Psychometric Evaluation of the Food Life Questionnaire-Short Form among Brazilian Adult Women

Measures of beliefs and attitudes toward food have generally been limited to the measurement of more pathological eating attitudes (e.g., disordered eating). The Food Life Questionnaire (FLQ) and its short form (FLQ-SF) were developed to examine attitudes toward a broader range of foods; however, the factor structure of the FLQ-SF was not confirmed in any study with young women. In the present study, we performed a psychometric evaluation of the Brazilian Portuguese translation of the FLQ-SF in a sample of 604 women. We evaluated the factor structure using a two-step, split-sample exploratory and confirmatory factor analytic approach. Results supported a four-factor structure (i.e., weight concern, diet-health orientation, belief in a diet-health linkage, and food and pleasure) with 18 items (χ2/df = 2.09; CFI = 0.95; TLI = 0.94; RMSEA = 0.05 (90% CI = 0.04; 0.06; p > 0.05); and SRMR = 0.08). Additionally, we found good internal consistency for all FLQ-SF subscales (McDonald's ω = 0.79-0.89) and convergent validity with measures of feelings, beliefs, and behaviors involved in food attitudes. Collectively, these results support the use of the FLQ-SF in Brazilian women and provide a foundation to expand the literature on beliefs and attitudes toward food in this population.

Acceptance of bite presentations and feeding behaviors of 8 to 12-month-old infants: A reflection of typical feeding development

PURPOSE

The lack of age-appropriate expectations for feeding acceptance patterns in early childhood is a barrier to early and accurate identification of pediatric feeding disorder (PFD). The objective of the study was to describe the process by which typically developing children 8-12 months of age accept or refuse bite presentations and their corresponding feeding behaviors, aiming to establish age-appropriate normative data for feeding acceptance.

METHOD

Using cross-sectional methodology, we studied the proportion of bite presentations accepted, the type of feeding behaviors-passive, disruptive, expulsion, feeding concerns- observed at presentation and acceptance or refusal, and the duration between presentation to acceptance or refusal in 63 healthy infants between 8 and 12 months of age. Descriptive statistics and a one-way ANOVA were conducted to compare the effect of age and texture.

RESULTS

Findings reveal high levels of bite acceptance of 80 % or > for children across ages, but with lower texture-specific differences. Both passive and disruptive behaviors were present even during acceptance of bites without any expulsion. Feeding concerns showed developmental trends with rapid reduction by 12 months suggesting improvement in oral feeding skills. The duration of acceptance and refusals revealed clear patterns by age and texture with an average of 3 s for acceptance but <1 s for refusal.

CONCLUSIONS

This study describes bite acceptance patterns in a cohort of typically developing infants between 8 and 12 months of age by examining the acceptance of bites, frequency and type of feeding behaviors, and duration differences when children accept versus refuse a bite. Findings may be applied in the future to provide more sensitive detection of problematic feeding patterns to aid in the detection of pediatric feeding disorder.

Factors associated with feeding behaviors among mothers of obese infants: a cross-sectional study

Background

Infant obesity is a risk factor for diseases in childhood and even in adulthood. Maternal feeding behaviors are strongly associated with infant obesity, hence factors relevant to mother's perception, socioeconomic status, and social support that influence the feeding behaviors need to be explored. Therefore, this study aimed to examine associated factors of feeding behaviors among mothers with obese infants.

Methods

This cross-sectional study was conducted at the pediatric wards of a tertiary hospital in Wenzhou, Zhejiang Province, China. Participants (n=134) were mothers of infant with obesity aged 6-12 months. Data were collected by structured questionnaires. Maternal feeding characteristics and the relationship between mothers' age, monthly personal income, parental self-efficacy, social support, benefits of maternal feeding behaviors, barriers to maternal feeding behaviors and feeding behaviors were examined. The Data was analyzed by descriptive statistics and multiple regression analysis.

Results

Most of the infants (84.3%) was in the 98^th-100^th percentile. Nearly half of the mothers were 30-39 years old and unemployed (46.3%). One-third (61.40%) were multiparous mothers and 73.1% cared for their infants for more than 6 hours per day. Monthly personal income, parenting self-efficacy and social support together explained 28% of variance on feeding behaviors (P<0.05). Parenting self-efficacy (β=0.309, P<0.05) and social support (β=0.224, P<0.05) had significantly positive influence on feeding behaviors. Maternal personal income (β=-0.196, P<0.05) had a significantly negative influence on feeding behaviors among mothers having infants with obesity.

