Page 381 - Encyclopedia of Nursing Research

348 n NuTRITION IN INFANCy AND CHILDHOOD

however, data indicate that low-income, eth- increases with age (Skinner, Ziegler, Pac, &
nically diverse infants continue to be a pop- Devaney, 2004; Ziegler, Briefel, Clusen, &
N ulation at risk. Devaney, 2006) throughout the first years of
Recent research attention has focused on life. Important in this context is that caloric
the relationship of infant nutrient intake and intake has increased across all age groups,
risk factors for adult-onset cardiovascular including infants and toddlers. Other data
disease, the protective role of breast-feeding indicate that dietary patterns are more
in prevention of childhood and adolescent adverse including increased number of eat-
overweight, and gene–diet interactions early ing events per day (snacks), larger portion
in life. Answers to questions raised in each of sizes, greater proportion of daily intakes
these areas will assist in defining guidelines consumed away from home, higher intakes
for preventive interventions relevant to die- on weekend days, and higher consumption
tary intake in early life. of sugar-sweetened beverages. Collectively,
The epidemic of overweight in children these observations point to the importance
and adolescents in the united States and glob- of both high-risk and population-based pre-
ally combined with the emphasis on the role ventive interventions focused on the deter-
of nutrition in health promotion and disease minants of children’s patterns of dietary
prevention has prompted several recent sur- intake.
veys of dietary intake in children and youth. Numerous agencies have advanced die-
Methodological differences make cross-study tary recommendations for children and
comparisons difficult to interpret; however, youth. Recent recommendations reflect the
accumulated data indicate that dietary pat- state of knowledge regarding diet–health
terns of u.S. children are not consistent with relationships and place emphasis on pru-
recent recommendations. Data from the dence and moderation in macronutrient
National Health and Nutrition examination consumption. While specific recommended
Surveys indicate that recommended intakes daily allowances vary as a function of age
of vegetables and fruits are not being achieved and other individual factors, recent guide-
and that fluid milk and whole grains as a lines also emphasize increased consumption
percent of energy intake have decreased of soluble and insoluble fiber and decreased
over time. Data derived from 24-hour die- consumption of sucrose and sodium. The
tary recalls (obtained by phone interviews AAP Committee on Nutrition (2005) and
with primary caregivers) of a nationally the American Heart Association (2006, 2009)
representative study of infants indicate that are consistent in recommending that chil-
greater than 20% of infants and toddlers did dren’s diets should provide calories to sup-
not consume one fruit or vegetable in a given port growth and developmental processes,
day (Fox, Pac, Devaney, & Jankowski, 2004). maintain desirable body weight, and include
Sixty percent of infants (6–11 months of age) a variety of foods. In addition, daily food
and 80% between 12 and 24 months of age, intake should provide 25%–35% of total cal-
however, had at least one fruit drink a day. ories from fat, less than 10% from saturated
By 2 years of age, parents reported that 10% fat, and less than 300 mg of cholesterol.
of total daily energy intake came from sugar- Pediatric health care professionals are
sweetened beverages other than fruit juice. In faced with both challenges and opportu-
addition, french fries were the most common nities in implementing these guidelines
vegetable consumed; none of the top five veg- across health care settings. Translating
etables consumed by those under 2 years of provider-oriented dietary guidelines and
age was a green leafy vegetable. Other data recommendations for consumers of varying
indicate that the frequency of consump- developmental, educational, and cultural
tion of nutrient-poor, energy-dense snacks backgrounds is a particular challenge. The