1
|
Hill KB, Mullen GP, Nagareddy PR, Zimmerman KA, Rudolph MC. Key questions and gaps in understanding adipose tissue macrophages and early-life metabolic programming. Am J Physiol Endocrinol Metab 2024; 327:E478-E497. [PMID: 39171752 PMCID: PMC11482221 DOI: 10.1152/ajpendo.00140.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 08/08/2024] [Accepted: 08/20/2024] [Indexed: 08/23/2024]
Abstract
The global obesity epidemic, with its associated comorbidities and increased risk of early mortality, underscores the urgent need for enhancing our understanding of the origins of this complex disease. It is increasingly clear that metabolism is programmed early in life and that metabolic programming can have life-long health consequences. As a critical metabolic organ sensitive to early-life stimuli, proper development of adipose tissue (AT) is crucial for life-long energy homeostasis. Early-life nutrients, especially fatty acids (FAs), significantly influence the programming of AT and shape its function and metabolism. Of growing interest are the dynamic responses during pre- and postnatal development to proinflammatory omega-6 (n6) and anti-inflammatory omega-3 (n3) FA exposures in AT. In the US maternal diet, the ratio of "pro-inflammatory" n6- to "anti-inflammatory" n3-FAs has grown dramatically due to the greater prevalence of n6-FAs. Notably, AT macrophages (ATMs) form a significant population within adipose stromal cells, playing not only an instrumental role in AT formation and maintenance but also acting as key mediators of cell-to-cell lipid and cytokine signaling. Despite rapid advances in ATM and immunometabolism fields, research has focused on responses to obesogenic diets and during adulthood. Consequently, there is a significant gap in identifying the mechanisms contributing metabolic health, especially regarding lipid exposures during the establishment of ATM physiology. Our review highlights the current understanding of ATM diversity, their critical role in AT, their potential role in early-life metabolic programming, and the broader implications for metabolism and health.
Collapse
Affiliation(s)
- Kaitlyn B Hill
- Department of Biochemistry and Physiology, Harold Hamm Diabetes Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Gregory P Mullen
- Department of Biochemistry and Physiology, Harold Hamm Diabetes Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Prabhakara R Nagareddy
- Department of Internal Medicine, Cardiovascular Section, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Kurt A Zimmerman
- Department of Internal Medicine, Division of Nephrology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Michael C Rudolph
- Department of Biochemistry and Physiology, Harold Hamm Diabetes Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| |
Collapse
|
2
|
Zhuang Y, Xie Z, Fu M, Luo H, Li Y, Ding Y, Wang Z. Assessment of Water Intake among Chinese Toddlers: The Report of a Survey. Nutrients 2024; 16:2012. [PMID: 38999760 PMCID: PMC11243501 DOI: 10.3390/nu16132012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/03/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
Toddlerhood (aged 13~36 months) is a period of dietary transition, with water intake being significantly influenced by parental feeding patterns, cultural traditions, and the availability of beverages and food. Nevertheless, given the lack of applicable data, it is challenging to guide and evaluate the water intake of toddlers in China. In this study, our objectives were to assess the daily total water intake (TWI), evaluate the consumption patterns of various beverages and food sources contributing to the TWI, determine the conformity of participants to the adequate intake (AI) recommendation of water released by the Chinese Nutrition Society, and analyze the various contributors to the daily total energy intake (TEI). The data for the assessment of water and dietary intake were obtained from the cross-sectional dietary intake survey of infants and young children (DSIYC, 2018-2019). A total of 1360 eligible toddlers were recruited in the analysis. The differences in related variables between two age groups were compared by Mann-Whitney U test and Chi-Square test. The potential correlation between water and energy intake was examined utilizing age-adjusted partial correlation. Toddlers consumed a median daily TWI of 1079 mL, with 670 mL (62.3%, r = 0.752) derived from beverages and 393 mL (37.7%, r = 0.716) from foods. Plain water was the primary beverage source, contributing 300 mL (52.2%, r = 0.823), followed by milk and milk derivatives (MMDs) at 291 mL (45.6%, r = 0.595). Notably, only 28.4% of toddlers managed to reach the recommended AI value. Among these, toddlers obtain more water from beverages than from foods. The median daily TEI of toddlers was 762 kcal, including 272 kcal from beverages (36.4%, r = 0.534) and 492 kcal from foods (63.6%, r = 0.894). Among these, the median daily energy intake from MMDs was 260 kcal, making up 94.6% of the energy intake from beverages (r = 0.959). As the pioneer survey on TWI of toddlers in China based on nationally representative data, attention to the quality and quantity of water intake and actions to better guide parents by both individuals and authorities are eagerly anticipated. Additionally, the revision of the reference value of TWI for Chinese toddlers is urgently required.
Collapse
Affiliation(s)
- Yiding Zhuang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.Z.); (Z.X.)
| | - Zhencheng Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.Z.); (Z.X.)
| | - Minghan Fu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.Z.); (Z.X.)
| | - Hongliang Luo
- Danone Open Science Research Center for Life-Transforming Nutrition, Shanghai 201204, China
| | - Yitong Li
- Danone Open Science Research Center for Life-Transforming Nutrition, Shanghai 201204, China
| | - Ye Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.Z.); (Z.X.)
| | - Zhixu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Y.Z.); (Z.X.)
- The Institute of Nutrition and Food Science, Nanjing Medical University, Nanjing 211166, China
| |
Collapse
|
3
|
Marks KJ, Boundy EO, Nakayama JY, Li R, Hamner HC. Early introduction of complementary foods/drinks and milk feeding type in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). MATERNAL & CHILD NUTRITION 2023; 19:e13541. [PMID: 37415299 PMCID: PMC10483945 DOI: 10.1111/mcn.13541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 07/08/2023]
Abstract
Infants younger than 4 months are not ready for complementary foods/drinks (any solid or liquid other than breast milk or infant formula). Almost half of US infants participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides nutrition education and support to low-income families. We describe the prevalence of early introduction (<4 months) of complementary foods/drinks and examine the association of milk feeding type (fully breastfed, partially breastfed or fully formula fed) with early introduction of complementary foods/drinks. We used data from 3310 families in the longitudinal WIC Infant and Toddler Feeding Practices Study-2. We described the prevalence of early introduction of complementary foods/drinks and modeled the association of milk feeding type at Month 1 with early introduction of complementary foods/drinks using multi-variable logistic regression. Thirty-eight percent of infants were introduced early to complementary foods/drinks (<4 months). In adjusted models, infants who were fully formula fed or partially breastfed at Month 1 were 75% and 57%, respectively, more likely to be introduced early to complementary foods/drinks compared with fully breastfed infants. Almost two in five infants were given complementary foods/drinks early. Formula feeding at Month 1 was associated with higher odds of early introduction of complementary foods/drinks. There are opportunities to support families participating in WIC to prevent early introduction of complementary foods/drinks and promote child health.
Collapse
Affiliation(s)
- Kristin J. Marks
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlantaGeorgiaUSA
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- United States Public Health ServiceRockvilleMarylandUSA
| | - Ellen O. Boundy
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
- United States Public Health ServiceRockvilleMarylandUSA
| | - Jasmine Y. Nakayama
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlantaGeorgiaUSA
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Ruowei Li
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| | - Heather C. Hamner
- Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and PreventionAtlantaGeorgiaUSA
| |
Collapse
|
4
|
Shaw MA, Liu A. Nutritional Considerations for the First Year of Life. Pediatr Ann 2023; 52:e316-e321. [PMID: 37695279 DOI: 10.3928/19382359-20230720-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Feeding during the first year of life is a dynamic process with unique questions, concerns, and milestones emerging at every step. This article will review a small selection of specific questions and concerns related to feeding in the first 12 months of infancy. The aim of this article is to inform and support pediatric providers and parents during this crucial developmental period. [Pediatr Ann. 2023;52(9):e316-e321.].
Collapse
|
5
|
Kim JH, Lee E, Ha EK, Lee GC, Shin J, Baek HS, Choi SH, Shin YH, Han MY. Infant Feeding Pattern Clusters Are Associated with Childhood Health Outcomes. Nutrients 2023; 15:3065. [PMID: 37447391 DOI: 10.3390/nu15133065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Feeding behavior habits have a pattern with a certain tendency during infancy. We aimed to identify the associations between feeding patterns in infancy and the subsequent 10-year childhood disease burden. (2) Methods: Data from 236,372 infants were obtained from the national health insurance and screening program records in South Korea. Parent-administered questionnaires during infancy provided details on the feeding type and types/frequency of complementary food for analyzing feeding patterns. The outcomes were all-cause hospitalization and the development of 15 representative childhood diseases until the age of 10 years. Anthropometric measurements obtained at 6 years of age were analyzed. To estimate outcome risks while considering multiple risk factors, we employed a Cox proportional hazard and modified Poisson regression. (3) Results: Three clusters were identified: high prevalence of breastfeeding with regular exposure to a variety of solid foods (n = 116,372, cluster 1), similar prevalence of breastfeeding and formula feeding with less exposure to solid foods (n = 108,189, cluster 2), and similar prevalence of breastfeeding and formula feeding with the least exposure to solid foods in infancy (n = 11,811, cluster 3). Compared with cluster 1, children in clusters 2 and 3 had increased risks of all-cause hospitalization (hazard ratio (HR), (95% confidence interval (CI)), 1.04 (1.03-1.06) and 1.08 (1.05-1.11), respectively). Children in clusters 2 and 3 had an increased risk of upper respiratory infection, pneumonia, and gastroenteritis, as well as neurobehavioral diseases. Overweight/obesity at the age of 6 years was associated with clusters 2 and 3. (4) Conclusions: Feeding patterns in infancy were associated with an increased risk of childhood disease burden.
Collapse
Affiliation(s)
- Ju Hee Kim
- Department of Pediatrics, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea
| | - Gi Chun Lee
- Department of Computer Science and Engineering, Konkuk University, Seoul 05029, Republic of Korea
| | - Jeewon Shin
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, 59, Yatap-ro, Seongnam 13496, Republic of Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul 05355, Republic of Korea
| | - Sun-Hee Choi
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Man Yong Han
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, 59, Yatap-ro, Seongnam 13496, Republic of Korea
| |
Collapse
|
6
|
Mphasha MH, Makwela MS, Muleka N, Maanaso B, Phoku MM. Breastfeeding and Complementary Feeding Practices among Caregivers at Seshego Zone 4 Clinic in Limpopo Province, South Africa. CHILDREN (BASEL, SWITZERLAND) 2023; 10:986. [PMID: 37371218 DOI: 10.3390/children10060986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
Breastfeeding and complementary feeding are key components of infant and young child feeding that ensure healthy growth, survival, and development. Initiating breastfeeding within an hour after delivery, exclusively breastfeeding for six months, and introducing complementary feeding at six months while continuing breastfeeding up to 24 months or beyond, helps in the prevention of malnutrition, which is a public health problem. The aim of this study was to determine breastfeeding and complementary feeding practices among caregivers of children under 24 months in Seshego, Limpopo Province. A quantitative and cross-sectional design was applied to collect data from 86 caregivers using convenience sampling. A structured questionnaire was utilised to gather data and analysed through statistical software, using descriptive and inferential statistics. Chi-square tests were used to determine associations at a 95% confidence interval where a p-value of <0.05 was considered statistically significant. The findings show that 55% of participants had good breastfeeding and complementary feeding practices. Moreover, 94.2% of participants breastfeed within an hour after delivery at a healthcare facility. Only 43.6% of children were exclusively breastfed. Most participants (52.3%) gave children food before six months and 45.1% introduced complementary feeding at the appropriate age. Also, 69.7% of children across all age groups were not given infant formula. No statistical association was observed between feeding practices and sociodemographic. Breastfeeding was initiated within an hour after delivery at the healthcare facilities, however, post discharge exclusive breastfeeding maintenance remains a challenge. Few infants were introduced to complementary feeding at the appropriate age. A post discharge intervention to practice exclusive breastfeeding, continued breastfeeding, and introduction of appropriate complementary feeding is recommended.
Collapse
Affiliation(s)
- M H Mphasha
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0727, South Africa
| | - M S Makwela
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0727, South Africa
| | - N Muleka
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0727, South Africa
| | - B Maanaso
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0727, South Africa
| | - M M Phoku
- Department of Human Nutrition and Dietetics, University of Limpopo, Polokwane 0727, South Africa
| |
Collapse
|
7
|
Wilujeng AP, Indriani N, Trianita D, Munif B, Yanuar A, Putri NS, Mawarni EE. Determinants of Infant Growth and Development Based on the Health Promotion Model. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The quality of future generations is largely determined by the growth and development of toddlers. All parents want their children to grow and develop optimally.
AIM: The purpose of this study was to identify the determinants of growth and development of infants aged 3–12 months based on the Health Promotion Model (HPM).
METHODS: The study used a cross-sectional study design, which was conducted at the Banyuwangi District Health Center. Respondents in this study were mothers who had infants aged 3–12 months as many as 217. The sampling technique used was random sampling. The independent variables using the components of the HPM theory are mother’s motivation, infant’s gestational age, perceived benefit, perceived barrier, perceived self-efficacy, and activity-related affect. The dependent variable is growth and development. Growth assessment is obtained from the BB/U value and compared with the z-score table. Developmental assessment was done using Pre-screening Development Questionnaire. The relationship between each independent variable and the dependent variable was analyzed using the Chi-square test. Determinants of growth and development of children under five were analyzed using multiple logistic regression.
RESULTS: The results of the independent variable logistic regression test with growth showed that the variable with p < 0.05 was the mother’s perceived self-efficacy with p = 0.013. While the independent variable logistic regression test with development showed that the variable with p < 0.05 was the mother’s perceived barrier with a p = 0.000.
CONCLUSION: Based on the HPM approach, it was found that the determinant of infant growth was the mother’s perceived self-efficacy, while the determinant of infant development was the mother’s perceived barrier. The growth and development of toddlers can be achieved optimally through efforts to increase the mother’s perceived self-efficacy and reduce the mother’s perceived barrier.
Collapse
|
8
|
Appiah PK, Amu H, Osei E, Konlan KD, Mumuni IH, Verner ON, Maalman RSE, Kim E, Kim S, Bukari M, Jung H, Kofie P, Ayanore MA, Amenuvegbe GK, Adjuik M, Tarkang EE, Alhassan RK, Donkor ES, Zotor FB, Kweku M, Amuna P, Gyapong JO, Kim SY. Breastfeeding and weaning practices among mothers in Ghana: A population-based cross-sectional study. PLoS One 2021; 16:e0259442. [PMID: 34767566 PMCID: PMC8589154 DOI: 10.1371/journal.pone.0259442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Children need good nutrition to develop proper immune mechanisms and psychosocial maturity, but malnutrition can affect their ability to realize this. Apart from the national demographic and health survey, which is carried out every 5 years, there have not been enough documented studies on child breastfeeding and weaning practices of caregivers in the Volta Region. We, therefore, examined child breastfeeding and weaning practices of mothers in the Volta Region of Ghana. METHODS A sub-national survey method was adopted and a semi-structured questionnaire was used to collect data from 396 mothers and their children. Descriptive and inferential statistics comprising frequency, percentage, chi-square, and logistic regression were employed in analysing the data. We defined exclusive breastfeeding as given only breast milk to an infant from a mother or a wet nurse for six months of life except drops or syrups consisting of vitamins, minerals, supplements, or medicines on medical advice, and prolonged breastfeeding as breastfeeding up to 24 months of age. RESULTS The prevalence of exclusive breastfeeding (EBF) was 43.7%. Mothers constituting 61.1% started breastfeeding within an hour of giving birth. In addition to breast milk, 5.1% gave fluids to their children on the first day of birth. About 66.4% started complementary feeding at 6 months, 22.0% breastfed for 24 months or beyond, while 40.4% fed their children on-demand. Child's age (AOR: 0.23, 95% CI:0.12-0.43, p<0.0001), prolonged breastfeeding (AOR: 0.41, 95%CI: 0.12-0.87, p = 0.001), mother's religion (AOR: 3.92, 95%CI: 1.23-12.61, p = 0.021), feeding practices counselled on (AOR: 1.72, 95%CI: 1.96-3.09, p = 0.023), mother ever heard about EBF (AOR: 0.43, 95%CI: 1.45-2.41, p = 0.039), child being fed from the bottle with a nipple (AOR: 1.53, 95%CI: 1.94-2.48, p = 0.003), and age at which complementary feeding was started (AOR: 17.43, 95%CI: 3.47-87.55, p = 0.008) were statistically associated with EBF. CONCLUSION Breastfeeding education has been ongoing for decades, yet there are still gaps in the breastfeeding practices of mothers. To accelerate progress towards attainment of the sustainable development goal 3 of ensuring healthy lives and promoting well-being for all at all ages by the year 2030, we recommend innovative policies that include extensive public education to improve upon the breastfeeding and weaning practices of mothers.
Collapse
Affiliation(s)
- Prince Kubi Appiah
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
- * E-mail:
| | - Hubert Amu
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Eric Osei
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
- Department of Public Health, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Kennedy Diema Konlan
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- College of Nursing, Yonsei Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Iddris Hadiru Mumuni
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | | | | | - Eunji Kim
- Korea Foundation for International Healthcare Ghana Office, Accra, Ghana
| | - Siwoo Kim
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Mohammed Bukari
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Hajun Jung
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Philip Kofie
- Yonsei University - University of Health and Allied Sciences Partnership Project Office, Ho, Ghana
| | | | | | - Martin Adjuik
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Robert Kaba Alhassan
- Directorate of International Affairs, University of Health and Allied Sciences, Ho, Ghana
| | | | - Francis Bruno Zotor
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Margaret Kweku
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Paul Amuna
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - John Owusu Gyapong
- Office of the Vice-Chancellor, University of Health and Allied Sciences, Ho, Ghana
| | - So Yoon Kim
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| |
Collapse
|
9
|
Liśkiewicz AD, Liśkiewicz D, Marczak Ł, Przybyła M, Grabowska K, Student S, Dębiec M, Sługocka A, Lewin-Kowalik J. Obesity-associated deterioration of the hippocampus is partially restored after weight loss. Brain Behav Immun 2021; 96:212-226. [PMID: 34087424 DOI: 10.1016/j.bbi.2021.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE Obesity is a multidimensional condition that is treatable by the restoration of a lean phenotype; however, some obesity-related outcomes may persist after weight normalization. Among the organs of the human body, the brain possesses a relatively low regenerative capacity and could retain perturbations established as a result of developmental obesity. Calorie restriction (CR) or a restricted ketogenic diet (KD) are successfully used as weight loss approaches, but their impact on obesity-related effects in the brain have not been previously evaluated. METHODS We performed a series of experiments in a rat model of developmental obesity induced by a 12-week cafeteria diet, followed by CR to implement weight loss. First, we assessed the impact of obesity on neurogenesis (BrdU incorporation into the hippocampus), cognitive function (water maze), and concomitant changes in hippocampal protein expression (GC/MS-MS, western blot). Next, we repeated these experiments in a rat model of weight loss induced by CR. We also measured mitochondrial enzyme activity in rats after weight loss during the fed or fasting state. This study was extended by additional experiments with restricted KD used as a weight loss approach in order to compare the efficacy of two different nutritional interventions used in the treatment of obesity on hippocampal functions. By using a modified version of the water maze we evaluated cognitive abilities in rats subjected to weight loss by CR or a restricted KD. RESULTS In this study, obesity affected metabolic processes, upregulated hippocampal NF-κB, and induced proteomic differences which were associated with impaired cognition and neurogenesis. Weight loss improved neurogenesis and enhanced cognition. While the expression pattern of some proteins persisted after weight loss, most of the changes appeared de novo revealing metabolic adjustment by overactivation of citrate synthase and downregulation of ATP synthase. As a consequence of fasting, the activity of these enzymes indicated hippocampal adaptation to negative energy balance during the weight loss phase of CR. Moreover, the effects on cognitive abilities measured after weight loss were negatively correlated with the animal weight measured at the final stage of weight gain. This was alleviated by KD, which improved cognition when used as a weight loss approach. CONCLUSIONS The study shows that cognition and mitochondrial metabolism in the hippocampus are affected by CR- or KD-induced weight loss.
Collapse
Affiliation(s)
- Arkadiusz D Liśkiewicz
- Department of Physiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland; Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice 40-065, Poland.
| | - Daniela Liśkiewicz
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice 40-065, Poland; Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Łukasz Marczak
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Poznan 61-704, Poland
| | - Marta Przybyła
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Konstancja Grabowska
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice 40-065, Poland; Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Sebastian Student
- Institute of Automatic Control, Silesian University of Technology, Gliwice 44-100, Poland; Biotechnology Centre, Silesian University of Technology, Gliwice 44-100, Poland
| | - Magdalena Dębiec
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice 40-065, Poland
| | - Anna Sługocka
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Joanna Lewin-Kowalik
- Department of Physiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| |
Collapse
|
10
|
Parental considerations during complementary feeding in higher income countries: a systematic review of qualitative evidence. Public Health Nutr 2021; 24:2834-2847. [PMID: 33877043 PMCID: PMC9884778 DOI: 10.1017/s1368980021001749] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Worldwide data suggest a clash between parental complementary feeding practices and recommendations. Understanding the circumstances under which parents form their feeding practices is a crucial step to improve such practices. This paper aimed to systematically review the existing qualitative literature and synthesise the factors that parents take into consideration in relation to complementary feeding. DESIGN A systematic review was undertaken. Four electronic databases were searched for qualitative studies published after 2001 exploring parental experiences during complementary feeding. A framework that included authors' outcomes of interest was used to extract and synthesise study findings. The Standards for Reporting Qualitative Research were used to critically assess the included studies. SETTING Upper-middle- and high-income countries. PARTICIPANTS Parents with a child below the age of 3 years. RESULTS A total of forty-seven studies met the eligibility criteria and were included in this systematic review. The themes were organised into three main categories: (1) factors related to introduction of complementary foods; (2) factors related to the type of complementary foods and (3) factors related to both timing and type. The selected literature highlights: prevalent baby cues that prompt parents to introduce solid foods; parents' views on the recommended timing of complementary feeding; factors that drive the choice of complementary foods and perceived value in advice received from health professionals and grandmothers. CONCLUSIONS This systematic review indicates factors that can be barriers to complying with the complementary feeding guidelines, and therefore, its findings are pertinent to improving parental feeding practices through intervention studies and through infant feeding education in a primary care setting.
Collapse
|
11
|
Hornsby PP, Conaway MR, Medico TJ, Gurka KK, Kellams A. Timing of Introduction of Complementary Foods and Beverages to Infants of Low-Income Women. Breastfeed Med 2021; 16:547-552. [PMID: 33781096 DOI: 10.1089/bfm.2020.0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Although rates of complementary food and beverage (CFB) consumption among infants under 4 to 6 months of age have been declining, they remain well above the American Academy of Pediatrics (AAPs) recommendations. It is unclear if women with low income in the United States are more likely than other women to introduce CFBs early. We examined timing of introduction of CFBs to infants of mothers with low income to further illuminate infant feeding practices in this potentially vulnerable population. Materials and Methods: We analyzed infant feeding data collected prospectively from 443 mother-infant dyads. Data were obtained by interview at 1, 3, and 6 months postpartum. We used Kaplan-Meier curves to show time to introduction of CFBs overall and by type of CFB, and log-rank tests to compare timing by demographic and clinical characteristics. Results: Participants were mostly non-Hispanic black or white, with a high school education or less. By month 3, 48% of infants were fed at least one CFB, increasing to over 83% by month 5. Women who did not work outside the home introduced CFBs significantly earlier than those who worked, as did women who smoked compared with those who did not. Timing did not differ by other participant characteristics. Conclusions: Introduction of CFBs before 4-6 months was common. Clinical guidance and intervention programs should support mothers toward the goal of improving infant diets in this at-risk population.
Collapse
Affiliation(s)
- Paige P Hornsby
- Department of Public Health Sciences and University of Virginia, Charlottesville, Virginia, USA
| | - Mark R Conaway
- Department of Public Health Sciences and University of Virginia, Charlottesville, Virginia, USA
| | - Tegan J Medico
- Department of Nutrition Services, University of Virginia, Charlottesville, Virginia, USA
| | - Kelly K Gurka
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Ann Kellams
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
12
|
Wood CT, Witt WP, Skinner AC, Yin HS, Rothman RL, Sanders LM, Delamater AM, Flower KB, Kay MC, Perrin EM. Effects of Breastfeeding, Formula Feeding, and Complementary Feeding on Rapid Weight Gain in the First Year of Life. Acad Pediatr 2021; 21:288-296. [PMID: 32961335 PMCID: PMC10910619 DOI: 10.1016/j.acap.2020.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/08/2020] [Accepted: 09/15/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine whether proportion of breast versus formula feeding and timing of complementary food introduction affect the odds of rapid gain in weight status in a diverse sample of infants. METHODS Using data from Greenlight Intervention Study, we analyzed the effects of type of milk feeding (breastfeeding, formula, or mixed feeding) from the 2- to 6-month well visits, and the introduction of complementary foods before 4 months on rapid increase in weight-for-age z-score (WAZ) and weight-for-length z-score (WLZ) before 12 months using multivariable logistic regression models. RESULTS Of the 865 infants enrolled, 469 had complete data on all variables of interest, and 41% and 33% of those infants had rapid increases in WAZ and WLZ, respectively. Odds of rapid increase in WAZ remained lowest for infants breastfeeding from 2 to 6 months (adjusted odds ratio [aOR] 0.34; 95% confidence interval [CI]: 0.17, 0.69) when compared to infants who were formula-fed. Adjusted for feeding, introduction of complementary foods after 4 months was associated with decreased odds of rapid increase in WLZ (aOR 0.64; 95% CI: 0.42, 0.96). CONCLUSIONS Feeding typified by predominant breastfeeding and delaying introduction of complementary foods after 4 months reduces the odds of rapid increases in WAZ and WLZ in the first year of life.
Collapse
Affiliation(s)
- Charles T Wood
- Division of Primary Care Pediatrics and Duke Center for Childhood Obesity Research, Department of Pediatrics, Duke University School of Medicine (CT Wood and EM Perrin), Durham, NC.
| | - Whitney P Witt
- College of Health, Lehigh University, (WP Witt), Bethlehem, PA
| | - Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Duke Clinical Research Institute (AC Skinner), Durham, NC
| | - Hsiang S Yin
- Departments of Pediatrics and Population Health, New York University School of Medicine/Bellevue Hospital Center (HS Yin), New York, NY
| | - Russell L Rothman
- Center for Health Services Research, Vanderbilt University Medical Center (RL Rothman), Nashville, Tenn
| | - Lee M Sanders
- Department of Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University (LM Sanders), Stanford, Calif
| | - Alan M Delamater
- Department of Pediatrics, University of Miami School of Medicine (AM Delamater), Miami, Fla
| | - Kori B Flower
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine (KB Flower), Chapel Hill, NC
| | - Melissa C Kay
- Duke Center for Childhood Obesity Research and Duke Global Digital Health Science Center, Duke University School of Medicine and Duke Global Health Institute (MC Kay), Durham, NC
| | - Eliana M Perrin
- Division of Primary Care Pediatrics and Duke Center for Childhood Obesity Research, Department of Pediatrics, Duke University School of Medicine (CT Wood and EM Perrin), Durham, NC
| |
Collapse
|
13
|
Liśkiewicz AD, Marczak Ł, Bogus K, Liśkiewicz D, Przybyła M, Lewin-Kowalik J. Proteomic and Structural Manifestations of Cardiomyopathy in Rat Models of Obesity and Weight Loss. Front Endocrinol (Lausanne) 2021; 12:568197. [PMID: 33716957 PMCID: PMC7945951 DOI: 10.3389/fendo.2021.568197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 01/05/2021] [Indexed: 12/12/2022] Open
Abstract
Obesity cardiomyopathy increases the risk of heart failure and death. Obesity is curable, leading to the restoration of the heart phenotype, but it is not clear if there are any after-effects of obesity present after weight loss. We characterize the proteomic landscape of obesity cardiomyopathy with an evaluation of whether the cardiac phenotype is still shaped after weight loss. Cardiomyopathy was validated by cardiac hypertrophy, fibrosis, oversized myocytes, and mTOR upregulation in a rat model of cafeteria diet-induced developmental obesity. By global proteomic techniques (LC-MS/MS) a plethora of molecular changes was observed in the heart and circulation of obese animals, suggesting abnormal utilization of metabolic substrates. This was confirmed by increased levels of cardiac ACSL-1, a key enzyme for fatty acid degradation and decreased GLUT-1, a glucose transporter in obese rats. Calorie restriction and weight loss led to the normalization of the heart's size, but fibrosis was still excessive. The proteomic compositions of cardiac tissue and plasma were different after weight loss as compared to control. In addition to morphological consequences, obesity cardiomyopathy involves many proteomic changes. Weight loss provides for a partial repair of the heart's architecture, but the trace of fibrotic deposition and proteomic alterations may occur.
Collapse
Affiliation(s)
- Arkadiusz D. Liśkiewicz
- Department of Physiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Łukasz Marczak
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Poznan, Poland
| | - Katarzyna Bogus
- Department of Histology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Daniela Liśkiewicz
- Laboratory of Molecular Biology, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Marta Przybyła
- Department for Experimental Medicine, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Lewin-Kowalik
- Department of Physiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
14
|
Bond LE, Mayerl CJ, Stricklen BM, German RZ, Gould FDH. Changes in the coordination between respiration and swallowing from suckling through weaning. Biol Lett 2020; 16:20190942. [PMID: 32264794 DOI: 10.1098/rsbl.2019.0942] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
All mammals undergo weaning from milk to solid food. This process requires substantial changes to mammalian oropharyngeal function. The coordination of swallowing and respiration is a crucial component of maintaining airway function throughout feeding and matures over infant development. However, how this coordination is affected by weaning is unknown. In this study, we ask how changes in posture, neural maturation and food properties associated with the weaning affect coordination of respiration and swallowing in a validated infant pig model. We recorded seven piglets feeding before and during the weaning age with liquid milk in a bottle and in a bowl, and solid feed in a bowl. Using videofluoroscopy synchronized with respiration, we found (i) the delay in the onset of inspiration after swallowing does not change with head position, (ii) the delay is different between solid food and bowl drinking at the same age and (iii) the delay increases over time when bottle feeding, suggesting a maturational effect. Significant changes in aerodigestive coordination occur prior to and post-weaning, resulting in distinctive patterns for liquid and solid food. The interplay of maturational timelines of oropharyngeal function at weaning may serve as a locus for behavioural and life-history plasticity.
Collapse
Affiliation(s)
- Laura E Bond
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
| | - Christopher J Mayerl
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
| | - Bethany M Stricklen
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
| | - Rebecca Z German
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA
| | - Francois D H Gould
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University (NEOMED), Rootstown, OH, USA.,Department of Cell Biology and Neuroscience, Rowan School of Osteopathic Medicine, Stratford, NJ, USA
| |
Collapse
|
15
|
Sanchez-Escobedo S, Azcorra H, Bogin B, Hoogesteijn AL, Sámano R, Varela-Silva MI, Dickinson F. Birth weight, birth order, and age at first solid food introduction influence child growth and body composition in 6- to 8-year-old Maya children: The importance of the first 1000 days of life. Am J Hum Biol 2020; 32:e23385. [PMID: 31994809 DOI: 10.1002/ajhb.23385] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To analyze the relationship of birth weight, birth order, breastfeeding duration, and age of introduction of solid foods with height, fat mass, and fat-free mass in a sample of Maya children when aged 6 to 8 years old. METHODS We collected data on anthropometry, body composition, children's birth weight, birth order, early feeding practices, and household socioeconomic characteristics in a sample of 260 Maya children aged 6 to 8 years living in Merida and Motul, two cities in Yucatan, Mexico. Multiple regression models were performed to identify variables associated with height-for-age (HAZ), fat mass index (FMI), and fat-free mass index (FFMI). The predictors included in the models were birth weight (kg), birth order, duration of breastfeeding (months), age at introduction of solid foods (months), maternal age (years), and height (cm). Models were adjusted for the influence of children's age and sex, maternal educational level, and household overcrowding. RESULTS HAZ was positively associated with child birthweight and maternal height and age, but inversely associated with birth order and age of introduction of solid foods. FMI was positively associated with birth weight, maternal age, and height, and negatively associated with birth order. FFMI was positively associated with maternal age and birth weight. CONCLUSIONS These results are evidence of the importance of the first 1000 days of life for the growth and body composition of Maya children and contributed to understand the development of nutritional dual burden in this population.
Collapse
Affiliation(s)
- Samantha Sanchez-Escobedo
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico.,Universidad Vizcaya de las Américas, Mérida, Yuc, Mexico
| | - Hugo Azcorra
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico.,Centro de Investigaciones Silvio Zavala, Universidad Modelo, Carretera a Cholul 200 mts periférico norte, Mérida, Yucatán, México
| | - Barry Bogin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,UCSD/Salk Center for Academic Research and Training in Anthropogeny (CARTA), Palo Alto, California
| | - Almira L Hoogesteijn
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico
| | - Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Miguel Hidalgo, Ciudad de México, Mexico
| | - Maria I Varela-Silva
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Federico Dickinson
- Departamento de Ecología Humana, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mérida, Yucatán, Mexico
| |
Collapse
|
16
|
Manohar N, Hayen A, Bhole S, Arora A. Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants-Results from HSHK Birth Cohort Study. Nutrients 2020; 12:E258. [PMID: 31963864 PMCID: PMC7019241 DOI: 10.3390/nu12010258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 11/21/2022] Open
Abstract
Early introduction of complementary foods can have a detrimental impact on children's long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was 'age at which particular core and discretionary food items were first introduced'. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54-7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99-5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17-11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.
Collapse
Affiliation(s)
- Narendar Manohar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
| | - Andrew Hayen
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
| | - Sameer Bhole
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, NSW 2010, Australia
- Oral Health Alliance, Oral Health Centre, University of Queensland, Brisbane, QLD 4072, Australia
- Metro North Oral Health Services, Stafford, QLD 4053, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia;
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW 2010, Australia;
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, University of Sydney Faculty of Medicine and Health, Westmead, NSW 2050, Australia
| |
Collapse
|
17
|
Habimana S, Biracyaza E. Risk Factors Of Stunting Among Children Under 5 Years Of Age In The Eastern And Western Provinces Of Rwanda: Analysis Of Rwanda Demographic And Health Survey 2014/2015. Pediatric Health Med Ther 2019; 10:115-130. [PMID: 31695558 PMCID: PMC6821046 DOI: 10.2147/phmt.s222198] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 09/25/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Stunting is one of the most public health burdens in Rwanda. Most deaths due to stunting are associated with inappropriate feeding practices that occur in the first 5 years of life. This study aimed at determining the risk factors for stunting in children under 5 years of age in the Eastern and Western provinces of Rwanda. METHOD Cross-sectional study using secondary data from Rwanda Demographic Health Survey 2014/2015. RESULTS Stunting was highly prevalent in eastern province compared to Western province. It was also highly prevalent in rural area in both provinces. Results indicated a significant association between maternal education and stunting (=6.868; p=0.001), maternal age group (=15.44; p=0.017), maternal occupation (=30.012; p=0.000), wealth index (=14.327; p=0.006), sex of child (=2.91; p=0.008) and giving child fortified food (=4.256; p=0.039). Results indicated that antenatal care visits were significantly associated with stunting (=6.653; p=0.01). Sharing a toilet was significantly associated with stunting (=25.88; p=0.000). Multiple logistic regression indicated that the gender of child [OR=1.08; 95% CI (1.057-1.093), p=0.008], household wealth index [OR=0.386; 95% CI (0.357-0.414)] and breastfeeding [OR=0.02; 95% CI (0.004-0.036), p=0.013] were the risk factors of stunting in eastern and western provinces. CONCLUSION Immediate and appropriate interventions targeted at community management of acute malnutrition and stunting are needed to manage the associated morbidity and mortality. Strengthening the health system for improving child health through prioritizing maternal and child by addressing poverty and increase food access is mostly needed. These tactics yield more sustainable improvement in child nutrition within Eastern and Western provinces.
Collapse
Affiliation(s)
- Samuel Habimana
- Rwanda Resilience and Grounding Organization (RRGO), Kigali, Rwanda
| | - Emmanuel Biracyaza
- Department of Community Health, School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| |
Collapse
|
18
|
Tussing-Humphreys L, Thomson JL, Goodman M, Landry A. Enhanced vs Standard Parents as Teacher Curriculum on Factors Related to Infant Feeding among African American Women. South Med J 2019; 112:512-519. [PMID: 31583410 DOI: 10.14423/smj.0000000000001024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To determine the comparative impact of the standard Parents as Teachers (PAT) to the nutrition and physical activity enhanced version (PATE) of the perinatal educational curriculum on compliance with infant feeding recommendations and changes in maternal infant feeding knowledge and beliefs. METHODS Women at least 18 years of age, <19 weeks pregnant, and residing in three Mississippi counties were randomized to the standard PAT or the PATE version of the perinatal educational curriculum. Infant diets were assessed via 24-hour diet recall at postnatal months 1 to 12. Maternal knowledge and beliefs about infant feeding were assessed via survey at baseline and postnatal month 12. Compliance with infant feeding recommendations and differences in compliance between treatment arms were assessed using Kaplan-Meier survival curves. Longitudinal changes in maternal knowledge and beliefs were assessed with McNemar tests of symmetry. RESULTS Postnatal retention for the PAT and PATE arms were 83% (25/30) and 88% (21/24). Compliance with feeding recommendations for PAT and PATE participants, respectively, was 40% and 63% for no solid food before 6 months; 23% and 21% for no sugar-sweetened beverages before 12 months; 100% (both) for no fruit juice before 6 months; and 43% and 46% for no snack chips, French fries, and other fried food and candy before 12 months. Median times to feeding sugar-sweetened beverages were 10.1 and 9.6 months in PAT and PATE arms. Significant differences in compliance between arms were not found (P > 0.05). Participants' knowledge and beliefs about infant feeding were generally in agreement with expert recommendations at baseline, with few changes over time or between arms. CONCLUSIONS Findings suggest the need for further intervention focused on translating knowledge into action to improve diets of weaning infants in this region of the United States.
Collapse
Affiliation(s)
- Lisa Tussing-Humphreys
- From the Department of Medicine and the Cancer Center, University of Illinois at Chicago, Chicago, Agricultural Research Service, US Department of Agriculture, Stoneville, Mississippi, and the Department of Family and Consumer Sciences, University of Central Arkansas, Conway
| | - Jessica L Thomson
- From the Department of Medicine and the Cancer Center, University of Illinois at Chicago, Chicago, Agricultural Research Service, US Department of Agriculture, Stoneville, Mississippi, and the Department of Family and Consumer Sciences, University of Central Arkansas, Conway
| | - Melissa Goodman
- From the Department of Medicine and the Cancer Center, University of Illinois at Chicago, Chicago, Agricultural Research Service, US Department of Agriculture, Stoneville, Mississippi, and the Department of Family and Consumer Sciences, University of Central Arkansas, Conway
| | - Alicia Landry
- From the Department of Medicine and the Cancer Center, University of Illinois at Chicago, Chicago, Agricultural Research Service, US Department of Agriculture, Stoneville, Mississippi, and the Department of Family and Consumer Sciences, University of Central Arkansas, Conway
| |
Collapse
|
19
|
Matvienko-Sikar K, Toomey E, Queally M, Flannery C, O Neill K, Dinan TG, Doherty E, Harrington JM, Hayes C, Heary C, Hennessy M, Kelly C, Mc Hugh SM, McSharry J, Stanton C, Heffernan T, Byrne M, Kearney PM. Choosing Healthy Eating for Infant Health (CHErIsH) study: protocol for a feasibility study. BMJ Open 2019; 9:e029607. [PMID: 31444187 PMCID: PMC6707649 DOI: 10.1136/bmjopen-2019-029607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/05/2019] [Accepted: 05/30/2019] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Childhood obesity is a public health challenge. There is evidence for associations between parents' feeding behaviours and childhood obesity risk. Primary care provides a unique opportunity for delivery of infant feeding interventions for childhood obesity prevention. Implementation strategies are needed to support infant feeding intervention delivery. The Choosing Healthy Eating for Infant Health (CHErIsH) intervention is a complex infant feeding intervention delivered at infant vaccination visits, alongside a healthcare professional (HCP)-level implementation strategy to support delivery. METHODS AND ANALYSIS This protocol provides a description of a non-randomised feasibility study of an infant feeding intervention and implementation strategy, with an embedded process evaluation and economic evaluation. Intervention participants will be parents of infants aged ≤6 weeks at recruitment, attending a participating HCP in a primary care practice. The intervention will be delivered at the infant's 2, 4, 6, 12 and 13 month vaccination visits and involves brief verbal infant feeding messages and additional resources, including a leaflet, magnet, infant bib and sign-posting to an information website. The implementation strategy encompasses a local opinion leader, HCP training delivered prior to intervention delivery, electronic delivery prompts and additional resources, including a training manual, poster and support from the research team. An embedded mixed-methods process evaluation will examine the acceptability and feasibility of the intervention, the implementation strategy and study processes including data collection. Qualitative interviews will explore parent and HCP experiences and perspectives of delivery and receipt of the intervention and implementation strategy. Self-report surveys will examine fidelity of delivery and receipt, and acceptability, suitability and comprehensiveness of the intervention, implementation strategy and study processes. Data from electronic delivery prompts will also be collected to examine implementation of the intervention. A cost-outcome description will be conducted to measure costs of the intervention and the implementation strategy. ETHICS AND DISSEMINATION This study received approval from the Clinical Research Ethics Committee of the Cork Teaching Hospitals. Study findings will be disseminated via peer-reviewed publications and conference presentations.
