Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study.

Shan-Xuan Lim,Yap-Seng Chong,Lynette Pei-Chi Shek,Kok-Hian Tan,Linde Van Lee,Jia-Ying Toh,Mary Foong-Fong Chong,Fabian Yap,Keith M Godfrey,Wee-Meng Han

doi:10.3390/ijerph15030488

Abstract

Adequate nutrition during complementary feeding is important for the growth, development and well-being of children. We aim to examine the energy and macronutrient intake composition and their main food sources in a mother–offspring cohort study in Singapore. The diets of infants were assessed by 24 h dietary recalls or food diaries collected from mothers when their offspring were 6 (n = 760), 9 (n = 893) and 12 (n = 907) months of age. Food sources of energy and macronutrients were determined using the population proportion methodology. Energy intakes per day (kcal; mean (standard deviation, SD)) of these infants were 640 (158) at 6 months, 675 (173) at 9 months, and 761 (208) at 12 months. Infant formula, breastmilk and infant cereals were the top three food sources of energy and macronutrient intakes in infants through the period 6 to 12 months. Other main energy and carbohydrate sources at 9 and 12 months of age were rice porridge, infant biscuits and fresh fruits, while fish, red meat and eggs were the other main protein and total fat sources. Breast-fed and mixed-fed infants had a more varied diet as compared to formula-fed infants. Formula-fed infants had consistently higher protein and lower total fat consumption compared to those who were breastfed. An understanding of these main food sources during complementary feeding can inform local dietary recommendations and policies.

Highlights

Complementary feeding or weaning is the process whereby solid foods and other liquids, in addition to milk, are introduced to meet a growing infant’s nutritional requirements [1]
Our results showed that infant formula, breastmilk and infant cereals were the top three food sources of energy through the period 6 to 12 months
Infants at 6, 9 and 12 months of age by identifying the top food sources of energy and macronutrient and differences in these intakes based on the type of milk feed (BF, MF or FF)

Summary

Introduction

Complementary feeding or weaning is the process whereby solid foods and other liquids, in addition to milk, are introduced to meet a growing infant’s nutritional requirements [1]. Macronutrient composition of the early diet are primary factors influencing childhood growth patterns and the subsequent risk of non-communicable diseases [2]. An understanding of the food sources of infants’. Energy and macronutrient intakes is important to enable targeted interventions to improve infants’. There has been a growing interest in examining infants’ nutrient intakes and their food sources in several countries worldwide. The Feeding Infants and Toddlers Study (FITS) in the US and the Maternal Infant Nutrition Growth (MING) Study in China have analysed food sources of nutrients in 6- to 11-month-old infants and reported that infant formula and breastmilk were key contributors to energy intakes [3,4]. The prevalence of macronutrient inadequacy was reported to be low in 6 to

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