Hot dogs, those ubiquitous and savory symbols of the American diet, have caught the attention of pediatricians at Johns Hopkins Children’s Center and elsewhere for a decidedly unappetizing reason — they are a choking hazard for young children.

Research, they say, shows that hot dogs are the top cause of food-related choking in children under the age of 3, with 17 percent of cases caused by hot dog inhalation, followed by hard candy (10 percent), grapes (9 percent) and nuts (8 percent).

But what makes hot dogs so dangerous?

“Every food poses a choking risk in young kids but the hot dog has just the right size and consistency to perfectly block the airway, it’s the perfect plug that doesn’t allow any air to get through,” said Johns Hopkins Children’s pediatrician Nisha Kapadia, M.D., during a recent presentation at the hospital.

Therefore, pediatricians should remind all parents to mince or thinly slice hot dogs before giving them to young children, Kapadia said. Other high-risk foods, like hard candy, grapes and nuts, should be withheld completely from children younger than 4, she says.

Because food choking causes nearly one childhood death in the United States every five days, pediatricians urge heightened awareness about high-risk foods among doctors and parents alike.

Infants and young children under 3 years of age are particularly prone to food-choking because they don’t have a full set of teeth to chew and grind the food before swallowing. Children between 3 and 4 years of age have molars but are still learning how to chew. Children’s high level of activity also puts them at risk for inhaling food while playing or running around, Kapadia says.

In February 2010, the American Academy of Pediatrics called for warning labels on foods that pose a choking hazard and for the creation of a national surveillance reporting system to monitor food-related choking incidents.

A 2001 analysis by the Centers for Disease Control (CDC) showed that 60 percent of the 17,537 non-fatal choking incidents seen in U.S. emergency rooms in children under 14 were caused by food, and 77 percent of these choking episodes occurred in children under the age of 3.