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Duffy EW, Ng SW, Bercholz M, Davis CR, De Marco M, Hall MG, Maselko J, Smith Taillie L. Special Supplemental Nutrition Program for Women, Infants, and Children Participant Grocery Store Purchases during the COVID-19 Pandemic in North Carolina. Curr Dev Nutr 2024; 8:102098. [PMID: 38440362 PMCID: PMC10909627 DOI: 10.1016/j.cdnut.2024.102098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 03/06/2024] Open
Abstract
Background Families participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) experienced barriers to accessing healthy food during the COVID-19 pandemic, but we do not yet understand how WIC participant food purchases shifted during the pandemic. Objectives We aimed to describe the association between the initial shock of the pandemic in March 2020 and WIC shoppers' food purchases and changes in purchases before and during the pandemic at a top grocery chain and examine differences in these relationships by duration of WIC use. Methods We used longitudinal food transaction data from WIC shoppers (n = 2,989,116 shopper-month observations from 175,081 unique WIC shoppers) from 496 stores in a top grocery store chain in North Carolina between October 2019 and May 2021. We used an interrupted time series design to describe the following: 1) the relationship between the initial shock of the pandemic and WIC shopper food purchases and 2) differences in purchases before and during the pandemic. To assess differences in purchases between shoppers consistently using WIC electronic benefit transfer (EBT) cards and shoppers starting or stopping WIC EBT use during the pandemic, we used models stratified by WIC group. Primary outcomes were share (%) of total calories purchased from fruits, vegetables, nuts, and legumes (FV), processed foods, and sugar-sweetened beverages (SSBs). Results We observed small decreases in the share of total calories from FV (-0.4%) and small increases in the share of calories from processed food (1.1%) and SSBs (0.5%) purchased at this retailer when comparing the pre and post March 2020 periods. Compared with shoppers that started or stopped using WIC benefits during the pandemic, shoppers that used WIC benefits consistently had slightly higher FV and lower processed food and SSB purchases at this retailer. Conclusions Future studies should examine whether additional supports for nutrient-dense food choices may be needed for families with low incomes in public health emergencies.
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Affiliation(s)
- Emily W Duffy
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Shu Wen Ng
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Population Center, Chapel Hill, NC, United States
| | | | - Cassandra R Davis
- Carolina Population Center, Chapel Hill, NC, United States
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Molly De Marco
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Marissa G Hall
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Population Center, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC, United States
| | - Joanna Maselko
- Carolina Population Center, Chapel Hill, NC, United States
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lindsey Smith Taillie
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Population Center, Chapel Hill, NC, United States
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Au LE, Arnold CD, Ritchie LD, Lin SK, Frongillo EA. Differences in Infant Diet Quality Index by Race and Ethnicity Predict Differences in Later Diet Quality. J Nutr 2023; 153:3498-3505. [PMID: 37858725 PMCID: PMC10843900 DOI: 10.1016/j.tjnut.2023.10.010] [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: 07/03/2023] [Revised: 08/15/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in infant-feeding practices may negatively influence diet quality and health. OBJECTIVES This study investigated the racial, ethnic, and language (English or Spanish) differences in infant diet quality, later diet quality, and weight status at 2-5 y, and whether these differences were explained through infant diet quality among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS Using the WIC Infant and Toddler Feeding Practices Study-2 (unweighted n = 2663; weighted n = 362,712), relationships between the Infant Dietary Quality Index (IDQI; range 0-1) and Healthy Eating Index-2020 (HEI-2020; range 0-100) and BMI z-score (BMIz) at 2-5 y were analyzed by race, ethnicity, and language preference [Hispanic Spanish-speaking, Hispanic English-speaking, non-Hispanic (NH) White, and NH Black participants]. Statistical interaction between IDQI and each group was evaluated in multivariable models. The mediation of each group through the IDQI was assessed using causal mediation methods. RESULTS Differences in IDQI [mean (standard deviation)] were observed between Hispanic Spanish-speaking participants [0.41 (0.10)], Hispanic English-speaking participants [0.37 (0.10)], NH White participants [0.36 (0.10)], and NH Black participants [0.35 (0.09)], P < 0.001. Differences in HEI-2020 occurred at 2-5 y, with the Hispanic Spanish-speaking participants having consistently higher HEI-2020 scores. Differences in BMIz were observed at 5 y, with higher scores among Hispanic Spanish-speaking participants. Interaction between race, ethnicity, and IDQI was observed for all outcomes except for BMIz at 3 y. Through mediation, IDQI explained 13%-20% of the difference in HEI-2020 scores between Hispanic Spanish-speaking and NH White participants at 2-5 y. IDQI explained 22%-25% of the difference in HEI-2020 scores between the Hispanic Spanish-speaking and NH Black participants at 4 y and 5 y. CONCLUSIONS Higher infant diet quality scores observed in Hispanic Spanish-speaking participants explain some of the racial and ethnic differences observed in later diet quality, suggesting that improving infant diet quality may help reduce diet disparities during early childhood.
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Affiliation(s)
- Lauren E Au
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States.
| | - Charles D Arnold
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA, United States
| | - Sarina K Lin
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States
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Hennessy Á, McCarthy EK, Ní Chaoimh C, Murray DM, Kiely ME. Poor Quality Diets Characterized by Low-Nutrient Density Foods Observed in One-Quarter of 2-Year-Olds in a High Resource Setting. J Nutr 2023; 153:2678-2688. [PMID: 37356499 DOI: 10.1016/j.tjnut.2023.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/17/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Young children have high nutritional requirements relative to their body size, making healthy diets critical for normal growth and development. OBJECTIVE We aimed to integrate analysis of dietary patterns among 2-y-old children with indicators of dietary quality, micronutrient status, and body weight status. METHODS Data from the 2-y follow-up of the Cork BASELINE Birth Cohort included dietary assessment using a 2-d weighed food diary, vitamin D and iron status biomarkers, and anthropometry (n = 468). K-means cluster analysis identified predominant dietary patterns based on energy contributions and associations with nutrient intakes and status and body weight were investigated. RESULTS Four dietary patterns emerged: "Cows' milk" (unmodified cows' milk: 32% of total energy (TE)); "Traditional" (wholemeal breads, butter, fresh meat, fruit); "Low Nutrient Density (LND) foods" (confectionary, processed meat, convenience foods) and "Formula" (young child formula: 23%TE). The LND pattern was associated with excessive free sugar intake (14%TE) and salt intake (153% of daily limit). No differences in patterns of overweight were observed between the 4 groups; however, the LND group had 3-fold higher odds of being underweight [aOR (95% CI): 3.2 (1.2, 8.5)]. Children consuming >400ml/d of cows' milk or formula exhibited lower dietary variety, fewer family-type meals, and continued use of feeding bottles (75% and 81%, respectively, vs. 35-37% in the other groups). CONCLUSIONS Unhealthy eating habits are common among young children. Dietary guidance to support families to provide healthy diets needs to maintain currency with eating habits and focus on food choices for meals, snacks, and beverages.
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Affiliation(s)
- Áine Hennessy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | - Elaine K McCarthy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | - Carol Ní Chaoimh
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland
| | - Deirdre M Murray
- The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland; Department of Paediatrics and Child Health, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland; The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork, Ireland.
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Zimmer M, Obbagy J, Scanlon KS, Gibbs K, Lerman JL, Hamner HC, Pannucci T, Sharfman A, Reedy J, Herrick KA. Count Every Bite to Make "Every Bite Count": Measurement Gaps and Future Directions for Assessing Diet From Birth to 24 Months. J Acad Nutr Diet 2023; 123:1269-1279.e1. [PMID: 37196980 PMCID: PMC10809843 DOI: 10.1016/j.jand.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 04/01/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Affiliation(s)
- Meghan Zimmer
- Harvard University, Cambridge, Massachusetts; U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD
| | - Julie Obbagy
- Food and Nutrition Service, USDA, Alexandria, Virginia
| | - Kelley S Scanlon
- Supplemental Nutrition and Safety Research and Analysis Division, Office of Policy Support, USDA Food and Nutrition Service, Alexandria, Virginia
| | - Kimberlea Gibbs
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Jennifer L Lerman
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD
| | | | | | | | - Jill Reedy
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD
| | - Kirsten A Herrick
- U.S. Department of Health and Human Services, National Cancer Institute, Bethesda, MD.
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Au LE, Arnold CD, Ritchie LD, Frongillo EA. The Infant Diet Quality Index Predicts Dietary and Adiposity Outcomes in US Children 2 to 4 years old. J Nutr 2023; 153:741-748. [PMID: 36806452 PMCID: PMC10196607 DOI: 10.1016/j.tjnut.2023.01.037] [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: 11/16/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Healthy nutrition during the first year of life is critical for optimal growth and development. Limited techniques are available to assess diet quality in infancy, and few have been shown to be predictive of dietary and adiposity outcomes in low-income children. OBJECTIVE The objectives of this study were to construct an Infant Diet Quality Index (IDQI) to assess the diet quality from birth to 12 mo and to determine whether the IDQI exhibits predictive validity by estimating the longitudinal associations of IDQI scores with diet quality and weight status at 2 to 4 y. DESIGN Data were analyzed from the longitudinal Women, Infants, and Children Infant and Toddler Feeding Practices Study-2 (unweighted, n = 2858; weighted. N = 392,439) using one 24-h dietary recall and survey responses during infancy. The newly constructed IDQI consists of 16 equally-weighted components: 1) breastfeeding duration; 2) exclusive breastfeeding; age of first introduction of: 3) solids, 4) iron-rich cereals, 5) cow milk, 6) sugar-sweetened beverages, 7) salty/sweet snacks, 8) other drinks/liquids, and 9) textured foods; frequency of consuming 10) fruit or 11) vegetables; frequency of consuming different 12) fruit or 13) vegetables; 14) nonrecommended bottle-feeding practices; 15) use of commercial baby foods; and 16) number of meals and snacks. Regression analysis was used to estimate associations between the total IDQI score (range, 0-1) and Healthy Eating Index-2015 (HEI-2015) scores and body mass index z-scores (BMIz) at 2 to 4 y of age, adjusted for covariates (e.g., child age, sex and race/ethnicity; maternal education level, etc.) RESULTS: The total IDQI score was positively associated with HEI-2015 at the age of 2 y (β = 16.7; 95% CI: 12.6, 20.9; P < 0.001), 3 y (β = 14.5; 95% CI: 8.1, 21.0; P < 0.001), and 4 y (β = 15.4; 95% CI: 8.4, 22.4; P < 0.001); and negatively associated with BMIz at the age of 2 y (β = -1.24; 95% CI: -2.01, -0.47; P = 0.002) and 4 y (β = -0.92; 95% CI: -1.53, -0.30; P = 0.003). CONCLUSIONS The IDQI has predictive validity for diet quality and weight status in low-income US children.
