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Ahluwalia N. Nutrition Monitoring of Children Aged Birth to 24 Mo (B-24): Data Collection and Findings from the NHANES. Adv Nutr 2020; 11:113-127. [PMID: 31390469 PMCID: PMC7442347 DOI: 10.1093/advances/nmz077] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Namanjeet Ahluwalia
- Division of Health and Nutrition Examination Surveys (DHANES), National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
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Cuadrado-Soto E, Risica PM, Gans KM, Mena NZ, Ellis C, Araujo CD, Lofgren IE, Stowers KC, Tovar A. Micronutrient Adequacy in Preschool Children Attending Family Child Care Homes. Nutrients 2019; 11:nu11092134. [PMID: 31500153 PMCID: PMC6770721 DOI: 10.3390/nu11092134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/28/2019] [Accepted: 09/02/2019] [Indexed: 01/09/2023] Open
Abstract
Limited data is available on the micronutrient intake and adequacy in preschool children enrolled in family child care homes (FCCH). The goal of this paper is to describe the micronutrient adequacy relative to age-specific recommendations of preschool-aged children (aged 2-5 years) attending FCCH in Rhode Island (RI). Dietary data among younger preschoolers (aged 2-3 years), n = 245) and older preschoolers (aged 4-5 years), n = 121) in 118 RI FCCH (N = 366 children) were analyzed. Nutrient adequacy was assessed as the amount of nutrient per 1000 kcal of the diet that would meet the Institute of Medicine nutrient requirements (critical nutrient density), and it was compared to the observed nutrient densities of the children. The sodium:potassium ratio was also calculated. For most micronutrients, the observed density met or exceeded the recommendation, meaning the children's intake was adequate. However, a high proportion of children had nutrient densities under the recommendation for vitamins D, E, K, and potassium (86.1%, 89.1%, 70.8%, and 99.2% of children, respectively). The mean vitamin B12, potassium, and zinc densities were statistically higher in younger vs. older preschoolers (p < 0.05 for all). Low densities in calcium and vitamins K and B5 were more frequent in older children vs. younger children (p < 0.05). In addition, older preschoolers had a higher sodium:potassium ratio than younger children (p < 0.05). The micronutrient intake density was adequate for most nutrients. However, intake of some nutrients was of concern. Further attention to training and compliance in FCCH may improve the diet quality of those cared for in these settings.
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Affiliation(s)
- Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040 Madrid, Spain;
| | - Patricia Markham Risica
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; (P.M.R.)
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA
| | - Kim M. Gans
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; (P.M.R.)
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269, USA;
| | - Noereem Z. Mena
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Carolyn Ellis
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Carolina D. Araujo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Ingrid E. Lofgren
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
| | - Kristen Cooksey Stowers
- Institute for Collaboration in Health, Interventions and Policy, University of Connecticut, Storrs, CT 06269, USA;
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA; (N.Z.M.); (C.E.); (C.D.A.); (I.E.L.)
- Correspondence: ; Tel.: +401-874-9855
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Palacios C, Rivas-Tumanyan S, Santiago-Rodríguez EJ, Sinigaglia O, Ríos EM, Campos M, Diaz B, Willett W. A Semi-Quantitative Food Frequency Questionnaire Validated in Hispanic Infants and Toddlers Aged 0 to 24 Months. J Acad Nutr Diet 2017; 117:526-535.e9. [PMID: 28188114 DOI: 10.1016/j.jand.2016.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 12/14/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are limited validated food frequency questionnaires (FFQs) for infants and toddlers, most of which were evaluated in Europe or Oceania, and the ones available for use in the United States have important limitations. OBJECTIVE Our aim was to assess the validity of an FFQ developed for infants and toddlers. DESIGN A semi-quantitative FFQ was developed that included 52 food items, their sources, and portion sizes. The FFQ inquired about diets over the previous 7 days. Its validity was assessed in a cross-sectional study. Participants completed the FFQ, followed by a 24-hour recall on two occasions with 1 week between data collection. PARTICIPANTS/SETTING A total of 296 caregivers of infants and toddlers aged 0 to 24 months enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children, Puerto Rico. MAIN OUTCOME MEASURES Intake of nutrients and food groups were averaged for the two FFQs and the two 24-hour food recalls, and adjusted for energy intake. STATISTICAL ANALYSES PERFORMED Spearman correlations were performed for intakes of energy, nutrients, and foods between administrations and between instruments. Correlation coefficients were de-attenuated to account for variation in the 24-hour recalls. RESULTS A total of 241 participants completed the study. Intake of all nutrients and foods were significantly correlated between FFQs and 24-hour recalls and between the means of FFQs and 24-hour food recalls. The de-attenuated correlation for nutrients between the FFQs and 24-hour recalls ranged from 0.26 (folate) to 0.77 (energy), with a mean correlation of 0.53. The de-attenuated correlation for food groups between the FFQs and 24-hour recalls ranged from 0.28 (sweets) to 0.80 (breast milk), with a mean correlation of 0.55. When analyses were restricted to those consuming foods other than breast milk or formula (n=186), results were similar. CONCLUSIONS This semi-quantitative FFQ is a tool that offers reasonably valid rankings for intake of energy, nutrients, foods, and food groups in this sample of infants and toddlers.
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Effect of fortified milk on growth and nutritional status in young children: a systematic review and meta-analysis. Public Health Nutr 2016; 20:1214-1225. [DOI: 10.1017/s1368980016003189] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AbstractObjectiveAdequate nutrition is critical for optimal growth and development. However, young children may be at risk of nutrient deficiencies when transitioning to weaning foods for a variety of reasons. Supplementation with fortified milk may provide potentially lacking essential nutrients, but effects on growth and nutritional status are yet to be established.DesignFive databases were searched for randomised controlled trials using fortified milk against control milk in young children. Outcomes were growth, body composition and/or biochemical markers. Pooled differences in means were calculated for continuous outcomes and odds ratios for binary outcomes.SettingRandomised controlled trials set in any country.SubjectsOtherwise healthy children aged 6–47 months.ResultsFifteen articles met the eligibility criteria. Fortification varied from Fe, Zn, vitamins, essential fatty acids, to pre- and/or probiotics. Frequently reported outcomes were weight, height and Fe status. Studies varied in geographical location, sample size and duration. Fortified milk had minimal effects on weight gain (mean difference=0·17 kg; 95 % CI 0·02, 0·31 kg) compared with control milk. The risk of anaemia was reduced in fortified milk groups (OR=0·32; 95 % CI 0·15, 0·66) compared with control groups. There were no significant effects on height gain, changes in body composition or Hb concentration.ConclusionsFortified milk is an effective source of complementary nutrition to supplement children in need when consumed in appropriate amounts in addition to a normal diet. Due to compositional differences, further research on fortified milk is warranted before making global recommendations on benefits for growth and nutritional outcomes in young children.
