Abstract  This report provides a set of early-life stage age groups for U.S. Environmental Protection Agency (EPA, or the Agency) scientists to consider when assessing children's exposure to environmental contaminants and the resultant potential dose. These recommended age groups are based on current understanding of differences in behavior and physiology that may impact exposures in children. A consistent set of early-life age groups, supported by an underlying scientific rationale, is expected to improve Agency exposure and risk assessments for children by increasing the consistency and comparability of risk assessments across the Agency, improving accuracy and transparency in assessments for those cases where current practice might too broadly combine behaviorally and physiologically disparate age groups, and fostering a consistent approach to future exposure surveys and monitoring efforts to generate improved exposure factors for children.

Abstract  OBJECTIVE: To describe the food consumption patterns of US infants and toddlers, 4 to 24 months of age.

DESIGN: Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers study based on telephone interviews and 24-hour dietary recalls.

SUBJECTS: A national random sample of 3,022 infants and toddlers age 4 to 24 months.

STATISTICAL ANALYSES PERFORMED: The percentage of infants and toddlers consuming foods from specific food groups was estimated for six age groups, using a single 24-hour recall.

RESULTS: Infants as young as 7 months of age showed food patterns that have been observed in older children and adults. From 18% to 33% of infants and toddlers between ages 7 and 24 months consumed no discrete servings of vegetables, and 23% to 33% consumed no fruits. French fries were one of the three most common vegetables consumed by infants 9 to 11 months of age. By 15 to 18 months, french fries were the most common vegetable. Almost half (46%) of 7- to 8-month-olds consumed some type of dessert, sweet, or sweetened beverage, and this percentage increased as age increased. By 19 to 24 months, 62% of toddlers consumed a baked dessert, 20% consumed candy, and 44% consumed a sweetened beverage.

APPLICATIONS: Parents and caregivers should be encouraged to offer a wide variety of vegetables and fruits daily, with emphasis on dark green, leafy, and deep yellow vegetables and colorful fruits. They should offer desserts, sweets, sweetened beverages, and salty snacks only occasionally, offering nutrient-dense, age-appropriate foods as alternatives (eg, fruit, cheese, yogurt, and cereals). Water, milk, and 100% fruit juices should be offered as alternative beverages. Because family food choices influence what foods are offered to children, family-based approaches to developing healthy eating habits may be helpful.

Abstract  OBJECTIVE: To assess the prevalence of breastfeeding and formula feeding, the age of introduction to specific foods, and the types of foods and beverages consumed by Hispanic infants and toddlers compared with similarly aged non-Hispanic infants and toddlers living in the United States.

DESIGN: Descriptive and comparative analysis of dietary recall data and responses to specific interview questions, which were collected in the 2002 Feeding Infants and Toddlers Study. Breastfeeding status, timing of introduction of complementary foods, percentage consuming foods from specific food groups, and the most frequently consumed fruits and vegetables by Hispanic and non-Hispanic children by age group (4-5 months, 6-11 months, 12-24 months).

SUBJECTS: A national random sample of 371 Hispanic and 2,637 non-Hispanic infants and toddlers between the ages of 4 and 24 months.

STATISTICAL ANALYSIS: To test for differences between Hispanic and non-Hispanic children in the percentage who consumed a particular food item, we calculated percentages and standard errors in SUDAAN and 95% and 99% confidence intervals. The most frequently consumed fruits and vegetables were determined by tallying the percentage of infants and toddlers who consumed each specific fruit or vegetable on a given day.

RESULTS: Although there were some similarities, the early flavor and food experiences of Hispanic infants were different from similarly aged non-Hispanic infants in several ways. Hispanic infants younger than 1 year of age were more likely to have ever been breastfed and those who were 4 to 5 months were more likely than non-Hispanics to be eating pureed baby foods on a daily basis. Although less likely to be eating non-infant cereals and baby food vegetables, 6- to 11-month-old Hispanics were more likely to be eating fresh fruits, fruit-flavored drinks, baby cookies, and foods such as soups, rice, and beans that are common in many Hispanic cultures. When fruits were introduced into the Hispanic child's diet, they were most commonly consumed fresh. This higher prevalence of being fed soups, rice, beans, and sweetened fruit-flavored drinks as well as tortillas was also observed among the 12- to 24-month-old toddlers.

CONCLUSIONS: Dietetics professionals should be aware of the cultural differences in the foods fed to infants and toddlers that may contribute to the development of long-term food preferences and impact on nutrition. Understanding the factors that underlie food preferences is important if we are to develop evidence-based strategies to improve children's eating habits and lower their risks factors associated with obesity and other chronic diseases.

Abstract  OBJECTIVE: Describe the study design, data collection methods, 24-hour dietary recall protocol, and sample characteristics of the Feeding Infants and Toddlers Study (FITS) 2008.

