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Johnston M, O'Sullivan T, Devine A, Wallace R, Costello L, Sambell R. Toddlers may be getting enough iron in long day-care services after all. J Hum Nutr Diet 2023; 36:1901-1911. [PMID: 37143380 DOI: 10.1111/jhn.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 04/16/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Previous research has suggested that toddlers are not provided with adequate dietary iron in long-day care (LDC) services. However, the iron bioavailability provided is unknown. The present study aimed to investigate the amount and bioavailability of iron provided to toddlers aged 2-3 years at LDC services. METHODS A cross-sectional audit was conducted using a 2-day weighed food record of 30 LDC services. Iron provision (not child intake) in LDC services across Perth, Australia was compared with the estimated average requirements (EAR) and LDC services provision guidelines (50% of EAR = 2 mg/day based on a 14% bioavailability factor). Bioavailability was estimated per mealtime using haem and non-haem iron, ascorbic acid, animal protein, calcium, soy, eggs and phytates using two pre-existing algorithms (by A. P. Rickard and colleagues and H. Hallberg and H. Hulten). RESULTS Median iron supplied (2.52 mg/day, interquartile range [IQR] = 2.43-3.17) was above the 50% of EAR of 2.0 mg/day (p < 0.001). Median bioavailable iron was 0.6 mg/day (IQR = 0.54-0.8) using the method of Rickard et al. and 0.51 mg/day (IQR = 0.43, 0.76 using that of Hallberg and Hulthen). The top three foods contributing to iron provision were bread, breakfast cereals and beef. CONCLUSIONS Our results suggest that LDC services in Perth are meeting the minimum recommendation of provision of 50% of the iron EAR, and also that toddlers are provided with sufficient bioavailable iron. Future strategies should focus on promoting food combinations to maintain the iron bioavailability in meals currently served at LDC services.
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Affiliation(s)
- Michaela Johnston
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Therese O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - Ruth Wallace
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Leesa Costello
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ros Sambell
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Nutrition & Health Innovation Research Institute, Edith Cowan University, Joondalup, WA, Australia
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van Belkom B, Umanets A, van Mil E, Havermans RC. Promoting vegetable acceptance in toddlers using a contingency management program: A cluster randomised trial. Appetite 2023; 184:106513. [PMID: 36849010 DOI: 10.1016/j.appet.2023.106513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/16/2023] [Accepted: 02/24/2023] [Indexed: 02/27/2023]
Abstract
Children learn to accept novel foods by repeated exposure to these foods. In the current study, we investigated in toddlers whether a contingency management program (The Vegetable Box), comprising repeated vegetable taste exposure with contingent non-food rewards, is particularly potent at increasing recognition of and willingness to try vegetables. A total of 598 children (1-4 years old) recruited at 26 different day-care centres in the Netherlands took part. The day-care centres were randomly assigned to one of three conditions ('exposure/reward', 'exposure/no reward', or 'no exposure/no reward'). At the start and directly after the 3-month intervention period, all children were asked to identify various vegetables (recognition test; max score = 14) and whether they would like to taste and consume 1 or 2 bite-size pieces of tomato, cucumber, carrot, bell pepper, radish, and cauliflower (willingness to try test). Data were analysed with linear mixed-effects regression analyses (for recognition and willingness to try separately) with condition and time as independent variables, and adjusting for day-care centre clustering. Vegetable recognition significantly increased in both the 'exposure/reward' and the 'exposure/no reward' group, relative to the 'no exposure/no reward' control group. The willingness to try vegetables only increased significantly in the 'exposure/reward' group. Offering vegetables to children at day-care centres significantly increased toddlers' ability to identify various vegetables, but rewards contingent upon tasting vegetables appear particularly effective to also increase children's willingness to try (i.e., taste and consume) different vegetables. This result corroborates and strengthens previous findings demonstrating the efficacy of similar reward-based programs.
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Affiliation(s)
- Britt van Belkom
- Chair Youth, Food & Health, Institute for Food, Health, & Safety by Design, Maastricht University Campus Venlo, the Netherlands.
| | - Alexander Umanets
- Chair Youth, Food & Health, Institute for Food, Health, & Safety by Design, Maastricht University Campus Venlo, the Netherlands
| | - Edgar van Mil
- Chair Youth, Food & Health, Institute for Food, Health, & Safety by Design, Maastricht University Campus Venlo, the Netherlands; Department of Paediatrics, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Remco C Havermans
- Chair Youth, Food & Health, Institute for Food, Health, & Safety by Design, Maastricht University Campus Venlo, the Netherlands; Laboratory of Behavioural Gastronomy, Institute for Food, Health, & Safety by Design, Maastricht University Campus Venlo, the Netherlands
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3
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Implementation of four strategies in Dutch day-care centres to stimulate young children's fruit and vegetable consumption. Appetite 2023; 181:106378. [PMID: 36402413 DOI: 10.1016/j.appet.2022.106378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022]
Abstract
The day-care setting is an ideal place to encourage children's fruit and vegetable (=F&V) eating. Whereas many studies have focused on the effectiveness to increase F&V consumption, little is known about how to successfully implement effective strategies in daily practice. This study aimed to investigate how day-care professionals evaluated the implementation of a self-chosen strategy to support children's F&V eating. Thirteen day-care locations chose one out of five promising strategies and implemented this strategy for 10-12 weeks. Before (N = 98) and after the study (N = 49), day-care professionals completed a questionnaire to assess their implementation experiences, the impact on children's F&V eating as well as their future intention to use the strategy (on a 5-point scale). Parents (N = 152) completed a short questionnaire at the end of the study to capture their experiences and potential transfer effects to the home situation. Results showed that acceptability, appropriateness, feasibility and sustainability of the strategies were generally satisfactory (scores ≥3.5 on a 5-point scale), but the strategy of cooking scored less favourable on appropriateness and sustained implementation. Children's willingness to taste F&V varieties (3.4 ± 0.7 vs. 2.8 ± 0.8; p < 0.001) and eating pleasure for vegetables (3.4 ± 0.6 vs. 3.1 ± 0.8; p = 0.01) increased, whereas children's F&V consumption did not change (p > 0.14). Parents valued the day-cares' efforts to encourage children's F&V consumption and a small group (∼20%) experienced positive effects at home. This study shows that implementing a self-chosen F&V strategy at the day-care is acceptable, appropriate and feasible for day-care professionals and has potential to positively impact children's F&V eating behaviour. Future research should investigate the effects of long-term implementation on children's eating behaviour and examine how structural implementation can be further supported.
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Lee C, Kim S, Kim J, Lim C, Jung M. Challenges of diet planning for children using artificial intelligence. Nutr Res Pract 2022; 16:801-812. [PMID: 36467765 PMCID: PMC9702545 DOI: 10.4162/nrp.2022.16.6.801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/13/2022] [Accepted: 03/23/2022] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND/OBJECTIVES Diet planning in childcare centers is difficult because of the required knowledge of nutrition and development as well as the high design complexity associated with large numbers of food items. Artificial intelligence (AI) is expected to provide diet-planning solutions via automatic and effective application of professional knowledge, addressing the complexity of optimal diet design. This study presents the results of the evaluation of the utility of AI-generated diets for children and provides related implications. MATERIALS/METHODS We developed 2 AI solutions for children aged 3-5 yrs using a generative adversarial network (GAN) model and a reinforcement learning (RL) framework. After training these solutions to produce daily diet plans, experts evaluated the human- and AI-generated diets in 2 steps. RESULTS In the evaluation of adequacy of nutrition, where experts were provided only with nutrient information and no food names, the proportion of strong positive responses to RL-generated diets was higher than that of the human- and GAN-generated diets (P < 0.001). In contrast, in terms of diet composition, the experts' responses to human-designed diets were more positive when experts were provided with food name information (i.e., composition information). CONCLUSIONS To the best of our knowledge, this is the first study to demonstrate the development and evaluation of AI to support dietary planning for children. This study demonstrates the possibility of developing AI-assisted diet planning methods for children and highlights the importance of composition compliance in diet planning. Further integrative cooperation in the fields of nutrition, engineering, and medicine is needed to improve the suitability of our proposed AI solutions and benefit children's well-being by providing high-quality diet planning in terms of both compositional and nutritional criteria.