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Hubbs-Tait L, Nation JR, Krebs NF, Bellinger DC. Neurotoxicants, Micronutrients, and Social Environments. Psychol Sci Public Interest 2016; 6:57-121. [DOI: 10.1111/j.1529-1006.2005.00024.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
SUMMARY—Systematic research evaluating the separate and interacting impacts of neurotoxicants, micronutrients, and social environments on children's cognition and behavior has only recently been initiated. Years of extensive human epidemiologic and animal experimental research document the deleterious impact of lead and other metals on the nervous system. However, discrepancies among human studies and between animal and human studies underscore the importance of variations in child nutrition as well as social and behavioral aspects of children's environments that mitigate or exacerbate the effects of neurotoxicants. In this monograph, we review existing research on the impact of neurotoxic metals, nutrients, and social environments and interactions across the three domains. We examine the literature on lead, mercury, manganese, and cadmium in terms of dispersal, epidemiology, experimental animal studies, effects of social environments, and effects of nutrition. Research documenting the negative impact of lead on cognition and behavior influenced reductions by the Center for Disease Control in child lead-screening guidelines from 30 micrograms per deciliter (μg/dL) in 1975 to 25 μg/dL in 1985 and to 10 μg/dL in 1991. A further reduction is currently being considered. Experimental animal research documents lead's alteration of glutamate-neurotransmitter (particularly N-methyl-D-aspartate) activity vital to learning and memory. In addition, lead induces changes in cholinergic and dopaminergic activity. Elevated lead concentrations in the blood are more common among children living in poverty and there is some evidence that socioeconomic status influences associations between lead and child outcomes. Micronutrients that influence the effects of lead include iron and zinc. Research documenting the negative impact of mercury on children (as well as adults) has resulted in a reference dose (RfD) of 0.1 microgram per kilogram of body weight per day (μg/kg/day). In animal studies, mercury interferes with glutamatergic, cholinergic, and dopaminergic activity. Although evidence for interactions of mercury with children's social contexts is minimal, researchers are examining interactions of mercury with several nutrients. Research on the effects of cadmium and manganese on child cognition and behavior is just beginning. Experimental animal research links cadmium to learning deficits, manganese to behaviors characteristic of Parkinson's disease, and both to altered dopaminergic functioning. We close our review with a discussion of policy implications, and we recommend interdisciplinary research that will enable us to bridge gaps within and across domains.
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Affiliation(s)
- Laura Hubbs-Tait
- Department of Human Development and Family Science, Oklahoma State University
| | | | - Nancy F. Krebs
- Department of Pediatrics, University of Colorado School of Medicine
| | - David C. Bellinger
- Department of Neurology, Harvard Medical School; Department of Environmental Health, Harvard School of Public Health; and Children's Hospital Boston
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Comerford KB, Ayoob KT, Murray RD, Atkinson SA. The Role of Avocados in Complementary and Transitional Feeding. Nutrients 2016; 8:E316. [PMID: 27213450 PMCID: PMC4882728 DOI: 10.3390/nu8050316] [Citation(s) in RCA: 8] [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: 02/18/2016] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 12/11/2022] Open
Abstract
Infant dietary patterns tend to be insufficient sources of fruits, vegetables, and fiber, as well as excessive in salt, added sugars, and overall energy. Despite the serious long-term health risks associated with suboptimal fruit and vegetable intake, a large percentage of infants and toddlers in the U.S. do not consume any fruits or vegetables on a daily basis. Since not all fruits and vegetables are nutritionally similar, guidance on the optimal selection of fruits and vegetables should emphasize those with the greatest potential for nutrition and health benefits. A challenge is that the most popularly consumed fruits for this age group (i.e., apples, pears, bananas, grapes, strawberries) do not closely fit the current general recommendations since they tend to be overly sweet and/or high in sugar. Unsaturated oil-containing fruits such as avocados are nutritionally unique among fruits in that they are lower in sugar and higher in fiber and monounsaturated fatty acids than most other fruits, and they also have the proper consistency and texture for first foods with a neutral flavor spectrum. Taken together, avocados show promise for helping to meet the dietary needs of infants and toddlers, and should be considered for inclusion in future dietary recommendations for complementary and transitional feeding.
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Affiliation(s)
- Kevin B Comerford
- Department of Nutrition, University of California at Davis, Davis, CA 95616, USA.
| | - Keith T Ayoob
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Robert D Murray
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA.
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Yu P, Denney L, Zheng Y, Vinyes-Parés G, Reidy KC, Eldridge AL, Wang P, Zhang Y. Food groups consumed by infants and toddlers in urban areas of China. Food Nutr Res 2016; 60:30289. [PMID: 26864648 PMCID: PMC4749863 DOI: 10.3402/fnr.v60.30289] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/17/2016] [Accepted: 01/18/2016] [Indexed: 02/07/2023] Open
Abstract
Background Food consumption patterns of young children in China are not well known. Objective Characterised food groups consumed by infants and young children in urban China using data from the Maternal Infant Nutrition Growth (MING) study. Design One 24-h dietary recall was completed for 1,350 infants and young children (436 infants aged 6–11 months and 914 young children aged 12–35 months), who were recruited from maternal and child care centres in eight cities via face-to-face interviews with the primary caregiver. All foods, beverages and supplements reported were assigned to one of 64 food groups categorised into the following: milk and milk products, grains, vegetables, fruits, protein foods and desserts/sweets. The percentage of infants and young children consuming foods from specific food groups was calculated, regardless of the amount consumed. Results Less than half of infants consumed breast milk (47%), whereas 59% of infants consumed infant formula and 53–75% of young children consumed growing-up (fortified) milk. Rice was the number one grain food consumed after 6 months (up to 88%) and the consumption of infant cereal was low. About 50% of infants did not consume any fruits or vegetables, and 38% of young children did not consume any fruits on the day of the recall. Only 40% of all children consumed dark green leafy vegetables and even fewer consumed deep yellow vegetables. Eggs and pork were the most commonly consumed protein foods. Conclusions The data provide important insight for developing detailed food consumption guidelines for this population group. Mothers of infants should be encouraged to continue breastfeeding after the first 6 months. Parents should be advised to offer a wide variety of vegetables and fruits daily, particularly dark green leafy and deep yellow vegetables and colourful fruits. The consumption of fortified infant cereal should be advocated to improve the iron intake of Chinese infants.
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Affiliation(s)
- Pan Yu
- School of Public Health, Peking University, Beijing, China
| | - Liya Denney
- Department of Public Health Nutrition, Nestlé Research Centre, Lausanne, Switzerland;
| | - Yingdong Zheng
- School of Public Health, Peking University, Beijing, China
| | | | | | - Alison L Eldridge
- Department of Public Health Nutrition, Nestlé Research Centre, Lausanne, Switzerland
| | - Peiyu Wang
- School of Public Health, Peking University, Beijing, China
| | - Yumei Zhang
- School of Public Health, Peking University, Beijing, China
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Susanto F. Nutrient intake evaluation among school age children in Jakarta, Indonesia. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2015. [DOI: 10.3233/mnm-150050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fu Q, Land KC. The Increasing Prevalence of Overweight and Obesity of Children and Youth in China, 1989–2009: An Age–Period–Cohort Analysis. POPULATION RESEARCH AND POLICY REVIEW 2015. [DOI: 10.1007/s11113-015-9372-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Paul IM, Williams JS, Anzman-Frasca S, Beiler JS, Makova KD, Marini ME, Hess LB, Rzucidlo SE, Verdiglione N, Mindell JA, Birch LL. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study. BMC Pediatr 2014; 14:184. [PMID: 25037579 PMCID: PMC4105401 DOI: 10.1186/1471-2431-14-184] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/09/2014] [Indexed: 12/15/2022] Open
Abstract
Background Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). Study is a longitudinal, randomized, controlled trial evaluating a responsive parenting intervention designed for the primary prevention of obesity. This “parenting” intervention is being compared with a home safety control among first-born infants and their parents. INSIGHT’s central hypothesis is that responsive parenting and specifically responsive feeding promotes self-regulation and shared parent–child responsibility for feeding, reducing subsequent risk for overeating and overweight. Methods/Design 316 first-time mothers and their full-term newborns were enrolled from one maternity ward. Two weeks following delivery, dyads were randomly assigned to the “parenting” or “safety” groups. Subsequently, research nurses conduct study visits for both groups consisting of home visits at infant age 3–4, 16, 28, and 40 weeks, followed by annual clinic-based visits at 1, 2, and 3 years. Both groups receive intervention components framed around four behavior states: Sleeping, Fussy, Alert and Calm, and Drowsy. The main study outcome is BMI z-score at age 3 years; additional outcomes include those related to patterns of infant weight gain, infant sleep hygiene and duration, maternal responsiveness and soothing strategies for infant/toddler distress and fussiness, maternal feeding style and infant dietary content and physical activity. Maternal outcomes related to weight status, diet, mental health, and parenting sense of competence are being collected. Infant temperament will be explored as a moderator of parenting effects, and blood is collected to obtain genetic predictors of weight status. Finally, second-born siblings of INSIGHT participants will be enrolled in an observation-only study to explore parenting differences between siblings, their effect on weight outcomes, and carryover effects of INSIGHT interventions to subsequent siblings. Discussion With increasing evidence suggesting the importance of early life experiences on long-term health trajectories, the INSIGHT trial has the ability to inform future obesity prevention efforts in clinical settings. Trial registration NCT01167270. Registered 21 July 2010.
