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Su X, Patel N, Chen J, Chen Y, Zhou X, Mo X, Zhu S. Association between serum vitamin C and body mass index in adolescents aged 12-19 years. BMC Public Health 2024; 24:2067. [PMID: 39085802 PMCID: PMC11293171 DOI: 10.1186/s12889-024-19588-2] [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: 05/29/2024] [Accepted: 07/25/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Evidence on the association between serum vitamin C (sVC) levels and obesity is limited. This study aimed to explore the relationship between sVC and body mass index (BMI) in adolescents aged 12 to 19 years. METHODS We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006, with 3952 participants. sVC and BMI were independent variables and dependent variables, respectively. The associations of sVC with BMI were examined using multivariable linear regression models. Age, sex, and race/ethnicity were analyzed as subgroups. Then, we devised smooth curve fittings and saturation threshold analysis to address the nonlinear relationship. RESULTS sVC had a negative correlation with BMI after adjusting for all covariates (β: -1.020, 95% CI: -1.359, -0.680). In the subgroup analysis by age, sex, and race/ethnicity, there was still a negative correlation between sVC and BMI (p < 0.05). The analysis of saturation effects of sVC and BMI showed the relationship between sVC and BMI in female adolescents followed an N-shaped curve, whereas the relationship between sVC and BMI in adolescents aged 12-15 years and Mexican Americans followed a U-shaped curve. CONCLUSION Based on the results, proper vitamin C supplementation may be beneficial to weight loss. However, considering the threshold effect, large-scale and good-quality randomized controlled trials are required to obtain the optimal vitamin C level for weight control.
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Affiliation(s)
- Xiaoqi Su
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Nishant Patel
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
- School of Public Health, Nanjing Medical University, Nanjing, 211666, China
| | - Jun Chen
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Ye Chen
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Xin Zhou
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Xuming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
| | - Shanliang Zhu
- Department of Ultrasound, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
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Shapiro ALB, Lawless MC, Charlifue-Smith R, Johnson SL. Complementary food exposure and children's early understanding of food words: the approaching eating through language (APPEAL) study. Front Nutr 2024; 11:1237698. [PMID: 38863587 PMCID: PMC11165136 DOI: 10.3389/fnut.2024.1237698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
Introduction Language skills, such as the ability to understand words (receptive language), develop during infancy and are built through interactions with the environment, including eating. Exposure to complementary foods also begins in infancy and may play a significant role in language development, especially in understanding of food-related words. However, the relationship between the complementary foods to which a child is exposed and early language acquisition has not been previously studied. We hypothesized that young children's food-related receptive language (FRL) would reflect the complementary foods to which they were frequently offered by caregivers. Methods Caregivers of young children (4-26 months; n = 408) in the Approaching Eating through Language (APPEAL) Study in the US were surveyed via Qualtrics. FRL was assessed by caregiver-report via a modified MacArthur-Bates Communicative Development Inventory. Complementary foods offered (CFO) by caregivers were assessed using a modified Food Frequency Questionnaire. Latent Class Analysis (LCA) was implemented to identify, 1) groupings of foods frequently offered (>1x/week) and 2) groupings of food-related words understood by the young children. Results A 5-class best fit LCA model was identified for CFO (-log likelihood [-llik]=-8727) and for FRL (-llik=-5476). Cross-classification of the CFO and FRL derived classes revealed that children with higher exposure to complementary foods were perceived by caregivers to be most likely to also understand a greater number of food-related words (Probability=0.48). As expected, children having been offered a greater number of complementary foods and who understood a greater number of food-related words were older, compared to those with less complementary food exposure and food-related language acquisition (p < 0.001). Discussion These findings support the potential role of introduction to complementary foods in development of food-related language.
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Affiliation(s)
- Allison L. B. Shapiro
- Section of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Megan C. Lawless
- Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Renee Charlifue-Smith
- JFK Partners, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Susan L. Johnson
- Section of Nutrition, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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Nazareth M, Pinto E, Severo M, Graça P, Lopes C, Rêgo C. Early feeding and nutritional status of Portuguese children in the first 36 months of life: EPACI Portugal 2012-a national representative cross-sectional study. Porto Biomed J 2024; 9:250. [PMID: 38681517 PMCID: PMC11049788 DOI: 10.1097/j.pbj.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/07/2024] [Accepted: 02/21/2024] [Indexed: 05/01/2024] Open
Abstract
Background Early feeding practices have a critical role in the future not only in health but also in modulating eating habits. This study aimed to assess breastfeeding and complementary feeding practices and the nutritional status of Portuguese toddlers aged 0-36 months. Methods EPACI Portugal 2012 is a cross-sectional study of a national representative sample. Trained interviewers collected data about early feeding practices and anthropometrics. Body mass index was classified according to World Health Organization criteria. Frequencies and survival analysis were used to characterize variables. Results More than 90% of children were initiated breastfeeding, around 20% were exclusively breastfed for six months, and about 20% were breastfed at 12 months while complementary feeding was taking place. Exclusive breastfeeding was determined by maternal prepregnancy body mass index (HR 1.01; 95% CI 1.00, 1.03, P=.03) and low birth weight (HR 1.61; IC 95% 1.21, 2.15, P=.001) of the infants. About 90% were initiated complementary feeding between four and six months, and almost 10% were introduced to cow's milk before 12 months. In the second year of life, 83.2% and 61.6% of toddlers have already consumed nectars and sweet desserts, respectively. About one-third of Portuguese toddlers showed a body mass index z-score >1, and 6.6% were overweight/obese (z-score >2). No association was found between the duration of breastfeeding or timing of complementary feeding and the body mass index z-score in children. Conclusions Despite the low prevalence of exclusive breastfeeding at six months, Portuguese infants effectively comply with dietary recommendations during the first year of life. The transition to the family diet must be carefully made. There is a high prevalence of Portuguese toddlers at least at overweight risk. The duration of breastfeeding or timing of complementary feeding was not associated with the expression of overweight/obesity.
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Affiliation(s)
- Margarida Nazareth
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Elisabete Pinto
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal
| | - Milton Severo
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- ICBAS—School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Carla Lopes
- EPIUnit/ITR—Laboratory for Integrative and Translational Research in Population Health—Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Carla Rêgo
- Universidade Católica Portuguesa, CBQF—Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
- Child and Adolescent Centre, CUF Hospital Porto, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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Moore AM, Fisher JO, Burgess B, Morris KS, Croce CM, Kong KL. Caregiver feeding decisions and sociodemographic characteristics are associated with snack food intake during infancy and toddlerhood. Appetite 2023; 186:106551. [PMID: 37024055 PMCID: PMC10213156 DOI: 10.1016/j.appet.2023.106551] [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: 07/31/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
Snacking starts early in childhood, yet little is known about child versus family influences on snacking during infancy and toddlerhood. This secondary analysis of baseline data examined associations of child characteristics (e.g., appetitive traits, temperament), caregiver feeding decisions, and sociodemographic characteristics with the mean frequency of (times/day) and mean energy from (kcal/day) child snack food intake. Caregivers and their children (ages 9-15 months) were recruited in Buffalo, NY from 2017 to 2019. Caregivers reported on sociodemographics, child appetitive traits (Baby Eating Behaviour Questionnaire), and child temperament (Infant Behavior Questionnaire-Revised). Three 24-h dietary recalls were collected, and USDA food categories were used to categorize snack foods (e.g., cookies, chips, and puffs). Hierarchical multiple linear regression models examined associations of child characteristics (Step 1: age, sex, baseline weight-for-length z-score, appetitive traits, and temperament), caregiver feeding decisions (Step 2: breastfeeding duration and age of solid food introduction), and caregiver sociodemographic characteristics (Step 3: caregiver age, prepregnancy BMI, education, and household size) with mean child snack food intake. Caregivers (n = 141) were on average 32.6 years of age, predominantly white (89.1%), and college-educated (84.2%). Age of solid food introduction (B = -0.21, p = 0.03), prepregnancy BMI (B = 0.03, p = 0.04), and household size (B = 0.23, p = 0.02) were significantly associated with the mean frequency of (times/day) snack food intake, over and above other variables of interest. Child age (B = 15.96, p = 0.002) was significantly associated with mean energy from (kcal/day) snack food intake. Household size (B = 28.51, p = 0.006) was significantly associated with mean energy from (kcal/day) snack food intake, over and above other variables of interest. There were no significant associations of other child characteristics with snack food intake. Findings show that child snack food intake is more closely associated with caregiver feeding decisions and sociodemographic characteristics than child characteristics. TRIAL REGISTRATION: National Institute on Child Health and Human Development, Grant/Award Number R01HD087082-01.
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Affiliation(s)
- Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer Orlet Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Brenda Burgess
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14203, USA
| | - Katherine S Morris
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14203, USA.
| | - Christina M Croce
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, 64108, USA; Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center Kansas City, KS, USA; Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA.
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Weber MB, Palmer W, Griffin M, Welsh JA. Infant and young child feeding practices and the factors that influence them: a qualitative study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:32. [PMID: 37055864 PMCID: PMC10103516 DOI: 10.1186/s41043-023-00371-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/25/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Early child feeding is important for healthy growth and forming positive eating behaviors. METHODS This qualitative study sought to describe early childhood feeding behaviors, challenges, and opportunities through four focus group discussions with a diverse group of mothers of at least one child under two years or pregnant with their first child. RESULTS Although providing healthy foods was a priority, feeding behaviors reflected the mothers' partial understanding of infant and child nutrition. Mothers sought guidance on early child feeding from several sources, including in-person and virtual relationships but made decisions based largely on their own instincts. Participants consulted clinicians the least often, and mothers often felt frustrated by strict guidelines and negative messaging. Mothers were most receptive to suggestions when they felt supported and valued in the decision-making process. CONCLUSIONS In order to help mothers provide the best nutrition for their young children, clinicians should use positive tones, provide flexibility when possible, and work to create open lines of communication with parents.
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Affiliation(s)
- Mary Beth Weber
- Hubert Department of Global Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA, USA.
- Emory Global Diabetes Research Center, Emory University, Atlanta, GA, USA.
| | - Wendy Palmer
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | | | - Jean A Welsh
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
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Urine Metabolomic Profile of Breast- versus Formula-Fed Neonates Using a Synbiotic-Enriched Formula. Int J Mol Sci 2022; 23:ijms231810476. [PMID: 36142388 PMCID: PMC9499619 DOI: 10.3390/ijms231810476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/04/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to compare the urine metabolic fingerprint of healthy neonates exclusively breastfed with that of neonates fed with a synbiotic-enriched formula (Rontamil® Complete 1) at four time points (the 3rd and 15th days of life and the 2nd and 3rd months). The determination of urine metabolic fingerprint was performed using NMR metabolomics. Multivariate data analyses were performed with SIMCA-P 15.0 software and R language. Non-distinct profiles for both groups (breastfeeding and synbiotic formula) for the two first time points (3rd and 15th days of life) were detected, whereas after the 2nd month of life, a discrimination trend was observed between the two groups, which was further confirmed at the 3rd month of life. A clear discrimination of the synbiotic formula samples was evident when comparing the metabolites taken in the first days of life (3rd day) with those taken in the 2nd and 3rd months of life. In both cases, OPLS-DA models explained more than 75% of the metabolic variance. Non-distinct metabolomic profiles were obtained between breastfed and synbiotic-formula-fed neonates up to the 15th day of life. Discrimination trends were observed only after the 2nd month of the study, which could be attributed to breastfeeding variations and the consequent dynamic profile of urine metabolites compared to the stable ingredients of the synbiotic formula.
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Rapson JP, von Hurst PR, Hetherington MM, Mazahery H, Conlon CA. Starting complementary feeding with vegetables only increases vegetable acceptance at 9 months: a randomized controlled trial. Am J Clin Nutr 2022; 116:111-121. [PMID: 35679432 PMCID: PMC9257464 DOI: 10.1093/ajcn/nqac080] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/29/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Starting complementary feeding (CF) with vegetables only may improve vegetable acceptance throughout childhood. OBJECTIVES We aimed to test whether exposure to vegetables only during the first 4 wk of CF increases later vegetable acceptance compared with a control group receiving fruit and vegetables. METHODS In this randomized, controlled, parallel-group study, 117 Auckland infants received either vegetables only (veg-only, n = 61) or a combination of fruit and vegetables (control, n = 56) for a duration of 4 wk, starting from the first day of CF at ∼4-6 mo of age. The primary outcome measure was intake of target vegetables (broccoli, spinach) provided by the study at 9 mo of age. Daily intake of vegetables (FFQs) at 9 mo was a supporting measure. Infants' iron status (serum ferritin, hemoglobin) was examined at all time points. RESULTS The veg-only infants consumed more broccoli and spinach than controls [mean difference (95% CI): 11.83 (0.82, 22.84) g, P = 0.036 and 10.19 (0.50, 19.87) g, P = 0.039, respectively]. Intake of pear was comparable among intervention groups (P = 0.35). At 9 mo, veg-only infants consumed target vegetables at a faster rate [mean difference (95% CI): broccoli, 3.37 (1.26, 5.47), P = 0.002; spinach, 4.12 (0.80, 7.45), P = 0.016] and showed greater acceptance for target vegetables [mean difference (95% CI): broccoli, 0.38 (0.07, 0.70), P = 0.019; spinach, 032 (0.04, 0.60), P = 0.024] than controls. The rate of eating and acceptance of pear was comparable among intervention groups (P = 0.42 and P = 0.98, respectively). Also, veg-only infants consumed more vegetables than controls [86.3 (52.5, 146.3) compared with 67.5 (37.5, 101.3) g, respectively, P = 0.042]. Introducing vegetables as the first food was not associated with 9-mo iron status. CONCLUSIONS Providing vegetables as first foods increased vegetable intake at 9 mo of age and may be an effective strategy for improving child vegetable consumption and developing preferences for vegetables in infancy.