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Affiliation(s)
- Lauren E Au
- Meyer Hall, Department of Nutrition, University of California, One Shields Avenue, Davis, CA, United States.
| | - Charles D Arnold
- Meyer Hall, Department of Nutrition, University of California, One Shields Avenue, Davis, CA, United States
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, 1111 Franklin Street, Oakland, CA, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1, 915 Greene Street, Room 529, Columbia, SC, United States
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Kay MC, Duffy EW, Sun B, Borger C. Comparing Diet Quality Indices for Low-Income 24-Month-Old Toddlers: Exploring Changes Driven by 2020-2025 Dietary Guidelines for Americans. J Nutr 2023; 153:215-224. [PMID: 36913456 PMCID: PMC10196569 DOI: 10.1016/j.tjnut.2022.11.016] [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: 09/20/2022] [Revised: 11/16/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Accurate assessment of toddler diet quality is essential for understanding current intakes and evaluating the effect of interventions and programs to promote healthy eating and prevent chronic disease. OBJECTIVES The goal of this article was to assess the diet quality among toddlers using two different indices appropriate for 24-mo-old toddlers and compare differences in scoring between the measures by race and Hispanic origin. METHODS We used cross-sectional data from 24-mo-old toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a national study that includes 24-hour dietary recall information from children enrolled in WIC at birth. The main outcome measure was diet quality using both the toddler diet quality index (TDQI) and the healthy eating index (HEI)-2015. We derived mean scores for overall diet quality and for each component. We examined associations between the distribution of diet quality scores across terciles and by race and Hispanic origin using Rao-Scott chi-square tests of association. RESULTS Nearly half of the mothers and caregivers self-identified as Hispanic (49%). Diet quality scores were higher when using the HEI-2015 compared with the TDQI (56.4 vs. 49.9, respectively). The difference in component scores was largest for refined grains, followed by sodium, added sugars, and dairy. Toddlers from Hispanic mothers and caregivers had significantly higher component scores for greens and beans and dairy but had lower scores for whole grains (P < 0.05) than those for the other racial and ethnic subgroups assessed. CONCLUSIONS We found noteworthy differences in toddler diet quality depending on whether the HEI-2015 or TDQI is used, and children of different racial and ethnic subgroups may be differentially classified as having high or low diet quality depending on which index is used. This may have important implications for understanding which populations are at risk of future diet-related diseases.
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Affiliation(s)
- Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC, USA.
| | - Emily W Duffy
- Department of Nutrition, Gillings School of Global Public Health and Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
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Hammersley ML, Buchanan L, Xu H, Wen LM. Early Childhood Dietary Intake and Subsequent Socioemotional and Cognitive School Readiness Among Australian Children. HEALTH EDUCATION & BEHAVIOR 2022; 49:10901981221096100. [PMID: 35668635 DOI: 10.1177/10901981221096100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dietary intake can affect the physical, cognitive, and socioemotional development of young children. Few studies have explored the relationships between dietary intake and the cognitive and socioemotional dimensions of school readiness. This study aimed to investigate the longitudinal associations between children's dietary intake in early childhood, and cognitive and socioemotional school readiness indicators at age 4-5 years using data from the Longitudinal Study of Australian Children. A total of 4,253 children were included in the analysis. Multiple linear regression models were built to investigate whether dietary intake (measured by questionnaire at parent interview) at age 2-3 years predicted school readiness indicators of socioemotional and behavioral functioning (measured by parent-reported Strengths and Difficulties Questionnaire [SDQ total score and pro-social scale]), verbal (assessed by Peabody Picture Vocabulary Test-Third Edition [PPVT-III]) and nonverbal (assessed by "Who Am I" test [WAI] cognitive skills) at age 4-5 years. Furthermore, using cross-sectional data at age 4-5 years, four multiple linear regression models were built to investigate if dietary intake was correlated with the aforementioned school readiness indicators. All models were adjusted for potential confounders. It was found that every one-point increase in child dietary intake score at age 2-3 years led to a decrease in SDQ total score by 0.19 (95% confidence interval [CI] = [0.10, 0.28], and an increase in SDQ pro-social scale, WAI score and PPVT score by 0.07 (95% CI = [0.03, 0.10]), 0.27 (95% CI = [0.13, 0.41]), and 0.20 (95% CI = [0.09, 0.30]), respectively, at age 4-5 years. Children's dietary intake was also a correlate of their school readiness at age 4-5 years. These results add to the limited evidence base suggesting that children's early dietary intake may play an important role in later socioemotional and behavioral development, and the development of cognitive skills, which are critical school readiness indicators.
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Affiliation(s)
- Megan L Hammersley
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Limin Buchanan
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, Australia
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Camperdown, NSW, Australia
| | - Huilan Xu
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, Australia
| | - Li Ming Wen
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Forest Lodge, NSW, Australia
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Camperdown, NSW, Australia
- The National Health and Medical Research Council Centre for Research Excellence in the Early Prevention of Obesity in Childhood (EPOCH CRE), Sydney, NSW, Australia
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8
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Borger C, Paolicelli CP, Sun B. Duration of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Participation is Associated With Children's Diet Quality at Age 3 Years. Am J Prev Med 2022; 62:e343-e350. [PMID: 35277313 DOI: 10.1016/j.amepre.2021.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/16/2021] [Accepted: 12/22/2021] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Adequate childhood nutrition contributes to prevention of chronic diseases. The supplemental foods and nutrition education provided by the Special Supplemental Nutrition Program for Women, Infants, and Children, a federal program serving women, infants, and children up to age 5 years in low-income families and at nutritional risk, intend to optimize dietary intakes. This study assesses associations between duration of the Special Supplemental Nutrition Program for Women, Infants, and Children participation, early feeding practices, and children's diet quality at age 3 years. METHODS Using data collected between 2013 and 2017 from the Special Supplemental Nutrition Program for Women, Infants, and Children Infant and Toddler Feeding Practices Study-2, investigators derived 4 mutually exclusive patterns of the Special Supplemental Nutrition Program for Women, Infants, and Children participation: participation in the child's first year only, participation into the second year, participation into the third year, and intermittent participation across 3 years. In 2021, multivariable regression assessed associations between these patterns, early feeding practices, and 2015 Health Eating Index total score at age 3 years. RESULTS When compared with children who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children into their third year, children who participated in their first year only (p<0.01) had 2015 Healthy Eating Index total scores that were 3.6 points lower on a given day. Children introduced to sugar-sweetened beverages in their first year had scores that were 2.4 points lower than children not introduced to them in their first 2 years (p=0.03), whereas those breastfed longer exhibited a small increase in scores (p<0.01). CONCLUSIONS Longer participation in the Special Supplemental Nutrition Program for Women, Infants, and Children improves children's diets, potentially mitigating chronic disease risk. Clinician efforts to refer at-risk families to the Special Supplemental Nutrition Program for Women, Infants, and Children during the early childhood years are supported.
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Affiliation(s)
| | - Courtney P Paolicelli
- Office of Policy Support, Food and Nutrition Service, U.S. Department of Agriculture, Alexandria, Virginia
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Mahmood L, González-Gil EM, Schwarz P, Herrmann S, Karaglani E, Cardon G, De Vylder F, Willems R, Makrilakis K, Liatis S, Iotova V, Tsochev K, Tankova T, Rurik I, Radó S, Moreno LA, Manios Y. Frequency of family meals and food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study. Eur J Pediatr 2022; 181:2523-2534. [PMID: 35353229 PMCID: PMC9110493 DOI: 10.1007/s00431-022-04445-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 02/02/2023]
Abstract
UNLABELLED A family meal is defined as a meal consumed together by the members of a family or by having ≥ 1 parent present during a meal. The frequency of family meals has been associated with healthier food intake patterns in both children and parents. This study aimed to investigate in families at high risk for developing type 2 diabetes across Europe the association (i) between family meals' frequency and food consumption and diet quality among parents and (ii) between family meals' frequency and children's food consumption. Moreover, the study aimed to elucidate the mediating effect of parental diet quality on the association between family meals' frequency and children's food consumption. Food consumption frequency and anthropometric were collected cross-sectionally from a representative sample of 1964 families from the European Feel4Diabetes-study. Regression and mediation analyses were applied by gender of children. Positive and significant associations were found between the frequency of family meals and parental food consumption (β = 0.84; 95% CI 0.57, 1.45) and diet quality (β = 0.30; 95% CI 0.19, 0.42). For children, more frequent family meals were significantly associated with healthier food consumption (boys, β = 0.172, p < 0.05; girls, β = 0.114, p < 0.01). A partial mediation effect of the parental diet quality was shown on the association between the frequency of family meals and the consumption of some selected food items (i.e., milk products and salty snacks) among boys and girls. The strongest mediation effect of parental diet quality was found on the association between the frequency of family breakfast and the consumption of salty snacks and milk and milk products (62.5% and 37.5%, respectively) among girls. CONCLUSIONS The frequency of family meals is positively associated with improved food consumption patterns (i.e., higher intake of fruits and vegetables and reduced consumption of sweets) in both parents and children. However, the association in children is partially mediated by parents' diet quality. The promotion of consuming meals together in the family could be a potentially effective strategy for interventions aiming to establish and maintain healthy food consumption patterns among children. TRIAL REGISTRATION The Feel4Diabetes-study is registered with the clinical trials registry (NCT02393872), http://clinicaltrials.gov , March 20, 2015. WHAT IS KNOWN • Parents' eating habits and diet quality play an important role in shaping dietary patterns in children • Family meals frequency is associated with improved diet quality of children in healthy population What is New: • Frequency of family meals was significantly associated with healthier food consumption among parents and children in families at high risk of type 2 diabetes in six European countries. • Parental diet quality mediates the association between family meals frequency and the consumption of some selected food items among children.
