1
|
Chokor FAZ, Hwalla N, Naja F, Nasreddine L. Food sources of fiber and micronutrients of concern among infants and young children in Lebanon: a national cross-sectional study. BMC Pediatr 2024; 24:57. [PMID: 38243229 PMCID: PMC10797939 DOI: 10.1186/s12887-024-04535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Intakes of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate were shown to be low in a substantial proportion of infants and children in Lebanon. The study aims to identify the top food sources of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate amongst infants and young children in Lebanon and to evaluate the evolution of food sources of these nutrients from the beginning of the complementary feeding journey up until the age of 47.9 months. METHODS A national cross-sectional survey was conducted in 2012 as part of the "Early Life Nutrition and Health in Lebanon" project using stratified cluster sampling. Dietary intakes for infants and young children aged 6-47.9 months (n = 763) were assessed using 24- Hour Dietary Recall. Food items were categorized into food groups and the percent contribution of each food group to nutrient intakes was determined to identify the top food sources of fiber and selected micronutrients for three age groups: 6-11.9 m (infants), 12-23.9 m (toddlers), and 24-47.9 m (preschoolers). RESULTS The top food source of fiber was vegetables among children aged 6-47.9 months. Among infants and toddlers, infant/young child formula was the main contributor to iron, zinc, calcium, vitamin D, vitamin A, and folate intakes. Baby cereals also contributed to around 14% of iron intakes among infants. Among preschoolers, meat and fish contributed to 13% of iron intakes and 29% of zinc intakes, while cow's milk was the major contributor of calcium (41%), vitamin D (81%) and vitamin A (25%) intakes. Sweetened beverages and sweet bakery were also ranked among the major food sources contributing to substantial intakes of key nutrients, including fiber, iron, zinc, calcium, vitamin A, and folate among infants, toddlers, and preschoolers. CONCLUSIONS In addition to milk sources, vegetables, beans and legumes, breads, meats, and rice and pasta, sweet bakery and sweetened beverages have contributed to intakes of key nutrients from early ages. This calls for implementing initiatives and designing approaches to support nutrition education and improve nutrient intakes in infancy and early childhood.
Collapse
Affiliation(s)
- Fatima Al Zahraa Chokor
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| |
Collapse
|
2
|
Song S, Shim JE. Food sources of zinc and nutritional status with usual dietary zinc intake in Korean toddlers and preschool children. Nutr Res Pract 2023; 17:1211-1224. [PMID: 38053829 PMCID: PMC10694412 DOI: 10.4162/nrp.2023.17.6.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/31/2023] [Accepted: 07/21/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to evaluate the food sources of zinc and the usual intake of dietary zinc among Korean toddlers and preschool children. SUBJECTS/METHODS A total of 2,679 children aged 1-5 years was selected from the 2009-2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. Dietary data collected from a single 24-h recall were used to evaluate the food sources of zinc. To estimate usual zinc intake, the distribution obtained from single 24-h recall data in the total sample was adjusted using the ratio of within-to-between-person variance in zinc intake obtained from 2-day 24-h recall sub-sample data of the 2009 KNHANES. The proportion of children with usual zinc intake below the estimated average requirement (EAR) and above the tolerable upper intake level (UL) was assessed. RESULTS The main sources of zinc in Korean children were grains, dairy products, and meat. The mean usual intakes of zinc among all individuals, those aged 1-2 yrs, and those aged 3-5 yrs were 5.50, 5.01, and 5.83 mg/d, respectively. In all participants, 1.1% of the children consumed zinc below the EAR, whereas 10.7% exceeded the UL. The proportion of children with excessive zinc intake was 25.6% in the 1-2 yrs age group and 0.6% in the 3-5 yrs age group. CONCLUSIONS According to the current UL, the risk of excessive zinc intake appears to be high among Korean toddlers. Future studies that monitor the health effects of excessive zinc intake are needed to appropriately guide zinc intake in children.
Collapse
Affiliation(s)
- SuJin Song
- Department of Food and Nutrition, Hannam University, Daejeon 34054, Korea
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, Daejeon 34520, Korea
| |
Collapse
|
3
|
Allen CK, Assaf S, Namaste S, Benedict RK. Estimates and trends of zero vegetable or fruit consumption among children aged 6-23 months in 64 countries. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001662. [PMID: 37368873 DOI: 10.1371/journal.pgph.0001662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Children require a diverse diet, that includes vegetables and fruits, to support growth and development and prevent non-communicable diseases. The WHO-UNICEF established a new infant and young child feeding (IYCF) indicator: zero vegetable or fruit (ZVF) consumption among children aged 6-23 months. We estimated the prevalence, trends, and factors associated with ZVF consumption using nationally representative, cross-sectional data on child health and nutrition in low-and-middle-income countries. We examined 125 Demographic and Health Surveys in 64 countries conducted between 2006-2020 with data on whether a child ate vegetables or fruits the previous day. Prevalence of ZVF consumption was calculated by country, region, and globally. Country trends were estimated and tested for statistical significance (p<0.05). Logistic regression analysis was used to examine the relationship between ZVF and child, mother, household, and survey cluster characteristics by world region and globally. Using a pooled estimate of the most recent survey available in each country, we estimate the global prevalence of ZVF consumption as 45.7%, with the highest prevalence in West and Central Africa (56.1%) and the lowest in Latin America and the Caribbean (34.5%). Recent trends in ZVF consumption varied by country (16 decreasing, eight increasing, 14 no change). Country trends in ZVF consumption represented diverse patterns of food consumption over time and may be affected by the timing of surveys. Children from wealthier households and children of mothers who are employed, more educated, and have access to media were less likely to consume ZVF. We find the prevalence of children aged 6-23 months who do not consume any vegetables or fruits is high and is associated with wealth and characteristics of the mother. Areas for future research include generating evidence from low-and-middle-income countries on effective interventions and translating strategies from other contexts to improve vegetable and fruit consumption among young children.
