[1505.67] Diversity of Complementary Feeding in the First Year of Life Differs by Country: the Global Exploration of Human Milk Study

Jessica G. Woo, Patricia M. Herbers, Barbara S. Davidson, Robert J. McMahon, Ardythe L. Morrow. Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Mead Johnson Pediatric Nutrition Institute, Glenview, IL.

BACKGROUND: The World Health Organization (WHO) recommends a diverse complementary food diet for infants over age 6 months of age. However, there is limited longitudinal data on the development of dietary diversity during the first year of life.
OBJECTIVE: To describe the development of dietary diversity to age 1 year in parallel birth cohorts in Shanghai, Mexico City and Cincinnati (USA).
DESIGN/METHODS: 365 breastfed infants (120 in Shanghai and Cincinnati, 125 in Mexico City) were enrolled near birth and dietary intake assessed weekly by 24-hour recall to age 1. Diet diversity per month from age 6 to 12 months was assessed using a modified WHO indicator, as at least 4 of 7 food groups on at least one week in the month. Diet diversity was analyzed longitudinally by cohort, controlling for month of age and the proportion of the diet composed of breast milk.
RESULTS: Dietary diversity increased by month of age, from 6 (31%) to 12 (92%) months, and was significantly more common for children with low (84%) versus high breastfeeding (38%, p<0.0001) in all cohorts. Less than 28% of highly breastfed Cincinnati infants achieved diverse diets between 6-12 months. Comparisons of cohorts by month of age reveal significantly different proportions achieving diet diversity in Shanghai, Mexico City and Cincinnati, with Shanghai demonstrating the highest proportion at each month of age. Logistic regression showed independent effects of age (p<0.0001), proportion of the diet as breast milk (p<0.0001), and cohort (Shanghai vs. Cincinnati: p<0.0001), Mexico City vs. Cincinnati: p=0.02) on diet diversity.

CONCLUSIONS: Development of dietary diversity in the first year of life differs widely by country, adjusting for age and breastfeeding, with infants in Shanghai demonstrating high diet diversity by age 8 months. Of particular concern are infants in the Cincinnati cohort who are highly breastfed between 6-12 months. Impacts on growth should be considered.
First Author Funded By Disclosure Information: Mead Johnson Nutrition Institute, Inc., supported the study (Global Exploration of Human Milk) from which the data are presented. Funds are received and managed by Cincinnati Children's Hospital Medical Center, and I serve as co-PI of the study. Funding from this project supports 20% of my salary.


Session: Poster Session: Epidemiology (1:00 PM - 4:00 PM)
Date/Time: Saturday, May 3, 2014 - 1:00 PM
Room: Exhibit Hall C - Vancouver Convention Centre
Board: 67
Course Code: 1505


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