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Development and validation of the baby eating behaviour coding system (BEBECS) to assess eating behaviour during complementary feeding. Appetite 2024; 196:107257. [PMID: 38364972 DOI: 10.1016/j.appet.2024.107257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
Eating behaviour in children is a matter of study for which diverse tools have been designed. Coding systems for videotaped meals allow the extraction of detailed in vivo information; however, there is no tool available for infants following a Baby-Led Weaning (BLW) method. This study aimed to create and validate a new tool to assess eating behaviour in infants during weaning, applicable regardless of the complementary feeding method. The Baby Eating Behaviour Coding System (BEBECS) was developed comprising time variables, behaviours, feeder-led actions, and other meal-related variables. Sixty videos of infants aged 6-18 months following spoon-feeding (SF) or BLW methods were coded by two trained coders. These scores were analysed together with intake and maternal ratings of liking and calmness. Additionally, combined analysis and internal comparison assessed the possible differences in BEBECS variables between SF and BLW. Inter-rater and test-retest reliability had good to excellent agreement: Cohen's Kappa >0.75, Lin's CCC >0.70, and Intraclass Correlation Coefficient >0.75, for almost all variables. Infants' liking and intake of the offered food correlated positively with meal duration and total count of mouth approaches but negatively with having leftovers and time between mouth approaches. Infants' calmness and tiredness were negatively correlated. More food than initially offered was available during the meal in BLW but not in SF. There was a tendency towards more autonomous behaviour in BLW infants regarding changes observed in the time the food was in the mouth at each stage (6, 12, and 18 months). In conclusion, BEBECS has the potential to be a valid tool for application in the research of infant eating behaviour during weaning by trained coders.
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Conceptual Considerations and Methodological Challenges to Measuring Food Acceptance During Infancy. Curr Nutr Rep 2023; 12:407-415. [PMID: 37460785 DOI: 10.1007/s13668-023-00480-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to (1) present a conceptual definition of infant food acceptance, (2) explore methodological challenges to measuring different components of food acceptance, and (3) provide recommendations for future research on food acceptance during infancy. RECENT FINDINGS Infant food acceptance includes separate but overlapping components: wanting, liking, and consumption. Recent evidence suggests that although these components are often correlated, there is variability in the sensitivity of these measures to detect differences in infants' responses to target foods. To date, consumption and caregiver perceptions of liking have been the primary outcome measures of interest in studies of infant food acceptance. More diverse and precise measures across the three components of infant food acceptance are needed to address a wider scope of research questions, which would in turn strengthen the interpretability and translational potential of research in this area.
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Examining links between child temperament and feeding, eating, and weight outcomes: An updated systematic review of the literature. Eat Behav 2023; 49:101739. [PMID: 37209569 DOI: 10.1016/j.eatbeh.2023.101739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Weight outcomes have been associated with child temperament, defined as individual differences in reactivity and self-regulation. The current systematic review aims to provide an updated summary of the evidence linking temperamental negative reactivity, surgency, and regulation superfactors to early childhood feeding, eating, and weight outcomes. METHODS PubMed, PsycINFO and Embase databases, as well as scientific meeting programs, were searched using keywords and subject headings. Publication dates were limited to 2012-2019 as prior reviews were published in 2012 and 2014. Identified studies were eligible if they included children ages 0-5 years, a measure of child temperament, and a measure of parent/caregiver feeding, child eating, or child weight. 7113 studies were identified and 121 met inclusion criteria. RESULTS Feeding, eating, and weight outcomes were largely unrelated to overarching negative reactivity, surgency, and effortful control superfactors. Examination of individual temperament dimensions suggested difficult temperament was frequently linked to non-responsive feeding practices, whereas elevated emotionality and decreased self-regulation were linked to maladaptive eating behaviors, and lower inhibitory control to adiposity. Analyses with infants reported greater percentages of significant associations compared to children, and cross-sectional studies generally reported fewer significant associations than other study designs. CONCLUSIONS Difficult temperament, greater emotionality and lower self-regulation and inhibitory control were the aspects of temperament most consistently related to poorer early childhood feeding, eating, and weight outcomes. Associations tended to be stronger in infancy, and when examined within a non-cross-sectional study design. Findings can inform the development of tailored efforts to promote healthy eating and growth throughout childhood.