Collapse
Affiliation(s)
- Karen Matvienko-Sikar
- School of Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Elaine Toomey
- School of Psychology, National University of Ireland-Galway National Centre for Biomedical Engineering Science, Galway, Ireland
| | - Michelle Queally
- J.E. Cairnes School of Business & Economics, National University of Ireland Galway, Galway, Ireland
| | - Caragh Flannery
- School of Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Kate O Neill
- School of Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Ted G Dinan
- Department of Psychiatry, Cork University Hospital and University College Cork, Cork, Ireland
- APC Microbiome Institute, University College Cork, Cork, Ireland
| | - Edel Doherty
- J.E. Cairnes School of Business & Economics, National University of Ireland Galway, Galway, Ireland
| | - Janas M Harrington
- School of Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Catherine Hayes
- Public Health and Primary Care, University of Dublin Trinity College, Dublin, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland-Galway National Centre for Biomedical Engineering Science, Galway, Ireland
| | - Marita Hennessy
- Health Behaviour Change Research Group, National University of Ireland, Galway, Ireland
| | - Colette Kelly
- Whitaker Institute for Innovation and Societal Change, National University of Ireland Galway College of Science, Galway, Ireland
| | - Sheena M Mc Hugh
- School of Public Health, University College Cork National University of Ireland, Cork, Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, National University of Ireland, Galway, Ireland
| | - Catherine Stanton
- APC Microbiome Institute, University College Cork, Cork, Ireland
- Moorepark Food Research Centre, Teagasc, Cork, Ireland
| | | | - Molly Byrne
- School of Psychology, University of Galway, Galway, UK
| | - Patricia M Kearney
- School of Public Health, University College Cork National University of Ireland, Cork, Ireland
| |
Collapse
|
20
|
Donovan SM, Rao G. Health benefits of yogurt among infants and toddlers aged 4 to 24 months: a systematic review. Nutr Rev 2019; 77:478-486. [DOI: 10.1093/nutrit/nuz009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Sharon M Donovan
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, Illinois, USA
| | - Goutham Rao
- Department of Family Medicine and Community Health, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio, USA
| |
Collapse
|
21
|
Cheney AM, Nieri T, Davis E, Prologo J, Valencia E, Anderson AT, Widaman K, Reaves C, Sullivan G. The Sociocultural Factors Underlying Latina Mothers' Infant Feeding Practices. Glob Qual Nurs Res 2019; 6:2333393618825253. [PMID: 30746425 PMCID: PMC6360473 DOI: 10.1177/2333393618825253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/11/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022] Open
Abstract
In this study, we examined the sociocultural factors underlying infant feeding practices. We conducted four focus groups with 19 Latina mothers of children 0 to 2 years of age enrolled in Early Head Start programs in the United States over a 1-year period. We found these mothers considered both science- and family-based feeding recommendations. However, advice from family was often inconsistent with science- and nutrition-based recommended feeding practices. In the interest of showing respect and preserving harmonious relationships, some mothers accepted family advice instead of recommended practices while others employed strategies to follow recommended practices without offending. Nutrition educators need to consider the intersection of macro, organizational, and community factors with micro-level processes in shaping the implementation of recommended feeding practices within family systems. Nutrition interventions for Latino families should capitalize on Latina mothers’ strategies for navigating multiple information sources while preserving cultural values and family relationships.
Collapse
Affiliation(s)
- Ann M Cheney
- University of California, Riverside, Riverside, California, USA
| | - Tanya Nieri
- University of California, Riverside, Riverside, California, USA
| | - Elizabeth Davis
- University of California, Riverside, Riverside, California, USA
| | - Joe Prologo
- Early Head Start, San Bernardino, San Bernardino, California, USA
| | - Esmirna Valencia
- Riverside County Office of Education, Riverside, California, USA
| | | | - Keith Widaman
- University of California, Riverside, Riverside, California, USA
| | | | | |
Collapse
|
22
|
Roess AA, Jacquier EF, Catellier DJ, Carvalho R, Lutes AC, Anater AS, Dietz WH. Food Consumption Patterns of Infants and Toddlers: Findings from the Feeding Infants and Toddlers Study (FITS) 2016. J Nutr 2018; 148:1525S-1535S. [PMID: 30247583 PMCID: PMC6126630 DOI: 10.1093/jn/nxy171] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/13/2018] [Accepted: 07/02/2018] [Indexed: 01/26/2023] Open
Abstract
Background The prevalence of obesity and type 2 diabetes continues to increase. These conditions disproportionately affect minorities and are associated with poor nutrition early in life. Current food-consumption patterns can inform pending dietary guidelines for infants and toddlers. Objective The aim of this study was to describe infant feeding, complementary feeding, and food and beverage consumption patterns of 0- to 23.9-mo-olds in the general population. Methods The Feeding Infants and Toddlers Study 2016 is a cross-sectional survey of caregivers of children aged <4 y. Dietary data were collected from a national random sample by using a 24-h dietary recall (n = 3235). The percentage of children consuming foods from >400 food groups was calculated. Differences in the percentage consuming between Hispanic, non-Hispanic white, and non-Hispanic black children aged 0-23.9 mo were evaluated with the use of ORs and 95% CIs. Results Eighty-three percent of 0- to 23.9-mo-olds (n = 2635) were ever breastfed, 34% of 0- to 3.9-mo-olds (n = 305) and 15% of 4- to 5.9-mo-olds (n = 295) were exclusively breastfed, and 24% of 12- to 14.9-mo-olds (n = 412) consumed breast milk on the day of the recall. Complementary foods were more likely to be introduced before 4 mo in formula-fed infants (27%) than in infants who did not consume formula (5%). Half of 4- to 5.9-mo-olds consumed iron-fortified infant cereal, but few consumed iron-rich meats. Among toddlers (12-23.9 mo; n = 1133), >20% consumed no servings of fruit or vegetables on the day of the recall, approximately half consumed 100% fruit juice, and one-quarter to one-third consumed a sugar-sweetened beverage (SSB). Conclusions Breastfeeding initiation and duration have improved, but exclusivity remains low. Low consumption of iron-rich foods, fruit, and vegetables and lack of variety in vegetable consumption are problems. Efforts to reduce the consumption of SSBs and 100% fruit juice are warranted in early childhood.
Collapse
Affiliation(s)
- Amira A Roess
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| | | | | | | | | | | | - William H Dietz
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| |
Collapse
|
23
|
Demmer E, Cifelli CJ, Houchins JA, Fulgoni VL. The Pattern of Complementary Foods in American Infants and Children Aged 0⁻5 Years Old-A Cross-Sectional Analysis of Data from the NHANES 2011⁻2014. Nutrients 2018; 10:nu10070827. [PMID: 29949890 PMCID: PMC6073528 DOI: 10.3390/nu10070827] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/18/2018] [Accepted: 06/20/2018] [Indexed: 11/24/2022] Open
Abstract
Proper nutrition early in life can influence children’s present and future health. While several authoritative sources provide eating/food recommendations, only a few studies have assessed whether these recommendations are followed. The goal of this paper was to examine food and nutrient intakes on any given day during infancy and early childhood among various ethnicities. Twenty-four-hour dietary recall data of 0–5 years-old children (n = 2431) from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 was used to estimate intakes of nutrients and food groups and prevalence of inadequate intake. Data was analyzed separately for various age groups and ethnicities, and differences in means by age and or race/ethnicity were determined by t-tests with p < 0.05 as significant. The results indicate that intakes of all food groups were expectedly low at 0–11 months, increased with age, and were influenced by race/ethnicity. Mixed dish consumption, which also increased with age, made substantial contributions to children’s food group intakes. However, there was a substantial percentage of the population among all age and race/ethnic groups who did not consume the recommended amounts for each food group and had inadequate intakes of key nutrients, such as calcium, vitamin D, and vitamin E. Non-Hispanic black children consumed less dairy and more protein foods, and a significantly greater proportion of these children had inadequate intakes of calcium and vitamin D compared to their peers. In conclusion, the results from this study suggest that a substantial population of American infants and children from 0 to five years of age did not meet food group recommendations and had inadequate intakes of key nutrients such as calcium, vitamin D, and vitamin E from foods.
Collapse
Affiliation(s)
- Elieke Demmer
- National Dairy Council, 10255 West Higgins Road, Suite 900, Rosemont, IL 60018-5616, USA.
| | - Christopher J Cifelli
- National Dairy Council, 10255 West Higgins Road, Suite 900, Rosemont, IL 60018-5616, USA.
| | - Jenny A Houchins
- National Dairy Council, 10255 West Higgins Road, Suite 900, Rosemont, IL 60018-5616, USA.
| | | |
Collapse
|
24
|
Matvienko-Sikar K, Kelly C, Sinnott C, McSharry J, Houghton C, Heary C, Toomey E, Byrne M, Kearney PM. Parental experiences and perceptions of infant complementary feeding: a qualitative evidence synthesis. Obes Rev 2018; 19:501-517. [PMID: 29243375 DOI: 10.1111/obr.12653] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/23/2017] [Accepted: 10/31/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND Interventions to prevent childhood obesity increasingly focus on infant feeding, but demonstrate inconsistent effects. A comprehensive qualitative evidence synthesis is essential to better understand feeding behaviours and inform intervention development. The aim of this study is to synthesize evidence on perceptions and experiences of infant feeding and complementary feeding recommendations. METHODS Databases CINAHL, EMBASE, MEDLINE, PsycINFO, Academic Search Complete, SocIndex and Maternity and Infant Care were searched from inception to May 2017. Eligible studies examined parents' experiences of complementary feeding of children (<2 years). Data were synthesized using thematic synthesis. RESULTS Twenty-five studies met inclusion criteria for review. Four key themes emerged. 'Guidelines and advice' highlights variety and inconsistencies between sources of complementary feeding information. 'Stage of weaning' describes infant feeding as a process involving different stages. 'Knowing and trying' outlines parents' engagement in feeding approaches based on instinct, prior experience or trial and error. 'Daily life' highlights problematic cost and time constraints for parents. DISCUSSION Parents predominantly understand and want to engage in healthy feeding processes. Consideration of infant feeding as a process that changes over time is necessary to support parents. Provision of clear, consistent information and guidance from trusted sources on when, what and how to feed is also essential.
