The U.S. States Best Supporting Childhood Nutrition: The States Giving Children the Healthiest Start
Supporting healthy habits from an early age is a key part of Juice Plus+'s mission.
The Juice Plus+ company and our Partners contribute over $50 Million in products, annually, through our healthy starts for children program, to support youth nutrition through healthy starts. The program provides families with free*, whole-food based nutrition products to help the next generation build strong, lifelong wellness habits.
Childhood nutrition varies across the United States. To better understand these differences, Juice Plus+ created the Childhood Nutrition Index.
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What is the Childhood Nutrition Index?
The Childhood Nutrition Index is a ranking of every U.S. state based on the conditions that support a healthy nutritional start for children between the ages of one and five. This ranking uses six government datasets covering children's diets, food security and child poverty.
Specifically, the index combines measures of fruit consumption, vegetable consumption, sugary drink intake, household access to nutritious food, child poverty and food insecurity to identify where children have the strongest nutrition environments during their early years.
The Importance of Childhood Nutrition
The CDC Early Childhood Nutrition 2025 report highlights that healthy nutrition during the first five years supports a child’s brain development, bone health and healthy growth, while also helping a child establish lifelong eating habits. These elements all play a role in establishing a solid foundation for a child’s future and emphasize why a healthy nutritional start matters.
According to Heather Koenig, Registered Dietitian at JuicePlus+ “Early years are a critical window for growth and development. During this time, children are developing eating habits that are often carried through adolescence and adulthood. Regular access to fruits, vegetables, and a varied diet helps provide the nutrients needed to support healthy growth, while repeated exposure to healthy foods can encourage children to build positive lifelong eating habits."
However, because access to nutritious food is also influenced by factors such as food security and poverty, the Childhood Nutrition Index looks beyond diet alone to assess the wider conditions that support healthy starts across the United States.
The Findings: Regional
The Childhood Nutrition Index reveals that a child's opportunity for a healthy nutritional start varies considerably depending on where they live. New Hampshire, Vermont and Maine rank as the three strongest states for childhood nutrition, while Mississippi, Louisiana and Arkansas rank at the bottom of the index.
A clear regional pattern emerges with New England accounting for five of the top 12 states, while Southern states are disproportionately represented among the lowest performers. Overall, the 58-point gap between first-placed New Hampshire (79) and last-placed Mississippi (21) highlights substantial differences in children's nutrition environments and how childhood nutritional requirements are met across the United States.
- 40% of states rank high or very high in the index
- 42% of states rank below average or low in the index
The Findings: Does Economic Hardship Affect Children's Diets?
Yes. Across all 50 U.S. states, every way that measured economic hardship - whether households can afford nutritious food, the child poverty rate, or household food insecurity - lines up with children eating less fruit and fewer vegetables, and drinking more sugary drinks. The relationships are strong, and they hold up to every check we ran for statistical rigor.
Statistically proven findings from the data:
- States with higher food affordability have children eating fruit and vegetables more often.
- Lower food affordability lines up with more sugary drink consumption.
- Higher child poverty is associated with less daily fruit intake, less daily vegetable intake, and more sugary drink consumption.
- Food insecurity correlates with less fruit intake, less vegetable intake, and more sugary drink consumption.
- States that are good at getting kids to eat fruit are almost always good at vegetables too: healthy eating habits cluster together.
Why New Hampshire Ranked First
New Hampshire's top ranking is driven by consistently strong performance across multiple indicators. The state has the lowest rate of sugary drink consumption among children aged 1–5 (35%), the lowest child poverty rate for children under five (8.3%), and the lowest household food insecurity rate in the country (7.4%).
