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Estimates of the quality of complementary feeding among Vietnamese infants aged 6-23 months varied by how commercial baby cereals were classified in 24-h recalls.

ABSTRACT: The World Health Organization's (WHO) standardized questionnaire for assessing infant and young child feeding practices does not include commercial baby cereals (CBC), which are derived from several food groups and are fortified with micronutrients. We examined how different scenarios for classifying CBC affect estimates of the quality of complementary feeding in children ages 6-23 months in Vietnam in 2014 (n = 4811). In addition to the WHO standardized 24-h recall questionnaire for infant and young child feeding, we asked mothers about the consumption of CBC. The five resulting scenarios were S1 - omitted CBC; S2 - CBC classified as grains; S3 - as grains and dairy; S4 - as grains, dairy and fruit/vegetables; and S5 - as grains, dairy, fruit/vegetables and any others. Including CBC resulted in 4-11 percentage points higher in the prevalence of children who were fed each of the six food groups compared with what was reported in the WHO standardized questionnaire. Minimum dietary diversity (% fed ≥ 4 out of the 7 food groups) was higher in S5 (90%) than in S1 (84%), S2 (84%), S3 (85%) and S4 (86%). Minimum acceptable diet was also higher in scenarios S5 (80%) than in S1 (74%), S2 (75%), S3 (75%) and S4 (77%). Consumption of iron-rich foods was 94% when CBC was accounted, which was higher than the alternative scenario (89%). In summary, when CBC were included, population-level estimates of dietary quality were higher than when CBC were omitted. Guidance is required from the WHO about how to account for the consumption of CBC when estimating the quality of complementary feeding.

SUBMITTER: Tuan NT

PROVIDER: S-EPMC6865973 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionUnderstanding which foods are introduced in the diet and when provides valuable information on complementary feeding. Fortified baby rice cereal is the most common first solid food given to infants, often followed by other baby cereals. The objective of this study was to examine food patterns among infants and toddlers consuming rice or non-rice baby cereals versus non-consumers.MethodsNHANES 2001-2014 data were used to assess dietary intake, nutrient adequacy, and food specific patterns of infants and toddlers. Groups were: baby cereal non-consumers (n = 3,910), non-rice baby cereal consumers (n = 711), and rice baby cereal consumers (n = 966). Those consuming both non-rice cereal and rice cereal were included in the rice cereal group (n = 9, 48, 61, and 10 for those 0-3, 4-6, 7-11, and 12-23 mos, respectively). Least-square means ± SEs were determined for nutrient intake and food group consumption by using covariate controlled regression analyses (p < 0.01).ResultsBaby cereal consumer groups, compared to non-consumers, had higher intakes of carbohydrates, iron, calcium, magnesium, zinc, and vitamin E, with lower percentage having intakes below the Estimated Average Requirement for iron, calcium, and vitamin E. Infants 0-3 mos and 4-6 mos in both baby cereal consumption groups consumed other solid foods, including baby foods and beverages, sweetened beverages, coffee and tea, 100% juice, vegetables (excluding potatoes), fruit, sugars, milk and yogurt, and mixed dishes. The baby cereal consumers and non-consumers groups had intakes aligned with the "American diet". Baby cereal non-consumers had a significantly higher percentage of exclusively breast fed at ages 0-3 mos and a lower percentage formula fed.ConclusionThis study provides detailed information on the introduction of baby cereals which was associated with better nutrient intakes and other complementary foods and intakes of nutrients that require special attention during early life. Further, cow's milk products and solid foods were introduced prior to the American Academy of Pediatrics' age recommendations.

Project description:BackgroundRegulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies.ObjectivesTo evaluate the reliability of estimating meal timing parameters, including overnight fasting duration, the midpoint of overnight fasting time, the number of daily eating episodes, the period with the largest percentage of daily caloric intake, and late last eating episode (> 09:00 pm) from repeated 24-h dietary recalls (24HRs).MethodsIntraclass correlation coefficients (ICC), Light's Kappa estimates, and 95% CIs were calculated from repeated 24HR administered in 3 epidemiologic studies: The United States-based Interactive Diet and Activity Tracking in AARP (IDATA) study (n = 996, 6 24HR collected over 12-mo), German EPIC-Potsdam Validation Study (European Prospective Investigation into Cancer and Nutrition Potsdam Germany cohort) (n = 134, 12 24HR collected over 12-mo) and EPIC-Potsdam BMBF-II Study (Federal Ministry of Education and Research, "Bundesministerium für Bildung und Forschung") (n = 725, 4 24HR collected over 36 mo).ResultsMeasurement reliability of overnight fasting duration based on a single 24HR was "poor" in all studies [ICC range: 0.27; 95% CI: 0.23, 0.32 - 0.46; 95% CI: 0.43, 0.50]. Reliability was "moderate" with 3 24HR (ICC range: 0.53; 95% CI: 0.47, 0.58 in IDATA, 0.62; 95% CI: 0.52, 0.69 in the EPIC-Potsdam Validation Study, and 0.72; 95% CI: 0.70-0.75 in the EPIC-Potsdam BMBF-II Study). Results were similar for the midpoint of overnight fasting time and the number of eating episodes. Reliability of measuring late eating was "fair" in IDATA (Light's Kappa: 0.30; 95% CI: 0.21, 0.39) and "slight" in the EPIC-Potsdam Validation study and the EPIC-Potsdam BMBF-II study (Light's Kappa: 0.19; 95% CI: 0.15, 0.25 and 0.09; 95% CI: 0.06, 0.12, respectively). Reliability estimates differed by sex, BMI, weekday, and season of 24HR administration in some studies.ConclusionsOur results show that ≥ 3 24HR over a 1-3-y period are required for reliable estimates of meal timing variables.

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Estimates of the quality of complementary feeding among Vietnamese infants aged 6-23 months varied by how commercial baby cereals were classified in 24-h recalls.

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