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Development of a live coding method to assess infant/toddler food acceptance. MATERNAL & CHILD NUTRITION 2022; 18:e13348. [PMID: 35615887 PMCID: PMC9218310 DOI: 10.1111/mcn.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/02/2022] [Accepted: 02/21/2022] [Indexed: 11/29/2022]
Abstract
Validated measures predicting infant consumption of nutrient supplements or fortified foods are essential for the success of nutritional interventions to improve undernutrition. Behavioural coding of food acceptance is one promising approach, though the required time and resources are limiting. The overarching goal of the present study was to adapt a video coding (VC) protocol for use as a live coding (LC) method to assess infant food acceptance in naturalistic settings. Infants (n = 59; ages 7–24 months) were fed a small‐quantity lipid‐based nutrient supplement (SQ‐LNS) mixed with a familiar food by caregivers in the State of Morelos, Mexico. Trained coders used a VC scheme to rate infant acceptance of each spoon offer using a 4‐point scale. The VC scheme was subsequently adapted for use as an LC method to be used in participant homes and a video live coding (VLC) method to monitor reliability. Reliability and validity of the LC method were tested in a subsample of dyads (n = 20). Intraclass correlation coefficients (ICCs) indicated that the inter‐rater reliability between coders using the LC method was moderate or good when compared to VC methods (ICCs = 0.75 and 0.87). Live coded acceptance scores were also moderately associated with consumption of the SQ‐LNS (ρ = 0.50, p = 0.03). The LC scheme demonstrated initial reliability and validity as an assessment of infant food acceptance. Since VC is both resource and time‐intensive, the LC scheme may be useful for assessing infant food acceptance in resource‐limited settings. Current measures to assess infant food acceptance in nutritional interventions are limited. This study presents a live coding scheme and protocol that can be used to objectively rate infants’ food acceptance in naturalistic settings. The coding method demonstrated initial reliability with video coding methods and was associated with infants’ consumption of a target food. The live coding protocol may be particularly useful for assessing infant food acceptance in resource‐limited settings.
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Infant and Toddler Responses to Bitter-Tasting Novel Vegetables: Findings from the Good Tastes Study. J Nutr 2021; 151:3240-3252. [PMID: 34191021 PMCID: PMC8485907 DOI: 10.1093/jn/nxab198] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/29/2021] [Accepted: 05/25/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Infants are born with the biological predisposition to reject bitterness. Dark green vegetables contain essential nutrients but also bitter compounds, making them more difficult to like. OBJECTIVE The Good Tastes Study was designed to determine whether reducing bitterness by adding small amounts of sugar or salt would alter infant acceptance of kale purées. METHODS Caregivers (n = 106, 94% mothers, 82% Non-Hispanic White) and children (53% male, aged 6-24 mo) participated in a videorecorded laboratory visit during which infants were offered 4 versions of puréed kale: plain, 1.2% or 1.8% added sugar, or 0.2% added salt. Caregivers rated their children's liking for each kale version. Videos were coded for the number of tastes accepted and for children's behaviors and acceptance of each kale version. A multilevel ordered logistic model was fit for the number of accepted tastes and caregiver ratings of child liking of kale versions with age, breastfeeding history, order effects, and kale version as predictors. RESULTS Infants 6 to <12 mo accepted more tastes (b = 2.911, P < 0.001) and were rated by caregivers as liking the kale more than older toddlers (≥18 mo; b = 1.874, P = 0.014). The plain kale was more likely to be accepted (P < 0.001); also, the first version offered was more likely to be rejected (b = -0.586, P < 0.007). Older infants (≥18 mo) exhibited more avoidant behaviors (b = 1.279, P < 0.001), more playing (b = 2.918, P < 0.001), and more self-feeding (b = 1.786, P = 0.005) than younger infants (6 to <12 mo). Children who were reported to have been breastfed more in the last 7 d were more likely to self-feed (b = 0.246, P < 0.001) and play with food (b = 0.207, P < 0.005). CONCLUSIONS Our findings support that there may be a sensitive period, during the early phase of complementary feeding, to improve success of introducing a novel, bitter, more difficult-to-like food. When low levels of sugar or salt were added, no advantage of bitterness reduction was observed. This study has been registered with ClinicalTrials.gov as NCT04549233.
