Every day we are learning about the latest research in the field of nutrition.
Nutrition is one of the newest sciences, so it’s no surprise when we see headlines touting a recent study showing “x” food can reduce our risk of “x” disease, or new research stating how limiting certain foods is better for our health.
As a public health dietitian with a background in child nutrition, this information is always more intriguing when it pertains to children and what they should or should not be consuming. Recently, new beverage guidelines were released for children up to five years of age. These types of insights are critical to ensuring optimal health and nutrition for kids.
An expert panel representing four key national health and nutrition organizations — the American Academy of Pediatrics, the Academy of Nutrition and Dietetics, the American Heart Association, and the American Academy of Pediatric Dentistry — created the guidelines. Healthy Eating Research, a Robert Wood Johnson Foundation program, funded the initiative, lead the process and helped the professionals convene.
When the guidelines were released, I was excited and eager to read them and see what was new. As with most research, it wasn’t totally out with the old and in with the new, but there are significant changes within the guidelines that stood out to me.
I like that the panel provided very specific recommendations and addressed a variety of beverages in the guidelines, including water, cow’s milk, plant-based/non-dairy beverages, juice, caffeinated beverages, flavored milk, toddler milk and sugar-sweetened beverages.
I have outlined here the highlights of their recommendations that healthcare providers, parents, and caregivers should adopt.
Plain Drinking Water
Consuming plain drinking water is one of the best ways to meet hydration needs. Those needs can vary, however, based on the individual.
The guidelines advise no drinking water for those ages 0-6 months because their hydration needs are met through breast milk or formula. They recommend ½-1 cup per day of plain, fluoridated drinking water consumed during meal times for those ages 6-12 months; 1-4 cups per day of plain, fluoridated drinking water for those ages 1-3 years; and 1.5-5 cups per day of plain, fluoridated drinking water for those ages 4-5 years.
The guidelines state that if no other beverages are consumed, all the hydration needs should be met with the upper range amounts. But if other beverages are consumed, such as milk or juice, those amounts should be factored into these recommendations. For example, if a three-year-old consumes one cup of milk, they should consume three cups of plain water to meet their hydration needs.
Plain, Pasteurized Milk
The guidelines for this beverage didn’t really change. No cow’s milk for children under 12 months of age. At 12 months of age, plain, pasteurized whole milk can be introduced.
From 12-24 months of age, children can have 2-3 cups of whole milk per day, unless a pediatrician suggests 2% or 1% milk for various health and family history reasons. For children ages 2-5 years, the guidelines state to transition to plain, pasteurized skim or 1% milk. Children ages 2-3 years can consume up to two cups per day and those ages 4-5 years can consume up to 2.5 cups per day.
I was thrilled to see these updated recommendations for juice. Even though children may be consuming 100% fruit or vegetable juice, it does NOT provide the same nutrients as consuming a whole fruit or vegetable. Consuming the whole fruit provides dietary fiber and other nutrients that are lacking in juice.
The guidelines state no juice is recommended for those ages 0-12 months, no more than four ounces of 100% juice per day for those ages 1-3 years, and no more than 4-6 ounces of 100% juice per day for those ages 4-5 years.
The panel also recommended that, if you are purchasing juice, it should be comprised only of 100% juice and should be diluted with water, if desired. Even if the juice is diluted, they point out to still stay within these ounce recommendations.
Non-Dairy Beverages or Plant Milks
I am glad the expert panel addressed non-dairy beverages, as they have grown in popularity over the last decade or so. For children ages 0-12 months, they do not recommend these beverages. For children ages 1-5 years of age, they do not recommend these beverages in place of cow’s milk, unless it is medically indicated.
If that is the case, the guidelines recommend consuming soy milk because its nutrient profile is most like that of cow’s milk. This recommendation is based on the low amount of nutrients in these types of beverages. Even if the drinks are fortified with certain nutrients, the panel expressed concern about whether these nutrients would be absorbed as well as when they naturally occur in foods and beverages.
The panel does not recommend consuming flavored milk for children ages 0-5 years due to the presence of added sugars and to avoid contributing to the sweet taste preference in this age group.
It is not surprising that the panel said no to consuming sugar-sweetened beverages. This category includes soda, sports drinks, energy drinks, fruitades and other sweetened beverages.
For those ages 0-12 months, the guidelines state that nutrient needs should be met by breast or formula milk, and toddler milk is not recommended. They also do not recommend this type of milk for children ages 1-5 years.
These types of beverages received a big no in the guidelines due to safety concerns and the potential for adverse effects.
Beverages with Low-Calorie Sweeteners: The guidelines are clear that these types of beverages should not be consumed by children ages 0-5 years. The panel cited the lack of evidence on both the short- and long-term impacts of these beverages for this age group.
The Glass Half Full
The guidelines make clear what beverages should be consumed and how much. They also make clear what beverages should not be consumed and why.
These recommendations are rooted in research, with most of it occurring in the last five years. It will be interesting to see how these new recommendations will be incorporated into the newest edition of the Dietary Guidelines for Americans — which are being created now — especially because for the first time they will be providing dietary guidance for the age group of birth to 24 months.
As with all nutrition research, I encourage consumers to stay up-to-date with the newest information because you never know when recommendations will change.
Bio: Stephanie Hodges (MS, MPH, RDN) is the founder and owner of The Nourished Principles, a public health and nutrition consulting business. She currently works with clients to strengthen nutrition and wellness within school districts, implement strong public health nutrition programs and policies, and engage with consumers on nutrition, and public health topics. Connect with her on Facebook at The Nourished Principles, Twitter at @nourishedprinc, Instagram at @thenourishedprinciples, and LinkedIn at Stephanie Simms Hodges.
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