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Affiliation(s)
- Ian M Paul
- Department of Pediatrics, HS83, Penn State College of Medicine, 500 University Dr,, Hershey 17033, PA, USA.
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Ahluwalia N, Herrick K, Paulose-Ram R, Johnson C. Data needs for B-24 and beyond: NHANES data relevant for nutrition surveillance of infants and young children. Am J Clin Nutr 2014; 99:747S-54S. [PMID: 24452232 PMCID: PMC6331057 DOI: 10.3945/ajcn.113.069062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The period from birth to 24 mo (B-24) is a critical phase in which nutrient requirements for growth and development are high and several transitions in food consumption practices occur. A few large-scale national studies (eg, the Feeding Infants and Toddlers Study and Infant Feeding Practices Study) offer important insights into infant feeding practices and food consumption patterns in young children in the United States. The NHANES collects comprehensive cross-sectional data on the nutrition and health of Americans including infants and toddlers. This article describes the NHANES program and data from NHANES 1999-2010 on young children that are relevant for the B-24 Project. NHANES is a nationally representative survey of the noninstitutionalized US population that combines personal interviews with standardized physical examination and measurements via mobile examination centers. Data on infant feeding practices (breastfeeding and timing of introduction and nature of complementary foods), dietary intake (two 24-h recalls), and nutrient supplements are collected. Data on demographic characteristics, anthropometric measurements, biomarkers of nutrient status, food security, and participation in federal nutrition programs are also available. Data can be accessed online, downloaded, and pooled over several survey cycles, allowing examination of infant feeding practices, food and nutrient intakes, and nutritional status of Americans <2 y old. Subgroup analyses by race-ethnicity and income status are also possible. NHANES responds to evolving data needs, as feasible, in the context of the survey design, research priorities, and funding. It offers a vehicle for potentially gathering additional data on children <2 y to address the objectives of the B-24 Project in the future.
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Affiliation(s)
- Namanjeet Ahluwalia
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
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Hoppu U, Isolauri E, Koskinen P, Laitinen K. Diet and blood lipids in 1-4 year-old children. Nutr Metab Cardiovasc Dis 2013; 23:980-986. [PMID: 23182924 DOI: 10.1016/j.numecd.2012.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 10/04/2012] [Accepted: 10/16/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM Early nutrition may programme blood lipid levels and thereby later cardiovascular health of children. The objective here was to evaluate the effects of maternal dietary counselling during pregnancy and breastfeeding on dietary intakes and blood lipid values in 1-4 year-old children. Further, the nutritional determinants of children's lipid profiles were assessed. METHODS AND RESULTS Mothers were randomised into dietary counselling or control groups at the first trimester of pregnancy. Their children were followed up clinically at 1, 2 and 4 years of age, by three-day food records and analyses of total cholesterol, HDL cholesterol and apolipoproteins A-I and B as well as lipoprotein (a). In general, the mean intake of saturated fatty acids as a proportion of total energy intake (E%) was higher than the recommended, while the mean intake of polyunsaturated fatty acids was low in children's diet. Over the first years, girls had higher concentration of non-HDL cholesterol than boys; 2.64 mmol/l (95% CI 2.54-2.74) vs. 2.49 (2.38-2.60); p = 0.038. Maternal dietary counselling was not reflected in the children's lipid values. Children's monounsaturated fatty acid intake (E%) correlated with apoA-I (p = 0.048) and, furthermore, there was a negative correlation between polyunsaturated fatty acid intake (E%) and apoB (p = 0.046). CONCLUSION Children's dietary fatty acid intake, but not maternal dietary counselling was shown to be related to blood apolipoproteins in children.
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Affiliation(s)
- U Hoppu
- Functional Foods Forum, 20014 University of Turku, Turku, Finland.
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Zhou SJ, Gibson RA, Gibson RS, Makrides M. Nutrient intakes and status of preschool children in Adelaide, South Australia. Med J Aust 2012; 196:696-700. [PMID: 22708768 DOI: 10.5694/mja11.11080] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the nutrient intakes and status of preschool children from a representative population sample in Adelaide. DESIGN, SETTING AND PARTICIPANTS Cross-sectional survey of children aged 1-5 years, using a stratified random sampling method and a doorknocking strategy, between September 2005 and July 2007. MAIN OUTCOME MEASURES Dietary intake, assessed using a 3-day weighed-food diary; anthropometrics, biomarkers of iron, zinc and vitamin B(12), and fatty acid profiles assessed using standard methods. RESULTS Median energy intakes were within dietary recommendations for the age group. Overall energy contributions from carbohydrate, protein, fat and saturated fat intakes were 50%, 17%, 33% and 16%, respectively. The rates of inadequate intake of iron, zinc, calcium and vitamin C were low, as was the prevalence of iron deficiency (5%). Only a minority of children achieved the adequate intake for n-3 long-chain polyunsaturated fatty acids (32%) and dietary fibre (18%). There was no association between socioeconomic status and intakes of macronutrients and key micronutrients. Fourteen per cent of children were obese (BMI, > 95th percentile); no association between BMI and energy intake was shown. CONCLUSIONS The dietary intake of children in the study was adequate for macronutrients and the majority of micronutrients. However, low intakes of fibre and n-3 long-chain polyunsaturated fatty acids and high saturated fat intakes have raised concerns that this dietary pattern may be associated with adverse long-term health effects.
