Associations of family feeding and mealtime practices with children's overall diet quality: Results from a prospective population-based cohort

Identifying sources of variation in added sugar intake for Alaska Native children using a hair biomarker

Sugars from sugar-sweetened beverages (SSBs) are an important risk factor for tooth decay. The study goal was to determine if there was variation in added sugar intake across communities and between and within households. In this cross-sectional study, intakes of total sugar, added sugar, and sugar-sweetened beverages (SSBs) were estimated for 282 Alaska Native children ages 0-10 years from 131 households in three Yukon-Kuskokwim (YK) Delta communities using biomarker equations based on hair carbon and nitrogen isotope ratios previously developed for the Yup'ik population. ANOVA was used to assess associations between each predictor (community and household) and outcome (estimated total sugars, added sugars, and SSB intake). Between- and within-household variation was estimated using a linear mixed-effects model with a random intercept for households with three or more children. There was no significant difference in mean estimated total sugar (p = 0.29), added sugar (p = 0.24), or SSB intake (p = 0.40) across communities. Significant variations were observed between and within households, with within-household variation amounting to 59% of the between-household variation. Added sugar intake in Alaska Native children from the three study communities is higher than the recommended maximum, and the variation is greater within households than between households.

Association between quality and quantity of carbohydrate intake with selected anthropometric indices among primary school girls in Kerman city, Iran: a cross-sectional study

BACKGROUND

The school-age is a crucial period of physical and cognitive growth, which requires an assessment of dietary intake and its influence on body weight and height. This study aims to determine the association between the quality and quantity of carbohydrate intake with selected anthropometric indices in primary school girls in Kerman City, Iran.

METHODS

This cross-sectional study was conducted on 330 primary school girls ages 6-12 years in Kerman. We used a validated and reliable dish-based 185-item food frequency questionnaire to evaluate people's food intake. We assessed the amount of carbohydrates in children's diets as the percentage of daily calories and grams per day. We used dietary fiber intake (grams/day), the glycemic load, the ratio of whole grain to total grain, and the ratio of solid carbohydrates to total carbohydrates to assess carbohydrate quality. Height, weight, and arm circumference were measured. We calculated body mass index (BMI) by dividing the weight in kilograms by the height in centimeters squared. We used the World Health Organization z-scores charts for girls 5 to 19 years old to assess z-scores for BMI-for-age (BAZ), height-for-age (HAZ), and weight-for-age (WAZ). Socioeconomic status and physical activity were assessed. We used ANOVA and ANCOVA statistical tests to assess the association between anthropometric indices and carbohydrate quantity and quality parameters.

RESULTS

Participants with the highest amount of carbohydrate intake had significantly higher anthropometric indices, including arm circumference, BMI-for-age z score (BAZ), and Height-for-age z score (HAZ) (p < 0.001, p < 0.001, and p = 0.009, respectively). With the increase in glycemic load (GL) and dietary fiber intake, anthropometric indices including arm circumference (GL: p < 0.001, Fiber: p < 0.001), BAZ (GL: p < 0.001, Fiber: P < 0.001), and HAZ (GL: P = 0.009, Fiber: p < 0.001) increased significantly.

CONCLUSIONS

We concluded that there was a positive association between the amount of carbohydrate intake and anthropometric indices (MUAC, BAZ, and HAZ). Also, with the increase in glycemic load and dietary fiber intake, the anthropometric indices including MUAC, BAZ, and HAZ increased.

Validation of the Comprehensive Feeding Practices Questionnaire (CFPQ) with Portuguese Caregivers of 2-to-8-Year-Olds

Recent findings have demonstrated an increase in the prevalence of childhood obesity and overweight in Portugal, urging the need to study modifiable risk factors such as parental feeding practices. The Comprehensive Feeding Practices Questionnaire (CFPQ) is an important self-report measure assessing a broad range of responsive and non-responsive feeding practices. However, the CFPQ has not yet been validated in Portugal. Therefore, the present study aimed to test the validity of this measure with Portuguese parents of 2-to-8-year-old children. A sample of 409 parents completed a Portuguese-adapted version of the CFPQ and the already validated Child Feeding Questionnaire (CFQ). Confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and psychometric analysis were conducted. CFA demonstrated the original 12-factor structure did not fit the sample. EFA identified an eight-factor structure comprising 29 items: Monitoring, Modeling, Environment, Involvement, Emotion Regulation, Restriction for Weight Control, Restriction for Health, and Pressure. Findings suggest that parental feeding practices are sensitive to parents' background cultures and children's developmental period.

