Newcastle University

Project:

Diet and Nutrition Survey of Infants and Young Children (DNSIYC)

From July 2009 to September 2012
Project Leader(s): Professor Ashley Adamson
Staff: Jennifer Delve
Homepage: http://www.mrc-hnr.cam.ac.uk/research/current-projects/diet-and-nutrition-survey-of-infants-and-young-children

Appropriate nutrition for the youngest age groups in the population is of paramount importance for ensuring optimal development and growth.  Breastfeeding during early life and introduction of appropriate weaning foods at key time points are critical for laying the foundations for health later in life.  In recent years, there have been changes to recommendations for exclusive breast feeding, with a worldwide declaration that all infants should be exclusively breast fed to 6 months of age, a policy which was adopted by the Department of Health in 2003 , updating the earlier recommendation that foods should be introduced after 4 months . Recommendations are also made about the introduction of solid foods, which foods should be avoided in the first year and which should be encouraged to enable adequate intakes of those nutrients which are low in breast milk, like iron.  Debates continue about supplementation of infants, with the United States recently introducing a recommendation that all breast-fed infants be supplemented with Vitamin D from the first few days of life.

In order to assess compliance with recommendations, and to determine the nutritional health of the youngest ages in the UK, it is necessary to conduct representative dietary surveys of this age group.  This group is not part of the new National Diet and Nutrition Survey rolling programme, which begins at age 18 months, and it has not been the subject of a large national survey for many years. The Department of Health has conducted an Infant Feeding Survey every 5 years since 1990.  This provides valuable information about infant feeding, particularly about breast feeding, through questionnaires, but does not assess intake quantitatively. Information on actual quantities consumed by this age group has been provided in the past by several studies, including the Food and Nutrient Intakes of British Infants age 6-12 months, conducted in 1986 and funded by MAFF, on 488 infants from a nationally representative commercial baby panel.  Much information has also been gained from the ALSPAC cohort (Avon Longitudinal Survey of Parents and Children), but this is confined to the Avon area of south west England, and it is also now some years since the participants in the cohort were infants and toddlers.  The Infant Feeding Surveys suggest that there are changing proportions of the population breast feeding and introducing foods at different ages.  The Millennium cohort has provided useful up to date information about feeding, but it too is not quantitative and cannot capture total amounts consumed or intakes of key nutrients.  Other smaller studies do provide detailed information, such as the Cambridge Baby Growth Study, the MRC Cambridge Growth Study and the Southampton Women’s Study, but these studies in the UK tend to be small and in only one region.  It is therefore apparent that a survey of infants and young children in the UK is needed.  Such a survey would complement the Infant Feeding Surveys and the National Diet and Nutrition Survey and provide up-to-date estimates of the dietary intakes and nutritional status for key nutrients for this age group.  The proposal that follows describes the approaches and procedures that we would use to conduct a Diet and Nutrition Survey of Infants and Young Children.

Aims of the survey
As outlined by the Agency, the aims of the Diet and Nutrition Survey on Infants and Young Children are to:

• provide detailed, quantitative information on the food and nutrient intakes, sources of nutrients and nutritional status of a representative sample of infants and young children aged 4 to 18 months from the UK population, as a basis for developing Government policy and measuring progress towards Agency Strategic Plan targets and other Government objectives;
• provide detailed information on breast and breast milk substitutes consumed by the population group under study;
• describe the characteristics of subjects with intakes and/or status of specific nutrients that are above and below national reference values;
• produce a database of food consumption to provide the basis for the calculation of likely dietary intakes of natural toxicants, contaminants, additives and other food chemicals for risk assessment;
• provide height (length), weight and other body measurements and examine their relationship to social, dietary and health data as well as data from blood analyses (if included);
• evaluate the diet of the population group under study to form a basis to establish the extent to which it is adequately nutritious and varied;
• establish the extent of deviation of the feeding practices adopted by carers of this population group from national policy for infant health;
• act as a basis for policy development;
• roughly establish the dietary habits of the mother, and other key family members, and link to the nutrient intake and nutritional status of this population group.
  

Prior to commencing the main stage of DNSIYC, a pilot study was conducted at Newcastle University to determine the most accurate approach for estimating portion sizes in infants aged 4-18 months. The aims of the pilot study were to assess whether the provision of measuring equipment alters either the foods given to children or the amount consumed by comparing measured intakes to weighed intakes. Further work has also been completed in which weighed intakes were compared to estimated intakes using household measures.