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Affiliation(s)
- Shao J Zhou
- Women's and Children's Health Research Institute, Adelaide, SA
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Vitolo MR, Bortolini GA, Campagnolo PDB, Hoffman DJ. Maternal dietary counseling reduces consumption of energy-dense foods among infants: a randomized controlled trial. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2012; 44:140-147. [PMID: 22189004 DOI: 10.1016/j.jneb.2011.06.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 04/24/2011] [Accepted: 06/30/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To evaluate the impact of a dietary counseling in reducing the intake of energy-dense foods by infants. DESIGN A randomized controlled trial. SETTING AND PARTICIPANTS São Leopoldo, Brazil. Mothers and infants of a low-income-group population were randomized into intervention (n = 163) and received dietary counseling during 10 home visits, or control (n = 234) groups. MAIN OUTCOMES MEASURES Child consumption of sugar-dense (SD) and lipid-dense (LD) foods at 12 to 16 months. ANALYSIS The effect of the intervention was expressed by relative risks and 95% confidence intervals. Poisson regression analysis was used to determine the association between exclusive breastfeeding and the energy-dense foods intake. RESULTS A smaller proportion of infants from the intervention group consumed candy, soft drinks, honey, cookies, chocolate, and salty snacks. In the intervention group, there was a reduction of 40% and 50% in the proportion of infants who consumed LD and SD foods, respectively. Being breastfed up to 6 months reduced the risk for consumption of LD and SD foods by 58% and 67%, respectively. CONCLUSIONS AND IMPLICATIONS Dietary counseling to mothers may be effective in reducing the consumption of energy-dense foods among infants, and it is helpful in improving early dietary habits.
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Affiliation(s)
- Marcia Regina Vitolo
- Department of Nutrition, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
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How much is enough? Tablespoon per year of age approach meets nutrient needs for children. Appetite 2011; 58:163-7. [PMID: 22005182 DOI: 10.1016/j.appet.2011.09.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 09/15/2011] [Accepted: 09/30/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Adults often ask health professionals for guidance on offering the appropriate serving sizes for young children and little research is available on whether serving size approaches meet children's nutrient needs. OBJECTIVE Determine whether three serving size approaches for young children meet dietary standards for nutrient adequacy. DESIGN We examined nutrient contents of three serving size approaches for children ages 2-5 years of age: 1 tablespoon per year of age (T/y), MyPyramid, and Child and Adult Care Food Program. Nutrient content of the three approaches were compared to the Estimated Energy Requirements (EER), Estimated Average Requirement (EAR), or Adequate Intake (AI) for each year of age for males and females; Analysis of Variance identified differences in nutrient content among the three approaches. RESULTS Young children's nutrient requirements were met for most nutrients by all approaches. However, the recommendation for vitamin E, potassium, and fat were not met by any approach, for any year, for either girls or boys. Energy content of the T/y serving size approach was below the EER for each year of age and for both sexes but still met minimal vitamin and mineral needs. CONCLUSION Health professionals can feel comfortable using any of the three approaches. However, the T/y approach is a more graduated serving size approach, may be more consistently age appropriate for young children, and may be implemented more easily by adults.
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Schwartz C, Chabanet C, Lange C, Issanchou S, Nicklaus S. The role of taste in food acceptance at the beginning of complementary feeding. Physiol Behav 2011; 104:646-52. [DOI: 10.1016/j.physbeh.2011.04.061] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 04/28/2011] [Accepted: 04/29/2011] [Indexed: 01/05/2023]
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Bramhagen AC, Svahn J, Hallström I, Axelsson I. Factors influencing iron nutrition among one-year-old healthy children in Sweden. J Clin Nurs 2011; 20:1887-94. [DOI: 10.1111/j.1365-2702.2010.03639.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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SZYMLEK-GAY EA, FERGUSON EL, HEATH ALM, FLEMING EA. Quantities of foods consumed by 12- to 24-month-old New Zealand children. Nutr Diet 2010. [DOI: 10.1111/j.1747-0080.2010.01471.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hurley KM, Black MM. Commercial Baby Food Consumption and Dietary Variety in a Statewide Sample of Infants Receiving Benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children. ACTA ACUST UNITED AC 2010; 110:1537-41. [DOI: 10.1016/j.jada.2010.07.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Accepted: 03/30/2010] [Indexed: 10/19/2022]
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Abstract
AbstractObjectiveTo study food consumption and nutrient intake in Finnish children aged 1–6 years and to assess the effect of age and sex on food consumption and nutrient intake.DesignCross-sectional samples of children participating in the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort study in Finland.SubjectsThe study population comprised healthy children recruited in the nutrition study within the DIPP study in 1998–2003. Three-day food records (2535 in total) from 1-, 2-, 3-, 4- and 6-year-old children were kept between the years 2003 and 2005.ResultsThe energy-adjusted consumption of fruits and berries, cereal products, infant formulas and meat dishes was higher and the consumption of vegetables, salads, breads, dairy products, fat spreads, drinks, sweets and sugar was lower among 1-year-old children than older age groups (P for all <0·05). The mean daily energy intake increased with age and was higher among boys than girls in all age groups, except among the 2-year-olds (P for all <0·05). The diet of the 2–6-year-old children contained too much saturated fat and sucrose, and too little PUFA compared with the current Nordic Nutrition Recommendations. The intakes of most vitamins and minerals met the recommendations. However, the intakes of vitamin D, E and iron fell below the recommended levels. The nutrient density of the diet decreased after the age of 1 year at the time that the children adapted to the regular family diet.ConclusionsIn order to improve the diet of young children, it is essential to evaluate the diet of the whole family.
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Hart CN, Raynor HA, Jelalian E, Drotar D. The association of maternal food intake and infants' and toddlers' food intake. Child Care Health Dev 2010; 36:396-403. [PMID: 20337642 PMCID: PMC8112730 DOI: 10.1111/j.1365-2214.2010.01072.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Young children's first experiences with food may influence development of food preferences and lifelong eating habits. However, little is known about what factors are associated with the development of eating behaviours in infants and toddlers. Studies with older children and adolescents suggest that parental food intake is associated with children's food intake. The purpose of the present paper is to determine whether this association starts even earlier during infancy and toddlerhood. METHODS A convenience sample of n= 98 primarily African American mothers of children 6-18 months old completed questionnaires, including questions on their own and their young child's food intake. Mothers completed questions while waiting to be seen by their child's primary care provider. RESULTS Per maternal report, children consumed fruit 2.45 (1.79) times, vegetables 1.63 (1.51) times and snack foods 2.22 (2.49) times each day. Infants' and toddlers' fruit (r= 0.54, P < 0.001), vegetable (r= 0.42, P < 0.001) and snack food (r= 0.37, P < 0.001) intake were significantly associated with maternal intake of each of these foods, respectively. These significant associations remained even after controlling for additional study variables. CONCLUSION Even at very young ages, maternal food intake is an important correlate of children's food intake. Taken together with findings documenting significant snack food consumption in this age group, findings suggest that development of prevention and intervention programmes to enhance healthy eating behaviours need to start very early, perhaps just prior to children being introduced to complementary foods.
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Affiliation(s)
- C. N. Hart
- Weight Control & Diabetes Research Center, The Miriam Hospital and The Alpert Medical School of Brown University, Providence, RI
| | - H. A. Raynor
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, TN
| | - E. Jelalian
- Weight Control & Diabetes Research Center, The Miriam Hospital and The Alpert Medical School of Brown University, Providence, RI
| | - D. Drotar
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Abstract
Elimination of iron deficiency and iron deficiency anemia in children is a crucial public health concern because these conditions have been linked to cognitive and behavioral deficits. In the infant age group, great strides have been made to reduce iron deficiency and iron deficiency anemia significantly. However, similar progress has not yet been made with toddlers. Cow's milk consumption has long been associated with iron deficiency and iron deficiency anemia in children. Because cow's milk is a staple in the diet of most toddlers, they are at particular risk for these conditions. Two unusual presentations of anemia in toddlers caused by excessive cow's milk consumption are described: one in a child with congestive heart failure, the other in a child with profound eosinophilia. The role of cow's milk in iron deficiency and iron deficiency anemia is also examined.