Food Behaviours and Health Indicators in Manitoba Adolescents and Relation to the Healthy Eating Index

Adolescence is a vital period of growth and development, both of which are dependent on adequate nutrition; however, concerns persist about poor nutrition and inappropriate food behaviours. In addition to nutrition assessment, the context of food and health behaviour is necessary to understand how dietary choices are shaped and related to diet quality. This study describes food-related behaviours and health indicators associated with dietary quality among adolescents in Manitoba, Canada. A stratified two-stage sampling method was used to collect data on the diet, food behaviours and health indicators of 1587 grade nine students. Diet quality was analysed using the Healthy Eating Index-Canada. Several food behaviours and health indicators varied by gender and school region (urban, rural, northern). The Independent Samples t-test and one-way ANOVA (analysis of variance) assessed differences between groups on the Healthy Eating Index-Canada. Higher Healthy Eating Index-Canada scores were found for those eating family dinners more frequently; consuming breakfast and lunch more frequently; consuming breakfast at home; eating lunch and morning snacks at school; purchasing fewer meals and snacks from cafeterias and vending machines; believing that food and nutrition education is important; not attempting to lose weight; being classified as 'healthy weight'; and getting more sleep. Many Manitoba youth are exhibiting food and health behaviours that increase their risk of having a poor diet.

Impacts of COVID-19 on the home food environment and eating related behaviors of families with young children based on food security status

This mixed-methods study endeavored to expand the current understanding of how early pandemic related disruptions impacted the home food environment and parent feeding practices of families with young children. Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2-5 year old children. Individual interviews were conducted by phone and video conference with mothers (n = 25) during August/September of 2020 and were coded using a hybrid deductive/inductive analysis approach. Parents also reported on their family's food insecurity status enabling qualitative findings to be stratified by family-level food security status. Two overarching themes were identified related to how families in this sample describe the COVID-19 pandemic's impact on their home food environment. Themes included 1) Impacts on obtaining food for one's family, and 2) Specific changes in parent feeding practices. Findings indicated variation within each theme by family food security status. Overall, families experiencing food insecurity more frequently discussed using various coping strategies, including stocking up, rationing food, and use of supplemental food resources, to overcome challenges associated with obtaining food brought on by COVID-19. Families with food insecurity also reported having more time for home cooked meals and more frequently discussed enforcing less structure (timing of meal, place) related to meals/snacks consumed at home during the pandemic. The impacts of the COVID-19 persist, ranging from ongoing economic challenges, inconsistent access to childcare for families, and the emergence of new, more contagious, variants. With this, interventions to address food insecurity amongst families with young children should consider how to optimize the home food environment and promote healthful parent feeding practices within the families they serve in the face of an evolving public health crisis.

Maternal iron status in early pregnancy and childhood body fat measures and cardiometabolic risk factors: A population-based prospective cohort

BACKGROUND

Whether maternal iron status during pregnancy is associated with cardiometabolic health in the offspring is poorly known.

OBJECTIVES

We aimed to assess the associations of maternal iron status during early pregnancy with body fat measures and cardiometabolic risk factors in children aged 10 y.

METHODS

In a population-based cohort study among 3718 mother-child pairs, we measured ferritin, transferrin, and transferrin saturation during early pregnancy. We obtained child BMI, fat mass index, and android/gynoid fat mass ratio by DXA, subcutaneous fat index, visceral fat index, pericardial fat index, and liver fat fraction by magnetic resonance imaging and assessed systolic and diastolic blood pressure, serum lipids, glucose, insulin, and CRP at 10 y.

