Abstract
Children aged <2 years should not be given meals with the addition of salt and sugar due to health risks and to promote healthier dietary habits. The aims of this study were: to assess the prevalence of the use of added salt (AS), sugar (ASu) and both salt and sugar (AS&Su) in the diets of Polish and Austrian toddlers aged 12–24 and 25–36 months; to explore the sociodemographic and early nutritional factors associated with the use of AS and ASu; to investigate the difference in dietary habits and maternal concerns about toddlers’ eating regarding the use of AS and ASu in toddlers’ diet. This cross-sectional anonymous study was conducted in 5893 mothers of children aged 12–36 months, recruited through social media in 2017–2019. The questionnaire consisted of questions about sociodemographics, early feeding practices and current children’s nutrition (e.g., use of AS and ASu, food frequency questionnaire). Multivariate logistic regression and cluster analyses were applied. Austrian mothers more often used AS than mothers from Poland (at 2 years old: 74.8% vs. 52.8%; at 3 years old 87.4% vs. 74.4%, p ≤ 0.001), however Polish mothers were more prone to use ASu (at 2 years old: 34.7% vs. 27.7%; at 3 years old: 59.0% vs. 45.8%, p ≤ 0.001). In younger toddlers (12–24 months), the odds of using of AS, ASu, and AS&Su increased with toddlers’ age, when the mother was a multipara, was not currently breastfeeding, or had exclusively breastfed for 4–5 months. This risk decreased when older toddlers (25–36 months) were introduced to solids by baby-led weaning (BLW). Toddlers from both countries who consumed meals with AS or ASu more often a followed Western-like dietary pattern. Our study emphasizes the need for parental nutritional education when beginning to introduce solid foods.
Highlights
The first 1000 days of children’s intensive growth and development are pivotal times during a life course
We found that shorter duration of exclusive breastfeeding and lack of any or current breastfeeding, as well as traditional spoon-feeding, may increase the risk of use of added salt, sugar, or both of them, whereas introducing solids using the baby-led weaning (BLW) method may decrease it
Alarming is that non-compliance with salt and sugar recommendations was related to other unhealthy feeding practices and poorer dietary habits (Western-like vs. pro-health dietary patterns) during infancy and toddlerhood
Summary
The first 1000 days of children’s intensive growth and development are pivotal times during a life course. According to the Developmental Origins of Health and Disease hypothesis (DOHaD), environmental exposures during prenatal life, infancy and toddlerhood can modify the risk of many metabolic and non-communicable diseases in further life [1]. This time is considered a sensitive period for establishing healthy dietary habits [2]. Breastfeeding, complementary feeding, parental feeding practices, and social and family environment, play a crucial role in the development of children’s food preferences, attitudes, and dietary patterns [2,3,4]. Public Health 2020, 17, 5025; doi:10.3390/ijerph17145025 www.mdpi.com/journal/ijerph
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