Implications of the weaning pattern on macronutrient intake, food volume and energy density in non-breastfed infants during the first year of life.

OBJECTIVES: To evaluate the implications of the patterns of weaning on the intake of macronutrients, energy intake, food volume and the energy density in healthy infants in the Mediterranean area of Spain. SUBJECTS AND STUDY
DESIGN: Cross-sectional study of 120 clinically-healthy, non-breastfed infants at the ages of 4, 6, 9 and 12 months randomly recruited from three pediatric out-patient clinics. Nutrition data were obtained from the infant's food preparer using the 24-hour dietary recall method.
RESULTS: Energy intake/kg body weight was within the recommended daily allowance and did not vary significantly with age (423 kJ/kg body weight at 4 months and 443.7 kJ/kg at 12 months). There was a progressive decrease in the intake volume (p < 0.001) in which carbohydrate-rich foodstuffs were the major factors, and an increase in the energy density (p < 0.001) in which the protein-rich items were the principal contributors. Lipid intake diminished progressively (p < 0.01) to a nadir of 26.4% of energy intake at 9 months of age. In each of the meals there was a tendency towards a progressive increase in energy intake with age. This increase was achieved by a significant increase in energy density (p < 0.001 in all meals, except dinner p < 0.05). Conversely, the intake volume of breakfast, lunch and dinner remained essentially unchanged between 6 and 12 months while that of the mid-evening meal decreased markedly.
CONCLUSION: Increased energy requirements for growth is achieved, mainly, by an increase in the energy density rather than the intake volume during food-item diversification in the non-breastfed infant. Cereals were the central food item in the weaning diet in our study sample and which adequately compensates, in terms of energy requirement, for the early reliance on the lipids contained in milk.