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Affiliation(s)
- Lubna Mahmood
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Esther M. González-Gil
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain ,grid.4489.10000000121678994Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Granada, Spain ,grid.4489.10000000121678994Institute of Nutrition and Food Technology “José Mataix”, Center of Biomedical Research, University of Granada. Avda. del Conocimiento S/N, 18016 Armilla, Granada, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter Schwarz
- grid.4488.00000 0001 2111 7257Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany ,grid.4488.00000 0001 2111 7257Faculty of Medicine, Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital, TU Dresden, 01307 Dresden, Germany ,grid.452622.5German Center for Diabetes Research (DZD E.V.), 85764 Neuherberg, Germany
| | - Sandra Herrmann
- grid.4488.00000 0001 2111 7257Department for Prevention and Care of Diabetes, Medical Faculty Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Eva Karaglani
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Greet Cardon
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Flore De Vylder
- grid.5342.00000 0001 2069 7798Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ruben Willems
- grid.5342.00000 0001 2069 7798Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Konstantinos Makrilakis
- grid.5216.00000 0001 2155 0800National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Stavors Liatis
- grid.5216.00000 0001 2155 0800National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Violeta Iotova
- grid.20501.360000 0000 8767 9052Department of Social Medicine and Health Care, Organization Medical University of Varna, Varna, Bulgaria
| | - Kaloyan Tsochev
- grid.20501.360000 0000 8767 9052Department of Social Medicine and Health Care, Organization Medical University of Varna, Varna, Bulgaria
| | - Tsvetalina Tankova
- grid.410563.50000 0004 0621 0092Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Imre Rurik
- grid.7122.60000 0001 1088 8582Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- grid.7122.60000 0001 1088 8582Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Luis A. Moreno
- grid.11205.370000 0001 2152 8769Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fisiopatología de La Obesidad Y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain ,grid.11205.370000 0001 2152 8769Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain ,grid.488737.70000000463436020Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Yannis Manios
- grid.15823.3d0000 0004 0622 2843Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece ,grid.419879.a0000 0004 0393 8299Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
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10
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Diet quality of Norwegian children at 3 and 7 years: changes, predictors and longitudinal association with weight. Int J Obes (Lond) 2022; 46:10-20. [PMID: 34462565 DOI: 10.1038/s41366-021-00951-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/28/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Poor diet quality in early life can have long-term health effects, but the evidence is largely from cross-sectional studies. Our objective was to examine diet quality of Norwegian children by applying a-priori diet quality indices, identify early life determinants and examine prospective associations with overweight. SUBJECTS/METHODS We included 34,074 preschoolers (3-year-olds) and 18,350 school-aged children (7-years-olds) from the prospective, population-based Norwegian Mother, Father and Child Cohort Study. Diet quality was assessed as (i) adherence to a Mediterranean diet, estimated by the food frequency-based Mediterranean Diet Score (fMDS, score range: 0-6) and (ii) by the diet quality index (DQI, score range: -33% to 100%), reflecting compliance to food-based dietary guidelines. In multivariate analyses we explored perinatal and childhood characteristics as potential determinants of diet quality. We used logistic regression to examine the associations between diet quality at 3 years and BMI status at 8 years, adjusting for relevant confounders and diet quality at 7 years. RESULTS One in three children had high MD adherence at 3 and 8 years, and DQI (mean 60%) at 3 and 7 years was strongly correlated (r = 0.48, p < 0.001). Short breastfeeding duration, physical activity and sleep duration and long screentime at 18 months were associated with 2-3% lower DQI at 3 years. At both ages, maternal diet quality was the strongest prospective predictor of DQI (beta = 5%, 95% CI = 4.7, 5.2 and beta = 3.1%, 95% CI = 2.8, 3.4), and screentime was the strongest cross-sectional predictor (beta = -5.2%, 95% CI = -5.9, -4.5 and beta = -4.1%, 95% CI = -5.0, -3.2). High DQI score at 3 years, but not MD adherence, was associated with a lower risk for overweight (including obesity) at 8 years, compared to low DQI (lower tertile) (adjusted OR = 0.77, 95% CI = 0.62, 0.96). CONCLUSIONS Our study provides evidences that high diet quality in early childhood may reduce the risk for overweight in later childhood, independent of the current dietary behaviors.
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11
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An index measuring adherence to New Zealand Infant Feeding Guidelines has convergent validity with maternal socio-demographic and health behaviours and with children's body size. Br J Nutr 2021; 127:1073-1085. [PMID: 34212833 PMCID: PMC8924492 DOI: 10.1017/s0007114521001720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Using data from a nationally generalisable birth cohort, we aimed to: (i) describe the cohort’s adherence to national evidence-based dietary guidelines using an Infant Feeding Index (IFI) and (ii) assess the IFI’s convergent construct validity, by exploring associations with antenatal maternal socio-demographic and health behaviours and with child overweight/obesity and central adiposity at age 54 months. Data were from the Growing Up in New Zealand cohort (n 6343). The IFI scores ranged from zero to twelve points, with twelve representing full adherence to the guidelines. Overweight/obesity was defined by BMI-for-age (based on the WHO Growth Standards). Central adiposity was defined as waist-to-height ratio > 90th percentile. Associations were tested using multiple linear regression and Poisson regression with robust variance (risk ratios, 95 % CI). Mean IFI score was 8·2 (sd 2·1). Maternal characteristics explained 29·1 % of variation in the IFI score. Maternal age, education and smoking had the strongest independent relationships with IFI scores. Compared with children in the highest IFI tertile, girls in the lowest and middle tertiles were more likely to be overweight/obese (1·46, 1·03, 2·06 and 1·56, 1·09, 2·23, respectively) and boys in the lowest tertile were more likely to have central adiposity (1·53, 1·02, 2·30) at age 54 months. Most infants fell short of meeting national Infant Feeding Guidelines. The associations between IFI score and maternal characteristics, and children’s overweight/obesity/central adiposity, were in the expected directions and confirm the IFI’s convergent construct validity.
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12
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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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13
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Hillesund ER, Sagedal LR, Bere E, Øverby NC. Family meal participation is associated with dietary intake among 12-month-olds in Southern Norway. BMC Pediatr 2021; 21:128. [PMID: 33722218 PMCID: PMC7958408 DOI: 10.1186/s12887-021-02591-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family meal participation is associated with healthier eating among children and adolescents. Less is known about family meal participation among infants and toddlers. The objective of the present study was to explore whether family meal participation at 12 months of age is associated with dietary intake and whether a potential relationship differs according to maternal education or child sex. METHODS Follow-up data from children born to mothers participating in the Norwegian Fit for Delivery (NFFD) trial during pregnancy were used to assess the frequency of intake of 11 dietary items according to frequency of participating in the respective family meals. Dietary differences according to seldom (0-3 times/week) or often (4-7 times/week) participating in each respective meal category were assessed in linear regression models. Potential dose-response associations with frequency of participation in all family meal categories combined were also estimated. Models were adjusted for maternal randomization status, education, and child sex. RESULTS The sample comprised 408 children. A total of 74, 53 and 74% had breakfast, lunch, and dinner with family ≥4 times/week, respectively, while 39% had supper and 27% between-meal snacks with family ≥4 times/week. Having family dinner ≥4 times/week was associated with more frequent intake of vegetables, homemade infant cereal, milk, and water, and less frequent intake of commercial infant foods while the other family meal categories were associated with fewer dietary outcomes. For each additional meal category eaten with family ≥4 times/week, frequency of vegetable intake (β = 0.45), water (β = 0.17), and milk (β = 0.09) per day increased, while commercial infant cereal was eaten less frequently (β = - 0.18). The inverse association between family meals and commercial infant cereal was only evident in children born to mothers in the intervention group. Several associations with diet were stronger and only significant among boys. CONCLUSIONS Being fed in the context of family meals at 12 months of age was associated with a more favorable diet. Including the infant in family meals has potential in the promotion of early nutritional health.
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Affiliation(s)
- Elisabet R Hillesund
- Department of Nutrition and Public Health, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.
| | - Linda R Sagedal
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway
| | - Elling Bere
- Department of Sport Science and Physical Education, Serviceboks 422, 4604, Kristiansand, Norway.,Department of Health and Inequalities & Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Nina C Øverby
- Department of Nutrition and Public Health, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
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14
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Dalwood P, Marshall S, Burrows TL, McIntosh A, Collins CE. Diet quality indices and their associations with health-related outcomes in children and adolescents: an updated systematic review. Nutr J 2020; 19:118. [PMID: 33099309 PMCID: PMC7585689 DOI: 10.1186/s12937-020-00632-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/30/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To describe a-priori diet quality indices used in children and adolescents, appraise the validity and reliability of these indices, and synthesise evidence on the relationship between diet quality and physical and mental health, and growth-related outcomes. METHODS Five electronic databases were searched until January 2019. An a-priori diet quality index was included if it applied a scoring structure to rate child or adolescent (aged 0-18-years) dietary intakes relative to dietary or nutrient guidelines. Diagnostic accuracy studies and prospective cohort studies reporting health outcomes were appraised using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS From 15,577 records screened, 128 unique paediatric diet quality indices were identified from 33 countries. Half of the indices' scores rated both food and nutrient intakes (n = 65 indices). Some indices were age specific: infant (< 24-months; n = 8 indices), child (2-12-years; n = 16), adolescent (13-18 years; n = 8), and child/adolescent (n = 14). Thirty-seven indices evaluated for validity and/or reliability. Eleven of the 15 indices which investigated associations with prospective health outcomes reported significant results, such as improved IQ, quality of life, blood pressure, body composition, and prevalence of metabolic syndrome. CONCLUSIONS Research utilising diet quality indices in paediatric populations is rapidly expanding internationally. However, few indices have been evaluated for validity, reliability, or association with health outcomes. Further research is needed to determine the validity, reliability, and association with health of frequently utilised diet quality indices to ensure data generated by an index is useful, applicable, and relevant. REGISTRATION PROSPERO number: CRD42018107630 .
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Affiliation(s)
- Phoebe Dalwood
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Skye Marshall
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia.
- Nutrition Research Australia, Sydney, New South Wales, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Ashleigh McIntosh
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
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15
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Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E. Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2020; 9:e014520. [PMID: 32389066 PMCID: PMC7660848 DOI: 10.1161/jaha.119.014520] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.