Collapse
Affiliation(s)
- Courtney K Allen
- Sociology Department, University of Washington, Seattle, Washington, United States of America
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Shireen Assaf
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Sorrel Namaste
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Rukundo K Benedict
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| |
Collapse
|
4
|
Whiting SJ, Ushula TW. Feeding Infants and Toddlers Studies (FITS) Provide Valuable Information for Setting Dietary Guidelines. Nutrients 2022; 14:4073. [PMID: 36235724 PMCID: PMC9571702 DOI: 10.3390/nu14194073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Adequate nutrition is essential from the early stages of life onward, to ensure proper growth and development as well as long-term health [...].
Collapse
Affiliation(s)
- Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Tolassa W. Ushula
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma 378, Ethiopia
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Rd, Herston, QLD 4006, Australia
| |
Collapse
|
5
|
Haileselassie M, Redae G, Berhe G, Henry CJ, Nickerson MT, Mulugeta A. The influence of fasting on energy and nutrient intake and their corresponding food sources among 6-23 months old children in rural communities with high burden of stunting from Northern Ethiopia. Nutr J 2022; 21:4. [PMID: 35031028 PMCID: PMC8759242 DOI: 10.1186/s12937-022-00759-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 01/04/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Limited studies in Ethiopia showed that infants and young children are at high risk of inadequate intake of energy and nutrients. However, inclusive assessment of both nutrient intakes and their food sources are lacking. We aimed at assessing energy and nutrient intakes and their food sources during religious fasting and non-fasting periods among 6-23 months old children in Northern Ethiopia. METHODS Data for this longitudinal study were collected following repeated multiple-pass 24-h dietary recall technique through face-to-face interviews with primary caregivers. Using a two-stage systematic random sampling method, a total of 570 and 551 children participated respectively in the lent fasting and non-fasting periods. Energy and nutrient intakes were estimated and compared with WHO daily requirements. All foods that a child consumed on the day preceding the date of data collection were recorded and processed with database software. Chi-square and t- tests were used to analyze the data. Non-normally distributed data were analyzed using Wilcoxon signed-rank test and statistical significance was set at p < 0.05. RESULTS The overall prevalence of child stunting was 41.4%. Almost all of children (99.6%) consumed grains, roots, and tubers. The inadequacy prevalence of energy, protein and eight selected micronutrients (calcium, iron, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin C) intake were 96.2, 44.9, and 95.5%, respectively. Calcium and zinc were the highest (100%) deficits observed across all age groups. Although consumption of animal source foods (ASFs) was very low (dairy 10.1%, meat 2.3% and eggs 23.6%), there was significantly higher consumption of meat and eggs during the non-fasting compared to fasting period (p < 0.001). CONCLUSIONS Inadequate intake of energy and nutrients was common among 6-23 months old children. Cereals were found to be the main sources of many of the nutrients. The consumption of ASFs among 6-23-month-old children was low which was also affected by the religious fasting period. Hence, strengthening social and behavior change communication, supporting rural households to raise poultry and small ruminants is recommended.
Collapse
Affiliation(s)
- Mekonnen Haileselassie
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. .,Tigray National Regional State, Bureau of Science and Technology, Mekelle, Tigray, Ethiopia.
