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Cavalcanti MB, Silva IDCGD, Lamarca F, de Castro IRR. Research on commercial milk formulas for young children: A scoping review. MATERNAL & CHILD NUTRITION 2024:e13675. [PMID: 38956436 DOI: 10.1111/mcn.13675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 07/04/2024]
Abstract
A scoping review of publications about commercial milk formulas intended for or consumed by children 12-36 months (CMF 12-36) was conducted. This review aimed to comprehensively map the existing literature, identify key concepts in the field and understand its evolution through time. A total of 3329 articles were screened and 220 were included, published between 1986 and 2024. Most works were published after 2016 (70.0%) and in high-income countries (71.8%). Original studies were the vast majority (81.8%) of publications. Most publications dealt with feeding practices or analysed the composition and/or contamination of specific products (44.1% and 35.9%), but since the late 2000s, publications about marketing, policy, legislation, and consumer perception started to appear. Most published works (65.5%) did not focus exclusively on CMF 12-36 and included formulas for other demographics or other foods. About half of the works (55.5%) did not consider CMF 12-36 to be a breast milk substitute. We found 81 distinct product denominations used to refer to CMF 12-36, Growing Up Milk was the most common (25.9%). CMF industry was involved in 41.8% of all analysed works, and industry participation and funding were not always clearly informed (22.5% lacked a conflict of interest statement, and 25.5% did not present any information about funding). In the last decade, publications about CMF 12-36 have increased in volume and diversified in scope and subject matter. CMF-industry participation has always been and still is present in the field, so possible vested interests should be taken into account when appreciating the literature.
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Affiliation(s)
| | | | - Fernando Lamarca
- Department of Applied Nutrition, Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro, 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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Al-Biltagi M, Faysal W, Alabdulrazzaq F, Alsabea H, Bassil Z, Chamseddine F, Chokr I, El-Beleidy A, Ezzat M, Farrah A, Mizyed M, Sayed AOS, Talib HA, Wali Y. Middle East consensus recommendations on the use of young child formula (YCF) in toddlers. J Nutr Sci 2022; 11:e53. [PMID: 35836695 PMCID: PMC9274381 DOI: 10.1017/jns.2022.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 02/07/2023] Open
Abstract
The transition of foods during toddlerhood and the suboptimal diets consumed in the Middle East make children susceptible to malnutrition and micronutrient deficiencies. Based on international recommendations, coupled with the merits of clinical studies on the application of young child formula (YCF), a group of fourteen experts from the Middle East reached a consensus on improving the nutritional status of toddlers. The recommendations put forth by the expert panel comprised twelve statements related to the relevance of YCF in young children; the impact of YCF on their nutritional parameters and functional outcomes; characteristics of the currently available YCF and its ideal composition; strategies to supply adequate nutrition in young children and educational needs of parents and healthcare professionals (HCPs). This consensus aims to serve as a guide to HCPs and parents, focusing on improving the nutritional balance in toddlers in the Middle Eastern region. The panellists considere YCF to be one of the potential solutions to improve the nutritional status of young children in the region. Other strategies to improve the nutritional status of young children include fortified cow's milk and cereals, vitamin and mineral supplements, early introduction of meat and fish, and the inclusion of diverse foods in children's diets.
