Associations between maternal concern for healthful eating and maternal eating behaviors, home food availability, and adolescent eating behaviors

OBJECTIVE: Evaluate the relationship between maternal concern for healthful eating and maternal and adolescent dietary intake, eating behavior, and home food environment. DESIGN: Mothers of a subsample of adolescents who participated in a school-based survey (Project Eating Among Teens [EAT]) completed telephone interviews. PARTICIPANTS: Seven hundred fourteen mother-adolescent pairs. VARIABLES MEASURED: Mothers responded to a question regarding how much they are personally concerned with eating healthfully, and adolescents responded to a question regarding perceptions of their mothers' concern about eating healthfully. Dependent variables included adolescent and parent food intake and home food environment. ANALYSIS: Multinomial cumulative logistic regression models, adjusted for maternal race/ethnicity, socioeconomic status (SES), and adolescent grade level. RESULTS: A positive association was found between maternal concern for healthful eating and maternal fruit and vegetable intake, maternal breakfast and lunch consumption, and serving fruits and vegetables in the home. Maternal concern for healthful eating (as reported by mothers) was not associated with adolescent behavior. Adolescent perception of maternal concern for healthful eating was positively associated with adolescent fruit and vegetable intake. CONCLUSIONS AND IMPLICATIONS: Mother's concern for healthful eating is associated with maternal eating behavior and the home food environment. Adolescent perceptions of maternal attitudes are a stronger predictor than actual maternal attitudes of adolescent behavior. Parents should be encouraged to share their beliefs regarding the importance of healthful eating with their adolescents.     

Predictors of nutritional adequacy in mother-toddler dyads from rural families with limited incomes

OBJECTIVE: To predict the mean adequacy ratio (MAR) scores of mothers and toddlers from intakes of fruits, vegetables, and dairy group foods and being seated during mealtimes. DESIGN/SUBJECTS: This was a regression analysis of cross-sectional data of the diet quality and being seated during mealtimes of 100 rural mother-toddler dyads from limited-income families using two 24-hour dietary recalls. Children were 11 to 25 months of age and at or below 100% of the poverty index. MEASURES OF OUTCOME: Dietary quality for mothers and toddlers was assessed using a MAR score for eight different nutrients (vitamin A, vitamin C, vitamin D, folate, calcium, zinc, iron, and magnesium), and a score of 85 or above was considered nutritionally adequate. The main food groups of interest were servings from the fruits, vegetables, and dairy group foods. Mealtime sitting behavior was the percentage of times the toddler remained seated while eating. RESULTS: Servings of fruits, vegetables, and dairy foods predicted 0.62 of the variance in the mother's MAR score, whereas vegetable and dairy intakes along with being seated while eating indicated nutritional adequacy for toddlers. Mothers with low MAR scores were most likely to have toddlers with poor diets, although few toddlers had poor diet quality. CONCLUSIONS: Adequate intakes of dairy, vegetables, and whole fruits along with being seated while eating could be quick assessment tools to screen toddlers for nutritional risk. Mothers with poor diet quality were likely to have toddlers with poor diets; low intakes of fruits, vegetables, and dairy foods were markers for poor diet quality in mothers.     

A Cross-sectional Study to Examine the Association Between Dietary Patterns and Risk of Overweight and Obesity in Hong Kong Chinese Adolescents Aged 10–12 Years

Objective: To describe the dietary patterns and examine the associations of these patterns with risk of overweight and obesity in Chinese adolescents.

Methods: Baseline data collected between November 2003 and October 2004 from 171 boys and 180 girls aged 10–12 years who participated in the Hong Kong Adolescent Bone Health Cohort Study were analyzed. Dietary intake was assessed using a food frequency questionnaire and dietary pattern calculated using factor analysis. Data on demographic characteristics, weight, height, and Tanner stage were collected. Overweight and obesity were defined using The International Obesity Task Force cutoff values. Cardiovascular fitness expressed as peak oxygen consumption was predicted using the postexercise heart rate by the 3-minute step test and was used as an objective measure of physical activity. Association between dietary patterns and risk of overweight and obesity was examined using multivariate logistic regression with adjustment for demographics, puberty, and physical activity.

