Associations between diet diversity during infancy and atopic disease in later life: Systematic review.

Background: The incidence of allergic disease remains high, and many studies have focused on the association between food diversity in infancy and allergic disease later in life, but their conclusions are still controversial. Objective: We aimed to synthesize the literature on the association between childhood diet diversity and atopic disease. Methods: We searched the PubMed, Cochrane Library, Embase, Scopus, VPCS, and Wanfang databases for studies about food diversity and atopic disease. Seventeen high-quality studies, 14 cohort studies, and 1 case-control study were included from 5244 studies with sample sizes ranging from 100 to 5225. Results: All high-quality cohort studies showed that increasing food diversity in infancy can effectively prevent the occurrence of food allergies (5/5). Moderate evidence showed that increased food diversity reduced the risk of asthma (4/6), food sensitization (3/5), and atopic dermatitis (3/5). However, its effect on eczema (5), allergic rhinitis (4), and other diseases remains controversial. Conclusions: Increasing food diversity during infancy is a potential method for preventing food allergy, asthma, atopic dermatitis, and food sensitization later in life. There is little or no comparative evidence about the protective effect of food diversity on other atopic diseases.

Production, acceptability, nutritional and pasting properties of orange-flesh sweet potato, cowpea and banana flour mix.

Promoting the intake of foods rich in vitamin A is key to combating the increase in vitamin A deficiency. This research focused on the utilization of orange-fleshed sweet potatoes (a tuber-based food), cowpea (a pulse), and ripe bananas (a fruit) for the production of flour mix as a means to reduce Vitamin A deficiency in children. Different ratios of sweet potato-cowpea-banana (PCB) mix, resulting in 8 different blended samples, were optimized. The flour mix was evaluated for its overall acceptability, vitamin A content, beta-carotene, and other nutritional and functional properties. The panelists rated the sweet potato-cowpea banana blends labeled PCB8 (60% OFSP, 30% cowpea, 5% ripe banana flour, and 5% sugar) as most preferred and acceptable with average scores of 8.96 points for color, 8.75 points for flavor, 8.88 points for appearance, 8.33 points for taste, 8.07 points for texture, and 8.39 points for overall acceptability on a 9-point hedonic scale. The vitamin A and beta-carotene contents ranged 7.62 to 8.35 mg/100 g and 0.15-0.17 mg/100 g for all blends. A significant difference in the functional properties of the flour mix were observed with an increase in the ratio of sweet potato flour addition. Findings from this study show that the flour mix PCB4 (65% sweet potato, 30% cowpea, and 5% ripe banana flour) was acceptable (8.15) and is recommended based on its vitamin A content (8.35 mg/100 g), nutritional properties, and functional properties. The study showed that locally available food commodities have good nutritional value that will help reduce vitamin A deficiency in children.

Effect of Gut Microbiota-Directed Complementary Food Supplementation on Fecal and Plasma Biomarkers of Gut Health and Environmental Enteric Dysfunction in Slum-Dwelling Children with Moderate Acute Malnutrition.

Dietary supplementation with a gut microbiota-directed complementary food (MDCF-2) significantly improved weight gain and repaired gut microbiota, as reported in a recent randomized controlled trial on Bangladeshi children with moderate acute malnutrition (MAM). Environmental enteric dysfunction (EED) is a small bowel disorder, and recent evidence shows that it is linked to growth failure in children. Therefore, we intended to investigate whether supplementation with MDCF-2 has any role in modifying gut health by changing the levels of biomarkers of EED and gut inflammation in children with MAM. We randomly assigned 124 children aged 12-18 months to one of two intervention diets, either MDCF-2 or ready-to-use supplementary food (RUSF). Approximately 50 g of the diet was administered in two feeding sessions daily for 12 weeks. Stool and plasma biomarkers were assessed to evaluate intestinal health. Results showed that the average change in citrulline concentration (µmol/L) significantly increased among children who consumed MDCF-2 compared to those who consumed RUSF (mean difference-in-differences: 123.10; 95% CI: 3.60, 242.61; p = 0.044). The research findings demonstrated that MDCF-2 might have a beneficial effect on improving the gastrointestinal health of malnourished children.

Energy, protein and iron densities of dabi teff-field pea-based optimised novel complementary flour and its contribution to daily energy and nutrients demand by 6-23-month-old children.