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Affiliation(s)
- Changhun Lee
- Department of Industrial Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Korea
| | - Soohyeok Kim
- Department of Industrial Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Korea
| | - Jayun Kim
- Kosin Innovative Smart Healthcare Research Center, Kosin University Gospel Hospital, Busan 49267, Korea
| | - Chiehyeon Lim
- Department of Industrial Engineering, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Korea
- Graduate School of Artificial Intelligence, Ulsan National Institute of Science and Technology (UNIST), Ulsan 44919, Korea
| | - Minyoung Jung
- Kosin Innovative Smart Healthcare Research Center, Kosin University Gospel Hospital, Busan 49267, Korea
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
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Mahmood L, Moreno LA, Flores-Barrantes P, Mavrogianni C, Schwarz P, Makrilakis K, Liatis S, Cardon G, Willems R, Rurik I, Radó S, Tankova T, Iotova V, Usheva N, Manios Y, Gonzalez-Gil EM. Parental food consumption and diet quality and its association with children's food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study. Public Health Nutr 2022; 25:1-12. [PMID: 36217747 PMCID: PMC9991723 DOI: 10.1017/s1368980022002245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/19/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the parental food consumption and diet quality and its associations with children's consumption in families at high risk for developing type 2 diabetes mellitus across Europe. Also, to compare food frequency consumption among parents and children from high-risk families to the European Dietary guidelines/recommendations. DESIGN Cross-sectional study using Feel4diabetes FFQ. SETTING Families completed FFQ and anthropometric measures were obtained. Linear regression analyses were applied to investigate the relations between parental food consumption and diet quality and their children's food consumption after consideration of potential confounders. PARTICIPANTS 2095 European families (74·6 % mothers, 50·9 % girls). The participants included parent and one child, aged 6-8 years. RESULTS Parental food consumption was significantly associated with children's intake from the same food groups among boys and girls. Most parents and children showed under-consumption of healthy foods according to the European Dietary Guidelines. Parental diet quality was positively associated with children's intake of 'fruit' (boys: β = 0·233, P < 0·001; girls: β = 0·134, P < 0·05) and 'vegetables' (boys: β = 0·177, P < 0·01; girls: β = 0·234, P < 0·001) and inversely associated with their 'snacks' consumption (boys: β = -0·143, P < 0·05; girls: β = -0·186, P < 0·01). CONCLUSION The present study suggests an association between parental food consumption and diet quality and children's food intake. More in-depth studies and lifestyle interventions that include both parents and children are therefore recommended for future research.
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Affiliation(s)
- Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Peter Schwarz
- Department of Medicine III, Technical University of Dresden, Dresden, Germany
| | - Konstantinos Makrilakis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Liatis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Imre Rurik
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Violeta Iotova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Esther M Gonzalez-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain
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6
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Boon PE, Pustjens AM, Te Biesebeek JD, Brust GMH, Castenmiller JJM. Dietary intake and risk assessment of elements for 1- and 2-year-old children in the Netherlands. Food Chem Toxicol 2022; 161:112810. [PMID: 35031389 DOI: 10.1016/j.fct.2022.112810] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 11/25/2022]
Abstract
In 2017, a total diet study (TDS) was conducted in the Netherlands to determine the intake of elements by 1- and 2-year-old children. Concentrations of 47 elements were analysed and long-term dietary intake was calculated for 24 elements. The 95th percentile (P95) intake estimates were compared with a tolerable daily or weekly intake (TDI or TWI) or tolerable upper intake level (UL), or a margin of exposure (MOE) was calculated. The P95 intake of cadmium and zinc exceeded the TWI or UL, respectively, and the P95 intake of inorganic arsenic and lead resulted in low MOEs. Food subgroups contributing most to the intake were "potatoes" for cadmium, "milk and milk-based beverages" for zinc, "concentrated fruit juices" and "rice" for inorganic arsenic, and "candies" for lead. For inorganic mercury, it could not be established if the intake was (too) high. P95 intake estimates of the other elements for which a risk characterisation could be performed were below the health-based guidance values. It was noted that the P50 intake estimate of manganese was a factor of 3 higher than the adequate intake level. Due to the absence of a UL, it is not clear if this intake is of concern.
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Affiliation(s)
- P E Boon
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3729, Bilthoven, the Netherlands.
| | - A M Pustjens
- Wageningen Food Safety Research (WFSR), Wageningen University and Research, P.O. Box 230, 6700, AE, Wageningen, the Netherlands
| | - J D Te Biesebeek
- National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3729, Bilthoven, the Netherlands
| | - G M H Brust
- Wageningen Food Safety Research (WFSR), Wageningen University and Research, P.O. Box 230, 6700, AE, Wageningen, the Netherlands
| | - J J M Castenmiller
- Netherlands Food and Consumer Product Safety Authority (NVWA), P.O. Box 43006, 3540 AA, Utrecht, the Netherlands
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Concina F, Pani P, Carletti C, Bravo G, Knowles A, Parpinel M, Ronfani L, Barbone F. Dietary Intake of the Italian PHIME Infant Cohort: How We Are Getting Diet Wrong from as Early as Infancy. Nutrients 2021; 13:nu13124430. [PMID: 34959981 PMCID: PMC8709248 DOI: 10.3390/nu13124430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/24/2022] Open
Abstract
Unhealthy dietary habits established in early infancy may lead to under or over nutrition later in life. This paper describes the energy, nutrients and food-type intake of 18-month-old infants belonging to the Italian PHIME cohort (n = 389) and evaluates adherence to the Italian dietary reference values (DRVs). Infant dietary data were collected using 7-day dietary records. Mean energy, macro and micronutrient intakes were estimated and compared with the DRVs. The percentage contribution of 19 selected food groups to total energy and macro- and micronutrient intake was determined with the aim of establishing the main food sources. Most infants’ diet shared common characteristics: poor variety, excessive intake of proteins (16.5 E% vs. 8–12 E% DRV) and saturated fatty acids (SFAs) (13.8 E% vs. <10 E% DRV), mainly derived from milk and dairy products, and low intake of total fats (33.2 E% vs. 35–40 E% DRV), polyunsaturated fatty acids (PUFAs) (3.1 E% vs. 5–10 E% DRV), vitamin D (1.1 vs. 15 µg/day DRV) and iron (4.5 vs. 8 mg/day DRV). The unbalanced distribution of macronutrients was reflected in energy intakes outside DRV ranges for more than half the infants. Public health interventions promoting healthy eating habits from early on, even from pregnancy, could yield significant short- and long-term health benefits.
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Affiliation(s)
- Federica Concina
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo’, Via dell’Istria 65/1, 34137 Trieste, Italy; (F.C.); (C.C.); (L.R.)
| | - Paola Pani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo’, Via dell’Istria 65/1, 34137 Trieste, Italy; (F.C.); (C.C.); (L.R.)
- Correspondence: (P.P.); (A.K.); Tel.: +39-040-3785236 (P.P. & A.K.)
| | - Claudia Carletti
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo’, Via dell’Istria 65/1, 34137 Trieste, Italy; (F.C.); (C.C.); (L.R.)
| | - Giulia Bravo
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100 Udine, Italy; (G.B.); (M.P.); (F.B.)
| | - Alessandra Knowles
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo’, Via dell’Istria 65/1, 34137 Trieste, Italy; (F.C.); (C.C.); (L.R.)
