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Chouraqui JP, Renella R, Turck D. Assessment of Dietary Iron Intake and Sources in Early Childhood in a Nationally Representative Cross-Sectional Survey. J Acad Nutr Diet 2024; 124:823-832.e1. [PMID: 38142742 DOI: 10.1016/j.jand.2023.12.009] [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: 12/18/2022] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Iron deficiency has particular importance in early childhood because of its impact on growth and development. Preventive food-based strategies of iron deficiency require knowledge of intakes and sources of iron. OBJECTIVE This study aimed to assess daily iron intakes (DIIs) in 2013, to compare them with the dietary reference values, to assess their evolution since 1981, and to identify iron food sources among nonbreastfed French children younger than 3 years. DESIGN This was a nationwide cross-sectional survey conducted in 2013 in France to assess DIIs by means of comparing them with the dietary reference values. Parents' reported diet diaries were collected for 3 nonconsecutive days. PARTICIPANTS/SETTING Of the 1,184 children enrolled in the study, 1,035 nonbreastfed healthy children aged 0.5 to 35 months stratified into 11 age groups were included after informed consent was obtained from parents and according to a weighted quota sampling method. MAIN OUTCOME MEASURES DII from the different food sources and trends in their evolution from 1981 to 2013 was assessed. STATISTICAL ANALYSES PERFORMED Results are expressed as median with interquartile range and range and mean ± SD. Student t test was used with the 2-sided α level of significance set at 5%. RESULTS Mean ± SD DII was 6.7 ± 2.3 mg/d before 6 months, 8.2 ± 2.7 mg/d from 6 months to 1 year, and 7.0 ± 3.2 mg/d from 1 to 3 years. The prevalence of infants older than 7 months with a DII less than the dietary reference values was 52.5%, and that of young children was 30%. After slightly increasing until 2005, DIIs decreased thereafter. Formulas contributed to most of the DIIs up to 2 years of age. Cereals were the second largest contributor to DIIs, and meat accounted for a small part of iron intake. CONCLUSIONS A substantial number of children between 6 months and 3 years of age were at risk of insufficient iron intake. This risk increased from 2005 to 2013. The role of formula in ensuring iron intake is highlighted. More research on health outcomes of low iron intakes is needed.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Paediatric Division of Nutrition and Gastroenterology, Pediatric Department, Grenoble-Alpes University Hospital, Grenoble, France.
| | - Raffaele Renella
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Switzerland
| | - Dominique Turck
- Department of Pediatrics, University of Lille, and INSERM U1286, Institute for Translational Research in Inflammation, Lille, France
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Madrigal C, Soto-Méndez MJ, Hernández-Ruiz Á, Ruiz-López MD, Samaniego-Vaesken MDL, Partearroyo T, Varela-Moreiras G, Gil Á. Dietary Intake, Nutritional Adequacy, and Food Sources of Selected Antioxidant Minerals and Vitamins; and Their Relationship with Personal and Family Factors in Spanish Children Aged 1 to <10 Years: Results from the EsNuPI Study. Nutrients 2022; 14:nu14194132. [PMID: 36235784 PMCID: PMC9573671 DOI: 10.3390/nu14194132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/28/2022] [Accepted: 10/01/2022] [Indexed: 11/23/2022] Open
Abstract
Minerals and vitamins involved in the antioxidant defense system are essential for healthy growth and proper development during infancy. Milk and dairy products are of particular importance for improving the supply of these nutrients to children. Indeed, the present study aimed to evaluate the nutrient intake and food sources of zinc (Zn), selenium (Se), retinol and carotenoids (sources of vitamin A), and vitamins C and E, and to analyze their relationships with personal and familiar factors in Spanish children from the EsNuPI study. One subpopulation representative of the Spanish population from 1 to <10 years old (n = 707) (reference group, REF) who reported consuming all types of milk over the last year, and another subpopulation of the same age who reported consuming fortified milk formulas (FMFs) (including follow-on formula, young child formula, growing up milk, toddler’s milk, and enriched and fortified milk) (n = 741) (fortified milk consumers, FMCs) completed two 24 h dietary recalls used to estimate their nutrient intakes and to compare them to the European Food Safety Authority (EFSA) Dietary Reference Values (DRVs). The REF reported higher median intakes than FMCs for Se (61 µg/kg vs. 51 µg/kg) and carotenoids (1079 µg/day vs. 998 µg/day). Oppositely, FMCs reported higher intakes than REF for Zn (7.9 mg/day vs. 6.9 mg/day), vitamin A (636 µg/day vs. 481 µg/day), vitamin E (8.9 mg/day vs. 4.5 mg/day), vitamin C (113 mg/day vs. 71 mg/day), and retinol (376 µg/day vs. 233 µg/day). In the REF group, more than 50% of the children met the EFSA recommendations for Zn (79.6%), Se (87.1%), vitamin A (71.3%), and vitamin C (96.7%), respectively. On the other hand, 92.2% were below the EFSA recommendations for vitamin E. In the FMC group, more than 50% of the children met the EFSA recommendations for Zn (55.2%), Se (90.8%), vitamin A (75.7%), vitamin E (66.7%), and vitamin C (100%). We found statistically significant differences between subpopulations for all cases except for Se. In both subpopulations, the main sources of all antioxidant nutrients were milk and dairy products. For carotenoids, the main sources were vegetables and fruits followed by milk and dairy products. A high percentage of children had vitamins A and E intakes below the recommendations, information of great importance to stakeholders. More studies using intakes and biomarkers are needed, however, to determine an association with diverse factors of oxidative damage.
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Affiliation(s)
- Casandra Madrigal
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Iberoamerican Nutrition Foundation (FINUT), 18016 Granada, Spain
| | | | | | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
- Iberoamerican Nutrition Foundation (FINUT), 18016 Granada, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18011 Granada, Spain
- Correspondence:
| | - María de Lourdes Samaniego-Vaesken
- Grupo USP-CEU de Excelencia “Nutrición Para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28660 Boadilla del Monte, Spain
| | - Teresa Partearroyo
- Grupo USP-CEU de Excelencia “Nutrición Para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28660 Boadilla del Monte, Spain
| | - Gregorio Varela-Moreiras
- Grupo USP-CEU de Excelencia “Nutrición Para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, 28660 Boadilla del Monte, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), 18016 Granada, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18011 Granada, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
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Al-Biltagi M, Faysal W, Alabdulrazzaq F, Alsabea H, Bassil Z, Chamseddine F, Chokr I, El-Beleidy A, Ezzat M, Farrah A, Mizyed M, Sayed AOS, Talib HA, Wali Y. Middle East consensus recommendations on the use of young child formula (YCF) in toddlers. J Nutr Sci 2022; 11:e53. [PMID: 35836695 PMCID: PMC9274381 DOI: 10.1017/jns.2022.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 06/10/2020] [Accepted: 06/14/2020] [Indexed: 02/07/2023] Open
Abstract
The transition of foods during toddlerhood and the suboptimal diets consumed in the Middle East make children susceptible to malnutrition and micronutrient deficiencies. Based on international recommendations, coupled with the merits of clinical studies on the application of young child formula (YCF), a group of fourteen experts from the Middle East reached a consensus on improving the nutritional status of toddlers. The recommendations put forth by the expert panel comprised twelve statements related to the relevance of YCF in young children; the impact of YCF on their nutritional parameters and functional outcomes; characteristics of the currently available YCF and its ideal composition; strategies to supply adequate nutrition in young children and educational needs of parents and healthcare professionals (HCPs). This consensus aims to serve as a guide to HCPs and parents, focusing on improving the nutritional balance in toddlers in the Middle Eastern region. The panellists considere YCF to be one of the potential solutions to improve the nutritional status of young children in the region. Other strategies to improve the nutritional status of young children include fortified cow's milk and cereals, vitamin and mineral supplements, early introduction of meat and fish, and the inclusion of diverse foods in children's diets.
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Affiliation(s)
- Mohammed Al-Biltagi
- Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
- University Medical Center, Arabian Gulf University, King Abdulla Medical City, Manama, Bahrain
| | - Wafaa Faysal
- Department of Pediatrics, Dr. Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
| | | | - Hassan Alsabea
- Pediatric Department, Medical Park Consultants, Abu Dhabi, United Arab Emirates
| | - Ziad Bassil
- Pediatric Department, Saint Joseph Hospital, Beirut, Lebanon
| | - Fadi Chamseddine
- Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Imad Chokr
- Pediatric Department, Al-Zahraa Hospital, Beirut, Lebanon
| | - Ahmed El-Beleidy
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Ezzat
- Pediatric Department, Dr. Hala Essa Bin Laden Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Antoine Farrah
- Department of Pediatrics, Saint George Hospital Ajaltoun, Beirut, Lebanon
| | - Mohammad Mizyed
- Department of Pediatrics, Dr. Sulaiman Al Habib Medical Group, Riyadh, Kingdom of Saudi Arabia
| | - Ashraf Othman Saleh Sayed
- Department of Pediatrics, Dar Al-Shifa Hospital, Hawally, Kuwait
- Faculty of Medicine, Minia University, Minya, Egypt
| | - Hussam Abu Talib
- Pediatric Department, Primary Health Care Corporation, Doha, Qatar
| | - Yasser Wali
- Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
- Department of Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Chouraqui JP. Dietary Approaches to Iron Deficiency Prevention in Childhood-A Critical Public Health Issue. Nutrients 2022; 14:1604. [PMID: 35458166 PMCID: PMC9026685 DOI: 10.3390/nu14081604] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/03/2022] [Accepted: 04/08/2022] [Indexed: 12/15/2022] Open
Abstract
Iron is an essential nutrient, and individual iron status is determined by the regulation of iron absorption, which is driven by iron requirements. Iron deficiency (ID) disproportionately affects infants, children, and adolescents, particularly those who live in areas with unfavorable socioeconomic conditions. The main reason for this is that diet provides insufficient bioavailable iron to meet their needs. The consequences of ID include poor immune function and response to vaccination, and moderate ID anemia is associated with depressed neurodevelopment and impaired cognitive and academic performances. The persistently high prevalence of ID worldwide leads to the need for effective measures of ID prevention. The main strategies include the dietary diversification of foods with more bioavailable iron and/or the use of iron-fortified staple foods such as formula or cereals. However, this strategy may be limited due to its cost, especially in low-income countries where biofortification is a promising approach. Another option is iron supplementation. In terms of health policy, the choice between mass and targeted ID prevention depends on local conditions. In any case, this remains a critical public health issue in many countries that must be taken into consideration, especially in children under 5 years of age.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Pediatric Nutrition and Gastroenterology Unit, Woman, Mother and Child Department, University Hospital of Lausanne, 1011 Lausanne, Switzerland
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Verduci E, Di Profio E, Corsello A, Scatigno L, Fiore G, Bosetti A, Zuccotti GV. Which Milk during the Second Year of Life: A Personalized Choice for a Healthy Future? Nutrients 2021; 13:nu13103412. [PMID: 34684413 PMCID: PMC8540900 DOI: 10.3390/nu13103412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/20/2023] Open
Abstract
Nutrition in early life is a crucial element to provide all essential substrates for growth. Although this statement may appear obvious, several studies have shown how the intake of micro and macronutrients in toddlers differs a lot from the recommendations of scientific societies. Protein intake often exceeds the recommended amount, while the intake of iron and zinc is frequently insufficient, as well as Vitamin D. Nutritional errors in the first years of life can negatively impact the health of the child in the long term. To date, no clear evidence on which milk is suggested during the second year of life is yet to be established. In this study, we compare the nutrient profiles of cow’s milk and specific formulas as well as nutritional risks in toddlers linked to growth and childhood obesity development. The purpose of this review is to resume the latest clinical studies on toddlers fed with cow’s milk or young children formula (YCF), and the potential risks or benefits in the short and long term.
