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'Every Bite Counts': The importance of monitoring diet in the first 24 months of life

Nutrition plays a vital role in the growth and development of infants and young children. Early childhood is a critical period for establishing health eating habits that can have long-term implications for health outcomes.

Study: Count every bite to make “Every Bite Count”: Measurement gaps and future directions for assessing diet from birth to 24 months. Image Credit: Evgeny Atamanenko /

About the study

A new study recently published in the Journal of the Academy of Nutrition and Dietetics addresses the need for improved methods of assessing dietary intake in infants and young children.

Herein, researchers from the National Collaborative for Childhood Obesity Research (NCCOR) assess the efficacy of the Dietary Guidelines for Americans (DGA) in reducing childhood obesity while also identifying gaps in dietary measurements. Moreover, the researchers also propose a novel approach to identify any measurement gaps that may exist

Limitations of current dietary assessment methods

Traditional dietary methods, such as 24-hour parental recall and food diaries, food frequency questionnaires, and image-based dietary assessment tools, are prone to errors due to difficulties in estimating portion sizes and accurately recalling consumed foods. Furthermore, many current dietary assessment methods are not standardized, have not been validated, and are not capable of capturing the diversity and complexity of early feeding practices.

Many common and overlapping measurement gaps have also been assessed in other domains of data collection. These include the inability to record the setting, increased burden on the participant, and demanding too much time or money for proper administration. Furthermore, proxy reporting by many different caregivers, biased reporting, and known variations in human milk composition are all potential sources of error, the impact of which on the accuracy of measurement remains unknown.

The development of artificial intelligence (AI)-based tools for data processing and analysis is expanding. However, not enough consideration is being paid to the effect of individual, social, and systemic bias in the construction of the algorithms that underlie AI.

Novel digital technologies have been and are being developed that can passively and actively collect information both passively and actively. Nevertheless, many of these approaches require further fine-tuning to ensure their adaptation

The bite-counting solution

To address these limitations, the researchers propose the use of bite-counting technology as a potential solution to overcome these measurement gaps. By quantifying the number of bites taken during feeding, this technology can provide objective data on food intake, feeding frequency, and self-regulation behaviors.

The adoption of bite-counting technology could lead to more accurate assessments of energy and nutrient intake in infants and young children. It may also help identify feeding patterns, preferences, and associations between dietary behaviors and health outcomes.

In the future, standardized assessment tools that integrate bite-counting technology could enhance the accuracy and reliability of dietary intake measurements in infants and young children. Additionally, these tools may be devised to consider age-specific variations in feeding practices, as well as the inclusion of culturally diverse tools.

Future outlook

The current study findings have significant implications for future research and public health initiatives focused on early childhood nutrition.

Importantly, future studies are needed to validate bite-counting technology as compared to established dietary assessment methods. By comparing the accuracy and reliability of bite counts with other measures, researchers can establish the validity of this new approach and ensure its applicability across diverse populations.

Bite-counting technology offers the potential to gain insights into feeding dynamics, such as self-regulation behaviors and eating behaviors. Further investigation into these dynamics can inform interventions aimed at promoting healthy eating habits and preventing childhood obesity.

Longitudinal studies are also needed to assess the long-term impact of early feeding practice on health outcomes. By tracking dietary patterns from birth to 24 months and beyond, researchers can establish associations between early nutrition and later health outcomes, such as growth, cognitive development, and the risk of chronic diseases.

With widespread collaboration, it is possible to not only make every bite count, but also to count every bite.”

Journal reference:
  • Zimmer, M., Obbagy, J., Scanlon, K. S., et al. (2023). Count every bite to make “Every Bite Count”: Measurement gaps and future directions for assessing diet from birth to 24 months. Journal of the Academy of Nutrition and Dietetics. doi: 10.1016/j.jand.2023.05.011.

Posted in: Child Health News | Medical Science News | Medical Research News

Tags: Artificial Intelligence, Childhood Obesity, Children, Chronic, Diet, Efficacy, Food, Frequency, Nutrition, Obesity, Public Health, Research, Technology

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Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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