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Ruggiero CF, Trexberg KM, Moore AM, Savage JS. Applying the family stress model to responsive feeding and early obesity prevention. Appetite 2024:107515. [PMID: 38797237 DOI: 10.1016/j.appet.2024.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Rapid weight gain during infancy and obesity during early childhood may lead to adverse health outcomes during later childhood and into adulthood, especially in families experiencing economic hardship. Families experiencing economic hardship may also experience food insecurity, which can impact child development and responsive feeding, an important target for obesity prevention in early life. The Family Stress Model suggests that stress, particularly economic hardship, can negatively impact parents' mental health, parenting, and quality of family relationships. This review proposes a conceptual model that expands upon the original Family Stress Model by including parent-child dyadic interactions during feeding (i.e., responsive feeding) as well as the coparenting relationship around feeding. Our conceptual model integrates responsive feeding into the Family Stress Model and includes the impact of food insecurity on feeding and child health outcomes. Such models that consider multiple influences on child development have implications for the design of effective interventions to promote healthy growth for entire families. Future directions in this research will empirically test the model and explore early intervention strategies that aim to promote responsive feeding, nutrition security, and health within families. Continuing interdisciplinary research between the fields of nutrition and family development will be key to addressing the complex interplay of family stressors, parent responsiveness, and childhood obesity.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kaitlin M Trexberg
- Department of Human Development and Family Studies, The Pennsylvania State University, 119 Health and Human Development Building, University Park, PA, 16802, USA.
| | - Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA; Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
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Bernate Angulo SV, Nezami BT, Martin SL, Kay MC, Richardson TN, Wasser HM. Concordance in dietary intake among caregivers and infants during the period of complementary feeding: A scoping review. Appetite 2024; 194:107178. [PMID: 38141877 PMCID: PMC11027945 DOI: 10.1016/j.appet.2023.107178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
Dietary intake during infancy shapes later food preferences and is important for short- and long-term health and wellbeing. Although caregivers are thought to influence the developing food preferences of infants, children less than two years have been notably absent in existing meta-analyses on the topic. This scoping review seeks to fill this gap by using a systematic process to identify and summarize the published literature on the resemblance of caregiver and infant diet during the period of complementary feeding (6-23 months). Articles were included if they assessed intake of foods or beverages other than human milk or commercial milk formula and reported a test of association between the intake of caregivers and infants. Four electronic databases (PubMed, EMBASE, Scopus, and Global Health) were systematically searched for articles published since 2000. Thirty-three articles, representing 32 studies, were identified. The majority of studies examined infant intake of food groups/items (n = 20), seven studies examined infant dietary patterns, and six studies examined dietary diversity. Studies predominantly reported associations between diets of mothers and infants (n = 31); three studies reported associations for fathers. Most studies assessed infant diet at one timepoint (n = 26), with 12 studies combining the intakes of younger (0-11 months) and older infants (12-23 months). Food groups examined, in order of frequency, included 'non-core' foods and beverages (n = 14), vegetables (n = 13), fruits (n = 12), protein foods (n = 6), grains (n = 5), and dairy foods (n = 4). Definitions of variables for food groups and dietary patterns were highly heterogeneous, but consistent for dietary diversity. Nearly all studies (n = 31) reported significant associations between dietary intakes of caregivers and infants. Findings suggest caregiver diet may be a promising focus for interventions aiming to shape the food preferences and dietary intakes of infants.
