The transition of foods during toddlerhood and the suboptimal diets consumed in the Middle East make children susceptible to malnutrition and micronutrient deficiencies. Based on international recommendations, coupled with the merits of clinical studies on the application of young child formula (YCF), a group of fourteen experts from the Middle East reached a consensus on improving the nutritional status of toddlers. The recommendations put forth by the expert panel comprised twelve statements related to the relevance of YCF in young children; the impact of YCF on their nutritional parameters and functional outcomes; characteristics of the currently available YCF and its ideal composition; strategies to supply adequate nutrition in young children and educational needs of parents and healthcare professionals (HCPs). This consensus aims to serve as a guide to HCPs and parents, focusing on improving the nutritional balance in toddlers in the Middle Eastern region. The panellists considere YCF to be one of the potential solutions to improve the nutritional status of young children in the region. Other strategies to improve the nutritional status of young children include fortified cow's milk and cereals, vitamin and mineral supplements, early introduction of meat and fish, and the inclusion of diverse foods in children's diets.
Keywords: Diet; Macronutrients; Malnutrition; Micronutrients; Vitamin D deficiency.
Verduci E, Di Profio E, Corsello A, Scatigno L, Fiore G, Bosetti A, Zuccotti GV.Nutrients. 2021 Sep 27;13(10):3412. doi: 10.3390/nu13103412.PMID: 34684413 Free PMC article. Review.
Suthutvoravut U, Abiodun P, Chomtho S, et al. (2015) Composition of follow-up formula for young children aged 12–36 months: recommendations of an international expert group coordinated by the nutrition association of Thailand and the early nutrition academy. Ann Nutr Metab 67, 119–132. doi:10.1159/000438495. - DOI - PubMed
Chouraqui J, Turck D, Tavourlaris G, et al. (2019) The role of young child formula in ensuring a balanced diet in young children. Nutrients 11, 2213. doi:10.3390/nu11092213. - DOI - PMC - PubMed
Al-Jawaldeh A, Taktouk M & Nasreddine L (2020) Food consumption patterns and nutrient intakes of children and adolescents in the Eastern Mediterranean Region: a call for policy action. Nutrients 12, 3345. doi:10.3390/nu12113345. - DOI - PMC - PubMed
Ali H, Ng S, Zaghloul S, et al. (2013) High proportion of 6 to 18-year-old children and adolescents in the United Arab Emirates are not meeting dietary recommendations. Nutr Res 33, 447–456, doi:10.1016/j.nutres.2013.03.008. - DOI - PubMed
Alsubaie A (2018) Intake of fruit, vegetables and milk products and correlates among school boys in Saudi Arabia. Int J Adolesc Med Health 33, 20180051, doi:10.1515/ijamh-2018-0051. - DOI - PubMed
Nasreddine L, Ayoub JJ & Al Jawaldeh A (2018) Review of the nutrition situation in the Eastern Mediterranean Region. East Mediterr Health J 24, 77–91, doi:10.26719/2018.24.1.77. - DOI - PubMed
EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) (2013) Scientific opinion on nutrient requirements and dietary intakes of infants and young children in the European Union. EFSA J 11, 3408. doi:10.2903/j.efsa.2013.3408. - DOI
Kehoe L, Walton J, McNulty BA, et al. (2017) Dietary strategies for achieving adequate vitamin D and iron intakes in young children in Ireland. J Hum Nutr Diet 30, 405–416. doi:10.1111/jhn.12449. - DOI - PubMed
Hojsak I, Bronsky J, Campoy C, et al. (2018) Young child formula: a position paper by the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr 66, 177–185, doi:10.1097/MPG.0000000000001821. - DOI - PubMed
Eussen S, Pean J, Olivier L, et al. (2015) Theoretical impact of replacing whole cow's milk by young-child formula on nutrient intakes of U.K. young children: results of a simulation study. Ann Nutr Metab 67, 247–256. doi:10.1159/000440682. - DOI - PubMed
Vieux F, Brouzes C, Maillot M, et al. (2016) Role of young child formulae and supplements to ensure nutritional adequacy in U.K. young children. Nutrients 8, 539. doi:10.3390/nu8090539. - DOI - PMC - PubMed
