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Omachi BA, van Onselen A, Kolanisi U. Nutrition knowledge and health vulnerability of mothers of pre-school children in north-central, Nigeria. PLoS One 2024; 19:e0292252. [PMID: 38295048 PMCID: PMC10829998 DOI: 10.1371/journal.pone.0292252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/15/2023] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE This study explores the contribution of nutrition knowledge to the health status of pre-school children's mothers in Niger State, North-Central, Nigeria. DESIGN The study is a descriptive cross-sectional design using a quantitative data collection method. SETTING/PARTICIPANTS A multi-stage sampling technique was used to recruit 450 mothers of pre-school children across Niger state, Nigeria. Chi-square and linear regression were used to test the level of statistical significance (at p < 0.05). Socioeconomic and demographic information, anthropometric indices and nutrition knowledge were obtained using semi-structured questionnaires. Feeding patterns were also assessed using a qualitative 7-day dietary recall. RESULT The results showed that the majority (63.8%) of the mothers were within 26-35 years, and more than half (51.6%) of the mothers lacked knowledge of a "balanced diet". Fruits, vegetables, and dairy products were the least consumed food group among the mothers (7.1% and 9.1%, respectively). Place of residence, occupation, and method of waste disposal were significantly associated with maternal minimum dietary diversity adequacy (p<0.05). Over half (57.6%) of the mothers were within the normal BMI range, and the mean waist/hip ratio was 0.82± 0.08. Social media/online was the most (36.4%) explored source of nutrition information among the mothers. This study shows no significant association between nutrition knowledge and adequacy of minimum dietary diversity among the mothers of preschool children (p = 0.09, χ2 = 13.682). CONCLUSION Dietary diversity among mothers was associated with the socioeconomic status and BMI of the mothers, which were strong determinants of meal quality and health outcomes in Nigeria and other developing countries experiencing food insecurity.
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Affiliation(s)
| | | | - Unathi Kolanisi
- University of Zululand, eMpageni, Kwazulu-Natal, South Africa
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Al-buobayd AA, Al-Otaibi HH, Farag HAS. Association of Maternal Feeding Style with Fruit and Vegetable Consumption in Saudi Preschoolers: A Nationwide Cross-Sectional Study. Nutrients 2023; 15:4735. [PMID: 38004129 PMCID: PMC10674286 DOI: 10.3390/nu15224735] [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: 10/11/2023] [Revised: 11/02/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Parental feeding style (PFS) remarkably influences fruit and vegetable (F&V) consumption in preschoolers. This study aimed to determine the association between PFS and preschoolers' F&V consumption, as influenced by socioeconomic factors. A nationwide cross-sectional study was conducted among 1418 mothers of children aged 3-5 years in Saudi Arabia. Multinomial logistic regression model analysis was performed to assess the association between PFS and children's daily F&V intake using the Parental Feeding Style Questionnaire. The influence of socioeconomic factors on this association was also evaluated. For mothers with university degrees, encouragement, emotional, and instrumental feeding enhanced their children's intake of F&Vs, fruits, and vegetables, respectively. Children from families earning SAR >10,000 monthly had increased F&V intake with encouragement feeding and increased fruit intake with emotional feeding. However, F&V intake was reduced in children of working mothers with controlling feeding styles. Breastfeeding for <6 months was associated with increased F&V intake through emotional feeding. The most prevalent feeding style was encouragement, followed by emotional, with control and instrumental styles being less common. This study provides strong evidence on the association between PFS and daily F&V intake in Saudi preschoolers. Interventional and longitudinal studies on PFS are required to confirm these findings.
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Affiliation(s)
| | - Hala Hazam Al-Otaibi
- Department of Food and Nutrition Science, College of Agricultural and Food Science, King Faisal University, Al-Ahsa 31982, Saudi Arabia; (A.A.A.-b.); (H.A.S.F.)
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Mahajan A, Haines J, Yu J, Darlington G, Buchholz AC, Duncan AM, Ma DWL. Sugar Intake among Preschool-Aged Children in the Guelph Family Health Study: Associations with Sociodemographic Characteristics. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1459. [PMID: 37761420 PMCID: PMC10530220 DOI: 10.3390/children10091459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND It is crucial to develop strategies targeted to promote healthy eating patterns in vulnerable populations, especially young children from diverse sociodemographic groups. Thus, the study objective was to investigate the associations between child age, child sex, child ethnicity, parent number of years living in Canada, annual household income, parent education and parent marital status with total, free and added sugar intakes in young children. METHODS This cross-sectional study was a secondary analysis of data gathered in the Guelph Family Health Study. The study included 267 children (129M; 138F) from 210 families aged 1.5 to 5 years. Parents completed questionnaires for children on sociodemographic characteristics and an online 24-hour diet recall. The associations between sociodemographic characteristics and sugar intakes were determined using generalized estimating equations applied to linear regression models. RESULTS The mean age of the children was 3.5 ± 1.2 years (mean ± std dev.). As children's age increased, there was a greater intake of free and added sugar (β^ = 8.6, p = 0.01, 95% CI = 2.4 to 14.7 and β^ = 6.5, p = 0.03, 95% CI = 0.8 to 12.2, respectively). Those children who identified as white had a higher total sugar intake than children of other ethnicities (β^ = 31.0, p = 0.01, 95% CI = 7.2 to 54.7). Additionally, higher annual household income was associated with lower was free sugar intake in children (β^ = -2.4, p = 0.02, 95% CI = -4.5 to -0.4). CONCLUSIONS This study underscores the significant influence of multiple sociodemographic characteristics on sugar intake in young children, providing valuable insights for public health policy and nutrition interventions. Moreover, this study highlights the need for early behaviour interventions focusing on reducing sugar intake in young children, while considering sociodemographic factors.