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Affiliation(s)
- Mohammed Al-Biltagi
- Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
- University Medical Center, Arabian Gulf University, King Abdulla Medical City, Manama, Bahrain
| | - Wafaa Faysal
- Department of Pediatrics, Dr. Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
| | | | - Hassan Alsabea
- Pediatric Department, Medical Park Consultants, Abu Dhabi, United Arab Emirates
| | - Ziad Bassil
- Pediatric Department, Saint Joseph Hospital, Beirut, Lebanon
| | - Fadi Chamseddine
- Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Imad Chokr
- Pediatric Department, Al-Zahraa Hospital, Beirut, Lebanon
| | - Ahmed El-Beleidy
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Ezzat
- Pediatric Department, Dr. Hala Essa Bin Laden Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Antoine Farrah
- Department of Pediatrics, Saint George Hospital Ajaltoun, Beirut, Lebanon
| | - Mohammad Mizyed
- Department of Pediatrics, Dr. Sulaiman Al Habib Medical Group, Riyadh, Kingdom of Saudi Arabia
| | - Ashraf Othman Saleh Sayed
- Department of Pediatrics, Dar Al-Shifa Hospital, Hawally, Kuwait
- Faculty of Medicine, Minia University, Minya, Egypt
| | - Hussam Abu Talib
- Pediatric Department, Primary Health Care Corporation, Doha, Qatar
| | - Yasser Wali
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Walsh JB, McCartney DM, Laird É, McCarroll K, Byrne DG, Healy M, O’Shea PM, Kenny RA, Faul JL. Title: Understanding a Low Vitamin D State in the Context of COVID-19. Front Pharmacol 2022; 13:835480. [PMID: 35308241 PMCID: PMC8931482 DOI: 10.3389/fphar.2022.835480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 12/19/2022] Open
Abstract
While a low vitamin D state has been associated with an increased risk of infection by SARS-CoV-2 in addition to an increased severity of COVID-19 disease, a causal role is not yet established. Here, we review the evidence relating to i) vitamin D and its role in SARS-CoV-2 infection and COVID-19 disease ii) the vitamin D status in the Irish adult population iii) the use of supplemental vitamin D to treat a deficient status and iv) the application of the Bradford-Hill causation criteria. We conclude that reverse causality probably makes a minimal contribution to the presence of low vitamin D states in the setting of COVID-19. Applying the Bradford-Hill criteria, however, the collective literature supports a causal association between low vitamin D status, SARS-CoV-2 infection, and severe COVID-19 (respiratory failure, requirement for ventilation and mortality). A biologically plausible rationale exists for these findings, given vitamin D's role in immune regulation. The thresholds which define low, deficient, and replete vitamin D states vary according to the disease studied, underscoring the complexities for determining the goals for supplementation. All are currently unknown in the setting of COVID-19. The design of vitamin D randomised controlled trials is notoriously problematic and these trials commonly fail for a number of behavioural and methodological reasons. In Ireland, as in most other countries, low vitamin D status is common in older adults, adults in institutions, and with obesity, dark skin, low UVB exposure, diabetes and low socio-economic status. Physiological vitamin D levels for optimal immune function are considerably higher than those that can be achieved from food and sunlight exposure alone in Ireland. A window exists in which a significant number of adults could benefit from vitamin D supplementation, not least because of recent data demonstrating an association between vitamin D status and COVID-19. During the COVID pandemic, we believe that supplementation with 20-25ug (800-1000 IU)/day or more may be required for adults with apparently normal immune systems to improve immunity against SARS-CoV-2. We expect that higher monitored doses of 37.5-50 ug (1,500-2,000)/day may be needed for vulnerable groups (e.g., those with obesity, darker skin, diabetes mellitus and older adults). Such doses are within the safe daily intakes cited by international advisory agencies.
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Affiliation(s)
- James Bernard Walsh
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Daniel M. McCartney
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin, Dublin, Ireland
| | - Éamon Laird
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Kevin McCarroll
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Declan G. Byrne
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Medicine Directorate, St. James’s Hospital, Dublin, Ireland
| | - Martin Healy
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Department of Clinical Biochemistry, St James’s Hospital, Dublin, Ireland
| | - Paula M. O’Shea
- Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Rose Anne Kenny
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - John L. Faul
- James Connolly Memorial Asthma Research Centre, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland
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Using food fortification to improve vitamin D bioaccessibility and intakes. Proc Nutr Soc 2022; 81:99-107. [DOI: 10.1017/s0029665121003803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Vitamin D intakes and status are low in many countries due to seasonal UVB exposure variation and the fact that few foods are naturally vitamin D rich. Data modelling studies show that vitamin D intakes increase with food fortification, and countries with mandatory fortification policies have higher vitamin D intakes and status compared to countries without. While many foods can be vitamin D fortified, vitamin D bioavailability differs depending on fortification methods, food structure and composition. Randomised controlled trials (RCT) report that vitamin D2 bioavailability varies between foods, whereas vitamin D3 is bioavailable from many foods. In vitro studies suggest that altering the lipid composition of fortified foods increases vitamin D3 absorption. Olive oil increased vitamin D3 absorption during in vitro digestion compared to other dietary oils. Additionally, when vitamin D3 was incorporated into micelles formed from in vitro digestion of olive oil, more vitamin D3 was absorbed compared to other dietary oils. However, in a human postprandial study, a preformed vitamin D3 micelle dairy drink did not increase vitamin D3 absorption, and a vitamin D3 olive dairy drink increased vitamin D3 absorption in vitamin D insufficient participants only. Action is urgently needed to improve vitamin D intakes and status worldwide. Food fortification improves vitamin D intakes; however, fortification strategies unique to each country are needed. This review will synthesise the literature describing data modelling and intervention trials that assess the safety and efficacy of vitamin D fortification strategies, and those manipulating food composition to alter vitamin D bioavailability from fortified foods. Additionally, RCT examining the impact of vitamin D fortification strategies on vitamin D intakes and status over time are reviewed.