Conclusions

Nursing interventions should be focused on enhancing parenting self-efficacy and promoting social support for the feeding behaviors of mothers.

Dual Behavior Regulation: Tether-Free Deep-Brain Stimulation by Photothermal and Upconversion Hybrid Nanoparticles

Optogenetics has been plagued by invasive brain implants and thermal effects during photo-modulation. Here, two upconversion hybrid nanoparticles modified with photothermal agents, named PT-UCNP-B/G, which can modulate neuronal activities via photostimulation and thermo-stimulation under near-infrared laser irradiation at 980 nm and 808 nm, respectively, are demonstrated. PT-UCNP-B/G emits visible light (410-500 nm or 500-570 nm) through the upconversion process at 980 nm, while they exhibit efficient photothermal effect at 808 nm with no visible emission and tissue damage. Intriguingly, PT-UCNP-B significantly activates extracellular sodium currents in neuro2a cells expressing light-gated channelrhodopsin-2 (ChR2) ion channels under 980-nm irradiation, and inhibits potassium currents in human embryonic kidney 293 cells expressing the voltage-gated potassium channels (KCNQ1) under 808-nm irradiation in vitro. Furthermore, deep-brain bidirectional modulation of feeding behavior is achieved under tether-free 980 or 808-nm illumination (0.8 W cm^-2 ) in mice stereotactically injected with PT-UCNP-B in the ChR2-expressing lateral hypothalamus region. Thus, PT-UCNP-B/G creates new possibility of utilizing both light and heat to modulate neural activities and provides a viable strategy to overcome the limits of optogenetics.

Assessment of Feeding Behaviors and Parents' Frustrations of Children with Autism Spectrum Disorder in Lebanon: A Case-Control Study

Children with autism spectrum disorder (ASD) exhibit restrictive and repetitive behaviors that affect their eating habits. The purpose of this study is to identify the behavioral feeding problems and eating habits among ASD children compared to typically developed (TD) children age/gender-matched controls, along with their parents'/caregivers' strategies for dealing with them. It included 43 ASD children and 43 TD children aged two to eleven years. The analysis was performed based on two valid questionnaires: the Behavior Pediatrics Feeding Assessment Scale (BPFA) and "My Child Eating Habits" (MCEH). The BPFA and MCEH scores conceded three manifestations that fall into food selectivity and problematic mealtime behavior in both groups of children. Compared to TD children, children with ASD exhibited higher BPFA scores, which indicated food-related behavioral and skill-based problems (p = 0.004). Children with ASD were less likely to consume fruits, vegetables, and milk than TD children, which may lead to nutritional deficiencies (p = 0.003, p = 0.003, and p = 0.010, respectively). Parents of ASD children were concerned about their behavioral problems and expressed their intention of an early intervention. These findings highlight the importance of nutritional clinical routines that incorporate the evaluation of the nutritional status and feeding behaviors of ASD children.

Postpartum Depressive Symptoms and Their Selected Psychological Predictors in Breast-, Mixed and Formula-Feeding Mothers

BACKGROUND

Although breastfeeding is recommended by WHO and professionals as the most beneficial for newborn babies, many women find it challenging. Previous research yielded ambiguous results concerning the role of breastfeeding in the development of postpartum depression. The study aimed to identify the best predictors of depressive symptoms for each of these feeding method.

METHODS

The participants were 151 women (mean age 29.4 yrs; SD = 4.5) who gave birth within the last 6 months and included 82 women classified as breastfeeding, 38 classified as mixed-feeding (breast and bottle), and 31 as formula-feeding. The study had a cross-sectional design using a web-based survey for data collection. The following measures were administered: The Edinburgh Postnatal Depression Scale; Sense of Stress Questionnaire; The Postpartum Bonding Questionnaire; Parenting Sense of Competence Scale; Infant Feeding Questionnaire.

RESULTS

Women in study groups differed in stress, bonding difficulties, and beliefs related to feeding practices and infancy. There were no significant differences in the severity of depressive symptoms, but all mean EPDS scores were above 12. Maternal satisfaction, intrapsychic stress, and concerns about feeding on a schedule were the best predictors of EPDS scores for breastfeeding women. For mixed-feeding - emotional tension, concern about infant's hunger, overeating, and awareness of infant's hunger and satiety cues; while for the formula-feeding group, predictors included emotional tension, bonding difficulties, and such maternal feeding practices and beliefs as concern about undereating, awareness of infant's hunger and satiety cues, concerns about feeding on a schedule and social interaction with the infant during feeding.

