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Surette VA, Smith‐Simpson S, Fries LR, Forde CG, Ross CF. Observations of feeding practices of US parents of young children with Down syndrome. Matern Child Nutr 2023; 19:e13548. [PMID: 37458153 PMCID: PMC10483950 DOI: 10.1111/mcn.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Parental behaviours influence food acceptance in young children, but few studies have measured these behaviours using observational methods, especially among children with Down syndrome (CWDS). The overall goal of this study was to understand parent feeding practices used during snack time with young CWDS (N = 111, aged 11-58 months). A coding scheme was developed to focus on feeding practices used by parents of CWDS from a structured home-use test involving tasting variously textured snack products. Behavioural coding was used to categorise parental feeding practices and quantify their frequencies (N = 212 video feeding sessions). A feeding prompt was coded as successful if the child ate the target food product or completed the prompt within 20 s of the prompt being given without a refusal behaviour. CWDS more frequently consumed the test foods and completed tasks in response to Autonomy-Supportive Prompts to Eat (49.3%), than to Coercive-Controlling Prompts to Eat (24.2%). By exploring the parent-CWDS relationship during feeding, we can identify potentially desirable parent practices to encourage successful feeding for CWDS. Future research should build upon the knowledge gained from this study to confirm longitudinal associations of parent practices with child behaviours during feeding.
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Affiliation(s)
| | - Sarah Smith‐Simpson
- Sensory and Consumer InsightsNestlé Nutrition North America (Gerber)FremontMichiganUSA
| | | | - Ciarán G. Forde
- Department of Agrotechnology and Food SciencesWageningen University & ResearchWageningenthe Netherlands
| | - Carolyn F. Ross
- School of Food ScienceWashington State UniversityPullmanWashingtonUSA
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2
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Toh MPS, Yang CY, Lim PC, Loh HLJ, Bergonzelli G, Lavalle L, Mardhy E, Samuel TM, Suniega-Tolentino E, Silva Zolezzi I, Fries LR, Chan SY. A probiotic intervention with Bifidobacterium longum NCC3001 on perinatal mood (PROMOTE: PRobiotics On MOThErs’ mood and stress): Protocol for a decentralized randomized controlled trial (Preprint). JMIR Res Protoc 2022; 12:e41751. [PMID: 37018024 PMCID: PMC10131660 DOI: 10.2196/41751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Perinatal mood disorders such as depression and anxiety are common, with subclinical symptomology manifesting as perinatal mood disturbances being even more prevalent. These could potentially affect breastfeeding practices and infant development. Pregnant and lactating women usually limit their exposure to medications, including those for psychological symptoms. Interestingly, the naturally occurring probiotic Bifidobacterium longum (BL) NCC3001 has been shown to reduce anxious behavior in preclinical models and feelings of low mood in nonpregnant human adults. During the COVID-19 pandemic, mental health issues increased, and conventionally conducted clinical trials were restricted by social distancing regulations. OBJECTIVE This study, Probiotics on Mothers' Mood and Stress (PROMOTE), aimed to use a decentralized clinical trial design to test whether BL NCC3001 can reduce symptoms of depression, anxiety, and stress over the perinatal period. METHODS This double-blind, placebo-controlled, randomized, and 3-parallel-arm study aimed to recruit 180 women to evaluate the efficacy of the probiotic taken either during pregnancy and post partum (from 28-32 weeks' gestation until 12 weeks after delivery; n=60, 33.3%) or post partum only (from birth until 12 weeks after delivery; n=60, 33.3%) in comparison with a placebo control group (n=60, 33.3%). Participants consumed the probiotic or matched placebo in a drink once daily. Mood outcomes were measured using the State-Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale questionnaires, captured electronically at baseline (28-32 weeks' gestation) and during e-study sessions over 5 further time points (36 weeks' gestation; 9 days post partum; and 4, 8, and 12 weeks post partum). Saliva and stool samples were collected longitudinally at home to provide mechanistic insights. RESULTS In total, 520 women registered their interest on our website, of whom 184 (35.4%) were eligible and randomized. Of these 184 participants, 5 (2.7%) withdrew after randomization, leaving 179 (97.3%) who completed the study. Recruitment occurred between November 7, 2020, and August 20, 2021. Advertising on social media brought in 46.9% (244/520) of the prospective participants, followed by parenting-specific websites (116/520, 22.3%). Nationwide recruitment was achieved. Data processing is ongoing, and there are no outcomes to report yet. CONCLUSIONS Multiple converging factors contributed to speedy recruitment and retention of participants despite COVID-19-related restrictions. This decentralized trial design sets a precedent for similar studies, in addition to potentially providing novel evidence on the impact of BL NCC3001 on symptoms of perinatal mood disturbances. This study was ideal for remote conduct: because of the high digital literacy and public trust in digital security in Singapore, the intervention could be self-administered without regular clinical monitoring, and the eligibility criteria and outcomes were measured using electronic questionnaires and self-collected biological samples. This design was particularly suited for a group considered vulnerable-pregnant women-during the challenging times of COVID-19-related social restrictions. TRIAL REGISTRATION ClinicalTrials.gov NCT04685252; https://clinicaltrials.gov/ct2/show/NCT04685252. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41751.
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Affiliation(s)
- Melissa P S Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Chui Yuen Yang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Phei Cze Lim
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Hui Li J Loh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Luca Lavalle
- Nestle Research, Lausanne, Lausanne, Switzerland
| | - Elias Mardhy
- Nestle Research, Lausanne, Lausanne, Switzerland
| | | | | | | | | | - Shiao Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Kwok KO, Fries LR, Silva-Zolezzi I, Thakkar SK, Iroz A, Blanchard C. Effects of Probiotic Intervention on Markers of Inflammation and Health Outcomes in Women of Reproductive Age and Their Children. Front Nutr 2022; 9:889040. [PMID: 35734372 PMCID: PMC9207510 DOI: 10.3389/fnut.2022.889040] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/03/2022] [Indexed: 11/13/2022] Open
Abstract
The human intestinal microbiota has been shown to be modulated during inflammatory conditions. Probiotic administration has been shown to affect the immune system and cytokine expression which can affect inflammation and health outcomes. There seems to be an association between the mother's intestinal microbiota and inflammation biomarkers, both of which may contribute to newborn early life immune and metabolic programming and impact short and long-term health outcomes. Probiotic supplementation during pregnancy has been shown to influence metabolic health, immunity, and gastrointestinal health of the mother, and can also have carry-over benefits to infants such as infant allergy risk reduction. Therefore, this review focuses on the evidence of probiotic administration in women of reproductive age, including during pregnancy and its impact on inflammatory markers and on maternal and infant health. We performed a PubMed search for articles published in English in the last 20 years. Immune markers were narrowed to serum and breast milk levels of TNF-α, IL-6 and TGF-β, IgA, and IL-10. Studies that investigated the beneficial effects of interventions in women with gestational diabetes mellitus, polycystic ovarian syndrome, and infant allergy management are summarized. These results show a beneficial or neutral effect on selected health outcomes and that it is safe for woman and their infants. The effect of probiotics on modulation of inflammatory markers was probiotic specific. More research is needed to further our understanding of the mechanisms underlying the effects of probiotics on inflammation and how these effects improve health outcomes.
