Commercial complementary food use amongst European infants and children: results from the EU Childhood Obesity Project

Animal and plant protein intake during infancy and childhood DNA methylation: a meta-analysis in the NutriPROGRAM consortium

BACKGROUND

Higher early-life animal protein intake is associated with a higher childhood obesity risk compared to plant protein intake. Differential DNA methylation may represent an underlying mechanism.

METHODS

We analysed associations of infant animal and plant protein intakes with DNA methylation in early (2-6 years, N = 579) and late (7̄-12 years, N = 604) childhood in two studies. Study-specific robust linear regression models adjusted for relevant confounders were run, and then meta-analysed using a fixed-effects model. We also performed sex-stratified meta-analyses. Follow-up analyses included pathway analysis and eQTM look-up.

RESULTS

Infant animal protein intake was not associated with DNA methylation in early childhood, but was associated with late-childhood DNA methylation at cg21300373 (P = 4.27 × 10¯8, MARCHF1) and cg10633363 (P = 1.09 × 10¯7, HOXB9) after FDR correction. Infant plant protein intake was associated with early-childhood DNA methylation at cg25973293 (P = 2.26 × 10-7, C1orf159) and cg15407373 (P = 2.13 × 10-7, MBP) after FDR correction. There was no overlap between the findings from the animal and plant protein analyses. We did not find enriched functional pathways at either time point using CpGs associated with animal and plant protein. These CpGs were not previously associated with childhood gene expression. Sex-stratified meta-analyses showed sex-specific DNA methylation associations for both animal and plant protein intake.

CONCLUSION

Infant animal protein intake was associated with DNA methylation at two CpGs in late childhood. Infant plant protein intake was associated with DNA methylation in early childhood at two CpGs. A potential mediating role of DNA methylation at these CpGs between infant protein intake and health outcomes requires further investigation.

Beliefs, Evaluations, and use of commercial infant Food: A survey among German parents

Complementary feeding is a critical milestone for parents, who must decide the extent to which they feed their infants with homemade foods (HMFs) or commercial infant foods (CIFs). The current study focused on how parents perceive and evaluate CIFs and what drives them to use these products. Understanding the wide variety of factors that influence parents' decisions to use CIFs as a food source is crucial to helping them make more balanced food choices for their infants. Data from an online survey with 858 German parents revealed their negative perceptions of CIFs, particularly in terms of nutritional quality and texture, and concerns that CIFs contain higher levels of pesticides and heavy metals compared to HMFs, despite acknowledging the expertise of the infant nutrition industry. These perceptions were likely to be driven by the 'natural-is-better' belief and parents' desire for control over the ingredients in their infants' meals, contributing to their skepticism towards CIFs. Additionally, our study found that while many parents know traditional nutrition guidelines, they are less familiar with recent updates. Parents' benefit beliefs about CIFs and parents' trust in the food industry strongly influenced the use of CIFs, while infant age and parent gender had a less strong, yet significant influence on CIFs consumption. Overall, the present study offers new quantitative insights into the factors that motivate parents to use CIFs. Furthermore, it underscores the need for health authorities to improve their communication strategies towards parents concerning new dietary guidelines.

Consumption frequency of ultra-processed foods and beverages among 6- to 36-month-olds in Kampala, Uganda

The nutrition transition in sub-Saharan Africa has led to increased consumption of ultra-processed foods in infancy, especially sweet foods. This has heightened the risk for nutrition-related non-communicable diseases, including dental caries and overweight/obesity, and promotes poor food choices later in life. The present study used a cross-sectional design to investigate the consumption frequency of ultra-processed foods and beverages among urban 6- to 36-month-olds attending four selected health facilities in Kampala using a standardised questionnaire and 24-h diet recall record. The primary outcome was the consumption of at least one ultra-processed food or beverage (UPFB) the previous day, and frequency of UPFB consumption of the week before was the secondary outcome. Four hundred and ten caregiver-child pairs were randomly recruited, 94% of caregivers being mothers with a mean age of 30.7 (±5.3) years. Fifty-nine per cent of mothers and 73% of fathers had attained a college education. The median age of children was 18 months and 51% were female. Most children (57%) consumed at least one UPFB the previous day. In the week before, 69% had consumed UPFB frequently (4-7 days) which was significantly positively associated with maternal education (odds ratio [OR] = 2.85, 95% confidence interval [CI]: 1.02-7.96, p = 0.045) and child's age ([OR = 2.87, 95% CI: 1.62-5.08, p < 0.001], [OR = 3.68, 95% CI: 1.88-7.20, p < 0.001]). In conclusion, the dietary habits of the surveyed Ugandan population were unhealthy, characterised by the frequent consumption of UPFB with added sugar. There is an urgent need to re-enforce existing Ugandan food regulation guidelines and policies and to build strong nutritional education programmes to enhance health-promoting environments in early childhood.

