Every Bite Counts: Why Eggs are an Important First Food

Shutterstock 269062799 Scrambled Egg In Kid Bowl (1)

Every Bite Counts: Why Eggs Are An Important First Food

Jen Houchins, PhD, RD

Eggs Across the Lifespan

Nutritious Dietary Patterns

The 2020 Dietary Guidelines Advisory Committee says “every bite counts” when it comes to feeding infants and toddlers. This is the first time in Dietary Guidelines history that the DGAC is making recommendations for the Birth to 24-month lifestage and addresses complementary feeding as “a critical period for growth and development… characterized by high nutrient needs in relation to the amount of food consumed.1

The Advisory Committee specifically recommended eggs as an important first food for infants and toddlers as they are a rich source of choline and because early introduction of eggs (after 4 months of age), when baby is developmentally ready, may help reduce the risk of developing a food allergy.

The following breaks down recommendations from the Advisory Committee based on age group.

BIRTH TO 6 MONTHS

For approximately the first 6 months of age, human milk, infant formula, or a combination of the two are an infant’s sole source of nutrition. Once developmentally ready (>4 months of age) – baby has good head and neck control, can sit upright, has lost the tongue-thrust reflex, and shows interest in food – complementary foods can be introduced.


6-12 MONTHS

During the 6-12 month period, an infant continues to receive human milk, infant formula, or a combination of the two, but also starts transitioning to a varied diet that includes complementary foods and beverages. This is where nutrient-rich foods with essential nutrients for growth and development come into play. The Advisory Committee recommends a variety of animal-source foods (meat, poultry, seafood, eggs, and dairy), fruits, and vegetables, nuts and seeds, and whole grain products in age-appropriate forms, beginning at ages 6 to 12 months, to provide key nutrients and build healthy dietary habits. 

For infants fed human milk, the Committee recommends complementary foods that contain iron and zinc, such as meats and fortified infant cereals. Modest amounts, (i.e., less than 1 ounce equivalent per week), of seafood, eggs, and nuts is recommended for infants 6 to 9 months and minimum weekly amounts of 3 oz seafood, 1 egg, and 0.5 oz, respectively, by ages 9 to 12 months.  Further, the DGAC recommends prioritizing fruits and vegetables, particularly those rich in potassium, vitamin A, and vitamin C, to provide adequate nutrition, but also to foster acceptance of these healthy foods.

During this time, the Committee also recommends the introduction of peanut-containing foods and eggs, to help reduce the risk of developing food allergies. Additionally, introducing baby to complementary foods like eggs, which are high in choline, supports brain health.2,3 It should also be noted that complementary feeding not only provides additional nutrients, but introduces different textures, and models healthy eating behaviors, as well. The table below outlines approximate amounts of complementary foods and beverages for ages 6 to 12 months.1

12-24 MONTHS

As baby moves past the 12-month mark and into the second year of life, many move away from human milk and infant formula entirely and transition to a fully varied diet of nutrient-rich foods and beverages. Others may choose to continue offering human milk in addition to a varied diet of nutrient-rich foods and beverages. Either way, the food patterns for this age group is consistent with proportions of food groups and subgroups recommended for children ages 2 years and older, which requires careful choices of foods to meet nutrient needs. The DGAC emphasizes offering developmentally appropriate forms of nutrient-rich animal-source foods, including meat, poultry, seafood, eggs, and dairy products, as well as nut and seed containing foods, fruits, vegetables, and grain products in age-appropriate forms. For toddlers whose diets do not include meat, poultry, or seafood, the Committee recommends eggs and dairy products on a regular basis, along with soy products and nuts or seeds, fruits, vegetables, grains, and oils. The tables below outline approximate amounts of foods and beverages for toddlers between the ages of 12 to 24 months, for those not receiving human milk or infant formula, those fed human milk, and for those following a vegetarian style eating pattern.1

EGGS AS A FIRST FOOD FOR INFANTS AND TODDLERS

Eggs are recommended after four months and when baby is developmentally ready for complementary foods, and throughout infancy and toddlerhood.

  • Eggs are a nutrient-rich choice providing a good or excellent source of eight essential nutrients.
  • Eggs provide various amounts of all the nutrients listed by the American Academy of Pediatrics4 as essential for brain growth.
  • Introducing eggs early and often may help reduce risk of developing an allergy.
  • Eggs are an affordable source of high-quality protein.
  • Eggs are versatile and can be used to make a wide variety of dishes and can be adjusted to fit various developmental stages and age-appropriate textures.

Interested in more information?  

