Abstract

Vitamin A is essential for growth and development. We investigated whether high consumption of energy-dense nutrient-poor foods in the diets of pre-school children is detrimental to diet quality with respect to vitamin A. Data were collected from 755 children at 18-months and 3½-years, from the Avon Longitudinal Study of Parents and Children, using 3-day unweighed dietary records completed by parents in 1994 and 1996, respectively. Energy, carotene and retinol intakes were calculated. The quality of the diet declined from 18-months to 3½-years with respect to vitamin A. Preformed retinol intakes decreased by −54 μg/day on average (p = 0.003). Carotene intakes were similar at each age although there was a 23% increase in energy intake by 3½-years. Longitudinally those in the highest quartile of intake at 18-months were twice as likely to remain in the highest quartile at 3½-years for retinol (OR 2.21 (95% CI 1.48–3.28)) and carotene (OR 1.66 (95% CI 1.11–2.50)) than to change quartiles. Nutrient-rich core foods provided decreasing amounts of carotene and preformed retinol over time (both p < 0.001). Vegetables and milk contributed the highest proportion of carotene at both ages, but milk’s contribution decreased over time. Milk and liver were the largest sources of retinol. Nutrient-poor foods provided an increased proportion of energy (p < 0.001) with low proportions of both nutrients; however fat spreads made an important contribution. It is recommended that pre-school children should take vitamin supplements; only 19% at 18-months did this, falling to 11% at 3½-years. Care should be taken to choose nutrient-rich foods and avoid energy-dense, nutrient-poor foods when feeding pre-school children.

Highlights

  • Vitamin A is an essential nutrient and plays an important role in the diets of pre-school children

  • We aimed to examine the dietary sources of carotene and retinol in pre-school children in the UK, to determine whether deficiency of intake is likely in this developed country setting

  • Children in the highest quartile of carotene intake at 18-months were 66% more likely to remain in the highest quartile at 31⁄2-years (OR 1.66 (CI 1.11, 2.50)) than to change quartiles

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Summary

Introduction

Vitamin A is an essential nutrient and plays an important role in the diets of pre-school children. It can be obtained naturally in two forms; pre-formed as retinol and as pro-vitamin A (carotenoids) [1,2]. Vitamin A is important for optimal functioning of the immune system, vision, growth and bone development [3] and low intakes can reduce a person‘s ability to fight infections [1]. Some studies have found a link between diets low in beta-carotene and some cancers [5], e.g., a higher intake of green and yellow vegetables associated with a decreased risk of lung cancer [6]. There is some evidence that large intakes of retinol can adversely affect the action of vitamin D in the uptake of calcium in the bones [9]

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