Nutrient Intakes and Vegetable and White Potato Consumption by Children Aged 1 to 3 Years

Child-reported vegetable neophobia is associated with risk avoidance for distaste in children aged 4-15 years

Children who are food neophobic and/or picky eaters often refuse intake of especially fruits and vegetables, thereby narrowing their dietary variety and impairing the quality of their food intake. In this preregistered study, we investigated whether picky eating and food neophobia are related to bitter taste sensitivity (PROP taster status) and risk avoidance for distaste. A total of 367 children (201 girls; M age = 8.7 years, range: 4-15 years) participated in the study. They completed the vegetable neophobia subscale of the fruit and vegetable neophobia instrument (FVNI). A caregiver completed the child food rejection scale (CFRS), a parent-report measure of food neophobia and picky eating. Children's bitter taste sensitivity was measured with a PROP (6-n-propylthiouracil) taste strip, and the children completed a modified Children's Gambling Task (Candy Gambling Game) to measure risk avoidance for distaste. In this task, children could select cards from a risky deck (chance of winning two tasty cherry-flavoured jelly beans, but also the risk of getting a distasteful soap-flavoured jelly bean) or a safe deck (chance of winning one tasty jelly bean or no jelly bean). The results show that picky eating and food neophobia (either parent- or self-reported) are not related to PROP taster status. However, children who self-reported higher levels of vegetable neophobia showed less risky choice behaviour in the Candy Gambling Game, although this relationship was not found with parent-reported food neophobia. We conclude that risk avoidance for distaste, but not taste function, is associated with children's self-reported food rejection tendencies. To broaden the food repertoire of children high in food neophobia, it might be useful to reduce the perceived risk of distaste, when introducing a novel food or meal.

Functional Food Based on Potato

Potato (Solanum tuberosum L.) has gradually become a stable food worldwide since it can be a practical nutritional supplement and antioxidant as well as an energy provider for human beings. Financially and nutritionally, the cultivation and utility of potatoes is worthy of attention from the world. Exploring the functionality and maximizing the utilization of its component parts as well as developing new products based on the potato is still an ongoing issue. To maximize the benefits of potato and induce new high-value products while avoiding unfavorable properties of the crop has been a growing trend in food and medical areas. This review intends to summarize the factors that influence changes in the key functional components of potatoes and to discuss the focus of referenced literature which may require further research efforts. Next, it summarizes the application of the latest commercial products and potential value of components existing in potato. In particular, there are several main tasks for future potato research: preparing starchy foods for special groups of people and developing fiber-rich products to supply dietary fiber intake, manufacturing bio-friendly and specific design films/coatings in the packaging industry, extracting bioactive proteins and potato protease inhibitors with high biological activity, and continuing to build and examine the health benefits of new commercial products based on potato protein. Notably, preservation methods play a key role in the phytochemical content left in foods, and potato performs superiorly to many common vegetables when meeting the demands of daily mineral intake and alleviating mineral deficiencies.

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Responsive Parenting Intervention for Firstborns Affects Dietary Intake of Secondborn Infants

BACKGROUND

Although previous work has shown that children with older siblings tend to have poorer diet quality, no study has directly compared diets of infant siblings.

OBJECTIVE

The goals of this analysis were to examine birth-order differences in dietary intake between firstborn (FB) and secondborn (SB) siblings, and to determine whether a responsive parenting (RP) intervention modified birth-order effects on diet.

METHODS

The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study randomly assigned first-time mothers to an RP intervention, which included guidance on feeding, sleep, soothing, and interactive play, or control. INSIGHT mothers who delivered a second child enrolled in an observation-only study of their SB infant (SIBSIGHT). Mothers completed FFQs for both children at ages 6 (n = 97 sibling pairs) and 12 (n = 100) mo. FB compared with SB intake of food groups of interest were compared, and the moderating effect of the RP intervention on birth-order differences was tested using generalized linear mixed models.

RESULTS

Though FBs and SBs had similar diets, more FBs than SBs consumed 100% fruit juice at both 6 (13.8 compared with 3.2%, P = 0.006) and 12 mo (46.0 compared with 32.0%, P = 0.01). SBs consumed fruit more frequently (FB 2.8 compared with SB 3.2 times/d, P = 0.01), and were more likely to consume fried potatoes (FB 38.4 compared with SB 57.6%, P = 0.0009) and processed meats (FB 43.0 compared with SB 58.0%, P = 0.02) than FBs at 12 mo. There were no differences by birth order in intake of sweets, snacks, or sugar-sweetened beverages at 12 mo. At 12 mo, RP-group SBs ate vegetables more times per day (3.2) than control SBs (2.2, P = 0.01). RP-SBs also consumed a greater variety of vegetables (10.2) than control-SBs (7.9, P = 0.01).

CONCLUSIONS

Birth order is not consistently associated with healthy or unhealthy infant dietary intake. However, an RP intervention delivered to first-time mothers may benefit subsequent infants' vegetable intake. This trial was registered at clinicaltrials.gov as NCT01167270.

Nutritional problems in childhood and adolescence: a narrative review of identified disparities

To inform programmes and policies that promote health equity, it is essential to monitor the distribution of nutritional problems among young individuals. Common nutritional problems include overall low diet quality, the underconsumption and overconsumption of certain dietary components, unhealthy meal and snack patterns, problematic feeding practices and disordered eating. The objective of the present narrative review was to summarise recent evidence of disparities among US children (2-19 years) according to age, sex, socio-economic status, ethnicity/race and rural-urban location. Searches in PubMed® and MEDLINE® were completed to identify peer-reviewed research studies published between January 2009 and January 2019. Findings from the ninety-nine reviewed studies indicate adolescent females, young individuals from lower socio-economic households and individuals who identify as non-Hispanic Black race are particularly vulnerable populations for whom targeted strategies should be developed to address evidence of increased risk with regards to multiple aspects of nutritional wellbeing. Limitations of the existing evidence relate to the accuracy of self-reported dietary data; the need for consistent definitions of disordered eating; the focus on individual dietary components v. patterns; the complexities of categorising socio-economic status, ethnicity/race, and rural and urban areas; and the cross-sectional, observational nature of most research designs. There is an urgent need for research to address these limitations and fill a large gap in evidence on rural-urban differences in nutritional problems. It will further be important for future studies to build greater understanding of how nutritional problems cluster among population groups.

Nutrition Monitoring of Children Aged Birth to 24 Mo (B-24): Data Collection and Findings from the NHANES

The first 2 y of life are characterized by several transitions that can affect growth, development, and eating patterns long term. These include a shift from a primarily milk-based eating pattern to introduction of complementary foods at ∼4-6 mo of age, and passage to family-meal patterns in toddler years. Recognizing the importance of this critical period, the Dietary Guidelines for Americans from 2020 onwards will include guidance for children aged birth to 24 mo (B-24). Few large-scale surveys provide comprehensive, nationally representative, quantitative, recent data on infant and toddler nutrition in the United States. The continuous NHANES has collected data relevant to this initiative since 1999 using standardized interview and examination protocols. These include data on infant feeding practices, dietary intakes (foods, beverages, and supplements), anthropometry, and blood-based nutritional status on nationally representative samples of infants and toddlers. NHANES data can be used to describe large group-level consumption patterns, as well as trends over time for B-24 children overall, and by demographic groups (e.g., race-ethnic and income groups). In addition, NHANES data can be analyzed to examine adherence to nutrition-related recommendations, such as those from the American Academy of Pediatrics (AAP), and to track Healthy People 2020 objectives. This paper provides an update on NHANES nutrition monitoring in B-24 children since our previous publication (which provided details through NHANES 2009-2010) and describes data collection since 2010 and plans for upcoming cycles. It also describes key NHANES-based findings published in the last 5 y on infant feeding practices, dietary intakes and supplement use, and nutritional status of US children aged <2 y. Findings related to existing recommendations, such as from the AAP, are presented when available. This information can inform researchers and policymakers on the state of nutrition in the US B-24 population and its subgroups of interest.

Trends in Mean Nutrient Intakes of US Infants, Toddlers, and Young Children from 3 Feeding Infants and Toddlers Studies (FITS)

BACKGROUND

Many updates to young child feeding recommendations have been published over the past decade, but concurrent intake trends have not been assessed.

