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Kathleen Reidy

Publications and source records attributed to Kathleen Reidy.

10 recordsLinked to original sources

Sources of energy and nutrients in the diets of infants and toddlers.

OBJECTIVE: To identify major sources of energy and 24 nutrients and dietary constituents in the diets of US infants and toddlers and to describe shifts in major nutrient sources as children age. DESIGN: Data from 24-hour recalls collected in the 2002 Feeding Infants and Toddlers Study were analyzed to determine the percentage contribution of foods and supplements to total intakes of energy, nutrients, and other dietary constituents. A total of 3,586 unique foods and dietary supplements were reported. Reported foods and supplements were classified into 71 groups based on similarities in nutrient content and use. Nine-hundred seventy-nine food mixtures were disaggregated into their ingredients and ingredients were classified into one of the 71 groups using the same decision rules that guided classification of foods analyzed at the whole food level. SUBJECTS/SETTING: A national random sample of 3,022 US infants and toddlers 4 to 24 months of age. STATISTICAL ANALYSES PERFORMED: The population proportion formula was used to determine the percentage contribution of each of the 71 groups to total intakes. This was done by summing the weighted amount of a given nutrient provided by a given group for all individuals in the sample and dividing by the total weighted amount of that nutrient consumed by all individuals from all foods and supplements. Groups that provided at least 1% of the nutrient in question were rank-ordered. Separate tabulations were prepared for three age groups (4-5 months, 6-11 months, and 12-24 months). RESULTS: Infant formula, breast milk, and milk are major contributors of energy and most nutrients in the diets of infants and toddlers. Among toddlers, juices and fruit-flavored drinks are the second and third most important sources of energy. Fortified foods make substantial contributions to intakes of many essential nutrients, and these contributions increase as children age. For example, among toddlers, fortified grain-based foods make substantial contributions to intakes of vitamin A, iron, and folate, relative to foods that are naturally rich in these nutrients. Supplements also make substantial contributions to intakes of vitamins and selected minerals, particularly among toddlers. CONCLUSIONS: In assessing dietary intakes of infants and toddlers, dietetics professionals need to carefully consider contributions of fortified foods and supplements. Dietetics professionals should educate caregivers of infants and toddlers about the importance of foods (rather than just nutrients) in promoting health and about the importance of early feeding practices in the development of lifelong eating habits. Caregivers should be encouraged to avoid relying on fortified foods and supplements to meet nutrient needs and educated about the potential risk of excessive intakes. Caregivers of toddlers and infants over 4 to 6 months of age who are consuming solid foods should be encouraged to feed a wide variety of fruits, vegetables, and whole grains, as well as foods naturally rich in iron.

Animals↗

Relationship between portion size and energy intake among infants and toddlers: evidence of self-regulation.

OBJECTIVES: To assess whether dietary intakes of infants and young toddlers show evidence of energy self-regulation. DESIGN: Data from 24-hour recalls collected in the 2002 Feeding Infants and Toddlers Study were analyzed. Multivariate regressions were used to explore the relationship between portion size and usual energy intake as well as the relationship between portion size, number of eating occasions, number of unique foods, and energy density. SUBJECTS/SETTING: A national random sample of 3,022 US infants and toddlers 4 to 24 months of age. STATISTICAL ANALYSES PERFORMED: To measure variability in portion size, an average portion size z score was computed for each child in the sample, across 45 different food groups. The number of eating occasions was defined as the total number of times a child had anything to eat or drink during the day, excluding eating occasions that included only water and/or supplements. The total number of unique foods in a day was defined as the number of unique food codes included in the 24-hour recall, and energy density was computed as kilocalories/gram, including all foods, beverages, and water. Linear regression models were used to assess the effect of portion size and other self-regulation mechanisms on energy intake and to assess the effect of these self-regulation mechanisms on portion size. Separate analyses were performed for three age groups: 4 to 5 months, 6 to 11 months, and 12 to 24 months. RESULTS: A significant negative association was found for all age groups between the number of eating occasions and average portion size z scores, indicating that children who eat less often during the day consume larger-than-average-portion sizes and children who eat more often during the day consume smaller-than-average portions. For infants (11 months and younger), a significant negative association was noted between energy density and average portion size z scores, indicating that, as the energy density of the diet goes down, infants consume larger-than-average portions and, as the energy density of the diet goes up, they consume smaller-than-average portions. Among infants 6 to 11 months, there was a significant positive relationship between portion size and the number of unique foods consumed. For toddlers, there was no association between average portion size z scores and energy density, suggesting that energy self-regulation mechanisms are diminished in this age group. CONCLUSIONS: Our findings confirm the presence of energy self-regulation among infants and young toddlers. These findings can be used to assure parents and caregivers that infants have an innate ability to regulate energy intake. At the same time, it is important to educate parents and caregivers about the potential for environmental cues to diminish natural hunger-driven eating behaviors, even among young toddlers. Dietetics professionals should emphasize the potential adverse effects that coercive feeding behaviors can have on children's innate ability to regulate energy intake. This includes not only admonitions to "clean your plate," but overrestriction of intake that may be motivated by concerns that children are overeating.

