Dietary and Complementary Feeding Practices of US Infants, 6 to 12 Months: A Narrative Review of the Federal Nutrition Monitoring Data.

Complementary foods and beverages (CFBs) are key components of an infant's diet in the second 6 months of life. This article summarizes nutrition and feeding practices examined by the 2020 Dietary Guidelines Advisory Committees during the CFB life stage. Breastfeeding initiation is high (84%), but exclusive breastfeeding at 6 months (26%) is below the Healthy People 2030 goal (42%). Most infants (51%) are introduced to CFBs sometime before 6 months. The primary mode of feeding (ie, human milk fed [HMF]; infant formula or mixed formula and human milk fed [FMF]) at the initiation of CFBs is associated with the timing of introduction and types of CFBs reported. FMF infants (42%) are more likely to be introduced to CFBs before 4 months compared with HMF infants (19%). Different dietary patterns, such as higher prevalence of consumption and mean amounts, were observed, including fruit, grains, dairy, proteins, and solid fats. Compared with HMF infants of the same age, FMF infants consume more total energy (845 vs 631 kcal) and protein (22 vs 12 g) from all sources, and more energy (345 vs 204 kcal) and protein (11 vs 6 g) from CFBs alone. HMF infants have a higher prevalence of risk of inadequate intakes of iron (77% vs 7%), zinc (54% vs <3%), and protein (27% vs <3%). FMF infants are more likely to have an early introduction (<12 months) to fruit juice (45% vs 20%) and cow's milk (36% vs 24%). Registered dietitian nutritionists and nutritional professionals should consider tailoring their advice to caregivers on dietary and complementary feeding practices, taking into account the primary mode of milk feeding during this life stage to support infants' nutrient adequacy. National studies that address the limitations of this analysis, including small sample sizes and imputed breast milk volume, could refine findings from this analysis.

Impact of typical rather than nutrient-dense food choices in the US Department of Agriculture Food Patterns.

BACKGROUND: The US Department of Agriculture (USDA) Food Patterns, released as part of the 2010 Dietary Guidelines for Americans, are designed to meet nutrient needs without exceeding energy requirements. They identify amounts to consume from each food group and recommend that nutrient-dense forms-lean or low-fat, without added sugars or salt-be consumed. Americans fall short of most food group intake targets and do not consume foods in nutrient-dense forms. Intake of calories from solid fats and added sugars exceed maximum limits by large margins. OBJECTIVE: Our aim was to determine the potential effect on meeting USDA Food Pattern nutrient adequacy and moderation goals if Americans consumed the recommended quantities from each food group, but did not implement the advice to select nutrient-dense forms of food and instead made more typical food choices. DESIGN: Food-pattern modeling analysis using the USDA Food Patterns, which are structured to allow modifications in one or more aspects of the patterns, was used. Nutrient profiles for each food group were modified by replacing each nutrient-dense representative food with a similar but typical choice. Typical nutrient profiles were used to determine the energy and nutrient content of the food patterns. RESULTS: Moderation goals are not met when amounts of food in the USDA Food Patterns are followed and typical rather than nutrient-dense food choices are made. Energy, total fat, saturated fat, and sodium exceed limits in all patterns, often by substantial margins. With typical choices, calories were 15% to 30% (ie, 350 to 450 kcal) above the target calorie level for each pattern. Adequacy goals were not substantially affected by the use of typical food choices. CONCLUSIONS: If consumers consume the recommended quantities from each food group and subgroup, but fail to choose foods in low-fat, no-added-sugars, and low-sodium forms, they will not meet the USDA Food Patterns moderation goals or the 2010 Dietary Guidelines for Americans.

Updated US Department of Agriculture Food Patterns meet goals of the 2010 dietary guidelines.

The US Department of Agriculture Food Patterns were updated for the 2010 Dietary Guidelines for Americans to meet new nutrition goals and incorporate results of food pattern modeling requested by the Dietary Guidelines Advisory Committee. The purpose of this article is to describe the process used and changes in the updated patterns. Changes include renaming the Meat and Beans and Milk Groups to the Protein Foods and Dairy Groups, respectively, to be more encompassing of foods in each. Vegetable subgroups now provide more achievable intake recommendations. Calcium-fortified soymilk is now included in the Dairy Group because of its similarity to foods in that group. Increased amounts of seafoods are recommended in the Protein Foods Group, balanced by decreased amounts of meat and poultry. A limit on calories from solid fats and added sugars is included, replacing the previous discretionary calorie allowance and emphasizing the need to choose nutrient-dense forms of foods. Lacto-ovo vegetarian and vegan patterns that meet nutrition goals were created by making substitutions in the Protein Foods Group, and for vegan patterns, in the Dairy Group. Patterns identify food choices that meet nutritional needs within energy allowances and encourage choosing a variety of foods. They rely on foods in nutrient-dense forms, including a limited amount of calories from solid fats and added sugars. The Food Patterns provide a useful template for educating consumers about healthful food choices while highlighting a large gap between choices many Americans make and healthy eating patterns.