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Flores-Barrantes P, De Miguel-Etayo P, Iglesia I, ChinAPaw MJ, Cardon G, De Craemer M, Iotova V, Usheva N, Kułaga Z, Kotowska A, Koletzko B, Birnbaum J, Manios Y, Androutsos O, Moreno LA, Gibson EL. Longitudinal associations between food parenting practices and dietary intake in preschool children: The ToyBox Study. Nutrition 2024; 124:112454. [PMID: 38788341 DOI: 10.1016/j.nut.2024.112454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/24/2024] [Accepted: 03/29/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Food Parenting Practices (FPPs) include the practices parents use in the act of feeding their children, which may further influence their health. OBJECTIVES To assess associations between changes in FPPs (permissiveness, food availability, guided choices, water encouragement, rules and limits and the use of food as reward) over 1 year and dietary intake (water, energy-dense/nutrient-poor and nutrient-dense foods) at follow-up in 4- to 6-year-old preschool-aged children. METHODS Longitudinal data from the control group of the ToyBox study, a cluster-randomized controlled intervention study, was used (NCT02116296). Multilevel ordinal logistic regression analyses including FPP as the independent variables and dietary intake as outcome. RESULTS Nine hundred sixty-four parent-child dyads (50.5% boys and 95.0% mothers) were included. Limited changes on the use of FPPs were observed over time. Nevertheless, in boys, often having F&V at home was associated with higher F&V consumption (OR = 6.92 [1.58; 30.38]), and increasing home availability of F&V was directly associated with higher water consumption (OR = 7.62 [1.63; 35.62]). Also, not having sweets or salty snacks available at home was associated with lower consumption of desserts (OR = 4.34 [1.75; 10.75]). In girls, having F&V availability was associated with higher F&V consumption (OR = 6.72 [1.52; 29.70]) and lower salty snack consumption (OR = 3.26 [1.50; 7.10]) and never having soft drinks at home was associated with lower consumption of sweets (OR = 7.89 [6.32; 9.86]). Also, never being permissive about soft drink consumption was associated with lower soft drink consumption (OR = 4.09 [2.44; 6.85]). CONCLUSION Using favorable FPPs and avoiding the negative ones is prospectively associated with healthier dietary intake, especially of F&V, and less intake of soft drinks, desserts, and salty snacks.
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Affiliation(s)
- Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Iris Iglesia
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin Network (RICORS), RD21/0012/0012, Instituto de Salud Carlos III, Madrid, Spain.
| | - Mai Jm ChinAPaw
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Public and Occupational Health, Amsterdam, The Netherlands
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University. Ghent, Belgium
| | | | - Violeta Iotova
- Department of Paediatrics, Medical University Varna, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Zbigniew Kułaga
- Public Health Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - Aneta Kotowska
- Public Health Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU-Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Julia Birnbaum
- Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children's Hospital, LMU-Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, Athens, Greece; Lab of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Instituto Agroalimentario de Aragón (IA2), Instituto De Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - E Leigh Gibson
- School of Psychology, University of Roehampton, London, United Kingdom
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Lutz MR, Orr CJ, Shonna Yin H, Heerman WJ, Flower KB, Sanders LM, Rothman RL, Schildcrout JS, Bian A, Kay MC, Wood CT, Delamater AM, Perrin EM. Television Time, Especially During Meals, Is Associated With Less Healthy Dietary Practices in Toddlers. Acad Pediatr 2024; 24:741-747. [PMID: 37802249 DOI: 10.1016/j.acap.2023.09.019] [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] [Received: 04/26/2023] [Revised: 09/23/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND While several studies examine the relationship between screen time and dietary practices in children and teenagers, there is limited research in toddlers. This study evaluates the association between television (TV) exposure and dietary practices in 2-year-old children. METHODS We conducted a cross-sectional, secondary data analysis from the Greenlight Intervention Study. Toddlers' daily TV watching time, mealtime TV, and dietary practices were assessed by caregiver report at the 24-month well-child visit. Separate regression models were used and adjusted for sociodemographic/household characteristics and clinic site. RESULTS Five hundred and thirty-two toddlers were included (51% Latino; 30% non-Latino Black; 59% ≤$20,000 annual household income). Median daily TV watching time was 42 minutes (interquartile range: 25, 60); 25% reported the TV was "usually on" during mealtimes. After adjustment, toddlers who watched more TV daily had higher odds of consuming sugar-sweetened beverages, fast food, and more junk food; those watching less TV had higher odds of consuming more fruits/vegetables. Those with the TV "usually on" during mealtimes were more likely to consume sugar-sweetened beverages (aOR 3.72 [95% confidence interval {CI} 2.16-6.43]), fast food (aOR 2.83 [95%CI 1.54-5.20]), and more junk food (aOR 4.25 [95%CI 2.71-6.65]). CONCLUSIONS Among toddlers from primarily minoritized populations and of lower socioeconomic status, those who watched more TV daily and usually had the TV on during meals had significantly less healthy dietary practices, even after adjusting for known covariates. This study supports the current American Academy of Pediatrics screen time guidelines and underscores the importance of early counseling on general and mealtime TV.