Why Mississippi Ranked Last
Mississippi records the highest rate of sugary drink consumption among children aged 1–5 (74%), the highest proportion of children eating fruit daily is one of the lowest proportions compared to other states (50%), and the lowest daily vegetable consumption (38%). It also has the second-highest child poverty rate for children under five (26.4%) and the joint-lowest proportion of households that can always afford nutritious food (59%), contributing to its overall
|
State |
Final index score /100 |
Ranking description |
|
New Hampshire |
79 |
Very high |
|
Vermont |
76 |
Very high |
|
Maine |
75 |
Very high |
|
Washington |
73 |
Very high |
|
Connecticut |
68 |
Very high |
|
Minnesota |
68 |
Very high |
|
Alaska |
64 |
Very high |
|
Wisconsin |
64 |
Very high |
|
Rhode Island |
63 |
Very high |
|
Montana |
63 |
Very high |
|
Oregon |
61 |
High |
|
Massachusetts |
60 |
High |
|
California |
60 |
High |
|
Virginia |
59 |
High |
|
Colorado |
59 |
High |
|
New Jersey |
59 |
High |
|
North Dakota |
59 |
High |
|
Michigan |
57 |
High |
|
Missouri |
56 |
High |
|
South Dakota |
56 |
High |
|
Pennsylvania |
55 |
Average |
|
Kansas |
53 |
Average |
|
Illinois |
53 |
Average |
|
North Carolina |
53 |
Average |
|
Iowa |
53 |
Average |
|
Maryland |
53 |
Average |
|
Ohio |
51 |
Average |
|
Hawaii |
51 |
Average |
|
Arizona |
50 |
Average |
|
Idaho |
49 |
Below average |
|
Georgia |
49 |
Below average |
|
Nebraska |
49 |
Below average |
|
Wyoming |
49 |
Below average |
|
Utah |
48 |
Below average |
|
Kentucky |
48 |
Below average |
|
New York |
48 |
Below average |
|
Delaware |
47 |
Below average |
|
New Mexico |
47 |
Below average |
|
Nevada |
46 |
Below average |
|
Indiana |
45 |
Below average |
|
West Virginia |
44 |
Low |
|
South Carolina |
44 |
Low |
|
Tennessee |
44 |
Low |
|
Florida |
41 |
Low |
|
Alabama |
40 |
Low |
|
Oklahoma |
35 |
Low |
|
Texas |
31 |
Low |
|
Arkansas |
28 |
Low |
|
Louisiana |
26 |
Low |
|
Mississippi |
21 |
Low |
How States Compare Across Key Nutrition Indicators
-
Fruit intake: Washington has the highest percentage of children aged 1–5 who eat fruit daily (81%), while Mississippi has the lowest (50%).
-
Vegetable consumption: Vermont records the highest daily vegetable consumption among children aged 1–5 (63%), while Mississippi records the lowest (38%).
-
Sugary drink consumption: New Hampshire has the lowest rate of sugary drink consumption among young children (35%), while Mississippi has the highest (74%).
-
Household nutrition affordability: Massachusetts has the highest proportion of households that can always afford nutritious food (79%), while Arkansas, Mississippi, Oklahoma and Texas are joint lowest (59%).
-
Child poverty: Louisiana has the highest child poverty rate among children under five (27.3%), while New Hampshire has the lowest (8.3%).
-
Three year average household food insecurity (2021-2023): Arkansas has the highest average household food insecurity rate (18.9%), while New Hampshire has the lowest (7.4%).
Note: Data below considers children aged 1-5 except for the USDA average household food insecurity, which is household-wide.
