The present invention generally relates to the field of nutrition. In particular the present invention relates to infant nutrition in the post natal period and in early life, more particular during the age period of 6-36 months or during a part thereof.
Evidence is accumulating that nutrition during early life can program the development of diseases later in life1, a discovery that was named “metabolic programming or imprinting”. This evidence, mainly driven from foetal development in-utero2-7, reveals the importance of optimal nutrition during early life for the health of the individual later in the life. Considering that many developmental processes still continue during early post natal life, it is evident that postnatal nutrition—especially during suckling and during the complementary feeding period—plays an important role for the health status and for the prevention of diseases later in life.
Prior evidence in rats demonstrates that a change in the fat and carbohydrate (CHO) content of milk during the suckling period may have an impact on the development of obesity and diabetes later in life. In these studies8-9 that relate to breast feeding without additives rats were artificially reared by using either a milk substitute formula low in fat content (LF) and rich in CHO (20% total energy from fat (fat E) and 56% total energy from carbohydrates (CHO E), respectively) or by using a milk composition similar to rat milk, namely high in fat (HF) and low in CHO (8% CHO E and 68% fat E) or were mother-fed from the age of 4 to 24 days postnatal. All groups were weaned onto a low fat laboratory standard chow diet. The LF feeding during the suckling period resulted in hyperinsulinemia which persisted into adulthood and lead to an increase in body weight and onset of adult obesity, an effect termed “metabolic programming”10-11. Beyond total milk feeding (suckling period) this effect was previously not investigated to the inventor's best knowledge.
Although during the suckling period “milk” as the first diet of infants and other mammals is very rich in fat (50% of energy from fat), the dietary fat intake is reduced considerably during the complementary feeding period as an infant is gradually weaned off milk onto semi solid foods.
This is due to the replacement of high-fat milk with weaning foods low in fat content, such as fruits, vegetables, weaning cereals, fruit juices etc.
It has been reported that the fat intake of infants, even in developed countries, is low (30% of energy from fat) during the complementary feeding period (6-12 months)12-13. Indeed the complementary feeding period has been referred to as “the period of life with the lowest fat intake during the life cycle of man”.
Data concerning nutritional recommendations for humans during the weaning period are scarce and recommendations are mainly based on estimates of the nutritional requirements of those of suckling infants adjusted for weight and energy intake. Infant nutrition during this period of rapid growth is surrounded by uncertainties and there is little agreement about what should constitute an optimal composition of the complementary diet and in particular an optimal fat and carbohydrate content of complementary diets.
The present uncertainty about the long-term consequences of the fat and CHO content of the weaning diet on health in general and—in particular—on development of obesity later in life led the present inventors to investigate these consequences in rats as model system for humans.
It is an advantage of the present invention to provide a nutritional concept for the transition period from nutrition with breast milk or breast milk-like products in terms of fat and CHO content during the suckling period to the subsequent nutrition with baby food that allows it to reduce the risk that the child develops a bad health status, in particular obesity and diabetes later in life.
The present invention provides kits, methods of reducing the risk of obesity and mealplans.
In one embodiment the present invention relates to a kit of parts comprising diet compositions for children during the age period of 6-36 months or during a part thereof. In an embodiment, the macronutrient content of the compositions is gradually changing in the form of a straight line from a composition that comprises about 40-50% energy from fat and about 40-49% energy from carbohydrates for children at the age of 6 months to a composition that comprises about 30-35% energy from fat and about 50-55% energy from carbohydrates for children at the age of 36 months.
A wide variety of kits and methods of using the kit are possible and envisioned by the present invention.
Additional features and advantages are described herein, and will be apparent from, the following Detailed Description and the figures.
% energy refers for the purpose of the present invention always to the K total amount of energy that is present in a diet composition. A diet composition that has 33% energy from fat will therefore have 67% energy from carbohydrates and/or proteins.
A diet composition means at least one meal or a part thereof. For example, a diet composition can be a complete meal such as breakfast, lunch or dinner. It can also be one or more, e.g. five, individual meals that are consumed during the day. It can also be more than one individual meal. It can also represent only a part of an individual meal or a part of more individual meals. It is preferred that the diet compositions of the present invention represent individual meals. Oftentimes dinner represents a substantial part of the diet on a caloric basis. In infants, the caloric intake during dinner can range from 15 to 35% of the daily caloric intake. Hence, in a preferred embodiment the meals are dinners. Dinners are the main meal of the day and can be served in the evening or at midday. Nutritionally well-balanced dinners can, hence, significantly contribute to the health of infants.