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Lyons OC, Kerr MA, McNulty H, Ward F, Walton J, Livingstone MBE, McNulty BA, Kehoe L, Byrne PA, Saul I, Flynn MAT. Addressing nutrient shortfalls in 1- to 5-year-old Irish children using diet modeling: development of a protocol for use in country-specific population health. Am J Clin Nutr 2021; 115:105-117. [PMID: 34718385 PMCID: PMC8755081 DOI: 10.1093/ajcn/nqab311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/10/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Dietary habits formed in early childhood can track into later life with important impacts on health. Food-based dietary guidelines (FBDGs) may have a role in improving population health but are lacking for young children. OBJECTIVES We aimed to establish a protocol for addressing nutrient shortfalls in 1- to 5-y-old children (12-60 mo) using diet modeling in a population-based sample. METHODS Secondary analysis of 2010-2011 Irish National Pre-School Nutrition Survey data (n = 500) was conducted to identify typical food consumption patterns in 1- to 5-y-olds. Nutrient intakes were assessed against dietary reference values [European Food Safety Authority (EFSA) and Institute of Medicine (IOM)]. To address nutrient shortfalls using diet modeling, 4-d food patterns were developed to assess different milk-feeding scenarios (human milk, whole or low-fat cow milk, and fortified milks) within energy requirement ranges aligned with the WHO growth standards. FBDGs to address nutrient shortfalls were established based on 120 food patterns. RESULTS Current mean dietary intakes for the majority of 1- to 5-y-olds failed to meet reference values (EFSA) for vitamin D (≤100%), vitamin E (≤88%), DHA (22:6n-3) + EPA (20:5n-3) (IOM; ≤82%), and fiber (≤63%), whereas free sugars intakes exceeded recommendations of <10% energy (E) for 48% of 1- to 3-y-olds and 75% of 4- to 5-y-olds. "Human milk + Cow milk" was the only milk-feeding scenario modeled that predicted sufficient DHA + EPA among 1- to 3-y-olds. Vitamin D shortfalls were not correctable in any milk-feeding scenario, even with supplementation (5 µg/d), apart from the "Follow-up Formula + Fortified drink" scenario in 1- to 3-y-olds (albeit free sugars intakes were estimated at 12%E compared with ≤5%E as provided by other scenarios). Iron and vitamin E shortfalls were most prevalent in scenarios for 1- to 3-y-olds at ≤25th growth percentile. CONCLUSIONS Using WHO growth standards and international reference values, this study provides a protocol for addressing nutrient shortfalls among 1- to 5-y-olds, which could be applied in country-specific population health.
