Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Maternal and Infant Characteristics
2.3. Infant Dietary Assessment
2.4. Statistical Analysis
3. Results
3.1. Characteristics of Participants
3.2. Energy and Macronutrient Intakes of Infants by Milk-Feed Type
3.3. Main Food Sources of Energy and Macronutrient of Infants
3.4. Key Food Sources of Energy and Macronutrient of Infants by Milk-Feed Type
4. Discussion
4.1. Energy and Macronutrient Intakes of All Infants and by Milk-Feed Type
4.2. Top Food Sources of Energy and Macronutrient of Infants
4.3. Strengths and Limitations
4.4. Implications for Local Recommendations and Policies
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Characteristics | Total Study Population | Completed at Least a Single-Day Dietary Record at 6, 9 and/or 12 Months | Did Not Complete Any Single-Day Dietary Record at 6, 9 and 12 Months | p-Value * |
---|---|---|---|---|
n (%) 1 | n (%) 1 | n (%) 1 | ||
Infant | ||||
Gender 2 | 0.703 | |||
Male | 619 (52.9) | 545 (52.7) | 74 (54.8) | |
Female | 551 (47.1) | 490 (47.3) | 61 (45.2) | |
Gestational Age 2 | 0.006 | |||
<37 weeks | 91 (7.8) | 72 (7.0) | 19 (14.1) | |
≥37 weeks | 1079 (92.2) | 963 (93.0) | 116 (85.9) | |
Parity 2 | 0.235 | |||
First child | 534 (46.0) | 465 (45.3) | 69 (51.1) | |
Not the first child | 628 (54.0) | 562 (54.7) | 66 (48.9) | |
Duration of any breastfeeding 2 | 0.005 | |||
Never | 50 (4.7) | 48 (4.7) | 2 (4.8) | |
<3 months | 423 (39.6) | 396 (38.6) | 27 (64.3) | |
≥3 months | 594 (55.7) | 581 (56.7) | 13 (31.0) | |
Age of introduction of first foods 2 | ||||
≤15 weeks | 20 (2.4) | 20 (2.4) | Missing data | NA |
16–23 weeks | 291 (34.6) | 291 (34.6) | ||
24–31 weeks | 495 (58.9) | 495 (58.9) | ||
≥32 weeks | 34 (4.0) | 34 (4.0) | ||
Maternal | ||||
Maternal age | <0.001 | |||
18 to 29 | 527 (42.6) | 419 (40.5) | 108 (53.5) | |
30 to 34 | 416 (33.6) | 352 (34.0) | 64 (31.7) | |
>34 | 294 (23.8) | 264 (25.5) | 30 (14.9) | |
Ethnicity | 0.012 | |||
Chinese | 691 (55.9) | 594 (57.4) | 97 (48.0) | |
Malay | 322 (26.0) | 253 (24.4) | 69 (34.2) | |
Indian | 224 (18.1) | 188 (18.2) | 36 (17.8) | |
Education 2 | <0.001 | |||
None/Primary/Secondary | 381 (31.2) | 299 (29.2) | 82 (41.6) | |
Post-secondary | 431 (35.3) | 360 (35.2) | 71 (36.0) | |
University and beyond | 408 (33.4) | 364 (35.6) | 44 (22.3) | |
Employment status 2 | 0.289 | |||
Unemployed | 358 (29.6) | 293 (28.9) | 65 (33.0) | |
Employed | 852 (70.4) | 720 (71.1) | 132 (67.0) | |
Monthly household income 2 | <0.001 | |||
≤$1999 | 181 (15.7) | 140 (14.5) | 41 (22.2) | |
$2000–$5999 | 640 (55.6) | 532 (55.0) | 108 (58.4) | |
≥$6000 | 331 (28.7) | 295 (30.5) | 36 (19.5) | |
Body mass index (BMI) at 26 weeks of gestation 2 | 0.508 | |||
<18.5 to 24.9 | 486 (46.6) | 422 (46.2) | 64 (48.9) | |
25 to 29.9 | 364 (34.9) | 319 (34.9) | 45 (34.4) | |
>30 | 194 (18.6) | 172 (18.8) | 22 (16.8) | |
Alcohol consumption before pregnancy 2 | 0.677 | |||
Yes | 410 (35.1) | 356 (34.8) | 54 (37.0) | |
No | 758 (64.9) | 666 (65.2) | 92 (63.0) | |
Alcohol consumption during pregnancy 2 | 0.986 | |||
Yes | 20 (1.7) | 18 (1.8) | 2 (1.4) | |
No | 1128 (98.3) | 985 (98.2) | 143 (98.6) | |
Smoking before pregnancy 2 | 0.019 | |||
Yes | 156 (13.3) | 127 (12.4) | 29 (19.9) | |
No | 1014 (86.7) | 897 (87.6) | 117 (80.1) | |
Smoking during pregnancy 2 | 0.285 | |||
Yes | 29 (1.7) | 23 (2.2) | 6 (4.1) | |
No | 1140 (97.5) | 1000 (97.8) | 140 (95.9) |
Dietary Intakes of Energy, Macronutrient and Fibre | Recommended Intakes | All | Breast-Fed (BF) | Mixed-Fed (MF) | Formula-Fed (FF) | p-Value (by Milk-Feed Type) | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
(n = 760, 893, 907) ‡ | (n = 120, 94, 57) ‡ | (n = 160, 149, 125) ‡ | (n = 480, 650, 725) ‡ | ||||||||
