Nestlé Nutrition, North America, Florham Park, N.J., USA.
Ann Nutr Metab. 2013;62 Suppl 3:27-36. doi: 10.1159/000351538. Epub 2013 Aug 19.
The latest exhaustive survey of dietary patterns in infants from the Feeding Infants and Toddlers Study (FITS) in North America documents and quantifies current trends in infant feeding. These include higher than generally recommended energy, protein, and saturated fat intakes. The majority of infants are bottle fed at some point in their first year of life, and their weaning diet often includes low intakes of fruits and vegetables, with high starchy, rather than green or yellow, vegetables. Early introduction of solids, use of cow's milk prior to 1 year of age, and high juice intake in the first 2 years - all less desirable diet practices - are improving, but are still prevalent. More preschoolers are likely to get sweets or sweetened beverages than a serving of fruit or a vegetable on a given day. These food intake patterns mimic the adult American diet and are associated with an increased risk of obesity in childhood and later life. But more importantly, these patterns appear to be set as early as 18 months of age, and by 20 months of age, they mimic the adult diet. Despite increase in total energy intake, and greater variety of foods, the basic characteristics of macronutrient intake distribution and food group contribution of energy to the diet before 2 years of age remain remarkably stable and similar to the family table. Obesity prevention needs to include specific targets in terms of breastfeeding and adequate formula feeding, as well as appropriate introduction of weaning foods with goals of changing the inadequate patterns documented in the FITS. These interventions will also require addressing parent and caregiver behaviors, including attending to hunger satiety cues (responsive feeding), and shaping early food preferences. This needs to be done starting at birth, in the first months of life. Early intervention offers a unique and potentially efficacious opportunity to shape the future dietary patterns of the next generation.
北美婴幼儿喂养研究（FITS）最近对婴儿饮食模式进行了详尽调查，记录并量化了当前婴儿喂养的趋势。这些趋势包括能量、蛋白质和饱和脂肪摄入量高于一般建议摄入量。大多数婴儿在生命的第一年中都会以奶瓶喂养，其断奶饮食通常包括水果和蔬菜摄入量低，而淀粉类蔬菜摄入量高，绿色或黄色蔬菜摄入量低。早期引入固体食物、1 岁前使用牛奶以及在前 2 年摄入高果汁——所有这些不太理想的饮食做法——都在改善，但仍然很普遍。在给定的一天，更多的学龄前儿童可能会吃甜食或甜饮料，而不是吃一份水果或蔬菜。这些饮食模式模仿了美国成年人的饮食模式，与儿童期和成年后肥胖的风险增加有关。但更重要的是，这些模式似乎早在 18 个月时就已经形成，到 20 个月时，它们就模仿了成年人的饮食模式。尽管总能量摄入增加，食物种类更多，但在 2 岁之前，宏量营养素摄入分布和食物组对饮食能量的基本特征仍然非常稳定，与家庭餐桌相似。肥胖预防需要针对母乳喂养和充足配方奶喂养制定具体目标，以及适当引入断奶食品，目标是改变 FITS 中记录的不足模式。这些干预措施还需要解决父母和照顾者的行为问题，包括关注饥饿饱腹感信号（响应喂养），并塑造早期食物偏好。这需要从出生开始，在生命的头几个月就进行。早期干预为塑造下一代未来的饮食模式提供了独特且潜在有效的机会。
