Abstract  OBJECTIVE: Describe the design, data collection procedures, and sample characteristics of the Feeding Infants and Toddlers Study.

DESIGN: We conducted up to three telephone interviews with a random sample of parents or caregivers of infants and toddlers four to 24 months of age from March to July 2002. The three interviews included (a) a recruitment and household interview; (b) a 24-hour dietary recall, with supplementary questions on growth, development, and feeding patterns; and (c) a second dietary recall for a random subset of the sample. Two age subgroups of infants (four to six months and nine to 11 months) were over sampled. Sample weights adjusted for over sampling, nonresponse, and under coverage of some subgroups in the sample frame.

SUBJECTS: A national random sample of 3,022 infants and toddlers, with two days of dietary recall available for 703 sample members.

RESULTS: Of sampled households that could be located and had an eligible child in the study age range, the response rate to the recruitment interview was 73%. Of recruited households, the response rate for the dietary recall interview was 94%.

APPLICATIONS/CONCLUSIONS: The Feeding Infants and Toddlers Study (FITS) provides a wealth of data on the food and nutrient intakes, background characteristics, growth and development milestones, and feeding patterns and transitions for a nationally representative sample of infants and toddlers. Subsequent papers in this journal issue present study findings and conclusions from in-depth analysis of the FITS data.

Abstract  The USDA National Nutrient Database for Standard Reference (SR) is the major source of food composition data in the United States. It provides the foundation for most food composition databases in the public and private sectors. As information is updated, new versions of the database are released. This version, Release 20 (SR20), contains data on 7,519 food items and up to 140 food components. It replaces SR19 issued in August 2006. SR20 includes composition data for all the food groups and nutrients published in the 21 volumes of AAgriculture Handbook 8@ (U.S. Department of Agriculture 1976B92), and its four supplements (U.S. Department of Agriculture 1990B93), which superseded the 1963 edition (Watt and Merrill, 1963). Since 1992, updated data have been published electronically on the USDA Nutrient Data Laboratory (NDL) website. SR20 supersedes all previous releases, including the printed versions, in the event of any differences. With the first release of data from the new Nutrient Databank System (NDBS) in July 2001, formats were changed and fields added to improve the descriptive information for food items and the statistical information about the nutrient values. While data in previous releases have been moved to the new NDBS, they may not have been updated through the complete system. Therefore, many of these new fields contain data only for those items that have been processed through the new NDBS and it will take a number of years before they are populated for most food items in the database. Data have been compiled from published and unpublished sources. Published sources include the scientific and technical literature. Unpublished data include those obtained from the food industry, other government agencies, and research conducted under contracts initiated by USDA Agricultural Research Service (ARS). These analyses are currently conducted under the National Food and Nutrient Analysis Program (NFNAP), in cooperation with the National Cancer Institute and 16 other offices and institutes of the National Institutes of Health (Pehrsson et al., 2000). Data from the food industry represents the nutrient content of a specific food or food product at the time the data is sent to NDL. The values may change due to reformulations or other processing changes by individual companies between the time that SR is released and the next update of the database. Values in the database may be based on the results of laboratory analyses or calculated by using appropriate algorithms, factors, or recipes, as indicated by the source code in the Nutrient Data file. Not every food item contains a complete nutrient profile.

Abstract  This publication contains estimates of food and nutrient intakes by individuals residing in households in the 48 conterminous States and Washington, D.C., based on data from the 1987-88 Nationwide Food Consumption Survey conducted by the U.S. Department of Agriculture. One-day food and nutrient intake data for 10,172 individuals of all ages were collected between April 1987 and August 1988. The data, collected using a 1-day recall in a personal interview, are provided in six tables. Food and nutrient intake data are tabulated for individuals by sex and age, region, income level, and race. For 64 food groups and subgroups, mean quantities of foods eaten per individual in a day and percentages of individuals who reported eating any food from the specified food groups and subgroups are presented. Also presented are tables of the mean intakes of food energy and nutrients; the percentages of total food energy from protein, total fat, fatty acids, and carbohydrate; and nutrient intakes expressed as percentages of the 1989 Recommended Dietary Allowances. Response rates were very low, approximately 31 percent at the individual level, and the possibility of nonresponse bias cannot be disregarded.

