Rethinking First Foods

To understand exploding obesity rates among the very young, researchers are looking into the critical period between breast or bottle and the school lunchroom, when lifelong food habits take shape. During the first year of life, experts say, babies self-regulate how much they eat; infants who aren't hungry will refuse another swallow, no matter how much parents try to feed them.

But in the second year, babies, like adults, begin responding less to hunger pangs and more to social cues: Is Mommy giving me more? Has everyone else at the table had seconds? I want to snack in front of the TV too!

That occurs at the very time when a baby's galloping growth rate is beginning to taper. A child typically triples its birth weight during the first 12 months, but babies don't normally approach the quadruple mark until their second birthday. With growth slowing, toddlers need fewer calories per kilogram than infants, but not manyparents seem to know that.

In fact, because toddlers tend to be pickier than infants and are less interested in sitting still for a meal, parents often grow concerned that their kids aren't eating enough. "It becomes a vicious cycle where the parent is chasing the toddler around with a spoon, trying to get him to eat," says Dr. W. Allan Walker, a professor of pediatrics and nutrition at Harvard Medical School and the author of Eat, Play, and Be Healthy. Many parents come to rely on snacks eaten on the go, which tend to be salty, sweet or otherwise unhealthy. At mealtimes, instead of offering whatever the parents are eating, moms will provide "kid food"--easy-to-prepare child pleasers like pizza, mac and cheese and chicken nuggets.

No wonder that, according to new data from the National Health and Nutrition Examination Survey, 26% of 2-to-5-year-olds are at risk of becoming overweight, and 14% are already overweight--more than twice the incidence in the mid-'70s and up 35% in the past four years alone. Those numbers could rise as much as 30% overnight if the U.S. adopts the new growth-chart guidelines issued last month by the World Health Organization. "I'm seeing younger and younger kids overweight--as young as 10 months old," says Jan Hangen, a clinical nutrition specialist at Children's Hospital Boston. "Parents bring babies into the office in these huge strollers packed with food and snacks, drinking soda and juice. We never used to see that."

In most cases, parents, particularly mothers, are the gatekeepers of what babies eat. An eight-year study of 70 baby-mother pairs at the University of Tennessee, published in 2002, confirmed that food preferences are established early: 8-year-olds usually like the same foods they did when they were 4, and preferences are often formed as early as age 2. Mothers tend not to offer their babies food they dislike themselves. So if Mom can't bear Brussels sprouts, chances are her child will never taste them.

That's a shame because babies are already not eating enough vegetables. According to the 2002 survey, Feeding Infants and Toddlers Study (FITS), which tracked the diets of more than 3,000 tots, a quarter of 9-to-11-month-olds do not routinely consume even one helping of vegetables a day. Those who do tend to have the least nutritious kind. By 9 months, potatoes, either mashed or fried, are the most commonly consumed vegetable; by 12 months, 13% of babies eat French fries every day, according to FITS, which was conducted by Mathematica Policy Research and sponsored by Gerber Products Co.

Babies and toddlers are also learning early on to indulge their sweet tooth. FITS found that 10% of 4-to-6-month-olds consume desserts, sweets or sweetened beverages daily. By the time they are 2, 60% of toddlers eat some kind of pastry every day. Although added sugar was removed from most jarred baby foods in the mid-1990s, baby-food companies continue to offer dessert lines with flavors such as vanilla custard pudding and peach cobbler, loaded with sugar and starch.

Early exposure to intensely sweet foods has long-term consequences, says Amy Lanou, a senior nutrition scientist for the Physicians Committee for Responsible Medicine, a Washington-based nonprofit. "When we're really young, our taste buds are especially attuned to sweet flavors. If you're offered bananas and berries at an early age, that level of sweetness will satisfy. But if you're given concentrated sweets, a taste for those intense sweets will follow you for the rest of your life."

On a more positive side, ethnic communities are introducing other Americans to the notion that babies need not subsist on pabulum. South Asian parents offer curries in small doses at young ages. Hispanic parents give their babies tortillas and other ethnic dishes.

"There is no good reason to feed babies bland food," says Nancy Butte, a professor of pediatrics at Baylor College of Medicine. "It's culturally determined, not scientifically based."

Another healthy trend is the growth of organic baby food. Sales were up 57% in the past four years, although organic still has only 2.7% of the U.S. baby-food market, according to ACNielsen. Some pediatricians say organic produce is especially beneficial to babies.

"Organic fruits and vegetables tend to have about 30% more antioxidants than nonorganics," says Dr. Alan Greene, a professor of pediatrics at Stanford University and host of DrGreene.com "This is when babies' brains are developing and are most in need of those benefits." Some researchers believe babies are particularly vulnerable to pesticides, traces of which can be found in commercially grown produce.

A study in California found that newborns exposed to higher levels of pesticides in utero were more likely to have abnormal neurological reflexes. Still, some doctors say because no definitive data support the benefits of organic baby food, the extra cost--sometimes over 50% more a jar--may not be worth it.

Pediatricians do agree on one thing: the period before age 2 is critical for establishing healthy eating. "We need to send a message to new parents," says Dr. Ari Brown, of Austin, Texas.

"Here's your opportunity to change the way a generation eats. By the time a child is 10, eating chips in front of the TV, it's almost too late."