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Affiliation(s)
- Kah Onn Kwok
- Food Science and Technology Programme, National University of Singapore, Singapore, Singapore
- Nestlé Research, Singapore, Singapore
| | | | | | | | - Alison Iroz
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
| | - Carine Blanchard
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Lausanne, Switzerland
- *Correspondence: Carine Blanchard
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Surette VA, Smith-Simpson S, Fries LR, Ross CF. Food texture experiences across age groups in 4- to 36-month-old children in the United States. J Texture Stud 2021; 53:18-30. [PMID: 34837388 DOI: 10.1111/jtxs.12649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/25/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022]
Abstract
The question of what to feed becomes a new challenge as an infant reaches the transition to complementary foods. Limited information is available that provides a texture progression map for complementary food introduction. Thus, the objective of this study was to determine the relationship between age and food texture experiences (FTE) in young children aged 4-36 months in the United States. A parent-reported survey was fielded with 328 children categorized into five age groups (AGs): 4-8 months (AG1), 9-12 months (AG2), 13-18 months (AG3), 19-24 months (AG4), and 25-36 months (AG5). The present study analyzed four questions focused on FTE, with statistical analyses including probit and logit models, and analysis of variance. Results showed that all 16 food textures were tried at least once (>50%) by AG3. The question answered by participants, "How well does your child manage a specific texture," showed that significant differences existed among AGs for the management of 10 food textures (including chewy, hard, soft), whereas teething alone had no effect. The most refused textures by the children were AG1-crispy (27%), AG2-leafy (23%), AG3-leafy (40%), AG4-tough meat (52%), and AG5-leafy (51%). With increasing AG, the refusal probability of nine food textures, including chewy, leafy, and rubbery, also increased (p < .05). The refusal probability of cold food temperatures decreased with increasing age (p < .05). This study observed FTE in children across AGs and provides useful information to parents and practitioners as they introduce food textures into children's diets.
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Affiliation(s)
- Victoria A Surette
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Sarah Smith-Simpson
- Sensory and Consumer Insights, Nestlé Nutrition, Gerber Products Company, Fremont, Michigan, USA
| | | | - Carolyn F Ross
- School of Food Science, Washington State University, Pullman, Washington, USA
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Guo S, Wang Y, Fries LR, Li Y, Zhang N, Zhang H, Wei H, Jiang X, Shang L. Infant and preschooler feeding behaviors in Chinese families: A systematic review. Appetite 2021; 168:105768. [PMID: 34688731 DOI: 10.1016/j.appet.2021.105768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/02/2022]
Abstract
A systematic review was conducted on the literature on feeding behaviors in Chinese families of children under 6 years old. Forty relevant publications were identified, of which 33 were published in Chinese, 7 in English. All studies were questionnaire-based and used a cross-sectional research design. Approximately half of the studies reported a score for each feeding practice/style, based on a Likert scale; the other half dichotomized these scores into a percentage of the population that reported frequent use of the behaviors. The most commonly reported feeding style of Chinese caregivers was a locally defined "active response" style that somewhat resembled authoritative parenting. The most commonly reported feeding practices were praise, encouraging trying new foods, encouragement of balanced diet and encouragement of healthy eating. Some behaviors showed a great deal of variance in prevalence between studies, which may be at least partially due to differences in methodology and how behaviors were defined. Some feeding behaviors varied in frequency depending on the child's age, although longitudinal studies are needed to better understand how these evolve over time. Child body composition was also associated with feeding behaviors use, although the direction of the association cannot be determined due to the cross-sectional nature of the research. There is still an important gap in the literature regarding the feeding behaviors of non-maternal caregivers, as grandparents often play an important role in childcare in China.
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Affiliation(s)
- Shibo Guo
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Yue Wang
- Department of Health Statistics, The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, The Fourth Military Medical University, Changle West Road 169#, Xi'an, Shaanxi, 710032, China.
| | | | - Yilin Li
- Nestlé Research, Beijing, China.
| | - Nini Zhang
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Haiyue Zhang
- Department of Health Statistics, The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, The Fourth Military Medical University, Changle West Road 169#, Xi'an, Shaanxi, 710032, China.
| | - Haixia Wei
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Xun Jiang
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Lei Shang
- Department of Health Statistics, The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, The Fourth Military Medical University, Changle West Road 169#, Xi'an, Shaanxi, 710032, China.
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6
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Wu W, Zhang J, Silva Zolezzi I, Fries LR, Zhao A. Factors influencing breastfeeding practices in China: A meta-aggregation of qualitative studies. Matern Child Nutr 2021; 17:e13251. [PMID: 34355869 PMCID: PMC8476444 DOI: 10.1111/mcn.13251] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 12/03/2022]
Abstract
The World Health Organization recommends that women exclusively breastfeed until their babies are 6 months old and continue to breastfeed while introducing complementary foods. A meta‐aggregation methodology was used to systematically review and synthesise the qualitative studies on factors influencing breastfeeding practices of healthy Chinese women in Greater China. English and Chinese databases were searched to identify peer‐reviewed qualitative studies (published 2008–2019). Relevant data were extracted, and key themes related to factors influencing breastfeeding practices were identified. Of 7587 articles identified, 22 qualitative studies met inclusion criteria for the review, 10 of which were published in Chinese. A total of 87 themes were extracted from all included studies and classified into 9 subcategories: government enactment of policies, implementation of policies in workplaces, social expectations, social support, medical and health services, services with Chinese characteristics, breastfeeding and pumping facilities, maternal perceptions of breastfeeding and self‐efficacy to breastfeed. The nine subcategories were then grouped into four categories. Potential effect associations among these influence factors of breastfeeding practices emerged from categories and subcategories. Family members' influence on breastfeeding motivation and self‐efficacy suggest a potential benefit of breastfeeding promotion interventions targeting the whole family. The role of primary care should be fully exploited in breastfeeding promotion, including both prenatal education and post‐partum visits. Standardising the training and qualifications of maternity matrons (yuesao) and folk breastfeeding specialists (cuirushi) can promote evidence‐based approaches to facilitating breastfeeding during the confinement period. Increased availability of breastfeeding and pumping facilities in the workplace would facilitate continuing breastfeeding after returning to work.
