Diet and disadvantage: observations on infant feeding from an inner city

Background: There are few detailed nutritional studies analysing dietary intakes and weaning practices of inner city infants aged 0–12 months. Pasteurized cow's milk (PCM) is not recommended as a main drink until after 1 year of age, although early usage is still common. Premature introduction of pasteurized cow's milk is associated with increased risk of iron deficiency anaemia. Methods: We therefore prospectively examined the dietary effect of early introduction of pasteurized cow's milk on the nutritional intake of 100 infants (mean age at recruitment 7.8 months), whose mothers had already elected to introduce cow's milk before the recommended age of 12 months in a deprived inner city area. In addition, a retrospective questionnaire on feeding practices and food choices was administered and information on parental education and employment was collected, together with a 3-day dietary diary of weighed intakes at recruitment. Results: The results indicate that weaning practices are handed down from family and friends and are intuitive rather than informed. Over 80% of the infants had intakes of iron, zinc and vitamin D below the reference nutrient intake (RNI) and a further 41% had low vitamin C intakes. Prior to introduction of PCM, there was also misuse of infant formula. Twenty per cent added an extra scoop of powder to the feeds, 10% added milk powder to the bottle before addition of water and 30% used microwave ovens to heat the infant bottle. Conclusion: Feeding practices in a deprived inner city area differed substantially from guidelines and infants were at risk of developing nutrient deficiencies as well as poor feeding practices.     

北京市远郊农村地区婴儿营养素补充剂添加现状初探

目的了解北京市远郊农村地区婴儿营养素补充剂添加现状。方法采用北京市疾病预防控制中心统一设计的调查问卷,对婴儿营养素补充剂添加情况进行入户询问调查。结果在调查的127名婴儿中有120名（94.5%）婴儿添加了营养素补充剂,主要添加种类为维生素A、维生素D、钙制剂、锌制剂、铁制剂。以上五类营养素补充剂添加的人数依次为84名（66.1%）、84名（66.1%）、111名（87.4%）、25名（19.7%）和3名（2.4%）,开始添加的平均时间依次为37.2、37.2、42.5、182.3、285.6 d。4~9月龄婴儿维生素A、维生素D、钙制剂平均每人每日的添加量分别为457、11μg和186 mg,10~12月龄婴儿维生素A、维生素D、钙制剂平均每人每日的添加量分别为583.4、10μg和243 mg。结论北京市远郊农村地区婴儿维生素A、D制剂的添加可以满足婴儿对于维生素A、D缺乏病的预防和治疗需要;钙营养素补充剂的添加能否满足婴儿的生长发育需要,还有待于进一步研究。     

The relative validity of a computerized food frequency questionnaire for estimating intake of dietary iron and its absorption modifiers

OBJECTIVE: To determine the relative validity of an iron food frequency questionnaire (iron FFQ) designed to assess intakes of dietary iron and its absorption modifiers. DESIGN: A computer-administered food frequency questionnaire was designed to estimate intake of total, non-haem, haem and meat iron as well as dietary components which influence iron absorption (vitamin C, phytate, calcium, grammes of meat/fish/poultry, tea and coffee) in women consuming a Western diet. The relative validity of the iron FFQ was assessed by comparing its results with those from weighed diet records collected over 11 days. SETTING: Dunedin, New Zealand. PARTICIPANTS: Forty-nine women aged 19-31 y attending the University of Otago. RESULTS: There was good agreement between the iron FFQ and the weighed diet records for median intakes of total iron, non-haem iron, calcium, tea and coffee. For dietary component intakes, correlations between the two methods ranged from 0.39 (for vitamin C) to 0.87 (for coffee) with 0.52 for total iron, and 0.61 for haem iron. In cross-classification with the weighed diet record, the iron FFQ correctly classified between 22% (for vitamin C) and 51% (for phytate) of participants into the same quartile. Actual values for surrogate categories indicated that the questionnaire can clearly differentiate between low and high intakes of all the dietary components assessed. The questionnaire also showed an acceptable level of agreement between repeat administrations (eg a correlation for total iron of 0.65). CONCLUSIONS: The iron FFQ is appropriate for assessing group intakes of total iron, and iron absorption modifiers, in population studies to assess the aetiology and treatment of iron deficiency states in adult women consuming a Western diet. SPONSORSHIP: This research was supported (in part) by a grant from the Health Research Council of New Zealand.     

