Carbohydrate intakes, food sources and tracking in Australian young children

Abstract

Carbohydrates are an important source of energy, playing a crucial role in the growth and development of children⁽¹⁾. Carbohydrate intakes in adults are well studied, but the intake and key food sources of carbohydrates during early childhood are poorly understood. Assessing carbohydrate intake and identifying key food sources of carbohydrates and their subtypes will aid in dietary monitoring to identify suboptimal intake and food sources. Thus, the current study aimed to describe the intakes of total carbohydrates and their subtypes (starch and total sugar), identify their main food sources, and examine tracking among young Australian children over the first 5 years of life. Data from children who participated in follow-ups at ages 9 months (n = 393), 18 months (n = 284), 3.5 years (n = 244), and 5 years (n = 240) in the Melbourne InFANT Program⁽²⁾ were used. Child dietary intake was collected using three 24-hour recalls. Descriptive statistics were used to summarise the total carbohydrate and subtype intakes and their main food sources. Tracking was examined using Pearson’s correlations of the residualised scores across different time points. From ages 9 months to 5 years, total carbohydrate intake increased from 99.7 g/d to 174 g/d. Total sugar and starch intakes (g/d) also increased throughout early childhood. The percentage of energy (%E) from total carbohydrates remained stable over time (48.4–50.5%). However, the %E from total sugar decreased from 29.4% at 9 months to 22.6% at 5 years, while the %E from starch increased from 16.7% at 9 months to 26.0% at 5 years. The primary source of total carbohydrates at 9 months was infant formula. At later ages (18 months, 3.5 years, and 5 years), the key sources of total carbohydrate intake were bread/cereals, fruits, and milk/milk products. The major sources of total sugar intake at all time points were fruits and milk/milk products. However, intakes of total sugar from discretionary foods such as cakes/cookies increased with age. The main food sources for starch intake were consistent across all ages which included breads/cereals, cakes/cookies, and pasta. Weak to moderate tracking of total carbohydrate, total sugar, and starch (g/d) was observed from as early as age 9 months to age 5 years. Given the detrimental effects of discretionary foods on health, our results reinforce the importance of reducing sugar intake from discretionary foods and promoting healthy alternatives, such as wholegrains, from early childhood. The tracking of carbohydrate intake from as early as age 9 months suggest that carbohydrate intakes were established early in life, emphasising the importance of early dietary interventions. Our findings revealed in-depth insights into carbohydrate intake trends during early childhood, which may contribute valuable evidence to inform the refinement of carbohydrate intake recommendations in young Australian children.