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Ruggiero CF, Trexberg KM, Moore AM, Savage JS. Applying the Family Stress Model to responsive feeding and early obesity prevention. Appetite 2024; 200:107515. [PMID: 38797237 DOI: 10.1016/j.appet.2024.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kaitlin M Trexberg
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
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Richardson TN, Reis P, Swanson M. Mental Health and Feeding Styles in Parents of Formula-Fed Infants. Child Obes 2024; 20:178-187. [PMID: 37130301 PMCID: PMC10979682 DOI: 10.1089/chi.2022.0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background: Nonresponsive feeding styles can contribute to rapid weight gain in infancy and subsequent obesity in childhood. There is a need to investigate factors such as parental mental health symptoms (stress, depression, and anxiety) that may contribute to nonresponsive feeding styles. The purpose of this study was to investigate the relationship between parental mental health symptoms and feeding styles in parents of healthy, term formula-fed infants during the first year of life. Methods: A cross-sectional, descriptive correlational design was employed using online surveys. We recruited participants through Facebook groups and pediatricians' offices. Instruments included a demographic questionnaire, the Perceived Stress Scale-10, Patient Health Questionnaire-Depression Module-9, 7-item Generalized Anxiety Disorder Assessment, and Infant Feeding Style Questionnaire. Results: Participants were 306 parents of formula-fed infants. Greater depressive symptoms was the strongest predictor of the pressuring style (β = 0.54), while greater symptoms of stress (β = -0.13) and anxiety (β = -0.28) were associated with lower pressuring scores. Greater depressive symptoms was the strongest predictor of the laissez-faire style (β = 0.48), while greater symptoms of stress (β = -0.17) and anxiety (β = -0.23) were associated with lower laissez-faire scores. Engaging in ≤50% of the infant's feeds was the strongest control variable predictor for the pressuring and laissez-faire styles. None of the mental health variables were significantly related to the restrictive style. Conclusions: We recommend increased screening for depressive symptoms in parents of infants and responsive feeding support, especially for those experiencing depressive symptoms.
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Affiliation(s)
| | - Pamela Reis
- College of Nursing, East Carolina University, Greenville, NC, USA
| | - Mel Swanson
- College of Nursing, East Carolina University, Greenville, NC, USA
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3
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Duh-Leong C, Canfield CF, Fuller AE, Gross RS, Reichman NE. Early Childcare Precarity and Subsequent Maternal Health. Womens Health Issues 2024; 34:115-124. [PMID: 37978038 PMCID: PMC10978296 DOI: 10.1016/j.whi.2023.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/30/2023] [Accepted: 10/05/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE We examined prospective associations between early childcare precarity, or the security and reliability of childcare arrangements, and subsequent maternal health. STUDY DESIGN We conducted a secondary analysis of survey responses from mothers of 2,836 children in the Future of Families and Child Wellbeing study. We assessed the following childcare measures: insecure childcare, insecure childcare with missed work, inadequate childcare, and emergency childcare support. We used linear and logistic regression models with robust standard errors to examine associations between these measures when the index child was age 3 and maternal health outcomes (overall health, depression, and parenting stress) later when the child was age 9. We then examined additive experiences of childcare measures across child ages 1 and 3 on maternal health outcomes. RESULTS Early inadequate childcare was associated with higher odds of later poor maternal overall health (adjusted odds ratio [aOR], 1.64; 95% confidence interval [CI], 1.11-2.41). All early childcare precarity measures were associated with higher odds of maternal depression (insecure childcare [aOR, 1.64; 95% CI, 1.23-2.18]; insecure childcare with missed work [aOR, 1.58; 95% CI, 1.13-2.22]; and inadequate childcare [aOR, 1.75; 95% CI, 1.22-2.51]). Emergency childcare support was associated with lower odds of adverse maternal health outcomes (poor overall health [aOR, 0.65; 95% CI, 0.48 to 0.88]; depression [aOR, 0.73; 95% CI, 0.54 to 0.99]; and parenting stress [B -0.45; 95% CI, -0.80 to -0.10]). Prolonged experiences had stronger associations with maternal health than shorter experiences. CONCLUSION Early childcare precarity has long-term adverse associations with maternal health, and emergency childcare support seems to be favorable for maternal health. These findings highlight childcare precarity as a social determinant of women's health for researchers, clinicians, and decision-makers.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York.
| | - Caitlin F Canfield
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | - Anne E Fuller
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | - Nancy E Reichman
- Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey; Child Health Institute of New Jersey, Rutgers University, New Brunswick, New Jersey
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4
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Cruz Herrera E, Figueroa-Nieves AI, Woo Baidal JA. The potential role of social care in reducing childhood obesity. Curr Opin Pediatr 2024; 36:10-16. [PMID: 37972976 DOI: 10.1097/mop.0000000000001309] [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: 11/19/2023]
Abstract
PURPOSE OF REVIEW This review evaluates the current evidence for relationships of social factors with childhood obesity and for a role of social care in reduction of childhood obesity. RECENT FINDINGS Most literature on the relationship between social factors and childhood obesity has examined food insecurity as a risk factor for obesity. Associations between food insecurity and excess weight in children are most consistent during infancy and among those with food insecurity at more than one time point. A few pilot food security interventions that link patients with produce or groceries show feasibility and potential promise for reducing childhood obesity risk factors. However, full-scale, randomized studies to examine interventions that reduce social needs and their effects on childhood obesity are lacking. Future research is needed to examine holistic social care approaches to effectively reduce childhood obesity risk factors. SUMMARY Food insecurity acts as a barrier to childhood obesity prevention and treatment. Patient-centered, validated measures of social needs and effective interventions to address social needs are needed to equitably prevent and treat childhood obesity.
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Affiliation(s)
- Evianna Cruz Herrera
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Irving Medical Center and NewYork-Presbyterian, New York, New York, USA
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Duh-Leong C, Ortiz R, Messito MJ, Katzow MW, Kim CN, Teli R, Gross RS. Household Food Insecurity and Maternal-Toddler Fruit and Vegetable Dietary Concordance. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:100-109. [PMID: 38142387 PMCID: PMC10922249 DOI: 10.1016/j.jneb.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE To examine whether prenatal or concurrent household food insecurity influences associations between maternal and toddler fruit and vegetable (FV) intake. DESIGN Application of a life-course framework to an analysis of a longitudinal dataset. SETTING Early childhood obesity prevention program at a New York City public hospital. PARTICIPANTS One-hundred and fifty-six maternal-toddler dyads self-identifying as Hispanic or Latino. VARIABLES MEASURED Maternal and toddler FV intake was measured using Centers for Disease Control and Prevention dietary measures when toddlers were aged 19 months. Household food insecurity (measured prenatally and concurrently at 19 months) was measured using the US Department of Agriculture Food Security Module. ANALYSIS Regression analyses assessed associations between adequate maternal FV intake and toddler FV intake. Interaction terms tested whether prenatal or concurrent household food insecurity moderated this association. RESULTS Adequate maternal FV intake was associated with increased toddler FV intake (B = 6.2 times/wk, 95% confidence interval, 2.0-10.5, P = 0.004). Prenatal household food insecurity was associated with decreased toddler FV intake (B = -6.3 times/wk, 95% confidence interval, -11.67 to -0.9, P = 0.02). There was a significant interaction between the level of maternal-toddler FV association (concordance or similarity in FV intake between mothers and toddlers) and the presence of food insecurity such that maternal-toddler FV association was greater when prenatal household food insecurity was not present (B = -11.6, P = 0.04). CONCLUSIONS AND IMPLICATIONS Strategies to increase FV intake across the life course could examine how the timing of household food insecurity may affect intergenerational maternal-child transmission of dietary practices.
