Pereira C., Ford R., Feeley A.B., Sweet L., Badham J., Zehner E. Cross-sectional survey shows that follow-up formula and growing-up milks are labelled similarly to infant formula in four low and middle income countries. This is in spite of the fact that the World Health Organization has deemed such products unnecessary and potentially harmful to childrens long-term health. Given the suggested suitability of some of these products for consumption between ages two and 13, it is yet to be seen what the consequences may be for child weight profiles globally in the coming years. These include fluid, electrolyte, mineral and vitamin imbalances, and issues of gastrointestinal absorption, immune competence, and thermal regulation that alter nutritional needs during recovery [18,19,20,21]. There have been a number of calls to stop misleading health claims among advertisements of infant and childrens food products [42]. Selling Taste in Consumer Societies. Ninety-two picky eaters aged 3 to 5 years with evidence of growth faltering were randomized to receive either nutrition counseling alone, or nutrition counseling plus the nutritional supplement for 90 days [36]. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (, growth patterns, infant feeding, cultural feeding expectations, health advertising, infant formula. HHS Vulnerability Disclosure, Help The age from three to five years is emerging as a critical period for childhood growth trajectories that precede obesity and later chronic disease, including increased blood pressure and diabetes [92,93,94]. Further explanations for the use of these types of fortified products comes from Chinese mothers in Singapore, who believe that certain follow-up formulas can enhance their infants Intelligence Quotient (IQ) [68]. Joint FAO/WHO Food Standards Programme Codex Committee on Nutrition and Foods for Special Dietary Uses. It is a specific case. Across time, infants and children normally get bigger, albeit by very different paths and rates [40]. Received 2016 Aug 29; Accepted 2016 Oct 27. Wit J.M., Boersma B. Catch-up growth: Definition, mechanisms and models. Food Nations. Barker D.J., Bagby S.P., Hanson M.A. Walker M. Formula supplementation of the breastfed infant. These are the circumstances under which a number of nutritional supplements were introduced. Shifting linear growth during infancy: Illustration of genetic factors in growth from fetal life through infancy. Careers. One example involves a FUF-YC product specifically marketed as Nutrition to help kids grow [78] and presently advertising its significance as a 2 per day snack, helping kids ages 34 grow out of at-risk weight-for-height percentiles as it helps kids gain weight in just 8 weeks [79]. The authors conclude that these results show a catch-up growth phase in weight followed by a maintenance growth phase of height gain, a successful preventive approach of targeting children at risk of undernutrition with significant benefits on growth and low risk of excessive weight gain as the WHZ change was below 0.67 [80]. Body size and growth in 04-year old children and the relation to body size in primary school age. Size is not growth. The marketing of infant foods is a unique niche. These data raise serious questions regarding the health implications of high-calorie liquid dietary supplement consumption among young children. Normal growth is not defined by adherence to a constant Z-score across age. Defining healthy growth beyond getting bigger is essential as infant and young child feeding industries expand. Two multinationals account for 80% of U.S. sales, with pediatric nutrition product net sales ranging between two and four billion dollars in 2015 [60,61,62]. Simply bolstering growth in response to perceptions that bigger is better is not without risk, and the long-term health ramifications of feeding supplements are becoming increasingly clear [9]. Only repeated measurements across time can document growth [30]. This is not without human consequences. The reported magnitude of weight gain is compatible with the extra energy intake as empirically predicted by a mathematical model of weight gain in children [85]. Breastfeeding and later cognitive and academic outcomes. Van Loon H., Saverys V., Vurlsteke J.P., Vlietnick R.F., Eeckels R. Local versus universal growth standards: The effect of using NCHS as universal reference. There is a scientific knowledge base against which evidentiary claims can be assessed that is not being thoroughly considered. As clearly documented in 1976, infants do not remain at the same size percentiles from birth to six months of age [49]. It may also be an effort to empower consumers by offering a sense of reassurance, trust, and support in product selection. With the United States prevalence of obesity among two- to 19-year-olds at 17% [118], and the prevalence of underweight less than 4% [119], it is time to reconsider current oversight of products initially targeted as supplements for small size or clinical repletion among infants and children. FOIA International Code of Marketing of Breast-Milk Substitutes. The most significant piece of legislation that created boundaries on the advertising and use of these products was the International Code of Marketing of Breast-Milk Substitutes [97]. Pediasure is known for aiding growth and development in kids. After four months intake, the average weight-for-height changed an average of 10 percentiles among 626 children who were 1 to 3 SDs below the median weight-for-height at study onset [37]. The Nielson Company; 2015. Scientific and health care partnerships are needed to consider current governmental oversight shortfalls in protecting vulnerable populations from overconsumption. The intervention was associated with a total weight gain of 0.5 kg after four weeks, 0.8 kg at eight weeks, and 0.2 to 0.3 kg per eight weeks thereafter, for a total accrual of 2.2 kg at 48 weeks. An increase in oversight going forward will involve assessing the accuracy of a number of product claims by clarifying the strength of the data upon which they are based and the assumptions upon which the interpretations rely. In order to carry out this legislation, the World Health Organization declared that formula companies must first demonstrate that their advertising will have no deleterious effects on breastfeeding before they can begin any widespread advertising campaigns [97]. The reality is that the products are being consumed as food and the supplementary feedings are associated with weight gain, which is neither growth nor healthy. The health risk of obesityBetter metrics imperative. In this scenario, an outcome of bigger was seen as a potential risk reduction, or promotion of health. A study of 578 children found that those with WHZ score changes less than 0.67 between 12 and 23 months of age had a higher prevalence of subsequent obesity by age four to five compared to their peers who experienced changes in WHZ scores of 0.671.0 [89].

