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From milk to solids: a reference standard for the transitional eating process in infants and preschool children in Japan

European Journal of Clinical Nutrition volume 58, pages 643–653 (2004)Cite this article

Abstract

Objective: This paper aims to establish a potential reference standard for the process of transition from milk to solid food in infants and preschool children in Japan, using the transitional food process (TFP) scale described by Sakashita et al. The background for variation and delay in the process are also discussed.

Design: A randomized sample survey covering entire Japan.

Setting: Mailing self-completion of questionnaires.

Subjects: Randomized sample of 14 000 children aged 0–6 y and their family from 13 prefectures in Japan, namely Hokkaido, Aomori, Iwate, Niigata, Tokyo, Saitama, Fukui, Nagano, Nagoya, Hyogo, Yamaguchi, Kagoshima, and Okinawa.

Methodology: Questionnaires requesting the TFP scale and background factors were sent to 14 000 children and families. The percentile ages were calculated. An eating ability index (EAI: number of accepted foods/total number of foods) × 100) was calculated. Regression analysis by analysis of covariance (ANCOVA; SPSS, 1997) was used to determine the influence of background factors on EAI.

Results: From the 6747 (48.2%) effective answers received, percentile curves of the acceptability of each food on the scale were drawn, and used as initial reference standards. The 50 percentile age range of these 20 standard foods covers from 5 to 42 months after birth. The sensitive period for increasing the acceptance of foods in children was between 6 months and 2½y of age. ANCOVA regression model (R2=0.605) showed that EAI was mostly influenced by age (P=0.000), followed by feeding style (P=0.000), infant food preparation (P=0.000), information source (P=0.000), and birth order (P=0.003). The dominant cause of digestive system problems was shown to be infection, not too-hard food. It seems that breast feeding, bottle feeding with chewing-type nipples, and the manner of preparing infant foods from the family table promote the progress in acceptance. Children whose mothers followed the information given in books or magazines showed a slower progress.

Conclusions: It seems appropriate to use this reference standard in the study of the transitional process from milk to solid food in infants and preschool children in Japan.

Sponsorship: Grant-in-Aid for Scientific Research, provided by the Japanese Ministry of Education, Culture, Sports, Science and Technology Project No. 07838030.

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References

  • Barrett RH & Hanson ML (1978): Oral Myofunctional Disorders. St Louis, MO: The CV Mosby Co.

    Google Scholar 

  • Beecher RM & Corruccini RS (1981): Effects of dietary consistency on craniofacial and occlusal development in the rat. Angle Orthod. 51, 61–65.

    CAS  PubMed  Google Scholar 

  • Betz CL, Hunsberger MM & Wright S (1994): Anticipatory guidance: teething. In Nursing Care of Children, p 170. Philadelphia: WB Saunders Company.

    Google Scholar 

  • Birch LL & Fisher JO (1998): Development of eating behaviors among children and adolescents. Pediatrics 101, 539–549.

    CAS  Google Scholar 

  • Birch LL (1998): Development of food acceptance patterns in the first years of life. Proc. Nutr. Soc. 57, 617–624.

    Article  CAS  Google Scholar 

  • Brandt MA, Skinner EZ & Coleman JA (1963): Texture profile method. J. Food Sci. 28, 404–409.

    Article  Google Scholar 

  • Bronner YL & Paige DM (1992): Current concepts in infant nutrition. J. Midwifery 37, 43–58.

    Google Scholar 

  • Cox DN, van Galen M, Hedderley D, Perry L, Moore PB & Mela DJ (1998): Sensory and hedonic judgments of common foods by lean consumers and consumers with obesity. Obes. Res. 6, 438–447.

    Article  CAS  Google Scholar 

  • Fisher JO, Mitchell DC, Smiciklas-Wright H & Birch LL (2002): Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes. J. Am. Diet. Assoc. 102, 58–64.

    Article  Google Scholar 

  • Grand RJ, Watkins JB & Torti FM (1976): Development of the human gastrointestinal tract. A review. Gastroenterology 70, 790–810.

    CAS  PubMed  Google Scholar 

  • Haller R, Rummel C, Henneberg S, Pollmer U & Koster EP (1999): The influence of early experience with vanillin on food preference later in life. Chem. Senses Aug. 24, 465–467.

    Article  CAS  Google Scholar 

  • Hartman WM & Sarle WS (1988): Varcluster. In SAS Statistical Text, eds. KP Ingraham, RC Luginbuhl, SD Schlotzhauer & H Watts, pp 995–1014. North Carolina: SAS Institution.

    Google Scholar 

  • Ikeda K (1998): Development of jaw muscle's function in rats fed a kneaded diet. Orthod. Waves 57, 163–172.

    Google Scholar 

  • Imamura E (1987): Weaning instruction (in Japanese). Crit. Pediatr. 50, 68–71.