DESIGN: A cross-sectional study designed to obtain information on the diets and feeding patterns of US infants, toddlers, and preschoolers ages birth to 47 months. Telephone interviews with parents and caregivers were conducted from June 2008 through January 2009 and included a household interview to recruit the household and collect information on household and child demographics and nutrition-related characteristics, and a dietary interview, including a 24-hour dietary recall collected using the 2008 Nutrition Data System for Research. A second dietary recall was collected on a random subsample to estimate usual nutrient intake distributions. Data collection instruments were built on those used in FITS 2002, with expanded survey content to address emerging issues in childhood nutrition and obesity. The dietary protocol was improved to increase reporting accuracy on portion sizes, and a bridging study was conducted to test effects of the changes in the food model booklet and protocol since FITS 2002 (n=240 cases aged 4 to 23 months).

SUBJECTS: A national random sample of 3,273 infants, toddlers, and preschoolers from birth up to age 4 years, with 2 days of dietary intake data for 701 cases.

RESULTS: Among sampled households with an age-eligible child, the response rate was 60% for the recruitment interview. Of recruited households, the response rate for the dietary interview was 78%.

CONCLUSIONS: The FITS 2008 provides rigorous, well-tested methods and survey questions for nutrition researchers to use in other dietary studies of young children. FITS 2008 findings on the food and nutrient intakes of US children from birth up to age 4 years can inform dietetics practitioners, pediatric health practitioners, and policymakers about the dietary issues of young children.

Abstract  OBJECTIVES: To describe current infant-feeding practices and current food group consumption patterns of infants and toddlers and to compare 2008 data with 2002 data to identify shifts in these practices and food consumption over time.

DESIGN: The Feeding Infants and Toddlers Study (FITS) 2008 is a cross-sectional survey of a national random sample of US children from birth up to age 4 years. Data for three age subgroups (infants 4 to 5.9 months and 6 to 11.9 months and toddlers 12 to 23.9 months) were used from the 2002 (n=2,884) and 2008 surveys (n=1,596).

STATISTICAL METHODS: All analyses use sample weights that reflect the US population aged 4 to 24 months. Descriptive statistics (means, proportions, and standard errors) and t tests were calculated using SUDAAN (release 9, 2005, Research Triangle Park Institute, Research Triangle Park, NC).

RESULTS: These data show a higher percentage of infants receiving breast milk from 4 to 11.9 months of age with a concurrent decreasing percentage of infants receiving formula, which is significantly different from data for the 9- to 11.9-month-old age group. The use of complementary foods also appears to be delayed in FITS 2008: There is a significantly lower proportion of infants consuming infant cereal at 9 to 11.9 months in FITS 2008 compared to 2002 data. Fruit and vegetable consumption remains lower than desired. Significant reductions in the percentage of infants and toddlers consuming any desserts or candy, sweetened beverages, and salty snacks were seen in 2008.

CONCLUSIONS: The findings presented here provide important insights to the content of messages and types of interventions that are still needed to improve the diets of infants and toddlers.

Abstract  BACKGROUND: The prevalence of childhood obesity among racial and ethnic minority groups is high. Multiple factors affect the development of childhood obesity, including dietary practices.

OBJECTIVE: To examine the racial and ethnic differences in reported dietary practices among the largest minority groups of California children.

METHODS: Data from the 2007 and 2009 California Health Interview Survey were analyzed using multivariate regression with survey weights to examine how race, ethnicity, sociodemographic characteristics, and child factors were associated with specific dietary practices.

RESULTS: The sample included 15,902 children aged 2 to 11 years. In multivariate regressions, substantial differences in fruit juice, fruit, vegetable, sugar-sweetened beverages, sweets, and fast-food consumption were found among the major racial and ethnic groups of children. Asians regardless of interview language were more likely than whites to have low vegetable intake consumption (Asians English interview odds ratio [OR] 1.20, 95% CI 1.01 to 1.43; Asians non-English-interview OR 2.09, 95% CI 1.23 to 3.57) and low fruit consumption (Asians English interview OR 1.69, 95% CI 1.41 to 2.03; Asians non-English interview OR 3.04, 95% CI 2.00 to 4.6). Latinos regardless of interview language were also more likely than whites to have high fruit juice (Latinos English interview OR 1.54, 95% CI 1.28 to 1.84 and Latinos non-English interview OR 1.29, 95% CI 1.02 to 1.62) and fast-food consumption (Latinos English interview OR 1.74, 95% CI 1.46 to 2.08 and Latinos non-English interview OR 1.48, 95% CI 1.16 to 1.91); but Latinos were less likely than whites to consume sweets (Latinos English interview OR 0.81, 95% CI 0.66 to 0.99 and Latinos non-English interview OR 0.56, 95% CI 1.16 to 1.91).

CONCLUSIONS: Significant racial and ethnic differences exist in the dietary practices of California children. Increased fruit and vegetable consumption appears to be associated with parent education but not income. Our findings suggest that anticipatory guidance and dietary counseling might benefit from tailoring to specific ethnic groups to potentially address disparities in overweight and obesity.

Abstract  OBJECTIVE: To compare total fruit and vegetable intake in cup equivalents and its individual components among Hispanic subgroups in California.