Risk of suboptimal iron and zinc nutriture among adolescent girls in Australia and New Zealand: causes,consequences, and solutions

Surveys in Australia, New Zealand and other industrialised countries report that many adolescent girls have dietary intakes of iron and zinc that fail to meet their high physiological requirements for growing body tissues, expanding red cell mass, and onset of menarche. Such dietary inadequacies can be attributed to poor food selection patterns, and low energy intakes. Additional exacerbating non-dietary factors may include high menstrual losses, strenuous exercise, pregnancy, low socioeconomic status and ethnicity. These findings are cause for concern because iron and zinc play essential roles in numerous metabolic functions and are required for optimal growth, immune and cognitive function, work capacity, sexual maturation, and bone mineralization. Moreover, if adolescents enter pregnancy with a compromised iron and zinc status, and continue to receive intakes of iron and zinc that do not meet their increased needs, their poor iron and zinc status could adversely affect the pregnancy outcome. Clearly, intervention strategies may be needed to improve the iron and zinc status of high risk adolescent subgroups in Australia and New Zealand. The recommended treatment for iron deficiency anaemia and moderate zinc deficiency is supplementation. Although dietary intervention is often recommended for treating non-anaemic iron deficiency and mild zinc deficiency, it is probably more effective and appropriate for prevention than for the treatment of suboptimal iron and zinc status. Many of the strategies for enhancing the content and bioavailability of dietary iron are also appropriate for zinc.     

Iron deficiency and risk factors for lower iron stores in 6-24-month-old New Zealanders

OBJECTIVES: To determine the prevalence of biochemical iron deficiency and identify factors associated with ferritin levels among 6-24-month-old urban South Island New Zealand children. DESIGN: Cross-sectional survey conducted from May 1998 to March 1999. SETTING: The cities of Christchurch, Dunedin and Invercargill. SUBJECTS: A total of 323 randomly selected 6-24-month-old children participated (response rate 61%) of which 263 provided a blood sample. METHODS: A complete blood cell count, zinc protoporphyrin, serum ferritin and C-reactive protein were measured on nonfasting venipuncture blood samples, 3-day weighed food records and general questionnaire data were collected. RESULTS: Among children with C-reactive protein<10 mg/l (n=231), 4.3% had iron deficiency anaemia, 5.6% had iron deficiency without anaemia, and 18.6% had depleted iron stores, when a ferritin cutoff of < or =12 g/l was used. Age (negative), sex (girls>boys), ethnicity (Caucasian>non-Caucasian), weight-for-age percentiles (negative) and birth weight (positive) were associated with ferritin after adjusting for infection and socioeconomic status. When current consumption of iron fortified formula and >500 ml of cows' milk per day were included, these were associated with a 22% increase and 25% decrease in ferritin, respectively (R2=0.28). CONCLUSIONS: The presence of suboptimal iron status (29%) among young New Zealand children is cause for concern, even though severe iron deficiency is rare, because children with marginal iron status are at risk of developing severe iron deficiency if exposed to a physiological challenge.     