CONCLUSION

Differences in predictors of postpartum depression for study groups suggest that breastfeeding itself may not be a risk for postpartum depression. However, the specificity of maternal experiences with the various types of feeding is related to difficulties promoting postpartum depression. Providing emotional and educational support appropriate for different types of feeding may be an essential protective factor for postnatal depression.

Healthy and Sustainable Dietary Patterns in Children and Adolescents: A Systematic Review

The need for adherence to a healthy and sustainable dietary pattern in the pediatric stage is discussed worldwide, being linked to a progressive incidence of noncommunicable diseases in adulthood. The aims of this systematic review were to summarize the healthy and/or sustainable dietary patterns, defined a priori, described in the literature for use during the pediatric stage; to evaluate the adherence to these dietary patterns; and identify the health-related benefits associated with adherence to these patterns. A literature search was carried out on Medline, Scopus, and Web of Science from 2010 up to 2021, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 128 articles were included according to the following criteria: participants 2-17 y old, healthy and/or sustainable dietary patterns defined by an a priori methodology; articles written in English or Portuguese; and published since 2010. Fifty instruments with 14 adaptations that measure adherence to healthy and/or sustainable dietary patterns in children and adolescents were found. The Mediterranean Diet was the most studied dietary pattern. Adherence to healthy and/or sustainable dietary patterns has wide variations worldwide. Most of the instruments described have been little studied at pediatric ages, reducing the ability to extrapolate results. Higher adherence to these dietary patterns was associated with lower body fat, waist circumference, blood pressure, and metabolic risk. There is no consensus regarding the association with BMI. No studies have proofs of the sustainability characteristics of these instruments, it being necessary to produce a new sustainable instrument or test the association of the previous ones with, for example, the ecological footprint. Further validations of these instruments in each country and more prospective studies are needed to establish temporal relations with health-related outcomes. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020221788.

Relationship between Stress and Feeding Behaviors in Parents of Children with Developmental Disabilities

Background: Controlling feeding practices are associated with negative child eating behaviors and an increased risk of obesity. Parental stress may be related to feeding practices. Children with developmental disabilities have increased obesity prevalence, and families may also experience increased stress. This study examined the relationship between family stress and parental feeding practices in children with developmental disabilities and how concern for the child's weight may moderate this relationship. Methods: Secondary analysis using a descriptive cross-sectional design was employed. Parents of children aged 5 to 15 years, with autism spectrum disorder (ASD), Down syndrome (DS), or spina bifida (SB) were recruited nationally. Demographics, the Child Feeding Questionnaire, and the Questionnaire on Resources and Stress were completed online. Analysis included regression with an empirical Bayesian effects model. Results: Five hundred twenty-three parents, 186 (ASD), 173 (DS) and 164 (SB), participated. Family stressors were associated with the use of controlling feeding practices. Direct effects included: (1) physical incapacitation on restriction and pressure to eat (ASD and DS); (2) pessimism (ASD) and concerns about child overweight (SB) on pressure to eat; and (3) parent/family problems on restriction (DS). Concern for child overweight moderated these relationships and resulted in two interactions (DS and SB). Conclusion: Understanding the relationship of family stressors with parental feeding practices and the role of parental concern for child overweight can potentially optimize feeding in this high-risk population. This study highlights the need to provide family-centered care with awareness of stress and its potential association with daily activities and children's health.

Food parenting practices and eating behaviors in childhood: a cross-lagged approach within the Generation XXI cohort

BACKGROUND

Food parenting practices have been associated with children's eating behaviors, but analyses exploring the bidirectional effects are limited.

OBJECTIVES

We aimed to examine the bidirectional relations between food parenting practices and the eating behavior of children from 4 to 7 y old.

METHODS

Participants are from the Generation XXI birth cohort (Portugal) assessed at both 4 and 7 y of age (n = 3698 singletons). A validated version of the Child Feeding Questionnaire and the overt/covert control scale were used. Three patterns of food parenting practices (Perceived Monitoring, Restriction, and Pressure to eat) were studied. Perception of children's eating behaviors (eating large amounts of food, eating very slowly, and food refusal) was reported by parents (measured using dichotomous questions). Cross-lagged analyses were performed to evaluate the direction of the associations (parenting practices at 4 y to behaviors at 7 y and the reverse).