Appetite Regulation↗

Average portions of foods commonly eaten by infants and toddlers in the United States.

OBJECTIVES: To examine average portion sizes consumed per eating occasion by infants and toddlers. Average portions reported for toddlers were compared to average portions for comparably aged children reported in the 1994 to 1996 and 1998 Continuing Survey of Food Intakes by Individuals. In addition, reported average portions were compared with minimum required portion sizes for meals served to infants and toddlers in the Child and Adult Care Food Program (CACFP). DESIGN: Data from 24-hour recalls collected in the 2002 Feeding Infants and Toddlers Study (FITS) were analyzed. Average portion sizes were determined for major food groups and individual foods that were reported by at least 5% of the population. Most foods were reported separately; however, sandwiches were disaggregated into their components. Gram weights of portions consumed were converted, on a food-by-food basis, to household units so that foods with different volume-to-weight ratios could be analyzed together. SUBJECTS/SETTING: A national random sample of 3,022 US infants and toddlers 4 to 24 months of age. STATISTICAL ANALYSES PERFORMED: For each food and food group, average portion sizes per eating occasion were computed for up to six age groups. An average per-eating occasion portion was determined for each child who consumed a given food by summing the total amount of food consumed over the day and dividing by the number of eating occasions. These estimates were then summed across all children who consumed the food and divided by the total number of consumers. The number of eating occasions was defined as the total number of times a child had anything to eat or drink during the day, excluding eating occasions that included only water and/or supplements. RESULTS: For most foods, there was a gradual increase in the average portion as age increased. Average portions reported for FITS toddlers were consistent with those reported for comparably aged children in the most recent Continuing Survey of Food Intakes by Individuals. The average portions reported for FITS infants and toddlers were consistent with CACFP-recommended portion sizes for formula, juice, meats, and cheese. For milk (toddlers only), cereal, breads, fruits, and vegetables, average portions reported in FITS were consistently larger than CACFP portion sizes. Distributions showed that, in many cases, the per-eating occasion portion sizes of 50% to 90% of FITS infants and toddlers exceeded the CACFP portion sizes. CONCLUSIONS: Dietitians, pediatricians, and health educators can use the data presented in this article to provide guidance to parents and caregivers about reasonable portion sizes for infants and toddlers. The data should also be useful to those who plan meals for infants and toddlers in child care settings and to researchers studying dietary intakes of infants and toddlers. Advice about reasonable portion sizes should always be tempered with appropriate cautions about avoiding coercive "clean your plate" feeding practices. Parents and caregivers should be encouraged to offer infants and toddlers appropriate portions of healthful foods from the basic food groups, with a special emphasis on fruits, vegetables, and whole grains, and allow them to eat until they are satiated.

Child, Preschool↗

Current electrolyte intakes of infants and toddlers.

