Healthy eating for 1–3 year‐olds: A food‐based guide

The UK's eatwell plate is a visual representation of the types and proportions of foods needed for a healthy, balanced diet. The Department of Health states that it can be gradually applied from the age of 2 years and applied in full from 5 years. However, there are currently no widely available specific food‐based models for 1–3 year‐olds (toddlers). The British Nutrition Foundation, with advice from an expert group, reviewed current dietary guidelines in the UK for 1–3 year‐olds in order to develop a visual food‐based resource depicting the main messages around healthy eating for toddlers. This article provides a summary of the development of this resource, which was produced to help parents, carers, health professionals and early years providers to understand and communicate the basics of healthy eating for this age group and consider other issues such as suitable snacking, healthy hydration, suitable portion sizes and advice regarding supplementation. It is hoped that this resource will help toddlers to establish good dietary habits that will persist into later life.     

Position of the Academy of Nutrition and Dietetics: Total Diet Approach to Healthy Eating

It is the position of the Academy of Nutrition and Dietetics that the total diet or overall pattern of food eaten is the most important focus of healthy eating. All foods can fit within this pattern if consumed in moderation with appropriate portion size and combined with physical activity. The Academy strives to communicate healthy eating messages that emphasize a balance of food and beverages within energy needs, rather than any one food or meal. Public policies and dietary patterns that support the total diet approach include the 2010 Dietary Guidelines for Americans, DASH (Dietary Approaches to Stop Hypertension) Diet, MyPlate, Let's Move, Nutrition Facts labels, Healthy People 2020, and the Dietary Reference Intakes. In contrast to the total diet approach, classification of specific foods as good or bad is overly simplistic and can foster unhealthy eating behaviors. Alternative approaches are necessary in some situations. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, time and convenience, environment, abundance of foods, economics, media/marketing, perceived product safety, culture, and attitudes/beliefs. To increase the effectiveness of nutrition education in promoting sensible food choices, skilled food and nutrition practitioners utilize appropriate behavioral theory and evidence-based strategies. Focusing on variety, moderation, and proportionality in the context of a healthy lifestyle, rather than targeting specific nutrients or foods, can help reduce consumer confusion and prevent unnecessary reliance on supplements. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes.     

Position of the American Dietetic Association: total diet approach to communicating food and nutrition information

It is the position of the American Dietetic Association that the total diet or overall pattern of food eaten is the most important focus of a healthful eating style. All foods can fit within this pattern, if consumed in moderation with appropriate portion size and combined with regular physical activity. The American Dietetic Association strives to communicate healthful eating messages to the public that emphasize a balance of foods, rather than any one food or meal. Public policies that support the total diet approach include the Dietary Guidelines for Americans, MyPyramid, the DASH Diet (Dietary Approaches to Stop Hypertension), Dietary Reference Intakes, and nutrition labeling. The value of a food should be determined within the context of the total diet because classifying foods as "good" or "bad" may foster unhealthful eating behaviors. Alternative approaches may be necessary in some health conditions. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, lifestyle, time challenges, economics, environment, attitudes and beliefs, social/cultural influences, media, food technology, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, food and nutrition professionals should utilize appropriate behavioral theory and evidence-based strategies. A focus on moderation and proportionality in the context of a healthful lifestyle, rather than specific nutrients or foods, can help reduce consumer confusion. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes.     

The food consumption patterns and perceptions of dietary advice of older people

Background Prevention policies do not have an upper age limit, and as the overwhelming majority of older people continue to reside in the community there is a growing role for community dietetics and primary care team members in the promotion of healthy eating.
Method The multi-method project ascertained the dietary beliefs and practices of older people residing in high-income, low-income and rural localities of Scotland. One hundred and fifty-two people aged 75 years and over were interviewed using a semistructured interview schedule and 24-h food recall questionnaire.
Results An analysis of the food recall questionnaire demonstrated that the diets of the elderly appear to differ little from the Scottish population as a whole. In all groups there was an under consumption of fruits and vegetables reported. Findings from the interviews demonstrated that dietary beliefs were found to be firmly rooted in childhood and lifetime experiences. Participants defined healthy eating as 'proper meals', 'proper foods', and a variety of foods eaten in moderation. These definitions were based upon the consumption of fresh foods which would be considered healthy. Changing and conflicting advice on health and nutrition was contrasted with personal experiences. Few knew of the role of the dietitian or community dietitian.
Conclusions This study demonstrates a contrast between stated beliefs and actual consumption patterns. Access to food, and the cost and quality of foods impacted upon food practices. The role of the community dietitian should be promoted. Advice on healthy eating must work with contemporary practices and beliefs building upon positive aspects of diet and eating and involving the food industry, retail sector and health services.     