RESULTS

Eating large amounts of food was unidirectionally associated with higher Restriction 3 y later (βstandardized = 0.047; 95% CI: 0.019, 0.075). Apart from Restriction, all associations had a bidirectional effect of similar magnitude. Eating large amounts of food and food refusal at age 4 influenced food parenting, such as Perceived Monitoring and Pressure to eat at age 7, but these practices were prospectively linked to these eating behaviors too (e.g., βstandardized = 0.033; 95% CI: 0.022, 0.064 for food refusal at age 4 and Pressure to eat at age 7, and βstandardized = 0.060; 95% CI: 0.034, 0.086, in the reverse direction). Parenting practices and children's eating behaviors showed significant moderate tracking (standardized path coefficients from 0.24 to 0.49).

CONCLUSIONS

Eating large amounts of food, eating slowly, and food refusal can influence parents to adopt certain food parenting practices, but these practices also influence children's behaviors after a few years. This reciprocal relation should be considered in future research. Parents should be advised to use food parenting practices associated with healthier eating behaviors.

Revising the Comprehensive Feeding Practices Questionnaire Used in Planning Preventive Overweight, Obesity, and Underweight Programs for 2-5-year-old Children

Background:

Overweight, obesity, and underweight are common child health problems in Iran. Child-feeding practices are one of the major factors affecting children's weight through eating behavior and dietary intake. The Comprehensive Feeding Practices Questionnaire (CFPQ), a 49-item measure comprising 12 subscales, assesses parental child-feeding practices. It is used to determine factors that may affect the development of overweight, obesity, and underweight and therefore, helps us plan appropriate preventive action. The aim of this study was to revise and adapt CFPQ to be used for 2–5-year-old children.

Methods:

This study including, 300 mothers selected by simple systematic random sampling, was conducted in the rural and urban areas of Birjand city, Iran. Health workers interviewed the mothers and completed questionnaire according to the standard protocol. Exploratory factor analysis (EFA), tests for internal consistency, and test–retest reliability were conducted.

Results:

EFA resulted in a final questionnaire with 39 items distributed over seven factors, including Healthy Eating Guidance, Modeling, Parent Pressure, Monitoring, Emotion Regulation, Child Control, and Restriction. The internal consistency reliability for the proposal scales was acceptable for five out of the seven factors and all of the seven factors demonstrated excellent test–retest reliability.

Conclusions:

The revised CFPQ is a valid tool for determining the various aspects of parental feeding practices aiming to prevent overweight, obesity, and underweight among 2–5-year-old children.

Dietary and Lifestyle Patterns in the Spanish Pediatric Population (One to <10 Years Old): Design, Protocol, and Methodology of the EsNuPI Study

The interest in a healthy diet and lifestyle during the early stages of life increased, pointing out its role in the development of noncommunicable chronic diseases throughout adult life. Dietary habits and dietary patterns begin to be established in early childhood and persist during adulthood. Therefore, the EsNuPI ("Nutritional Study in Spanish Pediatric Population") study aims to depict the dietary patterns, physical activity, and sedentary behaviors in Spanish children aged from one to <10 years old. This prospective, cross-sectional, observational study recruited a total of 1514 children from Spanish cities with >50,000 inhabitants, stratified by Nielsen areas. Participants were involved in one face-to-face survey, followed by a telephone survey after at least one week. Information about dietary intake and habits was obtained using a quantitative food frequency questionnaire and two 24-h dietary recalls. Physical activity and sedentary behaviors were registered using a specific questionnaire based on a seven-day record. Data were processed and stratified by categorical variables to be statistically analyzed in order to meet the study objectives. This study is the first of its kind in a Spanish reference population of this age range and the first to evaluate whether the consumption of adapted milk formulas and dairy products is associated with healthier dietary patterns and better diet quality and lifestyles in this group.

Neuropeptide PEN and Its Receptor GPR83: Distribution, Signaling, and Regulation

Neuropeptides are chemical messengers that act to regulate a number of physiological processes, including feeding, reward, pain, and memory, among others. PEN is one of the most abundant hypothalamic neuropeptides; however, until recently, its target receptor remained unknown. In this Review, we summarize recent developments in research focusing on PEN and its receptor GPR83. We describe the studies leading to the deorphanization of GPR83 as the receptor for PEN. We also describe the signaling mediated by the PEN-GPR83 system, as well as the physiological roles in which PEN-GPR83 has been implicated. As studies have suggested a role for the PEN-GPR83 system in food intake and body weight regulation, as well as in drug addiction and reward disorders, a thorough understanding of this novel neuropeptide-receptor system will help identify novel therapeutic targets to treat pathophysiological conditions involving PEN-GPR83.

