Fiber consumption and dietary difficulties in childhood: contributing foods and associated factors
DOI:
https://doi.org/10.5902/2236583448311Keywords:
Dietary fiber, Child nutrition, Picky eating, Food consumption.Abstract
Objectives: To describe fiber intake by children with feeding difficulties (FD) according to the recommendation of the Brazilian Society of Pediatrics (SBP), identify and describe the five foods that most contribute to fiber intake, and verify the factors associated with fiber consumption within the recommendation. Methods: This is a retrospective observational study, based on the use of data from medical records and with sampling assembled for convenience. The five foods that contributed most to fiber consumption (total, soluble and insoluble) were presented according to the percentage of contribution. The factors associated with fiber consumption within the recommendation were verified using logistic regression. Results: Most children (53.8%) had a consumption below the SBP recommendation. The major contributors to the total fiber intake were breads, rice and cereals, followed by fruits, beans and other pulses, vegetables and fruit juices. The contributors of soluble and insoluble fibers are similar to the total fiber rank. Parents’ education showed a positive association with fiber consumption within the recommendation (OR: 5.30; 95% CI 1.08-25.99; p = 0.039), while using distraction during the meal and lack of child autonomy to serve themselves showed a negative association (OR: 0.43; 95% CI 0.19-0.96; p = 0.040 and OR: 0.44; 95% CI 0.20-0.98; p = 0.045, respectively). Conclusion: Most children with FD presented fiber consumption below the recommendation. Most of contributing foods have good nutritional quality. The factors associated with fiber consumption were parents’ education, use of distraction during the meal and the child autonomy to serve themselves. Thus, the meals dynamics and the parentes role in food are important and should be evaluated and guided during the FD monitoring.Downloads
References
Sociedade Brasileira de Pediatria – Departamento de Nutrologia. Manual de Alimentação: orientações para alimentação do lactente ao adolescente, na escola, na gestante, na prevenção de doenças e segurança alimentar/Sociedade Brasileira de Pediatria. Departamento Científico de Nutrologia. 4ª. ed. São Paulo; 2018.
Edwards CA, Xie C, Garcia AL. Dietary fibre and health in children and adolescents. Proc Nutr Soc. 2015; 74(3): 292-302.
Catalani LA, Kang EMS, Dias MCG, Maculevicius J. Fibras alimentares. Rev Bras Nutr Clín. 2003;18(4): 178-182.
Kranz S, Brauchla M, Slavin JL, Miller KB. What do we know about dietary fiber intake in children and health? The effects of fiber intake on constipation, obesity, and diabetes in children. Adv Nutr. 2012; 3(1): 47–53.
Taylor CM, Northstone K, Wernimont SM, Emmett PM. Picky eating in preschool children: Associations with dietary fibre intakes and stool hardness. Appetite. 2016; 1; 100: 263-71.
Maranhão HS, de Aguiar RC, de Lira DTJ, Sales MUF, Nóbrega NAN. Dificuldades alimentares em pré-escolares, práticas alimentares pregressas e estado nutricional. Rev Paul Pediatr. 2018; 36(1): 45-51.
Nogueira-de-Almeida CA, de Mello ED, Filho DR, Maximino P, Fisberg M. Consenso da Associação Brasileira de Nutrologia sobre o uso de suplementos alimentares para crianças com dificuldades alimentares. International Journal Of Nutrology, Int J Nutrol. 2018;11(suppl S1): S4–S15.
American Society of Psichiatry. Diagnostic and Statistical Manual of Mental Disorders - DSM V. 2013.
Kerzner B. Clinical Investigation of Feeding Difficulties in Young Children: A Practical Approach. Clin Peditr. 2009; 48: 960-5.
Maximino P, Machado RHV, Junqueira P, Ciari M, Tosatti AM, Ramos CC, et al. Como acompanhar a criança com dificuldade alimentar em escopo multidisciplinar? Protocolo de atendimento multiprofissional na infância e adolescência - estudo piloto. J Hum Growth Dev. 2018; 26(3): 331-340.