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16
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English LK, Obbagy JE, Wong YP, Butte NF, Dewey KG, Fox MK, Greer FR, Krebs NF, Scanlon KS, Stoody EE. Complementary feeding and developmental milestones: a systematic review. Am J Clin Nutr 2019; 109:879S-889S. [PMID: 30982876 DOI: 10.1093/ajcn/nqy321] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Systematic reviews were conducted as part of the USDA and the US Department of Health and Human Services Pregnancy and Birth to 24 Months Project to examine the relation between complementary feeding and developmental milestones. OBJECTIVES The aim of this study was to describe systematic reviews examining the relationship between timing of introduction of complementary foods and beverages (CFB), and the types and amounts of CFB consumed, and developmental milestones. METHODS The literature was searched using 4 databases (PubMed, Cochrane, Embase, and CINAHL) to identify articles that met predetermined criteria for inclusion. Data extraction and risk of bias assessment were conducted for each included study. The body of evidence for each systematic review was qualitatively synthesized to develop a conclusion statement, and the strength of evidence was graded. RESULTS Three included articles (1 randomized controlled trial; 2 observational studies) examined timing of introduction of CFB. Eight included articles (3 randomized controlled trials; 5 observational studies) examined types and amounts of CFB. There was insufficient evidence to draw conclusions about the relation between either timing of CFB introduction or types and amounts of CFB, and developmental milestones. CONCLUSIONS The ability to draw conclusions about the relationship between complementary feeding and developmental milestones was restricted by an inadequate amount of evidence with potential for issues with reverse causality and wide variation in design, type/age of outcome assessment, exposure assessment, and reported results. Additional research to address these gaps and limitations would be useful.
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Affiliation(s)
| | - Julie E Obbagy
- USDA, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA
| | - Yat Ping Wong
- USDA, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA
| | - Nancy F Butte
- USDA-Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Department of Pediatrics, Houston, TX
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, Davis, CA
| | | | - Frank R Greer
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Kelley S Scanlon
- USDA, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA
| | - Eve E Stoody
- USDA, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA
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17
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English LK, Obbagy JE, Wong YP, Butte NF, Dewey KG, Fox MK, Greer FR, Krebs NF, Scanlon KS, Stoody EE. Types and amounts of complementary foods and beverages consumed and growth, size, and body composition: a systematic review. Am J Clin Nutr 2019; 109:956S-977S. [PMID: 30982866 DOI: 10.1093/ajcn/nqy281] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Systematic reviews (SRs) were conducted by the Nutrition Evidence Systematic Review (NESR) team for the USDA's and the Department of Health and Human Services' Pregnancy and Birth to 24 Months Project. OBJECTIVES The aim was to describe the SRs examining the relationship between types and amounts of complementary foods and beverages (CFBs) and growth, size, and body-composition outcomes. METHODS The NESR team collaborated with subject matter experts to conduct this SR. The literature was searched and screened using predetermined criteria. For each included study, data were extracted and risk of bias was assessed. The evidence was qualitatively synthesized to develop a conclusion statement, and the strength of evidence was graded. RESULTS This SR includes 49 articles that examined type, amount, or both of CFBs consumed and growth, size, and body-composition outcomes. Moderate evidence suggests that consuming either different amounts of meat, meat instead of iron-fortified cereal, or types of CFBs with different fats or fatty acids does not favorably or unfavorably influence growth, size, or body composition. In relation to overweight/obesity, insufficient evidence is available with regard to the intake of meat or CFBs with different fats or fatty acids. Limited evidence suggests that type and amount of fortified infant cereal does not favorably or unfavorably influence growth, size, body composition, or overweight/obesity. Limited evidence suggests that sugar-sweetened beverage consumption during the complementary feeding period is associated with increased obesity risk in childhood but is not associated with other measures of growth, size, or body composition. Limited evidence showed a positive association between juice intake and infant weight-for-length and child body mass index z scores. Insufficient evidence is available on other CFBs or dietary patterns in relation to outcomes. CONCLUSIONS Although several conclusions were drawn, additional research is needed that includes randomized controlled trials, examines a wider range of CFBs, considers issues of reverse causality, and adjusts for potential confounders to address gaps and limitations in the evidence.
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Affiliation(s)
| | | | | | - Nancy F Butte
- USDA-Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, Davis, CA
| | | | - Frank R Greer
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Nancy F Krebs
- Department of Pediatrics, University of Colorado School of Medicine, CO
| | | | - Eve E Stoody
- USDA, Food and Nutrition Service, Alexandria, VA
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18
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Taylor RM, Smith R, Collins CE, Evans TJ, Hure AJ. Dietary intake and food sources of one-carbon metabolism nutrients in preschool aged children. Eur J Clin Nutr 2018; 73:1179-1193. [PMID: 30538300 PMCID: PMC6760623 DOI: 10.1038/s41430-018-0376-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/14/2018] [Accepted: 11/19/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND It is hypothesised that epigenetic mechanisms including DNA methylation may underlie the relationship between early-life nutrition and child cognitive outcomes. This study aimed to identify dietary patterns associated with the intake of one-carbon metabolism nutrients in children aged 2-3 years. METHODS A validated 120-item semi-quantitative food frequency questionnaires at 2-3 years of age were used to estimate the intake of one-carbon metabolism nutrients (methionine, folate, choline and vitamins B2, B6, B12) and to quantify mean number of serves consumed of the food groups specified by the Australian Guide to Healthy Eating (AGHE). Descriptive statistics were used to analyse the contribution of each food group and food items to the total intake of one-carbon metabolism nutrients. Linear regression was used to test for linear trends in food group servings by nutrient intake quintiles. RESULTS No child (n = 60) from the Women And Their Children's Health (WATCH) study consumed the recommended number of serves for all AGHE food groups. Dairy and alternatives (18-44%), discretionary foods (6-33%) and meat and alternatives (6-31%) were the main sources of most one-carbon metabolism nutrients. Most child intakes of one-carbon metabolism nutrients exceeded the nutrient reference values (NRVs), except for the intake of choline, for which the mean intake was 9% below the adequate intake (AI). CONCLUSION Dairy and alternatives, discretionary foods and meat and alternatives food groups contributed significantly to the children's intake of one-carbon metabolism nutrients. The children generally had low intakes of meat and alternative foods, which may explain their inadequate intake of choline.
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Affiliation(s)
- Rachael M Taylor
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, 2308, Australia. .,Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
| | - Roger Smith
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, 2308, Australia.,Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Clare E Collins
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Callaghan, NSW, 2308, Australia.,Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Tiffany-Jane Evans
- Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Clinical Research Design IT and Statistical Support (CReDITSS) Unit, Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia
| | - Alexis J Hure
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Priority Research Centre for Generational, Health and Ageing, University of Newcastle, Callaghan, NSW, 2308, Australia
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19
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Dietary patterns and body adiposity in children in Brazil: a cross-sectional study. Public Health 2018; 166:140-147. [PMID: 30500570 DOI: 10.1016/j.puhe.2018.10.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/18/2018] [Accepted: 10/01/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Many factors are associated with the increase in total and central body adiposity in children, especially eating habits. This has led to an increasing number of studies analysing food patterns, which consider the synergistic effect of food and nutrient intake on the nutritional status. The objective of this study was to identify the dietary patterns of children aged 4-7 years and associate these with different indicators of total and central body adiposity. STUDY DESIGN Cross-sectional study METHODS: The study consisted of 403 children from a retrospective cohort in Minas Geraes, Brazil. Four indicators of body adiposity were evaluated: body mass index (BMI), waist-to-height ratio (WHtR) and percentages of total and central body fat (assessed by dual-energy X-ray absorptiometry). The dietary habits of the children were evaluated by identifying the dietary patterns using principal component analysis. The adjustment predictor variables were related to the socio-economic characteristics, lifestyle and duration of exclusive breastfeeding. Food patterns were identified by factor analysis. Linear regression was used to estimate the regression coefficient and the confidence interval, considering statistical significance of α = 5%. RESULTS Five dietary patterns were identified, which explained 42.3% of the data variance: 'Traditional', 'Unhealthy', 'Milk and chocolate', 'Snack' and 'Healthy'. The multiple linear regression model showed that a greater adherence to the 'Traditional' and 'Unhealthy' patterns was related to higher BMI, WHtR, and total and central body adiposity. CONCLUSION Children with a higher intake of food from the 'Traditional' and 'Unhealthy' patterns showed an increase in total and central body adiposity.
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20
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Bidirectional associations between diet and body composition measures from 2 to 15 years: Longitudinal Study of Australian Children. Br J Nutr 2018; 121:212-220. [PMID: 30375296 DOI: 10.1017/s0007114518003173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study investigates how dietary patterns and scores are associated with subsequent BMI and waist:height ratio (WHtR), and how BMI and WHtR are associated with subsequent dietary patterns or scores, from 2-3 to 10-11 and 4-5 to 14-15 years of age. In the Longitudinal Study of Australian Children, height, weight and waist circumference were measured biennially in children, yielding BMI z-score and WHtR. Parents, latterly children, reported frequency of child consumption of 12-16 food/drink items during the previous 24 h. At each wave, we empirically derived dietary patterns using factor analyses, and dietary scores based on the 2013 Australian Dietary Guidelines. We used structural-equation modelling to investigate cross-lagged associations (n 1972-2882) between diet and body composition measures in univariable and multivariable analyses. Dietary scores/patterns did not consistently predict WHtR and BMI z-score in the next wave, nor did BMI z-score and WHtR consistently predict diet in the next wave. The few associations seen were weak and often in the opposite direction to that hypothesised. The largest effect, associated with each standard deviation increase in BMI in wave 5 of the K cohort (age 12-13 years), was a 0·06 standard deviation estimated mean increase in dietary score (higher quality diet) in the subsequent wave (95 % CI 0·02, 0·11, P=0·003). Associations between dietary patterns/scores and body composition were not strongly evident in either direction. Better quantitative childhood dietary tools feasible for large-scale administration are needed to quantify how dietary patterns, energy intake and anthropometry co-develop.
