Nutrition in children from 1 to 7 years of age: challenges and legislation

Healthy nutrition is important for the growth, health and development of children. The national policy regarding the healthy nutrition of young children and preschool children is implemented by two ordinances of the Ministry of Health: Ordinance № 2 of 7 March, 2013 on healthy nutrition of children aged 0 to 3 years in kindergartens and children's kitchens, which regulates the requirements for healthy nutrition of children aged 0 to 3 years, organized on the territory of children's institutions and children's kitchens and Ordinance № 6 of 10 August 2011 on healthy nutrition of children aged 3 up to 7 years in children's institutions, regulates the requirements for healthy nutrition of children aged 3 to 7 years, organized on the territory of municipal, state and private children's institutions. The basis of these two ordinances are the requirements for energy and nutrient intake or the norms for the specific age groups of children, which best characterize the nutrition and allow for optimal growth and development of children. The results from the annual monitoring of the nutrition of children aged 1 to 3 and  3 to 7 years is used for the purposes of the national food policy, as a key strategy in increasing the well-being of children in Bulgaria

Impact of risk factors on growth of children from families with atopy

Nutritional and non-nutritional factors might interfere with growth of children with atopy in the first years of life and complicate even further weight gain and development. The purpose of our study is to evaluate the impact of nutrition and several environmental factors on the growth of children from families with atopy in early childhood. During the period 2017–2020, a prospective cohort study, which included 120 children 13–31 months of age (24.0±3.9 months) with family medical history for allergy was conducted in Varna, Bulgaria. The sample was followed for around 2 years. Sociodemographic data, family and personal history for smoking, pet presence, atopy and common acute infections was collected at regular intervals. Anthropometric measurements were taken at birth, 2, 4, 6 month, 1 year and 2 years. The conducted study found that factors from the living environment and nutritional nature are related to the processes of growth and development in children from families with allergy. The presence of diseases such as atopic dermatitis, acute infections of the digestive and excretory system, hospitalizations in connection with urinary infections, smoking have relation to the growth and development of children with a family history of atopy. The data resulting from our study may serve as a basis for further research so the mechanisms of atopy to be investigated better and potential preventive measures during pregnancy and early childhood to be specified. The impact of risk factors on children‘s growth during the first 1000 days could be modified by targeted behavioral interventions of the whole family

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Validation of a picture book to be used in a pan-European dietary survey

To view supplementary material for this article, please visit https://doi.org/10.1017/S1368980017004153Objective: To validate a picture book for estimation of food portion sizes using two approaches: (i) ‘perception’ of food portions by comparison with a series of food photos; and (ii) ‘conceptualization and memory’, using the same photos to estimate the amount of served food one hour after self-served food portions. Design: Each partner developed a country-specific picture book based on the so-called EPIC-Soft picture book. Representative and common photo series were chosen achieving approximately 25 % of the original picture book (n 23). Three portions from each photo series were randomly selected. Setting: The study was performed within the Pilot study in the view of a Pan-European dietary survey – Adolescents, adults and elderly (PILOT-PANEU) project. Subjects: A sample of adolescents and adults was recruited in five countries: Bulgaria (n 103), Finland (n 34), Germany (n 69), Hungary (n 62) and Portugal (n 77). Results: Among the portions of the corresponding photo series and depending on the type of food, from 18 % (cheese) to 96 % (ratatouille) of participants chose the correct portions. In the perception study, agreement between the portions shown and reported was substantial (intraclass correlation coefficient (ICC)=0·805) and the mean difference was very low. In the memory study, agreement between the served and reported portions was lower than in the perception study (ICC=0·536). Agreement also seemed to decrease as the appearance of food on the plate differed from food in the picture. Conclusions: Overall, the picture series selected can be applied in future intake surveys to quantify foods similar to those depicted in the pictures.The work was carried out within the frame of the PILOT-PANEU project sponsored by the European Food Safety Authority (EFSA) under grant agreement CFP/EFSA/DATEX/2010/02.info:eu-repo/semantics/publishedVersio

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified