Good nutrition in the early years of a person’s life is shown to have a positive impact on their long-term health. The impacts can be major and lifelong, and can vary from cardiovascular risk to intelligence, stunting or poor growth. Breastfeeding is globally recognised as the ideal nutritional start in the first 6 months of life and must be encouraged – but what happens once a baby starts eating solid foods?
Incredibly, in the Australian context we never really knew what happened, as the government-funded National Nutrition Survey only collects data from 2 years of age. While some small studies provided some indication, there was a clear gap nationally in the age segment that can have the biggest impact on long term health: birth to 2 years.
Closing the gap in nutrition knowledge
Recognising the gap in nutrition knowledge in this important age group, we began to explore the possibility of undertaking research in this area.
We consulted several paediatric experts in Australia, as well as the expertise of the Nestlé Research Centre in Switzerland which had conducted similar dietary surveys in other countries. These studies – known as ‘FITS’ (Feeding Infants and Toddlers Study) – have provided valuable nutritional insights in countries such as the USA, China, Brazil, Mexico and the Philippines.
A research partnership was formed with the South Australian Health and Medical Research Institute led by eminent nutrition expert Professor Maria Makrides, and called ‘OzFITS’.
The OzFITS Trial
The OzFITS trial included 1,140 infants and toddlers aged 0-2 years from all Australian states and territories, with data collected in 2020 and 2021. For the first time, a nationwide dietary survey now provided important insights into breastfeeding duration, the age and type of solid foods introduced, allergen introduction, dietary adequacy, and toddlerhood diets to name a few.
The full findings were published as a supplement in the journal Nutrients - Nutrients | Special Issue : The Australian Feeding Infants and Toddlers Study (OZFITS), 2021 (mdpi.com).
What were the findings?
The positives were that breastfeeding rates were strong, with 98% of mothers initiating breastfeeding and 44% of infants still receiving some breastmilk at 12 months of age.
Additionally, solid foods were generally introduced at the appropriate time of around 6 months, and the major allergens (peanut and hen’s egg) had been introduced to 95% of infants within the first 12 months – in line with current Australian recommendations.
The areas which require attention primarily related to a couple of nutrients – iron and sodium. Toddlers in particular were consuming too much sodium, primarily contained in common everyday foods such as breads and dairy products. For iron, it was significant that 75% of infants aged 6-12 months were not meeting their daily iron requirements, while 25% of toddlers aged 1-2 years were also consuming inadequate amounts of iron.
Deep dive on iron
Iron is a particularly important nutrient for growth and brain development, especially in the early years. Due to the 75% of infants aged 6-12 months not getting iron, it was agreed with the research team that we needed to look deeper. The results of this additional exploration were published in The Journal of Nutrition - Iron-Fortified Foods Are Needed To Meet the Estimated Average Requirement for Iron in Australian Infants Aged 6 to 12 Months - The Journal of Nutrition.
There are a number of dietary sources of iron. Based on dietary modelling, the researchers showed that if infants this age had one serve of iron-fortified infant cereal, the percentage of infants not meeting iron requirements decreased from 75% to only 5%. This is a very practical finding as iron-fortified infant cereals are a recommended first food from the Australian Infant Feeding Guidelines, are a commonly consumed food in this age group, and the amount (1 serve/day) is also very achievable.
Improving nutrition for the next generation
The OzFITS trial is part of Nestlé Nutrition Institute’s commitment to improve nutrition for the next generation of Australians. It has allowed us to focus our research where there are clear gaps in knowledge, benefiting health care professionals, and ultimately, parents and children.
The findings have provided extremely important insights, showing practical action that can be taken by consuming iron fortified infant cereal, helping address the high rates of iron inadequacy among Australian infants. These results will help Australian health professionals and ultimately parents and their children for many years to come.
