Majority of 1- to 3-year-olds fall short on recommended vitamin D and vitamin E intakes

By Mary Ellen Shoup

- Last updated on GMT

©GettyImages / yaoinlove
©GettyImages / yaoinlove

Related tags Food for kids Iron deficiency Vitamin d deficiency Vitamin e

Despite parents’ best efforts to introduce their children to a variety of foods, many children between the ages one and three are falling short of key nutrients including vitamin D, vitamin E, calcium, fiber, and iron, reveals a study examining National Health and Nutrition Examination Survey (NHANES) data from 2001 to 2016.

“Vitamin D and E ​[intake] was the most shocking to us,”​ lead author of the study​, Ariana Bailey, PhD, senior scientist at RB (Reckitt Benckiser), told FoodNavigator-USA.

The study found that 82.7% and 70.9% of children did not meet estimated average requirements (EARs) for vitamin D and vitamin E respectively, while 3.6% and 0.87% of 1- to 3-year-olds did not meet adequate intake of calcium and iron, according to the NHANES data.

What could be driving these significant deficiencies in vitamin D and E intake? Christina J. Valentine MD, MS, RD and North America Medical Director, RB Nutrition, argues that certain food-avoidance trends can start to play a role early on in a child's diet.

“There’s a lot of chatter out there about what a healthy diet is,”​ Dr. Valentine told FoodNavigator-USA.

“Unfortunately, we’re finding that children aren’t drinking their dairy like they have been in the past, and it is an issue because vitamin D is not only vital for their skeletal development but also their immune system,”​ said Dr. Valentine.

The study found that just 1% of children meet recommended intake of fiber.

“Our fiber intake is so low and I think it has to do with this culture that everyone needs to avoid gluten and grains, but in reality those food sources have good content of vitamin E and they have lots of fiber.”

Vitamin E deficiencies in children between one and three years of age are compounded by the fact that foods containing this essential vitamin can be hard to incorporate into a toddler’s diet (nuts, legumes, and seeds).

Iron deficiency

Authors of the study looked at a second set of biomarker data provided by the CDC to determine iron intake levels among children ages one to three and found that iron deficiency may be more of an issue than NHANES data suggests.

“It’s interesting to us that it doesn’t quite match the intake data,”​ said Dr. Bailey.

“We used ferritin as our cutoff for iron deficiency and hemoglobin to measure anemia status,”​ the two most reliable biomarkers available to researchers, said Dr. Bailey.

“We saw almost 7% of children one to three years of age had iron deficiencies determined by that ferritin cut off. But then we looked at the one to year age group specifically, and it was higher at 8.5%,” ​she noted.

Hispanic children, she noted, appeared to have the highest iron deficiencies (8.9% 1–3 years; 11.6% 1–2 years) when looking at the biomarker data.


What’s the most likely reason for iron deficiencies found in a considerable amount of children’s diets?

As a healthy practitioner and dietitian who advises families on nutrition, Dr. Valentine argues that parents must consider the bioavailability of iron in the foods they’re giving their children.

“Iron can be a big problem even in our developed country and perhaps folks need to look more carefully at the iron sources they’re using in their children’s diet to make sure that they really are bioavailable,”​ she noted.

What many parents may not realize, according to Dr. Valentine, is that even though they may be filling their child’s diet with ‘iron-rich’ foods such as beans, lentils, and dark leafy vegetables, the most bioavailable sources of iron for young kids come from lean red meat, chicken, and seafood.

Parents must also be aware that the transition from breastfeeding to supplementary foods and cow’s milk can have a significant impact on iron intake, said Dr. Valentine.

“What is known is that as a mom breastfeeds, the iron concentration in her milk is very bioavailable but the total concentration of iron falls dramatically between six and 12 months into breastfeeding,”​ she said.

'It starts with awareness'

With this data in hand, what can parents do to ensure their child's first 1,000 days meet the recommended levels of essential nutrients? Dr. Valentine suggests that the conversation between parents and healthy professionals must be re-framed and laser focused on how to get key nutrients into their child's diet. 

“A lot of folks will discuss with parents the importance of getting a variety of foods in their child’s diet. Well, it doesn’t appear that that conversation is really targeting the foods, the nutrients that this population needs as evidenced by this data,”​ she said.

"It all starts with awareness. Doing this in a way that’s more targeted at these nutrients."

Want to learn more about meeting children's nutrition needs? Tune in to FoodNavigator-USA's FOOD FOR KIDS virtual summit​ this fall. Register your interest​ to receive the latest event updates.

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