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Hopkins J, Merritt R. Strategies to Promote Success in Oral Feedings in Infants and Children with Intestinal Failure due to Short Bowel Syndrome. Gastroenterol Clin North Am 2024; 53:329-341. [PMID: 38719382 DOI: 10.1016/j.gtc.2024.01.008] [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] [Indexed: 05/25/2024]
Abstract
Infants and children with intestinal failure are at risk for pediatric feeding disorders, which challenge their oral feeding development. This article explores these challenges and offers several practical strategies that can be used by multidisciplinary care teams and at-home caregivers to help support the development of oral feeding in these children and eventually lead to their attaining enteral autonomy.
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Affiliation(s)
- Judy Hopkins
- Division of Occupational Therapy, Children's Hospital Los Angeles, Los Angeles, CA, USA.
| | - Russell Merritt
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Ares G, De Rosso S, Mueller C, Philippe K, Pickard A, Nicklaus S, van Kleef E, Varela P. Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets. Nutr Rev 2024; 82:536-552. [PMID: 37339527 PMCID: PMC10925906 DOI: 10.1093/nutrit/nuad072] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
Food literacy has emerged as a key individual trait to promote the transformation of food systems toward healthy and sustainable diets. Childhood and adolescence are key periods for establishing the foundations of eating habits. Different food literacy competencies are acquired as children develop different cognitive abilities, skills, and experiences, contributing to the development of critical tools that allow them to navigate a complex food system. Thus, the design and implementation of programs to support the development of food literacy from early childhood can contribute to healthier and more sustainable eating habits. In this context, the aim of the present narrative review is to provide an in-depth description of how different food literacy competencies are developed in childhood and adolescence, integrating the extensive body of evidence on cognitive, social, and food-related development. Implications for the development of multisectoral strategies to target the multidimensional nature of food literacy and promote the development of the 3 types of competencies (relational, functional, and critical) are discussed.
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Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Pando, Canelones, Uruguay
| | - Sofia De Rosso
- Centre des Sciences du Goût et de l’Alimentation, Centre National de la Recherche Scientifique, Institut National de la Recherche Agronomique, Institut Agro, Université de Bourgogne, Dijon, France
| | - Carina Mueller
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Kaat Philippe
- Centre des Sciences du Goût et de l’Alimentation, Centre National de la Recherche Scientifique, Institut National de la Recherche Agronomique, Institut Agro, Université de Bourgogne, Dijon, France
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Ireland
| | - Abigail Pickard
- Center for Food and Hospitality Research, Cognitive Science, Institut Paul Bocuse Research Center, Lyon, France
- Laboratoire d’Etude de l’Apprentissage et du Développement–Centre National de la Recherche Scientifique UMR5022, University of Burgundy, Dijon, France
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Sophie Nicklaus
- Centre des Sciences du Goût et de l’Alimentation, Centre National de la Recherche Scientifique, Institut National de la Recherche Agronomique, Institut Agro, Université de Bourgogne, Dijon, France
| | - Ellen van Kleef
- Marketing and Consumer Behaviour Group, Wageningen University and Research, Wageningen, the Netherlands
| | - Paula Varela
- Nofima AS, Ås, Norway
- Department of Chemistry, Biotechnology and Food Science, The Norwegian University of Life Science, Ås, Norway
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Bernate Angulo SV, Nezami BT, Martin SL, Kay MC, Richardson TN, Wasser HM. Concordance in dietary intake among caregivers and infants during the period of complementary feeding: A scoping review. Appetite 2024; 194:107178. [PMID: 38141877 PMCID: PMC11027945 DOI: 10.1016/j.appet.2023.107178] [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: 08/22/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
Dietary intake during infancy shapes later food preferences and is important for short- and long-term health and wellbeing. Although caregivers are thought to influence the developing food preferences of infants, children less than two years have been notably absent in existing meta-analyses on the topic. This scoping review seeks to fill this gap by using a systematic process to identify and summarize the published literature on the resemblance of caregiver and infant diet during the period of complementary feeding (6-23 months). Articles were included if they assessed intake of foods or beverages other than human milk or commercial milk formula and reported a test of association between the intake of caregivers and infants. Four electronic databases (PubMed, EMBASE, Scopus, and Global Health) were systematically searched for articles published since 2000. Thirty-three articles, representing 32 studies, were identified. The majority of studies examined infant intake of food groups/items (n = 20), seven studies examined infant dietary patterns, and six studies examined dietary diversity. Studies predominantly reported associations between diets of mothers and infants (n = 31); three studies reported associations for fathers. Most studies assessed infant diet at one timepoint (n = 26), with 12 studies combining the intakes of younger (0-11 months) and older infants (12-23 months). Food groups examined, in order of frequency, included 'non-core' foods and beverages (n = 14), vegetables (n = 13), fruits (n = 12), protein foods (n = 6), grains (n = 5), and dairy foods (n = 4). Definitions of variables for food groups and dietary patterns were highly heterogeneous, but consistent for dietary diversity. Nearly all studies (n = 31) reported significant associations between dietary intakes of caregivers and infants. Findings suggest caregiver diet may be a promising focus for interventions aiming to shape the food preferences and dietary intakes of infants.
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Affiliation(s)
- Sara V Bernate Angulo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Brooke T Nezami
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC, 27708, USA
| | - Taylor N Richardson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Heather M Wasser
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Saunders CM, Rehbinder EM, Carlsen KCL, Jonassen CM, LeBlanc M, Nordlund B, Skjerven HO, Söderhäll C, Vettukattil R, Carlsen MH. Feeding Practices and Dietary Diversity in the First Year of Life: PreventADALL, a Scandinavian Randomized Controlled Trial and Birth Cohort Study. J Nutr 2023; 153:2463-2471. [PMID: 37336319 PMCID: PMC10447610 DOI: 10.1016/j.tjnut.2023.06.015] [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: 11/18/2022] [Revised: 05/04/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Breastmik is considered the optimal source of nutrition in early infancy. However, recommendations and practices for when and how complementary food should be introduced in the first year of life vary worldwide. Early introduction of allergenic foods may prevent food allergies, but if early food introduction influences infant feeding practices is less known. OBJECTIVES We sought to assess infant feeding practices in the first year of life and to determine if early interventional food introduction influences breastfeeding and dietary diversity. METHODS Dietary intake was assessed in infants from the population-based clinical trial Preventing Atopic Dermatitis and ALLergies (PreventADALL) in children study. A total of 2397 infants were cluster-randomized at birth into 4 different groups: 1) control, 2) skin intervention, 3) introduction to 4 allergenic foods between 3 and 4 mo of age: peanut, cow milk, wheat, and egg, as small tastings until 6 mo, and 4) combined skin and food interventions. Dietary data were available from at least one of the 3-, 6-, 9-, and 12-mo questionnaires in 2059 infants. In the present analysis, groups 1 and 2 constitute the No Food Intervention group, whereas groups 3 and 4 constitute the Food Intervention group. We used the log-rank test and Cox regression to assess the impact of food intervention on age of breastfeeding cessation. Mixed effects logistic regression was used to compare dietary diversity, defined as the number of food categories consumed, between intervention groups. RESULTS At 3, 6, 9, and 12 mo, 95%, 88%, 67%, and 51% were breastfed, respectively, and breastfeeding duration was not affected by the food intervention. In the No Food Intervention group, mean age of complementary food introduction was 18.3 wk (confidence interval [CI]: 18.1, 18.5). In the Food Intervention group, the dietary diversity score was 1.39 units (CI: 1.16, 1.62) higher at 9 mo (P < 0.001) and 0.7 units (CI: 0.5, 0.9) higher at 12 mo (P < 0.001) compared to the No Food Intervention group. CONCLUSIONS Early food intervention did not affect breastfeeding rates and increased dietary diversity at 9 and 12 mo.
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Affiliation(s)
- Carina Madelen Saunders
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
| | - Eva Maria Rehbinder
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Department of Dermatology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Christine Monceyron Jonassen
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway; Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of LifeSciences, Ås, Norway
| | - Marissa LeBlanc
- Oslo University Hospital and University of Oslo, Oslo, Norway, Oslo Centre for Biostatistics and Epidemiology
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Håvard Ove Skjerven
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Riyas Vettukattil
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Monica Hauger Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Brunacci KA, Salmon L, McCann J, Gribble K, Fleming CAK. The big squeeze: a product content and labelling analysis of ready-to-use complementary infant food pouches in Australia. BMC Public Health 2023; 23:656. [PMID: 37024884 PMCID: PMC10077707 DOI: 10.1186/s12889-023-15492-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 03/21/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Encouraging the early development of healthy eating habits prevents diet-related chronic disease. It is well understood that highly processed foods with high amounts of sugars, salt and fats are a risk factor for non-communicable diseases. Commercial baby foods in ready-to-use squeeze pouches emerged in the global food market around 2012. The long-term effects of this now ubiquitous packaging on the quality of infant diets, baby food consumption and marketing are unknown. This study aimed to conduct a rigorous mixed-methods audit of squeeze pouches in Australia to inform product regulation and policy. METHODS Nutritional and marketing data were sourced from products available in Australian retailers. Analysis of nutritional content, texture and packaging labelling and serving size was conducted. Pouches were given a Nutrition Profile Index (NPI) score and compared with the Australian Infant Feeding Guidelines. Marketing text was thematically analysed and compared to existing infant nutrition policy around regulation of marketing claims. RESULTS 276 products from 15 manufacturers were analysed, targeting infants from 4 + to 12 + months. Total sugar content ranged 0.8-17.5 g/100 g, 20% (n = 56) of products had added sugars, 17% (n = 46) had added fruit juice, 71% (n = 196) had added fruit puree. Saturated fat content ranged from 0.0 to 5.0 g/100 g, sodium 0.0-69 mg/100 g and dietary fibre 0.0-4.3 g/100 g. Only two products were nutritionally adequate according to a nutrient profiling tool. Marketing messages included ingredient premiumisation, nutrient absence claims, claims about infant development and health, good parenting, and convenience. Claims of 'no added sugar' were made for 59% of pouches, despite the addition of free sugars. CONCLUSIONS Squeeze pouch products available in Australia are nutritionally poor, high in sugars, not fortified with iron, and there is a clear risk of harm tothe health of infant and young children if these products are fed regularly. The marketing messages and labelling on squeeze pouches are misleading and do not support WHO or Australian NHMRC recommendations for breastfeeding or appropriate introduction of complementary foods and labelling of products. There is an urgent need for improved regulation of product composition, serving sizes and labelling to protect infants and young children aged 0-36 months and better inform parents.
