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Martín-Rodríguez, A.;  Bustamante-Sánchez, �.;  Martínez-Guardado, I.;  Navarro-Jiménez, E.;  Plata-Sanjuan, E.;  Tornero-Aguilera, J.F.;  Clemente-Suárez, V.J. Infancy Dietary Patterns, Development, and Health. Encyclopedia. Available online: https://encyclopedia.pub/entry/25668 (accessed on 02 July 2024).
Martín-Rodríguez A,  Bustamante-Sánchez �,  Martínez-Guardado I,  Navarro-Jiménez E,  Plata-Sanjuan E,  Tornero-Aguilera JF, et al. Infancy Dietary Patterns, Development, and Health. Encyclopedia. Available at: https://encyclopedia.pub/entry/25668. Accessed July 02, 2024.
Martín-Rodríguez, Alexandra, Álvaro Bustamante-Sánchez, Ismael Martínez-Guardado, Eduardo Navarro-Jiménez, Erika Plata-Sanjuan, José Francisco Tornero-Aguilera, Vicente Javier Clemente-Suárez. "Infancy Dietary Patterns, Development, and Health" Encyclopedia, https://encyclopedia.pub/entry/25668 (accessed July 02, 2024).
Martín-Rodríguez, A.,  Bustamante-Sánchez, �.,  Martínez-Guardado, I.,  Navarro-Jiménez, E.,  Plata-Sanjuan, E.,  Tornero-Aguilera, J.F., & Clemente-Suárez, V.J. (2022, July 29). Infancy Dietary Patterns, Development, and Health. In Encyclopedia. https://encyclopedia.pub/entry/25668
Martín-Rodríguez, Alexandra, et al. "Infancy Dietary Patterns, Development, and Health." Encyclopedia. Web. 29 July, 2022.
Infancy Dietary Patterns, Development, and Health
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This entry is adapted from the peer-reviewed paper 10.3390/children9071072

Correct dietary patterns are important for a child’s health from birth to adulthood. Understanding a child’s health as a state of entire physical, mental, and social well-being is essential.

nutrition children infancy dietary patterns

1. Progenitors Culture and Dietary Patterns in Infancy

Culture is an integral component of food habits, affecting what, when, and how we eat [1]. These habits are achieved mostly through transference in parental guidance [2]. Thus, eating behaviors have been investigated over the years to develop healthy habits and command children’s nutrition for preemptive intentions. However, it seems to be a multifactorial context where progenitors’ culture and their domestic life play a role in setting up and promoting practices that will persist throughout the lifespan, not only in infancy [3]. Although preferences can change, children are also under the influence of biological, social, and environmental factors where their eating-related attitudes are built [4]. These attitudes could have crucial implications, such as undernutrition or, contrarily, increased obesity risk [5]. Even though progenitors’ practices should be appropriated to prevent unhealthy eating patterns, unfortunately, it is not always the case.
Regarding food selection, the relationship between nutrition and culture has been demonstrated previously [6]. This relationship is based on people’s beliefs and preferences. It is known that people can do an inadequate food selection and, therefore, have bad eating habits despite the fact all kinds of foods are available in their countries. For this reason, it is not surprising to find differences in food selection between countries, as well as between different locations in the same country. In fact, in the last decades, a phenomenon of nutrition transition has been developed, and it has been defined as the shift from the traditional to a ‘‘Westernized’’ diet. Evidence suggests that food choices are affected by demographic transition [7]. However, regardless of location, a child’s early experience influences food likes later in life [8]. After birth, in some cultures, children are deliberately exposed to strong flavors. For example, Mexican culture uses chili peppers to increase strength in food. Learning to like initially strong tastes may be part of the socialization process [3]. Moreover, in Western cultures, when tofu, or plain, salted, or sweetened foods are given to preschool children repeatedly, they came to prefer the version that had become familiar to them [9], which suggests that repeated exposure to food increases their acquaintance, and it is one of the substantive determinants of their acceptance.
Findings have also revealed that food choices and even new food practices are adopted by migrants when they start a new life in a new country as a part of their inclusion process [10][11]. Though traditional practices are maintained, they include new foods in their diet to generate a connection with the new location [9][12][13][14]. Therefore, due to mobility, urbanization, and every attempt to belong to the new culture, low-income immigrant families spend a lot of time away from home and are unable to establish healthy eating habits; thus, malnutrition and obesity have become major risks [14]. The latter phenomenon is also due, in part, to dietary acculturation, signaled by the adoption of the eating and consumption patterns of the host country. It is now widely recognized that the Western diet is deficient in nutrient-rich foods such as fruits, vegetables, and whole grains, and superfluous in energy sources of solid fats, added sugars, and alcoholic beverages [15].
Food selection and dietary habits are often conditioned by food allergies. Whether a child is more or less likely to suffer from a food allergy can be determined by family culture. It has been demonstrated that children of immigrants (second-generation immigrants) have been suggested to be at high risk of food sensitization. In addition, environmental changes in the microbiome and/or diet due to migration to industrialized and/or Western countries may contribute to atopy presentation [16]. Even migrants and natives living in the same geographical location have differing allergy prevalence that forces them to adjust their dietary habits. Increased populations living in cities, migration, and economic growth have led to an increase in the incidence of food allergies [17]. Studies show that the environment and ethnicity play a part in this [18].
Further research is needed to understand how progenitor culture affects infants´ dietary habits. Considering that societies are currently a mixture of traditional cultures and Western culture, as well as the results presented, as future research lines in this area, the study of the effect of this culture exchange on infant feeding. Knowing these mechanisms, pediatricians could develop effective nutrition programs and create healthy food practices among the child population.

