Kathleen Reidy

Infant Feeding Practices and Food Consumption Patterns of Children Participating in WIC

OBJECTIVE To describe feeding practices and food consumption of infants and children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN National, cross-sectional analysis of 24-hour dietary recall data from the 2008 Feeding Infants and Toddlers Study. PARTICIPANTS Random sample of infants (6-11 months of age), toddlers (12-23 months of age), and preschoolers (24-47 months of age); WIC participants (n = 794) and nonparticipants (n = 2,477). MAIN OUTCOME MEASURES Breastfeeding rates, introduction to solids, food consumption. ANALYSIS Used weighted descriptive statistics, chi-square tests, and t tests to identify dietary outcomes unique to WIC participants vs nonparticipants. RESULTS Compared with nonparticipants, fewer WIC infants were breastfed (P < .01) and consumed any vegetable (P < .05) but more consumed 100% juice (P < .05). Fewer WIC toddlers and preschoolers consumed any fruit vs nonparticipants (P < .01). The WIC toddlers were more likely to consume any sweet vs nonparticipants (P < .05), especially sugar-sweetened beverages (P < .01). Over 80% of all preschoolers consumed any sweet, and nearly half consumed sugar-sweetened beverages on an average day. CONCLUSIONS AND IMPLICATIONS Findings identify feeding and dietary issues that begin during infancy and are also present in toddler and preschool stages. These findings are useful for WIC nutritionists and health care practitioners to encourage the early development of healthful eating patterns.

Nutrient Intakes of Pregnant Women and their Associated Factors in Eight Cities of China: A Cross-sectional Study.

Background: During the last 3 decades, China has dramatic changes of the dietary pattern among its citizens, particularly in urban cities. This study aimed to determine the nutrient intake status and factors associated with nutrient intakes of urban Chinese pregnant women now-a-day. Methods: The multistage stratified random sampling method was applied in the cross-sectional study. 479 women in three trimesters of pregnancy from eight cities of China were recruited. Nutrient intakes were evaluated with one 24 h dietary recall, and compared with the Chinese Dietary Reference Intakes (DRIs) 2013 for available nutrients. Results: Most pregnant women had imbalanced macronutrient distribution with excessive energy derived from fat. Intakes of Vitamin A, B6, calcium, magnesium, and selenium were below Chinese Recommended Nutrient Intake (RNI) and Estimated Average Requirements (EARs) in all trimesters. Most pregnant women took more folic acid in the first trimester with a significant decrease in the second and third trimester (P < 0.05). Shortfall in iron intake was found in the third trimester whereas some women may be at the risk of excessive iron intake. Intakes of thiamin met RNI in the first trimester but were below EAR in all trimesters. Trimester phasing was positively associated with most nutrients (P < 0.05). Prepregnancy body mass index was inversely associated with energy, fat, Vitamin C, and calcium intake (P < 0.05). Educational level and household income were positively associated with folic acid intake (P < 0.05). Conclusions: Current prenatal dietary choices of urban pregnant women in China are imbalanced in the nutrient intake when compared with national DRIs 2013, particularly in intakes of energy derived from fat and micronutrients. Appropriate dietary advice to pregnant women should promote a balanced diet with emphasis on avoidance of foods of high fat content and incorporation of foods that are good sources of the key micronutrients that are usually lacking in a regular pregnancy diet. Further research is needed to understand the eating habits and food patterns that contribute to this imbalanced diet in order to be able to effectively improve prenatal womens nutrient intake status.

New Findings from the Feeding Infants and Toddlers Study 2008

The purpose of this chapter is to describe the infant feeding practices among infants and toddlers (aged 0-24 months) and to describe food group consumption patterns of these infants and young children (0-48 months) participating in the 2008 Feeding Infants and Toddlers Study (FITS). The FITS 2008 is a cross-sectional survey of a national sample of US children (n = 3,273). Results indicate a longer duration of breastfeeding; however, 17% of infants received cows milk before the recommended age of one year. Introduction of complementary foods also appears to be delayed until about 4-6 months. There was a decline in consumption of infant cereal after 8 months that may be contributing to iron deficiencies in the 9-11 months age group. Consumption of 100% juice (particularly among infants) and the daily consumption of desserts or candy, sweetened beverages (particularly among 12-to 20-month-olds), and salty snacks is lower than in the 2002 survey. Overall, 10-20 and 30% of children were not consuming any fruit or vegetable, respectively, in a given day. More preschoolers were drinking 2% milk than whole milk, but about one third were still drinking whole milk. Despite some of these positive changes, improvements in young childrens diet still are needed.

