Nutrient adequacy and imbalance among young children aged 1–3 years in the UK

Abstract

Toddlers and young children in the second and third years of life (12-35 months) may be nutritionally vulnerable, especially if they eat a limited range of foods or consume a diet that is energy rich but nutrient poor. We compared dietary intakes among children aged 18-35 months from the National Diet and Nutrition Survey (2008-2011) and children aged 12-18 months from the Diet and Nutrition Survey of Infants and Young Children (2011) with UK Dietary Reference Values (DRVs) to assess potential nutrient excess or inadequacy. Multiple criteria were used [reference nutrient intake (RNI), estimated average requirements (EAR) and lower reference nutrient intake (LRNI)], and where the LRNI or EAR were unavailable they were estimated as 75% of the EAR or RNI, respectively. Compared to current recommendations, there appear to be significant shortfalls in intakes of vitamin D in young children in the UK, and supplementation, although recommended by government, is not addressing the problem because take-up is low (9-11%). Vitamin D intakes (including supplements) averaged only 55% of the RNI among children aged 12-18 months and 33% of the RNI for those aged 18-35 months, while 64% and 87% of the younger and older group, respectively, had intakes below the LRNI (estimated). Endogenous synthesis of vitamin D may be insufficient to fulfil requirements, especially in winter. Iron intakes are also suboptimal among some groups. Based on the EAR cut-point method, the estimated population prevalence of dietary inadequacy for children aged 18-35 months was 91% for vitamin D and 31% for iron. Zinc, vitamin A and iodine had estimated levels of dietary inadequacy ranging from 5% to 19%. Mean energy intakes were below the 1991 DRV for energy but above the most recent DRV issued in 2011, while protein intakes in both surveys were in excess of the RNI. Further work is warranted to identify dietary patterns associated with low micronutrient intakes and status, and to assess the best strategies for ensuring adequacy, especially among vulnerable groups. Parents and healthcare professionals should be informed as to how to minimise the risks of both nutrient deficiency and excessive energy intakes for the young children in their care. Government can facilitate provision of appropriate advice via the healthcare system and encourage provision of appropriate foods and supplements via enabling legislation. The food industry also has a role in the responsible provision of fortified foods and drinks that can address nutrient inadequacy.

Theoretical Impact of Replacing Whole Cow's Milk by Young-Child Formula on Nutrient Intakes of UK Young Children: Results of a Simulation Study

“…On the other hand, nutrient excesses are also often observed in childhood. The DNSIYC reported that energy intake of 75% of the children exceeded the requirements and average protein intakes were more than twice the RNI, that is, 38 vs. 14.5 g/day representing 16% of total energy intake (%EI) [4,6]. In a 2013 opinion on nutritional intakes of infants and young children, the European Food Safety Authority (EFSA) Panel on Dietetic Products, Nutrition and Allergies (NDA) considered that a high intake of protein (up to 20%EI) is not at a level that is of concern [5].…”

Dietary strategies for achieving adequate vitamin D and iron intakes in young children in Ireland

“… Estimated average requirement [5 mg day −1 ] Under‐reporters were excluded from adequacy analysis (1 year olds, n = 109; 2 year olds, n = 93; 3 year olds, n = 81; 4 year olds, n = 96). …”

Food preferences, personality and parental rearing styles: analysis of factors influencing health of left-behind children

“…A number of studies have indicated that there is a significant correlation between food preferences and children's food intakes [32]. In general, monophagism increases the risk of under-nutrition [33]. Food preferences of children have been found to be related to, among other factors, parental feeding behaviors, economic conditions and knowledge of food nutrition [34].…”