Inadequate intake of age-specific energy and nutrients is among the prime immediate causes of child malnutrition. Thus, this study aimed to determine the energy, protein and Fe densities of pre-processed dabi teff-field pea-based optimised novel complementary flour and its contribution to daily energy and nutrients demand by 6-8, 9-11 and 12-23 month-old children. The optimal formula at overall optimisation was identified to be 34·66 % dabi teff, 25 % barley, 15 % oats, 15·34 % field pea, 5 % linseed and 5 % maize with response values of 15·74 % protein, 5·09 % fat, 2·26 % ash, 2·88 % fibre, 73·05 % carbohydrate, 1591·72 kJ/100 g (380·43 kcal/100 g) energy, 32·21 mg/100 g Fe, 77·51 mg/100 g Ca and 2·59 mg/100 g Zn. The energy density of the optimised novel complementary flour was 1·27 kcal/g which fulfilled the Pan American Health Organization/WHO recommendation (≥ 0·8 kcal/g), protein density was 4·14 g/100 kcal and the Fe density was 8·47 mg/100 kcal, which was 2·12 to 10·59 times higher than the recommended value where the optimal had demonstrated to contribute more than 100 % of the daily energy and protein demand and notably more than 200 % of daily Fe demand at moderate bioavailability (0·8-4 mg/100 kcal). These findings showed that the daily recommended dietary allowance for energy, protein and Fe could be attained by the developed dabi teff-field pea-based optimised novel complementary flour and its contribution to the children's daily energy and nutrients demand met the standard, where the product can be used as food-based nutrition intervention to manage protein-energy malnutrition and Fe deficiency anemia in children sustainably.

Comparação da introdução das consistências na introdução da alimentação complementar entre recém-nascidos prematuros e a termo - Coorte de 0 a 12 meses / Comparison of the introduction of consistencies in complementary feeding introduction between preterm and full-term newborns - Cohort from 0 to 12 months

RESUMO Objetivo Comparar a introdução das consistências no período da alimentação complementar de recém-nascidos prematuros e recém-nascidos a termo até os 12 meses de vida, bem como avaliar a presença de disfunção motora oral e a sua relação com dificuldade na introdução das consistências alimentares nestes grupos. Método Trata-se de um estudo do tipo observacional, analítico, coorte, com coleta de dados ambispectiva, realizado na Secretaria Municipal de Saúde de Mafra - SC. A amostra do estudo foi constituída de 87 recém-nascidos, sendo 41 a termo e 46 prematuros. Na coleta de dados, foram realizadas entrevistas com as mães/responsáveis. A avaliação antropométrica foi realizada por nutricionista por meio de mensuração do peso corporal, comprimento e perímetro cefálico, seguida de avaliação das habilidades motoras orais e funcionais por meio do PAD-PED adaptado, avaliação da mamada, avaliação do desenvolvimento neuropsicomotor, avaliação da presença de depressão materna e risco psíquico da criança, até os 12 meses de vida de idade corrigida. Resultados A disfunção motora oral foi observada em 15 recém-nascidos, em ambos os grupos, na consistência líquida na primeira avaliação, persistiu em dois casos nos recém-nascidos a termo e em três casos nos recém-nascidos pré-termo, na última avaliação para a consistência sólida. Conclusão Não foi observada diferença na introdução das consistências alimentares entre os grupos. O aleitamento materno foi mais frequente nos a termo na primeira avaliação e semelhante nas demais avaliações. Com relação aos preditivos para disfunção motora oral, a mamadeira aumentou a chance em cerca de 7 vezes e procedimentos orais invasivos cerca de 6 vezes.

ABSTRACT Purpose To compare the introduction of consistencies during the period of complementary feeding of preterm and full-term newborns up to 12 months of life, as well as to evaluate the presence of oral motor dysfunction and its relation to difficulty in introducing food consistencies in these groups. Methods This is an observational, analytical, cohort study, with ambispective data collection, carried out at the Municipal Department of Health of Mafra, state of Santa Catarina, Brazil. The study sample consisted of 87 newborns, 41 full-term and 46 preterm. While data was collected, interviews were held with the mothers/guardians. The anthropometric assessment was carried out by a nutritionist by measuring body weight, length, and head circumference, followed by assessment of oral and functional motor skills by the adapted Clinical Evaluation Protocol of Pediatric Dysphagia (PAD-PED), assessment of breastfeeding and neuropsychomotor development, and assessment of the presence of maternal depression and psychological risk of children with up to 12 months of corrected age. Results We verified oral motor dysfunction in 15 newborns, in both groups, in the liquid consistency in the first assessment, persisting in two cases in the full-term newborns and in three cases in the preterm infants, in the last assessment for the solid consistency. Conclusion We observed no difference in the introduction of food consistencies between groups. Breastfeeding was more frequent in newborns in the first assessment and similar in other assessments. Regarding the predictors for oral motor dysfunction, bottle feeding increased the odds by about seven times and invasive oral procedures by about six times.

Practices of hygiene during complementary food feeding and associated factors among women with children aged 6-24 months in Dedo district, Southwest Ethiopia: A cross-sectional study.

