Role of Young Child Formulae and Supplements to Ensure Nutritional Adequacy in U.K. Young Children
Abstract
:1. Introduction
2. Materials and Methods
2.1. Dietary Survey and Study Sample
2.2. Food Database
2.3. Diet Quality Indicators
2.4. Individual Diet Modeling with Linear Programming
2.5. Statistical Analysis
2.5.1. Comparison of Characteristics and Observed Diets in the 4 Groups of Children
2.5.2. Diets Modeled with “Repertoire-Only Foods”
2.5.3. Diets Modeled with “All-Foods”
3. Results
3.1. Description of the Sample
3.2. Nutrients in Observed Diets
3.3. Feasibility of Repertoire-Only Models
3.4. Dietary Changes Induced by the All-Foods Models
3.5. Variation of YCF and Cow’s Milk between Observed Diets and Those Modeled with All-Foods Models
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
Appendix A. Individual Diet Modeling with Linear Programming
Appendix A.1. Principle of Diet Modeling
Appendix A.2. Types of Models Defined by Two Sets of Food Variables
Appendix A.3. Nutritional and Acceptability Constraints
Appendix A.4. Objective Function
References
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All | No YCF, No Suppl a | No YCF, Suppl a | YCF, No Suppl a | YCF & Suppl a | p * | |
---|---|---|---|---|---|---|
Number of children (n) | 1147 | 707 | 56 | 341 | 43 | |
Gender (%) | ||||||
Male | 50.9 | 51.6 | 53.6 | 49.6 | 46.5 | 0.83 |
Female | 49.1 | 48.4 | 46.4 | 50.4 | 53.5 | |
Child's age (in months) | <0.001 1 | |||||
Mean | 14.3 | 14.6 | 14.5 | 13.8 | 14.4 | |
SD | 1.62 | 1.58 | 1.56 | 1.61 | 1.60 | |
Anthropometric data | ||||||
Infant height (cm) | ||||||
Mean | 79.7 | 79.8 | 79.8 | 79.5 | 79.2 | 0.31 |
SD | 3.46 | 3.50 | 3.35 | 3.24 | 4.52 | |
n missing | 145 | 89 | 6 | 45 | 5 | |
Infant weight (kg) | ||||||
Mean | 10.9 | 11.0 | 10.7 | 10.9 | 10.6 | 0.12 |
SD | 1.31 | 1.33 | 1.22 | 1.29 | 1.31 | |
Number of missing values | 42 | 27 | 2 | 10 | 3 | |
BMI (kg/m2) | ||||||
Mean | 17.1 | 17.2 | 16.7 | 17.1 | 16.8 | 0.16 |
SD | 1.56 | 1.54 | 1.54 | 1.62 | 1.52 | |
Number of missing values | 158 | 96 | 7 | 49 | 6 | |
Reported breastfeeding (%) | ||||||
Still breastfeeding | 7.41 | 8.49 | 14.3 | 4.40 | 4.65 | 0.02 |
No longer breastfeeding | 68.3 | 64.6 | 67.9 | 74.8 | 79.1 | 0.004 1 |
Never breastfed | 24.1 | 26.7 | 17.9 | 20.8 | 16.3 | 0.06 |
