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First foods: Diet quality among infants aged 6-23?months in 42 countries.

ABSTRACT: Diet quality is closely linked to child growth and development, especially among infants aged 6-23?months who need to complement breastmilk with the gradual introduction of nutrient-rich solid foods. This paper links Demographic and Health Survey data on infant feeding to household and environmental factors for 76,641 children in 42 low- and middle-income countries surveyed in 2006-2013, providing novel stylized facts about diets in early childhood. Multivariate regressions examine the associations of household socioeconomic characteristics and community level indicators of climate and infrastructure with dietary diversity scores (DDS). Results show strong support for an infant-feeding version of Bennett's Law, as wealthier households introduce more diverse foods at earlier ages, with additional positive effects of parental education, local infrastructure and more temperate agro-climatic conditions. Associations with consumption of specific nutrient-dense foods are less consistent. Our findings imply that while income growth is indeed an important driver of diversification, there are strong grounds to also invest heavily in women's education and food environments to improve diet quality, while addressing the impacts of climate change on livelihoods and food systems. These results reveal systematic patterns in how first foods vary across developing countries, pointing to new opportunities for research towards nutrition-smart policies to improve children's diets.

SUBMITTER: Choudhury S

PROVIDER: S-EPMC6894322 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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First foods: Diet quality among infants aged 6-23 months in 42 countries.

Choudhury Samira S Headey Derek D DD Masters William A WA

Food policy 20191001

Diet quality is closely linked to child growth and development, especially among infants aged 6-23 months who need to complement breastmilk with the gradual introduction of nutrient-rich solid foods. This paper links Demographic and Health Survey data on infant feeding to household and environmental factors for 76,641 children in 42 low- and middle-income countries surveyed in 2006-2013, providing novel stylized facts about diets in early childhood. Multivariate regressions examine the associati ...[more]

PMID: 31853163

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Project description:BackgroundAppropriate feeding of infants and young children is essential for healthy growth and the prevention of stunting, wasting, and overweight. We aimed to assess the beneficial versus harmful effects of providing fortified complementary foods to children in the complementary feeding period.MethodsIn this systematic review and meta-analysis, we searched the databases Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Global Index Medicus, Web of Science, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform from inception to March 9, 2021. We included randomised controlled trials and controlled clinical trials done in infants and children aged 6-23 months with no identified health problems. Consumption of foods fortified centrally (ie, during industrial processing) with one micronutrient or a combination of vitamins, minerals, or both was compared with the same complementary foods, but without micronutrient fortification. Two review authors independently screened studies for eligibility, extracted data, assessed risk of bias, and rated the certainty of the evidence. The main outcomes were growth (measured by Z scores for weight for age, weight for height or length, and height or length for age, or other growth measures), stunting, wasting, nutrient adequacy or excess, anaemia, haemoglobin concentration, iron status, serum zinc concentration, and serum retinol concentration. We used a random-effects meta-analysis for combining data. This study is registered with PROSPERO, CRD42021245876.FindingsWe included 16 studies with 6423 participants, 13 of which were done in malaria-endemic areas. Overall, 12 studies were included in the quantitative syntheses. We identified five further ongoing studies. There was no difference between participants who received fortified complementary foods and those who received non-fortified complementary foods in weight-for-age Z scores (mean difference -0·01, 95% CI -0·07 to 0·06; five trials; 1206 participants; moderate-certainty evidence), weight-for-height or length Z scores (-0·05, -0·19 to 0·10; four trials; 1109 participants; moderate-certainty evidence), and height or length-for-age Z scores (-0·01, -0·21 to 0·20; four trials; 811 participants; low-certainty evidence); stunting and wasting were not assessed in any study as outcomes. Moderate-certainty evidence from six trials with 1209 patients showed that providing fortified complementary foods to children aged 6-23 months reduced the risk of anaemia (risk ratio 0·57, 95% CI 0·39 to 0·82). Those who received fortified complementary foods compared with those who did not had higher haemoglobin concentrations (mean difference 3·44 g/L, 95% CI 1·33 to 5·55; 11 trials; 2175 participants; moderate-certainty evidence) and ferritin concentration (0·43 μg/L on log scale, 0·14 to 0·72; six trials; 903 participants; low-certainty evidence). The intervention led to no effects on serum zinc concentration (-0·13 g/dL, -0·82 to 0·56; two trials; 333 participants; low-certainty evidence) and serum retinol concentration (0·03 μmol/L, -0·02 to 0·08; five trials; 475 participants; moderate-certainty evidence).InterpretationFortified complementary foods are effective strategies to prevent anaemia in infants and young children aged 6-23 months in malaria-endemic regions. Effects of complementary food fortification should be further investigated in low-income and middle-income countries, but should also be assessed in high-income countries, and in regions where malaria is not endemic.FundingWHO.

