Global patterns show that worldwide obesity has more than doubled since 1980, 65% of world’s population live in countries where overweight & obesity kills more people than underweight. Nearly 43 million children under the age of five are overweight. In India diabetes has become a problem school based data reflects that obesity range 5.6% to 24% for children and adults while 10% population are cardiac patients, myocardial infarction among executives is l0 years ahead of global average age. There are various factors that cause metabolic stress like cholesterol, bacteria germs toxins etc. These problems of obesity mostly start from childhood. There are many adulthood diseases that are related to complimentary feeing. These depend on non-modifiable like parental factors, race and ethnicity, genetics and gender, and modifiable factors like lifestyle, dietary habits, breastfeeding and parental factors.
Complimentary feeding needs to be looked in two dimensions, firstly to prevent malnutrition, and nutrient and micronutrient deficiency leading to disease and death and secondly to prevent emerging lifestyle diseases in child and adult population and auto immune/allergies in adult population. Nutrition programming for adult health starts before birth as intra uterine programming and extra uterine programming. At birth breast milk is the dynamic food that facilitates complementary feeding. The advantages of breast feeding have been well documented; it exposes the baby to mothers’ dietary flavours and to poly flavours.
The domains of complementary feeding are time of initiation, methods of feeding and food discipline. The ideal time of feeding has been determined as 6 months by WHO, AAP, IAP etc. Complementary feeding techniques to be adopted are primarily determined by developmental milestones and odentogenisis or the development of teeth. The evolution of food habits and discipline also depends on external and internal feedback. The right food discipline can be taken care by regulation intake of food and energy, dining table culture and mannerisms and food acceptance and food preference of kids.
Special senses like taste and olfaction are also determinants of taste and appetite. Sense of olfaction develops in intrauterine period for example conditioning of the baby to smell of amniotic fluid facilitates latching to the breast. Taste, palatability and satiety are factors that determine food choices and eating habits. Palatable foods are one with high sugar and high fat like ice cream and cakes they are easily liked by kids. Satiating foods are one with high protein, fibre and water like porridges and fish which are not liked by kids. Some ideal food habits are to take the child to the dining table between 9 months to 1 year, infant/toddler should feed with family members on the dining Table and infants / toddler watch parents and learn eating techniques and habits.
The complimentary feeds should have low Glycemic index and Glycemic Load. Cereals like rice have higher GI and GL. Grains, oats, vegetables, barley have low GI and GL. Sprouting lowers GI and GL creamed porridges have medium GI and low GL especially if prepared from whole cereal / grains.
It needs to be remembered that prevention of adult onset energy balance disorders starts with promotion of breast feeding and continues with process of complementary feeding.