Longitudinal Study of Nutrient and Food Intakes of Infants Aged 2 to 24 Months

doi:10.1016/S0002-8223(97)00129-6

Journal of the American Dietetic Association

Volume 97, Issue 5, May 1997, Pages 496-504

https://doi.org/10.1016/S0002-8223(97)00129-6 Get rights and content

Abstract

Objective To determine the nutrient and food intakes of healthy, white infants from families of middle and upper socio-economic status and to compare intakes to current recommendations.

Design Using an incomplete random block design, we interviewed 98 mother-infant pairs longitudinally when infants were 2, 3, 4, 6, 8, 10, 12, 16, 20, and 24 months old. Data obtained included 24-hour dietary recalls, usual food intake, and food likes and dislikes.

Setting Interviews were conducted in the mother's home by registered dietitians. Subjects resided in two urban areas of Tennessee.

Subjects Of the original 98 subjects, 94 completed the 2-year study.

Results Mean energy and nutrient intakes generally met or exceeded the Recommended Dietary Allowance (RDA). Exceptions were zinc and vitamin D, which were each below 100% of the RDA at 9 of the 10 data points, and vitamin E, which was below the RDA in the infants’ second year. Fat intake decreased from more than 40% of energy in the first 6 months to 30% to 32% from 10 to 24 months. One third of the infants drank reduced-fat milks at 12 months and more than half drank them at 24 months. Although infants ate a variety of foods, vegetables often were the least favorite foods. A variety of dairy products provided calcium for the infant but lacked vitamin D.

Conclusions Several nutritional issues about infant feeding before 2 years of age arose. Low intakes of zinc, vitamin D, and vitamin E were observed. In the second year, low fat intake, use of reduced-fat milks, and dislike of vegetables were areas of concern. J Am Diet Assoc. 1997;97:496–504.

Section snippets

Recruitment of Subjects

A sample of 98 infant-mother pairs was recruited from two metropolitan areas in Tennessee. The socioeconomic, educational, and ethnic distributions of the cities are similar.

Recruitment methods included using birth announcements from newspapers; posters placed on bulletin boards in clinics, churches, and similar places where mothers might see them; and personal referrals. More than 90% of the subjects were recruited from birth announcements and referrals.

Birth announcements appearing in

Subjects’ Characteristics

Of the 98 mother-infant pairs initially enrolled in the study, 94 (96%) completed the 22-month study with at least six interviews. Of the four original subject pairs who were not retained for 22 months, two chose not to continue the study after meeting their initial obligation (ie, interviews during 2 to 12 months) and two moved out of state. Two mother-infant pairs were selected as replacements; they had three and four interviews, respectively. Data reported include all subjects who were

Discussion

As expected, there was strong consistency between favorite foods and food consumption data; many of the infants’ favorite foods were also those reported on the day of the 24-hour recall (Table 4) and cited as foods eaten regularly (Table 5). Many of the least favorite foods (green beans, broccoli, carrots, peas) were also reported to be eaten daily or nearly every day by children, at least until 16 months of age. Thus, it appears that mothers were not letting the child's preferences dictate

Applications

Dietetics practitioners need to encourage mothers to include additional food sources of zinc, vitamin D, and fat (such as meat and whole milk) in the infant's diet. In addition, mothers need to be advised that a low-fat diet is not desirable for infants younger than 2 years, because babies require dietary fat as a concentrated energy source for growth and for normal development of the brain and nervous system. ■

This study was supported by Gerber Products Company, Fremont, Mich.