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Affiliation(s)
- Sara V Bernate Angulo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Brooke T Nezami
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC, 27708, USA
| | - Taylor N Richardson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Heather M Wasser
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Adewumi O, Fijabi O. Higher Diet Quality Observed in Pregnant Women Compared to Women Living with and without Children in the US: NHANES 2011-2016. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024:1-7. [PMID: 38252077 DOI: 10.1080/27697061.2024.2302049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Women of reproductive age are a critical part of the population because their dietary habits and nutritional status impact the nutritional trajectory of future generations. Various studies have assessed the diet quality among women of reproductive age, but few studies have compared the diet quality of these women across the different life stages. OBJECTIVE To compare the diet quality among pregnant women, women living with children and women living without children in the United States of America (USA) using the Healthy Eating Index (HEI). METHODS This cross-sectional study was a secondary data analysis of the National Health and Nutrition Survey (NHANES), 2011-2016. Study participants comprised a total of 7120 women, ages 20-44 years in one of three life stage categories, pregnant women, women living in households with and without children less than 18 years. The HEI 2015 was used to assess the overall diet quality score as well as 13 dietary component scores-whole fruit, total fruit, greens and beans, whole grains, total vegetables, total protein foods, fatty acids, seafood and plant proteins, dairy, saturated fat, sodium, refined grains, and added sugars. The differences in HEI scores by life stage was assessed using linear regression models, adjusting for marital status, age, race and ethnicity, poverty index ratio, and educational status. RESULTS The mean overall HEI score of participants was 52.0 out of 100 points. The overall HEI scores of pregnant women was significantly higher than women living with and without children respectively (β = 4.6 ± 1.42, p = 0.002; β = 3.7 ± 1.34, p = 0.009). Also, pregnant women had significantly higher scores for whole fruit (β = 0.99 ± 0.18, p < 0.001; β = 0.98 ± 0.17, p < 0.001), dairy (β = 0.63 ± 0.27, p = 0.02; β = 0.68 ± 0.29, p = 0.02) and whole grains (β = 1.05 ± 0.40, p = 0.01; β = 0.97 ± 0.39, p = 0.02) than women living with and without children respectively. On the other hand, women living without children had significantly higher scores for total vegetables (β = 0.18 ± 2.04, p = 0.002), refined grains (β = 0.22 ± 0.10, p = 0.03) and added sugars (β = 0.35 ± 0.16, p = 0.04) than women living with children. CONCLUSION Pregnant women had the highest diet quality while women living in households with children had the lowest diet quality among the studied population.
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Affiliation(s)
- Opeyemi Adewumi
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, Alabama, USA
| | - Oluwatobi Fijabi
- Biological Sciences Department, University of Alabama, Tuscaloosa, Alabama, USA
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Movva N, Reichert H, Hooda N, Bylsma LC, Mitchell M, Cohen SS. Dietary eating patterns, dairy consumption, and anxiety: A systematic literature review. PLoS One 2023; 18:e0295975. [PMID: 38153944 PMCID: PMC10754443 DOI: 10.1371/journal.pone.0295975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/02/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Nutrition affects both physical and mental health but evidence is mixed regarding potential associations between anxiety and diet, particularly dairy consumption. We conducted a systematic literature review (SLR) of dairy consumption and/or various dietary patterns and risk of anxiety. METHODS Literature searches were conducted in PubMed and Embase. All study designs except case reports, small case series, and SLRs were considered for inclusion. Reference lists of previously published SLRs were reviewed for any relevant additional studies. Studies of populations without dairy sensitivities exploring the association between dietary patterns and/or dairy consumption and anxiety published through May 2022 were identified using predefined eligibility criteria. Study quality was determined using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS For this SLR, 132 studies were included; 80 were cross-sectional. Studies examined different dietary patterns (e.g., Mediterranean, gluten-free) and anxiety using various anxiety scales, with 19 studies specifically reporting on whole dairy consumption and anxiety. Dairy consumption was significantly associated with a lower risk of anxiety in 7 studies, while the remaining 12 studies showed no significant associations. Evidence was mixed for the association between various dietary patterns and anxiety, but more studies observed a lower risk of anxiety with greater adherence to "healthy" diets (e.g., Mediterranean, diet quality score, vegetarian/vegan) than a higher risk. Notable heterogeneity in study populations, time periods, geographical locations, dietary assessment methods, and anxiety scales was observed. CONCLUSIONS The results of this SLR suggest a potential link between diet including diary consumption and anxiety, but future studies, especially with longitudinal designs that measure diet and anxiety at several timepoints and comprehensively adjust for confounders, are needed to fully understand the relationship between diet and anxiety.
