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Wang J, Chang YS, Wei X, Cao Y, Winkley K. The effectiveness of interventions on changing caregivers' feeding practices with preschool children: A systematic review and meta-analysis. Obes Rev 2024; 25:e13688. [PMID: 38186213 DOI: 10.1111/obr.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/08/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024]
Abstract
Caregivers' feeding practices are critical in shaping preschool children's eating habits and preventing childhood obesity. We conducted a systematic review and meta-analysis to evaluate the effectiveness of existing interventions targeting caregivers of preschool children, which aimed to promote child healthy eating and/or manage child weight and/or prevent child nutrition-related problems and included feeding practices as one of the outcomes. Eighteen studies with 18 intervention programs and 3887 respondents that completed baseline evaluations were eligible for data synthesis. Behavior change techniques (BCTs) frequently used included the following: instruction on how to perform the behavior and demonstration of the behavior. The pooled effects of randomized controlled trials (RCTs) on pressure to eat (pooled standardized mean difference [SMD] = 0.61; 95%CI: -1.16, -0.06), use of food as a reward (pooled SMD = -0.31; 95%CI: -0.61, -0.01), and emotional feeding (pooled SMD = -0.36; 95%CI: -0.66, -0.06) were found statistically significant compared with control groups at post-intervention. However, there were no pooled effects on restrictive feeding and pressure to eat at other follow-ups or on other feeding practices at post-intervention. Interventions may have short-term effects on decreasing the adoption of coercive control. Future interventions should directly and adequately optimize feeding practices, include components of individual support, and contribute to the maintenance of the effects over the long term.
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Affiliation(s)
- Jian Wang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Xiaoxue Wei
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kirsty Winkley
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Lozano‐Casanova M, Sospedra I, Oliver‐Roig A, Richart‐Martinez M, Gutierrez‐Hervas A. The combined effect of family environment and parents' characteristics on the use of food to soothe children. Food Sci Nutr 2024; 12:2588-2596. [PMID: 38628189 PMCID: PMC11016393 DOI: 10.1002/fsn3.3941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/04/2023] [Accepted: 12/20/2023] [Indexed: 04/19/2024] Open
Abstract
Parental feeding practices, such as the use of food to soothe, can be shaped by various factors, including the family environment and parents' psychological characteristics and capacities. To our knowledge, the combined effect of these factors has not been studied. Furthermore, parental feeding practices have mainly been studied in women, resulting in a gender gap in the research. This study aims to investigate the combined effect of family environment and parental characteristics on the likelihood of using food to soothe children, taking the gender of both parents into account. This cross-sectional study included a sample of 846 parents (36.3% men) of 1-year-old children from different regions of Spain. Participants completed an online survey that included questionnaires to measure whether parents used food to soothe children, the family environment, parents' characteristics, and their psychological capacities. Binary logistic regression analyses were performed to identify associations between the variables. The final model showed that, within the family environment, higher levels of dyadic adjustment between couples (OR = 0.965; p = .026) were associated with a reduced likelihood of using food to soothe children, whereas the psychological characteristic of parental fatigue (OR = 1.053; p = .007) appeared to be associated with an increased likelihood. Also associated with an increased likelihood of this practice were higher parental sense of competence (OR = 1.028; p = .029) and the attention dimension of emotional intelligence (OR = 1.043; p = .007). Our study suggests that using food to soothe children may be influenced by factors at different levels, from the quality and adjustment of the couple's relationship to parental fatigue, self-competence, and emotional intelligence. For future research, it may be worthwhile contextualizing parental practices to gain a better understanding of children's behavior.
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Affiliation(s)
- Mar Lozano‐Casanova
- Nursing Department, Faculty of Health ScienceUniversity of AlicanteAlicanteSpain
| | - Isabel Sospedra
- Nursing Department, Faculty of Health ScienceUniversity of AlicanteAlicanteSpain
| | - Antonio Oliver‐Roig
- Nursing Department, Faculty of Health ScienceUniversity of AlicanteAlicanteSpain
| | | | - Ana Gutierrez‐Hervas
- Nursing Department, Faculty of Health ScienceUniversity of AlicanteAlicanteSpain
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Damian-Medina K, Cernioglo K, Waheed M, DiMaggio DM, Porto AF, Smilowitz JT. Cross-Sectional Analysis of Infant Diet, Outcomes, Consumer Behavior and Parental Perspectives to Optimize Infant Feeding in Response to the 2022 U.S. Infant Formula Shortage. Nutrients 2024; 16:748. [PMID: 38474876 DOI: 10.3390/nu16050748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
In May of 2022, millions of U.S. parents encountered uncertainty in safely feeding their infants due to the infant formula shortage. METHODS An anonymous, electronic, cross-sectional, retrospective survey was used. RESULTS U.S. parents (n = 178) whose infants were ~10 weeks old during the shortage completed the survey. Of parents, 81% switched formulas during the shortage, 87% switched because they could not find the formula they typically used, 34% switched 3-5 times, 29% of parents visited ≥4 stores/24 h and 26% of parents traveled >20 miles/24 h to purchase formula. Use of infant formula increased (p < 0.01); in infants requiring specialty formula, use of intact cow's milk formula increased (p < 0.05) and use of premature infant formulas decreased (p < 0.05). Infants relying on specialty formulas experienced at least one undesirable outcome compared with non-specialty users. Parents used social media, relatives/friends and healthcare providers for support during the shortage, but their helpfulness scores were suboptimal. Parents reported the need for greater infant formula availability, free prenatal lactation education and postpartum lactation support. CONCLUSIONS Government, regulatory and healthcare policy oversight are needed to protect the infant feeding system, including more commercially available products, access to banked donor milk and lactation support.
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Affiliation(s)
- Karla Damian-Medina
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
| | - Karina Cernioglo
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
| | - Maha Waheed
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
| | | | - Anthony F Porto
- School of Medicine, Yale University, New Haven, CT 06510, USA
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Harris HA, Kininmonth AR, Nas Z, Derks IPM, Quigley F, Jansen PW, Llewellyn C. Prospective associations between early childhood parental feeding practices and eating disorder symptoms and disordered eating behaviors in adolescence. Int J Eat Disord 2024; 57:716-726. [PMID: 38387486 DOI: 10.1002/eat.24159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Nonresponsive parental feeding practices are associated with poorer appetite self-regulation in children. It is unknown whether this relationship extends beyond childhood to be prospectively associated with the onset of eating disorder (ED) symptoms in adolescence. This exploratory study therefore investigated prospective associations between early childhood parental feeding practices and adolescent ED symptoms and disordered eating behaviors. METHODS Data were from two population-based cohorts with harmonized measures: Generation R (Netherlands; n = 4900) and Gemini (UK; n = 2094). Parents self-reported their pressure to eat, restriction and instrumental feeding (i.e., using food as a reward) at child age 4-5 years. Adolescents self-reported their compensatory behaviors (e.g., fasting, purging), binge-eating symptoms, restrained eating, uncontrolled eating, and emotional eating at 12-14 years. Associations between feeding practices and ED symptoms were examined separately in each cohort using generalized linear models. RESULTS In Gemini, pressure to eat in early childhood was associated with adolescents engaging in compensatory behaviors. In Generation R, parental restriction was associated with adolescents engaging in compensatory behaviors, restrained eating, uncontrolled eating, and emotional eating. Instrumental feeding was associated with uncontrolled eating and emotional eating in Generation R. DISCUSSION Nonresponsive parental feeding practices were associated with a greater frequency of specific ED symptoms and disordered eating in adolescence, although effect sizes were small and findings were inconsistent between cohorts. Potentially, the cultural and developmental context in which child-parent feeding interactions occur is important for ED symptoms. Further replication studies are required to better understand parents' role in the development and maintenance of ED-related symptoms. PUBLIC SIGNIFICANCE Prospective research examining how early childhood parental feeding practices might contribute to adolescent ED symptoms is limited. In two population-based cohorts, nonresponsive feeding practices (restriction, instrumental feeding, pressure to eat) predicted increased frequency of some ED symptoms and disordered eating behaviors in adolescence, although associations were small and further replication is required. Findings support the promotion of responsive feeding practices, which may benefit young children's developing relationship with food.
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Affiliation(s)
- Holly A Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Alice R Kininmonth
- School of Psychology, University of Leeds, Leeds, UK
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Zeynep Nas
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Ivonne P M Derks
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Fiona Quigley
- Institute for Nursing and Health Research, Ulster University, Belfast, Northern Ireland
| | - Pauline W Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
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Makwela MS, Mashaba RG, Ntimana CB, Seakamela KP, Maimela E. Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa. Front Glob Womens Health 2024; 5:1209784. [PMID: 38414908 PMCID: PMC10897026 DOI: 10.3389/fgwh.2024.1209784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 01/31/2024] [Indexed: 02/29/2024] Open
Abstract
Background Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa. Methodology A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively. Results Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%). Discussion Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.
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Affiliation(s)
- Maishataba Solomon Makwela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Reneilwe Given Mashaba
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Cairo Bruce Ntimana
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Kagiso Peace Seakamela
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Eric Maimela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
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Medin AC, Vik FN, Helle C, Helland SH, Wills AK, Osorio NG, Lian H, Ersfjord TI, Van Daele W, Bjørkkjær T, Valen EN, Gebremariam MK, Grasaas E, Kiland C, von Thiele Schwarz U, Abel MH, Love P, Campbell K, Rutter H, Barker ME, Hillesund ER, Øverby NC. Scaling up evidence-based digital early life nutrition interventions in a county setting: an implementation trial - protocol for Phase 2 of the Nutrition Now project. Front Public Health 2024; 11:1326787. [PMID: 38264256 PMCID: PMC10803599 DOI: 10.3389/fpubh.2023.1326787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Background Few effective health interventions transition from smaller efficacy or effectiveness studies to real-world implementation at scale, representing a gap between evidence and practice. Recognising this, we have developed Nutrition Now - a tailored digital resource building on four efficacious dietary interventions, aiming to improve nutrition in the important first 1,000 days of life. Nutrition Now targets and guides expectant parents and parents of 0-2 year olds, serves as a reliable source of evidence-based information for midwives and public health nurses at maternal and child healthcare (MCH) centres, and offers pedagogical tools for early childhood education and care (ECEC) staff. The aim of this study is to implement Nutrition Now at scale and evaluate the impact of different sets of multifaceted implementation strategies on implementation outcomes. Methods A quasi-experimental design with three study arms will be used, providing either low, medium or high implementation support, when rolled out in 50 municipalities in 2 counties in Norway. Nutrition Now will be implemented in MCH and ECEC settings and made available to expectant parents and parents of 0-2 year olds through social media and MCH. The implementation support builds on strategies described in the Expert Recommendations for Implementing Change (ERIC) implementation framework and is informed by dialogues with stakeholders. Impact of the different degree of implementation support will be assessed by examining reach, adoption, fidelity, and sustainability using usage data generated from the Nutrition Now resource, publicly available municipal data and qualitative interviews with MCH and ECEC staff. Discussion Nutrition Now Phase 2 will break new ground by scaling up successively delivered and complementary dietary interventions in the first 1,000 days of life in a real-life context. The project also seeks to identify what level of implementation support is most effective when implementing digital, scalable, evidence-based early-life nutrition interventions in community settings. The project will inform implementation research and provide knowledge about effective implementation strategies to be used in a national scale-up of Nutrition Now. Trial registration The study is registered prospectively (submitted 14/06/2022, registration date: 19/06/2022) in the International Standard Randomised Controlled Trial Number registry (ISRCTN): reg. Number: ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967.
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Affiliation(s)
- Anine Christine Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Sissel Heidi Helland
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Natalie Garzon Osorio
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Henrik Lian
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Torunn Iveland Ersfjord
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Wim Van Daele
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Tormod Bjørkkjær
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Erlend Nuland Valen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Mekdes Kebede Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Erik Grasaas
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Charlotte Kiland
- Department of Political Science and Management, Faculty of Social Sciences, University of Agder, Kristiansand, Norway
| | - Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Hope Abel
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Penny Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Harry Rutter
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Mary Elizabeth Barker
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
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So JTH, Nambiar S, Byrne R, Gallegos D, Baxter KA. Dads at Mealtimes: Associations between Food Security, Household and Work Chaos, and Paternal Feeding Practices among Australian Fathers Living with Disadvantage. Nutrients 2024; 16:205. [PMID: 38257098 PMCID: PMC10820457 DOI: 10.3390/nu16020205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Understanding how fathers engage in feeding while experiencing disadvantage is important for family-focused interventions. A cross-sectional online survey involving 264 Australian fathers was conducted to explore feeding involvement and the relationships between feeding practices, food insecurity, and household and work chaos. Practices related to coercive control, structure, and autonomy support were measured for two age groups (<2 years and 2-5 years). Multivariable linear regression was used to examine the associations for each practice. Three-quarters of the sample were food insecure, impacting adults more than children, and correlated with household chaos. Food insecurity was associated with increased 'persuasive feeding' and 'parent-led feeding' in younger children. Household chaos was positively associated with coercive control practices in both younger and older child groups, with the strongest associations for 'using food to calm' and 'overt restriction', respectively. In older child groups, household chaos was negatively associated with 'offer new foods' and 'repeated presentation of new foods'. Structure practices had no significant relationships with any factors, and work chaos did not predict any feeding practices. These findings emphasize a need for societal and structural support to address food insecurity and household chaos. Tailored strategies are crucial to support fathers in responsive feeding.
