Nutritional guidance is needed during dietary transition in early childhood

Objective. To assess dietary nutritional quality during dietary transition to a modified adult-style diet in the second year of life. Design. A total of 55 children from 12 to 18 months old and their parents were studied. Dietary intake and indices of growth were measured monthly. Dietary data were collected monthly and tabulated using the Minnesota Nutrient Data System. Data were evaluated using repeated-measures analysis of variance, time trend, and correlational analyses. Results. Mean energy intake increased from 12 to 18 months of age (926 +/- 24 kcal to 1062 +/- 33 kcal) with contributions from energy-yielding macronutrients remaining relatively constant. Throughout the study, fat intakes were below 30% of energy for 22% to 33% of the sample. Micronutrient intake patterns were diverse with intake for some nutrients (vitamins A, C, B-6, B-12, and D and calcium) remaining above recommended levels despite changes over the course of the study. Folate intakes increased from 79% of the recommended value at 12 months old to similar to 100% at 18 months old. Zinc and vitamin E intakes were well below recommended levels throughout the study, and iron decreased markedly from 96% of the recommended level at 12 months old to 76% at 18 months old. Applications/Conclusions. These data show that intakes of some key nutrients are low during the period of dietary transition in early childhood, and intakes for some nutrients actually decrease despite increases in energy intake. Furthermore, because a considerable portion of children studied were consuming low-fat diets, it is clear that many parents are not following the only pediatric nutrition recommendations that currently exist. These findings argue strongly for the development of dietary guidance that not only addresses fat restriction, but also assists parents in selecting diets that support optimum growth and development in young children.