Factors Associated with the Initiation of Added Sugar among Low-Income Young Children Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in the US
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Study Design
2.2. Sample
2.3. Outcome Measures
2.4. Age Stratification for Objectives 1 and 3
2.5. Independent Measures Explored to Address Objective 2
2.6. Statistical Analysis
3. Results
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study Participants Weighted Column % n = 3835 | Earliest Reported Feeding of Added Sugar to Infant/Toddler ≤ 24 Months 2 Weighted Column % n = 3328 (87%) | Introduced Added Sugar after 24 Months 2 n = 507 (13%) | |||
---|---|---|---|---|---|
Characteristics 3 | Birth to 24 Months | ≤7 Months n (%) 834 (25) | 8 to 13 Months n (%) 2155 (65%) | 14 to ≤24 Months n (%) 339 (10) | >24 Months |
Age of caregiver at childbirth | |||||
16–19 years | 450 (12.8) | 120 (15.7) | 221 (9.7) | 43 (13.0) | 76 (18.0) |
20–25 years | 1591 (39.5) | 355 (40.7) | 887 (39.1) | 144 (39.3) | 205 (42.6) |
26 years or older | 1779 (47.6) | 358 (43.5) | 1057 (51.2) | 152 (47.7) | 212 (39.4) |
Caregiver’s race/ethnicity | |||||
Hispanic | 1560 (50.7) | 327 (51.0) | 871 (49.0) | 147 (53.0) | 215 (50.0) |
Non-Hispanic White | 1018 (23.9) | 230 (23.0) | 586 (26.1) | 59 (15.8) | 143 (27.0) |
Non-Hispanic African American | 885 (18.1) | 198 (19.3) | 502 (18.2) | 96 (22.1) | 89 (15.4) |
Non-Hispanic others | 326 (7.2) | 70 (6.8) | 174 (6.7) | 30 (9.1) | 52 (7.6) |
Marital status | |||||
Married | 1148 (33.2) | 225 (30.6) | 687 (34.1) | 94 (38.7) | 142 (27.3) |
Not married | 2672 (66.8) | 608 (69.4) | 1468 (65.9) | 245 (61.3) | 351 (72.7) |
Caregiver’s education | |||||
High school or less | 2368 (61.5) | 533 (68.4) | 1279 (58.3) | 228 (68.5) | 328 (73.5) |
More than high school | 1442 (38.5) | 298 (31.6) | 872 (47.7) | 110 (31.5) | 162 (26.5) |
Caregiver’s employment status 4 | |||||
Full time (35 h or more) | 669 (19.8) | 151 (17.4) | 412 (19.2) | 61 (25.5) | 45 (24.7) |
Part time | 625 (18.9) | 168 (18.9) | 375 (19.4) | 52 (12.3) | 30 (19.5) |
Not working | 1829 (61.3) | 480 (63.8) | 1123 (61.4) | 143 (61.9) | 83 (53.8) |
Household poverty level at enrollment | |||||
<75% of poverty guideline | 2415 (61.8) | 563 (68.8) | 1318 (60.5) | 219 (59.3) | 315 (62.1) |
75–130% of poverty guideline | 1035 (27.3) | 207 (22.9) | 594 (27.8) | 99 (32.9) | 135 (26.6) |
>130% of poverty guideline | 385 (10.9) | 64 (8.4) | 243 (11.7) | 21 (7.8) | 57 (11.2) |
Mother’s Body Mass Index category at screening | |||||
Normal or underweight | 1716 (46.1) | 578 (29.7) | 1197 (55.5) | 155 (46.2) | 253 (48.3) |
Overweight or obese | 2119 (53.9) | 683 (70.3) | 958 (44.5) | 205 (53.8) | 254 (50.1) |
Parity | |||||
First birth | 1593 (43.0) | 375 (44.9) | 891 (42.5) | 123 (35.0) | 204 (41.9) |
Second birth | 1030 (26.1) | 206 (26.3) | 584 (25.8) | 108 (35.0) | 132 (25.4) |
Third or more birth | 1197 (30.9) | 252 (29.8) | 680 (31.7) | 108 (30.0) | 157 (32.7) |
Childbirth weight | |||||
Low | 278 (6.8) | 57 (7.4) | 153 (7.3) | 30 (8.9) | 38 (7.1) |
Normal | 3492 (92.1) | 766 (91.4) | 1972 (91.6) | 306 (90.3) | 448 (92.1) |
High | 50 (1.1) | 10 (1.2) | 30 (1.1) | 3 (0.88) | 7 (0.77) |
Child sex | |||||
Male | 1961 (50.3) | 428 (48.8) | 1089 (49.2) | 184 (57.9) | 260 (46.9) |
Female | 1874 (49.7) | 406 (51.3) | 1066 (50.8) | 155 (42.1) | 247 (48.7) |
Baby born >3 weeks before due date | |||||
Yes | 356 (9.2) | 59 (9.6) | 218 (10.2) | 41 (14.4) | 38 (8.0) |
No | 3068 (90.7) | 690 (90.4) | 1738 (89.8) | 258 (85.6) | 382 (92.0) |
