Table 1.

Dietary recommendations in pediatric populations.

Dietary Recommendations in Pediatric Populations
Focus on clinical indicators of ASCVD risk (e.g. lipids, blood pressure, glucose) rather than weight. Discussing or prescribing weight loss in pediatric populations may increase the risk of disordered eating and eating disorders [164]. Providers should focus on clinical indicators that provide a more comprehensive assessment of cardiometabolic risk.
Focus on nutrient-dense foods and beverages as recommended in the 2020–2025 Dietary Guidelines for Americans. Consistent evidence suggests that nutrition-dense dietary patterns can decrease future CVD risk [131]. Dietary recommendations should emphasize fruits, vegetables, whole grains, and varied protein foods (e.g. legumes, nuts, seeds, seafood) [165]. Acceptable macronutrient composition for age for children are shown in Table 2.
Emphasize small changes in eating behaviors to promote nutrient-dense dietary patterns. Providers should work collaboratively with pediatric patients to establish nutrition-related SMART goals that are focused, feasible, and measurable [166]. Remember to acknowledge and celebrate all forms of progress.
Tailor nutrition recommendations based on cultural and personal food preferences and support children's ability to self-regulate intake. Clinicians should be aware of cultural dynamics and food practices when working with pediatric patients and their families [167]. Encourage caregivers to foster positive eating environments and introduce nutrient-dense foods but trust children to determine how much and whether to eat these foods [168].
Provide support for navigating food choices at care centers, schools, and afterschool programs. School meals and child care programs can provide a significant proportion of children's daily nutritional needs and are an important resource for low-income families [169]. Clinicians should encourage consumption of nutrient-dense options (e.g. whole fruits, fruit cups, steamed or roasted vegetables, salads) when available in school and child care settings.
Involve pediatric patients in discussions about their health status and care plans [170]. Providers should consider patients’ age, ability to comprehend information, and food choice autonomy during clinical visits. Use accessible language and emphasize positive, weight-neutral outcomes of health behavior changes (e.g. increased energy, improved learning ability).