A Descriptive Study of Spanish and Ecuadorian Commercial Infant Cereals: Are They in Line with Current Recommendations?

Cereals are an important source of nutrients, especially used in complementary feeding. The objective of this study is to review the nutritional composition of cereal-based foods for infants from 4 months and toddlers that are offered in Spain and Ecuador, countries selected because of the opportunity to work in them, and due to their socio-economic differences (industrialized and developing countries, respectively). The number of these products was 105 cereals in Spain and 22 in Ecuador. The products were classified as gluten-free cereals, five cereals, eight cereals, multigrain cereals, and cookies. A 25 g serving was used to determine the percentage in which the samples analyzed can cover the Reference Nutrient Intake (RNI) for micronutrients in infants from 7 months and toddlers according to the European Food Safety Authority (EFSA). Nutritional information per 100 g of dry product was collected according to medium, minimum, and maximum units, and nutrient density was calculated. The age range in which these products are recommended is different in both countries. The nutritional composition presents some differences; Spanish cereals show a lower content of sodium, added sugars, hydrolyzed cereals, and maltodextrin than Ecuadorian cereals. Commercialized cereals could contribute to satisfying the nutritional needs of infants and toddlers; however, they can also be a source of non-recommended components.

Benchmarking the nutrient composition and labelling practices of dry or instant cereals for older infants and young children across seven Southeast Asian countries

In Southeast Asia, the increasing availability of commercially produced complementary foods (CPCF), including dry or instant cereals (CPCF cereals), has been noted, however, concerns exist around their nutrient profile and labelling practices. This 2021 study assessed the nutrient composition, labelling practices, and micronutrient content of CPCF cereals sold in the capital cities of seven Southeast Asian countries: Phnom Penh (Cambodia), Jakarta (Indonesia), Manila (Philippines), Bangkok (Thailand), Vientiane (Lao PDR), Hanoi (Vietnam), and Kuala Lumpur (Malaysia). The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older infants and young children. Micronutrient content of fortified CPCF cereals was assessed against fortification levels specified in the Codex Alimentarius guideline for formulated complementary foods. Of the 484 products assessed, 184 (38.0%) met all nutrient composition requirements. Around one-third of CPCF cereals contained added sugars and/or sweeteners (37.2%) and high levels of sodium (28.9%). None of the CPCF cereals met all labelling requirements, primarily due to the presence of inappropriate claims on the labels. Most fortified CPCF cereals contained adequate amounts of critical micronutrients, such as calcium, iron, zinc, vitamin A, and vitamin D. However, rates of fortification varied across the seven countries, and almost a third (30.8%) of CPCF cereals were not fortified with any micronutrients. To support the appropriate promotion of CPCF in the region, Southeast Asian countries need to strengthen and enforce national binding legal measures, including national standards for the composition, labelling, and fortification of CPCF cereals.

The nutritional profile of commercial complementary foods in Japan: comparison between low- and high-price products

Despite the increasing market share of commercial complementary foods, their nutritional characteristics and those associated with the price of products are still unknown in Japan. We compared the nutritional characteristics of commercially available complementary foods of different price levels in Japan. Data were obtained from the websites of Japanese brands of infant and young children's food. Nutrient profiles (unit/100 g), ingredients and food additives were compared between low- and high-priced products by product type. Sixty-three dry meals, 425 soft meals, 187 snacks and sweets, and 60 drinks were analysed. One-fifth of meals and snacks exceeded the CODEX-defined limit (200 mg Na/100 g). Most products lacked content information on nutrients non-mandated to be indicated. High-priced soft meals contained more protein (2·5 v. 1·9 g/100 g) and less Na (0·18 v. 0·46 g/100 g), less frequently used ≥ 1 added sugar (23 % v. 82 %), and less frequently used food additives than low-priced products; however, they had a lower variety of ingredients. The prevalence of products containing ≥ 1 added sugar was higher in low-priced snacks and sweets (91 % v. 77 %) but lower in drinks (48 % v. 84 %) than in their high-priced counterparts. High Na content is a concern among commercial complementary foods in Japan. Nonetheless, the relationship between the price and nutritional profile of these foods differs by product type. High-priced soft meals might be more favourable regarding nutrient content but not the variety of ingredients than low-priced counterparts. These findings elucidate the nutritional characteristics of commercial complementary foods in Japan.

