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AlTarrah D, Lanigan J, Feehan J, Al Dhaheri AS, Shah SM, Cheikh Ismail L, Singhal A. Infant feeding practices and risk of preschool obesity in AlAin, UAE: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002803. [PMID: 38330043 PMCID: PMC10852324 DOI: 10.1371/journal.pgph.0002803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024]
Abstract
Early childhood obesity is serious public health problem, and poses a risk of obesity in later life. The study aimed to investigate whether infant feeding affects risk of overweight and obesity in preschool children in the United Arab Emirates (UAE). A cross-sectional study was carried out. Data was collected in a kindergarten in Al Ain, UAE. One hundred and fifty parents and preschool children aged 2 to 6 years participated in the study. Univariate and multivariate linear regression were used to investigate associations. A longer duration of breastfeeding and later introduction of complementary foods were associated with a lower BMI z-score in preschool children. Each month of any breastfeeding was associated with a lower BMI z-score in the unadjusted model (β = -0.03; 95% CI -0.05, -0.01; p = 0.01), and each month increase in the age of introducing complementary foods was associated with a lower BMI z-score in the unadjusted model (β = -0.43; 95% CI: -0.60 to-0.027; p<0.001). These associations remained after adjustment for potential confounding factors (age, sex, maternal BMI, maternal education level, mother's age, social class, father's BMI) for duration of breastfeedinig (β = -0.02; 95% CI: -0.05 to 0.00; p<0.001) and age of complementary feeding (β = -0.39; 95% CI: -0.57 to-0.21; p<0.001). Poor infant feeding practices (shorter duration of breastfeedinig and early introduction of complementary foods) were found to be associated with higher BMI in preschool children. Promoting appropriate proper infant feeding practices in line with recommendations could be one strategy to help prevent childhood obesity in the UAE.
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Affiliation(s)
- Dana AlTarrah
- Department of Social and Behavioral Sciences, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait
| | - Julie Lanigan
- Joint institution UCL Great Ormond Street Hospital, Institute of Child Health, University College London, London, United Kingdom
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Ayesha S. Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Women’s and Reproductive Health, University of Oxford, Nuffield, Oxford, United Kingdom
| | - Atul Singhal
- Joint institution UCL Great Ormond Street Hospital, Institute of Child Health, University College London, London, United Kingdom
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Tavares M, Chiu CJ, Hasturk H, Lake K, O’Keefe AC, De Armas V, Yaskell T, Esberg A, Johansson I, Tanner AC. Household, dietary, and clinical characteristics of childhood caries and overweight progression-A prospective cohort study. Int J Paediatr Dent 2024; 34:35-46. [PMID: 37309985 PMCID: PMC10716355 DOI: 10.1111/ipd.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/08/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Childhood caries and obesity are complex chronic diseases with negative health outcomes. AIM This study sought a risk profile for childhood caries and overweight. DESIGN Children were recruited into a longitudinal prospective cohort study. Caries and overweight characteristics were obtained at baseline, 6, 12, and 18 months. Sequential data modeling steps determined a disease risk profile. RESULTS At baseline, 50% of the children (n = 194, 3.0 to 6.9 years) had caries; 24% were overweight, of whom 50% had caries. Correlation analysis separated child characteristics from household circumstances. Principal component modeling separated child snacking from meal-eating patterns, and household smoking from parent education variables. Baseline caries and overweight were not associated, but they grouped together in the modeling of composite features. Forty-five percent of children showed caries progression, 29% overweight progression, and 10% progression of both diseases. The strongest predictors of progression were disease presence, household-based characteristics, and sugary drinks. Children with caries and overweight progression shared multiple child- and household-based features. CONCLUSION Individually, caries and overweight were not associated. Children with progression of both conditions shared a profile and multiple risk characteristics suggesting these findings could be useful in assessing the risk for the most extreme cases of caries and overweight.