Ribeiro LW, Ricci R, Maximino P, Machado RHV, Bozzini AB, Ramos CC, et al. Clinical use of a food inventory to identify maternal underreport on children’s food intake: experience of a reference center in Brazil. Nutr Clín Diet Hosp. 2018; 38(1): 81-89.
Spinelli MGN, Goulart RMM, Santos ALP, Gumiero LDC, Farhud CC, de Freitas EB, et al. Consumo alimentar de crianças de 6 a 18 meses em creches. Rev Nutr. 2003; 16(4): 409-414.
Finn K, Jacquier E, Kineman B, Storm H, Carvalho R. Nutrient intakes and sources of fiber among children with low and high dietary fiber intake: the 2016 feeding infants and toddlers study (FITS), a cross-sectional survey. BMC Pediatrics. 2019; 19(1): 446.
Moshfegh A, Goldman J, Cleveland L. What we eat in America, NHANES 2001–2002. Usual nutrient intakes from food compared to Dietary Reference Intakes. Beltsville, MD: USDA, Agricultural Research Service, 2005.
Barbosa RMS, Soares EA, Lanzillotti HS. Avaliação da ingestão de nutrientes de crianças de uma creche filantrópica: aplicação do Consumo Dietético de Referência. Rev Bras Saúde Matern Infant. 2007; 7(2): 159-166.
Bosscher D, Caillie-Bertrand MV, Deelstra H. Daily dietary fibre intake of children, 2 to 3 years of age, living in Antwerp, Belgium. Nutrition Research. 2002; 22(12): 1401-1411.
Ricci R, Nogueira LR, Maximino P, Machado RHV, Ramos CC, Fisberg M. Repertório alimentar de crianças com dificuldades alimentares baseia-se em doces, sobremesas, produtos de panificação e biscoitos. RASBRAN (no prelo).
Galloway AT, Lee Y, Birch LL. Predictors and consequences of food neophobia and pickiness in young girls. J Am Diet Assoc. 2003;103(6):692–698.
Eswaran S, Muir J, Chey WD. Fiber and Functional Gastrointestinal Disorders. Am J Gastroenterol. 2013;108(5):718-27.
Korczak R, Kamil A, Fleige L, Donovan SM, Slavin JL. Dietary fiber and digestive health in children. Nutr Rev. 2017;75(4):241-259.
de Souza VBB, de Vasconcelos LPF, Araújo DGS, Lemos JOM, de Medeiros LSM, Nogueira RBSS, et al. Constipação intestinal em crianças e a importância das fibras alimentares: Uma revisão da literatura. Revista Eletrônica Acervo Saúde. 2019;(21): e561.
Slavin J. Fiber and Prebiotics: Mechanisms and Health Benefits. Nutrients. 2013; 5: 1417-1435.
Fuller S, Beck E, Salman H, Tapsell L. New Horizons for the Study of Dietary Fiber and Health: A Review. Plant Foods Hum Nutr. 2016;71(1):1-12.
Wegh CAM, Schoterman MHC, Vaughan EE, Belzer C, Benninga MA. The effect of fiber and prebiotics on children’s gastrointestinal disorders and microbiome. Expert Rev Gastroenterol Hepatol. 2017;11(11):1031-1045.
Wang H, Wang Y. Gut Microbiota‑brain Axis. Chin Med J (Engl). 2016;129(19):2373–2380.
Anderson JW, Baird P, Davis Jr RH, Ferreri S, Knudtson M, Koraym A, et al. Health benefits of dietary fiber. Nutr Rev. 2009;67(4):188-205.
Williams CL, Dietary fiber in childhood. The Journal of Pediatrics. 2006;5: S121-S130.
Satter E. Eating competence: definition and evidence for the Satter Eating Competence model. J Nutr Educ Behav. 2007; 39(5 Suppl): S142-53.
Machado RHV, Tosatti AM, Malzyner G, Maximino P, Ramos CC, Bozzini AB, et al. Maternal feeding practices among children with feeding difficulties-cross-sectional study in a Brazilian Reference Center. Front Pediatr. 2018;5:286.
Silva GAP, Costa KAO, Giugliani ERJ. Infant feeding: beyond the nutritional aspects. J Pediatr. 2016; 92(3 Suppl 1): S2-S7.