in a way that maximizes their chances for a healthy life. As a result of the distinct trend toward the onset of chronic disease risks much earlier in life, dietary guidance for children and youth has evolved from an historic emphasis on ensuring nutrient and energy (calorie) adequacy to meet basic metabolic needs to the more recent focus on ensuring dietary quality while avoiding calorie excesses. The current goal is to promote a lifestyle for children and youth that incorporates nutrient-dense foods and beverages into their diet, and balances their calorie consumption with levels of physical activity sufficient to create energy balance at a healthy weight.1

This chapter provides an overview of the dietary intake, eating patterns, and sources of nutrients for infants and toddlers, younger children, school-aged children, and adolescents. It examines how nutrient and food intakes compare to reference standards and guidelines, and it also addresses regional and income-related differences in food consumption and nutrient intake.


Public health and technological improvements over the past century have enhanced the survival and health of infants, school-aged children, and adolescents in the United States (NRC and IOM, 2004). Widespread access to potable water, vaccines, and antibiotics has reduced child morbidity and mortality rates attributed to infectious diseases (CDC, 1999; IOM, 2005b). Safety initiatives targeted to motor vehicles and children’s home and recreational environments have led to a 39 percent decline in unintentional injury deaths among children ages 14 and under from 1987 to 2000 (National SAFE KIDS Campaign, 2003). The introduction of various fluoride vehicles through municipal water systems and other sources has prompted a substantial decline in dental caries in children over the past two decades (DHHS, 2000b; Dye et al., 2004).

The health and nutritional well-being of millions of Americans have benefited from a number of interventions, including the fortification of the food supply with essential micronutrients such as B vitamins, iron, iodine, and folic acid (Hetzel and Clugston, 1999; Honein et al., 2001; IOM, 2003; Park et al., 2000; Pfeiffer et al., 2005). The diets of low-income families, their infants, and school-aged children have improved through the creation and expanded coverage of domestic food assistance programs to increase


Growing children, even those at a healthy body weight, must be in a slightly positive energy balance to satisfy the additional calorie needs of tissue deposition for normal growth. However, for the purpose of simplicity in this report, the committee uses the term energy balance in children and youth to indicate an equality between energy intake and energy expenditure that supports normal growth without promoting excess weight gain and body fat.

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