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      Dairy fortification as a good option for dietary nutrition status improvement of 676 preschool children in China: A simulation study based on a cross-sectional diet survey (2018–2019)

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          Abstract

          Background

          Chinese children are deficient in several essential nutrients due to poor dietary choices. Dairy products are a source of many under-consumed nutrients, but preschool children in China consume dairy products significantly less than the recommended level.

          Methods

          From the cross-sectional dietary intake survey of infants and young children aged 0–6 years in China (2018–2019), preschool children (age: 3–6 years) ( n = 676) were selected. The four-day dietary data (including 2 working days and 2 weekends) collected through an online diary with reference to the food atlas were used for analysis and simulation. In scenario 1, individual intake of liquid milk equivalents was substituted at a corresponding volume by soymilk, cow’s milk, or formulated milk powder for preschool children (FMP-PSC). In scenario 2, the amount of cow’s milk or FMP-PSC increased to ensure each child’s dairy intake reached the recommended amount (350 g/day). In both scenarios, the simulated nutrient intakes and nutritional inadequacy or surplus were compared to the survey’s actual baseline data.

          Results

          It was suggested suggested that replacing dairy foods with FMP-PSC at matching volume is better than replacing them with soymilk or cow’s milk to increase the intake of DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B 1, vitamin B 3, vitamin B 12, vitamin C and vitamin D. Moreover, our results suggested that adding FMP-PSC to bring each child’s dairy intake to the recommended amount can bring the intakes of dietary fiber, DHA, calcium, iron, zinc, iodine, vitamin A, vitamin B 1, vitamin B 3, vitamin B 9, vitamin B 12, vitamin C and vitamin D more in line with the recommendations when compared with cow’s milk.

          Conclusion

          Accurate nutrition information should be provided to the parents of preschool children so as to guide their scientific consumption of dairy products and the usage and addition of fortified dairy products can be encouraged as needed.

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          Most cited references34

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          Impact of diet on cardiometabolic health in children and adolescents

          The manifestation of cardiovascular risk factors, such as hypertension, diabetes, and particularly obesity begins in children and adolescents, with deleterious effects for cardiometabolic health at adulthood. Although the impact of diet on cardiovascular risk factors has been studied extensively in adults, showing that their cardiometabolic health is strongly lifestyle-dependent, less is known about this impact in children and adolescents. In particular, little is known about the relationship between their dietary patterns, especially when derived a posteriori, and cardiovascular risk. An adverse association of cardiovascular health and increased intake of sodium, saturated fat, meat, fast food and soft drinks has been reported in this population. In contrast, vitamin D, fiber, mono-and poly-unsaturated fatty acids, dairy, fruits and vegetables were positively linked to cardiovascular health. The aim of this review was to summarize current epidemiological and experimental evidence on the impact of nutrients, foods, and dietary pattern on cardiometabolic health in children and adolescents. A comprehensive review of the literature available in English and related to diet and cardiometabolic health in this population was undertaken via the electronic databases PubMed, Cochrane Library, and Medline. Electronic supplementary material The online version of this article (doi:10.1186/s12937-015-0107-z) contains supplementary material, which is available to authorized users.
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            Consumption of meat and dairy products in China: a review

            The objective of the present paper was to review the consumption status of meat and dairy products among Chinese residents. The research topics included production, consumption and health implications of dairy and meat, and the data sources included reports of national surveys, research papers and data from the National Bureau of Statistics of China. The average intake of meat, especially pork, has continued to increase in China. Pork intake increased from 37·1 g/d in 1992 to 64·3 g/d in 2012. There was a much higher margin in rural regions; pork intake of rural residents increased from 25·0 g/d in 1992 to 59·9 g/d in 2012, which resulted in a narrowed gap between urban and rural areas. Although the average intake of dairy products increased from 14·9 g/d in 1992 to 24·7 g/d in 2012, the overall level was still lower. There was a significant difference of dairy consumption between urban and rural residents. The gap of per capita consumption of milk between urban and rural households was 3·5 kg/year in 1990, reached the maximum of 16·9 kg/year in 2003, then decreased to 8·7 kg/year in 2012. In conclusion, the finding of this review sheds light on some problems with food consumption patterns in China. Effective strategies need to be adopted in order to change the consumption patterns. The consumption of milk and replacing pork with poultry or fish or other health foods should be encouraged.
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              Micronutrient Fortified Milk Improves Iron Status, Anemia and Growth among Children 1–4 Years: A Double Masked, Randomized, Controlled Trial