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Affiliation(s)
- Steven A. Bondi
- Department of Primary Care and Community Medicine, Irwin
Army Community Hospital, Fort Riley, Kansas,
| | - Kenneth Lieuw
- Uniformed Services University of the Health Sciences,
Bethesda, Maryland
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Paul IM, Bartok CJ, Downs DS, Stifter CA, Ventura AK, Birch LL. Opportunities for the primary prevention of obesity during infancy. Adv Pediatr 2009; 56:107-33. [PMID: 19968945 PMCID: PMC2791708 DOI: 10.1016/j.yapd.2009.08.012] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Many parents, grandparents, and clinicians have associated a baby’s ability to eat and gain weight as a sign of good health, and clinicians typically only call significant attention to infant growth if a baby is failing to thrive or showing severe excesses in growth. Recent evidence, however, has suggested that pediatric healthcare providers should pay closer attention to growth patterns during infancy. Both higher weight and upward crossing of major percentile lines on the weight-for-age growth chart during infancy have long term health consequences, and are associated with overweight and obesity later in life. Clinicians should utilize the numerous available opportunities to discuss healthy growth and growth charts during health maintenance visits in the first two years after birth. Further, providers should instruct parents on strategies to promote healthy behaviors that can have long lasting obesity preventive effects.
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Affiliation(s)
- Ian M Paul
- Pediatrics, Penn State College of Medicine, HS83, 500 University Drive, Hershey, PA 17033, USA.
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WEBB K, RUTISHAUSER I, KNEZEVIC N. Foods, nutrients and portions consumed by a sample of Australian children aged 16-24 months. Nutr Diet 2008. [DOI: 10.1111/j.1747-0080.2007.00224.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hubbs-Tait L, Kennedy TS, Droke EA, Belanger DM, Parker JR. Zinc, iron, and lead: relations to head start children's cognitive scores and teachers' ratings of behavior. ACTA ACUST UNITED AC 2007; 107:128-33. [PMID: 17197281 DOI: 10.1016/j.jada.2006.10.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2005] [Indexed: 12/21/2022]
Abstract
The objective of this study was to conduct a preliminary investigation of lead, zinc, and iron levels in relation to child cognition and behavior in a small sample of Head Start children. The design was cross-sectional and correlational. Participants were 42 3- to 5-year-old children attending rural Head Start centers. Nonfasting blood samples of whole blood lead, plasma zinc, and ferritin were collected. Teachers rated children's behavior on the California Preschool Social Competency Scale, Howes' Sociability subscale, and the Preschool Behavior Questionnaire. Children were tested individually with the McCarthy Scales of Children's Abilities. Hierarchical regression analyses revealed that zinc and ferritin jointly explained 25% of the variance in McCarthy Scales of Children's Abilities verbal scores. Lead levels explained 25% of the variance in teacher ratings of girls' sociability and 20% of the variance in teacher ratings of girls' classroom competence. Zinc levels explained 39% of the variance in teacher ratings of boys' anxiety. Univariate analysis of variance revealed that the four children low in zinc and iron had significantly higher blood lead (median=0.23 micromol/L [4.73 microg/dL]) than the 31 children sufficient in zinc or iron (median=0.07 micromol/L [1.54 microg/dL]) or the 7 children sufficient in both (median=0.12 micromol/L [2.52 microg/dL]), suggesting an interaction among the three minerals. Within this small low-income sample, the results imply both separate and interacting effects of iron, zinc, and lead. They underscore the importance of studying these three minerals in larger samples of low-income preschool children to make more definitive conclusions.
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Affiliation(s)
- Laura Hubbs-Tait
- Human Development and Family Science Department, Oklahoma State University, Stillwater, OK 74078-6141, USA
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Royo-Bordonada MA, Garcés C, Gorgojo L, Martín-Moreno JM, Lasunción MA, Rodríguez-Artalejo F, Fernández O, de Oya M. Saturated fat in the diet of Spanish children: relationship with anthropometric, alimentary, nutritional and lipid profiles. Public Health Nutr 2007; 9:429-35. [PMID: 16870014 DOI: 10.1079/phn2005870] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjectiveTo compare the anthropometric, alimentary, nutritional and lipid profiles and global diet quality of Spanish children according to saturated fat intake.DesignThis was a cross-sectional study. Food data were collected using a food-frequency questionnaire.Subjects and methodsThe sample included 1112 children of both sexes, aged between 6 and 7 years, selected by means of random cluster sampling in schools. The plasma lipid profile included measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (apoA1) and apolipoprotein B (apoB). Global diet quality was evaluated by the Dietary Variety Index (DVI) and the Healthy Eating Index (HEI).ResultsEnergy intake, DVI and HEI of children from the lower quartile of saturated fat intake (LL) were higher (P < 001) than in the remaining children (UL). However, there were no significant differences in average height or weight between groups. The UL children had lower intakes of meat, fish, vegetables, fruits and olive oil and a higher intake of dairy products (P < 0.001). The intakes of fibre, vitamins C, D, B6, E and folic acid were higher in the LL children, who had lower intakes of vitamin A and calcium. The ratios LDL-C/HDL-C and apoB/apoA1 were lower (P = 0.04) in the LL children (1.87 and 0.52, respectively) than in the UL children (2.02 and 0.54, respectively).ConclusionsThe growth rate of children does not seem to be affected by the level of saturated fat intake. Furthermore, at the levels of intake observed in this study, diets with less saturated fat are associated with better alimentary, nutritional and plasma lipid profiles.
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Affiliation(s)
- M A Royo-Bordonada
- Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain.
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Consumption of ‘extra’ foods (energy-dense, nutrient-poor) among children aged 16–24 months from western Sydney, Australia. Public Health Nutr 2006. [DOI: 10.1017/phn2006970] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveThis study evaluates the contribution of energy-dense, nutrient-poor ‘extra’ foods to the diets of 16–24-month-old children from western Sydney, Australia.DesignAn analysis of cross-sectional data collected on participants in the Childhood Asthma Prevention Study (CAPS), a randomised trial investigating the primary prevention of asthma from birth to 5 years. We collected 3-day weighed food records, calculated nutrient intakes, classified recorded foods into major food groups, and further classified foods as either ‘core’ or ‘extras’ according to theAustralian Guide to Healthy Eating.SettingPregnant women, whose unborn child was at risk of developing asthma because of a family history, were recruited from all six hospitals in western Sydney, Australia. Data for this study were collected in clinic visits and at participants’ homes at the 18-month assessment.ParticipantsFour hundred and twenty-nine children participating in the CAPS study; 80% of the total cohort.ResultsThe mean consumption of ‘extra’ foods was ∼150 g day− 1and contributed 25–30% of the total energy, fat, carbohydrate and sodium to the diets of the study children. ‘Extra’ foods also contributed around 20% of fibre, 10% of protein and zinc, and about 5% of calcium. Children in the highest quintile of ‘extra’ foods intake had a slightly higher but not significantly different intake of energy from those in the lowest quintile. However, significant differences were evident for the percentage of energy provided by carbohydrate and sugars (higher) and protein and saturated fat (lower). The intake of most micronutrients was also significantly lower among children in the highest quintile of consumption. The intake of ‘extra’ foods was inversely associated with the intake of core foods.ConclusionsThe high percentage of energy contributed by ‘extra’ foods and their negative association with nutrient density emphasise the need for dietary guidance for parents of children aged 1–2 years. These preliminary data on commonly consumed ‘extra’ foods and portion sizes may inform age-specific dietary assessment methods.