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Role of food neophobia and early exposure in children's implicit attentional bias to fruits and vegetables. Appetite 2021; 167:105647. [PMID: 34403721 DOI: 10.1016/j.appet.2021.105647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 05/07/2021] [Accepted: 08/11/2021] [Indexed: 12/13/2022]
Abstract
Children often struggle to eat the daily recommended servings of fruits and vegetables, and as a result many have poor nutrient intake. This is especially problematic for neophobic children; or those who are hesitant to try new foods. Maratos and Staples [Appetite, 91, 220-225 (2015)] found that children who are high in food neophobia show attentional biases to unfamiliar fruits and vegetables, which may be related to their low consumption of these healthy foods. The present study sought to replicate and extend these findings, by using a visual dot-probe task that paired images of fruits and vegetables to perceptually matched neutral control stimuli. Seventy-eight 5-8 year-old children (Mage = 6.4 years, SD = 1.1, 42% girls) participated. Initial analyses failed to reveal significant attentional biases to the foods in children who were high in neophobia. Subsequent exploratory analyses included children's previous exposure to the foods in the task as a moderator variable. These analyses revealed that overall, children showed an attentional bias away from familiar fruits and vegetables. Moreover, previous exposure to the foods moderated the effect of food neophobia on attentional bias. For children who were low in food neophobia, as their fruit and vegetable exposure increased, their attentional bias away from the familiar foods decreased. In contrast, for food neophobic children, as fruit and vegetable exposure increased, they showed more attentional bias away from familiar foods. Although these findings failed to replicate those reported by Maratos and Staples (2015), they suggest that children's attentional biases to healthy foods may be a result of the interplay between food neophobia and the food environment to which they are exposed.
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Studying Children's Eating at Home: Using Synchronous Videoconference Sessions to Adapt to COVID-19 and Beyond. Front Psychol 2021; 12:703373. [PMID: 34367027 PMCID: PMC8339197 DOI: 10.3389/fpsyg.2021.703373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/30/2021] [Indexed: 01/17/2023] Open
Abstract
The COVID-19 pandemic has disrupted many facets of developmental research, including research that measures children's eating behavior. Here, children's food intake is often measured by weighing foods that children are offered before and after in-person testing sessions. Many studies also examine children's food ratings (the extent to which they like or dislike a food), assessed via picture categorization tasks or hedonic scales. This paper reviews existing research on different methods for characterizing children's eating behavior (with a focus on food intake, preferences, and concepts) and presents a feasibility study that examined whether children's eating behaviors at home (including their food intake and ratings) can be measured via live video-chat sessions. The feasibility analyses revealed that an observational feeding paradigm at home yielded a majority (more than 70%) of video-chat recordings that had a sufficient view of the child and adequate sound and picture quality required for observational coding for the majority of the session's duration. Such positioning would enable behavioral coding of child food intake, parent food talk, and meal characteristics. Moreover, children were able to answer questions to stories and express their preferences via researcher screen-share methods (which can assess children's self-reported food preferences and beliefs) with low rates of exclusion across studies. The article ends with a discussion on the opportunities and challenges of using online platforms to conduct studies on children's eating behaviors in their home environments during the COVID-19 pandemic and beyond.
