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Child Feeding and Parenting Style Outcomes and Composite Score Measurement in the 'Feeding Healthy Food to Kids Randomised Controlled Trial'. CHILDREN-BASEL 2016; 3:children3040028. [PMID: 27834906 PMCID: PMC5184803 DOI: 10.3390/children3040028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 10/21/2016] [Accepted: 11/03/2016] [Indexed: 02/06/2023]
Abstract
Child feeding practices and parenting style each have an impact on child dietary intake, but it is unclear whether they influence each other or are amenable to change. The aims of this study were to measure child feeding and parenting styles in the Feeding Healthy Food to Kids (FHFK) Randomized Controlled Trial (RCT) and test a composite child feeding score and a composite parenting style score. Child feeding and parenting style data from 146 parent-child dyads (76 boys, aged 2.0–5.9 years) in the FHFK study were collected over a 12-month intervention. Parenting style was measured using parenting questions from the Longitudinal Study of Australian Children and the Child Feeding Questionnaire (CFQ) was used to measure child feeding practices. Data for both measures were collected at baseline, 3 and 12 months and then modelled to develop a composite child feeding score and a parenting score. Multivariate mixed effects linear regression was used to measure associations between variables over time. All child feeding domains from the CFQ were consistent between baseline and 12 months (p < 0.001), except for monitoring (0.12, p = 0.44). All parenting style domain scores were consistent over 12 months (p < 0.001), except for overprotection (0.22, p = 0.16). A significant correlation (r = 0.42, p < 0.0001) existed between child feeding score and parenting style score within the FHFK RCT. In conclusion, composite scores have potential applications in the analysis of relationships between child feeding and dietary or anthropometric data in intervention studies aimed at improving child feeding or parenting style. These applications have the potential to make a substantial contribution to the understanding of child feeding practices and parenting style, in relation to each other and to dietary intake and health outcomes amongst pre-school aged children.
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352
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Li Z, van der Horst K, Edelson-Fries LR, Yu K, You L, Zhang Y, Vinyes-Pares G, Wang P, Ma D, Yang X, Qin L, Wang J. Perceptions of food intake and weight status among parents of picky eating infants and toddlers in China: A cross-sectional study. Appetite 2016; 108:456-463. [PMID: 27825943 DOI: 10.1016/j.appet.2016.11.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 10/24/2016] [Accepted: 11/03/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Previous studies have suggested that children that are picky eaters may have a different and less varied diet than non-picky children, but the literature on picky eating in Chinese children is limited. OBJECTIVES To assess the prevalence of picky eating in 6-35 month-old Chinese children, and to explore how parents' perceptions of picky eating relate to children's intake and body composition. METHODS 1414 6-35 month-old infants and toddlers from 8 Chinese cities were included in this study. Questionnaires were used to collect information on family demographic factors, child picky eating behaviors, food group rejection, and parents' perception of child weight status. Dietary intake data was collected via 24-h recall. Children's length/height and weight were measured. RESULTS The reported prevalence of picky eating was higher in 24-35 month-olds (36% of children) compared to 6-11 month-olds (12%). There were no consistent significant differences in dietary intakes of nutrients between picky and non-picky eaters. Picky eating children whose parents indicated that they avoided eggs had lower intake of this food group compared to non-picky eaters, whereas those reported to avoid grains or meat had higher intakes of those food groups. Weight status was underestimated by parents of both picky and non-picky children. CONCLUSIONS Picky eating seems to occur at similar prevalence rates in China as has been reported in other countries. Parents' perceptions of food refusal do not reflect actual intakes, nor do nutrient intakes of picky eaters show additional gaps compared to non-picky eating children. In healthy children with typical growth patterns, picky eating seems to be a normal phase of development experienced by some children, without substantial consequences on their nutrient or food group intakes.
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Affiliation(s)
- Ziyi Li
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Klazine van der Horst
- Nestlé Research Center Lausanne, Vers-chez-les-Blanc, PO Box 44, 1000 Lausanne 26, Switzerland
| | - Lisa R Edelson-Fries
- Nestlé Research Center Lausanne, Vers-chez-les-Blanc, PO Box 44, 1000 Lausanne 26, Switzerland.
| | - Kai Yu
- Nestlé Research Center Beijing, Building E-F, No.5 Dijin Road, Haidian District, Beijing 100095, People's Republic of China; Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Lili You
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Gerard Vinyes-Pares
- Nestlé Research Center Beijing, Building E-F, No.5 Dijin Road, Haidian District, Beijing 100095, People's Republic of China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Defu Ma
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, No.38 Xueyuan Road, Haidian District, Beijing 100191, People's Republic of China
| | - Xiaoguang Yang
- Department of Nutrition and Food Hygiene, Chinese Center for Disease Control and Prevention, No. 155 Changbai Road, Changping District, Beijing 102206, People's Republic of China
| | - Liqiang Qin
- Department of Health Education, School of Public Health, Soochow University, No.199 Renai Road, Suzhou Industrial Park, Suzhou 215325, Jiangsu, People's Republic of China
| | - Jiaji Wang
- School of Public Health and General Medicine, Guangzhou Medical University, No.195 Dongfeng West Road, Guangzhou 510182, Guangdong, People's Republic of China
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353
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Shloim N, Vereijken CMJL, Blundell P, Hetherington MM. Looking for cues - infant communication of hunger and satiation during milk feeding. Appetite 2016; 108:74-82. [PMID: 27647500 DOI: 10.1016/j.appet.2016.09.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/08/2016] [Accepted: 09/16/2016] [Indexed: 01/30/2023]
Abstract
It is known that duration of breastfeeding and responsive feeding are associated with decreased risk of obesity. It is however, not clear whether breastfed infants signal more to mothers to facilitate responsive feeding, compared to formula fed, nor what communication cues are important during the feeding interaction. The present study aimed to explore feeding cues in milk-fed infants and to examine if such cues vary by mode of feeding. Twenty-seven mothers and infants were filmed while breastfeeding or formula feeding. Infants' age ranged from 3 to 22 weeks. Feeding cues were identified using a validated list of communication cues (NCAST). The frequency of each cue during the beginning, middle, and end of the meal was recorded. There were 22 feeding cues identified during the feeds, with significantly more frequent disengagement cues expressed than engagement cues. Significantly more frequent feeding cues were observed at the beginning than at the end of the meal showing that cue frequency changes with satiation. Breastfeeding infants exhibited more engagement and disengagement cues than formula fed infants. Supporting mothers to identify engagement and disengagement cues during a milk feed may promote more responsive feeding-strategies that can be acquired by mothers using different modes of feeding.
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Affiliation(s)
- N Shloim
- School of Healthcare, University of Leeds, Leeds, LS2 9JT, England, UK.
| | - C M J L Vereijken
- Danone Nutricia Research, Uppsalalaan 12, 3584 CT, Utrecht, The Netherlands
| | - P Blundell
- School of Psychology, University of Leeds, Leeds, LS2 9JT, England, UK
| | - M M Hetherington
- School of Psychology, University of Leeds, Leeds, LS2 9JT, England, UK
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354
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Zalbahar N, Najman J, McIntrye HD, Mamun A. Parental pre-pregnancy BMI influences on offspring BMI and waist circumference at 21 years. Aust N Z J Public Health 2016; 40:572-578. [PMID: 27624991 DOI: 10.1111/1753-6405.12574] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/01/2016] [Accepted: 05/01/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate the prospective association between parental pre-pregnancy BMI and adult male and female offspring BMI and waist circumference (WC). METHODS Sub-sample of 2,229 parent-offspring pairs with parental pre-pregnancy BMI and offspring BMI and WC at 21 years were used from the MUSP (Mater-University of Queensland Study of Pregnancy cohort). Multivariable results were adjusted for maternal factors around pregnancy (e.g. gestational weight and smoking during pregnancy) and offspring factors in early life (e.g. birth weight) and at 14 years (e.g. sports participation and mealtime with family). RESULTS After adjustments for confounders, each unit increase in paternal and maternal BMI, the BMI of young adult offspring increased by 0.33kg/m2 and 0.35kg/m2 , and the WC increased by 0.76 cm and 0.62 cm, respectively. In the combination of parents' weight status, offspring at 21 years were six times the risk being overweight/obese (OW/OB) when both parents were OW/OB, compared to offspring of healthy weight parents. CONCLUSIONS Prenatal parental BMI are independently related to adult offspring BMI and WC. IMPLICATIONS Both prenatal paternal-maternal weight status are important determinants of offspring weight status in long-term. Further studies are warranted to investigate the underlying mechanisms.