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Affiliation(s)
- Jeffrey T. H. So
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Smita Nambiar
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Rebecca Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Kimberley A. Baxter
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD 4101, Australia; (S.N.); (R.B.); (D.G.); (K.A.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
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Wang J, Wu R, Wei X, Chang YS, Tang X, Zhu B, Cao Y, Wu Y, Zhu D. Bidirectional Associations between Parental Feeding Practices and Child Eating Behaviors in a Chinese Sample. Nutrients 2023; 16:44. [PMID: 38201874 PMCID: PMC10780825 DOI: 10.3390/nu16010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Child eating behaviors (CEBs) and parental feeding practices (PFPs) play critical roles in childhood obesity. However, the bidirectional relationships between CEBs and PFPs remain equivocal. This longitudinal study aimed to explore their bidirectional relationships. METHODS A convenience sample of 870 parents with preschoolers was recruited in this longitudinal study (Shanghai, China). Three non-responsive feeding practices (NFPs), three responsive feeding practices (RFPs), five CEBs, and covariates were collected using validated questionnaires at baseline and the 6-month follow-up. Cross-lagged analyses using structural equation modeling (SEM) were performed to examine their bidirectional relationships. RESULTS Eight hundred and fifty-three parents completed questionnaires, with a response rate of 98%. The mean age of their children at baseline was 4.39 years (standard deviation = 0.72 years). Eighteen out of sixty longitudinal cross-lagged paths were statistically significant. Parental encouragement of healthy eating and content-restricted feeding were found to be bidirectionally associated with child food fussiness. Four parent-driven associations and one child-driven association were identified between RFPs and CEBs. For example, monitoring was negatively associated with children's unhealthy eating habits (β = -0.066, standard error (SE) = 0.025, p < 0.01). Eight child-driven associations and one parent-driven association were observed between NFPs and CEBs. For example, higher child satiety responsiveness predicted a higher pressure to eat (β = 0.057, SE = 0.029, p < 0.01) and the use of food as a reward (β = 0.083, SE = 0.031, p < 0.01). CONCLUSIONS There were bidirectional, parent-driven, and child-driven associations. Parents should be encouraged to adopt RFPs to shape CEBs. Increasing parents' understanding of CEBs and providing them with reasonable coping strategies would help optimize PFPs.
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Affiliation(s)
- Jian Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (R.W.); (X.W.); (B.Z.)
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK;
| | - Ruxing Wu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (R.W.); (X.W.); (B.Z.)
| | - Xiaoxue Wei
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (R.W.); (X.W.); (B.Z.)
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK;
| | - Xianqing Tang
- Department of Children’s Disease Prevention, Jinyang Community Health Service Center, Shanghai 200136, China;
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (R.W.); (X.W.); (B.Z.)
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Yinghui Wu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (R.W.); (X.W.); (B.Z.)
| | - Daqiao Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (R.W.); (X.W.); (B.Z.)
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Morris Z, Norman Å, Elinder LS, Patterson E, Warnqvist A, Raposo S, Sidney Annerstedt K. Validation of the Comprehensive Feeding Practices Questionnaire among parents of 5- to 7-year-old children in Sweden. Front Psychol 2023; 14:1205427. [PMID: 38098534 PMCID: PMC10719845 DOI: 10.3389/fpsyg.2023.1205427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Parents' behaviours towards food and mealtimes, also known as parental feeding practices, are important in the development of children's eating habits. The Comprehensive Feeding Practices Questionnaire (CFPQ) was designed to measure parental feeding practices. The aim of this study was to evaluate the validity of the CFPQ in Sweden and to assess how it performs across different groups of people. Methods Data were from the baseline of a trial promoting children's healthy dietary and physical activity behaviours, the Healthy School Start Plus intervention, conducted in 17 schools in the Stockholm region in Sweden. The CFPQ was completed by 263 parents (59% mothers) of 173 children, aged 5 to 7 years. Exploratory factor analysis and the omega reliability test were performed to identify the underlying factors in the data. Invariance testing was used to investigate the equivalence of these factors across parental sex, parental education and children's weight status. Results Five factors were identified: monitoring of children's food intake, pressure to eat, restriction of food, use of food for emotional regulation, and healthy eating guidance. All five factors were invariant across parental sex and education, though some questions were excluded to achieve invariance. The monitoring, pressure to eat and emotional regulation factors were invariant across children's weight status. Discussion These results suggest that the CFPQ is valid for use in Sweden, amongst parents of children aged 5 to 7 years. The measurement invariance allows for comparisons of all five underlying factors across mothers and fathers and parental education levels, though across children's weight status for only three factors. Due to the importance of parental feeding practices throughout childhood, this questionnaire should also be validated in other age groups in Sweden.
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Affiliation(s)
- Zoë Morris
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Åsa Norman
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Centre for Epidemiology and Community Medicine (CES), Stockholm, Sweden
| | - Emma Patterson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Swedish Food Agency, Uppsala, Sweden
| | - Anna Warnqvist
- Institute for Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Sara Raposo
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Centre for Epidemiology and Community Medicine (CES), Stockholm, Sweden
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10
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Owolabi AJ, Samuel FO, Feskens EJM, Schaafsma A, Melse-Boonstra A. Significant variations in feeding practices and choice of guidelines for the management of late preterm infants among healthcare professionals in Nigeria. Acta Paediatr 2023; 112:2137-2148. [PMID: 37460198 DOI: 10.1111/apa.16906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
AIM We aimed to gain insights into current nutritional management practices of late preterm infants (34-36 weeks gestational age) in Nigeria. METHODS Purposive sampling was employed to recruit 19 healthcare professionals (neonatologists, paediatricians, general practitioners and nurses) involved in the care and nutritional management of late preterm infants in Lagos and Ogun states, Nigeria. Data were collected using interviews, either individually or in small focus groups, between 15 August and 6 September 2022. Thematic analysis of interview transcripts was carried out to interpret the data. RESULTS Ten distinct themes emerged across the research questions and objectives. For growth monitoring, 11, 6, 1 and 1 of our participants preferred to use the 2006 WHO growth standards, Fenton preterm growth chart, Ballard score and Intergrowth-21, respectively. Regarding the growth velocity of late preterm infants, most healthcare professionals aimed for 15 g/kg BW/day or more during hospitalisation. Breastmilk was unanimously the primary feeding option for late preterm infants. Most healthcare professionals preferred to use international guidelines over local guidelines. CONCLUSION Our study shows that there is a wide divergence in the nutritional guidelines used in managing late preterm infants in Nigeria. Regarding growth monitoring, healthcare professionals tended to aim for a growth velocity higher than necessary for late preterm infants, which may be disadvantageous for their long-term health.
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Affiliation(s)
- Adedotun Joshua Owolabi
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Folake O Samuel
- Department of Human Nutrition and Dietetics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Anne Schaafsma
- Expert Nutrition Team, FrieslandCampina, Stationsplein, Amersfoort, The Netherlands
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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11
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Zhang X, Zhou Q, Vivor NK, Liu W, Cao J, Wang S. Sequential mediation of early temperament and eating behaviors in the pathways from feeding practices to childhood overweight and obesity. Front Public Health 2023; 11:1122645. [PMID: 37766743 PMCID: PMC10520502 DOI: 10.3389/fpubh.2023.1122645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Childhood eating behaviors and temperament may have important implication for constructing the pathways from maternal feeding practices to childhood overweight and obesity (OW/OB). Examining multiple feeding styles simultaneously to childhood OW/OB is critical through the mediators of early childhood temperament and eating behaviors. Methods This cross-sectional study recruited mothers mainly responsible for child care from two hospitals and two healthcare centers in eastern China. Sociodemographic characteristics, and data from the Infant Feeding Style Questionnaire (IFSQ), the short form of Children Behavior Questionnaire [Revised (IBQ-RSF)], and the Child Eating Behavior Questionnaire for toddler (CEBQ-T) were collected. Weight and recumbent length were measured to calculate the age- and sex-specific body mass index (BMI) z-scores (BMIz). The structural equation modeling (SEM) approach was used to examine direct and indirect pathways from five maternal feeding styles to childhood OW/OB through temperament and eating behaviors. Results A total of 486 children were recruited, 73 (15.02%) children were OW/OB; the age of the children was 14.55 (SD = 5.14) months, and the age of the mothers was 29.90 (SD = 3.63) years. The responsive feeding exerted significant direct (β = -0.098), indirect (β = -0.136) and total (β = -0.234) effects on childhood OW/OB. Restrictive feeding had significant direct (β = 0.222), indirect (β = 0.102) and total (β = 0.324) effects on childhood OW/OB. Indulgent feeding had significant direct (β = 0.220), indirect (β = 0.063), and total (β = 0.283) effects on childhood OW/OB. Pressuring feeding had significant direct (β = -0.116), indirect (β = -0.096) and total (β = -0.212) effects on childhood OW/OB. Discussion There was a direct effect of feeding practices on childhood OW/OB; feeding practices indirectly predicted childhood OW/OB through temperament and eating behaviors in children aged 6-23 months. This study could help governments agencies, policymakers, and healthcare workers to establish optimal intervention programs targeting feeding practices through childhood eating behaviors and temperament to prevent childhood OW/OB.
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Affiliation(s)
- Xiaoning Zhang
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, Zhejiang, China
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Qiong Zhou
- Department of Medical Nursing, Union Technical Institute, Lianyungang Subbranch of Traditional Chinese Medicine, Lianyungang, Jiangsu, China
| | | | - Wei Liu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Junli Cao
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Sheng Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
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Liu Y, Chang C. The relationship between early childhood development and feeding practices during the dietary transitional period in rural China: a cross-sectional study. Front Public Health 2023; 11:1202712. [PMID: 37637814 PMCID: PMC10450922 DOI: 10.3389/fpubh.2023.1202712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Early childhood feeding environments and practices not only affect children's nutritional status but also provide children with a variety of external stimulations to affect the development of the child's brain, especially for the first 1,000 days of children. The relationship between early childhood development (ECD) and feeding practices during the dietary transitional period has not previously been described. Method This study used quantitative survey data from the Integrated Early Childhood Development Project to investigate this association between ECD and feeding practices during the dietary transitional period in poor rural areas of China. Data concerning the child and family characteristics and feeding practices were collected through the questionnaire completed by caregivers. Developmental delays were explored through a five-pronged, structured, parent-completed Age and Stage Questionnaire. The chi-squared test and multivariate logistic regression analyses were used to explore the associated factors in ECD. Results The results showed that 33.6% of children had at least one area of developmental delay during the dietary transitional period. Of all five regions evaluated, the prevalence of fine motor developmental delays was highest (17.7%), followed by communication (14.9%), problem-solving (13.8%), personal-social skills (11.9%), and gross motor (11.8%), respectively. Significant predictors of increased odds of developmental delay included types of complementary foods (OR = 0.70, 95% CI = 0.53-0.94), adequate feeding frequency (OR = 0.69, 95% CI = 0.52-0.90), and breastfeeding time and bottle feeding (OR = 0.66, 95% CI = 0.50-0.88). Discussion According to the results, a high prevalence of developmental delay was observed in children during the dietary transitional period in the rural areas of China. The feeding practices of children were associated with their developmental status, including factors such as inadequate feeding frequency, types of complementary foods, breastfeeding duration, and low family income. These findings highlight the focus and potential direction for early identification and intervention.
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Affiliation(s)
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
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13
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Barbosa C, Lopes C, Costa A, Warkentin S, Oliveira A. Parental child- feeding practices at 4 years of age are associated with dietary patterns of 7-year-olds. J Hum Nutr Diet 2023; 36:1339-1348. [PMID: 36794574 DOI: 10.1111/jhn.13151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Parental child-feeding practices have been associated with child body mass index (BMI) and specific food group consumption; however, their role in the development of dietary patterns is less understood. We aim to study the association between parental child-feeding practices at 4 years old and dietary patterns at 7 years that explain BMI z-scores at age 10. METHODS Participants were children from the Generation XXI birth cohort (n = 3272). Three patterns of feeding practices at 4 years were previously identified: 'Perceived monitoring', 'Restriction' and 'Pressure to eat'. At 7 years, two dietary patterns were derived: 'Energy-dense foods', higher consumption of energy-dense foods and drinks and processed meats and lower consumption of vegetable soup (significantly associated with BMI z-scores at 10 years) and 'Fish-based', higher in fishery intake and lower in energy-dense food intake. Associations were estimated by linear regression models, adjusted for potential confounders (mother's age, education and pre-pregnancy BMI). RESULTS Girls whose parents used more Restriction, Perceived monitoring and Pressure to eat at 4 years were less likely to follow the 'Energy-dense foods' dietary pattern at 7 years (β̂ = -0.082; 95% confidence intervals [CI]: -0.134; -0.029; β̂ = -0.093; 95% CI: -0.146; -0.039; β̂ = -0.079; 95% CI: -0.135; -0.04, respectively). In both sexes, children whose parents used more Restriction and Perceived monitoring at 4 years were more likely to follow the 'Fish-based' dietary pattern at 7 years (girls: β̂ = 0.143; 95% CI: 0.077; 0.210; β̂ = 0.079; 95% CI: 0.011; 0.148; boys: β̂ = 0.157; 95% CI: 0.090; 0.224; β̂ = 0.104; 95% CI: 0.041; 0.168). CONCLUSIONS Children whose parents used more Restriction and Perceived monitoring at preschool age were more likely to follow healthier dietary patterns at age 7.