Check out these recipes for infants and toddlers:

  1. Dietary Guidelines Advisory Committee. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services,. 2020; Available from: https://www.dietaryguidelines.gov/sites/default/files/2020-07/ScientificReport_of_the_2020DietaryGuidelinesAdvisoryCommittee_first-print.pdf

  2. Wallace, T.C., A Comprehensive Review of Eggs, Choline, and Lutein on Cognition Across the Life-span. J Am Coll Nutr, 2018. 37(4): p. 269-285.

  3. Wallace, T.C., et al., Choline: The Underconsumed and Underappreciated Essential Nutrient. Nutr Today, 2018. 53(6): p. 240-253.

  4. Schwarzenberg, S.J., et al., Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health. Pediatrics, 2018. 141(2)

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Choline Throughout the Life-Span

11 NC Quinoa Crust Vegetable Quiche

Choline Throughout the Life-Span

Katie Hayes, RDN

Eggs Across the Lifespan

Cognition

WHY IS CHOLINE IMPORTANT?

Choline is an essential nutrient, meaning that we must consume adequate amounts in the diet to achieve optimal health. Unfortunately, most people do not consume enough choline. In fact, more than 90% of Americans (including approximately 90% of pregnant women) fail to meet the adequate intake.1 The Dietary Guidelines Advisory Committee has classified choline as a nutrient that poses special challenges for Americans due to underconsumption and encouraged eggs for pregnant women, as a complementary food for babies and toddlers, and for pre-teens and adolescents.2 Many foods offer choline in small amounts, however, only a few foods are significant choline sources.  Furthermore, most multivitamin supplements contain little, if any, choline. Fortunately, eggs are convenient, affordable, accessible, and an excellent source of choline.

Beginning in fetal development, Choline is critical to good health and remains essential throughout the lifespan. This nutrient is important in many ways.

  • During pregnancy, choline helps the baby’s brain and spinal cord develop properly and supports brain health throughout life.
  • Infants and young children need choline for continued brain development and health.
  • Choline is part of a neurotransmitter called acetylcholine, which is important for muscle control, memory and mood.3
  • Choline is also important for the support of membranes that surround your cells, the transportation of fats throughout the body and for liver health.
  • New research is exploring how choline throughout life may have lasting effects on cognition and prevention of cognitive decline.4

HOW MUCH CHOLINE DO WE NEED?

The amount of choline an individual needs depends on many things, including age, gender and stage of life. Table 1 lists the current Adequate Intakes (AIs) for choline.3

WHAT FOODS HAVE CHOLINE?

People of all ages need adequate choline for good health, but very few consume enough through food and supplements. While many foods contain some choline, only a handful of foods are considered good or excellent sources. Fortunately, two large eggs (about 300mg of choline) contain more than half of the recommended intake for pregnant women and can help them meet their needs. The table below lists food sources of choline.2

CHOLINE & COGNITION

Choline plays a role in early brain development during pregnancy and infancy. There is evidence that infants exposed to higher levels of maternal choline (930 mg/day) during the third trimester have improved information processing speed, an indicator of cognitive function,4,5 during the first year of life.

The American Medical Association (AMA) House of Delegates recommended the addition of choline to prenatal vitamins because of its essentiality in promoting cognitive development of the offspring.6 This recommendation from AMA highlights the increased recognition of choline as a nutrient of concern. The 2015-2020 Dietary Guidelines for Americans (DGAs) also list choline as a nutrient under consumed by most Americans. The DGAs recommend individuals shift to healthier eating patterns to help meet nutrient needs, including choline.7

Interested in more information about choline?

 

 

  1. Wallace TC, Fulgoni VL III. Assessment of total choline intakes in the United States. J Am Coll Nutr 2016, 35(2), 108-112.

  2. National Institutes of Health. Fact Sheet for Health Professionals: Choline. Version current 26 September 2018. ods.od.nih.gov/factsheets/Choline-HealthProfessional/Accessed June 22, 2020.

  3. Wallace TC. A comprehensive review of eggs, choline, and lutein on cognition across the life-span. J Am Coll Nutr 2018, 37(4), 269-285.

  4. Caudill MA, et al. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study. FASEB J. 2018;32:2172-2180.

  5. AMA Wire. AMA backs global health experts in calling infertility a disease. https://wire.ama-assn.org/ama-news/ama-backs-global-health-experts-calling-infertility-disease

  6. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.

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How To Help Selective Children Learn To Love Eggs

M Help Selective Children Learn To Love Eggs 1125x1125

How to Help Selective Children Learn to Love Eggs

Jennifer Anderson, MSPH, RD

Eggs Across the Lifespan

The Egg Nutrition Center partnered with Jennifer Anderson, MSPH, RD to write this blog post.

Have a picky eater?

Kids who are selective, often have a hard time getting what they need to be healthy. That’s why I help moms and dads teach their kids to like foods like eggs. Eggs are one food that I highly recommend to parents of small children.