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Preschoolers will drink their GREENS! Children accept, like, and drink novel smoothies containing dark green vegetables (DGVs). Appetite 2021; 162:105148. [PMID: 33549836 DOI: 10.1016/j.appet.2021.105148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/30/2021] [Accepted: 01/30/2021] [Indexed: 10/22/2022]
Abstract
Dark green vegetables (DGVs; e.g., spinach) are a nutrient rich source of essential vitamins and minerals; yet, children's intakes of DGVs fall well below dietary recommendations and creative solutions are needed. This study describes preschoolers (3-5 y) willingness to taste, liking, and intake of fruit-based smoothies containing DGVs (i.e., spinach, collards, kale), commonly referred to as "green smoothies," and explores individual differences in children's eating responses. Using a between-subjects design, preschoolers were randomized to either a FRUIT ONLY smoothie condition (n = 36) or FRUIT+DGV smoothie condition (n = 32). Children's acceptance and intake were collected in one tasting session and one ad libitum snack session, respectively. Parents reported on child food pickiness, food responsiveness, and approach, and children's intake of fruits and DGVs. Children self-reported on previous experience with the study fruits and DGVs. The initial tasting session revealed that the majority of children (84.3%) in the FRUIT+DGV condition willingly tasted all five green smoothies and rated the green smoothies as moderately liked (2.3 ± 0.1). Children in the FRUIT+DGV condition consumed 225.7 ± 31.4 g (9.0 ± 1.3 oz; 1.1 ± 0.2 cups; 91.9 ± 12.9 kcals) of their most preferred green smoothie, providing 18.3 ± 3.7 g (or 0.7 ± 0.1 cups) of DGVs. Children's willingness to try, liking, and intake did not differ by smoothie condition. Individual differences in children's intake are reported. In conclusion, children were willing to try fruit smoothies supplemented with DGVs. Children rated the green smoothies as moderately-liked and children's intake during snack met 31% of their weekly USDA recommendations for DGVs. Adding DGVs to fruit-based smoothies may compliment other effective feeding strategies for increasing children's vegetable consumption.
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The relationship between parental behavior and infant regulation: A systematic review. DEVELOPMENTAL REVIEW 2020. [DOI: 10.1016/j.dr.2020.100923] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Parental perceptions of child's healthy diet: Evidence from a rapidly developing country. J Family Med Prim Care 2020; 9:4949-4955. [PMID: 33209827 PMCID: PMC7652186 DOI: 10.4103/jfmpc.jfmpc_1252_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/06/2020] [Accepted: 08/03/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There are no studies in Qatar or in the Middle East to investigate parental perception of healthy diet in childhood. PURPOSE To investigate parental perception of childhood healthy diet in the State of Qatar. METHODS Cross-sectional prospective study at Hamad Medical Corporation, State of Qatar. Parents of children <14 years old were invited to complete a questionnaire. RESULTS A total of 398 parents agreed to participate, while 22 parents refused (response rate 94%). About 80% of parents were between 20 and 39 years of age, and 77% were females. Around 230 (58%) parents had ≥1 housemaid to help with housework, including food preparation. Whilst 151 children (37%) fell into the overweight and obese category, only 68 parents (17%) perceived that their child was in this category. Less than half the participants (n = 179, 45%) stated that childhood weight should be monitored prior to 5 years of age, while around 35% stated the same, but for children ages 5-14 years. Most participants (n = 324, 81%) agreed that parental eating habits could influence childhood weight. In terms of food preparation at home, mothers cooked almost 50% of the times, housemaids 30%, followed by grandmothers (16.6%), and fathers (3.4%). When asked about the frequency of school meals being prepared at home, 237 parents (60%) prepared their children's lunch box only 1-2 times per week. Moreover, 63% of parents chose the quality of food based on nutritional values, while 44% and 35% chose it based on safety and taste, respectively. When queried about whether the child's pediatrician or the primary care physician counsel families regarding childhood healthy diet, 187 families (47%) had not received counseling by their children's health care providers. Most families agreed that healthy diets lead to better school performance (n = 372, 94%) and better physical activity quality (n = 379, 96%). Compared to families living in the rural areas, parents living in the capital Doha had better insights that healthy diets result in better in school performance (p = 0.032). CONCLUSION Parental perception is an important target for public health interventions. Within the current sample, families were aware of the positive impact of healthy diet on overall wellbeing. Qatar is a well-resourced country and it would be cost effective to train and professionally develop pediatricians and primary care physicians to be more proactive in tackling childhood obesity.