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Affiliation(s)
- Nurzalinda Zalbahar
- School of Public Health, University of Queensland.,Department of Nutrition and Dietetics, Universiti Putra Malaysia
| | - Jake Najman
- School of Public Health, University of Queensland.,School of Social Science, University of Queensland
| | - Harold D McIntrye
- Mater Health Services, Queensland.,School of Medicine, University of Queensland
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355
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Warschburger P, Kroeller K, Haerting J, Unverzagt S, van Egmond-Fröhlich A. Empowering Parents of Obese Children (EPOC): A randomized controlled trial on additional long-term weight effects of parent training. Appetite 2016; 103:148-156. [DOI: 10.1016/j.appet.2016.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/02/2016] [Accepted: 04/07/2016] [Indexed: 10/22/2022]
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356
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Relationship between Parental Feeding Practices and Neural Responses to Food Cues in Adolescents. PLoS One 2016; 11:e0157037. [PMID: 27479051 PMCID: PMC4968823 DOI: 10.1371/journal.pone.0157037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/24/2016] [Indexed: 01/10/2023] Open
Abstract
Social context, specifically within the family, influences adolescent eating behaviours and thus their health. Little is known about the specific mechanisms underlying the effects of parental feeding practices on eating. We explored relationships between parental feeding practices and adolescent eating habits and brain activity in response to viewing food images. Fifty- seven adolescents (15 with type 2 diabetes mellitus, 21 obese and 21 healthy weight controls) underwent fMRI scanning whilst viewing images of food or matched control images. Participants completed the Kids Child Feeding Questionnaire, the Childrens’ Dutch Eating Behaviour Questionnaire (DEBQ) and took part in an observed meal. Parents completed the Comprehensive Feeding Practices Questionniare and the DEBQ. We were particularly interested in brain activity in response to food cues that was modulated by different feeding and eating styles. Healthy-weight participants increased activation (compared to the other groups) to food in proportion to the level of parental restriction in visual areas of the brain such as right lateral occipital cortex (LOC), right temporal occipital cortex, left occipital fusiform gyrus, left lateral and superior LOC. Adolescents with type 2 diabetes mellitus had higher activation (compared to the other groups) with increased parental restrictive feeding in areas relating to emotional control, attention and decision-making, such as posterior cingulate, precuneus, frontal operculum and right middle frontal gyrus. Participants with type 2 diabetes mellitus also showed higher activation (compared to the other groups) in the left anterior intraparietal sulcus and angular gyrus when they also reported higher self restraint. Parental restriction did not modulate food responses in obese participants, but there was increased activity in visual (visual cortex, left LOC, left occipital fusiform gyrus) and reward related brain areas (thalamus and parietal operculum) in response to parental teaching and modelling of behaviour. Parental restrictive feeding and parental teaching and modelling affected neural responses to food cues in different ways, depending on motivations and diagnoses, illustrating a social influence on neural responses to food cues.
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357
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The Parent Mealtime Action Scale revised (PMAS-R): Psychometric characteristics and associations with variables of clinical interest. Appetite 2016; 105:283-90. [PMID: 27221356 DOI: 10.1016/j.appet.2016.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 05/18/2016] [Accepted: 05/18/2016] [Indexed: 11/22/2022]
Abstract
The purpose of the present study was to provide a revised and more psychometrically-examined version of the Parent Mealtime Action Scale (PMAS-R), then to examine how well the PMAS-R subscales explained variance for four variables relevant in clinical settings. Study participants included 238 parents of children referred to a hospital-based feeding program (72.3% male children; mean age = 72.2 months; 80 with autism spectrum disorder, 77 with other special needs, 81 with no special needs). Parents completed questionnaires to report child demographics and diet habits. Parents also used a five-point rating instead of the original three-point rating to report their usage of the 31 PMAS feeding practices. Using five-point ratings, the nine subscales of the PMAS-R demonstrated improved internal reliability and test-retest reliability compared to those published for the original PMAS. ANCOVA indicated that special needs status was the child demographic variable most associated with PMAS-R feeding practices. Hierarchical multiple regression revealed that after controlling for child demographics, the nine PMAS-R subscales explained 26-49% of the variance for four variables of clinical interest (fruit and vegetable consumption, snack consumption, total food variety, and weight status). These variables of clinical interest were most often associated with "permissive" feeding practices including low Daily Fruit and Vegetable (FV) Availability, rarely using Insistence on Eating during meals, often using Many Food Choices, and often using Child-Selected Meals. The present study provides a more psychometrically-sound measure of child feeding practices, documents the association between "permissive feeding" and variables of clinical interest, and identifies specific parent practices included in "permissive feeding".
