Dietary quality and adequacy of micronutrient intakes in children.

Presented are longitudinal studies, extending from infancy (n 180) to 2 years of age (n 130) and 6 years of age (>70% participation) of diet and Fe status in a population with high birth weight, high frequency of breast-feeding and, at the time of the study, high intake of cow's milk during the weaning period. The association between socio-demographic and dietary factors was also studied, together with Fe status in early childhood and developmental status at 6 years. Fe status was found to be poorer than in the neighbouring Nordic countries. Every fifth 1-year-old was Fe-deficient (serum ferritin <12 microg/l and mean corpuscular volume <74 fl). It was demonstrated by regression analysis that Fe status was negatively associated with cow's milk consumption at 9-12 months (significant at >460 g/d) and was weakly positively associated with fish, meat and Fe-fortified cereal consumption. Fe-deficient infants had a shorter duration of breast-feeding, and breast-feeding was related to slower growth, which can protect from worsening Fe status. Fe deficiency was less common at ages 2 and 6 years. Maternal factors associated with lower adherence to the recommended infant diet were less education, lower age and smoking. In a multiple stepwise regression analysis that included food factors, socio-demographic factors were not found to be associated with Fe status. Fe-depleted and Fe-deficient 1-year-olds had lower fine motor scores when they were 6 years old than those who were not Fe-deficient or Fe-depleted. The findings of these studies have already led to changes in the local recommendations for diet in infancy. The results suggest that Fe deficiency at 12 months of age affects development at 6 years of age. The studies indicated that mothers with less education, who smoked and who were younger needed more guidance concerning recommendations about diet in infancy.