Mar 01st Nutrition Nutrition Nutrient Deficiencies: Closing the Gap By Stacey Segal, RD Over the last two decades, there have been various studies published on the average nutritional deficits in the dietary intake of children in the US & Canada. On a population level, these studies shine light on where and how we need to do better within our healthcare policy, education, and especially the food industry. On an individual level, however, there are many determinants that can lead to nutritional gaps in a child’s diet. Even more natural developmental milestones like transitioning from breastmilk or formula to solid foods, or developing taste preferences, can contribute to gaps in our little ones’ nutrition. There are many contributing factors to nutritional gaps that are beyond our control as parents, and as always, you should always consult your primary care doctor. This article is not meant to serve as a substitute to medical advice or counseling, but rather a piece of knowledge for those eager to learn more about the science behind their children’s gut and brain connection. IMPORTANT: Identifying a dietary deficiency does not mean your child is sick or is clinically deficient in a certain nutrient.Your diet can be low in iron, but that doesn’t necessarily mean you are iron deficient or anemic. It often takes a while for clinical nutrient deficiencies to show (as measured by biomarkers in our blood) because of how adaptable our bodies are in the short term. The data below identifies nutritional gaps in the daily dietary patterns of our little ones. It’s important to recognize where the gaps are to help PREVENT clinical deficiencies and help optimize brain development and whole body growth. If you suspect your child is nutrient deficient, please consult your healthcare provider. Nutrient Deficiencies Infants (6-11 months) The diets of infants are generally adequate for about the first 6 months of life, because breast milk and infant formula are nutritionally complete (with the exception of Vitamin D and iron in breast milk). But around 6 months of age, we see a gradual deviation once children begin their transition to solid foods. It can be challenging to meet older infants‘ nutritional needs as they still have tiny tummies and often will only eat a small amount at a time. And let’s be honest, it’s usually impossible to truly know how much they’ve eaten, as so much of the food ends up on their face, in the highchair, or on the floor (it will!). The key is to offer nutrient-dense foods right from the start and do our best to focus on the vulnerable nutrients. A vulnerable nutrient refers to nutrients that are identified in low quantities in the diets of specific groups within the population. Interestingly, each update of the study of North American infants and toddlers from 2002 to 2008 to 2016, showed a continual decline in infant intake of Iron, Vitamin D, Vitamin E, Vitamin C, Thiamin (Vitamin B1), Riboflavin (Vitamin B2), Niacin (Vitamin B3), Magnesium & Phosphorus. (2) Nutritional gaps for infants: Vitamin D Vitamin E Iron Zinc Fiber Choline Selenium How these nutrients impact developmentIron Approximately 75% of breastfed infants (6-12 months) are reported to have a diet inadequate in iron (1). At 6 months, the iron that babies have stored in their bodies becomes depleted. And breast milk is no longer adequate to meet iron requirements for older infants. The percentage of formula fed infants who have an overall diet low in iron is reported to be 10- 20%(1,2). These stats, while they may not necessarily represent all populations, highlight the importance of focusing on iron-rich foods at 6 months of age and beyond. Zinc Approximately 54% of breastfed infants’ (6-12 months) diets are low in Zinc (1). This is likely because the concentration of Zinc in breastmilk declines over the first 6 months of lactation and is not affected by maternal Zinc intake. So even if you eat a good variety of foods with Zinc, you cannot boost the amount in your breast milk. Formula has a more consistent amount of Zinc; however, as your babe takes less milk and eats more food (the fun part!), attention should be paid to the Zinc-rich foods to help prevent deficiency. Nutrient Deficiencies Toddlers (12-24 months) As babies grow into toddlers, their dietary patterns change — likely eating more solid foods than breast milk & formula, with bigger meals that more similarly resemble our own. They are also becoming fiercely independent (or at least they are trying to be), taking on more of a role in what, when, and how much they eat. Often this newfound sense of self-sufficiency can pose challenges in the eating