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Affiliation(s)
- Kaitlyn A Brunacci
- School of Health Sciences, Western Sydney University, Sydney, Australia.
| | - Libby Salmon
- School of Regulation and Global Governance, The Australian National University, Canberra, Australia
| | | | - Karleen Gribble
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Catharine A K Fleming
- School of Health Sciences, Western Sydney University, Sydney, Australia
- Translational Health Research Institute, Western Sydney University, Western Sydney University, Sydney, Australia
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Johansson U, Öhlund I, Lindberg L, Hernell O, Lönnerdal B, Venables M, Lind T. A randomized, controlled trial of a Nordic, protein-reduced complementary diet in infants: effects on body composition, growth, biomarkers and dietary intake at 12 and 18 months. Am J Clin Nutr 2023:S0002-9165(23)46303-4. [PMID: 36990225 DOI: 10.1016/j.ajcnut.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND High intake of protein and low intake of plant-based foods during complementary feeding (CF) can contribute to negative long-term health effects. OBJECTIVES To investigate the effects of a protein-reduced, Nordic complementary diet on body composition, growth, biomarkers and dietary intake, compared to current Swedish dietary recommendations for infants at 12 and 18 months. DESIGN Healthy, term infants (n=250) were randomly allocated to either a Nordic group (NG) or a conventional group (CG). From 4-6 months, NG participants received repeated exposures of Nordic taste portions. From 6 months to 18 months, NG was supplied with Nordic homemade baby food recipes, protein-reduced baby food products and parental support. CG followed the current Swedish dietary recommendations. Measurements of body composition, anthropometry, biomarkers and dietary intake were collected from baseline and at 12 and 18 months. RESULTS Of the 250 infants, 82% (n=206) completed the study. There were no group differences in body composition or growth. In NG, protein intake, blood urea nitrogen (BUN) and plasma insulin-like growth factor 1 (IGF-1) were lower compared to CG at 12 and 18 months. Infants in NG consumed 42-45% more fruits and vegetables compared to CG at 12 and 18 months, which was reflected in a higher plasma folate at 12 and 18 months. There were no between-group differences in energy intake (EI) or iron status. CONCLUSIONS Introduction of a predominantly plant-based, protein-reduced diet as part of complementary feeding is feasible and can increase fruit and vegetable intake. CLINICAL TRIAL REGISTRY OTIS; ClinicalTrials.gov registration number NCT02634749.
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Affiliation(s)
- Ulrica Johansson
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
| | - Inger Öhlund
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Lene Lindberg
- Department of Global Public Health, Karolinska Institutet and Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Olle Hernell
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Bo Lönnerdal
- Department of Nutrition, University of California, Davis, CA, United States
| | - Michelle Venables
- Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Torbjörn Lind
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
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Treatment of Food Aversion and Eating Problems in Children with Short Bowel Syndrome: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101582. [PMID: 36291518 PMCID: PMC9600729 DOI: 10.3390/children9101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/10/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Food Aversion (FA) is a strong refusing behaviour to the oral assumption of food that can affect children with Short Bowel Syndrome (SBS). Management includes behavioural and Messy Play treatments, with few reports on systematic strategies to return the patient to enjoyable eating. We conducted a systematic review to better understand this complex and vital issue. (1) Materials and Methods: We investigated publications using MEDLINE, Embase, and the Web of Science to include articles published up to July 2022. The inclusion criteria were original articles including paediatric patients (aged < 18 years old) affected by SBS and Intestinal Failure (IF) who underwent treatment for FA. (2) Results: A total of 24 patients received treatment—15 (62.5%) patients were male and 9 (37.5%) were female. The age range was from 1 month to 16 years. Treatment of FA was carried out by behavioural therapy in 2 patients and Messy Play Therapy in 12 patients already surgically and pharmacologically managed for SBS. The treatment results showed complete weaning from Parenteral Nutrition in 9/14 cases (64%) using the behavioural treatment and 7/12 cases using Messy Play Therapy. (3) Conclusions: FA is a rare but disabling condition that often affects SBS patients, worsening their overall health and quality of life. This condition should be addressed in an Intestinal Rehabilitation Centre context. Our review sheds light on the literature gap regarding FA, and further studies are required to understand better which treatment options best suit SBS paediatric patients.
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Fultz AK, Burns KF, Davey A, Trabulsi J, Robson SM. Dietary Energy Density from Infancy to 5 Years: Results from NHANES 2009-2018. J Nutr 2022; 152:1936-1943. [PMID: 35671169 DOI: 10.1093/jn/nxac133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/25/2022] [Accepted: 06/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nutrient-dense foods, which are often low in energy density (ED), are recommended for a healthy diet in infants and children. How ED changes during the transition from a complementary diet in infancy to a conventional diet is unknown. OBJECTIVES We aimed to describe the ED, the amount of energy (e.g., kcal) per weight (e.g., g), of food or beverage in infants and preschool-age children. It was hypothesized that ED would be higher among older children. METHODS The ED of food (ED-Food Only) and of food and all beverages excluding human milk and infant formula (ED-Food and Beverages) of children's (6 mo-5 y) diets were examined overall and by age subgroups using data from the NHANES (2009-2018). Survey-adjusted linear regression followed by pairwise comparisons were used to compare ED across age subgroups. The percentages of calories consumed from low-, medium-, and high-ED foods across age subgroups were also examined. RESULTS Mean ED-Food Only was 1.21 kcal/g (95% CI: 1.13, 1.29 kcal/g) among 6- to 11-mo-olds and 1.62 kcal/g (95% CI: 1.54, 1.69 kcal/g) among 12- to 17-mo-olds (P < 0.05). ED-Food and Beverages was higher across consecutive age subgroups from 0.99 kcal/g (95% CI: 0.96, 1.02 kcal/g) in 12-17 mo through 3 y (1.22 kcal/g; 95% CI: 1.19, 1.26 kcal/g; P < 0.05). Mean percentage of calories consumed from low-ED food (≤1.0 kcal/g) became lower with age from 6- to 11-mo-olds (47.3%; 95% CI: 44.3%, 50.4%) through 18- to 23-mo-olds (16.2%; 95% CI: 14.5%, 17.9%; P < 0.05). A greater percentage of calories was consumed from high-ED food (≥3.0 kcal/g) among 18- to 23-mo-olds (39.0%; 95% CI: 37.1%, 40.9%) than among 12- to 17-mo-olds (34.0%; 95% CI: 32.0%, 35.9%; P < 0.05). CONCLUSIONS ED increased across age subgroups, driven by a decrease in the percentage of calories consumed from low-ED food and an increase in the percentage of calories consumed from high-ED food.
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Affiliation(s)
- Amanda K Fultz
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA.,Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kaelyn F Burns
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA.,Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Adam Davey
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Jillian Trabulsi
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
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Gama AP, Matumba L, Munthali J, Namaumbo S, Chimbaza M, Ngoma T, Kammwamba K, Chisapo G, Chilembo M, Meleke N, Chirwa R, Fungo R. Acceptability of orange corn-common bean as an alternative to corn-soybean complementary porridge in Malawi. J Food Sci 2022; 87:3163-3172. [PMID: 35703569 DOI: 10.1111/1750-3841.16225] [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: 12/13/2021] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
Abstract
This study assessed the acceptability of porridge from a corn-common bean flour blend to increase the diversity of complementary foods in Malawi. Porridges prepared using commercial corn-soybean flour (C-CSB), homemade orange corn-soybean flour (H-CSB), and orange corn-common bean flour (CCBB) were evaluated by 101 pairs of mothers and their respective children aged from 6 to 24 months. A home use test (HUT) setup was used in this study, and the flours were given sequentially to participating households following a randomized complete block design. Each sample type was evaluated for 3 days in a row followed by a 1-day break (washout period) between sample types. Based on aggregate mean scores, all the samples were liked by both the children and their mothers. However, clustering results revealed two distinct consumer segments for mothers as well as for children. Most of the mothers (59.4% in cluster 1) liked all the samples, while the minority (cluster 2) were neutral (neither like nor dislike) regarding the H-CSB porridge. Likewise, most children (66.3% in cluster 2) liked all the samples, while the rest in cluster 1 did not like CCBB porridge. Infants (≤12 months) and those from food-insecure households, respectively, were 5.42 and 6.75 times more likely to like the CCBB porridge than their counterparts. The study has demonstrated the potential of introducing CCBB complementary porridge in Malawi and possibly in other countries with similar food preferences and socioeconomic stature. PRACTICAL APPLICATION: The study provides a solution to the limited diversity of complementary foods in sub-Saharan Africa and Malawi in particular. The findings can help food scientists, nutritionists, marketers, and policymakers develop strategies for promoting the consumption of orange corn-common bean porridge. Furthermore, the findings can inform decisions on commercializing orange corn-common bean flour by flour processors.
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Affiliation(s)
- Aggrey Pemba Gama
- Department of Food Science and Technology, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Limbikani Matumba
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Justice Munthali
- Alliance of Bioversity International and the International Centre for Tropical Agriculture (CIAT), Lilongwe, Malawi
| | - Sydney Namaumbo
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Monica Chimbaza
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Theresa Ngoma
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Kondwani Kammwamba
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Gift Chisapo
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Madalitso Chilembo
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Nyadani Meleke
- Food and Nutrition Group, Faculty of Life Sciences and Natural Resources, Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Rowland Chirwa
- Alliance of Bioversity International and the International Centre for Tropical Agriculture (CIAT), Lilongwe, Malawi
| | - Robert Fungo
- Alliance for Bioversity International and the CIAT, Kampala, Uganda
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Abou-Dakn M, Alexy U, Beyer K, Cremer M, Ensenauer R, Flothkötter M, Geene R, Hellmers C, Joisten C, Koletzko B, Mata J, Schiffner U, Somm I, Speck M, Weißenborn A, Wöckel A. Ernährung und Bewegung im Kleinkindalter. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01519-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Abstract
Intestinal failure (IF) secondary to short bowel syndrome is a challenging and complex medical condition with significant risk for surgical and medical complications. Significant advancements in the care of this patient population have led to improved survival rates. Due to their intensive medical needs children with IF are at risk for long-term complications that require comprehensive management and close monitoring. The purpose of this paper is to review the available literature emphasizing the surgical aspects of care for children with IF secondary to short bowel syndrome. A key priority in the surgical care of this patient population includes strategies to preserve available bowel and maximize its function. Utilization of novel surgical techniques and autologous bowel reconstruction can have a significant impact on children with IF secondary to short bowel syndrome related to the function of their bowel and ability to achieve enteral autonomy. It is also important to understand the potential long-term complications to ensure strategies are put in place to mitigate risk with early detection to improve long-term outcomes.
