Feeding Infants And Toddlers Study Research Articles

P14-035-23 Eating Occasion Frequency for Infants and Young Children Differs From That of Older Children and Adults: Data From the 2016 Feeding Infants and Toddlers Study (FITS)

P14-035-23 Eating Occasion Frequency for Infants and Young Children Differs From That of Older Children and Adults: Data From the 2016 Feeding Infants and Toddlers Study (FITS)

P29-021-23 Top Food Sources of Key Nutrients in the Diets of Infants: Data From the 2016 Feeding Infants and Toddlers Study (FITS)

P29-021-23 Top Food Sources of Key Nutrients in the Diets of Infants: Data From the 2016 Feeding Infants and Toddlers Study (FITS)

Food Sources of Fiber and Micronutrients of Concern in Infants and Children in the United Arab Emirates: Findings from the Feeding Infants and Toddlers Study (FITS) and the Kids Nutrition and Health Survey (KNHS) 2020.

We estimated the usual intakes of fiber, iron, zinc, calcium, folate, vitamin D, and vitamin A and the top foods that contribute to them among children in the UAE. Dietary intake was assessed using 24 h recalls among 5 age groups of infants and children. Foods were clustered into 54 food groups and ranked by their percentage contribution to the nutrients of interest in this study. The percentage achieving the adequate intake (AI) of fiber was negligible among all children. The top source of fiber was vegetables among children under 4 years, and white breads among those over 4 years. Only 45% of infants achieved iron adequacy, but iron standards were met by most children beyond the age of 1. The main contributors to iron intake were infant/young child formula and baby cereal in children under 4 years, while children over 4 years obtained it primarily from grains (fortified) and meat/fish. Vitamin D was inadequate across all age groups, with the percentage achieving adequacy ranging from 0 to 19% among pre-adolescents and toddlers, respectively. The top sources of vitamin D were fortified milks. Overall, nutrient inadequacies in fiber, calcium, and vitamin D highlight the need for greater intakes of whole grains and fortified dairy products in the UAE.

The Consumption of Sugar-Sweetened Beverages in a Michigan Cohort of Infants and Toddlers

ObjectivesThe proportion of Americans with overweight/obesity continues to rise such that 40% of children and teens are impacted and 14% of toddlers are considered obese. Many long-term health consequences are associated with childhood obesity demonstrating the importance of diet quality early in life. The objective of this study was to use data from a longitudinal cohort study to determine juice and sugar-sweetened beverage (SSB) consumption and compare to national data. MethodsData were collected through surveys filled out by mothers when the child was 12 (n = 44), 24 (n = 46), and 36 (n = 32) months of age. At 12 and 24 months, the survey contained a 24-hour diet recall and a 24-hour diet checklist. At 36 months, only the 24-hour dietary checklist was collected. Data were compared to results from the Feeding Infants and Toddlers Study (FITS), a national study of infant and toddler dietary intake, using chi square tests. ResultsThe 24-hour dietary recall indicated an increase in the proportion of infants consuming juice starting at 19.6% at 12 months, and increasing to 54.3% at 24 months, and 55.6% at 36 months. This was consistent with FITS data, which started with 27% consuming juice at ∼12 months and increased to 55% at ∼24 months. The 24-hour recall indicated an increase in non-juice SSB consumption from 0%, 10.9%, and 22.2% at 12, 24, and 36 months respectively. FITS reported 8.5% of infants at ∼12 months and 31% by ∼24th months consumed non-juice SSB. Notably, at 12 and 24 months, the consumption of non-juice SSB in FITS was significantly higher than in our cohort. ConclusionsThis population of Michigan children has consistent high rates of juice consumption, but lower rates of non-juice SSB consumption compared to rates reported nationally. Results suggest future efforts should emphasize the health implications of juice intake to caregivers. Funding SourcesUnrestricted funds provided to SSC by Michigan State University.

Total Usual Nutrient Intakes and Nutritional Status of United Arab Emirates Children (

ABSTRACTBackgroundThe transition from a predominantly milk-based diet to a diverse family diet is a window of opportunity for optimal child growth and development.ObjectivesThe study aims to examine the nutritional status and food-consumption patterns of children under 4 y of age in the United Arab Emirates (UAE) and their adherence to nutrient and dietary recommendations.MethodsA population-based cross-sectional survey of 525 children aged 0–47.9 mo was conducted in 3 major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometric measurements were obtained, and dietary assessment was conducted using the 24-h dietary recall approach. Usual intakes of energy, macronutrient, and micronutrients, including from supplements, were assessed using PC-SIDE software. Adherence to food-group recommendations was evaluated based on the American Heart Association/American Academy of Pediatrics dietary guidelines.ResultsAmong 0–4-y-old children, 10% were stunted, 6% were wasted, 17% were at risk of overweight, 5% were overweight, and 3% were obese. The contribution of sweets and sugar sweetened beverages to energy intake increased from 5% in 6–11.9-mo-old children to 17% in 36–47.9-mo-old children. Compared with dietary guidelines, the lowest adherence was for fruit (13–18%) and vegetables (7–12%), while protein was within the recommendations, and 92% and 89% of children (aged 24 to 35.9 mo and 36 to 47.9 mo, respectively) had high intakes of saturated fat. Almost all toddlers failed to meet the Adequate Intake for fiber. The proportions of children exceeding the free-sugar upper limit increased from 10.6% in infants (0–5.9 mo) to 56.7% in toddlers (12– 23.9 mo). Micronutrient inadequacies were observed, particularly for calcium, zinc, folate, and vitamins A and D.ConclusionsThis study suggests a triple burden of malnutrition among infants and young children in the UAE. Results call for national nutrition intervention strategies aimed at improving dietary quality in the pediatric population.

Breastfed and mixed fed infants who do not consume infant cereal are at risk for inadequate iron intake:data from the feeding infants and toddlers study 2016, a cross-sectional survey

BackgroundAccording to the Feeding Infants and Toddlers Study (FITS), the percentage of older infants consuming infant cereal has declined from 72% of 6–11.9 month old infants in 2002 to 52% in 2016. This is especially concerning for breastfed and mixed fed infants because of their increased need for dietary sources of iron. This study explored the association between infant cereal consumption and nutrient intakes among breastfed and mixed fed infants.MethodsFITS 2016 is the largest cross-sectional survey of food and nutrient intakes among caregivers of children less than 4 years old in the United States. For this analysis, we evaluated 24 h dietary recalls for infants 6–11.9 months who were either breastfed (no infant formula provided, n = 296) or mixed fed (breastmilk and infant formula provided, n = 102). Infants were further categorized as infant cereal consumers or non-consumers. Nutrient intakes were compared with Adequate Intakes or Estimated Average Requirements when available. Differences between cereal consumers and non-consumers were calculated using unpaired T-tests.ResultsSignificantly fewer breastfed cereal consumers had intakes below the Estimated Average Requirement for iron (19% vs. 96%) and zinc (61% vs. 16%, p < 0.0001). Additionally, significantly more breastfed cereal consumers had intakes above the Adequate Intake level for 12 other nutrients compared to non-consumers. Among mixed fed infants, significantly fewer cereal consumers had intakes below the Estimated Average Requirement for iron compared to non-consumers (5% vs. 70%), but differences in other nutrients were not observed.ConclusionsAlmost all (96%) of the breastfed infants who did not consume infant cereal had inadequate iron intakes. Even among mixed fed infants, significantly fewer infant cereal consumers had inadequate iron intakes compared to non-cereal consumers. Infant cereal is an important source of iron and other key nutrients, especially for infants receiving breastmilk.

Nutritional status and adequacy of feeding Practices in Infants and Toddlers 0-23.9\u2009months living in the United Arab Emirates (UAE): findings from the feeding Infants and Toddlers Study (FITS) 2020

BackgroundInfant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months.MethodsThis study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators.ResultsOverall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12–23.9 months did not meet food groups’ recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains.ConclusionsThis study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.

Many Foods Contribute Sodium in Toddlers’ and Preschoolers’ Diets: Data from the 2016 Feeding Infants and Toddlers Study (FITS)

List the top sources of sodium in the diets of toddler and preschool-aged children in the United States. The 2020-2025 Dietary Guidelines for Americans recommend limiting foods/beverages high in sodium for children under age 2 years, citing salty snacks, commercial toddler foods and processed meats as sodium sources. The guidelines recommend children ages 2-3 years reduce sodium intake if above 1200mg/day. FITS 2016 reported mean sodium intakes are 1448mg/day (age 1 year), 1978mg/day (age 2 years) and 2091mg/day (age 3 years). FITS is the largest national cross-sectional dietary survey of children under age four years. Food/beverage intake is assessed via 24-hr dietary recall. Sodium sources were ranked according to percent contribution to total sodium intake using 24-hour recalls of children ages 1- 3 years (n= 1733). Nineteen or more foods contribute 2% or more of sodium intake. As food groups mixed dishes (23-25% of sodium intake), meats (21-22%), grains (17-22%) and dairy (14-19%) are top sources for all ages. Individual foods contributing the most sodium at age 1 are milk (11%), chicken/turkey (7%) and processed meats (7%). By age 3, processed meats (8%), cheese (8%), and breads (8%) are top sources. Commercial toddler foods were not significant sources. Sodium intake among young children comes from many foods including those that provide nutrients like protein, iron, calcium and vitamin D. Examining sodium sources identifies how parents and caregivers may reduce their child’s sodium intake while providing a variety of nutritious foods. Strategies to reduce sodium include replacing processed meats with other meats, choosing lower sodium cheeses and aiming to lower sodium in mixed dishes.

Sugar Sweetened Beverages Are the Top Source of Added Sugars in Young Children: 2016 Feeding Infants and Toddlers Study (FITS)

List the top sources of added sugars for toddler and preschool aged children in the United States. Added sugars include syrups and sugars added during food processing or home preparation and exclude sugars naturally found in foods like milk and fruit. The 2020-2025 Dietary Guidelines for Americans recommend avoiding added sugars for children under two and limiting to less than 10% of calories for older children. FITS is the largest nationwide cross-sectional survey focused on dietary intakes and feeding practices of children under four years. Mean added sugar intake was calculated from the latest survey (2016) and the top sources were ranked according to percent contribution to total added sugar intake using 1-day 24 hour recalls of toddlers (12-23.9 months) and preschool-aged children (24-47.9 months). The mean daily added sugar intake was 22g (9.9% of calories) and 37g (14% of calories) among toddlers and preschoolers respectively. The primary source of added sugar among toddlers was sugar sweetened beverages (17%), followed by family cereal (10%), yogurt (9%), cookies/bars/brownies (8%), and sugar/syrup/preserves (7%). Sugar sweetened beverages were also the primary source of added sugars among preschoolers (21%), followed by sugar/syrup/preserves (9%), family cereal (8%), candy (7%), and yogurt (7%). Sugar sweetened beverages with low nutritive value are the leading dietary contributor to added sugars. Other sources such as fortified cereals and yogurts contain other important nutrients for young children such as iron, zinc, fiber, calcium, and vitamin D. Parents can focus on avoiding sugar sweetened beverages as they have low nutritive value, enter the diet early, and contribute more added sugar as children get older.

Pouch Use Among Infants Does Not Impact Exposure to Other Forms of Fruits and Vegetables: Data from the Feeding Infants and Toddlers Study (FITS) 2016

Abstract Objectives Baby food pouches have grown in popularity along with concerns about their impact on oral motor development. These concerns assume that baby food pouches are a primary food source and that they limit exposure to fruits and vegetables in other forms. The purpose of this study is to determine how often infants from the Feeding Infants and Toddlers Study (FITS) 2016 used pouches and if those who used pouches were as likely to also consume other forms of fruits and vegetables as those who did not. Methods FITS is the largest nationally representative cross-sectional dietary survey of caregivers of children aged 0–47.9 months in the U.S. For this analysis, a questionnaire and 24-hour dietary recall were used to assess pouch use and fruit and vegetable intake among children aged 6–11.9 months (n = 989). A “pouch user” was a child receiving a pouch at least once per week per the questionnaire. All others were categorized as “non-users.” In the 24-hour recall, fruits and vegetables were categorized as “baby food” if it was a commercial or homemade pureed fruit or vegetable or “non-baby food” if it was any other form of fruit or vegetable. Descriptive statistics were tabulated for frequency of pouch use and % of pouch users and non-users who consumed baby food and non-baby food fruits and vegetables. Results Per the questionnaire, 36% of 6–11.9 month olds were pouch users (n = 314) and 64% were non-users (n = 675). Among pouch users, 6% received food from a pouch daily (n = 51), and 5% received food from a pouch more than once per day (n = 40). Per the 24 hour recall, the percentages of pouch users and non-users who consumed baby food fruits (54.3% vs. 50.4%) and vegetables (45% vs. 43.3%) in any packaging were similar. More pouch users consumed non-baby food fruits and vegetables compared to non-users (54.3% vs. 36.5% and 49.2% vs. 37.4%, respectively). Conclusions Roughly a third of infants are pouch users, but daily use is not common. Pouch users consume non-baby food fruits and vegetables as often as non-users. These findings indicate that infants who are exposed to baby food pouches are also exposed to other forms of fruits and vegetables, so the impact of food pouches on oral motor development in infants may be limited. Funding Sources FITS 2016 and this analysis were funded by Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland.

The impact of wealth status on dietary diversity of infants and young children in the Philippines

AbstractIntroductionDietary diversity and socio-economic status are recognised as determinants of childhood malnutrition. The impact of wealth status on dietary diversity of infants and toddlers in Filipino infants and toddlers is currently unknown. Therefore, the aim of this analysis was to describe the impact of wealth status on dietary patterns using data from the 2013 Feeding Infants and Toddlers Study (FITS).MethodsThe FITS is a cross-sectional, national survey of infants (6–11.9mo;n = 362), younger toddlers (12–17.9mo;n = 360) and older toddlers (18–23.9mo;n = 373). Dietary data were collected using 24-hour recalls. Percentage consumption of food groups were calculated. Data were stratified by socio-economic status (SES) based on the characteristics of their dwelling units.ResultsFifty percent of the population were classified as low-SES, 20% middle-SES and 30% high-SES. Rice was the most commonly consumed food across all ages, followed by human milk and infant formula in infants and younger toddlers. Sixty-nine percent of infants from the low-SES consumed human milk compared to 41% of infants from the high-SES. In contrast, infant formula was consumed by 62% of high-SES infants compared to 25% of low-SES infants. Similarly, 54% of younger toddlers from the low-SES consumed human milk, compared to 24% of children from the high-SES, and only 10% of toddlers from poor-SES consumed toddler formula, compared to 47% of toddlers from the high-SES. Differences in non-milk based food groups were more evident in the older toddlers. Rice was consumed by approximately 90% of this population. Fish consumption varied by SES among toddlers (45% in low-SES compared to 33% in high-SES). However, pork, chicken and sausages were consumed by less than 10% of toddlers from the low-SES compared to 18%, 16% and 25%, respectively, from the high-SES. Vegetables were more highly consumed by toddlers from the low-SES (34%) than the high-SES (27%). Approximately 20% of older toddlers consumed cookies and 22% consumed sugar sweetened beverages, while cakes were consumed by 18% of toddlers from the high-SES compared to only 5% of toddlers from the low-SES.DiscussionDietary diversity in Filipino infants and toddlers is very limited. Rice, human milk and infant formula are the main source of nutrients for infants and young toddlers. Typically, there is low consumption of vegetables and protein-containing foods and high consumption of sugary foods, which is further impacted by SES. These data can be used to support public health initiatives to improve dietary diversity in the first years of life.

Screen-use, active-play and sleep behaviours in a nationally representative sample of infants, toddlers and pre-school children from the U.S.

AbstractIntroductionInadequate sleep, excessive screen-use and low-levels of physical activity may lead to an increased risk of childhood obesity. Caregivers during early childhood should limit screen-time, encourage active play and establish bedtime routines to ensure adequate sleep. The benefits of such may also extend to improved attention, learning, memory, psycho-social development and other factors. There is limited data on such lifestyle behaviours in infants and children in the U.S. Therefore, this analysis describes findings from the Feeding Infants and Toddlers Study (FITS) 2016.MethodsFITS 2016 is a national, cross-sectional survey of caregivers of children aged 0–3.9 y in the U.S. Demographic data and information on feeding practices, sleep, physical activity and screen-use were collected using a questionnaire (n = 4380). Differences in behaviours across age groups were assessed using a one-way ANOVA or chi-squared tests.ResultsChildren older than 12 months slept for an average of 9.6 (sd = 2.0) hours per night, which was significantly higher than infants (0–11.9mo) who slept for 8.9 (sd = 2.1) hours per night (P &lt; 0.001). All children slept for approximately one hour during the day. There were no significant difference in the weekly hours spent in active play (mean = 20.8,sd = 16.5) between younger and older children, while participation in sports was higher among older versus younger children. However, time spent playing video games, watching TV videos/DVDs and using a screen was significantly higher in older versus younger children (P &lt; 0.001). For example, infants spent 7.8 hours per week watching TV, compared to 9.4 hours in 3 year old children (P &lt; 0.001). Approximately 65% of caregivers reported that they did not allow electronics in the bedroom, however this decreased with increasing age (P = 0.036). Consequently, 5% of infants (0–11.9mo) viewed a tablet or smartphone in their bedroom, compared to 26% of 3 year old children (P &lt; 0.001).DiscussionRecent guidelines from the American Academy for Pediatrics (AAP) recommend that children younger than 18 months avoid use of screen media, and that children aged 2–5 should limit screen-time to one hour per day. This data from the US FITS suggests that children are exceeding these recommendations. However, the current population are meeting the AAP physical activity recommendation of minimum 60 minutes/day. Furthermore, infants and children in this population are also failing to meet the AAP sleep recommendations. Therefore, further emphasis needs to be placed on the importance of limiting screen-time and promoting physical activity and positive sleep behaviours in this young population.

Nutrient intakes and sources of fiber among children with low and high dietary fiber intake: the 2016 feeding infants and toddlers study (FITS), a cross-sectional survey

BackgroundIncreasing dietary fiber intake in children may improve overall diet quality. The purpose of this study was to compare nutrient intakes and sources of fiber between young children with low and high fiber intakes utilizing data from the Feeding Infants and Toddlers Study (FITS) 2016.MethodsThe FITS 2016 was a nationwide, cross sectional survey of caregivers designed to assess food and nutrient intakes, feeding behaviors, and dietary patterns among infants and young children living in the U.S. Energy adjusted macro and micronutrient intakes (nutrients/1000 kcals) of children with energy adjusted fiber intakes (g/1000 kcals) in the highest quartile were compared to those in the lowest quartile with paired t-tests. Sources of fiber for each quartile were ranked according to percent of total fiber intake.ResultsChildren with fiber intakes in the highest quartile had significantly lower intakes of total fat (mean difference ranged from 7.4–9.6 g, p < 0.0005) and saturated fat (mean difference ranged from 4 to 5.8 g, p < 0.0005), and significantly higher intakes of vitamin B-6 (mean difference ranged from 0.3–0.4 mg, p < 0.0005), magnesium (mean difference ranged from 57.2–61.8 mg, p < 0.0005), iron (mean difference ranged from 2.2–3.7 mg, p < 0.0005), and potassium (mean difference ranged from 318.2 mg to 446.1 mg, p < 0.0005) compared to children in the lowest quartile across all age groups. Children in the highest quartile had higher intakes of nut butters, legumes, fruits, and vegetables and consumed a greater percentage of grains as whole grains than those in the lowest quartile.ConclusionEncouraging intake of fruits, vegetables, legumes, nut butters, and at least 75% of grains as whole grains may help young children improve dietary fiber intake and overall diet quality.