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Affiliation(s)
- Naimisha Movva
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Heidi Reichert
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Naushin Hooda
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Lauren C. Bylsma
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Meghan Mitchell
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
| | - Sarah S. Cohen
- EpidStrategies, A Division of ToxStrategies, LLC, Katy, Texas, United States of America
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Folayan MO, Oginni AB, El Tantawi M, Adeniyi A, Alade M, Finlayson TL. Association between maternal decision-making and mental health and the nutritional status of children under 6 years of age in sub-urban Nigeria. BMC Public Health 2023; 23:1159. [PMID: 37322502 PMCID: PMC10268393 DOI: 10.1186/s12889-023-16055-2] [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: 10/03/2022] [Accepted: 06/05/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND We assessed the association between decision-making power and mental health status of mothers and the nutritional status of their children less than 6 years old in Ile-Ife, Nigeria. METHODS This was a secondary data analysis of 1549 mother-child dyads collected through a household survey conducted between December 2019 and January 2020. The independent variables were maternal decision-making and mental health status (general anxiety, depressive symptoms, parental stress). The dependent variable was the child's nutritional status (thinness, stunting, underweight and overweight). Confounders were maternal income, age, and education status, and the child's age and sex. The associations between the dependent and independent variables were determined using multivariable binary logistic regression analysis after adjusting for confounders. The adjusted odds ratios (AORs) were determined. RESULTS Children of mothers with mild general anxiety had lower odds of stunting than children of mothers with normal anxiety (AOR: 0.72; p = 0.034). Mothers who did not make decisions on children's access to health care (AOR: 0.65; p < 0.001) had children with lower odds of being thin than those whose mothers made decisions on their access to health care. Children of mothers with clinically significant parenting stress levels (AOR: 0.75; p = 0.033), severe depressive symptoms (AOR: 0.70; p = 0.041) and who were not decision makers on the access of their children to health care (AOR: 0.79; p = 0.035) had lower odds of underweight. CONCLUSIONS Maternal decision-making status and mental health status were associated with the nutritional status of children less than 6 years in a sub-urban community in Nigeria. Further studies are needed to understand how maternal mental health is associated with the nutritional status of Nigerian preschool children.
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Affiliation(s)
| | | | - Maha El Tantawi
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Abiola Adeniyi
- Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
| | - Michael Alade
- Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria
| | - Tracy L Finlayson
- School of Public Health, San Diego State University, San Diego, CA, USA
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Kay MC, Duffy EW, Sun B, Borger C. Comparing Diet Quality Indices for Low-Income 24-Month-Old Toddlers: Exploring Changes Driven by 2020-2025 Dietary Guidelines for Americans. J Nutr 2023; 153:215-224. [PMID: 36913456 PMCID: PMC10196569 DOI: 10.1016/j.tjnut.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/16/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Accurate assessment of toddler diet quality is essential for understanding current intakes and evaluating the effect of interventions and programs to promote healthy eating and prevent chronic disease. OBJECTIVES The goal of this article was to assess the diet quality among toddlers using two different indices appropriate for 24-mo-old toddlers and compare differences in scoring between the measures by race and Hispanic origin. METHODS We used cross-sectional data from 24-mo-old toddlers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Infant and Toddler Feeding Practices Study-2 (ITFPS-2), a national study that includes 24-hour dietary recall information from children enrolled in WIC at birth. The main outcome measure was diet quality using both the toddler diet quality index (TDQI) and the healthy eating index (HEI)-2015. We derived mean scores for overall diet quality and for each component. We examined associations between the distribution of diet quality scores across terciles and by race and Hispanic origin using Rao-Scott chi-square tests of association. RESULTS Nearly half of the mothers and caregivers self-identified as Hispanic (49%). Diet quality scores were higher when using the HEI-2015 compared with the TDQI (56.4 vs. 49.9, respectively). The difference in component scores was largest for refined grains, followed by sodium, added sugars, and dairy. Toddlers from Hispanic mothers and caregivers had significantly higher component scores for greens and beans and dairy but had lower scores for whole grains (P < 0.05) than those for the other racial and ethnic subgroups assessed. CONCLUSIONS We found noteworthy differences in toddler diet quality depending on whether the HEI-2015 or TDQI is used, and children of different racial and ethnic subgroups may be differentially classified as having high or low diet quality depending on which index is used. This may have important implications for understanding which populations are at risk of future diet-related diseases.
