24 May Feeding Children and Adolescents: The Latest Recommendations
This post is in collaboration with Beef. It’s What’s for Dinner., managed by NCBA, a contractor to the Beef Checkoff. All opinions are my own.
In December 2020, the 2020-2025 Dietary Guidelines for Americans (DGAs) were released, and this time the focus was on specific nutrient needs throughout various life stages. The theme of these latest guidelines is to “Make Every Bite Count,” starting at birth and throughout each and every life stage – including childhood and adolescents. Here’s a look into the updated dietary guidance for children and adolescents, including some of my go-to feeding tips for improving diet quality for these age groups through my own experience with my three kids.
How Healthfully Are Kids Eating?
The Healthy Eating Index (HEI) is a scale that measures diet quality quantifying how well diet intake aligns with key recommendations from the DGAs with a possible score ranging from 0 to 100.The higher the total HEI score indicates a higher diet quality. The HEI of all Americans between 2011 and 2012 was 60, while the average HEI of all Americans between 2013 and 2016 was 59. Clearly there is a lot of room for improvement in the American diet. But, specifically, how are children and adolescents doing?
In the DGAs, children and adolescents are categorized between the ages of 2 and 18 years. According to the 2020-2025 DGAs (where they chart the adherence of the U.S. population to the DGAs across life stages), here are the average HEI scores of children and adolescents between 2-18 years:
- 2-4 years: 61
- 5-8 years: 55
- 9-13 years: 52
- 14-18 years: 51
As you can see above, teenagers have the lowest HEI score, meaning there is significant room for improvement when it comes to healthy eating. These low HEI scores indicate low dietary quality, and that children and adolescents, on average, need to improve their current intake patterns. This can account for the fact that a high percentage of the U.S. population is overweight and obese, including 40% of all children and youth. The DGAs recommends shifting, even from the youngest of age, to healthier food and beverages choices and emphasize making every bite count. It’s never too early to improve food and beverage choices!
Shifting to a Healthier Balance
Many children and adolescents do not have well-balanced diets (as evidenced by average HEI scores referenced above). According to the DGAs, they tend to overconsume foods with added sugar and sodium and under-consume more nutrient-dense foods, leading to nutrient imbalances. Here’s a list of nutrients they may not be getting enough of:
Calcium, Vitamin D, Potassium, and Dietary Fiber: These are nutrients of concern in all stages of the life cycle, including children and adolescents. At this age, calcium and vitamin D help with building bones and making them rigid and strong. Getting enough of both these nutrients also helps prevent diseases such as osteoporosis later in life. Potassium is found in fruits and vegetables, and the lack of these minerals showcases the fact that kids aren’t eating enough produce. Fiber is also found in fruits and vegetables, but also in a variety of plant-based foods like beans, peas, lentils, nuts, seeds, and whole grains. Fiber has a plethora of health benefits including keeping the gastrointestinal tract healthy, helping you feed satisfied, helping to lower cholesterol and decreasing the risk of colon cancer.
Protein: Because teenage girls eat less meat, poultry, and eggs and lower amounts of seafood, beans, peas, and lentils, they tend to under consume protein.
Iron: Adolescent females tend to consume fewer iron-rich foods like beef, which can lead to insufficient iron intake; at the same time, the onset of menstruation increases this age group’s iron requirements. Iron is an essential part of red blood cells that transports oxygen from the lungs to the tissues within the body. In addition, iron is needed to help with growth and neurological development. Although you can find iron in plant-based foods like beans and lentils, they are most easily absorbed from animal-sourced food, such as lean beef and chicken.
Choline: Adolescent boys and girls tend to under consume choline which helps form lecithin, a structural part of every cell in the body. Choline is also needed by the brain and nervous system to regulate memory, mood, muscle control, and other functions. Foods high in choline include meat like beef, chicken, fish, eggs, and dairy products.
Folate: Adolescent girls tend to under consume this B-vitamin which is needed to make DNA and to help our cells divide. It can be found in vegetables like brussels sprouts, spinach, and asparagus, fruits like oranges and orange juice, and nuts, beans, and peas.
Vitamin B12: Adolescent girls also tend to under consume vitamin B12, which helps keep the body’s nerves and blood cells healthy and helps make DNA. It can be found in animal products like beef, eggs, and chicken—foods which adolescent girls tend not to eat enough of.
There are some foods or food groups that are of special concern to children and adolescents. They are listed below:
- Sugar-sweetened beverages: Beverages like soda, fruit drinks, sports drink, and energy drinks are not essential for a child or teenager. The data shows that children and teens increase their intake of added sugar during this life stage, with sugar-sweetened beverages being a top contributor. In childhood, sugar-sweetened beverages make up approximately 15-25% of total added sugar. By adolescence, sugar-sweetened beverages contribute about 32% — even more when you add in coffee and tea beverages with added sugar (that’s another 7%!). Children and adolescence should be encouraged to choose beverages with no added sugar such as water and unsweetened fat-free or low fat milk or fortified soy milk.
- Juice: Many fruit drinks provide minimal juice and are considered a sugar-sweetened beverage because they are mostly made from water and added sugar. If a child or teenager would like to consume 100% fruit juice, then it should be portion controlled between 4 to 10 fluid ounces, depending on age. As juice lacks fiber, an under consumed nutrient, it’s important that whole fruit also be included as part of a healthy dietary pattern.
- Dairy and Fortified Soy Alternative: During this life stage, milk as a beverage is lower and cheese intake in sandwiches, pizza and pasta is higher among adolescents compared to younger children. During this life stage, unsweetened fat-free and low fat (1%) milk, yogurt, cheese, fortified soy milk and yogurt, and low-lactose or lactose-free dairy products should be selected. These foods provide protein needed for growth and three of the nutrients of public health concern including calcium, potassium, and vitamin D.
Once children grow into teenagers they start feeding themselves more independently. They will go with their friends out to lunch and choose what they want to eat without a parent or caregiver overlooking them. Many teenagers may opt for foods high in saturated fat and added sugar (think pizza and soda), but here are some recommendations to help teenagers navigate menus to make healthier choices:
- Promote drinking calorie-free beverages like water, fat-free and low-fat milk. If they would like to drink coffee and tea, then minimize the added sugar and high calorie add-ins like cream.
- Review the menus from restaurants the teen visits without you. Come to an agreement with 1 or 2 menu items that are both healthy and delicious.
- Involve teenagers in selecting and preparing meals and snacks at home which can help teach them to make healthier choices. This includes choosing fruits, vegetables, lean protein, like beef and chicken and beans, peas, and lentils, whole grains, low and nonfat milk and dairy, and healthy oils. Below are several recipes you can cook together with your teenager.
- Find cookbooks and recipes that are simple to prepare and cook. Here are some favorites my teenage kids cook up that provide the nutrition they need: