Nutrition and health in infancy and childhood an epidemiological approach to the assessment of dietary habits, their determinants and implications

Sammanfattning: The aim of this thesis is to describe the distribution of feeding habits and dietary habits of Swedish children of different ages, to search for determinants of the observed distributions and to analyse some possible implications of those habits regarding health and growth. The present results emanate from a longitudinal study of feeding, growth and development of 312 infants and from a cross-sectional study on the dietary habits of 738 children aged 4,8 and 13 years.The dietary assessement techniques used in these epidemiological studies are evaluated (e.g. 24-hour recall, 7-day recording of food intake and dietary history technique).The infant feeding habits in three communities are described and the variation of those habits in different strata is discussed. Breastfeeding habits are analysed using multivariate techniques.The energy and nutrient intake of weaned infants aged 6 and 12 months was characterized by a good supply of most nutrients in comparison with recommended dietary allowances. The mean energy intake of the studied, normally-growing infants at 6 months was 80 per cent of the recommended intake.The growth velocity during the first three months of life for entirely breastfed infants was found to be higher than for mixed-fed or formula-fed infants. The need for a revision of present growth standards for use in breastfed populations during the first 6 months of life is discussed.An attempt was made to formulate a causal model for dental caries, including dietary factors and caries-preventive activities, and to make som quantitative interpretations from this model and the present set of data.Dietary habits associated with different short- or long-term health risks were analysed in the ages 4, 8 and 13 years. The dietary intake of iron was satisfactory and no cases of iron deficiency anaemia were found. On average 10 per cent of the daily energy intake derived from sucrose. The fat intake was characterized by a high intake of saturated fat and a low P/S ratio. Most children had a daily sodium intake above recommended levels. The prevalence of obesity differed between different social strata, especially in the oldest age group. Overweight children did not have a higher energy intake than normal-weight children. The need for a population approach to prevention in childhood of some diet-related health problems in adult life is discussed.The present dietary patterns and health of children in northern Sweden are compared with the situation 15 and 50 years ago, when nutrition surveys were performed in the same areas.