Whether it’s high sodium, too much sugar or misleading labels, nearly 60 per cent of infant and toddler foods sold in the United States aren’t as nutritious as they appear, according to a new study.

Published on Aug. 21 in Nutrients, the research found that most of these products fail to meet the nutritional guidelines and recommendations set by the World Health Organization (WHO).

Of the 651 products analyzed, 70 per cent did not meet protein requirements, while 44 per cent exceeded the recommended sugar levels. One in four products also fell short of calorie requirements and one in five exceeded the recommended sodium limits, the study said.

The names and brands of the foods were not disclosed in the study, but senior author, Elizabeth Dunford, an assistant professor in the Department of Nutrition at the University of North Carolina, told Global News that some of the products they looked at were sold in Canadian grocery stories, too.

“You do have some of the same brands. I am assuming Canada is more closely linked to the U.S. than any other country with labelling,” she said.

Labelling and nutrition are vital, Dunford argued, because early childhood is a crucial period of rapid growth when taste preferences and dietary habits are established. These early choices can pave the way for chronic diseases like obesity, diabetes, and even some cancers later in life, she said.

“Time-poor parents are increasingly choosing convenience foods, unaware that many of these products lack key nutrients needed for their child’s development and tricked into believing they are healthier than they really are,” she added.

The researchers argue that despite U.S. health guidelines advising against feeding infants foods with added sugars and high sodium, infants and toddlers worldwide — including in America — often fail to meet these recommendations.

In Canada, infant and toddler foods are regulated under the Safe Food for Canadians Act, requiring companies to properly label the nutritional content of their products, including calories, sodium and sugar levels.

Infant foods for ages six to twelve months are subject to maximum sodium levels; however, other nutritional guidelines, such as those for sugar and fat, are only recommended by Canada’s Nutrition for Healthy Term Infants guidelines.

But the problem with recommendations is there is no benchmark of what is allowed in products, Dunford said.

“There is definitely no limit, and one of the things I’d like to see is these products don’t meet some standard of health performance, such as sodium limits….if a product that does not meet that benchmark, then that product cannot put a claim on the product,” she said.

She explained that many companies add a “noise of claims” on their packaging, such as “no sugar added,” to create a misleading impression of healthiness. These claims contribute to what experts call a “health halo” around these baby food products.

For example, she said labels like “no sugar added” or “organic” can create an impression that the product is overall nutritious, even if it may still be high in other unhealthy ingredients like sodium or fats.

Baby food rules are the 'Wild West'

The researchers looked at the nutritional and promotional content of infant and toddler foods (aged six to 36 months) from the top 10 U.S. grocery store chains in 2023. The stores included: Walmart, Kroger, Costco, Ahold Delhaize, Publix, Sam’s Club, Target and Aldi.

Infant formulas, fortified milk and oral electrolytes were not included because the U.S. Food and Drug Administration regulates these products separately.

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The products were evaluated against the WHO’s Nutrient and Promotion Profile Model (NPPM) requirements. Dunford explained that this guideline was selected because the WHO sets high and healthy standards for baby and infant formula, which she noted is often lacking in many countries.

“When it comes to baby food regulation it’s a bit of the Wild West,” Dunford said, adding that without proper regulation, nutritional claims can go unchecked.

Of the 651 products examined, the study found that 60 per cent failed to meet the nutritional requirements of the NPPM, and none met the promotional requirements. Almost 100 per cent of products had at least one claim on-pack that was prohibited under the NPPM, with some products displaying up to 11 prohibited claims. Snack-size packages had the lowest compliance with nutrient requirements.

The lowest compliance among all products was found for “protein content” (29 per cent) and the highest for “total fat” (92.7 per cent).

Only 55 per cent of products were compliant with the total sugar recommendations, with compliance lowest for “dry or semi-dry snacks and finger foods.”

While the WHO’s baby food guidelines state that age labels should specify age in years or months, many products imply age through vague descriptions such as “sitter,” “tots,” “crawling baby,” or “toddler,” the researchers said.

Fruit pouches: use with caution

The researchers also found that baby food pouches are the fastest-growing segment in the market, with a 900-per-cent increase in sales over the last 13 years.

Pouches were among the least healthy products assessed, with fewer than seven per cent meeting total sugar recommendations.

Andrea Carpenter, a registered dietitian and owner of NutriKidz in Toronto, noted that fruit pouches are primarily marketed for convenience.

“Parents are busy and we’re looking for shortcuts as parents. And it’s unfortunate that we can’t always rely on products that are maybe geared specifically towards kids. Some of the bigger concerns I have with pouches is the potential that they become a staple in an infant’s diet,” she said.

While fruit pouches are fine in moderation, Carpenter warned that they often have high sugar content and can prevent a child from learning essential skills like chewing, biting, and swallowing. Introducing a variety of textures into an infant’s diet is crucial for their development, she said.

In terms of how much sugar is recommended, she said Canada does not have concrete guidelines.

“The recommendation is to avoid and keep it a minimum in children under two years. So we really want to keep the added sugars to a minimum,” she said.

What can be done?

Although Dunford doesn’t expect changes to regulations on infant and toddler food anytime soon, she believes these findings should serve as a wake-up call for policymakers. In the meantime, she encourages parents to educate themselves about the nutrition labels on baby products.

Carpenter believes that grocery store baby foods, like fruit pouches and rice crackers, can be fine in moderation. However, she emphasizes the importance of being creative to ensure your child gets the proper nutrition.

“If it’s larger rice rusk or if it’s something like the little star puffs, I think they can serve a great role for practicing skills like their pincer grasp,” she said.

“And it’s a great way to introduce some texture into kids who might be a little bit more apprehensive to self-feed themselves. You can utilize those as a vehicle for other foods. So the larger rice rusks, for example, adding more nutrient-dense [ingredients] like hummus or mashed avocado would allow that food to be used in a more appropriate way to kind of get better nutrition into that child.”

She emphasized that a key tip for the first few years of a child’s life is to minimize sugar and sodium intake. When cooking at home, it’s best to avoid adding too much salt or sugar.

Carpenter also recommended batch cooking to save time. She suggests making large batches of homemade baby food, then freezing it in small containers labelled with the contents and ingredients.

“Try to include a wide variety of flavours and textures, and try to introduce your infant to the flavours and foods that your family typically enjoys. Because the aim or the end goal would be that your infant will eventually eat with the rest of the family is eating,” Carpenter said.