To assess the usual nutrient intakes of 3,273 US infants, toddlers, and preschoolers, aged 0 to 47 months, surveyed in the Feeding Infants and Toddlers Study (FITS) 2008; and to compare data on the usual nutrient intakes for the two waves of FITS conducted in 2002 and 2008.
The FITS 2008 is a cross-sectional survey of a national random sample of US children from birth through age 47 months. Usual nutrient intakes derived from foods, beverages, and supplements were ascertained using a telephone-administered, multiple-pass 24-hour dietary recall.
Infants aged birth to 5 months (n=382) and 6 to 11 months (n=505), toddlers aged 12 to 23 months (n=925), and preschoolers aged 24 to 47 months (n=1,461) were surveyed.
All primary caregivers completed one 24-hour dietary recall and a random subsample (n=701) completed a second 24-hour dietary recall. The personal computer version of the Software for Intake Distribution Estimation was used to estimate the 10th, 25th, 50th, 75th, and 90th percentiles, as well as the proportions below and above cutoff values defined by the Dietary Reference Intakes or the 2005 Dietary Guidelines for Americans.
Usual nutrient intakes met or exceeded energy and protein requirements with minimal risk of vitamin and mineral deficiencies. The usual intakes of antioxidants, B vitamins, bone-related nutrients, and other micronutrients were adequate relative to the Adequate Intakes or Estimated Average Requirements, except for iron and zinc in a small subset of older infants, and vitamin E and potassium in toddlers and preschoolers. Intakes of synthetic folate, preformed vitamin A, zinc, and sodium exceeded Tolerable Upper Intake Level in a significant proportion of toddlers and preschoolers. Macronutrient distributions were within acceptable macronutrient distribution ranges, except for dietary fat, in some toddlers and preschoolers. Dietary fiber was low in the vast majority of toddlers and preschoolers, and saturated fat intakes exceeded recommendations for the majority of preschoolers. The prevalence of inadequate intakes, excessive intake, and intakes outside the acceptable macronutrient distribution range was similar in FITS 2002 and FITS 2008.
In FITS 2008, usual nutrient intakes were adequate for the majority of US infants, toddlers, and preschoolers, except for a small but important number of infants at risk for inadequate iron and zinc intakes. Diet quality should be improved in the transition from infancy to early childhood, particularly with respect to healthier fats and fiber in the diets of toddlers and preschoolers.
"Improving the diets of preschool-age children is a critical component of preventing unhealthy weight gain early in life. According to the 2002 and 2008 U.S. representative sample of 3,273 preschool-age children in the Feeding Infants and Toddlers Studies, young children consumed diets high in saturated fats or added sugars and low in dietary fiber . In another U.S. nationally representative sample of 2,442 children two to eight years of age, children with diets high in energy density, such as foods with added sugars and fats compared to fruits and vegetables, were more likely to be overweight or obese rather than normal weight . "
[Show abstract][Hide abstract] ABSTRACT: To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI).
A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post- intervention.
Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points.
The NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic.Trial registration: National Clinical Trials Number NCT01921842.
BMC Public Health 03/2014; 14(1):215. DOI:10.1186/1471-2458-14-215 · 2.26 Impact Factor
"Measurement of DQ is complex and requires a thorough understanding of the nutritional issues affecting the population of interest . While one commonly applied approach is based on capturing intake quantities and comparing them to individual food group or nutrient intake goals , additional information that is not captured by individual components of diets is assessed using composite assessment tools that can across the most pertinent nutritional concerns in reference to population-specific intake recommendations. This method cannot only provide information about the intake levels of food groups and nutrients, but also captures the underlying issues involved in overall diet—many of which are not known. "
[Show abstract][Hide abstract] ABSTRACT: Obesity has been associated with low diet quality and the suboptimal intake of food groups and nutrients. Two composite diet quality measurement tools are appropriate for Americans 2-18 years old: the Healthy Eating Index (HEI) 2005 and the Revised Children's Diet Quality Index (RC-DQI). The five components included in both indexes are fruits, vegetables, total grains, whole grains, and milk/dairy. Component scores ranged from 0 to 5 or 0 to 10 points with lower scores indicating suboptimal intake. To allow direct comparisons, one component was rescaled by dividing it by 2; then, all components ranged from 0 to 5 points. The aim of this study was to directly compare the scoring results of these five components using dietary data from a nationally representative sample of children (NHANES 2003-2006, N = 5,936). Correlation coefficients within and between indexes showed less internal consistency in the HEI; age- and ethnic-group stratified analyses indicated higher sensitivity of the RC-DQI. HEI scoring was likely to dichotomize the population into two groups (those with 0 and those with 5 points), while RC-DQI scores resulted in a larger distribution of scores. The scoring scheme of diet quality indexes for children results in great variation of the outcomes, and researchers must be aware of those effects.
Journal of obesity 09/2013; 2013(7):376314. DOI:10.1155/2013/376314
[Show abstract][Hide abstract] ABSTRACT: This review focuses on complementary feeding (CF) in westernized settings where primary health concerns are risk of obesity and micronutrient inadequacy. The current evidence is reviewed for: (1) when CF should be introduced, (2) what foods (nutrients and food types) should be prioritized and avoided, and (3) how the infant should be fed. Special attention is paid to the underlying physiological differences between breast- and formula-fed infants that often result in distinctly different nutritional and health risks. This difference is particularly acute in the case of micronutrient inadequacy, specifically iron and zinc, but is also relevant to optimal energy and macronutrient intakes. Emphasis is placed on the complex interplay among infants’ early dietary exposures; relatively high energy and nutrient requirements; rapid physical, social and emotional development; and the feeding environment—all of which interact to impact health outcomes. This complexity needs to be considered at both individual and population levels and in both clinical and research settings.
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