Feeding Infants and Toddlers Study: The Types of Foods Fed To Hispanic Infants and Toddlers JULIE A. MENNELLA, PhD; PAULA ZIEGLER, PhD, RD; RONETTE BRIEFEL, DrPH, RD; TIMOTHY NOVAK, MBA

Why I chose this study Breastfeeding and foods introduced to infants is a topic of interest Wanted to look for literature that supports what I am learning in Lifecycle Nutrition Teacher bases his lectures on experience not research

Goal of the Study To asses the prevalence of breastfeeding and formula feeding, the age of introduction of solid foods and the types of foods and beverages consumed by Hispanic vs. non- Hispanic infants and toddlers in the United States.

Introduction High incidence of childhood obesity, which is causing an epidemic of type 2 diabetes, and metabolic disorders among Hispanic youth. Food preferences are established during the first few years of life and will carry forward into adolescence. Developing strategies to eliminate health disparities and enhance acceptance of healthful foods early in life are important for long-term health. Strategies must consider cultural factors that interact with food availability and impact the development of dietary habits during childhood.

Methods Used 2002 Feeding Infants and Toddlers study (FITS), which describes: Prevalence of breastfeeding and formula feeding Age of introduction to certain foods Types of foods and beverages consumed Comparing non-Hispanic and Hispanic infants and toddlers (aged 4-24 months).

Methods 371 Hispanic infants and toddlers 4-5 months (n=84) 6-11 months (n=163) months (n=124) 2,637 non-Hispanic infants and toddlers 4-5 months (n=538) 6-11 months (n=1,228) months (n=871)

Dietary Data Parents or primary care givers were interviewed, using the Nutrition Data System for research to collect 24 hour dietary recalls. Additional question were asked about the age in which the first foods were introduction “on daily basis”, being infant cereals, pureed food and cows milk.

Classification of Foods Milk Grains and grain products Fruits Vegetables Meat and other protein sources Mixed dishes Sweets, sweetened beverages and desserts Salty snacks

Data Analysis Foods reported had to be consumed by at least 10% or more by age/ethnicity subgroup Foods are not double counted in the data table Ex: Grilled cheese at restaurant vs. homemade sandwich The vegetables and fruits estimated reflect when these foods where consumed as distinct items Ex: Peas included baby food peas, cooked and raw. However peas included in a stew were considered as a mixed dish. Estimates were calculated using SAS and SUDAAN Percentages and standard errors were calculated to look at differences between Hispanic and non-Hispanic groups

Results Table 1 (S99): shows prevalence of breastfeeding and introduction to formula, cows milk, infant cereals and baby food (determined by 24 hour recalls)

Results Figure 1: Refer to page S102 Table 2: Refer to page S Figure 2: Refer to page S103 Table 3: Refer to page S104

Strengths and Limitations Strengths Representative sample of Hispanic and non- Hispanic participants Included several cultural specific foods Had a large sample size Limitations Authors did not include a table of demographic differences between Hispanic and non-Hispanic participants Grouping of all ethnic subgroups in on category— Hispanic Lack of spicy food items such as salsas, candies and chips.

Discussion Early food experiences in Hispanic children were different from similarly aged non-Hispanic children. Differences in foods consumption patterns in Hispanic infants and toddlers reflects cultural beliefs and practices that contribute to the development of food preferences and impact nutrition. Foods like tortillas, beans, rice characteristics of Hispanic culture Hispanics and toddlers are more likely to drink sweetened fruit drinks. Drinking sweetened beverages containing fructose may favor the development obesity.

Conclusion “Dietetics professionals should be aware of the cultural differences in the foods fed to infants and toddlers and to ensure that foods chosen contain the needed nutrients. ”

What do we think of… The funding source is Gerber Products Company. Is this a conflict of interest? Do we think this article was published in the correct journal?