Eating habits of lactating women can influence the nutrient composition of human milk, which in turn influences nutrient intake of breastfed infants. The aim of the present study was to identify food patterns and nutritional adequacy among lactating women in Europe. Data from a multicentre European longitudinal cohort (ATLAS study) were analysed to identify dietary patterns using cluster analysis. Dietary information from 180 lactating women was obtained using 3-d food diaries over the first 4 months of lactation. Four dietary patterns were identified: ‘vege-oils’, ‘fish-poultry’, ‘confectionery-salads’ and ‘mixed dishes’. Nutrition adequacy was not significantly different between clusters, but the ‘vege-oils’ cluster tended to yield the highest nutrition adequacy measured by Mean Adequacy Ratio. Compared with European dietary reference values (DRVs) for lactating women, women in all clusters had inadequate intakes of energy, pantothenic acid, folate, vitamin C, vitamin A, vitamin D, zinc, iodine, potassium and linoleic acid. Adequate intake for fibre and α-linolenic acid was only achieved in the ‘vege-oils’ cluster. Overall, fat intake was above DRVs. The present study showed that various dietary patterns do not adequately supply all nutrients, indicating a need to promote overall healthy dietary habits for European lactating women.

Subclinical mastitis (SCM) is an inflammatory state of the lactating mammary gland, which is asymptomatic and may have negative consequences for child growth. The objectives of this study were to: (1) test the association between the dietary inflammatory index (DII^®) and SCM and (2) assess the differences in nutrient intakes between women without SCM and those with SCM. One hundred and seventy-seven women with available data on human milk (HM) sodium potassium ratio (Na:K) and dietary intake data were included for analysis. Multivariable logistic regression was used to examine the association between nutrient intake and the DII score in relation to SCM. Women without SCM had a lower median DII score (0.60) than women with moderate (1.12) or severe (1.74) SCM (p < 0.01). A one-unit increase in DII was associated with about 41% increased odds of having SCM, adjusting for country and mode of delivery, p = 0.001. Women with SCM had lower mean intakes of several anti-inflammatory nutrients. We show for the first time exploratory evidence that SCM may be associated with a pro-inflammatory diet and women with SCM have lower intakes of several antioxidant and anti-inflammatory nutrients.

Mexican and international authorities provide guidelines for milk and beverage consumption for young children. This study classifies beverages as appropriate or inappropriate by age (0–5.9, 6–11.9, and 12–23.9 months) and details consumption patterns, amounts consumed, and the associated socio-demographic characteristics. Analysis of the Mexican National Nutrition and Health Survey (ENSANUT 2012) was conducted (n = 949). Among 0–5.9 month olds, 66.7% consumed either breast milk, infant formula, or a combination with no other beverages, whereas 29.3% consumed breast milk and/or infant formula with water (mean = 58 g/day) and/or other beverages (mean = 115 g/day), such as 100% fruit juice, milk, and sugar-sweetened beverages (SSBs). For infants 6–11.9 months, appropriate beverages include breast milk, infant formula, and water; only 40.2% met these recommendations. Many 6–11.9 month olds consumed age-inappropriate beverages, including milk (31%) and SSBs (35%). After 12 months of age, appropriate beverages include water, milk, and a limited amount of 100% fruit juice and SSBs; 32.4% complied fully, 18.3% consumed appropriate and inappropriate beverages, and 49.3% consumed only inappropriate beverages. Among 12–23.9 month olds, 58% consumed milk, 18% juice, and 42% water while 63% consumed SSBs. Many infants and young children are not compliant with Mexican and international breastfeeding and complementary feeding guidelines for beverages. Communication and guidance about age-appropriate beverages should be improved.