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Abstract
AIM To study the relationship between early feeding disorders and nutritional intake during the second and third year of life. METHODS 15 children, nine girls and six boys, with a feeding problem identified at the Specialist Child Health Care Unit at a mean age of 14.5 mo were matched with respect to age and sex with healthy control children. Four-day dietary records were collected at inclusion (time 1) and follow-up of the study (time 2). Measures of growth at birth, at times 1 and 2 of the study, and at 3 y of age were obtained from Child Health Centre records. RESULTS A lower intake of energy, carbohydrate and protein was evident at times 1 and 2 for the group of children with feeding disorders compared to the controls. Zinc and vitamin B6 were the only micronutrients that differed for the feeding disorder group compared to the control group at times 1 and 2. Children with feeding disorders decelerated in weight during the second year of life and in height during the third year of life as compared to controls. CONCLUSION The criterion of a persistent failure to eat adequately with a subsequent failure to gain weight, required for the diagnosis of feeding disorders in DSM-IV, was supported by the findings in this study. The relation between nutrition and growth in feeding disorders has not, to our knowledge, been reported in previous research.
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Affiliation(s)
- Lene Lindberg
- Unit of Mental Health, Stockholm Centre of Public Health, Sweden.
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Hendricks K, Briefel R, Novak T, Ziegler P. Maternal and child characteristics associated with infant and toddler feeding practices. ACTA ACUST UNITED AC 2006; 106:S135-48. [PMID: 16376637 DOI: 10.1016/j.jada.2005.09.035] [Citation(s) in RCA: 124] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe maternal/child characteristics associated with important practices of feeding US infants and toddlers aged 4 to 24 months. DESIGN Cross-sectional analysis of data collected in the 2002 Feeding Infants and Toddlers Study. Maternal/child characteristics associated with compliance to American Academy of Pediatrics feeding guidelines, and maternal/child characteristics associated with specific feeding patterns were assessed. SUBJECTS A national random sample of mothers (n=2,515) whose infants and toddlers aged 4 to 24 months made up the Feeding Infants and Toddlers Study cohort. STATISTICAL ANALYSIS Student t tests were used to compare the means and standard errors and were considered significant if P<.05. To predict if the mother/child met a particular recommendation, logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals. RESULTS Having a college education was the maternal characteristic associated with the largest number of positive child feeding behaviors. Mothers with a college education were significantly more likely than mothers without a college education to initiate breastfeeding and breastfeed the child to age 6 and 12 months (OR 2.8, 3.2, and 3.9, respectively). College-educated mothers were significantly more likely to comply with the American Academy of Pediatrics juice and complementary feeding recommendations (OR 1.4 and 2.0). In addition, infants and toddlers whose mother had a college education were more likely to consume fruit and less likely to consume sweetened beverages and desserts or candy. Ever breastfeeding the sample child, living in the western region of the United States, and being married and older were also associated with multiple positive practices. The child being in day care was associated with decreased duration of breastfeeding at age 6 and 12 months as well as with consumption of salty snacks. CONCLUSIONS Initiatives to improve infant and toddler feeding practices should focus on assisting mothers who have less than a college education, who are unmarried, whose child is in day care, or who are enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children.
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Affiliation(s)
- Kristy Hendricks
- School of Medicine, Friedman School of Nutrition Science and Policy, Jaharis 262, Tufts University, Boston, MA 02111, USA.
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Webb K, Rutishauser I, Katz T, Knezevic N, Lahti-Koski M, Peat J, Mihrshahi S. Meat consumption among 18-month-old children participating in the Childhood Asthma Prevention Study. Nutr Diet 2005. [DOI: 10.1111/j.1747-0080.2005.tb00004.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pathmanathan B. Nutrition counseling focused on all components of healthful eating. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2005; 105:225-6. [PMID: 15668679 DOI: 10.1016/j.jada.2004.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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McConahy KL, Smiciklas-Wright H, Mitchell DC, Picciano MF. Portion size of common foods predicts energy intake among preschool-aged children. ACTA ACUST UNITED AC 2004; 104:975-9. [PMID: 15175599 DOI: 10.1016/j.jada.2004.03.027] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study evaluated the relationship of food intake behaviors to total energy intake among children aged 2 to 5 years old (N=5447) who participated in the Continuing Survey of Food Intakes by Individuals, 1994-1996, 1998 (CSFII 94-96, 98). Food intake behaviors examined were portion size for 10 commonly eaten foods, number of eating occasions per day, and number of foods consumed per day. Using regression models, we examined these eating behaviors as predictors of energy intakes with adjustment for body weight. Eating behaviors and body weight were positively related to energy intake, together explaining 38% to 39% of the variability. Portion size alone accounted for 17% to 19% of the variance in energy intake, whereas body weight predicted only 4%. Feeding recommendations should highlight the importance of age-appropriate portion sizes and provide guidance on the frequency of eating and number of foods consumed.
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Affiliation(s)
- Kristen L McConahy
- Department of GI and Nutrition, The Children's Hospital of Philadelphia, PA 16802, USA
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Le sevrage de l'allaitement. Paediatr Child Health 2004. [DOI: 10.1093/pch/9.4.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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MARTÍNEZ B, RINCÓN F, IBÁÑEZ MV, BELLÁN PA. Improving the Nutritive Value of Homogenized Infant Foods Using Response Surface Methodology. J Food Sci 2004. [DOI: 10.1111/j.1365-2621.2004.tb17884.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fox MK, Pac S, Devaney B, Jankowski L. Feeding infants and toddlers study: what foods are infants and toddlers eating? ACTA ACUST UNITED AC 2004; 104:s22-30. [PMID: 14702014 DOI: 10.1016/j.jada.2003.10.026] [Citation(s) in RCA: 229] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the food consumption patterns of US infants and toddlers, 4 to 24 months of age. DESIGN Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers study based on telephone interviews and 24-hour dietary recalls. SUBJECTS A national random sample of 3,022 infants and toddlers age 4 to 24 months. STATISTICAL ANALYSES PERFORMED The percentage of infants and toddlers consuming foods from specific food groups was estimated for six age groups, using a single 24-hour recall. RESULTS Infants as young as 7 months of age showed food patterns that have been observed in older children and adults. From 18% to 33% of infants and toddlers between ages 7 and 24 months consumed no discrete servings of vegetables, and 23% to 33% consumed no fruits. French fries were one of the three most common vegetables consumed by infants 9 to 11 months of age. By 15 to 18 months, french fries were the most common vegetable. Almost half (46%) of 7- to 8-month-olds consumed some type of dessert, sweet, or sweetened beverage, and this percentage increased as age increased. By 19 to 24 months, 62% of toddlers consumed a baked dessert, 20% consumed candy, and 44% consumed a sweetened beverage. APPLICATIONS Parents and caregivers should be encouraged to offer a wide variety of vegetables and fruits daily, with emphasis on dark green, leafy, and deep yellow vegetables and colorful fruits. They should offer desserts, sweets, sweetened beverages, and salty snacks only occasionally, offering nutrient-dense, age-appropriate foods as alternatives (eg, fruit, cheese, yogurt, and cereals). Water, milk, and 100% fruit juices should be offered as alternative beverages. Because family food choices influence what foods are offered to children, family-based approaches to developing healthy eating habits may be helpful.