- Correspondence: (P.P.); (A.K.); Tel.: +39-040-3785236 (P.P. & A.K.)
| | - Maria Parpinel
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100 Udine, Italy; (G.B.); (M.P.); (F.B.)
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS Burlo Garofolo’, Via dell’Istria 65/1, 34137 Trieste, Italy; (F.C.); (C.C.); (L.R.)
| | - Fabio Barbone
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100 Udine, Italy; (G.B.); (M.P.); (F.B.)
- Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Friuli Centrale, Via Colugna 50, 33100 Udine, Italy
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8
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Liu X, Zhou Q, Clarke K, Younger KM, An M, Li Z, Tan Y, Kearney JM. Maternal feeding practices and toddlers' fruit and vegetable consumption: results from the DIT-Coombe Hospital birth cohort in Ireland. Nutr J 2021; 20:84. [PMID: 34666760 PMCID: PMC8524861 DOI: 10.1186/s12937-021-00743-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/07/2021] [Indexed: 12/21/2022] Open
Abstract
Background Health benefits of fruit and vegetable have been well recognized. However, insufficient consumption of fruit and vegetable is prevalent among toddlers, and has become a global public health issue. Maternal feeding practices are potential factors influencing toddlers’ dietary intake, including fruit and vegetable intake. This study was conducted to explore the influence of maternal feeding practices on toddlers’ fruit and vegetable consumption in Ireland. Methods A follow-up to the DIT-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to participate in the present follow-up study by phone. A questionnaire assessing maternal feeding behavior and the child’s 3-day food diary was sent to mothers who agreed to take part in the present study by post, together with a self-addressed stamped envelope. Results There were 193 mother-children pairs included in the analysis, and the mean age of children was 2.4 (SD 0.7) years old. Toddlers’ mean daily intakes of vegetable and fruit were 67.57 (SD 45.95) g and 213.35 (SD 170.78) g, respectively. Logistic regression analyses showed that maternal practice of breastfeeding for more than 4 weeks was positively associated with fruit (OR = 2.93, 95% CI: 1.29–6.64) and vegetable (OR = 1.95, 95% CI: 1.00–3.81) intake or the contribution of fruit (OR = 2.62, 95% CI: 1.19–5.80) and vegetable (OR = 2.02, 95% CI: 1.02–3.99) to the total diet. Letting the child eat with other family members was associated with high vegetable intake (OR = 5.45, 95%CI: 1.69–17.61) and high contribution of vegetable to total diet (OR = 3.78, 95% CI: 1.04–13.82). Not being too worried about the child’s refusal to eat was positively associated with toddlers’ vegetable intake (OR = 2.10, 95%CI: 1.09–4.05). Conclusions To increase children’s fruit and vegetable intake, and develop good eating habits, parents should eat with their toddlers, be patient and not put much pressure on their children in the context of meal feeding. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00743-z.
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Affiliation(s)
- Xiyao Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.
| | - Keara Clarke
- School of Biological Sciences, Technological University Dublin, Dublin, Ireland
| | - Katherine M Younger
- School of Biological Sciences, Technological University Dublin, Dublin, Ireland
| | - Meijing An
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | | | - Yang Tan
- Shijiazhuang Foreign Language School, Shijiazhuang, Hebei, China
| | - John M Kearney
- School of Biological Sciences, Technological University Dublin, Dublin, Ireland
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9
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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.
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Affiliation(s)
- Cathriona Monnard
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., 1015 Lausanne, Switzerland;
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10
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Dietary intake of protein and fat of 12- to 36-month-old children in a Dutch Total Diet Study. Eur J Nutr 2021; 61:439-446. [PMID: 34427765 PMCID: PMC8783874 DOI: 10.1007/s00394-021-02653-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 07/30/2021] [Indexed: 01/14/2023]
Abstract
Purpose This study attempted gaining insight into the intake of protein and fat of 12- to 36-month-old children in the Netherlands. Methods In 2017, a Total Diet Study (TDS) was carried out in the Netherlands including following three age groups: 12–17-, 18–23- and 24- to 36-month-old children. Protein and fat concentrations of 164 composite samples were analysed and combined with the consumption data from the Dutch National Food Consumption Survey 2012–2016 (DNFCS). Results Median protein intake of the 12- to 35-month-old Dutch children based on the TDS was 35 g/day with main contributions from the food subgroups “milk and milk-based beverages”, “beef” and “yoghurts and desserts”. Median fat intake was 34 g/day with main contributions from the food subgroups “margarines”, “cheeses” and “milk and milk-based beverages”. For the youngest age group (12- to 18-month-old children), (ready to drink) follow-on formula was one of the main contributors to the fat intake. Conclusion Compared to the EFSA reference values, protein intake of the Dutch 12- to 36-month-old children is high, whereas fat intake follows the reference intake. A TDS is a suitable instrument to estimate macronutrient intakes. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02653-6.
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HADMAȘ RM, MARTIN ȘA, MĂRGINEAN O. Children anthropometric development: an analysis over food consumption and energy requirements. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.19.04310-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Garemo M, Elamin A, Gardner A. Home packed food for nursery children in United Arab Emirates provides suboptimal quality. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Early childhood nutrition is associated with health outcomes later in life, hence developing health promoting habits from an early age is imperative. OBJECTIVE: The aim of this study was to assess the nutritional adequacy of home-packed food brought to the nurseries by attending children. METHODS: In a cross sectional study conducted in 7 nurseries in Abu Dhabi, United Arab Emirates 315 food-boxes were assessed through detailed food observations at the nurseries prior to mealtimes. The food content was evaluated using the Alberta Guidelines for nursery food, Canada. RESULTS: Most food boxes contained refined grains (77.5%), fruits (74.6%), sweet/full fat dairy products (77.5%), discretionary-calorie-food-items (70.6%). Emirati children were offered sweetened drinks significantly more (p < 0.001). Non-dairy protein sources, vegetables, low-fat-natural-dairy products were offered to 45.4%, 44.1% and 3.9% of children, respectively. Overall, 70.2% of the food-boxes contained not-recommended food and 63.1% of the children were served a very poor food combination. CONCLUSIONS: Despite frequent inclusion of recommended food, many food boxes were nutritionally inadequate due to their low content of whole grains, low-fat dairy products, vegetables and animal proteins and high content of sweet food and drinks. The inadequate dietary patterns necessitate developing nutrition guidelines for nurseries in Abu Dhabi.
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Affiliation(s)
- Malin Garemo
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, United Arab Emirates
| | - Amal Elamin
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, United Arab Emirates
| | - Andrew Gardner
- School of Molecular Sciences, University of Western Australia, Crawley, Perth, WA, Australia
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Yen CE. Food and nutrient provision in preschools: Comparison of public and private preschools. Nutr Health 2020; 27:9-15. [PMID: 33040682 DOI: 10.1177/0260106020942430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A balanced diet is important for ensuring health and development in childhood. As preschool is the main place of childcare, the meals that they provide have a critical influence on children's dietary intake. AIM The objectives of this study were to evaluate the nutrition status of preschool meals and to compare the food and nutrient content in public and private preschool meals. METHODS This was a cross-sectional study of 12 randomly sampled, public and private preschools in Taichung City, Taiwan. The background questionnaires, which included the meal budget and provision status of preschool meals, were completed either by the principals or supervisors of the preschools. The food and nutrition levels of preschool meals were assessed by weighing the actual food provided to the preschool children. In addition, preschool menus were collected to evaluate the meals and food served. RESULTS Overall, the mean calcium provision of preschools was lower than half the daily dietary reference intake (DRI), and the mean sodium was higher than half the DRI. The mean energy, carbohydrate, protein, fat, iron and vitamins B1, B2 and C supplied by the public preschools were significantly higher than those in the private preschools. In addition, the whole grains, meat, vegetables, fruits, oil and nuts supplied in public preschools were significantly higher than those found in private preschools. CONCLUSIONS The mean energy and macronutrient provision of public preschools were significantly higher than those found in private preschools. Meal quality and nutrient levels offered in public preschools were generally higher than those found in private preschools.