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Affiliation(s)
- Christina Belza
- Group for Improvement of Intestinal Function and Treatment (GIFT), The Hospital for Sick Children, University of Toronto, Canada
| | - Paul W Wales
- Division of General and Thoracic Surgery, Cincinatti Children's Hospital Medical Center, University of Cincinnati, Cincinnatii, USA; Cincinnati Children's Intestinal Rehabilitation Program, Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, MLC 2023, Cincinnati, Ohio 45229, USA.
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Herawati HD, Putri AG, Purnamasari Y, Rahayu HK, Triastanti RK, Purnamasari SD, Lestari P. Nutrition Education using Booklet Media with and Without Counseling and the Association with Home Food Availability and Parent Feeding Practices in Preschool Children. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Fruit and vegetable consumption among preschool children in Indonesia is lower than recommendations, which may be due to types of food availability at home and unhealthy feeding practices such as restriction and parent pressure. Providing nutrition education through booklets and counseling on healthy food (fruit and vegetable) consumption can help to provide information to parent’s thus resulting healthy behavior, compared to merely providing booklets without counseling.
AIM: The aim of this study is to determine the effect of nutrition education using booklets with counseling versus without counseling on home food availability and parent feeding practices in preschool children.
METHODS: A quasi-experimental study utilized a pre-test and post-test design with a control group. Sampling methods included both purposive sampling and simple random sampling. Purposive sampling was used to select Danurejan district as the sub-district with the highest obesity percentage in Yogyakarta Municipality. Meanwhile, simple random sampling was applied to select children and schools (Early Childhood Education Program Pendidikan Anak Usia Dini [PAUD] or kindergartens Taman Kanak-kanak [TK]). There were 56 people (28 intervention and 28 controls) taken from 4 PAUD/TK. The intervention group received nutrition education using booklets as well as one 30–60 min counseling session carried out at the participant’s home. The control group was provided with booklets, but did not receive counseling. The pre-test was carried out before nutrition education was given, and the post-test was conducted 30 days after the nutrition education. Fruit and vegetable availability at home were assessed using questionnaire, and parent feeding practices were assessed using the Comprehensive Food Feeding Questionnaire. The statistical tests used to assess outcomes between groups included pair t-test, Wilcoxon, Mann–Whitney, and independent t-test.
RESULTS: There were increase in healthy eating guidance and monitoring before and after nutrition education was provided in the intervention group (p = 0.00; p < 0.05), but no differences were found in restriction, child control, and parent pressure (p = 0.11, p = 0.48, p = 0.28; p ≥ 0.05). There was a decrease in child control behavior before and after nutrition education in the control group (p = 0.00; p < 0.05), but there were no differences in healthy eating guidance, monitoring, restriction, and parent pressure (p = 0.17, p = 0.18, p = 0.53, 0.62; p ≥ 0.05).
CONCLUSIONS: Results demonstrate that using counseling in addition to nutrition education booklets can increase mother’s implementation use of healthy eating guidance and monitoring, with the potential to promote healthy weight within families.
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Supthanasup A, Banwell C, Kelly M, Yiengprugsawan VS. Recipe Components and Parents' Infant and Young Child Feeding Concerns: A Mixed-Methods Study of Recipe Posts Shared in Thai Facebook Groups for Parents. Nutrients 2021; 13:nu13041186. [PMID: 33916663 PMCID: PMC8065637 DOI: 10.3390/nu13041186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022] Open
Abstract
Social media is increasingly becoming a significant source of information for parents, including about feeding young children. However, little attention has been given to the characteristics of recipes for infants and young children and how they interact with parental perceptions regarding food decisions shared by users on social media. Building on findings related to shared recipe components and parental food choices, between December 2019 and July 2020, this study retrospectively collected 80 shared recipes each from five Thai Facebook groups. This extraction created 379 shared recipes with 1751 peers’ commentaries on the shared recipes’ posts. The shared recipes were classified and components quantified across child age groups, then the textual contents around the reasons behind the food choices were described qualitatively. The results showed that there were differences in meal types, food ingredients, and seasoning used across child age groups. Further analysis found that food allergy awareness was one driving concern behind parental perceptions on food choices in children’s diets. These concerns resulted in delays in the introduction of animal-source foods. Moreover, peers’ commentaries on shared recipes offered a venue for exchanging experiences with food products. Because of the potential influence on parental beliefs and perceptions, further studies are required to understand the impact of existing online communities on actual feeding practices.
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Affiliation(s)
- Abhirat Supthanasup
- Research School of Population Health, Australian National University, Acton, Canberra 2601, Australia; (C.B.); (M.K.); (V.S.Y.)
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi 11120, Thailand
- Correspondence: ; Tel.: +61-4-5261-2501
| | - Cathy Banwell
- Research School of Population Health, Australian National University, Acton, Canberra 2601, Australia; (C.B.); (M.K.); (V.S.Y.)
| | - Matthew Kelly
- Research School of Population Health, Australian National University, Acton, Canberra 2601, Australia; (C.B.); (M.K.); (V.S.Y.)
| | - Vasoontara Sbirakos Yiengprugsawan
- Research School of Population Health, Australian National University, Acton, Canberra 2601, Australia; (C.B.); (M.K.); (V.S.Y.)
- Australian Research Council Centre of Excellence in Population Ageing Research, University of New South Wales, Kensington, Sydney 2033, Australia
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Energy, Sugars, Iron, and Vitamin B12 Content of Commercial Infant Food Pouches and Other Commercial Infant Foods on the New Zealand Market. Nutrients 2021; 13:nu13020657. [PMID: 33670442 PMCID: PMC7922386 DOI: 10.3390/nu13020657] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 12/19/2022] Open
Abstract
There has been an important shift in the New Zealand infant food market over the past decade, with the majority of complementary foods now sold in “pouches”. Along with the increasing market share of commercial infant food pouches internationally, there have been growing concerns about their nutritional quality. However, research examining the nutritional quality of these pouches compared to other forms of commercial infant foods in New Zealand has not been undertaken. Nor have any studies reported the free sugars or added sugars content of these foods. To address this knowledge gap, a cross-sectional survey of infant foods sold in New Zealand supermarkets was conducted in 2019–2020. Recipes and nutrient lines were developed for the 266 foods identified (133 food pouches). The energy, iron, vitamin B12, total sugars, free sugars, and added sugars content of infant food pouches and other forms of commercial infant foods per 100 g were compared, both within food groups and by age group. Infant food pouches contained similar median amounts of energy, iron, and vitamin B12 to other forms of commercial infant foods but contained considerably more total sugars (8.4 g/100 g vs. 2.3 g/100 g). However, median free sugars and added sugars content was very low across all food groups except for “dairy” and “sweet snacks”. All “dry cereals” were fortified with iron whereas none of the infant food pouches were. Therefore, consuming food pouches to the exclusion of other commercial infant foods may place infants at risk of iron deficiency if they do not receive sufficient iron from other sources.
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Ifran MC, Suárez AB, Avellaneda MA, Kamenetzky GV. The presence of chemosensory cues transmitted through the mother's milk increases the search and ingestion responses toward bitter and sour solutions. Appetite 2021; 161:105147. [PMID: 33535059 DOI: 10.1016/j.appet.2021.105147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/06/2020] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
Olfaction is of major importance during early stages of life in altricial species. This sense allows newborns to develop different behaviors that will allow them to survive. Odors tend to be associated to contextual stimuli (such as warmth); this, in turn, enables the pups to recognize when to withdraw or approach. At the same time, olfaction modulates the acceptance of aversive flavors. The increase of approach responses toward a bitter substance during early life is enhanced by stimulation with familiar, pre-exposed odors. Newborn rats exhibit heightened grasp responses toward an artificial nipple dispensing quinine, and drink more of this bitter solution, in the presence of a pre-exposed odor (lemon or the mother's odor). The present research assessed the replicability of previous results by pre-exposing the subjects to the scent through maternal milk and using solutions with different aversive tastes. Half of the subjects (3 day-old Wistar rats) were pre-exposed to lemon odor through the maternal milk (the mother had previously ingested the lemon essence via an intragastric injection); 4 h later, all the rats were evaluated in the presence of the lemon odor with an artificial nipple containing quinine, citric acid, saline solution, or water. The results showed enhanced seeking and intake of the bitter (quinine) and sour solution (citric acid). However, this did not occur when the nipple contained water or saline solution. The evidence suggests that: During the early stages of development, familiar odors regulate the acceptance of non-palatable, otherwise rejected, flavors; and that the route of transmission of the pre-exposed odor can be through air, or through food (amniotic fluid in previous studies and, in this case, breast milk), that is, via the retronasal and orthonasal routes.
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Affiliation(s)
- María C Ifran
- Instituto de Investigaciones Médicas A Lanari, IDIM-CONICET, Universidad de Buenos Aires, Combatientes de Malvinas 3150, CP 1427, Buenos Aires, Argentina; Universidad Abierta Interamericana - Centro de Altos Estudios en Ciencias Humanas y de La Salud, Av. Montes de Oca 745, CP 1270, Buenos Aires, Argentina.
| | - Andrea B Suárez
- Instituto de Investigaciones Médicas A Lanari, IDIM-CONICET, Universidad de Buenos Aires, Combatientes de Malvinas 3150, CP 1427, Buenos Aires, Argentina
| | - Matías A Avellaneda
- Instituto de Investigaciones Médicas A Lanari, IDIM-CONICET, Universidad de Buenos Aires, Combatientes de Malvinas 3150, CP 1427, Buenos Aires, Argentina
| | - Giselle V Kamenetzky
- Instituto de Investigaciones Médicas A Lanari, IDIM-CONICET, Universidad de Buenos Aires, Combatientes de Malvinas 3150, CP 1427, Buenos Aires, Argentina; Universidad Abierta Interamericana - Centro de Altos Estudios en Ciencias Humanas y de La Salud, Av. Montes de Oca 745, CP 1270, Buenos Aires, Argentina
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Early consumption of ultra-processed foods among children under 2 years old in Brazil. Public Health Nutr 2020; 24:3341-3351. [DOI: 10.1017/s1368980020004759] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To evaluate the complementary food consumption according to the extent and purpose of food processing based on NOVA classification among children aged 6–24 months of Federal District, Brazil.Design:We performed a cross-sectional study using a 24-h recall to estimate the daily energy intake and nutrients according to NOVA classification. We conducted a linear regression to assess the association between the processed and ultra-processed foods (UPF) energy intake and the daily energy intake from saturated fat, daily energy intake from total sugars and daily intake of sodium.Setting:Federal District, Brazil.Participants:Five hundred and thirty-eight children aged between 6 and 24 months attended at Primary Health Care Units from March 2017 to March 2018.Results:On average, children aged from 6 to 12 and from 12 to 24 months consumed 2393 and 4054 kJ/d, respectively, and processed and UPF represented one-third of dietary energy intake. Group 2 (processed and UPF) was higher carbohydrate contributors, and lower protein, fibre and most micronutrient contributors, when compared with Group 1 (unprocessed, minimally processed foods and processed culinary ingredients). In addition, the higher the energy intake from processed and UPF, the higher was the daily energy intake from saturated fat, daily energy intake from total sugar and daily intake of sodium.Conclusion:Children are being exposed early to processed and UPF and their share affect the diet’s nutritional quality.