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Temperament in obesity-related research: Concepts, challenges, and considerations for future research. Appetite 2019; 141:104308. [PMID: 31158396 DOI: 10.1016/j.appet.2019.05.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 03/29/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
Temperament, defined as individual differences in reactivity and regulation, has important implications for the development of childhood obesity. Indeed, numerous studies have demonstrated associations between temperament and children's eating behavior, parent feeding practices, and children's weight outcomes. Together, these findings have significantly improved our understanding of the developmental pathways to obesity-related outcomes. However, to better our understanding of the role of temperament in children's health, greater attention to how temperament is conceptualized and measured is needed. The purpose of this paper is to review the concept and principles of temperament, describe challenges in the measurement of temperament, and provide considerations for future research aimed at understanding the relationship between temperament, food intake, and childhood obesity. Moving forward, a fuller appreciation of the complexity of the temperament concept and thoughtful selection of temperament measures may help improve predictions and identify targets for interventions aimed at decreasing the risk for obesity in childhood.
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Promoting healthy food preferences from the start: a narrative review of food preference learning from the prenatal period through early childhood. Obes Rev 2018; 19:576-604. [PMID: 29266778 DOI: 10.1111/obr.12658] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/03/2017] [Accepted: 06/19/2017] [Indexed: 01/16/2023]
Abstract
The palatable, energy-dense foods that characterize modern environments can promote unhealthy eating habits, along with humans' predispositions to accept sweet tastes and reject those that are sour or bitter. Yet food preferences are malleable, and examining food preference learning during early life can highlight ways to promote acceptance of healthier foods. This narrative review describes research from the past 10 years focused on food preference learning from the prenatal period through early childhood (ages 2-5 years). Exposure to a variety of healthy foods from the start, including during the prenatal period, early milk-feeding and the introduction to complementary foods and beverages, can support subsequent acceptance of those foods. Yet development is plastic, and healthier food preferences can still be promoted after infancy. In early childhood, research supports starting with the simplest strategies, such as repeated exposure and modelling, reserving other strategies for use when needed to motivate the initial tasting necessary for repeated exposure effects to begin. This review can help caregivers and practitioners to promote the development of healthy food preferences early in life. Specific implementation recommendations, the role of individual differences and next steps for research in this area are also discussed.
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Associations between bottle-feeding intensity and maternal encouragement of bottle-emptying. Public Health Nutr 2017; 20:3090-3098. [DOI: 10.1017/s1368980017002166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AbstractObjectiveTo explore longitudinal associations between bottle-feeding and maternal encouragement of infant bottle-emptying during the first 6 months of infancy.DesignMothers completed questionnaires during the third trimester of pregnancy, then monthly during the first 6 months postpartum. Questionnaires assessed family demographics, maternal and infant weight status, infant feeding patterns and maternal encouragement of infant bottle-emptying.SettingThe Infant Feeding Practices Study 2, conducted by the US Centers for Disease Control and Prevention and the Food and Drug Administration.SubjectsMothers (n 1776).ResultsRepeated-measures regression was used to explore associations between bottle-feeding intensity (BFI; defined as the percentage of daily feedings that were from a bottle) and encouragement of bottle-emptying. Mothers who reported consistently high or consistently low BFI also exhibited consistently higher or lower frequency of encouraging their infants to empty the bottle (respectively) across the first 6 months of infancy, whereas mothers who reported increases in their BFI also exhibited concomitant increases in the frequency to which they encouraged their infants to finish the bottle. More frequent encouragement of bottle-emptying was also associated with feeding expressed breast milk (P<0·001), and lower parity (P=0·01), pre-pregnancy BMI (P=0·002) and infant birth weight (P=0·001).ConclusionsMore frequent use of bottles for infant feeding was significantly associated with more frequent encouragement of bottle-emptying. Further research using causal designs is needed to better understand whether the use of bottles promotes this controlling feeding practice or whether mothers with more controlling feeding practices opt to bottle-feed.