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Affiliation(s)
- Elvira Verduci
- Department of Health Sciences, University of Milan, 20146 Milan, Italy
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
- Correspondence:
| | - Elisabetta Di Profio
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
- Department of Animal Sciences for Health, Animal Production and Food Safety, University of Milan, 20133 Milan, Italy
| | - Antonio Corsello
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Lorenzo Scatigno
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Giulia Fiore
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Alessandra Bosetti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children’s Hospital, 20154 Milan, Italy; (E.D.P.); (A.C.); (L.S.); (G.F.); (A.B.); (G.V.Z.)
- Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, 20157 Milan, Italy
- Pediatric Clinical Research Center Fondazione Romeo ed Enrica Invernizzi, University of Milan, 20157 Milan, Italy
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6
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Kostecka M, Jackowska I, Kostecka J. A Comparison of the Effects of Young-Child Formulas and Cow's Milk on Nutrient Intakes in Polish Children Aged 13-24 Months. Nutrients 2021; 13:nu13082511. [PMID: 34444672 PMCID: PMC8398400 DOI: 10.3390/nu13082511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/12/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
Adequately balanced daily food rations that provide the body with sufficient amounts of energy and nutrients, including minerals, are particularly important in early childhood when rapid physical, intellectual and motor development takes place. Cow’s milk (CM) and young-child formulas (YCFs) are introduced to a child’s diet past the first year of age. The main aim of the present study was to perform a qualitative and a quantitative analysis of daily food rations of young children based on the recommendations of the daily food ration model. An attempt was also made to determine whether the type of consumed milk (YCF or CM) adequately meets young children’s energy demands and contributes to the incorporation of different food groups into a balanced and healthy diet for children aged 13–24 months. A total of 714 parents between October 2019 and March 2020 filled out a food frequency questionnaire. In the second stage of the study, the parents participated in a dietary recall and were asked to keep diaries of all meals and foods consumed by children over a period of three days. The mean daily intake of CM/YCF and fermented milks was determined at 360 mL ± 128 mL, and it accounted for 55.4% of the guideline values. Flavored dairy products were consumed more frequently than fermented milks without added sugar or flavoring (94 ± 17 g vs. 56 ± 26 g, p < 0.05). Diets incorporating CM were significantly more abundant in protein than YCF diets (29.3 g vs. 21.9 g; p < 0.01). Liquid intake was somewhat higher in children fed YCFs (1280.8 mL vs. 1120.1; p < 0.05), mainly due to the higher consumption of fruit juice, nectars and sweetened hot beverages (246 ± 35 mL in the YCF group vs. 201 ± 56 mL in the CM group; p < 0.05). Children fed YCF consumed significantly larger amounts of sweetened beverages such as tea sweetened with sugar or honey, sweetened hot chocolate or instant teas (OR = 2.54; Cl: 1.32–3.26; p < 0.001), than children receiving CM. This group was also characterized by higher consumption of sweetened dairy products, mainly cream cheese desserts, fruit yogurt and yogurt with cereal (OR = 1.87; Cl: 1.36–2.54; p < 0.01), as well as a lower daily intake of plain fermented milks (OR = 0.56; Cl: 0.21–0.79; p < 0.001). The daily food intake and the quality of the diets administered to children aged 13–24 months were evaluated and compared with the model food ration. It was found that milk type influenced children’s eating habits and preference for sweet-tasting foods. The study also demonstrated that Polish parents and caregivers only have limited knowledge of nutritional guidelines for toddlers.
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Affiliation(s)
- Malgorzata Kostecka
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, Akademicka 15, 20-950 Lublin, Poland;
- Correspondence: ; Tel.: +48-814-456-846
| | - Izabella Jackowska
- Faculty of Food Science and Biotechnology, University of Life Sciences in Lublin, Akademicka 15, 20-950 Lublin, Poland;
| | - Julianna Kostecka
- Faculty of Medicine, Medical University of Lublin, Chodźki 19, 20-093 Lublin, Poland;
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Lovell AL, Milne T, Matsuyama M, Hill RJ, Davies PSW, Grant CC, Wall CR. Protein Intake, IGF-1 Concentrations, and Growth in the Second Year of Life in Children Receiving Growing Up Milk - Lite (GUMLi) or Cow's Milk (CM) Intervention. Front Nutr 2021; 8:666228. [PMID: 34179057 PMCID: PMC8224403 DOI: 10.3389/fnut.2021.666228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
The relationship of protein intake with insulin-like growth factor 1 (IGF-1) concentrations in well-nourished children during the second year of life is poorly understood. The aim of this study was to explore the effect of a reduced-protein Growing Up Milk Lite (GUMLi) or unfortified cow's milk (CM) on protein intake, growth, and plasma IGF-1 at 2 y. An exploratory analysis of a sub-sample of Auckland-based children (n = 79) in the GUMLi trial (a double-blind, randomised control trial, N = 160) completed in Auckland and Brisbane (2015-2017) was conducted. One-year old children were randomised to receive a reduced-protein GUMLi (1.7 g protein/100 mL) or a non-fortified CM (3.1 g protein/100 mL) for 12 months. Blood sampling and anthropometric measurements were made at 1 and 2 y. Diet was assessed using a validated food frequency questionnaire. Total protein intake (g/d) from all cow's milk sources was 4.6 g (95% CI: -6.7, -2.4; p < 0.005) lower in the GUMLi group after 12 months of the intervention, with a significant group-by-time interaction (p = 0.005). Length-for-age (LAZ) and weight-for-length (WLZ) z-scores did not differ between groups, however, mean body fat % (BF%) was 3.2% (95%CI: -6.2, -0.3; p = 0.032) lower in the GUMLi group at 2 y. There was no difference between the intervention groups in relation to IGF-1 and IGF-BP3 (p = 0.894 and 0.698, respectively), with no group-by-sex interaction. After combining the groups, IGF-1 concentration at 2 y was positively correlated with parameters of growth (all p < 0.05), total cow's milk intake (p = 0.032) after adjusting for sex, breastfeeding status, and gestation. Randomisation to a reduced protein GUMLi resulted in small reduction in %BF and lower total protein intakes but had no effect on growth. Plasma IGF-1 concentrations were independently associated with total protein intake from cow's milk at 2 y, highlighting a potential area of the diet to target when designing future protein-related nutrition interventions. Clinical Trial Registration: Australian New Zealand Clinical Trials Registry number: ACTRN12614000918628. Date registered: 27/08/2014.
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Affiliation(s)
- Amy L Lovell
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tania Milne
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Misa Matsuyama
- Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia
| | - Rebecca J Hill
- Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia
| | - Peter S W Davies
- Child Health Research Centre, University of Queensland, Brisbane, QLD, Australia
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand.,General Paediatrics, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Clare R Wall
- Department of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Milk Fat Globule Membrane Proteome and Micronutrients in the Milk Lipid Fraction: Insights into Milk Bioactive Compounds. DAIRY 2021. [DOI: 10.3390/dairy2020018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Milk lipids are composed of milk fat globules (MFGs) surrounded by the milk fat globule membrane (MFGM). MFGM protects MFGs from coalescence and enzymatic degradation. The milk lipid fraction is a “natural solvent” for macronutrients such as phospholipids, proteins and cholesterol, and micronutrients such as minerals and vitamins. The research focused largely on the polar lipids of MFGM, given their wide bioactive properties. In this review we discussed (i) the composition of MFGM proteome and its variations among species and phases of lactation and (ii) the micronutrient content of human and cow’s milk lipid fraction. The major MFGM proteins are shared among species, but the molecular function and protein expression of MFGM proteins vary among species and phases of lactation. The main minerals in the milk lipid fraction are iron, zinc, copper and calcium, whereas the major vitamins are vitamin A, β-carotene, riboflavin and α-tocopherol. The update and the combination of this knowledge could lead to the exploitation of the MFGM proteome and the milk lipid fraction at nutritional, biological or technological levels. An example is the design of innovative and value-added products, such as MFGM-supplemented infant formulas.
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9
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Madrigal C, Soto-Méndez MJ, Hernández-Ruiz Á, Valero T, Lara Villoslada F, Leis R, Martínez de Victoria E, Moreno JM, Ortega RM, Ruiz-López MD, Varela-Moreiras G, Gil Á. Dietary Intake, Nutritional Adequacy, and Food Sources of Protein and Relationships with Personal and Family Factors in Spanish Children Aged One to <10 Years: Findings of the EsNuPI Study. Nutrients 2021; 13:1062. [PMID: 33805229 PMCID: PMC8064310 DOI: 10.3390/nu13041062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 01/15/2023] Open
Abstract
Diet in the first years of life is an important factor in growth and development. Dietary protein is a critical macronutrient that provides both essential and nonessential amino acids required for sustaining all body functions and procedures, providing the structural basis to maintain life and healthy development and growth in children. In this study, our aim was to describe the total protein intake, type and food sources of protein, the adequacy to the Population Reference Intake (PRI) for protein by the European Food Safety Authority (EFSA), and the Recommended Dietary Allowance (RDA) by the Institute of Medicine (IoM). Furthermore, we analyzed whether the consumption of dairy products (including regular milk, dairy products, or adapted milk formulas) is associated with nutrient adequacy and the contribution of protein to diet and whole dietary profile in the two cohorts of the EsNuPI (in English, Nutritional Study in the Spanish Pediatric Population) study; one cohort was representative of the Spanish population from one to <10 years old (n = 707) (Spanish reference cohort, SRS) who reported consuming all kinds of milk and one was a cohort of the same age who reported consuming adapted milk over the last year (including follow-on formula, growing up milk, toddler's milk, and enriched and fortified milks) (n = 741) (adapted milk consumers cohort, AMS). The children of both cohorts had a high contribution from protein to total energy intake (16.79% SRS and 15.63% AMS) and a high total protein intake (60.89 g/day SRS and 53.43 g/day AMS). We observed that protein intake in Spanish children aged one to <10 years old was above the European and international recommendations, as well as the recommended percentages for energy intakes. The main protein sources were milk and dairy products (28% SRS and 29% AMS) and meat and meat products (27% SRS and 26% AMS), followed by cereals (16% SRS and 15% AMS), fish and shellfish (8% in both cohorts), eggs (5% SRS and 6% AMS), and legumes (4% in both cohorts). In our study population, protein intake was mainly from an animal origin (meat and meat products, milk and dairy products, fish and shellfish, and eggs) rather than from a plant origin (cereals and legumes). Future studies should investigate the long-term effect of dietary protein in early childhood on growth and body composition, and whether high protein intake affects health later in life.
