Assessment of Beverage Trends During Diet Transition Period Among American Children Age 1 to 5 Years and Nutritional Effects of Replacing Nondairy Caloric Beverages With Milk

Objectives: To investigate milk and beverage intake trends and nutrient intakes from these products and to model the effect of isocaloric substitution of nondairy beverages with milk among toddlers and preschoolers. Methods: Data from NHANES 2001-2018 for children age 1-5 years (n=4,696) were used and milk and other beverages intakes were estimated from the first 24-hour in-person dietary recall. Nutrient intake was determined using the NHANES cycle specific Food and Nutrient Database for Dietary Studies. Changes in nutrient intakes of children age 2-5 years were modeled assuming isocaloric substitution of all non-dairy beverages consumed during lunch and dinner meals combined with milk. Sample-weighted analyses were performed using SAS 9.4 and significance was set at P< 0.01. Results: Intake of milk decreased across 1 to 5 years of age (-60.4 g/d/year of age) while the intakes of total energy (+108 kcal/d/year of age), caloric beverages excluding milk (+24.7 g/d/year of age), as well as sugar sweetened beverages (+31.8 g/d/year of age) increased. Daily intake of nutrients from caloric beverages and milk combined decreased with age and % decreases between ages 1 year and 5 years were: energy (-17%), protein (-35%), fat (-52%), saturated fatty acids (-51%), calcium (-32%), magnesium (-24%), potassium (-26%), sodium (-24%), vitamin A (-26%), folate (-19%), vitamin B12 (-39%) and vitamin D (-39%); while the daily intake of fiber (56%) and added sugar (162%) increased. With the isocaloric replacement of non-dairy caloric beverages with milk (using nutrient contribution of USDA milk, NFS; 11100000) at lunch and dinner among children age 2 to 5 years, intakes increased for protein (5-6%), fat (3%), saturated fatty acids (5-6%), calcium (9-12%), magnesium (3-4%), potassium (3-5%), sodium (1%), vitamin A (8-9%), folate (1%), vitamin B12 (9-11%) and vitamin D (15-22%); while intakes decreased for carbohydrate (3-4%), fiber (1%), total sugar (5-6%) and added sugar (11-13%). Conclusions: Findings indicate that increased efforts are needed to reverse the decrease in milk intake as children age to better align with current dietary guidelines and help ensure the nutrient adequacy of their diets. Funding Sources: National Dairy Council.