Abstract  This two-disk CD-ROM contains microdata on food and nutrient intakes from The Supplemental Children's Survey (CSFII 1998) to the 1994-96 Continuing Survey of Food Intakes by Individuals (CSFII 1994-96). CSFII 1998 was conducted in response to the Food Quality Protection Act of 1996, which required the U. S. Department of Agriculture to provide data from a larger sample of children for use by the Environmental Protection Agency in estimating exposure to pesticide residues in the diets of children. The CSFII 1998 adds intake data from 5,559 children birth through age 9 years to the intake data collected from 4,253 children of the same ages participating in the CSFII 1994-96. The CSFII 1994-96 included the collection of data from persons of all ages (1-day dietary intake data for 16,103 individuals). The 1998 survey was designed so that the data could be combined with those from the 1994-96 survey, thus the approaches to sample selection, data collection, data file preparation, and weighting in CSFII 1998 were consistent with those used in the CSFII 1994-96. The survey data files on these disks contain data from both the CSFII 1994-96 and CSFII 1998; all 4 years of data are nationally representative surveys conducted by the Agricultural Research Service of the U.S. Department of Agriculture. The data set may be analyzed in a variety of ways: the combined 1994-96, 1998 data; the 1998 data separately; the 3-year CSFII 1994-96 data; or any of the 3 years of the CSFII 1994-96 separately. The seven data files include: household, household member, sample person, food line item, daily intake (food group amounts), daily intake (nutrients), and Diet and Health Knowledge Survey (from the 1994-96 survey only).

Abstract  OBJECTIVES: To examine average portion sizes consumed per eating occasion by infants and toddlers. Average portions reported for toddlers were compared to average portions for comparably aged children reported in the 1994 to 1996 and 1998 Continuing Survey of Food Intakes by Individuals. In addition, reported average portions were compared with minimum required portion sizes for meals served to infants and toddlers in the Child and Adult Care Food Program (CACFP).

DESIGN: Data from 24-hour recalls collected in the 2002 Feeding Infants and Toddlers Study (FITS) were analyzed. Average portion sizes were determined for major food groups and individual foods that were reported by at least 5% of the population. Most foods were reported separately; however, sandwiches were disaggregated into their components. Gram weights of portions consumed were converted, on a food-by-food basis, to household units so that foods with different volume-to-weight ratios could be analyzed together.

SUBJECTS/SETTING: A national random sample of 3,022 US infants and toddlers 4 to 24 months of age.

STATISTICAL ANALYSES PERFORMED: For each food and food group, average portion sizes per eating occasion were computed for up to six age groups. An average per-eating occasion portion was determined for each child who consumed a given food by summing the total amount of food consumed over the day and dividing by the number of eating occasions. These estimates were then summed across all children who consumed the food and divided by the total number of consumers. The number of eating occasions was defined as the total number of times a child had anything to eat or drink during the day, excluding eating occasions that included only water and/or supplements.

RESULTS: For most foods, there was a gradual increase in the average portion as age increased. Average portions reported for FITS toddlers were consistent with those reported for comparably aged children in the most recent Continuing Survey of Food Intakes by Individuals. The average portions reported for FITS infants and toddlers were consistent with CACFP-recommended portion sizes for formula, juice, meats, and cheese. For milk (toddlers only), cereal, breads, fruits, and vegetables, average portions reported in FITS were consistently larger than CACFP portion sizes. Distributions showed that, in many cases, the per-eating occasion portion sizes of 50% to 90% of FITS infants and toddlers exceeded the CACFP portion sizes.

CONCLUSIONS: Dietitians, pediatricians, and health educators can use the data presented in this article to provide guidance to parents and caregivers about reasonable portion sizes for infants and toddlers. The data should also be useful to those who plan meals for infants and toddlers in child care settings and to researchers studying dietary intakes of infants and toddlers. Advice about reasonable portion sizes should always be tempered with appropriate cautions about avoiding coercive "clean your plate" feeding practices. Parents and caregivers should be encouraged to offer infants and toddlers appropriate portions of healthful foods from the basic food groups, with a special emphasis on fruits, vegetables, and whole grains, and allow them to eat until they are satiated.

Abstract  OBJECTIVES: To examine the nutrient intakes, foods consumed, and feeding patterns of infants and toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

DESIGN: Cross-sectional telephone survey, including 24-hour dietary recalls of infants' and toddlers' food and nutrient intakes, as reported by parents or other primary caregivers.

