Portion size can be used strategically to increase intake of vegetables and fruits in young children over multiple days: a cluster-randomized crossover trial

2021 ◽  
Author(s):  
Liane S Roe ◽  
Christine E Sanchez ◽  
Alissa D Smethers ◽  
Kathleen L Keller ◽  
Barbara J Rolls
Keyword(s):  
Energy Intake ◽  
Daily Intake ◽  
Dietary Guidelines ◽  
Portion Size ◽  
Food Groups ◽  
Childcare Centers ◽  
Sustained Effects ◽  
Side Dishes ◽  
Cluster Randomized ◽  
Vegetables And Fruits

Abstract Background Although dietary guidelines recommend that vegetables and fruits make up half the diet, it is unclear whether serving vegetables and fruits in larger portions will have sustained effects on children's intake over multiple days. Objective This study tested the effects on children's intake of 2 strategies for increasing the proportion of vegetables and fruits: either adding or substituting extra portions as side dishes at meals and snacks over 5 days. Design In a cluster-randomized crossover design with 3 periods, we provided all meals and snacks for 5 days to 53 children aged 3–5 y in classrooms in their childcare centers. In the Control condition, we served typical portions for all food groups. In the Addition condition we increased portions of low-energy-dense vegetables and fruits by 50% and in the Substitution condition we increased portions of vegetables and fruits by 50% and also reduced portions of other foods by an equivalent weight. Results For vegetables, the Addition strategy increased daily intake compared to Control by 24% (mean ± SEM 12±3 g/d; P = 0.0002) and the Substitution strategy increased intake compared to Control by 41% (22±3 g/d; P < 0.0001). For fruits, consumption increased by similar amounts: Addition by 33% (60±6 g/d) and Substitution by 38% (69±8 g/d; both P < 0.0001). Both strategies increased vegetable and fruit intakes compared to Control across all 5 days (all P < 0.004), although the increase in fruit consumption with Addition declined over time (P < 0.0001). Daily energy intake compared to Control increased by 5% with Addition (57±17 kcal; P = 0.001) but decreased by 6% with Substitution (-64±21 kcal; P = 0.004). Conclusions Both the Addition and Substitution strategies promoted increases in vegetable and fruit intake over 5 days in preschool children. When excess energy intake is a concern, substituting vegetables and fruits for other foods is a better option than simply serving more. This trial was registered as NCT03242863 at https://clinicaltrials.gov/ct2/show/NCT03242863, where the protocol is available.

scholarly journals Serving a Larger Proportion of Vegetables and Fruits Improved Children's Intake Over 5 Days

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 811-811
Author(s):  
Christine Sanchez ◽  
Liane Roe ◽  
Kathleen Keller ◽  
Barbara Rolls
Keyword(s):  
Daily Intake ◽  
Crossover Design ◽  
Fruit Intake ◽  
Food Groups ◽  
Childcare Centers ◽  
Funding Sources ◽  
Sustained Effects ◽  
Daily Intakes ◽  
Vegetables And Fruits ◽  
Current Guidelines

Abstract Objectives Although current guidelines recommend that vegetables and fruits make up half the diet, it is not known whether serving a greater proportion of vegetables and fruits will have sustained effects on children's consumption over multiple days. This study tested the effects on children's intake of two strategies for increasing the proportion of vegetables and fruits served over 5 days, either adding or substituting extra portions. Methods In a crossover design with 3 periods, all meals and snacks for 5 days were provided to 3- to 5-year-old children in their childcare centers (n = 53; 47% girls; 16% with overweight). In the Baseline condition, typical portions for all food groups were served. In the Addition condition, the portions of vegetables and fruits were increased by 50% while other meal items remained unchanged, and in the Substitution condition, vegetable and fruit portions were increased by 50% while the portions of other foods were reduced. Vegetables and fruits provided 40% of the weight of food served in Baseline, 50% in Addition, and 60% in Substitution. All foods and beverages were weighed to determine daily intakes. Results For vegetables, the Addition strategy increased daily intake compared to Baseline by 24% (12 ± 3 g; P = 0.0002) and the effect of Substitution was even greater with a 41% increase (22 ± 3 g; P < 0.001). These greater vegetable intakes were sustained across all 5 days by both strategies. For fruits, the two strategies increased overall daily intake by similar amounts: 33% by Addition (60 ± 6 g/d) and 38% by Substitution (69 ± 8 g/d; both P < 0.0001). For Substitution, this greater fruit intake was sustained across all 5 days; for Addition, mean daily fruit intake decreased across the 5 days (P < 0.0001) but was still greater than Baseline by 20% (34 ± 11 g; P = .004). Children's age and body mass index did not significantly affect vegetable and fruit intakes in response to serving greater proportions. Conclusions Children's daily vegetable and fruit intakes increased when greater proportions were served, and these intakes were sustained above baseline for 5 days. These findings indicate that following dietary guidance to make vegetables and fruits half the diet can improve children's intake, especially when vegetables and fruits are substituted for other foods. Funding Sources NIDDK.