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Affiliation(s)
- Anisha Mahajan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (A.C.B.)
| | - Jessica Yu
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G2 W1, Canada;
| | - Andrea C. Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (A.C.B.)
| | - Alison M. Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
| | - David W. L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
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Schmitz J, Abbondanza F, Marianski K, Luciano M, Paracchini S. Identification of loci involved in childhood visual acuity and associations with cognitive skills and educational attainment. NPJ SCIENCE OF LEARNING 2023; 8:25. [PMID: 37491545 PMCID: PMC10368730 DOI: 10.1038/s41539-023-00175-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
Visual acuity significantly contributes to quality of life. Deficits in childhood are associated with reading difficulties, which can have detrimental effects on education outcomes. In adults, it has been observed that vision defects such as myopia are associated with higher educational attainment (EA). Understanding genetic factors contributing to visual acuity could help to dissect its links with cognitive skills, neurodevelopmental conditions, and education. We examined associations between distance visual acuity, cognitive measures including school grades, and neurodevelopmental conditions in a longitudinal cohort of British children (ALSPAC, n = 6807, M age = 11.8). We performed a genome-wide association study (GWAS, n = 5571) on visual acuity and tested for genetic associations with relevant phenotypes using polygenic scores (PGS) and genetic correlation analyses. Visual acuity was associated with better cognitive performance and school grades, and reduced in individuals with reading difficulties compared to controls. GWAS revealed genetic associations at the NPLOC4 locus and highlighted other genes involved in sensory function. In line with positive genetic correlations between visual acuity and cognitive measures, EA PGS were positively associated with visual acuity, while there was a less robust negative association with myopia PGS. In conclusion, increased visual acuity is associated with a range of positive outcomes, including better school grades. Our results suggest an association between a higher EA PGS and slightly increased visual acuity in childhood. This could indicate gene-environment correlation, in which environmental exposures linked to higher EA might have detrimental effects on vision offsetting the initial positive effect.
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Affiliation(s)
- Judith Schmitz
- School of Medicine, University of St Andrews, St Andrews, Scotland, UK
- Biological Personality Psychology, Georg-August-University Goettingen, Goettingen, Germany
| | | | | | - Michelle Luciano
- Department of Psychology, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Silvia Paracchini
- School of Medicine, University of St Andrews, St Andrews, Scotland, UK.
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Serasinghe N, Vepsäläinen H, Lehto R, Abdollahi AM, Erkkola M, Roos E, Ray C. Associations between socioeconomic status, home food availability, parental role-modeling, and children's fruit and vegetable consumption: a mediation analysis. BMC Public Health 2023; 23:1037. [PMID: 37259139 DOI: 10.1186/s12889-023-15879-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. METHODS Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. RESULTS The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51-4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10-1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35-1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 - -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06-1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40-1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. CONCLUSIONS Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
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Affiliation(s)
- Nithya Serasinghe
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Reetta Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, P.O. Box 63, Helsinki, FI-00014, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
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Sugianto R, Toh JY, Wong SF, Tint MT, Colega MT, Lee YS, Yap F, Shek LPC, Tan KH, Godfrey KM, Chong YS, Tai BC, Chong MFF. Dietary patterns of 5-year-old children and their correlates: findings from a multi-ethnic Asian cohort. Br J Nutr 2022; 127:763-772. [PMID: 33910654 PMCID: PMC7612427 DOI: 10.1017/s0007114521001434] [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] [Indexed: 11/06/2022]
Abstract
There is limited data on the dietary patterns of 5-year-old children in Asia. The study examined childhood dietary patterns and their maternal and child correlates in a multi-ethnic Asian cohort. Based on caregiver-reported 1-month quantitative FFQ of 777 children from the Growing Up in Singapore Towards healthy Outcomes cohort, cluster analysis identified two mutually exclusive clusters. Children in the 'Unhealthy' cluster (43·9 %) consumed more fries, processed meat, biscuits and ice cream, and less fish, fruits and vegetables compared with those in the 'Healthy' cluster (56·1 %). Children with mothers of lower educational attainment had twice the odds of being assigned to the 'Unhealthy' cluster (adjusted OR (95 % CI) = 2·19 (95 % CI 1·49-3·24)). Children of Malay and Indian ethnicities had higher odds of being assigned to the 'Unhealthy' cluster (adjusted OR = 25·46 (95 % CI 15·40, 42·10) and 4·03 (95 % CI 2·68-6·06), respectively), relative to Chinese ethnicity. In conclusion, this study identified two dietary patterns in children, labelled as the 'Unhealthy' and 'Healthy' clusters. Mothers' educational attainment and ethnicity were two correlates that were associated with the children's assignments to the clusters. These findings can assist in informing health promotion programmes targeted at Asian children.
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Affiliation(s)
- R Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - JY Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - SF Wong
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MT Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MT Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - YS Lee
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital and National University Health System, Singapore
| | - F Yap
- Duke-NUS Medical School, Singapore
- KK Women’s and Children’s Hospital, Singapore
| | - LPC Shek
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital and National University Health System, Singapore
| | - KH Tan
- Duke-NUS Medical School, Singapore
- KK Women’s and Children’s Hospital, Singapore
| | - KM Godfrey
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - YS Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - BC Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - MFF Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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Holmes JF, St. Laurent CW, Spencer RMC. Unhealthy Diet Is Associated With Poor Sleep in Preschool-Aged Children. J Genet Psychol 2021; 182:289-303. [PMID: 33876710 PMCID: PMC8764816 DOI: 10.1080/00221325.2021.1905598] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/04/2021] [Indexed: 10/21/2022]
Abstract
Unhealthy dietary choices are associated with poor sleep in children through adults. Yet, how diet and sleep are related in early childhood, when diet is reliant on parent choices around food availability, is unknown. The authors aimed to explore how frequency of fruit, vegetable, fast food, and soda consumption are associated with preschool children's sleep quality. They also considered how parenting factors may impact the relationship between children's sleep and diet. Actigraphy data were collected from 383 children 33-70 months old. Caregivers reported on child food and beverage frequency, demographics, and health items. Parenting strategies were assessed using the Parenting Scale. Multiple linear regression was used to examine associations between sleep and dietary measures with socioeconomic status, race-ethnicity, physical activity, and body mass index as covariates. Shorter nap duration was associated with more frequent consumption of fruits and vegetables (B = -3.6, p = .03). Shorter nighttime and 24-hr sleep durations were associated with more frequent consumption of fast food (B = -6.5, p = .01; B = -5.8, p = .01). Shorter nighttime sleep and later sleep onset were associated with more frequent soda consumption (B = -9.2, p = .01; B = 0.23, p = .001). Use of ineffective parenting strategies was negatively associated with fruit and vegetable consumption (r = -.29, p = .01) and positively associated with soda consumption (r = .25, p = .02) but was unrelated to sleep measures. Thus, ineffective parenting strategies may underlie child access to unhealthy foods, which, in turn, contributes to poor sleep. Encouraging healthier dietary habits and educating caregivers on how to reinforce such practices may lead to better sleep outcomes in early childhood.