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Affiliation(s)
- Chin-En Yen
- 63114Chaoyang University of Technology, Taichung
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14
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North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper: Plant-based Milks. J Pediatr Gastroenterol Nutr 2020; 71:276-281. [PMID: 32732790 DOI: 10.1097/mpg.0000000000002799] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Parents and caretakers are increasingly feeding infants and young children plant-based "milk" (PBM) alternatives to cow milk (CM). The US Food and Drug Administration currently defines "milk" and related milk products by the product source and the inherent nutrients provided by bovine milk. Substitution of a milk that does not provide a similar nutritional profile to CM can be deleterious to a child's nutritional status, growth, and development. Milk's contribution to the protein intake of young children is especially important. For almond or rice milk, an 8 oz serving provides only about 2% or 8%, respectively, of the protein equivalent found in a serving of CM. Adverse effects from the misuse of certain plant-based beverages have been well-documented and include failure to gain weight, decreased stature, kwashiorkor, electrolyte disorders, kidney stones, and severe nutrient deficiencies including iron deficiency anemia, rickets, and scurvy. Such adverse nutritional outcomes are largely preventable. It is the position of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Nutrition Committee, on behalf of the society, that only appropriate commercial infant formulas be used as alternatives to human milk in the first year of life. In young children beyond the first year of life requiring a dairy-free diet, commercial formula may be a preferable alternative to cow's milk, when such formula constitutes a substantial source of otherwise absent or reduced nutrients (eg, protein, calcium, vitamin D) in the child's restricted diet. Consumer education is required to clarify that PBMs do not represent an equivalent source of such nutrients. In this position paper, we provide specific recommendations for clinical care, labelling, and needed research relative to PBMs.
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Barone L, Carone N, Salazar-Jimenez JG, Ortíz Muñoz JA. Enhancing food habits via sensitivity in rural low-SES mothers of children aged 1-3 living in Colombia: a randomized controlled trial using video-feedback intervention. Attach Hum Dev 2020; 23:831-852. [PMID: 32597700 DOI: 10.1080/14616734.2020.1784243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In a randomized controlled trial with 25 Colombian rural low-SES mothers and their children (aged 1-3 years), the effectiveness of the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) in enhancing maternal sensitivity and food habits was tested pre-intervention, post-intervention, and at a 6-month follow-up. The study further verified whether maternal sensitivity represented a mechanism of change for food habits. Mixed models indicated that the VIPP-SD did promote higher maternal sensitivity and better food habits. Moreover, increased maternal sensitivity following the VIPP-SD predicted improved maternal food habits, both post-intervention and at the follow-up. The findings suggest that interventions aimed at preventing early inadequate parental food habits in low-SES communities should promote sensitive parenting during daily mother-child interactions, in addition to offering nutritional advice.
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Affiliation(s)
- Lavinia Barone
- Department of Brain and Behavioral Sciences, Lab on Attachment and Parenting LAG, University of Pavia, Pavia, Italy
| | - Nicola Carone
- Department of Brain and Behavioral Sciences, Lab on Attachment and Parenting LAG, University of Pavia, Pavia, Italy
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Prevalence of anaemia in Brazilian children in different epidemiological scenarios: an updated meta-analysis. Public Health Nutr 2020; 24:2171-2184. [PMID: 32398172 DOI: 10.1017/s1368980019005287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To update the estimation of the prevalence of anaemia in Brazilian children according to four different epidemiological scenarios. DESIGN A new systematic review was conducted with a meta-analysis of the results published between 2007 and May 2019. Literature search was carried out in the PubMed and LILACS databases using keywords anaemia, child and Brazil. A total of thirty-seven articles (17 741 children) were selected and categorised according to the origin of their respective samples: childcare centres (Childcare; n 13 studies/2697 individuals), health services (Services; n 4/755), populations with social inequities (Inequities, n 7/6798) and population-based studies (Populations; n 13/7491). Assuming a prevalence of 20·9 % as reference (Health National Survey; n 3455), the combined prevalence ratios (PR) were calculated. A random-effects model was used. PARTICIPANTS Brazilian children 6-60 months of age. RESULTS The prevalence of anaemia, by scenario, was: Childcare 24·8 % (PR 1·06; 95 % CI 0·81, 1·40); Services 39·9 % (PR 1·76, 95 % CI 1·33, 2·35); Inequities 51·6 % (PR 2·02, 95 % CI 1·87, 2·18); and Populations 35·8 % (PR 1·42, 95 % CI 1·23, 1·64). Therefore, the values were all higher than the national prevalence; the Inequities had the highest prevalence, and only Childcare did not reach statistical significance. Concerning the previous meta-analysis, there was a reduction in anaemia prevalence in all scenarios: -52·3, -33·7, -22·4 and -10·7 %, respectively. CONCLUSIONS Compared to the situation revealed in the previous meta-analysis, anaemia, although observed to a lesser extent, remains an important public health problem in the different scenarios analysed, especially for children living in Inequities. Access to Childcare mitigates the risk for this condition.
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Jiang T, Lu Y, Duan H, Zhang W, Liu A. A model-based approach for clustering of multivariate semicontinuous data with application to dietary pattern analysis and intervention. Stat Med 2020; 39:16-25. [PMID: 31702055 DOI: 10.1002/sim.8391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 11/10/2022]
Abstract
Semicontinuous data, characterized by a sizable number of zeros and observations from a continuous distribution, are frequently encountered in health research concerning food consumptions, physical activities, medical and pharmacy claims expenditures, and many others. In analyzing such semicontinuous data, it is imperative that the excessive zeros be adequately accounted for to obtain unbiased and efficient inference. Although many methods have been proposed in the literature for the modeling and analysis of semicontinuous data, little attention has been given to clustering of semicontinuous data to identify important patterns that could be indicative of certain health outcomes or intervention effects. We propose a Bernoulli-normal mixture model for clustering of multivariate semicontinuous data and demonstrate its accuracy as compared to the well-known clustering method with the conventional normal mixture model. The proposed method is illustrated with data from a dietary intervention trial to promote healthy eating behavior among children with type 1 diabetes. In the trial, certain diabetes friendly foods (eg, total fruit, whole fruit, dark green and orange vegetables and legumes, whole grain) were only consumed by a proportion of study participants, yielding excessive zero values due to nonconsumption of the foods. Baseline foods consumptions data in the trial are used to explore preintervention dietary patterns among study participants. While the conventional normal mixture model approach fails to do so, the proposed Bernoulli-normal mixture model approach has shown to be able to identify a dietary profile that significantly differentiates the intervention effects from others, as measured by the popular healthy eating index at the end of the trial.
