some cancers, diabetes, and osteoporosis. Parents, communities, the government, public health sector, health care systems, and private enterprise all face significant challenges to create an environment for our children and youth that turns the course and enhances their prospects for healthy lives.

DIETARY PATTERNS FOR CHILDREN AND YOUTH

Health-related behaviors such as eating habits and physical activity patterns develop early in life and often extend into adulthood. A healthful and balanced diet provides recommended amounts of nutrients and other food components to promote normal growth and development, reduce chronic disease risk, and foster appropriate energy balance and a healthy weight trajectory. Yet the diets of America’s children and adolescents depart substantially from recommended patterns that puts their health at risk. Although there have been some improvements with respect to the intake of certain micronutrients, overall our children and youth are not achieving basic nutritional goals. They are consuming excess calories and added sugars and have higher than recommended intakes of sodium, total fat, and saturated fats. Moreover, dietary intakes of whole grains, fiber, calcium, potassium, magnesium, and vitamin E are well below recommendations and are sufficiently low to warrant concern. Adolescent girls and low-income toddlers are especially at risk for inadequate intakes of iron.

The result is that the health of children and adolescents is not as good as it should or could be. Because of improvements in immunization levels, injury rates, and the availability of and access to children’s services, death and disease rates for children are generally low. But more sedentary lifestyles and diets that are too high in calories, fat, sugars, and sodium, are putting children’s futures at risk. Those who are poor face the greatest risk, as a result of their already greater health, social, and nutrition disparities.

If children and youth of all income and ethnic groups are to develop dietary patterns that will provide lifelong health promotion and disease prevention benefits, their diets will need to change significantly. They need to increase their intakes of fruits, vegetables, legumes, whole grains, and low-fat dairy products, and reduce their intakes of high-calorie and low-nutrient foods and beverages, including snack foods and sweetened beverages.

The dietary and related health patterns of children and youth result from the interplay of many factors (Figure ES-1)—genetics and biology, culture and values, economic status, physical and social environments, and commercial and media environments—all of which, apart from genetic predispositions, have undergone significant transformation over the past three decades. Among the various environmental influences, none has more rapidly assumed a central socializing role for young people than the media,



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