A two-component pictured-based appetite assessment tool is capable of detecting appetite sensations in younger children: A pilot study

Nutrition Management for Chronic Kidney Disease: Differences and Special Needs for Children and Adults

Common goals of nutritional therapy across the spectrum of pediatric and adult chronic kidney disease (CKD) include maintaining normal body mass and composition and reducing associated morbidity and mortality. Adult nephrologists caring for children and adolescents may be challenged by the existing complexities in identifying and interpreting the nutritional status and growth in children. Pediatric nephrologists may face situations that call for a sound knowledge of assessing nutritional status and providing nutrition therapy for adolescents and young adults. One important additional nutrition goal in children is to achieve normal growth and development. Children are growing and therefore need more calories and nutrients than just maintaining their body weight and composition. Lack of weight and height gain actually is considered failure to thrive in children. Some fundamental differences in approaches to nutritional therapy in CKD are necessitated based on the etiology of CKD. A large proportion of adults with CKD are diabetics, so the approach would be a low-carbohydrate diet. Children with CKD, especially young ones, often are anorexic, so calorie supplements that could include quite a lot of carbohydrates often are prescribed. More adults with CKD have hypertension and atherosclerotic comorbidities, which result in recommendations for low-salt and low-fat diets. Children with CKD often have salt and electrolyte wasting disease states and would require normal- or even high-salt diets, and fats often are included in supplements to bolster calorie intake. Low-protein diets often are recommended in adults with predialysis CKD to slow disease progression. Children are growing and have a higher protein daily requirement. Low-protein diets have not been found to be efficacious in children with CKD, in achieving normal growth, or in slowing disease progression. Adult nephrologists caring for children and adolescents may be challenged by the existing complexities in identifying and interpreting nutritional status and growth in children. Pediatric nephrologists may face situations that call for a sound knowledge of assessing nutritional status and providing nutrition therapy for adolescents and young adults. This article discusses the differences in the assessment of nutritional status between children and adults, as well as provides a comprehensive approach to nutritional management for CKD across the age spectrum. Semin Nephrol 43:x-xx © 2023 Elsevier Inc. All rights reserved.

Measurement is the foundation of research and theory on children's eating behaviours: Current issues and directions for progress

Eating behaviours affect food intakes and are involved in the aetiology of obesity. There has been impetus to translate findings about children's eating behaviour into intervention and policy programs. However, measurement limitations have hindered our capacity to understand and influence children's eating behaviours. In the present paper we provide an overview of some of the key methodological and measurement issues facing the field of children's eating behaviours and highlight implications for research and health promotion. Drawing on insight from parallel issues that occur in the measurement of early social and emotional development, we examine two overlapping themes in children's (aged 0-∼12 years) eating behaviours (Somaraki et al., 2021) measurement issues related to validity and reliability, and (Steinsbekk & Wichstrøm, 2015) associated methodological challenges, such as contextual influences and the importance of designing studies that use multiple informants and multiple methods. We then suggest insights and strategies aimed at advancing approaches to measurement of children's eating behaviours. To progress our understanding of children's eating behaviours, we conclude that a range of psychometrically sound, fit-for-purpose measurement instruments and procedures are needed for use in multi-trait, multi-method, multi-informant studies in a range of populations and contexts.

Predictive Validity of Image-Based Motivation-to-Eat Visual Analogue Scales in Normal Weight Children and Adolescents Aged 9-14 Years

Paper-based motivation-to-eat visual analogue scales (VASs) developed for adults are widely used in the pediatric age range. The VAS is comprised of four domains: hunger, fullness, desire to eat, and prospective food consumption. The purpose of the present study was to determine agreement between the traditional paper-based VAS and a novel digital VAS (with and without images), as well as the novel digital VAS's predictive validity for subsequent food intake (FI) in 9-14-year-old children and adolescents. Following an overnight fast and 3 h after consuming a standardized breakfast at home, children and adolescents (n = 17) completed three different VAS instruments (VAS_paper, VAS_images, VAS_no-images) in a randomized order at five time-points: 0 min (baseline), 5 min (immediately after consuming a 147 kcal yogurt treatment), 20 min, 35 min (immediately before an ad libitum lunch), and 65 min (immediately post ad libitum lunch). All three instruments were comparable, as shown by low bias and limits of agreement on Bland-Altman plots, moderate to excellent intraclass correlation coefficients for all domains at all time-points (ICC = 0.72-0.98), and no differences between the incremental area under the curve for any of the domains. All three instruments also showed good predictive validity for subsequent FI, with the strongest relationship observed immediately before the ad libitum lunch (p = 0.56-0.63). There was no significant association between subjective thirst and water intake, except with VAS_no-images at baseline (r = 0.49, p = 0.046). In conclusion, the present study suggests that a novel image-based digital VAS evaluating motivation-to-eat is interchangeable with the traditional paper-based VAS, and provides good predictive validity for next-meal FI in 9-14-year-old normal weight children and adolescents.