Number of missing values | 1 | 1 | 0 | 0 | 0 | |
Energy (kcal/day) | ||||||
Mean | 968 | 983 | 972 | 938 | 950 | 0.005 1 |
SD | 196 | 199 | 228 | 183 | 166 | |
Diet quality indicators | ||||||
Mean adequacy ratio (%) | ||||||
Mean | 90.9 | 88.6 | 92.5 | 94.8 | 97.5 | <0.001 1,2,3,4,5 |
SD | 6.05 | 5.34 | 4.73 | 5.28 | 2.16 | |
PRSL (mmol) | ||||||
Mean | 312 | 332 | 328 | 272 | 277 | <0.001 1,3,5,6 |
SD | 78.8 | 76.2 | 87.3 | 66.6 | 66.9 |
Nutrients | Reference Value | All (n = 1147) | No YCF, No Suppl a | No YCF, Suppl a | YCF, No Suppl a | YCF & Suppl a | p-Unadjusted Analysis * | p-Adjusted Analysis ** |
---|---|---|---|---|---|---|---|---|
(n = 707) | (n = 56) | (n = 341) | (n = 43) | |||||
Macronutrients | ||||||||
Water (H2O) | ≥1100 mL/day b | 28.2 | 29.3 | 26.8 | 25.2 | 37.2 | 0.30 | 0.18 |
Proteins | ≥1.14 g/kg body weight c | 99.9 | 100 | 100 | 99.7 | 100 | 0.50 *** | 0.99 *** |
Carbohydrates | 45%–60% energy d | 82.0 | 80.9 | 83.9 | 85.6 | 69.8 | 0.04 | 0.03 |
Carbohydrates min | ≥45% of energy d | 90.0 | 86.3 | 87.5 | 97.1 | 97.7 | <0.001 | <0.0001 |
Carbohydrates max | ≤60% of energy d | 92.0 | 94.6 | 96.4 | 88.6 | 72.1 | <0.001 | <0.0001 |
Fiber | >10 g/day b | 20.6 | 15.3 | 10.7 | 30.8 | 39.5 | <0.001 | <0.001 |
Total fats | 35%–40% energy d | 43.7 | 45.0 | 51.8 | 41.9 | 25.6 | 0.04 | 0.08 |
Total fats min | ≥35% of energy d | 59.0 | 62.9 | 66.1 | 54.0 | 25.6 | <0.001 | <0.001 |
Total fats max | ≤40% of energy d | 84.7 | 82.0 | 85.7 | 88.0 | 100 | 0.002 | 0.009 |
n-6 FA | ≥3% energy f | 86.7 | 81.2 | 80.4 | 97.6 | 100.0 | <0.001 | <0.001 *** |
n-3 FA | ≥0.5% energy f | 77.0 | 68.3 | 69.6 | 93.5 | 97.7 | <0.001 | <0.001 |
Vitamins | ||||||||
Thiamin | ≥0.5 mg/day c | 95.1 | 94.1 | 98.2 | 96.2 | 100.0 | 0.12 *** | 0.03 *** |
Riboflavin | ≥0.8 mg/day b | 93.1 | 93.5 | 96.4 | 90.9 | 100.0 | 0.08 *** | 0.37 *** |
Niacin | ≥9 mg nicotinic acid eq/day c | 97.3 | 98.6 | 98.2 | 94.4 | 97.7 | 0.001 *** | 0.007 |
Pantothenic acid | ≥4 mg/day b | 77.3 | 83.0 | 89.3 | 63.3 | 79.1 | <0.001 | <0.001 |
Vitamin B6 min | ≥0.7 mg/day c | 86.9 | 93.5 | 96.4 | 71.5 | 88.4 | <0.001 | <0.001 |
Vitamin B6 max | ≤5 mg/day e | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | N.A. | N.A. |
Biotin | ≥20 μg/day b | 60.1 | 66.0 | 67.9 | 48.4 | 44.2 | <0.001 | <0.001 |