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Affiliation(s)
- Carol Duh-Leong
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY.
| | - Robin Ortiz
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY; Institute for Excellence in Health Equity, New York University Langone Health, New York, NY
| | - Mary Jo Messito
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY
| | - Michelle W Katzow
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY
| | - Christina N Kim
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Radhika Teli
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Rachel S Gross
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY; Department of Population Health, New York University Grossman School of Medicine, New York, NY
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Kopp SJ, Kelly EA, DeFranco EA. Influence of social determinants of health on breastfeeding intent in the United States. Birth 2023; 50:858-867. [PMID: 37395480 DOI: 10.1111/birt.12740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 05/25/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Breastfeeding rates in the United States are suboptimal despite public health recommendations that infants are fed breastmilk for their first year of life. This study aimed to characterize the influence of social determinants of health on intended breastfeeding duration. METHODS This case-control study analyzed breastfeeding intent in 421 postpartum women. Data on social determinants and medical history were obtained from medical records and participant self-report. Logistic regression estimated the influence of demographic factors and social determinants on intent to breastfeed for durations of <6 months, 6-12 months, and at least 1 year. RESULTS Thirty-five percent of mothers intended to breastfeed for at least 6 months, and 15% for 1 year. Social determinants that negatively predicted breastfeeding intent included not owning transportation and living in a dangerous neighborhood (p < 0.05). Women were more likely to intend to breastfeed for 12 months if they had knowledge of breastfeeding recommendations (adjusted odds ratio [aOR] 6.19, 95% confidence interval [CI 2.67-14.34]), an identifiable medical provider (aOR 2.64 [CI 1.22-5.72]), familial support (aOR 2.80 [CI 1.01-7.80]), or were married (aOR 2.55 [CI 1.01-6.46]). Sociodemographic factors that negatively influenced breastfeeding intent included non-Hispanic Black race, no high school diploma, cigarette use, income below $20,000, fewer than five prenatal visits, and WIC or Medicaid enrollment (p < 0.05). CONCLUSIONS Women who lack familial support, an identifiable healthcare provider, or knowledge of breastfeeding guidelines are less likely to intend to breastfeed. Public health initiatives should address these determinants to improve breastfeeding and infant outcomes.
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Affiliation(s)
- Sarah J Kopp
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Elizabeth A Kelly
- Division of General Obstetrics and Gynecology, Department of Clinical Obstetrics and Gynecology, Women's Community Health Services, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Emily A DeFranco
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Cheng ER, Luo M, Perkins M, Blake-Lamb T, Kotelchuck M, Arauz Boudreau A, Taveras EM. Household food insecurity is associated with obesogenic health behaviours among a low-income cohort of pregnant women in Boston, MA. Public Health Nutr 2023; 26:943-951. [PMID: 35321774 PMCID: PMC9508288 DOI: 10.1017/s1368980022000714] [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: 09/24/2021] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine associations of household food insecurity with health and obesogenic behaviours among pregnant women enrolled in an obesity prevention programme in the greater Boston area. DESIGN Cross-sectional evaluation. Data were collected from structured questionnaires that included a validated two-item screener to assess household food insecurity. We used separate multivariable linear and logistic regression models to quantify the association between household food insecurity and maternal health behaviours (daily consumption of fruits and vegetables, sugar-sweetened beverages and fast food, physical activity, screen time, and sleep), mental health outcomes (depression and stress), hyperglycaemia status and gestational weight gain. SETTING Three community health centres that primarily serve low-income and racial/ethnic minority patients in Revere, Chelsea and Dorchester, Massachusetts. PARTICIPANTS Totally, 858 pregnant women participating in the First 1,000 Days program, a quasi-experimental trial. RESULTS Approximately 21 % of women reported household food insecurity. In adjusted analysis, household food insecurity was associated with low fruit and vegetable intake (β = -0·31 daily servings; 95 % CI -0·52, -0·10), more screen time (β = 0·32 daily hours; 95 % CI 0·04, 0·61), less sleep (β = -0·32 daily hours; 95 % CI -0·63, -0·01), and greater odds of current (adjusted odds ratio (AOR) 4·42; 95 % CI 2·33, 8·35) or past depression (AOR 3·01; 95 % CI 2·08, 4·35), and high stress (AOR 2·91; 95 % CI 1·98, 4·28). CONCLUSIONS In our sample of mostly low-income, racial/ethnic minority pregnant women, household food insecurity was associated with mental health and behaviours known to increase the likelihood of obesity.
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Affiliation(s)
- Erika R Cheng
- Division of Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine, 410 W. 10th Street, Suite 2000, Indianapolis, IN46220, USA
| | - Mandy Luo
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Meghan Perkins
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Tiffany Blake-Lamb
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Milton Kotelchuck
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Alexy Arauz Boudreau
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA
- Kraft Center for Community Health, Massachusetts General Hospital, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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8
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Frazier CM, Dharod J, Labban J, Raynor AN, Villasenor M, Hernandez M, Ramos-Castillo I. Breastfeeding: How is it related to food insecurity and other factors among low-income mothers? Health Care Women Int 2023; 44:234-245. [PMID: 34280071 PMCID: PMC10719584 DOI: 10.1080/07399332.2021.1929992] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/18/2021] [Accepted: 05/11/2021] [Indexed: 10/20/2022]
Abstract
A cross-sectional study was conducted to (1) examine breastfeeding initiation and continuation rates, and; (2) investigate association between food insecurity and breastfeeding status, among low-income mothers. Mothers of infants two-months or younger were recruited from a local pediatric clinic serving primarily low-income families. Upon giving consent, mothers were interviewed in-person or over the phone in either English or Spanish. Of the total 92 mothers interviewed, 90% initiated breastfeeding, but only 24% were doing exclusive breastfeeding at 2 months of infant's age. After controlling for socio-demographics, it was found that food-insecure mothers were less likely to continue with breastfeeding (β = -1.51, p = .024). Future research is warranted to understand pathways through which food insecurity affects breastfeeding and how this disparity can be prevented to ensure a safe and secure start for infants worldwide.
