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Daniel IC, Siqueira MSM, Romaneli GU, Rocha Orsi JS, Werneck RI. Food-Based Dietary Guidelines for Infants in Latin America and the Caribbean: A Systematic Review. Nutrients 2024; 16:1233. [PMID: 38674923 PMCID: PMC11053862 DOI: 10.3390/nu16081233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Food-based dietary guidelines (FBDGs) are tools for promoting healthy eating habits. For the population of children under two years old in Latin America and the Caribbean (LAC), there is a lack of reviews analyzing the quality of these guidelines. The objective of this systematic review is to evaluate publicly available FBDGs for the population under two years old in LAC until mid-2023. Guidelines aimed at caregivers of children were included, sourced from government websites in LAC countries and the Food and Agriculture Organization (FAO) portal. Documents targeted at healthcare professionals were excluded. For qualitative analysis, the Agree II guidelines assessment tool and the FAO guide principles for developing healthy and sustainable diets were used. The results showed that more recently released and revised FBDGs with a greater number of pages obtained better scores in both assessments. Additionally, out of the 32 LAC countries, only 13 had these FBDGs available on websites for public access. As a limitation, this study faced challenges in standardizing the searches on government websites. The authors emphasize the need to develop FBDGs for the population under two years old that align with current health and sustainability needs and promote health education.
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Affiliation(s)
| | | | | | | | - Renata Iani Werneck
- Graduate Program in Dentistry, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80242 980, Brazil; (I.C.D.); (G.U.R.); (J.S.R.O.)
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Arimond M, Wiesmann D, Grummer‐Strawn LM, Ferguson EL. Food pattern modeling to inform global guidance on complementary feeding of infants. MATERNAL & CHILD NUTRITION 2024; 20:e13590. [PMID: 38124469 PMCID: PMC10981476 DOI: 10.1111/mcn.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/02/2023] [Accepted: 10/26/2023] [Indexed: 12/23/2023]
Abstract
Nutrient needs are difficult to meet during infancy due to high nutrient requirements and the small quantities of food consumed. Guidelines to support food choice decisions are critical to promoting optimal infant health, growth and development and food pattern modeling can be used to inform guideline development. We employed the Optifood modeling system to determine if unfortified complementary foods could meet 13 nutrient targets for breastfed infants (6-11 months), and to describe food patterns that met, or came as close as possible to meeting targets. We also examined the impacts of eliminating food groups, increasing starchy staple foods or adding sentinel unhealthy foods. We collated a global food list from dietary studies in 37 countries and used this list to develop nutrient values for a set of 35 food subgroups. We analyzed infant dietary intakes from studies in eight countries to inform maximum quantities and frequencies of consumption for these subgroups in weekly food patterns. We found that unfortified foods could meet targets for most infants for 12 nutrients, but not for iron. For the smallest and youngest infants, with the lowest energy intakes, there were additional deficits for minerals. Best-case food patterns that met targets or came as close as possible to meeting targets included ample amounts of diverse vegetables, diverse plant- and animal-source protein foods, small amounts of whole grain foods and dairy and no refined grains or added fats or sugar. There were nutrient deficits if animal-source foods or vegetables were eliminated or if unhealthy foods were included.