Folates | ≥100 μg/day c | 88.7 | 87.1 | 92.9 | 90.0 | 100.0 | 0.03 | 0.02 *** |
Vitamin B12 | ≥0.9 μg/day c | 99.6 | 99.6 | 100.0 | 99.7 | 100.0 | 0.92 *** | 0.91 *** |
Vitamin C | ≥20 mg/day c | 95.9 | 93.3 | 100.0 | 100.0 | 100.0 | <0.001 *** | 0.99 *** |
Vitamin D min | ≥10 μg/day b | 7.9 | 0 | 16.1 | 15.5 | 67.4 | <0.001 *** | <0.001 *** |
Vitamin D max | ≤50 μg/day e | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | N.A. | N.A. |
Vitamin E | ≥6 mg tocopherol eq/d b | 29.2 | 5.7 | 33.9 | 70.4 | 83.7 | <0.001 | <0.001 |
Retinol equivalent | ≥400 μg /day b | 79.2 | 70.9 | 94.6 | 92.1 | 95.3 | <0.001 | <0.001 |
Retinol | ≤800 μg/day e | 98.5 | 99.6 | 89.3 | 99.4 | 86.0 | <0.001 *** | <0.001 *** |
Minerals | ||||||||
Sodium | ≥170 mg/day b | 99.8 | 100.0 | 100.0 | 99.4 | 100.0 | 0.19 *** | 0.97 *** |
Potassium | ≥800 mg/day c | 97.4 | 98.2 | 98.2 | 95.3 | 100.0 | 0.03 *** | 0.05 *** |
Magnesium | ≥85 mg/day c | 93.3 | 95.3 | 94.6 | 89.1 | 90.7 | 0.002 *** | 0.001 *** |
Chloride | ≥270 mg/day b | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | N.A. | N.A. |
Calcium | ≥600 mg/day c | 78.2 | 82.6 | 76.8 | 69.2 | 79.1 | <0.001 | <0.001 |
Phosphorus | ≥460 mg/day c | 94.2 | 96.0 | 96.4 | 90.0 | 93.0 | 0.001 *** | 0.002 *** |
Iodine min | ≥90 µg/day b,c | 88.1 | 91.65 | 91.1 | 81.2 | 79.1 | <0.001 | <0.001 |
Iodine max | ≤200 µg/day e | 62.1 | 49.1 | 50.0 | 87.7 | 88.4 | <0.001 | <0.001 |
Iron | ≥8 mg/day b,c | 28.2 | 9.9 | 19.6 | 61.0 | 79.1 | <0.001 | <0.001 |
Copper min | ≥0.4 mg/day c | 71.9 | 64.9 | 69.6 | 84.2 | 93.0 | <0.001 | <0.001 |
Copper max | ≤1 mg/day e | 99.5 | 99.9 | 98.2 | 98.8 | 100.0 | 0.08 *** | 0.13 *** |
Zinc min | ≥4 mg/day c | 91.6 | 89.1 | 89.3 | 96.2 | 100.0 | <0.001 *** | <0.001 *** |
Zinc max | ≤7 mg/day e | 91.2 | 97.2 | 91.1 | 81.8 | 67.4 | <0.001 *** | <0.001 *** |
Selenium min | ≥20 µg/day c | 59.4 | 55.3 | 60.7 | 66.3 | 69.8 | 0.004 | <0.001 |
Selenium max | ≤60 µg/day e | 100.0 | 100.0 | 100.0 | 100.0 | 100.0 | N.A. | N.A. |
Manganese | ≥0.5 mg/day b | 96.4 | 97.0 | 100.0 | 94.4 | 97. 7 | 0.07 *** | 0.94 *** |
All 1 (n = 1147) | No YCF, No Suppl b2 (n = 707) | No YCF, Suppl b3 (n = 56) | YCF, No Suppl b4 (n = 341) | YCF & Suppl b5 (n = 43) | Test of Modeled vs. Observed Variation Across Groups | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Observed | Modeled | Observed | Modeled | Observed | Modeled | Observed | Modeled | Observed | Modeled | Unadjusted p | Adjusted p ** | |||||||||||
Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | Mean | SD | |||
Supplements 1,2,3,4 | 0.11 | 0.54 | 0.74 | 1.03 | 0.00 | 0.00 | 0.81 | 1.03 | 1.30 | 1.34 | 1.82 | 1.55 | 0.00 | 0.00 | 0.36 | 0.59 | 1.29 | 1.37 | 1.35 | 1.36 | <0.001 | <0.001 |
Dairy products 1,2,3,4 | 503 | 185 | 529 | 134 | 484 | 185 | 512 | 128 | 519 | 207 | 441 | 157 | 536 | 178 | 577 | 126 | 539 | 177 | 551 | 124 | 0.001 | <0.001 |
YCF 1,2,3,4 | 119 | 200 | 345 | 154 | 0.00 | 0.00 | 312 | 132 | 0.00 | 0.00 | 157 | 135 | 353 | 186 | 439 | 143 | 383 | 190 | 399 | 155 | <0.001 | <0.001 |
Cow’s milk 1,2,3,4 | 303 | 228 | 122 | 87.9 | 399 | 200 | 133 | 86.9 | 413 | 203 | 192 | 125 | 113 | 142 | 88.2 | 69.3 | 88.8 | 117 | 106 | 76.9 | <0.001 | <0.001 |
Breast milk | 20.7 | 89.0 | 20.7 | 89.0 | 24.1 | 94.5 | 24.1 | 94.5 | 46.2 | 155 | 46.2 | 155 | 11.6 | 63.1 | 11.6 | 63.1 | 4.65 | 21.3 | 4.65 | 21.3 | ||
Fresh dairy products 1,2,3,4,5 | 51.5 | 40.0 | 33.9 | 33.1 | 52.0 | 40.3 | 34.7 | 33.6 | 51.6 | 39.1 | 38.2 | 34.0 | 50.5 | 39.3 | 31.8 | 32.1 | 51.7 | 43.1 | 32.7 | 31.8 | 0.73 | 0.79 |
Cheese and cream 1,2,4 | 8.49 | 9.71 | 7.49 | 8.66 | 8.47 | 9.69 | 7.75 | 8.81 | 8.22 | 9.87 | 7.19 | 8.46 | 8.23 | 9.44 | 6.76 | 7.97 | 11.1 | 11.6 | 9.43 | 11.1 | 0.22 | 0.32 |
Fruit and vegetable 1,2,3,4,5 | 156 | 99.0 | 222 | 91.1 | 161 | 97.2 | 223 | 90.3 | 185 | 115 | 268 | 94.2 | 139 | 96.0 | 211 | 88.9 | 167 | 112 | 228 | 98.4 | 0.03 | 0.10 |
Fruits 1,2,3,4 | 78.5 | 63.0 | 94.7 | 65.6 | 81.3 | 62.3 | 94.6 | 64.5 | 95.2 | 73.7 | 116 | 67.1 | 69.5 | 60.2 | 91.8 | 66.5 | 81.1 | 73.1 | 92. 6 | 69.8 | 0.02 | 0.02 |
Vegetables 1,2,3,4,5 | 56.1 | 44.9 | 106 | 52.5 | 56.7 | 45.1 | 105 | 51.9 | 69.3 | 51.3 | 132 | 53.3 | 51.9 | 43.0 | 103 | 53.4 | 62.3 | 44.5 | 115.3 | 46.6 | 0.09 | 0.04 |
Fruit juice | 13.0 | 38.7 | 12.4 | 33.1 | 13.2 | 37.7 | 13.2 | 33.8 | 13.3 | 33.3 | 12.4 | 30.5 | 11.4 | 39.6 | 10.1 | 31.1 | 22.1 | 52.4 | 17.8 | 39.0 | 0.77 | 0.90 |
Soups | 8.63 | 25.3 | 8.37 | 23.9 | 10.3 | 28.8 | 10.2 | 27.9 | 7.45 | 12.6 | 7.29 | 12.4 | 6.20 | 19.6 | 5.48 | 16.3 | 1.36 | 5.63 | 2.36 | 9.16 | 0.48 | 0.39 |
