Adapting the Food Guide Pyramid for Children: Defining the Target Audience

Family Economics and Nutrition Review, Winter, 1999 by Etta Saltos

The USDA's Food Guide, designed to help all healthy 2 years old and over use the Dietary Guidelines for Americans (38), and its graphic representation, the Food Guide Pyramid (Pyramid), have been distributed widely since the Food Guide was first introduced the mid-1980's. The Pyramid has been used widely in a variety of materials (including posters, textbooks, school curricula, and computer software) by nutrition educators and has also been used by industry on food labels. In materials accompanying the Pyramid, USDA recommends that preschool-age children obtain at least the minimal number of servings from the five major food groups, but this age group can have smaller servings from all food groups except the milk group (38). Nevertheless, nutrition educators have identified a need for nutrition guidance regarding the dietary needs of children,[1] and the 1995 Dietary Guidelines Advisory Committee has recommended that the development of separate dietary guide-in lines for children be considered (7). Adaptation of the Pyramid and its accompanying nutrition guidance materials specifically for children is an important component of the effort to help children apply the Dietary Guidelines for Americans.

The purpose of this study was to define the target audience for a food guide that would be adapted for children by recommending subgroups within the 2- to 18-year age range and ranking the subgroups in order of greatest need based on dietary requirements and user demand for nutrition education materials. Materials reviewed for this study included journal articles, reference materials (including the Recommended Dietary Allowances and nutrition textbooks), and published and unpublished reports from government agencies. Criteria used to define and rank the subgroups included the following:

* nutrient needs of children,

* nutrition recommendations for children by authoritative bodies, such as the Dietary Guidelines Advisory Committee,

* nutritional status of children, including macronutrient and micronutrient intake and anthropometric measurements, and

* children's knowledge and attitudes regarding nutrition.

These criteria were used to define subgroups and to list facts in favor of and against adapting a food guide for each subgroup.

Nutrient Needs of Children

The Recommended Dietary Allowances (RDA) provide information concerning children's nutrient needs, as well as the nutritional needs of the rest of the population (23). The 1989 RDA are expressed for the following age-gender groups: children, ages 1 to 3 years; children, ages 4 to 6 years; children, ages 7 to 10 years; males, ages 11 to 14 years; females, ages 11 to 14 years; males, ages 15 to 18 years; and females, ages 15 to 18 years.

The National Academy of Sciences' Food and Nutrition Board, however, is in the process of replacing these RDA with new dietary recommendations: Dietary Reference Intakes (DRI).[2] DRI were released recently for calcium, phosphorus, magnesium, fluoride, vitamin D, thiamin, riboflavin, niacin, vitamin [B.sub.6], folate, vitamin [B.sub.12], pantothenic acid, biotin, and choline (31,32). Reference intake values were published for the following age groups: 1 to 3 years, 4 through 8 years, 9 through 13 years, and 14 through 18 years.

The current RDA (or AI for calcium, fluoride, vitamin D, pantothenic acid, biotin, and choline) for children were

(a) extrapolated from infant or adult research results (vitamins A, K, C, [B.sub.6], [B.sub.12], riboflavin, niacin, folate, biotin, choline, pantothenic acid, selenium, iodine, and manganese),

(b) based on growth and consumption data (energy, protein, iron, phosphorus, and potassium),

(c) estimated based on weight (fluoride and vitamin E),

(d) based on studies on balance in children, but not necessarily with all the above age groups (thiamin, zinc, copper, sodium, calcium, and magnesium), or

(e) estimated based on biochemical markers (vitamin D) (23,31,32).

Because the RDA/AI for children were largely extrapolated or calculated rather than determined directly from studies of children, there is no overriding reason for using the RDA age-gender cutoffs for a children's food guide. Information on children's dietary intakes, nutritional status, and dietary recommendations--as well as information on their attitudes, knowledge, and behavior--must also be considered when determining which groups of children are most in need of nutrition guidance.

Nutrition Recommendations for Children

Recommendations of the U.S. Government

A number of recommendations indicate what constitutes a healthful diet for children. The Dietary Guidelines for Americans, the basis of Federal nutrition policy (39), provide advice about food choices that promote health and prevent disease among healthy Americans 2 years old and older. The Guidelines advise Americans to eat a varied diet with plenty of grain products, vegetables, and fruits, while moderating their intakes of fat, saturated fat, cholesterol, sugars, salt and sodium, and alcoholic beverages. In addition to emphasizing the benefits of physical activity, the Guidelines provide some specific advice for children: they should be taught to eat grain products; vegetables and fruits; lowfat milk products or other calcium-rich foods; beans, lean meat, poultry, fish or other protein-rich foods; and to participate in vigorous physical activity. The Guidelines caution that fat should not be restricted for children younger than age[3] 2, that major efforts to change a child's diet should be accompanied by monitoring of growth at regular intervals by a health professional, and that children should not consume alcoholic beverages. The Guidelines also recommend that children between the ages of 2 and 5 should gradually adopt a diet so that it contains no more than 30 percent of calories from fat by the time children are about 5 years old (39).