Nutrients

Research

11 pages, 535 KiB

Open AccessArticle

Examining the Influence of Cultural Immersion on Willingness to Try Fruits and Vegetables among Children in Guam: The Traditions Pilot Study

by Tanisha F. Aflague, Rachael T. Leon Guerrero, Treena Delormier, Rachel Novotny, Lynne R. Wilkens and Carol J. Boushey

Nutrients 2020, 12(1), 18; https://doi.org/10.3390/nu12010018 - 20 Dec 2019

Cited by 3 | Viewed by 2920

Abstract

This pilot study examined the influence of cultural immersion on willingness to try fruits and vegetables (FV) among children 3–12 years old in three summer camps in Guam with different cultural exposure levels: cultural immersion camp (CIC), high exposure; university day camp (UDC), [...] Read more.

This pilot study examined the influence of cultural immersion on willingness to try fruits and vegetables (FV) among children 3–12 years old in three summer camps in Guam with different cultural exposure levels: cultural immersion camp (CIC), high exposure; university day camp (UDC), moderate exposure; and recreational sports camp (RSC), zero exposure. Children, ages 3–12 years old for CIC and UDC and 5–12 years old for RSC, participated: CIC (n = 47), UDC (n = 23), and RSC (n = 33). Children’s willingness to try FV was assessed with the Adapted WillTry tool before and after each program. Whole FV intakes were assessed concurrently using the mobile food record in CIC and UDC. Using multivariate regression, WillTry post-assessment outcomes were modeled adjusting for pre-assessment, child characteristics, exposure, and parent cultural affiliation. Unique to the Adapted WillTry tool are three FV scales, local novel, local common, and imported, which are classified by source (local or imported) and/or familiarity (novel or common). WillTry adjusted mean FV post-scores by highest exposure camp to lowest were 2.2, 2.3, and 2.2 for local novel and 2.6, 2.6, and 2.6 for local common. No differences among camps were significant; however, there was an increase in the willingness to try scores for all FV score types and camps. The Traditions pilot study demonstrated: (1) feasibility of a multi-arm parallel design using existing community programs in limited-resource environments and (2) further examination of nutrition education components and contexts are needed to understand diet behaviors of indigenous populations. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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15 pages, 272 KiB

Open AccessArticle

Dietary Patterns and Risk of Obesity and Early Childhood Caries in Australian Toddlers: Findings from an Australian Cohort Study

by Lucinda K. Bell, Celeste Schammer, Gemma Devenish, Diep Ha, Murray W. Thomson, John A. Spencer, Loc G. Do, Jane A. Scott and Rebecca K. Golley

Nutrients 2019, 11(11), 2828; https://doi.org/10.3390/nu11112828 - 19 Nov 2019

Cited by 24 | Viewed by 5866

Abstract

We examined associations between dietary patterns at 12 months, characterised using multiple methodologies, and risk of obesity and early childhood caries (ECC) at 24–36 months. Participants were Australian toddlers (n = 1170) from the Study of Mothers’ and Infants’ Life Events affecting oral [...] Read more.

We examined associations between dietary patterns at 12 months, characterised using multiple methodologies, and risk of obesity and early childhood caries (ECC) at 24–36 months. Participants were Australian toddlers (n = 1170) from the Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE) birth cohort. Principal Components Analysis (PCA) and the Dietary Guideline Index for Children and Adolescents (DGI-CA) were applied to dietary intake data (1, 2 or 3-days) at 12 months, and regression analysis used to examine associations of dietary patterns with body mass index Z-score and presence of ECC at 24–36 months. Two dietary patterns were extracted using PCA: family diet and cow’s milk and discretionary combination. The mean DGI-CA score was 56 ± 13 (out of a possible 100). No statistically significant or clinically meaningful associations were found between dietary pattern or DGI-CA scores, and BMI Z-scores or ECC (n = 680). Higher cow’s milk and discretionary combination pattern scores were associated with higher energy and free sugars intakes, and higher family diet pattern scores and DGI-CA scores with lower free sugars intakes. The association between dietary patterns and intermediate outcomes of free sugars and energy intakes suggests that obesity and/or ECC may not yet have manifested, and thus longitudinal investigation beyond two years of age is warranted. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