Project description:Under nutrition remains a serious problem among children in Sub-Saharan Africa. Analysing how diets composed of local foods could achieve nutritional goals for infants and young children in low-income settings is essential. The objective of this study was to analyse how local foods can be used rationally and to what extent these foods can be supplemented to achieve nutrient requirements for children aged 6 - 23 months in resource-poor settings.A cross-sectional study was carried out to estimate dietary intakes of 400 children aged 6-23 months using a 12-h weighed dietary record, 24-h dietary recalls, and 7-days food records. Anthropometric measurements on each subject were also taken. Analyses were done to establish the level of nutrient intake, and nutritional status of the study population using Microsoft Excel 2013 and ProPAN software version 2.0.The results showed that the prevalence of stunting, wasting and underweight for children aged 6-23 months was 30-41%, 1.5-3% and 4-9%, respectively. In addition, the results showed that diets that were consumed by the subjects comprised of local foods met vitamin A, vitamin C, protein and energy requirements for children aged 6-23 months. However, the extent of deficit in iron, zinc and calcium in baseline diets was large and difficult to meet under the existing feeding practices.The study shows that local foods in the study area have a potential to achieve recommended dietary intakes of some essential nutrients, and that interventions are needed to meet the required amount of iron, zinc and calcium for children aged 6-23 months. The interventions we propose here may encourage changes in traditional feeding habits and practices of the target population. Possible intervention options are (1) supplementation of local foods with nutrient-dense foods that are not normally consumed in the locality (2) providing new avenues for increasing the production and wide consumption of local nutrient-dense foods, or optimizing the way local diets are constituted so as to achieve nutrient recommendations for infants and young children.

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:BackgroundAnemia is a problem of both the developed and developing world, which occurs in all age groups of the population. Half of the anemia cases are due to iron deficiency and affects physical growth and mental development. Nevertheless, there is a scarcity of information about anemia and associated factors among infants and young children aged 6 to 23 months in low-income countries like Ethiopia.ObjectiveThe aim of this study was to assess the prevalence of anemia and associated factors among infants and young children aged 6-23 months.MethodsA community-based cross-sectional study design was used among 531 mothers/caregivers-children pairs in Debre Berhan Town, North Shewa, Ethiopia, from February 1 to March 2, 2018. The cluster sampling technique was used to select the study participants. Sociodemographic data were collected from mothers/caregivers using pretested structured questionnaires. Hemoglobin levels were measured using a HemoCue analyzer machine (HemoCue® Hb 301, Ängelholm, Sweden). All relevant data were described using descriptive statistics such as frequencies, proportions, mean, and standard deviation. Odds ratio and 95% CI were estimated using binary logistic regression to measure the strength of the association between anemia and explanatory variables. The level of statistical significance was declared at P < 0.05.ResultsThe overall prevalence of anemia was 47.5% (95% CI: 43.1-51.4%) of which 18.3% were mildly anemic, 25% were moderately anemic, and 4.1% were severely anemic. In multivariable logistic regression analysis, household food insecurity (AOR = 2.7, 95% CI: 1.6-4.5), unmet minimum dietary diversity (AOR = 2.5, 95% CI: 1.4-4.3), stunting (AOR = 2.3, 95% CI: 1.2-4.3), and underweight (AOR = 2.7, 95% CI: 1.4-5.4) positively associated with anemia while having ≥4 antenatal care visits (AOR = 0.5, 95% CI: 0.3-0.9) and met minimum meal frequency (AOR = 0.25, 95% CI: 0.14-0.45) had a protective effect against anemia.ConclusionGenerally, the study showed that anemia was a severe public health problem among infants and young children in the study setting. Antenatal care visit, meal frequency, dietary diversity, underweight, stunting, and food insecurity significantly associated with anemia. Therefore, efforts should be made to strengthen infant and young child feeding practices and antenatal care utilization and ensure household food security, thereby improving the nutritional status of children.

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First foods: Diet quality among infants aged 6-23?months in 42 countries.

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First foods: Diet quality among infants aged 6-23 months in 42 countries.

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First foods: Diet quality among infants aged 6-23?months in 42 countries.

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First foods: Diet quality among infants aged 6-23 months in 42 countries.

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OmicsDI is part of the ELIXIR infrastructure

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First foods: Diet quality among infants aged 6-23 months in 42 countries.