Starchy foods 1,2,4,5 | 119 | 60.8 | 105 | 60.0 | 128 | 60.4 | 113 | 60.7 | 118 | 56.4 | 115 | 63.7 | 101 | 57.9 | 88. 9 | 54.3 | 111 | 66.7 | 94.9 | 60.5 | 0.13 | 0.08 |
Bread 1,2,4,5 | 27.9 | 19.8 | 20.6 | 17.4 | 30.9 | 21.0 | 23.2 | 18.6 | 21.4 | 13.9 | 19.1 | 14.1 | 24.0 | 17.6 | 16.6 | 14.5 | 18.2 | 13.0 | 13.1 | 12.5 | 0.03 | 0.02 |
Other starchy foods 1,2 | 91.0 | 57.1 | 84.7 | 54.8 | 97.0 | 56.2 | 89.9 | 55.0 | 96.6 | 55.5 | 95.8 | 59.1 | 77.5 | 55.9 | 72.3 | 51.46 | 92.7 | 67.2 | 81.7 | 58.4 | 0.40 | 0.34 |
Meat fish eggs 1,2,3,4,5 | 51.5 | 34.8 | 60.5 | 34.7 | 54.9 | 35.3 | 64.9 | 34.9 | 49.2 | 30.4 | 64.5 | 32.6 | 45.5 | 32.1 | 51.4 | 31.6 | 47.3 | 44.9 | 55.5 | 44.2 | <0.001 | 0.001 |
Meat 3 | 34.6 | 28.6 | 35.1 | 27.9 | 38.1 | 30.1 | 38.3 | 29.0 | 27.5 | 21.1 | 33.4 | 25.3 | 28.9 | 24.6 | 29.4 | 24.2 | 30.1 | 31.9 | 30.7 | 31.8 | <0.001 | <0.001 |
Fish 1,2 | 9.77 | 14.1 | 10.9 | 14.5 | 9.91 | 14.3 | 11.2 | 14.5 | 11.3 | 16.1 | 11.3 | 17.4 | 9.33 | 13.4 | 10.2 | 14.1 | 9.07 | 13.4 | 10.4 | 14.6 | 0.65 | 0.77 |
Eggs 1,2,3,4,5 | 7.20 | 11.5 | 14.5 | 17.8 | 6.87 | 11.3 | 15.4 | 19.0 | 10.5 | 14.3 | 19.7 | 19.2 | 7.23 | 11.7 | 11.8 | 14.8 | 8.18 | 9.42 | 14.4 | 15.3 | <0.001 | <0.001 |
Sweets & salted foods and drinks 1,2,4 | 74.5 | 128 | 65.0 | 120 | 88.6 | 146 | 77.6 | 138 | 70.1 | 112 | 67.8 | 110 | 48.5 | 79.4 | 41.1 | 76.3 | 52.8 | 83.5 | 44.9 | 72.2 | 0.06 | 0.05 |
Savory foods 1 | 2.16 | 3.78 | 2.00 | 3.62 | 2.51 | 3.99 | 2.35 | 3.84 | 1.76 | 3.91 | 1.81 | 3.99 | 1.57 | 3.21 | 1.38 | 2.93 | 1.60 | 3.65 | 1.51 | 3.64 | 0.86 | 0.75 |
Soft drinks 1,2 | 42.0 | 120 | 39.3 | 115 | 52.9 | 140 | 48.9 | 133 | 42.2 | 107 | 41.7 | 107 | 21.4 | 70.0 | 20.9 | 69.4 | 25.8 | 64.9 | 24.0 | 64.1 | 0.09 | 0.16 |
Sweet foods 1,2,4 | 30.3 | 31.4 | 23.7 | 25.7 | 33.2 | 30.6 | 26.3 | 26.7 | 26.1 | 26.1 | 24.2 | 25.4 | 25.5 | 30.3 | 18.8 | 22.8 | 25.5 | 48.7 | 19.4 | 25.7 | 0.29 | 0.24 |
Toddlers foods and drink 1,2,4 | 62.9 | 108 | 57.0 | 91.9 | 41.9 | 83.1 | 37.9 | 69.4 | 78.4 | 118 | 74.8 | 103 | 94.4 | 129 | 85.5 | 110 | 138 | 170 | 123 | 144 | 0.18 | 0.36 |
Toddlers foods | 52.7 | 85.1 | 50.9 | 81.9 | 35.6 | 65.8 | 34.5 | 63.0 | 67.7 | 90.6 | 68.2 | 92.9 | 81.4 | 107 | 77.8 | 103 | 86.2 | 92.5 | 83.5 | 89.1 | 0.49 | 0.78 |
Toddlers drinks 1,2 | 10.2 | 51.4 | 6.15 | 34.6 | 6.32 | 41.6 | 3.31 | 27.9 | 10.8 | 47.4 | 6.55 | 25.2 | 13.0 | 56.1 | 7.72 | 36.0 | 52.3 | 111 | 39.9 | 83.8 | 0.28 | 0.34 |
