Abstract
Background/Objective:
Complementary feeding is a critical developmental time for establishing variety, and appropriate feeding practices are important. These include recommendations for a maximum intake of sodium (salt), because of the potential harmful effect of excessive intake on the developing kidneys and blood pressure in later life. Sodium intakes were examined to establish, if inappropriate complementary feeding practices were contributing to high intakes.
Subjects/Methods:
Data were collected from a cohort of 1178 8-month-old infants born in 1991/92, participating in the Avon Longitudinal Study of Parents and Children, using a 3-day dietary records completed by their mothers. Sodium and energy intakes were calculated and infants were categorised into quartiles of sodium intake.
Results:
Majority of infants were first introduced to solids around 3–4 months, with plain baby rice, rusks and other cereals being the first foods consumed during complementary feeding. In the whole sample, 70% consumed in excess, of 400 mg sodium per day, the maximum UK recommendation for children up to age 12 months. The mean sodium intake for the highest quartile was 1060 mg per day. Infants in this quartile were often consuming cows’ milk as a main drink; eating three times the amount of bread compared with the lowest quartile and used salty flavourings such as yeast extract and gravy.
Conclusions:
Sodium intakes in this cohort of infants were higher than recommendations. Clear and practical education is needed on complementary feeding practice for mothers highlighting what foods to introduce and when. Manufacturers have a responsibility to reduce the sodium content of food products.
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References
Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B et al. (2008). Complementary feeding: A commentary by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr 46, 99–110.
Allcutt C, Sweeney MR (2010). An exploration of knowledge, attitudes and advice given by health professionals to parents in Ireland about the introduction of solid foods. A pilot study. BMC Public Health, doi:10.1186/1471-24-58-10-201.
ALSPAC Website: http://www.alspac.bris.ac.uk.
Bolling K, Grant C, Hamlyn B, Thornton A (2007). Infant Feeding Survey. A survey conducted on behalf of the Information Centre for health and social care and the UK Health Departments by BMRB Social Research. The Information Centre: London.
Cappuccio F, Capewell S (2010). There's no doubt about the health dangers of salt. New Scientist 2758, 22–23.
Cappuccio FP (2007). Salt and cardiovascular disease - Legislation to cut levels of salt in processed food is necessary and justified. Br Med J 334, 859–860.
Cappuccio FP (2009). Expert testimony on salt & cardiovascular disease. NICE CVD guidance expert testimony paper 3. NICE: London.
Department of Health (1991). Report on Health and Social Subjects, No 41. Dietary Reference Values for Food Energy and Nutrients for the UK. Report of the Committee on Medical Aspects of Food Policy. HMSO: London.
Department of Health (1994). Weaning and the weaning diet. Rep Health Soc Subj 45, HMSO: London.
Department of Health and Social Security (1988). Present day practice in infant feeding: Third report. HMSO: London.
Derbyshire E, Davies GJ (2007). Sodium: can infants consume too much? Nutr Food Sci 37, 400–405.
Emmett PM, North K, Noble SM, ALSPAC Study Team (2000). Types of drinks consumed by infants at 4 and 8 months of age: A descriptive study. Public Health Nutr 3, 211–217.
Fein SB, Labiner-Wolfe J, Scanlon KS, Grummer-Strawn LM (2008). Selected complementary feeding practices and their association with maternal education. Pediatrics 122, S91–S97.
Food Standards Agency Website (2010): http://www.food.gov.uk.
Gilbert PA, Heiser G (2005). Salt and health: the CASH and BPA perspective. Nutr Bull 30, 62–69.
Golding J, Pembrey M, Jones R, ALSPAC Study Team (2001). ALSPAC-The Avon Longitudinal Study of Parents and Children I. Study methodology. Paediatr Perinat Epidemiol 15, 74–87.
Hendricks K, Briefel R, Novak T, Ziegler P (2006). Maternal and child characteristics associated with infant and toddler feeding practices. J Am Diet Assoc 106, S135–S148.
Holland B, Unwin ID, Buss DH (1988). Cereals and cereal products. Third supplement to McCance & Widdowson's The Composition of Foods 4th edn The Royal Society of Chemistry: Cambridge.
Holland B, Unwin ID, Buss DH (1989). Milk products and eggs. Fourth supplement to McCance & Widdowson's The Composition of Foods 4th edn The Royal Society of Chemistry: Cambridge.
Holland B, Welch AA, Unwin ID, Buss DH, Paul AA, Southgate DAT (1991). McCance & Widdowson's The composition of foods 5th edn The Royal Society of Chemistry: Cambridge.
Hopkins D, Emmett P, Steer C, Rogers I, Noble S, Emond A (2007). Infant feeding in the second 6 months of life related to iron status: an observational study. Arch Dis Childhood 92, 850–854.
In Practice - Cow and Gate Practical Support for Healthcare Professionals Website (2011): http://www.in-practice.co.uk/page_Weaning+Foods_id-327.html.
Lawlor DA, Davey-Smith G (2005). Early life determinants of adult blood pressure. Curr Opin Nephrol Hypertens 14, 259–264.
Ministry of Agriculture, Fisheries and Food (1993). Food portion sizes 4nd edn HMSO: London.
More J, Jenkins C, King C, Shaw V (2010). Weaning infants onto solid foods. British Dietetic Association (BDA) Specialist Paediatric Group.
National Institute of Clinical Excellence (2010). Prevention of cardiovascular disease at population level. Public health guidance 25. NICE: London.
Noble S, Emmett P, ALSPAC Study Team (2001). Food and nutrient intake in a cohort of 8-month-old infants in the south-west of England in 1993. Eur J Clin Nutr 55, 698–707.
Savage SA, Reilly JJ, Edwards CA, Durnin JV (1998). Weaning practice in the Glasgow Longitudinal Infant Growth Study. Arch Dis Childhood 79, 153–156.
Scientific Advisory Committee on Nutrition (2003). Salt and Health. The Stationery Office: London.
World Health Organisation (2001). Global Strategy for Infant and Young Child Feeding. WHO: Geneva.
World Health Organisation (2004). Global Strategy on Diet, Phyiscal Activity and Health. World Health Organisation: Geneva.
World Health Organisation (2007). Reducing salt intakes in populations. World Health Organisation: Geneva.
World Health Organisation (2011). Review and updating of current WHO recommendations on salt/sodium and potassium consumption. Call for Public Comments. WHO: Geneva.
World Health Organisation Website (2011): http://www.euro.who.int.
Acknowledgements
We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. The UK Medical Research Council, the Wellcome Trust and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and PE will serve as guarantor for the contents of this paper. This research was specifically funded by Danone (Nutricia Ltd) and VC drafted the manuscript, performed the analyses and was involved in interpretation. JW and PE contributed to the interpretation of the data.
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The authors declare that funding was obtained from Danone (Nutricia Ltd); however, the work was carried out independently.
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Cribb, V., Warren, J. & Emmett, P. Contribution of inappropriate complementary foods to the salt intake of 8-month-old infants. Eur J Clin Nutr 66, 104–110 (2012). https://doi.org/10.1038/ejcn.2011.137
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DOI: https://doi.org/10.1038/ejcn.2011.137
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