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Affiliation(s)
- Tao Jiang
- School of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, China
| | - Yahui Lu
- School of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, China
| | - Huimin Duan
- School of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, China
| | - Wei Zhang
- Biostatistics and Bioinformatics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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Luecking CT, Mazzucca S, Vaughn AE, Ward DS. Contributions of Early Care and Education Programs to Diet Quality in Children Aged 3 to 4 Years in Central North Carolina. J Acad Nutr Diet 2019; 120:386-394. [PMID: 31831384 DOI: 10.1016/j.jand.2019.09.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/23/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parents and early care and education (ECE) are the key influencers of young children's diets, but there is limited information about how each contribute to children's overall diet quality. OBJECTIVE This study aimed to determine what proportion of children's dietary intake occurs within the ECE setting and whether diet quality is higher at ECE centers and, consequently, on weekdays than weekends. DESIGN This cross-sectional analysis of a larger cluster randomized controlled trial used multiple 24-hour dietary intakes measured through a combination of the Dietary Observation in Child Care protocol and parent-reported food diaries. PARTICIPANTS/SETTING Participants (N=840) included children aged 3 to 4 years enrolled in ECE centers in central North Carolina for whom 24-hour dietary intake was captured via observation of meals and snacks consumed at ECE and parent-report of all remaining meals and snacks. Data were collected from 2015 to 2016. MAIN OUTCOME MEASURES Diet quality at ECE and elsewhere was evaluated using the Healthy Eating Index 2015. STATISTICAL ANALYSES PERFORMED Mixed-effects models were used to determine differences in mean Healthy Eating Index 2015 component and total scores. Models were adjusted for children's age and sex and accounted for clustering within ECE centers and families. RESULTS Children consumed approximately 40% of daily energy, nutrients, and food groups at ECE centers. The mean total Healthy Eating Index 2015 score was higher for foods and beverages consumed at ECE centers (58.3±0.6) than elsewhere (52.5±0.6) (P<0.0001). The mean total Healthy Eating Index 2015 score was also higher on weekdays (58.5±0.5) than on weekends (51.3±0.5) (P<0.0001). CONCLUSIONS Children consume a majority of dietary intake away from ECE centers. Overall, diet quality is low, but the quality of foods consumed by children at ECE centers is higher than that consumed elsewhere. ECE centers remain an important source of nutrition and further investigation is warranted to identify ways to support both ECE centers and families to provide healthier eating environments.
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Kang M, Shim JE, Kwon K, Song S. Contribution of foods to absolute nutrient intake and between-person variations of nutrient intake in Korean preschoolers. Nutr Res Pract 2019; 13:323-332. [PMID: 31388409 PMCID: PMC6669073 DOI: 10.4162/nrp.2019.13.4.323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/30/2019] [Accepted: 07/05/2019] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES The aim of this study was to analyze specific foods influencing absolute nutrient intake and between-person variations of nutrient intake among Korean preschoolers. SUBJECTS/METHODS This study included 2,766 participants aged 1–5 years in the 2009–2013 Korea National Health and Nutrition Examination Surveys. Dietary data were obtained from a 24-h dietary recall method. Major food sources of absolute nutrient intake were evaluated based on percent contribution of each food. To assess the contribution of specific foods to between-person variations in nutrient intake, stepwise multiple regressions were performed and cumulative R2 was used. RESULTS White rice and milk were main food sources of energy, protein, carbohydrate, phosphorus, iron, potassium, thiamin, riboflavin, and niacin. The percentage of fat contributed by milk was 21.3% which was the highest, followed by pork, soybean oil, and egg. White rice accounted for 25% and 40% of total variability in total energy and carbohydrate intakes, respectively. About 39% of variation in calcium intake was explained by milk while 40% of variation in phosphorous intake was explained by cheese. The top 10 foods contributing to between-person variations in nutrient intakes were similar with food items that mainly contributed to absolute nutrient intakes. The number of foods explaining 90% of absolute amounts of nutrient intakes varied from 28 for vitamin A to 80 for iron. CONCLUSIONS This study identified specific foods that contributed to absolute nutrient intakes and between-person variations in nutrient intakes among Korean preschoolers. Our findings can be used to develop dietary assessment tools and establish food-based dietary guidelines for young children.
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Affiliation(s)
- Minji Kang
- Center for Gendered Innovations in Science and Technology Research (GISTeR), Korea Federation of Women's Science & Technology Associations, Seoul, 06130, Korea
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, Daejeon, 34520, Korea.,Daejeon Dong-gu Center for Children's Food Service Management, Daejeon, 34520, Korea.,Nutrition Counseling Center, Daejeon University, Daejeon, 34520, Korea
| | - Kyungmin Kwon
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, 08826, Korea
| | - SuJin Song
- Department of Food and Nutrition, Hannam University, 1646 Yuseong-daero, Yuseong-gu, Daejeon, 34054, Korea
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van der Veek SMC, de Graaf C, de Vries JHM, Jager G, Vereijken CMJL, Weenen H, van Winden N, van Vliet MS, Schultink JM, de Wild VWT, Janssen S, Mesman J. Baby's first bites: a randomized controlled trial to assess the effects of vegetable-exposure and sensitive feeding on vegetable acceptance, eating behavior and weight gain in infants and toddlers. BMC Pediatr 2019; 19:266. [PMID: 31370830 PMCID: PMC6670176 DOI: 10.1186/s12887-019-1627-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/15/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The start of complementary feeding in infancy plays an essential role in promoting healthy eating habits. Evidence shows that it is important what infants are offered during this first introduction of solid foods: e.g. starting exclusively with vegetables is more successful for vegetable acceptance than starting with fruits. How infants are introduced to solid foods also matters: if parents are sensitive and responsive to infant cues during feeding, this may promote self-regulation of energy intake and a healthy weight. However, the effectiveness of the what and the how of complementary feeding has never been experimentally tested in the same study. In the current project the what and how (and their combination) are tested in one study to determine their relative importance for fostering vegetable acceptance and self-regulation of energy intake in infants. METHODS A four-arm randomized controlled trial (Baby's First Bites (BFB)) was designed for 240 first-time Dutch mothers and their infants, 60 per arm. In this trial, we compare the effectiveness of (a) a vegetable-exposure intervention focusing on the what in complementary feeding; (b) a sensitive feeding intervention focusing on the how in complementary feeding, (c) a combined intervention focusing on the what and how in complementary feeding; (d) an attention-control group. All mothers participate in five sessions spread over the first year of eating solid foods (child age 4-16 months). Primary outcomes are vegetable consumption, vegetable liking and self-regulation of energy intake. Secondary outcomes are child eating behaviors, child anthropometrics and maternal feeding behavior. Outcomes are assessed before, during and directly after the interventions (child age 18 months), and when children are 24 and 36 months old. DISCUSSION The outcomes are expected to assess the impact of the interventions and provide new insights into the mechanisms underlying the development of vegetable acceptance, self-regulation and healthy eating patterns in infants and toddlers, as well as the prevention of overweight. The results may be used to improve current dietary advice given to parents of their young children on complementary feeding. TRIAL REGISTRATION The trial was retrospectively registered during inclusion of participants at the Netherlands National Trial Register (identifier NTR6572 ) and at ClinicalTrials.gov ( NCT03348176 ). Protocol issue date: 1 April 2018; version number 1.
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Affiliation(s)
- S. M. C. van der Veek
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - C. de Graaf
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - J. H. M. de Vries
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - G. Jager
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | | | - H. Weenen
- Danone Nutricia Research, P.O. Box 80141, 3508 TC Utrecht, The Netherlands
| | - N. van Winden
- Nutricia Early Life Nutrition, P.O. Box 445, 2700 AK Zoetermeer, The Netherlands
| | - M. S. van Vliet
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - J. M. Schultink
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - V. W. T. de Wild
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - S. Janssen
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - J. Mesman
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
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Sambell R, Wallace R, Costello L, Lo J, Devine A. Measuring food provision in Western Australian long day care (LDC) services: a weighed food record method/protocol at a service level. Nutr J 2019; 18:38. [PMID: 31311569 PMCID: PMC6636161 DOI: 10.1186/s12937-019-0462-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 06/25/2019] [Indexed: 11/23/2022] Open
Abstract
Background There are currently 1.3 million children utilising Early Childhood Education and Care (ECEC) services in Australia. Long day care (LDC), family day care and out of school hours care currently provide this service in different environments. This research reports findings from a LDC perspective. Children can consume 40–67% of their food intake whilst at LDC services, this highlights the importance of monitoring food provision at a service level. There are several methods to measure food provision which typically focus on intake at an individual level. There is limited evidence of measuring food provision accurately at a service level and for young children. Accurate and consistent dietary assessment methods are required to determine compliance with dietary guidelines and to provide rigour for comparison between studies. Methods Convenience sampling was used to recruit 30 LDC services and food provision assessed over two consecutive days. To ensure consistency, trained researchers weighed raw food ingredients used in food preparation at each service. Food and food weights were allocated to food groups to determine average serves of food group provision at morning tea, lunch and afternoon tea per child. All data were entered into Foodworks for dietary analysis and compliance with dietary guidelines was assessed using Wilcoxon signed-rank and one-sample t-tests (SPSS). Discussion This paper outlines the process of data collection for the measurement and auditing of food provision and food waste at a service level. There is an urgent need to ensure that food provision at a service level complies with current dietary guidelines and is accurately assessed. Following a standard method of data collection will allow a more accurate comparison between studies and allow change to be monitored more accurately over time to guide decision makers. Trial registration As this research project is conducted at a service level and not a clinical trial, registration was not required.
