Monday, March 10, 2014
Just as Hurricane Sandy reminds us that nature controls our environment and our lives, we need to remember that babies rely upon others for nutrients, at least until they are able to forage for food themselves. A new paper in the European Journal of Clinical Nutrition discusses the importance of nutrient adequacy of young children’s diet.
The WHO prescribes that correlative nourishment be acquainted with all newborn children at age 6 months and that breastfeeding be proceeded until age 18–24 months. Starting at age 6 months, integral nourishment ought to be pureed, mashed, or semisolid, however by age 12 months the kid ought to have the capacity to consume robust nourishments that are eaten by the family. Meat, poultry, fish, or eggs ought to be incorporated as frequently as one could.
However, in low-income countries, their diet is usually dominated by cereal-based porridges with low nutrient density and poor mineral bioavailability. Complementary feeding diets typically fall short in iron and zinc and sometimes in other nutrients.
WHO (World Health Organization) recommends exclusive breast feeding for the first 6 months of life with the introduction of complementary foods from 6 to 24 months of age. This 18-month interval is the largest part of the “1000 days” encompassing pregnancy and the first 2 years after birth, now viewed as the key window of opportunity for preventing under nutrition and its long-term adverse consequences.
Vossenaar and colleagues identify nutrient gaps facing Guatemalan infants. They modeled intakes for Guatemalan infants using growth estimates from their communities. They found that recommended nutrient intakes were not met for over half of the nutrients of interest. For girls, 6 or more nutrients (thiamin, riboflavin, niacin, calcium, iron and zinc) were inadequate at 7-9 months of age. The authors write that fortification of the foods consumed from 6-24 month is a requisite for assuring consumption of the recommended amounts of micronutrients.
This study builds upon an earlier publication by Vossenaar and Solomons where pediatric practioners and nutrition policy makers to contemplate the need for use of some home fortification or pre-fortified complementary foods to ensure satisfactory micronutrient intakes during the first 24 months of life.
Another potentially limiting nutrient that has previously been neglected is potassium. Like phosphorus, potassium is a building block of body tissue and hence essential for growth. The estimated intake of potassium from grain/legume-based diets used in emergency settings is only 62–71% of the recommended intake at 6–11 months of age, and even more deficient at 12–23 months of age depending on which value for recommended intake is used.
And maternal nutrition during pregnancy and lactation should not be overlooked. Roberfroid and colleagues have reported that children whose mothers received UNICEF/WHO multiple micronutrient supplementation had a 27% reduction in rate of stunting during the first months of age.
There is growing recognition that infants and young children need complementary foods that have very high nutrient density. This is especially true at 6-12 months and particularly for iron and zinc. But the reality is that in low-income populations, infant diets are usually dominated by cereal-based porridges with low nutrient density. The phytate in grains and legumes compounds the problem by reducing absorption of iron, zinc, calcium, and phosphorus. Most complementary food diets will fall short in iron and zinc unless unrealistic amounts of animal-source foods are included daily.