Parent Feeding Practices in the Australian Indigenous Population within the Context of non-Indigenous Australians and Indigenous Populations in Other High-Income Countries-A Scoping Review

Although extensive literature on parent feeding practices among the general Australian population exists, Australian Indigenous populations are generally overlooked. A systematic scoping review was carried out to map any source of literature showing Indigenous parent feeding practices in Australia in the context of what is known about parent feeding practices among broader Australian populations and Indigenous populations in other high-income countries.A search of 8 electronic health databases was conducted. Inclusion criteria were children aged <12 y and reporting ≥1 child outcome related to childhood overweight and/or obesity, body mass index, dietary intake, or eating behavior in the context of parent feeding practices. Studies were grouped according to Indigenous status of the population for data extraction and synthesis.A total of 79 studies were identified; 80% (n = 65) were conducted among the general Australian population and <20% (n = 14) focused on Indigenous populations. Although a wide range of feeding practices were identified among the general Australian population, Indigenous practices most closely aligned with highly responsive and permissive parenting dimensions. The highly valued child autonomy in Indigenous parenting is sometimes criticized by researchers when viewed through a Western lens because the child has agency in deciding what and when to eat.Evidence-based understanding and knowledge of Indigenous parent feeding practices in Australia are limited. Indigenous worldviews are expressed distinctly differently than the general Western worldview in parent feeding practices. How worldviews are represented in parent-child relationships is important to consider for the way in which research with Indigenous populations is conducted and the evidence it generates to inform policy and practice.

A salivary effector enables whitefly to feed on host plants by eliciting salicylic acid-signaling pathway

Phloem-feeding insects feed on plant phloem using their stylets. While ingesting phloem sap, these insects secrete saliva to circumvent plant defenses. Previous studies have shown that, to facilitate their feeding, many phloem-feeding insects can elicit the salicylic acid- (SA-) signaling pathway and thus suppress effective jasmonic acid defenses. However, the molecular basis for the regulation of the plant's defense by phloem-feeding insects remains largely unknown. Here, we show that Bt56, a whitefly-secreted low molecular weight salivary protein, is highly expressed in the whitefly primary salivary gland and is delivered into host plants during feeding. Overexpression of the Bt56 gene in planta promotes susceptibility of tobacco to the whitefly and elicits the SA-signaling pathway. In contrast, silencing the whitefly Bt56 gene significantly decreases whitefly performance on host plants and interrupts whitefly phloem feeding with whiteflies losing the ability to activate the SA pathway. Protein-protein interaction assays show that the Bt56 protein directly interacts with a tobacco KNOTTED 1-like homeobox transcription factor that decreases whitefly performance and suppresses whitefly-induced SA accumulation. The Bt56 orthologous genes are highly conserved but differentially expressed in different species of whiteflies. In conclusion, Bt56 is a key salivary effector that promotes whitefly performance by eliciting salicylic acid-signaling pathway.

Feeding behaviors during home-based treatment of moderate acute malnutrition using corn-soy blends or lipid-based nutrient supplements

Feeding behaviors have an important impact on children's nutritional status and are essential to consider when implementing nutrition programs. The objective of this study was to explore and compare feeding behaviors related to supplementary feeding with corn-soy blends (CSB) and lipid-based nutrient supplements (LNS) based on best practice feeding behaviors. The study was conducted as part of a randomized controlled trial assessing the effectiveness of new formulations of CSB and LNS and comprised 1,546 children from 6 to 23 months. The study included a mixed methods approach using questionnaires, focus group discussions and home visits and interviews with a subsample of 20 caretakers of trial participants. We found that LNS, compared to CSB, were more likely to be mixed into other foods (OR [95% CI] 1.7 [1.3-2.2], p = <.001), served with a meal (OR [95% CI] 1.6 [1.1-2.3], p = <.018)or between meals (OR [95% CI] 1.5 [1.1-1.9], p = <.005), and fed using an encouraging feeding style (mean difference in percentage points [95% CI] 23% [6%:40%], p = .01). CSB were more likely to be fed using a forced feeding style (mean difference in percentage points [95% CI] 18% [3%:33%], p = .02) and were often observed to be served unprepared. The main differences in feeding behaviors between the two diet groups were linked to how and when supplements were served. Educational instructions should therefore be adapted according to the supplement provided; when providing CSB, efforts should be made to promote an encouraging feeding style, and emphasis should be made to ensure preparations are made according to recommendations.

