A federal committee’s recommendations for what babies and toddlers should eat highlight growing concerns about nutrient deficiencies and later obesity. But advice that youngsters eat a significant amount of meat is spurring a backlash from advocates of plant-based diets.
The recommendations encourage parents to feed their children more whole grains—and fewer refined ones—along with fruits, vegetables, low-fat dairy products and no added sugar. They also suggest that babies and toddlers eat meat as well as poultry, seafood and eggs to meet the needs for critical nutrients for growth and development, particularly iron, zinc and choline.
The advice is part of a process of revising the U.S. Dietary Guidelines for Americans. It’s the first time the guidelines will include recommendations for kids under two. Dietary recommendations are a fractious topic right now, with debates over the impact of carbohydrates, meat and many other foods.
The goal of the committee’s recommendations for babies and toddlers is to lay the foundation for a lifetime of healthy eating, says Kathryn Dewey, professor emerita in the department of nutrition at the University of California, Davis, who chaired the birth to 24 months subcommittee. “If we can establish those healthier patterns right away, it will get them used to eating these types of foods,” says Sharon M. Donovan, professor of nutrition and health at the University of Illinois at Urbana-Champaign and a member of the committee.
The committee, which was composed of 20 academics and doctors, released its recommendations in July. The U.S. Department of Agriculture and the Department of Health and Human Services will review them and issue final guidelines by the end of the year. The dietary guidelines have a wide impact: They shape school lunch programs, mold state and local health-promotion efforts, and influence what food companies produce.
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The baby and toddler recommendations have drawn some criticism. The Physicians Committee for Responsible Medicine, a nonprofit organization that advocates plant-based diets, disagreed with the committee’s emphasis on animal products. “There isn’t scientific evidence to suggest somehow infants would be better off consuming meat, seafood, eggs and dairy,” says Susan Levin, a registered dietitian and the organization’s director of nutrition education. She says that infants and toddlers can get iron, for example, from foods like fortified cereals, spinach and lentils.
For adults, federal recommendations suggest eating less red meat—a diet high in red meat has been linked to a higher risk of cardiovascular disease, cancer and diabetes. The baby/toddler committee decided that developmental needs for kids younger than two are different, says Ronald Kleinman, chief of the department of pediatrics at Massachusetts General Hospital, and a member of the federal committee. “The most important message is that we eat somewhat differently at each life stage,” he said.
The recommendations reflect a shift in how doctors think about feeding babies who are ready to move beyond breast milk or formula alone, says Dr. Kleinman. Before “it was a pretty rigid prescription, you start with rice cereal and you move onto a fruit and onto a vegetable and so on,” says Dr. Kleinman. The protocol was partly shaped by a concern about food allergies. But, in recent years, studies have found that introducing foods like peanuts within the first year of life actually may reduce the risk of food allergies.
Also, as more mothers breast-feed, and for longer periods, and babies consume less fortified infant cereals, the issues of iron and zinc deficiency have taken on more urgency, says Steven Abrams, a professor of pediatrics at the Dell Medical School at the University of Texas at Austin and chair of the American Academy of Pediatrics’ committee on nutrition, who wasn’t on the federal committee. More than three-quarters of breast-fed infants ages six to 12 months don’t consume enough iron and 54% don’t get enough zinc, according to data analyzed by the federal committee. (Formulas and infant cereals are fortified with iron, zinc and other nutrients.) “In the first few years of life, the brain needs iron to develop normally,” says Dr. Abrams, who notes that red meat is a good source of iron. Dr. Dewey says chicken livers are a particularly rich source. Zinc is important for immune function, says Dr. Kleinman.
The committee recommends that infants be exclusively breast-fed until about six months old. The committee said it couldn’t develop a recommended dietary pattern that included all of the nutrients needed for babies six to 12 months old. But the members did offer a template that comes close. From six months to nine months, for example, babies should have between one-eighth to one-fourth cups of fruits and vegetables each per day, as well as fortified infant cereal, dairy and protein foods. Each week those protein foods should consist of between 4 ⅔ ounces and 16 ounces of red meat, one-half ounce to 1 ¼ ounces of poultry, as well as “modest amounts” of seafood, eggs, nuts and seeds.
For toddlers ages one to two years old who aren’t breast-fed or receiving formula, the committee developed a recommended diet for a variety of daily calorie needs ranging from 700 to 1,000 calories per day. For toddlers needing 1,000 calories a day, for example, the committee recommended 1 cup of fruits and 1 cup of vegetables, 3 ounces of grains (2 of which should be whole grains), 2 cups of dairy and 2 ounces of protein foods. Each week, they should eat 7.7 ounces of red meat and poultry, 3 ounces of seafood as well as eggs, nuts, seeds and soy. The committee also offered an alternative “vegetarian style” diet that includes eggs, which are a good source of choline, and dairy. Choline is important for vision and cognitive development. “A totally vegan diet at this age is really not going to meet nutrient needs unless you use a lot of fortified products,” Dr. Dewey says.
The committee recommends that children younger than two consume no added sugars—which are found in everything from fruit punch to yogurt to breakfast cereal—at all. That doesn’t include sugars naturally found in foods like fruits and dairy products. Nutrient needs are so high during this stage of life that there’s no room for added sugars without going beyond calorie needs, says Dr. Dewey.
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