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Affiliation(s)
- Catarina Barbosa
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Carla Lopes
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Alexandra Costa
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Sarah Warkentin
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Andreia Oliveira
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto (Institute of Public Health of the University of Porto), Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine of the University of Porto, Porto, Portugal
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14
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Lozano-Casanova M, Gutierrez-Hervas A, Richart-Martinez M, Oliver-Roig A, Sospedra I. Paternal feeding practices and styles: a systematic review. Nutr Rev 2023:nuad090. [PMID: 37500603 DOI: 10.1093/nutrit/nuad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
CONTEXT Studies on parenting, including feeding styles and practices in general, have focused mainly on mothers. Consequently, there is a gap with respect to fathers in the scientific literature. OBJECTIVE This study's main objective is to determine paternal feeding styles toward children aged 0 to 18 years and to identify those most commonly used by men. DATA SOURCES The PubMed, Scopus, Web of Science, Cochrane, and PsycINFO databases were consulted. DATA EXTRACTION Articles that were not published in English, Spanish, or Italian were excluded, as well as those that referred to other subjects, those whose sample did not include men, or those studying children with pathologies that could influence their diet. All the articles ultimately included were assessed using the STROBE checklist. DATA ANALYSIS A total of 183 articles were found. Of these, 13 were included in the review. No trend was found for paternal parenting style, and disparities existed among the authoritative, authoritarian, and permissive styles. In terms of feeding practices, men were more likely to use coercion. The most reported feeding styles were authoritarian and permissive. CONCLUSIONS The findings of systematic review suggest cultural and gender differences exist with respect to parenting styles and feeding styles and practices. In terms of paternal parenting styles, there is some disparity. However, when it comes to feeding, men showed a tendency toward an authoritarian feeding style and coercive feeding practices.
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Affiliation(s)
- Mar Lozano-Casanova
- Nursing Department, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Ana Gutierrez-Hervas
- Nursing Department, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | | | - Antonio Oliver-Roig
- Nursing Department, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Isabel Sospedra
- Nursing Department, Faculty of Health Sciences, University of Alicante, Alicante, Spain
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Masilela LN, Modjadji P. Child Nutrition Outcomes and Maternal Nutrition-Related Knowledge in Rural Localities of Mbombela, South Africa. Children (Basel) 2023; 10:1294. [PMID: 37628293 PMCID: PMC10453191 DOI: 10.3390/children10081294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023]
Abstract
Poor nutrition outcomes among children have become one of the major public health concerns in South Africa, attributed to poor feeding practices and maternal nutrition-related knowledge with conflicting data. In view of this, a cross-sectional study was conducted to determine the association of nutrition outcomes of children aged under two years with feeding practices and maternal nutrition-related knowledge in Mbombela, South Africa. Mothers' nutrition-related knowledge was estimated using an adapted structured questionnaire on colostrum, continued breastfeeding, diarrhea prevention and treatment using oral rehydration solution, immunization, and family planning, and scored as excellent (80-100), good (60-79), average (40-59), and fair (0-39). This was along with questions on socio-demographic factors and obstetric history, as well as anthropometric measurements. Child nutrition outcomes were estimated by WHO classification using z-scores for stunting (length-for-age (LAZ)), underweight (weight-for-age (WAZ)), and thinness (body mass index-for-age (BAZ)). Using STATA 17, 400 pairs of children (8 ± 6 months) and their mothers (29 ± 6 years) participated in the study and were living in a poor socio-economic status environment. Half of children were stunted (50%) and over half (54%) were obese, while mothers were underweight (39%) and overweight (34%). In addition to one third of mothers reporting obstetric complications, two thirds, initiated breastfeeding within one hour of delivery, 30% exclusively breastfed, 48% introduced early complementary feeding, and 70% practiced mixed feeding. Twenty-eight percent (28%) of mothers had fair nutrition-related knowledge, while 66% had average knowledge, 6% good knowledge, and none of the mothers had excellent knowledge. A chi-square test showed that mothers' nutrition-related knowledge was significantly associated with child stunting. The final hierarchical logistic regression showed significant associations of stunting with mothers' nutrition-related knowledge (average: AOR = 1.92, 95%CI: 1.12-3.29), child's age (6-11 months: AOR = 2.63, 95%CI: 1.53-4.53 and 12-23 months: AOR = 3.19, 95%CI: 1.41-7.25), and education (completing Grade 12: AOR = 0.36, 95%CI: 0.15-0.86). Contextual and intensified interventions on continued education for mothers to gain accurate information on nutrition-related knowledge and feeding practices could ultimately enhance child nutrition outcomes in poorer settings. Efforts should therefore be made to ensure that nutrition knowledge is appropriately provided based on the phases of child growth from 0 to 2 years, even beyond infancy into school age.
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Affiliation(s)
- Lucy Nomsa Masilela
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
- Non-Communicable Disease Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
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16
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Kubeka Z, Modjadji P. Association of Stunting with Socio-Demographic Factors and Feeding Practices among Children under Two Years in Informal Settlements in Gauteng, South Africa. Children (Basel) 2023; 10:1280. [PMID: 37628279 PMCID: PMC10453658 DOI: 10.3390/children10081280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/14/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023]
Abstract
Despite improvements in childhood undernutrition through integrated nutritional programs in South Africa, stunting among children remains persistent, and is attributed to poor socio-demographic status. This context has been implicated in disrupting mothers' decisions regarding effective infant feeding, ultimately meaning that children's nutritional demands remain unmet. In view of this, we conducted a cross-sectional study to determine the association between socio-demographic factors and infant and young child feeding (IYCF) practices and stunting among children under two years receiving primary health care in informal settlements in Gauteng, South Africa. A validated questionnaire was used to assess mothers' socio-demographic status and feeding practices using WHO core indicators. Stunting was defined as length-for age z-scores (LAZ) below -2 standard deviation, computed using WHO Anthro software version 3.2.2.1 using age, sex, and anthropometric measurements of children. Univariate and multivariate analyses were stratified by stunting to determine the relationship with socio-demographic, infant, and IYCF factors using STATA 17. The prevalence of stunting was 16% among surveyed children under two years (with a mean age of 8 ± 5 months) living in poor socio-demographic households. Poor feeding practices were characterized by delayed initiation of breastfeeding (58%), sub-optimal exclusive breastfeeding (29%), discontinued breastfeeding (44%), early introduction of solid foods (41%), and low dietary diversity (97%). Significant differences in terms of child's age, monthly household income, and ever being breastfed were observed (Chi square test and univariate analysis). After controlling for potential confounders, stunting was significantly associated with child's age [12-23 months: AOR = 0.35, 95% CI: 0.16-0.76], and monthly household income [ZAR 3000-ZAR 5000: AOR = 0.47, 95% CI: 0.26-0.86]. Despite the few aforementioned socio-demographic and IYCF factors associated with stunting, this study reiterates stunting as the commonest poor nutritional status indicator among children under two years, suggesting the presence of chronic undernutrition in these poverty-stricken informal settlements. A multisectoral approach to address stunting should be context-specific and incorporate tailor-made interventions to promote optimal infant-feeding practices. Conducting future nutrient assessments focusing on children is imperative.
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Affiliation(s)
- Zandile Kubeka
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa, Pretoria 0208, South Africa
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, Cape Town 7505, South Africa
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Awaf A, Elias A, Mahfouz MS. Complementary feeding practices among mothers having children less than two years old attending well-baby clinics in Jazan City, Saudi Arabia. Pan Afr Med J 2023; 45:45. [PMID: 37575523 PMCID: PMC10422035 DOI: 10.11604/pamj.2023.45.45.35451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 04/30/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction infant feeding practices are important determinants of growth and development not only in infancy but also in later life. The main objective of this study is to describe infant feeding practices and the factors affecting complementary feeding (CF) among mothers in Jazan City. Methods an observational cross-sectional study was conducted among 400 mothers having children less than 24 months old, attending the well-baby clinics in Primary Health Care Centers (PHCCs) in Jazan City, Saudi Arabia. A structured questionnaire was used to collect data in a face-to-face interview. Results on the mother's level of knowledge regarding proper infant feeding, 49% scored high, 41% scored medium, and 9.75% scored low. The mother's educational level, working status, family income, and knowledge source played a significant role in the knowledge scores (p < 0.05 for all). Overall, 15.8% of the mothers never breastfed (BF) their children, 39.8% BF less than six months, 17.5% BF 6-12 months, and 27% BF over 12 months. Breastfeeding feeding (BF) duration is significantly associated with maternal literacy and family income (p = 0.006 for both). Overall, approximately one-third of the women (36.2%) started CF at six months or later, while 63.8% started CF at 4-6 months. Conclusion Jazan women use some positive infant feeding practices, including breastfeeding. One-third of the women started CF at six months or later, which is considered the optimal time for the CF introduction. More nutrition education is necessary to raise maternal awareness regarding appropriate infant feeding and weaning practices.
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Affiliation(s)
- Aisha Awaf
- Department of Family Medicine, Ministry of Health, Jazan, Saudi Arabia
| | - Anas Elias
- Department of Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Mohamed Salih Mahfouz
- Department of Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Kozak A, Czepczor-Bernat K, Modrzejewska J, Modrzejewska A, Matusik E, Matusik P. Avoidant/Restrictive Food Disorder (ARFID), Food Neophobia, Other Eating-Related Behaviours and Feeding Practices among Children with Autism Spectrum Disorder and in Non-Clinical Sample: A Preliminary Study. Int J Environ Res Public Health 2023; 20:ijerph20105822. [PMID: 37239549 DOI: 10.3390/ijerph20105822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/27/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Previous research shows that children with autism spectrum disorder (ASD) may experience several difficulties-including those related to eating-and this area of research needs to be explored further. This study had two main objectives: (1) comparison of the clinical (autism spectrum disorder) and non-clinical sample of children in terms of avoidant/restrictive food disorder, food neophobia, other eating-related behaviours and feeding practices; (2) assessment of selected predictors of food neophobia. The final sample included 54 children and parents from the clinical sample (ASD) and 51 from the non-clinical sample. Parents completed: the autism spectrum rating scales (ASRS), the eating disorders in youth questionnaire (EDY-Q), the children food neophobia scale (CFNS), the child eating behaviour questionnaire (CEBQ), the child feeding questionnaire (CFQ), and a socio-demographic survey. Our analysis allowed us to partially confirm the first hypothesis since the clinical sample (vs. the non-clinical group) had significantly higher scores in such variables as (a) avoidant/restrictive food disorder (ARFID), (b) food neophobia, (c) other eating-related behaviours: emotional under-eating, desire to drink, food fussiness, (d) feeding practices: pressure to eat. Moreover, our analysis of predictors of food neophobia in the clinical and non-clinical samples also allowed us to partially confirm the second hypothesis because it turned out that only in the clinical sample (vs. the non-clinical sample) were the predictors significantly associated with food neophobia, but only two of them (food fussiness and selective eating). In conclusion, our study showed that children with ASD (compared to children without this diagnosis) experience increased difficulties in eating behaviours, and their parents present a stronger intensity of the feeding practice based on pressure to eat. This study showed that feeding problems for children in the ASD sample are a significant problem, and it is still worth exploring this area in research.
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Affiliation(s)
- Agata Kozak
- Non-public Health Care Center, Pediatric Neuropsychiatry Centre, 59-220 Legnica, Poland
| | - Kamila Czepczor-Bernat
- Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Justyna Modrzejewska
- Institute of Pedagogy, University of Bielsko-Biała, 43-309 Bielsko-Biala, Poland
| | - Adriana Modrzejewska
- Department of Psychology, Chair of Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Edyta Matusik
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Paweł Matusik
- Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
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19
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Lee H, Oldewage-Theron W, Dawson JA. Effects of a Theory-Based, Multicomponent eHealth Intervention for Obesity Prevention in Young Children from Low-Income Families: A Pilot Randomized Controlled Study. Nutrients 2023; 15:nu15102296. [PMID: 37242179 DOI: 10.3390/nu15102296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The purpose of this study was to evaluate a theory-based, multicomponent eHealth intervention aimed at improving child health behaviors and parental psychosocial attributes and feeding practices. A pilot randomized controlled trial was conducted among 73 parents with children (1-3 years). Intervention group participants (IG, n = 37) received theory-based educational videos, cooking tutorials, and text messages with key information for a total of 8 weeks. Control group participants (CG, n = 36) received a booklet about general nutrition recommendations for children. A parent-administered questionnaire was used for data collection at baseline and post-intervention. Linear models were performed using R version 4.1.1. for data analysis. Children in the IG significantly increased their daily intake of fruit (ΔΔ = 0.89 servings, p = 0.00057) and vegetables (ΔΔ = 0.60 servings, p = 0.0037) and decreased use of screen time (ΔΔ = -33.87 min, p = 0.026), compared to the CG. Parents in the IG improved significantly more than the CG in self-efficacy (p = 0.0068) and comprehensive feeding practices (p = 0.0069). There were no significant differences between the study groups for changes in child outcomes, such as physical activity and sedentary behaviors, and parental nutrition knowledge and attitudes.