Estimating usual intakes mainly affects the micronutrient distribution among infants, toddlers and pre-schoolers from the 2012 Mexican National Health and Nutrition Survey

Objective To compare estimates from one day with usual intake estimates to evaluate how the adjustment for within-person variability affected nutrient intake and adequacy in Mexican children. Design In order to obtain usual nutrient intakes, the National Cancer Institute’s method was used to correct the first 24 h dietary recall collected in the entire sample (n 2045) with a second 24 h recall collected in a sub-sample (n 178). We computed estimates of one-day and usual intakes of total energy, fat, Fe, Zn and Na. Setting 2012 Mexican National Health and Nutrition Survey. Subjects A total of 2045 children were included: 0–5·9 months old (n 182), 6–11·9 months old (n 228), 12–23·9 months old (n 537) and 24–47·9 months old (n 1098). From these, 178 provided an additional dietary recall. Results Although we found small or no differences in energy intake (kJ/d and kcal/d) between one-day v. usual intake means, the prevalence of inadequate and excessive energy intake decreased somewhat when using measures of usual intake relative to one day. Mean fat intake (g/d) was not different between one-day and usual intake among children >6 months old, but the prevalence of inadequate and excessive fat intake was overestimated among toddlers and pre-schoolers when using one-day intake (P<0·05). Compared with usual intake, estimates from one day yielded overestimated prevalences of inadequate micronutrient intakes but underestimated prevalences of excessive intakes among children aged >6 months. Conclusions There was overall low variability in energy and fat intakes but higher for micronutrients. Because the usual intake distributions are narrower, the prevalence of inadequate/excessive intakes may be biased when estimating nutrient adequacy if one day of data is used.

Food groups consumed by infants and toddlers in urban areas of China

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.

Usual food intakes of 2- and 3-year old U.S. children are not consistent with dietary guidelines

BackgroundThe primary purpose of this paper is to assess how well food consumption patterns of young children in the U.S. conform to the 2015 Dietary Guidelines for Americans. A secondary purpose is to gain insight into food choices that contribute to over- or under-consumption of key food groups and dietary constituents.MethodsThe analysis used data from the Feeding Infants and Toddlers Study 2008 (FITS 2008), and a national random sample of 1323 2- and 3-year old U.S. children. Children’s usual food intakes were estimated using the National Cancer Institute method and proportions of children whose usual diets did not include recommended amounts of food groups were assessed, as well as the proportions that consumed excess calories from solid fat and added sugars. Leading sources of vegetables, grains, oils, solid fat and added sugars were also examined.ResultsThe prevalence of usual food group intakes that did not meet recommendations was highest for vegetables (91%), whole grains (94%), and oils (>99%). In addition, virtually all children (>99%) had usual intakes of calories from solid fat and added sugars that exceeded the maximum allowance. The mean intake of calories from solid fat and added sugars was almost three times the maximum allowance.ConclusionsGiven that children’s food preferences and habits develop early in life, educating primary caregivers about recommended feeding patterns and how to promote them is critical. Infants and young children will readily accept sweet and salty foods, but the wider variety of foods associated with healthy eating patterns may only be accepted if children have repeated experience with them. There is evidence that some caregivers may overestimate the quality of their children’s diets, so specific, practical, and actionable guidance is needed. This advice should include education about children’s normal resistance to new foods, strategies for promoting acceptance and not using food to manage behavior. Given that one-third of children under the age of five attend regular child care outside the home, child care centers and family day care homes also have an important role to play in developing healthy food habits and preferences among young children.

Importance of Dietary Sources of Iron in Infants and Toddlers: Lessons from the FITS Study

Iron deficiency (ID) affects 13.5% of 1–2 years old children in the US and may have a negative impact on neurodevelopment and behavior. Iron-fortified infant cereal is the primary non-heme iron source among infants aged 6–11.9 months. The objective of this study was to compare iron intakes of infant cereal users with non-users. Data from the Feeding Infants and Toddlers Study 2008 were used for this analysis. Based on a 24-h recall, children between the ages of 4–17.9 months were classified as ‘cereal users’ if they consumed any amount or type of infant cereal and ‘non-users’ if they did not. Infant cereal was the top source of dietary iron among infants aged 6–11.9 months. The majority of infants (74.6%) aged 6–8.9 months consumed infant cereal, but this declined to 51.5% between 9–11.9 months and 14.8% among 12–17.9 months old toddlers. Infant cereal users consumed significantly more iron than non-users across all age groups. Infants and toddlers who consume infant cereal have higher iron intakes compared to non-users. Given the high prevalence of ID, the appropriate use of infant cereals in a balanced diet should be encouraged to reduce the incidence of ID and ID anemia.