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Ventura AK, Phelan S, Silva Garcia K. Maternal Diet During Pregnancy and Lactation and Child Food Preferences, Dietary Patterns, and Weight Outcomes: a Review of Recent Research. Curr Nutr Rep 2021; 10:413-426. [PMID: 34383279 DOI: 10.1007/s13668-021-00366-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Efforts to promote children's preferences for healthy foods hold much potential for improving diet quality and preventing obesity. The purpose of this review was to summarize recent evidence for associations between maternal diet during pregnancy and lactation and child food preferences, dietary patterns, and weight outcomes. RECENT FINDINGS Recent research illustrates greater maternal vegetable intakes during pregnancy and lactation predict greater child preferences for and intakes of vegetables. Recent randomized clinical trials to improve maternal weight outcomes during the perinatal period via behavioral lifestyle interventions that included dietary components have yielded mixed findings for effects on child weight outcomes. There is strong evidence that maternal diet during pregnancy and lactation shapes flavor preferences during infancy; more research is needed to understand factors that facilitate versus hinder the translation of these preferences to later dietary patterns and weight outcomes.
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Affiliation(s)
- Alison K Ventura
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, One Grand Ave, San Luis Obispo, CA, 93407, USA.
| | - Suzanne Phelan
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, One Grand Ave, San Luis Obispo, CA, 93407, USA
| | - Karina Silva Garcia
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, One Grand Ave, San Luis Obispo, CA, 93407, USA
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Johnson SL, Moding KJ, Grimm KJ, Flesher AE, Bakke AJ, Hayes JE. Infant and Toddler Responses to Bitter-Tasting Novel Vegetables: Findings from the Good Tastes Study. J Nutr 2021; 151:3240-3252. [PMID: 34191021 PMCID: PMC8485907 DOI: 10.1093/jn/nxab198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/29/2021] [Accepted: 05/25/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Infants are born with the biological predisposition to reject bitterness. Dark green vegetables contain essential nutrients but also bitter compounds, making them more difficult to like. OBJECTIVE The Good Tastes Study was designed to determine whether reducing bitterness by adding small amounts of sugar or salt would alter infant acceptance of kale purées. METHODS Caregivers (n = 106, 94% mothers, 82% Non-Hispanic White) and children (53% male, aged 6-24 mo) participated in a videorecorded laboratory visit during which infants were offered 4 versions of puréed kale: plain, 1.2% or 1.8% added sugar, or 0.2% added salt. Caregivers rated their children's liking for each kale version. Videos were coded for the number of tastes accepted and for children's behaviors and acceptance of each kale version. A multilevel ordered logistic model was fit for the number of accepted tastes and caregiver ratings of child liking of kale versions with age, breastfeeding history, order effects, and kale version as predictors. RESULTS Infants 6 to <12 mo accepted more tastes (b = 2.911, P < 0.001) and were rated by caregivers as liking the kale more than older toddlers (≥18 mo; b = 1.874, P = 0.014). The plain kale was more likely to be accepted (P < 0.001); also, the first version offered was more likely to be rejected (b = -0.586, P < 0.007). Older infants (≥18 mo) exhibited more avoidant behaviors (b = 1.279, P < 0.001), more playing (b = 2.918, P < 0.001), and more self-feeding (b = 1.786, P = 0.005) than younger infants (6 to <12 mo). Children who were reported to have been breastfed more in the last 7 d were more likely to self-feed (b = 0.246, P < 0.001) and play with food (b = 0.207, P < 0.005). CONCLUSIONS Our findings support that there may be a sensitive period, during the early phase of complementary feeding, to improve success of introducing a novel, bitter, more difficult-to-like food. When low levels of sugar or salt were added, no advantage of bitterness reduction was observed. This study has been registered with ClinicalTrials.gov as NCT04549233.
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Affiliation(s)
- Susan L Johnson
- Department of Pediatrics University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kameron J Moding
- Department of Human Development & Family Studies, Purdue University, West Lafayette, IN, USA
| | - Kevin J Grimm
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Abigail E Flesher
- Department of Pediatrics University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alyssa J Bakke
- Sensory Evaluation Center, The Pennsylvania State University, University Park, PA, USA
- Department of Food Science, The Pennsylvania State University, University Park, PA, USA
| | - John E Hayes
- Sensory Evaluation Center, The Pennsylvania State University, University Park, PA, USA
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Johnson SL, Shapiro ALB, Moding KJ, Flesher A, Davis K, Fisher JO. Infant and Toddler Consumption of Sweetened and Unsweetened Lipid Nutrient Supplements After 2-Week Home Repeated Exposures. J Nutr 2021; 151:2825-2834. [PMID: 34036363 PMCID: PMC8417920 DOI: 10.1093/jn/nxab148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/10/2021] [Accepted: 04/22/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Small-quantity lipid-based nutrient supplements (SQ-LNS) are designed to address undernutrition during the complementary feeding period. SQ-LNS contains added sugars, but limited research has assessed whether infants' acceptance varies between versions with and without sugars. OBJECTIVES Our objective was to examine the effects of repeated exposure on children's acceptance of sweetened and unsweetened SQ-LNS. We aimed to understand caregivers' perceptions of children's liking of the 2 SQ-LNS versions and their influences on infant acceptance of SQ-LNS. METHODS Caregivers (86% non-Hispanic White) and children (7-24 mo), participated in a randomized, 2-week home-exposure study and baseline and post-home exposure assessments. Children were randomized to receive sweetened or unsweetened SQ-LNS versions, mixed with infant oatmeal. At in-person visits, caregivers fed both SQ-LNS versions to children and rated their child's liking for each. Caregivers fed the SQ-LNS version to which their child was randomized until the child refused to eat more. Acceptance was measured as total grams consumed. Mixed-effects linear models tested the change in SQ-LNS consumed between baseline and postexposure by the SQ-LNS version and number of home exposures. Covariates included the amount of SQ-LNS consumed at baseline, child BMI z-score, child age, and breastfeeding experience. RESULTS Children's acceptance of both SQ-LNS versions increased from baseline to postexposure (β, 0.71 g; 95% CI: 0.54-0.89 g; P = 0.04), regardless of SQ-LNS version (P = 0.88) or number of home exposures (P = 0.55). Caregivers rated children's liking of unsweetened SQ-LNS higher at baseline (P = 0.02). Children with lower liking ratings at baseline showed the greatest increases in acceptance between baseline and postexposure (P = 0.01). CONCLUSIONS Children's acceptance of SQ-LNS increased with repeated exposure, whether offered the sweetened or unsweetened version, providing preliminary support that adding sugar to SQ-LNS may not improve acceptance in young children. Children who initially like the supplement less may need repeated experience to learn to accept SQ-LNS. This trial was registered at clinicaltrials.gov as NCT04544332.
