Friday, December 16, 2016

Whole Grains and Legumes: A Source of Dietary Fibre for Toddlers



By Jennifer Zhang

Why is toddler nutrition important?

The current Australian Dietary Guidelines and Infant Feeding Guidelines lack recommendations for whole grains and legumes for toddlers (a toddler is defined as a child aged between 1-3 years in this instance). This is also an issue amongst international guidelines where very few recommendations for whole grains and legumes are available for children under the age of three. This is most likely attributed to the lack of evidence regarding the benefits of whole grains and legumes on toddler health and the highly variable requirements amongst toddlers where a specific recommendation may result in inadequate or excessive intake for some children.

A focus on toddler nutrition is very important as this is when children are learning eating behaviours and forming attitudes towards food. The development of these attitudes and practices can determine lifelong eating patterns and thus influence health outcomes and risk of diet-related disease later in life (1). Therefore, the introduction of whole grains and legumes as part of a healthy diet for toddlers is important to promote healthy eating habits from a young age, as the benefits of consuming high fibre grain foods in adulthood are well established.

Why fibre?

Both whole grains and legumes have a range of nutrients including B-group vitamins (folate and thiamin), iron, magnesium, and most importantly, fibre. Dietary fibre refers to the indigestible parts of plant foods that are usually partially or completely fermented in the large intestine (2). The health benefits of fibre for adults is well documented, with evidence suggesting that higher intakes are associated with a reduced risk of cardiovascular disease, diabetes, obesity and some cancers, as well as improvements in blood glucose and cholesterol levels (3). Therefore, it is important to encourage adequate fibre intake from a young age to develop good eating habits and promote favourable health outcomes later in life.

Fibre is also an essential nutrient for bowel health where inadequate intake is associated with constipation, a common issue amongst toddlers (3). The prevalence of constipation varies between 5-30% of children where increasing dietary fibre (and water intake) is usually the recommended treatment (4). It has also been shown that preschool-aged children identified as picky eaters have lower intakes of dietary fibre and increased prevalence of hard stools (5). Therefore, adequate fibre intake is very important for toddlers to prevent constipation and maintain bowel health. The current recommendation for dietary fibre is an intake of 14g per day for those aged 1-3 years (2).

Current Intake of Whole grains and Legumes

The Australian Health Survey (AHS) 2011-13 found that 2-3 year olds consumed approximately three serves of core grain foods per day, which was below the four serve per day recommendation (6,7). The AHS also found that on average 2-3 year olds consumed 16g of fibre per day which is above dietary fibre recommendations. However, only 39% of grain foods consumed by 2-3 year olds were from whole grain or high fibre sources, which falls short of the Australian Dietary Guidelines recommendation to consume at least two thirds of grain intake from whole grain or high fibre varieties (6,7).

The AHS also looked at legume intake for children aged 2-3 years as part of both the vegetable and lean meat and alternatives food group. It was found that less than 1% of children aged 2-3 years consumed the recommended 2.5 serves of vegetables per day, with an average intake of 1.4 serves for males and 1.1 serves for females (6,7). Of the types of vegetables eaten by 2-3 year olds, only 11% were legumes or beans (6). Similarly, less than 16% of males and 6% of females aged 2-3 years met the one serve recommendation for lean meat and alternatives, with an average intake of 0.7 serves per day (6,7) and only 10% coming from legumes (6).

Therefore, overall intake of both legumes and whole grains is very low amongst toddlers. It is important to include whole grain foods and legumes in the toddler diet to ensure that requirements for important nutrients such as fibre are met.

Fibre in Whole Grains

But there is some good news! Fibre intake can be easily increased by substituting current grain foods with whole grains. See the below table comparing the amount of fibre in one serve of refined and whole grain versions of foods (8).


Amount of Fibre
% Increase in Fibre

Refined
Whole Grain
Bread (1 slice)
WHITE vs. WHOLE GRAIN
1.1 g
1.9 g
73%
Rice (1/2 cup)
WHITE vs. BROWN
0.9 g
1.4 g
56%
Breakfast Cereal (2/3 cup)
CORNFLAKES VS. SULTANA BRAN
0.8 g
4.6 g
475%
Pasta (1/2 cup)
WHITE vs. WHOLEMEAL
1.7 g
4.2 g
147%

Legume
Amount of Fibre per 75 g
(1/2 cup serve)
Baked Beans (Canned)
3.9 g
Black Beans
6.6 g
Kidney Beans
5.4 g
Split Peas
6.2 g
Lentils
2.8 g
Chickpeas
3.5 g


As you can see, simply switching refined options for whole grain options can increase dietary fibre intake dramatically, helping a toddler reach their goal for fibre intake. For example, one ½ cup serve of wholemeal pasta can provide up to one third of a toddler’s dietary fibre requirement (2).

Fibre in Legumes

The total amount of dietary fibre in legumes can vary widely between 3-6 g per 75 g of cooked legumes. Below is a table showing the amount of dietary fibre in commonly eaten legumes (8):

A portion of legumes as small as ½ cup cooked can provide up to 20-47% of a toddler’s dietary fibre requirements (2).

In summary, the consumption of whole grains and legumes can be very beneficial for increasing fibre intake for most toddlers, especially if you have a picky eater as each small portion of whole grains or legumes can provide a significant amount of fibre. The early introduction of whole grains and legumes should be encouraged to prevent childhood constipation, help form healthy eating habits from a young age and promote long term health.



References
1. Queensland Health. A healthy start in life: a nutrition manual for health professionals – Toddler nutrition [Internet]. 2008 [cited Dec 6]. Available from: https://www.health.qld.gov.au/ph/documents/saphs/hsil_toddlernutrit.pdf
2. Australian Government National Health and Medical Research Council. Nutrient Reference Values for Australia and New Zealand – Nutrients, Dietary Fibre [Internet]. 2014 [updated 2014 Sep 4; cited 2016 Dec 6]. Available from: https://www.nrv.gov.au/.
3.  Anderson JW, Baird P, Davis JRH, Ferreri S, Knudtson M, Koraym A, et al. Health benefits of dietary fiber. Nutrition reviews. 2009;67(4):188-205.
4. SA Child Health Clinical Network. South Australian Paediatric Practice Guidelines – Constipation in Children [Internet]. Government of South Australia; 2014 Feb 11 [cited 2016 Dec 13]. Available from: https://www.sahealth.sa.gov.au/wps/wcm/connect/f67aeb004329b2228184ed8bf287c74e/Constipation+in+children_May2014.pdf?MOD=AJPERES&CACHEID=f67aeb004329b2228184ed8bf287c74e
5. Taylor CM, Northstone K, Wernimont SM, Emmett PM. Picky eating in preschool children: Associations with dietary fibre intakes and stool hardness. Appetite. 2016;100:263-71.
6.  Australian Bureau of Statistics. 4364.0.55.012 - Australian Health Survey: Consumption of Food Groups from the Australian Dietary Guidelines, 2011-12. Canberra; 2016 May 11 [cited 2016 Dec 13]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.012main+features12011-12
7. National Health and Medical Research Council. Australian Dietary Guidelines [Internet]. Canberra: Australian Government; 2013 [cited 2016 Dec 13]. Available from: https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf
8. Food Standards Australia New Zealand. AUSNUT2011-13 – Australian food composition database [Internet]. Canberra: FSANZ; 2014 May 9 [updated 2016 Apr 27; cited 2016 Dec 6]. Available from: http://www.foodstandards.gov.au/science/monitoringnutrients/ausnut/foodnutrient/Pages/default.aspx