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Affiliation(s)
- Melissa R Lutz
- Department of Pediatrics (MR Lutz and EM Perrin), Johns Hopkins University School of Medicine, Baltimore, Md.
| | - Colin J Orr
- Department of Pediatrics (CJ Orr and KB Flower), University of North Carolina, Chapel Hill.
| | - Hsiang Shonna Yin
- Departments of Pediatrics and Population Health (HS Yin), New York University Grossman School of Medicine.
| | - William J Heerman
- Department of Pediatrics (WJ Heerman and RL Rothman), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Kori B Flower
- Department of Pediatrics (CJ Orr and KB Flower), University of North Carolina, Chapel Hill.
| | - Lee M Sanders
- Departments of Pediatrics and Health Policy (LM Sanders), Stanford University, Calif.
| | | | - Jonathan S Schildcrout
- Department of Biostatistics (JS Schildcrout and A Bian), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Aihua Bian
- Department of Biostatistics (JS Schildcrout and A Bian), Vanderbilt University Medical Center, Nashville, Tenn.
| | - Melissa C Kay
- Department of Pediatrics (CT Wood), Duke University School of Medicine, Durham, NC.
| | - Charles T Wood
- Department of Pediatrics (CT Wood), Duke University School of Medicine, Durham, NC.
| | - Alan M Delamater
- Mailman Center for Child Development (AM Delamater), University of Miami Miller School of Medicine, Fla.
| | - Eliana M Perrin
- Department of Pediatrics (MR Lutz and EM Perrin), Johns Hopkins University School of Medicine, Baltimore, Md; Division of General Pediatrics (EM Perrin), Department of Pediatrics, Schools of Medicine and Nursing.
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Rodríguez-Barniol M, Pujol-Busquets G, Bach-Faig A. Screen Time Use and Ultra-Processed Food Consumption in Adolescents: A Focus Group Qualitative Study. J Acad Nutr Diet 2024:S2212-2672(24)00202-8. [PMID: 38697354 DOI: 10.1016/j.jand.2024.04.015] [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: 01/30/2023] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Sedentary lifestyles and ultra-processed food (UPF) consumption contribute to a high prevalence of overweight and obesity among adolescents. Screen time may be associated with higher UPF consumption and affect eating behaviors substantially. OBJECTIVE The aim of this study was to explore adolescents' perceptions, attitudes, and motivations concerning the consumption of UPF when using screens; investigate their perceived educational needs regarding nutrition; and explore their knowledge about UPF. DESIGN This was a qualitative study using focus groups. PARTICIPANTS/SETTING Four focus groups with 30 adolescents aged 12 to 16 years at a Spanish high school were recruited in May 2022. Participants were chosen using purposive sampling based on a theoretical saturation criterion. ANALYSES Focus group discussions were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis. RESULTS Three themes emerged from the thematic analysis. Participants explained that most of their meals were eaten in front of screens. They confirmed more consumption of UPF at breakfast, as mid-afternoon snacks, on weekends, and during their main meals when alone. Participants reported that the high consumption of UPF during social gatherings was related to its easy availability, convenience, and palatability. Adolescents expressed that eating in front of screens and exposure to UPF advertising led to compulsive and impulsive consumption of these products. They described UPF as addictive and unhealthy. Although participants had little awareness of UPF health effects, they expressed interest in learning about healthy eating habits. Parental attitudes toward food were considered by the participants as relevant in establishing their eating behaviors. CONCLUSIONS Loneliness, social gatherings, and parental attitudes toward UPF consumption emerged as important influences on adolescents' dietary behaviors in front of screens. In addition, availability, palatability, and exposure to advertising were key factors reported to influence adolescents' UPF consumption in front of screens. Addressing these influences through nutritional and educational interventions, as well as regulating the adolescent obesogenic environment and managing screen time could help modulate these effects.
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Affiliation(s)
- Mònica Rodríguez-Barniol
- Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia), Barcelona, Spain; Department of Health, Institut Català de la Salut (Catalan Health Institute), Centre d'Atenció Primària (Primary Care Centre) Joanic, Barcelona, Spain.
| | - Georgina Pujol-Busquets
- Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia), Barcelona, Spain; Medical Research Council, Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Anna Bach-Faig
- FoodLab Research Group, Universitat Oberta de Catalunya (Open University of Catalonia), Barcelona, Spain
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Acosta P, Rojas-Humpire R, Newball-Noriega EE, Morales-García WC, Saintila J, Ruiz Mamani PG, Huancahuire-Vega S. Dietary practices and nutritional status of children served in a social program for surrogate mothers in Colombia. BMC Nutr 2023; 9:26. [PMID: 36747251 PMCID: PMC9901049 DOI: 10.1186/s40795-023-00685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Dietary practices are acquired in the family context and in turn can affect the health of family members, especially the nutritional status of children. The objective of this study was to determine the relationship between nutritional status and feeding practices in children from foster families served by the SOS Children's Villages program in Cartagena, Colombia. METHODS The study had a cross-sectional design. Through a non-probabilistic purposive sampling, 139 children from 0 to 5 years of age from the SOS Children's Villages Cartagena program were involved. The sociodemographic background of the participants was recorded and the nutritional status of the children was evaluated through anthropometric and biochemical measurements. Dietary practices were measured by means of a standardized questionnaire. Analyses were performed with Poisson regression models with robust variance. These regression models provided prevalence ratios (PR) with their respective 95% confidence intervals (95%CI). RESULTS Among dietary practices, it was observed that most families eat together at home (63.3%), watch television when they eat (55.4%), and have dietary norms (80.6%). Consumption of plant foods was predominantly high, especially vegetables (86.3%), fruits (92.1%), cereals (84.9%), root vegetables, and bananas (93.5%). Consumption < 4 times/week of soft drinks and industrialized juices increases 14.3 times the probability of low weight-for-height in the study population compared to the group that does not consume them. On the other hand, watching television while eating (PR: 2.82, 95%CI 1.32-4.69) and consumption of sweet snacks (PR: 2.24, 95%CI 1.03-4.87) increased the probability of low height-for-age; while having eaten norms at home decreased the probability of low height-for-age in the study population by 50%. CONCLUSION It is necessary to develop and implement interventions such as preventive measures and early diagnosis of inappropriate feeding behaviors to ensure adequate nutritional status among children under 5 years of age.