| | - Getachew Redae
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gebretsadik Berhe
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Carol J Henry
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Michael T Nickerson
- Department of Food and Bioproduct Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Afework Mulugeta
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| |
Collapse
|
6
|
Monnard C, Fleith M. Total Fat and Fatty Acid Intake among 1-7-Year-Old Children from 33 Countries: Comparison with International Recommendations. Nutrients 2021; 13:3547. [PMID: 34684548 PMCID: PMC8537778 DOI: 10.3390/nu13103547] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 12/27/2022] Open
Abstract
This work reviews available data on dietary intakes of total fat, saturated fatty acids (SFA) and individual polyunsaturated fatty acids (PUFA) in children in different countries worldwide and for the first time, compares them with recent international recommendations. Studies published before June 2021 reporting total fat, total SFA and individual PUFA intakes in children aged 1-7 y were included. Observed intakes were evaluated against FAO/WHO and EFSA recommendations. 65 studies from 33 countries were included. Fat intake was too low in 88% of studies in young children (1-3 y). SFA intake was >10%E in 69-73% of children, especially in Europe. Linoleic acid intake was <3%E in 24% of studies in 1-2 y olds and within FAO/WHO recommendations among all other ages. Alpha-linolenic acid intake was <0.5%E in almost half of studies. Docosahexaenoic acid (DHA) or eicosapentaenoic acid + DHA intakes were below recommendations in most studies. In summary, while total fat intake was too low among younger children, SFA intake was above, especially in Europe and n-3 PUFA intake, especially DHA, were below recommendations for all ages. Intake of n-3 PUFA, especially DHA, is generally suboptimal. More data, particularly from developing countries, are required to refine these findings and guide implementation of adapted nutrition policies.
Collapse
Affiliation(s)
- Cathriona Monnard
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., 1015 Lausanne, Switzerland;
| | | |
Collapse
|
7
|
Kim HS, Lee H, Provido SMP, Kang M, Chung GH, Hong S, Yu SH, Lee CB, Lee JE. Association Between Diet Quality and Prevalence of Obesity, Dyslipidemia, and Insulin Resistance Among Filipino Immigrant Women in Korea: The Filipino Women's Diet and Health Study. Front Public Health 2021; 9:647661. [PMID: 34277535 PMCID: PMC8281297 DOI: 10.3389/fpubh.2021.647661] [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: 12/30/2020] [Accepted: 06/03/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives: Diet quality may be a key modifiable factor for the prevention of non-communicable disease. We aimed to investigate the association between diet quality and prevalence of obesity, dyslipidemia, and insulin resistance among Filipino immigrant women in Korea. Methods: A total of 413 participants from the 2014–2016 baseline population of the Filipino Women's Diet and Health Study (FiLWHEL) were examined. Individual dietary intakes were evaluated through 24-h recalls and then converted into two dietary quality assessments: Minimum Dietary Diversity for Women (MDD-W) developed by the Food and Agriculture Organization (FAO) and the Data Derived Inflammation Index (DDII) originally developed by our group. Fasting blood levels of triglycerides, high-density lipoprotein cholesterols, glucose, and insulin were measured. We used logistic regression models for odds ratios (ORs) with 95% confidence intervals (CIs). Results: We found a statistically significant association between MDD-W scores and decreased prevalence of abdominal obesity; ORs (95% CIs) of the 3rd vs. 1st tertiles were 0.58 (0.36–0.94; p for trend = 0.029). Increased DDII was associated with elevated prevalence of dyslipidemia and insulin resistance; ORs (95% CIs) of the 5th vs. 1–3rd quintiles were 6.44 (2.56–16.20) for triglycerides (TG), 3.90 (1.92–7.90) for low-density lipoprotein (LDL) cholesterol, 3.36 (1.81–6.24) for total cholesterol (TC), 6.25 (2.53–15.41) for abnormal TG/HDL ratios, 3.59 (1.96–6.59) for HbA1c, 2.61 (1.11–6.17) for fasting blood glucose levels, 9.67 (4.16–22.48) for insulin levels, and 9.73 (4.46–21.25) for homeostasis model assessment of insulin resistance (HOMA-IR) (p for trend <0.001 for all, except 0.033 for fasting blood glucose). Conclusions: Greater dietary diversity was inversely associated with the prevalence of abdominal obesity in Filipino immigrant women. Proinflammatory scores based on diet and lifestyle factors were associated with an increased prevalence of dyslipidemia and insulin resistance. Further, epidemiological studies on the relationship between dietary acculturation and chronic disease are warranted.