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Does Temperament Underlie Infant Novel Food Responses?: Continuity of Approach-Withdrawal From 6 to 18 Months. Child Dev 2017; 89:e444-e458. [PMID: 28766867 DOI: 10.1111/cdev.12902] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study investigated whether temperamental approach-withdrawal underlies infants' responses to novel foods. Data were drawn from a longitudinal study of mother-infant dyads (n = 136). Approach-withdrawal responses to novel foods and novel toys were coded when infants were 6 and 12 months of age. When infants were 18 months of age, approach-withdrawal behaviors, positive affect, and negative affect were used in a latent profile analysis to identify groups of toddlers who exhibited similar responses to novelty. As predicted, novel food and novel toy responses were concurrently associated at 12 months and followed a similar developmental pattern across the 1st year. Furthermore, novel food acceptance at 12 months of age, but not 6 months, predicted greater toddler approach.
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Abstract
People who are overweight or have obesity are estimated to comprise 30% of the global population and up to 59% of companion dogs and cats are estimated to be above their optimal body weight. The prevalence of human and companion obesity is increasing. The direct and indirect costs of obesity and associated comorbidities are significant for human and veterinary healthcare. There are numerous similarities between obesity in people and companion animals, likely related to the shared environmental and lifestyle elements of this multifactorial disease. While the study of human obesity is relatively robust, research conducted in pets is generally limited to small studies, studies with cross-sectional designs or reports that have yet to be replicated. Greater understanding of human obesity may elucidate some of the factors driving the more recent rise in pet obesity. In particular, there are overlapping features of obesity in children and pets that are, in part, related to dependency on their 'parents' for care and feeding. When feeding is used in a coercive and controlling fashion, it may lead to undesirable feeding behaviour and increase the risk for obesity. A 'responsive parenting' intervention teaches parents to respond appropriately to hunger-satiety cues and to recognize and respond to others' distress. Such interventions may impact on childhood overweight and obesity and have the potential to be adapted for use with companion animals. Social behaviour towards people with obesity or owners of pets with obesity is often driven by beliefs about the cause of the obesity. Educating healthcare professionals and the public about the multifactorial nature of this complex disease process is a fundamental step in reducing the bias and stigma associated with obesity. Children living in low-income households have particularly high rates of obesity and as household income falls, rates of obesity also rise in pets and their owners. There are risk regulators (i.e. dynamic components of interconnected systems that influence obesity-related behaviours) and internal factors (i.e. biological determinants of obesity) that may influence the development of both childhood and pet obesity, and poverty may intersect with these variables to exacerbate obesity in low-income environments. This review discusses the costs, behaviours and psychology related to obesity in people and pets, and also proposes potential techniques that can be considered for prevention and treatment of this disease in pets. A 'One Health' approach to obesity suggests that an understanding of human obesity may elucidate some of the factors driving the more recent rise in pet obesity.