2. Socioeconomic Status of Progenitors and Dietary Patterns in Infancy

An unhealthy diet is a well-known risk factor that can lead to chronic non-communicable diseases such as obesity and hypertension. It should be noted that it is crucial not only to focus on the poor nutrition of children, but also on the poor nutrition of parents. The majority do little to change their lifestyle to prepare for pregnancy, and socioeconomic status plays a part in it. Pre-pregnancy Body Mass Index (BMI) (body weight (kg)/height2 (m)) and preconception supplementation are strongly related to health outcomes. This fact is important for fetal development; however, implementing healthy habits is not accessible to all [19]. Furthermore, both parents’ health is relevant, and some studies demonstrated that dietary zinc deficiency impairs reproduction in males and females [20]. It is estimated that one-third of the world population has a zinc shortage [21]. Particular attention should be also paid to the intake and status of some other micronutrients, especially folate, in women of reproductive age. Studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations [22]. Concretely, dietary supplementation with iron, vitamin D, vitamin B12, iodine, and others may be indicated in women at risk of poor supply and insufficiency of these micronutrients. Globally, preconception use of folic acid is estimated to be under 50% [23], with particular concern that young women from lower socio-economic backgrounds are the least likely to follow the recommendations [24].
As mentioned above, the economic status (SES) plays an important role in this process, and further research is needed in countries with resource-limited countries. Research in high-income countries partly attributes disparities in obesity and other health conditions to differences in dietary quality [25][26]. In most high-income countries, high-calorie foods are cheaper, whereas healthier foods tend to be more expensive [27][28], so this will be a crucial factor in determining diet quality [29][30]. Due to this, childhood obesity has increased, and it is now recognized as a global public health problem [31]. Several authors have confirmed a high incidence of overweight and obesity among children aged 5–18 years in various parts of the world [32][33][34]. Findings have also reported a prevalence of overweight among children ranging from 11.8% to 16.33%, whereas the prevalence of obesity was moderately lower, ranging from 4.9% to 10.69% [31][32][33][34].
In contrast, undernutrition is a global health issue concerning children in low- and middle-income countries (LMICs). Approximately one in five children worldwide suffers from childhood malnutrition and its complications, including increased susceptibility to inflammation and infectious diseases [35]. Even so, Coetzee et.al found in a 7-year longitudinal study conducted in 181 South African school children (63 Caucasian and 118 black and mixed-race) that BMI increased over the period studied (2010–2016). Children in higher SES groups were more likely to be overweight and obese (compared to lower socio-economic status groups (overweight: 1.09–2.17% and obese: 2.17–4.35%)). The results further indicate that although there was a decrease in obesity in high-SES children, its prevalence was still higher than in low-SES children [36].