Collapse
Affiliation(s)
- Hee Sun Kim
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, South Korea
| | - Heejin Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, South Korea
| | | | - Minji Kang
- Research Institute of Human Ecology, Seoul National University, Seoul, South Korea.,BK21 FOUR Education and Research Team for Sustainable Food & Nutrition, Seoul, South Korea
| | - Grace H Chung
- Research Institute of Human Ecology, Seoul National University, Seoul, South Korea.,Department of Child Development and Family Studies, College of Human Ecology, Seoul National University, Seoul, South Korea
| | - Sangmo Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Sung Hoon Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Chang Beom Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, South Korea.,Research Institute of Human Ecology, Seoul National University, Seoul, South Korea
| |
Collapse
|
8
|
Mejos KK, Ignacio MS, Jayasuriya R, Arcot J. Use of Linear Programming to Develop Complementary Feeding Recommendations to Improve Nutrient Adequacy and Dietary Diversity Among Breastfed Children in the Rural Philippines. Food Nutr Bull 2021; 42:274-288. [PMID: 34002635 DOI: 10.1177/0379572121998125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lack of dietary diversity in complementary feeding contributes to nutrient gaps leading to undernutrition. Food-based strategies have been successfully used to enrich the complementary diets of infants and young children. However, context-specific recommendations based on an objective diet optimization are needed to formulate sound and practical nutritional guidelines. OBJECTIVES The present study aimed to identify problem nutrients in complementary diets and formulate complementary feeding recommendations (CFRs) using linear programming analysis for children aged 6 to 23 months in the rural Philippines. METHODS A cross-sectional survey was conducted in the municipality of Mercedes, Philippines. Dietary intakes of breastfed children 6 to 8, 9 to 11, and 12 to 23 months of age (n = 297) were assessed using a multipass 24-hour recall method with 7-day food consumption frequency. A linear programming tool was used to identify the recommended nutrient intakes that could not be met within the existing local food patterns and develop CFRs that would best fulfill nutrient adequacy for 11 modeled micronutrients. RESULTS Problem nutrients in the current diets were iron and calcium in any age-group, zinc for 6 to 8 and 9 to 11 months old, and thiamine and folate for 12 to 23 months old children. Adoption of CFRs with 4 to 5 food groups in the diet would ensure the adequacy of 7 to 8 nutrients, depending on the age-group. CONCLUSION Within the boundaries of local dietary patterns, adequacy for most nutrients could be achieved by promoting realistic servings of nutrient-dense foods and food groups. The linear programming results provide an evidence-based strategy in designing interventions to improve the quality of Filipino complementary diets.
Collapse
Affiliation(s)
- Karen Kay Mejos
- Food and Health, School of Chemical Engineering, 7800UNSW Sydney, Australia
| | - Maria Socorro Ignacio
- Department of Nutrition, College of Public Health, 54725University of the Philippines Manila, Manila, Philippines
| | | | - Jayashree Arcot
- Food and Health, School of Chemical Engineering, 7800UNSW Sydney, Australia
| |
Collapse
|
9
|
Vitamin D Status and Usual Nutrient Intake of Filipino Children Aged 6–12 Years in Selected Areas in the Philippines: A 2018 National Nutrition Survey. J Nutr Metab 2021. [DOI: 10.1155/2021/8515607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. This study aimed to determine the prevalence of vitamin D deficiency, usual nutrient intake, and food sources of vitamin D of Filipino children aged 6–12 years in selected areas in the Philippines. Methods. The National Nutrition Survey (NNS) collected blood samples of children aged 6–12 years from selected study sites: Manila City and Quezon City in the National Capital Region (NCR); Cagayan Province and Baguio City in Luzon; Northern Samar and Siquijor in Visayas; and Butuan City and Sultan Kudarat in Mindanao. About 789 children aged 6–12 years participated in this study. Serum vitamin D was determined by electrochemiluminescence binding assay (ECLIA). Food intake data were collected using two-day nonconsecutive 24 h food recall. Usual nutrient intakes were estimated using Personal Computer Software for Intake Distribution Estimation (PC-SIDE) program. Results. The mean serum vitamin D of 25 (OH)D was 72.7 ± 0.67 μmol/L. The overall prevalence of combined vitamin D deficiency (<50 μmol/L) and insufficiency (51–74 μmol/L) among children aged 6–12 years was 60.6%. Females had a higher prevalence of vitamin D insufficiency compared to males. NCR (57.9%) had a higher deficiency compared to the other areas. The usual intake of vitamin D (2 μg/day) among children was below the adequate intake of 5 μg/day. The main food sources of vitamin D are coming from fish (53%), pork (19%), and egg/egg dishes (16%). Conclusion. This study revealed that there is a significantly high level of vitamin D insufficiency in children aged 6–12 years. Filipino females had higher prevalence of vitamin D deficiency and insufficiency compared to males. Among the areas, NCR has the highest prevalence of deficiency/insufficiency.
Collapse
|
10
|
Palacios C, Hofmeyr GJ, Cormick G, Garcia‐Casal MN, Peña‐Rosas JP, Betrán AP. Current calcium fortification experiences: a review. Ann N Y Acad Sci 2021; 1484:55-73. [PMID: 32949062 PMCID: PMC8246751 DOI: 10.1111/nyas.14481] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 12/11/2022]
Abstract
Low dietary calcium is very common in many populations, contributing to nutritional rickets/osteomalacia in children/adults and increasing the risk of several health problems. Calcium is a nutrient of concern as the recommended nutrient requirements are difficult to meet in the absence of dairy products. The provision of culturally acceptable calcium-fortified foods may improve calcium intake when it is a feasible and cost-effective strategy in a particular setting. This landscape review was conducted in 2019 and describes current calcium fortification efforts and lessons learned from these experiences. Worldwide, the United Kingdom is the only country where calcium fortification of wheat flour is mandatory. It is estimated that this fortified staple ingredient contributes to 13-14% of calcium intake of the British population. Other items voluntary fortified with calcium include maize flour, rice, and water. Current calcium fortification programs may lack qualified personnel/training, clear guidelines on implementation, regulation, monitoring/evaluation, and functional indicators. Also, the cost of calcium premix is high and the target groups may be hard to reach. There is a lack of rigorous evaluation, particularly in settings with multiple micronutrient programs implemented simultaneously, with low quality of the evidence. Further research is needed to assess the impact of calcium fortification programs.
