Adherence to Vitamin D Supplementation Recommendations for Breastfed Infants and Young Children: An Analysis of Canadian Community Health Survey Data Cycles From 2015 to 2018.

BACKGROUND: In Canada, nutrition policy, as outlined in the Nutrition for Healthy Term Infants recommendations, includes a daily vitamin D supplement of 10 µg (400 IU) for breastfed infants and young children to support adequate vitamin D status. OBJECTIVES: This study aimed to report on adherence to vitamin D supplementation recommendations for breastfed infants (≤12 months); and for children breastfed >12 mo. METHODS: Canadian Community Health Survey (paired-cycles 2015/2016 and 2017/2018) maternal experiences data for infants born 2012-2018 who received any breastmilk formed the sample (n = 7079). Whether the infant was given a vitamin D supplement (yes/no) and the frequency (daily/almost every day, 1-2/wk, or <1/wk) were surveyed. Weighted data (95% CI) were summarized according to breastfeeding history (exclusive to 6 mo and continuing; partial to 6 mo and continuing; and stopped ≤6 mo). Correlates of supplement adherence were explored using logistic regression. RESULTS: Overall, 87.1% (95% CI: 85.9%, 88.3%) of participants reported giving their infant (≤12 mo) a vitamin D supplement, and of these, 83.3% (95% CI: 81.9%, 84.7%) did so daily/almost every day, 12.4% (95% CI: 11.1%, 13.7%) did so 1-2/wk, and 4.3% (95% CI: 3.6%, 5.0%) did so <1/wk. Lower adjusted odds of adherence were observed among participants reporting: stopped breastfeeding ≤6 mo, lower education or income, recent immigration, and overweight prepregnancy body mass index; higher odds of adherence were observed in the western provinces. Regarding mothers of children >12 mo and breastfed (n = 2312), 58.0% (95% CI: 54.9%, 61.1%) gave a vitamin D supplement daily/almost every day. CONCLUSIONS: Adherence to providing a vitamin D supplement to breastfed infants is high in Canada. Nonetheless, we estimate that ∼27% of mothers are nonadherent to daily/almost every day administration of a vitamin D supplement and that adherence declines in children breastfed >12 mo. Further promotion to support uptake of the current guidance may be necessary, particularly for parents of recent immigration or lower socioeconomic status.

Implementation of a Rooftop Farm Integrated With a Teaching Kitchen and Preventive Food Pantry in a Hospital Setting.

Safety-net hospitals serving populations with disproportionately high levels of poverty, food insecurity, and chronic disease can utilize innovative strategies to improve the health and environment of their communities. Boston Medical Center in Boston, Massachusetts, constructed an on-site rooftop farm to provide fresh produce for the hospital's preventive food pantry, teaching kitchen, cafeterias, and inpatient meal services. This novel model can be replicated by other organizations aiming to alleviate food insecurity, encourage healthy eating, and promote environmental sustainability.

100% Juice, Fruit, and Vegetable Intake Among Children in the Special Supplemental Nutrition Program for Women, Infants, and Children and Nonparticipants.

INTRODUCTION: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides monthly food packages to low-income children (aged 1-4 years) in the U.S., including 128 ounces of 100% fruit juice and an $8 cash value voucher for purchasing fruits and vegetables. The fruit juice allowance translates to 71%-107% of the maximum intake recommended by the American Academy of Pediatrics (4-6 ounces/day). Careful examination of WIC food package allocations is necessary because overconsumption of fruit juice among young children has been linked to weight gain and juice lacks important nutrients found in whole fruit (e.g., fiber). METHODS: A total of 1,576 children aged 2-4 years were assessed using the 2009-2014 National Health and Nutrition Examination Surveys. Multiple linear regressions were conducted in 2017 to analyze the association between WIC program participation and intake of 100% fruit juice, whole fruits, and vegetables. Logistic regression was used to examine the association between WIC program participation and the odds of exceeding the American Academy of Pediatrics maximum intake for juice. RESULTS: Adjusting for child and parent/caregiver characteristics, WIC participants consumed significantly more 100% fruit juice (ß=0.22 cup equivalents/day, 95% CI=0.04, 0.40) compared with income-eligible nonparticipants, but not more whole fruits or total vegetables. WIC participants had 1.51-times greater odds (95% CI=1.06, 2.14) of exceeding the age-specific American Academy of Pediatrics maximum intake for juice compared with income-eligible nonparticipants. CONCLUSIONS: These findings support recommendations to reduce 100% fruit juice allowances in the WIC program and reallocate those funds to the cash value voucher to increase whole fruit and vegetable consumption.