The Relationship between Breastfeeding and Initial Vegetable Introduction with Vegetable Consumption in a National Cohort of Children Ages 1–5 Years from Low-Income Households

Infant diet quality index predicts nutrients of concern and ultra-processed food intake in low-income children in the United States

Background

Diet quality during infancy can influence nutrient intake and ultra-processed foods (UPFs) consumption throughout later childhood.

Objectives

This study investigated the predictive validity of Infant Diet Quality Index (IDQI) scores from 0 to 1 y of age and consumption of select nutrients and UPFs at different time points in low-income children aged 2-5 y.

Methods

Dietary surveys and 24-h dietary recalls collected between ages 0 and 12 months from 2613 Special Supplemental Women, Infants, and Children Infant Toddler Feeding Practices Study-2 participants were used to assess infant diet quality by final IDQI score ranging from 0 (nonadherence to dietary guidelines) to 1 (complete adherence to guidelines). Single 24-h recalls collected across multiple time points per child aged between 2 and 5 y were used to determine nutrient intakes: vitamin B12 (μg), vitamin D (μg), calcium (mg), iron (mg), zinc (mg), potassium (mg), saturated fat (g), dietary fiber (g), and added sugars (g). Likewise, Nova was used to classify foods (to estimate the percentage of energy from foods) by level of industrial processing at each point in time across ages 2-5 y. Survey-weighted regression analyses estimated associations between total IDQI score and nutrient intake and percentage of energy consumption from each Nova food group at each age between 2-5 y.

Results

IDQI scores based on diet quality from 0-1 y of age were positively associated with children's dietary fiber and potassium intake at ages 2-5 y. Additionally, IDQI was negatively associated with added sugar intake. No associations were observed between IDQI and saturated fat consumption. IDQI scores at age 1 were positively associated with the percentage of energy attributed to unprocessed/minimally processed foods (20%-23%) and negatively associated with UPF consumption at ages 2-5 y (-24% to -29%).

Conclusions

IDQI predicts intake of select nutrients and UPF consumption among low-income US children aged 2-5 y.This trial was registered at https://clinicaltrials.gov/study/NCT02031978 as "Feeding My Baby - A National WIC Study," NCT02031978.

Any Infant Formula Amount, but Not Infant Formula Type, Is Associated with Less Healthful Subsequent Beverage Intake among Special Supplemental Nutrition Program for Women, Infants, and Children-Participating Children

Background

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutrition assistance to low-income households, including infant formula for infants not fully breastfeeding. Issuance of lactose-reduced infant formula made with corn syrup solids (CSSF) is associated with elevated risk of obesity in early life, but associations between formula type and dietary intake have not been examined.

Objectives

To evaluate associations between infant formula (amount and type) issued by WIC with subsequent child diet at ages 12-59 mo.

Methods

Dietary data from 2014, 2017, and 2020 Los Angeles County WIC Survey respondents (n = 1339 children, 12-59 mo of age) were merged with WIC administrative data on infant feeding (amount and type of infant formula at ages 0-12 mo). Intake frequencies were available for sweetened beverages, sweets, juice, fast food, water, fruit, vegetables, and milk. Infant feeding was categorized by amount of WIC-issued formula (descending: fully formula fed, mostly formula fed, mostly breastfed, fully breastfed) and issuance of a CSSF (any, none). Associations between infant feeding (infant formula amount and type) and child diet were evaluated in multivariable generalized estimating equation negative binomial regression models, stratified by child age (12 to <24 mo, 24 to <60 mo).

Results

Any infant formula issuance in the first year of life was adversely associated with subsequent dietary intake. This included 21%-23% higher 100% juice intake at 24 to <60 mo and 11%-13% (at 24 to <60 mo) or 20%-22% (at 12 to <24 mo) lower water intake. CSSF receipt compared with only other infant formula was not consistently associated with subsequent child diet.

Conclusions

Any infant formula amount, but not CSSF receipt compared with other formula types, was associated with less healthful beverage intake patterns among WIC-participating children. WIC nutrition education may have a stronger impact if tailored based on infant feeding practices.

Breastfeeding Is Associated with Higher Adherence to the Mediterranean Diet in a Spanish Population of Preschoolers: The SENDO Project

OBJECTIVE

To assess whether breastfeeding during the first months of life is associated with adherence to the Mediterranean dietary (MedDiet) pattern in preschool children.

DESIGN

The Seguimiento del Niño para un Desarrollo Óptimo (SENDO) project is an ongoing pediatric cohort with open recruitment, started in 2015 in Spain. Participants, recruited when they are 4 to 5 years old at their primary local health center or school, are followed annually through online questionnaires. For this study, 941 SENDO participants with full data on study variables were included. Breastfeeding history was collected retrospectively at baseline. Adherence to the Mediterranean diet was assessed with the KIDMED index (range -3 to 12).

RESULTS

After accounting for multiple sociodemographic and lifestyle confounders, including parental attitudes and knowledge about dietary recommendations for children, breastfeeding was independently associated with a higher adherence to the MedDiet. Compared with children who were never breastfed, children breastfed for ≥6 months had a one-point increase on their mean KIDMED score (Mean difference +0.93, 95%confidence interval [CI]. 0.52-1.34, p for trend <0.001). The odds ratio of high adherence to the MedDiet (KIDMED index ≥8) was 2.94 (95%CI 1.50-5.36) in children who were breastfed for at least 6 months, as compared to their peers who were never breastfeed. Children who were breastfed for less than 6 months exhibited intermediate levels of adherence (p for trend <0.01).

CONCLUSION

Breastfeeding for 6 months or longer is associated with a higher adherence to the Mediterranean diet during the preschool years.

Infant and Young Child Feeding Practices and Health

Early childhood feeding practices are fundamental for a child's healthy growth, development and potential [...].