Collapse
Affiliation(s)
- Cristina Palacios
- Department of Dietetics and NutritionStempel School of Public HealthFlorida International UniversityMiamiFlorida
| | - G. Justus Hofmeyr
- Effective Care Research UnitEastern Cape Department of HealthUniversities of the Witwatersrand and Fort HareEast LondonSouth Africa
| | - Gabriela Cormick
- Department of Mother and Child Health ResearchInstitute for Clinical Effectiveness and Health Policy (IECS‐CONICET)Buenos AiresArgentina
- Departamento de SaludUniversidad Nacional de La MatanzaSan JustoArgentina
| | | | | | - Ana Pilar Betrán
- WHO–World Bank Special Programme of ResearchDevelopmentand Research Training in Human ReproductionDepartment of Reproductive Health and ResearchWorld Health OrganizationGenevaSwitzerland
| |
Collapse
|
11
|
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.
Collapse
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.)
| |
Collapse
|
12
|
Jacquier EF, Angeles-Agdeppa I, Lenighan YM, Toledo MB, Capanzana MV. Complementary feeding patterns of Filipino infants and toddlers lack diversity, especially among children from poor households. BMC Nutr 2020; 6:51. [PMID: 33117553 PMCID: PMC7586690 DOI: 10.1186/s40795-020-00376-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
Background Consumption of nutritionally adequate complementary foods is essential for optimal growth and development of infants and toddlers, including those in developing countries. The aim of this study was to describe the food and beverage consumption patterns among 6-23.9 month old Filipino infants and toddlers, by household wealth. Methods Data from 1087 infants and toddlers from the 2013 National Nutrition Survey were included. Dietary intake data was assessed using a 24Hr recall and population food intakes were stratified into pre-defined wealth categories. Results Breast milk, infant formula, powdered milk and rice were the most commonly consumed foods and beverages across the age groups. Several differences in complementary feeding by wealth status were observed. Infants from poor households (69%) reported significantly greater consumption of human milk, than those from rich households (42%) who reported a significantly greater consumption of infant/toddler formula (Poor: 22%, Rich: 56%) (P < 0.05). A higher percentage of toddlers from rich households consumed protein-containing foods, cookies and cakes. There was a significant difference in vegetable consumption in 12-17.9 month old children (Poor: 17%, Rich: 31%; P = 0.021). Human milk and formula were the top contributors to energy in 6-17.9 month old children, while rice was the top energy contributor in 18-23.9 month old children. Conclusion Milk and rice were the main dietary components in all Filipino children, contributing up to 60% of energy in the infants from poorer households. Consumption of protein-containing foods and vegetables were typically lower in poorer households. Interventions are required to enable caregivers of young Filipino children to provide complementary foods of high nutritional quality, particularly among children from the poor households.
Collapse
Affiliation(s)
- Emma F Jacquier
- Nestlé Research, Vers-Chez-Les-Blanc, 1000 Lausanne, Switzerland
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, The Philippines
| | | | - Marvin B Toledo
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, The Philippines
| | - Mario V Capanzana
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, The Philippines
| |
Collapse
|
13
|
Ford JL, Lopez-Teros V. Prediction of Vitamin A Stores in Young Children Provides Insights into the Adequacy of Current Dietary Reference Intakes. Curr Dev Nutr 2020; 4:nzaa119. [PMID: 32818165 PMCID: PMC7419538 DOI: 10.1093/cdn/nzaa119] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/25/2020] [Accepted: 07/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Limited data were available in infants and children when vitamin A (VA) DRIs were established; recommendations were developed based on average breast milk VA intake and extrapolation of data from adults. OBJECTIVES Our objective was to evaluate whether DRIs and reported intakes, with and without VA from intervention programs, would be sufficient to develop adequate VA stores from birth to age 5 y in Bangladeshi, Filipino, Guatemalan, and Mexican children. METHODS A mathematical relationship was established, defined by a series of equations, to predict VA total body stores (TBS) as a function of age based on VA intake and utilization. TBS calculated using reported VA intakes, with and without additional VA from intervention programs, were compared to those predicted using DRIs (specifically, Adequate Intake and RDA). Liver VA concentrations were also estimated. RESULTS Our predictions showed that for these 4 groups, DRIs were sufficient to attain liver VA concentrations >0.07 μmol/g by 1 wk of age and sustain positive VA balance for 5 y. Using reported intakes, which were lowest in Bangladeshis from 1 y on and highest in Guatemalans, predicted VA stores in Bangladeshi and Filipino children increased until ∼2-3 y, then TBS stabilized and liver VA concentrations decreased with age. When VA interventions were included, stores exceeded those predicted using DRIs by 12-18 mo. In contrast, reported intakes alone in Guatemalan and Mexican children resulted in VA stores that surpassed those calculated using DRIs. For all populations, reported intakes were sufficient to build liver concentrations >0.07 μmol/g by 3 mo. CONCLUSIONS Although more information is needed to better define dietary VA requirements in children, our results suggest that for an average, generally healthy child in a low- or middle-income country, current DRIs are sufficient to maintain positive VA balance during the first 5 y of life.