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Affiliation(s)
- Susan L Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Allison L B Shapiro
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kameron J Moding
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
| | - Abigail Flesher
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kathryn Davis
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jennifer O Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
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Neves RO, Guimarães LSP, Bosa VL, Nunes LM, da Silva CH, Goldani MZ, Bernardi JR. Infant processed food consumption and their interaction to breastfeeding and growth in children up to six months old. BMC Public Health 2021; 21:1512. [PMID: 34353303 PMCID: PMC8340519 DOI: 10.1186/s12889-021-11539-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 07/23/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Evidences suggest that early processed food (PF) consumption may cause harm to infant health. During the first 6 months of life, it is not known whether the timing and quantity of this food group can impact breastfeeding and growth. The aim of the study was to analyze the associations between time of introduction and quantity of infant PF consumption with duration of breastfeeding and infant growth at 6 months of age. METHODS Data were longitudinally collected in six interviews, from birth to 6 months, in a sample of Brazilian newborns with adverse intrauterine environments. PF consumption was calculated by gravity score of processed foods (GSPF) in relation to feeding supply quality and time. For the analysis, the scores were divided into tertiles, making scores severities: Null, Mild, Moderate, and Severe. The interaction between GSPF and breastfeeding (exclusive and non-exclusive) and growth parameters (analyzed in Z-scores, by weight for height, weight for age, and body mass index for age) was tested. RESULTS A total of 236 infants were included in the study. Greater GSPF were associated with better rates of breastfeeding practices and higher growth indicators scores in the sixth month of infants. These findings were confirmed after adjustment for family income, maternal age, pre-gestational body mass index, and growth z scores at birth. CONCLUSION The harms of eating PF in relation to breastfeeding and infant growth are more evident the greater and earlier they are consumed. Future studies should explore interventions to reduce and delay the consumption of these foods to prevent adverse health outcomes in later life.
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Affiliation(s)
- Renata Oliveira Neves
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | | | - Vera Lúcia Bosa
- Graduate Program in Food, Nutrition, and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Nutrition, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Clécio Homrich da Silva
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcelo Zubaran Goldani
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Rombaldi Bernardi
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Food, Nutrition, and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Nutrition, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Rapson JP, von Hurst PR, Hetherington MM, Conlon CA. Impact of a "vegetables first" approach to complementary feeding on later intake and liking of vegetables in infants: a study protocol for a randomised controlled trial. Trials 2021; 22:488. [PMID: 34311749 PMCID: PMC8314593 DOI: 10.1186/s13063-021-05374-7] [Citation(s) in RCA: 4] [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: 03/29/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Vegetables as first complementary foods for infants may programme taste preferences that lead to improved vegetable intake in children. Yet few studies have investigated the impact of a "vegetables first" approach to complementary feeding, especially in New Zealand. The purpose of this randomised control trial is to investigate the effect of starting complementary feeding with vegetables only on infants' later intake and liking of vegetables, compared to those starting with fruit and vegetables. METHODS/DESIGN One-hundred and twenty mother-infant pairs living in Auckland, New Zealand, will be randomised to receive either vegetables only (intervention) or fruit and vegetables (control) for 28 days, starting from the first day of complementary feeding at around 4-6 months of age. Infants will be presented with a brassica (broccoli), followed by a green leafy vegetable (spinach) and sweet fruit (pear) at 9 months of age. The primary outcome measures of intake of each food will be assessed using a weighed food diary. Secondary outcome measures of overall intake, liking and wanting of vegetables will be assessed using a food frequency questionnaire, liking tool and video coding tool, respectively, at 9, 12, and 24 months of age. Infant growth and iron status will be assessed as part of health screening and monitoring at baseline, post intervention and 9 months of age. Other biological samples to be collected include infant stool samples, vitamin D (mother and infant), iron status (mother), and mothers' diet. DISCUSSION This randomised, controlled trial will be the first to our knowledge to investigate a "vegetables first" approach to complementary feeding on infants' liking and intake of vegetables in New Zealand. Comparison against standard practice (fruit and vegetables as first foods) should complement other trials underway, such as the Baby's First Bites and Nordic OTIS trial. Results may contribute to the evidence supporting complementary feeding guidelines in New Zealand and worldwide. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ACTRN12619000737134 . Registered on 16 May 2019.
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Affiliation(s)
- Jeanette P. Rapson
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Pamela R. von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | | | - Cathryn A. Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
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Kalhoff H, Schmidt IV, Heindl I, Kunert J, Kersting M. Feeding frozen complementary foods promotes food acceptance in infants: The randomized intervention trial Baby Gourmet. Nutr Res 2021; 87:49-56. [PMID: 33601214 DOI: 10.1016/j.nutres.2020.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 12/08/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
Infancy may represent a sensitive window for establishing food preferences that could affect the individual's long-term potential to establish healthy eating patterns. Our study was based on the hypothesis that preserving the natural flavor of the ingredients of commercially prepared complementary foods would increase the acceptance of new foods, especially vegetables. Frozen vegetable-based meals for infants were developed to preserve the natural taste of the ingredients better than sterilization of meals in jars. In a 3-month randomized, controlled intervention study, 51 infants were fed either frozen menus (intervention group) or commercial sterilized meals in jars (control group) on at least 5 days per week. Then the acceptability of a known vegetable-based puree was tested in comparison to an unknown puree, measuring the quantities consumed and also the mother's assessment of the infants' liking. In conclusion, the results of this study clearly indicated that infants fed vegetable-based frozen meals for 3 months accepted a new vegetable better than infants fed sterilized commercial meals in jars.