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Affiliation(s)
- Mary Tavares
- The Forsyth Institute, Cambridge, MA, 02142, USA
- Harvard School of Dental Medicine, Boston, MA, 02115, USA
| | | | | | - Kristina Lake
- Waterville Community Dental Center, Waterville ME. 04901, USA
| | - Anna C. O’Keefe
- Waterville Community Dental Center, Waterville ME. 04901, USA
| | | | - Tina Yaskell
- The Forsyth Institute, Cambridge, MA, 02142, USA
| | - Anders Esberg
- Department of Odontology, Umeå University, Umeå, Sweden
| | | | - Anne C Tanner
- The Forsyth Institute, Cambridge, MA, 02142, USA
- Harvard School of Dental Medicine, Boston, MA, 02115, USA
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Krijger A, Steenbergen E, Schiphof-Godart L, van Rossum C, Verkaik-Kloosterman J, Elstgeest L, Ter Borg S, Raat H, Joosten K. Clusters of lifestyle behaviours and their associations with socio-demographic characteristics in Dutch toddlers. Eur J Nutr 2023; 62:1143-1151. [PMID: 36434406 PMCID: PMC10030397 DOI: 10.1007/s00394-022-03056-x] [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: 06/08/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aimed to identify clusters of lifestyle behaviours in toddlers and assess associations with socio-demographic characteristics. METHODS We used data from the Dutch National Food Consumption Survey 2012-2016 and included 646 children aged 1-3 years. Based on 24-h dietary recalls and a questionnaire, a two-step cluster analysis was conducted to identify clusters in the intake of fruit, vegetables, sugar-sweetened beverages and unhealthy snacks, physical activity and screen time. Logistic regression models assessed associations between socio-demographic characteristics and cluster allocation. RESULTS Three clusters emerged from the data. The 'relatively healthy cluster' demonstrated a high intake of fruit and vegetables, low sugar-sweetened beverage and unhealthy snack intake and low screen time. The 'active snacking cluster' was characterised by high unhealthy snack intake and high physical activity, and the 'sedentary sweet beverage cluster' by high intake of sugar-sweetened beverages and high screen time. Children aged 1 year were most likely to be allocated to the 'relatively healthy cluster'. Compared to children of parents with a high education level, children of parents with a low or middle education level were less likely to be in the 'relatively healthy cluster', but more likely to be in the 'sedentary sweet beverage cluster'. CONCLUSION Clusters of lifestyle behaviours can be distinguished already in children aged 1-3 years. To promote healthy lifestyle behaviour, efforts may focus on maintaining healthy behaviour in 1-year-olds and more on switching towards healthy behaviour in 2- and 3-year-olds.
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Affiliation(s)
- Anne Krijger
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands.
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Elly Steenbergen
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lieke Schiphof-Godart
- Department of Medical Informatics, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Caroline van Rossum
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Liset Elstgeest
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Sovianne Ter Borg
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Koen Joosten
- Department of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands
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Joint Effects of Prenatal Folic Acid Supplement with Prenatal Multivitamin and Iron Supplement on Obesity in Preschoolers Born SGA: Sex Specific Difference. Nutrients 2023; 15:nu15020380. [PMID: 36678251 PMCID: PMC9863758 DOI: 10.3390/nu15020380] [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: 12/24/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Prenatal maternal nutrient supplementation has been reported to be associated with offspring obesity, but the reports are inconsistent and have mainly ignored the differences between the total children population and children born small for gestational age (SGA). This study aimed to examine the joint effects of folic acid, iron, and multivitamin supplementation during pregnancy on the risk of obesity in preschoolers born SGA. A total of 8918 children aged 3-6.5 years born SGA were recruited from Longhua District in Shenzhen of China in 2021. Their mothers completed a structured questionnaire about the child's and parents' socio-demographic characteristics, maternal prepregnant obesity, and mothers' prenatal supplementation of folic acid, iron, and multivitamin. In addition, the children's current weight and height were measured by trained nurses. Logistic regression models were used to analyze the associations between prenatal supplementations and the current presence of childhood obesity. After controlling for potential confounders, the results of the logistic regression analysis showed that prenatal supplement of folic acid (OR = 0.72, 95% CI = 0.55~0.93) was associated with a lower likelihood of being an obese preschooler born SGA. In contrast, the ingestion of multivitamin or iron supplements during pregnancy did not seem to be related to the likelihood of childhood obesity in preschoolers born SGA. Moreover, cross-over analysis of prenatal folic acid and multivitamin obtained significant negative associations of prenatal folic acid supplement only (OR = 0.73, 95% CI = 0.55~0.97) and combination supplement of folic acid and multivitamin (OR = 0.67, 95% CI = 0.50~0.90) with obesity of preschoolers born SGA; while the cross-over analysis of prenatal folic acid and iron observed significant negative associations between obesity of preschoolers born SGA and a combination supplement of folic acid and iron (OR = 0.70, 95% CI = 0.52~0.96). Furthermore, the aforementioned significant associations were only found in girls and not in boys when the analyses were stratified by sex. Our findings suggest that the prenatal folic acid supplementation may decrease the risk of obesity in preschool girls born SGA, and that this effect may be modified by prenatal multivitamin or iron supplementation.
