subjects using one 24-h dietary recall. The population proportion was used to determine the contribution of foods and beverages to nutrient intakes. Overall infant formulas and baby foods were the leading sources of total energy and nutrients in infants aged 0–11.9 months. In toddlers, the diversity of food groups contributing to nutrient intakes was much greater. Important sources of total energy included milk, 100% juice and grain based mixed dishes. A number of foods of low nutritional quality also contributed to energy intakes including sweet bakery products, sugar-sweetened beverages and savory snacks. Overall non-flavored milks and ready-to-eat cereals were the most important contributors to micronutrient intakes. In conclusion this information can be used to guide parents regarding appropriate food selection as well as inform targeted dietary strategies within public health initiatives to improve the diets of infants and toddlers.

Early development of dietary patterns: transitions in the contribution of food groups to total energy—Feeding Infants and Toddlers Study, 2008

“…While there was a shift to more consumption of reduced fat milks (2% milk fat) after 2 years of age, there was little consumption of low fat milks (1% milk fat or skimmed milk). These FITS results are very similar to findings from NHANES, which report only approximately 3% of total daily energy from cow's milk from 6 to 11 months of age, increasing to 22.4% from 12 to 23 months [20]. Also in the second year of life, cow's milk is providing 47% of saturated fat [20].…”

“…About one-third of these additional calories comes from sweets and sweetened beverages, accounting for 15% of total daily energy at 24-47 months. Among younger children, 12-23 months old, sweets and sweetened beverages provided 10.4% of total daily energy, and although the food groups were slightly different, this is similar to the 10.2% daily energy from sweetened foods and beverages reported in NHANES for the same ages [20]. Early consumption of sugar sweetened beverages is problematic not only by displacing more energy dense foods [2], but also because early consumption of sugar sweetened beverages significantly increases the likelihood of consuming them later in childhood [12], along with higher odds of developing obesity [30].…”

“…In line with AAP recommendations at the time [2], few infants in our study consumed juice before the age of 6 months. Analysis from NHANES [20] shows that 100% juice contributes more calories (5.9% of daily energy) than fruits (4.8% of daily energy) for children 12-23 months, but this may be due to the fact that some of these data are older (beginning with the 2005-2006 NHANES release) and we have seen a change to less juice consumption between FITS 2002 and 2008 [18]. Our results show similar energy from fruits and 100% fruit juices from the age of 18 months, while for infants and younger children, fruit is more commonly consumed.…”

“…About 30% of all infants and children up to age 4 did not receive any discrete servings of vegetables during an average day, and by 2 years, more children consumed sweets than either fruit or vegetables [16]. Data from both FITS 2002 and the National Health and Nutrition Examination Survey (NHANES) 2005-2012 have shown that leading sources of energy in the diets of young children include 100% juice, grain based mixed dishes, fruits, sweet bakery products, breads, rolls and tortillas, poultry and sugar-sweetened beverages [15,20].…”

Cross-sectional analysis of eating patterns and snacking in the US Feeding Infants and Toddlers Study 2008

“…As children get older, snacking has been associated with poorer nutrient intakes (16) and frequent snacking has been associated with higher energy intakes, as reported among 9-15-year-olds in the USA and 6-13-year-olds in Mexico (17,18) . The foods and beverages first introduced to infants between meals are the same types of foods they consume early in the complementary feeding period: infant cereals, 100 % juice, baby food and regular fruits, and in later infancy, breakfast cereals and crackers, consistent with NHANES data showing sources of energy in infant diets (19) . Our data show that cow's milk was the most frequently consumed beverage from 12 months and fruits were the most commonly consumed foods eaten as snacks across all ages.…”