OBJECTIVE: To determine how sodium, chloride, and potassium intakes of today's infants and toddlers compare with the Dietary Reference Intakes (DRIs) of these nutrients established recently by the Food and Nutrition Board of the Institute of Medicine. STUDY DESIGN: Population estimates of usual intake distributions of sodium, chloride (assumed to be equamolar to sodium), and potassium of 4- to 5-, 6- to 11-, and 12- to 24-month-old infants and toddlers were calculated and compared with DRIs of these nutrients by 0- to 6-month-old, 7- to 12-month-old, and 1- to 3-year-old children. SUBJECTS: Infants and toddlers (n=3,022) who participated in the 2002 Feeding Infants and Toddlers Study. STATISTICAL ANALYSES: Means and distributions (percentiles) of the usual intakes of sodium, chloride, and potassium were calculated using Institute of Medicine-recommended procedures and compared with the DRIs (ie, Adequate Intake [AI] and tolerable upper intake level [UL]). RESULTS: Mean sodium and chloride intakes of 4- to 5-month-old infants (188 mg/day and 290 mg/day, respectively) were 57% greater than the AIs (120 mg/day and 180 mg/day) and mean potassium intake (730 mg/day) was 83% higher than the AI (400 mg/day). Mean sodium, chloride, and potassium intakes of 6- to 11-month-old infants were 493 mg/day, 761 mg/day, and 1,225 mg/day, respectively-33%, 33%, and 75% higher than the AIs of these nutrients for this age group (sodium, 370 mg/day; chloride, 570 mg/day; potassium, 700 mg/day). Even the 10th percentile of potassium intake of this age group was greater than the AI. The usual mean sodium and chloride intakes of 12- to 24-month-old toddlers (1,638 mg/day and 2,528 mg/day, respectively) were 64% higher than the AIs (1,000 mg/day and 1,540 mg/day, respectively) and the usual mean sodium and chloride intakes of 58% of this age group were above the ULs. In contrast, mean potassium intake of 12- to 24-month-old toddlers (1,971 mg/day) was only 66% of the AI (3,000 mg/day). At all ages, sources of sodium, chloride, and potassium intakes reflected current feeding guidelines, primarily human milk and formula prior to 6 months of age and primarily cow's milk and table foods after 1 year of age. CONCLUSIONS: Mean sodium and chloride intakes of infants and toddlers who participated in the 2002 Feeding Infants and Toddlers Study exceeded the recently established AIs of these nutrients and the mean intake of 58% of toddlers exceeded the ULs. Mean potassium intake of infants also exceeded the AI of potassium, but the mean potassium intake of toddlers was only 66% of the AI. Whether current intakes of sodium, chloride, and potassium by infants and toddlers are problematical is not clear. Nonetheless, it seems desirable to bring these intakes closer to AIs. This can be accomplished by continuing breast- or formula-feeding and delaying the introduction of cow's milk; limiting the amount of salt added to home-prepared foods; limiting the intake of high-sodium foods, such as processed meats and salty snacks; and increasing the intake of fruits (high potassium and low sodium content) and vegetables (moderate potassium and sodium content).

Bottle Feeding↗

Nutrient intakes and food choices of infants and toddlers participating in WIC.

OBJECTIVES: To examine the nutrient intakes, foods consumed, and feeding patterns of infants and toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN: Cross-sectional telephone survey, including 24-hour dietary recalls of infants' and toddlers' food and nutrient intakes, as reported by parents or other primary caregivers. SUBJECTS: National random sample of 3,022 children ages 4 to 24 months who participated in the 2002 Feeding Infants and Toddlers study. Sample sizes by age were infants 4 to 6 months: 265 WIC participants, 597 nonparticipants; infants 7 to 11 months: 351 WIC participants, 808 nonparticipants; and toddlers 12 to 24 months: 205 WIC participants, 791 nonparticipants. STATISTICAL ANALYSES PERFORMED: We used Statistical Analysis Software (version 8.2) to examine the breastfeeding status, infant feeding patterns, and foods consumed; the personal computer version of the Software for Intake Distribution Estimation to estimate mean usual intake of food energy and of key nutrients targeted by the WIC program; and methods recommended by the Institute of Medicine to assess nutrient adequacy. RESULTS: Infants participating in WIC were less likely than nonparticipants to have ever been breastfed or to be currently breastfeeding, and they were more likely to be consuming formula. Mean usual nutrient intakes exceeded the adequate intake for WIC participants, and the percentage with inadequate nutrient intake was less than 1%. Reported mean energy intakes exceeded mean energy requirements, with the largest discrepancy observed for WIC participants. Sizeable proportions of WIC and non-WIC infants and toddlers did not consume fruits and vegetables on the recall day. APPLICATIONS: WIC providers should focus nutrition education on appropriate infant and toddler feeding patterns, should continue to reinforce their message of the importance delaying the use of cow's milk until 1 year of age, and should stress the importance of fruit and vegetable consumption.

Breast Feeding↗

Feeding infants and toddlers study: Improvements needed in meeting infant feeding recommendations.