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Affiliation(s)
- Hyunjung Lee
- Department of Nutrition, Texas A&M University, College Station, TX 77843, USA
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX 79409, USA
| | | | - John A Dawson
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX 79409, USA
- Department of Economics, Applied Statistics, and International Business, New Mexico State University, Las Cruces, NM 88003, USA
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20
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Carretero-Bravo J, Díaz-Rodríguez M, Ferriz-Mas BC, Pérez-Muñoz C, González-Caballero JL. The Preschool Eating, Lifestyle, and Sleeping Attitudes Scale (PRELSA Scale): Construction and Pilot Testing of a Tool to Measure Factors Associated with Childhood Obesity. Healthcare (Basel) 2023; 11:healthcare11101365. [PMID: 37239651 DOI: 10.3390/healthcare11101365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Childhood obesity poses a global health challenge. In the period from two to six years, the fundamental risk factors are associated with modifiable habits, related to parental attitudes. In this study, we will analyze the construction and pilot test of the PRELSA Scale, designed to be a comprehensive tool that covers the whole problem of childhood obesity, from which we can later develop a brief instrument. (2) Methods: First, we described the scale construction process. After that, we conducted a pilot test on parents to check the instrument's comprehensibility, acceptability, and feasibility. We detected items to be modified or eliminated through two criteria: the frequencies of the categories of each item and responses in the Not Understood/Confused category. Finally, we sought expert opinion through a questionnaire to ensure the content validity of the scale. (3) Results: The pilot test on parents detected 20 possible items for modification and other changes in the instrument. The experts' questionnaire showed good values on the scale's content, highlighting some feasibility problems. The final version of the scale went from 69 items to 60. (4) Conclusions: Developing scales that detect parental attitudes associated with the onset of childhood obesity may be the basis for future interventions to address this health challenge.
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Affiliation(s)
- Jesús Carretero-Bravo
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Avenida Ana de Viya 52, 11009 Cádiz, Spain
| | - Mercedes Díaz-Rodríguez
- Department of Nursing and Physiotherapy, University of Cadiz, Avenida Ana de Viya 52, 11009 Cádiz, Spain
| | | | - Celia Pérez-Muñoz
- Department of Nursing and Physiotherapy, University of Cadiz, Avenida Ana de Viya 52, 11009 Cádiz, Spain
| | - Juan Luis González-Caballero
- Department of Statistics and Operations Research, University of Cadiz, Polígono Río San Pedro, 11510 Puerto Real, Spain
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21
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Glassman ME, Sarakki AP, Katz-Feigenbaum D, Zitaner J, Thind P, Stockwell MS. The Use of a Medical Center-Based Outpatient Breastfeeding Support Program with Telelactation to Provide Ongoing Breastfeeding Support to a Diverse Patient Population. Breastfeed Med 2023; 18:362-369. [PMID: 37074115 DOI: 10.1089/bfm.2022.0264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Background: Patients from low-income, minoritized communities have limited access to outpatient breastfeeding support with International Board Certified Lactation Consultants (IBCLCs). Telelactation may increase access particularly when appointments can be self-scheduled. Objective: To describe a medical center-based, outpatient breastfeeding support program that includes telelactation and serves a diverse patient population. Methods and Study Design: A retrospective electronic chart review was performed for patients with in-person or telelactation visit types between April 2020 and December 2021. Impact of demographics (language, race/ethnicity, insurance) on scheduling patterns (self-scheduled versus traditionally scheduled), visit reasons, and impact of initial visit type and reason on subsequent follow-ups were determined. Feeding practice-to-feeding goal ratios were compared between initial and last visit to determine if breastfeeding goals were met. Descriptive statistics, linear regression, chi-square, and paired t-tests were performed. Results: Two thousand twenty-three patients (37.9% Spanish-speakers, 76.6% Latinx; 8.0% black/non-Latinx, 79.0% publicly insured) made 2,791 visits, of which 50.6% were for telelactation. Self-scheduling resulted in decreased no show rates (25.3% versus 42.8%, p < 0.001). Commercially insured patients had greater odds of self-scheduling versus publicly insured (adjusted odds ratio: 9.22; 95% confidence interval, CI [6.27-13.57]) with no impact of race/ethnicity or language. Reasons for visit differed slightly by initial visit type. Practice-to-feeding goal ratios increased regardless of initial visit type: telelactation visit (0.84 to 0.88 [difference 0.04; 95% CI: 0.006-0.066; p = 0.017]); and in-person visit (0.77 to 0.84 [difference 0.07; 95% CI: 0.044-0.11 p < 0.001]). Conclusions: Telelactation as part of a medical center-based outpatient breastfeeding support program is a promising modality for both initial and follow-up visits. Self-scheduling decreased no show rates.
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Affiliation(s)
- Melissa E Glassman
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
| | - Alisha P Sarakki
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | | | - Jenna Zitaner
- NewYork-Presbyterian Hospital, New York, New York, USA
| | - Priyam Thind
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Melissa S Stockwell
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
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22
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Clément S, Tereno S. Attachment, Feeding Practices, Family Routines and Childhood Obesity: A Systematic Review of the Literature. Int J Environ Res Public Health 2023; 20:ijerph20085496. [PMID: 37107778 PMCID: PMC10138359 DOI: 10.3390/ijerph20085496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/26/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
Childhood obesity is considered a major public health problem. To help prevention and intervention programs targeting families with obese children, this paper is aimed at synthesizing multifactorial and transactional data resulting from studies and reviews assessing relational factors between the child and his or her parents and the child's obesity risk, including the child's and CG's attachment quality, parental feeding practices, and family routines. It is also aimed at assessing the mediation of these links by specific self-regulatory capacities across different developmental periods (0-2, 2-8, and 8-18 years old). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were applied in the review methodology. Ten papers were analyzed, including seven empirical studies and three reviews proposing etiological models of childhood obesity. The quality of empirical studies was assessed, and a synthetical model of the results was proposed. This literature review showed that the caregiver's (CG) and the child's attachment quality, along with controlling or permissive feeding practices, and few family routines are mostly mediated by appetite dysregulation and emotional regulation strategies with the development of child obesity. New research topics are proposed to understand other facets of childhood obesity, as well as how to better prevent and treat it.
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23
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Rahmaty Z, Johantgen ME, Storr CL, Wang Y, Black MM. Preschoolers BMI: Associations with Patterns of Caregivers' Feeding Practices Using Structural Equation Models. Child Obes 2023; 19:169-178. [PMID: 35649202 PMCID: PMC10122251 DOI: 10.1089/chi.2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Childhood obesity is a major health concern. Caregivers' feeding practices are modifiable targets of obesity prevention. The study tested two hypotheses: (1) autonomy-promoting feeding practices are associated with lower BMI; and (2) diet mediates the association. We also explored examined whether feeding practices and BMI z-score (BMIz) associations are moderated by child sex, caregiver race, education, family poverty level, and food insecurity. Methods: Cross-sectional study of 437 preschoolers (44.4% girls, 38.2% Black/Other, mean age 48.1 months) and caregivers (90.2% female) from 50 child care centers. Feeding Practices were measured by Comprehensive Feeding Practices Questionnaire, child-size perception by preschooler silhouettes, temperament by the Behavior Rating Inventory of Executive Function, child diet by Young Children Food and Drink Questionnaire, and BMIz by measured weight and height. Latent profile analysis delineated feeding practice patterns. Structure equation modeling assessed the patterns in relationship to BMIz. Mediation and multiple-group analyses were used to assess mechanisms of feeding practice patterns and BMIz association. Results: From the three feeding practice patterns, Controlling, Balancing, and Regulating, Regulating was associated with lower child BMIz (b = -0.09) compared to Controlling. Higher difficult temperament (b = 0.09), higher caregiver BMIz (b = 0.26), and caregiver desire for thinner (b = 0.23) were associated with BMIz (p < 0.05). Evaluations of moderators and mediators were not significant. Conclusions: Comprehensive feeding practices support family factors related to child BMIz. Longitudinal research is needed to examine temporal associations between feeding practices and BMIz, with attention to autonomy-supporting practices, promotion of young children's self-regulation, and caregivers' perceptions of child temperament and size. Trial Registration: NCT03111264.
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Affiliation(s)
- Zahra Rahmaty
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
- Institute of Higher Education and Research in Healthcare (IUFRS), Department of Biology and Medicine, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Mary E. Johantgen
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L. Storr
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- RTI International, Research Triangle Park, NC, USA
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24
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Tshiambara P, Hoffman M, Legodi H, Botha T, Mulol H, Pisa P, Feucht U. Comparison of Feeding Practices and Growth of Urbanized African Infants Aged 6-12 Months Old by Maternal HIV Status in Gauteng Province, South Africa. Nutrients 2023; 15:nu15061500. [PMID: 36986230 PMCID: PMC10053312 DOI: 10.3390/nu15061500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
Appropriate feeding practices are protective against malnutrition and poor growth. We compared feeding practices and growth in HIV-exposed-uninfected (HEU) and HIV-unexposed-uninfected (HUU) between 6-12 months of age in urbanized African infants in South Africa. A repeated cross-sectional analysis was used to determine differences in infant feeding practices and anthropometric measures by HIV exposure status at 6, 9, and 12 months in the Siyakhula study. The study included 181 infants (86 HEU; 95 HUU). Breastfeeding rates were lower in HEU vs. HUU infants at 9 (35.6% vs. 57.3%; p = 0.013) and 12 months (24.7% vs. 48.0%; p = 0.005). Introduction to early complementary foods was common (HEU = 16.2 ± 11.0 vs. HUU = 12.8 ± 9.3 weeks; p = 0.118). Lower weight-for-age Z-scores (WAZ) and head circumference-for-age Z-scores (HCZ) were found in HEU infants at birth. At 6 months, WAZ, length-for-age Z-scores (LAZ), HCZ, and mid-upper-arm circumference-for-age Z-scores (MUACAZ) were lower in HEU vs. HUU infants. At 9 months, lower WAZ, LAZ, and MUACAZ were found in HEU vs. HUU infants. At 12 months, lower WAZ, MUACAZ, and weight-for-length Z-scores (-0.2 ± 1.2 vs. 0.2 ± 1.2; p = 0.020) were observed. HEU infants had lower rates of breastfeeding and poorer growth compared to HUU infants. Maternal HIV exposure affects the feeding practices and growth of infants.
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Affiliation(s)
- Phumudzo Tshiambara
- Department of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, Pretoria 0084, South Africa
- Department of Consumer and Food Sciences, Faculty of Natural and Agricultural Sciences, University of Pretoria, Hatfield Campus, Pretoria 0028, South Africa
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
| | - Marinel Hoffman
- Department of Consumer and Food Sciences, Faculty of Natural and Agricultural Sciences, University of Pretoria, Hatfield Campus, Pretoria 0028, South Africa
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
| | - Heather Legodi
- Department of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, Pretoria 0084, South Africa
| | - Tanita Botha
- Department of Statistics, Faculty of Natural and Agricultural Sciences, University of Pretoria, Hatfield Campus, Pretoria 0028, South Africa
| | - Helen Mulol
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Paediatrics, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, Pretoria 0084, South Africa
| | - Pedro Pisa
- Department of Human Nutrition, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, Pretoria 0084, South Africa
| | - Ute Feucht
- Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria 0001, South Africa
- Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria 0001, South Africa
- Department of Paediatrics, Faculty of Health Sciences, University of Pretoria, Prinshof Campus, Pretoria 0084, South Africa
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25
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Costa A, Oliveira A. Parental Feeding Practices and Children's Eating Behaviours: An Overview of Their Complex Relationship. Healthcare (Basel) 2023; 11:healthcare11030400. [PMID: 36766975 PMCID: PMC9914567 DOI: 10.3390/healthcare11030400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Several studies have found an association between eating behaviours and weight status and obesity risk in childhood. Children's eating behaviours arise from a combination of genetic and environmental factors. Parents appear to play a central role in their development as the main responsible for shaping children's feeding environment and eating experiences. The purpose of this paper is to review the literature on parental influences on eating behaviours across childhood, mainly focusing on parental feeding practices. The associations between parental feeding practices and children's eating behaviours have been extensively studied. However, most of the findings come from cross-sectional studies, so the possibility of reverse causality cannot be ruled out (i.e., children's behaviours influencing parents). Most recently, a few longitudinal studies with a cross-lagged design have shown that the relationship between children's eating behaviours and parental feeding practices seems to be bidirectional, where it is not straightforward whether parental feeding practices are a predictor or a consequence of children's eating behaviours. Children's eating behaviours influence parents to adopt certain feeding practices, but these practices also influence children's behaviours over time. Parental feeding practices may have the potential to shape children's eating behaviours and should be targeted to promote the development of non-obesogenic traits. However, parent-child interactions are complex and therefore both parent and child characteristics and the family dynamics should be considered.