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Affiliation(s)
- Christina M Frazier
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Jigna Dharod
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Jeff Labban
- Offices of Research, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - A Nichole Raynor
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Miguel Villasenor
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Marlen Hernandez
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
| | - Isa Ramos-Castillo
- Department of Nutrition, University of North Carolina at Greensboro School of Health and Human Sciences, Greensboro, NC, USA
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Eagleton SG, Shriver LH, Buehler C, Wideman L, Leerkes EM. Longitudinal Associations Among Food Insecurity During Pregnancy, Parental Mental Health Symptoms, Controlling Feeding Styles, and Infant Food Responsiveness. J Nutr 2023; 152:2659-2668. [PMID: 36166350 PMCID: PMC9840003 DOI: 10.1093/jn/nxac225] [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: 03/24/2022] [Revised: 09/09/2022] [Accepted: 09/23/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Research is needed to identify pathways by which household food insecurity (FI) contributes to parental controlling feeding styles and infant food responsiveness, 2 factors that play a role in shaping obesity risk across infancy and early childhood. OBJECTIVES This longitudinal study tested the hypothesis that prenatal FI would be positively associated with higher infant food responsiveness via greater parental mental health symptomatology and controlling feeding styles (pressuring, restrictive). METHODS Participants included a community sample of 170 birth parents and their infants participating in an ongoing longitudinal study. Parents self-reported household FI and mental health symptoms (depression and anxiety) during pregnancy. Postnatally, parents reported their mental health symptoms, their use of controlling feeding styles, and infant food responsiveness. Path analyses with bias-corrected 95% bootstrapped CIs tested direct and indirect associations between prenatal FI and infant food responsiveness. RESULTS Prenatal FI was indirectly associated with higher infant food responsiveness via greater parental mental health symptomatology and pressuring to finish (b = 0.01; 95% CI: 0.001, 0.025). Prenatal FI was associated with greater parental mental health symptomatology across the peripartum period (β = 0.54; P < 0.001), which in turn was associated with more pressuring to finish at 2 months pospartum (β = 0.29; P = 0.01) and higher infant food responsiveness at 6 months (β = 0.17; P = 0.04). There were no direct effects of prenatal FI on controlling feedings styles or infant food responsiveness. CONCLUSIONS Our findings point to parental mental health as a potential pathway by which FI may be associated with obesity-promoting parental feeding styles and infant appetitive behaviors. In addition to ensuring reliable access to enough quality food during pregnancy, multipronged assistance that promotes emotional well-being during the peripartum period and clinical guidance on noncontrolling feeding styles could benefit parent and infant health and well-being.
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Affiliation(s)
- Sally G Eagleton
- Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Lenka H Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Cheryl Buehler
- Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Esther M Leerkes
- Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, NC, USA
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10
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Khalsa AS, Copeland KA, Kharofa RY, Geraghty SR, Dewitt TG, Woo JG. The Longitudinal Relation between Infant Feeding Styles and Growth Trajectories among Families from Low-Income Households. J Nutr 2022; 152:2015-2022. [PMID: 35641195 DOI: 10.1093/jn/nxac123] [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: 03/01/2022] [Revised: 04/11/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Parental feeding styles, including the emotional environment parents create to modify a child's eating behaviors, have been associated with measures of adiposity in cross-sectional studies. The longitudinal relation between parental feeding styles in early infancy and adiposity in later infancy/toddlerhood are scant and have shown mixed results, particularly in families from low-income households. OBJECTIVES This study examined the relation between parental feeding styles and infant BMI z-score trajectories between 6 and 18 mo in families from low-income households. METHODS Parent-infant dyads were recruited during the infant's 6-, 9-, or 12-mo well-child visit. Feeding styles were assessed using the Infant Feeding Style Questionnaire (IFSQ). Infant anthropometrics from birth through 18 mo were extracted from the electronic medical record. BMI z-score slopes were estimated for each infant between 0-6 mo and 6-18 mo. Associations between feeding styles and BMI z-score slopes were examined using mixed models controlling for demographic, clinical, and feeding covariates. RESULTS The final analytic sample included 198 dyads (69% Black; median infant age: 9.0 mo; IQR: 6.8-10.3 mo). The predominant parent feeding styles included the following: laissez-faire (30%), restrictive (28%), responsive (23%), and pressuring (19%). In adjusted models, the predominant feeding style at enrollment was associated with the BMI z-score slope between 6 and 18 mo, with the responsive feeding style exhibiting a steeper increase in BMI z-score than other feeding styles. Infant feeding style was not associated with BMI z-score slope between birth and 6 mo of age. Infants of parents who exhibited restrictive feeding styles were more likely to have a BMI ≥85th percentile at their last measurement. CONCLUSIONS The predominant parent feeding style during infancy in a low-income population was associated with infant BMI z-score between 6 and 18 mo of age, but not earlier. Further studies are needed to better understand how predictive factors collectively contribute to BMI increase in the first 2 y.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Primary Care Pediatrics and Center for Child Health Equity and Outcomes Research, Nationwide Children's Hospital, Columbus, OH.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH
| | - Kristen A Copeland
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Roohi Y Kharofa
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Sheela R Geraghty
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Thomas G Dewitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jessica G Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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11
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Coleta H, Schincaglia RM, Gubert MB, Pedroso J. Factors associated with infant feeding styles in the Federal District, Brazil. Appetite 2022; 179:106290. [DOI: 10.1016/j.appet.2022.106290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/10/2022] [Accepted: 08/26/2022] [Indexed: 01/21/2023]
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12
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Luo W, Cai Q, Zhou Y, Cai Y, Song H, Zhang Y, Chen Y, Liao Y. Variation of parental feeding practices during the COVID-2019 pandemic: a systematic review. BMC Public Health 2022; 22:1600. [PMID: 35999552 PMCID: PMC9395808 DOI: 10.1186/s12889-022-14027-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/19/2022] [Indexed: 01/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is highly contagious and has resulted in a protracted pandemic. Infections caused by new coronavirus strains, primarily Delta and Omicron and currently highly prevalent globally. In response to the epidemic, countries, and cities implemented isolation and quarantine guidance, such as limiting social contact, which have affected the lifestyles and quality of life of the population. Parental feeding behaviors may vary as a result of factors such as prolonged home isolation of parents and children, lack of supplies during isolation, and stress. This study was designed to assess the available evidence and its implications for parental feeding practices in the context of COVID-19. We screened and reviewed research published in five electronic databases between 2020 and 2022, and eight studies met the selection criteria. Parents were observed to use a variety of feeding practices, including high levels of coercive control and reduction of rules and limits according to Vaughn’s food parenting constructs. The findings suggest that parental feeding practices are changing as a result of the pandemic and that more research is needed to further explore how to provide supportive feeding guidance to parents during emergencies in order to jointly promote child health.