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Affiliation(s)
- Jeanette P Rapson
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Pamela R von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | | | - Hajar Mazahery
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
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Musicus AA, Hua SV, Moran AJ, Duffy EW, Hall MG, Roberto CA, Dillman Carpentier FR, Sorscher S, Wootan MG, Smith Taillie L, Rimm EB. Front-of-package claims & imagery on fruit-flavored drinks and exposure by household demographics. Appetite 2022; 171:105902. [PMID: 34968559 PMCID: PMC8821268 DOI: 10.1016/j.appet.2021.105902] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 11/11/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
Young children regularly consume sugary fruit drinks, in part because parents may falsely believe they are healthful due to front-of-package (FOP) claims and imagery. The goal of this study was to assess: 1) the prevalence of FOP claims/imagery on fruit-flavored beverages purchased by U.S. households with 0-5-year-olds, and 2) proportional differences in beverages purchased with FOP claims/imagery across household demographic groups. A content analysis of FOP claims/imagery (e.g., nutrient claims, fruit imagery) on beverages (n = 1365) purchased by households with 0-5-year-olds was conducted by linking beverage sales with FOP marketing data. Results were merged with purchasing data from a nationally representative sample of households (FoodAPS), and survey-weighted logistic regression was used to assess differences in the proportions of 100% juices and fruit drinks with specific FOP claims/imagery purchased by household race/ethnicity, income, and SNAP/WIC participation. The most common claims on fruit-flavored beverages included nutrient claims (fruit drinks: 73%; 100% juices: 68%; flavored waters: 95%), which most commonly highlighted vitamin C (35-41% across beverage categories) and the absence of sugar (31-48%). Most beverages also contained implied-natural claims (fruit drinks: 60%; 100% juices: 64%; flavored waters: 95%) and natural imagery (fruit drinks: 97%; 100% juices: 96%; flavored waters: 73%). A large proportion of fruit drinks and 100% juices purchased by households across all demographic groups contained FOP claims and imagery, with a few minor differences between racial/ethnic groups. In conclusion, most fruit drinks, 100% juices, and flavored waters purchased by households with 0-5-year-olds contained FOP claims and imagery that may lead consumers to believe the beverages are healthy and natural. FDA regulations should ensure parents are not misled by this marketing.
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Affiliation(s)
- Aviva A Musicus
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Sophia V Hua
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alyssa J Moran
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily W Duffy
- Department of Nutrition, Gillings School of Global Public Health; Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health; Carolina Population Center, And Lineberger Comprehensive Cancer Center; University of North Carolina, Chapel Hill, NC, USA
| | - Christina A Roberto
- Department of Medical Ethics & Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Sarah Sorscher
- Center for Science in the Public Interest, Washington, DC, USA
| | | | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health; Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Wei Kee Tan V, Lim AJ, McCrickerd K, Forde CG. Sensory profiles and mothers’ expectations and beliefs about age appropriate snacks for infants and toddlers in Singapore. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Frequency of sweet and salty snack food consumption is associated with higher intakes of overconsumed nutrients and weight-for-length z-scores during infancy and toddlerhood. J Acad Nutr Diet 2022; 122:1534-1542. [PMID: 35219920 PMCID: PMC9308635 DOI: 10.1016/j.jand.2022.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Current dietary guidelines recommend avoiding foods and beverages with added sugars and higher sodium before age 2 years. OBJECTIVE The aim was to describe daily snack food intake (frequency and total energy) and the associations with overconsumed nutrients (added sugars, sodium, and saturated fats) and child weight-for-length z scores. DESIGN A cross-sectional, secondary analysis of baseline data from an ongoing longitudinal intervention was conducted. PARTICIPANTS AND SETTING A sample of 141 caregivers with infants (aged 9 to 11 months) and toddlers (aged 12 to 15 months) was recruited in Buffalo, NY, between 2017 and 2019. MAIN OUTCOME MEASURES Three 24-hour dietary recalls were used to categorize 'sweet and salty snack foods' or 'commercial baby snack foods' based on the US Department of Agriculture What We Eat in America food group classifications and estimate nutrient intakes. Child recumbent length and weight were measured by trained researchers. STATISTICAL ANALYSIS Daily frequency (times/day), energy (kcal/day), and overconsumed nutrients from snack food intake were calculated. Multivariable regression models examined associations between the frequency of and energy from snack food intake with overconsumed nutrients and child weight-for-length z scores. RESULTS Infants consumed snack foods on average 1.2 times/day contributing 5.6% of total daily energy, 19.6% of added sugars, and 6.8% of sodium. Toddlers consumed snack foods on average 1.4 times/day contributing 8.9% of total daily energy, 40.0% of added sugars, and 7.2% of sodium. In adjusted models including all children, greater frequency of sweet and salty snack food intake, but not commercial baby snack foods, was associated with higher weight-for-length z scores. CONCLUSIONS Snack foods are frequently consumed by infants and toddlers and contribute to the intake of overconsumed nutrients such as added sugars and sodium. Given the current guidelines to avoid added sugars and higher sodium before age 2 years, additional recommendations related to nutrient-dense snack intake may be beneficial.
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Perraud E, Parker HW, Tovar A, Kaar J, Vadiveloo M. The relationship between maternal prenatal and postnatal vegetable intake and repeated measures of infant vegetable intake frequency in a national U.S. sample. Appetite 2022; 168:105781. [PMID: 34718072 DOI: 10.1016/j.appet.2021.105781] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/20/2021] [Accepted: 10/26/2021] [Indexed: 11/02/2022]
Abstract
Experimental research suggests that passive flavor transfer from maternal diet to the infant via amniotic fluid and breastmilk may improve infant vegetable intake. This secondary analysis examined associations between maternal (prenatal and postnatal) and infant vegetable intake in 696 mothers with eligible dietary data from the U.S. longitudinal Infant Feeding Practices Study II. Adjusted mixed models examined associations between 4 levels of maternal vegetable intake (mean splits of high/low on prenatal and postnatal food frequency questionnaires) and repeated measures of infant vegetable intake frequency (times/day, from monthly surveys). Mothers were on average 29.5 years old, mostly non-Hispanic White (86.2%) and educated (84.0% ≥some college). In base models, mothers with consistently high vegetable intake (vs. consistently low) reported more frequent infant vegetable intake. In multivariable models, infant vegetable intake was significantly more frequent amongst mothers with consistently high prenatal/high postnatal intake (0.9 times/day) versus consistently low intake (0.8 times/day). In this sample, maternal vegetable consumption was associated with frequency of infant vegetable consumption; consistently high vegetable intake across prenatal and postnatal periods was most strongly associated with infant intake. While infant vegetable intake is multifactorial, maternal prenatal and postnatal vegetable intake appeared to have a small but significant influence.
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Affiliation(s)
- Elie Perraud
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, Paris, France.
| | - Haley W Parker
- Department of Human Development and Family Studies, 2 Lower College Rd, University of Rhode Island, Kingston, RI, 02881, USA.
| | - Alison Tovar
- Department of Human Development and Family Studies, 2 Lower College Rd, University of Rhode Island, Kingston, RI, 02881, USA.
| | - Jill Kaar
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, 13123 East 16th Ave, Aurora, CO, 80045, USA.
| | - Maya Vadiveloo
- Department of Human Development and Family Studies, 2 Lower College Rd, University of Rhode Island, Kingston, RI, 02881, USA.
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Robinson SL, Sundaram R, Putnick DL, Gleason JL, Ghassabian A, Lin TC, Bell EM, Yeung EH. Predictors of Age at Juice Introduction and Associations with Subsequent Beverage Intake in Early and Middle Childhood. J Nutr 2021; 151:3516-3523. [PMID: 34486676 PMCID: PMC8564695 DOI: 10.1093/jn/nxab260] [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: 04/27/2021] [Revised: 05/18/2021] [Accepted: 07/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The American Academy of Pediatrics recommends that if parents choose to introduce juice, they wait until ≥12 months, citing concerns of obesity and dental caries. OBJECTIVES We sought to identify correlates of early juice introduction (<6 months) and determine whether early introduction establishes a pattern of sugary beverage intake in childhood. METHODS Upstate KIDS is a prospective birth cohort study with follow-up through 7 years (n = 4989). The age of juice introduction was assessed from responses on periodic questionnaires from 4-18 months and categorized as <6, 6 to <12, and ≥12 months. Sociodemographic information was reported using vital records or maternal questionnaires. At 24, 30, and 36 months and 7 years, mothers reported their child's regular juice, soda, water, and milk intakes. The analysis was restricted to singletons and 1 randomly selected twin from each pair with information on juice introduction (n = 4067). We assessed associations of sociodemographic correlates with juice introduction using Cox proportional hazard models. The relations of juice introduction with beverage intake were evaluated using Poisson or logistic regression for adjusted risk ratios (aRR) or ORs, adjusting for sociodemographic covariates and total beverage intake. RESULTS Of the mothers, 25% and 74% introduced juice prior to 6 and 12 months, respectively. Younger maternal age; black or Hispanic race/ethnicity; lower educational attainment; Special Supplemental Nutrition Program for Women, Infants, and Children participation (yes); smoking during pregnancy; a higher pre-pregnancy BMI; a lower household income; and living in a townhouse/condominium or mobile home were associated with earlier juice introduction. Earlier juice introduction was related to a higher childhood juice intake, any soda intake, and lower water intake, holding total beverage intake constant [aRR, 1.5 (95% CI: 1.3-1.7; P-trend < 0.0001); adjusted OR 1.6 (95% CI: 1.0-2.4; P-trend = 0.01); aRR 0.9 (95% CI: 0.8-0.9; P-trend < 0.0001), respectively]. CONCLUSIONS Markers of lower socioeconomic status are strongly associated with earlier juice introduction, which, in turn, relates to sugary beverage intake in childhood, potentially replacing water.
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Affiliation(s)
- Sonia L Robinson
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Rajeshwari Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Diane L Putnick
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Jessica L Gleason
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA,Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA,Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY, USA,Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY, USA
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13
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Etuk REO, Forestell CA. Role of food neophobia and early exposure in children's implicit attentional bias to fruits and vegetables. Appetite 2021; 167:105647. [PMID: 34403721 DOI: 10.1016/j.appet.2021.105647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 05/07/2021] [Accepted: 08/11/2021] [Indexed: 12/13/2022]
Abstract
Children often struggle to eat the daily recommended servings of fruits and vegetables, and as a result many have poor nutrient intake. This is especially problematic for neophobic children; or those who are hesitant to try new foods. Maratos and Staples [Appetite, 91, 220-225 (2015)] found that children who are high in food neophobia show attentional biases to unfamiliar fruits and vegetables, which may be related to their low consumption of these healthy foods. The present study sought to replicate and extend these findings, by using a visual dot-probe task that paired images of fruits and vegetables to perceptually matched neutral control stimuli. Seventy-eight 5-8 year-old children (Mage = 6.4 years, SD = 1.1, 42% girls) participated. Initial analyses failed to reveal significant attentional biases to the foods in children who were high in neophobia. Subsequent exploratory analyses included children's previous exposure to the foods in the task as a moderator variable. These analyses revealed that overall, children showed an attentional bias away from familiar fruits and vegetables. Moreover, previous exposure to the foods moderated the effect of food neophobia on attentional bias. For children who were low in food neophobia, as their fruit and vegetable exposure increased, their attentional bias away from the familiar foods decreased. In contrast, for food neophobic children, as fruit and vegetable exposure increased, they showed more attentional bias away from familiar foods. Although these findings failed to replicate those reported by Maratos and Staples (2015), they suggest that children's attentional biases to healthy foods may be a result of the interplay between food neophobia and the food environment to which they are exposed.
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Affiliation(s)
- Repairer E O Etuk
- Department of Psychological Sciences, William & Mary, P.O. Box 8795, Williamsburg, VA, 23187-8795, USA
| | - Catherine A Forestell
- Department of Psychological Sciences, William & Mary, P.O. Box 8795, Williamsburg, VA, 23187-8795, USA.