Why eggs?

Eggs are a naturally nutrient rich choice providing a good or excellent source of eight essential nutrients, including high-quality protein. It’s especially important to know that eggs are one of the most concentrated food sources of choline. Choline is essential for children for proper brain development. The Adequate Intake of choline for children ages 1-3 is 200 mg per day. A large egg has about 150 mg of choline. So, including eggs regularly in their diet is a great way to ensure a steady source of choline for your little one’s brain development.

Some selective children may reject eggs. There are tools you can use though. You can help your child move beyond the initial rejection and learn to like them.

No pressure

First, allow your child to decide whether to eat a piece of egg or not. I like to refer to this as the “no pressure” policy. My favorite thing to say to my own children if they reject a food is, “You don’t have to eat it.” Make sure that there is at least one food at every meal that your child does like. Removing pressure is important, because even being forced to take one bite can cause kids to dislike a food for a long time.

Exposure

Once there is no pressure, your child will be much more likely to start to explore new foods. At that point, make sure that you are serving eggs frequently. This is called “exposure.” You want them to see eggs often enough that eggs become routine and normal, not new or scary.

Variety

Next, think about what your child does and doesn’t like. There may be specific things about eggs that children don’t like. It could be the shape, temperature, or texture. So, try changing things up! Serve hardboiled eggs warm and cold. If the shape is the problem, you can use some mini cookie cutters to cut new shapes into an egg cooked flat. If texture is the problem, you can try different textures such as hard boiled, scrambled, or an omelet. If you experiment, you may find a method of preparing eggs that your child loves.

Novelty

Finally, find a way to make eggs novel. Give them a new name like “super hero eggs” or serve them with a new utensil. Cut them into a new shape. Have your child come help you in the kitchen and cook them together. Dye eggs together. All of these little things can add up to a child learning to taste and explore eggs.

Make sure and give your child time to learn to like eggs. Sometimes it can take a lot of exposures before children learn to like something new. In the meantime, you can include eggs in bakingand casseroles to make sure your child is getting all of the nutritional benefits of eggs.

_______________________

Jennifer Anderson is the registered dietitian nutritionist behind @kids.eat.in.color on Instagram and mom of 2.

  1. National Cancer Institute. Usual dietary intakes: food intakes, US population, 2007–10. Available at http://appliedresearch.cancer.gov/diet/usualintakes/pop/2007-10

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391775/

  3. Sievenpiper JL, Kendall CWC, et al. Effect of non-oil-seed pulses on glycaemic control: a systematic review and meta-analysis of randomized controlled experimental trials in people with and without diabetes. Diabetologia.2009;52:1479–1495.

  4. https://www.bmj.com/content/353/bmj.i2716

  5. Fuller N, et al. Effect of a high-egg diet on cardiometabolic risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) Study—randomized weight-loss and follow-up phase. Am J Clin Nutr. 2018;107:1-11.

  6. Sabaté J, Oda K, Ros E. Nut Consumption and Blood Lipid Levels: A Pooled Analysis of 25 Intervention Trials. Arch Intern Med. 2010;170(9):821-827.

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Power of the First 1000 Days: Early Nutrition for Lifelong Health

M Power Of The First 1000 Days Early Nutrition 1125x1125

Power of the First 1000 Days: Early Nutrition for Lifelong Health

Kathleen Zelman, MPH, RDN

Eggs Across the Lifespan

Featured article in the Winter 2019 Issue of Nutrition Close-Up; written by Kathleen Zelman, MPH, RDN

Good nutrition is important at every stage of life but most dynamic and with the greatest vulnerability in the first 1000 days (pregnancy and the first two years).

Researchers are connecting the impact of vital nutrients early in life with overall health, growth and neurodevelopment.

The first 1000 days establishes an imprint on the development of healthy tissues, organ structure and function for lifelong health.1 Brain development is most rapid during the last trimester of pregnancy and the first 1000 days harboring the greatest opportunity to ensure normal development. An emerging body of scientific evidence shows that providing essential building blocks during this crucial time period establishes a foundation of health across a person’s lifespan and their predisposition to chronic diseases such as heart disease, obesity, diabetes, cancer and more.1 This is, in part, because dietary habits, food preferences and behaviors are set early on and have the potential to affect choices throughout life. Improving nutrition during the first 1000 days safeguards children to reach their full potential.

 

It Starts in the Womb

A mother’s diet and lifestyle are critical to the infant’s health. Following a healthy eating pattern and taking complete pre-natal vitamins is the best thing a pregnant woman can do to promote normal development of the baby. Striking the right balance of proper nutrition sets the stage for good health whereas over or under nutrition can impact neurocognitive development and increase risks for metabolic syndrome, obesity and heart disease later in life.1

• Emerging evidence has shown that early microbiota colonization may influence brain development and the occurrence of diseases later in life.2,3

 Malnutrition early in life can lead to poor cognition and physical growth that ultimately impact the ability to learn and increases susceptibility to infection.4

• Some experts opine that the childhood obesity epidemic is in part due to maternal overnutrition along with infant feeding practices.