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Affiliation(s)
- Jennifer F. Holmes
- Department of Psychological & Brain Sciences, University of Massachusetts, Amherst
| | | | - Rebecca M. C. Spencer
- Department of Psychological & Brain Sciences, University of Massachusetts, Amherst
- Neuroscience & Behavior Program, University of Massachusetts, Amherst
- Institute for Applied Life Sciences, University of Massachusetts, Amherst
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Schmitz J, Abbondanza F, Paracchini S. Genome-wide association study and polygenic risk score analysis for hearing measures in children. Am J Med Genet B Neuropsychiatr Genet 2021; 186:318-328. [PMID: 34476894 DOI: 10.1002/ajmg.b.32873] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 06/11/2021] [Accepted: 08/10/2021] [Indexed: 01/04/2023]
Abstract
An efficient auditory system contributes to cognitive and psychosocial development. A right ear advantage in hearing thresholds (HTs) has been described in adults and atypical patterns of left/right hearing threshold asymmetry (HTA) have been described for psychiatric and neurodevelopmental conditions. Previous genome-wide association studies (GWASs) on HT have mainly been conducted in elderly participants whose hearing is more likely to be affected by external environmental factors. Here, we investigated HT and HTA in a children population cohort (ALSPAC, n = 6,743). Better hearing was associated with better cognitive performance and higher socioeconomic status. At the group level, HTA suggested a left ear advantage (mean = -0.28 dB) that was mainly driven by females. SNP heritability for HT and HTA was 0.13 and 0.02, respectively (n = 4,989). We found a modest negative genetic correlation between HT and reading ability. GWAS for HT (n = 5,344) did not yield significant hits but polygenic risk scores for higher educational attainment (EA, ß = -1,564.72, p = .008) and schizophrenia (ß = -241.14, p = .004) were associated with lower HT, that is, better hearing. In summary, we report new data supporting associations between hearing measures and cognitive abilities at the behavioral level. Genetic analysis suggests shared biological pathways between cognitive and sensory systems and provides evidence for a positive outcome of genetic risk for schizophrenia.
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Affiliation(s)
- Judith Schmitz
- School of Medicine, University of St Andrews, St Andrews, UK
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Dietary Patterns in Early Childhood and the Risk of Childhood Overweight: The GECKO Drenthe Birth Cohort. Nutrients 2021; 13:nu13062046. [PMID: 34203797 PMCID: PMC8232591 DOI: 10.3390/nu13062046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022] Open
Abstract
Limited and inconsistent evidence exists on the associations between dietary patterns and overweight during childhood. The present study describes dietary patterns of three-year-old Dutch children and associations between childhood overweight and body mass index (BMI) development between 3 and 10 years. In the GECKO Drenthe birth cohort (N = 1306), body height and weight were measured around the age of 3, 4, 5, and 10 years, and overweight was defined according to Cole and Lobstein. A validated food frequency questionnaire (FFQ) was used to measure diet at 3 years. Dietary patterns were derived using principal components analysis (PCA). Using logistic regression analyses, pattern scores were related to overweight at 3 and 10 years. A linear mixed-effect model was used to estimate BMI-SDS development between 3 to 10 years according to quartiles of adherence to the pattern scores. Two dietary patterns were identified: (1) 'minimally processed foods', indicating high intakes of vegetables/sauces/savory dishes, and (2) 'ultra-processed foods', indicating high intakes of white bread/crisps/sugary drinks. A 1 SD increase in the 'ultra-processed foods' pattern score increased the odds of overweight at 10 years (adjusted OR: 1.30; 95%CI: 1.08, 1.57; p = 0.006). The 'minimally processed foods' pattern was not associated with overweight. Although a high adherence to both dietary patterns was associated with a higher BMI-SDS up to 10 years of age, a stronger association for the 'ultra-processed foods' pattern was observed (p < 0.001). A dietary pattern high in energy-dense and low-fiber ultra-processed foods at 3 years is associated with overweight and a high BMI-SDS later in childhood.
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10
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Leme AC, Muszynski D, Mirotta JA, Caroll N, Hogan JL, Jewell K, Yu J, Fisberg RM, Duncan AM, Ma DWL, Haines J, On Behalf Of The Guelph Family Health Study. Diet Quality of Canadian Preschool Children: Associations with Socio-demographic Characteristics. CAN J DIET PRACT RES 2021; 82:131-135. [PMID: 33876988 DOI: 10.3148/cjdpr-2021-009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To examine associations between preschoolers' diet quality and parent and child socio-demographic variables.Methods: Cross-sectional analysis with 117 preschoolers. Parents reported socio-demographics and their children's diet using 3-day food records. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. Linear regression models were used to analyze associations between socio-demographics and HEI scores.Results: A total of 86% of children had an HEI-2015 score in the "needs improvement" category (51-80 out of a maximum of 100). Children's overall HEI-2015 score was inversely associated with children's age (β = -0.19, 95% CI -0.37, -0.02). Parental education was positively associated with children's overall HEI score (β = 9.58, 95% CI 3.81, 15.35) and with scores for total fruit (β = 1.00, 95% CI 0.39, 1.76), vegetables (β = 1.11, 95% CI 0.03, 2.18), total protein (β = 1.06, 95% CI 0.28, 1.84), and seafood/plant protein (β = 1.67, 95% CI 0.43, 2.89) components. Children who identified as Caucasian (β = 4.29, 95% CI 2.46, 6.14), had a Caucasian parent (β = 3.01, 95% CI 0.78, 5.25), or parents who were born in Canada (β = 2.32, 95% CI 0.53, 4.11) had higher scores for dairy.Conclusion: Our results suggest that preschoolers' diet quality needs improvement and that children's diet quality varies by children's age and parental education level.