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14
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Rapson JP, von Hurst PR, Hetherington MM, Conlon CA. Impact of a "vegetables first" approach to complementary feeding on later intake and liking of vegetables in infants: a study protocol for a randomised controlled trial. Trials 2021; 22:488. [PMID: 34311749 PMCID: PMC8314593 DOI: 10.1186/s13063-021-05374-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/15/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Vegetables as first complementary foods for infants may programme taste preferences that lead to improved vegetable intake in children. Yet few studies have investigated the impact of a "vegetables first" approach to complementary feeding, especially in New Zealand. The purpose of this randomised control trial is to investigate the effect of starting complementary feeding with vegetables only on infants' later intake and liking of vegetables, compared to those starting with fruit and vegetables. METHODS/DESIGN One-hundred and twenty mother-infant pairs living in Auckland, New Zealand, will be randomised to receive either vegetables only (intervention) or fruit and vegetables (control) for 28 days, starting from the first day of complementary feeding at around 4-6 months of age. Infants will be presented with a brassica (broccoli), followed by a green leafy vegetable (spinach) and sweet fruit (pear) at 9 months of age. The primary outcome measures of intake of each food will be assessed using a weighed food diary. Secondary outcome measures of overall intake, liking and wanting of vegetables will be assessed using a food frequency questionnaire, liking tool and video coding tool, respectively, at 9, 12, and 24 months of age. Infant growth and iron status will be assessed as part of health screening and monitoring at baseline, post intervention and 9 months of age. Other biological samples to be collected include infant stool samples, vitamin D (mother and infant), iron status (mother), and mothers' diet. DISCUSSION This randomised, controlled trial will be the first to our knowledge to investigate a "vegetables first" approach to complementary feeding on infants' liking and intake of vegetables in New Zealand. Comparison against standard practice (fruit and vegetables as first foods) should complement other trials underway, such as the Baby's First Bites and Nordic OTIS trial. Results may contribute to the evidence supporting complementary feeding guidelines in New Zealand and worldwide. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ACTRN12619000737134 . Registered on 16 May 2019.
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Affiliation(s)
- Jeanette P. Rapson
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Pamela R. von Hurst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | | | - Cathryn A. Conlon
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
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15
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Duffy EW, Taillie LS, Richter APC, Higgins ICA, Harris JL, Hall MG. Toddler milk perceptions and purchases: the role of Latino ethnicity. Public Health Nutr 2021; 24:2911-2919. [PMID: 33472718 PMCID: PMC8255274 DOI: 10.1017/s1368980021000264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/07/2021] [Accepted: 01/18/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Toddler milk (i.e. a nutrient-fortified milk-based drink marketed for children 12-36 months old) is increasingly being marketed in the USA despite not being recommended for young children. There is evidence of targeted toddler milk marketing to Latinos in the USA. This study aimed to explore toddler milk perceptions and behaviours among Latino and non-Latino parents. DESIGN An online survey assessed toddler milk perceptions, behaviours and interpretations of nutrition-related claims. Multivariable logistic and linear regression explored socio-demographic correlates of parent reported past purchases and perceived healthfulness. SETTING Online. PARTICIPANTS National convenience sample of 1078 US parents of children aged 2-12 years (48 % Latino). RESULTS About half of parents (51 %) had previously purchased toddler milk and few (11 %) perceived toddler milk as unhealthy. Latino parents were more likely to have purchased toddler milk than non-Latino parents (P < 0·001), but there were no differences in perceived product healthfulness (P = 0·47). Compared to parents born in the USA, parents living in the USA 10 years or less were more likely to have purchased toddler milk (P < 0·001) and perceive toddler milk as healthier (P = 0·002). Open-ended interpretations of claims were primarily positive, suggesting 'health halo' effects. CONCLUSIONS Common misperceptions about toddler milk healthfulness suggest stronger labelling regulations are needed. Greater reported purchases by Latino parents and recent immigrants warrant further investigation.
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Affiliation(s)
- Emily W Duffy
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Department of Nutrition and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Ana Paula C Richter
- Department of Health Behavior and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 123 W. Franklin St., Suite 210, Chapel Hill, NC27516, USA
| | - Isabella CA Higgins
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer L Harris
- University of Connecticut Rudd Center for Food Policy & Obesity, Hartford, CT, USA
| | - Marissa G Hall
- Department of Health Behavior and Carolina Population Center, University of North Carolina at Chapel Hill Gillings School of Global Public Health, 123 W. Franklin St., Suite 210, Chapel Hill, NC27516, USA
- UNC Lineberger Comprehensive Cancer Center, School of Medicine, CB #7295, Chapel Hill, NC27599, USA
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16
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Hornsby PP, Conaway MR, Medico TJ, Gurka KK, Kellams A. Timing of Introduction of Complementary Foods and Beverages to Infants of Low-Income Women. Breastfeed Med 2021; 16:547-552. [PMID: 33781096 DOI: 10.1089/bfm.2020.0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Although rates of complementary food and beverage (CFB) consumption among infants under 4 to 6 months of age have been declining, they remain well above the American Academy of Pediatrics (AAPs) recommendations. It is unclear if women with low income in the United States are more likely than other women to introduce CFBs early. We examined timing of introduction of CFBs to infants of mothers with low income to further illuminate infant feeding practices in this potentially vulnerable population. Materials and Methods: We analyzed infant feeding data collected prospectively from 443 mother-infant dyads. Data were obtained by interview at 1, 3, and 6 months postpartum. We used Kaplan-Meier curves to show time to introduction of CFBs overall and by type of CFB, and log-rank tests to compare timing by demographic and clinical characteristics. Results: Participants were mostly non-Hispanic black or white, with a high school education or less. By month 3, 48% of infants were fed at least one CFB, increasing to over 83% by month 5. Women who did not work outside the home introduced CFBs significantly earlier than those who worked, as did women who smoked compared with those who did not. Timing did not differ by other participant characteristics. Conclusions: Introduction of CFBs before 4-6 months was common. Clinical guidance and intervention programs should support mothers toward the goal of improving infant diets in this at-risk population.
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Affiliation(s)
- Paige P Hornsby
- Department of Public Health Sciences and University of Virginia, Charlottesville, Virginia, USA
| | - Mark R Conaway
- Department of Public Health Sciences and University of Virginia, Charlottesville, Virginia, USA
| | - Tegan J Medico
- Department of Nutrition Services, University of Virginia, Charlottesville, Virginia, USA
| | - Kelly K Gurka
- Department of Epidemiology, University of Florida, Gainesville, Florida, USA
| | - Ann Kellams
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
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17
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Kay MC, Duffy EW, Harnack LJ, Anater AS, Hampton JC, Eldridge AL, Story M. Development and Application of a Total Diet Quality Index for Toddlers. Nutrients 2021; 13:1943. [PMID: 34198828 PMCID: PMC8229507 DOI: 10.3390/nu13061943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 12/29/2022] Open
Abstract
For the first time, the 2020-2025 Dietary Guidelines for Americans include recommendations for infants and toddlers under 2 years old. We aimed to create a diet quality index based on a scoring system for ages 12 to 23.9 months, the Toddler Diet Quality Index (DQI), and evaluate its construct validity using 24 h dietary recall data collected from a national sample of children from the Feeding Infants and Toddlers Study (FITS) 2016. The mean (standard error) Toddler DQI was 49 (0.6) out of 100 possible points, indicating room for improvement. Toddlers under-consumed seafood, greens and beans, and plant proteins and over-consumed refined grains and added sugars. Toddler DQI scores were higher among children who were ever breastfed, lived in households with higher incomes, and who were Hispanic. The Toddler DQI performed as expected and offers a measurement tool to assess the dietary quality of young children in accordance with federal nutrition guidelines. This is important for providing guidance that can be used to inform public health nutrition policies, programs, and practices to improve diets of young children.
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Affiliation(s)
- Melissa C. Kay
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA;
| | - Emily W. Duffy
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Lisa J. Harnack
- School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA;
| | - Andrea S. Anater
- Research Triangle Institute International, Research Triangle Park, NC 27709, USA; (A.S.A.); (J.C.H.)
| | - Joel C. Hampton
- Research Triangle Institute International, Research Triangle Park, NC 27709, USA; (A.S.A.); (J.C.H.)
| | - Alison L. Eldridge
- Nestlé Research, Nestlé Institute of Health Sciences, Route du Jorat 57, 1000 Lausanne, Switzerland;
| | - Mary Story
- Duke Global Health Institute, Duke University, Durham, NC 27708, USA;
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18
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Heller RL, Mobley AR. Development and Qualitative Pretesting of Child Feeding and Obesity Prevention Messages for Parents of Infants and Toddlers. J Acad Nutr Diet 2021; 121:1528-1541.e1. [PMID: 33715977 DOI: 10.1016/j.jand.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/31/2021] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Consistent, evidence-based child feeding guidance targeted to parents of children ages birth to 24 months (B-24) is needed for early childhood obesity prevention. OBJECTIVE The aim was to develop and pretest a comprehensive set of child feeding and obesity prevention messages for parents of children ages B-24. DESIGN A qualitative, 2-phase protocol, grounded in social and behavior change, was used as a conceptual interview framework to pilot test early childhood feeding messages with parents. PARTICIPANTS/SETTING Participants were parents (n = 23) of children ages B-24. METHODS A core set of 12 messages and supporting materials were developed for parents of children ages B-24 based on previous research findings, current research evidence, and feeding guidance. Parents were individually interviewed using a semistructured script along with additional questions to rank perceptions of message qualities. MAIN OUTCOME MEASURES Overall comprehension, importance, believability, ease of implementation, and likelihood of use of messages were assessed. STATISTICAL ANALYSIS PERFORMED Data analysis included qualitative thematic analysis and descriptive statistics for Likert-scaled responses. RESULTS Participants were primarily female, non-Hispanic White, with a mean age of 33.3 ± 6.8 years and at least a bachelor's degree. Overall, most messages were understood, believable, perceived as important, and feasible by parents. Messages related to starting solid foods, encouraging child control of intake and self-feeding, and food allergen guidance were perceived as more difficult and less likely to be implemented by parents. CONCLUSIONS Additional research is needed to evaluate actual implementation of messages by diverse parents and resulting outcomes including impact on child weight.
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19
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Lutter CK, Grummer-Strawn L, Rogers L. Complementary feeding of infants and young children 6 to 23 months of age. Nutr Rev 2021; 79:825-846. [PMID: 33684940 DOI: 10.1093/nutrit/nuaa143] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Complementary feeding, when foods are introduced to complement a milk-based diet, generally occurs between 6 and 23 months of age. It is a critical period for both physical and cognitive development. During this period, the growth rate of the brain is one of the fastest during the life span and, consequently, the timing, dose, and duration of exposure to specific nutrients can result in both positive and negative effects. Complementary feeding is more than ensuring an adequate intake of nutrients; it also is about avoiding excess intakes of calories, salt, sugars, and unhealthy fats. Meals are cultural and social events where young children observe, imitate, learn about foods to like or dislike, and form lifelong eating habits and practices. Meals are also when a child learns to touch foods and connect food tastes to how foods look and feel. Ideally, complementary feeding is responsive and promotes child autonomy, but it can also be used to manage behavior problems or overly indulge a child, resulting in long-term consequences for nutrition and health. Therefore, in addition to what a child is fed, attention to how a child is fed is also important. In this review, 12 topics relevant for updating global guidance on complementary feeding were identified: age of introduction of complementary foods; continued breastfeeding; responsive feeding; safe preparation and storage of complementary foods; food textures, flavors, and acceptance; energy and meal and snack frequency; fats, protein, and carbohydrates; dietary diversity; milks other than breast milk; fluid needs; unhealthy foods and beverages; and use of vitamin and mineral supplements or supplementary foods.
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Affiliation(s)
- Chessa K Lutter
- Division of Food Security and Agriculture, RTI International, Washington, DC, USA
| | | | - Lisa Rogers
- Department of Nutrition and Food Safety, World Health Organization, Geneva, Switzerland
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20
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Wood CT, Witt WP, Skinner AC, Yin HS, Rothman RL, Sanders LM, Delamater AM, Flower KB, Kay MC, Perrin EM. Effects of Breastfeeding, Formula Feeding, and Complementary Feeding on Rapid Weight Gain in the First Year of Life. Acad Pediatr 2021; 21:288-296. [PMID: 32961335 PMCID: PMC10910619 DOI: 10.1016/j.acap.2020.09.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/08/2020] [Accepted: 09/15/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine whether proportion of breast versus formula feeding and timing of complementary food introduction affect the odds of rapid gain in weight status in a diverse sample of infants. METHODS Using data from Greenlight Intervention Study, we analyzed the effects of type of milk feeding (breastfeeding, formula, or mixed feeding) from the 2- to 6-month well visits, and the introduction of complementary foods before 4 months on rapid increase in weight-for-age z-score (WAZ) and weight-for-length z-score (WLZ) before 12 months using multivariable logistic regression models. RESULTS Of the 865 infants enrolled, 469 had complete data on all variables of interest, and 41% and 33% of those infants had rapid increases in WAZ and WLZ, respectively. Odds of rapid increase in WAZ remained lowest for infants breastfeeding from 2 to 6 months (adjusted odds ratio [aOR] 0.34; 95% confidence interval [CI]: 0.17, 0.69) when compared to infants who were formula-fed. Adjusted for feeding, introduction of complementary foods after 4 months was associated with decreased odds of rapid increase in WLZ (aOR 0.64; 95% CI: 0.42, 0.96). CONCLUSIONS Feeding typified by predominant breastfeeding and delaying introduction of complementary foods after 4 months reduces the odds of rapid increases in WAZ and WLZ in the first year of life.