Iron status and anaemia in preschool children in Sydney

Abstract: The purpose of this study was to determine the iron status of preschool children in Sydney. We assessed 678 children aged 9 to 62 months living in 32 randomly selected census collection districts in central and southern Sydney for iron status using plasma ferritin; of these 678 children, 542 had zinc protoporphyrin tests, red cell indices and haemoglobin tests. Risk factors for iron deficiency were assessed by an administered questionnaire. Overall, the prevalence of iron depletion was 10.5 per cent, iron deficiency 2.8 per cent and iron deficiency anaemia 1.1 per cent. The 24-to-35-month age group (176 children) had the highest prevalence of iron deficiency anaemia of 3.0 per cent, although iron depletion (18.7 per cent) and iron deficiency (5.4 per cent) were highest among the 9-to-23-month age group (182 children). Low iron status was related to age of under 24 months (odds ratio (OR) 2.86, 95 per cent confidence interval (CI) 1.72 to 4.76). After adjustment for this age effect, the consumption of red meat fewer than four times a week was significantly associated with iron depletion (OR 2.27, CI 1.25 to 4.17) and there was a tendency for children who were being given a vitamin supplement to be less likely to be iron depleted (OR 4.00, CI 0.95 to 16.67). Iron deficiency and iron deficiency anaemia do not represent a major public health problem in preschool children in Sydney. However, for children in the age range of 12 to 36 months there is scope for interventions to further reduce the prevalence of iron deficiency anaemia.     

Modified Version of Baby-Led Weaning Does Not Result in Lower Zinc Intake or Status in Infants: A Randomized Controlled Trial

Background

Little is known about zinc intakes and status during complementary feeding. This is particularly true for baby-led approaches, which encourage infants to feed themselves from the start of complementary feeding, although self-feeding may restrict the intake of zinc-rich foods.

深圳6～36月龄儿童营养状况与微营养素摄入情况分析

目的了解深圳6～36月龄儿童体格发育、营养状况、微营养素摄入情况,分析两者之间的关系。方法2012年3月至9月,采用首都儿科研究所制定的24小时膳食调查问卷询问318名主要养育人关于儿童过去24小时的膳食情况,同时测定儿童体重、身长,未梢血血红蛋白和微量元素锌、铜、镁、钙、铁。结果儿童轻度低体重发生率为5．97％,生长迟缓发生率为1．89％,超重发生率为14．47％,肥胖发生率为5．35％。轻度贫血发生率16．04％,1例中度贫血。锌缺乏发生率为78．1％,铁缺乏发生率为13．5％,铜、钙和镁未见异常。锌、血红蛋白量随年龄增长而增高,差异有统计学意义（F=9．938、28．543,均P〈0．05）。6～12月龄组缺锌和贫血发生率较其他年龄组高,差异有统计学意义（χ2=10．680、28．166,均P〈0．05）。膳食矿物质锌、铁摄入量明显低于推荐摄入量或适宜摄入量;添加辅食的月龄大（OR=1．384,P=0．003）、摄入的零食种类多（OR=1．749,P=0．046）为缺锌的危险因素。身高为中上及以上的儿童,膳食维生素c、钙、母乳摄入量较身高低于中上的儿童多,差异有统计学意义（t值分别为2．10、1．90、2．04,均P〈0．05）。结论深圳6～36月龄儿童的轻度贫血、锌缺乏症、肥胖和超重问题较多。坚持母乳喂养,及时添加辅食,注重营养均衡,特别是合理摄入微营养素,有利于预防营养性疾病,促进生长发育。     

Usual Nutrient Intake Distribution and Prevalence of Inadequacy among Australian Children 0–24 Months: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

(1) Background: Breastmilk provides all the nutrition an infant requires between 0–6 months. After that, complementary foods are needed to meet the child’s increasing energy and nutrient requirements. Inadequate energy and nutrient intake may lead to growth faltering, impaired neurodevelopment, and increased disease risk. While the importance of early life nutrition is well recognized, there are few investigations assessing the nutritional adequacy of Australian children <24 months. Here, we describe usual energy and nutrient intake distributions, including the prevalence of inadequate intakes and exceeding the upper limit (UL), in a national sample of Australian children 6– 24 months and infants < six months who had commenced solids and/or formula. (2) Methods: Dietary intakes were assessed using a one-day food record for 976 children with a repeat one-day record in a random subset. (3) Results: Based on the Nutrient Reference Values for Australia and New Zealand, children’s intakes were above the Adequate Intake or Estimated Average Requirement for most nutrients. Exceptions were iron and zinc where the prevalence of inadequacy was estimated to be 75% and 20%, respectively, for infants aged 6–11.9 months. Low iron intake was also observed in one quarter of toddlers 12–24 months. On average, children consumed 10% more energy than predicted based on Estimated Energy Requirements, and ~10% were classified as overweight based on their weight for length. One third of toddlers exceeded the tolerable upper limit for sodium and consumed > 1000 mg/day. Of the children under six months, 18% and 43% exceeded the UL for vitamin A (retinol) and zinc. (4) Conclusions: Compared to nutrient reference values, diets were sufficient for most nutrients; however, iron was a limiting nutrient for infants aged 6–11.9 months and toddlers 12–24 months potentially putting them at risk for iron deficiency. Excessive sodium intake among toddlers is a concern as this may increase the risk for hypertension.     

