Health consequences of nutrition in childhood and early infancy.
ABSTRACT Medical and scientific studies have proven that the body's metabolic programming can be influenced by diet and nutrition from early infancy. As a result, the incidence and outcome of several metabolic diseases such as obesity, hypertension and cardiovascular disorders have been found to be associated with birth weight, growth and feeding patterns, and the body composition in early childhood. Exclusive or partial breast feeding for at least 6 months is recommended by the World Health Organization, while the European Society of Pediatric Gastroenterology Hepatology and Nutrition Committee on Nutrition recommends the introduction of complementary foods at 4-6 months of age. The fat content of the diet should not be below 25% of the energy intake in order to maintain ideal growth while dietary proteins above 15% of the energy intake is related to future obesity. Long term benefits of breast feeding include a more ideal serum lipid profile and blood pressure, improved neuro-cognitive scores, and a decreased incidence for atopic dermatitis in children who have family members with atopic diseases. Several studies have also acknowledged the long term benefits for neuro-cognitive development from certain nutrients including long-chain polyunstaturated fatty acids and docosahexaenoic acid. Meat intake has proved to be beneficial to psychomotor development. It is suggested that early introduction for complementary foods before 4 months of age is a risk factor for atopic dermatitis; while no strong evidence showed delaying weaning foods can decrease the risk for allergic diseases.
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ABSTRACT: Identifying toddlers at dietary risk is crucial for determining who requires intervention to improve dietary patterns and reduce health consequences. The objectives of the present study were to develop a simple tool that assesses toddlers' dietary risk and investigate its reliability and validity. The nineteen-item Toddler Dietary Questionnaire (TDQ) is informed by dietary patterns observed in Australian children aged 14 (n 552) and 24 (n 493) months and the Australian dietary guidelines. It assesses the intake of 'core' food groups (e.g. fruit, vegetables and dairy products) and 'non-core' food groups (e.g. high-fat, high-sugar and/or high-salt foods and sweetened beverages) over the previous 7 d, which is then scored against a dietary risk criterion (0-100; higher score = higher risk). Parents of toddlers aged 12-36 months (Socio-Economic Index for Areas decile range 5-9) were asked to complete the TDQ for their child (n 111) on two occasions, 3·2 (sd 1·8) weeks apart, to assess test-retest reliability. They were also asked to complete a validated FFQ from which the risk score was calculated and compared with the TDQ-derived risk score (relative validity). Mean scores were highly correlated and not significantly different for reliability (intra-class correlation = 0·90, TDQ1 30·2 (sd 8·6) v. TDQ2 30·9 (sd 8·9); P= 0·14) and validity (r 0·83, average TDQ ((TDQ1+TDQ2)/2) 30·5 (sd 8·4) v. FFQ 31·4 (sd 8·1); P= 0·05). All the participants were classified into the same (reliability 75 %; validity 79 %) or adjacent (reliability 25 %; validity 21 %) risk category (low (0-24), moderate (25-49), high (50-74) and very high (75-100)). Overall, the TDQ is a valid and reliable screening tool for identifying at-risk toddlers in relatively advantaged samples.British Journal Of Nutrition 06/2014; · 3.34 Impact Factor
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ABSTRACT: This study examined the association between length of exposure to Women, Infants, and Children (WIC) services and breastfeeding initiation/duration. All women with singleton live births, first certified into MA WIC prenatally or postpartum (2001-2009), with complete breastfeeding and covariate data (maternal race, age, education, smoking status, BMI, HH income and size, birth weight, whether full or preterm, and sex) were included (n = 122,506). Regressions models were used to examine timing of WIC entry (i.e., trimester of prenatal or postpartum) with: (1) breastfeeding initiation, (2) mean duration (3) and 3, 6 and 12 month durations. Among prenatal entrants, first (vs. third) trimester entry was associated with a higher likelihood of initiation for both primiparous, and multiparous mothers (10 and 32 % respectively; p < .01). Prenatal entrants breastfed 1.7 (primiparous), and 3.4 (multiparous) weeks longer than postpartum entrants (p < .0001). Among multiparous women, first trimester entry was associated a greater likelihood of breastfeeding for three (15 % greater), six (25 % greater) and twelve (33 % greater) months compared to third trimester entrants (p < .0001). Greater exposure to WIC services improves breastfeeding rates among a low income diverse population of women.Maternal and Child Health Journal 04/2014; · 2.24 Impact Factor
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ABSTRACT: OBJECTIVE: This study investigated the complementary feeding practices and the factors associated with the appropriate timing of complementary feeding in children under one year of age. METHODS: The parents or caregivers of 1,176 children who attended the National Immunization Campaign in São Bernardo do Campo, Southeastern Brazil, in 2003 were interviewed to determine what the child was fed in the 24 hours prior to the interview. The prevalence of complementary food intake was estimated by a logistic regression model adjusted for age; the medians of the introduction of foods by survival analysis; and the factors associated with timely complementary feeding by Poisson regression with robust adjustment of variance and hierarchical variable selection. RESULTS: Complementary foods were introduced early: in the fourth month of age, nearly one-third of the children were already consuming fruit juices and one-fourth were consuming soft foods, fruits or soups. They were less likely to eat the same food as the family at eight months of age (48%). The median age for fruit intake was 266 days (95%CI 256-275), for vegetable soup was 258 days (95%CI 250-264) and for family meals 292 days (95%CI 287-303). Factors associated with the intake of solid foods before age six months were: healthcare system, maternal age, maternal employment and use of pacifiers. CONCLUSION: The early consumption of solid foods, a potential risk for the child's health and for the development of chronic diseases in adulthood, evidences the need for programmatic actions to reverse this situation.Revista de Nutrição 12/2010; 23(6):983-992. · 0.35 Impact Factor