OBJECTIVE

The aim of this study was to evaluate adequacy and trends in energy and nutrient intakes of US infants and children aged 0-47.9 mo through use of Feeding Infants and Toddlers Study (FITS) data from 2002, 2008, and 2016.

METHODS

FITS are cross-sectional surveys of parents/caregivers of infants and young children (FITS 2002, n = 2962; FITS 2008, n = 3276; FITS 2016, n = 3235). Dietary intakes were assessed by telephone with trained interviewers using the Nutrition Data System for Research. Mean ± SE nutrient intakes were calculated. Diet adequacy was assessed with the nutrient adequacy ratio (NAR) for 17 nutrients and the corresponding mean adequacy ratio.

RESULTS

Energy and macronutrient intakes were generally stable across surveys, but significant decreases for saturated fat and total sugars and an increase in fiber were observed among 6-11.9-mo-olds and 12-23.9-mo-olds (P-trend < 0.0001). Mean sodium intakes exceeded Adequate Intakes (AI) for all ages, whereas fiber intakes were universally below the AI. Nutrients with the lowest NAR values were vitamin D (range 0.41-0.67/1.00) and vitamin E (range 0.60-0.79/1.00 for 2008 and 2016). For iron, infants aged 6-11.9 mo had the lowest NAR values at 0.77-0.88/1.00, compared to 0.85-0.89/1.00 for 12-47.9-mo-olds. Potassium was low from 12 to 47.9 mo (NAR range 0.55-0.63/1.00 across survey years). The nutrients with the greatest decline in mean intakes were iron and vitamins D and E among 6-11.9-mo-olds, and vitamin D and potassium among 12-23.9-mo-olds in 2016 compared to 2002.

CONCLUSIONS

The diets of US infants and young children were generally adequate for most micronutrients and stable over time, but sodium intakes were too high, and nutrient gaps still existed, especially for vitamins D, E, and fiber across ages and for iron among infants.

Excess micronutrient intake: defining toxic effects and upper limits in vulnerable populations

Excessive micronutrient intake causes a variety of adverse health effects, depending on dose and duration. The risk of excess intake carries significant implications for micronutrient delivery interventions, particularly when such programs are overlapping. To minimize risk and provide public health guidance, several countries and the Food and Agriculture Organization of the United Nations/World Health Organization have set upper intake levels (ULs) for various life-stage populations using the risk assessment framework. However, there is a lack of international consensus on the actual ULs due to variability in application of this framework and a scarcity of evidence from which to draw upon, especially for children. Often ULs for children are established through a downward weight-based extrapolation from adult ULs, which is not always appropriate. The published ULs of nine organizations are compared, recent population nutrient intake evidence is presented, and the toxic effects of key minerals and vitamins are reviewed. Finally, the evidence for toxicity and setting of ULs for each nutrient is discussed including a comment on our degree of confidence in the strength of existing individual ULs. Challenges with risk assessment and opportunities for strengthening the definition of ULs are discussed.

Room for Improvement Remains in Food Consumption Patterns of Young Children Aged 2-4 Years

Background

Healthy food consumption patterns in early childhood support optimal growth and development and promote lifelong health.

Objective

The objective of the Feeding Infants and Toddlers Study (FITS) 2016 is to provide updated information on food consumption patterns of children aged 0 to <4 y. This article focuses on several key aspects of the food consumption patterns of 2- and 3-y-olds and how those patterns differ between racial/ethnic groups.

Methods

The FITS 2016 is a cross-sectional study in caregivers of children aged 0 to <4 y living in the United States. Dietary data were collected in a national random sample of children (n = 3235, of whom 600 were aged 24-47.9 mo) by using a 24-h dietary recall telephone survey with the primary caregiver of the child. Data from the recall were used to calculate the percentage of children consuming specific food groups on the day of the recall and energy from these foods (kilocalories per consumer). Differences in food patterns between racial/ethnic groups were analyzed by using ANOVA and t tests.