Collapse
Affiliation(s)
- Jennifer Lynn Ford
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | - Veronica Lopez-Teros
- Posgrado en Ciencias de la Salud, Universidad de Sonora, Hermosillo, Sonora, Mexico
| |
Collapse
|
14
|
O'Neill LM, Dwyer JT, Bailey RL, Reidy KC, Saavedra JM. Harmonizing Micronutrient Intake Reference Ranges for Dietary Guidance and Menu Planning in Complementary Feeding. Curr Dev Nutr 2020; 4:nzaa017. [PMID: 32161844 PMCID: PMC7059853 DOI: 10.1093/cdn/nzaa017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 01/21/2023] Open
Abstract
There are no published harmonized nutrient reference values for the complementary feeding period. The aim of the study was to develop proposals on adequate and safe intake ranges of micronutrients that can be applied to dietary guidance and menu planning. Dietary intake surveys from 6 populous countries were selected as pertinent to the study and reviewed for data on micronutrients. The most frequently underconsumed micronutrients were identified as iron, zinc, calcium, magnesium, phosphorus, potassium, and vitamins A, B6, B12, C, D, E, and folate. Key published reference values for these micronutrients were identified, compared, and reconciled. WHO/FAO values were generally identified as initial nutrient targets and reconciled with nutrient reference values from the Institute of Medicine and the European Food Standards Authority. A final set of harmonized reference nutrient intake ranges for the complementary feeding period is proposed.
Collapse
Affiliation(s)
| | - Johanna T Dwyer
- Tufts University School of Medicine and Friedman School of Nutrition Science and Policy, Boston, MA, USA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - Jose M Saavedra
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
15
|
Dairy Intake Would Reduce Nutrient Gaps in Chinese Young Children Aged 3-8 Years: A Modelling Study. Nutrients 2020; 12:nu12020554. [PMID: 32093307 PMCID: PMC7071369 DOI: 10.3390/nu12020554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/14/2020] [Accepted: 02/19/2020] [Indexed: 12/28/2022] Open
Abstract
Dairy foods are under-consumed among Chinese children. We modeled the impact of increased dairy consumption on nutrient inadequacy and assessed whether the consumption of formulated milk powder for children ≥3 years (FMP3+) is useful for reducing nutrient gaps. Data from 3–8-year-old children, with completed socio-demographic and dietary measurements from the China Health and Nutrition Survey 2015, were used (n = 1122). Dietary intakes were modeled in two scenarios: Scenario 1 added FMP3+ or cow’s milk to reported diet to reach recommended dairy intakes; Scenario 2 replaced the currently consumed milk with an equal volume of FMP3+. Reported nutrient intakes were compared with each model. Only 32.5% of children consumed dairy products; the average intake amount in total was 48.6 g/day. Most children (97.6%) did not meet dairy intake recommendation. Inadequate nutrient intakes were observed for calcium, potassium, thiamin, riboflavin, vitamin C and selenium. In Scenario 1, both FMP3+ and cow’s milk improved the intake of all analyzed nutrients. In Scenario 2, FMP3+ substitution increased the intake of most nutrients, and reduced the proportion of children with an inadequate intake of vitamin C, thiamin, vitamin A, iron, zinc and potassium. Thus, increasing dairy consumption would reduce nutrient gaps, and FMP3+ is a good food source to help children meet nutrient requirements.
Collapse
|
16
|
Mak TN, Angeles-Agdeppa I, Tassy M, Capanzana MV, Offord EA. Contribution of Milk Beverages to Nutrient Adequacy of Young Children and Preschool Children in the Philippines. Nutrients 2020; 12:nu12020392. [PMID: 32024102 PMCID: PMC7071197 DOI: 10.3390/nu12020392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/19/2020] [Accepted: 01/19/2020] [Indexed: 12/18/2022] Open
Abstract
Malnutrition is a major public health concern in the Philippines. Milk and dairy products are important sources of energy, protein, and micronutrients for normal growth and development in children. This study aims to assess the contribution of different types of milk to nutrient intakes and nutrient adequacy among young and preschool children in the Philippines. Filipino children aged one to four years (n = 2992) were analysed while using dietary intake data from the 8th National Nutrition Survey 2013. Children were stratified by age (one to two years and three to four years) and by milk beverage consumption type: young children milk (YCM) and preschool children milk (PCM), other milks (mostly powdered milk with different degrees of fortification of micronutrients), and non-dairy consumers (no milks or dairy products). The mean nutrient intakes and the odds of meeting nutrient adequacy by consumer groups were compared, percentage of children with inadequate intakes were calculated. Half (51%) of Filipino children (all ages) did not consume any dairy on a given day, 15% consumed YCM or PCM, and 34% consumed other milks. Among children one to two years, those who consumed YCM had higher mean intakes of iron, magnesium, potassium, zinc, B vitamins, folate, and vitamins C, D, and E (all p < 0.001) when compared to other milk consumers. Non-dairy consumers had mean intakes of energy, total fat, fibre, calcium, phosphorus, iron, potassium, zinc, folate, and vitamins D and E that were far below the recommendations. Children who consumed YCM or PCM had the highest odds in meeting adequacy of iron, zinc, thiamin, vitamin B6, folate, and vitamins C, D, and E as compared to other milks or non-dairy consumers, after adjusting for covariates. This study supports the hypothesis that dairy consumers had higher intakes of micronutrients and higher nutrient adequacy than children who consumed no milk or dairy products. Secondly, YCM or PCM have demonstrated to be good dairy options to achieve nutrient adequacy in Filipino children.