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Affiliation(s)
- Ana Carolina Leme
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON.,University of São Paulo, Department of Nutrition, School of Public Health, Brazil, São Paulo, Brazil.,Center for Excellence in Nutrition and Feeding Difficulties, Children's Hospital Sabará, PENSI Institute, Brazil
| | - Dabrowka Muszynski
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Julia A Mirotta
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Nicholas Caroll
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON
| | - Jaimie L Hogan
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Kira Jewell
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Jessica Yu
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Regina Mara Fisberg
- University of São Paulo, Department of Nutrition, School of Public Health, Brazil, São Paulo, Brazil
| | - Alison M Duncan
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - David W L Ma
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Jess Haines
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON
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Jaspers Faijer-Westerink H, Stavnsbo M, Hutten BA, Chinapaw M, Vrijkotte TGM. Ideal cardiovascular health at age 5-6 years and cardiometabolic outcomes in preadolescence. Int J Behav Nutr Phys Act 2021; 18:33. [PMID: 33676545 PMCID: PMC7936465 DOI: 10.1186/s12966-021-01090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The American Heart Association (AHA) developed a definition of ideal cardiovascular health (ICH) based on the presence of both ideal health behaviours (diet, physical activity, weight status and smoking) and ideal health factors (glucose, total cholesterol and blood pressure levels). However, research of ICH in the paediatric population is scarce. We aimed to study ICH at age 5-6 years by extending the original ICH score with the health behaviours: sleep duration, screen time and prenatal smoke exposure, and to evaluate its association with cardiometabolic outcomes at age 11-12. METHODS A total of 1666 children aged 5-6 years were selected from the database of the ABCD-study, a prospective cohort study on the health and development of children born in Amsterdam, the Netherlands. Of these, 846 (50.8%) were boys and 1460 (87.6%) had a healthy weight. Data on self-reported health behaviours and health factors were used to calculate the ICH scores (original and extended) by adding the frequency of scoring 'healthy' on each indicator, based on international cut-offs. The children were followed up for 6 years and cardiometabolic outcomes (carotid intima-media thickness (CIMT), blood pressure, glucose and lipids) were measured. Associations between ICH (both original and extended) and cardiometabolic outcomes were examined using multivariable regression models. RESULTS At age 5-6 years, 11% scored poor (score 1-5), 56% intermediate (score 6-7) and 33% good (score 8-9) on extended ICH. Healthy diet and normal total cholesterol concentrations were the least prevalent. Neither the original nor the extended ICH scores were associated with CIMT at age 11-12. A higher score on the extended ICH was associated with lower total cholesterol (p for trend < 0.001), lower systolic (p for trend = 0.012) and diastolic blood pressure (p for trend = 0.011), and lower body mass index (BMI) (p < 0.001) at age 11-12. The original ICH score was associated with lower total cholesterol (p < 0.001) and BMI (p < 0.001) only. CONCLUSION Our findings suggest that extending the ICH score in young children with additional health behaviours improves prediction of some cardiometabolic outcomes, but not CIMT in preadolescence, compared to the original ICH score. We would recommend other researchers to incorporate objective measures of health behaviours and longer follow-up to find out whether associations persist into adulthood.
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Affiliation(s)
- Hester Jaspers Faijer-Westerink
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J2-209, 1100 DE, Amsterdam, The Netherlands
| | - Mette Stavnsbo
- Department of Sports Science and Physical Education, University of Agder, PO BOX 422, 4604, Kristiansand, Norway
| | - Barbara A Hutten
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J1B-209-1, 1100 DE, Amsterdam, The Netherlands
| | - Mai Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, PO Box 7057, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, PO Box 22700, Meibergdreef 9, room J2-209, 1100 DE, Amsterdam, The Netherlands.
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Diet quality at age 5-6 and cardiovascular outcomes in preadolescents. Clin Nutr ESPEN 2021; 43:506-513. [PMID: 34024563 DOI: 10.1016/j.clnesp.2021.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 12/09/2020] [Accepted: 02/12/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND & AIMS Specific dietary components during childhood may affect risk factors for cardiovascular disease. Whether overall higher diet quality prevents children from adverse cardiovascular outcomes remains contradictive. We aimed to examine the associations between diet quality at age 5-6 years and cardiovascular outcomes after a 6-year follow-up. METHODS We used data from the Amsterdam Born Children and their Development study, a multi-ethnic birth cohort. Dietary intake was assessed at age 5-6 using a semi-quantitative food frequency questionnaire and diet quality was ascertained with the Dietary Approaches to Stop Hypertension (DASH) score and the child diet quality score (CDQS), an index specifically developed for Dutch school-age children. Cardiovascular outcomes were examined after 6-years follow-up (age 11-12, N = 869). Outcomes were body mass index (BMI), waist circumference (WC), blood pressure (BP), lipid profile, fasting glucose and carotid intima-media thickness (CIMT). Multivariable linear and logistic regression models adjusted for baseline value were used to examine associations between diet quality and cardiovascular outcomes. RESULTS Higher diet quality at age 5-6 was associated with lower BMI (DASH score: Δ quintile (Q) 5 and Q1: -0.35 kg/m2, p for trend = 0.016), lower WC (DASH score: Δ Q5 and Q1: -1.0 cm, p for trend = 0.028), lower systolic (DASH score: Δ Q5 and Q1: -2.7 mmHg, p for trend = 0.046) and diastolic BP (DASH score: Δ Q5 and Q1: -2.4, p for trend < 0.001) and with lower plasma triglycerides (DASH score: Δ Q5 and Q1: -0.20 mmol/L, p for trend = 0.032) after 6-years follow-up. Associations of the CDQS with these outcomes showed similar trends, but less pronounced. We found no statistically significant associations between diet quality and LDL-C, HDL-C, total cholesterol, fasting glucose or CIMT. CONCLUSIONS Higher diet quality in childhood at age 5-6 years predicted better health on some cardiovascular outcomes in preadolescence.
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Olmedo SI, Román MD, Berra S, Valeggia CR. Food Intake and the Significance of Feeding in Qom Children of Northern Argentina. Curr Dev Nutr 2020; 4:nzaa158. [PMID: 33215054 PMCID: PMC7658633 DOI: 10.1093/cdn/nzaa158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/03/2020] [Accepted: 10/09/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND As part of the ubiquitous nutritional transition indigenous are experiencing, the typical diet of most indigenous communities is being substituted by one with high-fat and high-energy-density foods. Domestic feeding transmits cultural factors through meaning and symbolism influential in food, preparation, and meal experiences, which in turn influence children's eating habits differently among social groups. OBJECTIVES The aims of this study were to explore the food consumption patterns of Qom preschoolers and to describe cultural domains about the significance of feeding in this indigenous population in northern Argentina. METHODS This cross-sectional and mixed-methods study was conducted in 2016-2017 and focused on 160 preschoolers and their mothers in the village of Namqom. It used a closed questionnaire, three 24-h recalls, and free listing techniques. RESULTS Qom preschoolers had a high prevalence of excess weight (25%) and stunting (16%). Mothers reported only 38 food items consumed by preschoolers. Almost all of the children (96%) consumed white bread, whereas 89% consumed milk, 87.5% sweet cookies, 84.7% some sort of stew, 72% fried dough, and 63.1% soup. In addition, it was found that preschoolers consumed neither fresh and varied vegetables, nor available fruits. They did not consume fresh fish and other meats, either. Caregivers related the term "feeding" with "having to eat," which might be associated with the context of poverty in which they live. Caregivers also mentioned "eating right" to get healthy or grow up strong. CONCLUSIONS The present study revealed a relatively elevated consumption of high-energy but nutritionally poor food, and malnutrition, which reflects the impacts of poverty. We found that the cultural domain of food is linked to survival and depletion ideas.