OBJECTIVE: To assess adherence to infant feeding recommendations among a sample of infants and toddlers four to 24 months of age in the United States. DESIGN: Descriptive analysis of data collected in the 2002 Feeding Infants and Toddlers Study (FITS) based on telephone interviews and 24-hour dietary recalls collected with the Nutrition Data System for Research of the University of Minnesota. SUBJECTS: A national random sample of 3,022 infants and toddlers age four to 24 months, including 2,024 infants age four to 11 months. MAIN OUTCOME MEASURES: Breastfeeding, timing of introduction of complementary foods, and adherence to infant feeding recommendations. STATISTICAL ANALYSES: Means and standard errors, percentile distributions, and percentages by age group (four to six months, seven to eight months, and nine to 11 months). RESULTS: About 76% of infants and toddlers were fully or partly breastfed at birth. This percentage declined to 30% at six months and 16% at 12 months-short of Healthy People 2010 goals of 50% and 25%, respectively. The average duration of breastfeeding was 5.5 months for all who initiated breastfeeding. About two-thirds of infants had been introduced to complementary foods between four and six months-the period recommended by the American Academy of Pediatrics (AAP); 17% consumed juice before the AAP recommended age of six months or later. Twenty-two percent of infants nine to 11 months consumed cow's milk on a daily basis before the recommended age of 12 months or later, and one in 10 consumed french fries and/or sweetened beverages on any given day. APPLICATIONS/CONCLUSIONS: More parents and caregivers can benefit from guidance about the introduction of developmentally appropriate, micronutrient-rich first solid foods such as iron-rich infant cereals, iron-fortified grain products, meats, soft fruits, and cooked vegetables and the importance of breastfeeding through the first year of life. A smaller proportion of parents and caregivers require guidance on delaying the introduction of juices until six months of age and cow's milk other than formula until one year of age.

Age Factors↗

Toddlers' transition to table foods: Impact on nutrient intakes and food patterns.

OBJECTIVE: To describe the differential changes in average intakes of nutrients and food groups among higher versus lower table food consumers during the transition from baby foods to table foods. DESIGN: A comparative analysis of food and nutrient intakes in the lowest versus highest quartile of energy from table foods based on 24-hour dietary recall data. SUBJECTS: A national random sample of 1,677 US infants and toddlers 9 to 24 months in the 2002 Feeding Infants and Toddlers Study (FITS). STATISTICAL ANALYSES: Mean and percentiles of energy intake from table foods; comparisons of mean daily nutrient intake and the percentages consuming various foods and beverages in the lowest versus highest quartile of energy from table foods, by age. RESULTS: The mean percentage of energy from table foods increased from 25% at 9 to 11 months to 63% at 19 to 24 months. Mean intakes of energy, macronutrients, sodium, folate, and fiber were significantly higher for children 9 to 11, 12 to 14, and 15 to 18 months in the highest table food energy quartiles compared to the lowest. Mean calcium intakes were significantly lower among toddlers 15 to 24 months consuming high table food energy, and associated with lower milk consumption. A higher percentage of children in the lowest quartiles of energy from table food were consuming deep yellow vegetables among ages 9 through 14 months. The percentage of children consuming popular items such as pizza, carbonated sodas, French fries, candy and other sweets was higher among those who consumed more energy from table foods in every age group. APPLICATIONS: The epidemic of overweight children mandates helping parents teach healthy eating habits early. Messages that educate parents and caregivers about toddler feeding include: (1) offer a wide variety of nutritious foods, particularly fruits and vegetables, in forms that are developmentally appropriate, (2) continue to feed foods that are good sources of iron, such as iron-fortified infant cereals, ready-to-eat cereals that are high in iron, and meats, (3) to ensure adequate calcium intake, build the habit of drinking milk, and (4) teach children to recognize and honor their hunger and satiety cues.

Child Nutrition Sciences↗

Looking at WIC.

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Child, Preschool↗

Do food-related experiences in the first 2 years of life predict dietary variety in school-aged children?

OBJECTIVE: To determine if food-related experiences in the first 2 years of life predict dietary variety in school-aged children. DESIGN/SETTING: Child/mother pairs were interviewed 7 or 8 times when children were 2 to 24 months using a randomized incomplete block design to schedule interviews. Each child/mother pair was interviewed when the child was ages 6, 7, and 8 years. PARTICIPANTS: Child/mother pairs (n = 70) were continuous participants in the longitudinal study. MAIN OUTCOME MEASURES: Dependent variables were children's vegetable and fruit dietary variety, assessed from 3 days of dietary data at ages 6, 7, and 8 years. Independent variables from the first 2 years of life were selected from the longitudinal data set. ANALYSES: General linear models. Adjustments for age that vegetables (or fruits) were introduced in the diet. RESULTS: Vegetable variety in the school-aged child was predicted by mother's vegetable preferences, R2 =.084. Fruit variety in the school-aged child was predicted by breast-feeding duration and either early fruit variety (R2 =.254) or fruit exposure (R2 =.246). CONCLUSIONS/IMPLICATIONS: Nutrition education messages for mothers should emphasize the importance of early food-related experiences to school-aged children's acceptance of a variety of vegetables and fruits.

Breast Feeding↗