Complementary feeding and micronutrient status: a systematic review

Author:

Obbagy Julie E1,English Laural K2ORCID,Psota Tricia L1ORCID,Wong Yat Ping1,Butte Nancy F3,Dewey Kathryn G4ORCID,Fox Mary Kay5ORCID,Greer Frank R6,Krebs Nancy F7,Scanlon Kelley S1,Stoody Eve E1ORCID

Affiliation:

1. USDA, Food and Nutrition Service, Alexandria, VA

2. Panum Group, Bethesda, MD

3. USDA, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX

4. Department of Nutrition, University of California, Davis, Davis, CA

5. Mathematica Policy Research, Cambridge, MA

6. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI

7. Department of Pediatrics, University of Colorado School of Medicine, Denver, CO

Abstract

ABSTRACTBackgroundProper nutrition during early life is critical for growth and development.ObjectivesThe aim was to describe systematic reviews conducted by the Nutrition Evidence Systematic Review team for the USDA and the Department of Health and Human Services Pregnancy and Birth to 24 Months Project to answer the following: What is the relation between 1) timing of introduction of complementary foods and beverages (CFBs) or 2) types and/or amounts of CFBs consumed and micronutrient status (iron, zinc, vitamin D, vitamin B-12, folate, and fatty acid status)?MethodsA literature search identified articles from developed countries published from January 1980 to July 2016 that met the inclusion criteria. Data were extracted and risk of bias assessed. Evidence was qualitatively synthesized to develop a conclusion statement, and the strength of the evidence was graded.ResultsNine articles addressed the timing of CFB introduction and 31 addressed types or amounts or both of CFBs. Moderate evidence suggests that introducing CFBs at age 4 mo instead of 6 mo offers no advantages or disadvantages in iron status among healthy full-term infants. Evidence is insufficient on the timing of CFB introduction and other micronutrient status outcomes. Strong evidence suggests that CFBs containing iron (e.g., meat, fortified cereal) help maintain adequate iron status or prevent deficiency in the first year among infants at risk of insufficient iron stores or low intake. Benefits for infants with sufficient iron stores (e.g., infant formula consumers) are less clear. Moderate evidence suggests that CFBs containing zinc (e.g., meat, fortified cereal) support zinc status in the first year and CFB fatty acid composition influences fatty acid status. Evidence is insufficient with regard to types and amounts of CFBs and vitamin D, vitamin B-12, and folate status, or the relation between lower-iron-containing CFBs and micronutrient status.ConclusionsSeveral conclusions on CFBs and micronutrient status were drawn from these systematic reviews, but more research that addresses specific gaps and limitations is needed.

Publisher

Oxford University Press (OUP)

Subject

Nutrition and Dietetics,Medicine (miscellaneous)

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