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Affiliation(s)
- Sofía I Olmedo
- Center for Research and Studies on Culture and Society, National University of Córdoba, Córdoba, Argentina
| | - María D Román
- Center of Research of Epidemiology and Health Services, National University of Córdoba, Córdoba, Argentina
- School of Nutrition, National University of Córdoba, Córdoba, Argentina
| | - Silvina Berra
- Center for Research and Studies on Culture and Society, National University of Córdoba, Córdoba, Argentina
- Center of Research of Epidemiology and Health Services, National University of Córdoba, Córdoba, Argentina
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Beyond maternal education: Socio-economic inequalities in children's diet in the ABCD cohort. PLoS One 2020; 15:e0240423. [PMID: 33048970 PMCID: PMC7553270 DOI: 10.1371/journal.pone.0240423] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 09/27/2020] [Indexed: 11/26/2022] Open
Abstract
Objective We examined whether the role of maternal education in children’s unhealthy snacking diet is moderated by other socio-economic indicators. Methods Participants were selected from the Amsterdam Born Children and their Development cohort, a large ongoing community-based birth cohort. Validated Food Frequency Questionnaires (FFQ) (n = 2782) were filled in by mothers of children aged 5.7±0.5yrs. Based on these FFQs, a snacking dietary pattern was derived using Principal Component Analysis. Socio-economic indicators were: maternal and paternal education (low, middle, high; based on the highest education completed) household finance (low, high; based on ability to save money) and neighbourhood SES (composite score including educational level, household income and employment status of residents per postal code). Cross-sectional multivariable linear regression analysis was used to assess the association and possible moderation of maternal education and other socio-economic indicators on the snacking pattern score. Analyses were adjusted for children’s age, sex and ethnicity. Results Low maternal education (B 0.95, 95% CI 0.83;1.06), low paternal education (B 0.36, 95% CI 0.20;0.52), lower household finance (B 0.18, 95% CI 0.11;0.26) and neighbourhood SES (B -0.09, 95% CI -0.11;-0.06) were independently associated with higher snacking pattern scores (p<0.001). The association between maternal education and the snacking pattern score was somewhat moderated by household finance (p = 0.089) but remained strong. Children from middle-high educated mothers (B 0.44, 95% CI 0.35;0.52) had higher snacking pattern scores when household finance was low (B 0.49, 95% CI 0.33;0.65). Conclusions All socio-economic indicators were associated with increased risk of unhealthy dietary patterns in young children, with low maternal education conferring the highest risk. Yet, within the group of middle-high educated mothers, lower household finance was an extra risk factor for unhealthy dietary patterns. Intervention strategies should therefore focus on lower educated mothers and middle-high educated mothers with insufficient levels of household finance.
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Beltrán-Velasco AI, Mendoza-Castejón D, Fuentes-García JP, Clemente-Suárez VJ. Behavioural, psychological, and physiological stress markers and academic performance in immigrant and non-immigrant preschool and school students. Physiol Behav 2020; 225:113081. [DOI: 10.1016/j.physbeh.2020.113081] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022]
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Chaudhary A, Sudzina F, Mikkelsen BE. Promoting Healthy Eating among Young People-A Review of the Evidence of the Impact of School-Based Interventions. Nutrients 2020; 12:nu12092894. [PMID: 32971883 PMCID: PMC7551272 DOI: 10.3390/nu12092894] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/24/2020] [Accepted: 09/03/2020] [Indexed: 01/09/2023] Open
Abstract
Intro: Globally, the prevalence of overweight and obesity is increasing among children and younger adults and is associated with unhealthy dietary habits and lack of physical activity. School food is increasingly brought forward as a policy to address the unhealthy eating patterns among young people. Aim: This study investigated the evidence for the effectiveness of school-based food and nutrition interventions on health outcomes by reviewing scientific evidence-based intervention studies amongst children at the international level. Methods: This study was based on a systematic review using the PRISMA guidelines. Three electronic databases were systematically searched, reference lists were screened for studies evaluating school-based food and nutrition interventions that promoted children’s dietary behaviour and health aiming changes in the body composition among children. Articles dating from 2014 to 2019 were selected and reported effects on anthropometry, dietary behaviour, nutritional knowledge, and attitude. Results: The review showed that school-based interventions in general were able to affect attitudes, knowledge, behaviour and anthropometry, but that the design of the intervention affects the size of the effect. In general, food focused interventions taking an environmental approach seemed to be most effective. Conclusions: School-based interventions (including multicomponent interventions) can be an effective and promising means for promoting healthy eating, improving dietary behaviour, attitude and anthropometry among young children. Thus, schools as a system have the potential to make lasting improvements, ensuring healthy school environment around the globe for the betterment of children’s short- and long-term health.
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Affiliation(s)
- Abina Chaudhary
- Independent Researcher, Kastrupvej 79, 2300 Copenhagen, Denmark;
| | - František Sudzina
- Department of Materials and Production, Faculty of Engineering and Science, Aalborg University, A. C. Meyers Vænge 15, 2450 Copenhagen, Denmark
- Department of Systems Analysis, Faculty of Informatics and Statistics, University of Economics, nám. W. Churchilla 1938/4, 130 67 Prague, Czech Republic
- Correspondence: or
| | - Bent Egberg Mikkelsen
- Department of Geosciences and Natural Resource Management, Faculty of Science, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark;
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Diet Quality among Women with Previous Gestational Diabetes Mellitus in Rural Areas of Hunan Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165942. [PMID: 32824308 PMCID: PMC7460136 DOI: 10.3390/ijerph17165942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 12/11/2022]
Abstract
Diet quality is critical for postpartum type 2 diabetes mellitus (T2DM) progression among women with a history of gestational diabetes mellitus (GDM). The Chinese Healthy Eating Index (CHEI) is a dietary index developed according to the latest Chinese Dietary Guidelines (CDG-2016). Our study aimed to assess the diet quality of women with previous GDM in rural areas of Hunan Province by applying the CHEI. Women with previous GDM in two counties of Hunan were enrolled. Their food intake data, which were used to calculate their CHEI scores, were collected by a 24-h dietary recall. The association of CHEI with sociodemographic and anthropometric variables was evaluated via linear regression models. 404 women were included in the final analysis. The mean score of the total CHEI was 54.9 (SD 7.9). The components of whole grains and mixed beans, seeds and nuts, tubers, dairy, and poultry scored extremely low. Ethnic minority groups and women younger than 30 years had lower CHEI scores. Our study observed an unsatisfactory diet quality among women with previous GDM in rural areas of Hunan Province. Future dietary education focusing on the CDG is needed to improve their diet quality and help in T2DM prevention among this population, especially young and ethnic minority women.