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Affiliation(s)
- Wen Luo
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
| | - Qian Cai
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
| | - You Zhou
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yepeng Cai
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
| | - Huizi Song
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yiran Zhang
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yuying Chen
- Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yuexia Liao
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China.
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13
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Balantekin KN, Moore AM, Ruggiero CF, Savage JS. A synthesis of early antecedents of eating behavior and weight status in girls: The legacy of girls' NEEDS project. Appetite 2022; 175:106052. [PMID: 35483476 PMCID: PMC9913538 DOI: 10.1016/j.appet.2022.106052] [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: 12/22/2021] [Revised: 03/18/2022] [Accepted: 04/12/2022] [Indexed: 01/27/2023]
Abstract
Dr. Leann Birch, an innovator in the field of children's eating behavior, was the first scientist to synergize the fields of developmental psychology and nutrition science. One of Leann's groundbreaking projects was the Girls' NEEDS Project (GNP), an NIH-funded observational study of the longitudinal development of eating and weight-related behaviors of girls across middle childhood and adolescence. At the time of GNP, obesity prevalence during childhood had roughly doubled during the previous two decades, research interest in dieting had increased as societal expectations of the 'thin ideal' got even thinner, and little was known about how environmental factors such as parenting influenced the development of maladaptive eating and weight-related behaviors. GNP resulted in over 70 publications, covering a range of topics from girls' dietary intake and physical activity to parental influences on girls' eating behavior, thus laying the groundwork for many topics in the obesity, food parenting, and dieting literature today. Therefore, this narrative review aims to summarize and synthesize the literature that resulted from the GNP and provide implications for future work building from this foundation.
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Affiliation(s)
- Katherine N Balantekin
- Department of Exercise and Nutrition Sciences, University at Buffalo, 3435 Main Street, Buffalo, NY, 14214, USA; Center for Ingestive Behavior Research, University at Buffalo, 355 Hochstetter Hall, Buffalo, NY, 14260, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA
| | - Cara F Ruggiero
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
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Buehler C, Girod SA, Leerkes EM, Bailes L, Shriver LH, Wideman L. Women's Social Well-Being During Pregnancy: Adverse Childhood Experiences and Recent Life Events. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:582-592. [PMID: 35814611 PMCID: PMC9258794 DOI: 10.1089/whr.2022.0023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse experiences during childhood and recent stressful life events are each associated with women's reduced well-being and poorer health during pregnancy. Few studies, however, have focused upon pregnant women's social well-being, and inclusion of both independent variables in the same analysis is rare. This study focuses upon adverse experiences during childhood as well as recent life events in relationship to four aspects of social well-being: social support, couple aggression for partnered women, neighborhood safety, and food insecurity. MATERIALS AND METHODS A diverse community sample of 176 pregnant women completed questionnaires during their third trimester. A cross-sectional design was used that included retrospective reports of childhood experiences, as well as reports of recent life events and current well-being. RESULTS Adverse experiences during childhood were uniquely associated with couple aggression (β = 0.206, p = 0.026) and lower neighborhood safety (β = -0.185, p = 0.021). Recent stressful life events were uniquely associated with lower social support (β = -0.247, p = 0.001) and greater food insecurity (β = 0.494, p = 0.000). For social support and food insecurity, there was a significant indirect pathway from adverse childhood experiences through recent stressful life events. Adverse child experiences and recent stressful life events did not interact. CONCLUSIONS A life-course perspective that considers women's experiences across their life span is critical for use by both researchers and health practitioners. Adverse childhood experiences and recent stressful life events are important for understanding social features of pregnant women's daily lives.
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Affiliation(s)
- Cheryl Buehler
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Savannah A. Girod
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Esther M. Leerkes
- Department of Human Development and Family Studies, University of North Carolina Greensboro, Greensboro, North Carolina, USA
- School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Lauren Bailes
- Department of Psychological Sciences, Vanderbilt University, Nashville, Tennessee, USA
| | - Lenka H. Shriver
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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15
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Baxter KA, Nambiar S, So THJ, Gallegos D, Byrne R. Parental Feeding Practices in Families Experiencing Food Insecurity: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095604. [PMID: 35564998 PMCID: PMC9099728 DOI: 10.3390/ijerph19095604] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 01/16/2023]
Abstract
Parental feeding practices and styles influence child diet quality and growth. The extent to which these factors have been assessed in the context of disadvantage, particularly household food insecurity (HFI), is unknown. This is important, as interventions designed to increase responsive practices and styles may not consider the unique needs of families with HFI. To address this gap, a scoping review of studies published from 1990 to July 2021 in three electronic databases was conducted. A priori inclusion criteria were, population: families with children aged 0–5 years experiencing food insecurity and/or disadvantage; concept: parental feeding practices/behaviours/style; and context: high income countries. The search identified 12,950 unique papers, 504 full-text articles were screened and 131 met the inclusion criteria. Almost all the studies (91%) were conducted in the United States with recruitment via existing programs for families on low incomes. Only 27 papers assessed feeding practices or styles in the context of HFI. Of the eleven interventions identified, two assessed the proportion of participants who were food insecure. More research is required in families outside of the United States, with an emphasis on comprehensive and valid measures of HFI and feeding practices. Intervention design should be sensitive to factors associated with poverty, including food insecurity.
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Affiliation(s)
- Kimberley A. Baxter
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
- Correspondence:
| | - Smita Nambiar
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove 4059, Australia
| | - Tsz Hei Jeffrey So
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
| | - Danielle Gallegos
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
| | - Rebecca Byrne
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove 4059, Australia
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16
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McCurdy K, Gans KM, Risica PM, Fox K, Tovar A. Food insecurity, food parenting practices, and child eating behaviors among low-income Hispanic families of young children. Appetite 2022; 169:105857. [PMID: 34896386 PMCID: PMC8748423 DOI: 10.1016/j.appet.2021.105857] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 02/03/2023]
Abstract
Food insecurity is associated with negative food parenting practices that may promote child obesity, including pressure to eat and food restriction. Less is known about the relationship between food insecurity and positive food parenting practices, including exposing the child to new foods and involving the child in food preparation. Further, few studies have investigated the associations between food insecurity and child eating behaviors that have been linked to poor dietary outcomes. Using baseline data collected as part of a larger pilot intervention, we examined the relationships between food security status, food parenting practices, and child eating behaviors in a predominately Hispanic, low-income sample of parents and their preschool aged children (n = 66). Between July of 2019 and 2020, caregivers recruited from 4 urban communities in Rhode Island completed assessments of household food security, food parenting practices, and four child eating behaviors: food responsiveness, emotional overeating, enjoyment of food, and satiety responsiveness. Although 46% of caregivers reported food insecurity, food insecurity was not directly associated with any food parenting practice. Children in food insecure households were rated as higher in levels of food responsiveness and enjoyment of food as compared to children in food secure households. Children in food insecure households were rated as lower in satiety responsiveness as compared to children in food secure households. Child emotional overeating did not vary by food security status. Future interventions to reduce child obesity among low-income Hispanic families should assess food security status and consider any level of food insecurity as a potential signal of unhealthy child eating behaviors.