Mean | Standard Deviation (SD) | Mean | SD | Mean | SD | Mean | SD | ||||
Energy (TE) (kcal) | EAR of Male/Female (HPB) † | ||||||||||
6 months | 600/560 | 640 | 158 | 652 | 112 | 647 | 98 | 634 | 182 | 0.450 | |
9 months | 670/620 | 675 | 173 | 580 a | 122 | 683 b | 137 | 687 b | 183 | <0.001 | |
12 months | 740/640 | 761 | 208 | 716 | 187 | 795 | 164 | 759 | 216 | 0.050 | |
Protein (TE%) | AMDR (IOM) † | ||||||||||
6 months | - | 9.9 | 2.5 | 7.1 a | 0.7 | 9.2 b | 1.8 | 10.8 c | 2.4 | <0.001 | |
9 months | - | 13.1 | 3.1 | 10.5 a | 3.0 | 11.6 b | 2.8 | 13.8 c | 2.8 | <0.001 | |
12 months | 5–20 | 14.5 | 3.4 | 10.9 a | 3.4 | 12.5 b | 2.7 | 15.1 c | 3.2 | <0.001 | |
Total Fat (TE%) | AMDR (IOM) † | ||||||||||
6 months | - | 42.0 | 6.3 | 49.7 a | 3.1 | 44.4 b | 4.3 | 39.2 c | 5.5 | <0.001 | |
9 months | - | 36.9 | 5.7 | 38.5 a | 5.1 | 41.7 b | 5.6 | 35.6 c | 5.1 | <0.001 | |
12 months | 30–40 | 34.6 | 7.5 | 42.1 a | 9.0 | 41.5 a | 7.0 | 32.8 b | 6.3 | <0.001 | |
Carbohydrate (TE%) | AMDR (IOM) † | ||||||||||
6 months | - | 48.1 | 5.3 | 43.1 a | 2.8 | 46.4 b | 3.7 | 50.0 c | 5.2 | <0.001 | |
9 months | - | 50.0 | 5.7 | 51.0 a | 5.3 | 46.7 b | 5.3 | 50.6 a | 5.5 | <0.001 | |
12 months | 45–65 | 50.9 | 7.6 | 47.0 a | 8.1 | 46.0 a | 6.5 | 52.1 b | 7.4 | <0.001 | |
Dietary Fibre (g per 1000 kcal of TE) § | |||||||||||
6 months | - | 2.5 | 2.7 | 1.1 a | 1.6 | 1.9 a | 2.2 | 3.0 b | 2.9 | <0.001 | |
9 months | - | 4.0 | 3.1 | 3.9 | 3.5 | 4.0 | 2.9 | 4.0 | 3.1 | 0.981 | |
12 months | - | 4.4 | 3.3 | 4.7 | 2.7 | 4.3 | 3.8 | 4.4 | 3.2 | 0.743 |
Dietary Intake of Energy (kcal) | Recommended Intakes | All | Breast-Fed | Mixed-Fed | Formula-Fed | |||||
---|---|---|---|---|---|---|---|---|---|---|
(n = 760, 893, 907) * | (n = 120, 94, 57) * | (n = 160, 149, 125) * | (n = 480, 650, 725) * | |||||||
EAR (HPB) † | Mean (Standard Deviation) | |||||||||
Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | |
6 months | 600 | 560 | 655 (164) | 623 (151) | 662 (129) | 642 (94) | 649 (103) | 644 (94) | 655 (186) | 611 (178) |
9 months | 670 | 620 | 692 (171) | 658 (175) | 592 (111) | 567 (134) | 682 (127) | 685 (148) | 709 (182) | 665 (182) |
12 months | 740 | 640 | 781 (219) | 741 (195) | 720 (129) | 711 (245) | 829 (187) | 757 (127) | 778 (229) | 741 (201) |
Dietary Intake of Energy (kcal) | EAR (HPB) † | Percentage of Infants Meeting the EAR (HPB) (%) # | ||||||||
Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | |
6 months | 600 | 560 | 62.6 | 69.5 | 70.2 | 90.5 | 72.1 | 90.3 | 57.8 | 56.1 |
9 months | 670 | 620 | 50.2 | 56.2 | 18.4 | 33.3 | 44.9 | 67.2 | 56.2 | 57.1 |
12 months | 740 | 640 | 54.3 | 67.3 | 46.9 | 52.0 | 71.2 | 84.2 | 51.9 | 65.6 |
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Lim, S.-X.; Toh, J.-Y.; Van Lee, L.; Han, W.-M.; Shek, L.P.-C.; Tan, K.-H.; Yap, F.; Godfrey, K.M.; Chong, Y.-S.; Chong, M.F.-F. Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study. Int. J. Environ. Res. Public Health 2018, 15, 488. https://doi.org/10.3390/ijerph15030488
Lim S-X, Toh J-Y, Van Lee L, Han W-M, Shek LP-C, Tan K-H, Yap F, Godfrey KM, Chong Y-S, Chong MF-F. Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study. International Journal of Environmental Research and Public Health. 2018; 15(3):488. https://doi.org/10.3390/ijerph15030488
Chicago/Turabian StyleLim, Shan-Xuan, Jia-Ying Toh, Linde Van Lee, Wee-Meng Han, Lynette Pei-Chi Shek, Kok-Hian Tan, Fabian Yap, Keith M. Godfrey, Yap-Seng Chong, and Mary Foong-Fong Chong. 2018. "Food Sources of Energy and Macronutrient Intakes among Infants from 6 to 12 Months of Age: The Growing Up in Singapore Towards Healthy Outcomes (GUSTO) Study" International Journal of Environmental Research and Public Health 15, no. 3: 488. https://doi.org/10.3390/ijerph15030488