Complementary feeding practice during infancy and its relevance for dietary behaviour in infancy and childhood

Emerging research indicates that besides innate taste preferences early sensory experiences in infancy via amniotic fluid, breast milk, and infant formula play a crucial role in the development of individual food preferences and dietary behaviour. With the introduction of complementary food (CF) during weaning, the spectrum of different flavours and textures increases further. However, the potential of CF’s sensory properties – particularly with regards to its preparation type, i.e. homemade or commercial – in shaping later food preferences has not been extensively examined so far. Thus, the overall aim of this thesis was to determine existing trends in complementary feeding practice, and their relevance for later dietary behaviour. Three analyses (Studies I-III) were conducted using data from the German DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study, an ongoing, open cohort study. Study I (n=366) revealed that commercial CF dominated infant feeding, especially in infants who were breast-fed for a shorter duration and whose mothers had a lower educational status. Both commercial and homemade CF showed opposing, nonlinear age trends; however, no time trends could be found during the observed study period (2004-2012). In Study II (n=281), a higher commercial CF proportion was associated with lower vegetable intake in infancy in both sexes. Prospectively, only boys showed an inverse association between a higher commercial CF proportion and a lower vegetable intake in preschool age as well as lower total fruit and vegetable intake in preschool and primary school age. For girls, no significant prospective association could be observed. With respect to fruit and vegetable variety, no distinct associations were found. Study III (n=288) indicated that infants with a high contribution of commercial CF had higher odds for a high consumption of added sugar from CF as well as a high total added sugar intake. Commercial CF consumption in infancy was also positively related to added sugar intake in preschool and primary school age. In conclusion, this thesis highlights the constantly high and widespread consumption of commercial CF in today’s infant nutrition and further provides first evidence of the preparation type of CF being a relevant modifiable factor shaping long-term dietary behaviour. Although the question, whether it is the early diet tracking through childhood or the sensory properties of CF imprinting later taste and food preferences cannot be conclusively answered, these results underline that the occasional provision of homemade CF can help infants to develop beneficial food preferences and contribute to a favourable dietary behaviour by means of increasing fruit and vegetable consumption as well as limiting added sugar intake in childhood.Fütterungspraktik von Beikost während des Säuglingsalters und deren Relevanz für das Ernährungsverhalten im Säuglings- und Kindesalter Neben angeborenen Geschmackspräferenzen spielen auch die frühen sensorischen Erfahrungen im Säuglingsalter durch Fruchtwasser, Muttermilch und Säuglingsformula eine entscheidende Rolle bei der Entwicklung von individuellen Lebensmittelvorlieben und dem Ernährungsverhalten. Mit der Einführung von Beikost während des Abstillens steigt das Spektrum der verschiedenen erlebten Geschmäcker und Konsistenzen weiter an. Allerdings wurde dabei die Bedeutung der sensorischen Eigenschaften von Beikost – insbesondere im Hinblick auf die Herstellungsart, d.h. selbst gekocht oder kommerziell – für die Formung der späteren Lebensmittelpräferenzen bis jetzt noch nicht eingehend untersucht. Daher war es das übergeordnete Ziel dieser Arbeit, bestehende Trends in der Fütterungspraktik von Beikost sowie deren Relevanz für das spätere Ernährungsverhalten zu bestimmen. Es wurden dazu drei Analysen (Studien I-III) mit Daten der deutschen DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Studie, einer fortlaufenden offenen Kohortenstudie, durchgeführt. Studie I (n=366) zeigte, dass kommerzielle Beikost die Säuglingsernährung dominiert, besonders bei Säuglingen mit einer kürzeren Stilldauer und Müttern mit einem niedrigeren Bildungsstatus. Kommerzielle und selbst gekochte Beikost zeigten gegensätzliche nicht-lineare Alterstrends, allerdings konnten keine Zeittrends in dem betrachteten Studienzeitraum (2004-2012) gefunden werden. In Studie II (n=281) war ein höherer Anteil kommerzieller Beikost bei beiden Geschlechtern mit einem niedrigeren Gemüseverzehr im Säuglingsalter assoziiert. Prospektiv zeigten nur Jungen eine inverse Assoziation zwischen einem höheren kommerziellen Beikostanteil und einem niedrigeren Gemüseverzehr im Vorschul- sowie einem niedrigeren Gesamtobst- und Gemüseverzehr im Vor- und Grundschulalter. Bei Mädchen konnten keine signifikanten prospektiven Zusammenhänge beobachtet werden. Im Hinblick auf die Obst- und Gemüsevarietät wurden keine eindeutigen Zusammenhänge gefunden. Studie III (n=288) legte nahe, dass Säuglinge mit einem hohen Anteil kommerzieller Beikost eher eine hohe zugesetzte Zuckerzufuhr aus Beikost sowie eine insgesamt höhere zugesetzte Zuckerzufuhr aufwiesen. Der Verzehr kommerzieller Beikost war auch positiv mit der zugesetzten Zuckerzufuhr im Vor- und Grundschulalter assoziiert. Zusammenfassend betont diese Arbeit den konstant hohen und weitverbreiteten Verzehr von kommerzieller Beikost in der heutigen Säuglingsernährung und liefert zudem erste Hinweise, dass die Herstellungsart von Beikost ein relevanter veränderbarer Einflussfaktor auf das langfristige Ernährungsverhalten ist. Auch wenn die Frage, ob die frühen Ernährungsmuster in der Kindheit beibehalten werden oder die sensorischen Eigenschaften der Beikost die späteren Geschmacks- und Lebensmittelvorlieben prägen, nicht abschließend beantwortet werden kann, unterstreichen diese Ergebnisse, dass das gelegentliche Anbieten von selbst gekochter Beikost Säuglingen helfen kann, vorteilhafte Lebensmittelvorlieben zu entwickeln und damit zu einem günstigen Ernährungsverhalten im Sinne eines höheren Obst- und Gemüseverzehrs sowie einer geringeren zugesetzten Zuckerzufuhr in der Kindheit beitragen kann

