Comprehensive Dietary Assessment of Children Aged 1 Year to 6 Years (5-72 Months) - a Cross-sectional, Nationwide Study: PITNUTS 2024

Background:

Correct nutrition is one of the most important factors for the optimal psychosomatic development of the child. Both short- and long-term observations emphasise the importance of nutritional factors in the childs development already in the foetal period and in the first two years of life (the idea of the first 1,000 days of life). Research shows that the components of the model of safe child nutrition, such as exclusive breastfeeding of the child in the first six months of life, breastfeeding and skilful expansion of the diet in the second six months of life and appropriate nutritional management in the post-natal and pre-school period form the basis for normal growth, the formation of healthy eating behaviour and also reduce the risk of diet-related diseases in adulthood. Parental awareness towards skilful dietary expansion and the introduction of foods with a favourable nutrient profile depends to a large extent on effective nutrition education (PITNUTS 2016). Data on infant and child nutrition in Poland are limited. The PITNUTS study, conducted in Poland in 2016 on a randomly selected sample (N=1059), found that the diet of infants and children aged 5-36 months deviated from the dietary recommendations. An analysis of the nutrient profile in the diets of postnatal children showed a varied energy value and a significantly higher protein supply in relation to population norms (Weker et al, 2017; Weker et al, 2019). A survey conducted during the COVID-19 pandemic by Horvath et al. also showed a discrepancy between mothers; nutritional knowledge and feeding practices of infants aged 4-12 months (Horvath et al, 2022). Inappropriate feeding practices translated into nutritional status, which was confirmed in a study conducted in Poland as part of the National Health Programme 2016-2020 (Kułaga ed. 2021). On the other hand, in a nationwide study conducted in 2017-2020 among pre-school and school children, abnormal body weight was found in more than 30% of respondents (PAN 2023). Observational studies conducted worldwide have confirmed the short- and long-term effects of nutrition on the nutritional status of infants and young children. A beneficial effect of diets including fortified foods on reducing the risk of deficiencies of nutrients such as iron, vitamin D and calcium and the energy balance of the diet has also been found (Lioret et al 2015, Schroeder et al 2015, Ahluwalia et al 2016, Hammer et al 2016, Akkermans et al 2017, McCarthy 2017, Finn et al 2017, Csölle Iet al 2022).

In recent years, updated and revised dietary recommendations for the paediatric population, for three age groups, have been issued, based on the latest reports and international recommendations (Fewtrell et al 2017, Hojsak et al 2018, Fidler et al 2017, Dereń et al 2019).

Updated Guidelines of nutrition for healthy infants - Position statement of the Polish Society of Gastroenterology, Hepatology and Child Nutrition, in line with current ESPGHAN guidelines, the Position statement of the Committee on Human Nutrition Science of the Polish Academy of Sciences on the principles of nutrition for children aged 1-3 years and the Position statement of the Committee on Human Nutrition Science of the Polish Academy of Sciences on the principles of nutrition for pre-school (4-6 years) and early school age children (7-9 years) were developed. Changes to the guidelines included, among others, the introduction of allergenic foods, the serving of plant-based beverages and fruit juices (in the first year of life), and the updating of safe nutrition models in relation to food rations (in the 1-3 years and 4-9 years groups) (Szajewska H. et al, 2021, PAN 2022, PAN 2023).

Understanding current practices and challenges in infant and child nutrition will allow better tailoring of nutrition education interventions targeting parents and children. The aim of this study is to assess the diet and nutritional status of infants and children aged 5-72 months, the consistency of feeding practices with current recommendations and to compare with the results of the previous PITNUTS survey conducted in 2016.