There is little literature available describing the associations between dietary intake and health outcomes in infants and toddlers (6 to < 24 months).  This lack of information makes it difficult to develop evidence-based dietary guidelines for children in these age groups.  As a result, few countries have attempted to develop guidelines for infants and toddlers.  The 2020 Dietary Guidelines Advisory Committee (DGAC) is the first DGAC to review this information in order to develop food-based guidelines for infants and toddlers in the US.  The committee summarizes their approach and discusses the implications in a paper published in the October 2021 issue of The Journal of Nutrition.

Their approach was to conduct food pattern modeling that included 5 steps:  1)  identify energy intake targets, 2) establish nutritional goals, 3) identify food groupings and expected amounts, 4) estimate expected nutrient intakes for each scenario, and 5) evaluate expected nutrient intakes against nutritional goals.

For infants 6 to <12 months of age, it is possible to develop combinations of complementary foods and beverages that come close to meeting almost all nutrient recommendations for children given human milk or formula if a high proportion of protein foods, particularly meat, and iron-fortified infant cereals are included in the diet. For toddlers not being fed human milk, two patterns were developed which were a Healthy US-Style Pattern and a Healthy Vegetarian (lacto-ovo) Pattern.  In order to achieve the nutrient recommendations, essentially no added sugars could be included in the diet. 

The authors concluded that in order to meet nutrient requirements of infants and toddlers, it is necessary to avoid foods containing added sugars.  They also recommended further work to: 1) establish a human milk composition profile, 2) improve DRI values for these age groups, and 3) incorporate optimization modeling with food pattern modeling to identify food combinations that meet all nutritional goals.


Dewey KG, Pannucci TR, Casavale KO, Davis TA, Donovan SM, Kleinman RE, Taveras EM, Bailey RL, Novotny R, Schneeman BO, Stang J, de Jesus J, Stoody EE.  Development of food pattern recommendations for infants and toddlers 6-24 months of age to support the Dietary Guidelines for Americans, 2020-2025. The Journal of Nutrition, Volume 151, Issue 10, October 2021, Pages 3113–3124,

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