The 2008 Feeding Infants and Toddlers Study: Data to Inform Action to Reduce Childhood Obesity

Transcription

1 The 2008 Feeding Infants and Toddlers Study: Data to Inform Action to Reduce Childhood Obesity Ronette Briefel, Dr.P.H., R.D. Senior Fellow Mathematica Policy Research FITS 2008

2 Feeding Infants & Toddlers Study (FITS) Why is FITS important? 2002 FITS -Groundbreaking dietary survey of 3,000 infants and toddlers first of this magnitude Public health concerns about childhood obesity Improved knowledge of nutrient requirements (DRIs) Filled an important gap in information on the nutrient intakes and food patterns of infants and toddlers in the U.S. Shared widely: findings published in over 21 peer reviewed journal articles Influenced public health policy FITS

3 FITS 2008 What s new? Expanded age range from birth to 48 months New interview topics for toddlers and preschoolers Research questions: 1) How have nutrient and food intake patterns of infants and toddlers 4 to 24 months of age changed since FITS 2002? 2) What are the nutrient and food intake patterns of younger infants (0 to 3 months) and preschoolers (24 to 48 months)? FITS

4 Study Design for FITS 2008 Cross-sectional household survey of parents and caregivers of 3,274 U.S. infants, toddlers, and preschoolers from birth to 4 years of age Conducted nationwide in June 2008 through January hr dietary recall of all foods, beverages, and dietary supplements consumed, 2nd recall on a random subsample 2008 Nutrition Data System for Research Statistical software (PC-SIDE) to adjust nutrient intake distributions FITS

5 FITS 2008 Sample Sizes by Age Dietary interviews completed for 3,274 infants, toddlers, and preschoolers from birth to 4 years: 0 to 5 months: 382 younger infants 6 to 11 months: 505 older infants 12 to 23 months: 925 toddlers 24 to 47 months: 1,462 preschoolers 30% participated in WIC (n=794) 0 to 5 months: 117 younger infants 6 to 11 months: 160 older infants 12 to 23 months: 238 toddlers 24 to 47 months: 279 preschoolers FITS

6 FITS 2008 Sample Characteristics 56% non-hispanic white; 14% non-hispanic black; 21% Hispanic; 8% other race/ethnicity 35% are first-born children 30% of children participate in WIC 51% of mothers work; 48% of children in day care 46% of mothers have a college degree or higher 13% have annual household incomes < $20,000; 17% have incomes > $100,000 Note: weighted data, n=3,274 FITS

7 Duration of breastfeeding appears longer Percentage of Children Consuming Any Breast Milk Healthy People 2010 Objective 75% Early Postpartum % at Age 6 Months * 25% at Age 12 Months 0 Ever breastfed * P < 0.05 FITS 2002 FITS 2008 FITS

8 Evidence substantiating the increased duration of breastfeeding Percentage of Children Consuming Any Formula * FITS 2002 FITS 2008 * P < 0.05 FITS

9 Less 100% juice consumption in 2008, especially among infants Percentage of Infants and Toddlers Consuming 100% Fruit Juice at Least Once a Day ** * ** *P < 0.05 ** P < 0.01 FITS 2002 FITS 2008 FITS

10 Less sweetened beverages being consumed from 12 to 20 months 100 Percentage of Infants and Toddlers Consuming Sweetened Beverages at Least Once a Day * * 0 *P < FITS 2002 FITS 2008 FITS

11 40% to 60% of preschoolers drank sweetened beverages 100 Percentage of Children Consuming Sweetened Beverages at Least Once a Day: FITS Any type Fruit drink Carbonated soda FITS

12 Two-thirds or more had a dessert or candy and roughly one-quarter had snack chips 100 Percentage of Children Consuming Dessert, Sweet or Snack Chips at Least Once a Day: FITS Any dessert/candy Cakes, cookies, pastry Candy Snack chips FITS

13 About 30% of older infants and toddlers in WIC are still not consuming fruit 100 Pe Consuming Any Fruit* Percentage of Children Consuming Any Fruit or Fruit Juice at Least Once a Day * 0 * Excludes 100% fruit juices FITS 2002 FITS 2008 * P < 0.05 FITS

14 About 30% of older infants and toddlers in WIC are still not consuming vegetables 100 Percentage of Infants and Toddlers in WIC Consuming Any Vegetable Percentage of Children Consuming Any Vegetable at Least Once a Day at Least Once a Day FITS 2002 FITS 2008 FITS

15 20% to 35% of preschoolers did not eat any fruit 100 e Percentage Consuming Any Fruit or Fruit Juice at Least Once a Day: FITS Fruit or 100% juice Fruit 100% juice FITS