Intake and blood levels of some minerals in an elderly Chinese population

Twenty-four hour intakes of potassium, calcium, and iron, and plasma concentration of potassium, copper and zinc were determined in a cluster sample of 400 apparently healthy subjects aged 60 years and over living in the community. Potassium and calcium intakes were lower in older men and lower in men compared to women. Both were much lower than intakes reported among Caucasian elderly, while iron intakes are comparable. Plasma potassium concentration was lower than values from studies of all ages and from studies of Caucasian elderly subjects. Copper and zinc concentrations were comparable to published values for adults of all ages. The significance of low potassium and calcium intake among elderly subjects in the population is discussed.     

Mineral content of colostrum and mature milk of lactating Nigerian women as influenced by stage of lactation

380 milk samples (96 colostrum and 284 mature milk samples) collected from 240 lactating Nigerian women within the first 9 months of lactation were analyzed for zinc, copper, iron, calcium, and magnesium concentrations by atomic absorption spectrophotometry. Mean levels of zinc, copper, iron, calcium, and magnesium in colostrum were 5.83, 0.52, 0.55, 400, and 33 mcg/ml, respectively; the levels for the same minerals in mature milk collected in the 8th and 12th week of lactation were 3.08, 0.29, 0.38, 300, and 31 mcg/ml, respectively. While milk levels of all minerals decreased with increase in lactation age, zinc levels showed the fastest rate of decrease. Milk zinc levels at the 9th month were only 13% of that in colostrum. Similar percentages for copper, iron, calcium, and magnesium were 49, 60, 34, and 74%, respectively. Estimates of intake by solely breastfed infants during the first 6 months showed gross inadequacies when compared with Recommended Daily Allowances. Results suggest the need for early supplementation, especially as zinc deficiencies as well as a high incicdence of iron deficiency anemia has been reported in Nigerian infants.     

Nutritional status of infants aged 4 to 18 months on macrobiotic diets and matched omnivorous control infants: a population-based mixed-longitudinal study. I. Weaning pattern, energy and nutrient intake

Information on food intake during weaning was collected as part of a mixed-longitudinal study on the nutritional status and growth of the 1985 Dutch birth cohort of infants on macrobiotic diets (n = 53) and a matched control group on omnivorous diets (m = 57). Weighed food records over 3d, including breast-milk, were obtained on 49 macrobiotic and 57 control infants at 2-monthly intervals between the ages of 6 and 16 months. Intake of energy and nutrients was calculated using the Dutch food composition table which was supplemented by our own analyses of 50 macrobiotic foods. Ninety-six per cent of the macrobiotic infants and 74 per cent of the control infants had been breast-fed, but breast-feeding continued longer in the macrobiotic group (13.6 vs 6.6 months, P less than 0.001). In the macrobiotic group, complementary feeding started at 4.8 months with water-based cereal porridges, followed later by vegetables, sesame seeds and pulses. Fruits were rarely given and products of animal origin were avoided. For all age groups combined, the intake of energy, protein, fat, calcium, riboflavin and vitamin B12 was significantly lower in the macrobiotic infants, whereas their intake of polysaccharides, fibre, iron and thiamin was higher than that of the control infants. The macrobiotic weaning diet tended to be bulky with a low energy density (2.4 kJ/g, controls: 3.4 kJ/g, P less than 0.05) and a high fibre content. Protein intake of the macrobiotic infants was only 80 per cent of the Dutch recommended daily intakes at the age of 6-8 months, and at 8 months, 69 per cent of this was derived from plant sources. Calcium intake was 280 mg/d; correction for calcium derived from hard tap-water raised the calcium intake to 308 mg in the macrobiotic age group of 14 months. The evidence of biochemical deficiencies of iron, riboflavin, vitamin B12, vitamin D and calcium is discussed. It is suggested that the macrobiotic diet should be supplemented with fat, fatty fish and dairy products.     