Discrimination rancidity degree of infant formula rice flour based on Headspace Solid-Phase Microextraction combined with Gas Chromatography-Mass Spectrometry as an alternative to sensory evaluation

To mitigating the serious threat of harmful volatile substances to the health of infants, an alternative method of odor evaluation were proposed based on Headspace solid-phase microextraction (HS-SPME) combined with Gas Chromatography-Mass Spectrometry (GC-MS) to discriminate the degree of rancidity of infant formula rice flour (IFRF). Inspectors can simply calculate the rancidity degree of infant formula rice flour according to the regression equation based on the concentration of rancidity markers. The results showed that the joint application of OPLS-DA, molecular sensory experiments, and unsaturated fatty acids (UFAs) degradation experiments could successfully recognize the rancidity markers without collinearity in multiple linear regression analysis. The rancidity markers curve fitting was helpful for the establishment of multivariate regression model of rancidity grading. The model had an accuracy of more than 92.90% by the verification of odor evaluation. The application of the model to investigate the market IFRF samples showed that about 3% of the samples collected in the experiment were unsuitable for infant feeding. Therefore, the established model was considered to be a robust and less workload method to replace the olfactory evaluation method for discriminating the rancidity degree of IFRF.

Commercial complementary food feeding and associated factors among mothers of children aged 6-23 months old in Mettu Town, Southwest Ethiopia, 2022

BACKGROUND

Commercial complementary foods (CCF) are unhealthy products for children under 24 months, containing unhealthy fats, refined starches, sugars, salt, and additives. The consumption of CCF is linked to non-communicable diseases, making it crucial to assess intake in Ethiopia, especially in Mettu town.

OBJECTIVE

To assess the prevalence of commercial complementary food feeding and associated factors among mothers of 6-23 months old children in Mettu Town, 2022.

METHOD

A community-based cross-sectional study was conducted in Mettu town, involving 386 randomly selected mothers of children aged 6-23 months. Data was collected using a pre-tested semi-structured questionnaire and analyzed using SPSS version 25. Variables with a P-value < 0.05 in the multivariable logistic regression were declared as having a statistically significant association with CCF feeding.

RESULTS

The prevalence of CCF feeding within 24 h before the reporting period was 44.3%. In multivariable regression analysis, the age of index child 0-11months (AOR = 2.43, 95%CI: 1.53-3.85), non-exclusive breastfeeding (AOR = 2.18, 95%CI: 1.34-3.52), exposure to CCF promotions (AOR = 2.15, 95%CI: 1.32-3.50), maternal employment (AOR = 2.10, 95%CI: 1.28-3.44), and higher tertile wealth status (AOR = 2.19, 95%CI: 1.17-4.10) were significantly associated with CCF feeding.

CONCLUSION

The current study revealed that nearly half of the mothers in Mettu town were feeding their children with commercially produced complementary foods. Age of child, non-exclusive breastfeeding, CCF promotions, maternal employment, and higher wealth status were found to have a significant association with CCF feeding. Therefore, continuous health education should be given to mothers to encourage exclusive breastfeeding until 6 months of age and to improve home-made complementary food feeding.

The relationship between early childhood development and feeding practices during the dietary transitional period in rural China: a cross-sectional study

Introduction

Early childhood feeding environments and practices not only affect children's nutritional status but also provide children with a variety of external stimulations to affect the development of the child's brain, especially for the first 1,000 days of children. The relationship between early childhood development (ECD) and feeding practices during the dietary transitional period has not previously been described.

Method

This study used quantitative survey data from the Integrated Early Childhood Development Project to investigate this association between ECD and feeding practices during the dietary transitional period in poor rural areas of China. Data concerning the child and family characteristics and feeding practices were collected through the questionnaire completed by caregivers. Developmental delays were explored through a five-pronged, structured, parent-completed Age and Stage Questionnaire. The chi-squared test and multivariate logistic regression analyses were used to explore the associated factors in ECD.