Results: The mean (SD) age of the study sample was 11.2 (0.6) years and there were 57 (16.2%) participants who were overweight/obese. Three dietary patterns were identified, namely, vegetables–fruits, snacks–beverages, and animal foods, fats, and condiments dominated. There was no significant linear association between each dietary pattern and the risk of overweight and obesity in this sample. Instead, the risk of overweight and obesity in this sample was positively associated with pubertal stage and inversely associated with physical activity.

Conclusions: Pubertal stage and physical activity, but not dietary patterns, were important factors contributing to the risk of overweight and obesity in this population.     

Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

ObjectivesThe aim of this study was to investigate the relationship between maternal diet during pregnancy and lactation and development of atopic disorders in childhood.MethodsWe included studies published up to August 2011 that assessed food-based maternal dietary interventions or that examined associations between maternal dietary intake during pregnancy and/or lactation and allergic outcomes (eczema, asthma, hay fever, and sensitization) in their children.ResultsWe included 42 studies (>40 000 children): 11 intervention studies (including 7 randomized control trials), 26 prospective cohort studies, 4 retrospective cohort studies, and 1 case–control study. In the randomized control trials, no significant difference was noted overall in the prevalence of eczema and asthma in the offspring of women on diets free from common food allergens during pregnancy. The prospective cohorts investigated a large number of potential associations, but reported few significant associations between maternal dietary intake and development of allergy. Maternal diets rich in fruits and vegetables, fish, and foods containing vitamin D and Mediterranean dietary patterns were among the few consistent associations with lower risk for allergic disease in their children. Foods associated with higher risk included vegetable oils and margarine, nuts, and fast food.ConclusionThis review did not find widespread or consistent links between mothers' dietary intake and atopic outcomes in their children. However, maternal consumption of Mediterranean dietary patterns, diets rich in fruits and vegetables, fish, and vitamin D-containing foods were suggestive of benefit, requiring further evaluation.     

Breast-feeding through the first year predicts maternal control in feeding and subsequent toddler energy intakes

OBJECTIVE: Current recommendations for infant feeding encourage breast-feeding through the first year. This research was conducted to evaluate associations among breast-feeding, maternal control of child feeding, and the dietary intake of toddlers during the second year of life. In particular, we sought to determine whether breast-feeding through the first year and subsequent toddler intake was mediated via maternal control of child feeding. DESIGN/SUBJECTS: Fifty-five white infants and their mothers were monitored longitudinally from age 12 or 13 months to age 18 months. MAIN OUTCOME MEASURES: Breast-feeding through the first year and maternal control in infant feeding were evaluated as predictors of energy intake at age 18 months. STATISTICAL ANALYSES PERFORMED: Regression analysis was used to evaluate predictors of toddler energy intake at age 18 months. A mediation model tested if the relationship between breast-feeding and infant intake was mediated by maternal control in feeding. RESULTS: Breast-feeding through the first year was associated with higher toddler energy intakes at age 18 months through its influence on maternal control in feeding. Mothers who breast-fed their infants for at least 12 months used lower levels of control in feeding. Lower levels of maternal control in feeding were associated with higher toddler energy intakes. The highest energy intakes among children aged 18 months were observed among taller and leaner toddlers. APPLICATIONS/CONCLUSIONS: Our findings suggest that breast-feeding through the first year may have an effect on children's energy intake by shaping mothers' child-feeding practices. These findings may be used by clinicians to assist parents in making informed decisions about choice of infant-feeding method and to provide anticipatory guidance regarding infant-feeding style when initiating dietary diversity.     

