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Best first food for baby: Meat vs cereal

By Tamzyn Murphy

BSc Med(Hons) Human Nutrition and Dietetics, RD

 

South African personality, sports scientist and Emeritus UCT Professor Tim Noakes is making news headlines again as the second and last day of the closing arguments of his “Baby Banting” trial before the Health Professions Council of South Africa (HPCSA) commences. The council is investigating Noakes for giving unconventional and un professional advice. The complaint laid by Association for Dietetics (ADSA) president, Claire Julsing-Strydom, is over ‘advice’ that Noakes tweeted in response to a mother’s query regarding the best food to introduce to her baby. Noakes advised the mother to introduce low carbohydrate, high fat (LCHF), Banting-friendly foods (which include meat and vegetables) to her baby from 6-month of age.

While the HPCSA will determine whether babies should or shouldn’t Bant, it is clear that Noakes is right about at least one thing: meat is far superior to cereal as babies’ first food. Health authorities’ recommendations that meat, meat alternatives (like eggs) and iron-fortified cereal are the best first food for babies imply that these are options are nutritional equals [1]. They are not. Here’s why meat beats cereal hands down.

 

Meating babies’ nutritional needs

Iron deficiency is very common in children in South Africa [2,3], and across the globe [4]. Many infants also don’t eat enough iron [2]. Infants with iron deficiency have impaired growth, mental development and problem solving ability [4]. Iron deficient babies score worse for mental and motor functioning when they’re older too [4]. By 6 months of age babies run out of iron stores [4]. Meat, fish and poultry are rich sources of the most readily absorbed heme form of iron. The iron contained in iron fortified cereal on the other hand, is in a non-haem form that is very poorly absorbed [4].

Meat, liver, poultry and fish – given as babies’ first foods in many traditional societies [1] – were the obvious iron-rich first foods to be introduced to babies before iron-fortified cereals were available. Since iron-fortified cereal was introduced it has replaced meat as the first food of choice for babies [4]. Not only is it a poor replacement as a source of bioavailable iron, but it also contains anti-nutrient phytates, which interfere with iron absorption, thereby reducing its bioavailability even further [2]. Therefore, cereal, even if it’s fortified with iron, may not be able to provide the iron that 6 month olds so desperately need.

Interestingly, zinc deficiency is also very common in babies and children. Meat is an excellent source of zinc. Introduction of meat as opposed to cereal as an early complementary food for exclusively breastfed infants is associated with improved zinc, iron and protein intake.  Babies fed meat instead of cereal have a higher head circumference and possibly also improved psychomotor development [5].

 

A weighty issue

Dietitian text books recommend that sugar and salt are not added to babies foods. Yet in the same breath they say that fortified infant cereal – usually packed with added sugar – is the first food to be introduced to babies [4].

Dietary sugar is linked to dental caries and the development of obesity and other lifestyle-related diseases. Even if parents do find baby cereal options that don’t include added sugar, they are still very refined (processed) and incredibly high in fast-release (high GI) carbohydrates.

Introducing cereals and fruit as babies’ first solid food is linked to the development obesity later in life [6]. Meat contains no carbohydrate and is high in fat and protein. A high fat intake during babies’ complementary feeding period doesn’t appear to increase their risk of becoming obese later [7]. There has been concern that high protein intake during infancy promotes weight and fat gain. However, a recent study indicates that this only holds true for high levels of protein from cow’s milk in formula fed infants. Breastfed babies who were fed meat instead of cereal, gained more weight and grew taller than those fed cereal, but they didn’t get fatter [8]. This indicates that higher protein levels from meat may not be linked to fatness after all.

Parents and health professionals await the outcome of Noakes’ HPCSA trial with bated breath. For now though, at least one aspect is clear: introducing ‘Banting-friendly’ meat to babies is a far better option than introducing cereal. From 6 months of age, babies should be offered pureed meat, liver, poultry, fish and eggs, progressing to the introduction of a variety of foods from family meals, such as vegetables mixed with pasture-fed butter, olive oil or breastmilk. Breastmilk continues to be the main source of nutrition throughout the first year. Breastfeeding is recommended for at least one year whenever possible, and preferably for up to two years or beyond.