Added fats 1,2,3,4,5 | 4.80 | 4.17 | 6.34 | 5.01 | 5.14 | 4.31 | 6.75 | 5.10 | 4.55 | 3.39 | 7.04 | 4.70 | 4.34 | 4.04 | 5.39 | 4.71 | 3.30 | 2.83 | 6.14 | 5.12 | 0.01 | 0.03 |
Animal fats 1,5 | 1.70 | 3.37 | 1.92 | 3.62 | 1.67 | 3.43 | 1.85 | 3.60 | 1.64 | 2.47 | 1.86 | 2.88 | 1.83 | 3.49 | 1.94 | 3.62 | 1.35 | 2.25 | 2.92 | 4.72 | 0.005 | 0.003 |
Vegetable fats 1,2,3,4,5 | 3.10 | 3.46 | 4.42 | 4.38 | 3.47 | 3.65 | 4.90 | 4.53 | 2.91 | 3.13 | 5.18 | 4.57 | 2.51 | 3.12 | 3.46 | 3.94 | 1.96 | 2.22 | 3.23 | 3.28 | 0.03 | 0.16 |
Water 1,2,3,4,5 | 121 | 129 | 231 | 154 | 119 | 134 | 223 | 162 | 158 | 125 | 301 | 152 | 116 | 120 | 235 | 137 | 141 | 124 | 238 | 118 | 0.04 | 0.09 |
Low calorie drinks, tea and coffee | 97.8 | 174 | 97.3 | 173 | 122 | 197 | 121 | 196 | 32.7 | 70.9 | 32.7 | 70.9 | 67.4 | 130 | 67.4 | 130 | 23.2 | 51.7 | 23.2 | 51.7 | 0.67 | 0.73 |
Low calorie drinks | 93.9 | 172 | 93.4 | 171 | 118 | 195 | 117 | 193 | 29.3 | 68.3 | 29.3 | 68.3 | 64.0 | 128 | 64.0 | 128 | 19.6 | 51.6 | 19.6 | 51.6 | 0.67 | 0.73 |
Tea coffee | 3.89 | 20.4 | 3.89 | 20.4 | 4.20 | 22.1 | 4.20 | 22.1 | 3.44 | 13.4 | 3.44 | 13.4 | 3.37 | 18.4 | 3.37 | 18.4 | 3.58 | 12.3 | 3.58 | 12.3 | 0.89 | 0.89 |
Others c,1,2,3,4 | 7.27 | 11.1 | 8.95 | 12.5 | 7.95 | 10.7 | 10.1 | 12.6 | 5.71 | 8.83 | 7.64 | 9.91 | 6.48 | 12.4 | 7.35 | 12.9 | 4.27 | 8.70 | 5.06 | 9.11 | 0.001 | 0.01 |
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
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Vieux, F.; Brouzes, C.M.C.; Maillot, M.; Briend, A.; Hankard, R.; Lluch, A.; Darmon, N. Role of Young Child Formulae and Supplements to Ensure Nutritional Adequacy in U.K. Young Children. Nutrients 2016, 8, 539. https://doi.org/10.3390/nu8090539
Vieux F, Brouzes CMC, Maillot M, Briend A, Hankard R, Lluch A, Darmon N. Role of Young Child Formulae and Supplements to Ensure Nutritional Adequacy in U.K. Young Children. Nutrients. 2016; 8(9):539. https://doi.org/10.3390/nu8090539
Chicago/Turabian StyleVieux, Florent, Chloé M. C. Brouzes, Matthieu Maillot, André Briend, Régis Hankard, Anne Lluch, and Nicole Darmon. 2016. "Role of Young Child Formulae and Supplements to Ensure Nutritional Adequacy in U.K. Young Children" Nutrients 8, no. 9: 539. https://doi.org/10.3390/nu8090539