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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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Ertaş Öztürk Y, Bozbulut R, Döğer E, Bideci A, Köksal E. The relationship between diet quality and insulin resistance in obese children: adaptation of the Healthy Lifestyle-Diet Index in Turkey. J Pediatr Endocrinol Metab 2018; 31:391-398. [PMID: 29494339 DOI: 10.1515/jpem-2017-0271] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 01/29/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Childhood obesity and its complications are serious health problems and diet/lifestyle changes can be beneficial for the prevention of diseases. Adaptation of the Healthy Lifestyle-Diet (HLD) Index in accordance with the dietary guidelines for Turkey (TR) and determination of the relationship between metabolic syndrome risk factors in obese children were the aims of this study. METHODS This study was conducted on 164 overweight or obese children (87 male, 77 female) aged 9-13 years. For all participants, the HLD-TR Index and a 24-h dietary recall were performed and the mean adequacy ratio (MAR) was calculated. Anthropometric measurements and the body composition of the children were taken. Metabolic syndrome risk factors and insulin resistance were assessed. RESULTS The mean age of the male and female children was 11.2±1.49 and 11.0±1.40 years, respectively. The majority of the children were obese in both genders. There were no statistically significant differences in the HLD-TR scores between the genders. As the index scores increased, a decrease in the energy intake and an increase in the MAR were observed. Negative correlations between the index scores and body mass, waist circumference and body fat mass were observed. Furthermore, a one-unit increase in the index score decreases the insulin resistance risk by 0.91 times after adjustments for age and gender (odds ratio: 0.91 [0.85-0.97]). CONCLUSIONS The HLD-TR Index is a valid tool that can give an idea about the quality of the diet in obese children. Furthermore, with the increase in the compliance with recommendations for diet/lifestyle changes, indicators of obesity and metabolic syndrome were decreased.
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Affiliation(s)
- Yasemin Ertaş Öztürk
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Rukiye Bozbulut
- Gazi University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Esra Döğer
- Gazi University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Aysun Bideci
- Gazi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Ankara, Turkey
| | - Eda Köksal
- Gazi University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
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Rigo M, Willcox J, Spence A, Worsley A. Mothers' Perceptions of Toddler Beverages. Nutrients 2018; 10:nu10030374. [PMID: 29562679 PMCID: PMC5872792 DOI: 10.3390/nu10030374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 11/25/2022] Open
Abstract
Background: The prevalence of obesity among Australian pre-school children is a major concern with links to poor health outcomes. One contributing factor is excess energy intake. Sugar-sweetened beverages are energy-dense, nutrient-poor, readily available and have been implicated in the increasing prevalence of obesity. Furthermore, preschooler beverage consumption may develop into dietary habits that track into adulthood. There is little research on factors influencing parents’ decision-making when serving beverages to their preschoolers, or on mothers’ perceptions of preschooler’s beverages. The aim of this study was to explore mothers’ perceptions of commonly consumed preschooler beverages. Methods: The Repertory Grid Technique and the Laddering Technique methodologies were utilized in interviews with 28 mothers from Melbourne, Australia, to explore beverage perceptions. Results: A large number of diverse perceptual categories (‘constructs’) (n = 22) about beverages were elicited, demonstrating the complexity of mothers’ perceptions when making beverage choices for their preschoolers. The five most common categories were related to health, sugar, dairy, packaging, and additives. Thematic analysis of responses from the laddering method identified three major themes: concerns about the types of beverages mothers would like to provide their preschoolers, the healthiness of a beverage, and the sugar content. Conclusions: Mothers’ perceptions of beverages are sophisticated and need to be included in the design of health communication strategies by health promoters and government agencies to influence mothers’ beverage selections for their preschoolers.
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Affiliation(s)
- Manuela Rigo
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | - Jane Willcox
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | - Alison Spence
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
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Kay MC, Wasser H, Adair LS, Thompson AL, Siega‐Riz AM, Suchindran CM, Bentley ME. Consumption of obesogenic foods in non-Hispanic black mother-infant dyads. MATERNAL & CHILD NUTRITION 2018; 14:e12482. [PMID: 28627126 PMCID: PMC6651737 DOI: 10.1111/mcn.12482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/12/2017] [Accepted: 05/18/2017] [Indexed: 01/29/2023]
Abstract
Obesity continues to be a problem in the United States. Of particular concern is the epidemic of early childhood obesity. A significant predictor of child diet is maternal diet, but little is known about this relationship during infancy. This study examined the association between maternal and infant consumption of key food groups from 6 to 18 months using data from the Infant Care, Feeding, and Risk of Obesity Study, a prospective cohort of 217 non-Hispanic black, low-income, first-time mothers. Using data from 24-hr dietary recalls collected during in-home visits at 6, 9, 12, and 18 months, we assessed longitudinal associations between mother and child intake of both energy-dense, nutrient-poor (obesogenic) food groups and fibre-, nutrient-rich food groups using random intercept logistic regression. Both mothers and their infants had high intake of sugar-sweetened beverages, desserts, and sweets and low intake of vegetables and whole grains. Infant consumption of key food groups was strongly associated with maternal consumption, suggesting the need for focused interventions to target maternal diet as a pathway to decreasing risk for the establishment of poor dietary patterns early in life.
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Affiliation(s)
- Melissa C. Kay
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Heather Wasser
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Linda S. Adair
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Amanda L. Thompson
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of AnthropologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Anna Maria Siega‐Riz
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
- Department of Public Health SciencesUniversity of VirginiaUSA
| | - Chirayath M. Suchindran
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Margaret E. Bentley
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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Swindle TM, Ward WL, Whiteside-Mansell L. Facebook: The Use of Social Media to Engage Parents in a Preschool Obesity Prevention Curriculum. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:4-10.e1. [PMID: 29325661 PMCID: PMC5769705 DOI: 10.1016/j.jneb.2017.05.344] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 05/13/2023]
Abstract
OBJECTIVE This study investigated the use of Facebook to deliver health-related education materials to augment a preschool classroom-based obesity prevention curriculum. DESIGN Cross-sectional, mixed methods (descriptive and interviews). SETTING Head Start classrooms administered by 2 large agencies (1 rural and 1 urban). PARTICIPANTS Convenience sample of parents in 13 classrooms (cohort 1, 3 classrooms; cohort 2, 10 classrooms). INTERVENTION Delivery of nutrition education curriculum content using social media (Facebook). VARIABLES MEASURED Qualitative interviews assessed barriers and facilitators to Facebook use. Parent views, likes, and comments were measured to reflect parent engagement with Facebook. ANALYSIS Content analyses (qualitative data) and descriptive statistics (quantitative data). RESULTS Family access (views) and interaction (comments and likes) with the posts varied based on type and content of posts. Rural families were more active. Barriers to parental Facebook engagement included a desire to see more posts from classroom teachers, lack of time, and misunderstanding about privacy protections. Facilitators of parental Facebook engagement included perceived utility of the content and social support. CONCLUSIONS AND IMPLICATIONS Facebook was found to be a feasible platform to provide nutrition education and facilitated varying levels of parental engagement. Lessons learned and implications for prevention and intervention programming are offered.
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Affiliation(s)
- Taren M Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Wendy L Ward
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR.
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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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Kay MC, Wasser H, Adair LS, Thompson AL, Siega-Riz AM, Suchindran CM, Bentley ME. Consumption of key food groups during the postpartum period in low-income, non-Hispanic black mothers. Appetite 2017; 117:161-167. [PMID: 28651972 DOI: 10.1016/j.appet.2017.06.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 05/14/2017] [Accepted: 06/21/2017] [Indexed: 11/18/2022]
Abstract
The postpartum period can impact diet quality and subsequently place women at greater risk for overweight or obesity. This study examined consumption of key food groups during the first 2 years postpartum among low income, non-Hispanic black, first-time mothers. Data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 mother-infant dyads, followed from 3 to 18 months postpartum, collected from 2003 to 2007. At each study visit (3, 6, 9, 12, and 18 months) 24-h dietary recalls were collected. Consumption levels were compared to those recommended from the 2010 Dietary Guidelines for Americans (DGAs) for each of the following food groups: fruits, vegetables, grains, whole grains, protein foods and dairy, as well as an estimated upper limit for sugar-sweetened beverage (SSB) consumption. At each time point, mothers met recommended intake levels for grains and protein foods only. In random-intercept logistic regression models, no demographic or household characteristics were associated with a likelihood of consuming recommended levels for any of the food groups according to the DGAs. Given the low intake of fruits, vegetables, whole grains and lean protein foods and high intake of SSBs and refined grains, interventions targeting women's diet during the postpartum period are warranted.
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Affiliation(s)
- Melissa C Kay
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States.
| | - Heather Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States
| | - Linda S Adair
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States
| | - Amanda L Thompson
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States; Department of Anthropology, University of North Carolina at Chapel Hill, 209-A Alumni Bldg, 3115 Chapel Hill, NC 27599, United States.
| | - Anna Maria Siega-Riz
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States; Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Charlottesville, VA 22908, United States.
| | - Chirayath M Suchindran
- Department of Biostatistics, University of North Carolina at Chapel Hill, 3103-A Mcgavran-Greenberg Hl, CB 7420, Chapel Hill, NC 27599, United States.
| | - Margaret E Bentley
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States
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An obesogenic refined low-fat diet disrupts attentional and behavioral control processes in a vigilance task in rats. Behav Processes 2017; 138:142-151. [DOI: 10.1016/j.beproc.2017.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 03/02/2017] [Accepted: 03/10/2017] [Indexed: 01/07/2023]
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Frongillo EA, Nguyen PH, Saha KK, Sanghvi T, Afsana K, Haque R, Baker J, Ruel MT, Rawat R, Menon P. Large-Scale Behavior-Change Initiative for Infant and Young Child Feeding Advanced Language and Motor Development in a Cluster-Randomized Program Evaluation in Bangladesh. J Nutr 2017; 147:256-263. [PMID: 28031374 DOI: 10.3945/jn.116.240861] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 09/14/2016] [Accepted: 12/05/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development. OBJECTIVE We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding. METHODS A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media campaign, and community mobilization (intensive) compared with usual nutrition counseling and mass media campaign (nonintensive). Twenty subdistricts were randomly assigned to receive either the intensive or the nonintensive intervention. Household surveys were conducted at baseline (2010) and at endline (2014) in the same communities (n = ∼4000 children aged 0-47.9 mo for each round). Child development was measured by asking mothers if their child had reached each of multiple milestones, with some observed. Linear regression accounting for clustering was used to derive difference-in-differences (DID) impact estimates, and path analysis was used to examine developmental advancement through indicators of improved IYCF and other factors. RESULTS The DID in language development between intensive and nonintensive groups was 1.05 milestones (P = 0.001) among children aged 6-23.9 mo and 0.76 milestones (P = 0.038) among children aged 24-47.9 mo. For gross motor development, the DID was 0.85 milestones (P = 0.035) among children aged 6-23.9 mo. The differences observed corresponded to age- and sex-adjusted effect sizes of 0.35 for language and 0.23 for gross motor development. Developmental advancement at 6-23.9 mo was partially explained through improved minimum dietary diversity and the consumption of iron-rich food. CONCLUSIONS Intensive IYCF intervention differentially advanced language and gross motor development, which was partially explained through improved complementary feeding. Measuring a diverse set of child outcomes, including functional outcomes such as child development, is important when evaluating integrated nutrition programs. This trial was registered at clinicaltrials.gov as NCT01678716.
