What Parents Should Know About the New USDA Dietary Guidelines

By: Katie Marks-Cogan, M.D

New USDA Dietary Guidelines have important recommendations including ‘no added sugar before 2 years old’ and ‘early allergen introduction by 4 months’.

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Following USDA guidelines, Allergist Katie Marks-Cogan MD recommends introducing food allergens to your baby’s diet as early as 4 months old. (Photo source: iStock)

In this article, I will talk about the new USDA Dietary Guidelines and key takeaways for parents and doctors. Including the following:

So, let’s dive into it

What are the USDA Dietary Guidelines for Americans?

The United States Department of Agriculture (USDA) just published the new 2020–2025 Dietary Guidelines for Americans (DGA) Report. It is the ninth edition of the national nutrition and health guidelines. All of its recommendations are backed by evidence and research.

Millions of Americans already use the USDA guidelines to help them make decisions about nutrition and diet. This year is the first time that the guidelines include recommendations for the 0–2 year age group. That happened as a result of a congressional mandate to create guidelines for this age range. The reasoning behind this addition is as follows:

“The first 1,000 days of an infant and child’s life, beginning at conception and continuing through the second year of life, are crucial for ensuring optimal physical, social, and psychomotor growth and development and lifelong health.” — USDA

2020 USDA Dietary Guidelines for Americans: What Families Need To Know

The 2020–2025 DGA will help shape the choices of millions of American families on diet and nutrition matters. Here are the 5 things every family should take away from the new guidelines:

1. No Added Sugar for Infants and Toddlers

The new guidelines state that parents should “avoid foods and beverages with added sugars during the first 2 years of life.” This is an effort to help reverse the rise in childhood obesity. The report notes that there are nearly 5 million American children suffering from obesity.

This recommendation is timely because, as the USDA Dietary Guidelines state that many 6–12-month-olds have already had some amount of added sugar in the foods that they eat.

2. Introduce Egg and Peanut to Every Baby

One of the key recommendations from the new report is to feed babies allergenic foods such as peanut and egg. This should be done as early as 4 months of age in order to prevent severe food allergies.

This is in light of new clinical trials, that demonstrate that introducing allergenic foods is safe and can help prevent up to 80% of food allergies.

These guidelines apply to any infant, no matter their risk factors (even for babies with eczema). This emphasizes how important early introduction is to help parents prevent their baby from developing food allergies.

To learn how to introduce allergens to your baby including recipes, visit preventallergies.org.

“Introducing peanut and egg in an age appropriate form, in the first year of life (after age 4 months) may reduce the risk of food allergy to these foods.” — USDA

3. Insufficient Evidence on Diet During Pregnancy for Food Allergy Prevention

According to the Dietary Guidelines, there is

“Insufficient evidence is available to determine the relationship between peanuts, eggs, or wheat consumed during pregnancy and risk of food allergy in the child.”

This means there is not enough research to support that eating allergy-causing foods during pregnancy will help protect your baby from food allergies.

The key takeaway for families is that early allergen introduction is still the only guideline for preventing food allergies in children.

4. Breastfeeding is still encouraged

The USDA found strong evidence that breastfeeding may reduce your child’s risk of being overweight, obese, type 1 diabetic, and asthmatic compared to children who have not been breastfed. Further, the USDA found that the longer children are breastfed, the less their chance of developing those diseases and conditions. However, it is important to note that the “optimal duration of breastfeeding with respect to these outcomes is not well understood”.

5. Obesity is a pressing public health concern

The guidelines indicate that over 70% of Americans are overweight or obese. Again, there is a strong link shown between added sugar consumption in children under 2 and the likelihood of developing obesity or becoming overweight. Furthermore, high rates of obesity are not only public health concerns, but they also drive diet-related chronic diseases, such as “cardiovascular disease (CVD), type 2 diabetes, and some types of cancer”.

New Research on Food Allergies: Prevention is Possible for Every Baby

As a Board-Certified Allergist, I’ve seen the rise in food allergies firsthand. That’s why it’s really exciting to see the new USDA dietary guidelines report include a strong food allergy recommendation. It states clearly that infants starting at four months of age should be introduced to allergenic foods like peanuts and eggs. Based on multiple landmark clinical trials, we have evidence that doing so can actually help prevent the development of a food allergy.


Additional information on food allergies and nutrition:

Severe Food Allergies: Deadly but Hard to Prevent
Your Genes and Food: The Science of Personalized Nutrition


In addition, any baby can develop a food allergy. It’s not solely based on genetics. Unfortunately, I think a lot of families may not know that genetics is not the only factor. In fact, there are multiple other things involved. Over half of babies diagnosed with a food allergy today actually have no direct family members with a food allergy.

How To Follow the USDA Food Allergy Prevention Guidelines At Home

You can do early and sustained allergen introduction at home by giving your baby allergenic foods such as peanut, egg, and milk. However, because you have to wait until your baby is developmentally ready to eat solids.

Further, the landmark clinical trials ( LEAP, EAT, PETIT) suggest that it may actually be more beneficial to give babies allergens such as peanut, egg, and milk starting at 4 months of age. This can be really challenging for parents because many babies are not developmentally ready to eat solid food until at least 6 months of age. In some children, it is even later.

In addition, it can be a time-consuming process because you can’t just give these foods to your baby only once and expect to see the same results as in the studies. These same clinical studies show that you have to offer allergens on a consistent and regular basis in order to have the most benefit in terms of reducing your child’s risk of food allergies.

Making early allergen introduction easy

I did try early allergen introduction with my son when he was a baby. It was challenging because I had to prepare all of the food. I also needed to pay attention to details such as how often I was giving the allergens. And, I had to make sure that all the food was getting into his mouth (and not everywhere else).

So I do understand that it can be a frustrating process. This is the main reason that my colleagues and I created a new product, Ready, Set, Food!, to make it easier for parents to do early allergen introduction. We have eliminated the stress of food preparation by creating an evidence-based product that makes it easy for families to follow the new guidelines at home.

Ready, Set, Food! is easy to use

The product is designed to be administered in two stages. The Stage 1 product consists of individual packets of the food allergen. The intended day of use is clearly labeled on each packet.

You empty the packet into a bottle with at least 2 ounces of breast milk, formula, or water. You shake the bottle to mix just before feeding the baby. It can also be added to food. It’s that simple.

Stage 2 is the maintenance phase. Use for 6+ months is recommended by the company. They state that sustained exposure is important to minimize risk. The product is sold in cartons containing 15 packets that contain all three allergens.

Note: this product is NOT intended for use by infants who have been diagnosed with food allergy. Further, if your has a sensitivity to the product, discontinue its use and contact your healthcare provider.

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Created by an allergist to make early allergen introduction easier for parents (Photo provided by author)

*This is an affiliate link. That means we receive a small commission on each sale made through this link. It does not affect the price you pay. It does help support our work.

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Katie Marks-Cogan, M.D.

Katie Marks-Cogan, M.D. is board certified in Allergy/Immunology and Internal Medicine and treats both pediatric and adult patients.

Originally from Cleveland, Ohio, she received her M.D. with honors from the University of Maryland School of Medicine. She then completed her residency in Internal Medicine at Northwestern and fellowship in Allergy/Immunology at the prestigious University of Pennsylvania and Children’s Hospital Pennsylvania (CHOP).

She works in private practice and is the owner of Clear Allergy and Chief Allergist for Ready, Set, Food!

She currently resides in Los Angeles with her husband, 5-year-old son, and 2-year-old daughter where she enjoys hiking, building LEGO castles with her kids, and cooking with her family.

Originally published at https://thedoctorweighsin.com on October 17, 2020.

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