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Affiliation(s)
- Alexandra Costa
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Correspondence:
| | - Andreia Oliveira
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
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26
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GeethaPriya PR, Asokan S, YogeshKumar TD, Elamathe M. Association between sleep patterns and early childhood caries in 3-4-year-old children: A cross-sectional study. J Indian Soc Pedod Prev Dent 2023; 41:22-28. [PMID: 37282408 DOI: 10.4103/jisppd.jisppd_146_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Aim The aim of this study was to assess the sleep practices of children and their association with early childhood caries (ECC) at three different age periods. Methodology A cross-sectional study was conducted to assess the sleep practices, feeding practices, and oral hygiene practices of children during nighttime from 0 to 2 years of age. A survey among 550 mothers of children aged 3-4 years with ECC (n = 275) and without ECC (n = 275) was conducted using a pretested and validated questionnaire. The three practices (sleep practices, feeding practices, and oral hygiene practices) of children at 0-3 months, 4-11 months, and 1-2 years of age were recorded and analyzed. Results Risk factors associated with ECC at 0-3 months of age were gender (odds ratio [OR]: 0.59, 0.36-0.98), no previous dental visit (OR: 2.30, 1.15-4.59), bedtime (OR: 3.54, 2.01-6.25), and intentional feeding practice at night (OR: 1.83, 1.0-3.35). At 4-11 months of age, no previous dental visit (OR: 3.28, 1.66-6.49), mother's education (OR: 0.42, 0.23-0.76), frequent night wakes (OR: 5.98, 1.89-19.21), and intentional feeding practice at night (OR: 111.09, 32.25-382.68) and, at 1-2 years of age, no previous dental visit (OR: 2.37, 1.45-3.88), intentional feeding practice at night (OR: 19.12, 9.09-40.21), and breastfeeding for more than 2 years (OR: 14.56, 7.17-29.56) were associated with ECC. Conclusion Lack of previous dental visit and intentional feeding at night were the common risk factors associated with ECC in children.
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Affiliation(s)
- P R GeethaPriya
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Sharath Asokan
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - T D YogeshKumar
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - M Elamathe
- Department of Pediatric and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
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Tan ST, Rajan DS, Rajan DS. Feeding Practices during the COVID-19 Lockdown: Is there a Difference between Stay-at-Home Mothers and Work-from-Home Mothers? Malays J Med Sci 2022; 29:164-169. [PMID: 36818892 PMCID: PMC9910377 DOI: 10.21315/mjms2022.29.6.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/25/2021] [Indexed: 12/25/2022] Open
Abstract
This study aims to compare the feeding practices adopted by stay-at-home mothers and work-from-home mothers during the COVID-19 lockdown. Feeding practices were assessed using a 39-item validated Comprehensive Feeding Practices Questionnaire (CFPQ). The Multivariate Analysis of Covariance (MANCOVA) was used to determine the mean difference in feeding practices by maternal employment status after adjusting for the mother's age and educational attainment and the child's age and gender. The current study revealed that a noticeable proportion of mothers adopted feeding practices that encourage balance and variety (4.45 ± 0.62), promote a healthy environment (4.34 ± 0.81) and impose dietary restrictions for health (4.32 ± 1.04) during the COVID-19 pandemic. There was no significant difference (P > 0.05) in the mean scores of feeding practices across maternal employment status, except for the emotion regulation and modelling subscales. Work-from-home mothers had a significantly higher mean score in the emotion regulation subscale than stay-at-home mothers (F = 14.892, P < 0.001). In comparison to work-from-home mothers, stay-at-home mothers had a significantly higher mean score in the modelling subscale during the COVID-19 pandemic (F = 4.163, P = 0.044). In conclusion, there was just a modest variation in the feeding practices adopted by stay-at-home mothers and work-from-home mothers in this unprecedented pandemic.
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28
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Shurson GC, Urriola PE, Hung YT. Too Much of a Good Thing: Rethinking Feed Formulation and Feeding Practices for Zinc in Swine Diets to Achieve One Health and Environmental Sustainability. Animals (Basel) 2022; 12:ani12233374. [PMID: 36496895 PMCID: PMC9739216 DOI: 10.3390/ani12233374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
The objectives of this review were to summarize current knowledge of Zn in swine nutrition, environmental concerns, potential contribution to antimicrobial resistance, and explore the use of alternative feeding strategies to reduce Zn excretion in manure while capturing improvements in productivity. Zinc is a required nutrient for pigs but is commonly supplemented at concentrations that greatly exceed estimated requirements. Feeding pharmacological concentrations of Zn from ZnO to pigs for 1 to 2 weeks post-weaning reduces post-weaning diarrhea and improves growth performance. Feeding elevated dietary levels of Zn to sows during the last 30 days of gestation can reduce the incidence of low-birth-weight pigs and pre-weaning mortality. Most of the dietary Zn consumed by pigs is not retained in the body and is subsequently excreted in manure, which led several countries to impose regulations restricting dietary Zn concentrations to reduce environmental impacts. Although restricting Zn supplementation in swine diets is a reasonable approach for reducing environmental pollution, it does not allow capturing health and productivity benefits from strategic use of elevated dietary Zn concentrations. Therefore, we propose feeding strategies that allow strategic use of high dietary concentrations of Zn while also reducing Zn excretion in manure compared with current feeding practices.
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Affiliation(s)
- Gerald C. Shurson
- Department of Animal Science, University of Minnesota, St. Paul, MN 55108, USA
- Correspondence:
| | - Pedro E. Urriola
- Department of Animal Science, University of Minnesota, St. Paul, MN 55108, USA
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29
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Gomes AI, Roberto MS, Pereira AI, Alves C, João P, Dias AR, Veríssimo J, Barros L. Development and Psychometric Characteristics of an Instrument to Assess Parental Feeding Practices to Promote Young Children's Eating Self-Regulation: Results with a Portuguese Sample. Nutrients 2022; 14:nu14234953. [PMID: 36500987 PMCID: PMC9736991 DOI: 10.3390/nu14234953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
A parental child-centered feeding approach is likely to keep children’s biological mechanisms activated while eating, protecting them in an obesogenic context. However, few feeding practice measures assess parents’ behaviors to guide and prompt children to identify and respond appropriately to their signs of hunger and satiety. We aimed to develop and study the reliability, validity, and measurement invariance of a new scale to assess parental feeding practices to promote children’s self-regulation of food intake. To pursue this aim, we conducted two descriptive, cross-sectional, online studies in Portugal in an online format; a total of 536 parents of 2- to 6-year-old children completed the evaluation protocol. Factorial analysis findings support the theoretical organization proposed for the scale. The confirmatory factorial analysis supported a first-order factor structure with two subscales, Prompting for eating self-regulation and Teaching about eating consequences, with eight items in total. Both scales presented good internal consistency and adequate temporal stability, with a significant, positive, and moderate relationship. The results showed metric invariance for the child’s sex. Both types of practices were positively correlated with the child’s enjoyment of food. Prompting for eating self-regulation showed negative associations with parents’ emotional lack of control, children’s satiety responsiveness, slowness in eating, and fussiness. Preliminary studies confirmed both the validity and reliability of the instrument and the adequacy of adopting a self-regulatory approach when assessing child-centered feeding practices. Combining this instrument with others that assess coercive practices can be beneficial to capture ineffective parents’ behaviors on children’s eating self-regulation.
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Affiliation(s)
- Ana Isabel Gomes
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Correspondence:
| | - Magda Sofia Roberto
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Ana Isabel Pereira
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Cátia Alves
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Patrícia João
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Ana Rita Dias
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - João Veríssimo
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Luísa Barros
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
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Eun Kyo H, Ju Hee K, Hey-Sung B, Eun L, Ji Hyeon B, Somin S, Young Hyeon K, Moreno LA, Seung Won L, Man Yong H. Association between complementary food introduction before age 4 months and body mass index at age 5-7 years: a retrospective population-based longitudinal cohort study. J Hum Nutr Diet 2022; 36:787-797. [PMID: 36222616 DOI: 10.1111/jhn.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/25/2022] [Indexed: 12/01/2022]
Abstract
AIM/OBJECTIVE The optimal time of starting complementary foods (CFs) in infants remains a subject of debate. This population-based longitudinal cohort study evaluated the association between early CF introduction and body mass index (BMI) in children aged 5-7 years. METHODS This study included 917,707 children born in Korea during 2008-2009. Initial timing of CF introduction was obtained by questionnaires administered between 4-6 months and 9-12 months of age. The cohort consisted of 154,565 eligible individuals who properly completed the screening program, including structured questionnaires, anthropometric measurements, and physical examinations. To balance baseline characteristics, children were subjected to propensity score matching based on 95 covariates, including indicators of baseline health such as perinatal condition, birth weight, economic status, clinical disease and drug exposure. Exposure was defined as introduction to CF at age <4 months, and outcomes were overweight (BMI z-score > 85th percentile) and obesity (BMI z-score > 95th percentile) at ages 5-7 years. RESULTS Of the 154,565 eligible children in the observed cohort, 10,499 (6.8%) were introduced to CF at age <4 months and 144,066 (93.2%) at age ≥4 months. Propensity score matching yielded 9,680 children introduced to CF at age <4 months and 35,396 at age ≥4 months. The risk for being overweight or obese at age 5-7 years was slightly higher among those who started CF at age <4 months than at age ≥4 months (adjusted relative risk [aRR] 1.06; 95% confidence interval [CI], 1.02-1.09). A similar but stronger association was observed for being obese at age 5-7 years (aRR 1.12; 95% CI, 1.05-1.19). CONCLUSION Early CF introduction before age 4 months was associated with increased BMI at age 5-7 years. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ha Eun Kyo
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.,Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Kim Ju Hee
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, College of Medicine, Seoul, Korea
| | - Baek Hey-Sung
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, College of Medicine, Seoul, Korea
| | - Lee Eun
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Baek Ji Hyeon
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Shim Somin
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Kim Young Hyeon
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Instituto Agroalimentario de Aragón (IA2) and Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Lee Seung Won
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea.,Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Han Man Yong
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
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Santos AF, Fernandes C, Fernandes M, Santos AJ, Veríssimo M. Associations between Emotion Regulation, Feeding Practices, and Preschoolers' Food Consumption. Nutrients 2022; 14:4184. [PMID: 36235837 DOI: 10.3390/nu14194184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/19/2022] [Accepted: 10/01/2022] [Indexed: 11/05/2022] Open
Abstract
Previous research identified emotion dysregulation, non-responsive feeding practices, and unhealthy food consumption as risk factors for childhood obesity. However, little is known about the relationships between these factors. This study examined associations between children’s emotion regulation, parental feeding practices, and children’s food consumption. The sample consisted of 163 mothers of children aged 3–5 years. Mothers completed the Emotion Regulation Checklist, the Child Feeding Questionnaire, and the Child Health Section from the Parent Interview of the Early Childhood Longitudinal Study-B to assess model variables. Results showed that healthy food consumption was associated with higher emotion regulation abilities, higher monitoring, and lower pressure to eat. For unhealthy food consumption, the associations were in opposite directions. Higher emotion regulation abilities were also associated with higher monitoring, lower pressure to eat, and lower restriction. For lability, the associations were in opposite directions. Regression analyses revealed that children’s lability, pressure to eat, and monitoring were significant predictors of children’s food consumption. These findings suggest that children’s emotion regulation and feeding practices are important determinants of children’s food consumption. Future longitudinal studies that examine bidirectional associations between children’s emotion regulation, parental feeding practices, children’s food consumption, and potential mechanisms accounting for these associations are needed.
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Neves PAR, Vaz JS, Ricardo LIC, Armenta-Paulino NN, Barros AJD, Richter L, Rollins N, Peréz-Escamilla R. Disparities in early initiation of breast feeding and prelacteal feeding: A study of low- and middle-income countries. Paediatr Perinat Epidemiol 2022; 36:741-749. [PMID: 35253935 DOI: 10.1111/ppe.12871] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/07/2022] [Accepted: 02/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early initiation of breast feeding (EIBF) reduces the risk of neonatal mortality. However, only 45% of newborns are breast-fed within the first hour after birth and prelacteal feeding (PLF) is widely prevalent in low- and middle-income countries (LMICs). OBJECTIVE To assess within- and between-country disparities in EIBF and PLF practices by household wealth and place of birth and to investigate the national-level correlation between these feeding indicators in LMICs. METHODS Data from Demographic Health Surveys and Multiple Indicator Cluster Surveys (2010-2019) in 76 LMICs were used to investigate within-country disparities in EIBF, any PLF, milk-based prelacteal feeding (MPLF), and water-based prelacteal feeding (WPLF) by wealth quintiles and place of childbirth (institutional [private or public sector] or in-home) for children under two years. We examined the between-country Pearson's correlation between EIBF and types of PLF, later adjusted for per capita gross domestic product (GDP). RESULTS No clear wealth-related differences were found for EIBF and WPLF; however, any PLF and MPLF were significantly higher in children belonging to the richest 20% of households but are also prevalent among lower income groups. Prevalence of any PLF was higher among institutional births in all LMICs, but especially for MPLF in private sector deliveries in East Asia & the Pacific, Eastern Europe & Central Asia, and Latin America & the Caribbean. WPLF was more common in all African regions. EIBF was inversely correlated with any PLF (r = -0.59, 95% CI -0.72, -0.42), MPLF (r = -0.41, 95% CI -0.58, -0.21) and WPLF (r = -0.34, 95% CI -0.53, -0.13). Adjustment for log-GDP did not affect the magnitude and direction of the results. CONCLUSION Clear prorich disparities exist in the prevalence of PLF, especially MPLF. Children born in private sector facilities are more likely to receive MPLF. EIBF is negatively associated with PLF practices in LMICs. The promotion of better early feeding practices is urgent to achieve the Sustainable Development Goal to reduce neonatal mortality to 12 deaths per 1000 live births.