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Affiliation(s)
- Casandra Madrigal
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain; (T.V.); (G.V.-M.)
| | | | - Rosaura Leis
- Unit of Pediatric Gastroenterology, Department of Pediatrics, Hepatology and Nutrition University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain;
- Health Research Institute of Santiago (IDIS), University of Santiago de Compostela, 15706 Santiago de Compostela, Spain
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Emilio Martínez de Victoria
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18100 Granada, Spain
| | - José Manuel Moreno
- Pediatric Department, University of Navarra Clinic, 28027 Madrid, Spain;
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18100 Granada, Spain
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain; (T.V.); (G.V.-M.)
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Biomedical Research Center, Institute of Nutrition and Food Technology “José Mataix”, University of Granada, 18100 Granada, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071 Granada, Spain
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Willcox JC, Februhartanty J, Satheannoppakao W, Hutchinson C, Itsiopoulos C, Worsley A. Commercial growing up milks: usage frequency and associated child and demographic factors across four Asia Pacific countries. J Hum Nutr Diet 2021; 34:524-533. [PMID: 33406319 DOI: 10.1111/jhn.12851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 10/31/2020] [Accepted: 11/18/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Commercial growing up milks (GUMs) targeted at children from 12 to 36 months of age are a rapidly growing industry, particularly across the Asia Pacific. METHODS The present study assessed the frequency of use and socio-demographic and child associations of commercial GUM feeding in children, aged between 12 and 36 months, in capital cities in four Asia Pacific countries. Mothers of children aged between 12 and 36 months were surveyed, assessing GUM feeding frequency in the past month. A market research company database was used to survey across Asia Pacific urban cities, including Bangkok Thailand, Jakarta Indonesia, Singapore and Australian Capital Cities (ACC). RESULTS More than 1000 women (n = 1051) were surveyed (Bangkok, n = 263; Jakarta, n = 275; ACC, n = 252; Singapore, n = 261). The mean (SD) age of mothers was 32.4 (5.3) years and that of children was 23.6 (6.7) months. In total, 62.7% of the children were fed GUMs more than once per week with significant country variance. In comparison with ACC, Asian countries were significantly more likely to feed GUMs ≥once per week: Bangkok [odds ratio (OR) = 5.7, 95% confidence interval (CI) = 3.8-8.6]; Jakarta (OR = 3.5, 95% CI = 2.3-5.5); and Singapore (OR = 7.4, 95% CI = 4.9-11.1). Associations of GUM feeding included: maternal tertiary education; mothers younger than 30 years; working full time; and feeding of commercial infant formula under 12 months. CONCLUSIONS This is the first published study to explore commercial GUM feeding in and between countries. The incidence of GUM feeding, in contrast to international recommendations, signals the need for further research into the drivers for GUM feeding and its contribution to the diet.
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Affiliation(s)
- J C Willcox
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - J Februhartanty
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO RECFON)/Pusat Kajian Gizi Regional (PKGR), Universitas Indonesia, Jakarta, Indonesia
| | - W Satheannoppakao
- Department of Nutrition, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - C Hutchinson
- Department of Nutrition, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - C Itsiopoulos
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia.,College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - A Worsley
- Institute for Physical Activity and Nutrition, Deakin University, Waurn Ponds, VIC, Australia
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11
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Patterns of the Consumption of Young Children Formula in Chinese Children Aged 1-3 Years and Implications for Nutrient Intake. Nutrients 2020; 12:nu12061672. [PMID: 32512709 PMCID: PMC7352521 DOI: 10.3390/nu12061672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 12/12/2022] Open
Abstract
The consumption of young children formula (YCF) is associated with reduced risk of inadequacies of nutrients that are frequently lacking in the diets of young children. In this study, we assessed the role of YCF in children’s diets and whether meeting dairy intake recommendations would improve nutrient intake in young Chinese children aged 12–36 months. Dietary intake data for children from the 2012 China Maternal and Infant Nutrition and Growth study were analyzed (n = 910). Nutrient intake was compared between YCF consumers and non-consumers, and the theoretical impact of meeting dairy intake recommendations by adding cow’s milk or YCF to children’s diets was assessed using diet modelling. The percent of children consuming YCF was 64.5% and was positively associated with family income and mother’s education level. Compared to non-consumers, YCF consumers had higher intakes of minerals (e.g., calcium, iron) and vitamins (e.g., C, D, B6) that are important for growth and immune function, and lower intakes of saturated fat. To meet dairy intake recommendations by adding either cow’s milk or YCF to children’s diets would improve intakes of vitamins and minerals in young Chinese children. YCF consumption contributes to the improvement of nutrient intakes in children aged 12–36 months in China.
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12
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Young children formula consumption and iron deficiency at 24 months in the general population: A national-level study. Clin Nutr 2020; 40:166-173. [PMID: 32507584 DOI: 10.1016/j.clnu.2020.04.041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 04/11/2020] [Accepted: 04/25/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND & AIMS Iron deficiency (ID) is considered the most frequent micronutrient deficiency in industrialized countries where strategies for its primary prevention vary widely and are insufficiently evaluated. We aimed to study the effectiveness for iron status of a national iron deficiency prevention strategy based on recommendations for young-child formula (YCF) use after age 12 months, taking into consideration other sources of iron and the family's socio-economic status. METHODS In a cross-sectional observational study conducted in primary care pediatrician offices throughout France from 2016 to 2017, infants aged 24 months were consecutively included for a food survey and blood sampling. Associations between YCF consumption and serum ferritin (SF) level were studied by multivariable regression after adjustment on sociodemographic, perinatal and dietary characteristics, notably other intakes of iron. RESULTS Among the 561 infants analyzed, the ID prevalence was 6.6% (37/561; 95% confidence interval [CI] 4.7-9.0). Daily iron intake excluding YCF and total daily iron intake including YCF were below the 5-mg/day recommended average requirements for 63% and 18% of children, respectively. ID frequency was significantly decreased (or SF level was independently higher) with any YCF consumption after age 10 months (odds ratio 0.15, 95% CI 0.07-0.31), current YCF consumption at age 24 months (median SF level 29 vs 21 μg/L if none), prolonged YCF consumption (28 μg/L if >12 months vs 17 μg/L if none), and increasing daily volume of YCF consumed at age 24 months from a small volume (e.g., 29 μg/L if <100 mL/day vs 21 μg/L if none). CONCLUSIONS Current or past YCF use was independently associated with a better iron status at age 24 months than non-use. The strategy recommending YCF use at weaning after age 12 months seems effective in the general population. CLINICALTRIALS. GOV IDENTIFIER NCT02484274.
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13
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Madrigal C, Soto-Méndez MJ, Hernández-Ruiz Á, Valero T, Ávila JM, Ruiz E, Lara Villoslada F, Leis R, Martínez de Victoria E, Moreno JM, M. Ortega R, Ruiz-López MD, Varela-Moreiras G, Gil Á. Energy Intake, Macronutrient Profile and Food Sources of Spanish Children Aged One to <10 Years-Results from the EsNuPI Study. Nutrients 2020; 12:E893. [PMID: 32218330 PMCID: PMC7231217 DOI: 10.3390/nu12040893] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/17/2020] [Accepted: 03/22/2020] [Indexed: 12/13/2022] Open
Abstract
The present study aimed to assess energy intake, nutrient profile and food sources in Spanish children participating in the EsNuPI ("Estudio Nutricional en Población Infantil Española") study. Plausibility of energy intake and adequacy of nutrient intakes to international recommendations were analyzed in a final sample of 1448 subjects (728 boys and 720 girls) and one group representative of the 1 to <10 years old urban Spanish children (reference sample (n = 707)) who consumed milk and one of the same age who consumed adapted milk over the last year (adapted milk consumers sample (n = 741)) were compared. Both groups completed data of a face-to-face and a telephone 24-h dietary recalls. Both the reference and the adapted milk consumers samples reported an adequate daily energy intake (1503 kcal/day and 1404 kcal/day); and a high contribution to total energy from protein (16.5% and 15.6%) and fat (36.5% and 35.9%). Also, a high percentage of children from both samples were below the lower limit of the recommendations for carbohydrates (47.8% and 39.3%). As the percentage of plausible energy reporters was high for both groups (84.7% and 83.5%, respectively), data for the whole sample were analyzed. Milk and dairy, cereals, meat and derived products, fats and oils, bakery and pastry, fruits and vegetables contributed to about 80% of the total energy intake in both groups. However, the reference sample reported significantly more contribution to energy from cereals, meat and meat products, bakery and pastry and ready to cook/eat foods; meanwhile, the adapted milk consumers sample reported significantly more energy from milk and dairy products, fruits and eggs. Those results suggest that adapted milk consumers have better adherence to the food-based dietary guidelines. Further analyses are warranted to characterize food patterns and the quality of the diet in the EsNuPI study population.
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Affiliation(s)
- Casandra Madrigal
- Department of Nutrition and Bromatology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
| | - Teresa Valero
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
| | - José Manuel Ávila
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
| | - Emma Ruiz
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
- CIBERESP, Consortium for Biomedical Research in Epidemiology and Public Health, Carlos III Health Institute, 28029 Madrid, Spain
- National Center for Epidemiology, Carlos III Health Institute, 28029 Madrid, Spain
| | | | - Rosaura Leis
- Unit of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University Clinical Hospital of Santiago, IDIS, ISCIII, University of Santiago de Compostela, 15700 Santiago de Compostela, Spain;
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Emilio Martínez de Victoria
- Department of Physiology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - José Manuel Moreno
- Pediatric Department, University of Navarra Clinic, Calle Marquesado de Sta. Marta, 1, 28027 Madrid, Spain;
| | - Rosa M. Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal s/n, 28040 Madrid, Spain;
| | - María Dolores Ruiz-López
- Department of Nutrition and Bromatology, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain;
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
| | - Gregorio Varela-Moreiras
- Spanish Nutrition Foundation (FEN), c/General Álvarez de Castro 20, 1ªpta, 28010 Madrid, Spain; (T.V.); (J.M.Á.); (E.R.); (G.V.-M.)
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, Urb. Montepríncipe, crta. Boadilla km. 5.3, Boadilla del Monte, 28668 Madrid, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 ª pta, Armilla, 18016 Granada, Spain; (M.J.S.-M.); (Á.H.-R.); (Á.G.)
- CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100 Granada, Spain
- Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Campus de Cartuja, s.n, 18071 Granada, Spain
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A comparison of the effect of a Growing Up Milk - Lite (GUMLi) v. cows' milk on longitudinal dietary patterns and nutrient intakes in children aged 12-23 months: the GUMLi randomised controlled trial. Br J Nutr 2020; 121:678-687. [PMID: 30912737 DOI: 10.1017/s0007114518003847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The second year of life is a period of nutritional vulnerability. We aimed to investigate the dietary patterns and nutrient intakes from 1 to 2 years of age during the 12-month follow-up period of the Growing Up Milk - Lite (GUMLi) trial. The GUMLi trial was a multi-centre, double-blinded, randomised controlled trial of 160 healthy 1-year-old children in Auckland, New Zealand and Brisbane, Australia. Dietary intakes were collected at baseline, 3, 6, 9 and 12 months post-randomisation, using a validated FFQ. Dietary patterns were identified using principal component analysis of the frequency of food item consumption per d. The effect of the intervention on dietary patterns and intake of eleven nutrients over the duration of the trial were investigated using random effects mixed models. A total of three dietary patterns were identified at baseline: 'junk/snack foods', 'healthy/guideline foods' and 'breast milk/formula'. A significant group difference was observed in 'breast milk/formula' dietary pattern z scores at 12 months post-randomisation, where those in the GUMLi group loaded more positively on this pattern, suggesting more frequent consumption of breast milk. No difference was seen in the other two dietary patterns. Significant intervention effects were seen on nutrient intake between the GUMLi (intervention) and cows' milk (control) groups, with lower protein and vitamin B12, and higher Fe, vitamin D, vitamin C and Zn intake in the GUMLi (intervention) group. The consumption of GUMLi did not affect dietary patterns, however, GUMLi participants had lower protein intake and higher Fe, vitamins D and C and Zn intake at 2 years of age.
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Mak TN, Angeles-Agdeppa I, Tassy M, Capanzana MV, Offord EA. Contribution of Milk Beverages to Nutrient Adequacy of Young Children and Preschool Children in the Philippines. Nutrients 2020; 12:nu12020392. [PMID: 32024102 PMCID: PMC7071197 DOI: 10.3390/nu12020392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/19/2020] [Accepted: 01/19/2020] [Indexed: 12/18/2022] Open
Abstract
Malnutrition is a major public health concern in the Philippines. Milk and dairy products are important sources of energy, protein, and micronutrients for normal growth and development in children. This study aims to assess the contribution of different types of milk to nutrient intakes and nutrient adequacy among young and preschool children in the Philippines. Filipino children aged one to four years (n = 2992) were analysed while using dietary intake data from the 8th National Nutrition Survey 2013. Children were stratified by age (one to two years and three to four years) and by milk beverage consumption type: young children milk (YCM) and preschool children milk (PCM), other milks (mostly powdered milk with different degrees of fortification of micronutrients), and non-dairy consumers (no milks or dairy products). The mean nutrient intakes and the odds of meeting nutrient adequacy by consumer groups were compared, percentage of children with inadequate intakes were calculated. Half (51%) of Filipino children (all ages) did not consume any dairy on a given day, 15% consumed YCM or PCM, and 34% consumed other milks. Among children one to two years, those who consumed YCM had higher mean intakes of iron, magnesium, potassium, zinc, B vitamins, folate, and vitamins C, D, and E (all p < 0.001) when compared to other milk consumers. Non-dairy consumers had mean intakes of energy, total fat, fibre, calcium, phosphorus, iron, potassium, zinc, folate, and vitamins D and E that were far below the recommendations. Children who consumed YCM or PCM had the highest odds in meeting adequacy of iron, zinc, thiamin, vitamin B6, folate, and vitamins C, D, and E as compared to other milks or non-dairy consumers, after adjusting for covariates. This study supports the hypothesis that dairy consumers had higher intakes of micronutrients and higher nutrient adequacy than children who consumed no milk or dairy products. Secondly, YCM or PCM have demonstrated to be good dairy options to achieve nutrient adequacy in Filipino children.
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Affiliation(s)
- Tsz-Ning Mak
- Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
- Correspondence:
| | - Imelda Angeles-Agdeppa
- Food and Nutrition Research Institute-Department of Science and Technology, Taguig City 1631, Philippines; (I.A.-A.); (M.V.C.)
| | - Marie Tassy
- Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
| | - Mario V. Capanzana
- Food and Nutrition Research Institute-Department of Science and Technology, Taguig City 1631, Philippines; (I.A.-A.); (M.V.C.)
| | - Elizabeth A. Offord
- Nestlé Research, Route du Jorat 57, 1000 Lausanne, Switzerland; (M.T.); (E.A.O.)
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Chouraqui JP, Turck D, Tavoularis G, Ferry C, Dupont C. The Role of Young Child Formula in Ensuring a Balanced Diet in Young Children (1-3 Years Old). Nutrients 2019; 11:nu11092213. [PMID: 31540250 PMCID: PMC6770074 DOI: 10.3390/nu11092213] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 12/20/2022] Open
Abstract
During the nutritional vulnerable period of 1–3 years of age, nutrient intake is often inadequate due to an unbalanced diet. Young child formula (YCF) has been proposed as a means of improving nutrition in this age group. We compared the food consumption and nutrient intake of 241 YCF consumers (YCF-C) to those of 206 non-consumers (YCF-NC), selected from among the children enrolled in the Nutri-Bébé survey, an observational cross-sectional survey, conducted from 3 January to 21 April 2013. Food consumption and nutrient intake were analyzed from a three-day dietary record. The YCF-C < 2 years group had a protein (−8 g/d; p < 0.0001) and sodium (−18%; p = 0.0003) intake that was lower than that of YCF-NC, but still above the respective EFSA (European Food Safety Authority) Average Requirement (AR) or Adequate Intake (AI). At all ages, the YCF-C group had higher intakes of essential fatty acids (p < 0.0001), vitamins C (p < 0.0001), A, D, and E (p < 0.0001), all B vitamins (p < 0.001) except B12, iron (9 vs. 5 mg/d, p < 0.0001), reaching the Dietary Reference Values (DRVs, AR or AI), but similar DHA and ARA intakes. Getting closer to the reference values proposed by EFSA required at least 360 mL/d of YCF. The consumption of YCF may help infants and children at risk of nutrient deficiencies to meet their nutritional requirements. However, protein, sodium, and vitamin A intakes remained above the EFSA DRVs, and DHA, ARA, and vitamin D remained below.
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Affiliation(s)
- Jean-Pierre Chouraqui
- Paediatric Nutrition and Gastroenterology, Division of Pediatrics, Woman, Mother and Child Department, Centre Hospitalier Universitaire Vaudois (CHUV), 21 rue du Bugnon, 1011 Lausanne, Switzerland.
| | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University, 59037 Lille, France.
- Jeanne de Flandre Children's Hospital and Faculty of Medicine, University of Lille; INSERM U995, 59037 Lille, France .
| | - Gabriel Tavoularis
- CREDOC (Centre de Recherche pour l'Etude et l'Observation des Conditions de Vie), 142 rue du Chevaleret, 75013 Paris, France.
| | | | - Christophe Dupont
- Pediatric gastroenterology department, Necker Enfants-Malades Hospital, Paris Descartes University, 75015 Paris, France.
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17
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Crowe M, O'Sullivan M, Cassetti O, O'Sullivan A. Estimation and consumption pattern of free sugar intake in 3-year-old Irish preschool children. Eur J Nutr 2019; 59:2065-2074. [PMID: 31325041 PMCID: PMC7351867 DOI: 10.1007/s00394-019-02056-8] [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: 02/17/2019] [Accepted: 07/15/2019] [Indexed: 01/06/2023]
Abstract
PURPOSES Dietary free sugars (FS) are the most important risk factor for dental caries and can contribute to excess energy intake. Measuring FS intake is limited by food composition databases and appropriate dietary assessment methods. The aim of this analysis was to estimate total sugar (TS) and FS intakes for Irish pre-schoolers and examine the proportion of dietary TS and FS captured using a short food questionnaire (SFQ). METHODS This is a secondary analysis of 3-year-old children from two national surveys; Growing Up in Ireland (GUI), N = 9793 of whom 49% were girls and the National Preschool Nutrition Survey (NPNS), N = 126 and 52% were girls. GUI used SFQs and NPNS used semi-weighed food diaries to collect dietary data from 3-year-old children. Dietary intake databases were linked using an established approach. Mean daily TS and FS intakes and frequency were calculated, and consumption patterns from foods and meals are presented. The proportion of foods that were covered or non-covered by the GUI SFQ was calculated by comparison with the NPNS food diary. RESULTS 75% of 3 year-olds had FS intake greater than the maximum recommended by WHO guidelines for free sugar intake, while 4% met the lower threshold. The median frequency of TS and FS consumption was 5.0 (4.0-6.0) and 4.0 (3.0-5.0) times/day. Less than one-quarter of TS intake (g/day) was non-covered by the GUI SFQ while less than one-third of FS intake was non-covered. CONCLUSIONS A large majority of 3-year-old Irish children do not meet the WHO recommended guidelines for FS intake and almost none meet the desired conditional recommendation. SFQs only capture two-thirds of FS intake at this early age.