3. Mother’s Diet during Pregnancy and Baby’s Health

To point out the factors that determine a correct dietary pattern during childhood, it is necessary to address the gestation process. In this line, it seems that to reduce health problems and the risk of suffering from chronic diseases during the early stages of life, it is very important to control the nutritional and metabolic environment during pregnancy [37].
The development of the child is affected by the diet and exercise habits of the pregnant woman [38][39]. Having a healthy lifestyle may prevent complications during pregnancy, as well as prevent the newborn from developing non-communicable diseases [40]. Due to this evidence, parents’ habits will possibly alter the whole life of their children [41]. Overweight and obesity have been linked to most diseases [42]. Fetal macrosomia and low birth weight have been associated with gestational diabetes in studies with overweight and obese mothers [43][44].
Thus, findings suggest that this maternal overweight or obesity may also lead to a lower life expectancy for the child, as well as miscarriages and premature births [45][46][47][48]. It has been shown that a high-calorie diet is detrimental to both the mother and the child’s health [49][50]. Therefore, during the pre-gestational period, mothers should try to maintain an adequate weight and healthy eating habits, since during the gestational period, their BMI will largely determine many of the consequences later on [51][52]. It has been shown that even a 10% weight loss in obese women can be a crucial factor for the development of the child. Regarding evidence and general recommendations, a balanced diet is required [52]. The increased consumption of vegetables and fruits, as well as wholegrain products, legumes, and fish showed a lower risk of gestational diabetes is needed to prevent diseases. Additionally, it should be noted that nutrient-dense foods are favorable during gestation because more energy is absorbed. In pregnant women, three servings of vegetables and two servings of fruit should be implemented every day [53]. Foods such as cereal products, especially whole grains, and potatoes are rich in vitamins, minerals, and fiber. Protein, calcium, and iodine may be provided by milk and dairy products [54]. Finally, fish is an important source of vitamin B 12, zinc, and iron. All of them are essential components of a balanced diet. Measures to achieve this should be indicated by medical personnel following scientific evidence [55].
A balanced diet, regular exercise, and a healthy lifestyle are very important before and during pregnancy. The time before conception and the first 1000 days of the child’s life provide the opportunity to lay the foundation for the health of the child and the mother-to-be. The revised recommendations presented here provide practical and up-to-date knowledge-based recommendations for pregnancy and also for women/couples wishing to have a child [41].

4. Nutrients Intake in Infancy and Child Development

Early child development is a crucial period for ensuring an individual’s physical and mental health, with nutrition being among the most important risk factors for early child development [56]. The latest estimates suggest that around 250 million children under five in low- and middle-income countries were at risk of not achieving their full development potential due to stunting and extreme poverty [57]. Contrary, in industrialized countries, child obesity is an important public health challenge, with the most recent data indicating that approximately 18.5% of the population from 2–19 years of age are obese in the United States alone, and current trends in the United Kingdom suggest that by 2050, 25% of all children under 20 years of age will be classified as obese [58][59].
Therefore, an optimal balance between micro and macronutrients is necessary for optimal development and to be able to avoid typical Western diseases in the future; thus, nutrition is essential to children’s future. Industrialized countries are more than sufficient to meet physiological requirements among children [60], but it is also easy to exceed it, and a high protein intake in early childhood has been linked to a higher risk of obesity [61]. One study showed high protein intake in early childhood to be associated with a higher fat mass index (FMI), but not with a higher fat-free mass index at school age. This association is stronger from animals than from vegetable protein [62]. An official upper limit of protein intake is yet to be established among children.
Regarding micronutrients (vitamins and minerals), research on the relationship between micronutrient status during early childhood and obesity in later life is urgently needed. Growth (weight and length) during the first 2 years of life shows the nutritional status of infants and young children is the consequence of breastfeeding and complementary feeding [63]. Particularly, a review carried out by Singhal et al. revealed that rapid weight gain in infancy is positively associated with obesity in later life [64]. A slower rate of weight gain and possibly a decreased risk of overweight in childhood and adolescence compared to formula feeding have been related to exclusive breastfeeding [63]. Breastfeeding is associated with ~a 20% reduction in the odds of being overweight, whereas a lack of breastfeeding, low birth weight, and rapid weight gain were associated with obesity [64].

