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Dietary fibre in infancy and childhood

Published online by Cambridge University Press:  05 March 2007

C. A. Edwards*
Affiliation:
Department of Human Nutrition, Glasgow University, Yorkhill Hospitals, Glasgow, G3 8SJ
A. M. Parrett
Affiliation:
Department of Human Nutrition, Glasgow University, Yorkhill Hospitals, Glasgow, G3 8SJ
*
*Corresponding author: Dr Christine Edwards, fax +44 141 201 9275, caeln@clinmed.gla.ac.uk
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Abstract

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There is very little evidence for the effects of dietary fibre in young children and current dietary guidelines are based on assumptions and data extrapolated from studies in adults. The first years of life may be critical for the establishment of a healthy colonic microflora, as well as good eating habits. The lack of clear and well-founded guidelines for the intake of dietary fibre in childhood may hinder both factors. The fears that a high-fibre diet in children <5 years of age will lead to growth faltering and mineral imbalance are not well supported in the literature, especially for children in the developed world. Indeed, with the rising levels of obesity, fibre intake may be of benefit in reducing energy intake. A low-fibre diet may also be implicated in the aetiology of childhood constipation and appendicitis. The latest proposals for the definition of dietary fibre include oligosaccharides, which may act as prebiotics. There are potential health benefits of including oligosaccharides in the diets of infants and children, but more research is needed to consider the long-term effects. The immature intestine of the infant may also result in a greater amount of starch entering the colon during weaning, and this starch would now be considered dietary fibre under the new definitions. Much new research is needed to allow adequate recommendations for the intake of dietary fibre in childhood based on data collected in appropriate age-groups.

Type
Symposium on ‘Dietary fibre in health and disease’ Session: General aspects of dietary fibre
Copyright
Copyright © The Nutrition Society 2003

References

Adamidis, D, Roma-Giannikou, E, Karamolegou, K, Tselalidou, E & Constantopoulos, A (2000) Fiber intake and childhood appendicitis. International Journal of Food Science and Nutrition 51, 153157.CrossRefGoogle ScholarPubMed
Aggett, PJ, Agostoni, C, Axelsson, I, Edwards, CA, Goulet, O, Hernell, O, Koletzko, B, Lafeber, HN, Michaelsen, KF, Micheli, J-L, Rigo, J, Szajewska, H & Weaver, LT (2003) Non-digestible carbohydrates in the diets of infants and young children – Comment by ESPGHAN Committee on Nutrition. Journal of Pediatric Gastroenterology and NutritionGoogle Scholar
Anon (2001) The definition of dietary fibre. Report of the Dietary Fiber Definition Committee of the American Association of Cereal Chemists. Cereal Food World 46, 112129.Google Scholar
Armstrong, EF, Eastwood, MA, Edwards, CA, Brydon, WG & MacIntyre, CCA (1992) The effect of weaning diet on the subsequent colonic metabolism of dietary fibre in the adult rat. British Journal of Nutrition 68, 741751.CrossRefGoogle ScholarPubMed
Bjorksten, B, Naaber, P, Sepp, E & Mikelsaar, M (1999) The intestinal microflora in allergic Estonian and Swedish 2 year old children. Clinical and Experimental Allergy 29, 342346.CrossRefGoogle ScholarPubMed
Bottcher, MF, Norin, EK, Sandin, A, Midtvedt, T & Bjorksten, B (2000) Microflora associated characteristics in faeces from allergic and non-allergic infants. Clinical and Experimental Allergy 30, 15901596.CrossRefGoogle Scholar
Brook, I, Barett, C, Brinkman, C, Martin, W & Finegold, S (1979) Aerobic and anaerobic bacterial flora of the maternal cervix and newborn gastric fluid and conjunctiva: a prospective study. Pediatrics 63, 451454.CrossRefGoogle ScholarPubMed
Christian, M, Edwards, CA & Weaver, LT (1999) Starch digestion in infancy. Journal of Pediatric Gastroenterology and Nutrition 29, 116124.Google ScholarPubMed