Background and Aims: Poor food handling practices contribute to food contamination, leading to food-borne illnesses and childhood diarrhea in developing countries like Ethiopia. This study examines hygienic complementary food feeding practices and associated characteristics among women with children ages 6-24 months in the Dedo District. Method: A community-oriented cross-sectional study design was used in a multistage sampling strategy to gather information from 501 mothers of children between May 25 and July 10, 2022. There were absolute and relative frequencies assigned to each variable. Multiple logistic models have been used for factors that were 20% significant in univariate analysis. Odds ratios with corresponding 95% confidence intervals (CI) were produced to identify the important predictors. Results: This study showed that mothers with a diploma (adjusted odds ratio [AOR]: 11.2; CI: 5.51-22.8), urban residency (AOR = 6.35; CI: 3.57-11.3), a positive attitude toward hygienic complementary food feeding (AOR = 2.23; CI: 1.19-4.20), good knowledge of complementary food feeding practices (AOR = 3.95; CI: 2.39-6.55), access to a hand washing facility close to the latrine (AOR = 2.60; CI: 1.55-4.36), and access to water close to their home (AOR = 2.42; CI: 1.27-4.59) were highly associated with good hygiene practices of mothers. Conclusion: This study shows that mothers of children aged between 6 and 24 months have a very low overall prevalence of good hygienic complementary feeding practices. The concerned parties should therefore establish a healthcare educational program for mothers that emphasizes the importance of hand washing and informs them about the dangers of improper complementary feeding practices.

Sensory panel results of a dried fish powder supplement among caregivers and young children in Zambia.

OBJECTIVE: To evaluate the acceptability of traditional Zambian dishes fortified with Complementary Food for Africa+Dried Fish Powder (ComFA+Fish), a locally sourced protein/micronutrient blend designed to impact nutrient deficiencies among infants and young children (IYC) and improve pregnancy and birth outcomes among women of reproductive age (WRA). DESIGN: During two sensory panels, caregivers evaluated: (1) the acceptability of four ComFA+Fish dishes for household consumption, including fortified chibwabwa fisashi, savory Kapenta chutney, fortified complementary maize porridge and fortified bean-vegetable soup and (2) whether their IYC found the fortified complementary maize porridge acceptable. SETTING: Lake Kariba, Southern Province, Zambia. PARTICIPANTS: Women of reproductive age (n 42) and their IYC aged 6-11 months (n 16) and 12-23 months (n 26) were recruited from fishing villages in Gwembe, Siavonga and Sinazongwe District. RESULTS: A majority of caregivers extremely liked/liked the: (1) fortified chibwabwa fisashi's sensory attributes (94·7 %), convenience (92·8 %) and overall acceptability (100 %); (2) savory Kapenta chutney's sensory attributes (81·8 %), convenience (92·8 %) and overall acceptability (100 %); (3) fortified complementary porridge's sensory attributes (83·5 %), convenience (90·5 %) and overall acceptability (88·1 %) and (4) fortified bean-vegetable soup's sensory attributes (66·8 %), convenience (87·5 %) and overall acceptability (87·5 %). Further, a majority of caregivers evaluated the fortified complementary porridge as highly acceptable to their IYC. CONCLUSIONS: Results suggest that ComFA+Fish is strategically well placed to fill nutritional gaps among IYC and WRA in Zambia and has the potential to be scaled across sub-Saharan Africa.

Commercial complementary food feeding and associated factors among mothers of children aged 6-23 months old in Mettu Town, Southwest Ethiopia, 2022.

BACKGROUND: Commercial complementary foods (CCF) are unhealthy products for children under 24 months, containing unhealthy fats, refined starches, sugars, salt, and additives. The consumption of CCF is linked to non-communicable diseases, making it crucial to assess intake in Ethiopia, especially in Mettu town. OBJECTIVE: To assess the prevalence of commercial complementary food feeding and associated factors among mothers of 6-23 months old children in Mettu Town, 2022. METHOD: A community-based cross-sectional study was conducted in Mettu town, involving 386 randomly selected mothers of children aged 6-23 months. Data was collected using a pre-tested semi-structured questionnaire and analyzed using SPSS version 25. Variables with a P-value < 0.05 in the multivariable logistic regression were declared as having a statistically significant association with CCF feeding. RESULTS: The prevalence of CCF feeding within 24 h before the reporting period was 44.3%. In multivariable regression analysis, the age of index child 0-11months (AOR = 2.43, 95%CI: 1.53-3.85), non-exclusive breastfeeding (AOR = 2.18, 95%CI: 1.34-3.52), exposure to CCF promotions (AOR = 2.15, 95%CI: 1.32-3.50), maternal employment (AOR = 2.10, 95%CI: 1.28-3.44), and higher tertile wealth status (AOR = 2.19, 95%CI: 1.17-4.10) were significantly associated with CCF feeding. CONCLUSION: The current study revealed that nearly half of the mothers in Mettu town were feeding their children with commercially produced complementary foods. Age of child, non-exclusive breastfeeding, CCF promotions, maternal employment, and higher wealth status were found to have a significant association with CCF feeding. Therefore, continuous health education should be given to mothers to encourage exclusive breastfeeding until 6 months of age and to improve home-made complementary food feeding.