SUBJECTS: National random sample of 3,022 children ages 4 to 24 months who participated in the 2002 Feeding Infants and Toddlers study. Sample sizes by age were infants 4 to 6 months: 265 WIC participants, 597 nonparticipants; infants 7 to 11 months: 351 WIC participants, 808 nonparticipants; and toddlers 12 to 24 months: 205 WIC participants, 791 nonparticipants.

STATISTICAL ANALYSES PERFORMED: We used Statistical Analysis Software (version 8.2) to examine the breastfeeding status, infant feeding patterns, and foods consumed; the personal computer version of the Software for Intake Distribution Estimation to estimate mean usual intake of food energy and of key nutrients targeted by the WIC program; and methods recommended by the Institute of Medicine to assess nutrient adequacy.

RESULTS: Infants participating in WIC were less likely than nonparticipants to have ever been breastfed or to be currently breastfeeding, and they were more likely to be consuming formula. Mean usual nutrient intakes exceeded the adequate intake for WIC participants, and the percentage with inadequate nutrient intake was less than 1%. Reported mean energy intakes exceeded mean energy requirements, with the largest discrepancy observed for WIC participants. Sizeable proportions of WIC and non-WIC infants and toddlers did not consume fruits and vegetables on the recall day.

APPLICATIONS: WIC providers should focus nutrition education on appropriate infant and toddler feeding patterns, should continue to reinforce their message of the importance delaying the use of cow's milk until 1 year of age, and should stress the importance of fruit and vegetable consumption.

Abstract  The Supplemental Children's Survey to the 1994-96 Continuing Survey of Food Intakes by Individuals (CSFII 1998) was conducted in response to the Food Quality Protection Act of 1996, which required the U.S. Department of Agriculture to provide data from a larger sample of children for use by the Environmental Protection Agency in estimating exposure to pesticide residues in the diets of children. The 1998 survey adds intake data from 5,559 children birth through 9 years of age to the intake data collected from 4,253 children of the same age participating in the CSFII 1994-96. The 1994-96 survey included the collection of data from persons of all ages. The CSFII 1998 was designed to be combined with the CSFII 1994-96, thus the approaches to sample selection, data collection, data file preparation, and weighting were consistent. The design, methodology, and operation of the CSFII 1994-96 are detailed in a separate report [Tippett and Cypel (eds.) 1997]. The CSFII 1998 was conducted between December 1997 and December 1998 by USDA's Agricultural Research Service.

Abstract  OBJECTIVE: To describe the food consumption patterns of US children aged 2 and 3 years.

DESIGN: Descriptive analysis of data collected in the Feeding Infants and Toddlers Study 2008 based on a single 24-hour dietary recall collected by telephone.

SUBJECTS: A national random sample of children aged 2 and 3 years (n=1,461).

STATISTICAL ANALYSES PERFORMED: The percentage of children consuming foods from specific food groups was estimated for the full sample of children aged 2 and 3 years and separately by year of age.

RESULTS: About a third of 2-year-olds and a quarter of 3-year-olds consumed whole milk at least once in a day. About 70% of 2- and 3-year-olds consumed vegetables as a distinct food item at least once in day. French fries and other fried potatoes were the most commonly consumed vegetable. Almost three quarters of children (73%) consumed fruit as a distinct food item at least once in a day, and 59% consumed 100% juice. Fresh fruit was the most commonly consumed type of fruit. About 85% of children consumed some type of sweetened beverage, dessert, sweet, or salty snack in a day. Percentages of children consuming such foods were consistently higher for 3-year-olds than for 2-year-olds.

CONCLUSIONS: Parents and caregivers should be encouraged to expose young children to a wide variety of fruits and vegetables, whole grains, low-fat dairy products, and healthier fats, and to limit consumption of low-nutrient, energy-dense foods and beverages. Dietary guidance should stress the fact that children in this age group have high nutrient needs and relatively low energy requirements, leaving little room for such foods. Parents need advice that is specific, practical, and actionable.

Abstract  Whole grain (WG) foods have been shown to reduce chronic disease risk and overweight. Total dietary fiber is associated with WG and its health benefits. The purpose was to determine whether associations exist between WG intake (no-WG intake, 0 ounce equivalent [oz eq]; low, >0-<3 oz eq; high, ≥3 oz eq) and total dietary fiber intake among Americans 2 years and older. One-day food intake data from the US National Health and Nutrition Examination Survey 2009 to 2010 (n = 9042) showed that only 2.9% and 7.7% of children/adolescents (2-18 years) and adults (≥19 years) consumed at least 3 WG oz eq/d, respectively. For children/adolescents and adults, individuals in the high WG intake group were 59 and 76 times more likely to fall in the third fiber tertile, respectively, compared with those with no-WG intake. Total dietary fiber intake from food sources varied by WG intake group for children/adolescents and adults with more total dietary fiber consumed from ready-to-eat (RTE) and hot cereals and yeast breads/rolls in the high WG intake group compared with the no-WG intake group. Major WG sources for children/adolescents and adults included yeast bread/rolls (24% and 27%, respectively), RTE cereals (25% and 20%, respectively), and oatmeal (12% and 21%, respectively). Among those with the highest WG intake, WG RTE cereal with no added bran was the greatest contributor to total dietary fiber compared with other RTE cereal types. Whole grain foods make a substantial contribution to total dietary fiber intake and should be promoted to meet recommendations.

Abstract  The mission of National Center for Environmental Assessment (NCEA) of EPA's Office of Research and Development is to provide guidance and risk assessments aimed at protecting human health and the environment. To accomplish this mission, NCEA works to develop and improve the models, databases, tools, assumptions, and extrapolations used in risk assessments. This handbook is a tool developed by NCEA aimed at refining the assumptions used in exposure assessments and reducing uncertainty. This handbook was first published in 1989 and later updated in 1997 to provide statistical data on the various human factors used in assessing exposure. This revised edition of the handbook provides the most up-to-date data on these exposure factors. The recommended values are based solely on our interpretations of the available data. In many situations different values may be appropriate to use in consideration of policy, precedent or other factors. The Exposure Factors Handbook provides a summary of the available statistical data on various factors used in assessing human exposure. This Handbook is addressed to exposure assessors inside the Agency as well as outside, who need to obtain data on standard factors to calculate human exposure to environmental agents. These factors include: drinking water consumption, soil ingestion, inhalation rates, dermal factors including skin area and soil adherence factors, consumption of fruits and vegetables, fish, meats, dairy products, homegrown foods, human milk intake, human activity factors, consumer product use, and building characteristics. Recommended values are for the general population and also for various segments of the population who may have characteristics different from the general population. NCEA has strived to include full discussions of the issues that assessors should consider in deciding how to use these data and recommendations.

Abstract  Older adults residing in rural communities are at risk for low dietary quality because of a variety of social, physical and environmental circumstances. Minority elders are at additional risk because of poorer health status and lower socioeconomic status. This study evaluated the food group intake of 130 older (>70 years) African American (34%), European American (36%), and Native American (30%) residents of two rural communities in central North Carolina. An interviewer-administered food frequency questionnaire was used to measure dietary intake. Food items were classified into food groups similar to the United States Department of Agriculture (USDA) Food Guide Pyramid and the National Cancer Institutes 5 A Day for Better Health program. None of the survey participants met minimum intake recommendations and most over-consumed fats, oils, sweets and snacks. African Americans and Native Americans consumed fewer servings of meats,fruits and vegetables, and fats, oils, sweets and snacks than European Americans. African American men consumed the fewest servings of fruits and vegetables of all gender/ethnic groups. Consumption of fats, oils and sweets was greatest among those 85 years and older and was more common among denture users. National strategies to educate the public about the importance of consuming a varied diet based on the recommendations presented in national nutrition education campaigns may not be reaching older adults in rural communities, particularly minority group members.