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Affiliation(s)
- Michael Crowe
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland.
| | - Michael O'Sullivan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
| | - Oscar Cassetti
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
| | - Aifric O'Sullivan
- UCD Institute of Food and Health, 2.05 Science Centre, South, UCD, Belfield, Dublin, Ireland
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Lovell AL, Milne T, Jiang Y, Chen RX, Grant CC, Wall CR. Evaluation of the Effect of a Growing up Milk Lite vs. Cow's Milk on Diet Quality and Dietary Intakes in Early Childhood: The Growing up Milk Lite (GUMLi) Randomised Controlled Trial. Nutrients 2019; 11:E203. [PMID: 30669521 PMCID: PMC6356321 DOI: 10.3390/nu11010203] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 01/12/2019] [Accepted: 01/15/2019] [Indexed: 12/19/2022] Open
Abstract
scores provide an alternative approach to measuring dietary quality. The Growing Up Milk-Lite (GUMLi) Trial was a multi-centre, double-blinded, randomised controlled trial of children randomised to receive a reduced protein GUM (GUMLi) or unfortified cow's milk (CM). In a secondary analysis of the GUMLi Trial, we used the Probability of Adequate Nutrient Intake (PANDiet) to determine the nutritional adequacy of the diets of participating children living in Auckland. The PANDiet was adapted to the New Zealand Nutrient Reference Values and data from four 24 h Recalls (24HR) collected at months 7, 8, 10, and 11 post-randomisation were used. Differences between randomised groups (GUMLi vs. CM) of the PANDiet and its components were made. Eighty-three Auckland participants were included in the study (GUMLi n = 41 vs. CM n = 42). Total PANDiet scores were significantly higher in the GUMLi group (p < 0.001), indicating better overall nutrient adequacy and diet quality. Dietary intakes of children in both groups met the recommendations for fat, total carbohydrates and most micronutrients; however, protein intakes exceeded recommendations. Consumption of GUMLi was associated with higher nutritional adequacy, with an increased likelihood of meeting nutrient requirements; however, the impact of the family diet and GUMLi on dietary diversity requires further evaluation.
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Affiliation(s)
- Amy L Lovell
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand.
| | - Tania Milne
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand.
| | - Yannan Jiang
- Department of Statistics, Faculty of Science, University of Auckland, Auckland 1142, New Zealand.
| | - Rachel X Chen
- Department of Statistics, Faculty of Science, University of Auckland, Auckland 1142, New Zealand.
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, University of Auckland, Grafton 1023, New Zealand.
- Centre for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland 1743, New Zealand.
- General Paediatrics, Starship Children's Hospital, Auckland District Health Board, Auckland, Auckland 1142, New Zealand.
| | - Clare R Wall
- Discipline of Nutrition and Dietetics, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand.
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19
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Crowe M, O'Sullivan M, McNulty BA, Cassetti O, O'Sullivan A. Data Mapping From Food Diaries to Augment the Amount and Frequency of Foods Measured Using Short Food Questionnaires. Front Nutr 2018; 5:82. [PMID: 30356824 PMCID: PMC6190565 DOI: 10.3389/fnut.2018.00082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/21/2018] [Indexed: 12/20/2022] Open
Abstract
Collecting accurate and detailed dietary intake data is costly at a national level. Accordingly, limited dietary assessment tools such as Short Food Questionnaires (SFQs) are increasingly used in large surveys. This paper describes a novel method linking matched datasets to improve the quality of dietary data collected. Growing Up in Ireland (GUI) is a nationally representative longitudinal study of infants in the Republic of Ireland which used a SFQ (with no portion sizes) to assess the intake of “healthy” and “unhealthy” food and drink by 3 years old preschool children. The National Preschool Nutrition Survey (NPNS) provides the most accurate estimates available for dietary intake of young children in Ireland using a detailed 4 days weighed food diary. A mapping algorithm was applied using food name, cooking method, and food description to fill all GUI food groups with information from the NPNS food datafile which included the target variables, frequency, and amount. The augmented data were analyzed to examine all food groups described in NPNS and GUI and what proportion of foods were covered, non-covered, or partially-covered by GUI food groups, as a percentage of the total number of consumptions. The term non-covered indicated a specific food consumption that could not be mapped using a GUI food group. “High sugar” food items that were non-covered included ready-to-eat breakfast cereals, fruit juice, sugars, syrups, preserves and sweeteners, and ice-cream. The average proportion of consumption frequency and amount of foods not covered by GUI was 44 and 34%, respectively. Through mapping food codes in this manner, it was possible, using density plots, to visualize the relative performance of the brief dietary instrument (SFQ) compared to the more detailed food diary (FD). The SFQ did not capture a substantial portion of habitual foods consumed by 3-year olds in Ireland. Researchers interested in focussing on specific foods, could use this approach to assess the proportion of foods covered, non-covered, or partially-covered by reference to the mapped food database. These results can be used to improve SFQs for future studies and improve the capacity to identify diet-disease relationships.
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Affiliation(s)
- Michael Crowe
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Michael O'Sullivan
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Breige A McNulty
- UCD School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Oscar Cassetti
- Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Aifric O'Sullivan
- UCD School of Agriculture and Food Science, UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
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20
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Lovell AL, Davies PSW, Hill RJ, Milne T, Matsuyama M, Jiang Y, Chen RX, Wouldes TA, Heath ALM, Grant CC, Wall CR. Compared with Cow Milk, a Growing-Up Milk Increases Vitamin D and Iron Status in Healthy Children at 2 Years of Age: The Growing-Up Milk-Lite (GUMLi) Randomized Controlled Trial. J Nutr 2018; 148:1570-1579. [PMID: 30281106 DOI: 10.1093/jn/nxy167] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 07/04/2018] [Indexed: 11/13/2022] Open
Abstract
Background Iron deficiency (ID) and vitamin D deficiency (VDD) are significant pediatric health issues in New Zealand and Australia and remain prevalent micronutrient deficiencies in young children globally. Objective We aimed to investigate the effect of a micronutrient-fortified, reduced-energy growing-up milk (GUMLi) compared with cow milk (CM) consumed for 1 y on dietary iron and vitamin D intakes and the status of New Zealand and Australian children at 2 y of age. Methods The GUMLi Trial was a multicenter, double-blind, randomized controlled trial in 160 healthy 1-y-old New Zealand and Australian children conducted in 2015-2017. Participants were randomly assigned 1:1 to receive GUMLi (1.7 mg Fe/100 mL; 1.3 µg cholecalciferol/100 mL) or CM (0.02 mg Fe/100 mL; 0.06 µg cholecalciferol/100 mL) for 12 mo. Secondary outcomes, reported here, included change in dietary iron and vitamin D intakes, iron status, and 25-hydroxyvitamin D [25(OH)D] concentrations from blood samples at age 2 y. All regression models were adjusted for baseline outcome and study center. Results GUMLi was a large contributor to dietary intakes of iron and vitamin D after 12 mo when compared with intakes from food and CM. The adjusted mean difference between groups for serum ferritin concentrations was 17.8 µg/L (95% CI: 13.6, 22.0 µg/L; P < 0.0001), and for 25(OH)D it was 16.6 nmol/L (95% CI: 9.9, 23.3 nmol/L; P < 0.0001). After 12 mo, ID was present in 16 (24%) participants in the CM group and 5 (7%) participants in the GUMLi group (P = 0.009), and the prevalence of VDD in the CM group increased to 14% (n = 10) and decreased to 3% (n = 2) (P = 0.03) in the GUMLi group. Conclusion In comparison with CM, GUMLi significantly improved dietary iron and vitamin D intakes and the iron and vitamin D status of healthy children at 2 y of age. This trial was registered with the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au) as ACTRN12614000918628.
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Affiliation(s)
| | - Peter S W Davies
- Children's Nutrition Research Center, UQ Child Health Research Center, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Rebecca J Hill
- Children's Nutrition Research Center, UQ Child Health Research Center, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | - Misa Matsuyama
- Children's Nutrition Research Center, UQ Child Health Research Center, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | | | | | | | - Cameron C Grant
- Department of Pediatrics, Child and Youth Health.,Center for Longitudinal Research He Ara ki Mua, University of Auckland, Auckland, New Zealand.,General Pediatrics, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
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21
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Christides T, Ganis JC, Sharp PA. In vitro assessment of iron availability from commercial Young Child Formulae supplemented with prebiotics. Eur J Nutr 2018; 57:669-678. [PMID: 27942845 PMCID: PMC5845627 DOI: 10.1007/s00394-016-1353-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 11/29/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE Iron is essential for development and growth in young children; unfortunately, iron deficiency (ID) is a significant public health problem in this population. Young Child Formulae (YCF), milk-derived products fortified with iron and ascorbic acid (AA, an enhancer of iron absorption) may be good sources of iron to help prevent ID. Furthermore, some YCF are supplemented with prebiotics, non-digestible carbohydrates suggested to enhance iron bioavailability. The aim of our study was to evaluate iron bioavailability of YCF relative to prebiotic and AA concentrations. We hypothesised that YCF with the highest levels of prebiotics and AA would have the most bioavailable iron. METHODS We used the in vitro digestion/Caco-2 cell model to measure iron bioavailability from 4 commercially available YCF with approximately equal amounts of iron, but varying amounts of: AA and the prebiotics fructo- and galacto-oligosaccharides. Caco-2 cell ferritin formation was used as a surrogate marker for iron bioavailability. RESULTS The YCF with the highest concentration of prebiotics and AA had the highest iron bioavailability; conversely, the YCF with the lowest concentration of prebiotics and AA had the lowest. After the addition of exogenous prebiotics, so that all tested YCF had equivalent amounts, there was no longer a significant difference between YCF iron bioavailability. CONCLUSION Our results suggest that ascorbic acid and prebiotics in YCF improve iron bioavailability. Ensuring that iron is delivered in a bioavailable form would improve the nutritional benefits of YCF in relation to ID/IDA amongst young children; therefore, further exploration of our findings in vivo is warranted.
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Affiliation(s)
- Tatiana Christides
- Department of Life and Sports Sciences, Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent, ME4 4TB, UK.
| | - Julia Clark Ganis
- Department of Life and Sports Sciences, Faculty of Engineering and Science, University of Greenwich, Medway Campus, Chatham Maritime, Kent, ME4 4TB, UK
| | - Paul Anthony Sharp
- Metal Metabolism Group, Diabetes and Nutritional Sciences Division, School of Medicine, King's College London, London, UK
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22
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O'Sullivan AJ, Pigat S, O'Mahony C, Gibney MJ, McKevitt AI. Predictive modelling of the exposure to steviol glycosides in Irish patients aged 1-3 years with phenylketonuria and cow's milk protein allergy. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2017; 35:40-48. [PMID: 29111886 DOI: 10.1080/19440049.2017.1401737] [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: 10/18/2022]
Abstract
Children with Phenylketonuria (PKU) and severe cow's milk protein allergy (CMPA) consume prescribed, specially formulated, foods for special medical purposes (FSMPs) as well as restricted amounts of normal foods. These patients are exposed to artificial sweeteners from the consumption of a combination of free and prescribed foods. Young patients with PKU and CMPA have a higher risk of exceeding acceptable daily intakes (ADI) for additives than age-matched healthy children. A predictive modelling approach has been adapted successfully to assess the additive exposure of young patients with PKU and CMPA to artificial sweeteners. Steviol glycosides (E960) are at various stages of regulatory approval for the various food categories in the EU but are not as yet permitted for use in products intended for young children. The aim of this study was to predict potential steviol glycoside exposure in young children with PKU and CMPA considering the potential for future provisions for the use of this sweetener. The recent introduction of steviol glycosides means that no exposure data are available for children with CMPA and PKU. Food consumption data were derived from the food consumption survey data of healthy young children in Ireland from the National Preschool and Nutrition Survey (NPNS, 2010-11). Specially formulated amino acid-based FSMPs are used to replace whole or milk protein foods and were included in the exposure model to replace restricted foods. The recommendations to ensure adequate protein intake in these patients were used to determine FSMP intake. Exposure assessment results indicated that the maximum permitted level (MPL) for FSMPs would warrant careful consideration to avoid exposures above the ADI. These data can be used to inform recommendations for the medical nutrition industry.