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Affiliation(s)
- Wei Wu
- Vanke School of Public Health, Tsinghua University, Beijing, China.,Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
| | | | | | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Franse CB, Boelens M, Fries LR, Constant F, van Grieken A, Raat H. Interventions to increase the consumption of water among children: A systematic review and meta-analysis. Obes Rev 2020; 21:e13015. [PMID: 32167233 PMCID: PMC7317453 DOI: 10.1111/obr.13015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/21/2020] [Indexed: 12/17/2022]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis on the effectiveness of interventions to increase children's water consumption. A systematic literature search was conducted in seven electronic databases. Studies published in English before 18 February 2019 that evaluated any type of intervention that measured change in water consumption among children aged 2 to 12 years by applying any type of design were included. Of the 47 interventions included in the systematic review, 24 reported a statistically significant increase in water consumption. Twenty-four interventions (17 randomized controlled trials and seven studies with other controlled designs) were included in the meta-analysis. On average, children in intervention groups consumed 29 mL/d (confidence interval [CI] = 13-46 mL/d) more water than did children in control groups. This effect was larger in eight interventions focused specifically on diet (MD = 73 mL/d, CI = 20-126 mL/d) than in 16 interventions focused also on other lifestyle factors (MD = 15 mL/d, CI = 1-29 mL/d). Significant subgroup differences were also found by study setting and socioecological level targeted but not by children's age group, intervention strategy, or study design. In conclusion, there is evidence that, on average, lifestyle interventions can lead to small increases in children's daily water consumption. More research is needed to further understand the specific intervention elements that have the greatest effect.
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Affiliation(s)
- Carmen B. Franse
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Mirte Boelens
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | | | | | - Amy van Grieken
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
| | - Hein Raat
- Department of Public HealthErasmus University Medical CenterRotterdamThe Netherlands
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Fries LR, van der Horst K, Moding KJ, Hughes SO, Johnson SL. Consistency Between Parent-Reported Feeding Practices and Behavioral Observation During Toddler Meals. J Nutr Educ Behav 2019; 51:1159-1167. [PMID: 31540865 DOI: 10.1016/j.jneb.2019.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess whether feeding questionnaire responses reflect observed mealtime behavior. DESIGN Cross-sectional associations between self-reported and observed behaviors. SETTING Participants' homes. PARTICIPANTS Parents (n = 75) of toddlers (mean age = 24.7 months) in the US. MAIN OUTCOME MEASURES Feeding behavior questionnaires and coded videos of children's dinner meals. ANALYSIS Parents' questionnaire responses of "never" (or "rarely") considered consistent with video observation if behavior was not observed; responses of "always" (or "most of the time") if behavior observed at least once. Proportion (%) of participants observed performing each behavior was calculated for the groups of parents reporting that they "never," "sometimes," or "always" used that feeding practice. These were compared across the 3 response groups. RESULTS Parents reported 6 behaviors consistently (≥70% agreement): allowing child to eat as much as wanted, helping child eat, prompting child to eat, television/screens on during meal, nonfood rewards, and hurrying child. The remaining 8 behaviors fell below the threshold. For many behaviors, all response groups (never, sometimes, always) had similar rates of participants demonstrating the behavior. Only 5 behaviors had observed rates falling in the expected direction (frequency of always > sometimes > never). For some behaviors, the "sometimes" group had a higher (eg, clean plate) or lower (praise) frequency than the other 2 groups. CONCLUSIONS AND IMPLICATIONS Self-reported questionnaire responses predicted whether some, but not all, behaviors were observed. Parents' use of "sometimes" remains difficult to interpret as parents may use "sometimes" inconsistently across behaviors and perhaps to mitigate socially undesirable responses. Self-reports of "sometimes" performing a behavior may have limited utility for prediction of behavior and likely requires additional exploration with the respondent.
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Affiliation(s)
- Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland.
| | - Klazine van der Horst
- Applied Research & Development in Nutrition and Dietetics, Bern University of Applied Sciences
| | - Kameron J Moding
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine
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Fries LR, Chan MJ, Quah PL, Toh JY, Fogel A, Goh AT, Aris IM, Broekman BFP, Cai S, Tint MT, Chong YS, Shek LP, Lee YS, Yap F, Tan KH, Gluckman PD, Godfrey KM, Silva Zolezzi I, Forde CG, Chong MFF. Maternal feeding practices and children's food intake during an ad libitum buffet meal: Results from the GUSTO cohort. Appetite 2019; 142:104371. [PMID: 31323246 PMCID: PMC6682493 DOI: 10.1016/j.appet.2019.104371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022]
Abstract
Parents' feeding practices have been shown to be associated with children's food intake and weight status, but little is known about feeding practices in Asian countries. This study used behavioral observation to explore the feeding practices of 201 mothers of 4.5 year-old children in Singapore during an ad libitum buffet lunch. Feeding practices were coded from videos, focusing on behaviors used to prompt the child to eat more food (autonomy-supportive and coercive-controlling prompts to eat, suggesting items from buffet), those to reduce intake (restriction, questioning food choice), and those related to eating rate (hurrying or slowing child eating). Child outcome measures included energy consumed, variety of food items selected, and BMI. Maternal restriction and trying to slow child eating rate were associated with higher energy consumed by the child (r = 0.19 and 0.13, respectively; p < 0.05). Maternal autonomy-supportive prompts and restriction were associated with a greater variety of items selected by children (r = 0.19 and 0.15, respectively; p < 0.05). The frequency of maternal feeding practice use differed across ethnic groups, with Malay mothers using the most prompts to eat (p < 0.05), Chinese mothers most likely to question a child's food choice (p < 0.01), and Indian mothers the last likely to tell the child to eat faster (p < 0.001). There were no differences between ethnic groups for other feeding practices. No associations were found between feeding practices and child BMI. It is possible that feeding practices related to restriction and slowing child eating are adopted in response to children who consume larger portions, although longitudinal or intervention studies are needed to confirm the direction of this relationship and create local recommendations.
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Affiliation(s)
- Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Case Postale 44, CH-1000, Lausanne, Switzerland.
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Psychiatry, VU Medical Centre, Amsterdam, The Netherlands, Research & Innovation, Location GGZ InGeest, Oldenaller 1, 1081, HJ, Amsterdam, the Netherlands.
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Mya Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Lynette P Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Fabian Yap
- Pediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-National University of Singapore Graduate Medical School, 8 College Road, 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore.
| | - Kok Hian Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Level 3, Singapore, 229899.
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS FT, Tremona Road, SO16 6YD, Southampton, UK.
| | - Irma Silva Zolezzi
- Nestlé Research Singapore Hub, 21 Biopolis Road Nucleos (South Tower), #04-22/23, 138567, Singapore.
| | - Ciaran G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, 117549, Singapore.
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10
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Franse CB, Wang L, Constant F, Fries LR, Raat H. Factors associated with water consumption among children: a systematic review. Int J Behav Nutr Phys Act 2019; 16:64. [PMID: 31409359 PMCID: PMC6693220 DOI: 10.1186/s12966-019-0827-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/29/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Water is recommended as the main beverage for daily fluid intake. Previous systematic reviews have studied the consumption of sugar-sweetened beverages (SSBs) among children, but none have focused on water consumption. Insight into factors that are associated with children's water intake is needed to inform the development of interventions aimed at the promotion of water consumption. The objective of this review was therefore to summarize the current evidence on factors associated with water consumption among children aged 2 to 12 years. METHODS A systematic literature search in seven electronic databases was conducted in May, 2018 and retrieved 17,850 unique records. Two additional studies were identified by hand-searching references of included articles. Studies were selected if they had a cross-sectional or longitudinal study design, focused on children aged 2-12 years and published in an English language peer-reviewed journal. Participants from clinical populations, studies that included data of < 10 participants and non-human studies were excluded. RESULTS A total of 63 articles met inclusion criteria and were included in the analysis. We identified 76 factors that were investigated in these studies; 17/76 were investigated in a longitudinal study. There was evidence of positive associations between water consumption and child's self-efficacy, parental education level, parental self-efficacy, use of feeding practices such as restriction or encouraging healthy eating and study year. Evidence was inconsistent (< 60% of studies reported an association) for child's age, sex, BMI, consumption of SSBs and ethnic background of the parent. There was no evidence (≤33% of studies reported an association) of associations between consumption of milk or juice, parental emotional-, modelling- or instrumental feeding practices, eating school lunch or outside temperature and water consumption. The remaining 54 factors were investigated in fewer than three studies. CONCLUSIONS There is some evidence for an association between potentially modifiable parental and child-related factors and water consumption. However, most factors identified in this review were only studied by one or two studies and most studies were cross-sectional. More longitudinal research is necessary to investigate environmental, parental and child-related factors associated with water consumption that are currently under-studied and could further inform intervention strategies. TRIAL REGISTRATION PROSPERO ID# CRD42018093362 , registered May 22, 2018.
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Affiliation(s)
- Carmen B. Franse
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - L. Wang
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | | | - Lisa R. Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
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11
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Quah PL, Fries LR, Chan MJ, Fogel A, McCrickerd K, Goh AT, Aris IM, Lee YS, Pang WW, Basnyat I, Wee HL, Yap F, Godfrey KM, Chong YS, Shek LPC, Tan KH, Forde CG, Chong MFF. Validation of the Children's Eating Behavior Questionnaire in 5 and 6 Year-Old Children: The GUSTO Cohort Study. Front Psychol 2019; 10:824. [PMID: 31031683 PMCID: PMC6470280 DOI: 10.3389/fpsyg.2019.00824] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 03/27/2019] [Indexed: 01/30/2023] Open
Abstract
Revised subscales of the Children’s Eating Behavior Questionnaire (CEBQ) have been proposed to be more appropriate for assessing appetitive traits in Singaporean 3 year-olds, but the CEBQ has not yet been validated in older children in this population. The current study aimed to validate the CEBQ at ages 5 (n = 653) and 6 (n = 449) in the ethnically diverse GUSTO cohort. Confirmatory factor analysis (CFA) examined whether the established eight-factor model of the CEBQ was supported in this sample. Overall, the CFA showed a poor model fit at both ages 5 and 6. At both ages 5 and 6, an exploratory factor analysis revealed a six-factor structure: food fussiness, enjoyment of food, slowness in eating, emotional undereating, emotional overeating and desire to drink. Cronbach’s alpha estimates ranged from 0.70 to 0.85 for all subscales. Criterion validity was tested by correlating subscales with the weight status of 6 years of age. At age 5 and 6, lower scores of slowness of eating while higher scores of enjoyment of food was associated with child overweight. At age 6, higher scores of desire to drink was also associated child overweight. In conclusion, a revised six factor-structure of the CEBQ at ages 5 and 6 were more appropriate for examining appetitive traits in this sample.