Results

On the day of the 24-h dietary recall, 27% of 2- and 3-y-olds did not consume a distinct portion of vegetables. Fried potatoes were the most commonly consumed vegetable. Approximately 75% consumed a distinct portion of fruit and 45% consumed 100% fruit juice. Eighty-one percent of children consumed cow milk. Almost all (95%) consumed a grain product, and 59% consumed a whole grain-rich product. The majority of children (88%) consumed meat or another protein food. Nearly all (90%) consumed a dessert, sugar-sweetened beverage (SSB), or sweet; and 45% consumed an SSB. Thirty-six percent of children consumed a savory snack. There were some differences in food consumption patterns between racial/ethnic groups.

Conclusion

Findings from the FITS 2016 indicate that individual-, community-, and policy-level strategies are needed to improve the diets of young children in the United States.

Potatoes and risk of obesity, type 2 diabetes, and cardiovascular disease in apparently healthy adults: a systematic review of clinical intervention and observational studies

BACKGROUND

Potatoes have been related to increased risks of obesity, type 2 diabetes (T2D), and cardiovascular disease (CVD) mainly because of their high glycemic index.

OBJECTIVE

We conducted a systematic review to evaluate the relation between intake of potatoes and risks of obesity, T2D, and CVD in apparently healthy adults.

DESIGN

MEDLINE, Embase, the Web of Science, and the Cochrane Central Register of Controlled Trials were searched for intervention and prospective observational studies that investigated adults without any known illnesses at baseline, recorded intake of potatoes, and measured adiposity (body weight, body mass index, or waist circumference), cases of T2D, cases of cardiovascular events, or risk markers thereof.

RESULTS

In total, 13 studies were deemed eligible; 5 studies were related to obesity, 7 studies were related to T2D, and one study was related to CVD. Only observational studies were identified; there were 3 studies with moderate, 9 studies with serious, and one study with critical risk of bias. The association between potatoes (not including french fries) and adiposity was neutral in 2 studies and was positive in 2 studies. French fries were positively associated with adiposity in 3 of 3 studies. For T2D, 2 studies showed a positive association, whereas 5 studies showed no or a negative association with intake of potatoes and T2D. French fries were positively associated with T2D in 3 of 3 studies that distinguished this relation. For CVD, no association was observed.

CONCLUSIONS

The identified studies do not provide convincing evidence to suggest an association between intake of potatoes and risks of obesity, T2D, or CVD. French fries may be associated with increased risks of obesity and T2D although confounding may be present. In this systematic review, only observational studies were identified. These findings underline the need for long-term randomized controlled trials. This trial was registered at the PROSPERO International prospective register of systematic reviews (www.crd.york.ac.uk/PROSPERO/) as CRD42015026491.

Strategies to improve the Willingness to Taste: The moderating role of children's Reward Sensitivity

The present study investigates the effectiveness of different strategies to improve Willingness to Taste disliked vegetables and the moderating role of Reward Sensitivity. Preschool children (N = 204; age: M = 4.48, SD = 1.01) were randomly allocated to one of four different Willingness to Taste strategies. The findings indicate that first, Willingness to Taste is higher in the modelling and reward strategies compared to neutral instructions. Second, there is a differential effect of Willingness to Taste strategies dependent upon individual differences: children high in Reward Sensitivity were more likely to taste immediately when rewarded, while children low in Reward Sensitivity were more willing to taste when verbally encouraged, but with hesitation. This article thus highlights the roles of both individual differences and behavioral techniques for promoting a healthy diet in children.

Next Steps for Science and Policy on Promoting Vegetable Consumption among US Infants and Young Children

Vegetables are an important part of a healthy diet for infants and young children, but they are poorly accepted and underconsumed. This paper highlights major themes and research needs for understanding how to raise children to consume and enjoy vegetables as part of a healthful diet. A range of factors impedes US infants and young children from eating as many vegetables as experts consider optimal for child nutrition, health, and development. Barriers include biological and behavioral issues relating to infant and child development, household- and family-related barriers, obstacles in the larger community, economic limitations, and some government policies and programs. These barriers must be removed to encourage children to eat more vegetables. Research gaps also must be filled. We summarize the basic and applied research that is needed to craft more effective messages, devise strategies for parents and other child caretakers to take within households, develop action in the larger community, and modify some government policies and programs.