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Affiliation(s)
- Patricia Acosta
- Aldeas Infantiles SOS Colombia, Programa Cartagena, Bolívar, Colombia
| | - Ricardo Rojas-Humpire
- grid.441893.30000 0004 0542 1648Departamento de Ciencias Básicas, Escuela de Medicina Humana, Facultad de Ciencias de La Salud, Universidad Peruana Unión, Lima, Perú ,grid.441893.30000 0004 0542 1648Grupo de Investigación P53, Escuela de Medicina Humana, Facultad de Ciencias de La Salud, Universidad Peruana Unión, Carretera Central Km 19, Ñaña, Lima 15, Peru
| | - Edda E. Newball-Noriega
- grid.441893.30000 0004 0542 1648Departamento de Ciencias Básicas, Escuela de Medicina Humana, Facultad de Ciencias de La Salud, Universidad Peruana Unión, Lima, Perú ,grid.441893.30000 0004 0542 1648Grupo de Investigación P53, Escuela de Medicina Humana, Facultad de Ciencias de La Salud, Universidad Peruana Unión, Carretera Central Km 19, Ñaña, Lima 15, Peru
| | - Wilter C. Morales-García
- grid.441893.30000 0004 0542 1648Unidad de Salud Pública Escuela de Posgrado, Universidad Peruana Unión, Lima, Perú
| | - Jacksaint Saintila
- grid.441720.40000 0001 0573 4474Escuela de Medicina Humana, Universidad Señor de Sipán, Chiclayo, Perú
| | - Percy G. Ruiz Mamani
- grid.441740.20000 0004 0542 2122Facultad de Ciencias de La Salud, Universidad Privada San Juan Bautista, Lima, Perú
| | - Salomón Huancahuire-Vega
- grid.441893.30000 0004 0542 1648Departamento de Ciencias Básicas, Escuela de Medicina Humana, Facultad de Ciencias de La Salud, Universidad Peruana Unión, Lima, Perú ,grid.441893.30000 0004 0542 1648Grupo de Investigación P53, Escuela de Medicina Humana, Facultad de Ciencias de La Salud, Universidad Peruana Unión, Carretera Central Km 19, Ñaña, Lima 15, Peru
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Perez O, Kumar Vadathya A, Beltran A, Barnett RM, Hindera O, Garza T, Musaad SM, Baranowski T, Hughes SO, Mendoza JA, Sabharwal A, Veeraraghavan A, O'Connor TM. The Family Level Assessment of Screen Use-Mobile Approach: Development of an Approach to Measure Children's Mobile Device Use. JMIR Form Res 2022; 6:e40452. [PMID: 36269651 PMCID: PMC9636534 DOI: 10.2196/40452] [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: 06/22/2022] [Revised: 08/30/2022] [Accepted: 09/15/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is a strong association between increased mobile device use and worse dietary habits, worse sleep outcomes, and poor academic performance in children. Self-report or parent-proxy report of children's screen time has been the most common method of measuring screen time, which may be imprecise or biased. OBJECTIVE The objective of this study was to assess the feasibility of measuring the screen time of children on mobile devices using the Family Level Assessment of Screen Use (FLASH)-mobile approach, an innovative method that leverages the existing features of the Android platform. METHODS This pilot study consisted of 2 laboratory-based observational feasibility studies and 2 home-based feasibility studies in the United States. A total of 48 parent-child dyads consisting of a parent and child aged 6 to 11 years participated in the pilot study. The children had to have their own or shared Android device. The laboratory-based studies included a standardized series of tasks while using the mobile device or watching television, which were video recorded. Video recordings were coded by staff for a gold standard comparison. The home-based studies instructed the parent-child dyads to use their mobile device as they typically use it over 3 days. Parents received a copy of the use logs at the end of the study and completed an exit interview in which they were asked to review their logs and share their perceptions and suggestions for the improvement of the FLASH-mobile approach. RESULTS The final version of the FLASH-mobile approach resulted in user identification compliance rates of >90% for smartphones and >80% for tablets. For laboratory-based studies, a mean agreement of 73.6% (SD 16.15%) was achieved compared with the gold standard (human coding of video recordings) in capturing the target child's mobile use. Qualitative feedback from parents and children revealed that parents found the FLASH-mobile approach useful for tracking how much time their child spends using the mobile device as well as tracking the apps they used. Some parents revealed concerns over privacy and provided suggestions for improving the FLASH-mobile approach. CONCLUSIONS The FLASH-mobile approach offers an important new research approach to measure children's use of mobile devices more accurately across several days, even when the child shares the device with other family members. With additional enhancement and validation studies, this approach can significantly advance the measurement of mobile device use among young children.
