Chapter 22 - Developing science-based dietary guidelines for infants and toddlers

Abstract

Complementary feeding, from 6 to 24months of age, is a critical period for nutrient adequacy as children transition from an exclusively milk based diet to one in which nutrient requirements are met from all food groups. Therefore, evidence-based food-based dietary guidelines (FBDG) are critical to promote optimal nutrition and health in early development. We review the main considerations in establishing quantitative FBDG for infants and toddlers. We also conducted a descriptive analysis evaluating the extent to which existing quantitative FBDG from developed countries align with nutrient reference values (NRVs). Quantitative FBDG from five countries were identified using pre-defined criteria. Seven-day menus were constructed using each FBDG and the nutrient content was compared to global and country-specific NRV. The FBDG could be translated to provide menus adequate in energy and macronutrients. Some of the FBDG translated menus were below NRV for key nutrients (potassium, calcium, zinc, iron, and vitamin D). FBDG developed using linear programming tended to best approximate micronutrient targets. In conclusion, quantitative FBDG for complementary feeding in several countries are not fully aligned with key nutrient requirements. Analytic approaches, such as linear programming, are helpful to guide the development of FBDG, particularly for difficult to reach nutrients.