Experimental Comparison of Efficacy for Three Handfeeding Techniques in Dementia

BACKGROUND

Nursing home (NH) residents who require assistance during mealtimes are at risk for malnutrition. Supportive handfeeding is recommended, yet there is limited evidence supporting use of a specific handfeeding technique to increase meal intake.

OBJECTIVES

To compare efficacy of three handfeeding techniques for assisting NH residents with dementia with meals: Direct Hand (DH), Over Hand (OH), and Under Hand (UH).

DESIGN

A prospective pilot study using a within-subjects experimental Latin square design with randomization to one of three handfeeding technique sequences.

SETTING AND PARTICIPANTS

30 residents living with advanced dementia in 11 U.S. NHs.

MEASUREMENTS

Time required for assistance; meal intake (% eaten); and feeding behaviors, measured by the Edinburgh Feeding Evaluation in Dementia (EdFED) scale.

INTERVENTION

Research Assistants provided feeding assistance for 18 video-recorded meals per resident (N = 540 meals). Residents were assisted with one designated technique for 6 consecutive meals, changing technique every 2 days.

RESULTS

Mean time spent providing meal assistance did not differ significantly between techniques. Mean meal intake was greater for DH (67 ± 15.2%) and UH (65 ± 15.0%) with both significantly greater than OH (60 ± 15.1%). Feeding behaviors were more frequent with OH (8.3 ± 1.8%), relative to DH (8.0 ± 1.8) and UH (7.7 ± 1.8).

CONCLUSION

All three techniques are time neutral. UH and DH are viable options to increase meal intake among NH residents with advanced dementia and reduce feeding behaviors relative to OH feeding.

A Semipersistent Plant Virus Differentially Manipulates Feeding Behaviors of Different Sexes and Biotypes of Its Whitefly Vector

It is known that plant viruses can change the performance of their vectors. However, there have been no reports on whether or how a semipersistent plant virus manipulates the feeding behaviors of its whitefly vectors. Cucurbit chlorotic yellows virus (CCYV) (genus Crinivirus, family Closteroviridae) is an emergent plant virus in many Asian countries and is transmitted specifically by B and Q biotypes of tobacco whitefly, Bemisia tabaci (Gennadius), in a semipersistent manner. In the present study, we used electrical penetration graph (EPG) technique to investigate the effect of CCYV on the feeding behaviors of B. tabaci. The results showed that CCYV altered feeding behaviors of both biotypes and sexes of B. tabaci with different degrees. CCYV had stronger effects on feeding behaviors of Q biotype than those of B biotype, by increasing duration of phloem salivation and sap ingestion, and could differentially manipulate feeding behaviors of males and females in both biotype whiteflies, with more phloem ingestion in Q biotype males and more non-phloem probing in B biotype males than their respective females. With regard to feeding behaviors related to virus transmission, these results indicated that, when carrying CCYV, B. tabaci Q biotype plays more roles than B biotype, and males make greater contribution than females.

Early Life Characteristics Associated with Appetite-Related Eating Behaviors in 7-Year-Old Children

OBJECTIVE

To assess early life characteristics associated with appetite-related eating behaviors in 7-year-old children.

STUDY DESIGN

The participants are children from the population-based birth cohort Generation XXI. Data on sociodemographics, health, and lifestyles and anthropometrics were collected at birth, and 4- and 7-year-old evaluations. A Portuguese version of the Children's Eating Behavior Questionnaire was completed by mothers (n = 3562 children) with children aged 7 years old. A 2-factor solution was identified: factor 1-appetite restraint and factor 2-appetite disinhibition. Associations were estimated through generalized linear models adjusted for maternal age, education, body mass index (BMI) before birth, family structure, number of siblings, and child's sex (β regression coefficients and 95% CIs).

RESULTS

Higher appetite restraint at 7 years old was associated with higher maternal age and educational level, families with both parents (1- vs 2-parent: β = -0.074, 95% CI -0.140, -0.007) and no siblings (≥2 vs 0: β = -0.152, 95% CI -0.224, -0.081), and more sedentary lifestyles at 4 years old. It was also associated with lower child and maternal BMI and waist circumference at 4 years old. In contrast, higher appetite disinhibition was associated with lower maternal educational background, having a 1-parent family, more sedentary behaviors (≥120 vs <120 min/d of media: β = 0.055, 95% CI 0.018, 0.093), and higher BMI and waist circumference at 4 years old.