 

References

[1] Health Canada. Nutrition for health term infants: Recommendations from six to 24 months. 24 Mar 2014

[2] Faber M, Wenhold F. Nutrition in contemporary South Africa. AJOL. 2007;33(3):393-400

[3] Visser J, Herselman M. Anaemia in South Africa: the past, the present and the future. S Afr J Clin Nutr. 2013;26(4):166-167

[4] Mahan LK, Escott-Stump S. Krause’s Food & Nutrition Therapy. International Edition 12. Saunders Elsevier. 2008

[5] Krebs NF, JE Wescott, N Butler, et al. Meat as a First Complementary Food for Breastfed Infants: Feasibility and Impact on Zinc Intake and Status. J Pediatr Gastroenterol Nutr. Feb 2006;42(2)

[6] Caroli M, Mele RM, Tomaselli MA, et al. Complementary feeding patterns in Europe with a special focus on Italy. Nutr Metab Cardiovasc Dis. Oct 2012;22(10):813-8

[7] Michaelsen KF, Larnkjaer A, Molgaard C. Early diet, insulin-like growth factor-1, growth and later obesity. World Rev Nutr Diet. 2013;106:113-8

[8] Tang M, Krebs NF. High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial. Am J Clin Nutr. Oct 2014;ajcn.088807

Diets that do and diets that don’t: Part 4 – The Dukan Diet

By Tamzyn Murphy

BSc Med(Hons) Human Nutrition and Dietetics, RD

 

Unlike the typical low carb diet, Dukan is high in protein (starting at 40% of calories) and low in fat (20% of calories). It’s big on rules and the restrictive phases are incredibly strict – any indiscretion is seen as a major failure. The idea is to replace much of your dietary carbs and fat with protein, which is filling, low in calories and takes time and work to digest. Studies on low carb, low fat, high protein diets show that you’ll naturally eat far fewer calories, feel full and you’ll likely experience metabolic benefits, including improved cholesterol, blood fat, glucose and insulin levels, thereby possibly reducing heart disease, diabetes and metabolic syndrome risk.[i], [ii] But weight loss benefits don’t appear to out-do other diets.

There are four phases. Phase one lasts about 5 days and consists almost exclusively of protein food – meat, seafood, poultry, eggs, vegetable-protein and fat-free dairy. No vegetables. Phase two allows non-starchy veg to be added to phase one’s protein foods, on every alternate day, and continues until you’ve lost the weight. The third phase last a few months and allows all the protein food and non-starchy veg you like, as well as limited fruit, whole grain bread and cheese. Phase three also allows two starch servings (e.g. pasta) and two anything-you-want meals each week. Phase four: eat what you like six days of the week, bearing in mind what you learnt during phase 3. On day seven you must eat like you did in phase one. A daily oat bran serving forms part of each phase, probably in an attempt to increase the fibre content of the diet.

Dukan’s excessive protein may increase your risk of gout[iii] and put strain on the kidneys[iv]. And a high protein and low fibre diet is bound to give you constipation. Cutting out entire food groups may put you at risk for nutritional deficiencies. So if you’re insistent on following this diet, it’s probably prudent to take a complete vitamin and mineral supplement, especially during the first two very restrictive phases. Phase four’s sudden dietary freedom may leave you directionless and reverting back to your old ways, resulting in rebound weight gain. And with all the expensive protein you’re guzzling, prepare for dent in your bank balance; as well as a conscience-prick at the number of animals that are being killed and the environmental impact of a carnivorous diet.

References

[i] Dumesnil JG, Turgeon J, et al. Effect of a low-glycaemic index–low-fat–high protein diet on the atherogenic metabolic risk profile of abdominally obese men. British Journal of Nutrition. Nov 2001;86(5):557-68 

[ii] Farnsworth E, Luscombe ND, et al. Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women.

[iii] Torralba KD, De Jesus E, Rachabattula S. The interplay between diet, urate transporters and the risk for gout and hyperuricemia: current and future directions. Int J Rheum Dis. 2012 Dec;15(6):499-506 

[iv] Juraschek SP, Appel LJ, et al. Effect of a high-protein diet on kidney function in healthy adults: results from the OmniHeart trial. Am J Kidney Dis. 2013 Apr;61(4):547-54