9 pages, 252 KiB

Open AccessArticle

Evaluation of the Proximity of Singaporean Children’s Dietary Habits to Food-Based Dietary Guidelines

by Iain A Brownlee, Jasmine Low, Naageswari Duriraju, Mavis Chun, Jessica Xiu Yan Ong, Mia Eng Tay, Gilly A Hendrie and Lourdes Santos-Merx

Nutrients 2019, 11(11), 2615; https://doi.org/10.3390/nu11112615 - 1 Nov 2019

Cited by 17 | Viewed by 5627

Abstract

Dietary habits in children may not only impact current health status but could also shape future, lifelong dietary choices. Dietary intake data in Singaporean children are limited. The current study aimed to define the overall diet quality of Singaporean children using an existing [...] Read more.

Dietary habits in children may not only impact current health status but could also shape future, lifelong dietary choices. Dietary intake data in Singaporean children are limited. The current study aimed to define the overall diet quality of Singaporean children using an existing cross-sectional dataset and to consider how demographic factors (i.e., body mass index (BMI) status, ethnicity, age, and sex) were associated with these scores. Existing, cross-sectional dietary data (n = 561 children aged 6–12 years, collected in 2014–2015) from duplicate 24-h recalls were assessed for diet quality using an index based on the Singaporean Health Promotion Board dietary guidelines. Total diet quality scores were calculated from ten different components (frequencies of rice and alternatives, whole grains, fruits, vegetables, meat and alternatives, dairy and alternatives, total fat, saturated fat, sodium intake, and added sugars). Association with demographic factors and BMI category was evaluated by one-way multivariate ANOVA (MANOVA) tests, with Bonferroni post hoc analyses. Median (interquartile range) total diet quality scores were 65.4 (57.1–73.0). Median scores for whole grains (0.0, 0.0–33.4), fruits (24.1, 0.0–65.3), vegetables (36.5, 10.4-89.8), and sodium (58.4, 0.0–100.0) intake were frequently sub-optimal. Children of Malay ethnic origin had statistically lower total diet quality scores ((55.3, 47.5–60.3) vs. other ethnic groups (combined median 65.4 (57.1, 73.0); p < 0.001). These findings highlight the need for continuing efforts to improve dietary intake in young Singaporeans and for longitudinal dietary monitoring in this group. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

10 pages, 242 KiB

Open AccessArticle

Racial/Ethnic Disparities in Dietary Intake of U.S. Children Participating in WIC

by Meghan C. Zimmer, Veronica Rubio, Kristina W. Kintziger and Cristina Barroso

Nutrients 2019, 11(11), 2607; https://doi.org/10.3390/nu11112607 - 31 Oct 2019

Cited by 20 | Viewed by 4673

Abstract

Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children [...] Read more.

Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children participating in WIC, with a focus on priority nutrients and food groups for future WIC food package revisions, as described in a recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM). We used data from the 2011–2014 National Health and Nutrition Examination Surveys (NHANES) and multivariable linear regression analysis to evaluate relationships between race/ethnicity and nutrient/food group intake of children participating in WIC. All data were analyzed using SAS 9.4 survey procedures, accounting for the complex survey design of the NHANES. Compared to non-Hispanic White children, Hispanic children had diets with better nutrient distribution and lower dietary energy density, while non-Hispanic Black children had diets with poorer nutrient intake. Hispanic children had higher potassium and fiber intake, and consumed more legumes, while non-Hispanic Black children had lower calcium and vitamin D intake, higher sodium intake, and lower total dairy intake, compared to non-Hispanic White children. These findings can inform WIC nutrition education messages and future food package revisions. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

14 pages, 296 KiB

Open AccessArticle

Micronutrient Adequacy in Preschool Children Attending Family Child Care Homes

by Esther Cuadrado-Soto, Patricia Markham Risica, Kim M. Gans, Noereem Z. Mena, Carolyn Ellis, Carolina D. Araujo, Ingrid E. Lofgren, Kristen Cooksey Stowers and Alison Tovar

Nutrients 2019, 11(9), 2134; https://doi.org/10.3390/nu11092134 - 6 Sep 2019

Cited by 4 | Viewed by 3397

Abstract

Limited data is available on the micronutrient intake and adequacy in preschool children enrolled in family child care homes (FCCH). The goal of this paper is to describe the micronutrient adequacy relative to age-specific recommendations of preschool-aged children (aged 2–5 years) attending FCCH [...] Read more.

