New NCCOR Paper Identifies Measurement Gaps and Provides Research Opportunities for Advancing Dietary Assessment in Infants and Toddlers

A new commentary paper from the National Collaborative on Childhood Obesity Research (NCCOR) underscores the importance of measuring dietary intake during the critical early stages of life. The paper, “Count Every Bite to Make ‘Every Bite Count’: Measurement Gaps and Future Directions for Assessing Diet from Birth to 24 Months,” is now available online in the Journal of the Academy of Nutrition and Dietetics (JAND). The diets of young children were the primary focus in the most recent Dietary Guidelines for Americans 2020-2025 (DGA), which for the first time included comprehensive recommendations for infants and toddlers, urging that “every bite counts.”

The new DGA guidance reflects a growing awareness that early dietary patterns influence children’s food and beverage choices later in life and have health benefits in both the short term and over time. It also presents a new challenge for infant and toddler nutrition: Since every bite counts, how do we count and measure every bite?

To address this question, NCCOR convened a dietary assessment workgroup to identify measurement gaps specific to the first two years of life and propose research opportunities for addressing these gaps. The new paper outlines the group’s process and presents its findings. For example, the workgroup identified nine research gaps for dietary assessment among very young children: measurement error, proxy reporting, biased reporting, estimations of usual intake, understanding human milk composition, lack of biomarkers, device limitations, data processing developments, and the complexity of multidimensional and dynamic dietary patterns. These research gaps often overlap, so innovative solutions to address one may be applicable in other contexts.

The following are strategies to address research gaps:

  1. Prioritizing diverse populations in research relevant to the DGA guidelines for infants and toddlers.
  2. Developing a national research agenda to prioritize and rank research questions and topics concerning this age group.
  3. Creating a comprehensive library of dietary assessment resources specifically designed for infants and toddlers.
  4. Forging diverse and interdisciplinary research collaborations to address the complexities associated with dietary assessment in this population.
  5. Acknowledging that multiple stakeholders across academia, government, and industry have a role in advancing dietary assessment for the birth to 24-month age group.

The paper concludes that with widespread collaboration, it is possible to not only follow the DGA and “make every bite count” but also measure every bite. This knowledge can contribute to improved dietary patterns, better health outcomes, and a reduced risk of childhood obesity. The commentary will be released in print in September as part of a JAND special issue.




The National Collaborative on Childhood Obesity Research (NCCOR) brings together four of the nation’s leading research funders — the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Robert Wood Johnson Foundation (RWJF), and the U.S. Department of Agriculture (USDA) — to accelerate progress in reducing childhood obesity in America. 




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