    Google Scholar 

  • Inoue N (1993): Collapse of dentition in Japan. In Culture of Food and Oral Health in Maori, ed. N Inoue, pp 67–78. Tokyo: Therapeia Publishing Co.

    Google Scholar 

  • Inoue N, Sakashita R & Kamegai T (1995): Reduction of masseter muscle activity in bottle fed babies. Early Hum. Dev. 42, 185–193.

    Article  CAS  Google Scholar 

  • Ito G, Kuroe K, Inoue N & Kamegai T (1982): Experimental approach to jaw reduction. J. Dent. Res. 61, 596 (abstract).

    Google Scholar 

  • Ito G, Mitani S & Kim JH (1988): Effects of soft diet on craniofacial growth in mice. Ant. Anz. 165, 151–166.

    CAS  Google Scholar 

  • James WP, Nelson M, Ralph A & Leather S (1997): Socioeconomic determinants of health. The contribution of nutrition to inequalities in health. Br. J. Med. 314, 1545–1549.

    Article  CAS  Google Scholar 

  • Launer LJ, Forman MR, Hundt GL, Sarov B, Berendes HW & Naggan L (1992): Maternal recall of infant feeding events is accurate. J. Epidemiol. Community Health 46, 203–206.

    Article  CAS  Google Scholar 

  • Lebenthal E (1985): Impact of digestion and absorption in the weaning period on infant feeding practice. Pediatrics 75, 201–213.

    Google Scholar 

  • Liu ZJ, Ikeda K, Harada S, Kasahara Y & Ito G (1998): Functional properties of jaw and tongue muscles in rats fed a liquid diet after being weaned. J. Dent. Res. 77, 366–376.

    Article  CAS  Google Scholar 

  • Marui E (1982): Statistical data and research. In Statistics, eds Y Toyokawa & H Yanai, pp 6–24. Tokyo: Gendai-Suugaku.

    Google Scholar 

  • Maternal and Child Health Division, The Ministry of Health and Welfare Japan (1986): Report on the Survey of Infant Nutrition, pp 1–102. Tokyo, Japan: The Ministry of Health and Welfare.

  • Maternal and Child Health Division, The Ministry of Health, Labour and Welfare Japan (1995): Basic of Weaning Food. Tokyo, Japan: The Ministry of Health, Labour and Welfare.

  • Maternal and Child Health Division, The Ministry of Health, Labour and Welfare Japan (2001): Surveys on the Growth of Infants and Preschool Children. Tokyo, Japan: The Ministry of Health, Labour and Welfare.

  • Mennella JA (1995): Mother’s milk: a medium for early flavor experiences. J. Hum. Lact. 11, 39–45.

    Article  CAS  Google Scholar 

  • Milla PJ (1986): The weanling's gut. Acta Pediatr. Scand. Suppl. 323, 5–13.

    Article  CAS  Google Scholar 

  • Mizuno T, Watanabe K & Sakashita R (2000): Finger food. In Eat, Play and Development, pp 34–36. Saitama: Kaiensha.

    Google Scholar 

  • Mutou S (2003): Child Nutrition, pp 1–81. Tokyo: Asakura-shoten.

    Google Scholar 

  • Northstone K, Emmett P & Nethersole F (2001): The effect of age of introduction to lumpy solids on foods eaten and reported feeding difficulties at 6 and 15 months. J. Hum. Nutr. Diet. 14, 43–54.

    Article  CAS  Google Scholar 

  • Owada M, Aoki K & Kitagawa T (2000): Taste preferences and feeding behaviour in children with phenylketonuria on a semisynthetic diet. Eur. J. Pediatr. 159, 846–850.

    Article  CAS  Google Scholar 

  • Pereira MA & Ludwig DS (2001): Dietary fiber and body-weight regulation. Observations and mechanisms. Pediatr. Clin. N. Am. 48, 969–980.

    Article  CAS  Google Scholar 

  • Persson LA & Carlgren G (1984): Measuring children's diets: evaluation of dietary assessment techniques and childhood. Int. J. Epidemiol. 13, 506–517.

    Article  CAS  Google Scholar 

  • Pliner P & Pelchar ML (1986): Similarities in food preferences between children and their siblings and parents. Appetite 7, 333–342.

    Article  CAS  Google Scholar 

  • Quandt SA (1987): Material recall accuracy for dates of infant feeding transitions. Hum. Organ. 46, 152–160.

    Article  Google Scholar 

  • Randolph PM & Dennison CI (1981): Diet, Nutrition and Dentistry. St Louis, MO: The CV Mosby Co.

    Google Scholar 

  • Rolland-Cachera MF, Deheeger M & Bellisle F (1997): Nutrient balance and body composition. Reprod. Nutr. Dev. 37, 727–734.

    Article  CAS  Google Scholar 

  • Sakashita R, Kamegai T & Inoue N (1996): Masseter muscle activity in bottle feeding with the chewing type bottle teat: evidence from electromyographs. Early Hum. Dev. 45, 83–92.