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Wu WC, Lin CI, Li YF, Chang LY, Chiang TL. The mediating effect of dietary patterns on the association between mother's education level and the physical aggression of five-year-old children: a population-based cohort study. BMC Pediatr 2020; 20:221. [PMID: 32414349 PMCID: PMC7227108 DOI: 10.1186/s12887-020-02126-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relatively few studies have investigated the effects of diet on behavior problems among preschoolers, particularly, physical aggression. In addition, children raised by poorly educated mothers usually have a higher probability of developing negative outcomes. Additionally, highly educated mothers have a higher probability of providing more healthy foods for their children. Thus, mothers providing healthy foods might mitigate children's behavior problems. The study aims to examine whether preschoolers' dietary pattern, as a manipulable factor, mediates the association between maternal education level and physical aggression. METHODS Data came from the Taiwan Birth Cohort Study (TBCS), a nationally representative population-based cohort study, which included 18,513 five-year-old Taiwanese children. Mothers and primary caregivers reported the information on preschoolers' physical aggression and food consumption at age 5 and maternal education level at age 6 months. Two dietary patterns, namely a healthy diet and a high-fat-sugar-salt (HFSS) diet, were retrieved by exploratory factor analysis. Mediation hypotheses were tested by a series of multiple regression models conducted using the PROCESS macro of SAS 9.4. All models were adjusted for children's sex, parental marital status, household income, mental distress at age 5 and children's physical aggression at age 3. RESULTS Maternal education positively linked to healthy dietary patterns (B = 0.014, p = 0.002) which was negatively associated with preschoolers' physical aggression (B = -0.096, p = 0.013), and it is negatively related to the HFSS dietary pattern (B = -0.042, p = 0.002) which was directly positively associated with preschoolers' physical aggression (B = 0.123, p = 0.008). The association between maternal education and preschoolers' physical aggression was partially mediated by preschoolers' healthy (B = -0.001, p < .001) and HFSS (B = -0.005, p = <.001) dietary patterns, respectively. The R-square of the mediation model is 0.178. CONCLUSIONS Preschoolers' dietary patterns directly associate with their physical aggression. In addition, mothers with poor education may provide less healthy foods and more unhealthy foods to their children, which may increase the level of physical aggression. The results imply partial mediating effects of dietary patterns between maternal education and physical aggression. It is suggested that a parent-based nutritional education program focusing on healthy meal preparation for poor educated mothers might be beneficial for preschoolers' healthy development.
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Affiliation(s)
- Wen-Chi Wu
- Department of Health Promotion and Health Education, National Taiwan Normal University, 17 Xuzhou Road, Taipei, 100, Taiwan
| | - Ching-I Lin
- Department of Nutrition and Health Sciences, Kainan University, No. 1, Kainan Road, Luzhu District, Taoyuan City, 338, Taiwan.
| | - Yi-Fan Li
- Division of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare, 11221 Room, No. 155-1, Section 2, Linong St, Beitou District, Taipei City, 112, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, School of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei, 100, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, School of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei, 100, Taiwan
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van Kleef E, Rongen FC, Vingerhoeds MH, Dijkstra SC, Seidell JC. Improving dietary intake during lunch through the provision of a healthy school lunch at Dutch primary schools: design of a pretest-posttest effectiveness study. BMC Public Health 2020; 20:662. [PMID: 32398052 PMCID: PMC7216421 DOI: 10.1186/s12889-020-08807-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/29/2020] [Indexed: 11/13/2022] Open
Abstract
Background Since there is a shift from eating lunch at home to eating lunch at primary schools in the Netherlands, providing a school lunch may be an important opportunity to improve the diet quality of Dutch children. Therefore, the aim of this Healthy School Lunch project is to encourage healthy eating behavior of children at primary schools by offering a healthy school lunch, based on the guidelines for a healthy diet. In this study, two research questions will be addressed. The first research question is: What and how much do children consume from a self-served school lunch and how do they evaluate the lunch? The second research question is: Do children compensate healthier school lunches by eating less healthy outside school hours? The purpose of this paper is to report the rationale and study design of this study. Methods In the Healthy School Lunch project children in grades 5–8 (aged 8–12 years) of three primary schools in the Netherlands will receive a healthy school lunch for a 6-month period. To answer research question 1, lunch consumption data will be collected at baseline and again at 3- and 6-months. This will be measured with lunch photos and questionnaires among children. To answer the second research question, a quasi-experimental, pre-test post-test intervention-comparison group design (3 intervention schools and 3 comparison schools) will be carried out. Potential compensation effects will be measured with a single brief questionnaire among parents at the three intervention and three comparison schools at month 6 of the lunch period. The school lunch will also be evaluated by parents (discussion groups) and teachers and support staff (brief questionnaires). Discussion Results of this study will provide valuable information to influence future school lunch interventions and policies. Trial registration This study is registered at the Netherlands trial register (NTR): trialregister.nl, Trial NL7402 (NTR7618), registered retrospectively at 2018-11-13.
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Affiliation(s)
- Ellen van Kleef
- Wageningen University & Research, Marketing and Consumer Behaviour group, Hollandseweg 1, 6706, KN, Wageningen, the Netherlands.