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Affiliation(s)
| | - Phuong H Nguyen
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC
| | - Kuntal K Saha
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC
| | | | | | | | | | - Marie T Ruel
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC
| | - Rahul Rawat
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC
| | - Purnima Menon
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC
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Karnopp EVN, Vaz JDS, Schafer AA, Muniz LC, Souza RDLVD, Santos ID, Gigante DP, Assunção MCF. Food consumption of children younger than 6 years according to the degree of food processing. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2016.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017; 64:119-132. [PMID: 28027215 DOI: 10.1097/mpg.0000000000001454] [Citation(s) in RCA: 493] [Impact Index Per Article: 70.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
UNLABELLED This position paper considers different aspects of complementary feeding (CF), focussing on healthy term infants in Europe. After reviewing current knowledge and practices, we have formulated these recommendations: Timing: Exclusive or full breast-feeding should be promoted for at least 4 months (17 weeks, beginning of the 5th month of life) and exclusive or predominant breast-feeding for approximately 6 months (26 weeks, beginning of the 7th month) is a desirable goal. Complementary foods (solids and liquids other than breast milk or infant formula) should not be introduced before 4 months but should not be delayed beyond 6 months. CONTENT Infants should be offered foods with a variety of flavours and textures including bitter tasting green vegetables. Continued breast-feeding is recommended alongside CF. Whole cows' milk should not be used as the main drink before 12 months of age. Allergenic foods may be introduced when CF is commenced any time after 4 months. Infants at high risk of peanut allergy (those with severe eczema, egg allergy, or both) should have peanut introduced between 4 and 11 months, following evaluation by an appropriately trained specialist. Gluten may be introduced between 4 and 12 months, but consumption of large quantities should be avoided during the first weeks after gluten introduction and later during infancy. All infants should receive iron-rich CF including meat products and/or iron-fortified foods. No sugar or salt should be added to CF and fruit juices or sugar-sweetened beverages should be avoided. Vegan diets should only be used under appropriate medical or dietetic supervision and parents should understand the serious consequences of failing to follow advice regarding supplementation of the diet. METHOD Parents should be encouraged to respond to their infant's hunger and satiety queues and to avoid feeding to comfort or as a reward.
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Karnopp EVN, Vaz JDS, Schafer AA, Muniz LC, Souza RDLVD, Santos ID, Gigante DP, Assunção MCF. Food consumption of children younger than 6 years according to the degree of food processing. J Pediatr (Rio J) 2017; 93:70-78. [PMID: 27393684 DOI: 10.1016/j.jped.2016.04.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 03/31/2016] [Accepted: 04/06/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To evaluate food intake according to the degree of processing, stratified by family income and age, in a representative sample of children younger than 6 years in the city of Pelotas, RS, Brazil. METHODS Cross-sectional population-based study carried out with 770 children aged 0-72 months of age living in the urban area of Pelotas. The dietary intake of children was assessed by 24-h recall administered to mothers or guardians. The energy intake was estimated and each food item was classified according to the food processing degree. Food consumption was stratified by age (younger than 24 months; 24 months or older) and associations between quintiles of family income and relative contribution of each food to total energy were performed by linear regression. The Wald test was applied to test linear trend across groups. RESULTS The mean energy intake was 1725.7kcal/day. The mean contribution of processed and ultraprocessed foods was 19.7% among children younger than 24 months and 37% in those aged 24 months or older, while the mean consumption of natural and minimally processed food was 61% and 44%, respectively. Among children aged 24 months or older, a greater consumption of canned foods, cheese and sweets was observed as family income quintiles increased, while breads were more consumed by those children belonging to the lower income quintiles. CONCLUSION A high caloric contribution of ultraprocessed foods in detriment to a lower consumption of natural and minimally processed foods was observed in the diet of children younger than 6 years.
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Affiliation(s)
- Ediana Volz Neitzke Karnopp
- Universidade Federal de Pelotas (UFPEL), Faculdade de Nutrição, Programa de Pós-graduação em Nutrição e Alimentos, Pelotas, RS, Brazil
| | | | - Antonio Augusto Schafer
- Universidade Federal de Pelotas (UFPEL), Departamento de Medicina Social, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Ludmila Correa Muniz
- Universidade Federal de Pelotas (UFPEL), Faculdade de Nutrição, Pelotas, RS, Brazil
| | | | - Iná Dos Santos
- Universidade Federal de Pelotas (UFPEL), Departamento de Medicina Social, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Denise Petrucci Gigante
- Universidade Federal de Pelotas (UFPEL), Departamento de Medicina Social, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Maria Cecilia Formoso Assunção
- Universidade Federal de Pelotas (UFPEL), Departamento de Medicina Social, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil.
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Hidaka BH, Kerling EH, Thodosoff JM, Sullivan DK, Colombo J, Carlson SE. Dietary patterns of early childhood and maternal socioeconomic status in a unique prospective sample from a randomized controlled trial of Prenatal DHA Supplementation. BMC Pediatr 2016; 16:191. [PMID: 27884184 PMCID: PMC5123236 DOI: 10.1186/s12887-016-0729-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 11/08/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Dietary habits established in early childhood and maternal socioeconomic status (SES) are important, complex, interrelated factors that influence a child's growth and development. The aim of this study was to define the major dietary patterns in a cohort of young US children, construct a maternal SES index, and evaluate their associations. METHODS The diets of 190 children from a randomized, controlled trial of prenatal supplementation of docosahexaenoic acid (DHA) were recorded at 6-mo intervals from 2-4.5 years by 24-h dietary recall. Hierarchical cluster analysis of age-adjusted, average daily intake of 24 food and beverage groups was used to categorize diet. Unrotated factor analysis generated an SES score from maternal race, ethnicity, age, education, and neighborhood income. RESULTS We identified two major dietary patterns: "Prudent" and "Western." The 85 (45%) children with a Prudent diet consumed more whole grains, fruit, yogurt and low-fat milk, green and non-starchy vegetables, and nuts and seeds. Conversely, those with a Western diet had greater intake of red meat, discretionary fat and condiments, sweet beverages, refined grains, French fries and potato chips, eggs, starchy vegetables, processed meats, chicken and seafood, and whole-fat milk. Compared to a Western diet, a Prudent diet was associated with one standard deviation higher maternal SES (95% CI: 0.80 to 1.30). CONCLUSIONS We found two major dietary patterns of young US children and defined a single, continuous axis of maternal SES that differed strongly between groups. This is an important first step to investigate how child diet, SES, and prenatal DHA supplementation interact to influence health outcomes. TRIAL REGISTRATION NCT00266825 . Prospectively registered on December 15, 2005.
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Affiliation(s)
- Brandon H Hidaka
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Elizabeth H Kerling
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Jocelynn M Thodosoff
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA
| | - John Colombo
- Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., Lawrence, KS, 66045, USA
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, MS 4013, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.
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Martins S, Carvalho G, Pires A, Silva R, Leite L, Lacerda E, Moreira J, Cruz C, Carvalho B. Use of Chemically Treated Tropical Forage on the Fatty Acid Profile of Milk. J FOOD QUALITY 2016. [DOI: 10.1111/jfq.12228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- S.C.S.G. Martins
- State University of Bahia Southwest; Rodovia BR-415 km 03 Itapetinga BA Brazil
| | - G.G.P. Carvalho
- Department of Animal Science; Federal University of Bahia; BA 40110-909 Salvador Brazil
| | - A.J.V. Pires
- State University of Bahia Southwest; Rodovia BR-415 km 03 Itapetinga BA Brazil
| | - R.R. Silva
- State University of Bahia Southwest; Rodovia BR-415 km 03 Itapetinga BA Brazil
| | - L.C. Leite
- Federal University of Recôncavo da Bahia; Cruz das Almas BA Brazil
| | - E.C.Q. Lacerda
- Federal University of Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - J.V. Moreira
- State University of Bahia Southwest; Rodovia BR-415 km 03 Itapetinga BA Brazil
| | - C.H. Cruz
- Department of Animal Science; Federal University of Bahia; BA 40110-909 Salvador Brazil
| | - B.M.A. Carvalho
- Institute of Agricultural Sciences, Federal University of Minas Gerais; Montes Claros MG Brazil
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Voortman T, Leermakers ETM, Franco OH, Jaddoe VWV, Moll HA, Hofman A, van den Hooven EH, Kiefte-de Jong JC. A priori and a posteriori dietary patterns at the age of 1 year and body composition at the age of 6 years: the Generation R Study. Eur J Epidemiol 2016; 31:775-83. [PMID: 27384175 PMCID: PMC5005385 DOI: 10.1007/s10654-016-0179-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 06/29/2016] [Indexed: 12/14/2022]
Abstract
Dietary patterns have been linked to obesity in adults, however, not much is known about this association in early childhood. We examined associations of different types of dietary patterns in 1-year-old children with body composition at school age in 2026 children participating in a population-based cohort study. Dietary intake at the age of 1 year was assessed with a food-frequency questionnaire. At the children's age of 6 years we measured their body composition with dual-energy X-ray absorptiometry and we calculated body mass index, fat mass index (FMI), and fat-free mass index (FFMI). Three dietary pattern approaches were used: (1) An a priori-defined diet quality score; (2) dietary patterns based on variation in food intake, derived from principal-component-analysis (PCA); and (3) dietary patterns based on variations in FMI and FFMI, derived with reduced-rank-regression (RRR). Both the a priori-defined diet score and a 'Health-conscious' PCA-pattern were characterized by a high intake of fruit, vegetables, grains, and vegetable oils, and, after adjustment for confounders, children with higher adherence to these patterns had a higher FFMI at 6 years [0.19 SD (95 % CI 0.08;0.30) per SD increase in diet score], but had no different FMI. One of the two RRR-patterns was also positively associated with FFMI and was characterized by intake of whole grains, pasta and rice, and vegetable oils. Our results suggest that different a priori- and a posteriori-derived health-conscious dietary patterns in early childhood are associated with a higher fat-free mass, but not with fat mass, in later childhood.