Dietary intake of soluble fiber and risk of islet autoimmunity by 5 y of age: results from the TEDDY study.

Deficient soluble fiber intake has been suggested to dysregulate the immune response either directly or through alterations of the microbial composition in the gut

Factors associated with longitudinal food record compliance in a paediatric cohort study.

Non-compliance with food record submission can induce bias in nutritional epidemiological analysis and make it difficult to draw inference from study findings. We examined the impact of demographic, lifestyle and psychosocial factors on such non-compliance during the first 3 years of participation in a multidisciplinary prospective paediatric study

Metadata harmonization–Standards are the key for a better usage of omics data for integrative microbiome analysis

International audienceAbstract Background Tremendous amounts of data generated from microbiome research studies during the last decades require not only standards for sampling and preparation of omics data but also clear concepts of how the metadata is prepared to ensure re-use for integrative and interdisciplinary microbiome analysis. Results In this Commentary, we present our views on the key issues related to the current system for metadata submission in omics research, and propose the development of a global metadata system. Such a system should be easy to use, clearly structured in a hierarchical way, and should be compatible with all existing microbiome data repositories, following common standards for minimal required information and common ontology. Although minimum metadata requirements are essential for microbiome datasets, the immense technological progress requires a flexible system, which will have to be constantly improved and re-thought. While FAIR principles (Findable, Accessible, Interoperable, and Reusable) are already considered, international legal issues on genetic resource and sequence sharing provided by the Convention on Biological Diversity need more awareness and engagement of the scientific community. Conclusions The suggested approach for metadata entries would strongly improve retrieving and re-using data as demonstrated in several representative use cases. These integrative analyses, in turn, would further advance the potential of microbiome research for novel scientific discoveries and the development of microbiome-derived products

Analgesic antipyretic use among young children in the TEDDY study : No association with islet autoimmunity

Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection