Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 1;83(6):1099-1132.
doi: 10.1093/nutrit/nuae212.

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

Bartlomiej M Zalewski  1 , Gisela A Weiss  2   3 , Cristina Campoy  4   5   6   7 , Tamás Decsi  8 , Elisabetta Di Profio  9   10 , Renaud Mestdagh  11 , Maryam Rakhshandehroo  12 , Hania Szajewska  1 , Stephan Theis  13 , Elaine E Vaughan  14 , Elvira Verduci  15 , Ching-Yu Chang  16
Affiliations

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

Bartlomiej M Zalewski et al. Nutr Rev. .

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.

Keywords: beverage; body composition; bowel habit; carbohydrate; glycemic; sugar.

PubMed Disclaimer

Conflict of interest statement

E.V. received honoraria, speaker’s fee, congress fee, and/or participated in advisory boards of Nutricia, Nutricia Metabolics, and Nestlé. H.S. serves as a board member of the International Scientific Association for Probiotics and Prebiotics (ISAPP), a role which is unpaid and voluntary. She has participated as a clinical investigator, advisory board member, consultant, and speaker for several companies, including Arla, BioGaia, Biocodex, Danone, Dicofarm, Nestlé, NNI, Nutricia, Mead Johnson, and Novalac. M.R. is an employee of Danone. S.T. is an employee of the Suedzuker/BENEO Group. E.E.V. is an employee of Sensus. C.C. is an employee of ILSI Europe. At the time of study execution, G.A.W. was an employee of Yili Innovation Center Europe and R.M. was an employee of Cargill.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Flow Diagram of the Literature Search and Study Selection Process. Reproduced from reference
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Commission Delegated Regulation (EU) 2016/127 of 25 September 2015 supplementing Regulation (EU) No 609/2013 of the European Parliament and of the Council as regards the specific compositional and information requirements for infant formula and follow-on formula and as regards requirements on information relating to infant and young child feeding. Published 2016. Accessed January 13, 2025. http://data.europa.eu/eli/reg_del/2016/127/oj
    1. Chouraqui JP, Tavoularis G, Emery Y, et al The French National Survey on Food Consumption of children under 3 years of age—Nutri-Bébé 2013: design, methodology, population sampling and feeding practices. Public Health Nutr. 2018;21:502-514. - PMC - PubMed
    1. EFSA Panel on Dietetic Products, Nutrition and Allergies. Scientific opinion on nutrient requirements and dietary intakes of infants and young children in the European Union. EFSA J. 2013;11:3408.
    1. EFSA Panel on Dietetic Products, Nutrition and Allergies. Scientific opinion on dietary reference values for carbohydrates and dietary fibre. EFSA J. 2010;8:1462.
    1. Fidler Mis N, Braegger C, Bronsky J, et al; ESPGHAN Committee on Nutrition. Sugar in infants, children and adolescents: a position paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2017;65:681-696. - PubMed

Publication types