Limited data is available on the micronutrient intake and adequacy in preschool children enrolled in family child care homes (FCCH). The goal of this paper is to describe the micronutrient adequacy relative to age-specific recommendations of preschool-aged children (aged 2–5 years) attending FCCH in Rhode Island (RI). Dietary data among younger preschoolers (aged 2–3 years), n = 245) and older preschoolers (aged 4–5 years), n = 121) in 118 RI FCCH (N = 366 children) were analyzed. Nutrient adequacy was assessed as the amount of nutrient per 1000 kcal of the diet that would meet the Institute of Medicine nutrient requirements (critical nutrient density), and it was compared to the observed nutrient densities of the children. The sodium:potassium ratio was also calculated. For most micronutrients, the observed density met or exceeded the recommendation, meaning the children’s intake was adequate. However, a high proportion of children had nutrient densities under the recommendation for vitamins D, E, K, and potassium (86.1%, 89.1%, 70.8%, and 99.2% of children, respectively). The mean vitamin B12, potassium, and zinc densities were statistically higher in younger vs. older preschoolers (p < 0.05 for all). Low densities in calcium and vitamins K and B5 were more frequent in older children vs. younger children (p < 0.05). In addition, older preschoolers had a higher sodium:potassium ratio than younger children (p < 0.05). The micronutrient intake density was adequate for most nutrients. However, intake of some nutrients was of concern. Further attention to training and compliance in FCCH may improve the diet quality of those cared for in these settings. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

18 pages, 692 KiB

Open AccessArticle

Does an Age-Specific Treatment Program Augment the Efficacy of a Cognitive-Behavioral Weight Loss Program in Adolescence and Young Adulthood? Results from a Controlled Study

by Petra Warschburger and Jana Zitzmann

Nutrients 2019, 11(9), 2053; https://doi.org/10.3390/nu11092053 - 2 Sep 2019

Cited by 4 | Viewed by 4166

Abstract

Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to [...] Read more.

Research on weight-loss interventions in emerging adulthood is warranted. Therefore, a cognitive-behavioral group treatment (CBT), including development-specific topics for adolescents and young adults with obesity (YOUTH), was developed. In a controlled study, we compared the efficacy of this age-specific CBT group intervention to an age-unspecific CBT group delivered across ages in an inpatient setting. The primary outcome was body mass index standard deviation score (BMI-SDS) over the course of one year; secondary outcomes were health-related and disease-specific quality of life (QoL). 266 participants aged 16 to 21 years (65% females) were randomized. Intention-to-treat (ITT) and per-protocol analyses (PPA) were performed. For both group interventions, we observed significant and clinically relevant improvements in BMI-SDS and QoL over the course of time with small to large effect sizes. Contrary to our hypothesis, the age-specific intervention was not superior to the age-unspecific CBT-approach. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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12 pages, 413 KiB

Open AccessArticle

Child-Report of Food Insecurity Is Associated with Diet Quality in Children

by Matthew J. Landry, Alexandra E. van den Berg, Fiona M. Asigbee, Sarvenaz Vandyousefi, Reem Ghaddar and Jaimie N. Davis

Nutrients 2019, 11(7), 1574; https://doi.org/10.3390/nu11071574 - 12 Jul 2019

Cited by 62 | Viewed by 7763

Abstract

Food insecurity (FI) is adversely associated with physical and mental wellbeing in children. The mechanism underlying this association is assumed to be dietary intake; however, evidence has been mixed. This study examined the relationship between self-reported FI and dietary quality among low-income children. [...] Read more.