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Affiliation(s)
- Hermann Kalhoff
- Pediatric Clinic, Klinikum Dortmund, Beurhausstrasse 40, D-44137 Dortmund, Germany; Research Department for Child Nutrition [FKE], Paediatric University Hospital, Ruhr University, Bochum, Germany; [formerly Research Institute of Child Nutrition, Dortmund].
| | - Inga V Schmidt
- Research Institute of Child Nutrition, Dortmund, Germany
| | - Ines Heindl
- Institute of Health, Nutrition and Sport Sciences, Europa-Universität, Flensburg, Germany
| | - Joachim Kunert
- Department of Statistics, Technical University of Dortmund, 44221 Dortmund, Germany
| | - Mathilde Kersting
- Research Department for Child Nutrition [FKE], Paediatric University Hospital, Ruhr University, Bochum, Germany; [formerly Research Institute of Child Nutrition, Dortmund]
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Johansson U, Lindberg L, Öhlund I, Hernell O, Lönnerdal B, Lundén S, Sandell M, Lind T. Acceptance of a Nordic, Protein-Reduced Diet for Young Children during Complementary Feeding-A Randomized Controlled Trial. Foods 2021; 10:275. [PMID: 33573094 PMCID: PMC7911089 DOI: 10.3390/foods10020275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/13/2023] Open
Abstract
Early life is critical for developing healthy eating patterns. This study aimed to investigate the effects of a Nordic, protein-reduced complementary diet (ND) compared to a diet following the current Swedish dietary guidelines on eating patterns and food acceptance. At 4-6 months (mo) of age infants were randomized to a Nordic group (NG, n = 41) or a Conventional group (CG, n = 40), and followed until 18 mo of age. Daily intake of fruits and vegetables (mean ± sd) at 12 mo was significantly higher in the NG compared to the CG: 341 ± 108 g/day vs. 220 ± 76 g/day (p < 0.001), respectively. From 12 to 18 mo, fruit and vegetable intake decreased, but the NG still consumed 32% more compared to the CG: 254 ± 99 g/day vs. 193 ± 67 g/day (p = 0.004). To assess food acceptance, both groups were tested with home exposure meals at 12 and 18 mo. No group differences in acceptance were found. We find that a ND with parental education initiates healthy eating patterns during infancy, but that the exposure meal used in the present study was insufficient to detect major differences in food acceptance. This is most likely explained by the preparation of the meal. Nordic produce offers high environmental sustainability and favorable taste composition to establish healthy food preferences during this sensitive period of early life.
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Affiliation(s)
- Ulrica Johansson
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85 Umeå, Sweden; (I.Ö.); (O.H.); (T.L.)
| | - Lene Lindberg
- Department of Public Health Sciences, Karolinska Institutet and Centre for Epidemiology and Community Medicine, Stockholm County Council, SE 104 31 Stockholm, Sweden;
| | - Inger Öhlund
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85 Umeå, Sweden; (I.Ö.); (O.H.); (T.L.)
| | - Olle Hernell
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85 Umeå, Sweden; (I.Ö.); (O.H.); (T.L.)
| | - Bo Lönnerdal
- Department of Nutrition, University of California, Davis, CA 95616, USA;
| | - Saara Lundén
- Functional Foods Forum, University of Turku, FI-20014 Turku, Finland; (S.L.); (M.S.)
| | - Mari Sandell
- Functional Foods Forum, University of Turku, FI-20014 Turku, Finland; (S.L.); (M.S.)
- Department of Food and Nutrition, University of Helsinki, FI-00014 Helsinki, Finland
| | - Torbjörn Lind
- Department of Clinical Sciences, Pediatrics, Umeå University, SE 901 85 Umeå, Sweden; (I.Ö.); (O.H.); (T.L.)
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Factors Affecting Complementary Feeding of Infants. A Pilot Study Conducted after the Introduction of New Infant Feeding Guidelines in Poland. Nutrients 2020; 13:nu13010061. [PMID: 33379149 PMCID: PMC7823849 DOI: 10.3390/nu13010061] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 01/07/2023] Open
Abstract
Adequate nutrition in the first year of life is the key prerequisite for a child’s healthy growth and development. The success of complementary feeding is influenced by various factors, including the family’s socioeconomic status, maternal age, place of residence and educational level, older children and duration of breastfeeding. Modified infant feeding guidelines were introduced in Poland in 2016. The aim of this study was to identify the factors that exert the greatest influence on infant feeding practices in the Polish population. A thorough understanding of maternal factors that are responsible for undesirable feeding practices is required to improve the mothers’ knowledge and to promote healthy feeding practices. This study was carried out in March–June 2018 and between November 2018 and March 2019 in the Region of Lublin in southeastern Poland. The mothers of children aged 9–14 months, who had introduced complementary foods, were invited to the study. A total of 441 mothers agreed to participate, and 289 of them fully and correctly completed the questionnaires. Logistic regression models were developed to assess the association between maternal factors, such as age, educational level and the nutrition knowledge score, and introduction of solid foods. The infant’s sex and birth weight and the mother’s place of residence had no significant influence on the duration of breastfeeding. The mother’s age and educational level, the number of children in the family and maternal nutrition knowledge scores contributed to significant differences in breastfeeding duration. Older mothers (30–34 years vs. 25–29 years, p = 0.001), better educated mothers (university vs. secondary school education p = 0.002) and mothers with one or two children exclusively breastfed their children for longer (17 weeks vs. 11 weeks, p = 0.002) than younger mothers with secondary school education and more than three children. Exclusive formula feeding was significantly correlated with untimely introduction of solid foods compared to exclusive breastfeeding (13 weeks vs. 19.7 weeks, p = 0.001). Mothers with nutrition knowledge scores in the upper tertile were more likely to adapt food consistency to the skills manifested by the child (88%) (OR = 1.88; Cl: 1.53–2.26, p < 0.05) and were less likely to delay the introduction of new foods that required chewing and biting (84%) (OR = 0.22; Cl: 0.09–0.34, p < 0.05) than mothers with nutrition knowledge scores in the bottom tertile. Maternal age, educational level and nutrition knowledge significantly increased the age at which infants were introduced to solid foods and the correct identification of the signs indicative of the child’s readiness to explore new tastes and foods with a new consistency. The above factors contributed to delayed, but not untimely, introduction of complementary foods (6 months of age or later), including gluten.