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Affiliation(s)
- Karen McCurdy
- Department of Human Development & Family Science, University of Rhode Island, Kingston, RI 02881, USA,Corresponding author: Karen McCurdy, Human Development & Family Science, University of Rhode Island, 2 Lower College Road, Kingston, RI 02881 USA;
| | - Kim M. Gans
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Patricia Markham Risica
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA
| | - Katelyn Fox
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA
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17
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Canavan CR, D'cruze T, Kennedy MA, Hatchell KE, Boardman M, Suresh A, Goodman D, Dev A. Missed opportunities to improve food security for pregnant people: a qualitative study of prenatal care settings in Northern New England during the COVID-19 pandemic. BMC Nutr 2022; 8:8. [PMID: 35067225 PMCID: PMC8784232 DOI: 10.1186/s40795-022-00499-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/29/2021] [Indexed: 01/20/2023] Open
Abstract
Background Food insecurity during pregnancy has important implications for maternal and newborn health. There is increasing commitment to screening for social needs within health care settings. However, little is known about current screening processes or the capacity for prenatal care clinics to address food insecurity among their patients. We aimed to assess barriers and facilitators prenatal care clinics face in addressing food insecurity among pregnant people and to identify opportunities to improve food security among this population. Methods We conducted a qualitative study among prenatal care clinics in New Hampshire and Vermont. Staff and clinicians engaged in food security screening and intervention processes at clinics affiliated with the Northern New England Perinatal Quality Improvement Network (NNEPQIN) were recruited to participate in key informant interviews. Thematic analysis was used to identify prominent themes in the interview data. Results Nine staff members or clinicians were enrolled and participated in key informant interviews. Key barriers to food security screening and interventions included lack of protocols and dedicated staff at the clinic as well as community factors such as availability of food distribution services and transportation. Facilitators of screening and intervention included a supportive culture at the clinic, trusting relationships between patients and clinicians, and availability of clinic-based and community resources. Conclusion Prenatal care settings present an important opportunity to identify and address food insecurity among pregnant people, yet most practices lack specific protocols for screening. Our findings indicate that more systematic processes for screening and referrals, dedicated staff, and onsite food programs that address transportation and other access barriers could improve the capacity of prenatal care clinics to improve food security during pregnancy. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00499-7.
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Affiliation(s)
- Chelsey R Canavan
- Department of Population Health, Dartmouth-Hitchcock Medical Center, Medical Center Drive, Lebanon, NH, 03766, USA. .,The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - Tiffany D'cruze
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Meaghan A Kennedy
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Kayla E Hatchell
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Maureen Boardman
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Arvind Suresh
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Daisy Goodman
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Alka Dev
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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18
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Bensignor MO, Freese RL, Sherwood NE, Berge JM, Kunin-Batson A, Veblen-Mortenson S, French SA. The Relationship between Household SNAP Participation, Parent Feeding Styles, and Child Eating Behaviors. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021; 19:23-37. [PMID: 38174344 PMCID: PMC10760976 DOI: 10.1080/19320248.2021.1994506] [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] [Indexed: 10/20/2022]
Abstract
This cross-sectional analysis of the Minnesota Now Everybody Together for Amazing Healthful Kids (NET-Works) study evaluated whether SNAP participation was associated with specific parental feeding styles and child eating behaviors. Associations between parent-reported feeding styles and child eating behaviors and SNAP participation were examined using multiple linear regression analyses and responses from 534 parent/child dyads (49.1% female children, 91.7% female parents). SNAP participation was not associated with specific feeding styles or child eating behaviors when adjusting for food insecurity, timing in SNAP cycle, and other covariates in this large, ethnically and racially diverse sample of predominantly mothers and preschool-aged children. Other factors, such as food insecurity, not SNAP participation, may influence parental feeding and child eating behaviors, and screening by health care providers is recommended.
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Affiliation(s)
- Megan O Bensignor
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN
| | - Nancy E Sherwood
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jerica M Berge
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Alicia Kunin-Batson
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
| | - Sara Veblen-Mortenson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Simone A French
- Healthy Weight Research Center, University of Minnesota, Minneapolis, MN
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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19
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Madzia J, McKinney D, Kelly E, DeFranco E. Influence of Gestational Weight Gain on the Risk of Preterm Birth for Underweight Women Living in Food Deserts. Am J Perinatol 2021; 38:e77-e83. [PMID: 32131115 DOI: 10.1055/s-0040-1705168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Preterm birth (PTB) and food insecurity are two of the most significant public health crises in the United States. Effects of being underweight among populations with low food security are not well understood. We assess whether the protective effect of gestational weight gain (GWG) for women with low prepregnancy body mass index (BMI) differs by accessibility to sources of healthy food. STUDY DESIGN Population-based retrospective cohort study using Ohio birth records analyzing all live births, 2006 to 2015. Analyses were stratified by maternal BMI (underweight, normal, overweight, and obese), Institute of Medicine (IOM) recommended GWG (under vs. met), and whether the U.S. Department of Agriculture (USDA) classified the residential census tract for each birth as a food desert. Food access data were retrieved from the USDA's 2018 Food Access Research Atlas. Covariates were selected using least absolute shrinkage and selection operator regression. Logistic regression models estimated the risk ratio (RR) of PTB for each group based on under or exceeded recommended GWG (reference = met), adjusting for coexisting risk factors. RESULTS Analysis was performed on 1,124,299 births. PTB risk was highest for underweight women below GWG recommendations (no food desert: 21.3%, RR = 2.15, 95% confidence interval [CI]: 1.81-2.57; food desert: 21.0%, RR = 1.46, 95% CI: 0.96-2.21). Underweight women living in food deserts who exceeded GWG recommendations had lower PTB risk than those who met GWG recommendations (13.5 vs. 14.3%, RR = 0.85, 95% CI: 0.51-1.41). Factors other than GWG significantly associated with PTB included in the adjusted analysis include maternal age and race, education, marital status, interpregnancy interval, and presence of prepregnancy diabetes or hypertension. CONCLUSION Underweight women who do not meet GWG recommendations are at high risk for PTB. Increasing pregnancy weight gain to a level that exceeds IOM recommendations was not associated with a reduction in PTB risk for underweight women who reside in food deserts compared with women who met GWG recommendations. KEY POINTS · Women with low prepregnancy BMI are at high risk of PTB.. · Food insecurity increases the risk of PTB for underweight women.. · Excessive GWG for underweight women in food deserts does not reduce PTB risk..