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Development of a new in-home testing method to assess infant food liking. Appetite 2017; 113:274-283. [PMID: 28274649 DOI: 10.1016/j.appet.2017.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 02/27/2017] [Accepted: 03/03/2017] [Indexed: 01/17/2023]
Abstract
The objective of this study was to develop a new elaborate method to evaluate infants' liking of foods that could be applied at home and to compare the results of this elaborate method with those of a basic method. Mothers of infants aged 4 to 7 (n = 44) and 12-15 months (n = 46) participated in this study. For the basic method, mothers were asked to assess their infant's global liking at the end of a meal. Then, for the elaborate method, mothers received detailed instructions on how to feed their infant, how infants might express like/dislike and when to stop the meal. During the first nine spoons, they were asked to report the presence/absence of positive and negative behaviours after each spoon, and the infant's initial liking was reported after each triplet of spoons. They also assessed their infant's global liking at the end of the meal. Both methods were applied using three commercial familiar baby foods adapted to each age range. In 4-7-month-olds, the elaborate method showed a significant difference across products for liking, whereas the basic method did not show any difference. In 12-15-month-olds, the elaborate method showed more differences across products for liking than the basic method. In both age groups, negative behaviours, despite being less frequently reported, provided better liking discrimination than positive behaviours. In conclusion, the elaborate method produced better product liking discrimination than the basic method by focusing maternal attention on infants' eating behaviours since the first spoons.
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An Experimental Approach to Study Individual Differences in Infants' Intake and Satiation Behaviors during Bottle-Feeding. Child Obes 2017; 13:44-52. [PMID: 27788024 PMCID: PMC5278825 DOI: 10.1089/chi.2016.0122] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND As a group, bottle-fed infants are at higher risk for rapid weight gain compared with breast-fed infants. However, little is known about individual differences in feeding behaviors of bottle-feeding infants, as well as maternal and infant characteristics associated with bottle-feeding outcomes. METHODS We conducted a 2-day, within-subject study of 21 formula-feeding dyads; the within-subject factor was feeding condition: mother-led (ML; mothers were given the instruction to feed their infants as they typically would) vs. infant-led (IL; the experimenter ensured feeding began when infants signaled hunger and ended when they rejected the bottle on three consecutive occasions). Intake was determined by bottle weight; feedings were video-recorded and later analyzed to determine feeding duration and types of satiation behaviors displayed. Percent difference scores were calculated for each outcome as [((ML - IL)/IL) × 100] to standardize differences among dyads. Mothers completed questionnaires of feeding styles and infant temperament. RESULTS On average, infants consumed ∼42% more formula during the ML- than IL-condition (p = 0.03). However, notable variation existed in difference scores for intake (range = -52.8% to 268.9%; higher scores reflect greater intake during ML than IL). Stepwise regression illustrated that greater intakes during the ML-condition were predicted by the combination of: (1) higher infant age; (2) lower levels of infant rhythmicity and adaptability; (3) higher levels of infant positive mood; and (4) lower levels of maternal restrictive and responsive feeding styles. CONCLUSIONS This objective, experimental approach illustrated that variation in bottle-feeding outcomes is associated with characteristics of both members of the dyad.
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Emotional expressiveness of 5–6 month-old infants born very premature versus full-term at initial exposure to weaning foods. Appetite 2016; 107:494-500. [DOI: 10.1016/j.appet.2016.08.124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 08/30/2016] [Accepted: 08/31/2016] [Indexed: 01/07/2023]
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Investigating the role of parent and child characteristics in healthy eating intervention outcomes. Appetite 2016; 105:291-7. [DOI: 10.1016/j.appet.2016.05.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/28/2016] [Accepted: 05/31/2016] [Indexed: 12/14/2022]
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[Guidelines for complementary feeding in healthy infants]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2016; 73:338-356. [PMID: 29384128 DOI: 10.1016/j.bmhimx.2016.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 06/07/2016] [Indexed: 12/20/2022] Open
Abstract
A proper nutrition during the first two years of life is critical to reach the full potential of every human being; now, this period is recognized as a critical window for promoting optimal growth, development, and good health. Therefore, adequate feeding at this stage of life has an impact on health, nutritional status, growth and development of children; not only in the short term, but in the medium and long term. This paper provides recommendations on complementary feeding (CF) presented as questions or statements that are important for those who take care for children during this stage of life. For example: When to start complementary feedings: 4 or 6 months of age?; Exposure to potentially allergenic foods; Introduction of sweetened beverages; Use of artificial sweeteners and light products; Food introduction sequence; Food consistency changes according to neurological maturation; Number of days to test acceptance and tolerance to new foods; Amounts for each meal; Inadequate complementary feeding practices; Myths and realities of complementary feeding; Developmental milestones; Practice of "Baby Led Weaning" and practice of vegetarianism.
