Many American babies start out eating relatively high amounts of healthy plant foods. By the time they move through childhood and adolescence, that pattern appears to change.
A new global analysis published in BMJ Global Health found that children and teens around the world are eating low amounts of fruits, vegetables, beans, legumes, nuts and seeds. In the United States, the shift was especially striking: Children younger than 2 consumed about 2.7 servings per day of these foods, while youth ages 2 to 19 consumed about 1.8 servings per day.
The study was not a clinical trial and did not test whether eating more of these foods caused better health outcomes. Instead, researchers used dietary data and statistical modeling to estimate how much of five categories of healthy plant foods children and adolescents consumed across 185 countries from 1990 to 2018.
Those categories included fruit, non-starchy vegetables, starchy vegetables excluding potatoes, beans and legumes, and nuts and seeds. That distinction is important. In this study, “plant-based” referred to whole or minimally processed plant foods, not highly processed foods that happen to be made from plant ingredients.
“Dietary habits established during childhood can influence health throughout life, yet we found that consumption of healthy plant-based foods remains low among youth across the globe,” said first author Sydney Yearley, a student in the Tufts MD/PhD Clinical & Translational Science program. “These findings provide an important benchmark for tracking progress and identifying opportunities to improve access to nutritious foods for children and adolescents.”
The researchers analyzed data from the Global Dietary Database, which compiles information from more than 1,200 dietary surveys. They estimated intake patterns by age, sex, country, region, household education and whether children lived in urban or rural areas.
Globally, estimated intake ranged from 1.19 servings per day in children under age 1 to 3.55 servings per day in 15- to 19-year-olds, with little variation by sex. Intake was estimated to be lowest in South Asia across all ages. East and Southeast Asia had some of the highest levels across many age groups, largely because children and teens there ate more non-starchy vegetables.
In most regions, intake of healthy plant foods increased with age. High-income countries were the exception. There, children tended to eat less of these foods as they got older, a pattern that may reflect greater independence, school and social food environments, family routines, food marketing or cultural norms around what children and teens eat.
The U.S. pattern stood out. According to the analysis, American children consumed among the highest amounts of healthy plant foods during infancy but among the lowest by later childhood and adolescence. The findings suggest that early feeding habits may be easier to establish than they are to maintain once children grow older and have more control over what they eat.
That does not mean families are simply falling short. Children’s diets are shaped by access, cost, school meals, time, convenience, taste preferences, peer influence and the foods available at home and in their communities. For many parents, keeping fruits, vegetables, beans, legumes, nuts and seeds in rotation becomes harder as schedules get busier and children’s preferences become stronger.
The study also does not show that any single food group is responsible for children’s health, learning, mood or long-term disease risk. But it does add to a larger body of nutrition research showing that fruits, vegetables, beans, legumes, nuts and seeds contribute fiber, vitamins, minerals and other compounds that support overall diet quality.
Senior author Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, said the findings point to the need for practical solutions that help children eat more minimally processed plant foods.
“When children don’t get enough of the right foods, it hurts their bodies and minds, limiting their energy, metabolism, learning, and mood,” Mozaffarian said.
The research was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences and the Gates Foundation.