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High Dietary Sugar Reshapes Sweet Taste to Promote Feeding Behavior in Drosophila melanogaster. Cell Rep 2020; 27:1675-1685.e7. [PMID: 31067455 DOI: 10.1016/j.celrep.2019.04.027] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 03/14/2019] [Accepted: 04/03/2019] [Indexed: 11/20/2022] Open
Abstract
Recent studies find that sugar tastes less intense to humans with obesity, but whether this sensory change is a cause or a consequence of obesity is unclear. To tackle this question, we study the effects of a high sugar diet on sweet taste sensation and feeding behavior in Drosophila melanogaster. On this diet, fruit flies have lower taste responses to sweet stimuli, overconsume food, and develop obesity. Excess dietary sugar, but not obesity or dietary sweetness alone, caused taste deficits and overeating via the cell-autonomous action of the sugar sensor O-linked N-Acetylglucosamine (O-GlcNAc) transferase (OGT) in the sweet-sensing neurons. Correcting taste deficits by manipulating the excitability of the sweet gustatory neurons or the levels of OGT protected animals from diet-induced obesity. Our work demonstrates that the reshaping of sweet taste sensation by excess dietary sugar drives obesity and highlights the role of glucose metabolism in neural activity and behavior.
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Is breastfeeding associated with later child eating behaviours? Appetite 2020; 150:104653. [PMID: 32151607 DOI: 10.1016/j.appet.2020.104653] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/06/2020] [Accepted: 03/06/2020] [Indexed: 01/02/2023]
Abstract
Individual differences in children's eating behaviours emerge early. We examined the relationship between breastfeeding exposure and subsequent eating behaviours among children from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort. Children (n = 970) were grouped according to their breastfeeding exposure: high (full breastfeeding ≥ 4 months with continued breastfeeding ≥ 6 months), low (any breastfeeding < 3 months or no breastfeeding) and intermediate (between low and high breastfeeding categories). Aspects of eating behaviour from ages 15 months to 6 years were captured using a combination of maternal reports (Child Eating Behaviour Questionnaire; Infant Feeding Questionnaire; Preschooler Feeding Questionnaire) and laboratory-based measures of meal size, oral processing behaviours (e.g. average eating speed and bite size) and tendency to eat in the absence of hunger. Most children had low (44%) or intermediate (44%) breastfeeding exposure; only 12% had high exposure. After adjusting for confounders, multivariable linear regression analyses indicated the high (but not intermediate) breastfeeding group was associated with significantly lower reported food fussiness at 3 years compared to low breastfeeding group (-0.38 [-0.70, -0.06]), with similar but non-significant trends observed at 6 years (-0.27 [-0.66, 0.11]). At 3 years, mothers in the high breastfeeding group also reported the least difficulty in child feeding compared to low breastfeeding group (-0.22 [-0.43, -0.01]). However, high breastfeeding was not associated with any other maternal-reports of child feeding or eating behaviours, and no significant associations were observed between breastfeeding exposure and any of the laboratory measures of eating behaviour at any of the time points. These results do not strongly support the view that increased breastfeeding exposure alone has lasting and consistent associations with eating behaviours in early childhood.
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Affiliation(s)
- Caroline C. Kim
- Food Nutrition and Health, The New Zealand Institute for Plant and Food Research Limited, Palmerston North, New Zealand
| | - Shanthi G. Parkar
- Food Nutrition and Health, The New Zealand Institute for Plant and Food Research Limited, Palmerston North, New Zealand
| | - Pramod K. Gopal
- Food Nutrition and Health, The New Zealand Institute for Plant and Food Research Limited, Palmerston North, New Zealand
- Riddet Institute, Massey University, Palmerston North, New Zealand
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Ara G, Sanin KI, Khanam M, Sarker SA, Khan SS, Rifat M, Chowdhury IA, Askari S, Afsana K, Ahmed T. Study protocol to assess the impact of an integrated nutrition intervention on the growth and development of children under two in rural Bangladesh. BMC Public Health 2019; 19:1437. [PMID: 31675943 PMCID: PMC6823939 DOI: 10.1186/s12889-019-7777-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 10/14/2019] [Indexed: 12/22/2022] Open
Abstract
Background The period from birth to two years is the “critical window” for achieving optimal growth and development. An inadequate quality and quantities of complementary foods, poor child-feeding practices and infection negatively impact the growth of under-twos. Approximately one-third of under-fives in developing countries are stunted; many are also micronutrient deficient. An estimated 6% of mortalities among under-fives can be prevented by ensuring optimal complementary feeding. The objective of the study was to assess the ability of a 12-month integrated nutrition intervention to improve the nutritional status (length-for-age Z-score) of 6 to 12-month-old children in rural Bangladesh. Methods In this community-based randomized controlled trial, the intervention group received a package of interventions that includes, food vouchers; to prepare egg-based nutritious snacks (suji firni for < 1-year-olds, suji halwa for > 1-year-olds), micronutrient powder to fortify children’s food at home, child feeding counselling and water, sanitation and hygiene (WASH), behaviour change communication. The control group received routine health messages provided by the government. Baseline and endline surveys were conducted; Data collection was performed monthly on children’s growth, food voucher utilization, child feeding and morbidity. In addition, we assessed the cognitive development of the children after 12 months of intervention. Conclusion This trial aims to explore whether an integrated nutrition intervention can mitigate childhood stunting during the critical window of opportunity in rural Bangladesh. The results may provide robust evidence to improve the linear growth of children in developing countries. Trial registration The study was retrospectively registered on August 17, 2018 and is available online at ClinicalTrials.gov (ID: NCT02768181).
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Affiliation(s)
- Gulshan Ara
- icddr,b, GPO BOX 128, 68, Shaheed Tajuddin Ahmed Sarani, Dhaka, Bangladesh.
| | | | - Mansura Khanam
- icddr,b, GPO BOX 128, 68, Shaheed Tajuddin Ahmed Sarani, Dhaka, Bangladesh
| | | | - Sihan Sadat Khan
- icddr,b, GPO BOX 128, 68, Shaheed Tajuddin Ahmed Sarani, Dhaka, Bangladesh
| | | | | | - Sufia Askari
- The Children's Investment Fund Foundation, 7 Clifford Street, London, W1S 2FT, UK
| | | | - Tahmeed Ahmed
- icddr,b, GPO BOX 128, 68, Shaheed Tajuddin Ahmed Sarani, Dhaka, Bangladesh
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Moding KJ, Ferrante MJ, Bellows LL, Bakke AJ, Hayes JE, Johnson SL. Nutritional Content and Ingredients of Commercial Infant and Toddler Food Pouches Compared With Other Packages Available in the United States. NUTRITION TODAY 2019; 54:305-312. [PMID: 32655191 PMCID: PMC7319259 DOI: 10.1097/nt.0000000000000385] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The ingredients and nutrients of infant and toddler foods (ITFs) sold in pouches were compared with products available in other packages, such as jars/packs and other containers. Company websites (n = 21) and in-store shelf inventory (n = 3) were used to create a database of commercial ITFs containing vegetables (n = 548) sold in the United States. Results indicated that ITFs containing vegetables were most commonly packaged in pouches (50%), followed by "other" packages (25%) and jars/packs (25%). Infant and toddler food pouches contained significantly more sugars per serving and per Reference Amount Customarily Consumed, as well as a greater percentage of calories from sugars, compared with both jars/packs and "other" packages. Pouches were also more likely to contain vegetable/fruit blends, whereas jars/packs were more likely to contain single-vegetable or multivegetable blends, and "other" packages were more likely to contain vegetable/other ingredient combinations (eg, grains and/or dairy). Pouches are popular, widely available, and convenient but may not represent the vegetable profiles and nutritional qualities that parents believe they are buying for their children.