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Affiliation(s)
- Charles T Wood
- Division of Primary Care Pediatrics and Duke Center for Childhood Obesity Research, Department of Pediatrics, Duke University School of Medicine (CT Wood and EM Perrin), Durham, NC.
| | - Whitney P Witt
- College of Health, Lehigh University, (WP Witt), Bethlehem, PA
| | - Asheley C Skinner
- Department of Population Health Sciences, Duke University School of Medicine, Duke Clinical Research Institute (AC Skinner), Durham, NC
| | - Hsiang S Yin
- Departments of Pediatrics and Population Health, New York University School of Medicine/Bellevue Hospital Center (HS Yin), New York, NY
| | - Russell L Rothman
- Center for Health Services Research, Vanderbilt University Medical Center (RL Rothman), Nashville, Tenn
| | - Lee M Sanders
- Department of Pediatrics, Center for Policy, Outcomes and Prevention, Stanford University (LM Sanders), Stanford, Calif
| | - Alan M Delamater
- Department of Pediatrics, University of Miami School of Medicine (AM Delamater), Miami, Fla
| | - Kori B Flower
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina School of Medicine (KB Flower), Chapel Hill, NC
| | - Melissa C Kay
- Duke Center for Childhood Obesity Research and Duke Global Digital Health Science Center, Duke University School of Medicine and Duke Global Health Institute (MC Kay), Durham, NC
| | - Eliana M Perrin
- Division of Primary Care Pediatrics and Duke Center for Childhood Obesity Research, Department of Pediatrics, Duke University School of Medicine (CT Wood and EM Perrin), Durham, NC
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21
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A recurrent cross-sectional qualitative study exploring how low-income mothers define snacks and reasons for offering snacks during infancy. Appetite 2021; 162:105169. [PMID: 33610639 DOI: 10.1016/j.appet.2021.105169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 01/17/2023]
Abstract
Despite rapid increases in snacking in recent decades, little is known about snacking during infancy. This study explored how low-income mothers define snacks and their reasons for offering snacks during infancy. A recurrent cross-sectional qualitative approach was used to identify themes from semi-structured interviews with low-income mothers when their infants were 6 and 12 months of age. A purposive sample of mothers (N = 15) was recruited from Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offices and childcare centers serving low-income families in Rhode Island. Mothers also completed demographic and infant feeding questionnaires. Independent thematic analyses were conducted to identify themes from the 6 and 12 month interviews. Themes from the 6 month interviews for how mothers defined snacks were: snacks are consumed between meals, snacks are smaller portions, and snacks are sweet. Themes from the 12 month interviews also included snacks are consumed between meals and snacks are smaller portions with one additional theme: snacks do not include all food groups. Themes from the 6 month interviews for the reasons mothers offered snacks were: infants seemed hungry, infants showed interest, and snacks help manage behavior. Themes from 12 month interviews also included snacks help manage behavior with two additional themes: snacks expose infants to different flavors and snacks expose infants to different textures. Findings suggest that snacks are commonly offered during infancy and that mothers define snacks as smaller portions that help with hunger between meals. However, during early infancy mothers describe snacks as sweet, and across infancy report using snacks to manage behavior, underscoring the importance of providing parents with guidance on healthy snacking during the first year of life.
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22
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Lee DL, Gurzo K, Nhan L, Homel Vitale E, Yoshida S, Ritchie LD. Nutrition Provided to Infants in Licensed Childcare Centers and Homes: A Descriptive Study. Matern Child Health J 2021; 24:932-942. [PMID: 32350730 DOI: 10.1007/s10995-020-02929-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Infant nutrition can influence development, eating behaviors and obesity risk. Nearly half of infants in the U.S. are in non-parental care where they consume much of their daily nutrition. Because little is known about the quality of infant nutrition in childcare, the study objective was to characterize the foods and beverages provided to infants in childcare in California. METHODS From a randomly selected sample of 2,400 licensed childcare in California, 736 responded to a 2016 survey; a subset of 297 cared for infants. Differences in 26 foods and 7 beverages provided between centers and homes, and by CACFP participation, were assessed using logistic regression models adjusted for CACFP participation and whether the site was a center or home, respectively. RESULTS Several differences between centers and homes were identified. One the day prior to the survey, more centers than homes ever provided cow's milk (25.1% vs 13.0%, p = 0.02) and whole grains (76.7% vs 62.9%, p = 0.03), and fewer centers than homes provided frozen treats (1.4% vs 10.3%, p = 0.003). When comparing difference by CACFP participation, fewer CACFP than non-CACFP sites usually provided breastmilk (32.6% vs 54.2%, p = 0.0004) and ever provided cow's milk (14.2% vs 37.1%, p < 0.0001). On the day prior to the survey, more CACFP than non-CACFP provided vegetables (91.0% vs 80.8%, p = 0.02), fruit (centers only) (97.2% vs 80.8%, p = 0.0003), and infant cereals (86.0% vs 61.2%, p < 0.0001). Fewer CACFP than non-CACFP provided sweetened yogurt (14.8% vs 36.7%, p < 0.0001). CONCLUSIONS FOR PRACTICE Childcare centers and CACFP participants tended to serve nutritious foods more than childcare homes and non-CACFP participants, respectively. Additional education and policies for childcare providers on appropriate foods and beverages for infants is recommended.
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Affiliation(s)
- Danielle L Lee
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, 2115 Milvia Street, 3rd Floor, Berkeley, CA, 94704, USA
| | - Klara Gurzo
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, 2115 Milvia Street, 3rd Floor, Berkeley, CA, 94704, USA.,Department of Public Health Sciences, Stockholm University, Sveavägen 160, 106 91, Sveaplan, Sweden
| | - Lilly Nhan
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, 2115 Milvia Street, 3rd Floor, Berkeley, CA, 94704, USA.,Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, 26-051B CHS, Box 951772, Los Angeles, CA, 90095, USA
| | - Elyse Homel Vitale
- California Food Policy Advocates, 1970 Broadway, Suite 760, Oakland, CA, 94612, USA.,Child Care Food Program Roundtable, Los Angeles, CA, USA
| | - Sallie Yoshida
- Sarah Samuels Center for Public Health Research & Evaluation, 1222 Preservation Park Way, Oakland, CA, 94612, USA.,Social Policy Research Associates, 1333 Broadway, Suite 301, Oakland, CA, 94612, USA
| | - Lorrene D Ritchie
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, 2115 Milvia Street, 3rd Floor, Berkeley, CA, 94704, USA.
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Brauchla M, Dekker MJ, Rehm CD. Trends in Vitamin C Consumption in the United States: 1999-2018. Nutrients 2021; 13:420. [PMID: 33525516 PMCID: PMC7911690 DOI: 10.3390/nu13020420] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/20/2022] Open
Abstract
Low intakes of fruits and vegetables have resulted in suboptimal intakes of several micronutrients, including vitamin C. This cross-sectional study used data from 84,902 children/adults (≥1 y) who completed a 24-h dietary recall as part of the United States National Health and Nutrition Examination Survey (1999-2018). Mean vitamin C intakes from foods/beverages were calculated as were trends in major food/beverage sources of vitamin C. Percentages below the Estimated Average Requirement (EAR) were estimated. Overall, mean vitamin C consumption declined by 23% (97-75 mg/d; p-value for trend < 0.001). 100% fruit juice was the leading source of vitamin C (25.6% of total or 21.7mg/d), but this declined by 48% (25-13 mg/d; p-value for trend < 0.001). Whole fruit increased among children/adolescents (+75.8%;10-17 mg/d; p-value for trend < 0.001), but not adults, while the vegetable contribution was generally unchanged. The proportion of the population below the EAR increased by 23.8% on a relative scale or 9 percentage points on an absolute scale (38.3-47.4%). Declines in vitamin C intake is driven largely by decreases in fruit juice coupled with modest increases in whole fruit. Due to associations between vitamin C intake and numerous health outcomes these trends warrant careful monitoring moving forward.
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Affiliation(s)
| | | | - Colin D. Rehm
- PepsiCo, 700 Anderson Hill Road, Purchase, NY 10577, USA; (M.B.); (M.J.D.)
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Beckman M, Harris J. Understanding individual and socio-cultural factors associated with hispanic parents' provision of sugar-sweetened beverages to young children. Appetite 2021; 161:105139. [PMID: 33513416 DOI: 10.1016/j.appet.2021.105139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 11/17/2022]
Abstract
Sugar-sweetened beverages (SSBs) contribute to childhood obesity, long-term risks for diet-related diseases, and health disparities affecting communities of color. Hispanic children are disproportionately affected by obesity, but research is needed to better understand culturally specific reasons for providing SSBs to Hispanic children. This exploratory study utilized the Social Ecological Model framework to evaluate Hispanic parents' perceptions of SSBs and serving them to young children. A cross-sectional survey (in English and Spanish) used a national US online panel to recruit a convenience sample of Hispanic parents (N = 350) with young children (aged 1-5 years). Participants reported types of drinks and SSB brands that they served their child in the past month and rated drink healthfulness. Attitude questions assessed individual, community-level, and socio-cultural factors, including normative beliefs, about serving SSBs to young children. Nearly all parents (98%) reported serving their child SSBs in the past month, averaging 6.7 different SSB types. For all categories of SSBs except fruit-flavored drinks, parents who served that type of SSB rated it as significantly healthier than parents who did not serve them. A linear regression model examined associations between individual and socio-cultural factors and number of SSB types served to their child. In the model, higher average rating of SSB healthfulness, child's age, normative beliefs that others serve SSBs to children, being born in the US/Puerto Rico, and parent and child enjoyment of SSBs were positively associated with serving more SSB types, while concerns about SSBs for their own health was negatively related. Language-related acculturation and community-level factors assessed were not significant. Public health initiatives should focus on healthfulness misperceptions of some SSB categories and address normative beliefs to help reduce serving SSBs to Hispanic children.
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Affiliation(s)
- Madeline Beckman
- Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH, 44106, USA.
| | - Jennifer Harris
- University of Connecticut Rudd Center for Food Policy & Obesity, One Constitution Plaza Suite 600 Hartford, CT, 06103, USA.
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25
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Duffy EW, Taillie LS, Richter APC, Higgins ICA, Harris JL, Hall MG. Parental Perceptions and Exposure to Advertising of Toddler Milk: A Pilot Study with Latino Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E528. [PMID: 33435227 PMCID: PMC7827454 DOI: 10.3390/ijerph18020528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/27/2020] [Accepted: 01/05/2021] [Indexed: 12/31/2022]
Abstract
Marketing of toddler milk (i.e., typically sugar-sweetened nutrient-fortified milk-based drinks marketed for children 12-36 months) is an emerging public health problem in the US. The American Academy of Pediatrics recommends against the consumption of toddler milk because it often contains added sugar and can displace nutrient-dense foods. Studies have not examined toddler milk perceptions among Latinos, an important gap given Latino children in the US are at high risk of having poor diet quality, and toddler milk is extensively advertised on Spanish-language TV. This study used an online survey of a convenience sample of 58 Latino parents to examine parents' experiences with toddler milk, understand their perceptions of the healthfulness and the nutrition-related claims on toddler milk, and describe their exposure to toddler milk advertising. Nearly half (44%) of parents in the sample reported purchasing toddler milk. When asked to provide open-ended interpretations of claims on toddler milk, almost all parents gave positive answers, suggesting potential "health halo" effects of the claims. More than half (56%) of parents reported seeing toddler milk advertisements, most commonly on Spanish-language TV. The misperceptions about toddler milk identified should be explored in further research using larger, more representative samples.
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Affiliation(s)
- Emily W. Duffy
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (E.W.D.); (L.S.T.)
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.P.C.R.); (I.C.A.H.)
| | - Lindsey S. Taillie
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (E.W.D.); (L.S.T.)
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.P.C.R.); (I.C.A.H.)
| | - Ana Paula C. Richter
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.P.C.R.); (I.C.A.H.)
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC 27599, USA
| | - Isabella C. A. Higgins
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.P.C.R.); (I.C.A.H.)
| | - Jennifer L. Harris
- Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT 06103, USA;
| | - Marissa G. Hall
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.P.C.R.); (I.C.A.H.)
- Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC 27599, USA
- School of Medicine, UNC Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA
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26
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The diets of children: Overview of available data for children and adolescents. GLOBAL FOOD SECURITY 2020. [DOI: 10.1016/j.gfs.2020.100442] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Moreira AC, Almeida Oliveira P, Borrego R, Nogueira T, Ferreira R, Virella D. Development of RisObIn.Com, a Screening Tool for Risk of Childhood Obesity in the Community. Nutrients 2020; 12:nu12113288. [PMID: 33121029 PMCID: PMC7692101 DOI: 10.3390/nu12113288] [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: 09/28/2020] [Revised: 10/16/2020] [Accepted: 10/23/2020] [Indexed: 01/08/2023] Open
Abstract
The prevalence of childhood overweight has increased considerably in the past three decades and there is evidence that childhood obesity can persist into adulthood. A simple tool to identify relevant risk factors may alert families and prevent overweight and obesity. This study aims to develop a pre-school screening tool to assess the risk of childhood obesity. Child anthropometric measurements and several risk factors for childhood obesity factors were obtained. The effect of the variables on the outcome of obesity (defined as increased anthropometry-estimated adiposity) was assessed by binary logistic regression analyses. The identified variables were submitted for expert panel validation and combined for the tool development. A total of 304 children were included. Eight items were included in the tool. A higher score of the tool indicates a greater risk for obesity in childhood with the cutoff point set at 0. The tool sensitivity for obesity was 95%, specificity was 74.4%, the positive predictive value was 37.3%, and negative predictive value was 98.9%. The Risk of childhood Obesity In the Community (RisObIn.Com) tool is proposed to be a comprehensive tool to identify children at high risk for late childhood obesity at admission to primary school. Further studies are needed to assess the performance of the tool.
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Affiliation(s)
- Ana Catarina Moreira
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal; (P.A.O.); (R.B.); (R.F.)
- H &TRC—Health & Technology Research Center, 1990-096 Lisboa, Portugal
- Correspondence:
| | - Patrícia Almeida Oliveira
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal; (P.A.O.); (R.B.); (R.F.)
- Faculdade de Medicina, Universidade de Lisboa, 1649-004 Lisboa, Portugal
| | - Rute Borrego
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal; (P.A.O.); (R.B.); (R.F.)
| | - Telma Nogueira
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Raquel Ferreira
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal; (P.A.O.); (R.B.); (R.F.)
- Núcleo de Educação e Qualidade Alimentar, Câmara Municipal de Sintra, 2710-307 Sintra, Portugal
| | - Daniel Virella
- Research Unit, Centro Hospitalar Universitário Lisboa Central, 1150-199 Lisboa, Portugal;
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Cheney AM, Nieri T, Ramirez Zarate A, Garcia G, Vaca L, Valencia E, Versteeg C, Molina A, Castillo M, Tovar A. Grow well/Crecer bien: a protocol for research on infant feeding practices in low-income families. BMC Public Health 2020; 20:1431. [PMID: 32958017 PMCID: PMC7503435 DOI: 10.1186/s12889-020-09471-1] [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: 07/13/2020] [Accepted: 08/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of obesity among children remains high. Given obesity's significant lifelong consequences, there is great interest in preventing obesity early in life. There is a need to better understand the relation of common infant feeding styles and practices to obesity in infants using longitudinal study designs. There is also an urgent need to understand the role of caregivers other than mothers in feeding. A better understanding of variation in feeding styles and practices can inform the identification of risk groups and the tailoring of interventions to them. METHODS In partnership with Early Head Start programs across four counties in southern California, mothers and infants will be enrolled in a two-year longitudinal study collecting survey and anthropometric data. A subsample of mothers and their selected other caregivers will participate in qualitative research involving feeding diaries and dyadic interviews. The results will be used to develop and test an enhanced nutrition education program. DISCUSSION We outline a study methodology to examine feeding styles and practices and their association with early childhood obesity risk and enhance an existing intervention to promote healthy infant feeding and growth among children in low-income families.
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Affiliation(s)
- Ann M Cheney
- Department of Social Medicine Population and Public Health, 900 University Ave, Riverside, 92501, USA.
| | - Tanya Nieri
- Department of Sociology, University of California Riverside, Riverside, USA
| | - Ana Ramirez Zarate
- School of Public Policy, University of California Riverside, Riverside, USA
| | - Gretel Garcia
- Graduate School of Education, University of California Riverside, Riverside, USA
| | - Lucero Vaca
- Department of Social Medicine Population and Public Health, 900 University Ave, Riverside, 92501, USA
| | | | | | - Arlene Molina
- San Bernardino County Preschool Services Department, San Bernardino, USA
| | | | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, USA
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29
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Hohman EE, Savage JS, Birch LL, Paul IM. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) Responsive Parenting Intervention for Firstborns Affects Dietary Intake of Secondborn Infants. J Nutr 2020; 150:2139-2146. [PMID: 32412629 PMCID: PMC7398778 DOI: 10.1093/jn/nxaa135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/29/2020] [Accepted: 04/20/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Although previous work has shown that children with older siblings tend to have poorer diet quality, no study has directly compared diets of infant siblings. OBJECTIVE The goals of this analysis were to examine birth-order differences in dietary intake between firstborn (FB) and secondborn (SB) siblings, and to determine whether a responsive parenting (RP) intervention modified birth-order effects on diet. METHODS The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study randomly assigned first-time mothers to an RP intervention, which included guidance on feeding, sleep, soothing, and interactive play, or control. INSIGHT mothers who delivered a second child enrolled in an observation-only study of their SB infant (SIBSIGHT). Mothers completed FFQs for both children at ages 6 (n = 97 sibling pairs) and 12 (n = 100) mo. FB compared with SB intake of food groups of interest were compared, and the moderating effect of the RP intervention on birth-order differences was tested using generalized linear mixed models. RESULTS Though FBs and SBs had similar diets, more FBs than SBs consumed 100% fruit juice at both 6 (13.8 compared with 3.2%, P = 0.006) and 12 mo (46.0 compared with 32.0%, P = 0.01). SBs consumed fruit more frequently (FB 2.8 compared with SB 3.2 times/d, P = 0.01), and were more likely to consume fried potatoes (FB 38.4 compared with SB 57.6%, P = 0.0009) and processed meats (FB 43.0 compared with SB 58.0%, P = 0.02) than FBs at 12 mo. There were no differences by birth order in intake of sweets, snacks, or sugar-sweetened beverages at 12 mo. At 12 mo, RP-group SBs ate vegetables more times per day (3.2) than control SBs (2.2, P = 0.01). RP-SBs also consumed a greater variety of vegetables (10.2) than control-SBs (7.9, P = 0.01). CONCLUSIONS Birth order is not consistently associated with healthy or unhealthy infant dietary intake. However, an RP intervention delivered to first-time mothers may benefit subsequent infants' vegetable intake. This trial was registered at clinicaltrials.gov as NCT01167270.
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Affiliation(s)
- Emily E Hohman
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, USA,Address correspondence to EEH (e-mail: )
| | - Jennifer S Savage
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, USA,Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
| | - Leann L Birch
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Ian M Paul
- Departments of Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
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30
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Lewis KH, Skelton J, Hsu FC, Ezouah P, Taveras EM, Block JP. Use of Electronic Health Record Data to Study the Association of Sugary Drink Consumption With Child Weight Status. Acad Pediatr 2020; 20:767-775. [PMID: 31712182 DOI: 10.1016/j.acap.2019.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 11/01/2019] [Accepted: 11/02/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sugar-sweetened beverages (SSBs) and, to some extent, fruit juice are modifiable risk factors for childhood obesity. Data on consumption have not been previously systematically collected in the electronic health record (EHR) in a way that could facilitate observational research and population health management. METHODS In 2017 to 2018, we used data from an EHR-based SSB and fruit juice screener to study the association between consumption and weight status among children 6 months through 17 years of age. We used linear models to examine the cross-sectional association between sugary drinks and BMIz, adjusting for sex, age, race/ethnicity, clinic site, and encounter type. We also used separate mixed-effects models to examine the association of baseline consumption with ∆BMIz. RESULTS Our dataset included 22,291 children (15% <2 years; 23% 2-5 years; 34% 6-11 years; 28% 12-17 years) of diverse race/ethnicity (27% African American, 30% Hispanic). Sugary drink consumption was very common; 43% reported ≥2 per day. For children 6 to 17 years, greater consumption was associated cross sectionally with higher BMIz (eg, 6-11 years old children consuming ≥3/day had 0.27 (95% CI, 0.18, 0.36) higher BMIz vs those consuming <1/week). In longitudinal models, sugary drink consumption was related to ∆BMIz for children 2 to 5 at the highest reported levels of consumption (∆0.35 (0.04, 0.65) BMIz/year more for children consuming ≥3/day versus <1x/week). Larger increases in BMIz were seen for 6 to 17 year olds reporting consumption at or above 1x/day, versus <1x/week. No consistent cross-sectional or longitudinal associations were observed among children under 2. CONCLUSIONS In our EHR-derived data, sugary drink consumption was most associated with high BMIz in school-aged children. Early childhood may be a critical period for intervening on sugary beverage consumption in obesity prevention efforts.
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Affiliation(s)
- Kristina H Lewis
- Division of Public Health Sciences, Wake Forest School of Medicine (KH Lewis, J Skelton, F-C Hsu, and P Ezouah), Winston-Salem, NC.
| | - Joseph Skelton
- Division of Public Health Sciences, Wake Forest School of Medicine (KH Lewis, J Skelton, F-C Hsu, and P Ezouah), Winston-Salem, NC; Department of Pediatrics, Wake Forest School of Medicine (J Skelton), Winston-Salem, NC
| | - Fang-Chi Hsu
- Division of Public Health Sciences, Wake Forest School of Medicine (KH Lewis, J Skelton, F-C Hsu, and P Ezouah), Winston-Salem, NC
| | - Pascaline Ezouah
- Division of Public Health Sciences, Wake Forest School of Medicine (KH Lewis, J Skelton, F-C Hsu, and P Ezouah), Winston-Salem, NC
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital (EM Taveras), Boston, Mass
| | - Jason P Block
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School (JP Block), Boston, Mass
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31
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Nabower AM, Lyden ER, Rodriguez FJ, Delair SF. Breastfeeding practices in Masaya, Nicaragua: a facility based cross-sectional study. Int Breastfeed J 2020; 15:31. [PMID: 32321564 PMCID: PMC7178974 DOI: 10.1186/s13006-020-00273-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/08/2020] [Indexed: 11/21/2022] Open
Abstract
Background The World Health Organization recommends exclusive breastfeeding for 6 months and total breastfeeding for at least 2 years. Despite this and multiple interventions promoting breastfeeding, early breastfeeding cessation remains high with little data as to the ongoing barriers contributing to early cessation. Methods Two groups of Nicaraguan mothers in an urban hospital were approached to complete a questionnaire to determine what newborn, maternal, and socioeconomic factors contributed to early cessation of breastfeeding. Group 1 participants were mothers of newborns in the newborn units, while group 2 were mothers of children 5 years or younger in the emergency room and pediatric ward. Descriptive statistics summarized the data. Fisher’s exact test evaluated factors associated with early breastfeeding cessation. Results In group 1, 97 participants were enrolled with 81% of mothers planning to fulfill the guideline for exclusive breastfeeding for 6 months. In group 2, there were 139 mothers of which 58% reported they had exclusively breastfed for 6 months. Only 25 and 27% of mothers in group 1 and 2 respectively planned to breastfeed or breastfed for 2 years. In group 1, mothers reported lack of knowledge regarding breastfeeding techniques and older mothers tended to plan for early cessation of exclusive breastfeeding. In group 2, mothers reported feeling uncomfortable with breastfeeding in public or had difficulty with latching. Cessation of any breastfeeding prior to 12 months was associated with being uncomfortable breastfeeding in public and knowing the WHO guidelines. In both groups, social media represented an expanding platform for receiving breastfeeding information. Conclusions Interventions focusing on reaching younger mothers and addressing breastfeeding knowledge and techniques while leveraging the increasing influence of social media platforms may help improve compliance with breastfeeding recommendations.