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de Bona Coradi F, Anele CR, Goldani MZ, da Silva CH, Bernardi JR. Maternal diet quality and associations with body composition and diet quality of preschool children: A longitudinal study. PLoS One 2023; 18:e0284575. [PMID: 37167269 PMCID: PMC10174545 DOI: 10.1371/journal.pone.0284575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/04/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Nutrition, associated with nutritional status, influences the growth of children. This study aimed to identify the association between maternal diet quality and the diet and body composition of their children. METHODS This is a prospective longitudinal study with mother-child pairs. To assess diet quality, nutritional status, and socioeconomic data, two interviews in the children's first and third months of life (2011-2016) and one interview when children were of preschool age (2017-2019) were performed. Diet quality was assessed based on daily food consumption and frequency, considering: 1) food groups, based on the Brazilian food pyramid; 2) level of processing, according to the NOVA classification (unprocessed and/or minimally processed foods, processed foods and ultra-processed foods). One-way ANOVA with Tukey post hoc and Kruskal-Wallis with Dunn's post hoc tests were used to evaluate the influence of factors on children's diet quality. Pearson and Spearman's correlations were used to evaluate the relationship between maternal and children's diet quality, maternal schooling level, and child age. Along with the nutritional assessment of children, multiple linear regression models assessed the impact of covariables on maternal and children's diet quality. RESULTS Eighty-three mother-child pairs participated in this study. The more frequent the maternal consumption of unprocessed and/or minimally processed foods, the higher the consumption of these foods by children (r = +0.30; p = 0.006) and the lower their subscapular skinfold (SSF) thickness (p = 0.011; β = -0.278). On the other hand, the higher the maternal consumption of ultra-processed foods, the higher the children's tricipital skinfold (TSF) thickness (p = 0.010; β = +0.274) and SSF (p = 0.043; β = +0.222). CONCLUSION Maternal diet quality was associated with the diet and body composition of children.
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Affiliation(s)
- Fernanda de Bona Coradi
- Graduate Program in Child and Adolescent Health, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Carolina Ribeiro Anele
- Graduate Program in Child and Adolescent Health, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marcelo Zubaran Goldani
- Graduate Program in Child and Adolescent Health, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Pediatrics, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Clécio Homrich da Silva
- Graduate Program in Child and Adolescent Health, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Pediatrics, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Juliana Rombaldi Bernardi
- Graduate Program in Child and Adolescent Health, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
- Department of Nutrition, Faculty of Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Zhang D, Zheng J. The Burden of Childhood Asthma by Age Group, 1990-2019: A Systematic Analysis of Global Burden of Disease 2019 Data. Front Pediatr 2022; 10:823399. [PMID: 35252064 PMCID: PMC8888872 DOI: 10.3389/fped.2022.823399] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/21/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Asthma is a common respiratory disease in children. We aimed to update information about the incidence and mortality and disability-adjusted life years (DALYs) of childhood asthma and provide evidence-based recommendations for childhood asthma prevention. METHODS Data were obtained from the Global Burden of Disease (GBD) study, which was conducted from 1990 to 2019 in 204 countries. First, we estimated incidence, mortality and DALY rates of childhood asthma using a Bayesian meta-regression model. Second, we analyzed the relationship between the sociodemographic index (SDI) and DALYs in different age groups. Third, we studied changes in trends of the age-standardized DALY rate between 1990 and 2019 based on age group, SDI, and risk factors. RESULTS Globally, the number of deaths due to childhood asthma and the incidence and DALY rates were 12.9 thousand (95% UI 10.6 to 15.7), 22 million (95% UI 15 to 31), and 5.1 million (95% UI 3.4 to 7.5) in 2019, decreasing by 65.1% (95% UI 47.6 to 72.4), 5.3% (95% UI 2.6 to 8.8) and 30% (95% UI 18 to 41) from those in 1990, respectively. With the exception of high-SDI regions, the age-standardized DALY rate in all age groups in all SDI regions declined. In 2019, the age-standardized DALY rate in 1- to 4-year-old individuals was highest in low-SDI regions and that of 5- to 19-year-old individuals was highest in high-SDI regions. In contrast to low-SDI regions, individuals in high-SDI regions had a higher risk of DALYs due to asthma, except in those aged 1 to 4 years. A high body mass index (BMI) was a stronger risk factor than occupational asthmagens for childhood asthma. CONCLUSION Our findings provide insight into asthma prevention and treatment through the identification of key factors related to childhood asthma. Based on the data available, different risk factors according to age group and region/country suggest different prevention strategies, which is key for preventing childhood asthma.