Social work and toddler overweight risk: Identifying modifiable child and parent factors across the socioeconomic gradient

ABSTRACT

Objective: Childhood obesity is associated with long-term health consequences, yet little is known about the prevalence of child and parent risk factors of overweight across the socioeconomic gradient in early life. This exploratory study documents the prevalence of risk factors that contribute to overweight among toddlers within and across socioeconomic status (SES). Methods: Obesity risk factors were examined within and across SES quintiles in a nationally representative sample. Data were collected from 5,100 mothers and 2-year-old children. Weighted regression models assessed child and parent characteristics that predict toddler weight status in a national sample and samples stratified by SES quintiles. Results: Higher rates of overweight were observed in Q1 (29.2%) and reduced with each successive SES quintile (16.9%—Q5), suggesting a gradient effect. Results indicated factors unique within quintiles, distinct from the full national sample: Q1—motor development; Q2—motor and mental development, maternal BMI, breastfeeding, bottle feeding, introduction of solid foods; Q3—breastfeeding; and Q4–5—introduction of solid foods. Discussion: Findings further existing knowledge of toddler obesity by uncovering risks relevant for specific SES groups. Results yield implications for social workers to refine strategies for improving toddler health and preventing overweight/obesity.     

Maternal dietary patterns during early pregnancy and the odds of childhood germ cell tumors: A Children's Oncology Group study

Maternal diet during pregnancy may be associated with cancer in offspring. Intake of individual foods, as well as dietary patterns, can be used when examining these relations. Here, the authors examined associations between maternal dietary intake patterns and pediatric germ cell tumors (GCTs) using principal components analysis and logistic regression. Mothers of 222 GCT cases aged less than 15 years who were diagnosed at a Children's Oncology Group institution between 1993 and 2001 and those of 336 frequency-matched controls completed a self-administered food frequency questionnaire of diet during early pregnancy. Four dietary patterns were identified: "Western," "fruits and vegetables," "protein," and "healthful." With adjustment for birth weight, parity, and vitamin use, the fruits and vegetables pattern was significantly associated with a lower odds for GCTs (odds ratio (OR) = 0.83, 95% confidence interval (CI): 0.69, 0.99; 2 sided). Upon stratification, the fruits and vegetables pattern was significantly associated with a lower odds in males (OR = 0.66, 95% CI: 0.47, 0.92) but not females (OR = 0.91, 95% CI: 0.72, 1.14). A quantitative assessment of assumed nondifferential reporting error indicated no notable deviations from unadjusted odds ratio estimates. Results of this exploratory analysis suggest that maternal prenatal dietary patterns could be considered in future studies of GCTs in offspring.     

Breastfeeding mothers consume more vegetables and a greater variety of fruits and vegetables than non‐breastfeeding peers: The influence of socioeconomic position

Aim: This study compared the diets of breastfeeding and non‐breastfeeding mothers from socioeconomically diverse regions of Melbourne to determine whether breastfeeding is a marker for healthier maternal dietary intakes. Methods: This cross‐sectional study obtained information via self‐reported questionnaire from 529 first‐time Melbourne mothers. Breastfeeding status was determined when the children were 3.9 months. Diet information was obtained using a validated Food Frequency Questionnaire. Maternal diet was assessed by seven indicators: average daily intake of fruit, vegetables, non‐core drinks, non‐core sweet snacks, non‐core savoury snacks, variety of fruit and variety of vegetables eaten in the preceding 12 months. Associations between breastfeeding status and each dietary variable were assessed using linear regression analyses. Socioeconomic position, maternal body mass index and the cluster‐based sampling design were controlled for. Results: Of the 529 subjects, 70% were breastfeeding their child. Compared with non‐breastfeeding mothers, breastfeeding mothers were found to consume more serves of vegetables (P= 0.001), a greater variety of fruit and vegetables (P= 0.001 and P≤ 0.001 respectively), and sweet snacks were consumed more frequently (P= 0.006). Differences were observed between low and high socioeconomic position mothers for fruit serves (P= 0.003), vegetable serves (P= 0.010) and fruit variety (P= 0.006). These associations persisted after controlling for socioeconomic position and maternal body mass index. Conclusions: The association between infant feeding (breastfeeding) and some aspects of maternal diet provides further evidence suggesting a link between maternal and child diets from a younger age than previously examined.     