Background: Only 47% of households in Pakistan's Sindh and Punjab provinces are food secure. More than 80% of 5-9 y old children are below recommended intakes of calcium, iron, zinc, and vitamin A and vitamin D. Although 89% consume dairy products daily, only 3% comply with Pakistan's recommended dairy consumption of 2-3 servings/d. Objectives: The objectives of this study were to evaluate the theoretical impact of substituting or adding fortified milk and/or buffalo milk in the diets of Pakistani school-aged children to address nutrient inadequacy. Methods: Dairy consumption and nutrient intakes were calculated using dietary data collected from 5842 children via a 24-h diet recall in the School-age Children Health and Nutrition Survey conducted in Sindh and Punjab provinces of Pakistan between 2019 and 2020. Given daily intakes documented in the School-age Children Health and Nutrition Survey, 2 modeling scenarios were applied to test the impact on nutrient intakes of 1) substituting current milk (buffalo, cow, and goat) consumption (volume by volume) with a fortified milk beverage and 2) adding a fortified milk beverage or buffalo milk to current consumption to meet dairy consumption recommendations. Results: The hypothetical substitution of current milk consumption with fortified milk lowered nutrient inadequacies for vitamin C (by 86%), vitamin A (by 45%), thiamin (by 26%), riboflavin (by 14%), vitamin B6 (by 13%), calcium (by 8%), and iron (by 7%), compared to baseline (relative percent reduction). Among children consuming <2 dairy servings/d, theoretically adding buffalo milk had a positive contribution to calcium, phosphorous, zinc, vitamin A, vitamin C, riboflavin, niacin, and folate; theoretically adding fortified milk additionally reduced inadequacies of iron, thiamin, vitamin B6, and greatly reduced vitamin C inadequacy. Conclusions: Buffalo milk and fortified milk each have their own value in closing nutrient gaps. Increasing their consumption can be integrated into a multi-pronged public health strategy (including fortified foods, ensuring food security, and diet diversity) to tackle nutrient inadequacies in children.

Background and objectives: Diet quality is critical for child growth and development. We previously identified a high prevalence of micronutrient inadequacies in Nigerian children’s diets. The objective of this study was to identify socio-economic predictors (socio-economic status (SES), main caregivers’ education, and household income) of the mean adequacy ratio (MAR), a proxy for diet quality, in this population. Methods: Data from the Ibadan Kids Nutrition and Health Study (I-KNHS) in Nigeria was used to calculate the Nutrient Adequacy Ratio (NAR) for 17 micronutrients. The MAR was calculated as the average of NARs in children aged both 4–8 years (y) (n = 510) and 9–13 y old (n = 434). Logistic regression was applied to examine the odds of having an MAR higher than the age group median. Results: The median (interquartile range (IQR)) MAR among 4–8 y old children was higher than that of the older children aged 9–13 y (0.67 (0.23) vs. 0.56 (0.24), p < 0.0001), which corresponds to a median of 67% and 56% of micronutrient requirements being met by younger and older children, respectively. Children aged 4–8 y in the highest SES tertile had higher (2.06 (95% CI 1.3–3.25)) odds of having a high MAR compared to the lowest SES tertile. However, this trend was the opposite in 9–13 y old children, with those in the highest SES tertile having lower (0.54 (0.33–0.89)) odds of having a high MAR compared to those in the lowest SES tertile. Higher main caregiver’s education and household income were associated with higher MARs in 4–8 y old children, but not in older children. The 4–8 y old children in the highest tertile of household income and main caregiver’s education had a higher MAR compared to those in the lowest tertile, with an OR of 1.85 (1.17–2.93) and 2.57 (1.46–4.52), respectively. Discussion: SES, main caregivers’ education, and household income were predictors of diet quality. However, contrasting associations were observed between these socio-economic variables and the diet quality between age groups. The cause may be due to older children from the highest SES group having greater freedom to make independent food choices. These findings suggest that interventions to improve the diets of children in Nigeria should address those beyond the lower socio-economic groups.

Environmental Health Perspectives is an Open Access journal published by the National Institute of Environmental Health Sciences. Environmental Health Perspectives is an Open Access journal published by the National Institute of Environmental Health Sciences.