Collapse
Affiliation(s)
- Tsz-Ning Mak
- Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
- Correspondence:
| | - Imelda Angeles-Agdeppa
- Food and Nutrition Research Institute-Department of Science and Technology, Taguig City 1631, Philippines; (I.A.-A.); (M.V.C.)
| | - Marie Tassy
- Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
| | - Mario V. Capanzana
- Food and Nutrition Research Institute-Department of Science and Technology, Taguig City 1631, Philippines; (I.A.-A.); (M.V.C.)
| | - Elizabeth A. Offord
- Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
| |
Collapse
|
17
|
Zhao Y, Qin R, Ma X, Qin Z, Yang Z, Hong H, Lv H, Ye K, Wei Y, Zheng W, Qi H, Ni Y, Zhang L, Yan J, Liu G, Wu A. Adiposity is not beneficial to bone mineral density in 0-5 year old Chinese children: The Jiangsu bone health study. Obes Res Clin Pract 2019; 14:39-46. [PMID: 31879074 DOI: 10.1016/j.orcp.2019.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 10/07/2019] [Accepted: 10/30/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Data on obesity in relation to bone mineral density(BMD) in infants and preschool children were sparse in China. The objective of this study was to examine the associations between body mass index (BMI) and BMD. SUBJECTS AND METHODS This was a large population-based multicenter study in which the representative children aged 0-5 years were recruited from 13 Children's Health Care Centers by a stratified cluster random-sampling method in Jiangsu Province, China. BMD was measured by using quantitative ultrasound. The association of BMD with BMI and obesity were evaluated using multiple linear regression and logistic regression analysis taking into account the effects of confounders. The relations between age, weight, height, BMI and BMD were analyzed by using Pearson's correlation and further tested using partial correlation in the additive model. RESULTS A total of 5,289 children (2786 boys and 2503 girls) were recruited. The BMD was positively linear relation with age, length/height, and was inversely linear relation with BMI (r=0.711, P<0.001; r=0.727, P<0.001; r=-0.318, P<0.001, respectively). The BMD gradually increased when the weight was in the range within 21.2kg, but started to gain slowlyand even decreased when the weight was over 21.2kg. After adjusting for confounders, compared with control group, children with obesityhad higher odds of low BMD (OR 95%CI: 2.73 (1.57, 4.76), P<0.001), the speed of sound (SOS)value in children with obesity was lower 47.45 (β=-47.45, 95%CI=-85.07, -9.83, P=0.013). CONCLUSIONS Adiposity was not advantageous for bone mineral density in 0-5-year-old Chinese children.
Collapse
Affiliation(s)
- Yan Zhao
- Department of Clinical Nutrition, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Rui Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China.
| | - Xianghua Ma
- Department of Clinical Nutrition, Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China.