• Studies have shown body mass index at two years of age is predictive of adult obesity.5,6

 

Maximize the First 1000 Days

The American Academy of Pediatrics recommends exclusive breastfeeding for about the first 6 months with continued breastfeeding alongside introduction of complementary foods until 1 year.

Nutritional needs change early in life and are constantly changing to meet growth and development. Nutrients not provided during this period may result in poor cognition even with nutrient repletion.1

Complementary feeding of a variety of foods including fruits, vegetables and single grains are recommended at 4-6 months of age. Baby’s diet should be slowly advanced with variety and texture including cooked soft meat, poultry and seafood, beans, whole milk dairy and eggs. Studies show that infant feeding practices influence food preferences and dietary patterns and can set the foundation for life long habits.7

 

Neurodevelopment

While all nutrients are important for brain development and overall growth, key nutrients during the first 1000 days are protein, polyunsaturated fatty acids, iron, zinc, copper, iodine, choline, folate and vitamins A, D, B6 and B12.1

Choline is a little-known nutrient that is under consumed yet vitally important to the functioning of all cells, and especially in the first 1000 days for brain development and the prevention of birth defects.8 Shockingly, 90-95 percent of pregnant women and 90 percent of adults don’t consume adequate choline.9
Most multivitamins and prenatal supplements do not supply adequate choline. A recent study found none of the top 25 prenatal vitamins contain the 450 mg daily-recommended choline intake for a pregnant woman.10

As a result, the American Medical Association highlighted this underappreciated nutrient by recommending that all prenatal vitamins contain 450 mg — the amount needed during pregnancy. Lactation requires 550 milligrams.

Closing the choline gap can be done with foods rich in choline such as eggs, beef liver, meat, seafood and wheat germ. Eggs are among the richest sources. Two large eggs contain 294 milligrams of choline, more than half the recommended amount for pregnant women.

 

Educating Caretakers

Since babies are totally dependent on caregivers for nourishment, educating them about the importance of appropriate infant feeding practices is essential. Messages should be targeted to adequate dietary patterns with clear and simple guidance. Utilizing digital and mobile technologies is an opportunity to promote healthy eating patterns for infants. Guidelines for birth to twenty-four months has not been included in previous Dietary Guidelines for Americans (DGA) but this is about to change. The 2020 DGA will include recommendations for birth to twenty-four months for the first time.

 

Bottom Line

Good nutrition during the first 1000 days is a unique window of opportunity and tremendous chance to impact neurodevelopment and a child’s ability to establish a healthy dietary pattern and lifestyle that will promote lifelong health.

Early intervention has the potential for enormous advantage across the life span. As dietitians, we have the capacity to improve early neurodevelopment and lifelong health with effective messaging and interventions.

  1. Schwarzenberg, SJ, et al. Advocacy for Improving Nutriti on in the First 1000 Days To Support Childhood Development and Adult Health. Pediatrics. 2018;141:e20173716.

  2. Goulet, O. Potenti al role of the intesti nal microbiota in programming health and disease. Nutr Rev. 2015;73 Suppl 1:32-40.

  3. Diaz Heijtz R. Fetal, neonatal, and infant microbiome: perturbations and subsequent eff ects on brain development and behavior. Semin Fetal Neonatal Med. 2016;21:410–417.

  4. Marti ns, Vinicius JB, et al. Long-Lasti ng Effects of Undernutrition. Int J Environ Res Public Health. 2011;8: 1817–1846.

  5. Winter JD, et al. Newborn adiposity by body mass index predicts childhood overweight. Clin Pediatr (Phila). 2010;49:866-70.

  6. Taveras EM, et al. Weight status in the first 6 months of life and obesity at 3 years of age. Pediatrics. 2009;123:1177-83.

  7. Briefel, RR. New Findings from the Feeding Infants and Toddlers Study: Data to Inform Action. J Am Diet Assoc. 2010;110:S5-7.

  8. Christi an, P, et al. Prenatal micronutrient supplementation and intellectual and motor function in early school-aged children in Nepal. JAMA, 2010; 304:2716-23.

  9. Wallace TC, et al. Assessment of Total Choline Intakes in the United States. J Am Coll Nutr. 2016;35:108-12.

  10. Bell, CC, et al. Prenatal Vitamins Deficient in Recommended Choline Intake for Pregnant Women. J Fam Med Dis Prev. 2016;2:048.

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