Nutrient supply in toddlerhood For effective support of vitamin D provision HiPP Junior COMBIOTIC ® Information for health care professionals Child-oriented recipe orientated towards low-fat cow’s milk specific adaptation of critical nutrients + iron + iodine + vitamin D - protein - saturated fatty acids Benefits proven in trial* Significantly improved vitamin D levels Contains the proven ingredients lactic acid culture L. fermentum (originally obtained from breast milk)** valuable fibre GOS*** AL44387-02.2019 – HiPP GmbH & Co. Vertrieb KG, 85273 Pfaffenhofen * HiPP Growing-up Milk Combiotic® 2+ with 2.9 μg/100 ml of vitamin D ** Breast milk contains many natural cultures which can each be different *** Galacto-oligosaccharides obtained from lactose HiPP Junior COMBIOTIC® hipp.com/hcp References 1 EFSA Panel on Dietetic Products, Nutrition and Allergies. EFSA Journal 2013; 11: 3408 2 Deutsche Gesellschaft für Ernährung (Hrsg.): Ernährungsbericht 2008 3 Reinehr T, Schnabel D, Wabitsch M et al. Monatsschr Kinderheilkd 2018; 166: 814. https://doi.org/10.1007/s00112-018-0502-6 4 Thierfelder W et al. Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 2007; 50: 757–770 5 Kunz C et al. Eur J Nutr 2018 doi: 10.1007/s00394-018-1717-y. [Epub ahead of print] 6 DGE (Hrsg. f. Deutschland): Referenzwerte für die Nährstoffzufuhr. Bonn, 2. Auflage, 1. Ausgabe (2015) 7 EFSA Dietary reference values for nutrients. 2017;doi: 10.2903/sp.efsa.2017.e15121 8 Souci, Fachmann u. Kraut. www.sfk-online.de. Accessed on 5 February 2019 9 Bergmann KE et al. Monatsschr Kinderheilk 2015;163:1012–1019 10 Wabitsch M et al. Monatsschr Kinderheilk 2011;159:766–774 11 Hower J et al. Eur J Pediatr 2013; 172: 1597–1605 For the most valuable in life.
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Nutrient supply in toddlerhood
For e� ective support of vitamin D provision
HiPP Junior COMBIOTIC®
Information for health care professionals
Child-oriented recipe
orientated towards low-fat cow’s milk speci� c adaptation of critical nutrients + iron + iodine + vitamin D - protein - saturated fatty acids
Bene� ts proven in trial* Signi� cantly improved vitamin D levels
Contains the proven ingredients lactic acid culture L. fermentum (originally obtained from breast milk)** valuable � bre GOS***
AL4
4387
-02.
2019
– H
iPP
Gm
bH &
Co.
Ver
trie
b KG
, 852
73 P
fa� e
nhof
en
* HiPP Growing-up Milk Combiotic® 2+ with 2.9 μg/100 ml of vitamin D
** Breast milk contains many natural cultures which can each be di� erent
*** Galacto-oligosaccharides obtained from lactose
HiPP Junior COMBIOTIC®
hipp.com/hcp
References 1 EFSA Panel on Dietetic Products, Nutrition and Allergies. EFSA Journal 2013; 11: 3408
2 Deutsche Gesellschaft für Ernährung (Hrsg.): Ernährungsbericht 2008
3 Reinehr T, Schnabel D, Wabitsch M et al. Monatsschr Kinderheilkd 2018;166: 814. https://doi.org/10.1007/s00112-018-0502-6
4 Thierfelder W et al. Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 2007; 50: 757–770
5 Kunz C et al. Eur J Nutr 2018 doi: 10.1007/s00394-018-1717-y. [Epub ahead of print]
6 DGE (Hrsg. f. Deutschland): Referenzwerte für die Nährsto� zufuhr. Bonn, 2. Au� age, 1. Ausgabe (2015)
7 EFSA Dietary reference values for nutrients. 2017;doi: 10.2903/sp.efsa.2017.e15121
8 Souci, Fachmann u. Kraut. www.sfk-online.de. Accessed on 5 February 2019
9 Bergmann KE et al. Monatsschr Kinderheilk 2015;163:1012–1019
10 Wabitsch M et al. Monatsschr Kinderheilk 2011;159:766–774
11 Hower J et al. Eur J Pediatr 2013; 172: 1597–1605
For the most valuable in life.
Vitamin D supply when consuming formula versus cow's milk
Kuhmilch HiPP Growing-up milk * p<0,001 cow´s milk
A toddler’s diet includes
too much protein and saturated fatty acids
too little iodine, iron, polyunsaturated fatty acids and vitamin D in particular.
Before winter (October)
n = 80
After winter (February)
n = 63
30
25
20
15
10
5
0
Study group: children 2-6 years old, HiPP Growing-up milk 2+ with 2.9 μg vitamin D/100 ml = 116 IU,
cow's milk with 0.03 μg/100 ml = 1.2 IU
Recommendations for increasing vitamin D
Spend time outdoors on a regular basis3
Sunlight boosts vitamin D and exercise promotes the development of bone mass.
Between April and September, go out in the sun twice a week between 10am and 3pm for 5-30 minutes with uncovered head, arms and legs.
Consume food containing vitamin D on a regular basis3
In particular fatty � sh, eggs and mushrooms
A child would have to eat 10 eggs, almost 1 kg mushrooms or 100 g salmon to meet their daily requirements (600 IU7 without exposure to sunlight).8
Supplements or forti� ed foods provide extra vitamin D9,10
e.g. growing-up milk
Quadrupling the intake recommendations in Gemany to 20 µg a day (800 IU)6 in 2012 led to no improvement in vitamin D status.
Vitamin D status for children and young people4
30
25
20
15
10
5
0
25 (O
H) v
itam
in D
(n
g/m
l in
seru
m; m
edia
n)
Vitamin D status before and after increasing intake recommendations
30
25
20
15
10
5
0
25 (O
H) v
itam
in D
(n
g/m
l in
seru
m; m
edia
n)
Year
Study group: 1909 children and teenagers (0-17 years)
2009 – 2012 2013 – 2014
Age in years14–171–2 3–6 7–10 11–13 14–171–2 3–6 7–10 11–13
Toddlers have an unbalanced supply of nutrients.1,2
Toddlers need 7 times more vitamin D than adults. 6,7
Intervention study shows that growing-up milk signi� cantly boosts vitamin D supply.11
Increasing vitamin D intake recommendations has had no e� ect on children.5
Growing-up milk with 2.9 μg/100 ml (116 IE) of vitamin D is a safe and simple nutritional measure which prevents against the decrease of 25(OH)D serum concentration during the winter.
per kg body weight
After a child’s second early summer they no longer receive vitamin D supplements.3
< 20 ng/ml = vitamin D de� ciency
Vitamin D levels are insu� cient once a vitamin D supplement is no longer given.
25 (O
H) v
itam
in D
(n
g/m
l in
seru
m; m
edia
n)
*
20 ng/ml = 50 nmol/l
1 µg vit. D = 40 IE
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