Study shows many children in rural areas receive high salt and sugar foods before age 2

A study of over 10,000 children in rural Pennsylvania revealed that a large proportion of children were fed foods that are high in sugar and salt in their first years of life.

Over half (53%) of the children in the study received high-sodium meats such as hot dogs, 37% received salty snacks such as potato chips, and one-third (34%) received cakes, cookies, or pudding before age two. In addition, over one-quarter (27%) of babies received juice before their first birthday.

"Given that these foods are not recommended for children, these numbers are concerning," said Carolyn F. McCabe, Ph.D., staff scientist in the Department of Population Health Sciences and the Center for Obesity and Metabolic Research at Geisinger. "Early exposure to foods and beverages high in sugar, fat, and sodium can potentially have negative consequences for the healthy growth and development of infants and children."

McCabe will present the findings at NUTRITION 2023, the annual meeting of the American Society for Nutrition held July 22–25 in Boston.

Current U.S. dietary guidelines recommend waiting until at least age one to introduce 100% fruit or vegetable juices, and that families avoid foods and beverages with added sugars and limit those high in sodium for children younger than two. These recommendations are designed to lower the risk of overweight and obesity, diabetes, asthma, and other chronic health conditions.

According to experts, exposing young children to overly sweet or salty foods can shape their taste preferences and lead to unhealthy eating habits in the long term.

"Early life is such a critical period for establishing eating habits and food preferences, and these preferences and behaviors around food can persist as children grow," said McCabe. She added that early exposure to these foods may mean some children are not getting enough of the healthy foods they need for proper nutrition. "Infants and toddlers have small stomachs, so it is important to make every bite count."

For the study, researchers analyzed questionnaires given at well-child visits for 10,614 children up to 26 months of age who visited Geisinger, a rural-serving health system in Pennsylvania between 2016–2020. In addition to early introduction of foods high in sugar, fat, and sodium, the study revealed that less than half (46%) of babies exclusively consumed human milk and/or formula for the first six months of life as dietary guidelines recommend. Twenty-nine percent of children received sweetened cereal and one in 10 received sugar-sweetened beverages before age two.

Children living in rural areas face many health and socioeconomic disparities. One in five rural children live in poverty and children in rural areas are 25% more likely to experience obesity compared with nonrural children. These disparities make it even more important to ensure rural families are aware of dietary guidelines for children and have the resources they need to follow them, McCabe said.