Abstract
BackgroundWhat we eat as infants and children carries long-term consequences. Apart from breastfeeding, the composition of the complementary diet, i.e. the foods given to the infant during the transition from breast milk/infant formula to regular family foods affects the child’s future health. A high intake of protein, a low intake of fruits, vegetables and fish and an unfavorable distribution between polyunsaturated and saturated fats are considered to be associate with health risks, e.g. obesity, type 2 diabetes and dyslipidemia later in life.MethodsIn a randomized, controlled study from 6 to 18 months of age we will compare the currently recommended, Swedish complementary diet to one based on Nordic foods, i.e. an increased intake of fruits, berries, vegetables, tubers, whole-grain and game, and a lower intake of sweets, dairy, meat and poultry, with lower protein content (30% decrease), a higher intake of vegetable fats and fish and a systematic introduction of fruits and greens. The main outcomes are body composition (fat and fat-free mass measured with deuterium), metabolic and inflammatory biomarkers (associated with the amount of body fat) in blood and urine, gut microbiota (thought to be the link between early diet, metabolism and diseases such as obesity and insulin resistance) and blood pressure.We will also measure the participants’ energy and nutrient intake, eating behavior and temperament through validated questionnaires, acceptance of new and unfamiliar foods through video-taped test meals and assessment of cognitive development, which we believe can be influenced through an increased intake of fish and milk fats, notably milk fat globule membranes (MFGM).DiscussionIf the results are what we expect, i.e. improved body composition and a less obesogenic, diabetogenic and inflammatory metabolism and gut microbiota composition, a more sustainable nutrient intake for future health and an increased acceptance of healthy foods, they will have a profound impact on the dietary recommendations to infants in Sweden and elsewhere, their eating habits later in life and subsequently their long-term health.Trial registrationNCT02634749. Registration date 18 December 2015.
Highlights
Introduction of complementary feedingThe switch from the liquid diet of the young infant to the mixed diet of the older infant or toddler is a gradual process
The positive effects of breastfeeding are well known [2], but less is known about how different types and timing of introduction of complementary foods, i.e. the foods used during the transition from breastfeeding or formula-feeding to family foods affect short- and long-term health [3]
From around 4–6 mo. of age eating habits of infants start to change from a liquid diet of breast milk or infant formula to a more diversified diet, mixing breast milk or formula with increasing amounts of solid foods, ending with the child eating the same food as the rest of the family
Summary
Introduction of complementary feedingThe switch from the liquid diet of the young infant to the mixed diet of the older infant or toddler is a gradual process. The dishes will be given as small taste meals to the participating infant when the parents feel it prudent to start offering the infant other foods besides breast milk or formula and the infant is deemed ready by the parent This time-point is to be chosen by the parents themselves. Of age eating habits of infants start to change from a liquid diet of breast milk or infant formula to a more diversified diet, mixing breast milk or formula with increasing amounts of solid foods, ending with the child eating the same food as the rest of the family During this time of complementary feeding, demands for energy and nutrients remain high, especially during the second half of the first year of life. All data collected will be regarded as confidential and stored electronically in coded format according to the Swedish Personal Data Act (1998:204) and the European Union General Data Protection Regulation (EU 2016/679), but paper copies of forms will be kept as well
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