Collapse
Affiliation(s)
| | - C Kelly
- Health Promotion Research Centre, National University of Ireland Galway, Ireland
| | - C Sinnott
- Cambridge Centre for Health Services Research, University of Cambridge, UK
| | - J McSharry
- School of Psychology, National University of Ireland Galway, Ireland
| | - C Houghton
- School of Nursing & Midwifery, National University of Ireland Galway, Ireland
| | - C Heary
- School of Psychology, National University of Ireland Galway, Ireland
| | - E Toomey
- School of Psychology, National University of Ireland Galway, Ireland
| | - M Byrne
- School of Psychology, National University of Ireland Galway, Ireland
| | - P M Kearney
- School of Public Health, University College Cork, Ireland
| |
Collapse
|
25
|
Barrera CM, Hamner HC, Perrine CG, Scanlon KS. Timing of Introduction of Complementary Foods to US Infants, National Health and Nutrition Examination Survey 2009-2014. J Acad Nutr Diet 2018; 118:464-470. [PMID: 29307590 PMCID: PMC5828913 DOI: 10.1016/j.jand.2017.10.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/18/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Although there has been inconsistency in recommendations regarding the optimal time for introducing complementary foods, most experts agree that introduction should not occur before 4 months. Despite recommendations, studies suggest that 20% to 40% of US infants are introduced to foods at younger than 4 months. Previous studies focused on the introduction of solid foods and are not nationally representative. OBJECTIVE Our aims were to provide a nationally representative estimate of the timing of introduction of complementary foods and to describe predictors of early (<4 months) introduction. DESIGN We conducted a cross-sectional analysis of 2009-2014 National Health and Nutrition Examination Survey data. PARTICIPANTS The study included 1,482 children aged 6 to 36 months. MAIN OUTCOME MEASURES Timing of first introduction to complementary foods (anything other than breast milk or formula) was analyzed. STATISTICAL ANALYSES PERFORMED Prevalence estimates of first introduction to complementary foods are presented by month. Logistic regression was used to assess characteristics associated with early (<4 months) introduction. RESULTS In this sample, 16.3% of US infants were introduced to complementary foods at <4 months, 38.3% between 4 and <6 months, 32.5% between 6 and <7 months, and 12.9% at ≥7 months of age. In unadjusted analyses, early introduction varied by breastfeeding status; race/Hispanic origin; Special Supplemental Nutrition Program for Women, Infants, and Children participation; and maternal age. In adjusted analyses, only breastfeeding status remained significant; infants who never breastfed or stopped at <4 months were more likely (odds ratio 2.27; 95% CI 1.62 to 3.18) to be introduced to complementary foods early than infants who breastfed ≥4 months. CONCLUSIONS Despite using a broader definition of complementary foods, this analysis found a lower prevalence of early introduction in this nationally representative sample than previous studies that included only solids. However, many young children were still introduced to complementary foods earlier than recommended. Strategies to support caregivers to adhere to infant feeding guidelines may be needed.
Collapse
|
26
|
Cartagena D, McGrath JM, Linares AM. Associations between Introduction of Age-Inappropriate Foods and Early Eating Environments in Low-Socioeconomic Hispanic Infants. J Pediatr Health Care 2018; 32:e27-e36. [PMID: 29249647 DOI: 10.1016/j.pedhc.2017.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 09/04/2017] [Accepted: 09/09/2017] [Indexed: 01/28/2023]
Abstract
PURPOSE To examine the associations between feeding practices and eating environments of low-socioeconomic Hispanic infants. METHODS Secondary analysis of cross-sectional data from a sample of 62 low-income immigrant Hispanic mothers and their infants (age range = 4-12 months). Measures of infant feeding practices (food groups and beverages consumption) and eating environment domains were included using the Infant Feeding Scale. RESULTS TV exposure and allowing the infant to play with toys during meals significantly correlated with intake of energy-dense foods in 4- to 6-month-olds (p = .05). Among 7- to 9-month-olds, mealtime TV watching correlated with consumption of snacks (p = .05) and sweetened beverages (p = .01). Consumption of energy-dense foods was significantly different among groups with higher mean intake in older infants (p = < .01). CONCLUSION Findings highlight the need for culturally and socioeconomically sensitive approaches to improve infant feeding practices and support low-income Hispanic families in providing healthy and nurturing eating environments required to prevent later obesity risk.
Collapse
|
27
|
The Changes of Colonic Bacterial Composition and Bacterial Metabolism Induced by an Early Food Introduction in a Neonatal Porcine Model. Curr Microbiol 2018; 75:745-751. [PMID: 29368025 DOI: 10.1007/s00284-018-1442-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/19/2018] [Indexed: 01/12/2023]
Abstract
The impact of an early food introduction on the microbiota composition and microbial metabolism in colon was investigated using a new-born piglet model. At day 4 after birth, 10 litters of piglets were randomly allocated to a sow-rearing group (SR group) and a milk-replacer supplementing group (MRS group) (n = 5). A commercial milk replacer was given to the suckling piglets in the MRS group from the 4th day to the 28th day. Pyrosequencing of the V3-V4 region of the 16S rRNA genes showed that the milk replacer supplementation significantly decreased the relative abundance of Lactobacillus, Clostridium XI, Blautia, Clostridium sensustricto and Escherichia (p = 0.08) in the colon of the piglets, but significantly increased the relative abundance of Paraprevotella on the 28th day. In addition, the abundance of Rumminococcus, Clostridium XlVa, Succiniclasticum, Clostridium IV tended to increase in the MRS group. The concentrations of acetate, propionate, butyrate, valerate and branch-chain fatty acids (BCFAs) in the colonic digesta increased with the milk replacer supplementary in the MRS group. In addition, the milk replacer supplementary increased the expression level of Toll-like receptor 4 (TLR4), but decreased the expression level of interleukin-6 (IL-6) in the colonic mucosa of the piglets. In conclusion, an early food introduction can influence the gut bacterial composition and metabolism, and may further affect the intestinal health by modifying the gene transcription related to the colonic function. These findings may provide some guidelines for the early nutrition supplementation for infants during the lactation period.
Collapse
|
28
|
Karmaus W, Soto-Ramírez N, Zhang H. Infant feeding pattern in the first six months of age in USA: a follow-up study. Int Breastfeed J 2017; 12:48. [PMID: 29213297 PMCID: PMC5712088 DOI: 10.1186/s13006-017-0139-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 11/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background Infant feeding may consist of direct breastfeeding (DBF), pumping and bottle feeding (P&F), formula feeding (FF), solid food feeding (SFF), and any combination. An accurate evaluation of infant feeding requires descriptions of different patterns, consistency, and transition over time. Methods In United States of America, the Infant Feeding Practice Study II collected information on the mode of feeding on nine occasions in 12 months. We focused on the first 6 months with six feeding occasions. To determine the longitudinal patterns of feeding the latent class transition analyses was applied and assessed the transition probabilities between these classes over time. Results Over 6 months, 1899 mothers provided feeding information. In month 1 the largest latent class is FF (32.9%) followed by DBF (23.8%). In month 2, a substantial proportion of the FF class included SFF; which increases over time. A not allocated class, due to missing information was identified in months 1-3, transitions to SFF starting in month 4 (8.9%). In month 1, two mixed patterns exist: DBF and P&F combined with FF (13.9%) and DBF combined with P&F (18.7%). The triple combination of DBF, P&F, and FF (13.9%) became FF in month 2 (transition probability: 24.8%), and DBF in combination with P&F (transition probability: 49.1%). The pattern of DBF combined with P&F is relatively stable until month 4, when at least 50% of these infants receive solid food. Only 23-26% of the infants receive direct breastfeeding (DBF) in months 1-4, in month 5-6 SFF is added. Mothers who used FF were less educated and employed fulltime. Mothers who smoke and not residing in the west of the United States were also more likely to practice formula feeding. Conclusion Infant feeding is complex. Breastfeeding is not predominant and we additionally considered the mixed patterns of feeding. To facilitate direct breastfeeding, a substantial increase in the duration of maternal leave is necessary in the United States.
Collapse
Affiliation(s)
- Wilfried Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38119 USA
| | - Nelís Soto-Ramírez
- College of Social Work, University of South Carolina, Columbia, SC 29208 USA
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38119 USA
| |
Collapse
|
29
|
Lucas CT, Messito MJ, Gross RS, Tomopoulos S, Fierman AH, Cates CB, Johnson SB, Dreyer B, Mendelsohn AL. Characteristics Associated With Adding Cereal Into the Bottle Among Immigrant Mother-Infant Dyads of Low Socioeconomic Status and Hispanic Ethnicity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:27-34.e1. [PMID: 27756595 PMCID: PMC5682590 DOI: 10.1016/j.jneb.2016.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 08/29/2016] [Accepted: 08/30/2016] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Determine maternal and infant characteristics associated with adding cereal into the bottle. DESIGN Secondary data analysis. PARTICIPANTS Study participants were immigrant, low-income, urban mother-infant dyads (n = 216; 91% Hispanic, 19% US-born) enrolled in a randomized controlled trial entitled the Bellevue Project for Early Language, Literacy and Education Success. MAIN OUTCOME MEASURES Maternal characteristics (age, marital status, ethnicity, primary language, country of origin, education, work status, income, depressive symptoms, and concern about infant's future weight) and infant characteristics (gender, first born, and difficult temperament). ANALYSIS Fisher exact test, chi-square test, and simultaneous multiple logistic regression of significant (P < .05) variables identified in unadjusted analyses. RESULTS Twenty-seven percent of mothers added cereal into the bottle. After adjusting for confounding variables identified in bivariate analyses, mothers who were single (P = .02), had moderate to severe depressive symptoms (P = .01) and perceived their infant had a difficult temperament (P = .03) were more likely to add cereal into the bottle. Conversely, mothers who expressed concern about their infants becoming overweight were less likely to add cereal (P = .02). CONCLUSIONS AND IMPLICATIONS Health care providers should screen for adding cereal in infant bottles. Further research is needed to investigate the impact of adding cereal into the bottle on weight trajectories over time. Causal associations also need to be identified to effectively prevent this practice.
Collapse
Affiliation(s)
- Candice Taylor Lucas
- Department of Pediatrics, New York University School of Medicine, New York, NY; Department of Pediatrics, Pediatric Exercise and Genomics Research Center, University of California, Irvine School of Medicine, Irvine, CA.
| | - Mary Jo Messito
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Rachel S Gross
- Department of Pediatrics, Children's Hospital of Montefiore and Albert Einstein College of Medicine, Bronx, NY
| | - Suzy Tomopoulos
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Arthur H Fierman
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | | | - Samantha Berkule Johnson
- Department of Pediatrics, New York University School of Medicine, New York, NY; Department of Psychology, Marymount Manhattan College, New York, NY
| | - Benard Dreyer
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Alan L Mendelsohn
- Department of Pediatrics, New York University School of Medicine, New York, NY
| |
Collapse
|
30
|
Alzaheb RA. Factors Associated with the Early Introduction of Complementary Feeding in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E702. [PMID: 27420081 PMCID: PMC4962243 DOI: 10.3390/ijerph13070702] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/05/2016] [Accepted: 07/08/2016] [Indexed: 01/01/2023]
Abstract
Mothers' instigation of complementary feeding before their infant reaches 6 months old risks shortening their breastfeeding duration, and high morbidity and mortality for their child. Complementary feeding practices require further investigation in Saudi Arabia. The present study aims to evaluate complementary feeding practices, and to establish which factors are associated with the early introduction of complementary feeding in the Saudi Arabian context. Cross-sectional research was conducted with 632 mothers of infants aged between 4 and 24 months attending five primary health care centers (PHCCs) between July and December 2015 in Saudi Arabia. Data on participants' socio-demographic characteristics and complementary feeding practices were collected via structured questionnaires. A regression analysis identified the factors associated with the early introduction of solid foods, defined as before 17 weeks. 62.5% of the study's infants received solid foods before reaching 17 weeks old. The maternal factors at higher risk of early introduction of solids were: younger age; Saudi nationality; shorter education; employment within 6 months post-birth; caesareans; not breastfeeding fully for six weeks post-birth, and living in low-income households. Complementary feeding prior to 6 months postpartum was common in Saudi Arabia. Public health interventions are needed to reduce early complementary feeding, focusing on mothers at highest risk of giving solids too early.