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Affiliation(s)
- Aaron J O'Sullivan
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | | | | | - Michael J Gibney
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
| | - Aideen I McKevitt
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Dublin , Republic of Ireland
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23
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Folgenahrungen für Kleinkinder im Alter von einem bis 3 Jahren (sog. Kindermilchgetränke). Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0311-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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24
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Kehoe L, Walton J, McNulty BA, Nugent AP, Flynn A. Dietary strategies for achieving adequate vitamin D and iron intakes in young children in Ireland. J Hum Nutr Diet 2016; 30:405-416. [PMID: 27990698 DOI: 10.1111/jhn.12449] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Inadequate intakes of vitamin D and iron have been reported in young children in Ireland. The present study aimed to identify the main foods determining vitamin D and iron intakes and to model the impact of dietary strategies to improve adequacy of these micronutrients in young children. METHODS The present study is based on the Irish National Pre-School Nutrition Survey (NPNS), which estimated food and nutrient intakes in a representative sample (n = 500) of children (aged 1-4 years) using a 4-day weighed food record. Dietary strategies were modelled using DaDiet© software (Dazult Ltd, Co. Kildare, Republic of Ireland) and the usual intake distribution, prevalence of inadequate intakes and risk of excessive intakes were estimated using the National Cancer Institute method. RESULTS Fortified foods and nutritional supplements were the key foods influencing the intakes of vitamin D and iron. Adding a 5 μg day-1 vitamin D supplement, fortifying cow's milk (CM) with vitamin D or replacing CM with growing-up milk (GUM) would modestly increase intakes of vitamin D. A combined strategy of fortifying CM with vitamin D or replacing CM with GUM plus a 5 μg day-1 vitamin D supplement would increase mean intakes of vitamin D (from 3.5 μg day-1 at baseline to ≥11 μg day-1 ) and substantially reduce the prevalence of inadequate intakes (from >95% to 12-36%). Fortifying CM with iron or replacing CM with GUM would increase mean intakes of iron (from 7.3 mg day-1 to >10 mg day-1 ), achieving adequate intakes across all ages. CONCLUSIONS Based on real food consumption data in a representative sample of Irish children, we have shown that through targeted dietary strategies adequate intakes of iron are achievable and intakes of vitamin D could be greatly improved.
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Affiliation(s)
- L Kehoe
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - J Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - B A McNulty
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - A P Nugent
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - A Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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25
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O'Sullivan AJ, Pigat S, O'Mahony C, Gibney MJ, McKevitt AI. Probabilistic modelling to assess exposure to three artificial sweeteners of young Irish patients aged 1-3 years with PKU and CMPA. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2016; 33:1660-1671. [PMID: 27612000 DOI: 10.1080/19440049.2016.1227479] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The choice of suitable normal foods is limited for individuals with particular medical conditions, e.g., inborn errors of metabolism (phenylketonuria - PKU) or severe cow's milk protein allergy (CMPA). Patients may have dietary restrictions and exclusive or partial replacement of specific food groups with specially formulated products to meet particular nutrition requirements. Artificial sweeteners are used to improve the appearance and palatability of such food products to avoid food refusal and ensure dietary adherence. Young children have a higher risk of exceeding acceptable daily intakes for additives than adults due to higher food intakes kg-1 body weight. The Budget Method and EFSA's Food Additives Intake Model (FAIM) are not equipped to assess partial dietary replacement with special formulations as they are built on data from dietary surveys of consumers without special medical requirements impacting the diet. The aim of this study was to explore dietary exposure modelling as a means of estimating the intake of artificial sweeteners by young PKU and CMPA patients aged 1-3 years. An adapted validated probabilistic model (FACET) was used to assess patients' exposure to artificial sweeteners. Food consumption data were derived from the food consumption survey data of healthy young children in Ireland from the National Preschool and Nutrition Survey (NPNS, 2010-11). Specially formulated foods for special medical purposes were included in the exposure model to replace restricted foods. Inclusion was based on recommendations for adequate protein intake and dietary adherence data. Exposure assessment results indicated that young children with PKU and CMPA have higher relative average intakes of artificial sweeteners than healthy young children. The reliability and robustness of the model in the estimation of patient additive exposures was further investigated and provides the first exposure estimates for these special populations.
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Affiliation(s)
- Aaron J O'Sullivan
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Dublin 4 , Ireland
| | - Sandrine Pigat
- b Creme Global , The Tower, Trinity Technology and Enterprise Campus , Grand Canal Quay, Dublin 2 , Ireland
| | - Cian O'Mahony
- b Creme Global , The Tower, Trinity Technology and Enterprise Campus , Grand Canal Quay, Dublin 2 , Ireland
| | - Michael J Gibney
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Dublin 4 , Ireland
| | - Aideen I McKevitt
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Dublin 4 , Ireland
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26
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Role of Young Child Formulae and Supplements to Ensure Nutritional Adequacy in U.K. Young Children. Nutrients 2016; 8:nu8090539. [PMID: 27598195 PMCID: PMC5037526 DOI: 10.3390/nu8090539] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/22/2016] [Accepted: 08/26/2016] [Indexed: 11/16/2022] Open
Abstract
The European Food Safety Authority (EFSA) states that young child formulae (YCFs) "cannot be considered as a necessity to satisfy the nutritional requirements" of children aged 12-36 months. This study quantifies the dietary changes needed to ensure nutritional adequacy in U.K. young children who consume YCFs and/or supplements and in those who do not. Dietary data from 1147 young children (aged 12-18 months) were used to identify, using linear programming models, the minimum changes needed to ensure nutritional adequacy: (i) by changing the quantities of foods initially consumed by each child (repertoire-foods); and (ii) by introducing new foods (non-repertoire-foods). Most of the children consumed neither YCFs, nor supplements (61.6%). Nutritional adequacy with repertoire-foods alone was ensured for only one child in this group, against 74.4% of the children consuming YCFs and supplement. When access to all foods was allowed, smaller food changes were required when YCFs and supplements were initially consumed than when they were not. In the total sample, the main dietary shifts needed to ensure nutritional adequacy were an increase in YCF and a decrease in cow's milk (+226 g/day and -181 g/day, respectively). Increasing YCF and supplement consumption was the shortest way to cover the EFSA nutrient requirements of U.K. children.
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27
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McCarthy EK, Ní Chaoimh C, Hourihane JO, Kenny LC, Irvine AD, Murray DM, Kiely M. Iron intakes and status of 2-year-old children in the Cork BASELINE Birth Cohort Study. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27501864 DOI: 10.1111/mcn.12320] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/26/2016] [Accepted: 02/23/2016] [Indexed: 01/08/2023]
Abstract
Young children are at risk of iron deficiency and subsequent anaemia, resulting in long-term consequences for cognitive, motor and behavioural development. This study aimed to describe the iron intakes, status and determinants of status in 2-year-old children. Data were collected prospectively in the mother-child Cork BASELINE Birth Cohort Study from 15 weeks' gestation throughout early childhood. At the 24-month assessment, serum ferritin, haemoglobin and mean corpuscular volume were measured, and food/nutrient intake data were collected using a 2-day weighed food diary. Iron status was assessed in 729 children (median [IQR] age: 2.1 [2.1, 2.2] years) and 468 completed a food diary. From the food diary, mean (SD) iron intakes were 6.8 (2.6) mg/day and 30% had intakes < UK Estimated Average Requirement (5.3 mg/day). Using WHO definitions, iron deficiency was observed in 4.6% (n = 31) and iron deficiency anaemia in five children (1.0%). Following an iron series workup, five more children were diagnosed with iron deficiency anaemia. Twenty-one per cent had ferritin concentrations <15 µg/L. Inadequate iron intakes (OR [95% CI]: 1.94 [1.09, 3.48]) and unmodified cows' milk intakes ≥ 400 mL/day (1.95 [1.07, 3.56]) increased the risk of low iron status. Iron-fortified formula consumption was associated with decreased risk (0.21 [0.11, 0.41] P < 0.05). In this, the largest study in toddlers in Europe, a lower prevalence of low iron status was observed than in previous reports. Compliance with dietary recommendations to limit cows' milk intakes in young children and consumption of iron-fortified products appears to have contributed to improved iron status at two years.
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Affiliation(s)
- Elaine K McCarthy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Ireland.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Ireland
| | - Carol Ní Chaoimh
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Ireland.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Ireland
| | - Jonathan O'B Hourihane
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Ireland
| | - Louise C Kenny
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Ireland.,Department of Obstetrics and Gynaecology, University College Cork, Ireland
| | - Alan D Irvine
- Department of Clinical Medicine, Trinity College, Dublin, Ireland.,Department of Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Ireland.,National Children's Research Centre, Dublin, Ireland
| | - Deirdre M Murray
- The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Ireland.,Department of Paediatrics and Child Health, University College Cork, Ireland
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Ireland.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Ireland
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28
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Nutrient intakes and iron and vitamin D status differ depending on main milk consumed by UK children aged 12-18 months - secondary analysis from the Diet and Nutrition Survey of Infants and Young Children. J Nutr Sci 2016; 5:e32. [PMID: 27547395 PMCID: PMC4976118 DOI: 10.1017/jns.2016.24] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 05/26/2016] [Indexed: 11/05/2022] Open
Abstract
Nutrition in the second year is important as this is a period of rapid growth and development. Milk is a major food for young children and this analysis evaluated the impact of the type of milk consumed on nutrient intakes and nutritional status. Data from the Diet and Nutrition Survey of Infants and Young Children were used to investigate the intakes of key nutrients, and Fe and vitamin D status, of children aged 12-18 months, not breastfed, and consuming >400 g/d fortified milk (n 139) or >400 g/d of whole cows' milk (n 404). Blood samples from eligible children for measurement of Hb (n 113), serum ferritin and plasma 25-hydroxyvitamin D (25(OH)D) concentrations (n 105) were available for approximately 20 % of children. Unpaired Mann-Whitney tests were used to compare nutrient intakes and status between consumers of fortified and cows' milk. Mean daily total dietary intakes of Fe, Zn, vitamin A and vitamin D were significantly higher in the fortified milk group. Mean daily total dietary intakes of energy, protein, Ca, iodine, Na and saturated fat were significantly higher in the cows' milk group. Hb was not different between groups. The fortified milk group had significantly higher serum ferritin (P = 0·049) and plasma 25(OH)D (P = 0·014). This analysis demonstrates significantly different nutrient intakes and status between infants consuming >400 g/d fortified milk v. those consuming >400 g/d whole cows' milk. These results indicate that fortified milks can play a significant role in improving the quality of young children's diets in their second year of life.