Adolescents from low‐income families in Hong Kong and unhealthy eating behaviours: Implications for health and social care practitioners

The development of dietary preferences of adolescents involves a complex interplay of individual behaviours and environmental factors. Interpersonal factors—such as peer influences and unpleasant school experiences—and institutional factors—such as school rules and policies—are closely associated with unhealthy eating of adolescents. Family support and guidance are also crucial in influencing adolescents’ eating habits. However, the low social status, low educational levels, and low household incomes of disadvantaged parents can markedly prevent their children from establishing healthy eating habits. Therefore, adolescents from low‐income families are more likely to engage in unhealthy dietary behaviours and hence to be more susceptible to diet‐related health problems. However, few studies have addressed the difficulties associated with inculcating healthy eating habits among adolescents from low‐income families. Therefore, to investigate the barriers to adopting healthy eating habits, this study adopted a qualitative research approach and conducted five focus‐group semistructured interviews with 30 junior‐ and senior‐form students of a secondary school in Hong Kong, all of whom were from low‐income families. The results revealed skipping meals because of poverty, following irregular meal patterns on school holidays, receiving poor guidance from family and peers, perceiving healthy eating as expensive and unappealing, and geographical inaccessibility to healthy food all prevented these students from healthy eating. These mutually reinforcing factors were interlocking with the economic strain that was experienced by the participants and their families. In particular, the stereotype of “healthful food is expensive” was strong. Therefore, we suggest students from low‐income families should be enabled to understand that healthy eating is not necessarily expensive. The participants’ stereotypes about healthy food was handed down by their parents. Such stereotypes, together with the low health literacy, influence the food preparation habits of the parents. Therefore, parents should be made to aware that healthful food can also be affordable.     

Dietary Characteristics and Influencing Factors on Chinese Immigrants in Canada and the United States: A Scoping Review

Background: Chinese immigrants are an integral part of Canadian and American society. Chinese immigrants believe diet to be an important aspect of health, and dietary behaviours in this population have been associated with changes in disease risk factors and disease incidence. This review aims to summarize the characteristics of the dietary behaviours of Chinese immigrants and the associated influencing factors to better inform individual, clinical, and policy decisions. Methods: This scoping review was written in accordance with PRISMA guidelines. MEDLINE, PsychINFO, CINAHL, AgeLine, ERIC, ProQuest, Nursing and Allied Health Database, PsychARTICLES, and Sociology Database were utilized for the literature search. Articles were included if they explored dietary or nutritional intake or its influencing factors for Chinese immigrants to Canada or the United States. Results: A total of 51 papers were included in this review. Among Chinese immigrants in Canada and the United States, the intake of fruits and vegetables, milk and alternatives, and fiber were inadequate against national recommendations. Chinese immigrants showed increased total consumption of food across all food groups and adoption of Western food items. Total caloric intake, meat and alternatives intake, and carbohydrate intake increased with acculturation. Individual factors (demographics, individual preferences, and nutritional awareness), familial factors (familial preferences and values, having young children in the family, and household food environment), and community factors (accessibility and cultural conceptualizations of health and eating) influenced dietary behaviours of Chinese immigrants. Discussion and Conclusion: Efforts should be undertaken to increase fruit, vegetable, and fibre consumption in this population. As dietary acculturation is inevitable, efforts must also be undertaken to ensure that healthy Western foods are adopted. It is important for healthcare providers to remain culturally sensitive when providing dietary recommendations. This can be achieved through encouragement of healthy ethnocultural foods and acknowledgement and incorporation of traditional health beliefs and values into Western evidence-based principles where possible.     

