Stronger nutrition programs needed as children globally fall short on healthy plant foods

A global analysis has uncovered critical childhood nutrition gaps, with not enough youths eating healthy plant-based foods, which are essential for growth and health. Out of the 185 countries studied for nearly 30 years, this trend was prevalent in the US where daily plant-based consumption declined with age, in contrast to most other countries. 

The researchers from Tufts University in the US detail that children under one consume 1.19 servings of plant-based foods daily and adolescents 15 to 19, 3.55 servings, with little variation by sex.

Fruits, vegetables, nuts, seeds, beans, and legumes are noted to be essential to healthy diets for all, but especially for children.

Countries with the highest intake of these foods include Vietnam, the Democratic Republic of the Congo, and Mexico, while it remains low in South Asia. High-income countries showed declines as children grow older.

The findings underscore an urgent need to improve accessibility to nutritious foods while highlighting the impact of dietary habits on lifelong health. Nutrition Insight speaks with the study’s first author to learn more.

How early life shapes diets

The study in BMJ Global Health points out that the US had a sharp decline in plant-based intake from infancy to adolescence, while most other countries see intake rise with age. 

Although the study cannot explain the exact reason for this trend, Sydney Yearley, M.D./Ph.D. a student at Tufts University, notes that the pattern tells an important story.

“Early in life, children mostly eat the foods their parents and caregivers provide, and many families benefit from nutrition guidance and programs that encourage healthy eating.” 

“As children grow older, they gain more independence and are increasingly surrounded by restaurants, convenience foods, advertising, and highly processed snacks. Together, these changes may make it harder to maintain the healthy eating habits established early in life.”

Healthy eating habits formed early in life can shape long-term health and development.A recent review linked nutritional influences to teenage cognitive outcomes, finding that unhealthy diets in early life, especially infancy, could have lasting consequences for intelligence in adolescence. 

Study details 

The researchers analyzed data from the Global Dietary Database, which compiles what people globally eat or drink, and incorporated data from 1,200 dietary surveys to study trends from 1990 to 2018.

They specifically looked at what children from birth up to 19 years of age ate, such as fruit, non-starchy and starchy vegetables (excluding potatoes), beans and legumes, and nuts and seeds.

The rates of plant-based food consumption were found to be the highest in East and Southeast Asia, mainly because children consumed more non-starchy vegetables. The rate was the lowest in South Asia.

Intake of plant-based foods increased as children aged, except in high-income countries, the researchers add. Top countries with high rates are Vietnam, the Democratic Republic of the Congo, and Mexico; the lowest are in Spain, Pakistan, and the UK.

Notably, the study reveals total intake of healthy plant-based foods increased globally except in South Asia. Also, US children consumed the highest levels of healthy plant-based foods in infancy and the lowest in childhood and adolescence.

Availability is not always better

Since plant-based intake decreases with age only in high-income countries, Yearley notes that the study findings are a reminder that having more food available does not always mean eating better.

Children around the world are eating too few fruits, vegetables, beans, nuts, and seeds.“Higher-income countries often have greater purchasing power and food availability, but children’s diets are shaped by many factors beyond access, including convenience, advertising, peer and family influence, school food environments, and cultural norms, to name a few.”

“In many lower- and middle-income countries, traditional dietary patterns that include more minimally processed plant foods are often preserved as children age,” he adds.

Recent US studies compared ultra-processed food marketing strategies to tobacco tactics, citing similarities driving consumption. For children, it targeted foods “to play with,” such as cartoon characters.

Globally, children are eating relatively low amounts of healthy plant-based foods, according to the study. Yearley believes this finding can reveal hints about some of the barriers to improving intake.

“We found large differences by age, education, and where children live. That tells us the challenges aren’t the same everywhere. Understanding the social, cultural, economic, and food system factors within each community will be critical for designing solutions that actually work.”

When children do not consume enough of the right foods, the study warns of impacts on their energy, metabolism, learning, and mood. 

Yearley points out: “The evidence is quite strong that early childhood nutrition matters. A large body of research has shown that diets consisting of fruits, vegetables, beans/legumes, and nuts/seeds, for example, are rich in essential nutrients and support a healthy microbiome, physical and mental development, body weight, and cardiometabolic risk profile.” 

“The eating habits children develop early in life affect both their health today and their health decades from now.”

Call for stronger nutrition programs

The study acts as a benchmark for tracking progress across countries, which urges solutions to make healthy foods more affordable, accessible, and convenient, Yearley states.

“This could be accomplished through stronger federal nutrition programs and policies, surveillance programs, and individual-level interventions like Food is Medicine and Produce Prescription programs.” 

“Because the challenges differ across subpopulations, regions, and countries, the solutions should too,” he concludes.

In related news, a study linked coordinated food policies targeting products high in fat, salt, and sugar in Chile to a significant reduction in childhood obesity. Such policies include front-of-package warning labels, marketing restrictions, and school food regulations. 

However, a review found limited effectiveness of front-of-pack food labels in reducing consumption among low-income or socioeconomically challenged consumers. However, the finding supports pairing food labeling with strategies like sugar taxation and nutrition education.