Soup-To-Nuts Podcast: What might the 2020 dietary guidelines for the first 1,000 days include?

By Elizabeth Crawford

- Last updated on GMT

Soup-To-Nuts Podcast: What might the 2020 dietary guidelines for the first 1,000 days include?

Related tags Soup-To-Nuts Podcast FNCE Dietary guidelines Infant nutrition

With emerging research showing that the diet of pregnant women and children under the age of 2 years can have a powerful impact on children’s brain development and future health, the upcoming recommendations for the 2020 Dietary Guidelines will, for the first time, include suggestions for the first 1,000 days of life.

Until now, the Dietary Guidelines for Americans has provided dietary advice for people 2 years and older, prompting caregivers – and healthcare practitioners – to turn to a disparate set of resources to figure out the best diet for pregnant women, infants and young children. These include famous books, such as “What to Expect When You’re Expecting,” and guidelines from various organizations, such as the American Heart Association and the American Academy of Pediatrics.

And while these are influential and well-researched recommendations, by bringing this group under the purview of the broader Dietary Guidelines for Americans, the US government will for the first time take ownership of them – a move that will provide a consistency that so far has been lacking.

The move also is a double-edged sword for the CPG industry. Some hope that including this group in the broader Dietary Guidelines for Americans will protect them undue corporate influence, while others see potential opportunities for innovative manufacturers creating solutions to help Americans meet the recommendations.

While we won’t know for sure what the guidelines will include until the recommendations are released and vetted, this episode of FoodNavigator-USA’s Soup-To-Nuts podcast​ explores some of the themes, suggestions and questions that dietitians and industry players would like to see addressed and how these issues might impact CPG manufacturers.

[Editor’s Note: Never miss another episode of FoodNavigator-USA’s Soup-To-Nuts Podcast​ – subscribe to us on iTunes​.]

A critical first step

Even though the Dietary Guidelines for Americans are designed with health care professionals in mind and, therefore, are not very “consumer-friendly,” Amy Kimerlain, a registered dietitian who specializes in children’s nutrition and a spokeswoman for the Academy of Nutrition and Dietetics, explained at the Food & Nutrition Conference & Expo in Philadelphia last month that the inclusion of recommendations for the first 1,000 days of life is a critical first step to improving the lives of women and children in the US.

“The dietary guidelines allow for general recommendations for healthy Americans across the population, and so now with the introduction of looking at the first 1,000 days, we’re obviously going to pay closer attention to now not only infants and toddlers, but also prenatally as well,”​ Kimerlain said. She added, these guidelines ultimately “will allow for people to look and reflect to see what changes they may need to make in order to improve their health over the long run.”

With that in mind, Kimerlain said she hopes the recommendations look not only at the nutrients that are critical to a child’s development, but also on what – and how much – pregnant women need to consume to keep themselves healthy. This includes advice around how many extra calories do women actually need when “eating for two,” guidance on how much weight they should expect to gain and remain healthy and how diet can help manage potential complications.

Zeroing in on key nutrients

Drilling deeper into what the guidelines might include for expecting women, Kristi King who is also a spokeswoman for the Academy of Nutrition and Dietetics and the senior pediatric dietitian at Texas Children’s Hospital in Houston, says she hopes the guidelines will include specific recommendations about choline intake.

She explained that choline is a “underrated nutrient, that we’re just now starting to figure out that within that first 1,000 days is so incredibly important for infants and brain development.”

She added that this could be an opportunity for supplement manufacturers as well as select food marketers.

An early mover on this from the supplement side is Life Extension, which is a Fort Lauderdale, Fla., based company that launched at FNCE its Prenatal Advantage multivitamin. Like most other prenatal supplements, Life Extension’s Prenatal Advantage includes folic acid and DHA, which have long been recognized as essential for developing infants. But it also is one of the few prenatal supplements that includes choline.

On the food side, one of the best sources of choline are eggs, one of which provides 25% of the recommended daily value.

Mickey Rubin, the executive director of the American Egg Board’s Egg Nutrition Center explained the importance of the eggs in providing choline as well as more generally supporting maternal and infant health.

Despite the importance of choline to developing infants, he noted only about 25% of expecting mothers are familiar with it, compared to 90% who know about folic acid. In addition, little more than half of health professionals currently are aware of choline.

Beyond choline, Rubin says the high amount of lutein in eggs also can help support developing infant’s cognitive development by increasing their macular pigment which has been linked to cognition.

Fiber & probiotics are on the wish list

Fiber is another necessary nutrient for expecting mothers, infants and young children that King says she wants the upcoming dietary guidelines to highlight. Not only does she say she wants to see stronger recommendations around how much should be consumed, but also guidance clarifying how best to get it – including, of course, fresh fruits and vegetables, but also canned and frozen produce as well.

Related to fiber and gut health, King says she would also like to see in the recommendations advice around probiotics, including if they are appropriate for children and expecting women and if so which ones and how much.

Breast is best, but fed is better

Scientifically-based guidance in the dietary guideline recommendations around breastfeeding versus the use of formula also likely will have a significant impact on the CPG industry, predicts King.

Like many dietitians, King advocates that breastfeeding is best, but also acknowledges it is not always an option. In those cases, she says, she would like to see the dietary guidelines recommend the use of FDA approved formula, which is held to a higher safety and nutrition standard than many others from around of the world.

In addition to addressing infant formula, King predicts, the recommendations will tackle toddler milks, for which there is not the same nutritional standard as infant formula but about which much confusion and controversy swirl.

Beverages more broadly also will likely be a hot button topic in the recommendations, with experts predicting the dietary guidelines will call for significantly reduced consumption of sugary drinks, potentially including juice. It likely also will expand or include recent guidelines to restrict drinks for children under five to breast milk, water and dairy milk with only occasional consumption of 100% fruit juice if whole fruit is not an option.

These likely are only a small sample of the issues that will be addressed in the guidance. While the upcoming guidance likely won’t make everyone happy or be perfect, as Kimerlain notes, it is a first step.

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