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Affiliation(s)
- Ros Sambell
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Ruth Wallace
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Leesa Costello
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Johnny Lo
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Amanda Devine
- Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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The Contribution of Preschool Meals to the Diet of Finnish Preschoolers. Nutrients 2019; 11:nu11071531. [PMID: 31284433 PMCID: PMC6683016 DOI: 10.3390/nu11071531] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/17/2019] [Accepted: 06/26/2019] [Indexed: 01/13/2023] Open
Abstract
Preschool meals may influence the formation of children's dietary habits and health. We assessed the contribution of preschool meals to the diet of Finnish children. We used food record data from the cross-sectional DAGIS survey and selected recording days which included all three meals (breakfast, lunch, afternoon snack) at preschool. We analyzed the diet of three- to four-year-olds (n = 324) and five- to six-year-olds (n = 233). Preschool meals accounted for 54% of the weekday's energy intake in both age groups, and provided ≥60% of total fiber, polyunsaturated fatty acids, and vitamins D and E. More than 60% of fish dishes but only one third of total daily fresh fruit were consumed at preschool. The mean (SD) percentages of energy from protein and fat at preschool were 17% (3%) and 30% (7%) in the younger and 17% (3%) and 31% (6%) in the older age group, respectively. The mean proportions of energy from added sugar at preschool were below 5% in both age groups. On average, salt intake exceeded recommendations and 60% of salt came from preschool food. Tackling high salt intake should be a future goal of guidance for early childhood education and care food services.
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Ter Borg S, Koopman N, Verkaik-Kloosterman J. Food Consumption, Nutrient Intake and Status during the First 1000 days of Life in the Netherlands: a Systematic Review. Nutrients 2019; 11:E860. [PMID: 30995816 PMCID: PMC6520769 DOI: 10.3390/nu11040860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/04/2019] [Accepted: 04/11/2019] [Indexed: 12/25/2022] Open
Abstract
Adequate nutrition is essential for growth and development in early life. Nutritional data serves as a basis for national nutritional guidelines and policies. Currently, there is no insight into the availability of such data during the first 1000 days of life. Therefore, a systematic review was performed, following the PRISMA reporting guideline, to identify studies on food consumption, nutrient intake or status in the Netherlands. Potential gaps were identified, and the quality of the studies is discussed. The databases Embase and Medline were used, as well as databases from national institutes. Articles published in 2008-2018 were screened by two independent reviewers. In total 601 articles were identified, of which 173 were included. For pregnant women, 32 studies were available with nutritional data, for young children 40 studies were identified. No studies were available for breastfeeding women. A large variety of foods and nutrients were assessed, however certain nutrients were lacking (e.g., vitamin K). Overall, the studies had methodological limitations, making the data unsuitable to assess nutrient inadequacies. There is a need for recent, high quality nutritional research to strengthen the understanding of the nutritional needs and deficiencies during early life, and is fundamental for national guidelines and policies.
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Affiliation(s)
- Sovianne Ter Borg
- National Institute for Public Health and the Environment, 3721 MA, Bilthoven, The Netherlands.
| | - Nynke Koopman
- National Institute for Public Health and the Environment, 3721 MA, Bilthoven, The Netherlands.
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Bournez M, Ksiazek E, Charles MA, Lioret S, Brindisi MC, de Lauzon-Guillain B, Nicklaus S. Frequency of Use of Added Sugar, Salt, and Fat in Infant Foods up to 10 Months in the Nationwide ELFE Cohort Study: Associated Infant Feeding and Caregiving Practices. Nutrients 2019; 11:E733. [PMID: 30934918 PMCID: PMC6520717 DOI: 10.3390/nu11040733] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/16/2019] [Accepted: 03/26/2019] [Indexed: 01/05/2023] Open
Abstract
The consumption of sugar, salt, and fat in infancy may influence later health. The objective of this study was to describe the frequency of use of added sugar, salt, and fat during the complementary feeding period and the associated infant caregiving practices. Data were obtained from a monthly questionnaire filled by parents for 10,907 infants from the French Etude Longitudinale Française depuis l'Enfance (ELFE) cohort. A score of frequency of use (SU) for added sugar, salt, and fat (oil, margarine, butter, and/or cream) was calculated from the age at complementary feeding introduction (CFI) to the 10th month. Associations between the SU of each added ingredient with infant feeding and caregiving practices were studied with multivariable linear regressions adjusted for familial characteristics. Only 28% of the parents followed the recommendation of adding fat and simultaneously not adding sugar or salt. Breastfeeding mothers were more prone to add sugar, salt, and fat than non-breastfeeding mothers. CFI before four months was positively associated with the SU of added sugar and salt and negatively associated with the SU of added fat. The use of commercial baby food was negatively related to the SU of added salt and fat. The use of these added ingredients was mainly related to breastfeeding, age at CFI, and use of commercial food, and it was independent of the household socioeconomic characteristics.
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Affiliation(s)
- Marie Bournez
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
- Centre Hospitalier Universitaire de Dijon, Hôpital d'Enfants, Pediatrics, 21079 Dijon, France.
| | - Eléa Ksiazek
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
| | - Marie-Aline Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early life research on later health Team (EAROH), F-75014 Paris, France.
- 12 rue de l'Ecole de Médecine, Paris Descartes University, 75006 Paris, France.
| | - Sandrine Lioret
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early life research on later health Team (EAROH), F-75014 Paris, France.
- 12 rue de l'Ecole de Médecine, Paris Descartes University, 75006 Paris, France.
| | - Marie-Claude Brindisi
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
- Centre Hospitalier Universitaire de Dijon, Hôpital d'Enfants, Endocrinology, Nutrition, 21079 Dijon, France.
| | - Blandine de Lauzon-Guillain
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early life research on later health Team (EAROH), F-75014 Paris, France.
- 12 rue de l'Ecole de Médecine, Paris Descartes University, 75006 Paris, France.
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Univ. Bourgogne Franche-Comté, 21000 Dijon, France.