A qualitative study of cardiac rehabilitation patients’ perspectives on making dietary changes

Background: Making healthier food choices is recognised as being important in the secondary prevention of coronary heart disease (CHD) and the provision of information about making dietary changes should be included in cardiac rehabilitation (CR), a secondary prevention strategy. Studies indicate that patients do not always make the recommended dietary changes, although research on CR patients’ perspectives on dietary change appears to be limited. The present study aimed to explore CR patients’ perspectives on making and maintaining dietary changes. Methods: Following ethical approval, in‐depth, audiotaped, qualitative interviews were conducted with 15 post‐myocardial infarction CR patients (11 men and four women) who had completed a hospital‐based CR programme. Participants comprised White British individuals aged 42–65 years, from a variety of socioeconomic backgrounds. Interview topics included perspectives on CHD and lifestyle changes, including diet. Follow‐up interviews with 10 patients, conducted approximately 9 months later, explored whether their perspectives had changed. Results: Patients tended to only make and maintain dietary changes if they perceived their diet to be a cause of their CHD. The only dietary changes patients reported involved ‘cutting things out’ of their diet; patients did not make dietary changes if they considered that they did not need to ‘cut things out’. Conclusions: These findings suggest that, despite receiving information about eating a balanced diet, CR patients may perceive dietary change in terms of whether or not they need to ‘cut things out’ of their diet. Greater emphasis may be needed in dietary information on increasing the proportion of healthy foods consumed and choosing healthier alternatives.     

Influence of parental attitudes in the development of children eating behaviour

The present paper is a review of available data on effects of parental feeding attitudes and styles on child nutritional behaviour. Food preferences develop from genetically determined predispositions to like sweet and salty flavours and to dislike bitter and sour tastes. There is evidence for existence of some innate, automatic mechanism that regulate appetite. However, from birth genetic predispositions are modified by experience. There are mechanisms of taste development: mere exposure, medicine effect, flavour learning, flavour nutrient learning. Parents play a pivotal role in the development of their child's food preferences and energy intake, with research indicating that certain child feeding practices, such as exerting excessive control over what and how much children eat, may contribute to childhood overweight. Mothers are of particular interest on children's eating behaviour, as they have been shown to spend significantly more time than fathers in direct interactions with their children across several familial situations.A recent paper describes two primary aspects of control: restriction, which involves restricting children's access to junk foods and restricting the total amount of food, and pressure, which involves pressuring children to eat healthy foods (usually fruits and vegetables) and pressuring to eat more in general. The results showed significant correlations between parent and child for reported nutritional behaviour like food intake, eating motivations, and body dis- and satisfaction. Parents create environments for children that may foster the development of healthy eating behaviours and weight, or that may promote overweight and aspects of disordered eating. In conclusion positive parental role model may be a better method for improving a child's diet than attempts at dietary control.     

Age and gender dependent profile of food choice

Several studies have described remarkable differences in food choice between men and women. Consistently, women are reported to have higher intakes of fruit and vegetables, higher intakes of dietary fiber and lower intakes of fat. In accordance with such more healthy food choice, women usually attach greater importance to healthy eating. In addition, the motivation of weight control is more prominent in women and they are more likely to diet or restrain their eating behavior. Recently, studies found that health beliefs and weight control motivation may explain up to 50 percent of gender differences in food choice. In addition, less healthy food choice profiles of men may be related to their poorer nutritional knowledge. However, health beliefs, eating attitudes and dieting appear to be phenomena which vary throughout the life span. In growing older, changes in the chemosensory perceptual systems play an important role in food choice. The decline of gustatory and--perhaps even more pronounced--in olfactory function may lead to a decrease of the pleasantness of food, thus limiting the reinforcing properties of food intake which eventually results in a decrease of appetite, often reported in elderly people. In addition, there are some indications that sensory-specific satiety diminishes with age. Sensory-specific satiety is the reduction in the pleasantness of food as it is consumed. This decrease of pleasantness usually motivates the choice of other foods and therefore, a varied diet. Therefore, the decrease of sensory-specific satiety may in part explain the limited variety of the diet sometimes seen in elderly people. However, lifestyle, socio-economic situation and other variables may limit the influence of such physiological changes and help to maintain an adequate food intake despite these age-related processes.     

Neophobia—A Natural Developmental Stage or Feeding Difficulties for Children?