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Affiliation(s)
| | | | | | - Elaine L. Ferguson
- Department of Population Health, Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
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Moore AM, Fisher JO, Burgess B, Morris KS, Croce CM, Kong KL. Caregiver feeding decisions and sociodemographic characteristics are associated with snack food intake during infancy and toddlerhood. Appetite 2023; 186:106551. [PMID: 37024055 PMCID: PMC10213156 DOI: 10.1016/j.appet.2023.106551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
Snacking starts early in childhood, yet little is known about child versus family influences on snacking during infancy and toddlerhood. This secondary analysis of baseline data examined associations of child characteristics (e.g., appetitive traits, temperament), caregiver feeding decisions, and sociodemographic characteristics with the mean frequency of (times/day) and mean energy from (kcal/day) child snack food intake. Caregivers and their children (ages 9-15 months) were recruited in Buffalo, NY from 2017 to 2019. Caregivers reported on sociodemographics, child appetitive traits (Baby Eating Behaviour Questionnaire), and child temperament (Infant Behavior Questionnaire-Revised). Three 24-h dietary recalls were collected, and USDA food categories were used to categorize snack foods (e.g., cookies, chips, and puffs). Hierarchical multiple linear regression models examined associations of child characteristics (Step 1: age, sex, baseline weight-for-length z-score, appetitive traits, and temperament), caregiver feeding decisions (Step 2: breastfeeding duration and age of solid food introduction), and caregiver sociodemographic characteristics (Step 3: caregiver age, prepregnancy BMI, education, and household size) with mean child snack food intake. Caregivers (n = 141) were on average 32.6 years of age, predominantly white (89.1%), and college-educated (84.2%). Age of solid food introduction (B = -0.21, p = 0.03), prepregnancy BMI (B = 0.03, p = 0.04), and household size (B = 0.23, p = 0.02) were significantly associated with the mean frequency of (times/day) snack food intake, over and above other variables of interest. Child age (B = 15.96, p = 0.002) was significantly associated with mean energy from (kcal/day) snack food intake. Household size (B = 28.51, p = 0.006) was significantly associated with mean energy from (kcal/day) snack food intake, over and above other variables of interest. There were no significant associations of other child characteristics with snack food intake. Findings show that child snack food intake is more closely associated with caregiver feeding decisions and sociodemographic characteristics than child characteristics. TRIAL REGISTRATION: National Institute on Child Health and Human Development, Grant/Award Number R01HD087082-01.
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Affiliation(s)
- Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer Orlet Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Brenda Burgess
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14203, USA
| | - Katherine S Morris
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14203, USA.
| | - Christina M Croce
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, 64108, USA; Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center Kansas City, KS, USA; Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA.
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JaBaay NR, Nel NH, Comstock SS. Dietary Intake by Toddlers and Preschool Children: Preliminary Results from a Michigan Cohort. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020190. [PMID: 36832319 PMCID: PMC9955406 DOI: 10.3390/children10020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/22/2023]
Abstract
Identifying the consumption patterns of toddlers and preschool children is critical to evaluating their potential for healthy development and future heath trajectories. The purpose of this longitudinal cohort study was to describe breastfeeding, nutritional trends, and dietary diversity in 12-to-36-month-old children in a Michigan cohort. Mothers completed surveys when their children were 12 (n = 44), 24 (n = 46) and 36 months old (n = 32). Mothers reported their child's dietary intake in the past 24 h and intake of specific foods in the past year. About 95% of 12-to-24-month-old children in the study population were ever breastfed, with 70% consuming human milk at 6 months and just over 40% at 12 months. Over 90% of participants gave their child a bottle since birth, with 75% providing human milk and 69% giving formula. Consumption of juice significantly increased with age and ~55% of the 36-month-old children consumed juice. A larger proportion of children consumed soda, chocolate, and candy as they aged. Though dietary diversity numerically increased with child age, this did not reach significance. Gut microbiota composition and structure was not associated with diet diversity. This research lays the foundation for future work to determine which nutritional interventions may be most effective in this population.