scholarly journals Promoting Vegetable Intake in Preschool Children: Does Enhancing the Taste of Vegetables Influence the Portion Size Effect?

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 974-974
Author(s):  
Hanim Diktas ◽  
Kathleen Keller ◽  
Liane Roe ◽  
Christine Sanchez ◽  
Barbara Rolls
Keyword(s):  
Preschool Children ◽  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Kidney Diseases ◽  
Dietary Guidelines ◽  
Portion Size ◽  
The Other ◽  
Childcare Centers ◽  
Effective Strategies ◽  
Funding Sources

Abstract Objectives To meet dietary guidelines, effective strategies are needed to encourage children to eat a greater proportion of their diet from vegetables. We tested whether serving a larger portion, enhancing the taste with small amounts of butter and salt, or combining these strategies would increase vegetable intake at a meal for preschool children. Methods Using a crossover design in childcare centers, we served lunch once a week for four weeks to 67 children aged 3–5 y (61% girls; 16% with overweight or obesity). The meal consisted of two familiar vegetables (broccoli and corn) along with fish sticks, rice, ketchup, applesauce, and milk. Across the four meals, we varied the portion of vegetables (60 or 120 g total weight) and served them either plain or enhanced (0.5% salt and 6.6% light butter by weight). The other items in the meal were not varied. All meals were consumed ad libitum and weighed to determine intake. At the end of the study, children rated their liking for the foods and parents completed questionnaires about their child's eating behavior. Results Doubling the portions of vegetables led to greater consumption of both broccoli and corn (P < 0.0001) and increased total vegetable intake by 68% (mean ± SEM 21 ± 3 g). Enhancing vegetables with butter and salt, however, did not influence their intake (P = 0.13) nor modify the effect of larger portions on their intake (P = 0.10). Serving more vegetables did not affect intake of the other meal components (P = 0.57), thus meal energy intake increased by 13 ± 5 kcal (5%; P = 0.02). Ratings indicated that children had similar liking for the plain and enhanced versions of both broccoli (P = 0.31) and corn (P = 0.97). Although 73% of children rated one or both plain vegetables as yummy or just okay, they ranked their preference for the other foods in the meal higher than for the vegetables (P < 0.0001). Children differed in their response to larger portions of vegetables: those with higher scores for food fussiness and parental pressure to eat had smaller increases in vegetable intake when portions were doubled (both P < 0.03). Conclusions Serving larger portions of vegetables at a meal was an effective strategy to promote vegetable intake in children. When familiar, well-liked vegetables were served, adding butter and salt was not necessary to increase vegetable consumption. Funding Sources National Institute of Diabetes and Digestive and Kidney Diseases.

scholarly journals Child-level evaluation of a web-based intervention to improve dietary guideline implementation in childcare centers: a cluster-randomized controlled trial

2020 ◽  
Vol 111 (4) ◽  
pp. 854-863 ◽  
Author(s):  
Sze Lin Yoong ◽  
Alice Grady ◽  
John H Wiggers ◽  
Fiona G Stacey ◽  
Chris Rissel ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Child Outcomes ◽  
Guideline Implementation ◽  
Dietary Guidelines ◽  
Childcare Centers ◽  
Web Based ◽  
Dietary Guideline ◽  
Z Scores ◽  
Cluster Randomized ◽  
The Impact

