New research from the WSU Elson S. Floyd College of Medicine’s Department of Nutrition and Exercise Physiology reveals that toddlers living in food-insecure households have significantly lower diet quality than their food-secure peers.
Published in The American Journal of Clinical Nutrition, the findings challenge assumptions that very young children are shielded from the effects of household food shortages and underscore the importance of early-life nutrition.
“This is an age group of children who predominantly depend on the household for their food needs,” said Assistant Professor Namrata Sanjeevi, PhD, an early career investigator who led the study. “I had imagined that toddlers might be shielded from food insecurity, but that did not seem to be the case.”
The study is among the first to examine the relationship between household food security and diet quality in toddlers. In 2023, nearly 18% of all U.S. households with children experienced food insecurity, defined as a lack of consistent access to enough food to meet the needs of every person in a household.
Researchers analyzed dietary intake and household food security status of 708 children aged 12 to 23 months using data from the National Health and Nutrition Examination Survey. Diet quality was measured with the Healthy Eating Index–Toddlers 2020 (HEI-Toddlers-2020), a tool developed to evaluate whether toddlers’ food intake aligns with the latest federal dietary guidelines. Previous versions of the Healthy Eating Index did not include scoring standards for children under two, only now making this analysis possible.
Results of the analysis showed that toddlers living in households with food insecurity scored significantly lower on the HEI-Toddlers-2020 than those in food-secure households. The gap was especially pronounced for whole fruits and whole grains—two food groups critical for early development.
“In addition to serving as the foundation for future dietary behaviors, early childhood nutrition could influence growth, cognitive, and metabolic outcomes,” Sanjeevi explained. “That’s why I think this research is important.”
Despite differences observed by food security status, the study found that food-secure toddlers also had low scores for certain food groups, including whole grains and greens and beans. The finding points to wider challenges in toddler nutrition across food security levels.
While the study did not assess interventions, the authors stress the need to address broader structural factors affecting diet quality. Sanjeevi noted that helping families gain access to nutrition assistance programs and resources could reduce food insecurity and improve nutrition and health outcomes. Increased food insecurity screenings in pediatric care settings were also cited as a promising way to identify and assist families in need.
Sanjeevi hopes the study will serve as a foundation for future research on toddler nutrition and health. As food insecurity continues to affect millions of families nationwide, this research adds to a growing body of literature supporting the importance of early childhood nutrition. By ensuring toddlers have access to healthy foods now, we can help shape a future where all children have the opportunity to thrive.
This research was supported in part by a grant from the USDA’s Research Innovation and Development Grants in Economics (RIDGE) Partnership. The authors note that the findings and conclusions should not be construed to represent any official USDA or U.S. Government determination or policy.
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Stephanie Engle, WSU Elson S. Floyd College of Medicine Communications and Marketing, 509-368-6937, stephanie.engle@wsu.edu