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358
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Helland SH, Bere E, Øverby NC. Study protocol for a multi-component kindergarten-based intervention to promote healthy diets in toddlers: a cluster randomized trial. BMC Public Health 2016; 16:273. [PMID: 26987876 PMCID: PMC4794829 DOI: 10.1186/s12889-016-2952-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 03/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is concern about the lack of diversity in children's diets, particularly low intakes of fruit and vegetables and high intakes of unhealthy processed food. This may be a factor in the rising prevalence of obesity. A reason for the lack of diversity in children's diets may be food neophobia. This study aimed to promote a healthy and varied diet among toddlers in kindergarten. The primary objectives were to reduce food neophobia in toddlers, and promote healthy feeding practices among kindergarten staff and parents. Secondary objectives were to increase food variety in toddlers' diets and reduce future overweight and obesity in these children. METHODS This is an ongoing, cluster randomized trial. The intervention finished in 2014, but follow-up data collection is not yet complete. Eighteen randomly selected kindergartens located in two counties in Norway with enrolled children born in 2012 participated in the intervention. The kindergartens were matched into pairs based on background information, and randomly assigned to the intervention or control groups. A 9-week multi-component intervention was implemented, with four main elements: 1) kindergarten staff implemented a pedagogical tool (Sapere method) in daily sessions to promote willingness to try new food; 2) kindergarten staff prepared and served the toddlers a cooked lunch from a menu corresponding to the pedagogical sessions; 3) kindergarten staff were encouraged to follow 10 meal principles on modeling, responsive feeding, repeated exposure, and enjoyable meals; and 4) parents were encouraged to read information and apply relevant feeding practices at home. The control group continued their usual practices. Preference taste tests were conducted to evaluate behavioral food neophobia, and children's height and weight were measured. Parents and staff completed questionnaires before and after the intervention. Data have not yet been analyzed. DISCUSSION This study provides new knowledge about whether or not a Sapere-sensory education and healthy meal intervention targeting children, kindergarten staff, and parents will: reduce levels of food neophobia in toddlers; improve parental and kindergarten feeding practices; improve children's dietary variety; and reduce childhood overweight and obesity. TRIAL REGISTRATION ISRCTN74823448 DOI 10.1186/ISRCTN74823448.
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Affiliation(s)
- Sissel H Helland
- Department of Public health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway.
| | - Elling Bere
- Department of Public health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway
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359
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Edelson LR, Mokdad C, Martin N. Prompts to eat novel and familiar fruits and vegetables in families with 1-3 year-old children: Relationships with food acceptance and intake. Appetite 2016; 99:138-148. [PMID: 26792770 DOI: 10.1016/j.appet.2016.01.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 01/05/2016] [Accepted: 01/09/2016] [Indexed: 12/17/2022]
Abstract
Toddlers often go through a picky eating phase, which can make it difficult to introduce new foods into the diet. A better understanding of how parents' prompts to eat fruits and vegetables are related to children's intake of these foods will help promote healthy eating habits. 60 families recorded all toddler meals over one day, plus a meal in which parents introduced a novel fruit/vegetable to the child. Videos were coded for parent and child behaviors. Parents completed a feeding style questionnaire and three 24-h dietary recalls about their children's intake. Parents made, on average, 48 prompts for their children to eat more during the main meals in a typical day, mostly of the neutral type. Authoritarian parents made the most prompts, and used pressure the most often. In the novel food situation, it took an average of 2.5 prompts before the child tasted the new food. The most immediately successful prompt for regular meals across food types was modeling. There was a trend for using another food as a reward to work less well than a neutral prompt for encouraging children to try a novel fruit or vegetable. More frequent prompts to eat fruits and vegetables during typical meals were associated with higher overall intake of these food groups. More prompts for children to try a novel vegetable was associated with higher overall vegetable intake, but this pattern was not seen for fruits, suggesting that vegetable variety may be more strongly associated with intake. Children who ate the most vegetables had parents who used more "reasoning" prompts, which may have become an internalized motivation to eat these foods, but this needs to be tested explicitly using longer-term longitudinal studies.
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360
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Hughes SO, Power TG, O'Connor TM, Orlet Fisher J, Chen TA. Maternal Feeding Styles and Food Parenting Practices as Predictors of Longitudinal Changes in Weight Status in Hispanic Preschoolers from Low-Income Families. J Obes 2016; 2016:7201082. [PMID: 27429801 PMCID: PMC4939194 DOI: 10.1155/2016/7201082] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 03/30/2016] [Accepted: 04/19/2016] [Indexed: 01/25/2023] Open
Abstract
Objective. The aim was to investigate the influence of feeding styles and food parenting practices on low-income children's weight status over time. Method. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) and again eighteen months later. At each time point, parents completed questionnaires and height and weight measures were taken on the child. Results. The indulgent feeding style (parent-report at baseline) was associated with increased child BMI z-score eighteen months later compared to other feeding styles. Authoritative, authoritarian, and uninvolved feeding styles were not significantly associated with increased child BMI z-score. Child BMI z-score at Time 1 (strongest) and maternal acculturation were positive predictors of child BMI z-score at Time 2. Maternal use of restriction positively predicted and maternal monitoring negatively predicted Time 2 BMI z-score, but only when accounting for feeding styles. Conclusion. This is the first study to investigate the impact of feeding styles on child weight status over time. Results suggest that indulgent feeding predicts later increases in children's weight status. The interplay between feeding styles and food parenting practices in influencing child weight status needs to be further explored.
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Affiliation(s)
- Sheryl O. Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Houston, TX 77030, USA
- *Sheryl O. Hughes:
| | - Thomas G. Power
- Washington State University, 513 Johnson Tower, P.O. Box 644852, Pullman, WA 99164-4852, USA
| | - Teresia M. O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Houston, TX 77030, USA
| | | | - Tzu-An Chen
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Houston, TX 77030, USA
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