Christian, MT, Edwards, CA, Preston, T, Johnson, LA, Varley, R & Weaver, LT (2000) Patterns of colonic starch fermentation from infancy to adulthood. Proceedings of the Nutrition Society 59, 36AGoogle Scholar
Committee on Nutrition of the American Academy of Pediatrics (1998) Carbohydrate and dietary fiber Pediatric Nutrition Handbook, pp.203211. Elk Grove Village, IL: American Academy of PediatricsGoogle Scholar
de Araujo, Santan, Anna, AM & Calcado, AC (1999) Constipation in school aged children at public school in Rio de Janeiro, Brazil. Journal of Pediatric Gastroenterology and Nutrition 29, 190193.Google Scholar
Department of Health Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no 41. London: H.M. Stationery Office.Google Scholar
Doré, J, Sghir, A, Hannequart-Grramet, G, Corthier, G & Pochart, P (1998) Design and evaluation of a 16S rRNA-targeted oligonucleotide probe for specific detection and quantitation of human faecal Bacteroides populations. Systematic and Applied Microbiology 21, 6571.CrossRefGoogle ScholarPubMed
Dwyer, JT (1995) Dietary fiber for children, how much?. Pediatrics 96, 10191022.Google ScholarPubMed
Dwyer, JT, Andrew, EM, Berkey, C, Valadian, I & Reed, RB (1983) Growth in ‘new’ vegetarian preschool children using the Jenss- 22 C. A. Edwards and A. M. Parrett Bayley curve fitting technique. American Journal of Clinical Nutrition 37, 815827.CrossRefGoogle Scholar
Edwards, CA, Parrett, AM, Balmer, SE & Wharton, BA (1994) Faecal short chain fatty acids in breast fed and formula fed babies. Acta Paediatrica 83, 459462.CrossRefGoogle ScholarPubMed
Gregory, JR, Collins, DL, Davies, PSW, Hughes, JM & Clarke, PC (1995) National Diet and Nutrition Survey of Children Aged 11/2–41/2 Years. London: H.M. Stationery OfficeGoogle Scholar
Gregory, J, Lowe, S, Bates, CJ, Prentice, A, Jackson, LV, Smithers, G, Wenlock, R & Farron, M (2000) National Diet and Nutrition Survey of Young People Aged 4–18 Years. London: H.M. Stationery Office.Google Scholar
Grönlund, M-M, Lehtonen, O-P, Eerola, E & Keeo, P (1999) Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal microflora after cesarean delivery. Journal of Pediatric Gastroenterology and Nutrition 28, 1925.Google ScholarPubMed
Guimaraes, EV, Goulart, EM & Penna, FJ (2001) Dietary fiber intake, stool frequency and colonic transit time in chronic functional constipation in children. Brazilian Journal of Medical and Biological Research 34, 11471153.CrossRefGoogle ScholarPubMed
Hamaker, BR, Rivera, K, Morales, E & Graham, GG (1991) Effects of dietary fiber and starch on faecal composition in preschool children consuming maize amaranth or cassava flours. Journal of Pediatric Gastroenterology and Nutrition 13, 5966.Google ScholarPubMed
Hanley, AJ, Harris, SB, Gittelsohn, J, Wolever, TM, Saksvig, B & Zinman, B (2000) Overweight among children and adolescents in a native Canadian community: prevalence and associated factors. American Journal of Clinical Nutrition 71, 693700.CrossRefGoogle Scholar
Harmsen, HJM, Elfferich, P, Schut, F & Welling, GW (1999) A 16S rRNA-targeted probe for the detection of lactobacilli and enterococci in faecal samples by fluorescent in situ hybridisation. Microbial Ecology in Health and Disease 11, 312.CrossRefGoogle Scholar
Harmsen, HJM, Wibleboer-Veloo, ACM, Raangs, GC, Wagendorp, AA, Klijn, N, Bindels, JG & Wellings, GW (2000) Analysis of intestinal flora development in breast-fed and formula-fed infants using molecular identification and detection methods. Journal of Pediatric Gastroenterology and Nutrition 30, 6167.Google ScholarPubMed
Hyams, JS (1982) Chronic abdominal pain caused by sorbitol malabsorption. Journal of Pediatrics 100, 772773.CrossRefGoogle ScholarPubMed
Isolauri, E (2001) Probiotics in the prevention and treatment of allergic disease. Pediatric Allergy and Immunology 12, 5659 Suppl. 14CrossRefGoogle ScholarPubMed
Jonsson, G, Midtvedt, AC, Norman, A & Midtvedt, T (1995) Intestinal microbial bile acid transformation in healthy children. Journal of Pediatric Gastroenterology and Nutrition 20, 394402.Google Scholar
Kalliomaki, M, Kirjavainen, P, Eerola, E, Kero, P, Salminen, S & Esolauri, E (2001) Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. Journal of Allergy and Clinical Immunology 107, 129134.CrossRefGoogle Scholar