department, causing parents and caregivers to focus more on ensuring their child is getting enough food vs. the overall nutrient balance. In fact, the new Dietary Guidelines for Americans (2020-2025) reports that nearly 90% of toddlers are not consuming enough vegetables or whole grains, while 60% exceeded the recommended intake of fruit. (1) And while fruit is a healthy part of a balanced diet, it does not provide the full suite of key nutrients all growing minds need (not to mention the high sugar content). Nutritional gaps for toddlers: FiberVitamin DVitamin EOmega-3 polyunsaturated fat (DHA) Choline How these nutrients impact developmentVitamin D A review of the data shows that 74% to 86% of toddlers have been reported to not meet their Vitamin D requirements (2,3). Vitamin D is beneficial to many processes in our body, including brain development, bone health and the immune system. It can be hard to remember to give kids their Vitamin D supplements. We all have days when we forget. For the general population (this is not intended to be medical individual advice), babies and kids need 400 IU of Vitamin D supplement daily. Vitamin E Vitamin E is important for the formation and function of the nervous system. Studies show that 82% of toddlers do not meet their Vitamin E requirements (2,3,4). It’s a nutritional gap that is easily overlooked because it’s not a frequently talked about nutrient. But clearly Vitamin E is a vulnerable nutrient in the North American population and deserves attention to help our kids meet their requirements. Omega-3 polyunsaturated fat (DHA) DHA can be hard to find in foods that are typical in a toddlers daily diet. It has been reported that 97-99% of toddlers (as well as in young children) do not meet the available recommended amount (5) for daily DHA intake (4). That’s almost the entire population of children in the study! This nutritional gap needs to be highlighted because DHA is critical to brain development in infants and toddlers. How to be more deficiency-conscious 1. Observe (& take notes!) Now that you’ve read this article, start taking note of what your child consumes in a day. Are they getting enough variety? What is the nutritional value of their usual meals? What foods groups are missing from their diet? Factor these gaps in as you plan out future meals.2. Get creative!Even the most sophisticated eater can become a picky eater overnight. Sometimes, it’s about HOW you serve the nutrients and incorporating them into their favorite meals. Make a nutrient-dense veggie-packed mac and cheese, or try our Beet Carrot pouch as a dipping sauce for chicken or plant-based nuggets. We promise we won’t tell them! 3. Take out the guess work!All Cerebelly pouches contain the 16 key brain-supporting nutrients needed for all growing brains – the average pouch on the market contains two or four, and not even meeting the minimal amounts for meaningful impact . Cerebelly pouches also boast veggie-first purees with no added sugar, so you’re little one can get the nutrients they need, with less risk of developing a super sweet tooth. Our pouches are shelf-stable, perfect for on-the-go nutrition & work wonderfully for cooking and baking. Conclusion “Good” nutrition is no different from anything else we strive for in our daily routine. No day will be perfect. Rarely is it realistic to get 100% of our nutritional requirements EVERY DAY consistently. But we can strive to close the nutritional gaps by consciously incorporating food sources of the vulnerable nutrients. Learn more about which foods provide which nutrients in our guide. Reading articles with stats can feel serious and daunting. My hope is that this article has instead made you feel empowered. Maybe it illuminated a potential gap in your own child’s diet (no guilt allowed here!) and gave you inspiration to make small changes. References: Dietary Guidelines for Americans 2020-2025. USDA. dietaryguidelines.com Trends in Mean Nutrient Intakes in US Infants, Toddlers and Young Children from 3 Feeding Infants and Toddlers Studies (FITS). Eldridge AL. J Nutr 2019;149:1230–1237.Usual Nutrient Intakes of US Infants and Toddlers. Ahluwalia N. Am J Clin Nutr 2016;104:1167–74. NHANES (National Health and Nutrition Examination Survey)Nutrient Intake Adequacy from Food and Beverage Intake of US Children Aged 1–6 Years from NHANES 2001–2016. Bailey ADL. Nutrients 2021; 13:827.Forsyth S. Dietary Intakes of Arachidonic Acid and Docosahexaenoic Acid in Early Life – With a Special Focus on Complementary Feeding in Developing Countries. Ann Nutr Metab. 2017; 70(3): 1–11. Have more questions? 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