Optimization of a formula to develop iron-dense novel composite complementary flour with a reduced phytate/minerals molar ratio from dabi teff-field pea-based blends using a D-optimal mixture design.

Iron deficiency anemia is one of the major public health problems in children associated with the inadequate intake of bioavailable iron. Thus, this research was aimed at incorporating dabi teff, an underutilized/forgotten crop, into other pre-processed local food crops, viz., germinated maize, roasted barley, roasted field pea, dehulled oats, and linseed, to develop optimized iron-dense novel composite complementary flour with a reduced phytate/minerals molar ratio. Nutrisurvey software was employed to define ranges, and they were constrained at 20-35% dabi teff, 0-30% field pea, and 5-20% maize, while the remaining were kept constant at 25% barley, 15% oats, and 5% linseed. Eleven experimental runs were generated from the six mixture components using Stat-Ease Design Expert® software version 11, D-optimal. Inductively coupled plasma-optical emission spectrometry was used to determine micronutrients. 'Scheffe' regression was used to fit and test the model's adequacy, and numerical multi-response optimization was performed using the Design Expert® to identify the optimal points. Dabi teff had a significantly higher (p < 0.05) iron content at 86.5 mg/100 g, iron density at 24.53 mg/100 kcal, and calcium content at 123.59 mg/100 g. The new formulations had a significantly higher iron content (3.31-4.36 times), iron density (3.25-4.27 times), and calcium content (1.49-1.58 times), as compared to the control flour, and fulfilled FAO/WHO recommendations. The optimal formula was identified at 34.66% dabi teff, 25% barley, 15% oats, 15.34% field pea, 5% linseed, and 5% maize flour ratios, with response values at the overall optimization as 32.21 mg/100 g iron, 77.51 mg/100 g calcium, 2.59 mg/100 g zinc, 0.233 phytate/iron molar ratio (Ph:Fe), 0.067 phytate/calcium molar ratio (Ph:Ca), 3.43 phytate/zinc molar ratio (Ph:Zn), and 6.63 phytate by calcium to zinc molar ratio (Ph*Ca:Zn). Furthermore, it contained iron at a level that is 2.01 times higher than the standard and 4.44 times higher than the control, as well as an iron density of 8.47 mg/100 kcal, which was 4.39 times higher than that of the control. These findings showed that the optimized dabi teff-field pea based iron-dense novel composite complementary flour with enhanced bioavailability can be developed and used as a sustainable food-based strategy to combat iron deficiency anemia among children in less developed countries, such as Ethiopia.

Avoidance of added salt for 6-12-month-old infants: A narrative review.

Most nutrition guidelines recommend avoiding foods with added salt for infants aged 6-12 months. However, the reason for no added salt lacks enough and reliable evidence. We re-searched and re-studied the relevant evidence. We searched PubMed and the Cochrane database for English-language studies published from 1904 through 2021. We also searched the databases of the websites of different national institutions. Randomized clinical trials (RCTs), systematic reviews, observational studies, and dietary guidelines were included in this review. The kidneys of infants aged 6-12 months have adequate sodium excretion capacity. There is insufficient evidence that high salt (sodium) intake early in life might lead to hypertension or salty diet preference in adults. Infants aged 6-12 months might be at risk of low sodium intake of only 150-300 mg of sodium/day, which may not meet the body's needs, if their supplementary food is not adequately salted.

Optimization of dabi teff-field pea based energy and protein dense novel complementary food with improved sensory acceptability using D-optimal mixture design.

Protein-energy malnutrition is unacceptably high among children in developing countries due to inadequate required nutrients and poor quality of complementary foods characterized by low protein and energy density and often monotonous. Thus, this research was aimed at examining the potential of including dabi teff, the underutilized/forgotten crop into pre-processed local food crops viz., germinated maize, roasted barley, roasted field pea, dehulled oats and linseed to develop energy and protein-dense optimized novel complementary food with improved sensory acceptability. Nutrisurvey software was employed to define ranges and they were constrained at 20-35% dabi teff, 0-30% field pea and 5-20% maize, while the rest were set constant at 25% barley, 15% oats and 5% linseed. Eleven experimental runs were generated from the six mixture components using D-optimal mixture design, Stat-Ease Design Expert ® software version 11. A 5-point Hedonic scale was used to evaluate the sensory attributes. 'Scheffe' regression was used to fit and test model adequacy and numerical multi-response optimization was performed to identify optimal points using the Design expert. Field pea and linseed contained significantly higher (P < 0.05) protein at 20.95% and 20.57%. The newly formulated products contained significantly higher protein (1.4-1.6 times) and protein density (1.31-1.56 times) as compared to the control and fulfilled the recommended standard. The optimal was identified at 34.66% dabi teff, 25% barley, 15% oats, 15.34% field pea, 5% linseed and 5% maize flour ratios with response values at overall optimization to be 5.57% moisture, 15.74% protein, 5.09% fat, 2.26% ash, 2.88% fiber, 73.05% carbohydrate, 380.43 kcal/100 g energy and 4.12 sensory acceptability score and it contained an energy density of 1.27 kcal/g and protein density of 4.14 g/100kacl. These findings showed that optimized dabi teff-field pea based novel complementary food can be used as a sustainable food-based strategy to combat protein-energy malnutrition among children in developing countries.

