Complementary Feeding: Food Group Diversity and Probability of Nutrient Adequacy among 6-12-Month-Old Infants in Southern Thailand
Abstract
Objective: To determine complementary food intake, food group diversity and nutritional adequacy of 6-12-month-old infants in southern Thailand.
Material and Methods: A total of 120 healthy infants, aged 6-12 months, were enrolled: from December 2020 to November 2021. A 24-hour food record was used to assess the type, amount and frequency of food intake in each infant. The infants’ food intake was classified into seven food groups. Macronutrient and micronutrient intakes were analysed using the INMUCAL software program; the standard program for the calculation of nutrients in Thai food.
Results: Of the 120 infants, 10 (8.3%) received breast and/or formula feeding without complementary food; 30 (25%) received 1, 66 (55%) received 2, and 14 (11.7%) 3-4 received complementary meals a day. The 4 most common supplementary foods given to the infants were rice mixed with vitamin A-rich fruits or vegetables, meat, eggs, or other fruits (mostly bananas). Infants who received 1 complementary meal, with 1-3 food groups a day, had significantly higher percentages of micronutrient inadequacies (iron, magnesium, selenium and vitamin E) than those receiving at least 2 complementary meals; with at least 4 food groups a day.
Conclusion: Infants in southern Thailand who were fed <4 food groups with <2 complementary meals a day were at risk of micronutrient inadequacies; such as iron, magnesium, selenium and vitamin E. Therefore, infants aged 6-7 months should be given a minimum meal frequency (MMF) of 2 meals, with a minimum dietary diversity (MDD) of 4 food groups per day.
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Pietrobelli A, Agosti M. The MeNu Group. Nutrition in the first 1000 days: ten practices to minimize obesity emerging from published science. Int J Environ Res Public Health 2017;14:1491.
Bouma S. Diagnosing pediatric malnutrition. Nutr Clin Pract 2017;32:52-67.
Lam LF, Lawlis TR. Feeding the brain-the effects of micronutrient interventions on cognitive performance among school-aged children: a systematic review of randomized controlled trials. Clin Nutr 2017;36:1007-14.
Sania A, Sudfeld CR, Danaei G, Fink G, McCoy DC, Zhu Z, et al. Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries. BMJ Open 2019;9:e026449.
Tuchman S. Disorders of mineral metabolism in the newborn. Curr Pediatr Rev 2014;10:133-41.
World Health Organization. Breastfeeding. [homepage on the Internet] Geneva: WHO. [cited 15 Jan 2023] Available from: https://www.who.int/health-topics/breastfeeding#tab=tab_1.
Selim L. Breastfeeding from the first hour of birth: What works and what hurts. [homepage on the Internet] NewYork: UNICEF. [cited 15 Jan 2023]. Available from: https://www.unicef.org/stories/breastfeeding-first-hour-birth.
World Health Organization. Complementary feeding. [homepage on the Internet] Geneva: WHO; [cited 15 Jan 2023]. Available from: https://www.who.int/health-topics/complementary-feeding.
Fewtrell M, Bronsky J, Campoy C, Domellöf M, Embleton N, Fidler M, et al. Complementary feeding: A position paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017;64:119-32.
The World Bank. The World Bank in Thailand. [homepage on the Internet] Bangkok: The World Bank; 2018. [cited 25 Sep 2023]. Available from: https://www.worldbank.org/en/country/thailand/overview.
Biswas T, Townsend N, Magalhaes RJS, Hasan M, Mamun A. Patterns and determinants of the double burden of malnutrition at the household level in South and Southeast Asia. Eur J Clin Nutr 2021;75:385-91.
Benedict L, Hong SA, Winichagoon P, Tejativaddhana P, Kasemsup V. Double burden of malnutrition and its association with infant and young child feeding practices among children under-five in Thailand. Public Health Nutr 2021;24:3058-65.