Food insecurity (FI) is adversely associated with physical and mental wellbeing in children. The mechanism underlying this association is assumed to be dietary intake; however, evidence has been mixed. This study examined the relationship between self-reported FI and dietary quality among low-income children. Cross-sectional data were used from TX Sprouts, a school-based cooking, gardening, and nutrition intervention. A sample of 598 children completed two 24-h dietary recalls and a questionnaire including an adapted version of the 5-item Child Food Security Assessment (CFSA). Food security was categorized as food secure or FI based on summed CFSA scores. Dietary quality was assessed using the Health Eating Index-2015 (HEI-2015). Mixed effects linear regression models examined associations between FI and dietary quality. Children were 64% Hispanic, 55% female, and were 9.2 years old on average. Adjusting for sociodemographic characteristics, BMI percentile, and energy intake, FI was associated with lower HEI-2015 total scores (β = −3.17; 95% CI = −5.28, −1.06; p = 0.003). Compared to food secure children, FI children had lower greens and beans (2.3 vs. 1.9, p = 0.016), seafood and plant protein (2.0 vs. 1.6, p = 0.006), and added sugar (7.4 vs. 8.0, p = 0.002) component scores. Interventions targeting low-income and FI children should investigate ways to improve dietary quality. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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16 pages, 728 KiB

Open AccessArticle

Examining Constructs of Parental Reflective Motivation towards Reducing Unhealthy Food Provision to Young Children

by Brittany J. Johnson, Gilly A. Hendrie, Dorota Zarnowiecki, Elisabeth K. Huynh and Rebecca K. Golley

Nutrients 2019, 11(7), 1507; https://doi.org/10.3390/nu11071507 - 1 Jul 2019

Cited by 3 | Viewed by 5083

Abstract

Parents are an ideal target to reduce children’s unhealthy food intake. Motivation is one component of behavior change; however, there is a paucity of research exploring parental motivation in unhealthy food provision. This study aimed to understand the relationships between, and relative importance [...] Read more.

Parents are an ideal target to reduce children’s unhealthy food intake. Motivation is one component of behavior change; however, there is a paucity of research exploring parental motivation in unhealthy food provision. This study aimed to understand the relationships between, and relative importance of, constructs of parents’ reflective motivation and children’s intake of unhealthy foods. An online survey captured parent-rated reflective motivation constructs based on the health action process approach (HAPA) model, and children’s intake of unhealthy food using the short food survey. The HAPA model includes constructs of self-efficacy, risk perception, outcome expectancies, intention, and planning. Structural equation modelling was used to examine relationships between constructs and the HAPA model in its structural form. Four-hundred and ninety-five parents of three to seven-year olds completed the study. Model fit statistics (X² = 210.03, df = 83, p < 0.001; Comparative fit index (CFI) = 0.96; Tucker Lewis index (TLI) = 0.94) supported suitability of the HAPA model. The HAPA model explained 9.2% of the variance in children’s unhealthy food intake. Constructs of self-efficacy (action to maintenance β = 0.69; maintenance to recovery β = 0.70; maintenance to planning β = 0.82) were found to be the most important constructs for reducing children’s unhealthy food intake, followed by planning (to unhealthy food intake β = −0.32) and intention (to planning β = 0.21). This study provides an initial insight into parental motivation and identifies primary intervention targets to enhance parental motivation to reduce unhealthy food provision, and subsequently children’s unhealthy food intake. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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22 pages, 1465 KiB

Open AccessArticle

Socio-Ecological Factors That Influence Infant and Young Child Nutrition in Kiribati: A Biocultural Perspective

by Stephen R. Kodish, Kelsey Grey, Maryam Matean, Uma Palaniappan, Stanley Gwavuya, Caitlin Gomez, Tinai Iuta, Eretii Timeon, Martina Northrup-Lyons, Judy McLean and Wendy Erasmus

Nutrients 2019, 11(6), 1330; https://doi.org/10.3390/nu11061330 - 13 Jun 2019

Cited by 14 | Viewed by 5791

Abstract

This study sought to elucidate the multi-level factors that influence behaviors underlying high childhood stunting and widespread micronutrient deficiencies in Kiribati. This two-phase formative research study had an emergent and iterative design using the socio-ecological model as the guiding theoretical framework. Phase 1 [...] Read more.

