Most baby and toddler food doesn’t meet nutrition standards, study finds

About 60% of packaged baby food sold in the United States doesn’t meet nutritional standards established by the World Health Organization, according to research published recently that opens a window into the role that inadequate diet poses in children’s health.

Researchers from the George Institute for Global Health, a medical research center in Australia, analyzed 651 commercial infant food products purchased from large U.S. grocery chains between March and May 2023. They used standards in the 2022 nutrient and promotion profile outlined by the WHO Regional Office for Europe as a benchmark for evaluating these products.

The researchers, whose study appeared last week in the journal Nutrients, found that 70% did not meet protein requirements that are part of WHO nutrition standards and that 44% exceeded total sugar limits.

While WHO nutrition standards are not legally binding, they serve as a guideline for countries. Many countries, including the United States, establish their own nutrition guidelines, with U.S. authorities emphasizing eating vegetables and fruits. In the study, the researchers noted that 1 in 4 products did not meet calorie requirements and that 1 in 5 exceeded recommended sodium levels.

The nutritional deficiencies highlighted in the study and the increased prevalence of ultra-processed foods underscore a growing concern for U.S. children, according to experts.

Elizabeth Dunford, one of the study’s authors and an adjunct assistant professor in the Department of Nutrition at the University of North Carolina, said people are not born with dietary preferences but instead adopt behaviors based on their environment and experiences.

As children grow, their food choices are heavily influenced by what they are exposed to, and many foods marketed to U.S. children are high in sugar, fat, and preservatives while lacking essential nutrients, Dunford said.

“Dietary preferences are established quite young,” Dunford said. “Half of all the sugar that young kids are consuming through these commercial foods come from squeezed pouches, so that’s certainly an area we have to be more careful about.”

The FMI — a trade group formerly known as the Food Marketing Institute that represents manufacturers and major grocers — said it seeks guidance from the Food and Drug Administration regarding nutrition and labeling standards.

The organization said the companies that it represents employ nutrition experts who research and develop products aligned with federal regulations and dietary guidance.

“It is critical that families feed their infants and toddlers a variety of foods to ensure they receive the nutrients needed for healthy development, and commercially available products can assist families in providing safe, nutritious, and affordable food to their children that meet their health needs,” said Hilary Thesmar, FMI’s chief science officer and senior vice president, food and product safety.

Some experts say the standards followed by FMI members don’t always match those set by professional health organizations.

The American Academy of Pediatrics has reported that on average, sugar constituted 17% of a child’s diet, an amount that exceeds the recommended 10%.

Sugar is added to ultra-processed foods because it enhances flavor, making products more appealing and encouraging repeat purchases. It also acts as a preservative, extending shelf life by inhibiting microbial growth; improves texture; and is cheaper than healthier alternatives, making it an attractive option for manufacturers looking to cut costs, according to Dunford.

Ultra-processed foods began to emerge in the 1980s. They became popular items in households, leading to a significant shift in dietary patterns. Families increasingly chose ready-to-eat options, so they often prioritized convenience over nutrition, which has led to a growing market.

Nearly half of the food analyzed in the study appearing in Nutrients came in pouches, while 25% were in ready-to-eat containers, including products that can be put directly into a microwave.

“This is a problem that’s been familiar to the professional pediatric nutrition community for a long time,” said Carolyn Kusenda, manager of the Johns Hopkins Children’s Center Pediatric Clinical Nutrition Center.

These foods often contain additives such as dyes, sweeteners, and emulsifiers. Many of the add-ons are used to prolong shelf life of foods, but Kusenda said they often come with side effects.

“Our bodies don’t know how to metabolize artificial coloring, artificial flavoring, artificial dyes,” Kusenda said.

Infant and toddler food is heavily promoted with health and nutrition claims that can mislead parents and caregivers about how healthy they are, Kusenda said. According to the researchers, manufacturers often use terms such as healthy, convenient, and appropriate for child development to distract from poor nutritional profiles.

“We need greater oversight over the production, marketing, and distribution of these types of foods in the United States,” Kusenda said. “It’s the products themselves. It’s the additives. It’s the suggestive portion sizes. It’s the unfounded claim that some of these foods improve development or improve neurocognitive development.”

While dozens of baby food brands are sold in the United States, only a handful of companies control these brands.

One major manufacturer is Nestlé, maker of Gerber baby food products. Nestlé did not return a request for comment.

Frances Fleming-Milici, director of marketing initiatives for the Rudd Center for Food Policy and Health at the University of Connecticut, said the boom in products marketed toward children can sometimes leave parents scratching their heads, wondering if the claims made on the front of packages are true.

With labels such as “support brain health” and “brain supporting nutrients,” Fleming-Milici said that parents are purchasing these products under pressure and that these types of claims are “confusing” and “not helpful to parents at all.”

“When you look at the front of packaging, there is pictures of fruit and the other things that really mislead consumers into thinking that what is contained in that jar or pouch or product is good for their babies,” Fleming-Milici said.

Many of these sugary foods have been associated with a rise in illness in children.

A study published in May in JAMA Network Open found that children who ate ultra-processed foods were at a higher risk of obesity and cardiometabolic issues.

Chronic diseases such as fatty liver, once primarily associated with adults, are increasingly being diagnosed in children. This can be attributed largely to consumption of ultra-processed foods, researchers have found.

In April, the Agriculture Department proposed updated nutrition standards for school meals that would include limiting added sugar, fat and salt. The rule, which will start rolling out in the next few years, was met with backlash despite the childhood obesity epidemic.

“When you have the opportunities like these companies do to be better for parents and they choose not to, it’s unfortunate,” Fleming-Milici said. “People want to make good choices for their babies, but they can’t do that if they don’t have the right information.”