Make Every Bite Count: Toddlers

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The new Dietary Guidelines provide two healthy eating patterns for toddlers between the ages of 12 and 23 months who are no longer taking breastmilk or formula. Both patterns include a variety of nutrient-dense foods and beverages.

Healthy U.S.-Style Dietary Pattern:

• Vegetables
• Fruits
• Grains
• Dairy: whole milk, yogurt, and cheese
  • Fortified soy milk (unsweetened) counts as a dairy food
• Protein foods: lean meats, poultry, eggs, nuts, and seeds
  • Seafood (see Seafood Safety below)
• Oils

Healthy Dietary Vegetarian Pattern for Toddlers (Lacto-Ovo Vegetarian):

• Vegetables: including beans/peas/lentils for protein.
• Fruits
• Grains
• Dairy: fortified soy milk (unsweetened), other soy dairy products.
• Protein foods: eggs, soy products, nuts, and seeds.
• Oils

Nutrients of Concern for Toddlers Following the Healthy Vegetarian Pattern:

• Iron: non-heme iron in plant foods is not absorbed as well as heme iron from animal foods.
• Vitamin B12: found only in animal foods.

Generally, the recommendation is to check with a healthcare provider to see if a supplement is needed.

Nutrients of Public Health Concern for All Toddlers:

• Underconsumption: vitamin D, calcium, dietary fiber, and potassium.
• Overconsumption: added sugars and sodium. 
• Saturated fat: Not limited to children under age 2.

How are Toddlers Doing?

• Not enough vegetables: About 90% don’t meet recommendations. Especially low intake of dark green veggies and beans/peas/lentils.
• Not enough whole grains: 95% don’t meet recommendations.
• Here's where they exceed recommendations:
  • Fruit: 60% meet or exceed recommendations.
  • Dairy (mostly cow’s milk)
  • Refined grains
• And toddlers are generally on target for protein foods. Their overall intake is adequate, but higher for meats and poultry and lower for seafood.

Toddlers & Added Sugars: 

• Recommendation: Avoid.
• Average intake: 104 calories/day from added sugars
• Where is added sugar coming from? More than 25% from sugar-sweetened beverages (mostly fruit drinks); 15% from sweet bakery products.
• Other sources of added sugars: yogurt, ready-to-eat cereal, candy, fruit, flavored milk, milk substitutes, baby food products, and bread.

Toddlers & Sodium: 

• Recommendation: limit to 1,200 mg/day.
• Average intake: 1,586 mg/day.
• Where is sodium coming from? Processed meats (hot dogs, deli meats, sausages) and refined grains (bakery products, crackers, savory snacks).

Foods for Toddlers to Avoid:

• Foods with added sugars 
• Foods with low-calorie and no-calorie sweeteners
• Higher sodium foods (salty snacks, commercial toddler foods, processed meats)
• Unpasteurized juice, milk, yogurt, or cheese

Healthy Beverages for Toddlers:

• Water (plain, fluoridated)
• Whole cow’s milk (unflavored) or unsweetened fortified soy beverages
• 100% fruit juice (up to 4 ounces/day) 

Toddler Drinks to Avoid:

• Toddler milk and drinks
• Sugar-sweetened beverages
• Caffeinated drinks

Healthy Shifts for Toddlers:

Here are some examples of shifts in common choices to healthier, more nutrient-dense food options:

• Shift from cereal with added sugars to cereal with minimal added sugars
• Replace fruit products with added sugars with plain fruit
• Skip fried vegetables (like potatoes) for roasted veggies
• Transition from high-sodium snacks to vegetables
• Shift from high-sodium meats to ground lean meats
• Replace beverages with added sugars with unsweetened beverages

A Note About Seafood Safety:

Methylmercury in seafood is a concern for young children. They can have up to 2-3 ounces of seafood per week; it should be cooked and on the Best Choices list in the FDA/EPA joint Advice About Eating Fish, available at FDA.gov/fishadvice and EPA.gov/fishadvice. 

Lower methylmercury choices from the Best Choices list include:

• Flatfish (e.g., flounder)
• Salmon
• Tilapia
• Shrimp
• Catfish
• Crab
• Trout
• Haddock
• Oysters
• Sardines
• Squid
• Pollock
• Anchovies
• Crawfish
• Mullet
• Scallops
• Whiting
• Clams
• Shad
• Atlantic mackerel. 

Avoid: Canned light tuna or white (albacore) tuna, cod, perch, and black sea bass.

By Hollis Bass, MEd, RD, LD

Source: U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

And here are the previous installments of the series, in case you'd like a refresher:

• Infants and Toddlers Overview Part One
• Infants and Toddlers Overview Part Two
• Older Infants