Nutritional aspects of commercial infant and toddler food products sold in Turkey.

Background: In recent years, there has been an increase in the variety and consumption of commercial infant and toddler food products. Aim: The aim of this study is to evaluate the nutritional profiles of commercial infant and toddler food products sold in Turkey. Methods: A cross-sectional survey of the nutritional composition of products available at in-store and online supermarkets in Turkey was derived from the nutritional information panel on the product label or information provided on manufacturer websites in March 2023. The targeted age group, package type, serving size, ingredients list, and nutrition information (energy [kcal], protein [g], total fat [g], carbohydrate [g], dietary fiber [g], total sugar [g], and sodium [mg] per 100 g) were recorded. Results: Of the 189 products identified, more than 90% (n = 47) of the first foods were fruit-based, while 2% (n = 4) contained only vegetables. Almost half of the products (n = 89, 49%) contained added sugar or sweeteners, 41 (22%) had added sugar, and 1 in 3 products (n = 68, 36%) had sugar from fruit-based sources. One in 10 products (n = 18, 9.5%) contained added salt while 40% of the products (n = 76) were above the WHO Europe sodium standards. Almost half of the products (n = 6, 46%) targeting the 12 months older age group were pureed foods using squeeze pouch packaging. Conclusions: The majority of commercial infant and toddler food products did not adhere to nutrition guidelines. There is a need for stronger composition standards for commercial infant and toddler food products by reducing sugar and sodium content, reducing the use of fruits and sweet vegetables, and increasing the variety of products containing different types of vegetables.

Orientações da introdução alimentar em puericultura realizadas em uma unidade básica de saúde de Mossoró RN: relato de experiência / Guidelines for food introduction in child culture carried out in a basic health unit in Mossoró-RN: experience report / Directrices para la introducción de alimentos en la cultura infantil realizada en una unidad básica de salud de Mossoró-RN: relato de experiencia

Introdução:Recomendada pela Organização Mundial da Saúde após os seis meses, a alimentação complementar merece atenção especial no que tange a escolha dos alimentos, pois é quando os hábitos alimentares começam a ser formados. Uma introdução alimentar inadequada podelevar o surgimento de alergias, doenças e levar ao déficit nutricional, por isso o acompanhamento desse processo é de extrema importância para assegurar o crescimento e desenvolvimento. Ações compartilhadas com as equipes multiprofissionais de saúdedevemser realizadasna APS,por meio da puericultura, consulta infantil feita de forma periódica com intuito de promover saúde.Objetivo:relatar a experiência do profissional nutricionista nas consultas de puericultura realizadasem uma Unidade Básica de Saúde localizada na cidade de Mossoró ­Rio Grande do Norte.Metodologia:estudo descritivo do tipo relato de experiência. Para a coleta de dados, fez-se o uso da observação e do diário de campo através de registros realizados no acompanhamento das consultas de puericultura.Resultados:Foi observado que algumas das crianças atendidas abandonaram o aleitamento materno antes de 1 ano e 6 meses de idade e que a introdução de outros alimentos foi variável e aconteceu de acordo com a quantidade de vezes que a criança mamava, inserindo incialmente frutas e verduras. Foi relatado ainda a dificuldade quanto a quantidade e forma de preparação dos alimentos.Conclusões:receioe desinformaçãodos cuidadoresnessa etapa da vida da criança, ressaltando a importância de uma orientação bem elaborada e individualizada realizada pelos profissionais de saúde, com destaque para a nutrição (AU).

Introduction: Recommended by theWorld Health Organization after six months, complementary feeding deserves special attention in terms of food choice, as this is when eating habits begin to be formed. A follow-up food introduction can lead to allergies, illnesses and lead to nutritional deficit, so monitoring this process is extremely important to ensure growth and development. Shared actions with multidisciplinary health teams should be carried out in the PHC, through childcare, child consultation carried out on a regular basis with the aim of promoting health. Objective: to report the experience of the professional nutritionist in childcare consultations carried out in a Basic Health Unit located in the city of Mossoró -Rio Grande do Norte. Methodology: descriptive study of the experience report type. For data collection, observation and a field diary were used through records made in the follow-up of childcare consultations. Results: It was observed that some of the children assisted abandoned breastfeeding before 1 year and 6 months of age and that the introduction of other foods was variable and happened according to the number of times the child was breastfed, initially introducing fruits and vegetables . It was also reported the difficulty regarding the amount and way of preparing food. Conclusions: receiving and misinformation from caregivers at this stage of the child's life, emphasizing the importance of well-elaborated and individualized guidance provided by health professionals, with emphasis on nutrition (AU).