Abstract  Below is a summary of the recommendations reached by the Methodological Subcommittee of the HNIS/NCHS Analytic Working Group on the issues of variance estimation and statistical reporting standards. Specific recommendations are underlined, whereas suggested practices are italicized. The implementation of these recommendations and suggestions will vary from survey to survey and, perhaps, from estimate to estimate. Nevertheless, official agency publications should contain a "statistical notes" section describing the variance estimation and statistical reporting standards used therein. The design-based approach to the estimation and analysis of survey data is assumed here. Unlike model-dependent alternatives, the design-based approach makes few assumptions about the nature of the data being summarized and/or analyzed. Two aspects of the sampling design must be taken into account when using this approach: the sample weights and the complex sample design (stratified, multi-stage sampling). Weights are used in the this approach when estimating mean, medians, and other descriptive statistics as well as analytical statistics like regression coefficients. Both weights and indicators of stratum and primary sampling unit (PSU) membership are used when estimating variances and testing for statistical significance. In general, using statistical weights that reflect the probability of selection and propensity of response for sampled individuals will affect parameter estimates, while incorporating the attributes of the complex sample design (i.e., clustering and stratification) will affect estimated standard errors and thereby test statistics and confidence intervals. The recommendations for presentation of statistical data that follow arise from the issue of sampling variability, and reflect the random way (in the rigorous statistical sense) in which the sample was selected. Although beyond the scope of this report, a consideration of nonsampling issues such as measurement error, nonresponse bias, and other methodological biases are necessary for any thorough interpretation and evaluation of the validity of survey findings.

Abstract  This report presents data on 1-day food and nutrient intakes of 9,620 individuals from the Nationwide Food Consumption Survey 1977-78 in: the 48 conterminous States of the United States in the spring of 1977. Average food intakes of individuals in 22 sex-age groups are summarized in i0 major food groups and 43 subgroups. Average intakes of food groups and subgroups for all individuals and for users only of each food group and the percentage of individuals using each food group are given. Also included are average intakes of energy and 14 nutrients, nutrient-to-calorie ratios, comparisons of intakes with the 1980 Recommended Dietary Allowances, nutrient contributions of major food groups, nutritive value of food eaten away from home, frequency and nutritive value of meals and snacks reported, certain characteristics of sample, and some comparisons with similar information collected in a 1965 survey. Data are presented in 75 tables with a summary of the main points.

Abstract  This report presents historical data on food consumption, prices, expenditures, and U.S. income and population. In 1997, each American consumed, on average, 81 pounds more of commercially grown vegetables than in 1970; 65 pounds more of grain products; 57 pounds more of fruit; 32 pounds more of caloric sweeteners; 13 pounds more of total red meat, poultry, and fish (boneless, trimmed equivalent); 17 pounds more of cheese; 13 pounds more of added fats and oils; 3 gallons more of beer; 70 fewer eggs; 10 gallons less of coffee; and 7 gallons less of milk. Retail food prices, as measured by the Consumer Price Index (CPI), increased 2.6 percent in 1997. Food price inflation in 1997 was higher than the overall increase in the CPI for all goods and services (2.3 percent) for the third consecutive year. Americans spent $715 billion for food in 1997 and another $95 billion for alcoholic beverages. Away-from-home meals and snacks captured 45 percent of the U.S. food dollar in 1997, up from 39 percent in 1980 and 34 percent in 1970. The percentage of disposable personal income spent on food declined from 13.8 percent in 1970 to 10.7 percent in 1997.

Abstract  This review examines the current knowledge of water intake as it pertains to human health, including overall patterns of intake and some factors linked with intake, the complex mechanisms behind water homeostasis, and the effects of variation in water intake on health and energy intake, weight, and human performance and functioning. Water represents a critical nutrient, the absence of which will be lethal within days. Water's importance for the prevention of nutrition-related noncommunicable diseases has received more attention recently because of the shift toward consumption of large proportions of fluids as caloric beverages. Despite this focus, there are major gaps in knowledge related to the measurement of total fluid intake and hydration status at the population level; there are also few longer-term systematic interventions and no published randomized, controlled longer-term trials. This review provides suggestions for ways to examine water requirements and encourages more dialogue on this important topic.

Abstract  This publication provides selected results from the 1994-96 Diet and Health Knowledge Survey (DHKS) and the 1994-96 Continuing Survey of Food Intakes by Individuals (CSFII). The tables include information from 5,649 individuals age 20 and over who participated in the DHKS and provided 2 days of dietary intake in the CSFII. The tables in the report provide information on people's perceptions about the adequacy of their own food and nutrient intakes, the personal importance they place on dietary guidance messages, their self-appraised weight status, the importance they place on factors related to buying food, and the beliefs they hold that may influence dietary behavior. Data are provided by sex and age, income, race, national origin, and education. Standard error tables are provided. Audiences for this report consist of food and nutrition program administrators, personnel in food regulatory agencies; nutrition educators; public health professionals; nutrition scientists and researchers; cooperative extension staff; agricultural and consumer economists; food industry personnel; researchers in government, universities, and private industry; Congress; and the media.