A comparison of perceived and demonstrated maternal role competence of adolescent mothers

This study investigated and compared the perceived and demonstrated maternal role competence of adolescent mothers. The subjects were 32 mothers who delivered by vaginal delivery, were primipara, and had normal healthy babies. The two criterion measures of perceived and demonstrated maternal role competence were the Parenting Sense of Competence Scale and the Method for Observation of Maternal and Infant Behavior. Data were collected between 12 and 24 hours post‐delivery for each mother. The results of data analysis indicated that there was no significant correlation between the perceived and demonstrated maternal role competence of adolescent mothers. The result lends support to the viewpoint that perceptions and attitudes are inconsistent with behavior. There are direct implications from this study concerning the appropriate methods for assessing the maternal role competence of adolescent mothers. However, additional research would be helpful to identify more effective and efficient methods for assessing maternal role competence of adolescent mothers and planning appropriate intervention.     

Parenting Style as a Predictor of Adolescent Weight and Weight-Related Behaviors

PurposeCurrent research indicates that specific parenting styles are associated with adolescent overweight, dietary intake, and physical activity; but most of the research has been cross-sectional, making it difficult to determine the temporal order of these associations. The current study adds to the previous research by examining 5-year longitudinal associations between parenting style and adolescent weight and weight-related behaviors.MethodsData from Project EAT, a population-based study with adolescents from diverse ethnic and socioeconomic backgrounds, were used. Adolescents (N = 2,516) from 31 Minnesota schools completed in-class assessments in 1999 (Time 1) and mailed surveys in 2004 (Time 2). Multiple linear regression models were used to predict mean levels of adolescent outcomes at Time 2 from parenting style at Time 1.ResultsTime 1 maternal authoritative parenting style predicted lower body mass index in adolescent sons and daughters at Time 2. Time 1 paternal permissive parenting style predicted more fruits and vegetables intake in daughters at Time 2. Significant associations were not found between parenting style and adolescent physical activity.ConclusionsFindings suggest that authoritative parenting style may play a protective role related to adolescent overweight and that the dimension of warmth and/or caring in the parent–adolescent relationship may be important in relation to female adolescent healthy dietary intake. Further exploration of opposite sex parent–adolescent dyad patterns related to parenting style and adolescent weight and weight-related behaviors is warranted.     

The Body Mass Index of Teen Mothers and their Toddler Children

Objectives To evaluate: change in Body Mass Index (BMI) of adolescent mothers (14–19 years of age) from pre-pregnancy to 36 months postpartum; BMI of their children age 2 or older; relationship between maternal BMI and children’s BMI. Methods Retrospective medical record abstraction of adolescent mothers attending a medical program in Massachusetts between 2001 and 2005 who had self-reported pre-pregnancy BMI data at first prenatal visit, at least one BMI measure 12 or more months postpartum, and who did not experience a repeat pregnancy (n = 52). Children of adolescent mothers were included if they had received their 2 (n = 41) and/or 3 (n = 28) year physical. Results Adolescent mothers: overweight increased from 25% pre-pregnancy to 33% at 24–36 months postpartum; obesity more than doubled in the same time period, from 15% to 36%. Those with BMI data available pre-pregnancy and postpartum had an increase in mean BMI from 25 pre-pregnancy to 29 at 24–36 months postpartum (P < 0.001). Two-year-old children: About 5% were at risk for overweight and 12% were overweight. Three-year-old children: About 18% were at risk for overweight and 18% were overweight. When BMI categories of children were compared to BMI categories of their mothers, there was a trend for adolescent mothers with overweight/obesity at 24–36 months postpartum to have 3-year-old children at risk for overweight or overweight (P = 0.092). Conclusions There was a significant increase in overweight/obesity in this cohort of adolescent mothers and their children followed 36 months postpartum. The long-term sequelae of overweight/obesity indicates a need for effective interventions.     