Kimm, SY (1995) The role of dietary fibre in the development and treatment of childhood obesity. Pediatrics 96, 10101014.CrossRefGoogle ScholarPubMed
Kneepkens, CMF, Vonk, RJ & Fernandes, S (1984) Incomplete intestinal absorption of fructose. Archives of Disease in Childhood 59, 735738.CrossRefGoogle ScholarPubMed
Kunz, C, Rudloff, S, Baier, W, Klein, N & Strobel, S (2000) Oligosaccharides in human milk: structural, functional and metabolic aspects. Annual Review of Nutrition 20, 699722.CrossRefGoogle ScholarPubMed
Lifshitz, F, Ament, ME, Kleinman, RE, Klish, W, Lebenthal, E, Perman, J & Udall, JN (1992) Role of juice carbohydrate malabsorption in chronic non-specific diarrhoea in children. Journal of Pediatrics 120, 825829.CrossRefGoogle Scholar
Livesey, G (1990) Energy values of unavailable carbohydrate and diets: an inquiry and analysis. American. Journal of Clinical Nutrition 51, 617637.CrossRefGoogle ScholarPubMed
Long, SS & Swenson, RM (1977) Development of anaerobic faecal flora in healthy newborn infants. Journal of Pediatrics 91, 298301.CrossRefGoogle ScholarPubMed
Lopez, HW, Coudray, C, Bellanger, J, Younes, H, Demigne, C & Remesey, C (1998) Intestinal fermentation lessens the inhibitory effects of phytic acid on mineral utilization in rats. Journal of Nutrition 128, 11921198.CrossRefGoogle ScholarPubMed
McClean, P & Weaver, LT (1993) Ontogeny of human pancreatic exocrine function. Archives of Disease in Childhood 68, 6265.CrossRefGoogle ScholarPubMed
Martin, F, Savage, SAH, Parrett, AM, Gramet, G, Dore, J & Edwards, CA (2000) Investigation of bacterial colonisation of the colon in breast-fed infants using novel techniques. Proceedings of the Nutrition Society 59, 64AGoogle Scholar
Midtvedt, AC, Carlstedt-Duke, B & Midtvedt, T (1994) Establishment of a mucin-degrading intestinal microflora in the first two years of human life. Journal of Pediatric Gastroenterology and Nutrition 18, 321326.Google ScholarPubMed
Midtvedt, AC, Carlstedt-Duke, B, Norin, KE, Saxerholt, H & Midtvedt, T (1988) Development of five metabolic activities associated with the intestinal microflora of healthy infants. Journal of Pediatric Gastroenterology and Nutrition 7, 559567.Google ScholarPubMed
Midtvedt, AC & Midtvedt, T (1992) Production of short chain fatty acids by the intestinal microflora during the first two years of human life. Journal of Pediatric Gastroenterology and Nutrition 15, 395403.Google Scholar
Midtvedt, AC & Midtvedt, T (1993) Conversion of cholesterol to coprostanol by the intestinal microflora during the first two years of human life. Journal of Pediatric Gastroenterology and Nutrition 17, 161168.Google ScholarPubMed
Moore, WEC & Holdeman, LV (1974) Human fecal flora: The normal flora of 20 Japanese-Haiwaiians. Applied Microbiology 27, 961979.CrossRefGoogle Scholar
Morais, MB, Vitolo, MR, Aguirre, AN, Fagundes-Neto, U (1999) Measurement of low dietary fibre intake as a risk factor for chronic constipation in children. Journal of Pediatric Gastroenterology and Nutrition 29, 132135.Google ScholarPubMed
Moro, G, Minoli, I, Mosca, M, Jelinek, J, Stahl, B & Boehm, G (2002) Dosage related bifidogenic effects of galacto and fructo oligo saccharides in formula fed term infants. Journal of Pediatric Gastroenterology and Nutrition 34, 291295.Google Scholar
Norin, KE, Gustafsson, BE, Lindblad, BS & Midtvedt, T (1985) The establishment of some microflora associated biochemical characteristics in feces from children during the first years of life. Acta Paediatrica Scandinavica 74, 207212.CrossRefGoogle ScholarPubMed
Ouwehand, AC, Isolauri, E, He, F, Hashimoto, H, Benno, Y & Salminen, S (2001) Differences in Bifidobacterium flora composition in allergic healthy infants. Journal of Allergy and Clinical Immunology 108, 144145.CrossRefGoogle ScholarPubMed
Parrett, AM (2001) Development of colonic fermentation in early life. PhD Thesis, University of Glasgow.Google Scholar
Parrett, AM & Edwards, CA (1997a) In vitro fermentation of carbohydrate by breast fed and formula fed infants. Archives of Disease in Childhood 76, 249253.CrossRefGoogle ScholarPubMed