Results

The results showed that 33.6% of children had at least one area of developmental delay during the dietary transitional period. Of all five regions evaluated, the prevalence of fine motor developmental delays was highest (17.7%), followed by communication (14.9%), problem-solving (13.8%), personal-social skills (11.9%), and gross motor (11.8%), respectively. Significant predictors of increased odds of developmental delay included types of complementary foods (OR = 0.70, 95% CI = 0.53-0.94), adequate feeding frequency (OR = 0.69, 95% CI = 0.52-0.90), and breastfeeding time and bottle feeding (OR = 0.66, 95% CI = 0.50-0.88).

Discussion

According to the results, a high prevalence of developmental delay was observed in children during the dietary transitional period in the rural areas of China. The feeding practices of children were associated with their developmental status, including factors such as inadequate feeding frequency, types of complementary foods, breastfeeding duration, and low family income. These findings highlight the focus and potential direction for early identification and intervention.

Evaluation of Selected Antioxidant Parameters in Ready-to-Eat Food for Infants and Young Children

Infants and young children have diverse dietary needs, so conducting a detailed analysis of the food they consume in terms of antioxidant activity and the content of antioxidant elements is of utmost importance. The aim of the study was to assess the antioxidant properties and the content of Cu (copper), Se (selenium), and Zn (zinc) in baby products. A total of 398 samples of ready-to-eat food consumed by children were tested. To evaluate the antioxidant activity (338 samples, without dairy), the Folin-Ciocalteu method and the 2,2-diphenyl-1-picrylhydrazyl radical scavenging test (DPPH) were employed to determine the total phenolic content (TPC). For the determination of mineral component content (398 samples), atomic absorption spectrometry (AAS) was used to analyze the levels of Cu and Zn, while inductively coupled plasma mass spectrometry (ICP-MS) was utilized for the quantification of Se. Fruit and vegetable mousses exhibited the highest average total phenolic content (TPC) and the highest percentage of free radical scavenging in the DPPH test. In terms of mineral content, the group of dairy products recorded the highest average levels of Cu and Se, while porridges contained the highest content of Zn. Notably, only organic baby food contained significantly more Zn compared to conventional food (12.2 ± 13.9 mg/kg vs. 10.7 ± 14.4 mg/kg). Ready-to-eat products designed for consumption by children provide antioxidant properties, and the presence of Zn, Cu, and Se can contribute to supporting antioxidant processes.

Health relevance of lowering postprandial glycaemia in the paediatric population through diet': results from a multistakeholder workshop

To summarize current knowledge and gaps regarding the role of postprandial glycaemic response in the paediatric population, a workshop was organized in June 2021 by the European branch of the International Life Science Institute (ILSI). This virtual event comprised of talks given by experts followed by in-depth discussions in breakout sessions with workshop participants. The main pre-specified topics addressed by the workshop organizing committee to the invited speakers and the workshop participants were: (1) the role of glycaemic responses for paediatric health, based on mechanistic insights from animal and human data, and long-term evidence from observational and intervention studies in paediatric populations, and (2) changes in metabolism and changes in dietary needs from infancy to adolescence. Each talk as well as the discussions were summarised, including the main identified research gaps. The workshop led to the consensus on the crucial role on health of postprandial glycaemic response in paediatric population. However, a lack of scientific data has been identified regarding detailed glucose and insulin profiles in response to foods commonly consumed by paediatric populations, as well as a lack of long-term evidence including the need for suitable predictors during childhood and adolescence to anticipate health effects during adulthood.

Impact of complementary feeding on obesity risk

PURPOSE OF REVIEW

To discuss recent evidence on the influence of complementary feeding (CF) timing, content and feeding methods on childhood obesity risk.

RECENT FINDINGS

The evidence-base is limited by heterogeneity, risk of bias and the predominance of observational studies. The content of the diet and feeding practices are more influential than timing for obesity risk. There is limited evidence that CF introduction before 4 months may be associated with increased risk. Intake of animal protein, particularly dairy protein, may contribute to rapid weight gain; protein from infant/follow-on formula shows the most robust association with later obesity risk. Evidence linking sugar intake to obesity risk is limited, but intake should be as low as possible given there is no nutritional requirement. Responsive feeding (RF) practices may promote appropriate infant growth and reduce risk. The effect of baby-led weaning (BLW) is inconclusive.