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Affiliation(s)
- Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Anna Fogel
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Keri McCrickerd
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Ai Ting Goh
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore.,Divisions of Pediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Wei Wei Pang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore - National University Health System, Singapore, Singapore
| | - Iccha Basnyat
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Fabian Yap
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, National Institute for Health Research Southampton Biomedical Research Centre, The University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore - National University Health System, Singapore, Singapore
| | - Lynette P C Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore, Singapore
| | - Kok Hian Tan
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ciaran G Forde
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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12
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Quah PL, Ng JC, Fries LR, Chan MJ, Aris IM, Lee YS, Yap F, Godfrey KM, Chong YS, Shek LP, Tan KH, Forde CG, Chong MFF. Longitudinal Analysis Between Maternal Feeding Practices and Body Mass Index (BMI): A Study in Asian Singaporean Preschoolers. Front Nutr 2019; 6:32. [PMID: 31001535 PMCID: PMC6454195 DOI: 10.3389/fnut.2019.00032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 03/06/2019] [Indexed: 12/13/2022] Open
Abstract
Bidirectional studies between maternal feeding practices with subsequent child weight are limited, with no studies in Asian populations. In longitudinal analyses, we assessed the directionality of the associations between maternal feeding practices and body mass index (BMI) in preschoolers. Participants were 428 mother child dyads from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort. Feeding practices were assessed using the Comprehensive Feeding Practices Questionnaire (CFPQ) at age 5 y. Child BMI was measured at ages 4 and 6 y. BMI and maternal feeding practices subscales were transformed to SD scores and both directions of their associations examined with multivariable linear regression and pathway modeling. Higher BMI at age 4 was associated with lower encouragement of balance and variety (β = −0.33; 95%CI: −0.53, −0.13), lower pressure to eat (β = −0.49; −0.68, −0.29) and higher restriction (β = 1.10; 0.67, 1.52) at age 5, adjusting for confounders and baseline feeding practices at 3 years. In the reverse direction, only pressure and restriction at age 5 were associated with lower and higher child BMI at age 6 years, respectively. After the adjustment for baseline BMI at age 5, the association with pressure was attenuated to non-significance (β = 0.01 (−0.01, 0.03), while the association with restriction remained significant (β = 0.02; 0.002, 0.03). Overall, associations from child BMI to maternal restriction for weight control and pressure feeding practices was stronger than the association from these maternal feeding practices to child BMI (Wald's statistics = 24.3 and 19.5, respectively; p < 0.001). The strength and directionality suggests that the mothers in the Asian population were likely to adopt these feeding practices in response to their child's BMI, rather than the converse. Clinical Trial Registry Number and Website This study was registered at clinicaltrials.gov as NCT01174875 (www.clinicaltrials.gov, NCT01174875).
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Affiliation(s)
- Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Jing Chun Ng
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Fabian Yap
- Departments of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Lynette P Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Divisions of Pediatric Allergy, Immunology, and Rheumatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.,Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ciaran G Forde
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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13
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Fries LR, van der Horst K. Parental Feeding Practices and Associations with Children's Food Acceptance and Picky Eating. Nestle Nutr Inst Workshop Ser 2019; 91:31-39. [PMID: 30865956 DOI: 10.1159/000493676] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Picky eating, which includes behaviors such as limited dietary variety, neophobia, food refusals, and sensory sensitivities, can be a source of stress for families. Parents can influence their children's mealtime behavior through the feeding practices they use when offering foods. Some practices are counterproductive to establishing healthy eating habits and should be avoided, but caregivers need alternative behaviors to replace them. Parents should be encouraged to keep trying after a food is refused, as children may need to be exposed to a food several times before it is accepted. Varying the preparation changes the taste, texture, and appearance of food, and children may prefer some variants to others. Some children refuse foods to express independence; thus, providing choices between two healthy options may allow children to express a preference without saying "no" altogether. Coercive feeding practices such as the use of pressure to eat or using food as rewards should be avoided, as these can create negative associations with the food or meals and lead to food refusals. Instead, caregivers can model eating and enjoying the food. Nonfood rewards, such as praise or stickers, can also be used to encourage children to taste a food without negative outcomes.
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14
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Drewnowski A, Caballero B, Das JK, French J, Prentice AM, Fries LR, van Koperen TM, Klassen-Wigger P, Rolls BJ. Novel public-private partnerships to address the double burden of malnutrition. Nutr Rev 2018; 76:805-821. [PMID: 30203056 PMCID: PMC6236421 DOI: 10.1093/nutrit/nuy035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Public–private partnerships are an effective way to address the global double burden of malnutrition. While public–private partnerships operate in multiple forms, their leadership usually falls to governments, public health agencies, or nongovernmental organizations, with the private sector taking a subordinate role. The rapid ascent of social media and mass communications worldwide has provided a disruptive technology for new nutrition intervention programs. A new model, provisionally called private–public engagement, takes advantage of social media, mass media, and integrated social marketing to reach parents, families, and communities directly. These new private–public engagement initiatives need to be managed in ways suggested for public–private partnerships by the World Health Organization, especially if the private sector is in the lead. Once the rationale for engagement is defined, there is a need to mobilize resources, establish in-country partnerships and codes of conduct, and provide a plan for monitoring, evaluation, and accountability. Provided here is an example consistent with the private–public engagement approach, ie, the United for Healthier Kids program, which has been aimed at families with children aged less than 12 years. Materials to inspire behavioral change and promote healthier diets and lifestyle were disseminated in a number of countries through both digital and physical channels, often in partnership with local or regional governments. A description of this program, along with strategies to promote transparency and communication among stakeholders, serves to provide guidance for the development of future effective private–public engagements.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Benjamin Caballero
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jai K Das
- Division of Woman and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jeff French
- Brighton Business School, Brighton University, Brighton, United Kingdom.,Strategic Social Marketing Ltd, Concord, Hampshire, United Kingdom
| | - Andrew M Prentice
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Keneba, Gambia.,MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lisa R Fries
- Corporate Nutrition, Health and Wellness Unit, Nestlé, Vevey, Switzerland.,Behavioral Science Group, Nestlé Research Center, Lausanne, Switzerland
| | | | - Petra Klassen-Wigger
- Corporate Nutrition, Health and Wellness Unit, Nestlé, Vevey, Switzerland.,Nutrition, Health and Wellness Unit, Nestlé Research Center, Lausanne, Switzerland
| | - Barbara J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
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15
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Labbe D, R Fries L, Ferrage A, Lenfant F, Godinot N, Martin N. Right Sizing: Sensory-Based Product Design Is a Promising Strategy to Nudge Consumers toward Healthier Portions. Nutrients 2018; 10:nu10101544. [PMID: 30347636 PMCID: PMC6212860 DOI: 10.3390/nu10101544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 11/24/2022] Open
Abstract
Research has shown that people consume more food when offered larger portions, and that reducing exposure to large food portions and packages could decrease the average daily energy consumed. In this context, our aim is to develop strategies to promote healthier eating behaviors by reducing portion selection and intake. The present research investigates the impact of different visual attributes of foods on quantity perception and portion selection. In the first study, we tested whether modifying the shape of a familiar food influenced the ideal portion size in adults. In the second study, we assessed the impact of shape, number of units, size, and color variety on a perceived quantity for a familiar multiunit product in children. Participants (N1 = 70 adults, N2 = 62 children) completed different picture-based computer tasks. As hypothesized: (1) adults selected a smaller ideal portion size for an elongated product than for wider and thicker shapes, and (2) children’s perception of food quantity was primarily driven by number of pieces, with smaller effects of size and elongation. Perceived quantity was not influenced by color variety. These findings suggest that it may be possible to reduce the size of food portions without negatively impacting perceived quantity, and to provide opportunities to nudge consumers towards smaller portions while maintaining satisfaction.
