What foods for toddlers?

A young child formula supplemented with a synbiotic mixture of scGOS/lcFOS and Bifidobacterium breve M-16V improves the gut microbiota and iron status in healthy toddlers

Early-life gut microbiota development depends on a highly synchronized microbial colonization process in which diet is a key regulator. Microbiota transition toward a more adult-like state in toddlerhood goes hand in hand with the transition from a milk-based diet to a family diet. Microbiota development during the first year of life has been extensively researched; however, studies during toddlerhood remain sparse. Young children's requirement for micronutrients, such as dietary iron, is higher than adults. However, their intake is usually sub-optimal based on regular dietary consumption. The Child Health and Residence Microbes (CHaRM) study, conducted as an adjunct to the GUMLi (Growing Up Milk "Lite") trial, was a double-blind randomized controlled trial to investigate the effects on body composition of toddler milk compared to unfortified standard cow's milk in healthy children between 1 and 2 years of age in Brisbane (Australia). In this trial, fortified milk with reduced protein content and added synbiotics [Bifidobacterium breve M-16V, short-chain galactooligosaccharides, and long-chain fructooligosaccharides (ratio 9:1)] and micronutrients were compared to standard unfortified cow's milk. In the present study, the effects of the intervention on the gut microbiota and its relationship with iron status in toddlers were investigated in a subset of 29 children (18 in the Active group and 11 in the Control group) who completed the CHaRM study. The toddler microbiota consisted mainly of members of the phyla Firmicutes, Bacteroidota, and Actinobacteriota. The abundance of the B. breve species was quantified and was found to be lower in the Control group than in the Active group. Analysis of blood iron markers showed an improved iron status in the Active group. We observed a positive correlation between Bifidobacterium abundance and blood iron status. PICRUSt, a predictive functionality algorithm based on 16S ribosomal gene sequencing, was used to correlate potential microbial functions with iron status measurements. This analysis showed that the abundance of predicted genes encoding for enterobactin, a class of siderophores specific to Enterobacteriaceae, is inversely correlated with the relative abundance of members of the genus Bifidobacterium. These findings suggest that healthy children who consume a young child formula fortified with synbiotics as part of a healthy diet have improved iron availability and absorption in the gut and an increased abundance of Bifidobacterium in their gut microbiome.

Effect of plant milk consumption on childhood growth: protocol for a systematic review

INTRODUCTION

There has been considerable debate about whether plant milks can support the nutritional requirements of growing children. The proposed systematic review aims to assess the evidence on the relationship between plant milk consumption and growth and nutritional status in childhood.

METHODS AND ANALYSIS

Ovid MEDLINE ALL (1946-present), Ovid EMBASE Classic (1947-present), CINAHL Complete (Cumulative Index to Nursing and Allied Health Literature), Scopus, the Cochrane Library and grey literature will be searched comprehensively (from 2000 to present; English language) to find studies that describe the association between plant milk consumption and growth or nutrition in children 1-18 years of age. Two reviewers will identify eligible articles, extract data and assess the risk of bias in individual studies. If a meta-analyses is not conducted, the evidence will be synthesised narratively and the overall certainty of evidence will be rated using the Grading of Recommendations Assessment, Development and Evaluation approach.

ETHICS AND DISSEMINATION

Ethical approval is not required for this study since no data will be collected. Results of the systematic review will be published in a peer-reviewed journal. Findings from this study may be useful in informing future evidence-based recommendations about plant milk consumption in children.

PROSPERO REGISTRATION NUMBER

CRD42022367269.

Prevalence of nutritional inadequacy in children aged 12-36 months: EPACI Portugal 2012

Adequate nutritional intake in the first years of life is crucial for future health. The purpose of this study is to assess the adequacy of nutritional intake in Portuguese toddlers. The EPACI Portugal 2012 is a cross-sectional study of a representative sample of toddlers (n = 2230), aged between 12 and 36 months. Data on diets were collected by trained interviewers. The current analysis included 853 children with full data from 3-day food diaries completed by parents/caregivers. Intakes of energy, macro- and micronutrients were estimated through Statistical Program to Assess Dietary Exposure (SPADE). Nutritional adequacy was evaluated using Dietary Reference Values established by the European Food Safety Authority. A large proportion of children exceeded the recommended energy intake. The median daily protein intake was 4.7 g/kg/day, five times more than that recommended. About 9% and 90% of the children consumed a lower proportion of energy than the lower limit of the Reference Intake range for carbohydrates and fat, respectively. Around a third consumed less fibre and magnesium and 100% less vitamin D than the recommended Adequate Intake (AI). Almost a third consumed less vitamin A than the recommended Average Requirement (AR) and 86% of the children showed excessive sodium consumption. Portuguese toddlers consumed a low proportion of energy from fat, had energy and protein intakes above the recommendations and excessive intakes of sodium, and inadequate intakes of vitamin A. Every child consumed less than the recommended AI for vitamin D.