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Abanto J, Maruyama JM, Pinheiro E, Matijasevich A, Antunes JLF, Bönecker M, Cardoso MA, Lourenço BH, Malta MB, Ferreira MU, Neves PAR, Damasceno AA, da Silva BP, de Souza RM, Andrade SL, de Castro MC. Prolonged breastfeeding, sugar consumption and dental caries at 2 years of age: A birth cohort study. Community Dent Oral Epidemiol 2022; 51:575-582. [PMID: 36380436 DOI: 10.1111/cdoe.12813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/28/2022] [Accepted: 11/05/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Previous cohort studies have found a positive association between prolonged breastfeeding (≥12 months) on dental caries, but few of them analysed the mediated effect of sugar consumption on this association. This study investigated whether prolonged breastfeeding is a risk factor for caries at 2-year follow-up assessment (21-27 months of age) and whether this effect is mediated by sugar consumption. METHODS A birth cohort study was performed in the Brazilian Amazon (n = 800). Dental caries was assessed using the dmf-t index. Prolonged breastfeeding was the main exposure. Data on baseline covariables and sugar consumption at follow-up visits were analysed. We estimated the OR for total causal effect (TCE) and natural indirect effect (NIE) of prolonged breastfeeding on dental caries using the G-formula. RESULTS The prevalence of caries was 22.8% (95% CI: 19.8%-25.8%). Children who were breastfed for 12-23 months (TCE = 1.13, 95% CI: 1.05-1.20) and for ≥24 months (TCE = 1.27, 95% CI: 1.14-1.40) presented a higher risk of caries at age of 2 years than those breastfed <12 months. However, this risk was slightly mediated by a decreased frequency of sugar consumption at age of 2 years only for breastfeeding from 12 to 23 months (NIE; OR = 0.95, 95% CI: 0.91-0.97). CONCLUSIONS In this study, the effect of prolonged breastfeeding on the increased risk of dental caries was slightly mediated by sugar consumption. Early feeding practices for caries prevention and promoting breastfeeding while avoiding sugar consumption should be targeted in the first 2 years of life.
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Affiliation(s)
- Jenny Abanto
- Department of Pediatric Dentistry, Faculty of Dentistry International University of Catalunya Barcelona Spain
- Department of Epidemiology School of Public Health, University of São Paulo São Paulo Brazil
| | - Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
| | - Emanuella Pinheiro
- Department of Pediatric Dentistry School of Dentistry, University of São Paulo São Paulo Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina Universidade de São Paulo São Paulo Brazil
| | - José L. F. Antunes
- Department of Epidemiology School of Public Health, University of São Paulo São Paulo Brazil
| | - Marcelo Bönecker
- Department of Pediatric Dentistry School of Dentistry, University of São Paulo São Paulo Brazil
| | - Marly A. Cardoso
- Department of Nutrition School of Public Health, University of São Paulo São Paulo Brazil
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Lenighan YM, Tassy M, Nogueira-de-Almeida CA, Offord EA, Mak TN. Milk beverages can reduce nutrient inadequacy among Brazilian pre-school children: a dietary modelling study. BMC Nutr 2022; 8:121. [PMID: 36316737 PMCID: PMC9623914 DOI: 10.1186/s40795-022-00620-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/13/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Previous studies found high prevalence of inadequate intakes of vitamins E, D and K, calcium and potassium among Brazilian pre-school children, with suboptimal consumption of dairy products. Dietary modelling was applied to determine the theoretical impact of improving dairy products consumption on nutrient adequacy in 4-5-year-old Brazilian children. METHODS Adherence to the dairy recommendation of two servings/day was calculated using data from the Brazil Kids Nutrition and Health Study (KNHS) (n = 228). Two modelling scenarios were applied to test the impact on nutrient intakes of (1) adding one or two servings of a frequently consumed cow's milk or a widely available fortified alternative: pre-school children milk (PCM), and of (2) substituting the current milk consumed by PCM. Mean nutrient intakes and percentage of children adhering to the nutrient recommendations were determined at baseline and after applying modelling scenarios. RESULTS Seventy-six percent (n = 174) of children did not meet the recommended daily two servings of dairy products, 56% had less than one serving of dairy products on the day of recall. The mean consumption of whole milk (fortified and unfortified) was 147 g/d, yoghurt 114 g/d and cheese 34 g/d. The addition of one serving of cow's milk demonstrated a 17% reduction in calcium inadequacy, 18% reduction in vitamin A and 3% reduction in zinc inadequacy. Adding one serving of PCM further reduced calcium inadequacy from 87 to 41%, vitamin E from 81 to 37%, and zinc inadequacy by 10%. Replacing the child's current milk with a PCM resulted in further reduction of micronutrient inadequacies, including calcium, vitamin D and vitamin E. CONCLUSIONS Dairy products consumption in pre-school children should be encouraged to reduce nutrient inadequacies. In particular, consumption of PCM would help to reduce calcium, vitamin D and vitamin E inadequacy, nutrients of concern in this population.
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Affiliation(s)
- Yvonne M. Lenighan
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Marie Tassy
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
| | | | - Elizabeth A. Offord
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Tsz Ning Mak
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
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Macchi AK, Banna J, Moreira S, Campos M, Palacios C. Effect of a Short Messaging Service (SMS) intervention delivered to caregivers on energy, nutrients, and food groups intake in infant participants of the WIC program. Front Public Health 2022; 10:986330. [PMID: 36249246 PMCID: PMC9559930 DOI: 10.3389/fpubh.2022.986330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/12/2022] [Indexed: 01/26/2023] Open
Abstract
Objectives To test the effect of a weekly test message (SMS) intervention for improving feeding practices on infant intake of energy, nutrients, and specific food groups. Methods This study was a multi-site, randomized clinical trial, in 202 caregivers of healthy term infants participating in either the Puerto Rico or Hawaii WIC program. Participants were randomized to receive weekly SMS about either infant's general health issues (control) or SMS for improving feeding practices (intervention) to complement WIC messages for 4 months. Anthropometrics and demographics were assessed at baseline. A validated infant food frequency questionnaire was assessed at the four-month visit to assess intake of general food groups. Data was summarized as median (25th and 75th percentiles) or percentage and differences between study arms was compared using Mann Whitney or chi-square. Results A total of 163 participants completed the study (n = 84 control and n = 79 intervention). Baseline characteristics were similar between both groups. At 4-6 months of age, compared to the control group, the intervention group had a significantly higher intake of total grains (0.28 oz; 0.00, 0.60; P = 0.033), protein (13.5 g, 10.5, 18.3; P = 0.022), calcium (472 mg; 418, 667; P = 0.012), and zinc (4.39 mg; 2.61, 6.51; P = 0.028). No differences were seen in the other food groups, including breastmilk. Conclusions for practice Feeding SMS to complement WIC messages led to higher intakes of some key nutrients but did not have an overall improvement in the intake of food groups. Messaging also did not delay the introduction of complimentary foods or improve breastfeeding rates. Future studies should evaluate the use of more intensive SMS interventions for continued care between WIC visits.
