More nutrition guidance needed to build good eating habits in growing children, says Nestle FITS survey

Parents and caregivers are hearing and following the feeding guidance for infants, yet continued work needs to be done to help them also build good eating habits for their growing children, suggests data from the Nestle Feeding Infants and Toddlers Study (FITS) released today at a symposium at the American Dietetic Association's Food & Nutrition Conference & Expo.

The study reveals both progress and areas of concern in the diets of young children in the United States. The data show some positive trends versus 2002 when Gerber Products Company, now part of the Nestle family, first commissioned the FITS study. Infants are being breastfed longer; and fewer infants and toddlers are consuming sweets and sweetened beverages on a given day. However, other findings are less positive -- on a given day, many toddlers and preschoolers aren't eating a single serving of vegetables or fruit; and many toddlers and preschoolers are consuming diets with less than the recommended 30-to-40 percent of calories from fat. Most preschoolers are eating too much saturated fat and sodium.

The FITS findings suggest that more guidance and support is needed to help caregivers better transition from feeding their babies to meeting the unique nutrition and feeding needs of a toddler or preschooler. As a result, too many young children are mirroring the often unhealthy eating patterns of American adults.

Leveraging science to nourish a healthier generation

"Good nutrition from birth through preschool sets the foundation for healthy habits later in life," said Dr. Kathleen Reidy, Head, Nutrition Science, Meals & Drinks, Nestle Nutrition. "The Nestle FITS data provide a rich source of information and we'll continue to analyze the data for new insights, sharing and applying our findings to advance the quality of children's diets."

Nestle FITS is a dietary intake survey of a large, cross-sectional sample of parents and caregivers that provides a snapshot of the eating patterns and nutrient intakes on a given day of infants, toddlers, and preschoolers living in the United States. Data were collected for a sample of 3,378 children age zero-to-four years and provided important information on what foods are eaten at various different stages of development as children transition from an all milk diet onto the foods of the family. Nestle FITS 2008 is an updated and expanded survey from FITS 2002 that provided dietary data on a sample of 3,000 infants and toddlers age four-to-24 months.

The 2008 study offers a comparison to 2002 for those children age four-to-24 months, and provides new data and insight into the eating patterns and nutrient intakes of children age zero-to-three months and preschoolers. Mathematica Policy Research, a nonpartisan research firm, conducted the study on behalf of Nestle. Mathematica also conducted the FITS 2002 study.

"Parents and caregivers need support and education around the unique nutrition needs of young children," said Dr. Nancy Butte, PhD. Professor, USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine. "The 2008 FITS data shows us that more feeding guidance is needed during the transition to table foods. We are seeing eating patterns in toddlers and preschoolers that mirror those of adults--24 percent of children ages two-to-five are overweight or obese in the United States. We need to put more focus on establishing healthy eating patterns during the first four years."

2008 Nestle FITS Study Highlights

• Fewer infants are consuming sweets or sweetened beverages. Seventeen percent of infants age six-to-eight months, consumed a dessert, sweet or sweetened beverage on a given day versus 36 percent in 2002. A similar change was seen for children age nine-to-11 months old, with 43 percent in 2008 versus 59 percent in 2002 consuming any dessert, sweet or sweetened beverage.
• Fruit and vegetable consumption remains a problem for all age groups studied. About 25 percent of older infants, toddlers and preschoolers don't eat a single serving of fruit on a given day, and 30 percent don't eat a single serving of vegetables. These findings are similar to those in FITS 2002 for infants and toddlers.
• Fewer toddlers were consuming sweetened beverages in 2008 than in 2002. This was especially true among children age 12-to-14 months (14 percent drank a sweetened beverage on a given day in 2008 versus 29 percent in 2002) and children 18-to-20 months (29 percent in 2008 versus 47 percent in 2002).
• On a given day 23 percent of toddlers 12-to-24 months and one third of preschoolers are consuming diets of less than the recommended 30-to-40 percent of calories from fat. Yet, 75 percent of preschoolers are consuming too much saturated fat.
• Mothers are breastfeeding their children longer. In 2008, 33 percent of nine-to-11 month olds are still receiving breast milk compared to just 21 percent in 2002.

Other survey findings

• French fries are still the most popular vegetable among toddlers and preschoolers. However, among older babies there were improvements, and French fries are no longer ranked in the top five vegetables among infants age nine-to-11 months, compared to FITS 2002, when French fries ranked among the top vegetables in the diets of older infants on a given day.
• There is a significant reduction in the number of infants, age four-to-11 months, consuming juice on a given day, versus 2002.
• A small but important number of older infants are not getting enough iron. Twelve percent of children from six-to-11 months of age are not getting enough iron on a given day.
• Seventy-one percent of toddlers and eighty-four percent of preschoolers consume more sodium than recommended on a given day.

A dietary snapshot by developmental stage

The Nestle FITS 2008 findings provide insight into the diets of children at key developmental stages--infants, toddlers and preschoolers. The good news is that caregivers are hearing and following the feeding guidance for infants, yet FITS 2008 shows that more progress is needed in the diets of toddlers and preschoolers. Compared to FITS 2002, the number of months children breastfeed is longer, which builds the child's immunity, aids a growing baby's brain and eye development, and may help to lower the child's risk of developing allergies and infections. What's more, the introduction of juice is being delayed for infants, and fewer are consuming French fries, sweetened beverages and sweets on a given day. While FITS 2008 shows positive trends in the diets of infants, the data reveal that some older infants have low intakes of iron and consumption of iron-fortified infant cereal is being stopped earlier.

As infants grow into toddlers, it is clear from the FITS 2008 findings that more nutrition guidance for parents is needed for this important developmental stage. Overall, on a given day, toddlers are meeting most of their nutrient requirements for healthy growth and development, however, FITS data show gaps in the intake of vegetables, fruit, fiber, vitamin E, potassium and total fat. The data reflect promising downward trends among toddlers in the consumption of French fries, sweets and sweetened beverages, but more improvement is needed.

FITS 2008 provides a first-of-its-kind nutrition snapshot of preschoolers (children ages 24-to-48 months). The findings show that on a given day, many preschoolers have unhealthy eating patterns reflective of the diets of older children and adults in the United States. In particular, preschoolers are not consuming enough fruits and vegetables, fiber, potassium and vitamin E and are taking in too much saturated fat and sodium.

Help for parents: Start Healthy, Stay Healthy((TM))( )

FITS 2002 was the foundation of the Start Healthy, Stay Healthy(TM) nutrition system, Nestle's patent-pending stage-based nutrition system that combines products, education and services to foster healthy growth and development and the early establishment of healthy eating habits from birth to preschool. Start Healthy, Stay Healthy Milestones Symbols(TM) direct parents to the information and products tailored to their child's developmental stage. The insights from FITS, along with dietary recommendations from the United States Department of Agriculture (USDA), the National Academy of Sciences/Institute of Medicine (NAS/ IOM) and the American Academy of Pediatrics (AAP) are the foundation of the Start Healthy, Stay Healthy feeding guidelines and resources(1).