Food consumption markers and minimum dietary diversity in different complementary feeding methods: a randomized clinical trial
DOI:
https://doi.org/10.12957/demetra.2023.67882Keywords:
Infant Nutrition. Diet Healthy. Eating. Minimum Dietary Diversity. Complementary Feeding. Infant and Young Child Feeding. Child Nutrition. Food Intake Markers.Abstract
Objective: To evaluate food consumption markers and minimum dietary diversity in 12-month-old infants exposed to different methods of food introduction. Methods: A randomized clinical trial with mother-infant pairs undergoing intervention on food introduction in three methods: Parent-Led Weaning (PLW), Baby-Led Introduction to SolidS (BLISS), and mixed (combination of the two techniques). Food consumption markers were evaluated by an online questionnaire at 12 months based on food consumed the previous day, using food consumption markers for children under 2 years of the Food and Nutrition Surveillance System. The study was approved by the ethics committee. Results: At 12 months, 136 children were evaluated: 45 allocated to PLW, 48 to BLISS, and 43 to mixed. The foods with the highest prevalence of consumption were breast milk 103 (75.7%), vegetables 122 (89.7%), meat 135 (99.3%), beans 115 (84.6%), rice, potatoes, or yam 135 (99.3%). Ultra-processed foods were present in the diet of infants, including hamburgers or sausages 3 (2.2%), sweetened beverages 2 (1.5%), instant noodles 4 (2.9%), and sandwich cookies 2 (1.5 %). No differences were found between the methods of introducing complementary feeding. The minimum dietary diversity was present in the diet of 22 infants (16.2%), being: 6 (13.3%) in the PLW, 8 (16.7%) in the BLISS, and 8 (18.6%) in the mixed (p=0.793). Conclusion: Breast milk, vegetables, meat, beans, and rice were present in the diet of most infants; however, the prevalence of minimal dietary diversity was low. The consumption of ultra-processed foods was also present in the diet of infants.
Brazilian Registry of Clinical Trials (ReBEC) identification RBR-229scm.
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References
Darling JC, Bamidis PD, Burberry J, Rudolf MCJ. The First Thousand Days: early, integrated and evidence-based approaches to improving child health: coming to a population near you? Arch Dis Child [periodical on line ]. 2020; 105 (9): 837-841. Available at: http://dx.doi.org/10.1136/archdischild-2019-316929
Nandi A, Behrman JR, Kinra S, Laxminarayan R. Early-Life Nutrition Is Associated Positively with Schooling and Labor Market Outcomes and Negatively with Marriage Rates at Age 20-25 Years: Evidence from the Andhra Pradesh Children and Parents Study (APCAPS) in India. J Nutri [serial on line ]. 2018; 148(1): 140-146. Available at: https://doi.org/10.1093/jn/nxx012
Brazil. Ministry of Health. Secretariat of Primary Health Care. Food guide for Brazilian children under 2 years old. Brasilia. 2019 [accessed on March 22, 2022]. Available at: http://189.28.128.100/dab/docs/portaldab/publicacoes/guia_da_crianca_201 9.pdf
Rapley G, Forste R, Cameron S, Brown A, Wright C. Baby-Led Weaning. ICAN Infant child teenager Nutri [periodical on line]. 2015; 7(2): 77-85. Available at: https://doi.org/10.1177/1941406415575931.
Daniels L, Heath A-LM, Williams SM, Cameron SL, Fleming EA, Taylor, BJ, et al. Baby-Led Introduction to SolidS (BLISS) study: a randomized controlled trial of a baby-led approach to complementary feeding. BMC Pediatr [serial on line ]. 2015; 15 (179). Available at: https://doi.org/10.1186/s12887-015-0491-8
Sotero AM, Cabral PC, Silva GAP. Socioeconomic, cultural and maternal demographic factors associated with the dietary pattern of infants. Rev Paul Pediatr [periodical on line ]. 2015; 33(4): 445-452. Available at: https://doi.org/10.1016/j.rpped.2015.03.006
Morison BJ, Heath A-LM, Haszard JJ, Hein K, Fleming EA, Daniels L, et al. Impact of a Modified Version of Baby-Led Weaning on Dietary Variety and Food Preferences in Infants. Nutrients [ online journal ]. 2018; 10:1092p. Available at: https://doi.org/10.3390/nu10081092
Robert R, Creed- Kanashiro H, Marin M, Penny M. Responsive Feeding Is Associated With Minimum Dietary Diversity in Rural Areas of Peru, Nicaragua and Indonesia. curr dev Nutri [periodical on line ]. 2021; 5 (Suppl 2): 682p. Available at: https://doi.org/ 10.1093/cdn/nzab045_064
Spaniol AM, da Costa THM, Bortolini GA, Gubert MB. Breastfeeding reduces ultra-processed foods and sweetened beverages consumption among children under two years old. BMC Public Health [journal on line ]. 2020; 20(1): 330p. Available at: https://doi.org/10.1186/s12889-020-8405-6
Brazil. Ministry of Health. Health Care Department. Guidelines for the evaluation of food consumption markers in primary care. Brasilia. 2015 [accessed March 22, 2022]. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/marcadores_consumo_alimentar_atencao_basica.pdf
Diop L, Becquey E, Turowska Z, Huybregts L, Ruel MT, Gelli A. Standard Minimum Dietary Diversity Indicators for Women or Infants and Young Children Are Good Predictors of Adequate Micronutrient Intakes in 24-59-Month-Old Children and Their Nonpregnant Nonbreastfeeding Mothers in Rural Burkina Faso. J Nutri [serial on line]. 2021; 151(2): 412-422. Available at: https://doi.org/10.1093/jn/nxaa360