5. Dietary Patterns in Infancy and Cognitive Function

Good cognitive development and brain function during the prenatal period and early years is influenced by nutrition [65]. Findings have suggested that children with a better nutritional status could have improved their cognitive and neuropsychological function [66]. The quality of nutrition during pregnancy and breastfeeding is reported to be relevant for better test scores of cognitive functions [67]. Furthermore, studies have looked at the relationship between early nutrition status and growth in infancy and childhood. Knowing these two aspects and the complex interactions between environmental stimuli and nutritional patterns, this issue should be further explored in future research.
Children´s growth is determined by their early nutrition status. Evidence has established that early nutrition can have a long-term effect on growth, metabolic outcome, and long-term health [68]. This status depends on many factors, including the mother’s diet [69], her socioeconomic status [69], and if her children are breastfed or not. Thus, a balanced maternal diet during pregnancy is essential. The formation of the neural tube depends on these nutrients, and a deficiency can adversely affect brain development, resulting in neural tube defects, spina bifida, and encephalocele [70]. Moreover, iron is necessary for neurogenesis and dopamine production. A deficiency in these nutrients may cause significant cognitive impairment in the offspring [71][72][73]. Concerning breastfeeding, neurological benefits of breastfeeding in infancy were demonstrated previously [70][74]. When the supply of long-chain polyunsaturated fatty acids through the placenta is interrupted, this supplementation depends on the mother´s diet [75]. The evolution of the mother’s body has created mechanisms that adjust the amount of fat in milk to the needs of the child [76]. Knowing that breast milk contains long-chain polyunsaturated fatty acids which form the major 34 structures of 35 neuronal membranes, it is important to highlight that it could play a critical role in human nervous system functioning [77][78]. Firstly, there is considerable evidence linking breastfeeding with better performance in intelligence tests [79]. Studies show that three months of breastfeeding improves intelligence quotients 2.1 times over others [67]. Additionally, improvements in motor skills, as well as language development, have also been found [80]. Even if breastfeeding is extended to 6 months, there seems to be a lower risk of developing attention deficit, hyperactivity, or autism spectrum syndrome [81]. However, other studies have found no difference between the promotion of exclusive breastfeeding and children aged 5–8 years on several measures of children’s cognitive development [82][83]. Although diets have been extensively studied concerning children’s cognitive development, there is less research showing interest in the transition from liquid foods to solids. Therefore, further research is needed to understand how the influence of context and socioeconomic status may influence cognitive functions. However, evidence suggests that the promotion and support of breastfeeding and other healthy feeding practices are especially important for children of low socioeconomic status, who are at increased risk of obesity [84] and cognitive impairment [85].
Regarding the nutritional status, the degree of nutrient deficiency may be modified or even increased during the mother’s and child’s lifespans. Findings suggest that certain types of deficiency, such as iron deficiency, are related to impaired brain development [86]. All the influences surrounding both mother and child have attributed a relevant role in this process. The rapid growth of the brain during the gestational period makes it very vulnerable to an inadequate diet. Comparing both types of countries, developing and industrialized, evidence in Kenya and Mexico showed that where the mother’s energy intake declines gradually throughout pregnancy, not only do mothers gain only half as much as European or North American women, but also, they even lose weight and fat in the last month of pregnancy [87]. In both, iron scantiness occurs commonly, which is known to adversely influence cognition [65][88]. Although maternal nutrient deficiencies could be modified with micronutrient supplementation starting in pregnancy, increasing birth weight, there is a burgeoning importance of maternal health before conception and the key risk factors for unfavorable birth outcomes, such as those related to cognitive development. There is a need to develop programs and policies to enhance nutritional status across the life course and especially during reproductive ages to promote healthy patterns in infancy. Moreover, the importance of health before and after pregnancy and possible actions to take may contribute to this [22].

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Alexandra Martín-Rodríguez
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Álvaro Bustamante-Sánchez
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Eduardo Navarro-Jiménez
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Erika Plata-SanJuan
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José Francisco Tornero-Aguilera
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Vicente Javier Clemente-Suárez
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Entry Collection: Gastrointestinal Disease
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Update Date: 01 Aug 2022
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