Introducción: Recomendada por la Organización Mundial de la Salud a partir de los seis meses, la alimentación complementaria merece especial atención en cuanto a la elección de los alimentos, ya que es cuando se empiezan a formar los hábitos alimentarios. Una introducción de alimentos de seguimiento puede provocar alergias, enfermedades y provocar un déficit nutricional, por lo que monitorear este proceso es extremadamente importante para garantizar el crecimiento y el desarrollo. En la APS se deben realizar acciones compartidas con los equipos multidisciplinarios de salud, a través de la atención al niño, la consulta infantil realizada de manera regular con el objetivo de promover la salud. Objetivo: relatar la experiencia del profesional nutricionista en las consultas de puericultura realizadas en una Unidad Básica de Salud ubicada en la ciudad de Mossoró -Rio Grande do Norte. Metodología: estudio descriptivo del tipo relato de experiencia. Para la recolección de datos se utilizó la observación y diario de campo a través de registros realizados en el seguimiento de las consultas de puericultura. Resultados: Se observó que algunos de los niños asistidos abandonaron la lactancia materna antes de1 año y 6 meses de edad y que la introducción de otros alimentos fue variable y ocurrió de acuerdo con el número de veces que el niño fue amamantado, introduciendo inicialmente frutas y verduras. También se relató la dificultad en cuanto a la cantidad y forma de preparación de los alimentos. Conclusiones: recepción y desinformación de los cuidadores en esta etapa de la vida del niño, destacando la importancia de la orientación bien elaborada e individualizada brindada por los profesionales de la salud, conénfasis en la nutrición (AU).

Feeding Practices and Dietary Diversity in the First Year of Life: PreventADALL, a Scandinavian Randomized Controlled Trial and Birth Cohort Study.

BACKGROUND: Breastmik is considered the optimal source of nutrition in early infancy. However, recommendations and practices for when and how complementary food should be introduced in the first year of life vary worldwide. Early introduction of allergenic foods may prevent food allergies, but if early food introduction influences infant feeding practices is less known. OBJECTIVES: We sought to assess infant feeding practices in the first year of life and to determine if early interventional food introduction influences breastfeeding and dietary diversity. METHODS: Dietary intake was assessed in infants from the population-based clinical trial Preventing Atopic Dermatitis and ALLergies (PreventADALL) in children study. A total of 2397 infants were cluster-randomized at birth into 4 different groups: 1) control, 2) skin intervention, 3) introduction to 4 allergenic foods between 3 and 4 mo of age: peanut, cow milk, wheat, and egg, as small tastings until 6 mo, and 4) combined skin and food interventions. Dietary data were available from at least one of the 3-, 6-, 9-, and 12-mo questionnaires in 2059 infants. In the present analysis, groups 1 and 2 constitute the No Food Intervention group, whereas groups 3 and 4 constitute the Food Intervention group. We used the log-rank test and Cox regression to assess the impact of food intervention on age of breastfeeding cessation. Mixed effects logistic regression was used to compare dietary diversity, defined as the number of food categories consumed, between intervention groups. RESULTS: At 3, 6, 9, and 12 mo, 95%, 88%, 67%, and 51% were breastfed, respectively, and breastfeeding duration was not affected by the food intervention. In the No Food Intervention group, mean age of complementary food introduction was 18.3 wk (confidence interval [CI]: 18.1, 18.5). In the Food Intervention group, the dietary diversity score was 1.39 units (CI: 1.16, 1.62) higher at 9 mo (P < 0.001) and 0.7 units (CI: 0.5, 0.9) higher at 12 mo (P < 0.001) compared to the No Food Intervention group. CONCLUSIONS: Early food intervention did not affect breastfeeding rates and increased dietary diversity at 9 and 12 mo.

Changes in beef protein digestibility in an in vitro infant digestion model with prefreezing temperatures and aging periods.

The protein digestibility of beef at three prefreezing temperatures (freezing at -20 °C, F20; freezing at -50 °C, F50; and freezing at -70 °C, F70) and aging periods (4, 14, and 28 days) was investigated using an in vitro infant digestion model. The increased cathepsin B activity in the frozen-then-aged treatments (P < 0.05) resulted in a higher content of 10% trichloroacetic acid-soluble α-amino groups than in the aged-only group on days 14 and 28 (P < 0.05). F50 had the most α-amino groups in the digesta and digested proteins under 3 kDa on day 28 (P < 0.05), with the disappearance of actin band in the digesta electrophoretogram. The secondary and tertiary structures of myofibrillar proteins revealed that F50 underwent irreversible denaturation (P < 0.05), especially in the myosin fraction, while F20 and F70 showed protein renaturation during aging (P < 0.05). In general, prefreezing at -50 °C then aging can improve the in vitro protein digestibility of beef through freezing-induced structural changes.

