A10 0 N + THE NEW YORK TIMES NATIONALTHURSDAY, SEPTEMBER 19, 2019
A panel of scientists issued new
nutritional guidelines for children
on Wednesday, describing in de-
tail what they should be allowed to
drink in the first years of life. The
recommendations, among the
most comprehensive and restric-
tive to date, may startle some par-
ents.
Babies should receive only
breast milk or formula, the panel
said. Water may be added to the
diet at 6 months; infants receiving
formula may be switched to cow’s
milk at 12 months. For the first five
years, children should drink
mostly milk and water, according
to the guidelines.
Children aged 5 and under
should not be given any drink with
sugar or other sweeteners, includ-
ing low-calorie or artificially
sweetened beverages, chocolate
milk or other flavored milk, caf-
feinated drinks and toddler for-
mulas.
Plant-based beverages, like al-
mond, rice or oat milk, also should
be avoided. (Soy milk is the pre-
ferred alternative for parents who
want an alternative to cow’s milk.)
In what may come as a shock to
parents with pantries full of juice
boxes, the panel also said that
young children should drink less
than a cup of 100 percent juice per
day — and that none at all is a bet-
ter choice.
The new guidelines were
produced by Healthy Eating Re-
search, a nutrition advocacy
group, and funded by the Robert
Wood Johnson Foundation. The
recommendations are likely to be
influential, as they were devel-
oped by the American Academy of
Pediatrics, the Academy of Nutri-
tion and Dietetics, the American
Heart Association and the Ameri-
can Academy of Pediatric Den-
tistry.
The cautions against sweet-
ened beverages arrive amid per-
sistent concerns about childhood
obesity, which can set the stage for
lifelong chronic illness. About 19
percent of children in the United
States are obese.
“Close to half of all 2- to 5-year-
olds in the U.S. drink sugary
drinks every day, which we know
increases their risk of obesity, dia-
betes and other health problems,”
said Megan Lott, deputy director
of Healthy Eating Research.
“These recommendations sim-
plify everything for parents — wa-
ter, milk and limited amounts of
100 percent fruit juice,” she added.
Children do not need juice and
are better off eating fruit, the pan-
el said. Excessive juice consump-
tion can lead to dental decay and
weight gain, and is linked to over-
all poor nutrition.
“When we talk about empty cal-
ories that are consumed through
beverages and the number of calo-
ries people get from sugar-sweet-
ened drinks, we’re not just talking
about soda,” said Dr. Richard
Besser, president and chief execu-
tive of the Robert Wood Johnson
Foundation. “Juice is another
source of calories that nutrition-
ally aren’t terrific.”
Recommendations to limit juice
are not new: The pediatrics acad-
emy has long advised that babies
not be given juice till they are a
year old, and that the amount of
juice be limited to four ounces per
day for children between the ages
of 1 and 3.
Plant-based milk beverages
like almond, oat and rice milk of-
ten contain added sweeteners or
artificial flavorings, and are less
nutritious than cow’s milk, a glass
of which contains eight grams of
protein along with nutrients such
as calcium.
With the exception of soy milk,
plant-based milks are poor in pro-
tein. Though they are often forti-
fied, scientists do not know
whether people are able to absorb
these nutrients as efficiently as
those naturally present in other
foods.
Formulas marketed for tod-
dlers are usually unnecessary,
since most toddlers eat solid food;
the products tend to be expensive
and often contain added sugars,
Ms. Lott said.There is no rigorous data from
studies of children about the
safety of artificially sweetened
drinks and other low-calorie
sweetened beverages, she said,
and the products can condition a
child to prefer sweet drinks gener-
ally.
A spokesman for the American
Beverage Association, William M.
Dermody Jr., said beverage com-
panies agree that “it’s important
for families to moderate sugar
consumption to ensure a bal-
anced, healthy lifestyle, and this is
especially true for young chil-
dren."
A spokesman for the Juice
Products Association, however,
said that for children with limited
access to fresh produce, juice can
help improve fruit intake. Federal
dietary guidelines recognize
three-quarters of a cup of 100 per-
cent juice as equivalent to three-
quarters of a cup of fruit.
But many products that appear
to contain natural juice may actu-
ally contain only a small amountof real juice, experts cautioned,
saying parents must read labels
carefully.
Children develop preferences
for foods and beverages at a
young age, and the recommenda-
tions are made with an eye to
shaping a healthy palate.
About a third of children and ad-
olescents in the United States are
overweight or obese, conditions
that increase the risk of develop-
ing chronic illnesses, such as high
blood pressure, high cholesterol,
sleep apnea, Type 2 diabetes,
heart disease, stroke and some
cancers.
“The hope is that through this
approach, you’ll help your child
develop a taste for what’s good for
them,” Dr. Besser said. Though
the occasional glass of 100 percent
juice is not going to be harmful,
“what you want your children as
they grow older to be drinking pri-
marily is water.”
The new recommendations are
broken down by age group:
BIRTH TO SIX MONTHSInfantsshould drink only breast milk or
infant formula. They should not
drink juice, milk, flavored milk, so-
called transition or weaning for-
mulas (also called toddler milks,
growing-up milks or follow-up for-
mula), low-calorie sweetened bev-
erages (diet or “light” drinks, or
those sweetened with Stevia or
Sucralose).
These children also should not
receive plant-based and nondairy
“milks,” caffeinated beverages
(soda, coffee, tea, energy drinks)
or sugar-sweetened beverages
(soda, fruit drinks and fruit-fla-
vored drinks, sports drinks, ener-
gy drinks, sweetened water, and
sweetened coffee or tea).
6 TO 12 MONTHSBabies should
still rely on breast milk or infant
formula. Once they have begun
eating solid food, they can start
sipping water. Parents should
avoid juice, milk, flavored milk,
transition formulas, low-calorie
sweetened beverages, plant-
based and nondairy milks, caf-
feinated beverages, and sugar-sweetened beverages.
12 TO 24 MONTHSChildren should
drink one to four cups of water
daily, and they can start drinking
plain pasteurized whole milk.
They should have no more than
four ounces of 100 percent fruit
juice per day; the juice may be wa-
tered down. Parents should avoid
other drinks (flavored milk, tran-
sition formulas, caffeinated
drinks, plant-based and nondairy
milks, sugar-sweetened bever-
ages and low-calorie sweetened
beverages).
2 TO 3 YEARS OLDToddlers should
drink one to four cups of water
daily and transition to fat-free or
low-fat (1 percent fat) milk. They
should drink no more than four
ounces of 100 percent juice and
should not be given other drinks.
4 TO 5 YEARS OLDThese toddlers
should drink 1.5 to five cups of wa-
ter a day, skim or low-fat milk, and
no more than four to six ounces of
100 percent fruit juice. They
should not be given other drinks.Guidelines Tell Parents
No Sweetened Drinks
For Children Under 6
Recommendations released Wednesday by a nutrition advocacy group say that children 5 or under should stick to milk and water.DUSTIN CHAMBERS FOR THE NEW YORK TIMESBy RONI CARYN RABINWASHINGTON — As Presi-
dent Trump weighs potential gun
safety legislation, his attorney
general on Wednesday floated a
plan to expand background
checks for gun buyers, but the
idea was met with skepticism
from key Republicans and ap-
peared to face serious obstacles
on Capitol Hill.
The proposal being circulated
by Attorney General William P.
Barr is similar to the so-called
Manchin-Toomey bill, which
would extend the current back-
ground checks system to all com-
mercial gun sales, including those
at gun shows and online. That bill
fell to a Senate filibuster in 2013.
The White House made clear
that the Barr proposal — which
senators described as an “ideas
list” or a work in progress — has
not yet received Mr. Trump’s
blessing, further underscoring the
degree to which bipartisan talks
around gun safety could fail. Mr.
Barr, speaking to reporters in the
Capitol, also played it down, say-
ing he was “just kicking around
some ideas” to see what could
gain traction in the Senate.
Mr. Trump, for his part, took to
Twitter on Wednesday in what ap-
peared to be a proactive effort to
lay blame on Democrats should
the bipartisan talks fail. He sin-
gled out Beto O’Rourke of Texas, a
former congressman and current
2020 Democratic presidential can-
didate, who has proposed a man-
datory government program to
buy back assault weapons — an
idea that makes even some Demo-
crats skittish.
“Dummy Beto made it much
harder to make a deal,” Mr. Trump
tweeted. “Convinced many that
Dems just want to take your guns
away. Will continue forward!”
On Wednesday evening, Mr.
Barr sat down with three of the
Senate’s strongest advocates of
expanded background checks:
Senators Christopher S. Murphy,
Democrat of Connecticut, and the
sponsors of the Manchin-Toomey
bill, Joe Manchin III, Democrat of
West Virginia, and Patrick J.
Toomey, Republican of Pennsyl-vania.
“There’s no question, the heart
of the attorney general’s idea is a
mechanism for expanding back-
ground checks beyond what we
have today,” Mr. Toomey said,
adding, “I have colleagues who
are open to that so I’m modestly
encouraged.”
Mr. Manchin also sounded up-
beat: “I personally think the pres-
ident wants to do something. We
would not be this engaged for this
long a period of time if he didn’t.”
