Micronutrient intake and the probability of nutrient adequacy among children 9-24 months of age: results from the MAL-ED birth cohort study.

Da Antiporta,B Maciel,A Turab,C Patil,Le Caulfield,Tc Mahopo,A Bauck,M Islam,A Bose,Bjj Mccormick,R Ambikapathi,Mp Olortegui

doi:10.1017/s1368980020000877

Abstract

To estimate the total energy and micronutrient intakes of children 9-24 months of age and evaluate the probability of adequacy (PA) of the diet in seven MAL-ED sites. Cohort study. Food intake was registered monthly using 24-h recalls beginning at 9 months. We estimated PA for thirteen nutrients and overall mean PA (MPA) by site and 3-month periods considering estimated breast milk intake. Seven sites in Asia, Africa and Latin America. 1669 children followed from birth to 24 months of age. Median estimated %energy from breast milk ranged from 4 to 70 % at 9-12 months, and declined to 0-39 % at 21-24 months. Iron bioavailability was low for all sites, but many diets were of moderate bioavailability for zinc. PA was optimal for most nutrients in Brazil and South Africa, except for iron and vitamin E (both), calcium and zinc (South Africa). PA for zinc increased only for children consuming a diet with moderate bioavailability. MPA increased 12-24 months as the quantity of complementary foods increased; however, PA for vitamin A remained low in Bangladesh and Tanzania. PA for vitamins D and E and iron was low for most sites and age groups. MPA increased from 12 to 24 months as children consumed higher quantities of food, while nutrient density remained constant for most nutrients. Ways to increase the consumption of foods containing vitamins D, E and A, and calcium are needed, as are ways to increase the bioavailability of iron and zinc.

Highlights

The enrolment WAZ of infants ranged from –1·41 (PKN) to 0·07 (BRF), and 48–50 % were female across the sites. They were born to mothers with mean age ranging from 24 years (INV) to 29 years (TZH), and median parity of two in most sites, but three in PKN and four in TZH
With 16–17 recalls per child, we quantified the intakes of non-breast milk foods, estimated the contribution of energy and micronutrients from breast milk, and utilised approaches to derive the estimates of usual nutrient intakes of children from 9 to 24 months of age
In general, the nutrient density of non-breast milk foods did not increase as children aged from 9 to 24 months

Summary

Introduction

The objectives of this study were to quantify the micronutrient intakes of these children, estimate the nutrients provided by breast milk (among those breastfed), and evaluate the overall probability of micronutrient adequacy of the diet over time. The majority of children in each site were breastfed for 18–24 months; to estimate the adequacy of their total dietary intake, energy and nutrient intake from breast milk needed to be accounted for.

Results

Conclusion