Macronutrients are those nutrients that together provide most metabolic energy to an organism. For the purpose of the present invention the three macronutrients are carbohydrates, proteins, and fats.
Gradually changing in the form of a straight line from a composition that comprises about 40-50% energy from fat and about 40-49% energy from carbohydrates for children at the age of 6 months to a composition that comprises about 30-35% energy from fat and about 50-55% energy from carbohydrates for children at the age of 36 months means any straight line or group of straight lines that is located on and/or between the two black lines in
Expressed in mathematical terms this means that the present invention discloses and comprises every kit of diet compositions for children during the age period of 6-36 months or during a part thereof, wherein the fat content of the diet composition is adjusted to any straight line, which is located on or between the straight lines
y=−1/2x+53 and y=−1/3x+42 (y is % energy from fat), and
wherein the carbohydrate content of the diet composition is adjusted to any straight line, which is located on or between the straight lines
y=1/5 x+47.8 and y−1/3x+38 (y is % energy from carbohydrates)
between x=6 and x=36, if x is the age of the child in months.
A kit of parts in accordance with the present invention provides a tool for the parents to improve infant nutrition in an optimal way without having to keep detailed records of the nutritional components that the infant has already ingested.
The present method and kit thus increase convenience and reduce the occurrence of consequences of non-optimal nutrition.
“Infants” as used in the present invention are in particular human children aged from 4 months to 3 years. The present method is particularly directed at infants aged from 6 to 36 months.
In one embodiment of the present invention the diet compositions are daily diet compositions. Daily diet compositions have the advantage that they can be used very effectively to tightly regulate the gradual change of the fat and carbohydrate content of the food of a child when it is gaining age. It is important to note that if the diet compositions are daily diet compositions the individual meals may well deviate somewhat from a macronutrient content that is gradually changing in the form of a straight line from a composition that comprises about 40-50% energy from fat and about 40-49% energy from carbohydrates for children at the age of 6 months to a composition that comprises about 30-35% energy from fat and about 50-55% energy from carbohydrates for children at the age of 36 months, as long as the individual meals to be consumed during a day together—that together are considered a daily diet composition—fulfil this requirement.
This way it is possible to adapt a mealplan of a child, e.g., in a way that it can consume food that is easy to digest in the evening to allow an easy sleep, while it consumes food compositions that are more difficult to digest during the day.
In one embodiment of the present invention the total energy content of the composition is gradually changing in the form of a straight line from a composition that comprises about 670-715 kcal/day for children at the age of 6 months to a composition that comprises about 1000-1200 kcal/day for children at the age of 36 months. This allows adapting the energy content of the diet compositions to the particular age of the child, so that it can be assured that a sufficient amount of energy is always present during this decisive period of development of the child, while an overfeeding is avoided.
Changing gradually means in one embodiment of the present invention that the fat and carbohydrate content of the diet composition is adjusted daily, based on the age of the child and the corresponding optimal fat content and carbohydrate content of the composition. Optionally, the total energy content is also adjusted daily along with the fat and carbohydrate content. This results in a very gradual change without any noticeable “steps” in diet composition. Consequently, the infant's organism will not have to adapt to any abrupt changes in food content.
In another embodiment of the present invention changing gradually means that the content of the diet composition is adjusted weekly, based on the age of the child and the corresponding optimal fat content and carbohydrate content of the composition. Also in this case the changes that are made to the diet composition are so marginal that the metabolism of the infant will not be faced with any abrupt changes.
In another embodiment of the present invention changing gradually means that the content of the diet composition is adjusted monthly, based on the age of the child and the corresponding optimal fat content and carbohydrate content of the composition. Even if the adjustment of the diet composition is made on a monthly level the resulting mealplan of a child will exhibit a smooth transition from a high fat-low carbohydrate composition at the age of 6 months to a low fat-high carbohydrate composition at the age of 36 months without any abrupt changes.