ABSTRACT Background Although it is recommended that childcare centers provide foods consistent with dietary guidelines, the impact of implementing sector-specific guidelines on child outcomes is largely unknown. Objectives This study aims to examine the impact of a web-based program and support to implement dietary guidelines in childcare centers on children's 1) diet; 2) BMI z scores; and 3) child health-related quality of life (HRQoL). Methods This study was a cluster-randomized controlled trial utilizing a Type-3 Hybrid implementation-effectiveness design conducted between October 2016 and March 2018. This study reports on child outcomes. Fifty-four childcare centers in New South Wales, Australia were randomly assigned to the intervention (a web-based menu-planning tool and support) or control group (usual care). The intervention was designed to address barriers and enablers to dietary guideline implementation according to the Theoretical Domains Framework. A quota of 35 consenting childcare centers undertook child-level evaluation of dietary intake where 522 parents consented to completing ≥1 component of data collection for their child. Child consumption of core and discretionary (unhealthy) foods while in care was assessed via dietary observations by blinded research assistants, childcare diet quality was assessed via educator-completed questionnaires, BMI z scores were assessed via measured weight and height, and child HRQoL was assessed via parent report at baseline and 12-mo follow-up. Results There was a significant increase in mean child consumption of fruit (0.39 servings; 95% CI: 0.12, 0.65 servings) and dairy foods (0.38 servings; 95% CI: 0.19, 0.57 servings) and a significant reduction in consumption of discretionary foods (−0.40 servings; 95% CI: −0.64, −0.16 servings) in care in the intervention group, relative to control at 12-mo follow-up. No significant differences were observed in diet quality, BMI z scores, or HRQoL. Conclusions A web-based intervention to support planning of childcare menus consistent with dietary guidelines can improve child consumption of healthier foods in daycare. This trial was registered at www.anzctr.org.au as ACTRN12616000974404.

scholarly journals Multi-Level, Multi-Component Intervention Improves Dietary Intake in Native American Adults

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 989-989
Author(s):  
Leslie Redmond ◽  
Michelle Estrade ◽  
Caroline Wensel ◽  
Brittany Jock ◽  
Tara Maudrie ◽  
...  
Keyword(s):  
Native American ◽  
Dietary Intake ◽  
Daily Intake ◽  
Intervention Group ◽  
Dietary Guidelines ◽  
Control Group ◽  
Food Groups ◽  
Total N ◽  
Multi Level ◽  
Group 1

Abstract Objectives To assess impact of a multi-level, multi-component (MLMC) intervention on dietary intake in Native American adults. Methods A MLMC obesity intervention ([blinded for review]) was implemented among Native American adults in six rural tribal communities in the US Southwest and Midwest. [Blinded for review] included institutional level components, demonstrations, and distribution of educational media/materials in food stores, worksites, and schools. Communities were randomized to intervention (Group 1; n = 3) or control (Group 2; n = 3). Data collection surveys included a semi-quantitative Block food frequency questionnaire and an Adult Impact Questionnaire for demographics and anthropometrics. This analysis assessed change in daily energy and macronutrient intake from baseline to follow-up, daily intake of types of dietary fat, and daily servings of food groups as defined by the 2015–2020 Dietary Guidelines for Americans using multilevel mixed-effects linear regression with clustering at the community level. All models were adjusted for age, gender, education, Material Style of Life score (proxy for socio-economic status), smoking, and baseline dependent variable of interest. Results 492 participants completed both baseline and post-intervention surveys: 31 were excluded due to reports of daily caloric intake outside of established cut-offs (<500 kcal or >7000 kcal per day), and 15 were excluded due to incomplete data, for a total n = 446 for this analysis. The between group effect was significant for change in energy intake (−188.21 kcal; P = 0.050), total grams of carbohydrate (−22.48 g; P = 0.047), total grams of fat (−8.82 g; P = 0.044), and total grams of saturated fat (−3.19 g; P = 0.031), with greater decreases observed in Group 1. Change in total grams of sugar trended towards significance (−12.06 g; P = 0.057); similarly, greater decreases were observed in Group 1. Change in daily servings of fats and sweets was also significantly different between groups (−0.39 servings; P = 0.036), with greater decreases observed in Group 1. Conclusions MLMC interventions can significantly impact dietary intake among rural Native American adults. This is especially important given the high risk of obesity and other diet-related chronic diseases among Native American adults. Funding Sources National Heart, Lung, and Blood Institute

scholarly journals Optimizing Complementary Diets to Provide Nutrient Adequacy for Infants 6 to 12 Months Old: A Dietary Modelling Study (P11-090-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lynda O'Neill ◽  
Anne Dattilo ◽  
Matthieu Maillot ◽  
Florent Vieux ◽  
Jose Saavedra
Keyword(s):  
Vitamin D ◽  
Breast Milk ◽  
Daily Intake ◽  
Dietary Guidelines ◽  
Food Groups ◽  
University Of Minnesota ◽  
Data Set ◽  
Nutrient Adequacy ◽  
Developmental Appropriateness ◽  
Breast Fed