Mr. Murphy, though, was cau-
tious: “Just finished meeting w At-
torney General Barr w @Sen-
Toomey and @Sen_JoeManchin,”
he wrote on Twitter. “It was a re-
ally good discussion. But the fact
remains that there is no good deal
that the gun lobby will support.
Now, the White House has a
choice to make.”
But Republicans who favor gun
rights said they wanted more spe-
cifics, and several said it was
pointless to even talk about Mr.
Barr’s plan at this point. As the na-
tion’s chief law enforcement offi-
cer, the attorney general will be acentral figure in the debate over
gun legislation, but senators
agree that the president will have
the final say.
“My question was: ‘Where is
the president on this?’ And I
asked this question directly: ‘Is
this something the president sup-
ports?’ And they didn’t have ananswer for that,” said Senator
Josh Hawley, Republican of Mis-
souri, who met with Mr. Barr on
Tuesday evening. “That’s an im-
portant piece. If the president
doesn’t support it, then there’s no
point.”
And Senator Ted Cruz, Republi-
can of Texas, who also met with
Mr. Barr on Tuesday evening,
warned against any legislationthat “raised the specter of confis-
cation” and said he was not inter-
ested in a bill that would “restrict
the Second Amendment rights of
law-abiding citizens.”
Mr. Cruz is pushing an alterna-
tive bill — the so-called lie and try
measure, which would make it
easier for law enforcement to
prosecute people who lie on back-
ground checks. That idea is also
included in the proposal that Mr.
Barr has circulated.
The issue of gun violence has
burst onto the Washington
agenda after a string of mass
shootings that terrorized the na-
tion over the summer. Democrats
have been demanding that the
president embrace a House-
passed bill expanding back-
ground checks to cover even pri-
vate gun sales. But that idea is a
nonstarter in a Senate controlled
by Republicans, as even Mr. Mur-
phy concedes.
“I wish they would endorse
H.R. 8, but that’s not going to hap-
pen,” he said, referring to the
House bill, adding, “so this is an it-
erative process.”Unlike the House bill, the
Manchin-Toomey bill would cover
only commercial sales, meaning
that sales between friends and
family members would be ex-
empted. Only two Republicans
who voted in favor of it in 2013 —
Mr. Toomey and Senator Susan
Collins of Maine — remain in the
Senate.
And while some Republican
newcomers, notably Senator Mitt
Romney of Utah, have said they
are inclined to support it, the
measure draws opposition from
many, like Mr. Hawley, who are
concerned that it would lead to a
federal registry of gun owners,
which gun rights advocates
strongly oppose.
The proposal being circulated
by Mr. Barr, first reported by The
Daily Caller, calls for a “newly cre-
ated class of licensed transfer
agents” who would not sell guns,
but would be authorized by the
government to conduct back-
ground checks. Mr. Toomey de-
scribed it as “a different mecha-
nism” from the Manchin-Toomey
bill.Plan From Attorney General as President Considers Gun-Safety Legislation
By SHERYL GAY STOLBERGA proposed expansion
of background checks
meets skepticism.
WASHINGTON — President
Trump said late Wednesday that
his administration would issue a
notice of environmental violation
against the city of San Francisco
because of what he described as
its homelessness problem.
Traveling aboard Air Force One
as he returned to Washington
from a three-day trip to California
and New Mexico, Mr. Trump told
reporters that San Francisco was
in “total violation” of environmen-
tal rules because of used needles
that were ending up in the ocean.
“They’re in total violation —
we’re going to be giving them a
notice very soon,” the president
said, indicating that the city could
be put on notice by the Envi-
ronmental Protection Agency
within a week that its homeless-
ness problem was causing envi-
ronmental damage.
He said tremendous pollution
was flowing into the ocean be-
cause of waste in storm sewers,
and he specifically cited used nee-
dles.
“They’re in serious violation,”
Mr. Trump said, adding, “They
have to clean it up. We can’t have
our cities going to hell.”
San Francisco’s mayor, London
Breed, called Mr. Trump’s com-
ments “ridiculous.”
“To be clear, San Francisco has
a combined sewer system, one of
the best and most effective in the
country, that ensures that all de-
bris that flow into storm drains
are filtered out at the city’s waste-
water treatment plants,” Ms.
Breed said in a statement
Wednesday night. “No debris flow
out into the bay or the ocean.”
She also said that the city would
be adding 1,000 shelter beds by
next year, and is seeking to pass a
$600 million bond to build more af-
fordable housing and increase
services for people with mental ill-
nesses and drug addictions.
“In San Francisco,” Ms. Breed
said, “we are focused on advanc-
ing solutions to meet the chal-
lenges on our streets, not throw-
ing off ridiculous assertions as we
board an airplane to leave the
state.”