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Affiliation(s)
- Juliana Madzia
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - David McKinney
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Elizabeth Kelly
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Emily DeFranco
- Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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20
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Hudak KM, Benjamin-Neelon SE. Timing of WIC Enrollment and Responsive Feeding among Low-Income Women in the US. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147695. [PMID: 34300147 PMCID: PMC8305462 DOI: 10.3390/ijerph18147695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022]
Abstract
We examined associations between the timing of The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment and responsive feeding and assessed food security as a possible effect modifier. We used data from the nationally representative WIC Infant and Toddler Feeding Practices Study-2. Our sample includes women-infant dyads interviewed through the first 13 months of age (n = 1672). We dichotomized WIC enrollment as occurring prenatally or after childbirth. The responsive feeding outcome was feeding on demand versus feeding on schedule. We used covariate-adjusted logistic regressions. Of women, 61.8% had a high school education or less and 62.9% lived at 75% or less of the federal poverty guideline. The majority (84.5%) of women enrolled in WIC before childbirth. In unadjusted estimates, 34% of women who enrolled prenatally practiced responsive feeding, compared to 25% of women who enrolled after childbirth. We found no evidence of food security as an effect modifier. In adjusted estimates, women who enrolled in WIC prenatally had 78% higher odds of practicing responsive feeding (OR: 1.78, 95% CI: 1.16, 2.73), compared to women who enrolled after childbirth. Prenatal enrollment in WIC was associated with higher odds of responsive feeding. Future studies should examine how the timing of WIC enrollment relates to responsive feeding in older children and over time.
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Affiliation(s)
- Katelin M. Hudak
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Correspondence:
| | - Sara E. Benjamin-Neelon
- Lerner Center for Public Health Promotion, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
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21
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Wu AJ, Aris IM, Rifas-Shiman SL, Oken E, Taveras EM, Hivert MF. Longitudinal associations of fruit juice intake in infancy with DXA-measured abdominal adiposity in mid-childhood and early adolescence. Am J Clin Nutr 2021; 114:117-123. [PMID: 33829237 PMCID: PMC8246602 DOI: 10.1093/ajcn/nqab043] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Excessive abdominal adiposity is associated with health risks in children and adults. Higher consumption of fruit juice and other sources of fructose has been shown to promote weight gain and specifically visceral adiposity in adulthood. OBJECTIVES We aimed to examine the longitudinal associations of fruit juice intake in infancy with visceral adiposity in mid-childhood and early adolescence. METHODS We analyzed data from 783 participants in Project Viva, a US prebirth cohort. Our exposure was fruit juice intake at 1 y old. We measured visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and total abdominal adipose tissue (TAAT) in mid-childhood (mean age 7.8 ± 0.7 y) and early adolescence (13 ± 0.8 y) using DXA. We examined longitudinal associations of fruit juice intake at 1 y with VAT, SAAT, and TAAT area sex-specific standard deviation scores (SDSs) in mid-childhood and early adolescence using linear mixed models. We adjusted for child age at outcome, sex, race/ethnicity, age and BMI z-score at 1 y-questionnaire, maternal prepregnancy BMI, level of education, and prenatal sugar-sweetened beverage intake, paternal BMI, and median household income at birth. RESULTS After adjusting for child and parental covariates, each serving (120 mL) per day of fruit juice intake at 1 y was associated with persistently greater VAT area SDS (β = 0.08; 95% CI: 0.03, 0.13) at both timepoints in boys and girls. The association of fruit juice intake with VAT appeared stronger than that with SAAT (β = 0.05; 95% CI: 0.00, 0.09) and TAAT (β = 0.05; 95% CI: 0.01, 0.10). CONCLUSIONS Higher fruit juice intake in infancy was associated with greater abdominal adiposity, particularly VAT, in mid-childhood and early adolescence. Our findings support limiting fruit juice intake in infancy, which can have later impact on visceral adiposity in childhood and adolescence.Clinical Trial Registry number: NCT02820402 (https://clinicaltrials.gov/ct2/show/NCT02820402).
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Affiliation(s)
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, USA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
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22
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Trabulsi JC, Smethers AD, Eosso JR, Papas MA, Stallings VA, Mennella JA. Impact of early rapid weight gain on odds for overweight at one year differs between breastfed and formula-fed infants. Pediatr Obes 2020; 15:e12688. [PMID: 32705816 PMCID: PMC7773222 DOI: 10.1111/ijpo.12688] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Early rapid weight gain (RWG) increases, whereas longer durations of breastfeeding decreases, odds for later obesity. OBJECTIVES To determine the independent and interactive effects of early weight gain and diet on infant weight status trajectories and odds for overweight at 1 year. METHODS We conducted secondary analysis on data from two longitudinal trials with repeated anthropometric measures. One trial consisted of predominantly or exclusively breastfed (BF, n = 97) infants, whereas the other consisted of exclusively formula-fed (FF, n = 113) infants. Weight-for-length z-score (WLZ) change from 0.5 to 4.5 months was used to categorize early weight gain as slow (<-0.67; SWG), normal (-0.67 to 0.67; NWG) or rapid (>0.67; RWG). Linear-mixed effects models were fit to examine the independent effects and interaction of early diet (BF, FF) and weight gain (SWG, NWG, RWG) groups on WLZ trajectories; logistic regression was used to assess odds for overweight at 1 year. RESULTS While similar percentages (41%) of BF and FF infants experienced RWG, we found a significant diet × early weight gain group interaction (P < .001) on weight status. At 1 year, the WLZ of FF infants with RWG (1.57 ± 0.99) was twice that of BF infants with RWG (0.83 ± 0.92). Using BF infants with NWG as the reference group, FF infants with RWG had increased odds [OR: 25.3 (95% CI: 3.21, 199.7)] for overweight at 1 year, whereas BF infants with RWG did not. CONCLUSIONS Early diet interacts with early weight gain and influences weight status trajectories and overweight risk at 1 year.