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Affiliation(s)
| | - Juliana S Vaz
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil.,Faculty of Nutrition, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Luiza I C Ricardo
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Aluísio J D Barros
- International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Linda Richter
- DSI-NRF Centre of Excellence in Child Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Nigel Rollins
- Department of Maternal, Newborn, Child, and Adolescent Health, World Health Organization, Geneva, Switzerland
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Klosowska J, Verbeken S, Braet C, De Henauw S, Michels N. Emotion Regulation Moderates the Associations of Food Parenting and Adolescent Emotional Eating. J Nutr Educ Behav 2022; 54:808-817. [PMID: 36087954 DOI: 10.1016/j.jneb.2022.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To explore parental feeding practices and eating behavior as predictors of the child's emotional eating (EE) and child's emotion regulation (ER) as a potential moderator. DESIGN Parental eating behavior (emotional, external, and restrained eating), 9 parental feeding practices (restriction, food as reward, food as ER, monitoring, healthy modeling, healthy environment, child control, and child involvement), ER, and EE were analyzed cross-sectionally and 5 parental practices longitudinally (subsample, n = 115). SETTING Belgium. PARTICIPANTS Two hundred eighteen adolescents (aged 13.7 ± 1.77 years) and parent dyads. MAIN OUTCOME MEASURES Child's EE. ANALYSIS Linear regression and moderation (cross-sectional) and linear mixed models (longitudinal). Models adjusted for multiple testing with a false discovery rate of 10% (Benjamini-Hochberg), age, sex, body mass index, socioeconomic status, and cohort. RESULTS Cross-sectionally but not longitudinally, there was a positive association between predictors restriction and monitoring with the outcome child's EE (β = 0.19, P = 0.006; β = 0.17, P = 0.01, respectively). Restrained eating of the parent was negatively associated with the child's EE (β = -0.22, P = 0.003). The child's maladaptive ER significantly moderated the associations of 5 feeding practices and parental EE with the child's EE. CONCLUSIONS AND IMPLICATIONS Parents continue to play a role in the eating behavior of their adolescent offspring, not only through their feeding practices (restrictive parenting was most detrimental) but also by displaying restrained eating (beneficial). A child's ER appears as an important moderator of the established associations; however, more research is needed to better understand these observations.
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Affiliation(s)
- Joanna Klosowska
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Nathalie Michels
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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Mcisaac JLD, Richard B, Turner J, Rossiter MD. Comparison of Responsive Feeding Practices in Child Care and Home Environments in Nova Scotia. CAN J DIET PRACT RES 2022; 83:168-174. [PMID: 36004728 DOI: 10.3148/cjdpr-2022-017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: The values, beliefs and practices between the family home and child care environment can play a role in shaping a responsive food environment for young children, but few studies have explored the differences across these settings. The purpose of this study was to compare responsive feeding practices in child care and home environments through the framework of the 2019 Canada Food Guide healthy eating recommendations.Methods: Nova Scotia families and child care providers completed an online survey on responsive feeding. Independent-samples t-tests explored the differences between family and child care respondents on variables related to the 2019 Canada's Food Guide, including: food variety, mindfulness, eating with others, cooking more often, and enjoyment of food. A directed content analysis was used to code the open-ended qualitative questions.Results: Family respondents (n = 603) were more likely to report offering a variety of foods, repeated exposures to new foods, and asking children about fullness. Child care respondents (n = 253) were more likely to sit with children during meals and less likely to encourage children to finish their food.Conclusions: The results identify potential points of intervention, including the importance of increasing communication to ensure mutually supportive messages and environments for healthy eating.
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Affiliation(s)
- Jessie-Lee D Mcisaac
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Nova Scotia.,Faculty of Education, Mount Saint Vincent University, Halifax, Nova Scotia.,Department of Child and Youth Study, Mount Saint Vincent University, Halifax, Nova Scotia
| | - Brenna Richard
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Nova Scotia.,Department of Child and Youth Study, Mount Saint Vincent University, Halifax, Nova Scotia
| | - Joan Turner
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Nova Scotia.,Department of Child and Youth Study, Mount Saint Vincent University, Halifax, Nova Scotia
| | - Melissa D Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island
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Nagge KA, Finch S, Rossiter MD. Family Feeding Practices of Parents on Prince Edward Island: A Focus on Responsive Feeding. CAN J DIET PRACT RES 2022; 83:198-202. [PMID: 36004725 DOI: 10.3148/cjdpr-2022-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The home environment and parental influence are strong predictors of eating behaviours in young children and can influence healthy development. The objective of this study was to describe the feeding practices of a sample of families on Prince Edward Island. Eleven parent participants were recruited, one-on-one interviews were held, and a thematic analysis was conducted. Conversations with parents revealed that the family feeding environment is influenced by a multitude of factors that change daily and need to be navigated based on the age of the child. Parents saw family meals as time together and an opportunity to model healthy eating behaviours; however, they faced several challenges at mealtimes, including perceived picky eating. Parents recognized their children's hunger and satiety cues, although they respected satiety signals more often if children ate what they perceived as a lot of food. Many parents used food as a reward to encourage their children to eat more but recognized that it could lead to the development of undesirable habits. Despite the complex factors that influence feeding, dietitians can work with families to foster a responsive feeding environment by encouraging family meals, recognizing and respecting hunger and satiety cues, and understanding typical changes in eating behaviours as children age.
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Affiliation(s)
- Katrina A Nagge
- Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island
| | - Sarah Finch
- Assistant Professor, Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island
| | - Melissa D Rossiter
- Associate Professor Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island
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Kundu S, Sayeed A, Azene AG, Rezyona H, Banna MHA, Khan MSI. Exploring the Factors Associated with Dietary Diversity of Children Aged 6-59 Months in Some Rural and Slum Areas of Bangladesh amid the COVID-19 Pandemic: A Mixed-Effect Regression Analysis. Curr Dev Nutr 2022; 6:nzac109. [PMID: 35957740 PMCID: PMC9362760 DOI: 10.1093/cdn/nzac109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/13/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Dietary diversity (DD) is a key component of diet quality, and malnutrition due to poor diet quality leads to child morbidity and mortality. However, in Bangladesh, there is a lack of information on childhood DD (for children aged 6-59 mo) amid the coronavirus disease 2019 (COVID-19) pandemic. Objectives The purpose of this study was to assess the minimum DD and its associated factors among children aged 6-59 mo during the COVID-19 pandemic in Bangladesh. Methods A cross-sectional study was carried out in 6 districts of Bangladesh. A total of 1190 respondents were included using cluster random sampling. The Individual Dietary Diversity Score (IDDS) for children was used to assess the children's DD. Factors associated with DD of children were identified using a multilevel binary logistics regression model. Results About 70% of the children aged 6-59 mo had minimum DD during the COVID-19 pandemic in Bangladesh. Children who belonged to slum areas [adjusted odds ratio (AOR): 0.45; 95% CI: 0.24, 0.83], family income 12,000-15,000 Bangladeshi taka (BDT) (AOR: 1.79; 95% CI: 1.06, 3.05) and >15,000 BDT (AOR: 2.59; 95% CI: 1.47, 4.57), mothers aged 26-30 y (AOR: 0.35; 95% CI: 0.20, 0.62) and >30 y (AOR: 0.43; 95% CI: 0.22, 0.85), respondents who had 2 children <5 y old (AOR: 0.43; 95% CI: 0.28, 0.66), and children aged 12-23 mo (AOR: 1.89; 95% CI: 1.14, 3.20) were significantly associated with DD among children aged 6-59 mo. Conclusions The findings of this study highlight the need for food and nutrition-related intervention, particularly targeting mothers of younger age and with >2 children <5 y old, mothers from slum regions, and fathers who were unemployed, to improve children's DD practices.
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Affiliation(s)
- Satyajit Kundu
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
- School of Public Health, Southeast University, Nanjing, China
| | - Abu Sayeed
- Department of Post-Harvest Technology and Marketing, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Abebaw Gedef Azene
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Humayra Rezyona
- Department of Food and Nutrition, Government College of Applied Human Science, Dhaka, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md Shafiqul Islam Khan
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
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Hoteit M, Ibrahim C, Saadeh D, Al-Jaafari M, Atwi M, Alasmar S, Najm J, Sacre Y, Hanna-Wakim L, Al-Jawaldeh A. Correlates of Sub-Optimal Feeding Practices among under-5 Children amid Escalating Crises in Lebanon: A National Representative Cross-Sectional Study. Children (Basel) 2022; 9:817. [PMID: 35740754 DOI: 10.3390/children9060817] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Sub-optimal feeding practices among under-5 children are the major drivers of malnutrition. This study aims to assess the prevalence of malnutrition and the factors affecting exclusive breastfeeding, bottle feeding, and complementary feeding practices among under 5 children amid the COVID-19 pandemic as well as the economic and the political crises in Lebanon. A nationally representative stratified random sample of mother-child dyads (n = 511) was collected from households using a stratified cluster sampling design. The survey inquired about infant's feeding and complementary feeding practices using a valid questionnaire. Anthropometric measurements of the mother and child were collected. Multivariate logistic regression was conducted to explore the determinants associated with under-5 children's practices. The prevalence of underweight, stunting, wasting, overweight and obese children was 0.5%, 8.4%, 6.7%, 16.8% and 8.9%, respectively. In total, among under-5 children, the prevalence of ever breastfeeding, exclusive breastfeeding, and bottle feeding at birth was 95.1%, 59.1% and 25.8%, respectively. Half the children in this study started solid foods between 4 and 6 months. Regression analysis showed that supporting breastfeeding at hospital (aOR = 8.20, 95% CI (3.03-22.17)) and husband's support (aOR = 3.07, 95% CI (1.9-4.92)) were associated with increased breastfeeding odds. However, mother's occupation (aOR = 0.18, 95% CI (0.55-0.58)) was inversely associated with breastfeeding practices. Male children (aOR = 2.119, 95% CI (1.37-3.27), mothers diagnosed with COVID-19 (aOR = 0.58, 95% CI (0.35-0.95)), and bottle feeding at hospital (aOR = 0.5, 95% CI (0.32-0.77)) were more likely to induce early initiation of solid foods at 4 months of age. This study demonstrated non-negligible rates of malnutrition, low prevalence of exclusive breastfeeding, and high rates of early introduction of formula feeding and solid foods among Lebanese under-5-children amid escalating crises.
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Baxter KA, Nambiar S, So THJ, Gallegos D, Byrne R. Parental Feeding Practices in Families Experiencing Food Insecurity: A Scoping Review. Int J Environ Res Public Health 2022; 19:ijerph19095604. [PMID: 35564998 PMCID: PMC9099728 DOI: 10.3390/ijerph19095604] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 01/16/2023]
Abstract
Parental feeding practices and styles influence child diet quality and growth. The extent to which these factors have been assessed in the context of disadvantage, particularly household food insecurity (HFI), is unknown. This is important, as interventions designed to increase responsive practices and styles may not consider the unique needs of families with HFI. To address this gap, a scoping review of studies published from 1990 to July 2021 in three electronic databases was conducted. A priori inclusion criteria were, population: families with children aged 0–5 years experiencing food insecurity and/or disadvantage; concept: parental feeding practices/behaviours/style; and context: high income countries. The search identified 12,950 unique papers, 504 full-text articles were screened and 131 met the inclusion criteria. Almost all the studies (91%) were conducted in the United States with recruitment via existing programs for families on low incomes. Only 27 papers assessed feeding practices or styles in the context of HFI. Of the eleven interventions identified, two assessed the proportion of participants who were food insecure. More research is required in families outside of the United States, with an emphasis on comprehensive and valid measures of HFI and feeding practices. Intervention design should be sensitive to factors associated with poverty, including food insecurity.
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Affiliation(s)
- Kimberley A. Baxter
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
- Correspondence:
| | - Smita Nambiar
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove 4059, Australia
| | - Tsz Hei Jeffrey So
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
| | - Danielle Gallegos
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
| | - Rebecca Byrne
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, Graham St, South Brisbane 4101, Australia; (S.N.); (T.H.J.S.); (D.G.); (R.B.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Rd, Kelvin Grove 4059, Australia
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Boulom S, Bon DM, Essink D, Kounnavong S, Broerse JEW. Understanding Discrepancies in Nutritional Outcomes Among Under-Fives in Laos: A Mixed-Methods Study Using the Positive Deviance Approach. Food Nutr Bull 2022; 43:303-322. [PMID: 35506170 PMCID: PMC9403390 DOI: 10.1177/03795721221096187] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Stunting is one of the main contributing factors in the under-five mortality rate worldwide. In Laos, the prevalence of stunting remains high, particularly in mountainous rural areas. To prevent stunting, insight into positive deviant behaviors can help understand how people can cope or adapt in resource-poor settings. OBJECTIVE This study aims to analyze the practices and underlying factors that explain discrepancies in nutritional outcomes in children under the age of 5 in remote mountainous areas in Laos. METHODS This mixed-methods study included all children under the age of 5 living in 6 selected villages. Anthropometric measurements were taken, and a Z-score for stunting was calculated to select the positive and negative deviant children. To identify the causes of discrepancies in childhood stunting, household questionnaires, focus group discussions, observations, and individual interviews with family members and health workers were conducted. RESULTS Fifty-five percent of children were stunted. Inappropriate care and feeding practices were observed such as providing unbalanced diets and not attending health facilities. Positive deviant mothers were less likely to follow inappropriate practices, experienced less food insecurity, and had higher motivation and autonomy, which resulted in prioritizing their children's health. An active role of fathers seemed to benefit positive practices within households. CONCLUSIONS The combination of many different practices in which positive deviant families are doing slightly better resulted in less stunting of children. Those practices are related to the household resources, such as access to food and social support; and the mother's motivation, autonomy, and perspectives on child health.