| | - Zhenying Qin
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Zi Yang
- Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China
| | - Hong Hong
- Department of Child Health Care, Drum Tower Maternity and Child Health Care Institute, Nanjing, 210009, China
| | - Heyu Lv
- Department of Child Health Care, Jiangning Maternity and Child Health Care Institute, Nanjing, 211100, China
| | - Kan Ye
- Department of Child Health Care, Suzhou Municipal Hospital, Suzhou, 215000, China
| | - Yarong Wei
- Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, 214000, China
| | - Wen Zheng
- Department of Child Health Care, Yancheng Maternity and Child Health Care Institute, Yancheng, 224000, China
| | - Hongxia Qi
- Department of Child Health Care, Xuzhou Children's Hospital, Xuzhou, 221000, China
| | - Yufei Ni
- Department of Child Health Care, Nantong Maternity and Child Health Care Hospital, Nantong, 226000, China
| | - Li Zhang
- Department of Child Health Care, Huai'an Maternity and Child Health Care Hospital, Huai'an, 223001, China
| | - Juhua Yan
- Department of Child Health Care, Kunshan Maternity and Child Health Care Institute, Kunshan, 215300, China
| | - Guoqin Liu
- Department of Child Health Care, Dafeng Maternity and Child Health Care Hospital, Dafeng, 224100, China
| | - Aiping Wu
- Department of Child Health Care, Xinghua Maternity and Child Health Care Hospital, Xinghua, 225700, China
| |
Collapse
|
18
|
Mak TN, Angeles-Agdeppa I, Lenighan YM, Capanzana MV, Montoliu I. Diet Diversity and Micronutrient Adequacy among Filipino School-Age Children. Nutrients 2019; 11:E2197. [PMID: 31547317 PMCID: PMC6770711 DOI: 10.3390/nu11092197] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/03/2019] [Accepted: 09/09/2019] [Indexed: 02/08/2023] Open
Abstract
Previous studies have shown that the dietary diversity of young Filipino children to be limited and that the prevalence of nutrient inadequacies is high. This study extends the current knowledge to examine the relationship between diet diversity and the probability of adequacy of micronutrients among Filipino schoolchildren (aged 6 to 12 years), by the wealth status and dwelling location. The dietary intake data were collected using a single 24-h recall from 6460 children in the Filipino National Nutrition Survey 2013. The diet diversity score (DDS) and the probability of adequacies (PA) of 11 micronutrients were calculated, and further stratified by socio-economic status (SES) and dwelling location. The diet diversity was generally low (mean DDS = 4 out of 9). Children from the lowest SES, and living in rural areas, tended to have a lower DDS. Children with a DDS of 1 were likely to be inadequate in all 11 micronutrients. The higher DDS (≥6) was associated with higher PAs for the B vitamins but not for calcium, folate, iron, vitamin A and to large extent, vitamin C. This suggests that it was difficult for this population to achieve adequacy in these 5 micronutrients. More rigorous research on the topic is needed. Better access to nutrient-rich or fortified staple foods, in tandem with increased education on the importance of dietary diversity, are potential strategies to support children in achieving adequate micronutrient intakes.
Collapse
Affiliation(s)
- Tsz-Ning Mak
- Nestlé Research, Route du Jorat 57, 1000 Lausanne-26, Switzerland.
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Taguig City 1631, Philippines.
| | | | - Mario V Capanzana
- Department of Science and Technology, Food and Nutrition Research Institute, Taguig City 1631, Philippines.
| | - Ivan Montoliu
- Nestlé Research, Route du Jorat 57, 1000 Lausanne-26, Switzerland.
| |
Collapse
|
19
|
Angeles-Agdeppa I, Denney L, Toledo MB, Obligar VA, Jacquier EF, Carriquiry AL, Capanzana MV. Inadequate nutrient intakes in Filipino schoolchildren and adolescents are common among those from rural areas and poor families. Food Nutr Res 2019; 63:3435. [PMID: 31143094 PMCID: PMC6525598 DOI: 10.29219/fnr.v63.3435] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/14/2019] [Accepted: 04/14/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Adequate nutrition during childhood and adolescence is essential to promote growth and development. OBJECTIVE This study evaluated usual energy and nutrient intakes of Filipino schoolchildren and adolescents. DESIGN Food and beverage intakes were collected from a nationally representative sample of schoolchildren aged 6-9 and 10-12 years (n = 3,594 and n = 2,971, respectively) and adolescents aged 13-18 years (n = 5,447) using 24-h dietary recalls. The distributions of usual energy and nutrient intakes and the prevalence of inadequate intakes, which is defined as the percent of children with intakes less than estimated average requirements or acceptable macronutrient distribution ranges, were estimated using the Personal Computer Software for Intake Distribution Estimation (PC-SIDE) program. RESULTS The results showed that the mean energy intakes were 19-35% lower than estimated energy requirement. High prevalence of inadequate intakes was found for most macro- and micronutrients. Prevalence of inadequacies was as follows: protein 12-47%, total fat (as percentage of energy) 38-52%, calcium 92-94%, iron 75-90%, vitamin C 68-96%, folate 61-93%, vitamin A 58-81%, riboflavin 58-91%, thiamin 27-75%, and phosphorus 18-91%. CONCLUSIONS Generally, prevalence of inadequacy of key nutrients were relatively high among adolescents and schoolchildren, especially those from poor families and rural areas. This study demonstrated that nutrient intakes of Filipino schoolchildren and adolescents were highly inadequate, particularly among the poor and those living in rural areas.
Collapse
Affiliation(s)
- Imelda Angeles-Agdeppa
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
| | - Liya Denney
- Nestlé Research, Vers-chez-les-Blanc, Lausanne 1000, Switzerland Nestlé Research Centre, Lausanne, Switzerland
| | - Marvin B. Toledo
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
| | - Virgilyn Anne Obligar
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
| | - Emma F. Jacquier
- Nestlé Research, Vers-chez-les-Blanc, Lausanne 1000, Switzerland Nestlé Research Centre, Lausanne, Switzerland
| | | | - Mario V. Capanzana
- Food and Nutrition Research Institute, Department of Science and Technology, Taguig City 1631, The Philippines
| |
Collapse
|