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Sitarik AR, Kerver JM, Havstad SL, Zoratti EM, Ownby DR, Wegienka G, Johnson CC, Cassidy-Bushrow AE. Infant Feeding Practices and Subsequent Dietary Patterns of School-Aged Children in a US Birth Cohort. J Acad Nutr Diet 2020; 121:1064-1079. [PMID: 33544667 DOI: 10.1016/j.jand.2020.08.083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Infant feeding practices are thought to shape food acceptance and preferences. However, few studies have evaluated whether these affect child diet later in life. OBJECTIVE The study objective was to examine the association between infant feeding practices and dietary patterns (DPs) in school-aged children. DESIGN A secondary analysis of data from a diverse prospective birth cohort with 10 years of follow-up (WHEALS [Wayne County Health Environment Allergy and Asthma Longitudinal Study]) was conducted. PARTICIPANTS/SETTING Children from the WHEALS (Detroit, MI, born 2003 through 2007) who completed a food screener at age 10 years were included (471 of 1,258 original participants). MAIN OUTCOME MEASURES The main outcome was DPs at age 10 years, identified using the Block Kids Food Screener. STATISTICAL ANALYSIS PERFORMED Latent class analysis was applied for DP identification. Breastfeeding and age at solid food introduction were associated with DPs using a 3-step approach for latent class modeling based on multinomial logistic regression models. RESULTS The following childhood DPs were identified: processed/energy-dense food (35%), variety plus high intake (41%), and healthy (24%). After weighting for loss to follow-up and covariate adjustment, compared with formula-fed children at 1 month, breastfed children had 0.41 times lower odds of the processed/energy-dense food DP vs the healthy DP (95% CI 0.14 to 1.25) and 0.53 times lower odds of the variety plus high intake DP (95% CI 0.17 to 1.61), neither of which were statistically significant. Results were similar, but more imprecise, for breastfeeding at 6 months. In addition, the association between age at solid food introduction and DP was nonsignificant, with each 1-month increase in age at solid food introduction associated with 0.81 times lower odds of the processed/energy-dense food DP relative to the healthy DP (95% CI 0.64 to 1.02). CONCLUSIONS A significant association between early life feeding practices and dietary patterns at school age was not detected. Large studies with follow-up beyond early childhood that can also adjust for the multitude of potential confounders associated with breastfeeding are needed.
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Balantekin KN, Anzman-Frasca S, Francis LA, Ventura AK, Fisher JO, Johnson SL. Positive parenting approaches and their association with child eating and weight: A narrative review from infancy to adolescence. Pediatr Obes 2020; 15:e12722. [PMID: 32881344 PMCID: PMC8018716 DOI: 10.1111/ijpo.12722] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022]
Abstract
Parents play a critical role in the development of children's eating behaviours and weight status, serving as providers, models and regulators of the food environment. Many research reviews have focused on the robust body of evidence on coercive control in feeding: how parenting practices such as restriction and pressure to eat increase children's risk for developing undesirable eating behaviours and unhealthy weight outcomes. Fewer reviews adopt a strengths-based perspective focusing on the ways that parents can actively support the development of healthy eating behaviours and weight trajectories. Emerging research on such positive parenting styles and practices offers solutions beyond the avoidance of coercive control, as well as opportunities to highlight parallels between research on food parenting and the broader, well-established developmental literature on positive parenting. The focus of this review is to summarize what is known regarding benefits of positive parenting styles and practices for child eating and weight outcomes and discuss recommendations for future research. Current evidence supports starting with responsive feeding and parenting during infancy and incorporating structure and limit setting in early childhood, with monitoring and mealtime structure remaining important during middle childhood and adolescence. Areas for future research include: (1) further examination of the implications of identified food parenting practices and styles among diverse groups and caregivers; (2) increased consideration of child factors (eg, temperament) as moderators or mediators; and (3) further clarification of the relationship between general parenting and food parenting.