              Background Multiple micronutrient deficiencies are highly prevalent among preschool children and often lead to anemia and growth faltering. Given the limited success of supplementation and health education programs, fortification of foods could be a viable and sustainable option. We report results from a community based double-masked, randomized trial among children 1–4 years evaluating the effects of micronutrients (especially of zinc and iron) delivered through fortified milk on growth, anemia and iron status markers as part of a four group study design, running two studies simultaneously. Methods and Findings Enrolled children (n = 633) were randomly allocated to receive either micronutrients fortified milk (MN = 316) or control milk (Co = 317). Intervention of MN milk provided additional 7.8 mg zinc, 9.6 mg iron, 4.2 µg selenium, 0.27 mg copper, 156 µg vitamin A, 40.2 mg vitamin C, and 7.5 mg vitamin E per day (three serves) for one year. Anthropometry was recorded at baseline, mid- and end-study. Hematological parameters were estimated at baseline and end-study. Both groups were comparable at baseline. Compliance was over 85% and did not vary between groups. Compared to children consuming Co milk, children consuming MN milk showed significant improvement in weight gain (difference of mean: 0.21 kg/year; 95% confidence interval [CI] 0.12 to 0.31, p<0.001) and height gain (difference of mean: 0.51 cm/year; 95% CI 0.27 to 0.75, p<0.001). Mean hemoglobin (Hb) (difference of 13.6 g/L; 95% CI 11.1 to 16.0, p<0.001) and serum ferritin levels (difference of 7.9 µg/L; 95% CI 5.4 to 10.5, p<0.001) also improved. Children in MN group had 88% (odds ratio = 0.12, 95% CI 0.08 to 0.20, p<0.001) lower risk of iron deficiency anemia. Conclusions/Significance Milk provides an acceptable and effective vehicle for delivery of specific micronutrients, especially zinc and iron. Micronutrient bundle improved growth and iron status and reduced anemia in children 1–4 years old. Trial Registration ClinicalTrials.gov NCT00255385
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                Author and article information

                Contributors
                Journal
                Front Nutr
                Front Nutr
                Front. Nutr.
                Frontiers in Nutrition
                Frontiers Media S.A.
                2296-861X
                08 December 2022
                2022
                : 9
                : 1081495
                Affiliations
                [1] 1Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University , Nanjing, China
                [2] 2Danone Open Science Research Center for Life-Transforming Nutrition , Shanghai, China
                Author notes

                Edited by: Maha Hoteit, Lebanese University, Lebanon

                Reviewed by: Amin Salehi-Abargouei, Shahid Sadoughi University of Medical Sciences and Health Services, Iran; Li Cai, Sun Yat-sen University, China

                *Correspondence: Zhixu Wang, zhixu_wang@ 123456163.com

                This article was submitted to Nutritional Epidemiology, a section of the journal Frontiers in Nutrition

                Article
                10.3389/fnut.2022.1081495
                9773072
                36570132
                5fd72010-4963-49c4-9284-66750510947a
                Copyright © 2022 Ding, Han, Xie, Li, Zhuang, Yin, Fu, You and Wang.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 27 October 2022
                : 24 November 2022
                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 35, Pages: 12, Words: 8267
                Categories
                Nutrition
                Original Research

                chinese preschool children,formulated milk powder,cow’s milk,soymilk,simulation

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