RESULTS

A one-standard deviation score (SDS) higher maternal ferritin was associated with lower fat mass index [difference -0.05 (95% CI: -0.08, -0.02) SDS] and subcutaneous fat index [difference -0.06 (95% CI: -0.10, -0.02) SDS] in children. One-SDS higher maternal transferrin was associated with higher fat mass index [difference 0.04 (95% CI: 0.01, 0.07) SDS], android/gynoid fat mass ratio [difference 0.05 (95% CI: 0.02, 0.08) SDS], and subcutaneous fat index [difference 0.06 (95% CI: 0.02, 0.10) SDS] in children. Iron status during pregnancy was not consistently associated with organ fat and cardiometabolic risk factors at 10 y.

CONCLUSIONS

Maternal lower ferritin and higher transferrin in early pregnancy are associated with body fat accumulation and distribution but are not associated with cardiometabolic risk factors in childhood. Underlying mechanisms and long-term consequences warrant further study.

Parental Self-Efficacy and Child Diet Quality between Ages 2 and 5: The STEPS Study

Parental self-efficacy (PSE), a measure of the subjective competence in the parental role, has been linked with child well-being and health. Research on the influence of PSE on child eating habits is scarce, and the few studies have concentrated on certain food groups, such as vegetables or fruits, and have mostly included only maternal PSE. Thus, the aim of this study was to explore the associations between PSE (separately for mothers and fathers and as a total family-level score) and child diet quality in a cross-sectional and longitudinal study setting. PSE was measured at child ages of 1.5 and 5 years, and diet quality was measured at ages 2 and 5. Participants are from the Steps to Healthy Development (STEPS) Study (n = 270-883). We found that maternal PSE and family level PSE score were associated with child diet quality. Paternal PSE was not, but the dimension Routines was associated with child diet quality. PSE was similarly associated with child diet quality at both age points. Our results suggest that PSE is an important construct in the development of healthy dietary habits in children, and supporting parenting programs aimed at higher PSE could promote healthy diet quality in children.

Family mealtime emotions and food parenting practices among mothers of young children: Development of the Mealtime Emotions Measure for Parents (MEM‐P)

Family mealtimes can be important for supporting children's healthy development, yet the emotional context of mealtimes can vary considerably, likely impacting their overall success and enjoyment. Yet, despite having an important role, little is known about how parents emotionally experience mealtimes with their family. The first aim of the current study was to assess the factor structure of a novel self‐report measure to assess parents’ emotional responses experienced during family mealtimes (Mealtime Emotions Measure for Parents; MEM‐P). The second aim was to examine relationships between maternal mealtime emotions and their food parenting practices. Mothers of children aged between 1.5 and 6 years participated in this study. Mothers were invited to complete an online questionnaire measuring family mealtime emotions, anxiety, depression and food parenting practices. Exploratory factor analysis produced a three‐factor solution comprising both positive and negative emotion subscales: MEM‐P Efficacy; MEM‐P Anxiety; MEM‐P Stress and Anger. Mothers' positive mealtime emotions (mealtime efficacy) were related to greater use of practices promoting autonomy, providing a healthy home food environment, and modelling healthy eating. Higher anxiety about mealtimes was related to greater reports of child control over eating, and mealtime stress and anger was associated with greater use of food to regulate emotions. These findings highlight novel relationships between how mothers emotionally experience family mealtimes and the food parenting practices they use with their children. It is important to develop resources to help promote positive maternal experiences of family mealtimes and food‐based interactions.

Mothers of young children experience a range of positive and negative emotions around family mealtimes.

Mothers' mealtime emotions are related to the food parenting practices they report using with their children.

Mothers with more positive emotional experiences of family mealtimes (i.e., greater mealtime efficacy) also reported higher use of food parenting practices which promote autonomy in children (e.g., involvement, balance and variety, teaching about nutrition) and which provide feeding structure (e.g., healthy food environment; modelling healthy eating).

Some parents may benefit from further support to help them promote more positive mealtime experiences and food‐based interactions.