Passanha A, Benício MHD, Venancio SI. Characterization of the food consumption of breastfed infants between six to twelve months of age in the state of São paul . Cien Saúde Colet [serial on line ]. 2020. Available at: https://doi.org/10.1590/1413-81232020251.00132018
Adair LS. How could complementary feeding patterns affect the susceptibility to NCD later in life? Nutrition, Metabolism and Cardiovascular Diseases [serial on line]. 2012; 22(10): 765-769. Available at: https://doi.org/10.1016/j.numecd.2012.03.011
Carvalho CA de, Fonseca PC de A, Nobre LN, Silva MA, Pessoa MC, Ribeiro AQ, et al. Factors associated with dietary patterns in the second semester of life. Cien Saúde Colet [serial on line ]. 2020; 25(2): 449-459. Available at: https://doi.org/10.1590/1413-81232020252.12982018
Marinho LMF, Capelli JDCS, Rocha CMM Da, Bouskela A, Carmo CN Do, Freitas SEAP De, et al. Situation of complementary feeding of children between 6 and 24 months assisted in the Basic Health Care Network of Macaé, RJ, Brazil. Cien Saúde Colet [serial on line ]. 2016; 21(3): 977-986. Available at: https://doi.org/10.1590/1413-81232015213.06532015
Nunes LM, Führ J, Belin CHS, Moreira PR, Neves RO, de Brito ML, Morando LA, Mariath AAS, Gomes E, Bernardi JR. Complementary feeding methods in the first year of life: a study protocol for a randomized clinical trial. Trials [ online journal]. 2021; 9; 22(1): 687p. Available at: https://doi.org/ 10.1186/s13063-021-05647-1
Pérez-Ríos M, Santiago-Pérez MI, Butler H, Mourino N, Malvar A, Hervada X. Baby-led weaning: prevalence and associated factors in Spain. Eur J Pediatrician [periodical on line]. 2020; 179 (6): 849-853. Available in: https://doi.org/10.1007/s00431-020-03579-7 .
UNICEF The State of the World's Children 2019. Children, Food and Nutrition: Growing Well in a Changing World. 2019 [accessed on March 22, 2022]. Available at: https://www.unicef.org/reports/state-of-worlds-children-2019
Rowan HM, Brown LA. Differences in dietary composition between infants introduced to complementary foods using Baby-led weaning and traditional spoon feeding. J Hum Nutri Diet. [periodical on line]. 2019; 32, 11–20. Available at: https://doi.org/ 10.1111/jhn.12616
Paramashanti B, Yhona P, Marsiswati M. Individual dietary diversity is strongly associated with stunting in infants and young children. journal chalk Klinik Indonesia [periodical on line ]. 2017; 14(1): 19-26. Available at: https://doi.org/10.22146/ijcn.15989
Passanha A, Benício MHD, Venâncio SI. Determinants of fruits, vegetables, and ultra-processed foods consumption among infants. Cienc e Saúde Coletiva [serial on line]. 2021; 26(1): 209-220. Available at: https://doi.org/10.1590/1413-81232020261.06892019
Pedraza DF, Santos EES dos. Food consumption markers and social context of children under 5 years of age. Cad. Collect Health [serial on line ]. 2021; 29(2): 163-178. Available at: https://doi.org/10.1590/1414-462X202129020072
Afolabi KA, Afolabi AO,Omishakin M YJ. Complementary feeding and associated factors: Assessing compliance with recommended guidelines among postpartum mothers in Nigeria. Population Medicine [journal on line]. 2021; 3:17. Available at: https://doi.org/10.18332/popmed/138939
Mulokozi G, Beckstead E, Jensen M, Baldauf M, Smith J, Dearden K, et al. Infant and Young Child Feeding Practices in Tanzania: The Impact of Mass Media and Interpersonal Communication. Current Developments in Nutrition [online journal]. 2021; 5(2): 670p. Available at: https://doi.org/10.1093/cdn/nzab045_052
Ali M, Arif M, Shah AA. Complementary feeding practices and associated factors among children aged 6–23 months in Pakistan. PLOS ONE [periodical on line]. 2021; 16 (2): 0247602. Available at: https://doi.org/10.1371/journal.pone.0247602
Facchini LA, Nunes BP, Motta JVS, Tomasi E, Silva SM, Thumé E, et al. Food insecurity in the Northeast and South of Brazil: magnitude, associated factors and patterns of per capita income to reduce inequities. Cad Saúde Pública [serial on line]. 2014; 30: 161-174. Available at: https://doi.org/10.1590/0102-311X00036013
Baldissera R, Issler RMS, Giugliani ERJ. Effectiveness of the National Strategy for Healthy Complementary Feeding in improving infant complementary feeding in a municipality in southern Brazil. Cad Public Health [serial on line]. 2016; 32(9): 1-11. Available at: https://doi.org/10.1590/0102-311X00101315
Olatona FA, Odozi MA, Amu EO. Complementary Feeding Practices among Mothers of Children under Five Years of Age in Satellite Town, Lagos, Nigeria. Food Public Health [journal on line]. 2014; 4(3): 93-98. Available at: http://doi.org/ 10.5923/j.fph.20140403.04
Young AM, Kang Y. Obstetrical Care Is Associated with Child Dietary Diversity in Indonesia: Analysis from Demographic and Health Survey 2015. Current Developments in Nutrition [online journal]. 2020; 4(2): 1108p. Available at: https://doi.org/10.1093/cdn/nzaa054_180
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Copyright (c) 2023 Paula Ruffoni Moreira, Leandro Meirelles Nunes, Bruna Oliveira de Vargas, Erissandra Gomes, Juliana Rombaldi Bernardi

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