This study sought to elucidate the multi-level factors that influence behaviors underlying high childhood stunting and widespread micronutrient deficiencies in Kiribati. This two-phase formative research study had an emergent and iterative design using the socio-ecological model as the guiding theoretical framework. Phase 1 was exploratory while phase 2 was confirmatory. In phase 1, in-depth interviews, free lists, seasonal food availability calendar workshops, and household observations were conducted. In phase 2, focus group discussions, pile sorts, participatory workshops, and repeat observations of the same households were completed. Textual data were analyzed using NVivo software; ethnographic data were analyzed with Anthropac software for cultural domain analysis. We found a combination of interrelated structural, community, interpersonal, and individual-level factors contributing to the early child nutrition situation in Kiribati. Despite widespread knowledge of nutritious young child foods among community members, households make dietary decisions based not only on food availability and access, but also longstanding traditions and social norms. Diarrheal disease is the most salient young child illness, attributable to unsanitary environments and sub-optimal water, sanitation, and hygiene behaviors. This research underscores the importance of a multi-pronged approach to most effectively address the interrelated policy, community, interpersonal, and individual-level determinants of infant and young child nutrition in Kiribati. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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11 pages, 237 KiB

Open AccessArticle

Egg Consumption in U.S. Children is Associated with Greater Daily Nutrient Intakes, including Protein, Lutein + Zeaxanthin, Choline, α-Linolenic Acid, and Docosahexanoic Acid

by Yanni Papanikolaou and Victor L. Fulgoni III

Nutrients 2019, 11(5), 1137; https://doi.org/10.3390/nu11051137 - 22 May 2019

Cited by 29 | Viewed by 5627

Abstract

Dietary pattern recommendations include consuming a variety of nutrient-dense foods in children and adolescents to promote optimal growth and development. The current study investigated associations with egg consumption and nutrient intakes, diet quality, and growth outcomes relative to non-egg consumers. The analysis used [...] Read more.

Dietary pattern recommendations include consuming a variety of nutrient-dense foods in children and adolescents to promote optimal growth and development. The current study investigated associations with egg consumption and nutrient intakes, diet quality, and growth outcomes relative to non-egg consumers. The analysis used data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2001-2012 in children and adolescents aged 2–18 years (N = 3,299, egg consumers; N = 17,030, egg non-consumers). Daily energy and nutrient intakes were adjusted for the complex sample design of NHANES using appropriate weights. Consuming eggs was associated with increased daily energy intake relative to non-egg consumption. Children and adolescents consuming eggs had elevated daily intake of protein, polyunsaturated, monounsaturated and total fat, α-linolenic acid, docosahexaenoic acid (DHA), choline, lutein + zeaxanthin, vitamin D, potassium, phosphorus, and selenium. Egg consumers had greater consumption, sodium, saturated fat, with reduced total and added sugar versus egg non-consumers. The analysis also showed that egg consumption was linked with lower intake of dietary folate, iron, and niacin. No associations were determined when examining diet quality and growth-related measures. A sub-analysis considering socioeconomic status showed that egg consumption was positively related with daily lutein + zeaxanthin and DHA intake. The current analysis demonstrated several nutrient-related benefits to support the continued inclusion of eggs in the dietary patterns of children and adolescents. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

16 pages, 620 KiB

Open AccessArticle

Children’s Dietary Quality and Micronutrient Adequacy by Food Security in the Household and among Household Children

by Shinyoung Jun, Mary J. Zeh, Heather A. Eicher-Miller and Regan L. Bailey

Nutrients 2019, 11(5), 965; https://doi.org/10.3390/nu11050965 - 27 Apr 2019

Cited by 38 | Viewed by 5014

Abstract

Children’s food-security status has been described largely based on either the classification of food security in the household or among household children, but few studies have investigated the relationship between food security among household children and overall dietary quality. Our goal was to [...] Read more.