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Affiliation(s)
- Jillian C. Trabulsi
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | | | - Jessica R. Eosso
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Mia A. Papas
- The Value Institute, Christiana Care Health System, Newark, Delaware
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Armstrong B, Hepworth AD, Black MM. Hunger in the household: Food insecurity and associations with maternal eating and toddler feeding. Pediatr Obes 2020; 15:e12637. [PMID: 32294800 PMCID: PMC9132245 DOI: 10.1111/ijpo.12637] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/09/2020] [Accepted: 03/15/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Research is needed to identify how food insecurity affects maternal eating behavior and child feeding practices, factors that may pose intergenerational risks for obesity. OBJECTIVES This longitudinal study investigated whether maternal restrained eating mediated the association between household food insecurity and feeding practices. METHODS Participants included 277 WIC-eligible mothers (69% below the poverty line, 70% African American) and their toddlers (Mage = 20.11 months, SD = 5.50) participating in a childhood obesity prevention trial. Maternal reports of household food insecurity, restrained eating, and child feeding practices (restrictive and responsive) were collected at baseline, 6 and 12 months and analyzed using multilevel mediation. RESULTS Forty percent of mothers reported some degree of household food insecurity over 12 months. Within-person analyses showed that relative increases in household food insecurity were indirectly related to increases in restrictive and decreases in responsive child feeding practices, mediated through increases in mothers' own restrained eating. CONCLUSIONS Relative change in household food insecurity (rather than overall severity) appears to have indirect effects on toddler feeding practices, through mothers' own eating. Stable household food security without transient food insecurity may improve health and wellbeing for both mothers and children.
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Affiliation(s)
- Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, US
| | - Allison D. Hepworth
- Department of Social Work, University of Maryland School of Social Work, Baltimore, Maryland, US
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, US,RTI International, Research Triangle Park, North Carolina, US
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Larson N, Laska MN, Neumark-Sztainer D. Food Insecurity, Diet Quality, Home Food Availability, and Health Risk Behaviors Among Emerging Adults: Findings From the EAT 2010-2018 Study. Am J Public Health 2020; 110:1422-1428. [PMID: 32673120 DOI: 10.2105/ajph.2020.305783] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To examine emerging adults' experiences of food insecurity in relation to measures of diet quality, food literacy, home food availability, and health behaviors.Methods. We used EAT 2010-2018 (Eating and Activity over Time) study data on 1568 participants who completed surveys as adolescents in 2009 to 2010 and follow-up surveys in 2017 to 2018 (mean age = 22.0 ±2.0 years; 58% female). At baseline, participants were recruited from 20 urban schools in Minneapolis-St Paul, Minnesota. Food insecurity was defined by emerging adult report of both eating less than they thought they should and not eating when hungry because of lack of money.Results. The prevalence at follow up of experiencing food insecurity in the past year was 23.3% among emerging adults. Food insecurity was associated with poorer diet quality (e.g., less vegetables and whole grains, more sugar-sweetened drinks and added sugars), lower home availability of healthy foods, skipping breakfast, frequently eating at fast-food restaurants, binge eating, binge drinking, and substance use (all P < .01).Conclusions. Assistance programs and policies are needed to address food insecurity among emerging adults and should be coordinated with other services to protect health.
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Affiliation(s)
- Nicole Larson
- The authors are with the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Melissa N Laska
- The authors are with the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Dianne Neumark-Sztainer
- The authors are with the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
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Dinour LM, Rivera Rodas EI, Amutah-Onukagha NN, Doamekpor LA. The role of prenatal food insecurity on breastfeeding behaviors: findings from the United States pregnancy risk assessment monitoring system. Int Breastfeed J 2020; 15:30. [PMID: 32306985 PMCID: PMC7169030 DOI: 10.1186/s13006-020-00276-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 04/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In addition to its health and nutritional benefits, breastfeeding can save low-income, food insecure mothers the cost of infant formula so that money can be spent on food and other necessities. Yet breastfeeding may exacerbate food insecurity by negatively affecting maternal employment. The relationship between food insecurity and breastfeeding has been explored previously, with varying results. The purpose of this study was to determine the relationship between prenatal food insecurity and breastfeeding initiation and early cessation (< 10 weeks) among U.S. mothers. METHODS Data were pooled from 2012 to 2013 (Phase 7) of the Pregnancy Risk Assessment Monitoring System, a population-based cross-sectional survey of postpartum women administered 2-4 months after delivery. The analytic sample was drawn from Colorado, Maine, New Mexico, Oregon, Pennsylvania, and Vermont, and limited to mothers aged 20 years and older whose infants were alive and living with them at the time of the survey (n = 10,159). We used binomial and multinomial logistic models to assess the predictive association between food insecurity and breastfeeding initiation and early cessation, respectively, while controlling for confounders. RESULTS Most women reported prenatal food security (90.5%) and breastfeeding initiation (91.0%). Of those who initiated breastfeeding, 72.7% breastfed for > 10 weeks. A larger proportion of food secure women compared to food insecure women, initiated breastfeeding (91.4% vs. 87.6%, P < 0.01), and patterns of early breastfeeding cessation differed significantly between the two groups (P < 0.01). In the final models, prenatal food insecurity was not associated with breastfeeding initiation or early cessation, with one exception. Compared to food secure mothers, mothers reporting food insecurity had a lower risk of breastfeeding for 4-6 weeks than for > 10 weeks, independent of covariates (relative risk ratio 0.65; 95% CI 0.50, 0.85; P < 0.01). Women who were married, had a college degree, and did not smoke were more likely to initiate breastfeeding and breastfeed for a longer time, regardless of food security status (P < 0.01). CONCLUSIONS Socioeconomic, psychosocial, and physiological factors explain the association between prenatal food insecurity and breastfeeding outcomes among this U.S. SAMPLE More targeted and effective interventions and policies are needed to encourage the initiation and duration of breastfeeding, regardless of food security status.