Studies of the relationship between the nutritional status of lactating mothers and milk composition as well as the milk intake and growth of their infants in Beijing. Pt. 5. Essential inorganic elements and vitamins in human milk]

The contents of vitamin A, vitamin B1, vitamin B2, niacin, and vitamin C in the breastmilk of 152 lactating mothers, as well as ash, calcium, phosphorus, magnesium, copper, zinc, and iron in 132 lactating mothers were measured within 6 months of lactation. The results indicated that the breastmilk vitamin B2 and zinc contents of urban mothers in Beijing were significantly higher than those of suburban and rural mothers. However, when lactation continued, the contents of these 2 elements in breastmilk decreased. The correlation analysis of these results showed that the animal protein intakes of the mothers were highly correlated with their breastmilk, vitamin B2, and zinc contents (r=0.75, p0.01 for vitamin B2; r=0.57, p. 0.05 for zinc). The average intakes of all nutrients from breastmilk alone, with the exception of vitamin B2 and vitamin C, could not meet the Chinese RDA for these infants. This was true especially for vitamin B1, niacin, zinc, and iron intakes which were substantially below the RDA. (author's modified)     

A longitudinal study of breastfeeding and weaning practices during the first year of life in Dunedin,New Zealand

OBJECTIVE: To investigate infant feeding practices during the first year of life in a group of white infants in Dunedin, New Zealand. DESIGN: Prospective study of infants from birth to 12 months of age. PARTICIPANTS: A self-selected sample of 74 white mothers and their infants born in Dunedin, New Zealand, between October 1995 and May 1996. Statistical analyses Regression analyses were performed to determine factors associated with successful breastfeeding initiation and duration. RESULTS: Among mothers, 88% (n=65) initiated breastfeeding, 42% (n=31) were exclusively breastfeeding at 3 months, and 34% (n=25) were partially breastfeeding at 12 months. Intention to breastfeed increased the likelihood of successful breastfeeding initiation. Mothers who reported that they did not have enough breastmilk tended to exclusively breastfeed for a shorter period of time. Tertiary education and exclusively breastfeeding at 1 month were associated with a longer duration of breastfeeding. Perception of breastfeeding in public as embarrassing was associated with a shorter duration of breastfeeding. Among infants, 45% (n=33) were given nonmilk foods before 4 months of age, and 69% (n=51) were given unmodified cow's milk as a beverage before 12 months. APPLICATIONS: Breastfeeding rates in this study, although higher than in many Western countries, were still lower than current recommendations. Our findings suggest that women should be taught how to increase their breastmilk supply. Parents should also be informed of the importance of delaying the introduction of nonmilk foods until their infant is 4 to 6 months of age and cow's milk until they are 12 months of age. Society also needs to address the social issue of embarrassment many mothers feel when breastfeeding in public.     

Effect of timing of introduction of complementary foods on iron and zinc status of formula fed infants at 12, 24, and 36 months of age