    Article  CAS  Google Scholar 

  • Sakashita R, Inoue N, Pan Q & Zhu H (1997): Diet and discrepancy between tooth and jaw size in the Yin-Shang period of China. Am. J. Phys. Anthrop. 103, 497–505.

    Article  CAS  Google Scholar 

  • Sakashita R, Inoue N, Watanabe K, Watanabe M & Kamegai T (1998): Electromyographic evidences for sufficient and insufficient developmental space in juvenile jaws. Orthod. Waves 57, 409–416.

    Google Scholar 

  • Sakashita R, Inoue N & Tastuki T (2001): Studies on transitional process from milk to solid food in infants. Kumamoto J. Maternal Health 5, 24–32.

    Google Scholar 

  • Sakashita R, Inoue N & Tastuki T (2003): Selection of reference foods for a scale of standards for use in assessing the transitional process form milk to solid food in infants and pre-school children. Eur. Clin. Nutr. 57, 803–809.

    Article  CAS  Google Scholar 

  • Sherman P (1969): A texture profile of foodstuffs based upon well-defined rheoloigical properties. J. Food Sci. 34, 458–462.

    Article  Google Scholar 

  • Simpson WJ & Cheung DK (1976): Developing infant occlusion related feeding methods and oral habit. J. Can. Dent. Assoc. 3, 124.

    Google Scholar 

  • Skinner JD, Carruth BR, Houck KS, Coletta F, Cotter R, Ott D & McLeod (1997): Longitudinal study of nutrient and food intakes of infants aged 2 to 24 months. J. Am. Diet Assoc. 97, 496–504.

    Article  CAS  Google Scholar 

  • Stanley EO & Lundeen DJ (1980): Tongue thrust in breast-fed and bottle-fed school children: a cross-cultural investigation. Int. J. Oral Myol. 6, 6.

    CAS  PubMed  Google Scholar 

  • Statistics and Information Department, Minister's Secretariat, Ministry of Health, Labour and Welfare, Japan (2001): The Basic Survey on National Life, pp 134–147. Tokyo: Health & Welfare Statistics Association.

  • Sullivan SA & Birch LL (1994): Infant dietary experience and acceptance of solid foods. Pediatrics 93, 271–277.

    CAS  Google Scholar 

  • Watt DG & Williams HM (1951): The effects of the physical consistency of food on the growth and development of the mandible and maxilla of the rat. Am. J. Orthod. 73, 895–928.

    Article  Google Scholar 

  • Westenhoefer J (2001): Establishing good dietary habits—capturing the minds of children. Public Health Nutr. 4, 125–129.

    Article  CAS  Google Scholar 

  • Wardle J, Sanderson S, Gibson EL & Rapoport L (2001): Factor-analystic structure of food preferences: I. Four-year-old children in the UK. Appetite 37, 217–223.

    Article  CAS  Google Scholar 

  • World Health Organization (2001): The optimal duration of exclusive breastfeeding. Results of a WHO systematic review. World Health Organization www.who.int/inf-pr-2001/en/note2001-07.html.

  • Yokomizo M (1992): Research on development of masticatory behavior in kindergartners (in Japanese). J. Dent. Health 42, 227–306.

    Article  Google Scholar 

Download references

Acknowledgements

This research was supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology in Japan, No. 07838030: a study on the developmental assessment of masticatory system in children from the aspect of morphological, functional, and behavioral development.

We express our sincere appreciation for the cooperation of the mothers of children studied. We are also indebted to the directors, public health nurses, and staff of public health centers in each district for their kind cooperation, support, and understanding of the authors’ aims. Finally, we thank Ms Veronica Hunt, Natural History Museum, London, for linguistic advice and comments on this paper.

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Author notes

  1. N Inoue and T Kamegai: Retired.

Authors and Affiliations

  1. Department of Nursing Physiology and Anatomy, College of Nursing Art and Science, Hyogo, Japan

    R Sakashita

  2. Department of Medicine, University of Tokyo, Chofu, Tokyo, Japan

    N Inoue

  3. Department of Orthodontics, Faculty of Dentistry, Iwate Medical College, Morioka, Iwate, Japan

    T Kamegai

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  1. R Sakashita
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  2. N Inoue
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  3. T Kamegai
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Contributions

Guarantor: Reiko Sakashita.

Contributors: RS participated in the study design, collected the data, carried out the statistical analysis, participated in the discussion of results, and wrote the paper. NI participated in the study design, coordinated the study, participated in the discussion of results, and reviewed the paper. TK coordinated the study and participated in the discussion of results.

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Correspondence to R Sakashita.

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Sakashita, R., Inoue, N. & Kamegai, T. From milk to solids: a reference standard for the transitional eating process in infants and preschool children in Japan. Eur J Clin Nutr 58, 643–653 (2004). https://doi.org/10.1038/sj.ejcn.1601860

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