RESUMO
BACKGROUND AND OBJECTIVES: The failure of infants in developing countries to meet nutrient intake recommendations is well documented. The objective of this study was to assess the nutritional adequacy and identify problem nutrients of the diets of Guatemalan infants with continued breastfeeding. METHODS AND STUDY DESIGN: A single previous-day dietary recall was collected from a convenience sample of 94 mothers of infants aged 6-11 mo attending a public health clinic in the urban area of Quetzaltenango, Guatemala. Energy and nutrient content of complementary feeding (CF) and breastmilk, modelled by subtracting estimated energy intakes from CF from energy requirements, were calculated and nutrient adequacy of the diet was assessed. Nutrient densities and critical nutrient densities of CF were computed to identify "problem nutrients" and main food sources of these nutrients. RESULTS: Complementary diets were adequate for protein, but likely to be inadequate for pantothenic acid and vitamins C, A, D, E, and K, as well as calcium, iron and zinc. In the worst-case scenario, i.e. for small girls with limited energy allowances, riboflavin, niacin, vitamin B-6 and magnesium were identified as "problem nutrients" as well. Formula milk, cow milk and Incaparina® were main food sources of "problem nutrients". CONCLUSIONS: The intake of micronutrients during the first six months of the recommend CF period in Guatemala has a number of notable inadequacies, but the gaps are narrower than traditionally reported for this age group in low-income settings.
Assuntos
Aleitamento Materno , Alimentos Infantis , Transtornos da Nutrição do Lactente/epidemiologia , Fenômenos Fisiológicos da Nutrição do Lactente/fisiologia , Nutrientes/deficiência , Países em Desenvolvimento , Ingestão de Energia , Feminino , Guatemala/epidemiologia , Humanos , Lactente , Masculino , Valor Nutritivo , População UrbanaRESUMO
OBJECTIVE: To examine the nature and energy contribution of complementary feeding in breastfed infants in their sixth month of life, and the prevalence of the use of bottles as a delivery method. MATERIALS AND METHODS: We recruited 156 breastfeeding infants at a health clinic in metropolitan Quetzaltenango, Guatemala. A previous-day recall was performed. RESULTS: Sixty nine mothers (44%) reported offering items other than breastmilk. The median contribution of energy from complementary foods among infants with mixed feeding (n=66) was 197 kcal/day (interquartile range [IQR] 49-353). The median energy contribution of formula or cow's milk among consumers (n=39) was 212 kcal/day (IQR 84-394). Bottles were used on the previous day by 55 (80%) of the 69 mothers not offering exclusive breastfeeding. CONCLUSIONS: Premature introduction of non-breastmilk items is commonly practiced in feeding Guatemalan infants. Adherence to the internationally recognized guidelines for early infant feeding should be an intervention priority for this population.
Assuntos
Alimentação com Mamadeira/normas , Aleitamento Materno , Ingestão de Energia , Alimentos Infantis/estatística & dados numéricos , Adolescente , Adulto , Animais , Alimentação com Mamadeira/estatística & dados numéricos , Bovinos , Estudos Transversais , Escolaridade , Etnicidade , Feminino , Guatemala , Fidelidade a Diretrizes , Guias como Assunto , Humanos , Lactente , Fórmulas Infantis/estatística & dados numéricos , Masculino , Leite , População Urbana , Adulto JovemRESUMO
Objective. To examine the nature and energy contribution of complementary feeding in breastfed infants in their sixth month of life, and the prevalence of the use of bottles as a delivery method. Materials and methods. We recruited 156 breastfeeding infants at a health clinic in metropolitan Quetzaltenango, Guatemala. A previous-day recall was performed. Results. Sixty nine mothers (44%) reported offering items other than breastmilk. The median contribution of energy from complementary foods among infants with mixed feeding (n=66) was 197 kcal/day (interquartile range [IQR] 49-353). The median energy contribution of formula or cow's milk among consumers (n=39) was 212 kcal/day (IQR 84-394). Bottles were used on the previous day by 55 (80%) of the 69 mothers not offering exclusive breastfeeding. Conclusions. Premature introduction of non-breastmilk items is commonly practiced in feeding Guatemalan infants. Adherence to the internationally recognized guidelines for early infant feeding should be an intervention priority for this population.
Objetivos. Examinar la naturaleza y contribución energética de la alimentación complementaria en infantes lactantes en el sexto mes de vida y la prevalencia del uso de biberones como método de alimentación. Material y métodos. Se seleccionaron 156 infantes lactantes en un centro de salud en la ciudad de Quetzaltenango, Guatemala. Se solicitó una rememoración de la alimentación del día anterior. Resultados. Sesenta y nueve madres (44%) reportaron dar alimentos adicionales a la leche materna. La mediana de contribución energética de alimentos complementarios en infantes con alimentación mixta (n=66) fue 197 kcal/día (rango intercuartil [RIC] 43-353). La mediana de contribución energética de leche de vaca entre consumidores (n=39) fue 212 kcal/día (RIC 84-394). De 69 madres que ofrecían alimentación mixta, 55 (80%) proporcionaron biberones. Conclusiones. Las madres guatemaltecas practican comúnmente la introducción prematura de la alimentación complementaria. La adhesión a las guías internacionalmente reconocidas para alimentación de infantes debe ser una prioridad de intervención en esta población.
Assuntos
Humanos , Animais , Masculino , Feminino , Lactente , Adolescente , Adulto , Adulto Jovem , Alimentação com Mamadeira/normas , Aleitamento Materno , Ingestão de Energia , Alimentos Infantis/estatística & dados numéricos , População Urbana , Alimentação com Mamadeira/estatística & dados numéricos , Bovinos , Etnicidade , Estudos Transversais , Guias como Assunto , Fidelidade a Diretrizes , Fórmulas Infantis/estatística & dados numéricos , Leite , Escolaridade , GuatemalaRESUMO
BACKGROUND: Consumer nutrition environment measures are important to understanding the food environment, which affects individual dietary intake. A nutrition environment measures survey for supermarkets (NEMS-S) has been designed on paper for use in Guatemala. However, a paper survey is not an inconspicuous data collection method. OBJECTIVE: To design, pilot test, and validate the Guatemala NEMS-S in the form of a mobile phone application (mobile app). METHODS: CommCare, a free and open-source software application, was used to design the NEMS-S for Guatemala in the form of a mobile app. Two raters tested the mobile app in a single Guatemalan supermarket. Both the interrater and the test-retest reliability of the mobile app were determined using percent agreement and Cohen's kappa score and compared with the interrater and test-retest reliability of the paper version. RESULTS: Interrater reliability was very high between the paper survey and the mobile app (Cohen's kappa > 0.90). Test-retest reliability ranged from kappa 0.78 to 0.91. Between two certified NEMS-S raters, survey completion time using the mobile app was 5 minutes less than that with the paper form (35 vs. 40 minutes). CONCLUSIONS: The NEMS-S mobile app provides for more rapid data collection, with equivalent reliability and validity to the NEMS-S paper version, with advantages over a paper-based survey of multiple language capability and concomitant data entry.