OBJECTIVE: The timing of introduction of complementary food to an infant's diet is variable throughout the world. Our objective was to determine whether early introduction of complementary foods affects iron and zinc status of formulated infants at 12, 24, and 36 months of age. DESIGN: A randomized, prospective trial was conducted. Infants were randomly assigned to receive either a) early introduction (at 3 to 4 months of age) of commercially prepared or parent's choice of complementary foods; or b) late introduction (at 6 months of age) of commercially prepared complementary foods or parent's choice of complementary foods. In addition to complementary foods, infants were fed commercial infant formula as recommended by their pediatrician. Hemoglobin, mean corpuscular volume, and serum ferritin and zinc concentrations were determined at 12, 24, and 36 months of age. Three-day diet diaries were completed at 3, 6, 12, 18, 24, 30, and 36 months of age. SUBJECTS/SETTING: One hundred seventy-five infants younger than 3 months were recruited by mailings to parents in the Cincinnati area. Of these, 172 were enrolled, 90 in the early-introduction group and 82 in the late-introduction group. One hundred thirty-three infants (n = 67 in the early, n = 66 in the late group) completed the study. STATISTICAL ANALYSES PERFORMED: Student t test and regression analyses were used to determine whether there were group differences and whether there was a relationship between serum parameters and dietary intake. RESULTS: Infants fed complementary foods early had significantly greater iron intakes until 6 months of age; however, there were no differences in the iron status parameters (ferritin, hemoglobin, and mean corpuscular volume) at 12, 24, or 36 months of age. The early introduction group consumed slightly less zinc than the late introduction group at 5 months (4.4 vs 4.8 mg/day, P < .01) and 6 months (4.4 vs 4.7 mg/day, P < .01). At all other times there were no differences between the early and late group in zinc intakes. The serum zinc concentration was not associated with dietary zinc. Both groups had normal serum zinc concentrations at 12, 24, and 36 months and there were no differences between groups. APPLICATIONS/CONCLUSIONS: The iron and zinc status of infants in this study was not influenced by the timing or type of complementary foods introduced. However, the infants were formula fed and the mean iron and zinc intakes that were equal or greater than the Recommended Dietary Allowances for the first 6 months of age.     

Eighteen-month follow-up of infants fed evaporated milk formula.

In parts of Canada including Newfoundland and Labrador and among Aboriginal peoples, infants still consume evaporated milk (EM) formulas for cultural and economic reasons. At 3 and 6 months, full-term infants fed EM (n = 30) received low intakes of iron, thiamine, selenium and had higher weight velocity than breastfed (BF, n = 29) infants. EM infants had greater anemia, lowered transketolase activity (thiamine) and lowered glutathione peroxidase (selenium) activity (p < 0.05). To determine the later effect of early feeding deficit on nutritional status, we examined these same infants at 18 months of age. At that time, there were no differences in dietary intakes of energy, protein, zinc, copper, selenium and iron, nor in plasma levels of zinc, copper, vitamin C, nor in red blood cell activity levels of glutathione reductase (riboflavin), transketolase, glutathione peroxidase, nor in superoxide dismutase. However, EM infants weighed more and were more likely to visit a physician, have anemia, and have iron depletion than were BF infants. We conclude that infants consuming evaporated milk formulas should receive iron supplements throughout infancy.     

Haemoglobin fortified cereal: a source of available iron to breast-fed infants

We tested in the field an extruded rice flour, fortified with a bovine haemoglobin concentrate (Fe:14 mg/100 g of powder). This cereal has a high iron bioavailability, good protein quality and amino acid score. Healthy, term breast-fed infants were prospectively studied. One group (n = 92) received the fortified cereal (from 4 to 12 months of age). As control, 96 infants received regular solid foods (cooked vegetables and meat) from age 4 months. At the end of the field trial, a subsample of infants in both groups was supplemented with 45 mg Fe during 90 d. Iron nutrition status was determined at 9, 12 and 15 months. At 12 months, iron deficiency anaemia was present in 17 per cent of controls, in 10 per cent of fortified infants as a whole, but only in 6 per cent of the babies who consumed over 30 g of cereal/d. In addition, this latter group did not show any significant changes in iron nutrition status after the supplementation trial. Results demonstrate that the consumption of a haemoglobin fortified cereal is effective in markedly reducing the incidence of iron deficiency in breast-fed infants.     