母亲孕期饮食模式与儿童早期BMI变化轨迹关联的队列研究

目的 探讨母亲孕期饮食模式与儿童早期BMI变化轨迹的关联。方法 研究对象为马鞍山母婴健康队列1 241对母子。使用食物频率问卷收集母亲孕期饮食数据,分别在儿童出生时、3、6、12、18和24月龄6个时间段随访,收集队列儿童身高和体重数据。使用主成分分析确定母亲孕期饮食模式类别,利用组基多轨迹模型拟合儿童早期BMI变化轨迹,采用多分类logistic回归模型评估母亲孕期饮食模式与儿童早期BMI变化轨迹的关联。结果 母亲孕期饮食模式记为蛋白型、健康型、素食型、加工型和饮料型5种饮食模式,可解释总饮食变异的50.04%,其中蛋白型饮食模式能解释21.34%,为主要饮食模式。儿童早期BMI变化轨迹记为偏瘦型、一般型和偏胖型变化轨迹,分别占42.9%、45.6%和11.5%。控制潜在混杂因素后,发现健康型和饮料型饮食模式与儿童早期BMI变化轨迹有统计学关联（P<0.05）。偏瘦型与一般型变化轨迹相比,健康型饮食模式低水平组儿童在生命早期更倾向于偏瘦型变化轨迹（OR=1.286,95%CI：1.002~1.651）。偏胖型与一般型变化轨迹相比,饮料型饮食模式高水平组儿童在生命早期更倾向于偏胖型变化轨迹（OR=0.565,95%CI：0.342~0.935）。其他饮食模式与儿童早期BMI变化轨迹无统计学关联。结论 母亲孕期饮食模式会影响儿童早期BMI变化轨迹,其中低水平健康型饮食模式为偏瘦型变化轨迹的独立危险因素,高水平饮料型饮食模式为偏胖型变化轨迹的独立危险因素。     

Commercial Baby Food Consumption and Dietary Variety in a Statewide Sample of Infants Receiving Benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children

Dietary variety and exposure to fruits and vegetables in infancy have been associated with nutritional benefits and later acceptance of these foods. The objective of this study was to examine the prevalence of fruit and vegetable commercial baby food consumption and its relation to dietary variety during infancy. A cross-sectional statewide telephone survey of 733 Maryland mothers and infants receiving benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was conducted between July 2004 and July 2005. A 24-hour dietary recall was examined to assess infant dietary variety. Among infants from birth to age 5 months, 54% had consumed complementary foods in the past 24 hours; 60% received commercial baby foods. Among infants aged 6 to 12 months, 98% had consumed complementary foods in the past 24 hours; 81% received commercial baby foods. In the latter age range, the average daily number of different types of fruits and vegetables consumed was 1.5±1.2, range 0 to 6). In a multivariate model, infants aged 6 to 12 months who received commercial baby foods consumed a greater variety of fruits and vegetables (β=.54, 95% confidence interval 0.26-0.84; P<0.001) than infants who did not, characterized by a diet that was lower in white potatoes (14% vs 22%) and higher in dark-green (6% vs 5%) and deep-yellow (35% vs 10%) vegetables. Commercial baby food is consumed by a majority of WIC infants, although many mothers introduce it before the recommended age of 6 months. Among infants aged 6 to 12 months, commercial baby food is associated with dietary variety in fruits and vegetables. By encouraging consumption of fruits and vegetables after 6 months of age, either through the provision of commercial baby foods and/or education and resources related to the preparation of fruits and vegetables for infants, WIC can increase dietary variety and appropriate introduction of complementary foods among infants.     

1~2岁幼儿依恋特征及有关影响因素的探讨

【目的】 了解128名1~2岁幼儿依恋特征及母亲敏感性、气质等基本因素对其影响作用。 【方法】 采用陌生情境试验和现场观察对儿童依恋状况和儿童母亲敏感性进行测评,并由母亲填写家庭一般人口学资料和幼儿气质问卷。 【结果】 128名幼儿中,安全型依恋99人(77.3%),回避型24人(18.8%),抗拒型5人(3.9%),未发现混乱型。不同依恋类型儿童母亲的敏感性得分差异显著;趋避性、心境、持久性、注意分散等气质维度与儿童某些依恋行为呈现明显相关关系。 【结论】 济南市城区幼儿依恋安全型比例较高;母亲敏感性是影响儿童依恋重要因素之一;儿童气质对依恋类型不产生直接影响,但某些气质维度影响儿童特定情景下的依恋行为表现。     

Relationships Among the Physical and Social Home Food Environments,Dietary Intake,and Diet Quality in Mothers and Children