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Affiliation(s)
- Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
| | - Stephanie Anzman-Frasca
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, New York, USA
- Department of Pediatrics, Jacobs School of Medicine, University at Buffalo, Buffalo, New York, USA
| | - Lori A Francis
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Alison K Ventura
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, California, USA
| | - Jennifer O Fisher
- Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania, USA
| | - Susan L Johnson
- Department of Pediatrics, University at Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Hodder RK, O'Brien KM, Tzelepis F, Wyse RJ, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2020; 5:CD008552. [PMID: 32449203 PMCID: PMC7273132 DOI: 10.1002/14651858.cd008552.pub7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Testing the effects of interventions to increase consumption of fruit and vegetables, including those focused on specific child-feeding strategies or broader multicomponent interventions targeting the home or childcare environment is required to assess the potential to reduce this disease burden. OBJECTIVES To assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 January 2020. We searched Proquest Dissertations and Theses in November 2019. We reviewed reference lists of included trials and handsearched three international nutrition journals. We contacted authors of included trials to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both among children aged five years and under, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included trials; a third review author resolved disagreements. Due to unexplained heterogeneity, we used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the quality of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 80 trials with 218 trial arms and 12,965 participants. Fifty trials examined the impact of child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Fifteen trials examined the impact of parent nutrition education only in increasing child fruit and vegetable intake. Fourteen trials examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. Two trials examined the effect of a nutrition education intervention delivered to children in increasing child fruit and vegetable intake. One trial examined the impact of a child-focused mindfulness intervention in increasing vegetable intake. We judged 23 of the 80 included trials as free from high risks of bias across all domains. Performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining trials. There is low-quality evidence that child-feeding practices versus no intervention may have a small positive effect on child vegetable consumption, equivalent to an increase of 5.30 grams as-desired consumption of vegetables (SMD 0.50, 95% CI 0.29 to 0.71; 19 trials, 2140 participants; mean post-intervention follow-up = 8.3 weeks). Multicomponent interventions versus no intervention has a small effect on child consumption of fruit and vegetables (SMD 0.32, 95% CI 0.09 to 0.55; 9 trials, 2961 participants; moderate-quality evidence; mean post-intervention follow-up = 5.4 weeks), equivalent to an increase of 0.34 cups of fruit and vegetables a day. It is uncertain whether there are any short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.13, 95% CI -0.02 to 0.28; 11 trials, 3050 participants; very low-quality evidence; mean post-intervention follow-up = 13.2 weeks). We were unable to pool child nutrition education interventions in meta-analysis; both trials reported a positive intervention effect on child consumption of fruit and vegetables (low-quality evidence). Very few trials reported long-term effectiveness (6 trials), cost effectiveness (1 trial) or unintended adverse consequences of interventions (2 trials), limiting our ability to assess these outcomes. Trials reported receiving governmental or charitable funds, except for four trials reporting industry funding. AUTHORS' CONCLUSIONS Despite identifying 80 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains limited in terms of quality of evidence and magnitude of effect. Of the types of interventions identified, there was moderate-quality evidence that multicomponent interventions probably lead to, and low-quality evidence that child-feeding practice may lead to, only small increases in fruit and vegetable consumption in children aged five years and under. It is uncertain whether parent nutrition education or child nutrition education interventions alone are effective in increasing fruit and vegetable consumption in children aged five years and under. Our confidence in effect estimates for all intervention approaches, with the exception of multicomponent interventions, is limited on the basis of the very low to low-quality evidence. Long-term follow-up of at least 12 months is required and future research should adopt more rigorous methods to advance the field. This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Kate M O'Brien
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Rebecca J Wyse
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
- Priority Research Centre in Health and Behaviour, University of Newcastle, Callaghan, Australia
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van der Veek SMC, de Graaf C, de Vries JHM, Jager G, Vereijken CMJL, Weenen H, van Winden N, van Vliet MS, Schultink JM, de Wild VWT, Janssen S, Mesman J. Baby's first bites: a randomized controlled trial to assess the effects of vegetable-exposure and sensitive feeding on vegetable acceptance, eating behavior and weight gain in infants and toddlers. BMC Pediatr 2019; 19:266. [PMID: 31370830 PMCID: PMC6670176 DOI: 10.1186/s12887-019-1627-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/15/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The start of complementary feeding in infancy plays an essential role in promoting healthy eating habits. Evidence shows that it is important what infants are offered during this first introduction of solid foods: e.g. starting exclusively with vegetables is more successful for vegetable acceptance than starting with fruits. How infants are introduced to solid foods also matters: if parents are sensitive and responsive to infant cues during feeding, this may promote self-regulation of energy intake and a healthy weight. However, the effectiveness of the what and the how of complementary feeding has never been experimentally tested in the same study. In the current project the what and how (and their combination) are tested in one study to determine their relative importance for fostering vegetable acceptance and self-regulation of energy intake in infants. METHODS A four-arm randomized controlled trial (Baby's First Bites (BFB)) was designed for 240 first-time Dutch mothers and their infants, 60 per arm. In this trial, we compare the effectiveness of (a) a vegetable-exposure intervention focusing on the what in complementary feeding; (b) a sensitive feeding intervention focusing on the how in complementary feeding, (c) a combined intervention focusing on the what and how in complementary feeding; (d) an attention-control group. All mothers participate in five sessions spread over the first year of eating solid foods (child age 4-16 months). Primary outcomes are vegetable consumption, vegetable liking and self-regulation of energy intake. Secondary outcomes are child eating behaviors, child anthropometrics and maternal feeding behavior. Outcomes are assessed before, during and directly after the interventions (child age 18 months), and when children are 24 and 36 months old. DISCUSSION The outcomes are expected to assess the impact of the interventions and provide new insights into the mechanisms underlying the development of vegetable acceptance, self-regulation and healthy eating patterns in infants and toddlers, as well as the prevention of overweight. The results may be used to improve current dietary advice given to parents of their young children on complementary feeding. TRIAL REGISTRATION The trial was retrospectively registered during inclusion of participants at the Netherlands National Trial Register (identifier NTR6572 ) and at ClinicalTrials.gov ( NCT03348176 ). Protocol issue date: 1 April 2018; version number 1.
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Affiliation(s)
- S. M. C. van der Veek
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - C. de Graaf
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - J. H. M. de Vries
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - G. Jager
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | | | - H. Weenen
- Danone Nutricia Research, P.O. Box 80141, 3508 TC Utrecht, The Netherlands
| | - N. van Winden
- Nutricia Early Life Nutrition, P.O. Box 445, 2700 AK Zoetermeer, The Netherlands
| | - M. S. van Vliet
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - J. M. Schultink
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - V. W. T. de Wild
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - S. Janssen
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
| | - J. Mesman
- Institute of Education and Child Studies (trial sponsor), Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands
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Barends C, Weenen H, Warren J, Hetherington MM, de Graaf C, de Vries JH. A systematic review of practices to promote vegetable acceptance in the first three years of life. Appetite 2019; 137:174-197. [DOI: 10.1016/j.appet.2019.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 01/14/2019] [Accepted: 02/08/2019] [Indexed: 12/18/2022]
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Spill MK, Johns K, Callahan EH, Shapiro MJ, Wong YP, Benjamin-Neelon SE, Birch L, Black MM, Cook JT, Faith MS, Mennella JA, Casavale KO. Repeated exposure to food and food acceptability in infants and toddlers: a systematic review. Am J Clin Nutr 2019; 109:978S-989S. [PMID: 30982874 DOI: 10.1093/ajcn/nqy308] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Repeated exposure has been found to be an effective strategy to increase acceptability of foods in older children and adults, but little is known about its effectiveness in the birth to 24-mo population. OBJECTIVES This systematic review was conducted to examine the effects of repeated exposure to a single or multiple foods on acceptance of those or other foods among infants and toddlers. METHODS A search was conducted for peer-reviewed articles related to food acceptability, flavor, taste, and infants and toddlers in 12 databases (e.g., PubMed, Embase, Cochrane, and CINAHL) with a date range of January 1980 to July 2017. The Nutrition Evidence Library (NEL) Bias Assessment Tool was used to assess potential bias in the included studies, and the NESR grading rubric was used to grade evidence supporting the conclusion statement. RESULTS From the 10,844 references obtained, 21 studies (19 controlled trials and 2 longitudinal cohort studies) published from 1980 to 2015 were included in this review. Moderate evidence indicates that tasting a single vegetable or fruit or multiple vegetable(s) or fruit(s) 1 food per day for 8-10 or more days is likely to increase acceptability of an exposed food (indicated by an increase in intake or faster rate of feeding after comparison with before the exposure period) in infants and toddlers 4-24 mo old. The effect of repeated exposure on acceptability is likely to generalize to other foods within the same food category but not foods from a different food category. Findings are based on the effects of repeated exposure to mostly vegetables with some findings on repeated exposure to fruits. CONCLUSION This review advances the understanding of early food experiences and the development of food acceptability. Additional research is needed using diverse foods and textures with a focus on the transition to table foods.