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Affiliation(s)
- Melissa C Kay
- Department of Pediatrics, Duke University, Durham, NC, USA.
| | - Emily W Duffy
- Department of Nutrition, Gillings School of Global Public Health and Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
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Campbell H, Wood AC. Challenges in Feeding Children Posed by the COVID-19 Pandemic: a Systematic Review of Changes in Dietary Intake Combined with a Dietitian's Perspective. Curr Nutr Rep 2021; 10:155-165. [PMID: 33993426 PMCID: PMC8123103 DOI: 10.1007/s13668-021-00359-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW To examine the evidence that the dietary quality of children changed between the period preceding the COVID-19 pandemic and the first year during the pandemic. RECENT FINDINGS A systematic review of the evidence for dietary changes occurring as a result of the pandemic-related restrictions, in Part I of this article, yielded 38 original research articles. These articles had conflicting results, some describing improvements in overall quality and some describing deteriorations. As a whole the studies were characterized by a low study quality, and children were poorly represented. Taken together, these studies do not provide enough evidence to draw conclusions about whether dietary habits changed or not as a result of the pandemic. However, in a wider, narrative review of the psychosocial changes occurring as a result of the COVID-19 pandemic, and the known associations of these factors with a dietary intake in Part II, we conclude that there is a reason to expect that the dietary quality of children might have been adversely affected by the COVID-19 pandemic. One the one hand, the literature fails to provide conclusive evidence on changes in the dietary quality of children resulting from the COVID-19 pandemic. On the other hand, the broader literature supports the hypothesis that children's dietary quality will have declined during the pandemic. Taken together, we urgently need more high-quality research on children's changes in dietary intake occurring over the pandemic. This will provide important information on whether any potential long-term consequences of such changes, if they exist, need to be examined and ameliorated.
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Affiliation(s)
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1000 Bates Street, Houston, TX, 77071, USA.
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Mooney J, Lipsky LM, Liu A, Nansel TR. Does stress attenuate motivation for healthful eating in pregnancy and postpartum? Appetite 2021; 163:105207. [PMID: 33737210 DOI: 10.1016/j.appet.2021.105207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/23/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
Despite high motivation for healthful eating during pregnancy, maternal diet quality is inadequate. During pregnancy, women may relax effortful control over eating to reduce stress; thus, stress may override motivation to eat healthfully. This secondary analysis of data from the Pregnancy Eating Attributes Study longitudinal cohort investigated associations of motivation for healthful eating and perceived stress with diet quality during pregnancy (n = 365) and postpartum (n = 266), and investigated whether stress modifies associations of motivation with diet quality. Women (Mage = 31.3; gestational age ≤ 12 weeks) were recruited from the Chapel Hill, North Carolina area and completed multiple 24-h diet recalls (once each trimester of pregnancy, and at 4-6 weeks, 6 months, and 1 year postpartum) and validated measures of perceived stress and motivation for healthful eating (autonomous and controlled). Hierarchical multiple regressions tested associations of diet quality (Healthy Eating Index-2015) with stress, motivation, and their interactions. Additionally, themes extracted from previously-analyzed focus groups conducted with a subsample of participants were re-examined for content relevant to stress, motivation, and diet. Pregnancy and postpartum diet quality was positively associated with autonomous motivation, but was unassociated with controlled motivation and stress. Interaction terms did not appreciably improve model fit. Focus group participants described both internal and external forces contributing to their motivation for healthy eating during pregnancy and described the impact of stress on eating behaviors through amplification of food cravings. Future research is needed to identify influences on maternal motivation for healthful eating.
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Affiliation(s)
- Jan Mooney
- Health Psychology Ph.D. Program, University of North Carolina at Charlotte, Colvard Hall, 9201 University City Boulevard, Charlotte, NC, 28223, USA; Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA.