The present inventors have found that the object of the present invention can still well be achieved by adjusting the macronutrient content of the diet composition stepwise, based on the age of the child and the corresponding optimal fat content and carbohydrate content of the composition as detailed above, preferably in 3-10 steps, most preferred in 3-4 steps during the age of 6-36 months.
This stepwise adjustment is preferable made at a child age of 6, 8, 12, 18, 24 and/or 36 months.
In one preferred embodiment of the present invention changing gradually includes that the content of the diet composition is adjusted also with respect to the total calorie content based on the age of the child and the corresponding optimal calorie content of the composition.
For example, a kit according to the present invention can comprise at least one diet composition that comprises about 44-46% energy from fat and about 47-49% energy from carbohydrates during the age of 6-8 months, at least one diet composition that comprises about 39-41% energy from fat and about 49-52% energy from carbohydrate during the age of 8-12 months, and/or at least one diet composition that comprises about 34-35% energy from fat and about 51-53% energy from carbohydrate during the age of 12-36 months. Preferably, the at least one diet composition for consumption during the age of 6-8 months comprises about 670-715 kcal/day, the at least one diet composition for consumption during the age of 8-12 months comprises about 715-850 kcal/day, and/or the at least one diet composition for consumption during the age of 12-36 months comprises about 750-1200 kcal/day.
The diet compositions of the present invention further comprise a protein source. The amount of protein source present is preferably adjusted to the need of the child of the particular age in question and can generally be calculated as follows:
% energy from protein=100−(% energy from fat+% energy from carbohydrates)
In a particular preferred embodiment of the present invention the content of carbohydrates in the compositions is gradually changing from a composition that comprises about 48% energy from carbohydrates for children at the age of 6 months to a composition that comprises about 53% energy from carbohydrates for children at the age of 36 months.
Generally the kit of the present invention comprises at least one, preferably at least two diet compositions. A diet composition preferably constitutes one or more complete meals, one or more parts of a complete meal or one or more snacks or a part thereof.
The number of diet compositions the kit of the present invention can contain is not particularly limited and is only regulated by the storage stability of the food product. Hence, a kit intended for use in a nursery or in a hospital can be significantly larger than a kit for private households.
In a preferred embodiment the kit of the present invention comprises diet compositions for at least one day. In this respect the kit might comprise 2 or more, preferably 3-10, even more preferred 5 individual meals. The daily food intake can, e.g., be divided into three meals and 2 up to 3 snacks. More meals with corresponding smaller portions have the advantage that the child's metabolism will not be faced with too large amount of food and at the same time periods with an “empty stomach” are avoided.
In further embodiments of the present invention the kit comprises diet compositions for three days, for a week or for a month. It is preferred that the diet compositions represent one or more individual meals. In this case the kit can for example comprise at least 3, preferably 3-21, most preferred 9 individual meals.
It is further preferred that the diet compositions represent a total diet, which is to be understood as sum of food to be consumed by a person over a given period of time.
Preferably, the diet composition of the present invention also comprises micronutrients and/or minerals to arrive at an ideally balanced food product for the child at the particular age. Also these components can preferably be varied based on the specific needs of the child at a particular age.
In a preferred embodiment of the present invention the fat component comprises essential fatty acids. Essential fatty acids are fatty acids that cannot be produced by the body. They are capable of fulfilling important functions in the human body. Two families of essential fatty acids are in particular important, the omega-3 and the omega-6 family. Alpha-linolenic acid (ALA, a fatty acid with a chain length of 18 carbon atoms and containing three double bonds) is an example of a member of the omega-3 family. ALA is, e.g., found in flaxseed and various vegetable oils and nuts. An example of a member of the omega-6 family of essential fatty acids is linoleic acid (LA, a fatty acid with a chain length of 18 carbon atoms and containing two double bonds). The weight ratio of omega-6/omega-3 fatty acids in the diet compositions of the present invention is preferably between 5 and 15.
Preferably, the diet compositions of the present invention are of a liquid nature. Preferred embodiments have a consistency of a liquid or of a mash. This can be achieved by the presence of water in the diet compositions of the present invention. Preferably, they contain between 75 and 90 wt-% water based on the total weight of the diet composition, more preferably between 78 and 85 wt-% water.