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Affiliation(s)
| | | | | | | | | | | | - Leann Birch
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine and RTI International, Baltimore, MD
| | - John T Cook
- Department of Pediatrics, Boston University School of Medicine, Boston, MA
| | - Myles S Faith
- Department of Counseling, School and Educational Psychology, Graduate School of Education, University at Buffalo, Buffalo, NY
| | | | - Kellie O Casavale
- United States Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Rockville, MD
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Appleton KM, Hemingway A, Rajska J, Hartwell H. Repeated exposure and conditioning strategies for increasing vegetable liking and intake: systematic review and meta-analyses of the published literature. Am J Clin Nutr 2018; 108:842-856. [PMID: 30321277 PMCID: PMC6186211 DOI: 10.1093/ajcn/nqy143] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/03/2018] [Accepted: 05/28/2018] [Indexed: 12/16/2022] Open
Abstract
Background Vegetable intakes are typically lower than recommended for health. Although repeated exposure has been advocated to increase vegetable liking and consumption, no combination of the evidence yet provides a measure of benefit from repeated exposure or alternative conditioning strategies. Objective This work aimed to identify and synthesize the current evidence for the use of repeated exposure and conditioning strategies for increasing vegetable liking and consumption. Design Three academic databases were searched over all years of records using prespecified search terms. Published data from all suitable articles were tabulated in relation to 3 research questions and combined via meta-analyses. Results Forty-three articles detailing 117 comparisons investigating the use of repeated exposure and conditioning strategies for increasing liking and intakes of vegetables were found. Our analyses demonstrate: 1) increased liking and intakes of the exposed vegetable after repeated exposure compared with no exposure; 2) increased liking for the exposed vegetable after conditioning compared with repeated exposure, increased intakes after the use of rewards, and some suggestion of decreased intakes after flavor-nutrient conditioning; and 3) increased liking and intakes of a novel vegetable after repeated exposure to a variety of other vegetables compared with no exposure or repeated exposure to one other vegetable. Effect sizes, however, are small, and limited evidence suggests long-term benefits. Our analyses, furthermore, are limited by limitations in study design, compliance, and/or reporting. Conclusions Based on our findings, we recommend the use of repeated exposure to one and a variety of vegetables, and the use of rewards, for increasing vegetable liking and consumption. Confirmation from further large, well-conducted studies that use realistic scenarios, however, is also required. This study was registered at PROSPERO as CRD42017056919.
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Affiliation(s)
- Katherine M Appleton
- Research Centre for Behaviour Change, Department of Psychology, Faculty of Science and Technology, Bournemouth University, Bournemouth, United Kingdom
| | - Ann Hemingway
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, United Kingdom
| | - Jessica Rajska
- Research Centre for Behaviour Change, Department of Psychology, Faculty of Science and Technology, Bournemouth University, Bournemouth, United Kingdom
| | - Heather Hartwell
- Faculty of Management, Bournemouth University, Bournemouth, United Kingdom
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Specht IO, Rohde JF, Olsen NJ, Heitmann BL. Duration of exclusive breastfeeding may be related to eating behaviour and dietary intake in obesity prone normal weight young children. PLoS One 2018; 13:e0200388. [PMID: 29995949 PMCID: PMC6040730 DOI: 10.1371/journal.pone.0200388] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/25/2018] [Indexed: 12/20/2022] Open
Abstract
Infants who are breastfed are introduced to a variety of flavours from the maternal milk, and thus the transition from maternal milk to complementary foods may be easier for these children. The aim of this study was to investigate if duration of exclusive breastfeeding was associated with pickiness or dietary intake of vegetables, fruit, starchy foods or sugar sweetened beverages among obesity prone normal weight children aged 2–6 years. This cohort study was based on data from the Healthy Start primary intervention study, the Danish Medical Birth registry and the Danish Health Visitor’s Child Health Database. Infant feeding was registered by health nurses while home-visiting the mother and child up to four times within the first year. Information on eating behaviour and diet intake at age 2–6 years was obtained by parents. Crude and adjusted logistic and general linear regression models were used to investigate associations. A total of 236 children had complete information on all variables. Data showed lower odds of picky eating behaviour when exclusively breastfed until age 4–5 months compared to exclusively breastfed for 0–1 months (OR = 0.35, 95CI = 0.16;0.76, p = 0.008). In the crude analysis only, exclusively breastfed until age 6–10 months was associated with a higher daily intake of vegetables (p = 0.04). This study suggests that exclusive breastfeeding duration seems to influence pickiness and may contribute to facilitate the consumption of more vegetables in later childhood in obesity prone normal weight children.