Appreciation is

References (49)

I.M. Parraga et al.
Feeding patterns of urban black infants
J Am Diet Assoc.
(1988)
D. Sanjur et al.
Dietary patterns, nutrient intakes, and nutritional anthropometry of urban Puerto Rican toddlers
J Nutr Educ.
(1994)
J. Bowering et al.
Infant feeding practices in East Harlem
J Am Diet Assoc.
(1978)
D. Biegelson et al.
Breast-feeding practices in a low-income population in New York Citya study of selected health department child health stations
J Am Diet Assoc.
(1986)
D. Sanjur et al.
Dietary patterns and nutrient intakes of toddlers from low-income families in Denver, Colorado
J Am Diet Assoc.
(1990)
G. Block et al.
Sources of energy and six nutrients in diets of low-income Hispanic-American women and their childrenquantitative data from HHANES, 1982–1984
J Am Diet Assoc.
(1995)
B.D. Brogan et al.
Infant feeding practices of low and middle income families in Nebraska
J Am Diet Assoc.
(1984)
C.A. Stewart
The use of cereal-thickened formulas to promote maternal nursing
J Pediatr.
(1943)
M. Brodwick et al.
Patterns of infant feeding in a tri-ethnic population
J Am Diet Assoc.
(1989)
A. Gabriel et al.
Cultural values and biomedical knowledgechoices in infant feeding
Soc Sci Med.
(1986)

T. Baranowski et al.

Social support, social influences, ethnicity and the breastfeeding decision

Soc Sci Med.

(1983)

J.A. Ernst et al.

Food and nutrient intake of 6- to 12-month-old infants fed formula or cow milka summary of four national surveys

J Pediatr.

(1990)

R.E. Olson

The dietary recommendations of the American Academy of Pediatrics

Am J Clin Nutr.

(1995)

S.C. Hardy et al.

Fat and cholesterol in the diet of infants and young childrenimplications for growth, development, and long term health

J Pediatr.

(1994)

M. Kokinos et al.

Infant feeding practices of migrant Mexican American families in Northern California

Ecol Food Nutr.

(1986)

K.S. Tippett et al.

Food and Nutrient Intakes by Individuals in the United States, I Day, 1989-91

(1995)

Phase 1, 1988-91

MMWR.

(1994)

D.C. Peters et al.

Infant feeding practices of middle class breastfeeding and formula feeding mothers

Birth.

(1982)

A. Bachu

Fertility of American Women June 1992

(1993)

Food and Nutrition Board. Recommended Dietary Allowances

(1989)

W.M.F. Gough

A new approach to infant feeding

Can Med Assoc J.

(1953)

A.M. Butler et al.

Trends in the early feeding of supplementary foods to infants

Q Rev Pediatr.

(1954)

V.A. Beal

On the acceptance of solid foods and other food patterns of infants and children

Pediatrics.

(1957)

H.A. Guthrie

Effect of early feeding of solid foods on nutritive intake of infants

Pediatrics.

(1966)

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Longitudinal Study of Nutrient and Food Intakes of Infants Aged 2 to 24 Months

Abstract

Section snippets

Recruitment of Subjects

Subjects’ Characteristics

Discussion

Applications

J Am Diet Assoc.

J Nutr Educ.

J Am Diet Assoc.

J Am Diet Assoc.

J Am Diet Assoc.

J Am Diet Assoc.

J Am Diet Assoc.

J Pediatr.

J Am Diet Assoc.

Soc Sci Med.

Soc Sci Med.

J Pediatr.

Am J Clin Nutr.

J Pediatr.

Infant feeding practices of migrant Mexican American families in Northern California

Ecol Food Nutr.

Food and Nutrient Intakes by Individuals in the United States, I Day, 1989-91

Phase 1, 1988-91

MMWR.

Infant feeding practices of middle class breastfeeding and formula feeding mothers

Birth.

Fertility of American Women June 1992

Food and Nutrition Board. Recommended Dietary Allowances

A new approach to infant feeding

Can Med Assoc J.

Trends in the early feeding of supplementary foods to infants

Q Rev Pediatr.

On the acceptance of solid foods and other food patterns of infants and children

Pediatrics.

Effect of early feeding of solid foods on nutritive intake of infants

Pediatrics.