SUMMARY

Recent evidence supports current recommendations to avoid high protein intakes, especially from infant/follow-on formula, for infants in high income countries; and to promote RF practices for all infants. Studies in low- and middle-income countries are required to define optimal CF practices given increasing rates of child obesity alongside double-burden malnutrition.

Moving Complementary Feeding Forward: Report on a Workshop of the Federation of International Societies for Pediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN) and the World Health Organization Regional Office for Europe

The WHO Regional Office for Europe and the Federation of International Societies for Pediatric Gastroenterology, Hepatology, and Nutrition held a joint workshop, "Moving Complementary Feeding Forward" at the sixth World Congress Pediatric Gastroenterology, Hepatology, and Nutrition in 2021. Here we summarize workshop presentations and discussions. The workshop covered health implications of complementary feeding (CF) including allergies, challenges to meet dietary needs during the CF period, quality of commercial complementary foods (CFD) and respective marketing practices, national CF guidelines in Europe, a nutrient profiling system for CFD, and global policy perspectives on the standards and regulation of marketing for CFD. Adequate CF practices are of critical importance for short and long-term child health, prevention of nutrient deficiencies, normal growth and development, and reducing the risk of allergies. The workshop identified the need to improve feeding practices, harmonize evidence-based information and develop guidance jointly with various stakeholders, improve the composition and marketing practices of commercial CFD and their transparent labeling based on nutrient profiling. Renewed efforts for collaboration between scientists, public health experts, pediatric associations, national governments, and the WHO are necessary for advancing progress.

Commercial Complementary Food in Germany: A 2020 Market Survey

As consumption of commercial complementary food (CCF) during infancy and toddlerhood is common, the aim of the present study was to describe the current (2020) German market of CCF products targeted at infants and toddlers with a special focus on ingredients, macronutrients, and the practice of nutrient fortification. Information on age declarations, ingredients, energy and nutrient contents, and nutrient fortification was obtained in a market survey by contacting the producers and searching manufacturers’ websites. Each product was assigned to 1 of 13 product categories (menus, milk−cereal−meal, fruit−cereal−meal, oil, vegetables, meat, fish, fruits, cereals, snack foods, pouches, desserts, beverages). Descriptive statistics were used. We identified 1057 CF products on the German market (infants’ CCF (<12 months): n = 829; toddlers’ CCF (>12 months): n = 228)). The highest protein content (% of energy content, %E) was found in meat products. In pouches, beverages, cereal fruit meals, and fruits, more than 50% of energy came from total sugar. The highest median salt content was found in toddlers’ menus and desserts. Around one-third of infants’ CCF products and one quarter of toddlers’ products were fortified with nutrients. Vitamin B1 (thiamin) was the most frequently fortified nutrient, followed by vitamin C, iron, calcium, and vitamin D. Apple was the type of fruit listed most often in products with fruits, whereas carrot was the most frequent vegetable among CCF with vegetables. In particular, the high total sugar content of most CCFs currently available on the German market may promote unhealthy dietary habits. Parents need to be advised about the optimal selection of products.

Extensive use of on-pack promotional claims on commercial baby foods in the UK

OBJECTIVE

To explore and categorise the nature of promotional claims on packaging of commercial baby foods (CBFs).

SETTING

UK METHODOLOGY: An online survey of CBFs (for infants up to 12+ months) in 7 UK supermarkets and Amazon in 2020. On-pack promotions were classified as marketing, composition, health, and nutrient claims using the WHO Nutrient Profile Model draft for infants and young children, and European Union regulation on health and nutrition claims.

MAIN OUTCOME MEASURE

Distribution and proportion of claim types, and association between product characteristics and claim types.

RESULTS

A total of 6265 promotional claims were identified on 724 products. Marketing (99%, n=720), composition (97%, n=705) and nutrient claims (85%, n=616) were found on the majority of CBFs, compared with health claims (6%, n=41). The median (Q1, Q3) number of total claims per product was 9 (7, 10), marketing 5 (3, 6), composition 2 (1, 2), nutrient 2 (1, 2), and 0 (0, 0) health. Marketing claims were mainly texture (84%, n=609, eg, super smooth) and taste related (70%, n=511, eg, first tastes). The main composition claim was organic (63%, n=457) while nutrient claims were mainly around 'no added' or 'less' sugar (58%, n=422) and salt (57%, n=417). Baby led weaning claims (BLW) (eg, encourages self-feeding) were found on 72% of snacks, with a significantly higher (p<0.01) number of BLW claims on snacks (99%, n=209) compared with other product types.