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Grants
- The design of the Generation R Study was made possible with financial support from the Erasmus Medical Center, Rotterdam; the Erasmus University, Rotterdam; the Dutch Ministry of Health, Welfare and Sport; and the Netherlands Organization for Health Research and Development (ZonMw).
- The authors TV, ETML, OHF, EHH, and JCKJ work in ErasmusAGE, a research centre funded by Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA. The funders had no role in design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review or approval of the manuscript.
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Affiliation(s)
- Trudy Voortman
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - Elisabeth T M Leermakers
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Henriette A Moll
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Edith H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Leiden University College, The Hague, the Netherlands
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Tandon PS, Tovar A, Jayasuriya AT, Welker E, Schober DJ, Copeland K, Dev DA, Murriel AL, Amso D, Ward DS. The relationship between physical activity and diet and young children's cognitive development: A systematic review. Prev Med Rep 2016; 3:379-90. [PMID: 27419040 PMCID: PMC4929214 DOI: 10.1016/j.pmedr.2016.04.003] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 04/04/2016] [Accepted: 04/20/2016] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Given the high prevalence of suboptimal nutrition and low activity levels in children, we systematically reviewed the literature on the relationship between physical activity and dietary patterns and cognitive development in early childhood (six months to five years). METHODS In February 2016, we conducted two different searches of MEDLINE, PsycINFO, and ERIC. Each search included either physical activity (including gross motor skills) or diet terms, and neurocognitive development outcome terms. Included studies were in English, published since 2005, and of any study design in which the physical activity or diet measure occurred prior to age five. RESULTS For physical activity, twelve studies (5 cross-sectional, 3 longitudinal and 4 experimental) were included. Eleven studies reported evidence suggesting that physical activity or gross motor skills are related to cognition or learning. Both acute bouts and longer term exposures showed benefit. For diet, eight studies were included consisting of secondary analyses from longitudinal cohort studies. A healthier dietary pattern was associated with better cognitive outcomes in all studies, although some of the reported associations were weak and the measures used varied across the studies. CONCLUSIONS Physical activity and healthy diets in early childhood are associated with better cognitive outcomes in young children. The paucity of literature and the variability in the type and quality of measures used highlight the need for more rigorous research. Given that the early childhood years are critical for both obesity prevention and neurocognitive development, evidence that the same healthy behaviors could promote both should inform future interventions.
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Affiliation(s)
- Pooja S. Tandon
- Seattle Children's Research Institute, M/S CW-8, PO Box 5371, Seattle, WA 98145, United States
- University of Washington, Seattle, WA, United States
| | - Alison Tovar
- The University of Rhode Island, Department of Nutrition and Food Sciences, Kingston RI, Fogarty, Rm. 143c, Kingston, RI 02881, United States
| | - Avanthi T. Jayasuriya
- Seattle Children's Research Institute, M/S CW-8, PO Box 5371, Seattle, WA 98145, United States
| | - Emily Welker
- Duke Global Health Institute, Duke University, 803 Lancaster Street Apartment D, Durham, NC, United States
| | - Daniel J. Schober
- DePaul University, Master of Public Health Program, 14 E. Jackson Blvd, Mailstop – Master of Public Health, Daily 710, Chicago, IL 60604, United States
| | - Kristen Copeland
- Department of Pediatrics, University of Cincinnati College of Medicine and Cincinnati Children's Hospital Medical Center, Division of General and Community Pediatrics, 3333 Burnet Avenue, Cincinnati, OH 45229, United States
| | - Dipti A. Dev
- 135 home Economics, Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE 68588, United States
| | | | - Dima Amso
- Brown University, Cognitive, Linguistic & Physiological Sciences, Providence, RI, United States
| | - Dianne S. Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, United States
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Comerford KB, Ayoob KT, Murray RD, Atkinson SA. The Role of Avocados in Complementary and Transitional Feeding. Nutrients 2016; 8:E316. [PMID: 27213450 PMCID: PMC4882728 DOI: 10.3390/nu8050316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 12/11/2022] Open
Abstract
Infant dietary patterns tend to be insufficient sources of fruits, vegetables, and fiber, as well as excessive in salt, added sugars, and overall energy. Despite the serious long-term health risks associated with suboptimal fruit and vegetable intake, a large percentage of infants and toddlers in the U.S. do not consume any fruits or vegetables on a daily basis. Since not all fruits and vegetables are nutritionally similar, guidance on the optimal selection of fruits and vegetables should emphasize those with the greatest potential for nutrition and health benefits. A challenge is that the most popularly consumed fruits for this age group (i.e., apples, pears, bananas, grapes, strawberries) do not closely fit the current general recommendations since they tend to be overly sweet and/or high in sugar. Unsaturated oil-containing fruits such as avocados are nutritionally unique among fruits in that they are lower in sugar and higher in fiber and monounsaturated fatty acids than most other fruits, and they also have the proper consistency and texture for first foods with a neutral flavor spectrum. Taken together, avocados show promise for helping to meet the dietary needs of infants and toddlers, and should be considered for inclusion in future dietary recommendations for complementary and transitional feeding.
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Affiliation(s)
- Kevin B Comerford
- Department of Nutrition, University of California at Davis, Davis, CA 95616, USA.
| | - Keith T Ayoob
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
| | - Robert D Murray
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA.
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Abstract
Understanding the role and importance of nutrition in early postnatal life, as an influence on lifelong vulnerability to poor health, is an important part of current research. We need to be able to define optimal patterns of infant feeding, not just to support growth and development in infancy, but also as determinants of later health. To date, much of the focus on the long-term effects of infant nutrition has been on milk feeding, to compare breast and formula feeding and to evaluate the effects of exclusivity, timing and duration of feeding different types of milk in infancy; other aspects of infant feeding such as age at introduction of solid foods and type of weaning diet have received less attention, and relatively little is known about their links to later health. Contemporary data are needed to enable us to move beyond explanation of historical infant feeding data in order to understand and predict health outcomes in future generations. Ongoing and new population studies, that include infants from diverse settings, will be key to providing generalizable data that can be used to define optimal feeding practice. There are some methodological challenges ahead, although significant progress has already been made, and further progress is envisaged in the future. In particular, the opportunity to bring together epidemiological studies and new mechanistic insights that will help identify key aspects of infant nutrition and their causal effects offer great promise both in moving this field forward as well as the potential for health benefits for future generations.
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Affiliation(s)
- S M Robinson
- 1MRC Lifecourse Epidemiology Unit,University of Southampton,Southampton,UK
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Woods-Townsend K, Bagust L, Barker M, Christodoulou A, Davey H, Godfrey K, Grace M, Griffiths J, Hanson M, Inskip H. Engaging teenagers in improving their health behaviours and increasing their interest in science (Evaluation of LifeLab Southampton): study protocol for a cluster randomized controlled trial. Trials 2015; 16:372. [PMID: 26292675 PMCID: PMC4546100 DOI: 10.1186/s13063-015-0890-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/28/2015] [Indexed: 02/02/2023] Open
Abstract
Background Lifestyle and health behaviours are strongly linked to non-communicable disease risk, but modifying them is challenging. There is an increasing recognition that adolescence is an important time for lifestyle and health behaviours to become embedded. Improving these behaviours in adolescents is important not only for their own health but also for that of their future children. LifeLab Southampton has been developed as a purpose-built classroom and laboratory in University Hospital Southampton. Secondary school students visit LifeLab to learn how childhood, adolescent and parental nutrition influences health, understand the impact of their lifestyle on their cardiovascular and metabolic health, and to inspire them with the excitement of research and future career possibilities in science. The LifeLab visit is part of a programme of work linked to the English National Curriculum. Pilot work has indicated that attitudes towards health can be changed by such LifeLab sessions. Methods/Design A cluster randomised controlled trial is being conducted to evaluate the effectiveness of the LifeLab intervention, the primary outcome being a measurement of the change in nutrition, health and lifestyle literacy from before to after the LifeLab intervention. The LifeLab intervention comprises professional development for the teachers involved; preparatory lessons for the school students, delivered in school; a hands-on practical day at LifeLab, including a ‘Meet the Scientist’ session; post-visit lessons delivered in school; and the opportunity to participate in the annual LifeLab Schools’ Conference. This study aims to recruit approximately 2,500 secondary school students aged 13 to 14 years from 32 schools (the clusters) from Southampton and neighbouring areas. Participating schools will be randomised to control or intervention groups. The intervention will be run over two academic school years, with baseline questionnaire data collected from students at participating schools at the start of the academic year and follow- up questionnaire data collected approximately 12 months later. Trial registration Evaluation of LifeLab is a cluster randomised controlled trial (ISRCTN71951436, registered 25 March 2015), funded by the British Heart Foundation (PG/14/33/30827). Electronic supplementary material The online version of this article (doi:10.1186/s13063-015-0890-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kathryn Woods-Townsend
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK. .,NIHR Southampton Biomedical Research Centre in Nutrition, University Hospital Southampton, NHS Foundation Trust, Southampton, UK.
| | - Lisa Bagust
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
| | - Andri Christodoulou
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
| | - Hannah Davey
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
| | - Keith Godfrey
- NIHR Southampton Biomedical Research Centre in Nutrition, University Hospital Southampton, NHS Foundation Trust, Southampton, UK. .,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
| | - Marcus Grace
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
| | - Janice Griffiths
- Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK. .,Mathematics and Science Learning Centre, Southampton Education School, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
| | - Mark Hanson
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
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Swindle TM, Ward WL, Whiteside-Mansell L, Bokony P, Pettit D. Technology use and interest among low-income parents of young children: differences by age group and ethnicity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2014; 46:484-90. [PMID: 25087748 DOI: 10.1016/j.jneb.2014.06.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 06/06/2014] [Accepted: 06/07/2014] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To examine demographic differences in frequency of use of technologies and interest in receiving nutrition information via technology by low-income parents and caregivers. DESIGN Descriptive, cross-sectional study. SETTING Head Start and state-funded child care programs. PARTICIPANTS A total of 806 parents and caregivers from low-income families. VARIABLES MEASURED A 20-item survey assessed frequency of use and interest in technologies (dependent variables) and collected participant age and ethnicity (independent variables). ANALYSIS Multivariate ANOVA analysis investigated whether age, ethnicity, and their interactions were related to frequency of use and interest in technology types. RESULTS Daily rates of usage for Internet, text messaging, and cell phone use were over 60%. However, Twitter and blogs were accessed daily by < 13% of respondents. The omnibus 2-way interaction of ethnicity and age was nonsignificant. However, main effects for ethnicity (Wilks' λ = .85; F = 3.13; P < .001) and age (Wilks' λ = .89; F = 2.29; P < .001) were observed. CONCLUSIONS AND IMPLICATIONS Facebook, e-mail, texting, and smartphone applications may be innovative modalities to engage with low-income parents and caregivers aged ≤ 45. However, some strategies may be ineffective for reaching Hispanic families as they reported less use of the Internet, Facebook, and e-mail as well as less interest in e-mail.