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Affiliation(s)
- David Labbe
- Nestlé Institute of Material Sciences, Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Lisa R Fries
- Nestlé Institute of Material Sciences, Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Aurore Ferrage
- Nestlé Institute of Material Sciences, Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Francine Lenfant
- Nestlé Institute of Material Sciences, Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Nicolas Godinot
- Nestlé Institute of Material Sciences, Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
| | - Nathalie Martin
- Nestlé Institute of Material Sciences, Nestlé Research, Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland.
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16
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Quah PL, Syuhada G, Fries LR, Chan MJ, Lim HX, Toh JY, Sugianto R, Aris IM, Lee YS, Yap F, Godfrey KM, Gluckman PD, Chong YS, Shek LP, Tan KH, Forde CG, Chong MFF. Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population. PLoS One 2018; 13:e0203045. [PMID: 30226881 PMCID: PMC6143183 DOI: 10.1371/journal.pone.0203045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/14/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In Asia, little is known about how maternal feeding practices are associated with dietary intakes and body mass index (BMI) in preschoolers. OBJECTIVE To assess the relationships between maternal feeding practices with dietary intakes and BMI in preschoolers in Asia using cross-sectional analysis in the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort. PARTICIPANT SETTINGS Mothers (n = 511) who completed the Comprehensive Feeding Practices Questionnaire (CFPQ) and a semi-quantitative Food Frequency Questionnaire (FFQ) when children were 5 years old. STATISTICAL ANALYSIS Associations between 12 maternal feeding practices (mean scores divided into tertiles) and children's dietary intakes of seven food groups and BMI z-scores were examined using the general linear regression model. Weight and height of the child were measured, and dietary intakes derived from the FFQ. RESULTS Compared to those in the low tertile, mothers in the high tertile of modelling healthy food intakes had children with higher intakes of vegetables[+20.0g/day (95%CI:11.6,29.5)] and wholegrains[+ 20.9g/day (9.67,31.1)] but lower intakes of sweet snacks[-10.1g/day (-16.3,-4.94)] and fast-foods[-5.84g/day (-10.2,-1.48)]. Conversely, children of mothers in the high tertile for allowing child control (lack of parental control) had lower intake of vegetables[-15.2g/day (-26.6,-5.21)] and wholegrains[-13.6g/day (-22.9,-5.27)], but higher intakes of sweet snacks[+13.7g/day (7.7, 19.8)] and fast-foods[+6.63g/day (3.55,9.72)]. In relation to BMI at 5 years, food restrictions for weight was associated with higher BMI z-scores [0.86SD (0.61,1.21)], while use of pressure was associated with lower BMI z-scores[-0.49SD(-0.78,-0.21)]. CONCLUSIONS AND IMPLICATIONS Modelling healthy food intakes by mothers was the key feeding practice associated with higher intakes of healthy foods and lower intakes of discretionary foods. The converse was true for allowing child control. Only food restrictions for weight and use of pressure were associated with BMI z-scores.
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Affiliation(s)
- Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Ginanjar Syuhada
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | | | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Hui Xian Lim
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Ray Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Izzuddin M. Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Health System, Singapore, Singapore
| | - Fabian Yap
- Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore, Singapore
- Duke-NUS Graduate Medical School, Lee Kong Chian School of Medicine, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Peter D. Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap- Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Ciaran G. Forde
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mary F. F. Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
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17
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Fogel A, Mccrickerd K, Fries LR, Goh AT, Quah PL, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Chong MFF, Forde CG. Eating in the absence of hunger: Stability over time and associations with eating behaviours and body composition in children. Physiol Behav 2018; 192:82-89. [PMID: 29609000 PMCID: PMC6020992 DOI: 10.1016/j.physbeh.2018.03.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND/OBJECTIVES Eating in the absence of hunger (EAH) has been linked to obesity in adults and children. This study examined the stability of EAH in children between 4.5 and 6 years old, and associations with energy intake and portion selection, as well as cross-sectional and prospective associations with body composition. METHODS The participants were 158 boys and girls from the Growing Up in Singapore Towards healthy Outcomes cohort. At ages 4.5 and 6 years old children were provided lunch ad libitum, and immediately afterwards were exposed to palatable snacks to measure energy intake in the absence of hunger. At age 6 children completed an additional computer-based task to measure ideal portion size, where they selected pictures of the portions they would like to eat across eight foods. Measures of anthropometry (height/weight/skinfolds) were collected at both ages. RESULTS Children who consumed energy during the EAH task at age 4.5 years were 3 times more likely to also do so at age 6 years. Children with high EAH intakes at age 4.5 years had high EAH intakes at age 6, highlighting stability of this behaviour over time. Energy consumed at lunch was unrelated to energy consumed during the EAH task, but children who ate in the absence of hunger cumulatively consumed more energy over lunch and the EAH task. Children who showed EAH tended to select larger ideal portions of foods during the computer task. EAH was not associated with measures of body composition. CONCLUSIONS EAH is a stable behavioural risk factor for increased energy intake, but was not associated with body composition in this cohort. The majority of children ate in the absence of hunger, suggesting that interventions aimed at reducing responsiveness to external food cues could help to reduce energy intakes. Trial Registry Number: NCT01174875; https://clinicaltrials.gov/.
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Affiliation(s)
- Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
| | - Keri Mccrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
| | | | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Fabian Yap
- KK Women's and Children's Hospital, Singapore.
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Michael J Meaney
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Douglas Mental Health University Institute, McGill University, Montréal, Canada.
