Nutrient intakes and food patterns of toddlers' lunches and snacks: Influence of location

Objective To describe nutrient intake and food patterns of lunches and snacks eaten at various locations by US toddlers. Design A national, cross-sectional telephone survey in which mothers and primary caretakers reported toddlers' food and beverage intake for a 24-hour period. Subjects Toddlers (n=632), aged 15 to 24 months, a subset in the 2002 Feeding Infants and Toddlers Study. Analyses Mean +/- standard errors of the mean, percentages, t tests of mean differences, mean energy and nutrient intake, and nutrient density of toddlers' lunches and snacks. Results Overall, on any given day, 42.6% of toddlers consumed all meals and snacks at home, 8.1% consumed any meal or snack at day care (and others at home), and 49.3% consumed any meal or snack away from home (all other locations excluding day care). Mean energy intake at lunch ranged from 281 kcal at home to 308 kcal away from home to 332 kcal at day care. There were no significant differences in mean macronutrient intake or fiber intake across locations, but lunches eaten at day care were significantly higher in calcium, phosphorus, magnesium, vitamin D, potassium, and riboflavin compared with those eaten at home or away (P <.05). Mean trans fat intake was significantly (P <.01) lower for lunches consumed at home compared with away from home. For lunches consumed at away locations, the most frequently consumed item, by 35% of toddlers, was french fries. Carbonated beverages were consumed at away lunches by 16% of toddlers, compared with 3% at home and none at day care. Morning snacks provided 124 to 156 kcal and afternoon snacks provided from 139 to 170 kcal, depending on the location. Foods typically eaten at morning snacks for all locations were water, cow's milk, crackers, and 100% juice. Beverages frequently consumed at afternoon snacks were water, whole cow's milk, fruit-flavored drinks, and 100% apple juice. The most frequently consumed foods for an afternoon snack at home or day care were crackers or non-baby food cookies. Conclusions Nutritious choices such as milk, fruits, vegetables, and whole grains need to be encouraged in a variety of forms to give toddlers an opportunity to build broader food preferences for life. The consumption of milk at home and other locations, such as restaurants and friends' homes, needs to be encouraged in place of fruitflavored drinks or other sweetened beverages. For lunches at home, parents may be especially receptive to suggestions about appropriate and easy-to-serve foods, homemade or commercial, for a toddler's lunches and snacks. Day-care providers should be encouraged to use menu planning aids, such as those available from the US Department of Agriculture, even if they are not regulated by a government program.