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Affiliation(s)
- Lauren M. Dinour
- College of Education and Human Services, Montclair State University, 1 Normal Avenue, Montclair, NJ 07043 USA
| | - Elizabeth I. Rivera Rodas
- College of Education and Human Services, Montclair State University, 1 Normal Avenue, Montclair, NJ 07043 USA
| | | | - Laurén A. Doamekpor
- Scientific Research, Health Policy Research Consortium, CTIS Inc, 6401 Golden Triangle Drive, Suite #310, Greenbelt, MD 20770 USA
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Duh-Leong C, Jo Messito M, Katzow MW, Tomopoulos S, Nagpal N, Fierman AH, Gross RS. Material Hardships and Infant and Toddler Sleep Duration in Low-Income Hispanic Families. Acad Pediatr 2020; 20:1184-1191. [PMID: 32650047 PMCID: PMC9286002 DOI: 10.1016/j.acap.2020.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess relationships between material hardships, shortened sleep duration, and suboptimal sleep practices across infancy and toddlerhood in low-income Hispanic families. METHODS We analyzed longitudinal data of 451 low-income Hispanic mother-child pairs from a child obesity prevention trial. During infancy and toddlerhood, we used adjusted linear regression to assess associations between material hardship (financial difficulty, food insecurity, housing disrepair, and multiple hardships), sleep duration (24-hour, night), and the number of suboptimal sleep practices (eg, later bedtime, co-sleeping). We used adjusted linear regression to assess the longitudinal association between the number of suboptimal sleep practices in infancy and toddlerhood, and tested whether specific or multiple hardships moderated this association. RESULTS In infants, financial difficulty and multiple hardships were associated with decreased night sleep (B = -0.59 hours, 95% confidence interval [CI]: -1.04, -0.14; and B = -0.54 hours, 95% CI: -1.00, -0.08). Housing disrepair was associated with decreased 24-hour sleep (B = -0.64 hours, 95% CI: -1.29, -0.01). In toddlers, each additional suboptimal sleep practice was associated with a decrease in night sleep (B = -0.19 hours, 95% CI: -0.29, -0.09). Each additional suboptimal sleep practice in infancy was associated with a 0.30 increase in the number of suboptimal sleep practices in toddlerhood (P < .001), with greater increases for those with food insecurity or multiple hardships. CONCLUSION Specific and multiple hardships shortened sleep duration during infancy, and moderated the increase of suboptimal sleep behaviors between infancy and toddlerhood. Future studies should consider these early critically sensitive periods for interventions to mitigate material hardships and establish healthy sleep practices.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine (C Duh-Leong, MJ Messito, S Tomopoulos, N Nagpal, AH Fierman, and RS Gross).
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Michelle W. Katzow
- Division of General Pediatrics, Department of Pediatrics, Zucker School of Medicine at, Hofstra/Northwell, 269-01 76th Ave, New Hyde Park, NY 11040 USA
| | - Suzy Tomopoulos
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Nikita Nagpal
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Arthur H. Fierman
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
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Gross RS, Mendelsohn AL. Food Insecurity During Early Childhood: Marker for Disparities in Healthy Growth and Development. Pediatrics 2019; 144:peds.2019-2430. [PMID: 31501234 DOI: 10.1542/peds.2019-2430] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rachel S Gross
- Divisions of General Pediatrics and Developmental-Behavioral Pediatrics, Department of Pediatrics, School of Medicine, New York University, New York, New York
| | - Alan L Mendelsohn
- Divisions of General Pediatrics and Developmental-Behavioral Pediatrics, Department of Pediatrics, School of Medicine, New York University, New York, New York
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Gross RS, Mendelsohn AL, Arana MM, Messito MJ. Food Insecurity During Pregnancy and Breastfeeding by Low-Income Hispanic Mothers. Pediatrics 2019; 143:e20184113. [PMID: 31088893 PMCID: PMC6564052 DOI: 10.1542/peds.2018-4113] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Pregnancy, infancy, and toddlerhood are sensitive times in which families are particularly vulnerable to household food insecurity and when disparities in child obesity emerge. Understanding obesity-promoting infant-feeding beliefs, styles, and practices in the context of food insecurity could better inform both food insecurity and child obesity prevention interventions and policy guidelines. METHODS We performed purposive sampling of low-income Hispanic mothers (n = 100) with infants in the first 2 years of life, all of whom were participants in a randomized controlled trial of an early child obesity prevention intervention called the Starting Early Program. Bilingual English-Spanish interviewers conducted semistructured qualitative interviews, which were audio recorded, transcribed, and translated. By using the constant comparative method, transcripts were coded through an iterative process of textual analysis until thematic saturation was reached. RESULTS Three key themes emerged: (1) contributors to financial strain included difficulty meeting basic needs, job instability, and high vulnerability specific to pregnancy, infancy, and immigration status; (2) effects on infant feeding included decreased breastfeeding due to perceived poor maternal diet, high stress, and limiting of healthy foods; and (3) coping strategies included both home- and community-level strategies. CONCLUSIONS Stakeholders in programs and policies to prevent poverty-related disparities in child obesity should consider and address the broader context by which food insecurity is associated with contributing beliefs, styles, and practices. Potential strategies include addressing misconceptions about maternal diet and breast milk adequacy, stress management, building social support networks, and connecting to supplemental nutrition assistance programs.
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Affiliation(s)
| | - Alan L Mendelsohn
- Developmental and Behavioral Pediatrics, Department of Pediatrics, School of Medicine, New York University, New York, New York
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29
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Khalsa AS, Woo JG, Kharofa RY, Geraghty SR, DeWitt TG, Copeland KA. Parental intuitive eating behaviors and their association with infant feeding styles among low-income families. Eat Behav 2019; 32:78-84. [PMID: 30658288 DOI: 10.1016/j.eatbeh.2019.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 01/07/2019] [Accepted: 01/09/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Feeding styles, the attitudes and behaviors parents use to direct their child's eating, shape a child's ability to self-regulate food intake and affects their future risk of obesity. This study examined how parental intuitive eating, where parents follow their own hunger and satiety cues, relates to infant feeding styles in a low-income, predominately Black population. METHODS Parents of healthy infants aged 5.5-12.5 months were recruited during well-child visits at two urban primary care clinics. Parent's intuitive eating behaviors and infant feeding styles were measured using the Intuitive Eating Scale-2 (IES-2) and the Infant Feeding Style Questionnaire (IFSQ), respectively. Multivariable regression analysis, controlling for maternal and child demographic variables, was conducted to determine the relationship between parent intuitive eating behaviors and five infant feeding styles: restrictive, pressuring, indulgent, laissez-faire, and responsive. RESULTS 201 parents completed the study, 90% were mothers and 69% were Black. Average infant age was 8.8 ± 2.0 months. Parents who reported relying on their own hunger and satiety cues when eating were more likely to feed their infant in a responsive style (β 0.10 ± 0.04, p < 0.05). Parents who reported eating unconditionally, not labeling foods as forbidden, were more likely to feed their infant in a laissez-faire (β 0.16 ± 0.06, p < 0.05) and indulgent (β 0.09 ± 0.03, p < 0.05) feeding style. CONCLUSIONS Parental intuitive eating behaviors are associated with both responsive and non-responsive infant feeding styles. Future studies should examine how parental intuitive eating and infant feeding styles affect infant growth trajectories.
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Affiliation(s)
- Amrik Singh Khalsa
- Division of Ambulatory Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, The Ohio State University College of Medicine, 370 W. 9th Ave., Columbus, OH 43210, USA.
| | - Jessica G Woo
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 5041, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
| | - Roohi Y Kharofa
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 7035, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
| | - Sheela R Geraghty
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 7035, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
| | - Thomas G DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 7035, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
| | - Kristen A Copeland
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 7035, Cincinnati, OH 45229, USA; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, USA
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