Complementary feeding and nutritional status of infants on cow's milk proteins elimination diet.

OBJECTIVE: To evaluate the diet and nutritional status of infants on an elimination diet of cow's milk proteins. METHODS: Observational and cross-sectional study that compared: Infants on a cow's milk protein elimination diet (n=60) assisted at a hypoallergenic formula distribution unit and a control group of same age and gender without dietary restrictions (n=60). Age ranged from 6 to 24 months. The diet was evaluated using the 24-hour food survey and weight and height were measured. RESULTS: The macronutrient intake of both groups reached nutritional recommendations. The proportions of infants in the group of elimination of cow's milk proteins with insufficient intake were lower, compared to controls, for iron (13.3 and 31.7%; p=0.029), zinc (5.0 and 18.3%; p=0.047), and vitamin D (25.0 and 71.7%; p<0.001). The hypoallergenic formula contributed to a greater supply of nutrients than dairy foods for the control group. Between 12 and 24 months, the number of infants on a restriction diet who never consumed meat, fish, cereals, and eggs was higher than in the control group (p<0.05). The length-age Z scores in infants on a cow's milk protein elimination diet (-0.4±1.6) were lower (p=0.039) than in the control group (+0.2±1.3). CONCLUSIONS: The diet of infants with exclusion of cow's milk protein was adequate despite the delay in the introduction of some complementary foods. Infants on an elimination cow's milk protein diet showed lower linear growth without weight deficit.

Complementary feeding and nutritional status of infants on cow's milk proteins elimination diet / Alimentação complementar e estado nutricional de lactentes em dieta de exclusão das proteínas do leite de vaca

Abstract Objective: To evaluate the diet and nutritional status of infants on an elimination diet of cow's milk proteins. Methods: Observational and cross-sectional study that compared: Infants on a cow's milk protein elimination diet (n=60) assisted at a hypoallergenic formula distribution unit and a control group of same age and gender without dietary restrictions (n=60). Age ranged from 6 to 24 months. The diet was evaluated using the 24-hour food survey and weight and height were measured. Results: The macronutrient intake of both groups reached nutritional recommendations. The proportions of infants in the group of elimination of cow's milk proteins with insufficient intake were lower, compared to controls, for iron (13.3 and 31.7%; p=0.029), zinc (5.0 and 18.3%; p=0.047), and vitamin D (25.0 and 71.7%; p<0.001). The hypoallergenic formula contributed to a greater supply of nutrients than dairy foods for the control group. Between 12 and 24 months, the number of infants on a restriction diet who never consumed meat, fish, cereals, and eggs was higher than in the control group (p<0.05). The length-age Z scores in infants on a cow's milk protein elimination diet (-0.4±1.6) were lower (p=0.039) than in the control group (+0.2±1.3). Conclusions: The diet of infants with exclusion of cow's milk protein was adequate despite the delay in the introduction of some complementary foods. Infants on an elimination cow's milk protein diet showed lower linear growth without weight deficit.

Resumo Objetivo: Avaliar a dieta e o estado nutricional de lactentes em dieta de exclusão das proteínas do leite de vaca. Métodos: Estudo observacional, transversal, que comparou: lactentes em dieta de exclusão das proteínas do leite de vaca (n=60) atendidos em unidade de dispensação de fórmulas hipoalergênicas e lactentes sem restrições alimentares (n=60), de mesma idade e sexo (grupo controle). A idade variou de seis a 24 meses. A dieta foi avaliada com o emprego do inquérito alimentar e foram mensurados o peso e a estatura. Resultados: A ingestão de macronutrientes foi adequada em ambos os grupos. No grupo em dieta de exclusão das proteínas do leite de vaca, as proporções de lactentes com ingestão insuficiente foram menores em relação aos controles, para ferro (13,3 e 31,7%; p=0,029), zinco (5,0 e 18,3%; p=0,047) e vitamina D (25,0 e 71,7%; p<0,001). A fórmula hipoalergênica contribuiu com maior oferta de nutrientes do que os alimentos lácteos para o grupo controle. Entre 12 e 24 meses, o número de lactentes em dieta de exclusão que nunca consumiram carne bovina, peixe, cereais e ovo foi maior do que no grupo controle (p<0,05). Os escores Z de comprimento-idade nos lactentes em dieta de exclusão das proteínas do leite de vaca (-0,4±1,6) foram menores (p=0,039) do que no grupo controle (+0,2±1,3). Conclusões: A dieta de lactentes em exclusão do leite de vaca foi adequada apesar do atraso na introdução de alguns alimentos. Lactentes em dieta de exclusão apresentaram menor crescimento linear não acompanhado de déficit ponderal.