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Affiliation(s)
- Alison K. Macchi
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Stephanie Moreira
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Maribel Campos
- Center for Community Outreach for Health Across the Lifespan (COHeAL), University of Puerto Rico, San Juan, PR, United States
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States,*Correspondence: Cristina Palacios
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Commercial Complementary Food in Germany: A 2020 Market Survey. Nutrients 2022; 14:nu14183762. [PMID: 36145138 PMCID: PMC9502210 DOI: 10.3390/nu14183762] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Abou-Dakn M, Alexy U, Beyer K, Cremer M, Ensenauer R, Flothkötter M, Geene R, Hellmers C, Joisten C, Koletzko B, Mata J, Schiffner U, Somm I, Speck M, Weißenborn A, Wöckel A. Ernährung und Bewegung im Kleinkindalter. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01519-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Murphy MM, Barraj LM, Higgins KA. Healthy U.S.-style dietary patterns can be modified to provide increased energy from protein. Nutr J 2022; 21:39. [PMID: 35717373 PMCID: PMC9206338 DOI: 10.1186/s12937-022-00794-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background Dietary patterns developed by the USDA provide modest levels of protein (14–18% energy) within the Acceptable Macronutrient Distribution Range (AMDR) of 10–35% for adults, though diets providing a higher percentage of energy may be beneficial for some individuals. The purpose of this study was to determine if it is feasible to modify the Healthy U.S.-Style Eating Pattern (“HEP”) to provide a higher percentage of energy from protein. Methods Using the framework implemented by the USDA in developing the HEP, energy from protein was set at 20%, 25%, and 30%. Amounts of protein foods were proportionally increased while amounts of other foods were adjusted iteratively within specified parameters. The models also disaggregated total meat/poultry into fresh and processed forms to develop patterns maintaining current proportions, current levels, reduced, or no processed meat/poultry. Nutrient intakes were compared with nutrient goals for representative U.S. populations with 2,000 kcal needs (females 19–30 years, males 51–70 years), with 90% of the Recommended Dietary Allowance or Adequate Intake regarded as sufficient. Results Dietary patterns with 20% energy from protein were constructed with minor deviations from the current 2,000 kcal HEP. Dietary patterns with 25% energy from protein were constructed for all levels of processed meat/poultry excluding the current proportion model, though relative to the current HEP the constructed patterns reflect substantial reductions in amounts of refined grains and starchy vegetables, and substantial increases in protein foods consumed as beans and peas, seafood, and soy products. It was not possible to develop a pattern with 30% energy from protein without reducing the percentage of energy from carbohydrate below the AMDR or non-compliance with other modeling constraints. Stepwise reductions in processed meat/poultry reduced sodium intake. Conclusions It is feasible to develop dietary patterns in a 2,000 kcal diet while mirroring the HEP that meet recommended intakes of nutrients with 20% or 25% energy from protein, though the pattern with 25% energy from protein may be more idealistic than realistic. Reduced levels of processed meat/poultry may translate to lower sodium intake.
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Affiliation(s)
- Mary M Murphy
- Exponent, Inc., 1150 Connecticut Ave, NW, Washington, DC, 20036, USA.
| | - Leila M Barraj
- Exponent, Inc., 1150 Connecticut Ave, NW, Washington, DC, 20036, USA
| | - Kelly A Higgins
- Exponent, Inc., 1150 Connecticut Ave, NW, Washington, DC, 20036, USA.,USDA-ARS, BHNRC, Food Components and Health Lab, 10300 Baltimore Avenue, RM. 231, BG. 307B, BARC-EAST, Beltsville, MD, 20705, USA
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Chittchang U, Rojroongwasiukul N, Winnichagoon P, Watson L, Ferguson E. Mathematical modeling to inform the development of national guidelines on infant feeding in Thailand. Ann N Y Acad Sci 2022; 1511:142-153. [PMID: 35061914 PMCID: PMC9303245 DOI: 10.1111/nyas.14738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022]
Abstract
The development of national dietary guidelines promoting healthy food choices is a public health priority in Thailand. In developing the recent national complementary feeding guidelines (CFGs) for 6‐ to 12‐month‐old children, mathematical modeling was used to inform decisions. Model parameters were derived from nationally representative dietary data and analyzed for 11 micronutrients by age group, using linear programming analysis in Optifood. Models were run to identify micronutrients whose nutrient reference values could not be met using local foods as consumed (problem nutrients), evaluate the original 2012 Thai CFGs, and predict the nutritional benefits of a specific fortified complementary food. The results identified three problem nutrients (iron, calcium, and zinc), which, for 9‐ to 11‐month‐olds, were reduced to one when the fortified food was modeled. The number of servings/week of vegetables and meat, fish or eggs were higher, and of oil and fruit were lower, in the modeled nutritionally best rather than observed diets (medians). When modeled, the original Thai CFGs were not feasible because the energy constraint was exceeded; hence, in revising them, the recommended number of servings/week of oil and fruit were reduced. This study demonstrates the advantages of using mathematical modeling, when revising national CFGs, to evaluate and improve them.
