Читать книгу Global Landscape of Nutrition Challenges in Infants and Children - Группа авторов - Страница 29

As noted above, the guidelines recommend exclusive breastfeeding until infants are 6 months of age with the gradual introduction of nutritionally safe and adequate complementary foods [6]. To measure adequacy of CF, the WHO indicators defined above are used: MDD, MMF, and MAD [16]. Dietary diversity reflects a nutritionally adequate diet. Children aged 6–23 months should eat food from at least 4 of the following food groups a day: grains, roots and tubers, legumes and nuts, dairy products, meat and fish, eggs, Vitamin A-rich fruits and vegetables, and other fruits and vegetables. A diet lacking in diversity can increase a child’s risk of micronutrient deficiencies [7]. Yet, only 29% of the world’s children meet the requirements [27]. Additionally, children need to eat frequently throughout the day to meet their energy and nutrient requirements. However, only 50% of young children (6–23 months) are meeting the MMF requirements. Among children under 2 years old, there is an equity gap between rich and poor for both MDD and MMF [7]. Globally, children from poorer households consume less diverse and more infrequent meals compared to those from richer households. Low maternal education levels and maternal media exposure were also associated with suboptimal CF practices in multiple countries [28-33].

Within India, the only CF indicator evaluated in both the 2005–2006 and the 2015–2016 national surveys was the percent of children aged 6–8 months receiving solid or semi-solid food and breastmilk [19, 20]. The percent of children who received solid or semi-solid food and breastmilk decreased by 10%, despite data that showed the breastfeeding indicators substantially increased during this period (Table 1) [19, 20]. While the reasons for this decrease are not clear, CF programs and policies should be strengthened as part of infant and young child nutrition (IYCN) programs.

Accompanying the nutrition transition, multinational beverage companies and their products are more accessible worldwide [34]. Global data on child beverage consumption is extremely limited, especially among children under 2 years old. Most of the literature is specific to the United States and results from the Feeding Infants and Toddlers Study [35]. From the Feeding Infants and Toddlers Study data, Kay et al. [35] found that breastmilk and formula were the top 2 beverages consumed among children younger than 12 months, and as expected, cow’s milk consumption continued to increase as children aged. Children older than 12 months had an average 100% juice consumption of 8 ounces per day, almost twice the recommended amount [35, 36].

Beverage data are limited within India as well. An analysis of the 2005–2006 Indian National Family Health Survey showed that nearly 10% of children (ages 6–59 months) had not consumed any water in the last 24 h [37]. Of those children, over 50% reported not drinking any beverages, while a quarter reported drinking 2 or more beverages such as tea, coffee, or juice. Children over 2 years old were more likely to consume non-milk beverages compared to younger children. The authors found in settings where water is scarce, sugar-sweetened beverages, such as juice or soda, are more widely consumed among younger children [37]. More global data on beverage consumption during early childhood are needed to track sugar-sweetened beverage consumption and its impact on growth throughout early childhood.