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Affiliation(s)
- Oonagh C Lyons
- Food Safety Authority of Ireland, Dublin, Ireland,Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Fiona Ward
- Clinical Nutrition and Dietetics, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Janette Walton
- Department of Biological Sciences, Munster Technological University, Cork, Ireland
| | - M Barbara E Livingstone
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
| | - Breige A McNulty
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Laura Kehoe
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | | | - Ita Saul
- Clinical Nutrition and Dietetics, Children's Health Ireland at Crumlin, Dublin, Ireland
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Akalu Y, Yeshaw Y, Tesema GA, Demissie GD, Molla MD, Muche A, Diress M, Tiruneh SA. Iron-rich food consumption and associated factors among children aged 6-23 months in sub-Saharan Africa: A multilevel analysis of Demographic and Health Surveys. PLoS One 2021; 16:e0253221. [PMID: 34138916 PMCID: PMC8211154 DOI: 10.1371/journal.pone.0253221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/31/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Anemia remains a major public health problem for children in sub-Saharan Africa (SSA). Iron-rich foods consumption has a determinant role on the anemia status. Hence, this study aimed to determine the prevalence of good consumption of iron-rich foods and its associated factors among children aged 6-23 months in SSA. MATERIALS AND METHODS The recent Demographic and Health Survey data sets of thirty-five SSA countries were used. Data were analyzed using STATA/MP version 16.0 and all statistical analyses were done after weighting the data. A generalized linear mixed model using Poisson regression with robust error variance was used to determine factors associated with good consumption of iron-rich food. Association of variables was declared at a p-value of ≤0.05 and adjusted prevalence ratio (aPR) ratio with its 95% confidence interval (CI) was calculated for each variable. RESULTS The total weighted samples of 77,001 children aged 6-23 months were included. The prevalence of consumption of iron rich foods was 42.1% (95% CI: 41.78-42.48). Children with age of 12-17 (adjusted prevalence ratio (aPR) = 1.96, 95% CI: 1.89-2.04) and 18-23 months (aPR = 2.05, 95% CI: 1.97-2.14), who took drugs for intestinal parasites (aPR = 1.30, 95% CI: 1.26-1.34), with postnatal check within 2 months (aPR = 1.09, 95% CI: 1.06-1.13), and children from women with ANC visit of 1-3 (aPR = 1.31, 95% CI: 1.24-1.37) and ≥4 (aPR = 1.41, 95% CI: 1.34-1.48) had higher prevalence of good consumption of iron rich foods. Moreover, the prevalence of consumptions of iron rich foods was higher among children from; family with rich (aPR = 1.36, 95%CI: 1.30-1.42) and middle (aPR = 1.14 95% CI: 1.09-1.19) wealth index, and mother with media exposure (aPR = 1.26, 95%CI: 1.22-1.31). CONCLUSION The prevalence of good consumption of iron-rich foods among children aged 6-23 months in SSA countries is low. Child factors, family factors, and community-level factors were significantly associated with consumption of iron rich foods. Strategies to increase the consumption of iron-rich foods during this critical stage of growth and development should be designed in SSA.
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Affiliation(s)
- Yonas Akalu
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Yigizie Yeshaw
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getu Debalkie Demissie
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Muche
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Mak TN, Angeles-Agdeppa I, Tassy M, Capanzana MV, Offord EA. The Nutritional Impact of Milk Beverages in Reducing Nutrient Inadequacy among Children Aged One to Five Years in the Philippines: A Dietary Modelling Study. Nutrients 2020; 12:E3330. [PMID: 33138121 PMCID: PMC7692769 DOI: 10.3390/nu12113330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
Around half of Filipino children are not consuming any dairy products on a given day, which has shown to be associated with increased risk of inadequate nutrient intakes. The current study applies dietary modelling to assess the nutritional impact of meeting dairy recommendations in reducing nutrient inadequacy in children aged one to five years in the Philippines. Dietary intake data of Filipino children aged one to five years (n = 3864) were analyzed from the 8th National Nutrition Survey 2013. Children who did not meet national dairy recommendations were identified. Two scenarios were applied, based on two types of commonly consumed milk products by the survey participants. In scenario one, one serving of powdered milk was added to the diet of these children. In scenario two, one serving of a young children milk (YCM) or preschool children milk (PCM) was added to the diet of children aged one to two years and three to five years, respectively. Mean nutrient intakes and percentages of children with inadequate intakes were estimated before and after applying modelling scenarios. Scenario one demonstrated improvement in calcium, phosphorus, sodium, vitamin A and riboflavin intakes, while in scenario two, further improvement of intakes of a wider range of nutrients including iron, selenium, zinc, magnesium, potassium, vitamins C, D, E, thiamin, niacin, vitamins B6, and B12 was observed. In both scenarios, if all children would meet their dairy recommendations, theoretical reductions in population nutrient inadequacy would be observed for all micronutrients, for example, only 20% of children aged one to two years would be inadequate in vitamin A instead of the current 60%, iron inadequacy would see a 5% reduction, and approximately 10% reduction for calcium and 20% reduction for folate. The present study is the first to apply dietary modelling to assess the theoretical impact of meeting dairy recommendations on nutrient inadequacy in children in the Philippines. Dairy consumption should be encouraged as part of the strategy to reduce nutrient inadequacies. Calcium, iron, vitamins D, E, and folate are of concern in the Philippines as the level of inadequacies are extremely high in early years, YCM and PCM can help increase the intake of these nutrients.
