Study: US toddlers’ diets improved significantly over 2 decades

Key takeaways:

• The improvement seen in U.S. toddlers’ diets were similar to improvements among older children, teens and adults.
• Toddlers are consuming significantly fewer added sugars than they did in 1999.

The overall diet quality of U.S. toddlers has improved significantly since 1999, and they consume fewer added sugars, according to a cross-sectional study published in Pediatrics.

“Despite the importance of early life influences on diet, the Dietary Guidelines for Americans (DGA) had minimal dietary recommendations for 0- to 2-year-olds until the 2020-2025 iteration,” Meghan Zimmer, MPH, a PhD student in the department of nutrition at Harvard T. H. Chan School of Public Health, and colleagues wrote.

Previous research has found dietary improvements among older children and adults, but according to Zimmer and colleagues, no studies have investigated dietary trends for toddlers.

Zimmer and colleagues assessed diet information for 2,541 toddlers aged 12 to 23 months collected by the National Health and Nutrition Examination Survey between 1999 and 2018. They scored toddlers’ diet quality from 0 to 100 points using the 2020 Health Eating Index, with 100 points meaning their diet met all of the guidelines from the 2020-2025 DGA.

Participants’ mean diet score in 1999-2000 was 63.7 points. In 2017-2018, the mean score was 67.7 points, according to the researchers.

“This 4-point increase is consistent with the modest improvements widely reported for other age groups using the same dataset, including youth aged 2 to 19 years old, adults, adults with diet-related medical conditions like diabetes, and higher income adults,” the researchers wrote.

Overall, participants’ diet quality improved 0.24 points per year (P < .001) according to a sensitivity analysis, which excluded 2011-2012 data due to a smaller sample size and significantly higher total scores. The researchers found that diet quality improved in all socioeconomic status subgroups as well.

At baseline, most toddlers met guidelines for total fruit, dairy and total protein foods, according to Zimmer and colleagues. Component scores improved over time for whole fruits, whole grains and fatty acids, and consumption of refined grains and added sugars decreased. The researchers did not find significant improvements for consumption of total vegetables, greens and beans, seafood and plant proteins, sodium or saturated fats.

“The strongest improvement between 1999 and 2018 in toddler diet quality was in scores for added sugars,” Zimmer and colleagues wrote. “This is consistent with well-known declines in added sugar intake among other age groups.”