Fermented Gluten-Free Multi-Grain Cereal Paste Development: The Role of the Orange-Fleshed Sweet Potato (OFSP) as a Dietary Supplement.

Vitamin A deficiencies is a becoming persistent among young children and a growing concern to parents in sub-Saharan Africa, especially in crisis-affected areas. Fermented cereal paste from maize, millets, and sorghum grains are significant food for young children. Thus, the study focuses on food fortification using orange-fleshed sweet potato (OFSP) as fortifier as studies have confirmed the presence of nutrients that can help meet the Vitamin A dietary requirement. The cereals were soaked ambient temperature (27 ± 1°C) for 72 hours and were blended with OFSP (90:10, 80:20, 70:30, 60:40, 50:50), and the formulated products were studied for Vitamin A, ß-carotene, proximate composition, physicochemical, functional properties, and storage. Application of OFSP as forticant increased the Vitamin A (4.98-6.65 mg/100 g), ß-carotene (0.10-0.17 mg/100 g) and the calorific value (222.03-301.75 kcal) of the gluten-free multi-grain cereal paste. The addition of OFSP also increased the ash content (1.41%-3.35%), crude fiber (2.56%-4.225%), carbohydrate (39.83%-48.35%), total solid content (55.20%-60.87%), and water absorption capacity (112.20%-137.49%) of the formulated cereal samples. The fortified fermented paste was objectively stable throughout on the shelf from the storage studies. The study deduced that addition of orange-fleshed sweet potato to fermented mixed cereal paste as a fortifier can help increase the nutritional quality of the complementary food.

[Effects of the timing of complementary food on infant physical development].

OBJECTIVE: To analyze the timing of supplementary food and its effect on the development of infants at 6-8 months of age. METHODS: A total of 168 breastfed healthy infants in Beijing and Chenzhou were selected and followed up from birth to 8 months of age. According to the time of the first supplementary food addition, the survey subjects were divided into a reasonable supplementary food group and an unreasonable supplementary food group. Repeated measures analysis was used to compare the differences in the Z scores of the two groups of infants. RESULTS: Infants who added complementary food between 4-6 months accounted for 80.4%(n=135). There were 6.0%(n=10) of infants who added complementary food for more than 8 months of age(added too late), and the timing was earlier than 4 months old infants accounted for 6.5%(n=11). The result of repeated measurement analysis showed that the body mass index for age Z score(BAZ) of infants whose complementary foods were added at an unreasonable time was different from that of infants with reasonable complementary food addition(P=0.046). Infants whose complementary food was added at an unreasonable time had higher BAZ at the age of 6 months(ß=0.615, 95%CI 0.053-1.178). CONCLUSION: Few infants add complementary foods too early or too late, and the timing of complementary foods for most infants was between 4-6 months of age. Unreasonable complementary food addition time might have a short-term impact on the infants' BAZ.

Timing of introduction of complementary foods, breastfeeding, and child cardiometabolic risk: a prospective multiethnic Asian cohort study.

BACKGROUND: The timing of introduction of complementary foods and the duration of breastfeeding (BF) have been independently associated with child overweight and obesity; however, their combined influence on body fat partitioning and cardiometabolic risk is unclear. OBJECTIVE: We investigated the associations of the timing of introduction of complementary foods, the duration of BF, and their interaction with child adiposity and cardiometabolic risk markers. METHODS: We analyzed data from 839 children in the prospective Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Mothers reported the age at which infants were first fed complementary foods and BF duration, classified as early (≤4 mo) versus typical (>4 mo) complementary feeding (CF) and short (≤4 mo) versus long (>4 mo) duration of any BF, respectively. We measured adiposity and cardiometabolic risk markers at the age of 6 y and examined their associations with infant feeding patterns using multiple regression, adjusting for sociodemographics, parents' body mass index (BMI), maternal factors, birth weight for gestational age, and infant weight gain. RESULTS: Of 839 children, 18% experienced early CF, whereas 54% experienced short BF. Short (vs. long) BF and early (vs. typical) CF were independently associated with higher z-scores of BMI [ß (95% confidence interval), short BF, 0.18 standard deviation score (SDS) (-0.01, 0.38); early CF, 0.34 SDS (0.11, 0.57)] and sum of skinfolds [short BF, 1.83 mm (0.05, 3.61); early CF, 2.73 mm (0.55, 4.91)]. Children who experienced both early CF and short BF (vs. typical CF-long BF) had synergistically higher diastolic blood pressure [1.41 mmHg (-0.15, 2.97), P-interaction = 0.023] and metabolic syndrome score [0.81 (0.16, 1.47), P-interaction = 0.081]. Early CF-long BF (vs. early CF-short BF) was associated with a lower systolic blood pressure [-3.74 mmHg (-7.01, -0.48)], diastolic blood pressure [-2.29 mmHg (-4.47, -0.11)], and metabolic syndrome score [-0.90 (-1.80, 0.00)]. CONCLUSIONS: A combination of early CF and short BF was associated with elevated child adiposity and cardiometabolic markers. Longer BF duration may protect against cardiometabolic risk associated with early CF. This trial was registered at clinicaltrials.gov as NCT01174875.