Bureau of Nutrition, Department of Health, Ministry of Public Health, Thailand. Dietary reference intake for Thais 2020. [homepage on the Internet] Bangkok: A.V.Progressive. March 2020. [cited 15 Jan 2023] Available from http://www.nutrition.anamai.moph.go.th/images/dri2563.pdf.
Supthanasup A, Cetthakrikul N, Kelly M, Sarma H, Banwell C. Determinants of complementary feeding indicators: a secondary analysis of Thailand multiple indicators cluster survey 2019. Nutrients 2022;14:4370.
Kasemsripitak S, Jaruratanasirikul S, Boonrusmee S, Saengkaew T, Sriplung H. Prevalence and risk factors for vitamin D insuffciency in 6-12-month-old infants: a cross-sectional study in southern Thailand. BMC Pediatr 2022;22:729.
Rojroongwasinkul N, Kijboonchoo K, Wimonpeerapattana W, Purttiponthanee S, Yamborisut U, Boonpraderm A, et al. SEANUTS: the nutritional status and dietary intakes of 0.5-12-year-old Thai children. Br J Nutr 2013;110(Suppl 3):S36-44.
World Health Organization. WHO child growth standards [homepage on the Internet] Geneva: WHO; [cited 15 Jan 2023]. Available from: https://www.who.int/tools/child-growth-standards.
Ruel MT, Menon P. Child feeding practices are associated with child nutritional status in Latin America: innovative uses of the demographic and health surveys. J Nutr 2002;6:1180-7.
Lohia N, Udipi SA. Infant and child feeding index reflects feeding practices, nutritional status of urban slum children. BMC Pediatr 2014;14:290.
Institute of Nutrition, Mahidol University. Food composition database NDI for INMUCAL Program. Nakhon Pathom: Mahidol University; 2018.
Morseth MS, Torheim LE, Chandyo RK, Ulak M, Shrestha SK, Shrestha B, et al. Severely inadequate micronutrient intake among children 9-24 months in Nepal-the MAL-ED birth cohort study. Matern Child Nutr 2018;14:e12552.
Antiporta DA, Ambikapathi R, Bose A, Maciel B, Mahopo TC, Patil C, et al; MAL-ED Network Investigators. Micronutrient intake and the probability of nutrient adequacy among children 9-24 months of age: results from the MAL-ED birth cohort study. Public Health Nutr 2021;24:2592-602.
Thaweekul P, Sinlapamongkolkul P, Tonglim J, Sritipsukho P. Associations between the infant and young child feeding index and nutritional status. Pediatr Int 2021;63:958-64.
Wageesha ND, Ekanayake S, Jansz ER, Lamabadusuriya S. Studies on hypercarotenemia due to excessive ingestion of carrot, pumpkin and papaw. Int J Food Sci Nutr 2011;62:20-5.
Priyadarshani AM. Insights of hypercarotnemia: a brief review. Clin Nutr ESPEN 2018;23:10-24.
Sirichakawal PP, Puwastien P, Polngam J, Kongkachuichai R. Selenium content of Thai foods. J Food Compos Anal 2005;18:47-59.
Sih T, Bunnag C, Ballali S, Lauriello M, Bellussi L. Nuts and seed: a natural yet dangerous foreign body. Int J Pediatr Otorhinolaryngol 2021;76(Suppl 1):S49-52.
D’Souza JN, Valika TS, Bhushan B, Ida JB. Age-based evaluation of nut aspiration risk. J Otolaryngol Head Neck Surg 2020;49:73.
Winichagoon P. Thailand nutrition in transition: situation and challenges of maternal and child nutrition. Asia Pac J Clin Nutr 2013;22:6-15.
Thaweekul P, Surapolchai P, Sinlapamongkolkul P. Infant feeding practices in relation to iron status and other possible nutritional deficiencies in Pathumthani, Thailand. Asia Pac J Clin Nutr 2019;28:577-83. doi: 10.6133/apjcn.201909_28(3).0017.
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