Children’s food-security status has been described largely based on either the classification of food security in the household or among household children, but few studies have investigated the relationship between food security among household children and overall dietary quality. Our goal was to examine children’s dietary quality and micronutrient adequacy by food-security classification for the household and among household children. Data from 5540 children (2–17 years) from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 were analyzed. Food-security status was assessed using the U.S. Household Food Security Survey Module and categorized into high, marginal, low, and very low food security for the households and among household children. Dietary quality and micronutrient adequacy were characterized by the Healthy Eating Index (HEI) 2015 and Mean Adequacy Ratio (MAR; based on total nutrient intakes from diet and dietary supplements), respectively. The HEI 2015 scores did not substantially vary by either food-security classification, but the MAR was greater in high compared to very low food security in households and among household children; a linear relationship was found only among household children. In general, very good agreement was observed between the classifications, but the strength of agreement differed by children’s age, race/Hispanic origin, and family income. In conclusion, micronutrient adequacy, but not dietary quality, significantly differed by food-security status. While the agreement between food security in the household and among household children is very good, classification of food security among household children may be more sensitive to detecting differences in exposure to nutrients. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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19 pages, 436 KiB

Open AccessArticle

The Development and Evaluation of a Diet Quality Index for Asian Toddlers and Its Perinatal Correlates: The GUSTO Cohort Study

by Ling-Wei Chen, Si Ming Fung, Doris Fok, Lai Peng Leong, Jia Ying Toh, Hui Xian Lim, Wei Wei Pang, Kok Hian Tan, Yap-Seng Chong, Fabian Yap, Keith M Godfrey, Yung Seng Lee and Mary Foong-Fong Chong

Nutrients 2019, 11(3), 535; https://doi.org/10.3390/nu11030535 - 1 Mar 2019

Cited by 16 | Viewed by 6420

Abstract

Early childhood diet may have lifelong influences on health outcomes, yet development of indices to assess diet quality is scarce in toddlers, especially in Asian countries. We aimed to develop and evaluate a Diet Quality Index (DQI) in a multi-ethnic Asian mother–offspring cohort [...] Read more.

Early childhood diet may have lifelong influences on health outcomes, yet development of indices to assess diet quality is scarce in toddlers, especially in Asian countries. We aimed to develop and evaluate a Diet Quality Index (DQI) in a multi-ethnic Asian mother–offspring cohort and identify perinatal correlates of early childhood diet. Based primarily on the Singapore dietary guidelines, the DQI includes seven food components: rice, bread and alternatives; fruit; vegetables; meat and alternatives; milk and dairy products; whole grains; and foods high in sugar. The DQI was developed using parental report of Food Frequency Questionnaires (FFQ) data for 18-month-old toddlers (n = 561). The mean ± SD of DQI for the study toddlers was 44.2 ± 8.9 (theoretical range: 0–65). A higher DQI (better diet quality) was associated with higher intakes of several nutrients and food groups (e.g., vegetables, dietary fibre, and beta-carotene; all p < 0.001). Further construct validity was demonstrated by substantial agreement between the FFQ-DQI and 24-hour-recall-DQI (Intraclass-correlation-coefficient: 0.70). Independent predictors of lower DQI included higher maternal pre-pregnancy BMI [β(95% CI): −0.23(−0.39, −0.07)], Malay ethnicity [−1.88(−3.67, −0.09)], lower household income [−1.97(−3.91, −0.03)], lower education level [−2.57(−4.85, −0.28)] and never breastfeeding [−6.17(−11.06, −1.28)]. We developed a valid DQI for assessing the overall quality of the diets of Asian toddlers. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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13 pages, 263 KiB

Open AccessArticle

Evaluation of a Primary Care Weight Management Program in Children Aged 2–5 years: Changes in Feeding Practices, Health Behaviors, and Body Mass Index

by Jared M. Tucker, Renee DeFrang, Julie Orth, Susan Wakefield and Kathleen Howard

Nutrients 2019, 11(3), 498; https://doi.org/10.3390/nu11030498 - 27 Feb 2019

Cited by 20 | Viewed by 5399

Abstract

Background: Primary care offers a promising setting for promoting parenting practices that shape healthy eating and physical activity behaviors of young children. This study assessed the impact of a parent-based, primary care intervention on the feeding habits, health behaviors, and body mass index [...] Read more.