METHODS: Data are from the adult portion of the 2005 California Health Interview Survey. Hispanic/Latino subjects (n=7,954) were grouped into six subcategories (Mexican, Central American, Caribbean, Spanish American, South American, and >1 group). Total fruit and vegetable intake in cup equivalents was estimated from frequency responses about seven food categories. Both t test and chi(2) test were used to assess differences in sociodemographic characteristics across Hispanic subgroups. Multivariate linear regressions using SUDAAN software (Survey Data Analysis, version 9.0.1, 2005, Research Triangle Institute, Research Triangle Park, NC) were conducted to obtain means of total fruit and vegetable intake in cup equivalents and its components by Hispanic subgroups controlling for confounders.

RESULTS: Hispanic subgroups did not differ in their intake of total fruit and vegetable intake in cup equivalents (mean 3.4 c and 2.9 c for men and women, respectively). Small but significant differences (P<0.01) were found across Hispanic subgroups in individual fruit and vegetable components (green salad [women only], cooked dried beans and nonfried white potatoes) after adjusting for potential sociodemographic and acculturation confounders.

CONCLUSIONS: Fruit and vegetable intake by Hispanic respondents did not meet the national recommendation, although their reported intake is higher compared to other race/ethnicity groups. The public health message remains the same: Increase fruit and vegetable intake. Examination of intake for subgroups of Hispanics may enhance the utility of dietary information for surveillance, program and message design, and intervention and evaluation.

Abstract  This report updates the Canned Fruit and Vegetable Consumption in the United States: Report to the United States Congress (September 2008), using more recent data through 2008, where available. Both reports were prepared and published in response to requests from Congress. We used data from the Economic Research Services Food Availability Data System, Bureau of Labor Statistics Consumer Expenditure Surveys, and the U.S. Department of Agricultures food intake surveys to study U.S. consumption of and spending on canned fruits and vegetables. Data since 1970 suggest that the share of canned fruit out of total fruit consumed will continue to be fairly constant at around 6 percent in the short term, while the share of canned vegetables out of total vegetables consumed will continue to fluctuate but mostly decline from the 24 percent share in 2008. The analysis tracks the changes in canned fruit and vegetable expenditures since the previous report, and breaks down these expenditures by demographic characteristics of households, including age and ethnicity.

Abstract  BACKGROUND: More frequent cooking at home may help improve diet quality and be associated with food values, particularly for individuals participating in the Supplemental Nutrition Assistance Program (SNAP).

OBJECTIVE: To examine patterns of fruit and vegetable consumption and food values among adults (aged 20 and older) in the United States, by SNAP participation and household cooking frequency.

METHODS: Analysis of cross-sectional 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2007-2010 (N=9560).

RESULTS: A lower percentage of SNAP participants consumed fruit (total: 35% vs. 46%, p=0.001; fresh: 30% vs. 41%, p<0.001) and vegetables (total: 49% vs. 58%, p=0.004; fresh: 35% vs. 47%, p<0.001) than those ineligible for SNAP. Among SNAP participants, cooking >6times/week was associated with greater vegetable consumption compared to cooking <2times/week (175g vs. 98g, p=0.003). SNAP-eligible individuals who cooked ≥2times/week were more to report price (medium cookers: 47% vs. 33%, p=0.001; high cookers: 52% vs. 40%, p<0.001), ease of preparation (medium cookers: 36% vs. 28%, p=0.002; high cookers: 36% vs. 24%, p<0.001) and how long food keeps (medium cookers: 57% vs. 45%, p<0.001; high cookers: 61% vs. 50%, p<0.001) as important compared to SNAP-ineligible individuals.

CONCLUSIONS: Fruit and vegetable consumption in the United States is low regardless of cooking frequency. Efforts to improve diet quality should consider values on which food purchases are based.

Abstract  Principal component analysis (PCA) is a popular method of dietary patterns analysis, but our understanding of its use to describe changes in dietary patterns over time is limited. Using a FFQ, we assessed the diets of 12,572 nonpregnant women aged 20-34 y from Southampton, UK, of whom 2270 and 2649 became pregnant and provided complete dietary data in early and late pregnancy, respectively. Intakes of white bread, breakfast cereals, cakes and biscuits, processed meat, crisps, fruit and fruit juices, sweet spreads, confectionery, hot chocolate drinks, puddings, cream, milk, cheese, full-fat spread, cooking fats and salad oils, red meat, and soft drinks increased in pregnancy. Intakes of rice and pasta, liver and kidney, vegetables, nuts, diet cola, tea and coffee, boiled potatoes, and crackers decreased in pregnancy. PCA at each time point produced 2 consistent dietary patterns, labeled prudent and high-energy. At each time point in pregnancy, and for both the prudent and high-energy patterns, we derived 2 dietary pattern scores for each woman: a natural score, based on the pattern defined at that time point, and an applied score, based on the pattern defined before pregnancy. Applied scores are preferred to natural scores to characterize changes in dietary patterns over time because the scale of measurement remains constant. Using applied scores, there was a very small mean decrease in prudent diet score in pregnancy and a very small mean increase in high-energy diet score in late pregnancy, indicating little overall change in dietary patterns in pregnancy.