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Temperamental approach/withdrawal and food neophobia in early childhood: Concurrent and longitudinal associations. Appetite 2016; 107:654-662. [PMID: 27622985 DOI: 10.1016/j.appet.2016.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/06/2016] [Accepted: 09/09/2016] [Indexed: 11/19/2022]
Abstract
The purpose of the present study was to investigate whether temperamental approach/withdrawal processes were concurrently and longitudinally associated with parent ratings and behavioral observations of food neophobia at 4.5 years of age. Additionally, maternal feeding practices were examined as potential moderators of the association between toddler temperament and food neophobia. Data were drawn from a longitudinal study following individuals (n = 82) from infancy through early childhood. At 18 months of age, toddlers were observed in an unfamiliar laboratory setting with an experimenter and their reactions were coded. At 4.5 years of age, the children were again observed in an unfamiliar setting and were also offered three novel foods (lychee, nori, and haw jelly). The number of foods they refused to taste was used as a measure of behavioral neophobia. Finally, mothers reported on their child's food neophobia and temperament, as well as their own feeding practices. As expected, temperament was associated with concurrent measures of food neophobia at 4.5 years of age. Also, low approach children who exhibited high negative affect and low positive affect in response to novelty at 18 months of age had higher levels of food neophobia at 4.5 years of age compared to their peers. Furthermore, evidence emerged to show that these neophobic tendencies in low approach children were strengthened by a maternal pressuring feeding style. Collectively, the results of this study emphasize that children who have low levels of temperamental approach are at a heightened risk for developing food neophobia during childhood.
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The role of food experiences during early childhood in food pleasure learning. Appetite 2016; 104:3-9. [DOI: 10.1016/j.appet.2015.08.022] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/18/2015] [Accepted: 08/18/2015] [Indexed: 10/23/2022]
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Stability of food neophobia from infancy through early childhood. Appetite 2015; 97:72-8. [PMID: 26612089 DOI: 10.1016/j.appet.2015.11.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/19/2015] [Accepted: 11/11/2015] [Indexed: 11/23/2022]
Abstract
The purpose of the present study was to examine whether rejection of novel foods during infancy predicted child behavioral and parent-reported neophobia at 4.5 years of age. Data for the present study were drawn from a longitudinal study following individuals (n = 82) from infancy through early childhood. At 6 and 12 months of age, the infants tasted a novel food (green beans, hummus, or cottage cheese) and their reactions were coded for rejection of the food (i.e. crying, force outs, or refusals). The children returned to the laboratory at 4.5 years of age and participated in a behavioral neophobia task where they were offered three novel foods (lychee, nori, and haw jelly) and the number of novel foods they tasted was recorded. Mothers also reported their own and their children's levels of food neophobia. Regression analyses revealed that rejection of novel foods at 6 months interacted with maternal neophobia to predict parent-rated child neophobia. Infants who exhibited low levels of rejection at 6 months showed higher levels of parent-rated neophobia when their mothers also showed high compared to low levels of neophobia. At 12 months of age, however, infants who exhibited high levels of rejection tended to have high levels of parent-rated neophobia regardless of their mothers' levels of neophobia. These results provide preliminary evidence that rejection of novel foods during infancy does predict neophobia during early childhood, but the results vary depending on when rejection of new foods is measured.
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