Addressing nutrient shortfalls in 1- to 5-year-old Irish children using diet modeling: development of a protocol for use in country-specific population health

Background Dietary habits formed in early childhood can track into later life with important impacts on health. Food-based dietary guidelines (FBDGs) may have a role in improving population health but are lacking for young children. Objectives We aimed to establish a protocol for addressing nutrient shortfalls in 1- to 5-y-old children (12–60 mo) using diet modeling in a population-based sample. Methods Secondary analysis of 2010–2011 Irish National Pre-School Nutrition Survey data (n = 500) was conducted to identify typical food consumption patterns in 1- to 5-y-olds. Nutrient intakes were assessed against dietary reference values [European Food Safety Authority (EFSA) and Institute of Medicine (IOM)]. To address nutrient shortfalls using diet modeling, 4-d food patterns were developed to assess different milk-feeding scenarios (human milk, whole or low-fat cow milk, and fortified milks) within energy requirement ranges aligned with the WHO growth standards. FBDGs to address nutrient shortfalls were established based on 120 food patterns. Results Current mean dietary intakes for the majority of 1- to 5-y-olds failed to meet reference values (EFSA) for vitamin D (≤100%), vitamin E (≤88%), DHA (22:6n–3) + EPA (20:5n–3) (IOM; ≤82%), and fiber (≤63%), whereas free sugars intakes exceeded recommendations of