Child Autistic Traits, Food Selectivity, and Diet Quality: A Population-Based Study

BACKGROUND

Children with Autism Spectrum Disorders (ASDs) tend to be selective in their food intake, which may compromise their diet quality. While ASD diagnoses capture severe levels of impairment, autistic traits vary on a continuum throughout the population. Yet, little is known about how autistic traits relate to diet quality at the population level.

OBJECTIVES

This study examines the association between autistic traits in early childhood and diet quality in mid-childhood and explores the mediating role of food selectivity.

METHODS

Participants were children (n = 4092) from the population-based Generation R Study. Parents reported their child's autistic traits at 1.5, 3, and 6 years; food selectivity at 4 years; and food intake at 8 years, from which a diet quality score was derived. Associations of autistic traits and the autistic trait trajectory (identified using Latent Class Growth Modelling) with diet quality were examined using multiple linear regression models. The indirect effect of food selectivity in the association between autistic traits at 1.5 years and diet quality was examined using mediation analysis.

RESULTS

Autistic traits were associated with diet quality (e.g., 1.5 years: β = -0.09; 95% CI: -0.13 to -0.06). Two classes captured the autistic trait trajectories from 1.5 to 6 years: children with "low and stable" (95%) and "high and increasing" (5%) mean scores. Children in the high and increasing group had poorer diet quality than those in the low and stable group (β = -0.28; 95% CI: -0.44 to -0.11). Food selectivity mediated the association between autistic traits at 1.5 years and diet quality at 8 years (βindirect = -0.03; 95% CI: -0.03 to -0.02).

CONCLUSIONS

Autistic traits in early childhood are associated with poorer diet quality in mid-childhood, and food selectivity appears to mediate this association. Interventions intended to optimize nutrition in children with elevated autistic traits may integrate behavioral strategies to support parents' responding to their child's food selectivity.

Impact of a Series of Educational Talks Taught by Health Professionals to Promote Healthy Snack Choices among Children

BACKGROUND

One of the great challenges facing today's society is the need to combat overweight and obesity in schoolchildren. This study aimed to analyze the impact of a cycle of didactic talks-given to families by a specialist in pediatrics, a specialist in nutrition and dietetics and a specialist in physical exercise-on childrens' snack choices and nutrition quality.

METHODS

A longitudinal, quasi-experimental and quantitative investigation was designed, working with a total sample of 50 students divided into control and experimental groups. The nutritional quality of daily snacks was recorded during the month before and the month after the cycle of talks given by health experts.

RESULTS

An increase in the nutritional quality of the snacks was observed in the days after the talk-but, after a week, values returned to normal.

CONCLUSIONS

The giving of educational talks to promote healthy habits may have a positive impact on the nutritional quality of school snacks in the days immediately following the talks. However, some forgetfulness was detected over time, which reduced the nutritional quality of the snacks once more. For future work, it is recommended that researchers measure the impact produced by giving regular talks.

Cross-Sectional Associations Between Mothers and Children's Breakfast Routine-The Feel4Diabetes-Study

Positive influences of family members have been associated with a high probability of children’s daily breakfast consumption. Therefore, the aim of this study was to scrutinize the association of breakfast routines between mothers and their children. The baseline data of the Feel4Diabetes-study was obtained in 9760 children (49.05% boys)–mother pairs in six European countries. A parental self-reported questionnaire gauging the frequency of breakfast consumption and of breakfast´ foods and beverages consumption was used. Agreement in routines of mothers and their children’s breakfast consumption was analyzed in sex-specific crosstabs. The relationship of breakfast routine and food groups’ consumption between mothers and their children was assessed with analysis of covariance. The highest proportion of children who always consumed breakfast were those whose mothers always consumed it. Children consuming breakfast regularly had a higher intake of milk or unsweetened dairy products and all kind of cereal products (low fiber and whole-grain) than occasional breakfast consumers (p < 0.05). The strong similarity between mothers and children suggests a transfer of breakfast routine from mothers to their children, as a high proportion of children who usually consume breakfast were from mothers also consuming breakfast. All breakfast foods and beverages consumption frequencies were similar between children and their mothers.