Mealtime Regularity Is Associated with Dietary Balance among Preschool Children in Japan—A Study of Lifestyle Changes during the COVID-19 Pandemic
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants and Design
2.2. Calculating the Healthy Diet Score (HDS)
2.3. Changes in the HDS during COVID-19: Changed-Healthy Diet Score (C-HDS)
2.4. Ethical Considerations
2.5. Analysis
2.5.1. Data Set for Analysis
2.5.2. Statistical Analysis
3. Results
3.1. Comparison of Participant Characteristics according to Changes in Mealtime Regularity Compared with before COVID-19
3.2. Comparison of the Healthy Diet Score (HDS) according to Changes in Mealtime Regularity Compared with before COVID-19
3.3. Multiple Regression Analyses with the Healthy Diet Score (HDS) as the Dependent Variable
3.4. Multiple Logistic Regression Analysis with the Change in Healthy Diet Score (C-HDS) as the Dependent Variable
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Became Regular | Originally Regular, No Change | Became Irregular | Originally Irregular, No Change | ||||||
---|---|---|---|---|---|---|---|---|---|
(n = 125) | (n = 1514) | (n = 63) | (n = 148) | ||||||
Respondent’s relationship to the child | Father | 56 | (44.8) | 618 | (40.8) | 22 | (34.9) | 74 | (50.0) |
Mother | 69 | (55.2) | 896 | (59.2) | 41 | (65.1) | 74 | (50.0) | |
Employment status of the child’s mother | Employed | 78 | (62.4) | 827 | (54.6) | 38 | (60.3) | 74 | (50.0) |
Other | 47 | (37.6) | 687 | (45.4) | 25 | (39.7) | 74 | (50.0) | |
Child’s sex | Boy | 69 | (55.2) | 752 | (49.7) | 30 | (47.6) | 68 | (45.9) |
Girl | 56 | (44.8) | 762 | (50.3) | 33 | (52.4) | 80 | (54.1) | |
Child’s age (years) | 3.2 | ±1.4 | 3.4 | ±1.4 | 3.2 | ±1.4 | 2.9 | ±1.4 | |
Height (cm) | 105.6 | ±12.1 | 105.9 | ±11.4 | 105.6 | ±12.1 | 102.9 | ±11.5 | |
Weight (kg) | 17.3 | ±4.6 | 17.3 | ±3.9 | 17.2 | ±4.1 | 16.5 | ±3.7 | |
BMI percentile | 46.7 | ±36.0 | 44.9 | ±34.2 | 39.7 | ±32.0 | 49.9 | ±33.2 |
Became Regular | Originally Regular, No Change | Became Irregular | Originally Irregular, No Change | p Value * | ||||||
---|---|---|---|---|---|---|---|---|---|---|
(n = 125) | (n = 1514) | (n = 63) | (n = 148) | |||||||
Wakeup time | Before 8 a.m. on weekdays and holidays | 83 | (66.4) | 1066 | (70.4) | 32 | (50.8) | 54 | (36.5) | <0.001 |
Other | 42 | (33.6) | 448 | (29.6) | 31 | (49.2) | 94 | (63.5) | ||
Bed time | Before 10 p.m. on weekdays and holidays | 91 | (72.8) | 1156 | (76.4) | 34 | (54.0) | 53 | (35.8) | <0.001 |
Other | 34 | (27.2) | 358 | (23.6) | 29 | (46.0) | 95 | (64.2) | ||
Physical activity time (weekdays) | <1 h (/day) | 68 | (54.4) | 708 | (47.0) | 35 | (55.6) | 74 | (51.0) | 0.200 |
≥1 h (/day) | 57 | (45.6) | 799 | (53.0) | 28 | (44.4) | 71 | (49.0) | ||
Physical activity time (holidays) | <1 h (/day) | 69 | (55.2) | 743 | (49.3) | 35 | (55.6) | 74 | (50.7) | 0.485 |
≥1 h (/day) | 56 | (44.8) | 764 | (50.7) | 28 | (44.4) | 72 | (49.3) | ||
Screen time (weekdays) | <2 h (/day) | 97 | (79.5) | 1219 | (80.8) | 44 | (71.0) | 98 | (66.7) | <0.001 |
≥2 h (/day) | 25 | (20.5) | 289 | (19.2) | 18 | (29.0) | 49 | (33.3) | ||
Screen time (holidays) | <2 h (/day) | 85 | (69.7) | 983 | (65.2) | 37 | (59.7) | 76 | (52.4) | 0.009 |
≥2 h (/day) | 37 | (30.3) | 525 | (34.8) | 25 | (40.3) | 69 | (47.6) | ||
Frequency of defecation | Almost every day | 94 | (76.4) | 1072 | (70.9) | 34 | (54.0) | 105 | (71.4) | 0.014 |
Other | 29 | (23.6) | 439 | (29.1) | 29 | (46.0) | 42 | (28.6) | ||