|
State |
Ate fruit at least once daily (CDC) |
Ate vegetables at least once daily (CDC) |
Drank a sugary drink once or more times weekly (CDC) |
Living in households that could always afford to eat nutritious foods. (CDC) |
Child poverty under age 5 % (CENSUS ACS) |
AVERAGE of Household food insecurity (%, three-year average), 2021-23* (USDA) |
|
Alabama |
60% |
44% |
67% |
65% |
22.70% |
11.50% |
|
Alaska |
71% |
59% |
52% |
68% |
13.50% |
10.40% |
|
Arizona |
71% |
47% |
61% |
66% |
15.30% |
11.80% |
|
Arkansas |
59% |
46% |
73% |
59% |
21.10% |
18.90% |
|
California |
71% |
53% |
50% |
77% |
14.50% |
11.40% |
|
Colorado |
72% |
52% |
56% |
74% |
13% |
9.90% |
|
Connecticut |
75% |
56% |
43% |
74% |
12.60% |
10.40% |
|
Delaware |
62% |
45% |
56% |
68% |
13.60% |
11.30% |
|
Florida |
56% |
39% |
50% |
61% |
17% |
12% |
|
Georgia |
67% |
54% |
66% |
69% |
16.20% |
12.80% |
|
Hawaii |
61% |
45% |
51% |
65% |
11.20% |
9.60% |
|
Idaho |
65% |
50% |
67% |
66% |
13.80% |
9.80% |
|
Illinois |
72% |
47% |
57% |
74% |
15% |
11.30% |
|
Indiana |
65% |
45% |
60% |
67% |
19.30% |
12.40% |
|
Iowa |
70% |
53% |
61% |
68% |
14.70% |
12.20% |
|
Kansas |
68% |
49% |
57% |
69% |
14.60% |
10.60% |
|
Kentucky |
62% |
50% |
64% |
60% |
20.90% |
10.60% |
|
Louisiana |
51% |
40% |
68% |
61% |
27.30% |
16.20% |
|
Maine |
79% |
62% |
39% |
72% |
12.70% |
10.90% |
|
Maryland |
67% |
47% |
54% |
77% |
11.40% |
10.40% |
|
Massachusetts |
69% |
50% |
48% |
79% |
12.50% |
9.30% |
|
Michigan |
72% |
53% |
52% |
71% |
19.80% |
13% |
|
Minnesota |
75% |
57% |
49% |
77% |
11.10% |
9.10% |
|
Mississippi |
50% |
38% |
74% |
59% |
26.40% |
16.20% |
|
Missouri |
70% |
57% |
58% |
63% |
17.10% |
12.70% |
|
Montana |
79% |
55% |
59% |
70% |
11.20% |
10.60% |
|
Nebraska |
68% |
51% |
63% |
64% |
12.80% |
12.90% |
|
Nevada |
64% |
49% |
63% |
64% |
16.60% |
12.50% |
|
New Hampshire |
79% |
57% |
35% |
75% |
8.30% |
7.40% |
|
New Jersey |
69% |
47% |
45% |
75% |
11.50% |
9.80% |
|
New Mexico |
66% |
53% |
69% |
68% |
23.30% |
12.90% |
|
New York |
63% |
45% |
52% |
73% |
18.80% |
12.30% |
|
North Carolina |
67% |
52% |
60% |
69% |
17.20% |
10.90% |
|
North Dakota |
70% |
53% |
60% |
72% |
13.30% |
8.60% |
|
Ohio |
67% |
49% |
53% |
71% |
17.90% |
12.80% |
|
Oklahoma |
63% |
44% |
70% |
59% |
22% |
15.40% |
|
Oregon |
77% |
54% |
52% |
73% |
14.90% |
12.80% |
|
Pennsylvania |
70% |
49% |
56% |
70% |
15.90% |
10.80% |
|
Rhode Island |
71% |
50% |
42% |
77% |
20.60% |
9.70% |
|
South Carolina |
66% |
47% |
60% |
70% |
19.10% |
14.40% |
|
South Dakota |
69% |
50% |
59% |
70% |
10.10% |
9% |
|
Tennessee |
66% |
48% |
72% |
68% |
18.10% |
11.70% |
|
Texas |
59% |
44% |
69% |
60% |
19.40% |
16.60% |
|
Utah |
70% |
48% |
66% |
73% |
10.20% |
11.80% |
|
Vermont |
76% |
63% |
42% |
78% |
10.30% |
9.20% |
|
Virginia |
70% |
54% |
56% |
72% |
12.30% |
10% |
|
Washington |
81% |
60% |
49% |
75% |
11.70% |
9.50% |
|
West Virginia |
63% |
54% |
69% |
62% |
20.60% |
13.70% |
|
Wisconsin |
74% |
58% |
54% |
70% |
13.40% |
10.70% |
|
Wyoming |
69% |
52% |
66% |
72% |
12.40% |
13.10% |
"The eating habits children develop during their early years often lay the foundation for lifelong health. While no family's diet is perfect, consistently offering nutrient-rich foods, limiting sugary drinks where possible and creating positive mealtime routines can help children build healthy behaviors that last well beyond childhood."
