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

Abstract 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

Location influences snacking behavior of US infants, toddlers and preschool children

Abstract Background Compare at-home and away-from-home snacking patterns of US infants and young children. Methods A secondary analysis was conducted using nationwide, cross-sectional dietary survey data from the US Feeding Infants and Toddlers Study (FITS) 2008. The sample included infants (6–11.9 months, n = 505), toddlers (12–23.9 months, n = 925), preschool children (24–47.9 months, n = 1461). Weighted population descriptive statistics (means and standard errors) were calculated using SAS. Significance was determined at P ≤ 0.05. The main outcome measures of the analyses were the percent of children consuming snacks by location (at home, away from home) and snacking period (morning, afternoon and evening), energy and food groups consumed during snacks. Results Snacking at home was more prevalent than snacking away from home (toddlers, 73% vs 27%; preschoolers, 67% vs 33%). Away-from-home snacks provided about 50 additional calories per day for toddlers (346 vs 298 kcal/day, P ≤ 0.05) and preschoolers (371 vs 326 kcal/day, P ≤ 0.05) versus snacks consumed at home. Caregivers made similar snack choices for toddlers and preschoolers (milk/milk products, fruit/juice, grains and sweets) but differed in frequency of consumption by location. Among toddlers, milk/milk products were the most frequently consumed snacks at home (66%), while sweets were the top snacks consumed away from home (69%). Among preschoolers, sweets were the top snacks both at home (60%) and away (83%). Conclusions Location is an important factor influencing snacking patterns of young children and should be considered when developing feeding guidelines. This data may be of use in the upcoming development of dietary guidelines in the U.S. for the population aged 0–2 years

Early development of dietary patterns: transitions in the contribution of food groups to total energy—Feeding Infants and Toddlers Study, 2008

BACKGROUND: Early dietary patterns are critical to growth and development and play an important role in development of food preferences and habits. The objective of this paper is to describe when different foods enter the diet and how food consumption changes over the period of complementary feeding. METHODS: We analyzed cross-sectional 24-h dietary recall data from the Feeding Infants and Toddlers Study (FITS) 2008, a nationally representative sample of young children. Data are presented for 7 age groups: 6–8.9 months (n = 249), 9–11.9 months (n = 256), 12–14.9 months (n = 243), 15–17.9 months (n = 251), 18–20.9 months (n = 219), 21–23.9 months (n = 212) and 24–47.9 months (n = 1461). Per capita energy was calculated from major food groups and specific types of food within each food group. RESULTS: The predominant source of energy in the infant diet was milk (breast milk and infant formula), contributing 98% of energy at 0–3 months, and 91% at 4–5 months. At 6–8 months, when complementary feeding had begun for most infants, 69% of daily energy was coming from milk, 11% from grains, 6% from fruits, 5% from vegetables and 4% from mixed dishes. The diet then quickly transitioned until at 21–23.9 months, 26% of energy came from milk, with other key sources of energy being grains (17%), mixed dishes (14%), meats (12%) and sweets (12%). The period from 4 to 14 months was the most dynamic period of change regarding the introduction of complementary foods for all food groups, with a slower rate of change between 15 and 24 months. After 24 months, the diet stabilized and included less energy from milk (20%) and vegetables (4%) and more energy from mixed dishes (18%), grains (16%), and sweets (17%), and began to resemble adult diets. CONCLUSIONS: Feeding in the first 24 months shapes dietary patterns, and thus provides a critical window of opportunity to shape subsequent dietary patterns and eating habits. Findings from FITS identified high sweet and low vegetable consumption as key issues. Education is needed for health care professionals and parents on feeding during this important period. These findings can be used to support the development of specific and actionable feeding guidance for parents

Early development of dietary patterns: transitions in the contribution of food groups to total energy—Feeding Infants and Toddlers Study, 2008

BACKGROUND: Early dietary patterns are critical to growth and development and play an important role in development of food preferences and habits. The objective of this paper is to describe when different foods enter the diet and how food consumption changes over the period of complementary feeding. METHODS: We analyzed cross-sectional 24-h dietary recall data from the Feeding Infants and Toddlers Study (FITS) 2008, a nationally representative sample of young children. Data are presented for 7 age groups: 6–8.9 months (n = 249), 9–11.9 months (n = 256), 12–14.9 months (n = 243), 15–17.9 months (n = 251), 18–20.9 months (n = 219), 21–23.9 months (n = 212) and 24–47.9 months (n = 1461). Per capita energy was calculated from major food groups and specific types of food within each food group. RESULTS: The predominant source of energy in the infant diet was milk (breast milk and infant formula), contributing 98% of energy at 0–3 months, and 91% at 4–5 months. At 6–8 months, when complementary feeding had begun for most infants, 69% of daily energy was coming from milk, 11% from grains, 6% from fruits, 5% from vegetables and 4% from mixed dishes. The diet then quickly transitioned until at 21–23.9 months, 26% of energy came from milk, with other key sources of energy being grains (17%), mixed dishes (14%), meats (12%) and sweets (12%). The period from 4 to 14 months was the most dynamic period of change regarding the introduction of complementary foods for all food groups, with a slower rate of change between 15 and 24 months. After 24 months, the diet stabilized and included less energy from milk (20%) and vegetables (4%) and more energy from mixed dishes (18%), grains (16%), and sweets (17%), and began to resemble adult diets. CONCLUSIONS: Feeding in the first 24 months shapes dietary patterns, and thus provides a critical window of opportunity to shape subsequent dietary patterns and eating habits. Findings from FITS identified high sweet and low vegetable consumption as key issues. Education is needed for health care professionals and parents on feeding during this important period. These findings can be used to support the development of specific and actionable feeding guidance for parents

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

BACKGROUND: The 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. METHODS: The 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. RESULTS: The 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. CONCLUSIONS: Given 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