Abstract  This report contains estimates of food intakes by individuals residing in households in the entire United States. The estimates were based on information obtained from 14,262 non-breast fed individuals ages 2 and above who provided 2 days of dietary intake information in the 1994-96 Continuing Survey of Food Intakes by Individuals (CSFII 1994-96), conducted by the U.S. Department of Agriculture. Food intake data were collected by in-person interviews from 1994 through 1996.

Abstract  OBJECTIVE: To describe feeding practices and food consumption of infants and children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

DESIGN: National, cross-sectional analysis of 24-hour dietary recall data from the 2008 Feeding Infants and Toddlers Study.

PARTICIPANTS: Random sample of infants (6-11 months of age), toddlers (12-23 months of age), and preschoolers (24-47 months of age); WIC participants (n = 794) and nonparticipants (n = 2,477).

MAIN OUTCOME MEASURES: Breastfeeding rates, introduction to solids, food consumption.

ANALYSIS: Used weighted descriptive statistics, chi-square tests, and t tests to identify dietary outcomes unique to WIC participants vs nonparticipants.

RESULTS: Compared with nonparticipants, fewer WIC infants were breastfed (P < .01) and consumed any vegetable (P < .05) but more consumed 100% juice (P < .05). Fewer WIC toddlers and preschoolers consumed any fruit vs nonparticipants (P < .01). The WIC toddlers were more likely to consume any sweet vs nonparticipants (P < .05), especially sugar-sweetened beverages (P < .01). Over 80% of all preschoolers consumed any sweet, and nearly half consumed sugar-sweetened beverages on an average day.

CONCLUSIONS AND IMPLICATIONS: Findings identify feeding and dietary issues that begin during infancy and are also present in toddler and preschool stages. These findings are useful for WIC nutritionists and health care practitioners to encourage the early development of healthful eating patterns.

Abstract  This report provides a set of early-life stage age groups for U.S. Environmental Protection Agency (EPA, or the Agency) scientists to consider when assessing children's exposure to environmental contaminants and the resultant potential dose. These recommended age groups are based on current understanding of differences in behavior and physiology that may impact exposures in children. A consistent set of early-life age groups, supported by an underlying scientific rationale, is expected to improve Agency exposure and risk assessments for children by increasing the consistency and comparability of risk assessments across the Agency, improving accuracy and transparency in assessments for those cases where current practice might too broadly combine behaviorally and physiologically disparate age groups, and fostering a consistent approach to future exposure surveys and monitoring efforts to generate improved exposure factors for children.

Abstract  OBJECTIVE: To describe the food consumption patterns of US infants and toddlers, 4 to 24 months of age.

DESIGN: Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers study based on telephone interviews and 24-hour dietary recalls.

SUBJECTS: A national random sample of 3,022 infants and toddlers age 4 to 24 months.

STATISTICAL ANALYSES PERFORMED: The percentage of infants and toddlers consuming foods from specific food groups was estimated for six age groups, using a single 24-hour recall.

RESULTS: Infants as young as 7 months of age showed food patterns that have been observed in older children and adults. From 18% to 33% of infants and toddlers between ages 7 and 24 months consumed no discrete servings of vegetables, and 23% to 33% consumed no fruits. French fries were one of the three most common vegetables consumed by infants 9 to 11 months of age. By 15 to 18 months, french fries were the most common vegetable. Almost half (46%) of 7- to 8-month-olds consumed some type of dessert, sweet, or sweetened beverage, and this percentage increased as age increased. By 19 to 24 months, 62% of toddlers consumed a baked dessert, 20% consumed candy, and 44% consumed a sweetened beverage.

APPLICATIONS: Parents and caregivers should be encouraged to offer a wide variety of vegetables and fruits daily, with emphasis on dark green, leafy, and deep yellow vegetables and colorful fruits. They should offer desserts, sweets, sweetened beverages, and salty snacks only occasionally, offering nutrient-dense, age-appropriate foods as alternatives (eg, fruit, cheese, yogurt, and cereals). Water, milk, and 100% fruit juices should be offered as alternative beverages. Because family food choices influence what foods are offered to children, family-based approaches to developing healthy eating habits may be helpful.