CONCLUSION

Promotional claims on CBF packaging are extensively used and, for the most part, unregulated. CBFs are promoted using 'healthy halo' connotations that might confuse parents. Regulations on their use should be implemented to avoid inappropriate marketing.

Food additives in childhood: a review on consumption and health consequences

OBJECTIVE

To discuss the context of scientific publications on the consumption of food additives by children and the possible health consequences in this age group.

METHODS

A literature review, with a search carried out between April 2020 and April 2021 in the Web of Science, Scopus, PubMed and Google Scholar databases, as well as in websites of Brazilian and foreign official bodies. Official documents and studies published since 2000 were selected. Keywords related to food additives, children, food consumption, and health were used for the search.

RESULTS

Food additives are substances intentionally added to foods for technological purposes. Processed foods are the main sources of additives in food and their consumption occurs since childhood. It is observed, however, that there are limitations inherent to the scientific method regarding the analysis of consumption and toxicity of food additives in humans, causing scarcity of data in the scientific literature. Additionally, existing data suggest that the additives have a higher toxic potential in children, considering that the body weight in this age group is lower than in adults. This context emphasizes the need to observe the precautionary principle, according to which risks of harm must be prevented.

CONCLUSIONS

This is a scenario in which the literature points to a risk to people's health and, in particular, to children, about whom the duty of protection must be even greater, with absolute priority. Thus, the relevance of an expanded technical-scientific debate regarding the establishment of specific and stricter parameters for children is considered, regarding the consumption and toxicity of additives, as well as the different sources of exposure to these substances.

Consumption of Added Sugar among Chinese Toddlers and Its Association with Picky Eating and Daily Screen Time

Objectives: This study aimed to examine the relationship between daily screen time, picky eating, and consumption frequency of sugared foods and sugar-sweetened beverages (SSBs). Methods: The research data came from the Young Investigation (YI) study conducted in 10 cities in China. This study used sociodemographic information, feeding behavior, picky eating reported by parents, and the consumption frequency of sugared foods and SSBs of 879 toddlers aged 1−3 years. The relationship between daily screen time and picky eating behavior was assessed using logistic regression. The zero-inflated negative binomial (ZINB) model was used to fit the consumption frequencies of sugared foods and SSBs. Results: In all, 13.1% (n = 115) of toddlers did not have sugared foods 1 month before the survey, while 73.3% (n = 644) of toddlers did not have SSBs 1 month before the survey. The consumption rate of sugared foods was relatively higher than SSBs (χ2 = 661.25, p < 0.001). After adjusting for social demographic information, no relationship was found between daily screen time and picky eating (OR = 1.437; 95% CI: 0.990,2.092). The ZINB model showed that, among children who ate sugared foods, children who were picky eaters ate them more often (IRR = 1.133; 95% CI: 1.095,1.172), but no association was found between picky eating and the chance of avoiding sugared foods (OR = 0.949; 95% CI: 0.613,1.471). Children who were picky eaters were less likely not to drink SSBs (OR = 0.664; 95% CI: 0.478,0.921). However, among children who consumed SSBs, picky eaters drank them less frequently (IRR = 0.599; 95% CI: 0.552,0.650). Children with a screen time of no less than 1 h/d ate sugared foods more frequently (IRR = 1.383; 95% CI: 1.164,1.644), and they were less likely to avoid sugared foods (OR = 0.223; 95% CI: 0.085,0.587). The longer the screen time per day was, the less likely children did not have SSBs (<1 h/d: OR = 0.272; 95% CI: 0.130, 0.569; ≥1 h/d: OR = 0.136; 95% CI: 0.057, 0.328). Conclusions: The consumption rate of sugared foods was higher than that of SSBs. Picky eating and daily screen time were related to the consumption frequency of added sugar among Chinese toddlers aged 1−3 years. Picky eaters consumed sugared foods more frequently and were more likely to drink SSBs. Children whose daily screen time reached 1 h/d were more likely to eat sugared foods and drink SSBs.

[Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study]

INTRODUCTION

complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households.

METHODOLOGY

a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age.

RESULTS

a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations.

CONCLUSION

the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.

Effects of Whole-Grain and Sugar Content in Infant Cereals on Gut Microbiota at Weaning: A Randomized Trial

The introduction of complementary foods during infancy marks an important step in the development of the infant gut microbiome. Infant cereals are popular weaning foods but consistent evidence on their effect on the intestinal microbiota, especially when differing in nutritional quality, is lacking. Fecal samples from 4–7-month-old Spanish infants who consumed infant cereals differing in whole grain and sugar content as first weaning foods were analyzed on changes in microbial composition by massively parallel sequencing of the 16S ribosomal RNA gene at baseline and after 7 weeks of intervention. Samples were obtained from a previous trial conducted in Spain demonstrating whole-grain cereal acceptability. In total, samples of 18 infants consuming 0% whole grain cereals with 24 g sugar (0-WG) and 25 infants consuming 50% whole grain cereals with 12 g sugar (50-WG) were analyzed. Microbial composition changed significantly over time (p = 0.001), per intervention group (p = 0.029) and per infant (p = 0.001). Abundance of genus Veillonella increased in both groups while Enterococcus decreased. Within the 0-WG group, phylum Actinobacteria decreased along with genus Bifidobacterium. In the 50-WG, we observed an increase in Lachnoclostridium and Bacteroides. In addition, 50-WG decreased Proteobacteria and Escherichia to levels lower than 0-WG. Although weaning itself appeared to be responsible for most changes, the increased presence of anaerobic fermenters together with inhibition of pathogenic Escherichia may indicate a supporting effect of infant cereals with 50% whole grains and a reduced sugar content over infant cereals manufactured with refined hydrolyzed flours on the infant microbiota. In fact, using a novel methodology for the identification of microbial signatures, we found two groups of microbial taxa predictive of infants consuming enriched whole-grain infant cereals with a high predictive value of about 93%.

Feeding frozen complementary foods promotes food acceptance in infants: The randomized intervention trial Baby Gourmet

Infancy may represent a sensitive window for establishing food preferences that could affect the individual's long-term potential to establish healthy eating patterns. Our study was based on the hypothesis that preserving the natural flavor of the ingredients of commercially prepared complementary foods would increase the acceptance of new foods, especially vegetables. Frozen vegetable-based meals for infants were developed to preserve the natural taste of the ingredients better than sterilization of meals in jars. In a 3-month randomized, controlled intervention study, 51 infants were fed either frozen menus (intervention group) or commercial sterilized meals in jars (control group) on at least 5 days per week. Then the acceptability of a known vegetable-based puree was tested in comparison to an unknown puree, measuring the quantities consumed and also the mother's assessment of the infants' liking. In conclusion, the results of this study clearly indicated that infants fed vegetable-based frozen meals for 3 months accepted a new vegetable better than infants fed sterilized commercial meals in jars.

Nutritional Adequacy of Commercial Complementary Cereals in Germany

Commercial cereals are among the first complementary foods fed to infants in Germany and elsewhere. The purpose of this national survey is to describe the nutritional adequacy of commercial complementary cereals. A comprehensive, cross-sectional survey of cereal manufacturer websites (n = 15) was conducted from March to April 2019. Food labels were analyzed for iron, zinc, iodine, sodium, and sugar contents in commercial complementary cereals, and ingredient lists were evaluated for whole grains and added sugars. Preparation instructions were evaluated for the type of liquid recommended for reconstitution. Among 164 commercial complementary cereals, few contain iron (n = 43, 26%), zinc (n = 23, 14%) or iodine (n = 43, 26%). Sodium contents fall within EU thresholds. Most cereals were single grain, containing only wheat (n = 54), with half of the products (n = 86, 52%) containing whole grains. The average carbohydrate content of dry cereals is 69 g/100 g ± 9 g of which 14 ± 15 g is sugar. Preparation instructions for breakfast porridges and cereals recommend formula or toddler milk, while few recommend human milk (n = 13, 18%). Few commercial complementary cereals contain appreciable amounts (at least 15% of daily reference values) of zinc, iron, or iodine. A quarter of cereal carbohydrates are sugar and one-third of the products contain added sugars. Future directives should stipulate minimum micronutrient levels, strictly regulate sugar contents, and include human milk among preparation instructions.