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Affiliation(s)
- Sayvisene Boulom
- VU Amsterdam University, Amsterdam, the Netherlands.,National University of Laos, Vientiane, Lao PDR
| | | | - Dirk Essink
- VU Amsterdam University, Amsterdam, the Netherlands
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Kerr EM, Kelly B, Hammersley ML, Norman J, Hernandez L, Furber S, Vuong C, Wardle K, Ryan S, Okely AD. Assessment of Feeding Practices and Mealtime Environments in Australian Family Daycare Services. J Nutr Educ Behav 2022; 54:442-448. [PMID: 35027307 DOI: 10.1016/j.jneb.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Assess educators' feeding practices and mealtime environments in family daycare services and examine the factors associated with educators' feeding practices and mealtime environments. METHODS Cross-sectional observational study of family daycare services (n = 33) in Australia. Best practices for mealtime environments and educator feeding practices were assessed during each mealtime using the Environment Policy Assessment and Observation instrument. Correlates assessed via survey included: socioeconomic status, main language spoken at home, early childhood career experience, and nutrition professional development. Descriptive statistics and independent t tests were calculated. RESULTS Educators typically had higher scores, indicating better practices, for (the absence of) negative practices compared with positive practices. The only positive practice meeting best-practice standards was educators sitting with children during the meal. There were no significant correlations for educators' feeding practices or mealtime environment. CONCLUSIONS AND IMPLICATIONS Educators may benefit from professional development targeting positive feeding practices and supportive mealtime environments.
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Affiliation(s)
- Erin M Kerr
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.
| | - Bridget Kelly
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Megan L Hammersley
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health Medical Research Institute, Wollongong, New South Wales, Australia
| | - Jennifer Norman
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health Medical Research Institute, Wollongong, New South Wales, Australia; Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, New South Wales, Australia
| | - Lara Hernandez
- Centre for Population Health, NSW Ministry of Health, St Leonards, New South Wales, Australia
| | - Susan Furber
- Illawarra Health Medical Research Institute, Wollongong, New South Wales, Australia; Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, New South Wales, Australia; School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Australia
| | - Cecilia Vuong
- Health Promotion Service, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Karen Wardle
- Health Promotion Service, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Sarah Ryan
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anthony D Okely
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia; Illawarra Health Medical Research Institute, Wollongong, New South Wales, Australia
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Surve S, Kulkarni R, Patil S, Sankhe L. Impact of intervention on nutritional status of under-fives in tribal blocks of Palghar District in Maharashtra, India. Indian J Public Health 2022; 66:159-165. [PMID: 35859498 DOI: 10.4103/ijph.ijph_1770_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND There is a need to improve their nutritional status of under-five children through specific targeted interventions. The present study discusses the impact of intervention on nutritional status among under-five children in Palghar district from Maharashtra. OBJECTIVE The objective is to improve the nutritional status of under-five children by implementing multi-component health and nutrition education intervention, focusing on dietary counseling and modification keeping in view the cultural and socio-economic status of population. METHODS A prospective pre- and post-intervention study was conducted in two tribal blocks. Total 480 under-five children were included in pre- and post-intervention survey each. RESULTS Exclusive breastfeeding rates improved from 48.9% to 50.5% and initiation of complementary feeding at 6 months improved from 48.3% to 72.5% in post intervention survey as compared to preintervention survey. Among other Infant and Young Child Feeding indicators, Minimum Meal Frequency increased significantly to 67.03% from 5.91% and minimum acceptable diet improved from 5.37% to 47.2% in post intervention survey. The prevalence of Severe Acute Malnutrition (SAM) reduced from 5.4% to nil whereas severe stunting and underweight significantly decreased by 17% and 8% respectively in post intervention survey. Severe anemia decreased from 16.24% to nil post intervention. CONCLUSION The study reveals a substantial improvement in timely initiation of complementary feeds, nil cases of SAM, stunting, and underweight along with severe anemia in postintervention phase. This highlights the impact of multicomponent health and nutrition education interventions which may be adapted at a programmatic level to reduce child mortality and morbidity in India.
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Affiliation(s)
- Suchitra Surve
- Scientist C, Department of Clinical Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, Maharashtra, India
| | - Ragini Kulkarni
- Scientist E, Department of Operational Research, National Institute for Research in Reproductive Health, Indian Council of Medical Research, Mumbai, Maharashtra, India
| | - Sagar Patil
- Assistant District Health Officer, Zilla Parishad, Palghar, Public Health Department, Government of Maharashtra, Mumbai, Maharashtra, India
| | - Lalit Sankhe
- Associate Professor, Department of Community Medicine, Grant Medical College and Sir JJ Hospital, Mumbai, Maharashtra, India
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Pérez L, Vizcarra M, Hughes SO, Papaioannou MA. Food Parenting Practices and Feeding Styles and Their Relations with Weight Status in Children in Latin America and the Caribbean. Int J Environ Res Public Health 2022; 19:ijerph19042027. [PMID: 35206214 PMCID: PMC8871894 DOI: 10.3390/ijerph19042027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 12/22/2022]
Abstract
While a growing body of literature looks at the associations between food parenting practices, and feeding styles, and child’s weight status in developed countries, little is known for less developed countries, in general, and the Latin America and the Caribbean (LAC) region, in particular. This study systemically reviews and synthesizes existing evidence on the associations between child caregivers’ food parenting practices and feeding styles and 2 to 12-year-old child weight status. Keywords were used to search in PubMed, Web of Science, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature. Among the ten eligible articles, all of them reported significant associations between food parenting practices and feeding styles and child weight status. Existing studies have limitations, mainly related to cross-sectional convenience samples, which limit the generalization of the results. Additionally, small sample, heterogeneous feeding measures and weight related outcomes were other limitations. Future research is needed to understand caregiver–child interactions in the food situation and its link to child weight status in 2 to 12-year-old children in areas of LAC with diverse forms of malnutrition and contextual factors of countries.
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Affiliation(s)
- Luisa Pérez
- Carrera de Nutrición y Dietética, Facultad de Medicina—Clínica Alemana, Universidad del Desarrollo, Av. Plaza 680, Santiago 7610658, Chile;
| | - Marcela Vizcarra
- Food Behavior Research Center, School of Nutrition and Dietetics, College of Pharmacy, University of Valparaíso, Av. Gran Bretaña 1093, Valparaíso 2360102, Chile
- Correspondence:
| | - Sheryl O. Hughes
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA; (S.O.H.); (M.A.P.)
| | - Maria A. Papaioannou
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA; (S.O.H.); (M.A.P.)
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Netting MJ, Moumin NA, Knight EJ, Golley RK, Makrides M, Green TJ. The Australian Feeding Infants and Toddler Study (OzFITS 2021): Breastfeeding and Early Feeding Practices. Nutrients 2022; 14:nu14010206. [PMID: 35011081 PMCID: PMC8747366 DOI: 10.3390/nu14010206] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/10/2022] Open
Abstract
The Australian Feeding Infants and Toddler Study 2021 (OzFITS 2021) is a nationwide survey of Australian caregivers' infant and toddler feeding practices. Here, we describe breastfeeding rates and duration, use of breastmilk substitutes, and introduction of complementary (solid) foods, including common food allergens. Caregivers (n = 1140) were recruited by a digital marketing company and were interviewed using a structured telephone questionnaire to obtain information. Breastfeeding was initiated in 98% of infants, but the duration of exclusive breastfeeding to six months was less than 1%. Nearly 40% of children continued to receive breastmilk beyond one year, with 10% of toddlers receiving breastmilk at two years. One-quarter of infants were introduced to solid foods between 4 to 5 months, and nearly all infants had received solid foods by 7 months. New guidelines encourage the early introduction of potential food allergens to reduce the risk of allergy, and by 12 months, over 90% of children had been given eggs and peanuts. One-third of children received no breastmilk substitutes during their first year. One-third of infants first received breastmilk substitutes following birth and before discharge from the hospital. Of these infants, 30% ceased breastmilk substitute use after discharge. Our findings suggest a high rate of continued breastfeeding with 44% receiving breastmilk beyond 1 year. One approach to increase the duration of exclusive breastfeeding is to reduce breastmilk substitute use while in hospital.
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Affiliation(s)
- Merryn J. Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; (N.A.M.); (E.J.K.); (M.M.); (T.J.G.)
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
- Nutrition Department, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
- Correspondence: ; Tel.: +61-881-284-403
| | - Najma A. Moumin
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; (N.A.M.); (E.J.K.); (M.M.); (T.J.G.)
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Emma J. Knight
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; (N.A.M.); (E.J.K.); (M.M.); (T.J.G.)
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Rebecca K. Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia;
| | - Maria Makrides
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; (N.A.M.); (E.J.K.); (M.M.); (T.J.G.)
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Tim J. Green
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia; (N.A.M.); (E.J.K.); (M.M.); (T.J.G.)
- Discipline of Paediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
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Øverby NC, Hillesund ER, Helland SH, Helle C, Wills AK, Lamu AN, Osorio NG, Lian H, Ersfjord TI, Van Daele W, Bjørkkjær T, Valen EN, Gebremariam MK, Grasaas E, Kiland C, Schwarz UVT, Abel MH, Love P, Campbell K, Rutter H, Barker ME, Vik FN, Medin AC. Evaluating the effectiveness and implementation of evidence-based early-life nutrition interventions in a community setting a hybrid type 1 non-randomized trial - the Nutrition Now project protocol. Front Endocrinol (Lausanne) 2022; 13:1071489. [PMID: 36704042 PMCID: PMC9871808 DOI: 10.3389/fendo.2022.1071489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
UNLABELLED Disappointingly few efficacious health interventions are successfully scaled up and implemented in real world settings. This represents an evidence-to-practice gap, with loss of opportunity to improve practice. Aiming to improve nutrition in the first 1000 days of life, we have combined four efficacious dietary interventions into a single adapted digital resource (Nutrition Now) for implementation in a Norwegian community setting. Nutrition Now targets pregnant women and parents of 0-2-year-olds with messages focusing on healthy dietary behaviours. Early childhood education and care (ECEC) staff are provided with pedagogical tools addressing healthy food exposure and child food acceptance. Objectives: a) evaluate the effectiveness of provision of the Nutrition Now resource on child diet and diet-related outcomes, with special attention to the influence of socio-economic position, b) gather information on the effectiveness of the implementation process to inform forthcoming scale-up and c) perform trial- and model-based economic evaluations. This is a hybrid type 1 implementation study, focusing on evaluation of effectiveness. A quasi-experimental design with pre- and post-tests, where one municipality gets access to the resource (n~800), while a matched non-equivalent control municipality (n~800) does not, will be used. Effectiveness will be assessed by examining e.g., diet outcomes, developmental outcomes, and feeding practices. The resource will be implemented in ECEC settings and made available to pregnant women and parents through the Norwegian system of maternal and child health (MCH) care. The implementation process includes iterative adjustments and implementation strategies from the implementation framework Expert Recommendations for Implementing Change (ERIC) informed by dialogues with stakeholders. Implementation outcomes (e.g., acceptability and adoption) will be assessed through questionnaires and interviews with parents, ECEC and MCH staff, with particular attention to ethnic diverse groups. Both within-trial and modelling-based economic evaluation will be performed. Nutrition Now will bridge the existing evidence-to-practice gap through rigorous scientific effectiveness evaluation of municipal scale up and inform subsequent county scale up. The study is the first to implement efficacious nutrition interventions in early life with potential for health improvement using technology to maximise the reach and impact of both parental and MCH dietary guidance and ECEC practice. CLINICAL TRIAL REGISTRATION https://www.isrctn.com/, identified ISRCTN10694967.