Parrett, AM & Edwards, CA (1997b) The effect of weaning on fermentation capacity in formula fed infants. Proceedings of the Nutrition Society 56, 309AGoogle Scholar
Parrett, AM, Khanna, S & Edwards, CA (2000) Excretion of faecal starch and fat in breast fed and formula fed infants during weaning. Proceedings of the Nutrition Society 59, 64AGoogle Scholar
Parrett, AM, Lokerse, E & Edwards, CA (1997) Colonic fermentation in vitro: development during weaning in breast fed infants is slower for complex carbohydrates than for sugars. American Journal of Clinical Nutrition 65, 927933.CrossRefGoogle ScholarPubMed
Pathmakanthan, S, Meance, S & Edwards, CA (2000) Probiotics: A review of human studies to date and methodological approaches. Microbial Ecology in Health and Disease 2, 1030 Suppl.CrossRefGoogle Scholar
Roma, E, Adamidis, D, Nikolara, R, Constantopoulos, A & Messaritakis, J (1999) Diet and chronic constipation in children: the role of fiber. Journal of Pediatric Gastroenterology and Nutrition 28, 169174.Google ScholarPubMed
Ruxton, CH, Kirk, TR, Holmes, MA & Belton, NR (1995) No adverse effects on growth seen in Scottish school children consuming either low fat diets or diets relatively high in non-starch polysaccharides. Health Bulletin 53, 398401.Google ScholarPubMed
Satakori, RM, Vaughan, EE, Favier, CF, Dore, J, Edwards, C, de Vos, WM (2002) Diversity of Bifidobacterium and Lactobacillus spp in breast fed and formula fed infants as assessed by 16S rDNA sequence differences. Microbial Ecology in Health and Disease 14, 97105.CrossRefGoogle Scholar
Sanders, TA (1988) Growth and Development of British vegan children. American Journal of Clinical Nutrition 48, 822825 Suppl. 3CrossRefGoogle ScholarPubMed
Schmitz, J & McNeish, AS (1987) Development of structure and function of the gastrointestinal tract: Relevance for weaning In Weaning: Why, What and When? pp.143 [Ballabriga, A, Rey, J, edditor]. New York: Nestlé Nutrition, Vevey/Raven PressGoogle Scholar
Scholz-Ahrens, KE, Schaafsma, G, van de Heuvel, EG, Schrezenmeir, J (2001) Effects of prebiotics on mineral metabolism. American Journal of Clinical Nutrition 73 459S – 464SCrossRefGoogle ScholarPubMed
Shull, MW, Reed, RB, Valadian, I, Palombo, R, Thorns, H & Dwyer, JT (1977) Velocities of growth in vegetarian pre-school children. Pediatrics 60, 410417.CrossRefGoogle Scholar
Stark, PL & Lee, A (1982) The microbial ecology of the large bowel of breast-fed and formula-fed infants during the first year of life. Journal of Medical Microbiology 15, 189203.CrossRefGoogle ScholarPubMed
Szylit, O & Andrieux, C (1993) Physiological and pathophysiological effects of carbohydrate fermentation. World Review of Nutrition and Dietetics 74, 88122.CrossRefGoogle ScholarPubMed
Tannock, GW, Fuller, R, Smith, SL & Hall, MA (1990) Plasmid profiling of members of the family Enterobacteriaceae, lactobacilli, and bifidobacteria to study the transmission of bacteria from mother to infant. Journal of Clinical Microbiology 28, 12251228.CrossRefGoogle Scholar
Tse, PW, Leung, SS, Chan, T, Sien, A & Chan, AK (2000) Dietary fibre intake and constipation in children with severe developmental disabilities. Journal of Paediatrics and Child Health 36, 236239.CrossRefGoogle ScholarPubMed
Vaughan, EE, Schut, F, Heilig, HGHJ, Zoetendal, EG, de Vos, WM & Akkermans, ADL (2000) A molecular view of the intestinal ecosystem. Current Issues in Intestinal Microbiology 1, 112.Google ScholarPubMed
Verity, K & Edwards, CA (1994) Resistant starch in young children. Proceedings of the Nutrition Society 53 105AGoogle Scholar
Williams, CL, Bollella, M & Wynder, EL (1995) A new recommendation for dietary fiber in childhood. Pediatrics 96, 985988.CrossRefGoogle ScholarPubMed
Younes, H, Coudray, C, Bellnager, J, Demigne, C, Rayssiguier, Y & Remesy, C (2001) Effects of two fermentable carbohydrates (inulin and resistant starch) and their combination on calcium and magnesium balance in rats. British Journal of Nutrition 86, 479485.CrossRefGoogle ScholarPubMed
Zetterstrom, R, Bennet, R, Nord, K-E (1994) Early infant feeding and the microecology of the gut. Acta Paeditrica Japonica 36, 562571.CrossRefGoogle ScholarPubMed