Abstract Objectives The purpose of this study was to determine the optimal composition of complementary diets for infants 6 to 12 months old (m.o), in terms of daily intake of food groups to ensure nutrient adequacy. A secondary goal was to determine differences in these optimized diets with fortified versus unfortified foods. Methods Dietary modelling using linear programming was applied to the Feeding Infants and Toddlers Study 2016 data set to develop theoretical diets that satisfy nutrient requirements, while meeting median energy needs, for 6 to 8 m.o. and 9 to 12 m.o. breast-fed, formula-fed, and mixed-fed infants. The food data set was adjusted to ensure, among other criteria, developmental appropriateness and safety. Using the Nutrition Data System for Research (NDSR, version 2015: University of Minnesota, Minneapolis, MN), the current US fortification for grains was included, and analyses were then performed without fortification. Results Among modelled diets for 6 to 8 m.o., a greater amount of total food, particularly vegetables, was required to achieve nutrient adequacy in the absence of fortification. The quantity of vegetables ranged from 54 g/day (3.5% of total energy (E)) in the formula based fortified diet up to 206 g/day (15% of E) in the breast milk unfortified diet. The modelling showed that inclusion of starches and grains was negligible in the unfortified diets, being primarily replaced by vegetables and pulses. For 9 to 12 m.o., daily intake of vegetables were particularly high at 222 g/day (12% of E), in the breast-fed, unfortified group. Pulses, nuts and seeds were featured in the unfortified diets at a level of 61 g/day (10% of E) in both the breast milk diet and the mixed diet. In terms of nutrient adequacy, all requirements were met apart from iron in the breast fed unfortified diet for 6 to 8 m.o.. Meeting Vitamin D was unachievable in all but the formula based diets for 6 to 8 m.o. Conclusions Fortification or supplementation is required to provide adequate iron to breast-fed infants, particularly in the early months of complementary feeding, and vitamin D to most infants. The diet optimization, which could be the basis for food based dietary guidelines, showed that complementary diets should be adapted according to the milk source in the infant diet. Funding Sources Nestlé Nutrition, Vevey, Switzerland.

scholarly journals Demographic and socio-economic factors related to food intake and adherence to nutritional recommendations in a cohort of pre-school children

2011 ◽  
Vol 14 (6) ◽  
pp. 1096-1104 ◽  
Author(s):  
Lise Dubois ◽  
Anna Farmer ◽  
Manon Girard ◽  
Daniel Burnier ◽  
Marion Porcherie
Keyword(s):  
Food Intake ◽  
Energy Intake ◽  
Healthy Eating ◽  
School Children ◽  
Demographic Factors ◽  
Dietary Guidelines ◽  
Care Staff ◽  
Food Groups ◽  
Dietary Recommendations ◽  
The Mean

AbstractObjectiveTo examine: (i) children's food intake and adherence to both Canada's Food Guide for Healthy Eating and Dietary Reference Intakes; and (ii) the social and demographic factors related to children's food intake.DesignA cross-sectional study.SettingData were obtained through the Quebec Longitudinal Study of Child Development 1998–2010, a representative sample (n 2103) of children born in 1998 in the province of Quebec, Canada. Information on energy, macronutrient and food consumption was derived from responses to a 24 h dietary recall interview addressed to children's mothers and day-care staff when the children were 4 years old.SubjectsA total of 1549 children aged 4 years who participated in a nutritional sub-study.ResultsThe mean daily total energy intake was 6360 kJ (1520 kcal) for girls and 6916 kJ (1653 kcal) for boys. For boys and girls alike, energy intake was comprised of approximately 54 % carbohydrates, 31 % fats and 15 % proteins. The mean number of servings consumed from each of the four essential food groups closely approached the dietary recommendations made by Canada's Food Guide for Healthy Eating; however, <2 % of the children in the present study actually met the full dietary guidelines. The dietary intake of pre-school children was associated with socio-economic and demographic factors, most notably mother's level of education, mother's immigrant status and sex of the child.ConclusionsDiet-related disparities associated with socio-economic and demographic factors exist from as early as 4 years of age.