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
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Covington L, Armstrong B, Trude ACB, Black MM. Longitudinal Associations Among Diet Quality, Physical Activity and Sleep Onset Consistency With Body Mass Index z-Score Among Toddlers in Low-income Families. Ann Behav Med 2020; 55:653-664. [PMID: 33196078 DOI: 10.1093/abm/kaaa100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Habits surrounding health behaviors (i.e., sleep, physical activity, diet) are developed in toddlerhood. Lack of consistent health habits may increase obesity risk among toddlers in low-income families. PURPOSE To compare the role of sleep onset consistency, physical activity and diet quality as mediators between household poverty and toddler weight. METHODS Two hundred and seven toddlers (mean age = 20.2 months, 46% female, 68.1% Black) participating in an obesity prevention trial were assessed at three time points over 12 months. Using Actical accelerometers, we assessed sleep and physical activity at each time point for up to 1 week. We defined sleep onset consistency as the standard deviation of sleep onset across all days. We calculated the Healthy Eating Index-2015 from a 24-hr dietary recall. We used WHO standards to calculate BMI-for-age z-scores from toddlers' weight/length, and calculated poverty ratio from parent-reported income and family size. Multilevel mediation models tested toddler sleep onset consistency, physical activity, and diet quality as mediators between household poverty and toddler BMI z-score. RESULTS Toddlers from households with higher poverty ratios had more inconsistent sleep onset times. Toddlers with more inconsistent sleep onset times had higher BMI z-scores across all timepoints, even when accounting for physical activity and diet quality. Sleep onset consistency indirectly explained the association between household poverty and BMI z-score. CONCLUSIONS Inconsistent sleep schedules could help explain the association between poverty and BMI. Future research should examine strategies to support low-income families to develop and maintain routines as a mechanism to prevent obesity and reduce disparities. TRIAL REGISTRATION NUMBER NCT02615158.
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Affiliation(s)
| | - Bridget Armstrong
- Arnold School of Public Health, Department of Exercise Science, Columbia, SC, USA
| | - Angela C B Trude
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, Baltimore, MD, USA
| | - Maureen M Black
- University of Maryland Baltimore School of Medicine, Department of Pediatrics, Baltimore, MD, USA.,RTI International, Research Triangle Park, NC, USA
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Trude ACB, Black MM, Surkan PJ, Hurley KM, Wang Y. Maternal anxiety and diet quality among mothers and toddlers from low-income households. MATERNAL AND CHILD NUTRITION 2020; 16:e12992. [PMID: 32147951 PMCID: PMC7507505 DOI: 10.1111/mcn.12992] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/24/2020] [Accepted: 02/18/2020] [Indexed: 01/23/2023]
Abstract
We evaluated the association between maternal anxiety score and diet quality over time among mothers and toddlers in low‐income families. Longitudinal data were collected from 267 mother–toddler dyads in an obesity prevention trial. Participants were recruited from the Special Supplemental Nutrition Program for Women, Infants and Children and paediatric clinics between 2007 and 2010. Dyads were assessed at study enrolment (Time 1), 6‐month (Time 2), and 12‐month follow‐up (Time 3). On the basis of a 1‐day 24‐hr dietary recall, we estimated maternal and toddler diet quality using the Healthy Eating Index 2015. Anxiety, a time‐varying variable, was assessed via the State–Trait Anxiety Inventory. Associations between maternal anxiety score and maternal and toddler diet quality over time were assessed in adjusted mixed models. Maternal and toddler diet quality were positively correlated (r = .48, p < .001). Higher maternal anxiety scores were related to lower toddler Healthy Eating Index scores (b = −0.51, 95% confidence interval, CI [−0.87, −0.15]) with no significant variation over time. The relation between maternal diet quality and anxiety score varied over time (b = 0.28, p = .03, for time–anxiety interaction). Higher maternal anxiety scores were associated with lower maternal diet quality at Time 1 (b = −0.71, 95% CI [−1.09, 0.34]) and at Time 2 (b = −0.51, 95% CI [−0.97, −0.05]), but not at Time 3 (b = −0.14, 95% CI [−0.54, 0.26]). Findings suggest that mothers and toddlers exhibited similar low‐quality dietary patterns and that lower diet quality was associated with higher maternal anxiety scores. Approaches to enhance diet quality may consider incorporating anxiety‐reducing strategies into maternal and toddler care and feeding behaviour guidelines.
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Affiliation(s)
- Angela C B Trude
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Maureen M Black
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.,RTI International, Research Triangle Park, North Carolina, USA
| | - Pamela J Surkan
- Social and Behavioral Intervention Program, International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kristen M Hurley
- Center for Human Nutrition, International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yan Wang
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
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