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Puschner B, Gallego SM. Chemical hazards associated with milk and dairy. CHEMICAL HAZARDS IN FOODS OF ANIMAL ORIGIN 2019. [DOI: 10.3920/978-90-8686-877-3_15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Birgit Puschner
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, 149 Briggs Hall, Davis, CA 95616, USA
| | - Steven M. Gallego
- California Department of Food and Agriculture, Animal Health and Food Safety Services, 2135 Civic Center Drive, Redding, CA 96001, USA
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Healthy Nutrition and Physical Activity in Childcare: Views from Childcare Managers, Childcare Workers and Parents on Influential Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122909. [PMID: 30572600 PMCID: PMC6313341 DOI: 10.3390/ijerph15122909] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 01/10/2023]
Abstract
Childhood obesity is an important public health issue influenced by both personal and environmental factors. The childcare setting plays an important role in children’s energy balance-related behaviours (EBRB), such as physical activity, sedentary behaviour and healthy nutrition. This study aimed to explore facilitators and barriers of healthy EBRB in childcare in a comprehensive way, from the perspective of three crucial stakeholders: childcare managers, childcare workers and parents. A qualitative study was performed using semi-structured interviews. Content analysis was performed using the ‘Environmental Research framework for weight Gain prevention’ (EnRG framework) to guide the analysis. Forty-eight interviews were held with a total of 65 participants (9 childcare managers, 23 childcare workers and 33 parents). Influential factors in all types of environment (physical, sociocultural, economic and political) were mentioned. Although a need for change was not always expressed, the interviews revealed opportunities for improvement of healthy EBRB in childcare. These opportunities were related to the sociocultural, physical and political environment. Childcare workers and managers expressed an influence of the home setting on the childcare setting, resulting in a need for more congruence between these settings. There are opportunities for improvement in the childcare setting to promote healthy EBRB in young children in the Netherlands. It appears important to align intervention components between the childcare and home setting.
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Er V, Dias KI, Papadaki A, White J, Wells S, Ward DS, Metcalfe C, Jago R, Kipping R. Association of diet in nurseries and physical activity with zBMI in 2-4-year olds in England: a cross-sectional study. BMC Public Health 2018; 18:1262. [PMID: 30428858 PMCID: PMC6236905 DOI: 10.1186/s12889-018-6138-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood obesity tracks into adulthood with detrimental effects on health. We aimed to examine the relationships of diet in childcare settings and daily physical activity (PA) of preschoolers with body mass index z-score (z-BMI). METHODS We conducted a cross-sectional study of 150 children aged 2-4-years participating in the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) UK study to examine the associations of their diet in childcare settings and daily PA with z-BMI. Dietary intake was observed and recorded by fieldworkers using a validated tick-list food questionnaire and diet quality was assessed based on adherence to Children's Food Trust (CFT) guidelines. PA was measured using accelerometers. We derived z-BMI scores using the UK 1990 and International Obesity Taskforce growth reference charts. Multilevel regression models were used to estimate associations between diet and PA with z-BMI separately, adjusted for age, gender, ethnicity, parental education level and clustering. RESULTS Among children who consumed one main meal or snack at childcare, 34.4% and 74.3% met the standards on fruits and vegetables and high sugar or fat snacks, respectively. Adherence to CFT guidelines was not associated with zBMI. Only 11.4% of children met recommended UK guidelines of three hours per day of physical activity. Minutes spent in light PA (β = 0.08, 95% CI = 0.01, 0.15) and active time (β = 0.07, 95% CI = 0.01, 0.12) were positively associated with UK 1990 zBMI scores. CONCLUSIONS The low proportion of children meeting the standards on fruits and vegetables and high sugar or fat snacks and recommended physical activity levels highlight the need for more work to support nurseries and parents to improve preschool children's diet and activity. In our exploratory analyses, we found children with higher zBMI were more physically active which could be attributed to fat-free mass or chance finding and so requires replication in a larger study. TRIAL REGISTRATION ISRCTN16287377 . Registered 12 June 2014.
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Affiliation(s)
- Vanessa Er
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Kaiseree Ioni Dias
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK
| | - James White
- Centre for Trials Research, Cardiff University, 7th Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF144YS, UK
| | - Sian Wells
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Dianne Stanton Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Chris Metcalfe
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.,National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West (CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK
| | - Ruth Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
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Baek Y, Shim JE, Song S. Dietary intake of fat and fatty acids by 1-5-year-old children in Korea: a cross-sectional study based on data from the sixth Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2018; 12:324-335. [PMID: 30090170 PMCID: PMC6078869 DOI: 10.4162/nrp.2018.12.4.324] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/05/2018] [Accepted: 07/16/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/OBJECTIVES We examined dietary fat intake and the major food sources by young children in Korea. SUBJECTS/METHODS A total of 1,041 children aged 1–5 years were identified from the 2013–2015 Korea National Health and Nutrition Examination Survey. Data on total fat and fatty acid intake were obtained by a single 24-h dietary recall. Food sources were identified based on the amounts of total fat and fatty acids consumption according to each food. Fat and fatty acid intakes and their food sources were presented by age group (1–2-y, n = 401; 3–5-y, n = 640). Fat and fatty acid intakes were also evaluated according to socioeconomic characteristics. RESULTS The mean intake of fat was 27.1 ± 0.8 g in the 1-2-y group and 35.5 ± 0.7 g in the 3-5-y group, and about 23% of the total energy was obtained from fat in both age groups. The mean intake of saturated fatty acids (SFA) was 10.5 ± 0.3 g in the 1-2-y group and 12.7 ± 0.3 g in the 3-5-y group, with the 1-2-y group obtaining more energy from SFA than the 3-5-y group (9.2% vs. 8.3%). The mean intake of polyunsaturated fatty acids (PUFA) was 6.3 ± 0.1 g in the total subjects, with 0.8 ± 0.03 g of n-3 fatty acids and 5.5 ± 0.1 g of n-6 fatty acids being consumed. Milk, pork, and eggs were major food sources of total fat, SFA, and monounsaturated fatty acids, and soybean oil was the main contributor to PUFA in both age groups. In the 1-2-y group, children in rural areas had significantly higher intake of PUFA and n-3 fatty acids than did those in urban areas. CONCLUSIONS Our findings provide current information on dietary fat intake among young Korean children and could be used to establish dietary strategies for improvement of health status.
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Affiliation(s)
- YounJoo Baek
- Department of Human Ecology, Korea National Open University, Seoul 03087, Korea
| | - Jae Eun Shim
- Department of Food and Nutrition, Daejeon University, Daejeon 34520, Korea
| | - SuJin Song
- Department of Food and Nutrition, Hannam University, 1646 yuseong-daero, Yuseong-gu, Daejeon 34054, Korea
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Effect of the dietary delivery matrix on vitamin D3 bioavailability and bone mineralisation in vitamin-D3-deficient growing male rats. Br J Nutr 2017; 119:143-152. [PMID: 29268806 DOI: 10.1017/s0007114517003518] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study assessed bioavailability and utilisation of vitamin D3 in two feeding trials using young, growing Sprague-Dawley male rats. Trial one fed animals standard AIN-93G diet (casein protein) containing no vitamin D3 and goat or cow skimmed milk supplemented with vitamin D3. Trial two fed animals modified dairy-free AIN-93G diet (egg albumin) containing no vitamin D3 and goat or cow skimmed or full-fat milk supplemented with vitamin D3. Control groups received AIN-93G diets with or without vitamin D, and water. At 8 weeks of age, blood samples were collected for vitamin and mineral analysis, and femurs and spines were collected for assessment of bone mineralisation and strength. In both trials, analyses showed differences in bioavailability of vitamin D3, with ratios of serum 25-hydroxyvitamin D3 to vitamin D3 intake more than 2-fold higher in groups drinking supplemented milk compared with groups fed supplemented solid food. Bone mineralisation was higher in groups drinking supplemented milk compared with groups fed supplemented solid food, for both trials (P<0·05). There was no difference in the parameters tested between skimmed milk and full-fat milk or between cow milk and goat milk. Comparison of the two trials suggested that dietary protein source promoted bone mineralisation in a growing rat model: modified AIN-93G with egg albumin produced lower bone mineralisation compared with standard AIN-93G with casein. Overall, this study showed that effects of vitamin D3 deficiency in solid diets were reversed by offering milk supplemented with vitamin D3, and suggests that using milk as a vehicle to deliver vitamin D is advantageous.