Micronutrient Intake in Healthy Toddlers: A Multinational Perspective

Adequate nutrient intake during early childhood is of particular importance for optimal growth and future health. However, cross-national comparative research on nutrient intake of toddlers is still limited. We conducted a literature review to examine the nutrient intake in healthy toddlers from some of the world's most populous nations currently on different stages of socioeconomic development: Brazil, Germany, Russia and the United States. We aimed to identify national surveys reporting mean intakes of the following nutrients: vitamins A, D, E, folate, calcium, iron and zinc. To calculate the prevalence of inadequate nutrient intake, we used a modified version of the Estimated Average Requirement cut-point method. Overall, five studies with 6756 toddlers were eligible for inclusion in this review. In countries where data were available, a prevalence of inadequate intake higher than 20% was found for vitamins A, D, E and calcium. In Germany, folate intake also appeared to be inadequate. The results of our review indicate that inadequate micronutrient intake in toddlers might be a global challenge affecting also affluent countries. However, to explore the full scope of this important public health issue joint efforts of researchers worldwide are needed to combine existing data and fill in data gaps.

Parenting Efficacy and Health-promoting Behaviors for Children of Mothers from Native and Multicultural Families in Korea

PURPOSE

The aim of this study was to examine the levels of parenting efficacy and health-promoting behaviors for children of mothers, and to explore the relationships between parenting efficacy and the behaviors of mothers from native and multicultural families in South Korea.

METHODS

Data was collected by a self-report questionnaire completed by 258 mothers who had 6-month to 36-month-old children attending kindergartens or multicultural family support centers located in Seoul and in Gyeounggi Province, South Korea.

RESULTS

No significant difference in parenting efficacy was found, depending on the maternal country of origin. However, Chinese mothers performed health-promoting behaviors more frequently for their children than Korean and Vietnamese mothers did (F = 6.87, p < .001). The significant positive correlations between parenting efficacy and maternal health-promoting behaviors for children were found, regardless of maternal country of origin (r = .57, p < .001 for Korean, r = .42, p < .001 for Chinese, and r= .40, p < .001 for Vietnamese mothers).

CONCLUSIONS

Since maternal health-promoting behaviors were different depending on the native country of the mothers, maternal country of origin should be considered in designing programs for improving maternal health-promoting behaviors for their children. In addition, increasing the level of parenting efficacy can be an effective way for improvement of maternal health-promoting behaviors.

Challenges to improving the uptake of milk in a nursery class: a case study

Purpose

The purpose of this paper is to examine why the uptake of free milk in a particular nursery class was low, to explore the meanings children attribute to drinks given to them in school and those brought from home, and make suggestions as to what might be done to improve children's intake of free school milk.

Design/methodology/approach

This paper is based on a case study of a nursery class attached to a primary school in West London. A total of 24 morning sessions were observed, comprising of 72 snack times. In addition, interviews were carried out with parents and early years' practitioners i.e. teachers and nursery nurses. Children's views were elicited through use of narrative observations and an activity using their drinks' cartons.

Findings

This study found that these young children linked drinks brought in from home to having choices whereas drinking school milk was associated with having little or no choice. Unlike school milk, drinks from home were linked to stories of personal identity and family life. The children seemed to exert pressure on their parents to provide them with a drink from home and appeared to be attracted to drinks that included representations of characters from popular culture as well as particular brands.

Research limitations/implications

This research is based on one case study, therefore issues raised may not be generalisable to all nursery settings.

Practical implications

This paper encourages early years' practitioners to look in detail at how they organize snack times and the way that this might contribute to negative perceptions of healthy foods/drinks. It offers practical suggestions around how the uptake of milk could be improved in a nursery setting, emphasizing the need for the active involvement of the children. In addition, the study highlights the importance of informal as well as formal discussions with parents about food and drinks. The study recommends that improvements need to be made to early years' practitioners' initial and subsequent training in this area, given the significant role they play in health promotion.

Originality/value

The value of this paper lies in the way it elicits the active participation of young children in the research as well as the focus on the minutiae of nursery practice and its implications for promoting healthy eating/drinking.