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Affiliation(s)
- Aleisha M Nabower
- Pediatrics, University of Nebraska Medical Center, 985525 Nebraska Medical Center, Omaha, NE, USA. .,Children's Hospital and Medical Center, 8200 Dodge St, Omaha, NE, USA.
| | - Elizabeth R Lyden
- University of Nebraska College of Public Health, 984355 Medical Center, Omaha, NE, USA
| | - Francisco J Rodriguez
- Pediatrics, Hospital Dr. Humberto Alvarado Vásquez, Mcdo Municipal 2 ½ c al E, Masaya, Nicaragua
| | - Shirley F Delair
- Pediatrics, University of Nebraska Medical Center, 985525 Nebraska Medical Center, Omaha, NE, USA.,Children's Hospital and Medical Center, 8200 Dodge St, Omaha, NE, USA
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Ahluwalia N. Nutrition Monitoring of Children Aged Birth to 24 Mo (B-24): Data Collection and Findings from the NHANES. Adv Nutr 2020; 11:113-127. [PMID: 31390469 PMCID: PMC7442347 DOI: 10.1093/advances/nmz077] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The first 2 y of life are characterized by several transitions that can affect growth, development, and eating patterns long term. These include a shift from a primarily milk-based eating pattern to introduction of complementary foods at ∼4-6 mo of age, and passage to family-meal patterns in toddler years. Recognizing the importance of this critical period, the Dietary Guidelines for Americans from 2020 onwards will include guidance for children aged birth to 24 mo (B-24). Few large-scale surveys provide comprehensive, nationally representative, quantitative, recent data on infant and toddler nutrition in the United States. The continuous NHANES has collected data relevant to this initiative since 1999 using standardized interview and examination protocols. These include data on infant feeding practices, dietary intakes (foods, beverages, and supplements), anthropometry, and blood-based nutritional status on nationally representative samples of infants and toddlers. NHANES data can be used to describe large group-level consumption patterns, as well as trends over time for B-24 children overall, and by demographic groups (e.g., race-ethnic and income groups). In addition, NHANES data can be analyzed to examine adherence to nutrition-related recommendations, such as those from the American Academy of Pediatrics (AAP), and to track Healthy People 2020 objectives. This paper provides an update on NHANES nutrition monitoring in B-24 children since our previous publication (which provided details through NHANES 2009-2010) and describes data collection since 2010 and plans for upcoming cycles. It also describes key NHANES-based findings published in the last 5 y on infant feeding practices, dietary intakes and supplement use, and nutritional status of US children aged <2 y. Findings related to existing recommendations, such as from the AAP, are presented when available. This information can inform researchers and policymakers on the state of nutrition in the US B-24 population and its subgroups of interest.
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Affiliation(s)
- Namanjeet Ahluwalia
- Division of Health and Nutrition Examination Surveys (DHANES), National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
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33
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Duffy EW, Kay MC, Jacquier EF, Catellier D, Hampton J, Anater AS, Story M. Trends in Food Consumption Patterns of US Infants and Toddlers from Feeding Infants and Toddlers Studies (FITS) in 2002, 2008, 2016. Nutrients 2019; 11:nu11112807. [PMID: 31744210 PMCID: PMC6893614 DOI: 10.3390/nu11112807] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 12/24/2022] Open
Abstract
The Feeding Infants and Toddlers Study (FITS) is the largest survey of dietary intake among infants and young children in the United States. Dietary patterns in early childhood are a key component of prevention of diet-related chronic diseases, yet little is known about how food consumption patterns of infants and young children have changed over time. The objective of this study is to examine trends in food and beverage consumption among children ages 6–23.9 months using data from the FITS conducted in 2002, 2008, and 2016. A total of 5963 infants and young children ages 6–23.9 months were included in these analyses. Food consumption data were collected using a multiple-pass 24-h recall by telephone using the Nutrition Data System for Research. Linear trends were assessed using the Wald’s test in a multivariable linear regression model. Positive significant findings include increases in breast milk consumption and decreases in the consumption of sweets, sugar-sweetened beverages, and 100% fruit juice. More troubling findings include decreasing infant cereal consumption, stagnant or decreasing whole grain consumption, and stagnant consumption of vegetables. Our findings suggest some promising improvements in dietary intake among infants and toddlers in the United States over the past 15 years, but further policy, programmatic, and industry efforts are still needed.
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Affiliation(s)
- Emily W. Duffy
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
- Correspondence: ; Tel.: +1-336-341-9149
| | - Melissa C. Kay
- Duke Global Health Institute, Duke University, Durham, NC 27110, USA; (M.C.K.); (M.S.)
| | | | - Diane Catellier
- RTI International, Research Triangle Park, NC 27709, USA; (D.C.); (J.H.); (A.S.A.)
| | - Joel Hampton
- RTI International, Research Triangle Park, NC 27709, USA; (D.C.); (J.H.); (A.S.A.)
| | - Andrea S. Anater
- RTI International, Research Triangle Park, NC 27709, USA; (D.C.); (J.H.); (A.S.A.)
| | - Mary Story
- Duke Global Health Institute, Duke University, Durham, NC 27110, USA; (M.C.K.); (M.S.)
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Moore AM, Vadiveloo M, Tovar A, McCurdy K, Østbye T, Benjamin-Neelon SE. Associations of Less Healthy Snack Food Consumption with Infant Weight-for-Length Z-Score Trajectories: Findings from the Nurture Cohort Study. Nutrients 2019; 11:nu11112752. [PMID: 31766167 PMCID: PMC6893797 DOI: 10.3390/nu11112752] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/03/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022] Open
Abstract
Little is known about the impact of less healthy snack foods on weight trajectories during infancy. This secondary analysis of data from the Nurture cohort explored prospective associations of less healthy snack foods with infant weight trajectories. Pregnant women were recruited and, upon delivery of a single live infant, 666 mothers agreed to participate. Mothers completed sociodemographic and infant feeding questionnaires, and infant anthropometrics were collected during home visits at 3, 6, 9, and 12 months. Less healthy snack food consumption was assessed by asking how frequently baby snacks and sweets were consumed each day during the previous three months. Multilevel growth curve models explored associations of baby snacks and sweets with infant weight-for-length (WFL) z-scores. On average, mothers were 27 years old, 71.5% were non-Hispanic Black, and 55.4% had household incomes of ≤$20,000/year. Consumption of less healthy snack foods increased during infancy with a median intake of 3.0 baby snacks/day and 0.7 sweets/day between 10 and 12 months. Growth curve models showed that infants who consumed sweets >2 times/day had significantly higher WFL z-scores during the second half of infancy compared to infants who never consumed sweets. Less healthy snacks may contribute to the risk of obesity during infancy and promoting healthy snack food choices during this critical time is important.
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Affiliation(s)
- Amy M. Moore
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Rd., Kingston, RI 02881, USA
- Correspondence: ; Tel.: +1-(740)-591-7984
| | - Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Rd., Kingston, RI 02881, USA
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, 41 Lower College Rd., Kingston, RI 02881, USA
| | - Karen McCurdy
- Department of Human Development and Family Studies, University of Rhode Island, 2 Lower College Rd., Kingston, RI 02881, USA
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University Medical Center, DUMC 2914, Durham, NC 27710, USA
| | - Sara E. Benjamin-Neelon
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
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Bradbury KM, Turel O, Morrison KM. Electronic device use and beverage related sugar and caffeine intake in US adolescents. PLoS One 2019; 14:e0223912. [PMID: 31639162 PMCID: PMC6805001 DOI: 10.1371/journal.pone.0223912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/01/2019] [Indexed: 12/21/2022] Open
Abstract
Background Despite recent declines in consumption of sugary beverages, energy drinks (ED) and sodas continue to contribute a substantial amount of sugar and caffeine to the diet of youth. Consumption of these beverages has been linked with electronic device use, however in-depth associations between sugar and caffeine intake from energy drinks and sodas with various electronic devices are not clear. Objective Describe the relationship of soda and energy drink consumption and associated added sugar and caffeine intake with electronic device use among adolescents. Methods Secondary data from the 2013–2016 cycles of Monitoring the Future Survey, a national, repeated, cross-sectional study, were analyzed. Information on energy drink and soda consumption by students in grades 8 and 10 (n = 32,418) from 252–263 schools randomly sampled from all US states was used. Results Soda and energy drink consumption decreased each year from 2013–2016 while daily use of electronic devices remained stable. An additional hour/day of TV was linked to a 6.92g (6.31,7.48; p<0.001) increase in sugar intake and a 32% (OR = 1.32; 1.29,1.35; p < .001) higher risk of exceeding World Health Organization (WHO) recommended sugar intakes. Further, each hour/day of TV was linked to a 28% increased risk of exceeding caffeine recommendations (OR = 1.25–1.31; p<0.001). Each hour per day talking on a cellphone was associated with an increased risk of exceeding WHO sugar and caffeine intakes by 14% (OR = 1.11–1.16; p<0.001) and 18% (OR = 1.15–1.21; p<0.001) respectively. Video game use was only weakly linked to caffeine intake. Computer use for school was associated with lower likelihood of exceeding sugar intake cut-offs. Conclusion While a trend towards reduced energy drink and soda intake from 2013–2016 was evident, greater electronic device use, especially TV time, was linked to higher intake of beverage-derived added sugar and caffeine amongst adolescents. Addressing these behaviours through counselling or health promotion could potentially help to reduce excess sugar and caffeine intake from sodas and energy drinks among this population.
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Affiliation(s)
- Kelly M. Bradbury
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
| | - Ofir Turel
- Department of Information Systems and Decision Sciences, Mihaylo College of Business and Economics, California State University—Fullerton, Fullerton, California, United States of America
| | - Katherine M. Morrison
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
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Morel K, Nichols K, Nong Y, Charles N, Price S, Taveras E, Goldman R, Woo Baidal JA. Parental and Provider Perceptions of Sugar-Sweetened Beverage Interventions in the First 1000 Days: A Qualitative Study. Acad Pediatr 2019; 19:748-755. [PMID: 30677540 PMCID: PMC6642844 DOI: 10.1016/j.acap.2019.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/11/2019] [Accepted: 01/19/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Novel approaches to reduce sugar-sweetened beverage (SSB) consumption during the first 1000 days-pregnancy through age 2 years-are urgently needed. OBJECTIVE To examine perceptions of SSB consumption and acceptability of potential intervention strategies to promote SSB avoidance in low-income families in the first 1000 days. METHODS In this qualitative research, we performed semistructured, in-depth interviews of 25 women and 7 nutrition/health care providers. Eligible women were Women, Infants, and Children program-enrolled and pregnant or had an infant younger than age 2 years. Eligible providers cared for families during the first 1000 days. Using immersion-crystallization techniques, we examined perceptions, barriers, and facilitators related to avoidance of SSB consumption; acceptability of messages framed as positive gains or negative losses; and perceived influence on SSB consumption of various intervention modalities. RESULTS Themes related to SSB consumption included parental confusion about healthy beverage recommendations and maternal feelings of lack of control over beverage choices due to pregnancy cravings and infant tastes. Themes surrounding message frames included negative health consequences of sugary drink consumption are strong motivators for behavior change; and savings and cost count, but are not top priority. Highly acceptable intervention strategies included use of images showing health consequences of SSB consumption, illustrations of sugar content at the point of purchase, and multimodal delivery of messages. CONCLUSIONS Messages focused on infant health consequences and parental empowerment to evaluate and select healthier beverages based on sugar content should be tested in interventions to reduce SSB consumption in the first 1000 days.
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Affiliation(s)
- Kayla Morel
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics (K Morel, K Nichols, Y Nong, and JA Woo Baidal); Institute of Human Nutrition (K Morel and Y Nong), Columbia University Medical Center
| | - Kelsey Nichols
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics (K Morel, K Nichols, Y Nong, and JA Woo Baidal)
| | - Yvonne Nong
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics (K Morel, K Nichols, Y Nong, and JA Woo Baidal); Institute of Human Nutrition (K Morel and Y Nong), Columbia University Medical Center
| | - Nalini Charles
- New York Presbyterian Hospital Special Supplemental Nutrition Program for Women, Infants, and Children (N Charles), New York, NY
| | - Sarah Price
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children (S Price and E Taveras), Boston, Mass
| | - Elsie Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children (S Price and E Taveras), Boston, Mass
| | - Roberta Goldman
- Warren Alpert Medical School, Brown University (R Goldman), Pawtucket, RI
| | - Jennifer A Woo Baidal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics (K Morel, K Nichols, Y Nong, and JA Woo Baidal).
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Harada M, Amariglio N, Wills H, Koolwijk I. Feeding Issues in Young Children. Adv Pediatr 2019; 66:123-145. [PMID: 31230689 DOI: 10.1016/j.yapd.2019.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Melissa Harada
- Department of Pediatrics, UCLA David Geffen School of Medicine, 300 UCLA Medical Plaza, Suite 3300, Los Angeles, CA 90095, USA
| | - Nelly Amariglio
- Department of General Pediatrics, Children's Hospital of Los Angeles, 4650 Sunset Boulevard, MS #53, Los Angeles, CA 90027, USA
| | - Hope Wills
- Department of Clinical Nutrition Services, Children's Hospital of Los Angeles, 4650 Sunset Boulevard, MS #53, Los Angeles, CA 90027, USA
| | - Irene Koolwijk
- Department of Pediatrics, UCLA David Geffen School of Medicine, 300 UCLA Medical Plaza, Suite 3300, Los Angeles, CA 90095, USA.