Under-reporting of energy intake is more prevalent in a healthy dietary pattern cluster

2008 ◽  
Vol 100 (5) ◽  
pp. 1060-1068 ◽  
Author(s):  
Fernanda B. Scagliusi ◽  
Eduardo Ferriolli ◽  
Karina Pfrimer ◽  
Cibele Laureano ◽  
Caroline S. F. Cunha ◽  
...  
Keyword(s):  
Energy Intake ◽  
Dietary Pattern ◽  
Dietary Guidelines ◽  
Food Groups ◽  
Anthropometric Data ◽  
Doubly Labelled Water ◽  
Daily Frequency ◽  
Sweet Foods ◽  
Reporting Rates ◽  
Starchy Foods

The aim of the present study was to determine whether under-reporting rates vary between dietary pattern clusters. Subjects were sixty-five Brazilian women. During 3 weeks, anthropometric data were collected, total energy expenditure (TEE) was determined by the doubly labelled water method and diet was measured. Energy intake (EI) and the daily frequency of consumption per 1000 kJ of twenty-two food groups were obtained from a FFQ. These frequencies were entered into a cluster analysis procedure in order to obtain dietary patterns. Under-reporters were defined as those who did not lose more than 1 kg of body weight during the study and presented EI:TEE less than 0·82. Three dietary pattern clusters were identified and named according to their most recurrent food groups: sweet foods (SW), starchy foods (ST) and healthy (H). Subjects from the healthy cluster had the lowest mean EI:TEE (SW = 0·86, ST = 0·71 and H = 0·58; P = 0·003) and EI − TEE (SW = − 0·49 MJ, ST = − 3·20 MJ and H = − 5·08 MJ; P = 0·008). The proportion of under-reporters was 45·2 (95 % CI 35·5, 55·0) % in the SW cluster; 58·3 (95 % CI 48·6, 68·0) % in the ST cluster and 70·0 (95 % CI 61·0, 79) % in the H cluster (P = 0·34). Thus, in Brazilian women, under-reporting of EI is not uniformly distributed among dietary pattern clusters and tends to be more severe among subjects from the healthy cluster. This cluster is more consistent with both dietary guidelines and with what lay individuals usually consider ‘healthy eating’.

scholarly journals Adherence to Pakistan dietary guidelines – Findings from major cities of Pakistan

2020 ◽  
Author(s):  
Ibrar Rafique ◽  
Arif Nadeem Saqib Muhammad ◽  
Nighat Murad ◽  
Muhammad Kashif Munir ◽  
Aftab Khan ◽  
...  
Keyword(s):  
Female Gender ◽  
Food Group ◽  
Dietary Guidelines ◽  
Local Context ◽  
Food Groups ◽  
Community Based ◽  
Food Frequency ◽  
Vegetables And Fruits ◽  
Eating Practices ◽  
Score Point

AbstractBackgroundPakistan dietary guidelines for better nutrition were developed to cater the local need and prevent nutritional deficiency by providing information to public about healthy eating practices.AimsTo assess the level of adherence to Pakistan Dietary Guidelines for Better Nutrition (PDGN)MethodsIt was a community based study conducted in five cities with two stage stratified sampling approach. Total of 448 participants were interviewed using Food frequency questionnaire adapted to local context. Five food groups (proteins, cereals, dairy, vegetables and fruits) were taken as per country guidelines. A score point of 1 was given to each food group making a total of 5 scores. Data were analyzed using SPSS.ResultsOverall adherence to PDGN was poor as none of the participants had 05 score while only 1% achieved score 04. However, adherence was more in females (B = 0.45, 95%CI = 0.24; 0.66), graduates (B = 0.45, 95% CI = 0.25; 0.64), unmarried (B = 0.30, 95% CI = 0.18; 0.43), unemployed (B = 0.22, 95% CI = 0.01-0.43) and aged >50 years (B = 0.34, 95% CI = 0.08; 0.60) as compared to others. Among food groups, mean intake of cereals (carbohydrates) was high (3.38±1.39) followed by other items with fruits was least (0.76±0.91). Overall, at least one serving of discretionary food was taken by participants which was more female gender (p= 0.001), graduates (p= 0.003), high socio-economic group (p=0.001) and employed persons (p= 0.04).ConclusionThe adherence to PDGN was poor and there is a need to bring behavior change by information education and communication to the society.