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Psychiatry, VU Medical Centre, VU University, Amsterdam, Netherlands
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton, NHS Foundation Trust, Southampton, United Kingdom.
| | - Mary Foong Fong Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Ciarán G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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18
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Fogel A, Fries LR, McCrickerd K, Goh AT, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Chong MFF, Forde CG. Prospective associations between parental feeding practices and children's oral processing behaviours. Matern Child Nutr 2018; 15:e12635. [PMID: 30051652 DOI: 10.1111/mcn.12635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 04/10/2018] [Accepted: 05/22/2018] [Indexed: 12/18/2022]
Abstract
Previous research demonstrated that faster eating rates are linked with increased intake of energy during a meal. Here, we examined whether within-meal parental feeding practices show cross-sectional and prospective associations with children's oral processing behaviours and whether the previously demonstrated association between faster eating rates and higher energy intakes varies by parental feeding practices. A subset (n = 155) of children and their mothers from the Growing Up in Singapore Towards healthy Outcomes cohort participated in an ad libitum meal at age 4.5 years. Children's oral processing behaviours (eating rate, bite size, chews per gram, oral exposure time, and meal duration) and parental feeding practices (autonomy-supporting and coercive prompts, restrictions, hurrying, and slowing) were recorded during the meal. Subsequently, 94 of the children participated in a follow-up meal without their mothers at age 6 years. Parental feeding practices were not consistently associated with child oral processing behaviours overall. However, exploratory post hoc analyses revealed some sex differences. The mothers of girls with faster eating rates, larger bite sizes, and fewer chews were more likely to use hurrying, slowing, and restrictions, but similar associations were not observed among boys. Children who had the most problematic eating style and were eating fast and for long experienced more restrictions, instructions to slow down, and prompts. Faster eating rates were linked with the highest energy intakes if children were additionally prompted to eat. Prospective analyses showed that children who were more often prompted using coercive techniques and less frequently hurried at age 4.5 years had faster eating rates at 6 years and a larger increase in eating rates between ages 4.5 and 6 years but did not consume more energy. Although the direction of these associations cannot be assumed, these exploratory analyses suggest sex differences in the associations between feeding practices and oral processing behaviours and highlight the potential role of parents in the development of children's oral processing behaviours.
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Affiliation(s)
- Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | | | - Keri McCrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Fabian Yap
- KK Women's and Children's Hospital, Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.,Douglas Mental Health University Institute, McGill University, Montréal, Québec, Canada
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Psychiatry, VU Medical Centre, VU University, Amsterdam, The Netherlands
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mary Foong Fong Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ciarán G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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19
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Fogel A, Fries LR, McCrickerd K, Goh AT, Quah PL, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Fong Chong MF, Forde CG. Oral processing behaviours that promote children's energy intake are associated with parent-reported appetitive traits: Results from the GUSTO cohort. Appetite 2018; 126:8-15. [PMID: 29551400 PMCID: PMC5973283 DOI: 10.1016/j.appet.2018.03.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 02/27/2018] [Accepted: 03/14/2018] [Indexed: 01/29/2023]
Abstract
Oral processing behaviours associated with faster eating rates have been consistently linked to increased energy intakes, but little is known about their links to children's appetitive traits. This study used the Child Eating Behaviour Questionnaire (CEBQ) to explore cross-sectional and prospective associations between parent-reported appetitive traits and observed oral processing behaviours. Participants were 195 children from the Growing Up in Singapore Towards healthy Outcomes cohort, who participated in a video-recorded ad libitum lunch at 4.5 (Time 1) and 6 years (Time 2). Their mothers completed the CEBQ around the same time points. Children's bites, chews and swallows were coded, and used to calculate their eating rate, bite size, chews per bite, chew rate, oral exposure time and oral exposure per bite. At Time 1, children with higher scores in slowness in eating had lower eating and chew rates. At Time 2, higher scores for food enjoyment and lower for satiety responsiveness, slowness in eating, and food fussiness were linked with higher eating rates and greater energy intakes (r > 0.16, p < 0.05). Post-hoc analyses revealed that these associations were moderated by BMI and only present among children with higher BMI. Faster eating rates mediated the associations between greater food enjoyment, lower slowness in eating, lower food fussiness and higher intakes of energy. Children with higher slowness in eating scores had lower increases in eating rates over time, and children with higher BMI who had greater food enjoyment and food responsiveness scores had greater increases in eating rates over time. The findings suggest that oral processing behaviours linked with increased obesity risk may be underpinned by appetitive traits and may be one of the behavioural pathways through which these appetitive traits influence energy intakes.
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Affiliation(s)
- Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
| | | | - Keri McCrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | | | - Fabian Yap
- KK Women's and Children's Hospital, Singapore.
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Michael J Meaney
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Douglas Mental Health University Institute, McGill University, Montréal, Canada.
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Psychiatry, VU Medical Centre, VU University, Amsterdam, The Netherlands.
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
| | - Mary Foong Fong Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
| | - Ciarán G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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20
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Afeiche MC, Villalpando-Carrión S, Reidy KC, Fries LR, Eldridge AL. Many Infants and Young Children Are Not Compliant with Mexican and International Complementary Feeding Recommendations for Milk and Other Beverages. Nutrients 2018; 10:nu10040466. [PMID: 29642599 PMCID: PMC5946251 DOI: 10.3390/nu10040466] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 12/18/2022] Open
Abstract
Mexican and international authorities provide guidelines for milk and beverage consumption for young children. This study classifies beverages as appropriate or inappropriate by age (0-5.9, 6-11.9, and 12-23.9 months) and details consumption patterns, amounts consumed, and the associated socio-demographic characteristics. Analysis of the Mexican National Nutrition and Health Survey (ENSANUT 2012) was conducted (n = 949). Among 0-5.9 month olds, 66.7% consumed either breast milk, infant formula, or a combination with no other beverages, whereas 29.3% consumed breast milk and/or infant formula with water (mean = 58 g/day) and/or other beverages (mean = 115 g/day), such as 100% fruit juice, milk, and sugar-sweetened beverages (SSBs). For infants 6-11.9 months, appropriate beverages include breast milk, infant formula, and water; only 40.2% met these recommendations. Many 6-11.9 month olds consumed age-inappropriate beverages, including milk (31%) and SSBs (35%). After 12 months of age, appropriate beverages include water, milk, and a limited amount of 100% fruit juice and SSBs; 32.4% complied fully, 18.3% consumed appropriate and inappropriate beverages, and 49.3% consumed only inappropriate beverages. Among 12-23.9 month olds, 58% consumed milk, 18% juice, and 42% water while 63% consumed SSBs. Many infants and young children are not compliant with Mexican and international breastfeeding and complementary feeding guidelines for beverages. Communication and guidance about age-appropriate beverages should be improved.