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Sámano R, Hernández-Chávez C, Chico-Barba G, Córdova-Barrios A, Morales-Del-Olmo M, Sordo-Figuero H, Hernández M, Merino-Palacios C, Cervantes-Zamora L, Martínez-Rojano H. Breakfast Nutritional Quality and Cognitive Interference in University Students from Mexico City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152671. [PMID: 31357381 PMCID: PMC6695580 DOI: 10.3390/ijerph16152671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/16/2019] [Accepted: 07/18/2019] [Indexed: 02/04/2023]
Abstract
Skipping breakfast might have an impact on cognitive functions, such as interference, which is a basic capacity of executive functions that denotes the possibility of controlling an automated response. This study aimed to analyze the association between nutritional quality of breakfast and cognitive interference in a sample of university students. A cross-sectional study was conducted, a total of 422 students between 18 and 25 years participated. Cognitive interference was assessed with the Stroop Test. Breakfast was assessed with a questionnaire assigning a score for each serving of each food group that was consumed. Logistic regression models were performed. The performance in cognitive tasks was slower in those who had a poor breakfast (32.9 ± 6 vs 29.3 ± 6 s, p < 0.050). Poor cognitive interference was greater in students with poor breakfast (53% versus 23%, p = 0.001). A slower word reading was associated with skipping vegetables (OR: 2.78, 95% CI: 0.09-2.13), and cereals (OR: 1.70, 95% CI: 1.03-2.81). Wrong color identification was associated with skipping fruits (OR: 1.55, 95% CI: 1.43-1.99) and animal protein sources (OR: 1.63, 95% CI: 1.07-2.49). Skipping fat-rich cereals was a protector factor (OR: 0.55, 95% CI: 0.36-0.85). Difficulty in the ability to inhibit interference was associated with skipping vegetables (OR: 2.72, 95% CI: 1.25-4.80) and cereals (OR: 2.65, 95% CI: 1.28-4.68). The nutritional quality of breakfast was associated with the time spent answering the Stroop test, but not with cognitive interference.
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Affiliation(s)
- Reyna Sámano
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP 11000, México
| | - Carmen Hernández-Chávez
- Departamento de Neurobiología del Desarrollo, Instituto Nacional de Perinatología, Secretaría de Salud, Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP 11000, México.
| | - Gabriela Chico-Barba
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP 11000, México
- Escuela de Enfermería, Universidad Panamericana, Augusto Rodin 498, Insurgentes Mixcoac, Alcaldía Benito Juárez CP 03920, México
| | - Armando Córdova-Barrios
- Coordinación de Psicología, Instituto Nacional de Perinatología, Secretaría de Salud, Montes Urales 800, Miguel Hidalgo, Lomas Virreyes, Ciudad de México CP 11000, México
| | - Mayela Morales-Del-Olmo
- Universidad del Valle de México-Chapultepec, Avenida Observatorio 400, 16 de Septiembre, Ciudad de México CP 11810, México
| | - Hortensia Sordo-Figuero
- Universidad del Valle de México-Chapultepec, Avenida Observatorio 400, 16 de Septiembre, Ciudad de México CP 11810, México
| | - Miguel Hernández
- Universidad del Valle de México-Chapultepec, Avenida Observatorio 400, 16 de Septiembre, Ciudad de México CP 11810, México
| | - Carmen Merino-Palacios
- Universidad del Valle de México-Chapultepec, Avenida Observatorio 400, 16 de Septiembre, Ciudad de México CP 11810, México
| | - Lucero Cervantes-Zamora
- Universidad del Valle de México-Chapultepec, Avenida Observatorio 400, 16 de Septiembre, Ciudad de México CP 11810, México
| | - Hugo Martínez-Rojano
- Departamento de Posgrado e Investigación, Escuela Superior de Medicina del Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Colonia Casco de Santo Tomas, Alcaldía Miguel Hidalgo, Ciudad de México CP 11340, México
- Coordinación de Medicina Laboral, Instituto de Diagnóstico y Referencia Epidemiológicos, Secretaría de Salud, Francisco de P, Miranda 177, col. Unidad Lomas de Plateros Alcaldía Álvaro Obregón C.P, Ciudad de México 01480, México
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Maternal predictors of infant beverage consumption: results from the Nurture cohort study. Public Health Nutr 2019; 22:2591-2597. [PMID: 31106724 DOI: 10.1017/s1368980019000934] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The goal of the present study was to estimate prevalence and maternal risk factors for infant beverage consumption. DESIGN Observational birth cohort. SETTING Central North Carolina, USA. PARTICIPANTS Mothers 20-36 weeks pregnant were surveyed every 3 months through their infant's first year (n 666) on their sociodemographics and infant's consumption frequency of 100 % fruit and vegetable juices and sugar-sweetened-beverages (SSB). Repeated-measure models, using a compound symmetry covariance structure, were used to assess the association of sociodemographic and maternal predictors with introducing juice and SSB separately and explored interaction terms with time to determine how the effects of the predictors change over time. RESULTS On average, mothers were 28 years old, 72 % were non-Hispanic Black and 59 % were low-income. We found time by race, income, education, maternal age and breast-feeding duration interactions for both juice and SSB consumption. At approximately 6-7 months of age through 12 months of age, being Black, having a lower income (≤$US 20 000 v. >$US 20 000 per year) and education (less than high-school degree v. high-school degree or higher), being younger (<26 years v. ≥26 years) and breast-feeding for fewer than 26 weeks were each associated with introduction of both juice and SSB consumption. CONCLUSIONS Future efforts are needed to raise awareness on the importance of national recommendations of limiting juice and SSB for infants, together with decreasing disparities in unhealthy beverage intake early in life.
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Home environment predictors of vegetable and fruit intakes among Australian children aged 18 months. Appetite 2019; 139:95-104. [PMID: 30991083 DOI: 10.1016/j.appet.2019.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 11/21/2022]
Abstract
Suboptimal vegetable and fruit consumption by young children is common. Identifying predictors of vegetable and fruit intakes is important for informing strategies to promote sufficient intakes of these foods from early life. The aim of the present study was to examine predictors of toddlers' vegetable and fruit intakes at age 18 months. This study involved secondary analysis of data from 361 child-mother dyads participating in the Melbourne Infant Feeding, Activity and Nutrition Trial in 2008-2010 at child ages four, nine and 18 months. Children's vegetable and fruit intakes were assessed at age 18 months using multiple 24-h dietary recalls. Data on potential predictor measures were collected via parent-completed questionnaires when children were four or nine months of age. Bivariate and multivariable linear regression models were used to test associations between children's average daily vegetable or fruit intake and potential predictors controlling for treatment arm and clustering by parent group. Multivariable models also controlled for covariates and potential confounders. Home availability of vegetables at age nine months was found to predict children's vegetable intake at age 18 months and remained significant (β = 20.19, 95% CI:7.23, 33.15, p = 0.003) in the multivariable model. Children's average daily fruit intake at age 18 months was predicted by maternal education at child age four months and the availability of fruits in their home at child age nine months. Maternal education remained significant (β = 30.83, 95% CI:12.17, 49.48, p = 0.002) in the multivariable model. Strategies to promote adequate vegetable and fruit intakes among young children should address known barriers to the availability of vegetables and fruits in the home from early in life. Additionally, messages encouraging fruit consumption may need to be tailored to mothers with lower levels of education.
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Au LE, Paolicelli C, Gurzo K, Ritchie LD, Weinfield NS, Plank KR, Whaley SE. Contribution of WIC-Eligible Foods to the Overall Diet of 13- and 24-Month-Old Toddlers in the WIC Infant and Toddler Feeding Practices Study-2. J Acad Nutr Diet 2019; 119:435-448. [DOI: 10.1016/j.jand.2018.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 10/24/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022]
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Mendez MA, Miles DR, Poti JM, Sotres-Alvarez D, Popkin BM. Persistent disparities over time in the distribution of sugar-sweetened beverage intake among children in the United States. Am J Clin Nutr 2019; 109:79-89. [PMID: 30535176 PMCID: PMC6698637 DOI: 10.1093/ajcn/nqy123] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/09/2018] [Accepted: 05/15/2018] [Indexed: 12/13/2022] Open
Abstract
Background Recent research suggests that sugar-sweetened beverage (SSB) consumption has been declining among US children aged 2-18 y. However, most studies focused on changes in mean intake, ignore high SSB consumers and do not examine intake among vulnerable groups and, including adolescents, low-income households, and several racial/ethnic minorities. Objective The aim was to estimate usual SSB intake from NHANES surveys from 2003-2004 to 2013-2014 to examine shifts at both the median and 90th percentile among US children, evaluating the extent to which intake disparities in total SSBs and subtypes have persisted. Design Children 2-18 y from NHANES 2003, 2005, 2007, 2009, 2011 and 2013. SSBs were all non-diet beverages sweetened with sugars including revising all beverages to as consumed status and excluding soy and dairy based beverages. The NCI usual intake method was used to estimate usual intake from two 24-hour recalls. A 2-part correlated model accounted for nonconsumers. Quantile regression was then used to examine differences in SSB usual intakes at the 50th and 90th percentiles by race-ethnicity, and examine interactions indicating whether racial-ethnic disparities in intake were modified by income. Results Despite considerable declines, children's SSB intake remains high, particularly among heavy consumers. Among adolescents, median SSB intake in 2013-2014 was on the order of 150-200 kcal/d, and heavy intake at the 90th percentile was on the order of 250-300 kcal/d. There were important disparities in intake that persisted over time. Although high household income was associated with lower SSB intake in non-Hispanic white (NHW) children, intakes of non-Hispanic black (NHB) and Mexican-American (MA) children from these households were similar to or higher than those from poor households. There were also large racial/ethnic differences in the types of SSBs consumed. The consumption of regular sodas by NHB children was somewhat lower than among MA and NHW children, whereas fruit drink intake was markedly higher. Conclusions Overall, these findings suggest that, despite recent declines, strategies are needed to further reduce SSB consumption, and particularly heavy intake, especially among NHB children where fruit drinks also are key source of SSBs.
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Affiliation(s)
- Michelle A Mendez
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Donna R Miles
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jennifer M Poti
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Barry M Popkin
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Au LE, Gurzo K, Paolicelli C, Whaley SE, Weinfield NS, Ritchie LD. Diet Quality of US Infants and Toddlers 7-24 Months Old in the WIC Infant and Toddler Feeding Practices Study-2. J Nutr 2018; 148:1786-1793. [PMID: 30383276 DOI: 10.1093/jn/nxy192] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/19/2018] [Indexed: 12/24/2022] Open
Abstract
Background Despite the important implications of childhood dietary intakes on lifelong eating habits and health, data are lacking on the diet quality of low-income infants and toddlers. Objective The objective of this study was to characterize diet quality in low-income US infants and toddlers. Methods A national observational study was conducted of 7- to 12-mo-old (n = 1261), 13-mo-old (n = 2515), and 24-mo-old (n = 2179) children enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prenatally/at birth from 2013 to 2016. The study used a 24-h dietary recall and survey questions. For 7- to 12-mo-olds, an adapted Complementary Feeding Utility Index (CFUI) was used, and for 13- and 24-mo-olds, the Healthy Eating Index-2015 (HEI-2015) was used. Descriptive statistics were calculated for CFUI and HEI-2015 scores. Results For 7- to 12-mo-olds, the CFUI score (mean ± SE) was 0.56 ± 0.003 (range: 0.34-0.90, maximum possible 1.0). Most children met CFUI standards for exposure to iron-rich cereal (86.7%), and low exposure to energy-dense nutrient-poor foods (72.2%) and teas/broths (67.5%). Conversely, at 7-12 mo of age, exposure was low for vegetables (7.0%), fruits (14.4%), any sugary drinks (14.0%), and 12-mo breastfeeding duration (23.8%). At 13 and 24 mo of age, the HEI-2015 total score (maximum possible 100), on average, was 64.0. At both 13 and 24 mo of age, participants achieved, on average, maximal HEI-2015 component scores for total and whole fruits and dairy; however, scores for total vegetables, greens and beans, whole grains, seafood and plant proteins, fatty acids, and saturated fats were relatively low. Scores for refined grains, sodium, and added sugar were lower at 24 than at 13 mo of age, representing higher consumption, on average, over time. Conclusions Although findings demonstrate that young children are doing well on some dietary components, there is room for improvement, especially as children age. Findings may be used to inform the Pregnancy and Birth to 24-mo (P/B-24) Project. This trial was registered at clinicaltrials.gov as NCT02031978.