Changes in Food Consumption of WIC-Participating Infants and Children, 2008 vs. 2016 (P11-066-19)

Abstract Objectives The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritionally at-risk low-income pregnant women, infants and children up to 5 years of age with foods tailored to their nutritional needs, along with nutrition education. In 2009, USDA made major revisions to WIC food packages to better conform to expert dietary guidance. Notable changes included increased fruits and vegetables, and lower-fat milk for children 2 years and older. This study uses data from the 2008 and 2016 Feeding Infants and Toddlers Study (FITS) to compare foods consumed by children participating in WIC to foods consumed by children not participating in WIC before and after the food package changes. Methods FITS 2008 (n = 3273) and 2016 (n = 3235) are cross-sectional nationally-representative surveys of caregivers of children &lt; 4 years living in the U.S. Trained telephone interviewers collected 24-hour dietary data. Tests of interaction were used to determine whether the trends in consumption of select foods between 2008 and 2016 differed between children who participate in WIC compared to those who do not, while controlling for income and household size. Results The percentage of WIC infants (6-11.9 months) eating vegetables increased from 2008 to 2016, but the % eating fruit (including 100% juice) was unchanged. WIC infants shifted from being less likely than non-WIC infants to eat babyfood fruits and vegetables in 2008 to being more likely to eat them in 2016; at the same time, the % of WIC participants consuming non babyfood fruit and vegetables declined. The percentage of WIC children (12-23.9 months) drinking whole milk increased and drinking reduced fat (2%) milk decreased in 2016 compared to 2008; whereas older WIC children (24-47.9 months) were more likely to drink low or nonfat milk and less likely to drink reduced-fat milk. Conclusions Babyfood fruits and vegetables, added to the WIC food package in 2009, have become important contributors to WIC infants’ fruit and vegetable intakes. In 2016, WIC children were more likely to follow expert advice to shift to lower fat milks at ages 2 and above. Significant changes in the relationship of these food patterns to WIC participation between 2008 and 2016 suggest an important public health role of the revised WIC food packages. Funding Sources FITS 2008 and 2016 supported by Nestlé Research Center, Lausanne Switzerland.

Concerning Impact of Decreasing Infant Cereal Consumption on Essential Nutrient Intakes of Breastfed Babies: Feeding Infants and Toddlers Study (FITS) 2016 (P11-064-19)

Abstract Objectives Infant cereal consumption among 6–11.9 month old infants has declined from 72% in 2002 to 52% in 2016. This is especially concerning for breastfed infants since infant cereal is a top source of iron and other key nutrients. The purpose of this study is to determine how infant cereal consumption impacts nutrient intakes of breastfed infants. Methods FITS 2016 is a cross sectional survey of caregivers across the U.S. assessing food and nutrient intakes. A 24 hour dietary recall was administered to caregivers of children aged 0–47.9 months (n = 3235). For this analysis, only infants aged 6–11.9 months who were either breastfed (no infant formula provided, n = 296) or mixed fed (breastmilk and infant formula provided, n = 102) were included. If any amount of infant cereal was consumed, the infant was considered a cereal user. Dietary supplements were excluded to determine usual nutrient intakes from diet only. Infants were categorized as a breastfed cereal user, breastfed non-user, mixed fed cereal user, or mixed fed non-user. The percentage of infants with dietary nutrient intakes below the adequate intake (AI) or estimated average requirement (EAR) were analyzed for significant differences between cereal users and non-users among breastfed and mixed fed infants using paired T-tests. Results Among breastfed infants, a significantly higher percentage of cereal users had intakes above the EAR or AI level for iron, vitamin C, thiamine, riboflavin, niacin, vitamin B6, folate, vitamin B12, calcium, phosphorus, magnesium, vitamin A, zinc, potassium, and choline compared to non-users (See Figure 1). Among mixed fed infants, a significantly higher percentage of cereal users had intakes above the EAR or AI level for iron, magnesium, and choline (See Figure 2). Most infants had inadequate intakes of vitamin D. Conclusions Breastfed and mixed fed infants who consume infant cereal are more likely to have adequate intakes of iron, choline, and magnesium than their non-infant cereal consuming counterparts. Among breastfed infants, infant cereal consumers are also more likely to consume adequate amounts of 12 other nutrients compared to non-users. Infant cereal is a source of many key nutrients and is an important complementary food, especially for breastfed infants. Funding Sources Nestlé Research Center, Switzerland. Supporting Tables, Images and/or Graphs

The 2016 Feeding Infants and Toddlers Study (FITS): Dietary Intakes and Practices of Children in the United States from Birth to 48 Months.

