ILSI Europe Systematic Review: The Impact of Digestible and Nondigestible Carbohydrate Consumption for Toddlers (1–4 Years) in Relation to Health Outcomes

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Abstract
Context: Early dietary habits play a crucial role in shaping long-term health outcomes. Understanding the effects of different carbohydrate types on physiological markers is essential for developing evidence-based nutritional guidelines for toddlers. Objective: The aim was to systematically evaluate the impact of both digestible and nondigestible carbohydrate intake during early childhood (1–4 years of age) on various health outcomes, including growth patterns, metabolic parameters, and the development of risk of cardiovascular diseases. Data Sources: PubMed, Embase, and CENTRAL databases were searched up to April 2022 to identify studies investigating carbohydrate consumption in toddlers. Data Extraction: The types of carbohydrates consumed, their sources, and their associations with growth parameters and metabolic markers were extracted. Thirty-one publications, including 18 cohort studies and 2 randomized controlled trials, were included. Data Analysis: The risk of bias was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was performed, with a visual summary table of the direction of effects. Conclusion: In toddlers, the negative impact on health risks later in life is more pronounced for digestible dietary carbohydrate intake in liquid forms, such as sugar-sweetened beverages and fruit juice, compared with solid forms. Higher nondigestible carbohydrate (dietary fiber) intake during early childhood showed a beneficial trend on later lipid profile. Further studies are required to comprehensively assess the effect of digestible and nondigestible carbohydrate intake in toddlers on cognitive and psychomotor development, infections, bowel function, and gut microbiota.

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