BackgroundBoth the physical and social home food environment (HFE) are believed to influence dietary intake and diet quality, but few studies have examined both aspects together.ObjectiveThe purpose of this study was to examine the relationships among the physical and social HFE, dietary intake, and diet quality in mothers and children.DesignThis was a cross-sectional substudy of a larger study.Participants/settingThe study included 24 mothers (aged ≥30 years) with a biological child aged 6 to 12 years living in the Newark, DE, area between June and November 2018.Main outcome measuresThe outcome measures of interest included the physical HFE (ie, home food availability); aspects of the social HFE (ie, parenting styles, family meal frequency, and policies); maternal and child intake of fruits, vegetables, sugar-sweetened beverages, and snacks; and diet quality using the 2015 Healthy Eating Index total score.Statistical analysisPearson correlations were used to examine the relationship between physical HFE and dietary intake as well as social HFE and dietary intake in both mothers and children. The relationships were further examined through exploratory regression analyses.ResultsIn mothers, fruit availability in the physical HFE was correlated with fruit intake (r = 0.50; P = 0.02). Fruit and vegetable availability in the physical HFE were correlated with 2015 Healthy Eating Index total score in both the mother and child. Family meals participation was correlated with dietary intake (vegetable intake in children, r = 0.44; P = 0.04; and snack intake in mothers, r = –0.74; P < .001). Exploratory regression analysis showed vegetables in the HFE was associated with vegetable intake and 2015 Healthy Eating Index total score in mothers, and fruits and vegetables in the HFE were associated with child 2015 Healthy Eating Index total score. Family meals participation was negatively associated with maternal snack intake and child sugar-sweetened beverages intake. Authoritative parenting was negatively associated with child snack intake and permissive parenting was negatively associated with mother’s fruit intake.ConclusionsBoth the physical and social HFE are associated with maternal and child dietary intake, but only the physical HFE was associated with dietary quality. Although preliminary, these data indicate the importance of future studies that include measures to assess both the physical and social HFE to better elucidate the influences of the HFE on dietary intake.     

Changes in dietary habits and prevalence of cardiovascular risk factors among school students in Macao,China

ObjectiveGiven the increasing burden of childhood obesity, it is important to examine the changes in dietary habits and prevalence of cardiovascular risk factors among Macao students.MethodsA cross-sectional study was conducted among primary and secondary school students in Macao, China in 2014–2015 with addition to data collected from 2008 to 2009 for comparison. The dietary behaviours, prevalence of obesity and dyslipidaemia were compared by study period.SubjectsIn 2014–2015, dietary assessment was conducted among 3635 students, physical assessment was conducted among 1427 school students. In 2008–2009, dietary assessment was conducted among 4271 students, physical assessment was conducted among 1700 school students.ResultsWhen compared with students in 2008, higher percentage of students from present study period consumed dairy products, crispy food and chocolate, while fewer students had fruits, vegetables and fried food at least once every day. Despite lower prevalence of elevated total cholesterol and low-density-lipoprotein cholesterol, the rate of general obesity, low high-density-lipoprotein cholesterol and hyperglycaemia has increased significantly in 2014–2015. Students aged 12–14 consumed less fruits and vegetables and suffered from higher rate of general and abdominal obesity, as well as low high-density-lipoprotein cholesterol and elevated serum triglycerides in 2014–15.ConclusionsThe students’ diet had both favourable and unfavourable changes. The rate of obesity and dyslipidaemia rises, while the situation for students aged 12–14 is more concerning.     

Food consumption by pregnant adolescents in Rio de Janeiro, Brazil

The increase in teenage pregnancy has been viewed with concern by public health experts. Food consumption to help maintain high nutrient demands has been identified as one of the most relevant components. This study aims to present the habitual consumption of food and energy-specific nutrients by pregnant adolescents. A total of 1,180 adolescent mothers were interviewed in maternity hospitals in the City of Rio de Janeiro, and a simplified questionnaire on semi-quantitative frequency of food consumption was applied. Lower consumption of fruit juice, vegetables, and fruits was observed among adolescent mothers over 15. Adolescent mothers classified in the lowest quartile of consumption lack the minimum recommended consumption of energy and nutrients. An inverse association was found between the number of household members and energy and nutrient consumption. Adolescent mothers who received dietary information and changed their eating habits during pregnancy showed better results concerning the consumption of energy and nutrients. Prenatal care was a key factor for improving the results of pregnancy, emphasizing the importance of providing dietary information.     