Collapse
Affiliation(s)
- Riyadh A Alzaheb
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia.
| |
Collapse
|
31
|
The Predictors of Diet Quality among Australian Children Aged 3.5 Years. J Acad Nutr Diet 2016; 116:1114-1126.e2. [DOI: 10.1016/j.jand.2015.12.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 12/11/2015] [Indexed: 11/18/2022]
|
32
|
Comerford KB, Ayoob KT, Murray RD, Atkinson SA. The Role of Avocados in Complementary and Transitional Feeding. Nutrients 2016; 8:E316. [PMID: 27213450 PMCID: PMC4882728 DOI: 10.3390/nu8050316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 12/11/2022] Open
Abstract
Infant dietary patterns tend to be insufficient sources of fruits, vegetables, and fiber, as well as excessive in salt, added sugars, and overall energy. Despite the serious long-term health risks associated with suboptimal fruit and vegetable intake, a large percentage of infants and toddlers in the U.S. do not consume any fruits or vegetables on a daily basis. Since not all fruits and vegetables are nutritionally similar, guidance on the optimal selection of fruits and vegetables should emphasize those with the greatest potential for nutrition and health benefits. A challenge is that the most popularly consumed fruits for this age group (i.e., apples, pears, bananas, grapes, strawberries) do not closely fit the current general recommendations since they tend to be overly sweet and/or high in sugar. Unsaturated oil-containing fruits such as avocados are nutritionally unique among fruits in that they are lower in sugar and higher in fiber and monounsaturated fatty acids than most other fruits, and they also have the proper consistency and texture for first foods with a neutral flavor spectrum. Taken together, avocados show promise for helping to meet the dietary needs of infants and toddlers, and should be considered for inclusion in future dietary recommendations for complementary and transitional feeding.
Collapse
Affiliation(s)
- Kevin B Comerford
- Department of Nutrition, University of California at Davis, Davis, CA 95616, USA.
| | - Keith T Ayoob
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Robert D Murray
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA.
| | | |
Collapse
|
33
|
Reat AM, Crixell SH, Friedman BJ, Von Bank JA. Comparison of Food Intake Among Infants and Toddlers Participating in a South Central Texas WIC Program Reveals Some Improvements After WIC Package Changes. Matern Child Health J 2016; 19:1834-41. [PMID: 25656719 DOI: 10.1007/s10995-015-1697-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In 2009, WIC began issuing revised food packages with the intent of improving dietary practices such as breastfeeding, delaying the introduction of complementary foods until about 6 months, limiting juice intake, and increasing intake of fruits, vegetables, whole grains, and baby food meats as appropriate for age. This observational study investigated whether dietary intake and feeding practices of a sample of majority-Hispanic infants and toddlers participating in a WIC clinic in south central Texas improved after the package changes. Feeding practices data and 24-h recalls were collected during telephone interviews with 84 caregivers of infants (4-12 months) and toddlers (1-2 years) in 2009 before the package change and with 112 caregivers in 2011 after the package change. The Nutrition Data System for Research was used to collect 24-h recalls. Outcomes for the two study years were compared using Chi square analysis for categorical and Mann-Whitney U analysis for continuous variables. Breastfeeding initiation, breastfeeding duration, age of introduction of complementary foods, and exposures to baby food fruits, vegetables, and meats among infants did not improve after the package changes. Significantly fewer infants received cereal in their bottles and fewer toddlers consumed vegetables and eggs after the package changes. The observed feeding practices of infants and toddlers among this sample did not reflect the WIC package changes. Strategic and comprehensive breastfeeding and nutrition education are recommended. Package modifications such as adding eggs back to the toddler package and allowing more flexibility for purchasing fresh produce and baby foods may be warranted.
Collapse
Affiliation(s)
- Amanda M Reat
- School of Family and Consumer Sciences, Texas State University, San Marcos, TX, 78666, USA,
| | | | | | | |
Collapse
|
34
|
Oshiro CES, Novotny R, Grove JS, Hurwitz EL. Race/Ethnic Differences in Birth Size, Infant Growth, and Body Mass Index at Age Five Years in Children in Hawaii. Child Obes 2015; 11:683-90. [PMID: 26561722 DOI: 10.1089/chi.2015.0027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Factors at birth and infancy may increase risk of being overweight in childhood. The aim of this study was to examine the relationship of birth size and infant growth (2-24 months) with BMI at age 5 years in a multiethnic population. METHODS This was a retrospective study (using electronic medical records of a health maintenance organization in Hawaii) of singleton children born in 2004-2005, with linked maternal and birth information, infant weights (n = 597) and lengths (n = 473) in the first 2 years, and BMI measures at age 5 years (n = 894). Multiple regression models were used to estimate the association of BMI at age 5 years with birth size and infant growth. RESULTS Birth weight was positively associated with BMI at age 5 years, adjusting for gestational age, sex, race/ethnicity, and maternal prepregnancy weight, age, education, and smoking. A greater change in infant weight was associated with a higher BMI at age 5 years, though the effect of birth weight on BMI was neither mediated nor modified by infant growth rate. Birth weight, change in infant weight, and BMI at age 5 years varied by race/ethnicity. Change in infant BMI in the first 2 years was higher in other Pacific Islanders and whites (Δ = 0.966; confidence interval [CI] = 0.249-1.684; p = 0.02) than in Asian, other, and part Native Hawaiian race/ethnic groups. CONCLUSIONS Early biological measures of birth weight and infant weight gain varied by race/ethnicity and positively predicted BMI at age 5 years.
Collapse
Affiliation(s)
- Caryn E S Oshiro
- 1 Kaiser Permanente, Center for Health Research Hawaii , Honolulu, HI
| | - Rachel Novotny
- 2 Department of Human Nutrition, Food, and Animal Sciences, University of Hawaii , Mānoa, HI
| | - John S Grove
- 3 Department of Public Health Sciences, Office of Public Health Studies, University of Hawaii , Mānoa, HI
| | - Eric L Hurwitz
- 3 Department of Public Health Sciences, Office of Public Health Studies, University of Hawaii , Mānoa, HI
| |
Collapse
|
35
|
Abstract
OBJECTIVES The aim of the present study was to determine the odds of early introduction of solid foods in a nationally representative sample of preterm infants when compared with term infants and to examine whether factors associated with early introduction are the same for preterm and term infants. METHODS Our sample of 7650 came from the first wave of the Early Childhood Longitudinal Study, Birth Cohort (2001-2002). We performed multivariable logistic regression to determine whether preterm infants were introduced to solid foods more frequently before 4 months than term infants using adjusted age for preterm infants and chronological age for term infants. In a separate analysis in preterm infants, we used multivariable logistic regression to determine whether the factors associated with early introduction in term infants were the same in the preterm sample. RESULTS Infants born 22 to 32 weeks' gestation had a 9.90 (95% confidence interval 5.54-18.0) odds of being fed solid food before 4 months compared with term infants, and infants born 33 to 36 weeks' gestation had a 6.19 (95% confidence interval 4.58-8.36) odds. Race/ethnicity and maternal smoking were the only factors that predicted early solid feeding in both preterm and term infants; the remaining predictors differed. CONCLUSIONS Preterm infants are significantly more likely to be introduced to complementary foods early compared with term infants. The predictors of early solid feeding differ for preterm infants. Given the health implications, specific guidelines for preterm infants should be developed and future research should examine predictors of early introduction in preterm infants.
Collapse
|
36
|
Adherence to complementary feeding recommendations for infants and implications for public health. Public Health Nutr 2015; 19:638-49. [DOI: 10.1017/s1368980015001433] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AbstractObjectiveThe current study investigates (i) the extent to which breast-feeding and non-breast-feeding mothers follow the Canadian Nutrition for Healthy Term Infants (NHTI) recommendations; (ii) the first complementary foods given and the differences by breast-feeding status; (iii) whether any breast-feeding is associated with earlier introduction to complementary foods relative to non-breast-feeding, after controlling for potentially confounding factors; and (iv) the need for improvements in timing and resources of interventions by examining breast-feeding rates over time and information sources used by mothers.DesignLongitudinal data from the Kingston, Frontenac, and Lennox & Addington (KFL&A) Infant Feeding Survey were used. Mothers completed a survey at the end of their hospital stay and were interviewed by telephone at 2, 4, 6 and 12 months thereafter.SettingThe study took place in the KFL&A region of Ontario, Canada.SubjectsThe sample consisted of 325 mothers who gave birth to a live infant of at least 36 weeks’ gestation and a birth weight of at least 1500 g at Kingston General Hospital between January and July of 2008.ResultsFour in five mothers introduced complementary foods prior to 6 months. Mothers not breast-feeding at 6 months introduced water, juice, infant cereals, fruit and vegetables, and foods not recommended by Canada’s Food Guide sooner than breast-feeding mothers. Breast-feeding mothers were more likely to introduce milks appropriately, but had low adherence to giving their infants vitamin D supplements.ConclusionsTo support adherence to NHTI recommendations, interventions should be conducted during early infancy and deliver consistent, evidence-based recommendations.
Collapse
|
37
|
Motee A, Jeewon R. Importance of Exclusive Breastfeeding and Complementary Feeding among Infants. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2014. [DOI: 10.12944/crnfsj.2.2.02] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this review is to document the advantages of exclusive breastfeeding along with concerns which may hinder the practice of breastfeeding and focuses on the appropriateness of complementary feeding and feeding difficulties which infants encounter. Breastfeeding, as recommended by the World Health Organisation, is the most cost effective way for reducing childhood morbidity such as obesity, hypertension and gastroenteritis as well as mortality. There are several factors that either promote or act as barriers to good infant nutrition. Factors which influence breastfeeding practice in terms of initiation, exclusivity and duration are namely breast engorgement, sore nipples, milk insufficiency and availability of various infant formulas. On the other hand, introduction of complementary foods, also known as weaning, is done around 4 to 6 months and mothers usually should start with home-made nutritious food. Difficulties encountered during the weaning process are often refusal to eat followed by vomiting, colic, allergic reactions and diarrhoea.
