Nutritional data from the second National Health and Nutrition Examination Survey (NHANES II) were analyzed to assess dietary patterns of a representative sample of U.S. children and youth ages 1-17 years. The data show that the average U.S. child's diet is relatively high in total and saturated fat and low in the ratio of polyunsaturated to saturated fat. These dietary patterns deviate from current dietary recommendations for the prevention of cardiovascular diseases. The percentage contributions of specific macronutrients to total energy intake (in kilocalories) were total fat, 35-36%; total carbohydrates, 49-51%; and protein, 15-16%. This is in contrast to current expert recommendations for children of 30% of kilocalories as total fat, 55% as carbohydrates, and 15% as protein. The observed intake of saturated fat in U.S. children was 13% of kilocalories vs a recommended level of 10% of kilocalories. The observed ratio of polyunsaturated to saturated fat intake was 0.4 vs a recommended ratio of 1.0. There were important racial differences in fat intakes, with blacks generally having higher cholesterol and total fat intakes. White children generally consumed more of their calories as carbohydrates than did black children, but there were no differences in protein intakes between the two groups. In summary, these data suggest that the average U.S. child's diet deviates from recommended dietary guidelines for fat and cholesterol intakes. Black children's dietary patterns appear less favorable for cardiovascular health than those of white children. However, the data also show that achieving recommended dietary intake patterns probably will not require drastic changes in the U.S. child's diet.