Background: Primary care offers a promising setting for promoting parenting practices that shape healthy eating and physical activity behaviors of young children. This study assessed the impact of a parent-based, primary care intervention on the feeding habits, health behaviors, and body mass index (BMI) of 2–5 year olds with elevated or rapidly-increasing BMI. Methods: Four private pediatric offices in West Michigan were assigned as control (n = 2) or intervention (n = 2) sites based on patient load and demographics. Treatment families were recruited at well-child visits to receive physician health-behavior counseling and four visits with a registered dietitian nutritionist (RDN) over a 6-month period. Intervention outcomes were age- and sex-specific BMI metrics, including BMI z-scores and percent of the 95th percentile (%BMI_p95), the Family Nutrition and Physical Activity survey (FNPA), and the Feeding Practices and Structure Questionnaire (FPSQ). Results: Of 165 enrolled families, 127 completed follow-up measures (77% retention). Mean (±SD) FNPA scores improved in treatment vs. control (4.6 ± 4.6 vs. 0.1 ± 4.2; p < 0.001), and screen time (h/day) decreased (−0.9 ± 1.8 vs. 0.3 ± 1.1; p < 0.001). Non-responsive feeding practices (i.e., reward for behavior (p = 0.006) and distrust in appetite (p < 0.015)) and structure-related feeding practices (structured meal timing (p < 0.001)) improved in treatment parents vs. controls. Reductions in child BMI measures did not differ between groups. Conclusions: Families with preschool children participating in a low-intensity, primary care intervention improved obesogenic health behaviors, parent feeding habits, and child screen time, but not child adiposity. Future research should assess the sustainability of these family lifestyle improvements, and evaluate their future impact on the health and development of the children. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

16 pages, 629 KiB

Open AccessArticle

Free Sugars Intake, Sources and Determinants of High Consumption among Australian 2-Year-Olds in the SMILE Cohort

by Gemma Devenish, Rebecca Golley, Aqif Mukhtar, Andrea Begley, Diep Ha, Loc Do and Jane A. Scott

Nutrients 2019, 11(1), 161; https://doi.org/10.3390/nu11010161 - 13 Jan 2019

Cited by 23 | Viewed by 4318

Abstract

In the first 2 years of life, it is important to limit exposure to foods high in free sugars, in order to lay foundations for lifelong eating patterns associated with a reduced risk of chronic disease. Intake data at this age is limited, [...] Read more.

In the first 2 years of life, it is important to limit exposure to foods high in free sugars, in order to lay foundations for lifelong eating patterns associated with a reduced risk of chronic disease. Intake data at this age is limited, so compliance with recommendations is not known. This analysis describes free sugars intakes, food sources and determinants of high consumption among Australian children at 2 years of age. Free sugars intakes were estimated using a customized Food Frequency Questionnaire, and median usual free sugars intake at 2 years was 22.5 (Interquartile Range (IQR) 12.8–37.7) g/day, contributing a median 8% of the estimated energy requirement (EER). Based on the EER, most children (71.1%) exceeded the World Health Organization recommendation that <5% of energy should come from free sugars, with 38% of participants exceeding the <10% recommendation. Children from households with the greatest socioeconomic disadvantage were more likely to exceed the 10% recommendation (Prevalence Ratio (PR) 1.44, 95% Confidence Interval (95% CI) 1.13–1.84), and be in the top tertile for free sugars intake (PR 1.58, 95% CI 1.19–2.10) than the least disadvantaged. Main sources of free sugars were non-core foods, such as fruit juice, biscuits, cakes, desserts and confectionery; with yogurt and non-dairy milk alternatives the two notable exceptions. Improved efforts to reduce free sugars are needed from the introduction of solid food, with a particular focus on fruit juice and non-core foods. Full article

(This article belongs to the Special Issue Dietary Intake and Eating Behavior in Children)

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