Snack frequency | 0−1 time (/day) | 79 | (64.8) | 1056 | (70.1) | 31 | (50.0) | 84 | (57.9) | <0.001 |
2 times (/day) | 37 | (30.3) | 390 | (25.9) | 25 | (40.3) | 40 | (27.6) | ||
≥3 times (/day) | 6 | (4.9) | 60 | (4.0) | 6 | (9.7) | 21 | (14.5) | ||
Breakfast frequency | Eat every day | 112 | (89.6) | 1442 | (95.2) | 47 | (74.6) | 116 | (78.4) | <0.001 |
Other | 13 | (10.4) | 72 | (4.8) | 16 | (25.4) | 32 | (21.6) | ||
Eat together (breakfast) | Eat with an adult | 106 | (86.2) | 1249 | (82.7) | 51 | (81.0) | 97 | (67.4) | <0.001 |
Other | 17 | (13.8) | 262 | (17.3) | 12 | (19.0) | 47 | (32.6) | ||
Eat together (dinner) | Eat with an adult | 122 | (97.6) | 1457 | (96.4) | 61 | (96.8) | 135 | (91.8) | 0.041 |
Other | 3 | (2.4) | 55 | (3.6) | 2 | (3.2) | 12 | (8.2) | ||
How often the respondent cooks | 1−2 times per week | 36 | (28.8) | 469 | (31.2) | 20 | (31.7) | 55 | (37.9) | 0.474 |
3−6 times per week | 27 | (21.6) | 330 | (22.0) | 17 | (27.0) | 34 | (23.4) | ||
Every day | 62 | (49.6) | 702 | (46.8) | 26 | (41.3) | 56 | (38.6) | ||
Frequency with which the child is involved in cooking | Rarely | 41 | (32.8) | 672 | (44.4) | 17 | (27.4) | 82 | (55.4) | <0.001 |
≥1 time per week | 84 | (67.2) | 840 | (55.6) | 45 | (72.6) | 66 | (44.6) | ||
Someone in the family works remotely | 51 | (40.8) | 390 | (25.8) | 25 | (39.7) | 28 | (18.9) | <0.001 | |
Financial security | Yes | 54 | (43.5) | 567 | (37.5) | 24 | (38.1) | 38 | (25.7) | 0.003 |
Neither yes nor no | 42 | (33.9) | 459 | (30.4) | 19 | (30.2) | 42 | (28.4) | ||
No | 28 | (22.6) | 484 | (32.1) | 20 | (31.7) | 68 | (45.9) | ||
Has free time | Yes | 40 | (32.3) | 452 | (29.9) | 16 | (25.4) | 29 | (19.6) | 0.039 |
Neither yes nor no | 44 | (35.5) | 479 | (31.7) | 15 | (23.8) | 52 | (35.1) | ||
No | 40 | (32.3) | 580 | (38.4) | 32 | (50.8) | 67 | (45.3) |
Became Regular | Originally Regular, No Change | Became Irregular | Originally Irregular, No Change | p Value | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
(n = 125) | (n = 1516) | (n = 63) | (n = 148) | ||||||||||
Current intake of the different food groups | |||||||||||||
Healthy Diet Score * (0−40 points) | 29.7 | ±4.7 | a | 31.6 | ±4.0 | abc | 29.6 | ±4.8 | b | 28.3 | ±4.6 | c | <0.001 |
Grain dishes, main dishes (mean), and side dishes (0−12 points) | 9.1 | ±2.4 | a | 9.3 | ±1.8 | b | 8.6 | ±2.5 | 8.2 | ±2.2 | ab | <0.001 | |
Grain dishes, main dishes (mean), side dishes, fruit, and dairy products (0−20 points) | 15.3 | ±3.8 | a | 15.7 | ±3.0 | b | 14.8 | ±3.9 | 13.9 | ±3.3 | ab | <0.001 | |
Grain dishes, main dishes (total), side dishes, fruit, and dairy products ** (0−32 points) | 23.8 | ±6.0 | a | 23.8 | ±4.6 | b | 22.8 | ±5.7 | 21.1 | ±5.1 | ab | <0.001 | |
Infrequently consuming unhealthy foods (0−16 points) † | 11.0 | ±3.8 | a | 12.2 | ±2.7 | ab | 11.4 | ±3.3 | 11.0 | ±2.9 | b | <0.001 | |
Changes compared with before the pandemic # | |||||||||||||
Changed Healthy Diet Score # (−13~+13) | 0.8 | ±2.3 | abc | 0.1 | ±1.3 | a | −0.1 | ±1.6 | b | 0.0 | ±1.0 | c | <0.001 |
Increased score (−4~9 points) | 0.9 | ±2.0 | ab | 0.1 | ±1.1 | a | 0.3 | ±1.5 | 0.0 | ±0.9 | b | <0.001 | |
Decreased score (−9~4 points) | −0.1 | ±1.0 | 0.0 | ±0.5 | a | −0.4 | ±0.9 | ab | 0.0 | ±0.5 | b | <0.001 |
Item Category | Simple Regression | Model 1 | Model 2 | |||||
---|---|---|---|---|---|---|---|---|
Standardized Coefficient β | p Value | Standardized Coefficient β | p Value | Standardized Coefficient | p Value | |||
Basic attributes | Relationship to child | 0.163 | <0.001 | 0.156 | <0.001 | 0.110 | <0.001 | # |