Dietary intakes of urban, high body mass index, African American children: family and child dietary attributes predict child intakes

ObjectiveTo identify family and child nutrition and dietary attributes related to children's dietary intakes.DesignAfrican American children (ages 8-11 years, n = 156), body mass index > 85th percentile, from urban, low-income neighborhoods. Baseline, cross-sectional data collected as part of an ongoing diabetes prevention intervention. Dietary intakes were collected by 3-day food diary to assess total energy, percent fat, discretionary fat, added sugar, whole grains, vegetables, fruit, meat, and dairy. Questionnaires on nutrition and dietary attributes administered to children and parents were used to develop 5 diet-related indices: child knowledge, child preferences, child snack habits, child beverage habits, and family food habits.ResultsA higher child nutrition knowledge score was significantly related to a lower starchy vegetable intake. Higher scores on the child snack habits index were significantly related to higher intakes of fruit, total fruits and vegetables, total fruits and nonstarchy vegetables, and to lower intakes of added sugars. A higher score on the family food habits index was significantly related to lower intakes of total energy and discretionary fat.Conclusions and ImplicationsTargeting both child and family food and nutrition attributes may be used to promote more healthful eating among urban, low-income, overweight African American children.     

Maternal Nutrition and Birth Size among Urban Affluent and Rural Women in India

Background: Varying results of worldwide intervention programs to pregnant mothers necessitate the need to understand the relationship between maternal nutrition and birth size among well nourished and undernourished mothers.

Objective: To examine this relationship among urban affluent mothers and to compare the findings with those on rural Indian mothers.

Subjects: Data collected on urban affluent mothers (n = 236) was compared with rural mothers (n = 633).

Design: Mothers were contacted at 18 ± 2 and 28 ± 2 wk of gestation for anthropometry, dietary intakes [24-hr recall, Food Frequency Questionnaire (FFQ)] and after delivery for neonatal anthropometry.

Results: Despite large differences in nutritional status of urban and rural mothers ( pre-pregnant weight 55.9 ± 9.2 Vs 41.5 ± 5.2 kg, respectively) maternal fat intakes at 18 wk were associated with birth weight (p < 0.05), length (p < 0.01) and triceps skin fold thickness (p < 0.05) of the newborn in urban and rural mothers. Consumption of fruits was associated with birth length (p < 0.05) in urban (18wk) and with birth weight (p < 0.01) and length (p < 0.01) in rural (28wk) mothers, when their energy intakes were low. Maternal consumption of milk too, was associated with newborn's triceps (p < 0.01) in urban (28wk) while with birth weight (p < 0.05) and length (p < 0.05) in rural (18wk) mothers. The findings mainly underscore the importance of consumption of micronutrient rich foods, when energy intakes are limiting during pregnancy, for improving birth size.

Conclusions: Creating nutritional awareness and motivating rural mothers for consuming micronutrient rich foods like green leafy vegetables and seasonal fruits that are easily available in rural areas, will be a much affordable solution for combating the problem of low birth weight rather than waiting for improvement in the existing nationwide programs for pregnant women.     

Sweetened Food Purchases and Indulgent Feeding Are Associated With Increased Toddler Anthropometry

ObjectiveTo explore the role of feeding practices and food purchases in toddler dietary intake and anthropometry.MethodsA convenience sample of Latino mother and toddler pairs were interviewed at baseline and at 6-month follow-up. Data on feeding practices, toddler dietary intake, anthropometry, and food purchases were collected using the Toddler-Feeding Questionnaire; 24-hour recalls; measurements of weight, height, and/or length; and food purchase receipts.ResultsIndulgent feeding scores and high intake of sweetened beverage were associated with a 0.52 increase (P = .03) and 0.46 increase in toddler weight-for-height z-score (P = .05), respectively. Households with 10 percentage points of more sweetened food and beverage expenditures were associated with increases in weight indicator z-scores.Conclusions and ImplicationsIndulgent feeding, high intake, and purchase of sweetened beverage are associated with weight gain in Latino toddlers. Programs should target food purchasing decisions and provide concrete guidance for the division of responsibility around feeding.