The Need for Dietary Guidelines for Children Under 2
Creators: name: Lai, Breana
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2011

description: The rising prevalence of overweight and obesity among Americans coupled with the associated health consequences and costs represent a major public health problem (Reilly JJ). If current trends continue, over 78% of all adults older than 20 years of age, and over 25% of children older than 6 years of age will be overweight by 2020 (Wang Y). This means children born in the past decade may have a shorter life expectancy than their parents (Olshanski SJ). Currently, obesity in the U.S. contributes to a life expectancy ranking of 32nd, lower than that of most other industrialized nations (Preston SH). Data from the National Health and Nutrition Survey (NHANES), the Centers for Disease Control and Prevention (CDC) Pediatric Nutrition Surveillance System, and the Massachusetts Health Maintenance Organization, all report significant increases in the prevalence of overweight in young children (Ogden CL; Mei Z; Kim J). While the prevalence of overweight and obesity increased faster for adults than children, weight status during childhood is a strong predictor of weight status as an adult (Wang Y; Charney E; Whitaker RD). NHANES data from 2003 to 2006 shows 24.4% of children aged 2 to 5 years were already classified as overweight or obese (Ogden CL). With the obesity epidemic continuing to grow, prevention and intervention programs have begun to focus their attention on early age groups to improve the health of current and future generations. Rapid growth and development are hallmarks of infancy. Normally, babies double in weight by 4-6 months and triple in weight by 12 months of age (Jung El). Many parents and caregivers believe that "a chubby baby is a healthy baby," (Sullivan SA) however, excess weight gain during infancy is associated with a risk of obesity during childhood (Baird J; Stettler N). Parents often misclassify their children's weight status and have minimal understanding of tracking along growth charts (Jain A; Lucas P). Though more research is needed, it has been suggested that overfeeding at a young age leads to a 'programming' effect on appetite and metabolism that affects future weight status (Cripps RL). Eating habits formed in the first years of life often remain into childhood and adulthood, and may contribute to the formation of unhealthy dietary behaviors (Cooke L; Birch LL). At the Institute of Medicine's Conference on Preventing Childhood Obesity, it was remarked, "the prenatal period, infancy, and early childhood may be stages of particular vulnerability to obesity development because they are unique periods for cellular differentiation and development. This unique vulnerability might make it possible for actions taken at these stages to determine the future course of adiposity (Lederman SA)." The establishment of healthy eating patterns thus begins at birth and continues when complementary foods are introduced, and the diet of an infant transforms from a sole-source milk diet to a varied multi-source diet. Multiple studies suggest that exclusive breastfeeding and the timing of the introduction of complementary foods, as well as what foods are introduced and how the foods are introduced, can lead to short and long-term health consequences if not completed appropriately. The risks of inappropriate infant feeding include inadequate intake of nutrients for optimal growth and development, and increased risks of allergy, obesity, and picky eating (Paul IM; Centers for Disease Control and Prevention; Norris JM). Weaning practices, dietary variety, and sensory properties of foods introduced during infancy all influence future acceptance and palatability of foods consumed by older children and adults (Nicklaus S). Thus, exposure to first foods may influence lifelong eating behaviors, especially because humans are born with few 'innate' food preferences (Davis CM). Dietary guidance for infants seems not only necessary, but also an integral piece in optimal child development.