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Affiliation(s)
| | | | | | - Louise Watson
- Department of Population Health London School of Hygiene & Tropical Medicine London UK
| | - Elaine Ferguson
- Department of Population Health London School of Hygiene & Tropical Medicine London UK
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Mennella JA, Smethers AD, Decker JE, Delahanty MT, Stallings VA, Trabulsi JC. Effects of Early Weight Gain Velocity, Diet Quality, and Snack Food Access on Toddler Weight Status at 1.5 Years: Follow-Up of a Randomized Controlled Infant Formula Trial. Nutrients 2021; 13:nu13113946. [PMID: 34836199 PMCID: PMC8625308 DOI: 10.3390/nu13113946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/22/2022] Open
Abstract
This study followed children who participated in a feeding trial in which the type of randomized infant formula fed from 2 weeks significantly affected weight gain velocity during the first 4 months and weight-for-length Z (WLZ) scores up to 11.5 months. We focused on measures of anthropometry, dietary intakes, and parenting related to the provision of snack foods that were collected at the end of the trial (1 year) and the 1.5 years follow-up visit. We not only describe what toddlers are eating, but we also determined the independent and/or interactive effects of randomized formula group, early weight gain velocity, the nutrient content of the post-formula diet, and maternal snack food practices, on toddlers’ weight status. Diet quality underwent drastic changes during this 6-month period. As infant formula disappeared from the diet, fruit and 100% fruit juice intake increased slightly, while intake of “What We Eat in America” food categories sweetened beverages and snacks and sweets more than doubled. Added sugars accounted for 5% of energy needs at 1 year and 9% at 1.5 years. Generalized linear mixed models revealed that, independent of the randomized formula group, greater velocities of weight gain during early infancy and lower access to snacks as toddlers predicted higher WLZ and a greater proportion of toddlers with overweight at 1.5 years. Energy and added sugar intake had no significant effects. These findings add to the growing body of evidence that unhealthy dietary habits are formed even before formula weaning and that, along with improving early diet, transient rapid weight gain and parental feeding practices are modifiable determinants that may reduce risks for obesity.
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Affiliation(s)
- Julie A. Mennella
- Monell Chemical Senses Center, Philadelphia, PA 19104, USA;
- Correspondence:
| | | | - Jessica E. Decker
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19173, USA; (J.E.D.); (M.T.D.); (J.C.T.)
| | - Michelle T. Delahanty
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19173, USA; (J.E.D.); (M.T.D.); (J.C.T.)
| | | | - Jillian C. Trabulsi
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19173, USA; (J.E.D.); (M.T.D.); (J.C.T.)
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Dietary Guidelines for Americans, 2020-2025: Understanding the Scientific Process, Guidelines, and Key Recommendations. NUTRITION TODAY 2021; 56:287-295. [PMID: 34987271 PMCID: PMC8713704 DOI: 10.1097/nt.0000000000000512] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Dietary Guidelines for Americans, 2020–2025 was
issued jointly by the US Departments of Agriculture and of Health and Human
Services in December 2020. It is the ninth edition of the Dietary
Guidelines and is the first to provide recommendations by life
stage, from birth to older adulthood. The Dietary Guidelines is
grounded in the current body of scientific evidence on diet and health outcomes
and aims to promote health and prevent chronic diseases. The process to develop
the Dietary Guidelines involved 4 steps: (1) identifying the
topics and supporting scientific questions, (2) appointing a Dietary Guidelines
Advisory Committee (Committee) to review current scientific evidence, (3)
developing the new edition of the Dietary Guidelines, and (4)
implementing the Dietary Guidelines. The 2020-2025 edition
provides 4 overarching guidelines and supporting key recommendations that
encourage healthy dietary patterns across the life span. The foods and beverages
that people consume have a profound impact on health, and it is never too late
or too early to eat healthfully.
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