北京市城乡乳母的营养状况、乳成分、乳量及婴儿生长发育关系的研究 Ⅴ.母乳中维生素及无机元素的含量

对北京市产后0～6个月的152名乳母乳汁中维生素A、硫胺素、核黄素、尼克酸及维生素C的含量,以及132名乳母乳中灰分、钙、磷、镁、锌、铜、铁含量进行了测定。所得结果表明,城市母乳中核黄素及锌的含量明显地高于郊区,随着哺乳期的延长,这两种成分的含量也随之有规律的下降。相关性的分析结果证实,乳母的动物蛋白质摄取量与乳中核黄素(r=0.75,P<0.01)及锌(r=0.57,P<0.05)的含量呈明显相关。与供给量相比较,平均每个婴儿每日从母奶中所获得的营养素,除核黄素及维生素C外,均感不足。其中尤以硫胺素、尼克酸、锌和铁严重不足。     

汶川大地震一年后灾区农村60月龄以下儿童的营养状况

目的 了解汶川大地震对受灾地区儿童营养和生长发育状况的影响,以及灾后1年灾区儿童的维生素A、D缺乏及营养性贫血的流行状况及原因.方法 于2009年4月中旬调查了466名灾区农村60月龄以下儿童(其中0～月龄儿童162名,24～59月龄儿童304名)的生长发育状况、贫血发生率,以及24～59月龄儿童的铁缺乏发生率、维生素A、D、B12和叶酸的营养状况,并与2002年中国居民营养与健康状况调查中农村相应年龄儿童的结果进行比较.结果 灾区6月龄以下婴儿的基本纯母乳喂养率仅为58.8%(30/51).在0～23月龄儿童中,1 h内开奶率仅为10.7%(16/150),有92.0%(149/162)的儿童从未使用过营养素补充剂.灾区24～59月龄儿童的谷薯类平均摄入量为(267.2±154.3)g/d,高于2002年全国农村儿童水平(178.75 g/d;u=9.995,P＜0.01);蔬菜、水产和禽肉类的摄入量分别为(63.6±56.7)、(2.6±7.9)和(19.4±24.0)g/d,低于2002年全国农村儿童水平(135.05、8.82和32.23 g/d;u值分别为21.971、13.728和9.321,P值均＜0.01);水果、乳制品和豆类食品的摄入量分别为(102.2±110.8)、(65.2±123.8)和(20.5±29.0)g/d,高于2002年的调查结果(分别为32.81、2.87和6.50 g/d;u值分别为10.919、8.778和8.417,P值均＜0.01).维生素A缺乏和边缘缺乏率分别为15.4%(29/188)和30.3%(57/188),维生素D缺乏和不足合计为92.0%(183/199),0～月龄儿童和24～59月龄儿童的贫血发生率分别为47.5%(77/162)和21.5%(60/279),24～59月龄儿童铁缺乏率为45.7%(86/188),锌缺乏率为65.5%(129/197).儿童的身高发育迟缓,24～59月龄儿童的生长迟缓率为13.6%(38/279).结论 地震影响地区儿童的膳食结构不合理,供热食物和供蛋白质(植物来源)食物的摄入量基本能满足要求,但是存在肉、豆、奶、水产和蔬菜类食物摄入不足.维生素A、D、铁、锌缺乏较为普遍.     

Food Sources of Fiber and Micronutrients of Concern in Infants and Children in the United Arab Emirates: Findings from the Feeding Infants and Toddlers Study (FITS) and the Kids Nutrition and Health Survey (KNHS) 2020

We estimated the usual intakes of fiber, iron, zinc, calcium, folate, vitamin D, and vitamin A and the top foods that contribute to them among children in the UAE. Dietary intake was assessed using 24 h recalls among 5 age groups of infants and children. Foods were clustered into 54 food groups and ranked by their percentage contribution to the nutrients of interest in this study. The percentage achieving the adequate intake (AI) of fiber was negligible among all children. The top source of fiber was vegetables among children under 4 years, and white breads among those over 4 years. Only 45% of infants achieved iron adequacy, but iron standards were met by most children beyond the age of 1. The main contributors to iron intake were infant/young child formula and baby cereal in children under 4 years, while children over 4 years obtained it primarily from grains (fortified) and meat/fish. Vitamin D was inadequate across all age groups, with the percentage achieving adequacy ranging from 0 to 19% among pre-adolescents and toddlers, respectively. The top sources of vitamin D were fortified milks. Overall, nutrient inadequacies in fiber, calcium, and vitamin D highlight the need for greater intakes of whole grains and fortified dairy products in the UAE.