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Work Under Way

Question

What is the relationship between complementary feeding and growth, size, and body composition?

Approach to Answering the Question
Existing NESR Systematic Review

Subcommittee
Birth to 24 Months Subcommittee

Existing Systematic Review Protocol
Developed for each scientific question being examined, the protocol describes the plan for how the systematic review will be conducted. For this question, the existing NESR systematic reviews were conducted during the Pregnancy and Birth to 24 Months Project, and captures evidence published from January 1980 to July 2016. The Complementary Feeding Technical Expert Collaborative conducted the systematic reviews in collaboration with staff from USDA’s Nutrition Evidence Systematic Review (NESR). Complete documentation of the existing systematic reviews and the related publication in the American Journal of Clinical Nutrition is available on the NESR website:

For additional details, see the full protocol for the question, What is the relationship between complementary feeding and growth, size and body composition?

View Full Protocol

Draft Conclusion Statement

The draft conclusion statements listed below describe the state of the science related to the specific question examined. Draft conclusions are not considered final until they have been deliberated with and decided upon by the full Committee and published in the Committee’s final advisory report. Individual conclusion statements should not be interpreted as dietary guidance or the Committee’s overarching advice to the Departments.

Timing of Introduction of Complementary Foods or Beverages

Moderate evidence suggests that first introduction of any complementary food or beverage (CFB) between the ages of 4 and 5 months compared to approximately 6 months of age is not associated with weight status, body composition, body circumferences, weight, or length among generally healthy, full-term infants. Grade: Moderate

Limited evidence suggests that introducing CFB before age 4 months of age may be associated with higher odds of overweight or obesity. Grade: Limited

There is not enough evidence to determine the relationship between introduction of CFB at 7 months of age or older on growth, size, or body composition. Grade: Grade Not Assignable

Types and Amounts of Complementary Foods or Beverages

Moderate evidence indicates that higher versus lower meat intake or meat versus iron-fortified cereal intake over a short duration (about 3 months) during the complementary feeding period does not favorably or unfavorably influence growth, size, and/or body composition. There is insufficient evidence to determine a relationship between meat intake and prevalence/incidence of overweight or obesity. Grade: Moderate

Limited evidence suggests that type or amount of cereal given does not favorably or unfavorably influence growth, size, body composition, and/or prevalence/incidence of overweight or obesity. Grade: Grade Not Assignable

Moderate evidence suggests that consumption of complementary foods with different fats and/or fatty acid composition does not favorably or unfavorably influence growth, size, or body composition. There is not enough evidence to determine a relationship between consumption of complementary foods with different fats and/or fatty acid composition and/or prevalence/incidence of overweight or obesity. Grade: Moderate

Limited evidence suggests that sugar-sweetened beverage consumption during the complementary feeding period is associated with increased risk of obesity in childhood, but is not associated with other measures of growth, size, and body composition. Grade: Limited

Limited evidence showed a positive association between juice intake and infant weight-for-length and child BMI-for-age z-scores. Grade: Limited

No conclusion could be made about the relationship between other complementary foods (vegetables, fruit, dairy products and/or cow’s milk, cereal-based products, milk-cereal drink, and/or categories such as “ready-made foods“) and growth, size, body composition, and/or prevalence/incidence of overweight or obesity. Grade: Grade Not Assignable

No conclusion could be made about the relationship between distinct dietary patterns during the complementary feeding period and growth, size, body composition, and/or prevalence/incidence of malnutrition, overweight or obesity. Grade: Grade Not Assignable