Are young children getting their daily veggies?

3 min read • By: Gerber Medical Hub

Young girl standing in kitchen cutting a cucumber on the counter

Quick summary

Nearly 1/2 of 1-5-year-old children in the United States did not eat a daily vegetable according to recent data from the 2021 National Survey of Children’s Health. Veggies provide essential nutrients. Research suggests early introduction, variety, and repeated exposure to boost veggie consumption. Barriers include preferences and access. Parents can help by offering colorful veggies, making it fun, trying new ones, and setting a good example. Tips for families include daily veggie exposure, considering all forms, using dips, offering variety, using non-food rewards, educating about nutrition, and being a role model.

Table of contents

Test Your Knowledge
Why are vegetables important in the diets of young children?
What does the literature inform us about vegetable exposure?
What are the reported barriers to vegetable consumption by young children?
What are evidence-based messages that can be shared with parents and caregivers?
What are some practical tips to help support families?
References

Test Your Knowledge

On average, what percentage of 1-5-year-old children in the United States do not eat vegetables daily?

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Reveal the correct answer

C. 49% of 1-5-year-old children in the United States did not eat a daily vegetable according to recent data from the 2021 National Survey of Children’s Health (NSCH). The percent of children in this age group lacking daily vegetable consumption was also reported for individual states. Findings ranged from 30% of children in Vermont, to 64% of children in Louisiana not eating a daily vegetable. In 20 states, more than half of children did not eat a vegetable daily during the preceding week ^{(CDC 2023).} Previous findings from the Feeding Infants and Toddlers Study ^{(FITS 2016)} found that 28% of 12-23.9m and 27% of 24-47.9 m children did not consume a discrete serving of vegetables on a given day.

The NSCH and FITS data focused on discrete vegetable consumption (e.g., carrots, sweet potatoes, or green beans) and did not disaggregate and pull vegetables from sources like mixed dishes (e.g., soups/stews, stir-fry, lasagna, omelets, and quesadillas) which is a limitation. Some good news from the 2020 Dietary Guidelines Advisory Committee Data Supplement: Infants and Toddlers Food Group and Nutrient Intakes is that when vegetables from all sources are considered, 90% of children consume some vegetable in a given day but even then, the mean intake is ½ serving of vegetables ^{(DGAC 2020).}

Why are vegetables important in the diets of young children?

According to the Dietary Guidelines for Americans 2020 ^{(USDA 2020):}

A healthy dietary pattern for young children includes a variety of nutrient-dense fruits, vegetables, grains, protein foods (including lean meats, poultry, eggs, seafood, nuts, and seeds), dairy (including milk, yogurt, and cheese), and oils.
A variety of colored vegetables provides a variety of different nutrients such as potassium, vitamin A, vitamin C, and fiber.

What does the literature inform us about vegetable exposure?

The most promising strategies to promote vegetable intake in children, starting with complementary feeding until they are 3 years of age are as follows ^{(Barends 2019, Bell 2021, Chambers 2016, Issanchou 2017, Lang 2013, Nekitsing 2022, Pietrobelli 2017, Thompson 2022):}

Introducing vegetables at the beginning of complementary feeding ^{(Barends 2013, Barends 2014, Barse 2017, Fildes 2015, Hetherington 2015)}
Giving a different type of vegetable every day i.e., variety ^{(Gerrish 2001, Maier 2008, Mennella 2008, Barends 2013, Coulthard 2014, Fewtrell 2017, Fildes 2015)}
Ensuring repeated exposure to the same vegetable following an interval of a few days ^{(Ahern 2013, Barends 2013, Barends 2014, Coulthard 2014, Maier-Noth 2016, Remy 2013, Spill 2019)}

What are the reported barriers to vegetable consumption by young children?

There are many barriers to vegetable consumption by young children. The underlying themes are child behavioral factors ^{(Arthur 2022, Fisher 2016, Johnson 2016, Krolner 2011)}, parental and family environment ^{(Arthur 2022, Fisher 2016, Gerritsen 2019, Haynes-Maslow 2013, Holley 2017, Krolner 2011),} community challenges ^{(Fisher 2016, Gerritsen 2019, Haynes-Maslow 2013, Holley 2017, Krolner 2011),} and external influences ^{(Arthur 2022, Fisher 2016, Gerritsen 2019, Krolner 2011).} Some of the main key challenges include, but are not limited to food preferences, food neophobias, availability and exposure to vegetables, lack of access to fresh and affordable vegetables, and the availability of other foods that are preferred over choosing vegetables.

What are evidence-based messages that can be shared with parents and caregivers?

Eat your colors: Parents can be encouraged to offer their child a ‘rainbow’ of vegetables and fruits ^{(Chambers 2016, USDA 2020).}
Make it fun: Educating children about vegetables through songs, stories, and/or games while repeatedly making vegetables accessible and available to children significantly increases vegetable consumption as experiential learning and nutrition education expand children’s knowledge, awareness, and willingness to taste and eat vegetables ^{Braga-Pontes 2022, Holley 2017, Nekitsing 2018.}
Novel vegetables: Repeated exposure ^{(Karagiannaki 2021, Nekitsing 2019)} and/or the use of stickers as a reward may be a valid strategy to promote the consumption of unfamiliar vegetables ^{Braga-Pontes 2022.}
Disliked vegetables: Repeated taste exposure, in combination with small rewards, has been shown to increase children’s acceptance of previously disliked foods (Fildes 2014, Nekitsing 2019).
Healthy dietary pattern: This includes a variety of nutrient-dense vegetables that encompass colorful vegetables (dark-green, red, and orange), legumes (beans, split peas, and lentils), starchy vegetables (corn, potatoes, and fresh green peas), and other vegetables (cauliflower, mushrooms, and onions) ^{(MyPlate.gov, USDA 2020).}
Recent research (McLeod 2023) concludes that offering vegetables to children at breakfast time in the kindergarten setting is feasible and acceptable to children.

Table 1. Healthy U.S. Style Dietary Pattern: Toddlers Ages 12 Through 23 Months Who Are No Longer Receiving Human Milk or Infant Formula

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Table 2. Healthy U.S. Style Dietary Pattern: Ages 2 Through 8

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What are some practical tips to help support families?

Repeated exposure: Encourage vegetable consumption daily by offering vegetables on the plate along with other foods and mixed into sauces or baked goods.
All forms count: Fresh, frozen, and canned are all nutrient-dense options that contribute toward vegetable consumption.
Vegetables in mixed dishes count too: Tomatoes, beans, and corn are a few examples.
Use dips and spreads: Combine vegetables with dressings or hummus to add flavor and healthy fats.
Eat your colors: Focus on offering a variety of colorful veggies such as red bell peppers, orange carrots, yellow squash, green broccoli, purple cabbage, and white cauliflower.
Non-food rewards: Provide stickers as a reward for your child when he or she tries or eats vegetables. There are also food-based edible stickers that children can place on whole or sliced vegetables to make them more kid-friendly and fun.
Nutrition education: The opportunity for young children to explore different vegetables (taste, smell, and texture) combined with learning about their characteristics and health benefits can boost consumption of, and preference for, vegetables.
Role modeling: Being a role model by eating vegetables with your child will help your child to accept vegetables.