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Affiliation(s)
- Tsz-Ning Mak
- Nestlé Institute of Health Sciences, Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology-Food and Nutrition Research Institute, Taguig City 1631, Philippines; (I.A.-A.); (M.V.C.)
| | - Marie Tassy
- Nestlé Institute of Health Sciences, Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
| | - Mario V. Capanzana
- Department of Science and Technology-Food and Nutrition Research Institute, Taguig City 1631, Philippines; (I.A.-A.); (M.V.C.)
| | - Elizabeth A. Offord
- Nestlé Institute of Health Sciences, Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
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Patterns of the Consumption of Young Children Formula in Chinese Children Aged 1-3 Years and Implications for Nutrient Intake. Nutrients 2020; 12:nu12061672. [PMID: 32512709 PMCID: PMC7352521 DOI: 10.3390/nu12061672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 12/12/2022] Open
Abstract
The consumption of young children formula (YCF) is associated with reduced risk of inadequacies of nutrients that are frequently lacking in the diets of young children. In this study, we assessed the role of YCF in children’s diets and whether meeting dairy intake recommendations would improve nutrient intake in young Chinese children aged 12–36 months. Dietary intake data for children from the 2012 China Maternal and Infant Nutrition and Growth study were analyzed (n = 910). Nutrient intake was compared between YCF consumers and non-consumers, and the theoretical impact of meeting dairy intake recommendations by adding cow’s milk or YCF to children’s diets was assessed using diet modelling. The percent of children consuming YCF was 64.5% and was positively associated with family income and mother’s education level. Compared to non-consumers, YCF consumers had higher intakes of minerals (e.g., calcium, iron) and vitamins (e.g., C, D, B6) that are important for growth and immune function, and lower intakes of saturated fat. To meet dairy intake recommendations by adding either cow’s milk or YCF to children’s diets would improve intakes of vitamins and minerals in young Chinese children. YCF consumption contributes to the improvement of nutrient intakes in children aged 12–36 months in China.
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McCourt A, McNulty BA, Walton J, O'Sullivan A. Efficacy and safety of food fortification to improve vitamin D intakes of older adults. Nutrition 2020; 75-76:110767. [PMID: 32248053 DOI: 10.1016/j.nut.2020.110767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine the best foods for potential vitamin D food fortification and to model the efficacy and safety of different food fortification scenarios in adults ≥50 y of age in Ireland. METHODS National Adult Nutrition Survey vitamin D data for participants ≥50 y of age were updated. Vitamin D from foods with natural and added vitamin D was estimated and daily vitamin D intake patterns were examined. Data modeling was used to estimate the effects of target food fortification scenarios. RESULTS Almost two-thirds of the mean daily vitamin D intake of adults ≥50 y of age (7 ± 7 µg) comes from foods with added vitamin D. Milk and bread are the most frequently consumed foods across all meals and were subsequently targeted for the data modeling exercise. Results from the data modeling show that vitamin D intake increased between 9 and 17 µg/d, depending on the fortification scenario. Fortifying milk or bread resulted in ∼30% or ∼55% of individuals meeting the Recommended Daily Allowance (RDA); however, fortifying both simultaneously resulted in ∼70% meeting the RDA. CONCLUSIONS Currently, the majority of Irish adults ≥50 y of age are not meeting dietary recommendations for vitamin D. Fortification of commonly consumed foods such as milk and bread could improve daily intakes such that ∼70% of the cohort would meet the minimum recommendation. Future research should examine the efficacy of different food fortification scenarios to improve vitamin D intakes for older adults.
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Affiliation(s)
- Aislinn McCourt
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Breige A McNulty
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Janette Walton
- School of Biological Sciences, Cork Institute of Technology, Cork, Ireland
| | - Aifric O'Sullivan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland.