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Affiliation(s)
- Lauren E Au
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, CA
| | - Klara Gurzo
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, CA
| | - Courtney Paolicelli
- Office of Policy Support, Food and Nutrition Service, US Department of Agriculture, Alexandria, VA
| | | | | | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Berkeley, CA
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Woo Baidal JA, Morel K, Nichols K, Elbel E, Charles N, Goldsmith J, Chen L, Taveras E. Sugar-Sweetened Beverage Attitudes and Consumption During the First 1000 Days of Life. Am J Public Health 2018; 108:1659-1665. [PMID: 30359102 DOI: 10.2105/ajph.2018.304691] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To examine the relationship of parental sugar-sweetened beverage (SSB) attitudes with SSB consumption during the first 1000 days of life-gestation to age 2 years. METHODS We studied 394 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-enrolled families during the first 1000 days of life in northern Manhattan, New York, in 2017. In regression models, we assessed cross-sectional relationships of parental SSB attitude scores with habitual daily parent SSB calories and infant SSB consumption, adjusting for demographic and socioeconomic characteristics. RESULTS Each point higher parental SSB attitude score was associated with lower parental SSB consumption (-14.5 median kcals; 95% confidence interval [CI] = -22.6, -6.4). For infants, higher parental SSB attitude score was linked with lower odds of infant SSB consumption (adjusted odds ratio [AOR] = 0.84; 95% CI = 0.71, 0.99), and adjustment for socioeconomic factors slightly attenuated results (AOR = 0.85; 95% CI = 0.71, 1.02). CONCLUSIONS During the first 1000 days of life, greater negativity in parental attitudes toward SSB consumption was associated with fewer parental calories consumed from SSBs and lower likelihood of infant SSB consumption. Public Health Implications. Parental attitudes toward SSBs should be targeted in future childhood obesity interventions during pregnancy and infancy.
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Affiliation(s)
- Jennifer A Woo Baidal
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Kayla Morel
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Kelsey Nichols
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Erin Elbel
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Nalini Charles
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Jeff Goldsmith
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Ling Chen
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Elsie Taveras
- Jennifer A. Woo Baidal, Kayla Morel, Kelsey Nichols, and Erin Elbel are with the Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New, York, NY. Nalini Charles is with the New York Presbyterian Hospital Special Supplemental Nutrition, Program for Women, Infants, and Children, New York, NY. Jeff Goldsmith is with the Mailman School of Public Health, Columbia University Medical Center, New York, NY. Ling Chen is with the Department of Ob-Gyn, Columbia University Medical Center. Elsie M. Taveras is with the Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
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Goetz AR, Mara CA, Stark LJ. Greater Breastfeeding in Early Infancy Is Associated with Slower Weight Gain among High Birth Weight Infants. J Pediatr 2018; 201:27-33.e4. [PMID: 30007772 PMCID: PMC9578150 DOI: 10.1016/j.jpeds.2018.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine whether feeding patterns from birth to age 6 months modify the association between birth weight and weight at 7-12 months of age. STUDY DESIGN Longitudinal mixed models were used to examine feeding trajectories across categories of birth weight and weight at 7-12 months of age in 1799 mother-infant dyads enrolled in the Infant Feeding Practices Study II. The percentage of breast milk received and the average daily formula consumption were calculated from birth to 6 months of age. Birth weights were classified as high (≥4000 g) and normal (≥2500 g and <4000 g). Weights at 7-12 months of age were categorized as high (z score >1) or normal (z score ≤1). A secondary analysis was performed using categories defined by birth weight adjusted for gestational age percentiles (>90% and 10th-90th percentile). RESULTS High birth weight (HBW) infants with high weights at 7-12 months of age demonstrated a rapid decline in the percentage of breast milk feedings compared with HBW infants with normal weights at 7-12 months of age. Normal birth weight infants with high weights at 7-12 months of age received a lower percentage of breast milk and had greater absolute intakes of formula than those with normal weights at 7-12 months of age; these associations did not vary over time. Results were similar when infants were categorized by birth weight percentiles. CONCLUSIONS A lower proportion of breast milk feedings was associated with excess weight at 7-12 months of age in HBW infants. These findings suggest an initial target for obesity prevention programs focusing on the first 6 months after birth.
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Dwyer JT. The Feeding Infants and Toddlers Study (FITS) 2016: Moving Forward. J Nutr 2018; 148:1575S-1580S. [PMID: 30247582 PMCID: PMC6126635 DOI: 10.1093/jn/nxy159] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 07/02/2018] [Indexed: 12/31/2022] Open
Affiliation(s)
- Johanna T Dwyer
- Tufts University School of Medicine and Frances Stern Nutrition Center, Tufts Medical Center, Boston, MA,Address correspondence to JTD (e-mail: )
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47
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Roess AA, Jacquier EF, Catellier DJ, Carvalho R, Lutes AC, Anater AS, Dietz WH. Food Consumption Patterns of Infants and Toddlers: Findings from the Feeding Infants and Toddlers Study (FITS) 2016. J Nutr 2018; 148:1525S-1535S. [PMID: 30247583 PMCID: PMC6126630 DOI: 10.1093/jn/nxy171] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/13/2018] [Accepted: 07/02/2018] [Indexed: 01/26/2023] Open
Abstract
Background The prevalence of obesity and type 2 diabetes continues to increase. These conditions disproportionately affect minorities and are associated with poor nutrition early in life. Current food-consumption patterns can inform pending dietary guidelines for infants and toddlers. Objective The aim of this study was to describe infant feeding, complementary feeding, and food and beverage consumption patterns of 0- to 23.9-mo-olds in the general population. Methods The Feeding Infants and Toddlers Study 2016 is a cross-sectional survey of caregivers of children aged <4 y. Dietary data were collected from a national random sample by using a 24-h dietary recall (n = 3235). The percentage of children consuming foods from >400 food groups was calculated. Differences in the percentage consuming between Hispanic, non-Hispanic white, and non-Hispanic black children aged 0-23.9 mo were evaluated with the use of ORs and 95% CIs. Results Eighty-three percent of 0- to 23.9-mo-olds (n = 2635) were ever breastfed, 34% of 0- to 3.9-mo-olds (n = 305) and 15% of 4- to 5.9-mo-olds (n = 295) were exclusively breastfed, and 24% of 12- to 14.9-mo-olds (n = 412) consumed breast milk on the day of the recall. Complementary foods were more likely to be introduced before 4 mo in formula-fed infants (27%) than in infants who did not consume formula (5%). Half of 4- to 5.9-mo-olds consumed iron-fortified infant cereal, but few consumed iron-rich meats. Among toddlers (12-23.9 mo; n = 1133), >20% consumed no servings of fruit or vegetables on the day of the recall, approximately half consumed 100% fruit juice, and one-quarter to one-third consumed a sugar-sweetened beverage (SSB). Conclusions Breastfeeding initiation and duration have improved, but exclusivity remains low. Low consumption of iron-rich foods, fruit, and vegetables and lack of variety in vegetable consumption are problems. Efforts to reduce the consumption of SSBs and 100% fruit juice are warranted in early childhood.
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Affiliation(s)
- Amira A Roess
- The George Washington University, Milken Institute School of Public Health, Washington, DC
| | | | | | | | | | | | - William H Dietz
- The George Washington University, Milken Institute School of Public Health, Washington, DC
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Kay MC, Welker EB, Jacquier EF, Story MT. Beverage Consumption Patterns among Infants and Young Children (0⁻47.9 Months): Data from the Feeding Infants and Toddlers Study, 2016. Nutrients 2018; 10:E825. [PMID: 29949886 PMCID: PMC6073729 DOI: 10.3390/nu10070825] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 01/08/2023] Open
Abstract
(1) Background: Data about early life beverage intake patterns is sparse. We describe beverage patterns among infants and young children from the Feeding Infants and Toddlers Study (FITS) 2016. (2) Methods: FITS 2016 is a cross-sectional survey of U.S. parents/caregivers of children 0⁻47.9 months (n = 3235). Food and beverage intakes were collected by 24-h dietary recalls to describe beverage consumption patterns including: a) prevalence of consumption, per capita and per consumer intake, b) contribution to intake of calories and key nutrients, and c) prevalence according to eating occasions. (3) Results: Breast milk and infant formula were commonly consumed among <12-month-olds. Among 12⁻23.9-month-olds, the most commonly consumed beverage was whole milk (67% consuming), followed by 100% juice (50% consuming). Plain drinking water was consumed by 70% of 12⁻23.9-month-olds and 78% of 24⁻47.9-month-olds. Among 12⁻47.9-month-olds, milks provided more energy and key nutrients than all other beverages. Across eating occasions, sugar-sweetened beverage (SSB) consumption, especially in the form of fruit-flavored drinks, was higher among 24⁻47.9 compared to 12⁻23.9-month-olds. Only 23⁻32% of ≥12-month-olds consumed milk or water at lunch or dinner. (4) Conclusions: Opportunities exist to improve beverage patterns. Future interventions may benefit from focusing on timely introduction of age-appropriate beverages and reducing consumption of SSBs.
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Affiliation(s)
- Melissa C Kay
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27708, USA.
| | - Emily B Welker
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27708, USA.
| | - Emma F Jacquier
- Nestlé Research Center, Vers-Chez-les-Blanc, Route du Jorat 57, Case Postale 44, 1000 Lausanne-26, Switzerland.
| | - Mary T Story
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC 27708, USA.
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Simione M, Loret C, Le Révérend B, Richburg B, Del Valle M, Adler M, Moser M, Green JR. Differing structural properties of foods affect the development of mandibular control and muscle coordination in infants and young children. Physiol Behav 2018; 186:62-72. [PMID: 29343459 DOI: 10.1016/j.physbeh.2018.01.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
Abstract
The development of chewing is an essential motor skill that is continually refined throughout early childhood. From a motor control perspective, the advancement of textures is dependent upon the fit between a child's oral anatomic and motor system and food properties. The purpose of this exploratory study is to identify age-related changes in chewing motor coordination and control and to determine if these changes are associated with the differing structural properties of solid foods, as well as to explore the role of explanatory variables such as the emergence of teeth and bite force. The masticatory muscle coordination (i.e., coupling of synergistic and antagonistic muscle pairs) and control (i.e., speed, displacement, chewing rate, duration, and number of chews) of fifty children were assessed cross-sectionally at five ages: 9-, 12-, 18-, 24-, and 36-months using electromyography (EMG) and 3D optical motion capture while children ate three foods that had differing structural properties. The results of this study found that children made gains in their chewing motor control (decreased duration of chewing sequences and lateral jaw displacement) and coordination (improved jaw muscle coupling) throughout this period. The structural differences in foods also affected chewing performance at all ages. These preliminary findings suggest that some solid textures are better adapted for immature mandibular control than others and that the development of chewing is a protracted process that may be impacted by the emergence of teeth and changes to bite force.
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Affiliation(s)
- Meg Simione
- Department of Pediatrics, MassGeneral Hospital for Children, United States
| | | | | | - Brian Richburg
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, United States
| | | | | | | | - Jordan R Green
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, United States.
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50
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Ha DH, Do LG, Spencer AJ, Thomson WM, Golley RK, Rugg-Gunn AJ, Levy SM, Scott JA. Factors Influencing Early Feeding of Foods and Drinks Containing Free Sugars-A Birth Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101270. [PMID: 29065527 PMCID: PMC5664771 DOI: 10.3390/ijerph14101270] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/15/2017] [Accepted: 10/18/2017] [Indexed: 12/22/2022]
Abstract
Early feeding of free sugars to young children can increase the preference for sweetness and the risk of consuming a cariogenic diet high in free sugars later in life. This study aimed to investigate early life factors influencing early introduction of foods/drinks containing free sugars. Data from an ongoing population-based birth cohort study in Australia were used. Mothers of newborn children completed questionnaires at birth and subsequently at ages 3, 6, 12, and 24 months. The outcome was reported feeding (Yes/No) at age 6–9 months of common foods/drinks sources of free sugars (hereafter referred as foods/drinks with free sugars). Household income quartiles, mother’s sugar-sweetened beverage (SSB) consumption, and other maternal factors were exposure variables. Analysis was conducted progressively from bivariate to multivariable log-binomial regression with robust standard error estimation to calculate prevalence ratios (PR) of being fed foods/drinks with free sugars at an early age (by 6–9 months). Models for both complete cases and with multiple imputations (MI) for missing data were generated. Of 1479 mother/child dyads, 21% of children had been fed foods/drinks with free sugars. There was a strong income gradient and a significant positive association with maternal SSB consumption. In the complete-case model, income Q1 and Q2 had PRs of 1.9 (1.2–3.1) and 1.8 (1.2–2.6) against Q4, respectively. The PR for mothers ingesting SSB everyday was 1.6 (1.2–2.3). The PR for children who had been breastfed to at least three months was 0.6 (0.5–0.8). Similar findings were observed in the MI model. Household income at birth and maternal behaviours were significant determinants of early feeding of foods/drinks with free sugars.
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Affiliation(s)
- Diep H Ha
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide 5005, Australia.
| | - Loc G Do
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide 5005, Australia.
| | - Andrew John Spencer
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide 5005, Australia.
| | | | - Rebecca K Golley
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide 5005, Australia.
| | - Andrew J Rugg-Gunn
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.
| | - Steven M Levy
- College of Dentistry, University of Iowa, Iowa, IA 52242, USA.
| | - Jane A Scott
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
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