CONCLUSIONS

Higher maternal age and education, and a family with both parents at 4 years old seem to influence higher appetite restraint, but less appetite disinhibition at 7 years old. More sedentary lifestyles at 4 years old were associated with higher appetite restraint and appetite disinhibition scores later in childhood. These results can be useful for the development of prevention guidelines and educational strategies aimed at improving healthy eating behaviors.

Postdischarge Feeding Interactions and Neurodevelopmental Outcome at 1-Year Corrected Gestational Age

OBJECTIVE

To determine the extent to which postdischarge feeding behaviors and interactions among caregiver-preterm infant dyads are associated with infant neurodevelopment at 1-year corrected gestational age (CGA).

STUDY DESIGN

We studied 119 preterm infants born <34 weeks gestation and <1750 g at birth, and their caregivers, enrolled in the Collaborative Home Infant Monitoring Evaluation with in-person feeding assessments according to the Nursing Child Assessment Feeding Scale (NCAFS) at 39-59 weeks postmenstrual age that completed Bayley Scales of Infant Development, Second Edition testing at 1 year CGA.

RESULTS

Mean ± SD gestational age was 29.6 ± 2.4 weeks, and birth weight was 1260 ± 320 g. After adjustment for maternal and infant demographics, gestational age at birth, discharge and birth weight, mode of infant feeding, and caregiver type during the postdischarge NCAFS assessment, overall NCAFS scores were positively associated with higher 1-year CGA Bayley mental developmental index (MDI) scores (for each 1 SD increase in overall NCAFS score, MDI increased by 2.8 [95% CI 0.7, 4.9] points). Among individual NCAFS domains, strongest effects were seen for caregiver responsiveness to infant distress, such that, compared with dyads having domain scores of 11 (highest possible score), the adjusted mean difference in MDI was 8.3 points (95% CI -15.2, -1.4) lower among dyads with scores <9.

CONCLUSIONS

Caregiver-preterm infant feeding interaction and caregiver responsiveness to preterm infant feeding distress were associated with preterm infant Bayley MDI at 1-year CGA. Caregiver-infant feeding interaction may represent a modifiable factor to improve the neurodevelopment of at-risk preterm infants.

The elegance of energy balance: Insight from circuit-level manipulations

Mechanisms of energy balance were first examined using very powerful neuroscience techniques such as lesions and electrical stimulation. This early work identified the hypothalamus as a key structure involved in hunger and feeding; however, neural resolution of cell-defined populations contributing to appetite regulation remained elusive. Recent innovations in neuroscience have produced constructs that allow for a high degree of specificity in loss- and gain-of-function manipulations in molecularly circumscribed neural subsets as well as monosynaptic circuit mapping and in vivo neurophysiology. These complimentary techniques have provided researchers an unprecedented amount of empirical agility. As a result, cell populations in two subregions of the hypothalamus have emerged as key players in the physiological control of feeding behavior. The arcuate nucleus of the hypothalamus and the paraventricular nucleus of the hypothalamus contain neural populations that have a direct role in the promotion of hunger and satiety. These include neurons that express agouti-related peptide, pro-opiomelanocortin, single-minded homolog 1 protein, and the melanocortin-4 receptor. This review focuses on how these neural subsets communicate with one another, link up to build elaborate networks, and ultimately contribute to alterations in food intake. The continuing advancement of neuroscience tools, as well as a multimodal integration of findings, will be critical in illuminating an exhaustive and clinically relevant hunger circuit.

Toward a Scalable and Sustainable Intervention for Complementary Food Safety

BACKGROUND

Contaminated complementary foods are associated with diarrhea and malnutrition among children aged 6 to 24 months. However, existing complementary food safety intervention models are likely not scalable and sustainable.

OBJECTIVE

To understand current behaviors, motivations for these behaviors, and the potential barriers to behavior change and to identify one or two simple actions that can address one or few food contamination pathways and have potential to be sustainably delivered to a larger population.

METHODS

Data were collected from 2 rural sites in Bangladesh through semistructured observations (12), video observations (12), in-depth interviews (18), and focus group discussions (3).

RESULTS

Although mothers report preparing dedicated foods for children, observations show that these are not separate from family foods. Children are regularly fed store-bought foods that are perceived to be bad for children. Mothers explained that long storage durations, summer temperatures, flies, animals, uncovered food, and unclean utensils are threats to food safety. Covering foods, storing foods on elevated surfaces, and reheating foods before consumption are methods believed to keep food safe. Locally made cabinet-like hardware is perceived to be acceptable solution to address reported food safety threats.