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Affiliation(s)
- Kameron J Moding
- is an assistant professor in the Department of Human Development & Family Studies at Purdue University in West Lafayette, Indiana
- is a PhD candidate in the Department of Food Science & Human Nutrition at Colorado State University in Fort Collins, Colorado
- is an associate professor in the Department of Food Science and Human Nutrition at Colorado State University in Fort Collins, Colorado
- is a research scientist and an instructor at the Pennsylvania State University in State College, Pennsylvania
- is an associate professor of food science and the director of the Sensory Evaluation Center at the Pennsylvania State University in State College, Pennsylvania
- is a professor of pediatrics at the University of Colorado Anschutz Medical Campus and the director of the Children's Eating Laboratory in Aurora, Colorado
| | - Mackenzie J Ferrante
- is an assistant professor in the Department of Human Development & Family Studies at Purdue University in West Lafayette, Indiana
- is a PhD candidate in the Department of Food Science & Human Nutrition at Colorado State University in Fort Collins, Colorado
- is an associate professor in the Department of Food Science and Human Nutrition at Colorado State University in Fort Collins, Colorado
- is a research scientist and an instructor at the Pennsylvania State University in State College, Pennsylvania
- is an associate professor of food science and the director of the Sensory Evaluation Center at the Pennsylvania State University in State College, Pennsylvania
- is a professor of pediatrics at the University of Colorado Anschutz Medical Campus and the director of the Children's Eating Laboratory in Aurora, Colorado
| | - Laura L Bellows
- is an assistant professor in the Department of Human Development & Family Studies at Purdue University in West Lafayette, Indiana
- is a PhD candidate in the Department of Food Science & Human Nutrition at Colorado State University in Fort Collins, Colorado
- is an associate professor in the Department of Food Science and Human Nutrition at Colorado State University in Fort Collins, Colorado
- is a research scientist and an instructor at the Pennsylvania State University in State College, Pennsylvania
- is an associate professor of food science and the director of the Sensory Evaluation Center at the Pennsylvania State University in State College, Pennsylvania
- is a professor of pediatrics at the University of Colorado Anschutz Medical Campus and the director of the Children's Eating Laboratory in Aurora, Colorado
| | - Alyssa J Bakke
- is an assistant professor in the Department of Human Development & Family Studies at Purdue University in West Lafayette, Indiana
- is a PhD candidate in the Department of Food Science & Human Nutrition at Colorado State University in Fort Collins, Colorado
- is an associate professor in the Department of Food Science and Human Nutrition at Colorado State University in Fort Collins, Colorado
- is a research scientist and an instructor at the Pennsylvania State University in State College, Pennsylvania
- is an associate professor of food science and the director of the Sensory Evaluation Center at the Pennsylvania State University in State College, Pennsylvania
- is a professor of pediatrics at the University of Colorado Anschutz Medical Campus and the director of the Children's Eating Laboratory in Aurora, Colorado
| | - John E Hayes
- is an assistant professor in the Department of Human Development & Family Studies at Purdue University in West Lafayette, Indiana
- is a PhD candidate in the Department of Food Science & Human Nutrition at Colorado State University in Fort Collins, Colorado
- is an associate professor in the Department of Food Science and Human Nutrition at Colorado State University in Fort Collins, Colorado
- is a research scientist and an instructor at the Pennsylvania State University in State College, Pennsylvania
- is an associate professor of food science and the director of the Sensory Evaluation Center at the Pennsylvania State University in State College, Pennsylvania
- is a professor of pediatrics at the University of Colorado Anschutz Medical Campus and the director of the Children's Eating Laboratory in Aurora, Colorado
| | - Susan L Johnson
- is an assistant professor in the Department of Human Development & Family Studies at Purdue University in West Lafayette, Indiana
- is a PhD candidate in the Department of Food Science & Human Nutrition at Colorado State University in Fort Collins, Colorado
- is an associate professor in the Department of Food Science and Human Nutrition at Colorado State University in Fort Collins, Colorado
- is a research scientist and an instructor at the Pennsylvania State University in State College, Pennsylvania
- is an associate professor of food science and the director of the Sensory Evaluation Center at the Pennsylvania State University in State College, Pennsylvania
- is a professor of pediatrics at the University of Colorado Anschutz Medical Campus and the director of the Children's Eating Laboratory in Aurora, Colorado
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Eldridge AL, Catellier DJ, Hampton JC, Dwyer JT, Bailey RL. Trends in Mean Nutrient Intakes of US Infants, Toddlers, and Young Children from 3 Feeding Infants and Toddlers Studies (FITS). J Nutr 2019; 149:1230-1237. [PMID: 31049587 PMCID: PMC6602894 DOI: 10.1093/jn/nxz054] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/10/2019] [Accepted: 03/04/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Many updates to young child feeding recommendations have been published over the past decade, but concurrent intake trends have not been assessed. OBJECTIVE The aim of this study was to evaluate adequacy and trends in energy and nutrient intakes of US infants and children aged 0-47.9 mo through use of Feeding Infants and Toddlers Study (FITS) data from 2002, 2008, and 2016. METHODS FITS are cross-sectional surveys of parents/caregivers of infants and young children (FITS 2002, n = 2962; FITS 2008, n = 3276; FITS 2016, n = 3235). Dietary intakes were assessed by telephone with trained interviewers using the Nutrition Data System for Research. Mean ± SE nutrient intakes were calculated. Diet adequacy was assessed with the nutrient adequacy ratio (NAR) for 17 nutrients and the corresponding mean adequacy ratio. RESULTS Energy and macronutrient intakes were generally stable across surveys, but significant decreases for saturated fat and total sugars and an increase in fiber were observed among 6-11.9-mo-olds and 12-23.9-mo-olds (P-trend < 0.0001). Mean sodium intakes exceeded Adequate Intakes (AI) for all ages, whereas fiber intakes were universally below the AI. Nutrients with the lowest NAR values were vitamin D (range 0.41-0.67/1.00) and vitamin E (range 0.60-0.79/1.00 for 2008 and 2016). For iron, infants aged 6-11.9 mo had the lowest NAR values at 0.77-0.88/1.00, compared to 0.85-0.89/1.00 for 12-47.9-mo-olds. Potassium was low from 12 to 47.9 mo (NAR range 0.55-0.63/1.00 across survey years). The nutrients with the greatest decline in mean intakes were iron and vitamins D and E among 6-11.9-mo-olds, and vitamin D and potassium among 12-23.9-mo-olds in 2016 compared to 2002. CONCLUSIONS The diets of US infants and young children were generally adequate for most micronutrients and stable over time, but sodium intakes were too high, and nutrient gaps still existed, especially for vitamins D, E, and fiber across ages and for iron among infants.
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Affiliation(s)
- Alison L Eldridge
- Nestlé Institute of Health Science, Nestlé Research, Lausanne, Switzerland,Address correspondence ALE (e-mail: )
| | | | | | - Johanna T Dwyer
- School of Medicine and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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Assessing the Potential for Integrating Routine Data Collection on Complementary Feeding to Child Health Visits: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101722. [PMID: 31100804 PMCID: PMC6571620 DOI: 10.3390/ijerph16101722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 01/17/2023]
Abstract
There is no routine data collection in the UK on infant dietary diversity during the transition to solid foods, and health visitors (HVs) (nurses or midwives with specialist training in children and family health) have the potential to play a key role in nutrition surveillance. We aimed to assess items for inclusion in routine data collection, their suitability for collecting informative data, and acceptability among HVs. A mixed-methods study was undertaken using: (i) an online survey testing potential questionnaire items among parents/caregivers, (ii) questionnaire redevelopment in collaboration with community staff, and (iii) a survey pilot by HVs followed by qualitative data collection. Preliminary online questionnaires (n = 122) were collected to identify useful items on dietary diversity. Items on repeated exposure to foods, aversive feeding behaviors, flavor categories, and sugar intake were selected to correspond to nutrition recommendations, and be compatible with electronic records via tablet. HVs surveyed 187 parents of infants aged 12 months. Semi-structured interviews indicated that HVs found the questionnaire comparable with standard nutrition conversations, which prompted helpful discussions, but questions on eating behavior did not prompt such useful discussions and, in some cases, caused confusion about what was 'normal.' Lack of time among HVs, internet connectivity issues, and fear of losing rapport with parents were barriers to completing electronic questionnaires, with 91% submitted by paper. Routine nutrition data collection via child health records seems feasible and could inform quality improvement projects.
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Tarragon E, Moreno JJ. Role of Endocannabinoids on Sweet Taste Perception, Food Preference, and Obesity-related Disorders. Chem Senses 2019; 43:3-16. [PMID: 29293950 DOI: 10.1093/chemse/bjx062] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The prevalence of obesity and obesity-related disorders such as type 2 diabetes (T2D) and metabolic syndrome has increased significantly in the past decades, reaching epidemic levels and therefore becoming a major health issue worldwide. Chronic overeating of highly palatable foods is one of the main responsible aspects behind overweight. Food choice is driven by food preference, which is influenced by environmental and internal factors, from availability to rewarding properties of food. Consequently, the acquisition of a dietary habit that may lead to metabolic alterations is the result of a learning process in which many variables take place. From genetics to socioeconomic status, the response to food and how this food affects energy metabolism is heavily influenced, even before birth. In this work, we review how food preference is acquired and established, particularly as regards sweet taste; towards which flavors and tastes we are positively predisposed by our genetic background, our early experience, further lifestyle, and our surroundings; and, especially, the role that the endocannabinoid system (ECS) plays in all of this. Ultimately, we try to summarize why this system is relevant for health purposes and how this is linked to important aspects of eating behavior, as its function as a modulator of energy homeostasis affects, and is affected by, physiological responses directly associated with obesity.
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Affiliation(s)
- Ernesto Tarragon
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Germany
| | - Juan José Moreno
- Department of Nutrition, Food Sciences and Gastronomy, Institute of Nutrition and Food Safety, University of Barcelona, Spain.,CIBEROBN Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain
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Costa CS, Rauber F, Leffa PS, Sangalli CN, Campagnolo PDB, Vitolo MR. Ultra-processed food consumption and its effects on anthropometric and glucose profile: A longitudinal study during childhood. Nutr Metab Cardiovasc Dis 2019; 29:177-184. [PMID: 30660687 DOI: 10.1016/j.numecd.2018.11.003] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 11/11/2018] [Accepted: 11/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Obesity and insulin resistance development are related to known risk factors (such as diet) that begin in childhood. Among dietary factors, the consumption of ultra-processed foods has received attention. The present study investigated the association between ultra-processed foods consumption at preschool age and changes in anthropometric measurements from preschool to school age and glucose profile at school age. METHODS AND RESULTS The present study was a follow-up of a randomized controlled trial, conducted with 307 children of low socioeconomic status from São Leopoldo, Brazil. At ages 4 and 8 years, children's anthropometric assessments were collected from preschool to school age including body-mass index (BMI) for-age, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold. At the age 8 years, blood tests were performed to measure glucose profile. Dietary data were collected through 24-h recalls and the children's ultra-processed food intake was assessed. Linear regression analysis was used to assess the relationship between ultra-processed food consumption and the outcomes. The percentage of daily energy provided by ultra-processed foods was 41.8 ± 8.7 (753.8 ± 191.0 kcal) at preschool age and 47.8 ± 8.9 (753.8 ± 191.0 kcal) at school age, on average. The adjusted linear regression analyses showed that ultra-processed food consumption at preschool age was a predictor of an increase in delta WC from preschool to school age (β = 0.07; 95%CI 0.01-0.14; P = 0.030), but not for glucose metabolism. CONCLUSION Our data suggest that early ultra-processed food consumption played a role in increasing abdominal obesity in children. These results reinforce the importance of effective strategies to prevent the excessive consumption of ultra-processed foods, especially in early ages.
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Affiliation(s)
- C S Costa
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil.
| | - F Rauber
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, SP, Brazil
| | - P S Leffa
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
| | - C N Sangalli
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
| | - P D B Campagnolo
- School of Health, Universidade do Vale do Rio dos Sinos, Sao Leopoldo, RS, Brazil
| | - M R Vitolo
- Graduate Program in Paediatrics, Attention to Children and Adolescent Health, Brazil
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Bell LK, Jansen E, Mallan K, Magarey AM, Daniels L. Poor dietary patterns at 1-5 years of age are related to food neophobia and breastfeeding duration but not age of introduction to solids in a relatively advantaged sample. Eat Behav 2018; 31:28-34. [PMID: 30086453 DOI: 10.1016/j.eatbeh.2018.06.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/14/2018] [Accepted: 06/21/2018] [Indexed: 01/17/2023]
Abstract
Previous studies have investigated associations between individual foods or food group intake, and breastfeeding duration, age of solid introduction and food neophobia. This study aimed to investigate associations between whole dietary patterns in young children, and breastfeeding duration, age of solid introduction and food neophobia. Parents of children (N = 234) aged 1-5 years completed an online questionnaire. Dietary risk scores were calculated using the Toddler (1-3 years) or Preschool (>3-<5 years) Dietary Questionnaires which evaluates the previous week's food-group intake (scored 0-100; higher score = higher risk of poor dietary quality). Neophobia was measured using the Child Food Neophobia scale (1.0-4.0; higher score = more neophobic). Associations were investigated using multivariable linear regression, adjusting for covariates. Children (54% female, 3.0 ± 1.4 years) were from advantaged families and were breastfed until 11.8 (5.0-16.0) months, started solids at 5.6 ± 1.4 months of age, moderately neophobic (2.1 ± 0.7) and at moderate dietary risk (29.2 ± 9.2). Shorter breastfeeding duration (β = -0.21; p = 0.001) and poorer child food neophobia scores (β = 0.36; p < 0.001) were associated with higher dietary risk scores. Age of introduction to solids showed no association with dietary risk (p = 0.744). These findings suggest that in addition to breastfeeding promotion, supporting parents to manage neophobic behaviour may be important in promoting healthy eating patterns in early childhood.