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Affiliation(s)
- Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
- *Correspondence: Nina Cecilie Øverby,
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Sissel Heidi Helland
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Admassu Nadew Lamu
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Natalie Garzon Osorio
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Henrik Lian
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Torunn Iveland Ersfjord
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Wim Van Daele
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Tormod Bjørkkjær
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Erlend Nuland Valen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Mekdes Kebede Gebremariam
- Department of Community Medicine and Global Health , Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Erik Grasaas
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Charlotte Kiland
- Department of Political Science and Management, Faculty of Social Sciences, University of Agder, Kristiansand, Norway
| | - Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Hope Abel
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Penny Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Harry Rutter
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Mary Elizabeth Barker
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Anine Christine Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
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Tongo OO, Olwala MA, Talbert AW, Nabwera HM, Akindolire AE, Otieno W, Nalwa GM, Andang'o PEA, Mwangome MK, Abdulkadir I, Ezeaka CV, Ezenwa BN, Fajolu IB, Imam ZO, Umoru DD, Abubakar I, Embleton ND, Allen SJ. Enteral Feeding Practices for Very Preterm and Very Low Birth Weight Infants in Nigeria and Kenya. Front Pediatr 2022; 10:892209. [PMID: 35633964 PMCID: PMC9130927 DOI: 10.3389/fped.2022.892209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Optimizing nutrition in very preterm (28-32 weeks gestation) and very low birth weight (VLBW; 1,000 g to <1,500 g) infants has potential to improve their survival, growth, and long-term health outcomes. Aim To assess feeding practices in Nigeria and Kenya for very preterm and VLBW newborn infants. Methods This was a cross-sectional study where convenience sampling was used. A standard questionnaire was sent to doctors working in neonatal units in Nigeria and Kenya. Results Of 50 respondents, 37 (74.0%) were from Nigeria and 13 (26.0%) from Kenya. All initiated enteral feeds with breastmilk, with 24 (48.0%) initiating within 24 h. Only 28 (56.0%) used written feeding guidelines. Starting volumes ranged between 10 and 80 ml/kg/day. Median volume advancement of feeds was 20 ml/kg/day (IQR 10-20) with infants reaching full feeds in 8 days (IQR 6-12). 26 (52.0%) of the units fed the infants 2 hourly. Breastmilk fortification was practiced in 7 (14.0%) units, while folate, iron, calcium, and phosphorus were prescribed in 42 (84.0%), 36 (72.0%), 22 (44.0%), 5 (10.0%) of these units, respectively. No unit had access to donor breastmilk, and only 18 (36.0%) had storage facilities for expressed breastmilk. Twelve (24.0%) used wet nurses whilst 30 (60.0%) used formula feeds. Conclusion Feeding practices for very preterm and VLBW infants vary widely within Nigeria and Kenya, likely because of lack of locally generated evidence. High quality research that informs the feeding of these infants in the context of limited human resources, technology, and consumables, is urgently needed.
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Affiliation(s)
- Olukemi O. Tongo
- College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Macrine A. Olwala
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya
| | - Alison W. Talbert
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- *Correspondence: Alison W. Talbert
| | - Helen M. Nabwera
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Alder Hey Children's Hospital NHS Trust, Liverpool, United Kingdom
| | | | - Walter Otieno
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya
- Department of Nutrition and Health, Maseno University, Maseno, Kenya
| | - Grace M. Nalwa
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya
- Department of Nutrition and Health, Maseno University, Maseno, Kenya
| | | | | | - Isa Abdulkadir
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Chinyere V. Ezeaka
- College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Beatrice N. Ezenwa
- College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Iretiola B. Fajolu
- College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Zainab O. Imam
- Lagos State University Teaching Hospital, Lagos, Nigeria
| | | | - Ismaela Abubakar
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Nicholas D. Embleton
- Newcastle University, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Stephen J. Allen
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Mutare S, Feehan J, Cheikh Ismail L, Ali HI, Stojanovska L, Shehab A, Khair H, Ali R, Hwalla N, Kharroubi S, Hills AP, Fernandes M, Al Dhaheri AS. The First United Arab Emirates National Representative Birth Cohort Study: Study Protocol. Front Pediatr 2022; 10:857034. [PMID: 35463875 PMCID: PMC9021697 DOI: 10.3389/fped.2022.857034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In recent years, the prevalence of non-communicable diseases (NCDs) has escalated. Evidence suggests that there are strong associations between nutrition in early life and the risk of disease in adulthood. This manuscript describes the study protocol of the First United Arab Emirates National Representative Birth Cohort Study (UAE-BCS), with the objective of investigating nutrition and lifestyle factors in the first 1,000 days of life. The main aims of the study are (1) to address critical issues relating to mother and child nutrition and their effect on growth and development, (2) to profile maternal nutrition, child growth, health, and development outcomes in early life, and (3) to study the associations between these factors among the Emirati population in the UAE. METHODS/DESIGN In this study, a multidisciplinary team of researchers was established including credible researchers from the UAE, Lebanon, Australia, and the United Kingdom to launch the First United Arab Emirates 3-year birth cohort study. We aim to recruit 260 pregnant Emirati women within their first trimester, which is defined by the study as from 8 to 12 weeks pregnant, from obstetrics and gynecology clinics in the UAE. Participants will be recruited via face-to-face interviews and will receive a total of 11 visits with 1 visit in each trimester of pregnancy and 8 visits after delivery. Maternal data collection includes, socio-demographic and lifestyle factors, dietary intake, anthropometric measurements, physical activity, maternal psychological state, and blood samples for biochemical analysis. Post-partum, visits will take place when the child is 0.5, 4, 6, 9, 12, 18, and 24 months old, with data collection including infant anthropometric measurements, young child feeding practices, dietary intake, supplement use and the eating environment at home, as well as all maternal data collection described above, apart from blood samples. Additional data collection for the child includes early child developmental assessments taking place at three timepoints: (1) within 2 weeks of birth, (2) at 10-14 months and (3) at 22-26 months of age. Early child developmental assessments for the infant include vision, hearing, cognition, motor skills, social-emotional reactivity, neurodevelopmental, and sleep assessments. DISCUSSION The United Arab Emirates Birth Cohort study protocol provides a standardized model of data collection methods for collaboration among the multisectoral teams within the United Arab Emirates to enrich the quality and research efficiency in early nutrition, thereby enhancing the health of mothers, infants, and children.
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Affiliation(s)
- Sharon Mutare
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Jack Feehan
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Habiba I Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Abdullah Shehab
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Howaida Khair
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Raghib Ali
- Public Health Research Centre, New York University, Abu Dhabi, United Arab Emirates
| | - Nahla Hwalla
- Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Samer Kharroubi
- Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Michelle Fernandes
- MRC Lifecourse Epidemiology Centre and Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Nuffield Department of Women's & Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Ayesha Salem Al Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Ma T, Bu S, Paneth N, Kerver JM, Comstock SS. Vitamin D Supplementation in Exclusively Breastfed Infants Is Associated with Alterations in the Fecal Microbiome. Nutrients 2022; 14:202. [PMID: 35011077 DOI: 10.3390/nu14010202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 02/01/2023] Open
Abstract
Breastfeeding and introduction of solid food are the two major components of infant feeding practices that influence gut microbiota composition in early infancy. However, it is unclear whether additional factors influence the microbiota of infants either exclusively breastfed or not breastfed. We obtained 194 fecal samples from infants at 3–9 months of age, extracted DNA, and sequenced the V4 region of the 16S rRNA gene. Feeding practices and clinical information were collected by questionnaire and abstraction of birth certificates. The gut microbiota of infants who were exclusively breastfed displayed significantly lower Shannon diversity (p-adjust < 0.001) and different gut microbiota composition compared to infants who were not breastfed (p-value = 0.001). Among the exclusively breastfed infants, recipients of vitamin D supplements displayed significantly lower Shannon diversity (p-adjust = 0.007), and different gut microbiota composition structure than non-supplemented, breastfed infants (p-value = 0.02). MaAslin analysis identified microbial taxa that associated with breastfeeding and vitamin D supplementation. Breastfeeding and infant vitamin D supplement intake play an important role in shaping infant gut microbiota.
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Motebejana TT, Nesamvuni CN, Mbhenyane X. Nutrition Knowledge of Caregivers Influences Feeding Practices and Nutritional Status of Children 2 to 5 Years Old in Sekhukhune District, South Africa. Ethiop J Health Sci 2022; 32:103-116. [PMID: 35250222 PMCID: PMC8864407 DOI: 10.4314/ejhs.v32i1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/17/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of this study was to determine caregivers' nutrition knowledge and its influence on feeding practices and nutritional status on young children. METHODS A cross-sectional survey was conducted in 120 caregiver-child pairs. A validated questionnaire was used to collect caregivers' nutrition knowledge and feeding practices. Nutritional status was estimated using anthropometric measurements. Z-scores were computed using WHO Antro software. Chi-square test was used to determine the association between caregivers' nutrition knowledge and feeding practices. Significance was set at p <0.05. RESULTS Forty three percent of caregivers reported health professionals as their source of nutrition information. Almost all children (94.2%) were breastfed at one stage in their lives, with 62.5% introduced to solid foods before six months. Maize meal porridge (87.5%) and bread (54.2%) were consumed daily by most of the children, while 48.3% consumed meat and meat products three to four times per week. One in eight children consumed fruits daily and 5.8% vegetables daily. Forty one percent of children were stunted. Family income showed positive correlation with the nutritional status of children (weight-for-age R = 0.207, p < .05; height-for-age R°=°0.203*, p°= .026). An association was observed between the duration of breastfeeding and alternative food, to milk (R = 0.302**, p = .001), amount of fruit consumed daily (R = 0.197*, p = .031) and number of meals consumed daily (R = 0.284**, p = .048). Conclusion: Nutrition knowledge and feeding practices of the caregivers were not satisfactory.
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Affiliation(s)
- Tubatse Tiny Motebejana
- Nutrition Department, School of Health Sciences, University of Venda, Thohoyandou, South Africa, and Limpopo Provincial Department of Health in South Africa;
| | - Cebisa Noxolo Nesamvuni
- Nutrition Department, School of Health Sciences, University of Venda, Thohoyandou, South Africa;
| | - Xikombiso Mbhenyane
- Human Nutrition Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, 7505, PO Box 241, Cape Town, 8000, South Africa;
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Moumin NA, Golley RK, Mauch CE, Makrides M, Green TJ, Netting MJ. The Australian Feeding Infants and Toddlers Study (OzFITS) 2021: Study Design, Methods and Sample Description. Nutrients 2021; 13:4524. [PMID: 34960074 PMCID: PMC8708463 DOI: 10.3390/nu13124524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 12/04/2022] Open
Abstract
(1) Background: Caregiver feeding practices during the first two years of a child's life influence nutrition, growth, and development, as well as long term taste preferences and dietary patterns. Suboptimal feeding practices lead to poorer health outcomes, such as obesity, that persist into adulthood. Although the importance of early life nutrition is well-established, there are no Australia-wide surveys of dietary intakes of children under two years of age. The 2021 Australian Feeding Infants and Toddlers Study (OzFITS) aims to fill this gap. This paper describes the methods and study sample of OzFITS 2021. (2) Methods: OzFITS 2021 is a cross-sectional study of children aged 0 to 23.9 months of age and their caregiver across Australia. Data were collected between April 2020 and April 2021. A telephone-based survey was completed with a caregiver to obtain information on child and caregiver characteristics and feeding practices. For exclusively breastfed infants, the number of breastfeeds in a 24 h period was reported. Dietary intakes for mixed fed children were estimated using a one-day food record, with 30% of caregivers completing a second food record on a non-consecutive day. (3) Results: We enrolled 1140 caregiver and child dyads. Of those eligible to complete a food record, 853 (87%) completed the food record. Compared to the Australian population, caregivers were more likely to be university-educated (>75%), married or in a de facto relationship (94%), and have a household income >$100,000/y (60%). (4) Conclusions: OzFITS 2021 is the first national study to examine food and nutrient intake in Australian children aged under 2 years. The study will provide information on breastfeeding rates and duration, use of breast milk substitutes, and timing of solid food introduction. Dietary intake data will allow the comparison of core food groups and discretionary food intake to Australian guidelines and estimate the prevalence of inadequate intake of key nutrients, like iron. Healthcare practitioners and policymakers can use the study findings as a source of evidence to inform the next iteration of infant feeding guidelines.
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Affiliation(s)
- Najma A. Moumin
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Rebecca K. Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia; (R.K.G.); (C.E.M.)
| | - Chelsea E. Mauch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia; (R.K.G.); (C.E.M.)
| | - Maria Makrides
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Tim J. Green
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Merryn J. Netting
- Discipline of Pediatrics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia; (N.A.M.); (M.M.); (T.J.G.)
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Nutrition Department, Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
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Giuliani NR, Kelly NR. Maternal Attentional Control Moderates the Association Between Increased Depression and Controlling Feeding Practices During the COVID-19 Pandemic. J Prev Health Promot 2021; 2:294-310. [PMID: 36873601 PMCID: PMC9980833 DOI: 10.1177/26320770211032346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parental distress is associated with less healthful child feeding practices. In this preliminary study, we examined how changes in distress from before to during the COVID-19 pandemic were associated with similar changes in feeding practices in a sample of mothers of preschool-aged children. In addition, we examined how pre-pandemic laboratory measures of maternal self-regulation moderated this association. A total of 36 mothers from an ongoing study on parent and child self-regulation completed surveys assessing parental distress (i.e., maternal depression, parenting stress) and child feeding practices during pandemic-related stay-at-home orders in May-June 2020. These mothers had completed the same measures approximately 2 years earlier, along with laboratory assessments of inhibitory and attentional control. Pre-pandemic laboratory measures of attentional control significantly moderated the association between increased maternal depression and use of controlling feeding practices, such that mothers with better attentional, but not inhibitory, control scores did not show an effect of increased depression on feeding practices. These results provide preliminary evidence that acute increases in parental distress associated with "stay-at-home" orders affect feeding practices, specifically for mothers with lower levels of attentional control abilities.
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