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O'Neil CE, Nicklas TA, Fulgoni VL. Food Sources of Energy and Nutrients of Public Health Concern and Nutrients to Limit with a Focus on Milk and other Dairy Foods in Children 2 to 18 Years of Age: National Health and Nutrition Examination Survey, 2011⁻2014. Nutrients 2018; 10:nu10081050. [PMID: 30096892 PMCID: PMC6116120 DOI: 10.3390/nu10081050] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 07/30/2018] [Accepted: 08/02/2018] [Indexed: 12/25/2022] Open
Abstract
Many children are not meeting current nutrient recommendations. The objective of this study was to determine the food sources of energy, nutrients of public health concern, and nutrients to limit with a focus on dairy foods. Twenty-four-hour dietary recall data from children 2–5 (n = 1511), 6–11 (n = 2193), and 12–18 years (n = 2172) participating in NHANES 2011–2014 were analyzed. Energy, fiber, calcium, potassium, vitamin D, added sugars, saturated fatty acids (SFA), and sodium intakes were sample-weighted and ranked on percentage contribution to the diet using specific food group intake and disaggregated data for dairy foods. For children 2–5, 6–11, and 12–18 years, milk, sweet bakery products, and sweetened beverages, respectively were the top food sources of energy, respectively. For calcium, potassium, and vitamin D, milk was the top ranked food source in all age groups. For children 2–5, 6–11, and 12–18 years, milk, sweet bakery products, and pizza, respectively were the top three ranked food sources of SFA; and sugar sweetened beverages and sweet bakery products were to top two food group sources of added sugars. Cured meats/poultry, pizza, and pizza, respectively, were the top ranked food sources of sodium for the three age groups. Identification of food sources of these nutrients can help health professionals implement appropriate dietary recommendations and plan age-appropriate interventions.
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Affiliation(s)
- Carol E O'Neil
- Louisiana State University Agricultural Center (Emeritus), School of Nutrition and Food Science, 143 Kenilworth Parkway, Baton Rouge, LA 70808, USA.
| | - Theresa A Nicklas
- USDA/ARS/CNRC, 1100 Bates St., Baylor College of Medicine, Houston, TX 77030, USA.
| | - Victor L Fulgoni
- Louisiana State University Agricultural Center (Emeritus), School of Nutrition and Food Science, 143 Kenilworth Parkway, Baton Rouge, LA 70808, USA.
- Nutrition Impact, LLC, 9725 D Drive North, Battle Creek, MI 49014, USA.
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12
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Itkonen ST, Erkkola M, Lamberg-Allardt CJE. Vitamin D Fortification of Fluid Milk Products and Their Contribution to Vitamin D Intake and Vitamin D Status in Observational Studies-A Review. Nutrients 2018; 10:nu10081054. [PMID: 30096919 PMCID: PMC6116165 DOI: 10.3390/nu10081054] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022] Open
Abstract
Fluid milk products are systematically, either mandatorily or voluntarily, fortified with vitamin D in some countries but their overall contribution to vitamin D intake and status worldwide is not fully understood. We searched the PubMed database to evaluate the contribution of vitamin D-fortified fluid milk products (regular milk and fermented products) to vitamin D intake and serum or plasma 25-hydroxyvitamin D (25(OH)D) status in observational studies during 1993–2017. Twenty studies provided data on 25(OH)D status (n = 19,744), and 22 provided data on vitamin D intake (n = 99,023). Studies showed positive associations between the consumption of vitamin D-fortified milk and 25(OH)D status in different population groups. In countries with a national vitamin D fortification policy covering various fluid milk products (Finland, Canada, United States), milk products contributed 28–63% to vitamin D intake, while in countries without a fortification policy, or when the fortification covered only some dairy products (Sweden, Norway), the contribution was much lower or negligible. To conclude, based on the reviewed observational studies, vitamin D-fortified fluid milk products contribute to vitamin D intake and 25(OH)D status. However, their impact on vitamin D intake at the population level depends on whether vitamin D fortification is systematic and policy-based.
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Affiliation(s)
- Suvi T Itkonen
- Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, 00790 Helsinki, Finland.
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, 00790 Helsinki, Finland.
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13
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Folgenahrungen für Kleinkinder im Alter von einem bis 3 Jahren (sog. Kindermilchgetränke). Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0311-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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