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Affiliation(s)
- Lucinda K Bell
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia.
| | - Elena Jansen
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4101, Australia
| | - Kimberley Mallan
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4101, Australia; School of Psychology, Australian Catholic University, 1100 Nudgee Road, Banyo, Queensland 4014, Australia
| | - Anthea M Magarey
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia
| | - Lynne Daniels
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, South Australia 5042, Australia; Centre for Children's Health Research, Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland 4101, Australia
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Ferreira VR, Sangalli CN, Leffa PS, Rauber F, Vitolo MR. The impact of a primary health care intervention on infant feeding practices: a cluster randomised controlled trial in Brazil. J Hum Nutr Diet 2018; 32:21-30. [DOI: 10.1111/jhn.12595] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- V. R. Ferreira
- Graduate Program in Health Sciences; Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre RS Brasil
- Nutrition Research Group (NUPEN); Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre RS Brasil
| | - C. N. Sangalli
- Graduate Program in Health Sciences; Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre RS Brasil
- Nutrition Research Group (NUPEN); Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre RS Brasil
| | - P. S. Leffa
- Graduate Program in Health Sciences; Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre RS Brasil
- Nutrition Research Group (NUPEN); Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre RS Brasil
| | - F. Rauber
- Faculdade de Saúde Pública; University of São Paulo; São Paulo Brasil
| | - M. R. Vitolo
- Nutrition Research Group (NUPEN); Universidade Federal de Ciências da Saúde de Porto Alegre; Porto Alegre RS Brasil
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Afeiche MC, Villalpando-Carrión S, Reidy KC, Fries LR, Eldridge AL. Many Infants and Young Children Are Not Compliant with Mexican and International Complementary Feeding Recommendations for Milk and Other Beverages. Nutrients 2018; 10:nu10040466. [PMID: 29642599 PMCID: PMC5946251 DOI: 10.3390/nu10040466] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 12/18/2022] Open
Abstract
Mexican and international authorities provide guidelines for milk and beverage consumption for young children. This study classifies beverages as appropriate or inappropriate by age (0-5.9, 6-11.9, and 12-23.9 months) and details consumption patterns, amounts consumed, and the associated socio-demographic characteristics. Analysis of the Mexican National Nutrition and Health Survey (ENSANUT 2012) was conducted (n = 949). Among 0-5.9 month olds, 66.7% consumed either breast milk, infant formula, or a combination with no other beverages, whereas 29.3% consumed breast milk and/or infant formula with water (mean = 58 g/day) and/or other beverages (mean = 115 g/day), such as 100% fruit juice, milk, and sugar-sweetened beverages (SSBs). For infants 6-11.9 months, appropriate beverages include breast milk, infant formula, and water; only 40.2% met these recommendations. Many 6-11.9 month olds consumed age-inappropriate beverages, including milk (31%) and SSBs (35%). After 12 months of age, appropriate beverages include water, milk, and a limited amount of 100% fruit juice and SSBs; 32.4% complied fully, 18.3% consumed appropriate and inappropriate beverages, and 49.3% consumed only inappropriate beverages. Among 12-23.9 month olds, 58% consumed milk, 18% juice, and 42% water while 63% consumed SSBs. Many infants and young children are not compliant with Mexican and international breastfeeding and complementary feeding guidelines for beverages. Communication and guidance about age-appropriate beverages should be improved.
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Affiliation(s)
- Myriam C Afeiche
- Institute of Nutritional Science, Nestlé Research Center, Route du Jorat 57, 1000 Lausanne, Switzerland.
| | - Salvador Villalpando-Carrión
- Hospital Infantil de Mexico, Gastroenterology and Nutrition, Mexico City and Nestlé Infant Nutrition, Av. Ejercito Nacional 453, Delegacion Miguel Hidalgo, Col. Granada, Mexico City 11520, Mexico.
| | - Kathleen C Reidy
- Nestlé Nutrition Global R&D, 12 Vreeland Road, Florham Park, NJ 07932, USA.
| | - Lisa R Fries
- Consumer Science and Applied Nutrition, Institute of Material Science, Nestlé Research Center, Route du Jorat 57, 1000 Lausanne, Switzerland.
| | - Alison L Eldridge
- Institute of Nutritional Science, Nestlé Research Center, Route du Jorat 57, 1000 Lausanne, Switzerland.
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Food Consumption Patterns and Micronutrient Density of Complementary Foods Consumed by Infants Fed Commercially Prepared Baby Foods. ACTA ACUST UNITED AC 2018; 53:68-78. [PMID: 29706668 PMCID: PMC5902138 DOI: 10.1097/nt.0000000000000265] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Nutrition is critically important in the first 1000 days, and while most American babies are fed commercial baby foods, there is little or no evidence from nationally representative data to understand the implications of such consumption. We used 24-hour dietary recall data for 505 infants from The Feeding Infants and Toddlers Study to describe food consumption patterns and micronutrient density of complementary foods consumed by infants fed commercially prepared baby food fruit, vegetables, and dinners and compared with those eaten by nonconsumers of these products. Results show that consumers were significantly more likely to report eating all vegetables (excluding white potatoes, 71% vs 51%), deep yellow vegetables (42% vs 18%), and fruits (79% vs 65%) and were less likely to report eating white potatoes (10% vs 24%), dark green vegetables (4% vs 20%), and sweets (23% vs 47%) than were nonconsumers. Nutrient density of the complementary foods of consumers was greater for fiber, potassium, vitamin A, vitamin C, vitamin E, and magnesium, but lower in sodium and vitamin D. We conclude that infants fed commercially prepared baby foods were more likely to eat vegetables and fruits, and their diets were higher in several micronutrients. These findings provide important insights on complementary feeding and are useful to support the development of evidence-based infant-feeding guidelines.
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Beckerman JP, Alike Q, Lovin E, Tamez M, Mattei J. The Development and Public Health Implications of Food Preferences in Children. Front Nutr 2017; 4:66. [PMID: 29326942 PMCID: PMC5741689 DOI: 10.3389/fnut.2017.00066] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/05/2017] [Indexed: 12/17/2022] Open
Abstract
Food preferences are a primary determinant of dietary intake and behaviors, and they persist from early childhood into later life. As such, establishing preferences for healthy foods from a young age is a promising approach to improving diet quality, a leading contributor to cardiometabolic health. This narrative review first describes the critical period for food preference development starting in utero and continuing through early childhood. Infants’ innate aversion to sour and bitter tastes can lead them to initially reject some healthy foods such as vegetables. Infants can learn to like these foods through exposures to their flavors in utero and through breastmilk. As solid foods are introduced through toddlerhood, children’s food preferences are shaped by parent feeding practices and environmental factors such as food advertising. Next, we discuss two key focus areas to improve diet quality highlighted by the current understanding of food preferences: (1) promoting healthy food preferences through breastfeeding and early exposures to healthy foods and (2) limiting the extent to which innate preferences for sweet and salty tastes lead to poor diet quality. We use an ecological framework to summarize potential points of intervention and provide recommendations for these focus areas, such as worksite benefits that promote breastfeeding, and changes in food retail and service environments. Individuals’ choices around breastfeeding and diet may ultimately be influenced by policy and community-level factors. It is thus crucial to take a multilevel approach to establish healthy food preferences from a young age, which have the potential to translate into lifelong healthy diet.
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Affiliation(s)
- Jacob P Beckerman
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Queen Alike
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Erika Lovin
- Harvard Kennedy School of Government, Cambridge, MA, United States.,Wharton School of the University of Pennsylvania, Philadelphia, PA, United States
| | - Martha Tamez
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Broilo MC, Vitolo MR, Stenzel LM, Levandowski DC. Mothers' perceptions of their own diets and the diets of their children at 2-3 years of age. PSICOLOGIA-REFLEXAO E CRITICA 2017; 30:13. [PMID: 32025955 PMCID: PMC6964162 DOI: 10.1186/s41155-017-0067-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 05/26/2017] [Indexed: 11/10/2022] Open
Abstract
This is a cross-sectional analysis of a follow-up study to examine the perceptions of mothers treated at public health centers, regarding their own diets and the diets of their children aged 2–3. Among the 464 participants, 57% (n = 267) reported perceiving their own diets as unhealthy while 72% (n = 334) perceiving their children’s diets as healthy. The mothers’ perceptions of their own diets as healthy were associated with less maternal schooling and having received health care from professionals who had received special training (p < 0.05). The mothers’ perceptions of their children’s diets as healthy were associated with more maternal schooling (p < 0.05). This difference between the mothers’ perceptions of their own diets and those of their children reinforce the importance of considering maternal beliefs and attitudes in infant nutritional intervention programs.