The threat from the president
was the second time in two days
that Mr. Trump has clashed with
politicians in California. On Tues-
day, the administration said it
would revoke the state’s ability to
set tougher auto emissions stand-
ards, drawing a fierce rebuke from
Gavin Newsom, the state’s Demo-
cratic governor.
The president has indicated for
weeks that he is angry and frus-
trated by what he sees as an out-
of-control homeless problem in
San Francisco and Los Angeles —
two heavily Democratic cities runby politicians who have been reg-
ularly critical of Mr. Trump.
On Twitter in July, the president
lashed out at Speaker Nancy
Pelosi, whose district includes
San Francisco, saying that the city
was “not even recognizeable
lately.”
“Something must be done be-
fore it is too late,” he added. “The
Dems should stop wasting time on
the Witch Hunt Hoax and start fo-
cusing on our Country!”
During an interview in July
with Tucker Carlson of Fox News,
Mr. Trump lamented the state of
American cities like San Fran-
cisco, Los Angeles and New York,
suggesting that homelessness
and drug use was so bad that it
was a public health hazard.
“You can’t have what’s happen-
ing — where police officers are
getting sick just by walking the
beat,” Mr. Trump told Mr. Carlson
He added that when world lead-
ers come to an American city, they
should not see homeless people.
“They’re riding down a highway,
they can’t be looking at that,” he
said.
Before the president’s trip this
week to California, the adminis-
tration signaled that the federal
government would be looking for
ways to address homelessness. A
report in The Washington Post
said several agencies had been or-
dered to find ways to confront the
problem.
But there had been no indica-
tion before Wednesday night that
the Trump administration in-
tended to use environmental lawsto do so.
It was also unclear what spe-
cific laws or regulations the E.P.A.
would cite, or what actions the
agency would demand from the
city’s leaders in order to avoid the
citation.
Tens of thousands of hypoder-
mic needles are collected every
month from the streets of San
Francisco.
City officials have a longstand-
ing program of distributing clean
needles in an effort to reduce in-
fectious diseases like H.I.V.
But the police have reported a
sharp increase in heroin use on
the streets; in August 2018 alone,
the city’s Public Health Depart-
ment, which has a needle recov-
ery program, retrieved 164,
needles, both through a disposal
program and through street
cleanups.
As the number of unsheltered
people has increased, the amountof feces collected and cleaned up
has also swelled. Last year, the
city established a designated fe-
ces cleanup crew. The city has also
increased the availability of mo-
bile toilets.
Even before the president’s re-
marks aboard Air Force One,
Democratic officials in California
had been in the awkward position
of agreeing with Mr. Trump about
the need for a solution to home-
lessness — though they remained
suspicious of the president’s real
motivations.
In fact, Mr. Trump has repeat-
edly indicated that his frustration
with homeless people in some of
the country’s major cities has
more to do with making sure that
others do not have to see them and
less to do with concern about the
homeless.
“In many cases, they came from
other countries and they moved to
Los Angeles or they moved to SanFrancisco because of the prestige
of the city, and all of a sudden they
have tents,” Mr. Trump said before
attending one of his fund-raisers
in Silicon Valley. “Hundreds and
hundreds of tents and people liv-
ing at the entrance to their office
building. And they want to leave.”
Ben Carson, the secretary of
housing and urban development,
joined Mr. Trump on his trip out
West and toured a new public
housing development in San Fran-
cisco. But Mr. Trump’s comments
on Wednesday indicated that he
was not satisfied with addressing
homelessness the usual way.
Homelessness in the San Fran-
cisco Bay Area has surged in re-
cent years. The city of San Fran-
cisco has 8,011 homeless people,
according to a count conducted
this year, a 17 percent increase
over 2017, the last time a count
was conducted. Other nearby cit-
ies have had even larger in-
creases, including San Jose (up 42
percent from two years ago) and
Oakland (up 47 percent).
In Los Angeles County, an esti-
mated 59,000 people are home-
less, of which about 75 percent of
whom are unsheltered, according
to a point-in-time count released
this year.
One major difference with the
East Coast is that a large propor-
tion of homeless in California are
unsheltered — nearly 70 percent
of the homeless, or about 90,
people, live on the street.San Francisco Violating Rules, Trump Says
This article is by Michael D.
Shear, Thomas Fullerand Peter
Baker.
Tents in San Francisco. The
president has directed ire at the
city over what he sees as out-of-
control homelessness.JEFF CHIU/ASSOCIATED PRESSMichael D. Shear reported from
Washington, Thomas Fuller from
San Francisco, and Peter Baker
from aboard Air Force One. Conor
Dougherty contributed reporting
from San Francisco, and Jose A.
Del Real from Los Angeles.