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Briefel RR, Reidy K, Karwe V, Jankowski L, Hendricks K. Toddlers’ transition to table foods: impact on nutrient intakes and food patterns. ACTA ACUST UNITED AC 2004; 104:s38-44. [PMID: 14702016 DOI: 10.1016/j.jada.2003.10.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To describe the differential changes in average intakes of nutrients and food groups among higher versus lower table food consumers during the transition from baby foods to table foods. DESIGN A comparative analysis of food and nutrient intakes in the lowest versus highest quartile of energy from table foods based on 24-hour dietary recall data. SUBJECTS A national random sample of 1,677 US infants and toddlers 9 to 24 months in the 2002 Feeding Infants and Toddlers Study (FITS). STATISTICAL ANALYSES Mean and percentiles of energy intake from table foods; comparisons of mean daily nutrient intake and the percentages consuming various foods and beverages in the lowest versus highest quartile of energy from table foods, by age. RESULTS The mean percentage of energy from table foods increased from 25% at 9 to 11 months to 63% at 19 to 24 months. Mean intakes of energy, macronutrients, sodium, folate, and fiber were significantly higher for children 9 to 11, 12 to 14, and 15 to 18 months in the highest table food energy quartiles compared to the lowest. Mean calcium intakes were significantly lower among toddlers 15 to 24 months consuming high table food energy, and associated with lower milk consumption. A higher percentage of children in the lowest quartiles of energy from table food were consuming deep yellow vegetables among ages 9 through 14 months. The percentage of children consuming popular items such as pizza, carbonated sodas, French fries, candy and other sweets was higher among those who consumed more energy from table foods in every age group. APPLICATIONS The epidemic of overweight children mandates helping parents teach healthy eating habits early. Messages that educate parents and caregivers about toddler feeding include: (1) offer a wide variety of nutritious foods, particularly fruits and vegetables, in forms that are developmentally appropriate, (2) continue to feed foods that are good sources of iron, such as iron-fortified infant cereals, ready-to-eat cereals that are high in iron, and meats, (3) to ensure adequate calcium intake, build the habit of drinking milk, and (4) teach children to recognize and honor their hunger and satiety cues.
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Marshall TA, Levy SM, Broffitt B, Eichenberger-Gilmore JM, Stumbo PJ. Patterns of beverage consumption during the transition stage of infant nutrition. ACTA ACUST UNITED AC 2003; 103:1350-3. [PMID: 14520256 DOI: 10.1016/s0002-8223(03)01078-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We describe beverage intakes during the transition stage of infant nutrition. Mean daily intakes of infant formula, cow's milk, combined juice and juice drinks, water, and other beverages estimated from a beverage frequency questionnaire were analyzed cross-sectionally at ages six through 24 months (n=701). Most children (97%) consumed human milk, infant formula, or cows' milk at each age studied. Mean daily intakes of combined infant formula and cows' milk declined from 28.0 oz at six months to 12.1 oz at 24 months. The percentage of children consuming juice and/or juice drinks increased with age, and mean daily consumption peaked at 9.1 oz at 20 months. Combined formula and cows' milk intakes were inversely associated with juice and juice drink intakes at all ages (-0.25 < r < 0; P<.01). Juice and juice drinks appear to replace formula and milk intakes during the transition stage of infant nutrition.
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Affiliation(s)
- Teresa A Marshall
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry, Iowa City, IA 52242, USA.
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Smiciklas-Wright H, Mitchell DC, Mickle SJ, Goldman JD, Cook A. Foods commonly eaten in the United States, 1989-1991 and 1994-1996: are portion sizes changing? JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2003; 103:41-7. [PMID: 12525792 DOI: 10.1053/jada.2003.50000] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare quantities consumed per eating occasion in 1989-1991 and 1994-1996 was the objective of this study. DESIGN This study was a comparison over time. Subjects/setting Subjects were respondents in the Continuing Survey of Food Intakes by Individuals (CSFII) in 1989-1991 or 1994-1996. Intake data were processed and analyzed to provide estimates of amounts of commonly eaten foods consumed per eating occasion. Statistical analyses performed Approximate t tests were used to compare quantities of foods consumed by 1989-1991 and 1994-1996 survey respondents. Analyses were conducted for all persons aged 2 years and over and for 10 age and sex groups. Significance was set at.001. RESULTS Significant differences in amounts consumed were reported for approximately one third of the 107 foods examined. Larger amounts were reported in 1994-1996 by all persons aged 2 years and over and selected age/sex subgroups for several foods including soft drinks, coffee, tea, and ready-to-eat cereal. Smaller amounts were reported for fewer foods: margarine, mayonnaise, chicken, macaroni and cheese, and pizza. APPLICATIONS/CONCLUSIONS Amounts of foods consumed per eating occasion are widely used for the formation of public policy, counseling, and dietary assessment. Changes in amounts consumed should be monitored to evaluate the need for revisions in policy and diet assessment protocols.
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Soh P, Ferguson EL, McKenzie JE, Skeaff S, Parnell W, Gibson RS. Dietary intakes of 6-24-month-old urban South Island New Zealand children in relation to biochemical iron status. Public Health Nutr 2002; 5:339-46. [PMID: 12020386 DOI: 10.1079/phn2002257] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate food sources and intakes of iron, and dietary factors associated with serum ferritin levels in 6-24-month-old children. DESIGN A cross-sectional survey employing proportionate cluster sampling was conducted in 1998/1999. Dietary intakes were assessed using a non-consecutive 3-day weighed food record. Serum ferritin and C-reactive protein were analysed from non-fasting venepuncture blood samples and general sociodemographic data were collected. SETTING Cities of Christchurch, Dunedin and Invercargill, New Zealand. SUBJECTS Randomly selected healthy 6-24-month-old non-breast-feeding children (n = 226). RESULTS Total iron intakes (+/- standard deviation (SD)) among non-breast-feeding infants (< 12 months old; n = 42) and toddlers (> or = 12 months old; n = 184) were 8.4 +/- 2.9 mg day(-1) and 5.0 +/- 2.5 mg day(-1), respectively. Fifteen per cent of infants and 66% of toddlers were at risk of inadequate iron intakes. Main sources of dietary iron were infant formula (60%) for infants and cereals (31%) for toddlers. Meat contributed on average 2% and 10% of dietary iron in the infant and toddler diets, respectively. Dietary factors positively associated with serum ferritin were intakes of iron and vitamin C, whereas intakes of calcium and dietary fibre were negatively associated. For each 1% increase in percentage of energy from iron-fortified formula concomitant with a 1% decrease from dairy products, there was a 4.2% increased odds of replete iron stores (ferritin > or = 20 microg l(-1)). CONCLUSIONS Toddlers were at higher risk of sub-optimal iron intakes than infants. Results suggest that a diet high in bioavailable iron is important for optimising the iron stores of young children in New Zealand.