In a preferred embodiment, the diet compositions to be administered to the infants each have a volume between 90 and 500 ml, more preferably between 125 and 300 ml. The diet compositions of the present invention may all have about the same volume (i.e. difference between greatest and smallest volume is less than 50 ml) or they may have increasing volumes with the increasing age of the child to reflect an increased caloric content.
Preferably, the diet compositions of the present invention are to be consumed at a temperature of between 15 and 55° C., more preferred between 30 and 50° C., and even more preferably between 35 and 45° C.
The diet compositions according to the present invention are preferably individually packaged and provided as a kit of parts. The kit of parts contains in one embodiment several different meals. The diet compositions in the kit are preferably in ready-to-eat and/or dried form. From the dried form, a ready-to-eat form can be easily produced by reconstitution in a suitable liquid, e.g. water. The ready-to-eat form can normally be administered directly to the infant, optionally after heating and/or mixing.
The present invention relates also to the use of a series of diet compositions, wherein the macronutrient content of the compositions is gradually changing from a composition that comprises about 40-50% energy from fat and about 40-49% energy from carbohydrates for children at the age of 6 months to a composition that comprises about 30-35% energy from fat and about 50-55% energy from carbohydrates for children at the age of 36 months for the preparation of a kit to prevent the development of obesity.
The kit that is to be prepared by the use of the present invention can be any kit of the present invention and can have any feature or any combination of features as described herein.
The series of diet compositions comprises 2 or more individual diet compositions, preferably 3-35 diet compositions.
Finally, the present invention also relates to a mealplan for children that comprises a kit of the present invention. The mealplan is intended for the prevention of obesity later in life.
Those skilled in the art will understand that it is possible to freely combine features and embodiments of the present invention as described herein without departing from the scope of the present invention as disclosed.
By way of example and not limitation, examples of the present invention will now be given.
Experiment 1
The consequence of fat and CHO content of weaning diet on the later development of obesity was investigated using rats.
Seventy two male Sprague-Dawley rats were separated from their dam at the age of 16 days. The animals were divided into three study groups (24 animals/group) and were pair-fed, on an iso-energetic and iso-protein basis, with one of the following weaning diets (Table 1) differing only in energy distribution from Fat and CHO as: (% energy) 10/70 (group A); 30/50 (group B) and 60/20 (group C). for 20 days (Phase I: age 16 to 36 days). All groups were then fed ad libitum with a standard low-fat commercial chow diet (Kliba 3434, 13% fat E:) for 20 weeks (phase II: age 5 to 25 weeks), after which all groups were challenged with a high-fat diet (45% fat E: Kliba 2126) that was fed ad-libitum for a period of 18 weeks (phase III: age 35 to 53 weeks).
Food intake was measured daily during the weaning period (period I) and twice per week during the post-weaning periods (period II &III). Body weight was measured 2-3 times per week throughout the study.
The body composition, which is body fat and fat free mass, was measured during post weaning phases II and III using NMR imaging (EchoMRI 2004), at 27, 35, 47 and 52 weeks of age.
However, the rats fed with a low-fat (10% E), high-carbohydrate (70% E), diet only during 19 days weaning period gained significantly more body weight (
These results show that a weaning diet with a macronutrient composition (fat and CHO) close to that consumed during the suckling period (high fat diet) has a beneficial effect toward reducing the risk of development of obesity later in life, while a high-CHO, low-fat diet during the weaning period increases the susceptibility to excess body weight and fat mass gain later in life.
The inventors believe that this is the first report on “metabolic programming” during the complementary feeding period and reveals the importance of the Fat/CHO content of complementary diet for obesity prevention later in life.
In the following sample diet compositions are provided for the age period of 6-8 months (*=carbohydrates as monosaccharides):
In the following sample diet compositions are provided for the age period of 8-12 months (*=carbohydrates as monosaccharides):
In the following sample diet compositions are provided for the age period of 12-36 months (*=carbohydrates as monosaccharides):
It should be understood that various changes and modifications to the presently preferred embodiments described herein will be apparent to those skilled in the art. Such changes and modifications can be made without departing from the spirit and scope of the present subject matter and without diminishing its intended advantages. It is therefore intended that such changes and modifications be covered by the appended claims.