| | - Frédérique C Rongen
- Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
| | - Monique H Vingerhoeds
- Food, Health & Consumer Research, Wageningen Food & Biobased Research, P.O. Box 17, 6700, AA, Wageningen, The Netherlands
| | - S Coosje Dijkstra
- Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
| | - Jaap C Seidell
- Vrije Universiteit Amsterdam, Faculty of Science, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, the Netherlands
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Weight development between age 5 and 10 years and its associations with dietary patterns at age 5 in the ABCD cohort. BMC Public Health 2020; 20:427. [PMID: 32238152 PMCID: PMC7110614 DOI: 10.1186/s12889-020-08559-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 03/19/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Social inequalities in bodyweight start early in life and track into adulthood. Dietary patterns are an important determinant of weight development in children, towards both overweight and underweight. Therefore, we aimed to examine weight development between age 5 and 10 years by ethnicity, SES and thereafter by BMI category at age 5, to explore its association with dietary patterns at age 5. METHODS Participants were 1765 children from the Amsterdam Born Children and their Development (ABCD) cohort that had valid data on BMI at age 5 and 10 and diet at age 5. Linear mixed model analysis was used to examine weight development between age 5 and 10 years and to assess if four previously identified dietary patterns at age 5 (snacking, full-fat, meat and healthy) were associated with weight development. Analyses were adjusted for relevant confounders, stratified by ethnicity and SES and thereafter stratified per BMI category at age 5. RESULTS Overall, weight decreased in Dutch and high SES children and increased in non-Dutch and low/middle SES children. Across the range of bodyweight categories at age 5, we observed a conversion to normal weight, which was stronger in Dutch and high SES children but less pronounced in non-Dutch and low/middle SES children. Overall, the observed associations between weight development and dietary patterns were mixed with some unexpected findings: a healthy dietary pattern was positively associated with weight development in most groups, regardless of ethnicity and SES (e.g. Dutch B 0.084, 95% CI 0.038;0.130 and high SES B 0.096, 95% CI 0.047;0.143) whereas the full-fat pattern was negatively associated with weight development (e.g. Dutch B -0.069, 95% CI -0.114;-0.024 and high SES B -0.072, 95% CI -0.119;-0.026). CONCLUSIONS We observed differential weight development per ethnic and SES group. Our results indicate that each ethnic and SES group follows its own path of weight development. Associations between dietary patterns and weight development showed some unexpected findings; follow-up research is needed to understand the association between dietary patterns and weight development.
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Abstract
Background: Childhood overweight and obesity are recognized as predictors of the risk of obesity in adulthood. The aim of this systematic literature review was to determine the association between dietary pattern and obesity risk among children. Methods: Articles were selected from databases (Cochrane Library, Lilacs, Eric, Livivo, and PubMed/Medline), without limitations regarding language or date. Database-specific search terms included the key words "obesity," "diet," "dietary pattern," "childhood," "children," "adolescents," and relevant synonyms. The review included studies that reported the assessment of the dietary pattern in childhood and that correlated eating patterns with the obesity risk through cluster analysis (CA) and/or factor analysis and/or principal component analysis and presented odds ratios (ORs). The methodology of the selected studies was evaluated using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Owing to the heterogeneity among the assessments of the association of dietary patterns and obesity, the results are described narratively. Results: Using a selection process in two phases, 16 articles were included. Fifteen studies used a cross-sectional design, and one case-control study. The included studies showed variation in sample size (range = 232 to 10,187 children/adolescents) and age (range = 1-19 years old). The studies reported between two and five dietary patterns each. The OR for the relationship between the dietary pattern and the risk of childhood obesity ranged from OR = 1.02; confidence interval (95% CI) (0.91-1.15) to OR = 3.55; 95% CI (1.80-7.03). In this study, the dietary patterns identified by the studies were given different names. The food intake patterns identified could, in most factor or CA studies, be categorized as (1) potentially obesogenic foods that increased risk of becoming overweight (including fatty cheeses, sugary drinks, processed foods, fast food, candies, snacks, cakes, animal products, whole milk, and refined grains) or (2) food classified as healthy with the weakest association with the risk of becoming overweight or obese (including low levels of sugar and fat and high levels of fruits, vegetables, whole grains, fish, nuts, legumes, and yogurt). Conclusion: Overall, the results indicated from most studies that a diet with a lower percentage of obesogenic foods should be effective in reducing the risk of developing obesity.
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Affiliation(s)
- Rafaela Liberali
- Post-Graduation Program in Medical Sciences, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Emil Kupek
- Department of Public Health, Federal University of Santa Catarina, Florianopolis, SC, Brazil
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de Wilde JA, Eilander M, Middelkoop BJC. Effect of neighbourhood socioeconomic status on overweight and obesity in children 2-15 years of different ethnic groups. Eur J Public Health 2019; 29:796-801. [PMID: 30698695 DOI: 10.1093/eurpub/cky277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Studies on the influence of neighbourhood socioeconomic status (N-SES) on overweight and obesity rates in children from different ethnic backgrounds are scarce. This study investigated the differential effect of N-SES on overweight (including obesity) and obesity prevalence in different ethnic groups, and if N-SES explains ethnic differences in the prevalence of overweight and obesity. DESIGN A population based study of 109 766 body mass index (BMI) measurements of 86 209 children 2-15 years of Dutch, Turkish, Moroccan and South Asian descent. BMI class was determined with The International Obesity Task Force, and South Asian specific BMI cut-offs. WHO BMI criteria were applied for reference purposes. The effect of N-SES on prevalence rates was studied with generalized linear mixed models. RESULTS Neighbourhood SES was negatively associated with overweight and obesity. However, the effect of N-SES on overweight was stronger in Dutch children (OR 0.75, 95% CI 0.73-0.77) than in Turkish (OR 0.86, 95% CI 0.82-0.90), Moroccan (OR 0.91, 95% CI 0.86-0.97) and South Asian (OR 0.90, 95% CI 0.84-0.96) children. The influence of N-SES on obesity showed a similar pattern, except for Moroccan children in whom obesity prevalence remained stable over the whole N-SES range. At the same N-SES, overweight and obesity prevalence was significantly higher in Turkish, Moroccan and especially South Asian children compared with Dutch children. Adjusting for N-SES attenuated the ethnic differences. CONCLUSIONS Neighbourhood SES was negatively associated with overweight and obesity rates in all ethnic groups, but only partly explained the ethnic differences in overweight and obesity prevalence.