Food neophobia is the tendency to reject or be reluctant to try new and unfamiliar foods. Due to the period of its occurrence, which falls in the years of early childhood, it can significantly affect the child’s food choices, shape taste preferences, and significantly influence the quality of the child’s diet. The neophobic attitude has an important evolutionary significance because it protects the individual from ingesting potentially dangerous substances. On the other hand, it fosters avoidance behaviors that can also relate to the beneficial aspects of obtaining and consuming food. Currently, the strong emphasis placed on food safety means that neophobia may be less adaptive; nevertheless, a conservative attitude toward new foods still prevails. There is a strong association between food neophobia and the diversity of a person’s diet and previous exposure to different foods. This review describes behaviors associated with food neophobia and analyzes other feeding and eating difficulties in children that should be differentiated from food neophobia. Management approaches affecting the reduction in food neophobia in children through various dietary and psychological interventions are also proposed.     

Effecting dietary change

A world epidemic of diet-related chronic disease is currently being faced. In the UK incidence of obesity alone has tripled in the last 20 years and this trend is predicted to continue. Consensus exists for the urgent need for a change in diet and other lifestyle factors and for the direction and targets for this change. The evidence for how this change can be achieved is less certain. It has been established that disease processes begin in childhood. Recent evidence indicates that dietary habits too are established in childhood but that these habits are amenable to change. While establishing a healthy lifestyle in childhood is paramount, interventions have the potential to promote positive change throughout the life course. Success in reversing current trends in diet-related disease will depend on commitment from legislators, health professionals, industry and individuals, and this collaboration must seek to address not only the food choices of the individual but also the environment that influences such choices. Recent public health policy development in England, if fully supported and implemented, is a positive move towards this goal. Evidence for effective strategies to promote dietary change at the individual level is emerging and three reviews of this evidence are discussed. In addition, three recent dietary intervention studies, in three different settings and with different methods and aims, are presented to illustrate methods of effecting dietary change. Further work is required on what factors influence the eating behaviour and physical activity of individuals. There is a need for further theory-based research on which to develop more effective strategies to enable individuals to adopt healthier lifestyles.     

Position of The American Dietetic Association: Total Diet Approach to Communicating Food And Nutrition Information

It is the position of the American Dietetic Association that all foods can fit into a healthful eating style. The ADA strives to communicate healthful eating messages to the public that emphasize the total diet, or overall pattern of food eaten, rather than any one food or meal. If consumed in moderation with appropriate portion size and combined with regular physical activity, all foods can fit into a healthful diet. Public policies that support the total diet approach include Reference Dietary Intakes, Food Guide Pyramid, Dietary Guidelines for Americans, Nutrition Labeling and Healthy People 2010. The value of a food should be determined within the context of the total diet because classifying foods as "good" or "bad" may foster unhealthy eating behaviors. Eating practices are influenced by taste and food preferences, concerns about nutrition and weight control, physiology, lifestyle, environment, and food product safety. To increase the effectiveness of nutrition education in promoting sensible food choices, dietetics professionals plan communications and educational programs that utilize theories and models related to human behavior. Communication campaigns/programs should implement an active, behaviorally focused approach within the larger context of food choices. Nutrition confusion can be reduced by emphasizing moderation, appropriate portion size, balance and adequacy of the total diet over time, the importance of obtaining nutrients from foods, and physical activity.     

Predictors of nutritional adequacy in mother-toddler dyads from rural families with limited incomes

OBJECTIVE: To predict the mean adequacy ratio (MAR) scores of mothers and toddlers from intakes of fruits, vegetables, and dairy group foods and being seated during mealtimes. DESIGN/SUBJECTS: This was a regression analysis of cross-sectional data of the diet quality and being seated during mealtimes of 100 rural mother-toddler dyads from limited-income families using two 24-hour dietary recalls. Children were 11 to 25 months of age and at or below 100% of the poverty index. MEASURES OF OUTCOME: Dietary quality for mothers and toddlers was assessed using a MAR score for eight different nutrients (vitamin A, vitamin C, vitamin D, folate, calcium, zinc, iron, and magnesium), and a score of 85 or above was considered nutritionally adequate. The main food groups of interest were servings from the fruits, vegetables, and dairy group foods. Mealtime sitting behavior was the percentage of times the toddler remained seated while eating. RESULTS: Servings of fruits, vegetables, and dairy foods predicted 0.62 of the variance in the mother's MAR score, whereas vegetable and dairy intakes along with being seated while eating indicated nutritional adequacy for toddlers. Mothers with low MAR scores were most likely to have toddlers with poor diets, although few toddlers had poor diet quality. CONCLUSIONS: Adequate intakes of dairy, vegetables, and whole fruits along with being seated while eating could be quick assessment tools to screen toddlers for nutritional risk. Mothers with poor diet quality were likely to have toddlers with poor diets; low intakes of fruits, vegetables, and dairy foods were markers for poor diet quality in mothers.     