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Affiliation(s)
- Daoqi Zhang
- Department of Internal Medicine Teaching and Research Section, Xuancheng Vocational and Technical College, Xuancheng, China
| | - Jinxin Zheng
- Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Farewell CV, Donohoe R, Thayer Z, Paulson J, Nicklas J, Walker C, Waldie K, Leiferman JA. Maternal depression trajectories and child BMI in a multi-ethnic sample: a latent growth modeling analysis. BMC Pregnancy Childbirth 2021; 21:827. [PMID: 34903186 PMCID: PMC8667413 DOI: 10.1186/s12884-021-04308-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perinatal (antenatal and postpartum) depression impacts approximately 12% of mothers. Perinatal depression can impact everyday functioning for mothers, and the relationship with, and development of, their children. The purpose of this study was to investigate depression trajectories from the antenatal period through 54-months postpartum and associations with child body mass index at 54-months postpartum. METHODS This study applied latent growth modeling to the Growing Up in New Zealand study, which is a longitudinal pregnancy cohort study that provides nationally representative-level data, to investigate associations between depression at three time points (antenatal, 9-months postpartum, 54-months postpartum) and child body mass index at 54-months (n=4897). RESULTS The average slope of depression for this sample is low and decreases over time. When child BMI was added to the model as an outcome variable, both antenatal depression (B=.25, p<.01), and the rate of change of depression across the perinatal and postpartum periods (B=.09, p<.01) were associated with child BMI at 54-months postpartum. After controlling for sociodemographic characteristics, antenatal depression, but not the slope of depression, remained significantly associated with child BMI (B=.05, p<.05). When controlling for maternal pre-pregnancy BMI the effect of antenatal depression on child BMI at 54-months was entirely attenuated (χ2 (9) = 39.60, p < .05, SRMR = 0.01, CFI = .99, RMSEA = 0.03, BIC=53213). CONCLUSIONS Our findings align with the Developmental Origins of Health and Disease theory and imply that both the physical and mental health of mothers during pregnancy may be important indicators of child growth and development outcomes. Early intervention directed towards women who have even mild depression scores during pregnancy may promote healthy child development outcomes. Additionally, given the heterogeneity of depressive symptoms over time seen in this study, multiple assessment periods across the postpartum period may be valuable to adequately address and support maternal mental health.
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Affiliation(s)
- Charlotte V Farewell
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA.
| | - Ryley Donohoe
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA
| | | | - James Paulson
- Old Dominion University, Norfolk University, Norfolk, VA, USA
| | - Jacinda Nicklas
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA
| | | | | | - Jenn A Leiferman
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado - Anschutz Medical Campus, 13001 East 17th place Mail Stop B119, Aurora, CO, 80045, USA
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KOÇ ET, ÇALIŞKAN Z, ERDEM E. Factors affecting obesity in preadolescents: the case of Cappadocia. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.920570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Exploring Feeding Practices and Food Literacy in Parents with Young Children from Disadvantaged Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041496. [PMID: 33557440 PMCID: PMC7915516 DOI: 10.3390/ijerph18041496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
Early childhood provides an opportunity to optimize growth and development and parents play a fundamental role in forming healthy eating habits in their children. A healthy diet improves quality of life and wellbeing and reduces the risk of chronic disease. The aim of this research was to explore parents' experiences of feeding 0-5-year-old children and food literacy behaviors. This qualitative study employed a general inductive inquiry approach. Participants were recruited through community-based parenting organizations in disadvantaged areas. Eight focus groups were conducted with 67 parents (92.5% female) living in socially disadvantaged areas within metropolitan Perth of Western Australia. Ten themes emerged from the preliminary analysis and were aligned with domains of relatedness, autonomy, and competence within the self-determination theory. Themes included relatedness (1) feeding is emotional, (2) variations in routine and feeding structures, (3) external influences, autonomy (4) power struggles, (5) it must be quick and easy, (6) lack of strategies for feeding autonomy, competency (7) whatever works, (8) healthy is important but for some unattainable, (9) improvements in food literacy skills, and (10) conflicting information overload. This research informed the development of a food literacy program for parents. Parents faced many challenges when trying to provide healthy food. This research has shown parents would benefit from support to achieve healthy eating practices for their families.
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