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Affiliation(s)
- Mônica Cristina Broilo
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil.
| | - Márcia Regina Vitolo
- Department of Nutrition, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
| | - Lucia Marques Stenzel
- Department of Psychology, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
| | - Daniela Centenaro Levandowski
- Department of Psychology, Federal University of Health Sciences of Porto Alegre-UFCSPA, Sarmento Leite 245, Porto Alegre, RS, 90050-170, Brazil
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32
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Hopkins J, Cermak SA, Merritt RJ. Oral Feeding Difficulties in Children With Short Bowel Syndrome: A Narrative Review. Nutr Clin Pract 2017; 33:99-106. [DOI: 10.1177/0884533617707493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Judy Hopkins
- Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Sharon A. Cermak
- Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
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Stoeckel LE, Birch LL, Heatherton T, Mann T, Hunter C, Czajkowski S, Onken L, Berger PK, Savage CR. Psychological and neural contributions to appetite self-regulation. Obesity (Silver Spring) 2017; 25 Suppl 1:S17-S25. [PMID: 28229541 PMCID: PMC5328502 DOI: 10.1002/oby.21789] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This paper reviews the state of the science on psychological and neural contributions to appetite self-regulation in the context of obesity. METHODS Three content areas (neural systems and cognitive functions; parenting and early childhood development; and goal setting and goal striving) served to illustrate different perspectives on the psychological and neural factors that contribute to appetite dysregulation in the context of obesity. Talks were initially delivered at an NIH workshop consisting of experts in these three content areas, and then content areas were further developed through a review of the literature. RESULTS Self-regulation of appetite involves a complex interaction between multiple domains, including cognitive, neural, social, and goal-directed behaviors and decision-making. Self-regulation failures can arise from any of these factors, and the resulting implications for obesity should be considered in light of each domain. In some cases, self-regulation is amenable to intervention; however, this does not appear to be universally true, which has implications for both prevention and intervention efforts. CONCLUSIONS Appetite regulation is a complex, multifactorial construct. When considering its role in the obesity epidemic, it is advisable to consider its various dimensions together to best inform prevention and treatment efforts.
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Affiliation(s)
- Luke E. Stoeckel
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Leann L. Birch
- Department of Foods and Nutrition, University of Georgia, Athens, GA
| | - Todd Heatherton
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH
| | - Traci Mann
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Christine Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | - Lisa Onken
- National Institute on Aging, Bethesda, MD
| | - Paige K. Berger
- Department of Foods and Nutrition, University of Georgia, Athens, GA
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Haro-Vicente JF, Bernal-Cava MJ, Lopez-Fernandez A, Ros-Berruezo G, Bodenstab S, Sanchez-Siles LM. Sensory Acceptability of Infant Cereals with Whole Grain in Infants and Young Children. Nutrients 2017; 9:nu9010065. [PMID: 28098769 PMCID: PMC5295109 DOI: 10.3390/nu9010065] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/09/2016] [Accepted: 01/06/2017] [Indexed: 01/06/2023] Open
Abstract
In many countries, infant cereals are one of the first foods introduced during the complementary feeding stage. These cereals are usually made with refined cereal flours, even though several health benefits have been linked to the intake of whole grain cereals. Prior evidence suggests that food preferences are developed at early stages of life, and may persist in later childhood and adulthood. Our aim was to test whether an infant cereal with 30% of whole grain was similarly accepted both by parents and infants in comparison to a similar cereal made from refined flour. A total of 81 infants between 4 and 24 months old were included in the study. Parent-infant pairs participated in an 8-day experimental study. Acceptance was rated on hedonic scales (4-points for infants and 7-points for parents). Other attributes like color, smell, and taste were evaluated by the parents. Acceptability for infant cereals with whole grain and refined cereals was very similar both for infants (2.30 ± 0.12 and 2.32 ± 0.11, p = 0.606) and parents (6.1 ± 0.8 and 6.0 ± 0.9, p = 0.494). Therefore, our findings show that there is an opportunity to introduce whole grain cereals to infants, including those who are already used to consuming refined infant cereals, thereby accelerating the exposure of whole grain in early life.
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Affiliation(s)
| | | | - Amparo Lopez-Fernandez
- Department of Food Science and Nutrition, University of Murcia, Campus de Espinardo, Espinardo, Murcia 30071, Spain.
| | - Gaspar Ros-Berruezo
- Department of Food Science and Nutrition, University of Murcia, Campus de Espinardo, Espinardo, Murcia 30071, Spain.
| | - Stefan Bodenstab
- Department of Research and Development, Hero Group, Lenzburg 5600, Switzerland.
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Reidy KC, Deming DM, Briefel RR, Fox MK, Saavedra JM, Eldridge AL. Early development of dietary patterns: transitions in the contribution of food groups to total energy—Feeding Infants and Toddlers Study, 2008. BMC Nutr 2017. [DOI: 10.1186/s40795-016-0124-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Moore DA, Goodwin TL, Brocklehurst PR, Armitage CJ, Glenny AM. When Are Caregivers More Likely to Offer Sugary Drinks and Snacks to Infants? A Qualitative Thematic Synthesis. QUALITATIVE HEALTH RESEARCH 2017; 27:74-88. [PMID: 27956658 DOI: 10.1177/1049732316673341] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Many children consume more sugar than is recommended, and caregivers often find it difficult to change this habit once established. This thematic synthesis aims to identify the "critical situations" where caregivers may be more likely to offer infants sugary drinks and snacks. This thematic synthesis is reported in accordance with the statement for enhancing transparency in reporting the synthesis of qualitative research (ENTREQ). Our confidence in the findings of our synthesis was assessed using the CERQual (Confidence in the Evidence From Reviews of Qualitative Research Approach). We included 16 studies from the United States, the United Kingdom, Australia, and Denmark. We identified eight "critical situations" when caregivers may be more likely to offer sugary drinks and snacks to infants. Interventions that seek to reduce sugar intake for caries prevention in infants and young children may be more successful if they provide caregivers with practical parenting strategies to replace the nonnutritive functions of sugary foods and drinks, as opposed to taking an information-giving approach.
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Affiliation(s)
- Deborah Anne Moore
- University of Manchester, Manchester, United Kingdom
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Tom Lloyd Goodwin
- University of Manchester, Manchester, United Kingdom
- Central Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
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Longfier L, Soussignan R, Reissland N, Leconte M, Marret S, Schaal B, Mellier D. Emotional expressiveness of 5–6 month-old infants born very premature versus full-term at initial exposure to weaning foods. Appetite 2016; 107:494-500. [DOI: 10.1016/j.appet.2016.08.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 01/07/2023]
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Baldissera R, Issler RMS, Giugliani ERJ. [Effectiveness of the National Strategy for Healthy Complementary Feeding to improve complemantary feeding of infants in a municipality in Southern Brazil]. CAD SAUDE PUBLICA 2016; 32:e00101315. [PMID: 27653194 DOI: 10.1590/0102-311x00101315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 02/12/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to assess the effectiveness of the National Strategy for Healthy Complementary Feeding (ENPACS) in improving complementary feeding in the first year of life in a Brazilian municipality (county). This was an impact evaluation study that enrolled 340 infants from 6 to 12 months of age, followed at primary healthcare units. The target outcomes were prevalence rates for the consumption of vegetables, legumes, fruits, and unhealthy foods, and the prevalence of foods with adequate consistency for age. Poisson regression showed that the strategy was associated with reductions of 32% in the consumption of sodas and/or industrialized juices, 35% of industrialized foods, and 5% of unhealthy foods. There was no increase in the consumption of fruits, legumes, vegetables, or foods with adequate consistency for age. In conclusion, the strategy's positive effect was partial, but it has the potential to help improve infant nutrition, based on its effectiveness in reducing the consumption of unhealthy foods.
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Rolland-Cachera MF, Akrout M, Péneau S. Nutrient Intakes in Early Life and Risk of Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13060564. [PMID: 27275827 PMCID: PMC4924021 DOI: 10.3390/ijerph13060564] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/20/2016] [Accepted: 05/26/2016] [Indexed: 02/08/2023]
Abstract
There is increasing evidence that environmental factors in early life predict later health. The early adiposity rebound recorded in most obese subjects suggests that factors promoting body fat development have operated in the first years of life. Birth weight, growth velocity and body mass index (BMI) trajectories seem to be highly sensitive to the environmental conditions present during pregnancy and in early life (“The first 1000 days”). Particularly, nutritional exposure can have a long-term effect on health in adulthood. The high protein-low fat diet often recorded in young children may have contributed to the rapid rise of childhood obesity prevalence during the last decades. Metabolic programming by early nutrition could explain the development of later obesity and adult diseases.
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Affiliation(s)
- Marie Françoise Rolland-Cachera
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny F-93017, France.
| | - Mouna Akrout
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny F-93017, France.
| | - Sandrine Péneau
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle, Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny F-93017, France.
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42
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Commercial complementary food consumption is prospectively associated with added sugar intake in childhood. Br J Nutr 2016; 115:2067-74. [DOI: 10.1017/s0007114516001367] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractGiven that commercial complementary food (CF) can contain high levels of added sugar, a high consumption may predispose to a preference for sweet taste later in life. This study examined cross-sectional associations between commercial CF consumption and added sugar intake in infancy as well as its prospective relation to added sugar intake in pre-school and primary-school age children. In all, 288 children of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study with 3-d weighed dietary records at 0·5 and 0·75 (infancy), 3 and 4 (pre-school age) and 6 and 7 years of age (primary-school age) were included in this analysis. Individual commercial CF consumption as percentage of total commercial CF (%cCF) was averaged at 0·5 and 0·75 years. Individual total added sugar intake (g/d, energy percentage/d) was averaged for all three age groups. Multivariable logistic and linear regression models were used to analyse associations between %cCF and added sugar intake. In infancy, a higher %cCF was associated with odds for high added sugar intake from CF and for high total added sugar intake (>75th percentile, P<0·033). Prospectively, a higher %cCF was related to higher added sugar intake in both pre-school (P<0·041) and primary-school age children (P<0·039), although these associations were attenuated in models adjusting for added sugar intake in infancy. A higher %cCF in infancy may predispose to higher added sugar intake in later childhood by virtue of its added sugar content. Therefore, offering home-made CF or carefully chosen commercial CF without added sugar might be one strategy to reduce sugar intake in infancy and later on.
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Application and validation of the Feeding Infants: Behaviour and Facial Expression Coding System (FIBFECS) to assess liking and wanting in infants at the time of complementary feeding. Food Qual Prefer 2016. [DOI: 10.1016/j.foodqual.2015.09.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Edelson LR, Mokdad C, Martin N. Prompts to eat novel and familiar fruits and vegetables in families with 1-3 year-old children: Relationships with food acceptance and intake. Appetite 2016; 99:138-148. [PMID: 26792770 DOI: 10.1016/j.appet.2016.01.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 01/05/2016] [Accepted: 01/09/2016] [Indexed: 12/17/2022]
Abstract
Toddlers often go through a picky eating phase, which can make it difficult to introduce new foods into the diet. A better understanding of how parents' prompts to eat fruits and vegetables are related to children's intake of these foods will help promote healthy eating habits. 60 families recorded all toddler meals over one day, plus a meal in which parents introduced a novel fruit/vegetable to the child. Videos were coded for parent and child behaviors. Parents completed a feeding style questionnaire and three 24-h dietary recalls about their children's intake. Parents made, on average, 48 prompts for their children to eat more during the main meals in a typical day, mostly of the neutral type. Authoritarian parents made the most prompts, and used pressure the most often. In the novel food situation, it took an average of 2.5 prompts before the child tasted the new food. The most immediately successful prompt for regular meals across food types was modeling. There was a trend for using another food as a reward to work less well than a neutral prompt for encouraging children to try a novel fruit or vegetable. More frequent prompts to eat fruits and vegetables during typical meals were associated with higher overall intake of these food groups. More prompts for children to try a novel vegetable was associated with higher overall vegetable intake, but this pattern was not seen for fruits, suggesting that vegetable variety may be more strongly associated with intake. Children who ate the most vegetables had parents who used more "reasoning" prompts, which may have become an internalized motivation to eat these foods, but this needs to be tested explicitly using longer-term longitudinal studies.