Collapse
Affiliation(s)
- Ashmika Motee
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
| | - Rajesh Jeewon
- Department of Health Sciences, Faculty of Science, University of Mauritius, Réduit, Mauritius
| |
Collapse
|
38
|
Cartagena DC, Ameringer SW, McGrath J, Jallo N, Masho SW, Myers BJ. Factors contributing to infant overfeeding with Hispanic mothers. J Obstet Gynecol Neonatal Nurs 2014; 43:139-59. [PMID: 24502196 DOI: 10.1111/1552-6909.12279] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To evaluate existing evidence on factors potentially contributing to infant overfeeding among Hispanic mothers that may explain the high infant overweight rates often seen among this ethnic group. DATA SOURCES Electronic databases including CINHAL and MEDLINE were searched for relevant studies published from 1998 to January 2012. Related article searches and reference list searches were completed on all included studies. STUDY SELECTION Thirty-five studies (nine qualitative, 15 cross-sectional, nine cohort, and two longitudinal) were identified that met the following inclusion criteria: (a) studies of Hispanic-only or multiethnic mothers, (b) studies of healthy full-term infants or toddlers, (c) studies in which a majority of the sample included children within the target age group (0-24 months of age), and (d) studies conducted in the United States. The methodological quality of the studies ranged from fair to excellent. DATA EXTRACTION Data extraction included content related to Hispanic infant feeding and weight gain. DATA SYNTHESIS Reviewed research fell into three main foci of inquiry: breastfeeding and formula-feeding beliefs, attitudes, and practices; family and cultural influences of maternal feeding beliefs and practices; and maternal perceptions of infant feeding satiety and weight gain. The Preferred Reporting Items of Systematic Reviews Meta-Analysis (PRISMA) guidelines were followed for data extraction and reporting the results of this integrative review. CONCLUSION Three major feeding practices and beliefs among Hispanic mothers potentially contribute to infant overfeeding. Hispanic mothers are more likely to practice nonexclusive breastfeeding, initiate early introduction of solid foods including ethnic foods, and perceive chubbier infants as healthy infants. Cultural norms driving family influences and socioeconomic factors play a role in the feeding tendencies of Hispanics. Empirical research is needed to further define the primary factors that influence Hispanic mothers feeding decisions and practices that contribute to excessive weight gain in their infants.
Collapse
|
39
|
Abstract
BACKGROUND Recommendations for the introduction of solids and fluids to an infant's diet have changed over the past decade. Since these changes, there has been minimal research to determine patterns in the introduction of foods and fluids to infants. METHODS This retrospective cohort study surveyed mothers who birthed in Queensland, Australia, from February 1 to May 31, 2010, around 4 months postpartum. Frequencies of foods and fluids given to infants at 4, 8, 13, and 17 weeks were described. Logistic regression determined associations between infant feeding practices, the introduction of other foods and fluids at 17 weeks, and sociodemographic characteristics. RESULTS Response rate was 35.8%. At 17 weeks, 68% of infants were breastfed and 33% exclusively breastfed. Solids and water had been introduced in 8.6% and 35.0% of infants, respectively. The introduction of solids by 17 weeks was associated with younger maternal age and the infant being given water and infant formula at 4 weeks. The infant being given water at 17 weeks was associated with younger maternal age, the infant being given infant formula at 4 weeks, level of education, relative socioeconomic disadvantage, parity, and birth facility. CONCLUSION Over the past decade, there has been a significant reduction in the proportion of infants in Australia who have been given solids by 17 weeks. Sociodemographic characteristics and formula feeding practices at 4 weeks were associated with the introduction of solids and water by 17 weeks. Further research should examine these barriers to improve compliance with current infant feeding recommendations.
Collapse
Affiliation(s)
- Wendy Brodribb
- School of Medicine, The University of Queensland, Australia.
| | | |
Collapse
|
40
|
Clayton HB, Li R, Perrine CG, Scanlon KS. Prevalence and reasons for introducing infants early to solid foods: variations by milk feeding type. Pediatrics 2013; 131:e1108-14. [PMID: 23530169 PMCID: PMC3608486 DOI: 10.1542/peds.2012-2265] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2012] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the prevalence of, and mothers' self-reported reasons for, introducing solid foods to infants earlier than recommended (aged <4 months) and the variation in reasons for early introduction by milk feeding type. METHODS The study included 1334 mothers who participated in the national longitudinal Infant Feeding Practices Study II (2005-2007). Monthly 7-day food-frequency questions throughout infancy were used to determine infant age at solid food introduction and to classify infant's milk feeding at introduction as breast milk only, formula only, or mixed. Reasons for introducing solid foods at age <4 months were assessed through maternal responses to a list of 12 potential reasons. Analyses included descriptive statistics and multivariable logistic regression. RESULTS Overall, 40.4% of mothers introduced solid foods before age 4 months. Prevalence varied by milk feeding type (24.3%, 52.7%, and 50.2% for breastfed, formula-fed, and mixed-fed infants, respectively). The most commonly cited reasons for early introduction of solid food were as follows: "My baby was old enough," "My baby seemed hungry," "I wanted to feed my baby something in addition to breast milk or formula," "My baby wanted the food I ate," "A doctor or other health care professional said my baby should begin eating solid food," and "It would help my baby sleep longer at night." Four of these reasons varied by milk feeding type. CONCLUSIONS Our findings highlight the high prevalence of early introduction of solids and provide details on why mothers introduced solid foods early.
Collapse
Affiliation(s)
- Heather B Clayton
- Epidemic Intelligence Service, Office of Workforce Development, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | | | | | | |
Collapse
|
41
|
Factors associated with the timing of introduction of complementary feeding: the Generation R Study. Eur J Clin Nutr 2013; 67:625-30. [PMID: 23462942 DOI: 10.1038/ejcn.2013.50] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Many parents do not follow recommendations for the timing of introduction of complementary feeding. The aim of this study was to identify determinants associated with the timing of introduction of complementary feeding in a multiethnic birth cohort. SUBJECTS/METHODS Subjects were 3561 mothers and infants participating in a prospective cohort study. The timing of introduction of complementary feeding and maternal and infant characteristics were obtained by parent-derived questionnaires. Regression analyses were performed to identify determinants for the timing of introduction of complementary feeding (<3, 3-6 and ≥ 6 months). RESULTS In total, 62% of infants were introduced to complementary feeding before the age of 6 months. Determinants for very early (<3 months) introduction were being a single parent and infant day care attendance. Determinants for early (3-6 months) introduction were young maternal age, multiple parities, no infant family history of asthma, atopy and no infant history of allergy to cow's milk. Determinants for both very early and early introduction were low educational level and not fully breastfeeding for 4 months. Maternal educational level was only significantly associated with the timing of introduction in mothers of Western origin. CONCLUSIONS This study confirmed determinants for the timing of introduction of complementary feeding that have been identified by previous studies, which may be appropriate targets for education and guidance. Moreover, mothers whose infants attend day care and have a family history of asthma, atopy or allergy to cow's milk may need guidance to follow infant feeding recommendations.
Collapse
|
42
|
Coit J, Grossman X, Buczek M, Feldman-Winter L, Merewood A. Introducing solid foods: validity of report among mothers who do not adhere to recommended US guidelines. J Hum Lact 2012; 28:490-4. [PMID: 22777763 DOI: 10.1177/0890334412448928] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Introducing solids foods to infants before 6 months has been associated with adverse long-term health outcomes. Studies and surveys frequently use maternal report to identify the age when infants start solid foods. OBJECTIVE To address the accuracy of maternal report at 1 year postpartum regarding introduction of solid foods. METHODS Between 2008 and 2009, the authors enrolled mothers of healthy term singletons at an urban Boston hospital within 72 hours of giving birth. We called mothers monthly for 6 months and asked if they had given their baby solid foods in the previous month. At 1 year, we contacted mothers again and asked when they first gave solid foods; answers at 1 year were compared with the data collected monthly. RESULTS The authors analyzed data on 157 women, all of whom had, according to monthly responses, started solid foods before 6 months. At 1 year, only 14% (22/157) of reports matched data recorded monthly. Although 100% of women introduced solids before 6 months, at 1 year, 41.4% reported starting solids at 6 months. CONCLUSIONS Among women who started feeding solids before 6 months, most did not give an accurate response at 1 year. Most said they started giving solids later than they did. Maternal report may not be the best way to collect such data, and health outcomes based on such data may be biased toward the null.
Collapse
Affiliation(s)
- Julia Coit
- Research Assistant, the Breastfeeding Center, Boston Medical Center, Boston, MA, USA
| | | | | | | | | |
Collapse
|
43
|
Gatica G, Barros AJD, Madruga S, Matijasevich A, Santos IS. Food intake profiles of children aged 12, 24 and 48 months from the 2004 Pelotas (Brazil) birth cohort: an exploratory analysis using principal components. Int J Behav Nutr Phys Act 2012; 9:43. [PMID: 22510615 PMCID: PMC3424118 DOI: 10.1186/1479-5868-9-43] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 04/17/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To identify food intake profiles of children during their first four years of life and assess its variations according to sociodemographic and behavioral characteristics. METHODS The Pelotas Birth Cohort Study (Brazil) recruited 4,231 liveborns, who were followed-up at ages 3, 12, 24 and 48 months. Food consumption data of children aged 12, 24 and 48 months was collected using a list of foods consumed during a 24-hour period prior to the interview. The food profiles were identified with the use of principal component analysis (PCA) for each age studied. RESULTS Five components were identified at each age, four of them similar in all time points, namely: beverages, milks, staple, and snacks. A meat & vegetables component was identified at 12 and 24 months and a treats component at 48 months. The greatest nutritional differences were found among children from different socioeconomic levels. With regard to the milks component, higher breast milk intake compared to cow's milk was seen among poorer children (12- and 24-month old) and higher milk and chocolate powdered milk drink consumption was seen among more affluent children aged 48 months. Poorer children of less educated mothers showed higher adherence to the treats component (48 months). Regarding to the snack component, poorer children consumed more coffee, bread/cookies while more affluent children consumed proportionately more fruits, yogurt and soft drinks. Child care outside of the home was also a factor influencing food profiles more aligned with a healthier diet. CONCLUSIONS The study results showed that very early in life children show food profiles that are strongly associated with social (maternal schooling, socioeconomic position and child care) and behavioral characteristics (breast-feeding duration, bottle-feeding and pacifier use).
Collapse
Affiliation(s)
- Giovanna Gatica
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | | | | |
Collapse
|