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Affiliation(s)
- Oriana Perez
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Anil Kumar Vadathya
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Alicia Beltran
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - R Matthew Barnett
- Center for Research Computing, Rice University, Houston, TX, United States
| | | | - Tatyana Garza
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Salma M Musaad
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Tom Baranowski
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Sheryl O Hughes
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Jason A Mendoza
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, United States.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Ashutosh Sabharwal
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Ashok Veeraraghavan
- Department of Electrical & Computer Engineering, Rice University, Houston, TX, United States
| | - Teresia M O'Connor
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
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Review and meta-analysis for the caregiver's feeding styles questionnaire administered to low-income families. Eat Behav 2022; 46:101659. [PMID: 35964363 DOI: 10.1016/j.eatbeh.2022.101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/29/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these low-income samples, on average, were heavier than their same-aged peers across all parent feeding styles.
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Litterbach EK, Zheng M, Campbell KJ, Laws R, Spence AC. Mealtime TV Use Is Associated with Higher Discretionary Food Intakes in Young Australian Children: A Two-Year Prospective Study. Nutrients 2022; 14:nu14132606. [PMID: 35807787 PMCID: PMC9268203 DOI: 10.3390/nu14132606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/29/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Mealtime television use has been cross-sectionally associated with suboptimal diets in children. This study aimed to assess the two-year prospective association between baseline mealtime television use and subsequent diets in young children, and identify socioeconomic differences. Methods: Parents reported their child’s television use at meals, and fruit, vegetable, and discretionary food intakes. Multivariable linear and logistic regression analyses assessed the association between baseline mealtime television use and follow-up diet outcomes. Differences were assessed by socioeconomic position. Results: Participants were 352 Australian parents of children aged six months to six years. Daily mealtime television use (average frequency/day) was associated with higher daily frequency of discretionary food intakes (β 0.2, 95% confidence interval (CI) 0.07–0.67) at the 2-year follow-up. Individually, television use during breakfast and dinner (1–2 days/week compared to never) predicted higher daily intake frequency of discretionary food, β 0.36 (95% CI 0.12–0.60) and β 0.19 (95% CI 0.00–0.39), respectively. Similarly, 3–7 days/week of television use during breakfast and lunch predicted higher frequency of discretionary food intake, β 0.18 (95% CI 0.02–0.37) and β 0.31 (95% CI 0.07–0.55), respectively. Associations were not socioeconomically patterned. Conclusions: Investigating mealtime television use motivators across the socioeconomic spectrum could inform interventions targeting the high consumption of discretionary foods in children.
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Child meal microstructure and eating behaviors: A systematic review. Appetite 2022; 168:105752. [PMID: 34662600 PMCID: PMC8671353 DOI: 10.1016/j.appet.2021.105752] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/06/2021] [Accepted: 10/09/2021] [Indexed: 01/03/2023]
Abstract
Observational coding of children's eating behaviors and meal microstructure (e.g., bites, chews) provides an opportunity to assess complex eating styles that may relate to individual differences in energy intake and weight status. Across studies, however, similar terms are often defined differently, which complicates the interpretation and replication of coding protocols. Therefore, this study aimed to compile methods of coding meal microstructure in children. To limit bias and ensure a comprehensive review, a systematic search was conducted in January 2021 across three databases (PubMed, PsychInfo, Web of Science) resulting in 46 studies that coded at least one meal-related behavior in healthy children (i.e., no medical/psychological disorders) who were able to self-feed (i.e., no spoon-, breast-, or bottle-feeding). While the majority of studies had good interrater reliability, the details reported about study foods and the clarity of the definitions used for behavioral coding varied considerably. In addition to reported microstructure behaviors, a non-exhaustive review of individual differences was included. While few studies reported individual differences related to age and sex, there was a larger literature related to weight status that provided evidence for an 'obesogenic' style of eating characterized by larger Bites, faster Eating and Bite Rates, and shorter Meal Durations. However, some studies may not have been optimally designed or powered to detect individual differences because they did not set out a priori to examine them. Based on this systematic review, best practices for the field are recommended and include reporting more details about foods served and coded eating behaviors to improve reproducibility. These suggestions will improve the ability to examine patterns of individual differences across studies, which may help identify novel targets for intervention.
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