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Campbell MK. Biological, environmental, and social influences on childhood obesity. Pediatr Res 2016; 79:205-11. [PMID: 26484623 DOI: 10.1038/pr.2015.208] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 09/30/2015] [Indexed: 01/04/2023]
Abstract
The prevalence of childhood obesity has increased globally over the past three decades, with evidence of recent leveling off in developed countries. Reduction in the, currently high, prevalence of obesity will require a full understanding of the biological and social pathways to obesity in order to develop appropriately targeted prevention strategies in early life. Determinants of childhood obesity include individual level factors, including biological, social, and behavioral risks, acting within the influence of the child's family environment, which is, in turn, imbedded in the context of the community environment. These influences act across childhood, with suggestions of early critical periods of biological and behavioral plasticity. There is evidence of sex and gender differences in the responses of boys and girls to their environments. The evidence that determinants of childhood obesity act at many levels and at different stages of childhood is of policy relevance to those planning early health promotion and primary prevention programs as it suggests the need to address the individual, the family, the physical environment, the social environment, and social policy. The purpose of this narrative review is to summarize current, and emerging, literature in a multilevel, life course framework.
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Affiliation(s)
- M Karen Campbell
- Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ontario, Canada.,Department of Pediatrics, The University of Western Ontario, London, Ontario, Canada.,Department of Obstetrics & Gynecology, The University of Western Ontario, London, Ontario, Canada.,Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
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Mennella JA, Reiter AR, Daniels LM. Vegetable and Fruit Acceptance during Infancy: Impact of Ontogeny, Genetics, and Early Experiences. Adv Nutr 2016; 7:211S-219S. [PMID: 26773029 PMCID: PMC4717875 DOI: 10.3945/an.115.008649] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Many of the chronic illnesses that plague modern society derive in large part from poor food choices. Thus, it is not surprising that the Dietary Guidelines for Americans, aimed at the population ≥2 y of age, recommends limiting consumption of salt, fat, and simple sugars, all of which have sensory properties that we humans find particularly palatable, and increasing the variety and contribution of fruits and vegetables in the diet, to promote health and prevent disease. Similar recommendations may soon be targeted at even younger Americans: the B-24 Project, led by the US Department of Health and Human Services and the USDA, is currently evaluating evidence to include infants and children from birth to 2 y of age in the dietary guidelines. This article reviews the underinvestigated behavioral phenomena surrounding how to introduce vegetables and fruits into infants' diets, for which there is much medical lore but, to our knowledge, little evidence-based research. Because the chemical senses are the major determinants of whether young children will accept a food (e.g., they eat only what they like), these senses take on even greater importance in understanding the bases for food choices in children. We focus on early life, in contrast with many other studies that attempt to modify food habits in older children and thus may miss sensitive periods that modulate long-term acceptance. Our review also takes into consideration ontogeny and sources of individual differences in taste perception, in particular, the role of genetic variation in bitter taste perception.
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van der Heul M, Lindeboom R, Haverkort E. Screening Solid Foods Infants 1 (SSFI-1) development of a screening tool to detect problems in the transition from milk to solid food in infants from six to nine months of age. Infant Behav Dev 2015. [PMID: 26196473 DOI: 10.1016/j.infbeh.2015.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM To establish the psychometric properties of a newly developed screening tool Screening Solid Foods Infants 1 (SSFI-1) used by early childhood professionals, to detect problems in the transition from milk to solid food of smooth consistency in infants 6-9 months of age. METHODS The SSFI-1 score was filled out by the parents of a subgroup with term infants (n=35); healthy preterm infants (n=26); infants with comorbidity (n=17); infants with feeding problems (n=13). Internal consistency, reproducibility, construct, criterion and related validity was evaluated. RESULTS The preterm subgroup differed significantly in age when starting with fruits/vegetables and period of experience (p<0.01). The SSFI-1 was sufficiently reliable for the total group and term subgroup (α=0.78 and 0.76), but not for the preterm and comorbidity/feeding problem subgroup (α=0.51 and 0.69). Inter-rater reliability was high for the total score (n=25, ICC r=0.93), and moderate to good for individual items (weighted kappa range 0.55-0.95). Validity was confirmed by significantly higher scores for the comorbidity/feeding problem subgroups and clinically distinguishable subgroups (p<0.05) and area under the curve values>0.78. The initial 10-item screening tool was modified to a seven item screening tool. A SSFI-1 score of 4, +2 SD of the term subgroup, had 76.9% sensitivity and 82.1% specificity, for detecting the presence of a feeding problem. CONCLUSION The seven-item screening tool Screening Solid Foods 1 may be used as a screening tool for term infants. Further testing of the SSFI-1 in new infants is needed, to confirm reliability and validity both for term, preterm and (risk for) feeding problem infants.
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Affiliation(s)
- Marise van der Heul
- Department of Otorhinolaryngology, University Medical Center Utrecht, KJ.01.521.0, PO Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Robert Lindeboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands
| | - Elisabeth Haverkort
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, The Netherlands; Department of Dietetics and Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
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Wahlqvist ML, Krawetz SA, Rizzo NS, Dominguez-Bello MG, Szymanski LM, Barkin S, Yatkine A, Waterland RA, Mennella JA, Desai M, Ross MG, Krebs NF, Young BE, Wardle J, Wrann CD, Kral JG. Early-life influences on obesity: from preconception to adolescence. Ann N Y Acad Sci 2015; 1347:1-28. [PMID: 26037603 PMCID: PMC4522218 DOI: 10.1111/nyas.12778] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 03/30/2015] [Indexed: 12/12/2022]
Abstract
The double burden of under- and overnutrition profoundly affects human health globally. According to the World Health Organization, obesity and diabetes rates have almost doubled worldwide since 1980, and, in 2011, more than 40 million children under 5 years of age were overweight. Ecologic factors, parental genetics and fitness, and the intrauterine environment significantly influence the likelihood of offspring developing the dysmetabolic diathesis of obesity. This report examines the effects of these factors, including preconception, intrauterine and postnatal energy balance affecting programming of transgenerational transmission, and development of chronic diseases later in life-in particular, diabesity and its comorbidities.
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Affiliation(s)
| | - Stephen A Krawetz
- C.S. Mott Center for Human Growth and Development and Center for Molecular Medicine and Genetics, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
| | - Nico S Rizzo
- Center of Community Resilience, School of Public Health, Loma Linda University, Loma Linda, California
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Shari Barkin
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ann Yatkine
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Robert A Waterland
- Departments of Pediatrics and Molecular and Human Genetics, Baylor College of Medicine and USDA/ARS Children's Nutrition Research Center, Houston, Texas
| | | | - Mina Desai
- University of California Los Angeles Medical Center, Los Angeles, California
| | - Michael G Ross
- University of California Los Angeles Medical Center, Los Angeles, California
| | - Nancy F Krebs
- University of Colorado School of Medicine, Aurora, Colorado
| | | | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Christiane D Wrann
- Dana-Farber Cancer Institute and Department of Cell Biology, Harvard Medical School, Boston, Massachusetts
| | - John G Kral
- SUNY Downstate Medical Center, Brooklyn, New York
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Abstract
Research suggests that repeatedly offering infants a variety of vegetables during weaning increases vegetable intake and liking. The effect may extend to novel foods. The present study aimed to investigate the impact of advising parents to introduce a variety of single vegetables as first foods on infants' subsequent acceptance of a novel vegetable. Mothers of 4- to 6-month-old infants in the UK, Greece and Portugal were randomised to either an intervention group (n 75), who received guidance on introducing five vegetables (one per d) as first foods repeated over 15 d, or a control group (n 71) who received country-specific ‘usual care’. Infant's consumption (g) and liking (maternal and researcher rated) of an unfamiliar vegetable were assessed 1 month post-intervention. Primary analyses were conducted for the full sample with secondary analyses conducted separately by country. No significant effect of the intervention was found for vegetable intake in the three countries combined. However, sub-group analyses showed that UK intervention infants consumed significantly more novel vegetable than control infants (32·8 (sd 23·6) v. 16·5 (sd 12·1) g; P =0·003). UK mothers and researchers rated infants' vegetable liking higher in the intervention than in control condition. In Portugal and Greece, there was no significant intervention effect on infants' vegetable intake or liking. The differing outcome between countries possibly reflects cultural variations in existing weaning practices. However, the UK results suggest in countries where vegetables are not common first foods, advice on introducing a variety of vegetables early in weaning may be beneficial for increasing vegetable acceptance.
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Feeding practices in early life and later intake of fruit and vegetables among Japanese toddlers: the Osaka Maternal and Child Health Study. Public Health Nutr 2015; 19:650-7. [PMID: 26036251 DOI: 10.1017/s1368980015001779] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE A growing body of evidence from Western countries shows that infant feeding practices are associated with later childhood dietary habits, but little is known about these relationships in non-Western countries with different food cultures. We examined the association of breast-feeding duration and age at introduction of solid foods with later intake of fruit and vegetables among Japanese toddlers. DESIGN Information on breast-feeding duration, age at introduction of solid foods and child's intake frequency of fruit and vegetables were collected with a self-administered questionnaire at 16-24 months postpartum. Logistic regression analysis was used to calculate odds ratios of low intake (<1 time/d) of fruit or vegetables for each infant feeding practice. SETTING Japan. SUBJECTS Japanese mother-child pairs (n 763) from a prospective birth cohort study. RESULTS Neither breast-feeding duration nor age at introduction of solid foods was associated with fruit intake at 16-24 months of age. Breast-feeding duration, but not age at introduction of solid foods, was associated with later intake of vegetables. When breast-feeding duration was categorized into two groups with the cut-off at 6 months, children who were breast-fed for ≥6 months had a significantly decreased risk of low intake of vegetables (OR=0·53; 95% CI 0·34, 0·84) than those breast-fed for <6 months. This association was independent of potential confounders including maternal education and maternal vegetable intake (OR=0·59; 95% CI 0·36, 0·97). CONCLUSIONS This finding suggests that ≥6 months of breast-feeding may prevent low intake of vegetables in early childhood among Japanese toddlers.
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