Employment status of child’s mother | −0.061 | 0.009 | −0.038 | 0.119 | −0.006 | 0.788 | ||
Child’s sex | 0.018 | 0.448 | 0.026 | 0.280 | 0.040 | 0.070 | ||
Child’s age | −0.043 | 0.065 | −0.019 | 0.425 | −0.075 | 0.001 | # | |
BMI percentile | −0.051 | 0.037 | −0.036 | 0.137 | −0.016 | 0.462 | ||
Lifestyle habits | Wakeup time (weekdays and holidays) | −0.143 | <0.001 | −0.052 | 0.028 | −0.054 | 0.025 | # |
Bed time (weekdays and holidays) | −0.174 | <0.001 | −0.079 | 0.001 | −0.093 | <0.001 | # | |
Physical activity time (weekdays) | 0.079 | 0.008 | 0.033 | 0.196 | ||||
Physical activity time (holidays) | 0.079 | 0.001 | 0.045 | 0.075 | 0.077 | <0.001 | # | |
Screen time (weekdays) | −0.101 | <0.001 | −0.009 | 0.757 | ||||
Screen time (holidays) | −0.089 | 0.001 | −0.027 | 0.326 | ||||
Frequency of defecation | 0.136 | <0.001 | 0.101 | <0.001 | 0.107 | <0.001 | # | |
Snack frequency | −0.291 | <0.001 | −0.233 | <0.001 | −0.236 | <0.001 | # | |
Breakfast frequency | 0.249 | <0.001 | 0.141 | <0.001 | 0.137 | <0.001 | # | |
Originally regular meal times | 0.229 | <0.001 | 0.139 | <0.001 | 0.131 | <0.001 | # | |
Household circumstances | Eat together (breakfast) | 0.070 | 0.003 | 0.059 | 0.013 | 0.022 | 0.326 | |
Eat together (dinner) | 0.062 | 0.008 | 0.051 | 0.031 | 0.034 | 0.134 | ||
How often the respondent cooks | ||||||||
Every day | 0.192 | <0.001 | 0.187 | <0.001 | 0.092 | 0.007 | # | |
3−6 times a week | −0.099 | <0.001 | −0.007 | 0.795 | −0.013 | 0.650 | ||
Rarely | - | - | - | |||||
Frequency with which the child is involved in cooking | 0.034 | 0.149 | 0.017 | 0.468 | ||||
Someone in the family works remotely | −0.024 | 0.305 | −0.022 | 0.336 | ||||
Financial security | ||||||||
Yes | 0.067 | 0.004 | 0.028 | 0.319 | 0.021 | 0.423 | ||
No | −0.062 | 0.008 | −0.061 | 0.034 | −0.021 | 0.419 | ||
Neither yes nor no | - | - | - | |||||
Has free time | ||||||||
Yes | 0.033 | 0.151 | 0.035 | 0.202 | ||||
No | 0.011 | 0.647 | 0.052 | 0.064 | ||||
Neither yes nor no | - | - | - |
n (%) | Increase # | p Value | Decrease # | p Value | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
OR (95% CI) | OR (95% CI) | ||||||||||||
Meal regularity | Became regular | 125 | (6.7) | 2.21 | (1.35 | − | 3.61) | 0.002 | 1.50 | (0.80 | − | 2.80) | 0.205 |
Became irregular | 63 | (3.4) | 1.23 | (0.60 | − | 2.53) | 0.564 | 1.85 | (0.92 | − | 3.72) | 0.083 | |
No change | 1664 | (89.8) | 1.00 | 1.00 |
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Tada, Y.; Ueda, Y.; Sasaki, K.; Sugiura, S.; Suzuki, M.; Funayama, H.; Akiyama, Y.; Haraikawa, M.; Eto, K. Mealtime Regularity Is Associated with Dietary Balance among Preschool Children in Japan—A Study of Lifestyle Changes during the COVID-19 Pandemic. Nutrients 2022, 14, 2979. https://doi.org/10.3390/nu14142979
Tada Y, Ueda Y, Sasaki K, Sugiura S, Suzuki M, Funayama H, Akiyama Y, Haraikawa M, Eto K. Mealtime Regularity Is Associated with Dietary Balance among Preschool Children in Japan—A Study of Lifestyle Changes during the COVID-19 Pandemic. Nutrients. 2022; 14(14):2979. https://doi.org/10.3390/nu14142979
Chicago/Turabian StyleTada, Yuki, Yukari Ueda, Kemal Sasaki, Shiro Sugiura, Mieko Suzuki, Hiromi Funayama, Yuka Akiyama, Mayu Haraikawa, and Kumi Eto. 2022. "Mealtime Regularity Is Associated with Dietary Balance among Preschool Children in Japan—A Study of Lifestyle Changes during the COVID-19 Pandemic" Nutrients 14, no. 14: 2979. https://doi.org/10.3390/nu14142979