Available online: Hyunh D.T.T., Estorininos E., Capeding R.Z., Oliver J.S., Low Y.L., Rosales F.J. Longitudinal growth and health outcomes in nutritionally at-risk children who received long-term nutritional intervention. This is important because we may be doing more harm than good. official website and that any information you provide is encrypted The importance of aberrant growth patterns during critical periods has been emphasized as a direct link to risks for health sequelae later in life, with higher rates of metabolic disorders [4], for example, among individuals who were born relatively small and grew rapidly in the first years of life [5]. Auxiliary information, both online and in printed materials, is frequently offered to provide guidance, particularly among direct marketing enterprises. While this may not be a legal breach, perhaps it is time to question whether this makes it an acceptable practice and if further oversight might be beneficial. Moreover, the International Code provided additional provisions to protect vulnerable populations or groups that are more likely to succumb to advertising campaigns due to increased exposure in the marketplace, less education, or less experience [98]. and transmitted securely. The original target for a number of liquid supplementation products was clinically small individuals for whom smallness was associated with health risks. Adopted by the World Health Assembly in 1981, this code attempted to define appropriate avenues of marketing and distribution for formula products by prohibiting their advertisement when represented as total or partial replacements for breast milk. These products are currently sold to a wide customer base in what was estimated in early 2016 to be the fastest-growing packaged food market globally [15]. With this choice, parents reduce food variety in their childs diet and delay the important transition to family foods. Statista. Berry N.J., Jones S.C., Iverson D. Toddler milk advertising in Australia: Infant formula advertising in disguise. In: Preedy V., editor. Lampl M., Mummert A. Thus, the null hypothesis proposed in this product test case was incorrect, both at the time of the study and its report.

If you are still wondering about where to buy the Pediasure products? David Barkers Developmental Origins of Health and Disease model (DOHaD) has led to the recognition of healthy growth as a cornerstone for lifespan health. Spotlight on infant formula: Coordinated global action needed. In fact, rapid infant growth among the relatively small predicts rising chronic disease risks among adults [1,3,4,5,9,25]. [36] offered the nutritional product in addition to nutritional counseling, as a comparison to the control group that was provided counseling only. Barker D.J., Eriksson J., Forsn T., Osmond C. Infant growth and income 50 years later. Nicklaus S., Boggio V., Chabanet C., Issanchou S. A prospective study of food variety seeking in childhood, adolescence and early adult life. The challenges in any intervention aiming to promote bigger size among smaller children include, first and foremost, the definition of small. The authors define individuals between the 2.3 and <25th percentile in weight-for-height as at-risk of wasting. Available online: Abbott Laboratories; 2016. Ljungkrantz M., Ludvigsson J., Samuelsson U. Bethesda, MD 20894, Web Policies Gluckman P.D., Hanson M.A. These fundamental biological facts are often misunderstood and/or mis-stated. [(accessed on 1 October 2016)]. Instead, they summarize data on childrens sizes at targeted ages. [(accessed on 1 October 2016)]. Hager E.R., Candelaria M., Latta L.W., Hurley K.M., Want Y., Caulfield L.E., Black M.M. Pediasure is a paediatrician-recommended brand which helps parents to provide proper nutrition to their kids. Contrary to the conclusions of the authors, the data cannot describe catch-up growth [40,83] and do not describe saltation and stasis growth [46].