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Affiliation(s)
- J A de Wilde
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Child Health, TNO, Leiden, The Netherlands
| | - M Eilander
- Department of Youth Health Care, Centrum Jeugd en Gezin (Center for Youth and Family), The Hague, The Netherlands
| | - B J C Middelkoop
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Department of Epidemiology, Municipal Health Service The Hague (GGD Haaglanden), The Hague, The Netherlands
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Yau A, Adams J, White M, Nicolaou M. Differences in diet quality and socioeconomic patterning of diet quality across ethnic groups: cross-sectional data from the HELIUS Dietary Patterns study. Eur J Clin Nutr 2019; 74:387-396. [PMID: 31292529 PMCID: PMC7062636 DOI: 10.1038/s41430-019-0463-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/24/2019] [Accepted: 06/27/2019] [Indexed: 01/21/2023]
Abstract
Background/objectives Socioeconomic inequalities in diet quality are consistently reported, but few studies have investigated whether and how such inequalities vary across ethnic groups. This study aimed to examine differences in diet quality and socioeconomic patterning of diet quality across ethnic groups. Subjects/methods Cross-sectional data from the HELIUS study were used. Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan adults (aged 18–70 years) were randomly sampled, stratified by ethnicity. Dietary intake was estimated among a subsample (n = 4602) from 200-item, ethnic-specific food frequency questionnaires, and diet quality was assessed using the Dutch Healthy Diet Index 2015 (DHD15-Index). Wald tests were used to compare non-Dutch and Dutch participants. Adjusted linear regression models were used to examine differences in DHD15-Index by three indicators of socioeconomic position: educational level, occupational status and perceived financial difficulties. All analyses were stratified by sex. Results Dutch participants had lower median DHD15-Index than most ethnic minority participants (P < 0.001). Lower educational level was associated with lower DHD15-Index among Dutch men (Ptrend < 0.0001), South-Asian Surinamese men (Ptrend = 0.01), Dutch women (Ptrend = 0.0001), African Surinamese women (Ptrend = 0.002) and Moroccan women (Ptrend = 0.04). Lower occupational status was associated with lower DHD15-Index in Dutch men, β −7.8 (95% CI −11.7, −3.9) and all women (β −4.4 to −8.8), except Turkish women. DHD15-Index was not associated with perceived financial difficulties in most groups. Conclusions We observed variations in diet quality across ethnic groups. Low socioeconomic position was not consistently associated with poor diet quality in all ethnic groups. This may be due to ethnicity-specific retention of traditional diets, irrespective of socioeconomic position.
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Affiliation(s)
- Amy Yau
- Centre for Diet and Activity Research, Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK.
| | - Jean Adams
- Centre for Diet and Activity Research, Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK
| | - Martin White
- Centre for Diet and Activity Research, Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, Cambridge Biomedical Campus, University of Cambridge School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK
| | - Mary Nicolaou
- Amsterdam UMC, University of Amsterdam Department of Public Health, Amsterdam Public Health Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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do Carmo MS, Santos CID, Araújo MC, Girón JA, Fernandes ES, Monteiro-Neto V. Probiotics, mechanisms of action, and clinical perspectives for diarrhea management in children. Food Funct 2019; 9:5074-5095. [PMID: 30183037 DOI: 10.1039/c8fo00376a] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Infectious diarrhea is the second most common cause of morbidity and mortality in children under 5 years of age in the underdeveloped areas of the world. Conventional treatment consists of rehydration, which may be coupled with antimicrobial agents in more severe bacterial infections or with antiprotozoal agents. In the last few decades, research on the use of probiotic strains, such as Lactobacillus rhamnosus GG ATCC 53013 (LGG), Lactobacillus reuteri DSM 17938 and Saccharomyces boulardii, has gained much attention to prevent and treat diarrheal diseases. However, they are rarely used in the clinical routine, perhaps because there are still gaps in the knowledge about the effective benefit to the patient in terms of the reduction of the duration of diarrhea and its prevention. Furthermore, only a few probiotic strains are safely indicated for usage in pediatric practice. This review summarizes the current knowledge on the antimicrobial mechanisms of probiotics on distinct enteropathogens and their role in stimulating host defense mechanisms against intestinal infections. In addition, we highlight the potential of probiotics for the treatment and prevention of diarrhea in children. We conclude that the use of probiotics is beneficial for both the treatment and prevention of diarrhea in children and that the identification of other candidate probiotics might represent an important advance to a greater reduction in hospital stays and to prevent infectious diarrhea in a larger portion of this population.
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Affiliation(s)
- Monique Santos do Carmo
- Programa de Pós-graduação em Ciências da Saúde, Universidade Federal do Maranhão, São Luís, MA, Brazil
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Sirkka O, Vrijkotte T, Halberstadt J, Abrahamse‐Berkeveld M, Hoekstra T, Seidell J, Olthof M. Prospective associations of age at complementary feeding and exclusive breastfeeding duration with body mass index at 5-6 years within different risk groups. Pediatr Obes 2018; 13:522-529. [PMID: 29695025 PMCID: PMC6099412 DOI: 10.1111/ijpo.12289] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 03/16/2018] [Accepted: 03/21/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Children with overweight or obesity are at risk for developing obesity in adulthood. Certain maternal characteristics, such as ethnicity, education, body mass index (BMI) or neighbourhood, are determinants for childhood overweight risk. There are large variations in how mothers differing in these characteristics feed their infants. Therefore, associations of age at complementary feeding, exclusive breast feeding duration with childhood overweight may differ in these groups. Understanding these associations would be essential to develop overweight prevention strategies. OBJECTIVES The objective of this study is to study the associations of age at complementary feeding, exclusive breastfeeding duration with BMI-standard deviation score (SDS) at 5-6 years within risk groups. METHODS Using data from the Amsterdam Born Children and their Development study, a population-based birth cohort (n = 4495), we formed groups of children at varying risk of overweight according to maternal characteristics of ethnicity, education, pre-pregnancy BMI and neighbourhood. Linear and logistic regression analyses were conducted. RESULTS Complementary feeding after 5 months of age was associated with lower BMI-SDS in children of mothers of Dutch ethnicity (B: -0.12; 95% CI: -0.21, -0.04), medium-level education (-0.19; -0.30, -0.08), normal BMI (-0.08; -0.16, -0.01) and high-risk neighbourhood (-0.16; -0.29, -0.02). Compared with exclusive breastfeeding for <3 months, exclusive breastfeeding for ≥6 months was associated with lower BMI-SDS in groups of medium-level education (-0.28; 0.44, -0.11), normal BMI (-0.18; -0.29, -0.08) and medium-risk (-0.18; -0.33, -0.04) and high-risk (-0.22; -0.42, -0.02) neighbourhoods. CONCLUSIONS Associations between infant feeding practices and childhood BMI may differ between risk groups, implying that overweight prevention strategies should be group-specific.
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Affiliation(s)
- O. Sirkka
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands,Danone Nutricia ResearchUtrechtThe Netherlands
| | - T. Vrijkotte
- Department of Public Health, Academic Medical Centre, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamThe Netherlands
| | - J. Halberstadt
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | | | - T. Hoekstra
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - J. Seidell
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - M. Olthof
- Department of Health Sciences, Faculty of ScienceVrije Universiteit Amsterdam, Amsterdam Public Health Research InstituteAmsterdamThe Netherlands
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