Finding 1: Food affordability vs. fruit & vegetable intake
Do states where more households can always afford nutritious food also have kids eating more fruit and vegetables?
Yes. States with higher food affordability have children eating fruit and vegetables more often. The relationship is strong for fruit (r = 0.72) and moderate for vegetables (r = 0.51). Both are highly unlikely to be chance (p < .001), and dropping the single most influential state barely changes the result - this isn't being driven by one unusual state.
Finding 2: Food affordability vs. sugary drink consumption
Do states with lower food affordability have kids drinking more sugary drinks?
Yes. Lower food affordability lines up with more sugary drink consumption (r = −0.70, a strong relationship, p < .001). Combined with Finding 1, the pattern is consistent: worse affordability means less produce and more sugary drinks, not just one isolated habit.
Finding 3: Child poverty vs. all three diet outcomes
Does the traditional, income-based poverty measure show the same pattern as affordability?
Yes, across the board. Higher child poverty is associated with less daily fruit intake (r = −0.71), less daily vegetable intake (r = −0.54), and more sugary drink consumption (r = 0.58). All three are statistically solid (p < .001) and hold up under the outlier check. This mirrors the affordability findings closely - poverty and affordability are two different lenses on the same underlying economic squeeze.
Doing Our Part Supporting Healthy Starts
We all have a role to play in helping the next generation grow up healthy and happy. The Juice Plus+ Healthy Starts program makes it easier to support a young person's nutrition by providing Juice Plus+ Fruit & Vegetable Blend Capsules or Chewables at *no cost.
*Available for any young person aged 4 to 25 with a qualifying adult purchase. Just pay handling fee every four months.
Healthy Starts is designed to encourage healthier habits from an early age. According to feedback from participating **families:
-
71% cut back on fast food and sugary drinks
-
61% increased their fruit and vegetable intake
-
71% drank more water
-
66% said they visited the doctor less frequently
**Figures are based on self-reported feedback collected over 20+ years from more than 250,000 participating adults whose families used Juice Plus+ while making positive lifestyle changes, including improvements to nutrition, hydration, exercise and sleep.
Methodology
The index is calculated using six publicly available government datasets. Each metric is normalized using min-max scaling to produce a score between 0 and 100, where 100 always represents the strongest outcome.
The metrics included are:
-
Percentage of children aged 1–5 who eat fruit daily.
-
Percentage of children aged 1–5 who eat vegetables daily.
-
Percentage of children aged 1–5 who consume sugary drinks (reverse scored).
-
Percentage of households that can always afford nutritious food.
-
Percentage of children under five living below the federal poverty line (reverse scored).
-
Percentage of households experiencing food insecurity (reverse scored).
Each metric is weighted equally and averaged to produce an overall state score out of 100.
Higher scores indicate stronger performance across the combined nutrition and socioeconomic indicators.
States were grouped into performance bands using quintiles. Where multiple states shared the same score at a quintile boundary, tied scores were kept within the same performance band to avoid assigning different categories to identical scores.
Sources:
U.S. Department of Agriculture (USDA), Economic Research Service (ERS), Food Environment Atlas.
Statistical analysis:
This analysis uses state-level data from the input data, which compiles figures from the CDC, U.S. Census (ACS), and USDA across all 50 U.S. states (Washington D.C. and territories are not included). For each state, the three measures of economic hardship was compared: household food affordability, child poverty rate, and household food insecurity, against three measures of children's diet quality: daily fruit intake, daily vegetable intake, and sugary drink consumption, to test whether harder economic conditions line up with worse diets.
Each relationship was measured using Pearson correlation, and checked for statistical rigor with a p-value and 95% confidence interval, a rank-based (Spearman) cross-check to rule out results driven by nonlinearity, and a leave-one-out test to confirm no single state was solely responsible for the pattern. When scanning all six metrics against each other at once, a stricter (Bonferroni-corrected) significance threshold was applied to account for testing multiple relationships simultaneously. Because the data is aggregated at the state level rather than the individual-family level, and because correlation does not establish causation, these findings should be read as consistent, statistically robust patterns across states - not as proof of what causes what, or as a claim about any individual family.