16 Almost a third of preschoolers did not eat any vegetables 100 Percentage Consuming Any Vegetable at Least Once a Day: FITS Any Form Cooked Raw FITS

17 French Fries are not among the Top 5 for infants Top 5 Vegetables Consumed by Age Group: FITS 2008 #1 Sweet Potatoes Sweet Potatoes Mashed Potatoes 1 #2 Green Beans Mixed Garden Vegetables Sweet Potatoes #3 Squash Carrots Broccoli 1 #4 Carrots Peas Green Beans 1 #5 Peas Squash Green Beans Table Food FITS

18 French Fries are still popular among toddlers Top 5 Vegetables Consumed by Age Group: FITS 2008 #1 French Fries Mashed Potatoes Carrots French Fries #2 Mashed Potatoes Green Beans Corn Green Beans #3 Green Beans Peas Green Beans Corn #4 Carrots French Fries French Fries Carrots #5 Other Potatoes Corn Mashed Potatoes Peas FITS

19 French Fries were the most commonly consumed vegetable among preschoolers Top 5 Vegetables Consumed by Age Group: FITS 2008 #1 French Fries French Fries French Fries French Fries #2 Mashed Potatoes Broccoli Broccoli Corn #3 Green Beans Carrots (raw) Mixed Veggies Green Beans #4 Corn Green Beans Corn Tomatoes #5 Lettuce Corn Green Beans Carrots (raw) FITS

20 Positive changes in consumption patterns of infants and toddlers Delayed introduction of complementary foods with slightly longer duration of BF? Less fruit juice consumption through 2 years of age Decreased consumption of desserts, sweets and sweetened beverage from 4 to 12 months of age Decreased salty snacks consumption from 6 to 12 months of age FITS

21 Preschooler Diets: Improvements Needed 20-35% of preschoolers ate no discrete fruit Almost a third of preschoolers ate no discrete vegetables Consumption of dark-green and orange vegetables was low French fries were the most common vegetable Substantial drop in prevalence of whole milk at 24 months, as recommended But about a third were still consuming whole milk and 2% milk was more common than 1% or skim FITS

22 Preschooler Diets: Improvements Needed Extras that contribute discretionary calories were commonly consumed About half of preschoolers had cake, cookies, or pastry About a quarter had candy A quarter or more had salty snacks 40-60% had sweetened beverages Consumption of whole grain breakfast cereals was low Presweetened and not-sweetened cereals about equal FITS

23 FITS Collaborators Project Leaders Ronette Briefel, DrPH, RD Senior Fellow Mathematica Policy Research Mary Kay Fox, MEd Nutritionist and Senior Researcher Mathematica Policy Research Lisa Harnack, DrPH, RD, Nutritional Epidemiologist and Director Nutrition Coordinating Center, University of Minnesota Denise Deming, PhD Principal Scientist, Meals & Drinks Nestlé Nutrition Kathleen Reidy, DrPH, RD Head, Nutrition Science, Meals & Drinks Nestlé Nutrition Advisory Panel Nancy Butte, MPH, RD, PhD Professor of Pediatrics USDA/ARS Children s Nutrition Research Center, Baylor College of Medicine Johanna Dwyer, DSc, RD Professor of Medicine and Community Health Friedman School of Nutrition Science and Policy and School of Medicine and Jean Mayer Human Nutrition Research Center on Aging at Tufts University Barry Popkin, PhD Professor, Department of Nutrition Director, UNC Interdisciplinary Obesity Center University of North Carolina at Chapel Hill Anna Maria Siega-Riz, PhD, RD Professor and Associate Chair of Epidemiology University of North Carolina at Chapel Hill FITS

24 FITS 2008 Extra slides

25 Adequate energy intakes Mean Energy (kcal/d) Intakes: FITS Energy intake (kcal/day) EER EER EER EER EER EER based on CDC median weights (Kuczmarski, 2000) FITS

26 Major findings of nutrient intake assessment in FITS 2008 Age (months) Supplement Use Significant % population < EAR Mean Intake < AI Significant % population > UL Significant % population < AMDR Infants (0 to 11) 8 to17% Iron and Zinc in infants 6 to 11 months Mean intakes all other nutrients exceed AIs Zinc, vitamin A in infants 6 to 11 months Toddlers (12 to 23) 24 to 30% Vitamin E Fiber and potassium Folate, zinc, vitamin A, sodium Total fat % < AMDR Preschoolers (24 to 47) 34 to 48% Vitamin E Fiber and potassium Folate, zinc, vitamin A, sodium Total fat % < AMDR SFA > 10% E FITS