Dietary and lifestyle measures to enhance satiety and weight control

A healthy rate of weight loss of 0.5–1.0 kg/week can be achieved by invoking an energy deficit of 450–900 kcal/day. This assumes an energy cost of weight loss of 6300 kcal/kg. This value will increase with percent body fat. Diet and physical activity strategies should be combined to lose weight. However, dietary approaches to weight management appear most efficacious for initial weight loss. Energy density should be the cornerstone of dietary weight reduction strategies because it helps people develop and optimise healthy eating habits that are sustainable in the longer‐term. However, healthy diets for weight management should be seen as a package including reduced fat, energy density, sugars and salt, increased fibre, protein and water content of foods. Healthy diets also have to be palatable, to maintain interest in healthy eating. Monotherapies for weight loss are subject to the laws of diminishing returns. Practical approaches to weight management should be focused on a package of weight loss and maintenance strategies, including relapse prevention. It is important to provide consumers with a flexible approach to behaviour change and lifestyle solutions that they can match to their individual lifestyle needs. Evidence from studies of successful weight‐loss maintainers shows that people can work this out for themselves if they can access the right tools, continuing care, guidance and social support to achieve sustainable lifestyle change.     

The meaning of food in our lives: a cross-cultural perspective on eating and well-being

Humans are biologically adapted to their ancestral food environment in which foods were dispersed and energy expenditure was required to obtain them. The modern developed world has a surplus of very accessible, inexpensive food. Amid the enormous variety of different foods are "super" foods, such as chocolate, which are particularly appealing and calorie dense. Energy output can be minimal to obtain large amounts of food. In terms of education (eg, in nutrition and risk-benefit thinking) and environment design, modern cultures have not kept pace with changes in the food world. Overweight and worrying about food result from this mismatch between human biological predispositions and the current food environment. The French have coped with this mismatch better than Americans. Although at least as healthy as Americans, they focus more on the experience of eating and less on the health effects of eating. They spend more time eating, but they eat less, partly because of smaller portion sizes. French traditions of moderation (versus American abundance), focus on quality (versus quantity), and emphasis on the joys of the moment (rather than making life comfortable and easy) support a healthier lifestyle. The French physical environment encourages slow, moderate social eating, minimal snacking, and more physical activity in daily life.     

Bringing the sense back into healthy eating advice

Conflicting messages about diet in the media, including publicity for "fad" diets, tend to distort the public's understanding of healthy eating. Several myths also persist, such as "skipping meals is a good way to lose weight," "all fats are bad" or "carbohydrates should be limited when trying to lose weight" Food labels, including the "traffic light" system, may also be confusing for some people. Food preferences vary between individuals, but health professionals can help guide individuals and towards a varied, balanced diet. This will include foods the individual and family enjoy, but based on appropriate proportions of all the five food groups, cooked in healthy ways. Some simple healthy eating tips are given to pass on to clients.     

A whole diet approach to healthy eating

This paper reviews the importance of a whole diet approach to healthy eating, detailing the development of the Balance of Good Health and explaining why such a healthy eating model works for the UK population. Comparisons are made between dietary recommendations (from the Balance of Good Health) and current eating patterns in the UK. This paper also discusses why it is important to consume foods from each of the four major food groups and discusses the health issues associated with cutting out a food group from the diet, as occurs in a number of popular diets.     

Would Students Prefer to Eat Healthier Foods at School?