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Affiliation(s)
- Patsy Soh
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Rogers I, Emmett P. Fat content of the diet among pre-school children in Britain; relationship with food and nutrient intakes. Eur J Clin Nutr 2002; 56:252-63. [PMID: 11960301 DOI: 10.1038/sj.ejcn.1601335] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2001] [Revised: 08/09/2001] [Accepted: 09/06/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the relationship between the percentage of energy from fat and food and nutrient intakes at 18 and 43 months of age. DESIGN Diet was assessed using a 3 day unweighed food record. The children were divided into quartiles of fat intake as a percentage of energy (QFI), and food and nutrient intakes in the different QFIs were compared. SUBJECTS A total of 1026 children at 18 months and 863 children at 43 months, taking part in the Avon Longitudinal Study of Pregnancy and Childhood, participated. RESULTS At 18 months the mean (s.d.) fat intake was 31.2 (2.8) % of energy in the lowest QFI and 43.1 (2.2) % in the highest. Energy intake increased slightly with increasing QFI. The percentage of energy derived from total sugar, and in particular non-milk extrinsic sugar fell as QFI increased, as did the ratio of polyunsaturated to saturated fatty acids. Intakes of retinol equivalents and zinc increased significantly with increasing QFI, while intakes of iron and most water soluble vitamins fell. There was a particularly marked fall in vitamin C intake as fat intake increased, from 11.8 mg/MJ in the lowest QFI, to 6.0 mg/MJ in the highest (P<0.001). Consumption of whole milk increased substantially with percentage energy from fat, from 51 g/MJ in the lowest QFI to 116 g/MJ in the highest (P<0.001), while consumption of fruit and fruit juice fell. The results obtained at 43 months were very similar. CONCLUSIONS The chances of a suboptimal intake of zinc and retinol were higher at lower fat intakes. However, intakes of the fat-soluble vitamins E and D were unrelated to fat intake and intakes of iron and vitamin C fell as fat intakes increased. Some suggestions for improving diet in this age group have been given. SPONSOR University of Bristol.
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Affiliation(s)
- I Rogers
- Unit of Paediatric and Perinatal Epidemiology, Division of Child Health, University of Bristol, 24 Tyndall Avenue, Bristol BS8 1TQ, UK
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Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr 2002. [PMID: 11841046 DOI: 10.1177/0148607102026001011] [Citation(s) in RCA: 468] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Brown RT, Sammons MT. Pediatric psychopharmacology: A review of new developments and recent research. ACTA ACUST UNITED AC 2002. [DOI: 10.1037/0735-7028.33.2.135] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
BACKGROUND High-fat whole milk is the major dietary source of total and saturated fat for young children. Children from low-income families have higher total and saturated fat intakes and their parents have higher rates of cardiovascular disease compared with children from higher income families. We identified factors that predict the use of either high-fat whole milk or low-fat (1% and/or skim) milk by children to facilitate the development of targeted intervention strategies to reduce their dietary fat intakes. METHODS Adults (91% mothers) with children > or =1 through <5 years of age, participating in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) at 50 agencies throughout New York State, completed questionnaires. RESULTS Most (75%) of the 1,938 children drank whole milk, while only 6.9% consumed exclusively 1% and/or skim milk. The children tended to drink the same type of milk as other family members. In multivariate logistic regression, use of whole milk was associated with younger child age, black race or Hispanic ethnicity, parent/guardian belief that whole milk was healthier for children over 2, and parent/guardian having never tried reduced-fat milks (all P < 0.0001). In contrast, use of 1% and/or skim milk was associated with older child age, female gender, nonblack race, older parent/guardian age, parent/guardian belief that reduced-fat milks were healthier for children over 2, and parent/guardian having tried 1%-fat milk (all P < 0.01). CONCLUSIONS Individualized family-based strategies are needed to target specific behaviors and/or health beliefs held by different parent groups. For example, taste testing might be an effective strategy for parents who have never tasted reduced-fat milk. Interventions to overcome cultural barriers to the use of low-fat milk may require changing parental health beliefs, in addition to providing education about the health benefits of low-fat milk.
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Affiliation(s)
- B A Dennison
- Research Institute, Bassett Healthcare, Cooperstown, New York 13326, USA
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Wahl RA, Shapiro E, Elliott SP, Binkiewicz AI. Office laboratory procedures, office economics, parenting and parent education, and urinary tract infection. Curr Opin Pediatr 2001; 13:603-15. [PMID: 11753115 DOI: 10.1097/00008480-200112000-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We once again review four areas of interest to office-based pediatricians: office laboratory procedures, office economics, parenting and patient education, and urinary tract infections. Sean Elliott reviews the current status of the Clinical Laboratories Improvement Amendments (CLIA) and their continuing impact on physician office laboratories. Eve Shapiro reviews office economics, this year focusing on managed care, the physician workforce, practice management, and health care financing for the uninsured. Anna Binkiewicz provides an update on parenting and parent education, with recent reports on nutrition and childhood immunizations. Richard Wahl again reviews recent research on urinary tract infection, discussing voiding physiology, dysfunctional voiding patterns, acute urinary retention, urine collection techniques, diagnosis in young infants, and antibiotic prophylaxis.
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Affiliation(s)
- R A Wahl
- University of Arizona College of Medicine and Steele Memorial Children's Research Center, Tucson, Arizona 85724-5073, USA.
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Abstract
The American Academy of Pediatrics (AAP) recommends screening for anemia between the ages of 9 to 12 months with additional screening between the ages of 1 and 5 years for patients at risk. The screening may be universal or selective depending on the prevalence of iron deficiency anemia in the population. Improved infant rearing practices-including wider availability, acceptance, and use of iron-fortified formulas; iron fortification of foods; and increased awareness of the importance of dietary iron supplementation especially early in life-have lead to significant decline in the incidence of anemia in the first year of life. However, incidence of iron deficiency and ensuing anemia in children between 1 and 2 years continues to be significant and an important issue. Although iron deficiency may develop soon after cessation of or inadequate iron intake, anemia secondary to iron deficiency develops gradually over a period of several weeks to months. For children who have received/are receiving iron-fortified infant formulas and foods, hemoglobin screening at 9 to 12 months of age is inappropriate as there may not have been sufficient time to develop anemia, despite the rapid growth rate at this age. Widespread implementation of hemoglobin electrophoresis included in the neonatal metabolic screening programs in many states in the United States now has resulted in earlier diagnosis of hemoglobinopathies. Screening children at 9 to 12 months of age for hemoglobinopathies is somewhat redundant now. Screening for anemia before or around 1 year of age should continue to be important for communities and children at risk. Universal screening of toddlers at a later time allows sufficient time for nutritional anemia to become evident after the child has been weaned off iron-fortified formulas, for the influence of toddler dietary fads to manifest, and for evaluation of tolerance of cow's milk protein. This may be addressed via 2 approaches. The first involves postponing the currently recommended screening or an additional screening for anemia between 15 to 18 months of age. Determination of hemoglobin (or hematocrit) is not the optimal way to identify children at risk from effects of iron deficiency as it fails to identify patients who are iron-deficient but are not anemic. Long-term psychomotor, behavioral, and developmental effects secondary to iron deficiency anemia are known but sufficient data are lacking regarding the role of iron deficiency without anemia. Development and evaluation of sensitive, specific, and cost-effective screening tools to identify children at risk for iron deficiency is important. Until such methods are instituted, the AAP should emphasize and recommend universal screening for anemia during the second year of life.
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Affiliation(s)
- M Kohli-Kumar
- University of South Florida, Department of Pediatrics, Tampa, Florida 33606, USA.
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Dennison BA, Rockwell HL, Nichols MJ. Use of low-fat milk by children in the New York State WIC varies with parental characteristics. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2001; 101:464-6. [PMID: 11320955 DOI: 10.1016/s0002-8223(01)00119-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- B A Dennison
- Research Institute of Bassett Healthcare, One Atwell Rd., Cooperstown, NY 13326, USA
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Eden AN. Iron supplementation for 1- to 2-year-olds. Pediatrics 2000; 106:1166. [PMID: 11185068 DOI: 10.1542/peds.106.5.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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