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Impact of long-term use of oral nutritional supplement on nutritional adequacy, dietary diversity, food intake and growth of Filipino preschool children. J Nutr Sci 2016; 5:e20. [PMID: 27293557 PMCID: PMC4891560 DOI: 10.1017/jns.2016.6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/02/2016] [Accepted: 02/09/2016] [Indexed: 11/30/2022] Open
Abstract
Nutrient deficiencies during childhood have adverse effects on child growth and health. In a single-arm 48-week long-term intervention, we previously reported the efficacy of oral nutritional supplementation (ONS) and dietary counselling on catch-up growth and growth maintenance in nutritionally at-risk Filipino children. The present analysis was done to assess the contributing effects of ONS to nutritional adequacy, dietary diversity, food intake and longitudinal growth. ONS (450 ml) was consumed daily providing 450 kcal (1880 kJ) and at least 50 % of micronutrient requirements among 200 children aged 3–4 years with weight-for-height percentiles between 5th and 25th (WHO Growth Standards). Weight, height and dietary intakes using 24-h food recalls were measured at baseline, and at weeks 4, 8, 16, 24, 32, 40 and 48. Nutrient adequacy and dietary diversity score (DDS) were calculated. Generalised estimating equations were used to assess the effects of total nutrient intakes, DDS, ONS compliance and sociodemographic factors on longitudinal growth. The percentages of children with adequate intake of energy, protein, Fe, Ca and some vitamins at each post-baseline visit were improved from baseline, reaching 100 % for most nutrients. DDS was also increased from baseline and reached significance from week 16 onwards (P < 0·01). Male children, total energy intake and parental employment status were associated with weight-for-height percentile gain (P < 0·05), whereas higher parental education level and ONS compliance were significantly associated with height-for-age percentile gain over time (P < 0·05). Long-term ONS intervention did not interfere with normal food intake and helped promote nutritional adequacy and growth of Filipino children.
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30
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Martyn DM, Nugent AP, McNulty BA, O'Reilly E, Tlustos C, Walton J, Flynn A, Gibney MJ. Dietary intake of four artificial sweeteners by Irish pre-school children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2016; 33:592-602. [PMID: 26939625 DOI: 10.1080/19440049.2016.1152880] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In spite of rigorous pre- and post-market reviews of safety, there remains a high level of debate regarding the use of artificial sweeteners in foods. Young children are of particular interest when assessing food chemical exposure as a result of their unique food consumption patterns and comparatively higher exposure to food chemicals on a body weight basis when compared with the general population. The present study examined the intakes of four intense sweeteners (acesulfame K, aspartame, saccharin, sucralose) in the diets of children aged 1-4 years using food consumption and sweetener presence data from the Irish National Pre-school Nutrition Survey (2010-11) and analytical data for sweetener concentration in foods obtained from a national testing programme. Four exposure assessment scenarios were conducted using the available data on sweetener occurrence and concentration. The results demonstrated that the mean daily intakes for all four sweeteners were below the acceptable daily intake (ADI) (17-31%), even considering the most conservative assumptions regarding sweetener presence and concentration. High consumer intakes (P95) were also below the ADI for the four sweeteners when more realistic estimates of exposure were considered. Both sweetener occurrence and concentration data had a considerable effect on reducing the estimated intake values, with a combined reduction in intakes of 95% when expressed as a proportion of the ADI. Flavoured drinks were deemed to be a key contributor to artificial sweetener intakes in this population cohort. It was concluded that there is no health risk to Irish pre-school children at current dietary intake levels of the sweeteners studied.
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Affiliation(s)
- Danika M Martyn
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Belfield, Dublin 4 , Ireland
| | - Anne P Nugent
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Belfield, Dublin 4 , Ireland
| | - Breige A McNulty
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Belfield, Dublin 4 , Ireland
| | - Emer O'Reilly
- b Food Safety Authority of Ireland; Block D, E and F, Abbey Court , Dublin 1 , Ireland
| | - Christina Tlustos
- b Food Safety Authority of Ireland; Block D, E and F, Abbey Court , Dublin 1 , Ireland
| | - Janette Walton
- c School of Food & Nutritional Sciences , University College Cork , Cork , Ireland
| | - Albert Flynn
- c School of Food & Nutritional Sciences , University College Cork , Cork , Ireland
| | - Michael J Gibney
- a UCD Institute of Food and Health, School of Agriculture and Food Science , University College Dublin , Belfield, Dublin 4 , Ireland
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Pontes MV, Ribeiro TCM, Ribeiro H, de Mattos AP, Almeida IR, Leal VM, Cabral GN, Stolz S, Zhuang W, Scalabrin DMF. Cow's milk-based beverage consumption in 1- to 4-year-olds and allergic manifestations: an RCT. Nutr J 2016; 15:19. [PMID: 26920136 PMCID: PMC4769487 DOI: 10.1186/s12937-016-0138-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/18/2016] [Indexed: 12/31/2022] Open
Abstract
Background Nutrients such as docosahexaenoic acid (DHA), prebiotics and β-glucan have been associated with reduced incidence of respiratory illnesses and allergic manifestations (AM). Our objective was to assess if consumption of a cow’s milk-based beverage with these and other nutrients supports respiratory, gastrointestinal, and skin health in otherwise well-nourished, healthy children. Methods In this double-blind, randomized, controlled trial, healthy children (1–4 years of age) from two daycare centers in Brazil were fed three servings/day of a cow’s milk-based beverage (CMBB; n = 125) containing DHA, the prebiotics polydextrose (PDX) and galactooligosaccharides (GOS), β-glucan, and other key nutrients, or a control cow’s milk-based beverage (control; n = 131) for up to 28 weeks. Occurrence of respiratory infections, diarrheal disease and AM was assessed by study pediatricians and the number of episodes were analyzed with the Cochran-Mantel-Haenszel test and the Andersen-Gill model. Results The CMBB group had fewer episodes of AM, which included allergic rhinitis or conjunctivitis, wheezing, allergic cough, eczema and urticaria, compared to the control group (p = 0.021). The hazard ratio for increased number of episodes of AM was lower in the CMBB group compared to control (HR, 0.64; 95 % CI 0.47–0.89; p = 0.007). There was no difference in the incidence of respiratory infections and diarrheal disease between groups. Conclusion A cow’s milk-based beverage containing DHA, PDX/GOS, and yeast β-glucan, and supplemented with micronutrients, including zinc, vitamin A and iron, when consumed 3 times/day for 28 weeks by healthy 1- to 4-year-old children was associated with fewer episodes of allergic manifestations in the skin and the respiratory tract. Trial registration registration number: NCT01431469
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Affiliation(s)
- M V Pontes
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - T C M Ribeiro
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - H Ribeiro
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - A P de Mattos
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - I R Almeida
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - V M Leal
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - G N Cabral
- Federal University of Bahia, Salvador, Bahia, Brazil.
| | - S Stolz
- Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA.
| | - W Zhuang
- Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA.
| | - D M F Scalabrin
- Mead Johnson Pediatric Nutrition Institute, Evansville, IN, USA.
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Morino GS, Cinelli G, Di Pietro I, Papa V, Spreghini N, Manco M. NutricheQ Questionnaire assesses the risk of dietary imbalances in toddlers from 1 through 3 years of age. Food Nutr Res 2015; 59:29686. [PMID: 26689315 PMCID: PMC4685971 DOI: 10.3402/fnr.v59.29686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/11/2015] [Accepted: 11/19/2015] [Indexed: 01/12/2023] Open
Abstract
Background Although a nutrient-poor diet may affect children's growth, especially early in life, few tools to assess dietary imbalances in 1- to 3-year-old children have been developed. Objectives To investigate the accuracy and test–retest reliability of the NutricheQ Questionnaire in the identification of toddlers with the risk of inadequate intake of micro- and macronutrients in a sample of Italian toddlers. Design A 3-day weighed food record was performed, and results were compared with outcomes of the NutricheQ Questionnaire in 201 toddlers (training set: 1–3 years old). The accuracy of NutricheQ in the identification of categories of nutritional risk was evaluated using the receiver operating characteristic (ROC) curves. Test–retest of the tool was estimated using the intraclass correlation coefficient (ICC) and the Cronbach's alpha statistic, in a validation set of 50 toddlers. Results The NutricheQ Questionnaire is a valid tool for the identification of toddlers at risk for dietary imbalances. Significant differences in nutrient intake (p<0.005) were found among the three groups of risk identified by the questionnaire: toddlers included in the high-risk group had a lower intake of key nutrients such as iron, vitamin D and other vitamins, and fibre compared to those included in the low-risk group. NutricheQ is also reliable between administrations, as demonstrated by its test–retest reliability. ICC and Cronbach's alpha were 0.73 and 0.83, respectively, for Section 1 of NutricheQ, and 0.55 and 0.70 for Section 2. Conclusions The NutricheQ Questionnaire is a reliable and consistent tool for the assessment of possible dietary risk factors in Italian toddlers. It consistently identifies toddlers with a high probability of having poor iron and vitamin D intake, and other dietary imbalances.
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Affiliation(s)
- Giuseppe S Morino
- Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giulia Cinelli
- Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Ilaria Di Pietro
- Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Vittoria Papa
- Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Nicola Spreghini
- Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases and Nutritional Department, Bambino Gesù Children's Hospital, Rome, Italy;
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Evaluation of a nutrient-based diet quality index in UK young children and investigation into the diet quality of consumers of formula and infant foods. Public Health Nutr 2015; 19:1785-94. [PMID: 26522249 DOI: 10.1017/s1368980015003134] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To adapt and evaluate a nutrient-based diet quality index (PANDiet) for UK young children and to determine the nutritional adequacy of their diets according to consumption of young child formula (YCF) and commercial infant foods (CIF). DESIGN Content and construct validity of the PANDiet were assessed by studying associations between the PANDiet and its components, energy intake, food intakes, and child and maternal characteristics. Four groups of children were defined according to their intake of YCF and CIF: (i) no consumption; (ii) consumption of YCF; (iii) consumption of CIF; and (iv) consumption of YCF and CIF. Child and maternal characteristics, PANDiet scores and food intakes of these four groups were compared. SETTING Secondary analysis of data from the UK Diet and Nutrition Survey of Infants and Young Children (DNSIYC, 2011). SUBJECTS Young children (n 1152) aged 12-18 months. RESULTS The PANDiet was adapted to the UK based on twenty-five nutrients. A lower PANDiet score was linked to lower intakes of YCF, CIF, vegetables and fruits. Determinants of having a lower score were being older, having siblings and having a younger mother with a lower educational level. Compared with children consuming neither YCF nor CIF, PANDiet scores were higher in children consuming CIF (+1·4), children consuming YCF (+7·2) and children consuming YCF and CIF (+7·8; all P<0·001). CONCLUSIONS The PANDiet is a valid indicator of the nutrient adequacy of the diet of UK young children. Consuming CIF was not found to be associated with lower nutritional adequacy whereas consuming YCF was associated with higher nutritional adequacy.