Verger E, Eussen S & Holmes B (2016) Evaluation of a nutrient-based diet quality index in U.K. young children and investigation into the diet quality of consumers of formula and infant foods. Public Health Nutr 19, 1785–1794. doi:10.1017/S1368980015003134. - DOI - PubMed
Akkermans M, Eussen S, van der Horst-Graat J, et al. (2017) A micronutrient-fortified young-child formula improves the iron and vitamin D status of healthy young European children: a randomized, double-blind controlled trial. Am J Clin Nutr 105, 391–399. doi:10.3945/ajcn.116.136143. - DOI - PubMed
Kosuwon P, Lao-Araya M, Uthaisangsook S, et al. (2018) A synbiotic mixture of scGOS/lcFOS and Bifidobacterium breve M-16V increases faecal Bifidobacterium in healthy young children. Benef Microbes 9, 541–552. doi:10.3920/BM2017.0110. - DOI - PubMed
Chatchatee P, Lee W, Carrilho E, et al. (2014) Effects of growing-up milk supplemented with prebiotics and LCPUFAs on infections in young children. J Pediatr Gastroenterol Nutr 58, 428–437. doi:10.1097/MPG.0000000000000252. - DOI - PMC - PubMed
Chouraqui J, Tavoularis G, Emery Y, et al. (2018) The French national survey on food consumption of children under 3 years of age – Nutri-Bébé 2013: design, methodology, population sampling and feeding practices. Public Health Nutr 21, 502–514. doi:10.1017/S1368980017002518. - DOI - PubMed
Hower J, Knoll A, Ritzenthaler KL, et al. (2013) Vitamin D fortification of growing up milk prevents decrease of serum 25-hydroxyvitamin D concentrations during winter: a clinical intervention study in Germany. Eur J Pediatr 172, 1597–1605. doi:10.1007/s00431-013-2092-6. - DOI - PubMed
Wall C, Hill R, Lovell A, et al. (2019) A multicenter, double-blind, randomized, placebo-controlled trial to evaluate the effect of consuming growing up milk “Lite” on body composition in children aged 12–23 months. Am J Clin Nutr 109, 576–585. doi:10.1093/ajcn/nqy302. - DOI - PubMed
Hwalla N, Al Dhaheri A, Radwan H, et al. (2017) The prevalence of micronutrient deficiencies and inadequacies in the Middle East and approaches to interventions. Nutrients 9, 229. doi:10.3390/nu9030229. - DOI - PMC - PubMed
Green RJ, Samy G, Miqdady MS, et al. (2015) Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days. S Afr Med J 105, 603–605. doi:10.7196/SAMJNEW.7785. - DOI - PubMed
Abdulrazzaq YM, Nagelkerke N, Abdulla S, et al. (2016) Nutrient intake of infants and toddlers in the United Arab Emirates: The feeding infants and toddlers study. East Mediterr Health J 22, 293–300. https://apps.who.int/iris/handle/10665/259965 - PubMed
Ghisolfi J, Fantino M, Turck D, et al. (2013) Nutrient intakes of children aged 1–2 years as a function of milk consumption, cows’ milk or growing-up milk. Public Health Nutr 16, 524–534. doi:10.1017/S1368980012002893. - DOI - PubMed
Walton J & Flynn A (2013) Nutritional adequacy of diets containing growing up milks or unfortified cow's milk in Irish children (aged 12–24 months). Food Nutr Res 57, 21836. doi:10.3402/fnr.v57i0.21836. - DOI - PMC - PubMed
Lippman H, Desjuex J, Ding Z, et al. (2016) Nutrient recommendations for growing-up milk: a report of an expert panel. Crit Rev Food Sci Nutr 56, 141–145. doi:10.1080/10408398.2012.702702. - DOI - PubMed
Kostecka M, Jackowska I, Kostecka J, et al. (2021) A comparison of the effects of young-child formulas and cow's milk on nutrient intakes in Polish children aged 13–24 months. Nutrients 13, 2511. doi:10.3390/nu13082511 - DOI - PMC - PubMed
Vandenplas Y, De Ronne N, Van De Sompel A, et al. (2014) A Belgian consensus-statement on growing-up milks for children 12–36 months old. Eur J Pediatr 173, 1365–1371. doi:10.1007/s00431-014-2321-7. - DOI - PubMed
Alkazemi D & Salmean Y (2021) Fruit and vegetable intake and barriers to their consumption among university students in Kuwait: a cross-sectional survey. J Environ Public Health 9, 9920270. doi:10.1155/2021/9920270. - DOI - PMC - PubMed