scholarly journals A Food Group Based Approach to Satisfy Nutrient Recommendations in Toddlers (12-24 Months) Using Dietary Modelling (P11-091-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Lynda O'Neill ◽  
Anne Dattilo ◽  
Matthieu Maillot ◽  
Florent Vieux ◽  
Jose Saavedra
Keyword(s):  
Vitamin D ◽  
Daily Intake ◽  
Food Group ◽  
Dietary Guidelines ◽  
Food Groups ◽  
University Of Minnesota ◽  
Dietary Recommendations ◽  
Data Set ◽  
Food Component ◽  
Nutrient Adequacy

Abstract Objectives The aim of this study was to optimize the quantity of daily intake of food groups to meet energy, nutrient needs, and to assess differences in diets using fortified versus unfortified foods to provide nutrient adequacy in the second year of life. Methods Mathematical modeling was applied to the Feeding Infants and Toddlers Study 2016 (observed diet) data set to develop optimized theoretical toddler (12 – 24 months old) diets. The model was constrained to meet median energy requirements and appropriate nutrient reference values and minimize the deviation from the average observed diet. Only the complementary food component of the diet was modelled. Using the Nutrition Data System for Research (NDSR, version 2015: University of Minnesota, Minneapolis, MN), the current US fortification of grains and dairy were accounted for and the analysis was repeated without fortification. Results The mathematically modeled diets revealed a lower quantity of food (613 to 732 g/day less) and energy (449.3 kcal/per day) were needed to meet nutrient recommendations, compared to the observed diet. The modelled diets contained less meat and fish and less starches and grains, compared to the observed diet. However, the modelled diets contained greater quantities of vegetables and fruit than the observed diet. Additional fruit and vegetables were required when the modelled diet was unfortified rather than when it was fortified. However, the fortified diet allowed for greater variety, and inclusion of other dairy (yogurt and cheese), and starches and grains compared with the unfortified diet. In terms of nutrient adequacy, the modelled fortifed diet met all recommendations, whereas the unfortified diet met all but vitamin D. Conclusions Our results indicate that with the exception of Vitamin D, nutrient needs of young toddler age children can be satisfied with lower and more appropriate energy intake than currently observed. These findings can assist with dietary recommendations based on a food group approach, for meal planning, or for the development of food based dietary guidelines. Funding Sources Nestlé Nutrition, Vevey, Switzerland.

scholarly journals Grain Foods in US Infants Are Associated with Greater Nutrient Intakes, Improved Diet Quality and Increased Consumption of Recommended Food Groups

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2840
Author(s):  
Yanni Papanikolaou ◽  
Victor L. Fulgoni
Keyword(s):  
Dietary Fiber ◽  
Diet Quality ◽  
Dietary Pattern ◽  
Vitamin B6 ◽  
Daily Intake ◽  
Food Group ◽  
Dietary Guidelines ◽  
Committee Report ◽  
Food Groups ◽  
Grain Foods

There are limited data providing guidance on grain foods as part of a healthy dietary pattern in infants and may represent a gap in knowledge for the development of the 2020–2025 Dietary Guidelines for Americans Scientific Advisory Committee report currently in progress. An analysis using infant data from the National Health and Nutrition Examination Survey was conducted to assess grain food relationships with nutrient and energy intakes, diet quality, and food group consumption in infant consumers relative to non-consumers. Grain consumers were defined as infants consuming foods from the main grain food group, as defined by the US Department of Agriculture, and included whole and refined/enriched grains. All infants consuming grain foods had greater energy (kcal) vs. grain non-consumers (p’s < 0.0047). While infant grain consumers 6- to 12-months-old (N = 942) had higher daily intakes of sodium and added and total sugars, these infants also had significantly higher dietary fiber, calcium, folate, potassium, magnesium, zinc, phosphorus, choline, thiamin, riboflavin, and vitamin B6 compared to non-consumers. In 13- to 23-month-olds (N = 1668), grain consumption was associated with greater daily dietary fiber, iron, zinc, magnesium, phosphorus, folate, riboflavin, niacin, thiamin, vitamin A, vitamin B6, and vitamin B12 relative to non-consumers. Diet quality scores were significantly higher in all infant grain consumers examined in comparison to non-consumers (p’s < 0.0065). Grain intake was also linked with greater daily intake of several recommended food groups in both younger and older infants versus non-consumption of grains. The current analysis provides evidence to substantiate the inclusion of whole and enriched grain foods as part of the infant dietary pattern as beneficial associations between grain food consumption and dietary quality are apparent. Eliminating and/or reducing grain foods in infant dietary patterns may lead to unintended nutrient and health consequences.

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