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Eussen SR, Pean J, Olivier L, Delaere F, Lluch A. Theoretical Impact of Replacing Whole Cow's Milk by Young-Child Formula on Nutrient Intakes of UK Young Children: Results of a Simulation Study. ANNALS OF NUTRITION AND METABOLISM 2015; 67:247-56. [DOI: 10.1159/000440682] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 08/26/2015] [Indexed: 11/19/2022]
Abstract
Background: Research into the role of young-child formulae (YCF) in a child's diet is limited and there is no consensual recommendation on its use. We evaluated the theoretical nutritional impact of replacing the existing practice of consuming cow's milk by YCF. Methods: From the UK Diet and Nutrition Survey of Infants and Young Children, whole cow's milk consumers, aged 12-18 months (n = 591) were selected for simulation scenarios. In Scenario 1, we tested the replacement of all whole cow's milk (434 ± 187 ml/day) by a matching volume of YCF, and in Scenario 2, all whole cow's milk was replaced by the on-pack recommended daily intake of 300 ml. Nutrient intakes before and after simulation scenarios were compared and evaluated against nutrient recommendations. Results: Intakes of protein and saturated fatty acids were significantly decreased, whereas essential fatty acid intakes were increased. The prevalence of nutrient inadequacy before simulation was 95.2% for vitamin D and 53.8% for iron. After simulation, inadequacy decreased to 4.9% (Scenario 1) and 0% (Scenario 2) for vitamin D and to 2.7% (Scenario 1) and 1.1% (Scenario 2) for iron. Conclusions: Replacement of habitual cow's milk intake by a matching volume or 300 ml of YCF may lead to nutritional intakes more in line with recommendations in young children.
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Suthutvoravut U, Abiodun PO, Chomtho S, Chongviriyaphan N, Cruchet S, Davies PSW, Fuchs GJ, Gopalan S, van Goudoever JB, Nel EDLR, Scheimann A, Spolidoro JV, Tontisirin K, Wang W, Winichagoon P, Koletzko B. Composition of Follow-Up Formula for Young Children Aged 12-36 Months: Recommendations of an International Expert Group Coordinated by the Nutrition Association of Thailand and the Early Nutrition Academy. ANNALS OF NUTRITION AND METABOLISM 2015; 67:119-32. [PMID: 26360877 DOI: 10.1159/000438495] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 07/07/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND There are no internationally agreed recommendations on compositional requirements of follow-up formula for young children (FUF-YC) aged 1-3 years. AIM The aim of the study is to propose international compositional recommendations for FUF-YC. METHODS Compositional recommendations for FUF-YC were devised by expert consensus based on a detailed literature review of nutrient intakes and unmet needs in children aged 12-36 months. RESULTS AND CONCLUSIONS Problematic nutrients with often inadequate intakes are the vitamins A, D, B12, C and folate, calcium, iron, iodine and zinc. If used, FUF-YC should be fed along with an age-appropriate mixed diet, usually contributing 1-2 cups (200-400 ml) of FUF-YC daily (approximately 15% of total energy intake). Protein from cow's milk-based formula should provide 1.6-2.7 g/100 kcal. Fat content should be 4.4-6.0 g/100 kcal. Carbohydrate should contribute 9-14 g/100 kcal with >50% from lactose. If other sugars are added, they should not exceed 10% of total carbohydrates. Calcium should provide 200 mg/100 kcal. Other micronutrient contents/100 kcal should reach 15% of the World Health Organization/Food and Agriculture Organization recommended nutrient intake values. A guidance upper level that was 3-5 times of the minimum level was established. Countries may adapt compositional requirements, considering recommended nutrient intakes, habitual diets, nutritional status and existence of micronutrient programs to ensure adequacy while preventing excessive intakes.
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Affiliation(s)
- Umaporn Suthutvoravut
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Rice N, Gibbons H, McNulty BA, Walton J, Flynn A, Gibney MJ, Nugent AP. Development and validation testing of a short nutrition questionnaire to identify dietary risk factors in preschoolers aged 12-36 months. Food Nutr Res 2015; 59:27912. [PMID: 26058751 PMCID: PMC4461756 DOI: 10.3402/fnr.v59.27912] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/01/2015] [Accepted: 05/07/2015] [Indexed: 12/01/2022] Open
Abstract
Background Although imbalances in dietary intakes can have short and longer term influences on the health of preschool children, few tools exist to quickly and easily identify nutritional risk in otherwise healthy young children. Objectives To develop and test the validity of a parent-administered questionnaire (NutricheQ) as a means of evaluating dietary risk in young children (12–36 months). Design Following a comprehensive development process and internal reliability assessment, the NutricheQ questionnaire was validated in a cohort of 371 Irish preschool children as part of the National Preschool Nutrition Survey. Dietary risk was rated on a scale ranging from 0 to 22 from 11 questions, with a higher score indicating higher risk. Results Children with higher NutricheQ scores had significantly (p<0.05) lower mean daily intakes of key nutrients such as iron, zinc, vitamin D, riboflavin, niacin, folate, phosphorous, potassium, carotene, retinol, and dietary fibre. They also had lower (p<0.05) intakes of vegetables, fish and fish dishes, meat and infant/toddler milks and higher intakes of processed foods and non-milk beverages, confectionery, sugars and savoury snack foods indicative of poorer dietary quality. Areas under the curve values of 84.7 and 75.6% were achieved for ‘medium’ and ‘high’ dietary risk when compared with expert risk ratings indicating good consistency between the two methods. Conclusion NutricheQ is a valid method of quickly assessing dietary quality in preschoolers and in identifying those at increased nutritional risk. In Context Analysis of data from national food and nutrition surveys typically identifies shortfalls in dietary intakes or quality of young children. This can relate to intakes of micronutrients such as iron or vitamin D as well as to the balance of macronutrients they consume (e.g. fat or sugar). Alongside this lie concerns regarding overweight and obesity and physical inactivity. This combination of risk factors has potential negative effects for both short and longer term health. Hence, screening tools, such as NutricheQ described here, offer an opportunity for early identification and subsequent appropriate timely intervention from 12 months of age. This paper describes the development and validation of NutricheQ, a short user-friendly questionnaire. Designed to be administered by parents or carers, it aims to help healthcare professionals identify children at risk based on known, evidence-based nutritional risk factors. It is hoped in the longer term that this tool can be adapted for use globally and improve child health through early identification, which can be followed up by targeted, cost-effective interventions.
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Affiliation(s)
- Niamh Rice
- Previs Healthcare Ltd, Kilmacanogue, Wicklow, Ireland
| | - Helena Gibbons
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - Breige A McNulty
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - Janette Walton
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Albert Flynn
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Michael J Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland
| | - Anne P Nugent
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin 4, Ireland;
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Turck D. Quelle place pour les laits « Croissance »? Arch Pediatr 2015; 22:85-6. [DOI: 10.1016/s0929-693x(15)30044-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Foterek K, Hilbig A, Kersting M, Alexy U. Age and time trends in the diet of young children: results of the DONALD study. Eur J Nutr 2015; 55:611-620. [PMID: 25827084 DOI: 10.1007/s00394-015-0881-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/11/2015] [Indexed: 01/11/2023]
Abstract
PURPOSE To describe age and time trends of energy and macronutrient intake during infancy and toddlerhood and to set a special focus on dietary practices with respect to milk, complementary food, and family food intake. METHODS Three-day dietary records (n = 2241) collected at 3, 6, 9, 12, 18, 24, and 36 months (480 subjects) between 2004 and 2013 from the ongoing open cohort DONALD (Dortmund Nutritional and Anthropometric Longitudinally Designed) study were evaluated using repeated-measures regression analyses for trend analysis. RESULTS Significant age trends were found for macronutrients with a decrease in fat intake (% of energy intake, %E) and an increase in carbohydrates (%E) and protein (%E). Exclusive and partial breastfeeding rates at 3 and 6 months did not differ between 2004 and 2008 and 2009 and 2013 (p > 0.05). Macronutrient pattern was virtually stable over time, whereas food group intake (% of total food intake excluding beverages, % TFI) changed significantly during the study period. Breast/bottle milk (% TFI) intake increased over time in the toddler subgroup, whereas family food (% TFI) decreased. CONCLUSIONS Our data demonstrate a period of stagnation in the last 10 years with respect to breastfeeding duration in infancy. Further breastfeeding promotion in Germany is needed to continue the favourable progress of the previous decades. In toddlerhood, breast/bottle milk remains a substantial part of the diet and has increased during the last 10 years. Parents should be encouraged to implement healthy eating habits during early toddlerhood and to facilitate their child's participation in appropriate family meals.
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Affiliation(s)
- Kristina Foterek
- IEL-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany
| | - Annett Hilbig
- Research Institute of Child Nutrition, Dortmund, Germany
| | | | - Ute Alexy
- IEL-Nutritional Epidemiology, DONALD Study, University of Bonn, Heinstück 11, 44225, Dortmund, Germany.
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Vandenplas Y, De Ronne N, Van De Sompel A, Huysentruyt K, Robert M, Rigo J, Scheers I, Brasseur D, Goyens P. A Belgian consensus-statement on growing-up milks for children 12-36 months old. Eur J Pediatr 2014; 173:1365-71. [PMID: 24764116 DOI: 10.1007/s00431-014-2321-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/10/2014] [Accepted: 04/10/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED Growing-up milks (GUM) are milk-based drinks with low protein and added minerals and vitamins intended for children 12-36 months. Since the advantages of GUM are heavily debated, we reviewed the literature. A literature search was done using the classic databases (Pubmed, Embase, Cochrane) on the use of GUM in 12- to 36-month-old young children. Only limited data are available. GUM have a highly variable composition as their marketing is not regulated. Nevertheless, all papers conclude that GUM help to cover nutritional requirements of 12- to 36-month-old infants. CONCLUSION Appropriate intakes of macro- and micronutrients in 1- to 3-year-old children have long-term health benefits. Present diets offered to toddlers do in general not meet the requirements. Supplemented foods are therefore helpful, of which GUM is a possibility.
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Affiliation(s)
- Yvan Vandenplas
- Department of Pediatrics, UZ Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium,
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