FITS (the Feeding Infants and Toddlers Study) 2016 is a national, cross-sectional survey to evaluate the diets and feeding practices of US infants and children <48 months (n = 3,235). Dietary intakes were assessed using 24-h recalls, including a replicate subsample (n = 799), to estimate usual intake distributions and compliance with dietary reference intakes using the National Cancer Institute method. Infant feeding practices and 1-day food group consumption were assessed by age and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Initiation and duration of breastfeeding were higher in 2016 compared to previous FITS surveys. Nutrient intakes of infants were largely adequate, except for vitamins D and E and iron (18% did not meet the iron recommendations at 6-11.9 months). WIC-participating infants were more likely to meet iron recommendations, potentially due to higher use of infant formula. More nutrient inadequacies were noted among toddlers and preschoolers, including low intakes of potassium (12+ months), fiber (12+ months), and vitamins D and E (12+ months), combined with high intakes of sodium and added sugars, especially among WIC participants, and saturated fat among those 24-36 months. These imbalances result from low intakes of vegetables and whole grains, and high intakes of processed meats, sweetened bakery foods, and sugar-sweetened beverages.

Feeding Patterns of Infants and Toddlers: The Mexico Case Study.

Understanding the feeding patterns of Mexican infants and toddlers has required large efforts due to the lack of recent reliable data. The double burden of obesity and micronutrient undernutrition is a public health problem in Mexico. This chapter reviews a series of papers reporting the FITS (Feeding Infants and Toddlers Study) Mexico effort. Secondary data analyses from a nationally representative sample of over 5,000 children from the Mexican National Nutrition and Health Study 2012 ENSANUT (Encuesta Nacional de Salud y Nutrición) were used to review the feeding and drinking patterns of Mexican infants and young children. Feeding patterns in Mexican children are established early in life. Low rates of exclusive breastfeeding were found in infants under 6 months of age. Only half of 6- to 47.9-month-old children consumed fruits, and 80% did not consume any vegetables (including potatoes) on the day of the survey. From the age of 12 months, more than 80% consumed sweets or sweetened beverages on any given day. For nutrients, 61% of infants 6-11.9 months old did not meet the estimated average requirement for iron, indicating a nutritional risk. High intakes of food groups with poor micronutrient and high energy levels might explain the nutritional condition for the Mexican population. Mexican experts have used this information to make recommendations and establish complementary feeding guidelines for healthy infants. Public policy and practice must now change accordingly.

Location influences snacking behavior of US infants, toddlers and preschool children

BackgroundCompare at-home and away-from-home snacking patterns of US infants and young children.MethodsA secondary analysis was conducted using nationwide, cross-sectional dietary survey data from the US Feeding Infants and Toddlers Study (FITS) 2008. The sample included infants (6–11.9 months, n = 505), toddlers (12–23.9 months, n = 925), preschool children (24–47.9 months, n = 1461). Weighted population descriptive statistics (means and standard errors) were calculated using SAS. Significance was determined at P ≤ 0.05. The main outcome measures of the analyses were the percent of children consuming snacks by location (at home, away from home) and snacking period (morning, afternoon and evening), energy and food groups consumed during snacks.ResultsSnacking at home was more prevalent than snacking away from home (toddlers, 73% vs 27%; preschoolers, 67% vs 33%). Away-from-home snacks provided about 50 additional calories per day for toddlers (346 vs 298 kcal/day, P ≤ 0.05) and preschoolers (371 vs 326 kcal/day, P ≤ 0.05) versus snacks consumed at home. Caregivers made similar snack choices for toddlers and preschoolers (milk/milk products, fruit/juice, grains and sweets) but differed in frequency of consumption by location. Among toddlers, milk/milk products were the most frequently consumed snacks at home (66%), while sweets were the top snacks consumed away from home (69%). Among preschoolers, sweets were the top snacks both at home (60%) and away (83%).ConclusionsLocation is an important factor influencing snacking patterns of young children and should be considered when developing feeding guidelines. This data may be of use in the upcoming development of dietary guidelines in the U.S. for the population aged 0–2 years.