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Affiliation(s)
- Ina Olmer Specht
- The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Jeanett Friis Rohde
- The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Nanna Julie Olsen
- The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Berit Lilienthal Heitmann
- The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.,The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, Australia.,Department of Public Health, Section for General Medicine, University of Copenhagen, Copenhagen, Denmark
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Schwartz C, Vandenberghe-Descamps M, Sulmont-Rossé C, Tournier C, Feron G. Behavioral and physiological determinants of food choice and consumption at sensitive periods of the life span, a focus on infants and elderly. INNOV FOOD SCI EMERG 2018. [DOI: 10.1016/j.ifset.2017.09.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Costantini C, Harris G, Reddy V, Akehurst L, Fasulo A. Introducing Complementary Foods to Infants: Does Age Really Matter? A Look at Feeding Practices in Two European Communities: British and Italian. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/13575279.2017.1414033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Cristina Costantini
- Department of Psychology, Oxford Brookes University, Oxford, UK
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Gillian Harris
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Vasudevi Reddy
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Lucy Akehurst
- Department of Psychology, University of Portsmouth, Portsmouth, UK
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Evaluation of a pilot sensory play intervention to increase fruit acceptance in preschool children. Appetite 2018; 120:609-615. [DOI: 10.1016/j.appet.2017.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 07/14/2017] [Accepted: 10/06/2017] [Indexed: 11/17/2022]
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Abstract
PURPOSE OF REVIEW A sensitive period in development is one in which it is easier for learning to take place; the behaviour can however still be learned at a later stage, but with more difficulty. This is in contrast to a critical period, a time at which a behaviour must be learned, and if this window of opportunity is missed, then the behaviour can never be acquired. Both might determine food acceptance in childhood. RECENT FINDINGS There is evidence to support the idea of a sensitive period for the introduction of tastes, a critical period for the introduction of textures and for the development of oral motor function, and a possible critical period for the introduction of new foods but only in children where there is an innate disposition to develop early and extreme disgust responses. SUMMARY There are both sensitive and critical periods in the acquisition of food preferences.
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Affiliation(s)
- Gillian Harris
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Sarah Mason
- School of Psychology, University of Birmingham, Birmingham, UK
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Avery A, Anderson C, McCullough F. Associations between children's diet quality and watching television during meal or snack consumption: A systematic review. MATERNAL AND CHILD NUTRITION 2017; 13. [PMID: 28211230 DOI: 10.1111/mcn.12428] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 11/26/2022]
Abstract
Studies have identified an association between watching television (TV) and childhood obesity. This review adds context to existing research by examining the associations between TV viewing, whilst eating, and children's diet quality. Web of Science and PubMed databases were searched from January 2000 to June 2014. Cross-sectional trials of case control or cohort studies, which included baseline data, measuring the associations between eating whilst watching TV and children's food and drink intake. Quality of selected papers was assessed. Thirteen studies, representing 61,674 children aged 1-18 yrs, met inclusion criteria. Of six studies reporting overall food habits, all found a positive association between TV viewing and consumption of pizza, fried foods, sweets, and snacks. Of eight studies looking at fruit and vegetable consumption, seven identified a negative association with eating whilst watching TV (p < .0001). Four out of five studies identified a positive association between watching TV whilst eating and servings of sugar-sweetened beverages (p < .0001). Four studies identified an association between low socioeconomic status and increased likelihood of eating whilst watching TV (p ≤ .01). Family meals did not overcome the adverse impact on diet quality of having the TV on at mealtimes. Eating whilst watching television is associated with poorer diet quality among children, including more frequent consumption of sugar-sweetened beverages and high-fat, high-sugar foods and fewer fruits and vegetables. Although these differences in consumption are small, the cumulative effect may contribute to the positive association between eating whilst watching TV and childhood obesity.
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Affiliation(s)
- Amanda Avery
- Division of Nutritional Sciences, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Catherine Anderson
- Division of Nutritional Sciences, School of Biosciences, University of Nottingham, Nottingham, UK
| | - Fiona McCullough
- Division of Nutritional Sciences, School of Biosciences, University of Nottingham, Nottingham, UK
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Longfier L, Soussignan R, Reissland N, Leconte M, Marret S, Schaal B, Mellier D. Emotional expressiveness of 5–6 month-old infants born very premature versus full-term at initial exposure to weaning foods. Appetite 2016; 107:494-500. [DOI: 10.1016/j.appet.2016.08.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 01/07/2023]
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Complementary Feeding Strategies to Facilitate Acceptance of Fruits and Vegetables: A Narrative Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111160. [PMID: 27869776 PMCID: PMC5129370 DOI: 10.3390/ijerph13111160] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 11/15/2016] [Accepted: 11/16/2016] [Indexed: 12/17/2022]
Abstract
Complementary feeding (CF), which should begin after exclusive breastfeeding for six months, according to the World Health Organization (WHO), or after four months and before six months according to the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), is a period when the infant implicitly learns what, when, how, and how much to eat. At the onset of CF, the brain and the gut are still developing and maturing, and food experiences contribute to shaping brain connections involved in food hedonics and in the control of food intake. These learning processes are likely to have a long-term impact. Children’s consumption of fruit and vegetables (FV) is below recommendations in many countries. Thus, it is crucial to establish preferences for FV early, when infants are learning to eat. The development of food preferences mainly starts when infants discover their first solid foods. This narrative review summarizes the factors that influence FV acceptance at the start of the CF period: previous milk feeding experience; timing of onset of CF; repeated exposures to the food; variety of foods offered as of the start of the CF period; quality and sensory properties of the complementary foods; quality of the meal time context; and parental responsive feeding.
