This study presents data on the dietary intake and food patterns of infants and toddlers specific to Baltimore, MD. Devaney et al., (2004) found that US toddlers aged 12–24 months had similar mean daily energy intakes to toddlers 13–24 months in this Baltimore population (1,249 kcal and 1,123 kcal, respectively) [14
]. Among our study population, the mean intakes of all nutrients examined for infants 0–6 and 7–12 months of age were, on average, adequate. However toddlers 13–24 months of age had inadequate mean intakes of omega-3 and omega-6 fatty acids, fiber, vitamins A, D, and E.
The consumption of high-sugar, high-fat foods increased with each age group; comparable observations have been reported in FITS [13
]. Similarly, data from the 2005–2007 Infant Feeding Practices Study II (IFPS II) found that at 12 months two-thirds of infants were consuming high sugar and fat foods, including french fries, or sweetened drinks, and 77% of infants were consuming fruit juice [10
]. Similarly we found that on a daily basis most toddlers consumed a dessert or snack and fruit juice more than once, and half consumed a sweetened drink.
For this study, a food list was compiled from the foods reported in the 24-hour dietary recalls based on our study population’s current eating habits, similar to previous studies [20
]. The final food list is essential in the development of an accurate dietary assessment tool (i.e. FFQ) that can be used in intervention strategies for the GLB obesity prevention program [26
]. For example, formula feeding was more frequent than breastfeeding in our study population. Research indicates that a shortened period of breastfeeding increases the risk of childhood obesity [28
]. Furthermore, formula-fed newborns experience weight gain, which can increase the risk of childhood chronic disease [30
]. Other strategies to consider for nutritional intervention include reducing milk and sweetened drinks and increasing fruit, vegetable, and whole grain intake among toddlers 13–24 months. Milk and sweetened drinks were identified as top contributors to sugar and fat intake indicating breastfeeding and complementary feeding education should be included as intervention components.
While the use of single 24-hour dietary recalls does not capture usual nutrient intake, single 24-hour recalls provide a snapshot of the study population’s current nutrition situation. Comparable studies using single 24-hour dietary recalls have also found that infants exceeded recommended levels for all nutrients, while toddlers 12–24 months of age failed to meet recommendations for vitamin E and fiber [14
]. The observation of nutrient inadequacy among older infants and toddlers may have been due to low breast milk intake (which was excluded from ten most frequently reported foods) or the discontinuation of formula feeding. Inappropriate food choices by caregivers have also been observed in previous studies [34
The accurate assessment of food intakes in children is challenging [1
]. While parents tend to reliably report their children’s food intake in the home setting [2
], interviews with caregivers in childcare settings could potentially be subject to bias due to low levels of interest and motivation [3
]. As using multiple 24-hour recalls is the most reliable method of dietary assessment for preschool children [4
], the information from a single day may not accurately reflect the usual diet of an individual [5
]. Limitations of the study include the use of a single 24-hour recall to obtain dietary intake and the small sample size. While multiple 24-hour dietary recalls or weighed food records are ideal for obtaining nutrient intake data [36
] the main purposes of this study was to obtain baseline dietary data, develop an appropriate food list, and identify the need for a nutritional intervention program. The relatively small sample population limits the generalizability of the results; however, the proposed nutrition intervention will target infants and toddlers residing in Baltimore. Although breast milk consumption was estimated based on established literature, this study contributes substantially to the limited literature on nutrient intake and dietary quality of infants and toddlers in Baltimore, MD.