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Affiliation(s)
- Taren M Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
| | - Wendy L Ward
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Patti Bokony
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Dawn Pettit
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
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Baird J, Jarman M, Lawrence W, Black C, Davies J, Tinati T, Begum R, Mortimore A, Robinson S, Margetts B, Cooper C, Barker M, Inskip H. The effect of a behaviour change intervention on the diets and physical activity levels of women attending Sure Start Children's Centres: results from a complex public health intervention. BMJ Open 2014; 4:e005290. [PMID: 25031194 PMCID: PMC4120404 DOI: 10.1136/bmjopen-2014-005290] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/24/2014] [Accepted: 06/26/2014] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The UK government's response to the obesity epidemic calls for action in communities to improve people's health behaviour. This study evaluated the effects of a community intervention on dietary quality and levels of physical activity of women from disadvantaged backgrounds. DESIGN Non-randomised controlled evaluation of a complex public health intervention. PARTICIPANTS 527 women attending Sure Start Children's Centres (SSCC) in Southampton (intervention) and 495 women attending SSCCs in Gosport and Havant (control). INTERVENTION Training SSCC staff in behaviour change skills that would empower women to change their health behaviours. OUTCOMES Main outcomes dietary quality and physical activity. Intermediate outcomes self-efficacy and sense of control. RESULTS 1-year post-training, intervention staff used skills to support behaviour change significantly more than control staff. There were statistically significant reductions of 0.1 SD in the dietary quality of all women between baseline and follow-up and reductions in self-efficacy and sense of control. The decline in self-efficacy and control was significantly smaller in women in the intervention group than in women in the control group (adjusted differences in self-efficacy and control, respectively, 0.26 (95% CI 0.001 to 0.50) and 0.35 (0.05 to 0.65)). A lower decline in control was associated with higher levels of exposure in women in the intervention group. There was a statistically significant improvement in physical activity in the intervention group, with 22.9% of women reporting the highest level of physical activity compared with 12.4% at baseline, and a smaller improvement in the control group. The difference in change in physical activity level between the groups was not statistically significant (adjusted difference 1.02 (0.74 to 1.41)). CONCLUSIONS While the intervention did not improve women's diets and physical activity levels, it had a protective effect on intermediate factors-control and self-efficacy-suggesting that a more prolonged exposure to the intervention might improve health behaviour. Further evaluation in a more controlled setting is justified.
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Affiliation(s)
- Janis Baird
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Megan Jarman
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Wendy Lawrence
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Christina Black
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Jenny Davies
- Public Health Team, NHS Southampton City, Civic Centre, Southampton, UK
| | - Tannaze Tinati
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Rufia Begum
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Andrew Mortimore
- Public Health Team, NHS Southampton City, Civic Centre, Southampton, UK
| | - Sian Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Barrie Margetts
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Nutrition Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Mary Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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43
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Emmett PM, Jones LR. Diet and growth in infancy: relationship to socioeconomic background and to health and development in the Avon Longitudinal Study of Parents and Children. Nutr Rev 2014; 72:483-506. [PMID: 24947274 DOI: 10.1111/nure.12122] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
To assess the relationship between diet and growth in infancy and socioeconomic background, all publications from the Avon Longitudinal Study of Parents and Children (ALSPAC) covering breastfeeding, diet and growth in infancy, and the associations of these factors with socioeconomic background and later health and developmental outcomes were reviewed. Diet was assessed by parent-completed food records and parent-completed food frequency questionnaires covering infant feeding practices. Infancy growth was monitored through routine screening and by standardized measurements. Indicators of socioeconomic background were obtained by parent-completed questionnaires. Childhood outcomes were measured by standardized procedures. Rapid early weight gain was associated with later obesity. Longer breastfeeding duration was associated with lower body fat, but not lower body mass index, and with higher IQ in mid-childhood. Breastfed infants were better at regulating their energy intake than bottle-fed infants. In bottle-fed infants, energy intake at 4 months was associated with greater weight gain up to 5 years of age. Feeding cow's milk as a main drink in infancy was associated with anemia and high salt intake. Maternal education was a strong determinant of dietary differences: low education was associated with never breastfeeding and not following feeding guidelines. ALSPAC has provided unique insights into the relationship between diet and growth in infancy and later developmental outcomes.
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Affiliation(s)
- Pauline M Emmett
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
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Kelishadi R, Poursafa P. A review on the genetic, environmental, and lifestyle aspects of the early-life origins of cardiovascular disease. Curr Probl Pediatr Adolesc Health Care 2014; 44:54-72. [PMID: 24607261 DOI: 10.1016/j.cppeds.2013.12.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 12/04/2013] [Indexed: 12/29/2022]
Abstract
This article is a comprehensive review on developmental origins of health and disease regarding various factors related to the origins of cardiovascular diseases from early life. It presents a summary of the impacts of various factors such as epigenetics; gene-environment interaction; ethnic predisposition to cardiovascular diseases and their underlying risk factors; prenatal factors; fetal programming; maternal weight status and weight gain during pregnancy; type of feeding during infancy; growth pattern during childhood; obesity; stunting; socioeconomic status; dietary and physical activity habits; active, secondhand, and thirdhand smoking, as well as environmental factors including air pollution and global climate change on the development and progress of cardiovascular diseases and their risk factors. The importance of early identification of predisposing factors for cardiovascular diseases for primordial and primary prevention of cardiovascular diseases from early life is highlighted.
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Affiliation(s)
- Roya Kelishadi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parinaz Poursafa
- Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Marshall S, Burrows T, Collins CE. Systematic review of diet quality indices and their associations with health-related outcomes in children and adolescents. J Hum Nutr Diet 2014; 27:577-98. [PMID: 24524271 DOI: 10.1111/jhn.12208] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Diet quality indices add an important dimension to dietary assessment. The aim of this systematic review was to: (i) identify and describe the attributes and applications of diet quality indices developed for use or used in paediatric populations; (ii) describe associations between these diet quality indices and health-related variables in paediatric populations; and (iii) identify factors that are associated with diet quality in paediatric populations worldwide. METHODS Studies were identified by searching electronic databases for relevant papers from 1980 to October 2013 using keywords. Inclusion criteria were original studies that utilised a quantitative measure of diet quality in children and adolescents aged 0-18 years. RESULTS One hundred and nineteen studies met the inclusion criteria, from which 80 different diet quality indices were identified. The majority of studies had >1000 participants and were of acceptable quality. Of the 56 studies that investigated health-related outcomes, weight status was the most researched. Europe produced the most number of diet quality indices (n = 27 indices). Of the 119 studies, seven intervention studies were identified. Paediatric diet quality indices were found to be associated with environmental, behavioural and maternal factors. CONCLUSIONS The use of diet quality indices in paediatric populations is a rapidly expanding area of research in diverse populations internationally. In economically disadvantaged countries, diet quality indices may be predictive of child growth. However, prospective cohort, intervention and validation studies are required to draw stronger conclusions concerning risk of future disease in paediatric populations in general.
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Affiliation(s)
- S Marshall
- Nutrition and Dietetics, Faculty of Health, School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
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Mittinty MN, Golley RK, Smithers LG, Brazionis L, Lynch JW. A preference based measure of complementary feeding quality: application to the Avon longitudinal study of parents and children. PLoS One 2013; 8:e76111. [PMID: 24155886 PMCID: PMC3796535 DOI: 10.1371/journal.pone.0076111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 08/21/2013] [Indexed: 11/18/2022] Open
Abstract
This paper presents the development of the Complementary Feeding Utility Index (CFUI), a composite index aimed to measure adherence to infant feeding guidelines. Through an axiomatic characterization this paper shows the advantages in using the CFUI are the following: it avoids the use of arbitrary cut-offs, and by converting observed diet preferences into utilities, summing the score is meaningful. In addition, as the CFUI is designed to be scored continuously, it allows the transition from intake of beneficial foods (in low quantities) and intake of detrimental foods (in high quantities) to be more subtle. The paper first describes the rationale being the development of the CFUI and then elaborates on the methodology used to develop the CFUI, including the process of selecting the components. The methodology is applied to data collected from the Avon Longitudinal Study of Parents and Children to show the advantages of the CFUI over traditional diet index approaches. Unlike traditional approaches, the distribution of the CFUI does not peak towards mean value but distributes evenly towards the tails of the distribution.
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Affiliation(s)
- Murthy N. Mittinty
- Discipline of Public Health, The University of Adelaide, Adelaide, Australia
- * E-mail:
| | - Rebecca K. Golley
- Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Lisa G. Smithers
- Discipline of Public Health, The University of Adelaide, Adelaide, Australia
| | - Laima Brazionis
- Discipline of Public Health, The University of Adelaide, Adelaide, Australia
| | - John W. Lynch
- Discipline of Public Health, The University of Adelaide, Adelaide, Australia
- School of Social and Community Medicine, University of Bristol, Bristol, England
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