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Hauta-Alus HH, Korkalo L, Holmlund-Suila EM, Rosendahl J, Valkama SM, Enlund-Cerullo M, Helve OM, Hytinantti TK, Mäkitie OM, Andersson S, Viljakainen HT. Food and Nutrient Intake and Nutrient Sources in 1-Year-Old Infants in Finland: A Cross-Sectional Analysis. Nutrients 2017; 9:E1309. [PMID: 29194422 PMCID: PMC5748759 DOI: 10.3390/nu9121309] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 02/07/2023] Open
Abstract
The infant diet has short- and long-term health consequences. Updated data regarding the dietary intake of Finnish infants are lacking. The objectives of this study were to describe infant food and nutrient intake and to identify food sources of the nutrients. Altogether, 739 healthy infants were studied. Dietary intake and breastfeeding frequency were assessed with a three-day food record at 1 year of age. Dietary intake was calculated separately for non-breastfed and breastfed infants. One-third (36%) of the infants were partially breastfed and 95% consumed mass-produced baby foods. The infants' diet consisted mainly of infant formula, dairy milk, porridges, fruit and berry foods, and meat dishes. The mean vegetable, fruit and berry consumption was 199 g/day. Most nutrient intakes were adequate except for fat, linoleic acid, vitamin D and iron from food. Mean sucrose intake, as a percentage of total energy intake (E%), was 5-6 E%. High protein intake (>20 E%) was observed in 19% of non-breastfed infants. Overall, the infants' diet was favorable since vegetable and fruit consumption was reasonably high and nutrient intake was mostly adequate. However, the fat intake was lower, and protein intake higher than recommended. Increasing the consumption of vegetable oils and reducing the intake of red meat and dairy milk may further improve the diet of 1-year-olds.
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Affiliation(s)
- Helena H Hauta-Alus
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Liisa Korkalo
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
| | - Elisa M Holmlund-Suila
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Jenni Rosendahl
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Saara M Valkama
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Maria Enlund-Cerullo
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Otto M Helve
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Timo K Hytinantti
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Outi M Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
- Center for Molecular Medicine, Karolinska Institute and Clinical Genetics, Karolinska University Hospital, Solna, 171 76 Stockholm, Sweden.
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Biomedicum 2C, P.O. Box 705, 00020 HUS Helsinki, Finland.
| | - Heli T Viljakainen
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland.
- Folkhälsan Research Center, Haartmaninkatu 8, P.O. Box 63, 00014 Helsinki, Finland.
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Brunner TA, Casetti L, Haueter P, Müller P, Nydegger A, Spalinger J. Nutrient intake of Swiss toddlers. Eur J Nutr 2017; 57:2489-2499. [PMID: 28812189 DOI: 10.1007/s00394-017-1521-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/06/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE During the first years of life, food preferences are shaped that might last throughout a person's entire life affecting his/her health in the long term. However, knowledge on early feeding habits is still limited for toddlers. Therefore, the goal of the present study was to: (1) assess toddlers' nutrient intake; (2) compare the findings to past studies as well as to national feeding recommendations and (3) identify major food sources for energy and macronutrients. METHODS A food survey using a 4-day diary was conducted. The dietary software nut.s® was used to analyse the data. RESULTS A cohort of 188 healthy toddlers (aged 1-3 years) was analysed. The energy intake of most toddlers was below the recommended daily intake (RDI) but in accordance with earlier studies. Protein intake was three- to fourfold higher than the RDI and reached the proposed upper limit of 15% of total energy intake. Fat intake was in accordance with the RDI, but the balance of saturated and unsaturated fatty acids should be improved. Carbohydrate intake met the RDI. For the micronutrients, iron and vitamin D intakes showed critical values. CONCLUSION As in other European countries, the diet of Swiss toddlers in general seems adequate but does not meet all nutritional requirements. In particular, the quality of the fats and vitamin D supplementation should be improved. For proteins and iron, additional research is needed to gain more confidence in the recommendations.
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Affiliation(s)
- Thomas A Brunner
- School of Agricultural, Forest and Food Sciences, Food Science and Management, Bern University of Applied Sciences, Länggasse 85, 3052, Zollikofen, Switzerland.
| | - Luca Casetti
- School of Agricultural, Forest and Food Sciences, Food Science and Management, Bern University of Applied Sciences, Länggasse 85, 3052, Zollikofen, Switzerland
| | - Petra Haueter
- School of Agricultural, Forest and Food Sciences, Food Science and Management, Bern University of Applied Sciences, Länggasse 85, 3052, Zollikofen, Switzerland
| | - Pascal Müller
- Paediatric Gastroenterology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Andreas Nydegger
- Paediatric Gastroenterology, Department of Paediatrics, University of Lausanne, Lausanne, Switzerland
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López-Sobaler AM, Aparicio A, González-Rodríguez LG, Cuadrado-Soto E, Rubio J, Marcos V, Sanchidrián R, Santos S, Pérez-Farinós N, Dal Re MÁ, Villar C, Robledo T, Castrodeza JJ, Ortega RM. Adequacy of Usual Vitamin and Mineral Intake in Spanish Children and Adolescents: ENALIA Study. Nutrients 2017; 9:E131. [PMID: 28208814 PMCID: PMC5331562 DOI: 10.3390/nu9020131] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/03/2017] [Accepted: 02/08/2017] [Indexed: 11/17/2022] Open
Abstract
Background: The National Dietary Survey on the Child and Adolescent Population in Spain (ENALIA) provides data to assess the usual micronutrient intake among Spanish infants, children, and adolescents. Methods: Cross-sectional survey (November 2012-July 2014) of a representative sample of Spanish children and adolescents (six months-17 years) (n = 1862). Dietary information was collected using two non-consecutive one-day food diaries (six months-10 years old) or two 24 h dietary recalls (11 years and older) separated by at least 14 days. Estimates were calculated using the Iowa State University method and PC-SIDE software (version 1.0, department of statistics, center for agricultural and rural development, Ames, IA, USA) to account for within- and between-person variation. Results: Usual intake of vitamin D was insufficient in practically all individuals. Vitamin E, folate, and calcium were insufficient, especially from nine years of age, and magnesium and iodine from 14 years of age. The percentage of subjects with insufficient intakes was higher among females. Sodium intake was excessive in a considerable percentage of the population, especially in males, and it increased with age. Finally, over half of children under four years of age had zinc usual intakes that exceeded the Tolerable Upper Level. Conclusion: Vitamin and mineral intake in Spain should be improved, especially in late childhood and adolescence. Nutritional intervention and educational strategies are needed to promote healthy eating habits and correct micronutrient inadequacies in Spanish children and adolescents.
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Affiliation(s)
- Ana M López-Sobaler
- VALORNUT Research Group, Department of Nutrition, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, Madrid 28040, Spain.
| | - Aránzazu Aparicio
- VALORNUT Research Group, Department of Nutrition, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, Madrid 28040, Spain.
| | - Liliana G González-Rodríguez
- VALORNUT Research Group, Faculty of Health Sciences, Alfonso X El Sabio University, Villanueva de la Cañada, Madrid 28691, Spain.
| | - Esther Cuadrado-Soto
- VALORNUT Research Group, Department of Nutrition, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, Madrid 28040, Spain.
| | - Josefa Rubio
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Victoria Marcos
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Rosa Sanchidrián
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Sara Santos
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Napoleón Pérez-Farinós
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Marian Ángeles Dal Re
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Carmen Villar
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Teresa Robledo
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - J Javier Castrodeza
- Spanish Agency for Consumer Affairs, Food Safety and Nutrition, Ministry of Health, Social Services and Equality, C/Alcalá 56, Madrid 28071, Spain.
| | - Rosa M Ortega
- VALORNUT Research Group, Department of Nutrition, Faculty of Pharmacy, Complutense University, Plaza Ramón y Cajal s/n, Madrid 28040, Spain.
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