Influences during Infancy and the Toddler Years 14 All of these trends are associated with decreased diet quality 3, 5, 9, 14 and may partially explain the fact that most adolescents are failing to meet the majority of dietary recommendations. 13 Meal patterns also tend to change, as teenagers are more likely to skip breakfast 8 and less likely to participate in family dinners. The transition into late childhood and adolescence can also be characterized by undesirable changes in eating behaviours such as increased consumption of sugar sweetened beverages (e.g., soda) 8, calorie-dense, nutrient poor snacks 11 and food away from home (e.g., fast food) 12 and a decline in the consumption of milk and other nutrient-dense foods. 10 These children also fall short of reaching the recommended servings for grains and milk products, thereby suggesting that poor eating habits among children are endemic. 8, 9 The Canadian Community Health Survey (CCHS) suggests that seven out of ten children aged 4 to 8 years fail to meet the minimum number of servings for vegetables and fruit in Canada's Food Guide to Healthy Eating. 7 Unfortunately, there is also evidence that these patterns tend to persist throughout childhood and into adolescence, and that diet quality tracks and declines from early childhood through adolescence. Additionally, reported energy intakes exceeded requirements by 10 to 30%. 6 Of particular concern was the finding that 18% to 33% of infants and toddlers consumed no distinct servings of vegetables on a typical day and when vegetables were consumed the most common choice was french fries. The Feeding Infants and Toddlers Study (FITS), which provided data on the dietary patterns of 3022 infants and toddlers, revealed that 4 to 24 month old children typically consumed significant amounts of developmentally inappropriate, energy-dense, nutrient poor foods. 4, 5 The impact of these ongoing practices on children's dietary intake can be seen in several recent dietary surveys. These feeding practices, which include behaviours such as providing large portions of palatable foods and encouraging children to eat, are still pervasive in most cultures, despite the fact that in many regions the balance has shifted from food scarcity to food excess and over-consumption has become a new threat. Across human history, undernutrition and food scarcity have been major threats to children's survival, and parental feeding practices have evolved in response to these threats.
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