Nutrition Publications

Diarrhea remains one of the most common causes of mortality in children under five years of age in India. Latest NFHS-5 data suggests prevalence of diarrhea in the 2 weeks preceding the survey to be 9.2% in children under 5 years of age. However, various individual studies suggest the prevalence of diarrhea to be 20-40% in children under 5 years of age.

Preterm infants often demand intensive care due to associated risks and their unique demand for nutrition during hospitalizations and post-discharge. Although the mother’s milk has been universally accepted as the best feed for an infant it might not suffice the needs of a preterm infant. This article discusses the importance of preterm nutrition along with the factors that need to be considered during the fortification of human milk.

Micronutrient deficiencies particularly that of iron early in life is often linked with adverse outcomes in growing infants and later life. In India, in most of the regions, ragi is used as one of the complementary foods for infants due to its quality of being a powerhouse of nutrients such as proteins, iron, calcium, phosphorus, and many more.

Toddlers have high nutritional requirements relative to their size

To support their rapid growth and development, toddlers need more nutrients than an adult, per kg bodyweight.

This article aims to deliver a critical review of the management of functional gastrointestinal disorders (FGIDs) and the importance of probiotics (Lactobacillus reuteri) to strengthen the gut defense in toddlers.

<p>Anaerobic Dominated by:</p>

<p>Firmicutes Bacteroidetes</p>

<p>Dietary intake during toddlerhood sets the foundation for a healthy life</p>

<ul>
<li>Solid foods enrich microbiota with genes that code for the utilization of a larger variety of
<ul>
<li>Carbohydrates</li>
<li>Vitamin biosynthesis</li>
<li>Xenobiotic degradation</li>
</ul>
</li>
<li>Imbalanced gut microbiota canoptimal amount lead to GIDs like constipation</li>
<li>Diversity of microorganisms in the gut microbiota is correlated with overall health</li>
</ul>

MEETING THE IRON NEEDS OF YOUNG CHILDREN

Iron is the world’s most abundant But... 40% Indians suffer from iron deficiency anemia

59% of Indian children suffer from Iron deficiency

CORRECTING ANEMIA DOES NOT ALWAYS REVERSES ITS CONSEQUENCES

Improvements to the diet:

Iron-rich foods

Iron-fortified foods Milk fortifiers

<p>Gut microbiota:</p>

<ul>
<li>Plays a crucial role in influencing immune system</li>
<li>Early life microbiota undergoes the process of maturation before stabilizing</li>
<li>More stabilized by the age of 3–4 years</li>
<li>Gut microbiome plays critical role in growth and development</li>
<li>It modulates immune system development, host nutrient metabolism, and promotes differentiation of mucosal structure and function</li>
<li>Eubiosis throughout life plays a key role in overall health</li>
</ul>

In toddlerhood, children learn new skills and show prominent changes in growth and development. While toddlers are undergoing rapid growth and development, a balanced diet is essential to help them develop their gastrointestinal tract and gut microbiota. In turn, healthy gut microbiota plays beneficial role in growth and development and for optimal immune system function of the toddler.

L. reuteri is the most studied probiotic and has demonstrated effectiveness in prevention and management of FGIDs. It helps to modulate the immune response in the gut. L. reuteri has multiple beneficial effects on health:
Antimicrobial effect (due to production of substances like reuterin), modulation of gut microbiota, immunomodulatory effects, reduction
of visceral pain, and promotes gut mucosal integrity.

Optimum nutrition in the first thousand days is vital for establishing a child’s future health, with impacts that last even in adulthood. At each stage during this critical window, nutrition is important not only for growth, but also for developing a child’s immunity, developmental skills, and neurocognition.

Protein intake, both quantity, and quality, during the first two years of life has important effects on growth, neurodevelopment, and long-term health. Protein composition is an essential factor contributing to gastric emptying. Whey protein is rapidly emptied from the stomach and is easy to digest.

Early life growth patterns can exert a long-term impact on risk of overweight and obesity development.
As per the interventional and observational studies, infant diet is one of the most influential and modifiable factors that affect the growth and later health status of adults.

Nutrition during the initial years is extremely crucial for brain development that is genetically programmed to grow at faster pace compared to other organs; adequate nutrition during this sensitive period of brain development, when language, attention and other skills are shaped, ensures proper cognitive development.

Immune health is influenced by environment, genetics and nutrition. Multiple nutrients work in tandem to provide a holistic positive impact on the developing immune system. Maternal nutrition and post-natal child nutrition influences gut microbiota and immune development. Gut microbiota plays a major role in immune maturation.

The period from 2 to 5 years of childhood marks rapid cognitive, social, emotional, and motor development. Nutrient requirements in children are quite high during this period, both in terms of quality and quantity. Most often, high-energy, low-quality foods are offered to children belonging to this age group because of their unpredictable eating behaviours, thereby increasing the risk of nutritional deficiencies and thus contributing to childhood obesity. A good supply of macronutrients as well as micronutrients, such as iron, calcium, vitamin A, and vitamin C, is essential to support rapid growth and development. Growing-up milk can be a good source of these key micronutrients that support the high and changing nutritional needs of children, and thus bridge the nutritional deficiencies.

Infantile colic, otherwise known as excessive crying, is one of the most common reasons for parents to consult their pediatricians, especially during the first few months of their infants’ life. Apart from causing considerable stress to parents, management of colic also presents as a significant challenge for the caregivers. Although the exact cause of infantile colic is unknown, various factors may act in tandem, leading to gastrointestinal tract disturbances that result in excessive, inconsolable crying in infants. The composition of gut microbiota is strongly associated with infantile colic, and altering the gut microbiota may be one of the potential ways to resolve colic in infants. Probiotics, such as Lactobacillus reuteri, has shown to be effective in treating infantile colic because of their ability to alter the gut microbiota.

Toddlers are children, during this growing phase, they have specific nutritional requirements. If these specific requirements are not met, they are at an increased risk for multiple nutritional deficiencies or malnutrition. It is, therefore, necessary to have a healthy balanced nutritional diet during infancy and toddler-hood. Growing-up milk (GUM) or nutritious milk for a growing toddler is one such way of making sure that toddlers have the appropriate nutrition in the required amount.

Early dietary behavior, right from the complementary feeding period, influences the food preferences and health outcomes later in life. Complementary feeding practices are important to ensure an adequate nutrition for a child from 6 to 24 months of life, which is a critical window for optimal nutrition. Understanding the frequency of feeds, consistency of food, the need for nutrients, and the eating behavior not only helps in providing the required nutrition but also molds healthy eating habits in later life. Unhealthy eating habits, on the other hand, can not only increase the risk for non-communicable diseases in adulthood, but can also have adverse long-term consequences on intelligence quotient and cognitive development.