Consumption of enhanced waters and health-specific drinks touting all manner of benefits, offered in easy-to-consume packaging for on-the-go lifestyles, has been embraced by the same consumer population that is targeted by the infant supplement products. Recommendation for the composition of follow-up formula and Beikost. In spite of concerns over infant formula advertising and neonatal marketing within hospitals, 70% of U.S. maternity units participated in formula company marketing programs, and one in four hospitals provided formula supplements to more than half of all healthy, full-term infants prior to discharge in 2007 [110]. This is important because a plethora of liquid-based nutritional supplements are presently being marketed to otherwise healthy children of normal size. Individuals under the 3rd or 5th-percentile for age, for example, do not share a common set of conditions. These reference data sources include the growth charts found among the working tools of clinicians, community health workers, and others involved in monitoring child health and well-being. Delivery time may vary depending on store and country. Michelle Lampl, Amanda Mummert, and Meriah Schoen contributed equally to the content and writing of the paper. Ahima R.S., Lazar M.A. Bartick M., Stuebe A., Shealy K.R., Walker M., Grummer-Strawn L.M. Along with physical development, mental development is also necessary thats why this product got DHA omega-3 which helps in nourishing the brain effectively. A rapid size increase, compared to peers of similar age, translates to a relatively larger size and a correspondingly higher percentile of size-for-age. Problematically, neither of these statements is accurate. Given the human stakes, this may require more than reliance on reviewers and editors, and calls for more formal oversight. [(accessed on 30 October 2016)]. May, 2016. The first three studies previously outlined describe observations from fewer than 60 ill children with no control groups [35,38,39]. Available online: Wills A.K., Strand B.H., Glavin K., Silverwood R.J., Hovengen R. Regression models for linking patterns of growth to a later outcome: Infant growth and childhood overweight. Energy gap in the aetiology of body weight gain and obesity: A challenging concept with a complex evaluation and pitfalls.

Despite this history, a number of such supplements have expanded beyond the clinical realm and are available over-the-counter for consumption by infants and children regardless of their actual nutritional status, size and health state. It is a number one Clinically proven health product that helps kids to grow.

20150086622 A1. This removes any overt culpability on the part of the product providers for consumers choosing to purchase the product. Food and Drug Administration Regulations on statements made for dietary supplements concerning the effect of the product on the structure or function of the body; final rule. Akram D.S., Bharmal F.Y., Hussain T. PediaSure.

The utility of growth charts are often misunderstood. Collectively, these studies provided a concentrated liquid supplement (1 kcal/mL; 12% protein, 44% carbohydrate, 44% fat) and are cited to support the statement clinically proven nutrition to help kids grow [34]. Rapid infancy weight gain and subsequent obesity: Systematic reviews and hopeful suggestions. One perspective comes from a report issued by an international expert panel convened in 2014 to address the lack of international oversight regarding FUF and GUM nutritional composition [75]. Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: Findings from five birth cohort studies. CDC growth charts: United States. Available online: Poon W., Ho W., Yeo C. Survey on parenting practices among Chinese in Singapore. These specific provisions included the prohibition of breastmilk substitute promotion directly to mothers, restrictions on contact between company employees and mothers, and constraints on interactions between formula companies and health professionals [97]. These details are important.

If growing is gaining weight, many children at this time do not need help and growing bigger is not necessarily healthy. While body size has long been used as an indicator of health and well-being at both the individual and population levels [2], Barkers work has brought new attention to the fundamental role of growth in not only reflecting an individuals health status, but determining it [3]. [(accessed on 2 October 2016)]; Food and Drug Administration Modernization Act of 1997. This is not merely a matter of overall size but extends to organ structure and function, with implications for long-term health [25]. In agreement with the conclusions of the European Food Safety Association (EFSA) [76], this expert group concluded that FUF-YC can contribute to improving the supply of critical nutrients, overall nutritional status and hence help to support child health when comprised of an appropriate composition, under appropriate conditions of use among one to three year olds. As infants food intake is largely liquid across the first year of life, it may be time to abandon the distinction between marketing for infant foods and supplements and to specifically require pre-market approval for items targeted to infants and young children. After 14 days, 30 of 40 severely malnourished Pakistani children aged 1 to 5 years gained weight and accrued fat [35]. At an individual level, the same approach estimates that a child at the 50th percentile for body weight at the age of five, consuming an extra 400 kcal per day over the next five years, would become 10 kg overweight by comparison with a peer who did not. A relatively short four-year-old may become a relatively tall five-year-old, for example, and this biological growth trajectory may take him from a size at the 35th percentile among four-year-olds to the 60th percentile among five-year-olds a year later.

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