Global dietary patterns and diets in childhood: implications for health outcomes

This article provides an overview of child feeding recommendations and how these relate to actual practice and dietary adequacy, primarily in developing countries. From birth to 6 months, recommendations focus on optimal breastfeeding practices, although these are still suboptimal in about one third of infants in developing countries. From 6 months of age, breast milk can no longer meet all the nutrient requirements of the child, so from 6 months through at least 24 months, the recommendation is to continue breastfeeding but gradually introduce complementary foods. In poorer populations, the available foods for complementary feeding are primarily cereals and legumes, to which small amounts of fruits and vegetables are added, and even less animal source foods. Based on intake data from infants and preschoolers, it is evident that usual diets typically fall far short of supplying micronutrient needs. By adding more fruits, vegetables, and animal source foods the diet can be improved. Intervention studies show that increasing animal source food intake improves growth, muscle mass, and cognitive function of school children. Milk and dairy product intakes are correlated with greater child growth in many studies, even in industrialized countries. However, for many families, substantially improving children's diets by providing higher quality foods is often financially unrealistic. Newer approaches to home fortification of children's foods using micronutrient powders or lipid-based nutrient supplements hold great potential to prevent micronutrient deficiencies at reasonable cost, thus preventing the adverse consequences of these deficiencies for child development.