Characteristics | Hazards Ratio | (95% CI) | p-Value |
---|---|---|---|
Age of caregiver at childbirth | |||
16–19 years | 0.90 | 0.89–0.91 | <0.0001 |
20–25 years | 0.94 | 0.93–0.95 | <0.0001 |
26 years or older | Reference | Reference | |
Caregiver’s race/ethnicity | |||
Hispanic | 1.30 | 1.29–1.32 | <0.0001 |
Non-Hispanic White | 1.08 | 1.07–1.09 | <0.0001 |
Non-Hispanic African American | Reference | Reference | |
Non-Hispanic others | 1.05 | 1.04–1.07 | <0.0001 |
Marital status | |||
Married | Reference | Reference | |
Not married | 1.01 | 1.00–1.02 | 0.0361 |
Caregiver’s education | |||
High school or less | 1.07 | 1.07–1.08 | <0.0001 |
More than high school | Reference | Reference | |
Caregiver’s employment status | |||
Full time (35 h or more) | 1.13 | 1.12–1.14 | <0.0001 |
Part time | 1.11 | 1.10–1.12 | <0.0001 |
Not working | Reference | Reference | |
Household poverty level at enrollment | |||
<75% of poverty guideline | 1.03 | 1.01–1.04 | <0.0001 |
75–130% of poverty guideline | 1.00 | 0.99–1.01 | 0.4614 |
>130% of poverty guideline | Reference | Reference | |
Caregiver’s weight status | |||
Normal or underweight | Reference | Reference | |
Overweight or obese | 1.04 | 1.04–1.05 | <0.0001 |
Parity | |||
First birth | Reference | Reference | |
Second birth | 0.95 | 0.94–0.96 | <0.0001 |
Third or more birth | 0.94 | 0.93–0.95 | <0.0001 |
Child birthweight | |||
Low | 0.90 | 0.89–0.92 | <0.0001 |
Normal | Reference | Reference | |
High | 0.97 | 0.94–1.00 | 0.0232 |
Child sex | |||
Male | Reference | Reference | |
Female | 1.04 | 1.04–1.05 | <0.0001 |
Premature birth | |||
Yes | 1.07 | 1.05–1.08 | <0.0001 |
No | Reference | Reference |
Ranking | From Birth–7 Months Fed Any Added Sugar n = 834 | Top Added Sugar Food Intake between 8–13 Months n = 2989 | Top Added Sugar Food Intake between 14–24 Months n = 3328 | |||
---|---|---|---|---|---|---|
Food Item | % of Children Fed This Item | Food Item | % of Children Fed This Item | Food Item | % of Children Fed This Item | |
1 | Baby cereal | 64.9 | Baby cereal | 58.8 | Crackers | 47.0 |
2 | Crackers | 42.1 | Crackers | 50.0 | Sweetened beverage | 27.0 |
3 | Apple sauce | 30.6 | Apple sauce | 31.0 | Yogurt | 25.4 |
4 | Dessert | 26.6 | Dessert | 30.0 | Sugar, syrup, preserves | 23.8 |
5 | Cookie | 19.8 | Cookie | 22.2 | Presweetened cereal | 23.0 |
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Bably, M.B.; Paul, R.; Laditka, S.B.; Racine, E.F. Factors Associated with the Initiation of Added Sugar among Low-Income Young Children Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in the US. Nutrients 2021, 13, 3888. https://doi.org/10.3390/nu13113888
Bably MB, Paul R, Laditka SB, Racine EF. Factors Associated with the Initiation of Added Sugar among Low-Income Young Children Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in the US. Nutrients. 2021; 13(11):3888. https://doi.org/10.3390/nu13113888
Chicago/Turabian StyleBably, Morium B., Rajib Paul, Sarah B. Laditka, and Elizabeth F. Racine. 2021. "Factors Associated with the Initiation of Added Sugar among Low-Income Young Children Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in the US" Nutrients 13, no. 11: 3888. https://doi.org/10.3390/nu13113888
APA StyleBably, M. B., Paul, R., Laditka, S. B., & Racine, E. F. (2021). Factors Associated with the Initiation of Added Sugar among Low-Income Young Children Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in the US. Nutrients, 13(11), 3888. https://doi.org/10.3390/nu13113888