Toddler diet quality is improving, but has far to go


The quality of diets in children is improving, but especially in low-income and racially diverse groups, there is still a long way to go in meeting nutritional recommendations.

Multiple studies have examined the relationship between socioeconomic status and diet quality in children, but a new study took a closer look at diet quality and how it relates to obesity risk in children from low-income and racially diverse backgrounds.

A report published by the National Institutes of Health earlier this year revealed that although diets of children in the United States have improved somewhat overall, diet quality among kids in general still remains poor. Older children have the worst diets, according to the report, and household income and parental education levels play a big role in diet quality. Consumption of sugar-sweetened beverages declined over the study period, from 1999 to 2016, but sodium increased, significantly exceeding guidelines. This is in large part believed to be due to increased consumption of processed foods and foods not cooked at home.

Now, a new study published in the Journal of Pediatric Gastroenterology and Nutrition investigated diet quality in two-year-olds from racially and ethnically diverse backgrounds using the Healthy Eating Index as a benchmark.1

The research team assessed diet quality of toddlers aged 2 to 3 years across 4 clinics using a 24-hour recall of the foods they ate according to their caregivers. Most of the participants in the study were hispanic and non-hispanic Black, and from low-income areas. The research team found that hispanic children, and those with parents who were not obese, aged older than 35 years, and born outside the United States had the highest Healthy Eating Scores.

The research team also notes that even in children with higher diet scores, few achieved their best possible scores when it came to certain foods. In fact, only 13% met goals in terms of whole grain consumption, 10% met vegetable goals, and only 7% achieved maximum scores for fatty acid ratio consumption.

The study concluded that even when toddlers in diverse and low-income groups met recommendations for some food categories—like fruit, dairy, and proteins—there is still a lot lacking nutritionally when it comes to overall diet quality in low-income toddlers.


1. Kay M, Silver H, Yin S, et al. Assessing diet quality in a racially and ethnically diverse cohort of low-income toddlers. J Pediatr Gastroenterol Nutr. 2020;71(5):679-685. doi:10.1097/MPG.0000000000002871

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