Selection of reference foods for a scale of standards for use in assessing the transitional process from milk to solid food in infants and pre-school children

Abstract

Objective: This paper describes the development of a reliable scale of standards for use in evaluating the progress of the transition from milk to solid food in infants and preschool children. The maturation of chewing and swallowing behavior in infants and young children, which enables processing of solid food, varies, and a scale would assist not only in the instruction of mothers and nurses but also in preventing delay in the introduction of solid food. Design: A range of 159 reference foods were selected on the basis of intake during the period of transition from liquid to solid food. These foods were listed in our previous study, Validity and reliability were tested to create a scale. Methodology: Foods were selected on the basis of 50% of the subjects studied being able to eat them, and on the food groups classified by cluster analyses using the Varclus procedure of SAS. Validity, of the scale was tested by using Pearson's correlation coefficient between the scale score of selected food items and the total score of all 159 food items. The total score of 159 food items was calculated using the general linear models (GLM) procedure of SAS. Reliability was tested using Cronbach's coefficient a. Setting: Public health centers in Aomori, Tokyo, Saitama, Nagano, and Okinawa (Japan). Subject: Five hundred and eighty healthy mothers and children from 2 to 46 months were randomly selected and 470 (81.0%) completed the study. To avoid regional bias, subjects were drawn from northern to southern prefectures in Japan, namely Aomori, Tokyo, Saitama, Nagano, and Okinawa. Results: Twenty food items were selected. By analyzing the score correlation using Pearson's correlation coefficient (R ¼ 0.97, Po0.001) and GLM (R 2 ¼ 0.95, Po0.001), it was confirmed that these 20 food items adequately represented the original 159. The reliability was also found to be sufficient (Cronbach's coefficient a ¼ 0.96).Conclusions: The findings demonstrate that a scale of standards for measuring progress in chewing ability can be created using 20 food items. Such a standard will provide a useful basis against which to assess delay of solid food introduction in childhood. IntroductionThe ways in which the maturation of chewing and swallowing behavior in an infant enables it to eat solid food are various. In Japan, a suggested program for the transitional process from liquid to solid food focused on 1 y after birth and was supported by the Japanese Ministry of Health and Welfare (Society for Maternal and Child Health, 1997). However, many babies do not follow the instructed transitional process (Sakashita, 1992), and many pre-school children are not good at chewing and swallowing due to Contributors: RS participated in the study design, collected the data, did the statistical analysis, participated in the discussion of results and wrote the paper. NI participated in the study design, coordinated the study participated in the discussion of results and reviewed the paper. TT coordinated the study, and participated in the discussion of results. ...

Patterns and predictors of food texture introduction in French children aged 4–36 months

“…2015-A00323-46). The survey design was inspired by a survey conducted in Japan that aimed to develop a reference standard to document progress in the transition to solid foods during the CF period ( 17 , 29 ) .…”

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Infant Cereals: Current Status, Challenges, and Future Opportunities for Whole Grains

“…During weaning, clear changes in the infant’s gut microbiota have been observed upon the addition of either wheat, sorghum, rice, or oats into a large intestine in vitro [17], and a higher proportion of complex carbohydrates in infant cereals has been shown to lead to a higher fermentative activity of the intestinal microbiota of infants aged six to 10 months in vivo [18]. (4) Cereals have a mild taste and a semi-solid texture and consistency, which is adequate for the transition from milk toward the acceptation of solid foods at the beginning of complementary feeding [19,20].…”

From milk to solids: a reference standard for the transitional eating process in infants and preschool children in Japan

“…They were selected using the following criteria: daily use, geographical commonality, ready availability, and mild taste. In the second study (Sakashita et al, 2003), 20 reference foods were chosen from the 159, based on the period when 50% of the subjects could eat them, and on the food groups classified by cluster analyses using the Varclus procedure of SAS (Hartman & Sarle, 1988). The validity of the scale was tested by Pearson's correlation coefficient between the scale score of selected food items and the total score of all 159 food items.…”

“…Before the causes of eating problems can be discussed, it is necessary to clarify the actual condition and variance of the progress in food types among children. For this reason, a scale for use in assessing the transitional process from milk to solid food in infants and preschool children, the transitional food process (TFP) scale, was developed (Sakashita et al, 2001(Sakashita et al, , 2003.…”