BACKGROUND: This study sought to elucidate students' perceptions of school food environments and to assess correlations between perceptions and purchasing and consumption behaviors at school. METHODS: Seventh and ninth graders (n = 5365) at 19 schools in multiethnic, low‐income California communities participating in the Healthy Eating Active Communities program completed questionnaires assessing their attitudes and behaviors regarding school food environments during spring 2006. RESULTS: Most students (69%) reported that fresh fruit was important to be able to buy at school; more than chips (21%), candy (28%), or soda (31%). Reported importance of food offerings was correlated with the consumption of those items. Most students did not perceive foods/beverages offered at school to be healthy; fewer than a quarter reported eating fruits or vegetables (FV) at school. Students eating school lunch were more than twice as likely to consume FV, though if they also purchased from competitive venues, their consumption of candy, chips, and soda was similar to their peers who purchased only competitive foods. CONCLUSION: Students report healthy foods to be important to be able to buy at school, but do not perceive their school food environment to be healthy and consume more unhealthy foods at school. Students served healthy items via school lunch are more likely to consume them; however, they also purchase and consume unhealthy items if available. Findings suggest that modifying school food environments to facilitate consumption of healthy foods and limit unhealthy foods will better match students' preferences and could lead to improved dietary intake.     

Multivariate analysis of diet among three-year-old children and associations with socio-demographic characteristics. The Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) Study Team

STUDY OBJECTIVE: The study of the whole diet in combination rather than the consumption of individual food items or the intake of specific nutrients could be enlightening. This has been previously performed using principal components analysis (PCA) on adult diets but not on those of children. DESIGN: The frequency of consumption of a range of food items was recorded for 10,139 3-y-old children by their mothers using self-completion postal questionnaires. These children form part of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). METHODS: PCA was performed to identify individual dietary types which were then related to various socio-economic and demographic characteristics. RESULTS: Four distinct dietary components were obtained explaining 23.5% of the total variation in the sample, and the socio-demographic characteristics of the sample were related to them. The first represented a diet based on convenience foods and was associated with younger, less educated mothers and the presence of older siblings. The second was associated with a high consumption of foods currently considered to be healthy and was particularly related to vegetarian mothers and higher education levels. The third component described the established British 'meat and two veg' diet and was associated with girls and children with no older siblings, while the fourth had high loadings for snack and finger foods and was related to socially advantaged conditions and the presence of older siblings. CONCLUSIONS: Identifiable groups of mothers were associated with feeding their child each of the four dietary types, supporting the hypothesis that social, demographic and lifestyle factors relating to the mother have an influence on the early eating patterns of children. This analysis will form a basis for the future study of various childhood outcomes including growth, health and development. SPONSORSHIP: University of Bristol European Journal of Clinical Nutrition (2000) 54, 73-80     

Does Food Intake of Australian Toddlers 12–24 Months Align with Recommendations: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

(1) Background: Food-based dietary guidelines promote population health and well-being through dietary patterns that reduce chronic disease risk while providing adequate energy and nutrients. In Australia, recommended dietary patterns based on servings per day from the five food groups—fruits, vegetables, cereals and grains, meats and alternatives, and dairy—have been developed for toddlers 1–2 years of age. However, no study has assessed the intake of the five food groups in this age group nationally. (2) Aim: To compare daily servings and the percentage of energy from the five food groups and discretionary foods in toddlers 1–2 years old to the Australian Dietary Guidelines. (3) Methods: Dietary intake was assessed using a one-day food record for 475 toddlers. (4) Results: Apart from fruit and dairy, servings of the five food groups were below the recommendations. Two-thirds of toddlers did not consume enough vegetables, and only 10% consumed the recommended number of servings for cereals and grains. On average, toddlers consumed only half the recommended servings of meat and alternatives. Nearly all toddlers (89%) consumed discretionary foods, which accounted for ~12% of total energy. Forty-five percent of toddlers received breastmilk. On average, breastfed toddlers consumed fewer servings from the five food groups than non-breastfed toddlers. Dairy contributed 20% of daily energy in all toddlers; however, this food group accounted for 13% in breastfed and 32% in non-breastfed toddlers on the day of the food record. (4) Conclusions: Compared to the recommendations, alignment with the servings of the five food group foods was not achieved by most toddlers, except for fruit and dairy. Discretionary foods may have displaced nutritious family foods. Consistent with Australian Infant Feeding Guidelines, many toddlers in this study continued to receive breastmilk but the recommended dietary patterns do not include breastmilk. Dietary modeling, including breastmilk as the primary milk source, is urgently needed, along with practical advice on incorporating breastmilk in a toddler’s diet while optimizing food consumption.