Association between complementary food introduction before age 4 months and body mass index at age 5-7 years: A retrospective population-based longitudinal cohort study.

BACKGROUND: The optimal time of starting complementary foods (CFs) in infants remains a subject of debate. This population-based longitudinal cohort study evaluated the association between early CF introduction and body mass index (BMI) in children aged 5-7 years. METHODS: The present study included 917,707 children born in Korea during 2008-2009. Initial timing of CF introduction was obtained by questionnaires administered between 4 and 6 months and 9 and 12 months of age. The cohort consisted of 154,565 eligible individuals who properly completed the screening programme, including structured questionnaires, anthropometric measurements and physical examinations. To balance baseline characteristics, children were subjected to propensity score matching based on 95 covariates, including indicators of baseline health such as perinatal condition, birth weight, economic status, clinical disease and drug exposure. Exposure was defined as introduction to CF at age < 4 months, and outcomes were overweight (BMI z-score > 85th percentile) and obesity (BMI z-score > 95th percentile) at ages 5-7 years. RESULTS: Of the 154,565 eligible children in the observed cohort, 10,499 (6.8%) were introduced to CF at age < 4 months and 144,066 (93.2%) at age ≥ 4 months. Propensity score matching yielded 9680 children introduced to CF at age < 4 months and 35,396 at age ≥ 4 months. The risk for being overweight or obese at age 5-7 years was slightly higher among those who started CF at age < 4 months than at age ≥4 months (adjusted relative risk = 1.06; 95% confidence interval = 1.02-1.09). A similar but stronger association was observed for being obese at age 5-7 years (adjusted relative risk = 1.12; 95% confidence interval = 1.05-1.19). CONCLUSIONS: Early CF introduction before age 4 months was associated with increased BMI at age 5-7 years.

Adherence to different methods for introducing complementary food to 7-month-old babies: a randomized clinical trial / Adesão a diferentes métodos de introdução da alimentação complementar aos 7 meses de vida: um ensaio clínico randomizado

Abstract Objective: To assess the adherence to three methods of food introduction for 7-month-old babies. Methods: This is a randomized clinical trial conducted with mother-infant pairs, submitted to the intervention with five and a half months of age and three different methods for food introduction according to randomization: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), or mixed (specially developed for this study). Adherence to the method was assessed at the seventh month of age, via telephone call to the caregiver by a researcher blinded to the method. The analyses were performed using the Chi-Square test and data are presented in absolute numbers and percentages. Results: A total of 139 mother-infant pairs were evaluated; 46 of them were allocated to the PLW method; 47, to the BLISS; and 46, to the mixed. At seven months of age, 60 (43.2%) mothers reported that the infants were following the proposed feeding method. When analyzing each approach, the mixed method showed a higher likelihood of adherence (71.7%, n=33), followed by the PLW method (39.1%, n=18) and by the BLISS (19.2%, n=9) (p<0.001). Among the sample that did not follow the proposed method, those that had been randomized to the PLW and BLISS methods mostly migrated to the mixed method (92.9%; n=26 and 92.1%; n=35, respectively) (p<0.001). Conclusions: Complementary feeding in a mixed approach obtained greater adherence in 7-month-old babies.

RESUMO Objetivo: Avaliar a adesão a três métodos de introdução alimentar aos 7 meses de vida. Métodos: Ensaio clínico randomizado com pares mães-lactentes submetidos à intervenção aos 5 meses e meio de vida sobre três diferentes métodos de introdução alimentar, conforme randomização: tradicional, Baby-Led Introduction to SolidS (introdução de sólidos guiada pelo bebê, em português) ou misto (criado especialmente para este estudo). A adesão ao método foi avaliada aos 7 meses em ligação telefônica feita para o cuidador por pesquisador cego em relação ao método. As análises foram realizadas por teste do qui-quadrado e os dados apresentados em número absoluto e percentual. Resultados: Foram avaliados 139 pares mães-lactentes, 46 alocados no método tradicional, 47 no Baby-Led Introduction to SolidS e 46 no misto. Aos 7 meses, 60 (43,2%) mães relataram que seus lactentes seguiam o método alimentar proposto. Analisando-se cada abordagem, o método misto apresentou maior probabilidade de adesão (71,7%, n=33), seguido do tradicional (39,1%, n=18) e de introdução de sólidos guiada pelo bebê (19,2%, n=9) (p<0,001). Da amostra que não seguiu o método proposto, aqueles que haviam sido randomizados para os métodos tradicional e de introdução de sólidos guiada pelo bebê migraram majoritariamente para o misto (92,9%; n=26 e 92,1%; n=35, respectivamente) (p<0,001). Conclusões: A alimentação complementar em abordagem mista obteve maior adesão aos 7 meses de idade.