Food Consumption Patterns of Infants and Toddlers: Findings from the Feeding Infants and Toddlers Study (FITS) 2016

BackgroundThe prevalence of obesity and type 2 diabetes continues to increase. These conditions disproportionately affect minorities and are associated with poor nutrition early in life. Current food-consumption patterns can inform pending dietary guidelines for infants and toddlers.ObjectiveThe aim of this study was to describe infant feeding, complementary feeding, and food and beverage consumption patterns of 0- to 23.9-mo-olds in the general population.MethodsThe Feeding Infants and Toddlers Study 2016 is a cross-sectional survey of caregivers of children aged <4 y. Dietary data were collected from a national random sample by using a 24-h dietary recall (n = 3235). The percentage of children consuming foods from >400 food groups was calculated. Differences in the percentage consuming between Hispanic, non-Hispanic white, and non-Hispanic black children aged 0–23.9 mo were evaluated with the use of ORs and 95% CIs.ResultsEighty-three percent of 0- to 23.9-mo-olds (n = 2635) were ever breastfed, 34% of 0- to 3.9-mo-olds (n = 305) and 15% of 4- to 5.9-mo-olds (n = 295) were exclusively breastfed, and 24% of 12- to 14.9-mo-olds (n = 412) consumed breast milk on the day of the recall. Complementary foods were more likely to be introduced before 4 mo in formula-fed infants (27%) than in infants who did not consume formula (5%). Half of 4- to 5.9-mo-olds consumed iron-fortified infant cereal, but few consumed iron-rich meats. Among toddlers (12–23.9 mo; n = 1133), >20% consumed no servings of fruit or vegetables on the day of the recall, approximately half consumed 100% fruit juice, and one-quarter to one-third consumed a sugar-sweetened beverage (SSB).ConclusionsBreastfeeding initiation and duration have improved, but exclusivity remains low. Low consumption of iron-rich foods, fruit, and vegetables and lack of variety in vegetable consumption are problems. Efforts to reduce the consumption of SSBs and 100% fruit juice are warranted in early childhood.

Usual Nutrient Intakes from the Diets of US Children by WIC Participation and Income: Findings from the Feeding Infants and Toddlers Study (FITS) 2016

BackgroundA recent report of the National Academies of Sciences, Engineering, and Medicine (NASEM) outlined priority nutrients for infants and children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).ObjectiveThe objective of this study was to assess usual nutrient intakes from foods and beverages (not supplements) among US children aged <4 y by WIC participation status.MethodsA national random sample of children aged <4 y (n = 3,235) from the Feeding Infants and Toddlers Study (FITS) 2016 was categorized by WIC participation status (participants, lower-income nonparticipants, or higher-income nonparticipants) and age (younger infants aged 0–5.9 mo, older infants aged 6–11.9 mo, toddlers aged 12–23.9 mo, or preschoolers aged 24–47.9 mo). All participants contributed one 24-h dietary recall, with a second recall from a representative subsample (n = 799). Usual intakes and compliance with federal dietary recommendations were estimated by using the National Cancer Institute method. Differences between WIC participants and either lower-income nonparticipants or higher-income nonparticipants were tested using t tests.ResultsThe diets of infants (aged <12 mo) were nutritionally adequate in general. Older infants participating in WIC had higher compliance with iron and vitamin D guidelines than either group of nonparticipants and greater compliance with calcium, zinc, and potassium guidelines than higher-income nonparticipants. WIC toddlers had a higher risk of inadequate calcium and excessive sodium intakes than higher-income nonparticipants. Eight percent of WIC toddlers exceeded added sugar guidelines compared with either nonparticipant group (∼2%). WIC toddlers and preschoolers had a lower risk of inadequate vitamin D intake than lower-income nonparticipants, but inadequacy was >75% across all subgroups. WIC preschoolers had higher compliance with saturated fat guidelines but lower compliance with sodium and added sugar guidelines than higher-income nonparticipants.ConclusionsWIC participants had better intakes of iron (ages 6–23.9 mo), zinc and potassium (ages 6–11.9 mo), saturated fat (ages 24–47.9 mo), and vitamin D (all ages). Regardless of WIC participation status, most infants and children met the calcium and zinc guidelines, but large proportions had intakes not meeting the recommendations for iron (ages 6–11.9 mo), vitamin D, potassium, fiber, saturated fat, and sodium.