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Chambers L, Hetherington M, Cooke L, Coulthard H, Fewtrell M, Emmett P, Lowdon J, Blissett J, Lanigan J, Baseley C, Stanner S. Reaching consensus on a ‘vegetables first’ approach to complementary feeding. NUTR BULL 2016. [DOI: 10.1111/nbu.12220] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - L. Cooke
- University College London; London UK
| | | | - M. Fewtrell
- Department of Paediatric Nutrition; UCL Institute of Child Health; London UK
| | | | - J. Lowdon
- Manchester Children's Hospital; Manchester UK
| | - J. Blissett
- Childhood Eating Behaviour; University of Birmingham; Birmingham UK
| | - J. Lanigan
- UCL Institute of Child Health; London UK
| | - C. Baseley
- Consultant Nutritionist; representing Ella's Kitchen; UK
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Le Heuzey MF, Turberg-Romain C. Nutri-bébé 2013 Study Part 3. Nutri-Bébé Survey 2013:3/Behaviour of mothers and young children during feeding. Arch Pediatr 2016; 22:10S20-9. [PMID: 26474670 DOI: 10.1016/s0929-693x(15)30742-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This new study by the Secteur français des aliments de l'enfance (SFAE) (French Agency for Children's Foods) confirms the improvement in the nutritional environment of young children, particularly in sharing family meals. Incorporating the sample of breastfed children is a new feature, although food refusal behavior in infants did not appear to differ greatly whether or not they were being breastfed, and mothers expressed a need to be informed and guided in order for their children to better accept varied foods. We still found long-term continuation of feeding bottles and in parallel excessively early introduction of adult foods and significant and inappropriate viewing of screens for age.
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Affiliation(s)
- M-F Le Heuzey
- Service de psychiatrie de l'enfant et de l'adolescent, Hôpital Robert Debré, 48 boulevard, Sérurier, 75019 Paris, France.
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Age at introduction of solid foods and feeding difficulties in childhood: findings from the Southampton Women's Survey. Br J Nutr 2016; 116:743-50. [PMID: 27356464 DOI: 10.1017/s0007114516002531] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study aimed to determine whether age at introduction of solid foods was associated with feeding difficulties at 3 years of age. The present study was carried out using data from the Southampton Women's Survey (SWS). Women enrolled in the SWS who subsequently became pregnant were followed-up during pregnancy and postpartum, and the offspring have been studied through childhood. Maternal socio-demographic and anthropometric data and child anthropometric and feeding data were collected through interviews and self-administered questionnaires. When the children were 3 years of age, mothers/carers rated six potential child feeding difficulty questions on a four-point Likert scale, including one general question and five specific feeding difficulty questions. Age at introduction of solids as a predictor of feeding difficulties was examined in 2389 mother-child pairs, adjusting for child (age last breast fed, sex, gestation) and maternal characteristics (parity, pre-pregnancy BMI, age, education, employment, parenting difficulties, diet quality). The majority of mothers/carers (61 %) reported some feeding difficulties (general feeding difficulty question) at 3 years of age, specifically with their child eating enough food (61 %), eating the right food (66 %) and being choosy with food (74 %). Children who were introduced to solids ≥6 months had a lower risk of feeding difficulties (RR 0·73; 95 % CI 0·59, 0·91, P=0·004) than children who were introduced to solids between 4 and 6 months. No other significant associations were found. There were few associations between feeding difficulties in relation to age at introduction of solid foods. However, general feeding difficulties were less common among infants introduced to solid foods ≥6 months of age.
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Rapley G. Are puréed foods justified for infants of 6 months? What does the evidence tell us? ACTA ACUST UNITED AC 2016. [DOI: 10.12968/johv.2016.4.6.289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gill Rapley
- Writer, part-time lecturer, Canterbury Christ Church University
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Harris G, Coulthard H. Early Eating Behaviours and Food Acceptance Revisited: Breastfeeding and Introduction of Complementary Foods as Predictive of Food Acceptance. Curr Obes Rep 2016; 5:113-20. [PMID: 26956951 PMCID: PMC4796330 DOI: 10.1007/s13679-016-0202-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Current dietary advice for children is that they should eat at least five portions of fruit and vegetables a day (Department of Health. National Diet and Nutrition Survey, 2014). However, many parents report that children are reluctant to eat vegetables and often fail to comply with the five-a-day rule. In fact, in surveys carried out in areas in the UK, the number of children eating according to the five-a-day rule has been found to be as low as 16 % (Cockroft et al. Public Health Nutr 8(7):861-69, 2005). This narrative review looks at those factors which contribute to food acceptance, especially fruit and vegetables, and how acceptance might be enhanced to contribute to a wider dietary range in infancy and later childhood. The questions we address are whether the range of foods accepted is determined by the following: innate predispositions interacting with early experience with taste and textures, sensitive periods in infancy for introduction, breastfeeding and the pattern of introduction of complementary foods. Our conclusions are that all of these factors affect dietary range, and that both breastfeeding and the timely introduction of complementary foods predict subsequent food acceptance.
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Affiliation(s)
- Gillian Harris
- />School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Helen Coulthard
- />Division of Psychology, De Montfort University, Leicester, LE1 9BH UK
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Increasing vegetable intakes: rationale and systematic review of published interventions. Eur J Nutr 2016; 55:869-96. [PMID: 26754302 PMCID: PMC4819941 DOI: 10.1007/s00394-015-1130-8] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 12/06/2015] [Indexed: 02/07/2023]
Abstract
Purpose
While the health benefits of a high fruit and vegetable consumption are well known and considerable work has attempted to improve intakes, increasing evidence also recognises a distinction between fruit and vegetables, both in their impacts on health and in consumption patterns. Increasing work suggests health benefits from a high consumption specifically of vegetables, yet intakes remain low, and barriers to increasing intakes are prevalent making intervention difficult. A systematic review was undertaken to identify from the published literature all studies reporting an intervention to increase intakes of vegetables as a distinct food group. Methods Databases—PubMed, PsychInfo and Medline—were searched over all years of records until April 2015 using pre-specified terms. Results Our searches identified 77 studies, detailing 140 interventions, of which 133 (81 %) interventions were conducted in children. Interventions aimed to use or change hedonic factors, such as taste, liking and familiarity (n = 72), use or change environmental factors (n = 39), use or change cognitive factors (n = 19), or a combination of strategies (n = 10). Increased vegetable acceptance, selection and/or consumption were reported to some degree in 116 (83 %) interventions, but the majority of effects seem small and inconsistent. Conclusions Greater percent success is currently found from environmental, educational and multi-component interventions, but publication bias is likely, and long-term effects and cost-effectiveness are rarely considered. A focus on long-term benefits and sustained behaviour change is required. Certain population groups are also noticeably absent from the current list of tried interventions.
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