CONCLUSION

Conventional approaches that include teaching food safety and highlighting benefits such as reduced contamination may be a disincentive for rural mothers who need solutions for their physical environment. We propose extending existing beneficial behaviors by addressing local preferences of taste and convenience.

Bidirectional association between parental child-feeding practices and body mass index at 4 and 7 y of age

BACKGROUND

Evidence of the association between parental child-feeding practices and the child's body mass index (BMI) is controversial, and bidirectional effects have been poorly studied.

OBJECTIVE

We aimed to examine bidirectional associations between parental child-feeding practices and BMI at 4 and 7 y of age.

DESIGN

This study included 3708 singleton children from the Generation XXI birth cohort with data on parental child-feeding practices and BMI at 4 and 7 y old. Feeding practices were assessed through a self-administered questionnaire by combining the Child Feeding Questionnaire and the Overt/Covert Control scale and then adapting it to Portuguese preschool children. Weight and height were measured according to standardized procedures, and age- and sex-specific BMI z scores were computed based on the WHO Growth References. Linear regression models were used to estimate the bidirectional associations between each practice and BMI z score. Crosslagged analyses were performed to compare the directions of those associations (the mean score of each practice and BMI z score at both ages were standardized to enable effect size comparisons).

RESULTS

After adjustments, pressure to eat and overt control at 4 y of age were associated with a lower BMI z score 3 y later (β: -0.05; 95% CI: -0.08, -0.03 and β: -0.05; 95% CI: -0.09, -0.01, respectively). Regarding the opposite direction of association, a higher BMI z score at 4 y of age was significantly associated with higher levels of restriction and covert control at 7 y of age (β: 0.06; 95% CI: 0.03, 0.08 and β: 0.06; 95% CI: 0.04, 0.08, respectively) and with lower levels of pressure to eat (β: -0.17; 95% CI: -0.20, -0.15). The only bidirectional practice, pressure to eat, was more strongly influenced by the BMI z score than the reverse (βstandardized: -0.17 compared with βstandardized: -0.04; likelihood ratio test: P < 0.001).

CONCLUSIONS

We found that parents both respond to and influence the child's weight; thus, this child-parent interaction should be considered in future research.

Yolk hormones influence in ovo chemosensory learning, growth, and feeding behavior in domestic chicks

In this study, we assessed whether prenatal exposure to elevated yolk steroid hormones can influence in ovo chemosensory learning and the behavior of domestic chicks. We simulated a maternal environmental challenge by experimentally enhancing yolk progesterone, testosterone, and estradiol concentrations in hen eggs prior to incubation. The embryos from these hormones-treated eggs (HO) as well as sham embryos (O) that had received the vehicle-only were exposed to the odor of fish oil (menhaden) between embryonic Days 11 and 20. An additional group of control embryos (C) was not exposed to the odor. All chicks were tested following hatching for their feeding preferences between foods that were or were not odorized with the menhaden odor. In the 3-min choice tests, the behavior of O chicks differed significantly according to the type of food whereas C and HO chicks showed no preference between odorized and non-odorized food. Our result suggests weaker response in HO chicks. In addition, HO chicks showed impaired growth and reduced intake of an unfamiliar food on the 24-h time scale compared to controls. Our data suggest that embryonic exposure to increased yolk hormone levels can alter growth, chemosensory learning, and the development of feeding behaviors.

Parental perception of premature infant growth and feeding behaviors: use of gestation-adjusted age and assessing for developmental readiness during solid food introduction

BACKGROUND

The extent to which pediatricians inform parents about gestation-adjusted age growth plotting is unclear. Uninformed parents may have decreased satisfaction of infant growth. Subsequent early introduction of solid foods may lead to avoidant feeding behaviors and poor parental perception of infant feeding patterns.

METHODS

Questionnaires regarding infant growth and feeding behaviors were given to parents (n = 76) of premature infants. The Wilcoxon rank-sum and χ(2)/Fisher's exact tests were used.

RESULTS

Uninformed parents were less satisfied with their infant's growth (P < .002). Uninformed parents had more developmentally unready infants at the time of solid food introduction compared with informed parents (P = .03). Significant differences were found in avoidant feeding behaviors and parental perception of infant feeding patterns between developmentally ready and unready infants.

CONCLUSION

Pediatricians should adjust for gestational age when plotting growth and assess for developmental readiness for premature infants when recommending solid foods.