American children consume low levels of several important nutrients, deemed select nutrients of concern. One is calcium. Most older children and adolescents in the United States do not meet recommended calcium intakes, which is problematic as calcium is necessary for bone health and the development of peak bone mass, both of which prevent fractures and osteoporosis later in life. Optimal calcium intake is particularly important during adolescence, when most bone mineralization occurs and calcium requirements are higher than during any other period of life. One way to help children obtain a range of healthful nutrients is to provide nutrient-dense snack options in a pleasant eating environment. (INFOGRAPHIC 18.8)

Many children under the age of three years also have inadequate dietary intakes of iron, because they often consume a lot of cow’s milk, which is low in iron, in place of iron-rich foods. This can lead to iron-deficiency anemia, a form of anemia that can, during infancy and childhood, affect short-term and long-term neurological development.

Iron is also important for adolescents and older teens as it supports accelerated growth and, in females, helps to replace iron lost through menstruation. The DRIs recommend that adolescent boys (14 to 18 years of age) consume 11 mg of iron per day, more than the 8 mg recommended for younger boys and men older than 19. In teenage girls, iron needs increase from 8 mg to 15 mg during adolescence. Because few teenage girls consume enough iron to meet this increased need, approximately 10% of adolescent girls are iron deficient.

Fiber is another nutrient of concern, as 9 of every 10 U.S. children—particularly those with low-income and minority backgrounds—fail to meet the IOM’s recommendations for fiber intake. Recent surveys suggest that children and adolescents only consume about half of the fiber they should; teens are particularly deficient. Fiber plays an important role in the health of children and adults and has been shown to reduce the risk of several chronic diseases. It also alleviates constipation, which many children experience.

Adequate intake of vitamin D is crucial for skeletal health and optimal bone growth and development in children, but few children and adolescents get enough of this vitamin either. This is in part because of the low levels of vitamin D naturally found in most foods. Milk is almost always fortified with vitamin D, but as noted, many children opt for soda or other beverages at mealtimes. Also sunlight exposure, which can help meet all or part of vitamin D needs, has decreased in recent decades as children spend more time indoors. The IOM recently increased its recommended intake of vitamin D by 50% to 15 micrograms (600 IU) for children and adolescents. Health care providers may recommend supplementation for some children to meet these recommended levels.