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Affiliation(s)
- Myriam C Afeiche
- Institute of Nutritional Science, Nestlé Research Center, Route du Jorat 57, 1000 Lausanne, Switzerland.
| | - Salvador Villalpando-Carrión
- Hospital Infantil de Mexico, Gastroenterology and Nutrition, Mexico City and Nestlé Infant Nutrition, Av. Ejercito Nacional 453, Delegacion Miguel Hidalgo, Col. Granada, Mexico City 11520, Mexico.
| | - Kathleen C Reidy
- Nestlé Nutrition Global R&D, 12 Vreeland Road, Florham Park, NJ 07932, USA.
| | - Lisa R Fries
- Consumer Science and Applied Nutrition, Institute of Material Science, Nestlé Research Center, Route du Jorat 57, 1000 Lausanne, Switzerland.
| | - Alison L Eldridge
- Institute of Nutritional Science, Nestlé Research Center, Route du Jorat 57, 1000 Lausanne, Switzerland.
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21
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Ferrage A, R Fries L, Godinot N, Labbe D, Martin N. Fairness-Based Tasks for Assessing Children's Perceptions of Food Quantities and Associations with Portion Selection. Nutrients 2018; 10:nu10040453. [PMID: 29642371 PMCID: PMC5946238 DOI: 10.3390/nu10040453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 03/28/2018] [Accepted: 04/03/2018] [Indexed: 01/20/2023] Open
Abstract
It is critical to develop ecologically valid experimental methods to assess consumers’ food-related behaviors. Ad libitum approaches are often used but may not be appropriate for studies with children or with products that are not typically consumed until the individual feels full. The current study presents novel methods to assess children’s size perception and portion preference for gummy candies. In the first study, 62 children (30 boys, 32 girls) aged 6 to 9 years completed two matching tasks: one using pictures on a computer screen, and a similar task where the products were physically manipulated. Results of the two matching tasks were correlated, demonstrating that a computer-based approach could be used to predict the factors influencing children’s perception of food amount: the number, size, and shape of pieces. In the second study, a portioning measure was developed to investigate whether the factors identified in the matching tasks were confirmed in a task that more closely represented portion selection in the real world. The effects observed in the matching tasks could not be replicated in the portioning task. The size of each item had no significant impact on the portion selection, suggesting that it may be possible to reduce the size of pieces in snacks where multiple pieces are typically consumed without negatively impacting perceived quantity in children, thus offering a promising strategy to nudge children toward choosing smaller portions.
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Affiliation(s)
- Aurore Ferrage
- Consumer Science & Applied Nutrition Department, Nestlé Research Center, 1000 Lausanne, Switzerland.
| | - Lisa R Fries
- Consumer Science & Applied Nutrition Department, Nestlé Research Center, 1000 Lausanne, Switzerland.
| | - Nicolas Godinot
- Consumer Science & Applied Nutrition Department, Nestlé Research Center, 1000 Lausanne, Switzerland.
| | - David Labbe
- Consumer Science & Applied Nutrition Department, Nestlé Research Center, 1000 Lausanne, Switzerland.
| | - Nathalie Martin
- Consumer Science & Applied Nutrition Department, Nestlé Research Center, 1000 Lausanne, Switzerland.
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22
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Fogel A, Goh AT, Fries LR, Sadananthan SA, Velan SS, Michael N, Tint MT, Fortier MV, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Chong MFF, Forde CG. A description of an 'obesogenic' eating style that promotes higher energy intake and is associated with greater adiposity in 4.5year-old children: Results from the GUSTO cohort. Physiol Behav 2017; 176:107-116. [PMID: 28213204 DOI: 10.1016/j.physbeh.2017.02.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/23/2017] [Accepted: 02/12/2017] [Indexed: 01/23/2023]
Abstract
Recent findings confirm that faster eating rates support higher energy intakes within a meal and are associated with increased body weight and adiposity in children. The current study sought to identify the eating behaviours that underpin faster eating rates and energy intake in children, and to investigate their variations by weight status and other individual differences. Children (N=386) from the Growing Up in Singapore towards Healthy Outcomes (GUSTO) cohort took part in a video-recorded ad libitum lunch at 4.5years of age to measure acute energy intake. Videos were coded for three eating behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min) and measures of eating microstructure: eating rate (g/min), total oral exposure (min), average bite size (g/bite), chews per gram, oral exposure per bite (s), total bites and proportion of active to total mealtime. Children's BMIs were calculated and a subset of children underwent MRI scanning to establish abdominal adiposity. Children were grouped into faster and slower eaters, and into healthy and overweight groups to compare their eating behaviours. Results demonstrate that faster eating rates were correlated with larger average bite size (r=0.55, p<0.001), fewer chews per gram (r=-0.71, p<0.001) and shorter oral exposure time per bite (r=-0.25, p<0.001), and with higher energy intakes (r=0.61, p<0.001). Children with overweight and higher adiposity had faster eating rates (p<0.01) and higher energy intakes (p<0.01), driven by larger bite sizes (p<0.05). Eating behaviours varied by sex, ethnicity and early feeding regimes, partially attributable to BMI. We propose that these behaviours describe an 'obesogenic eating style' that is characterised by faster eating rates, achieved through larger bites, reduced chewing and shorter oral exposure time. This obesogenic eating style supports acute energy intake within a meal and is more prevalent among, though not exclusive to, children with overweight. Clinical Trial Registry Number: NCT01174875; https://clinicaltrials.gov/.
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Affiliation(s)
- Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | | | | | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Bio-Imaging Consortium, A*STAR, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Mya Thway Tint
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marielle Valerie Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Fabian Yap
- KK Women's and Children's Hospital, Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Douglas Mental Health University Institute, McGill University, Montréal, Canada
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Mary Foong Fong Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ciarán G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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