Search Results (81)

Background: Childhood obesity disproportionately affects Hispanic families in the U.S. Although parenting practices and interventions appear to be viable approaches to lower the risk of childhood obesity, there is limited information on which parenting practices would be relevant and culturally appropriate for Hispanic families. This study aimed to document the health-related factors that impact Hispanic parenting practices to inform evidence-based parenting interventions to improve child health outcomes and reduce the risk of childhood obesity. Methods: We conducted cross-sectional, formative research guided by the COREQ checklist. Hispanic parents of elementary school-aged children were recruited using purposive and snowball sampling. Eligible parents completed a brief sociodemographic survey, the Comprehensive Feeding Practices Questionnaire (CFPQ), and an individual semi-structured interview. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using a coding-based thematic approach. Results: Seventeen parents (88.2% female) participated in the study, and the majority reported Spanish as their preferred language (70.6%). According to parent-reported data, the children’s (52.9% female) mean age was 8.4 ± 1.5 years, and over half were classified as having overweight or obesity. The CFPQ analysis indicated that parents scored highest on subscales related to encouraging healthy eating and eating variety, a finding that was reinforced by interview data. Qualitative analysis identified four key themes: 1. parenting roles, routines, and strategies for promoting culturally appropriate and healthy meals; 2. beliefs of children’s health and weight; 3. beliefs on physical activity and screen time; and 4. environmental and social factors affecting access to healthy food and physical activity. Conclusions: Both quantitative and qualitative results emphasize that parents engage in healthy eating guidance and eating variety and are aware of the factors that impact parenting practices and their children’s health. To improve child health outcomes and reduce the risk of childhood obesity among Hispanic families, parenting interventions need to be culturally responsive and address the factors that influence parenting practices. The findings from this study highlight four key areas to prioritize when designing or adapting parenting interventions to lower the risk of childhood obesity among Hispanic families. Full article

Background: Poor nutrition in childhood can have irreversible impacts on development and health, potentially resulting in cognitive impairments and an increased risk of chronic disease later in life. Aim: This study aimed to develop and validate the Parent Carer-Food Choice Questionnaire (PC-FCQ) to determine the key factors influencing the parental food choices of children aged between two and five years. Methods: A sample of 737 Australian parents and carers completed the questionnaire consisting of 98 items on a 10-point frequency of influence anchored at 1 never to 10 always. Principal component analysis (PCA) was employed to identify the key factors and refine the questionnaire. Results: The PCA extracted 65 items organized into 12 factors explaining 62.8% of the total variance. The factors were named ethical concerns, nutritional attributes, child preferences, child mood, awareness, parent sensory, convenience, situation, culture, professional advice, accessibility and weight control. The final Kaiser–Meyer–Olkin measure was 0.93, and the Bartlett test of sphericity was statistically significant X2(4753) = 39,643.87, p < 0.001. Moderate intercorrelations were detected between seven factors. Conclusions: This research resulted in a PC-FCQ that includes factors specifically relevant to parental food choice. The PC-FCQ will enable researchers and clinicians to more effectively provide nutrition education and dietary interventions to suit the parent and child. The next phase of this research will be to test the accuracy and reliability of the PC-FCQ in an independent sample via confirmatory factor analysis. Full article

Background/Objectives: Early childhood represents a sensitive period for developing positive dietary preferences and important school readiness skills. However, few evidence-based programs leverage opportunities to support children’s development in both areas. Our study aimed to assess the preliminary effects of multi-level, teacher-led More PEAS Please! on Head Start children’s (3–5 years old) science knowledge, development of academic language, fruit-and-vegetable (FV) liking, and dietary quality. Methods: In this pilot study, we used a repeated-measure research design to assess child-level outcomes. Trained teachers implemented 16 food-based science-learning activities. We assessed child outcomes using validated measures of science knowledge, academic language, FV liking, and dietary quality (Veggie Meter^®). We used linear mixed models to examine changes from the baseline to post intervention. Fixed effects included age, sex, and race/ethnicity, while the center was treated as a random effect. Results: A total of 273 children were enrolled in the study. The children were mostly male (51.6%), Black/African American (82.1%) and, on average, 3.94 (SD = 0.70) years old. The children demonstrated significant improvements in science knowledge (T1 M = −0.01, SD = 0.82; T4 M = 0.33, SD = 0.90; 95% CI [0.17, 0.50]; p < 0.001) and vocabulary (T1 M = 14.4, SD = 4.5; T4 M = 16.7, SD = 5.3; 95% CI [1.4, 3.3]; p < 0.001). The children’s dietary quality improved from the baseline, but the changes were not significant. Conclusions: The findings suggest that the intervention may support improvements in science knowledge and academic vocabulary among preschool-aged children. We theorize a longer intervention with additional FV exposures may be needed to observe significant dietary changes. Future research should evaluate program effects with a comparison group. Full article

Background/Objectives: This study examines the relationship of eating in the absence of hunger (EAH) with child sex, food preference, and body mass index (BMI) percentiles in primarily Hispanic preschoolers, an understudied population. Methods: This was a secondary analysis of data from 211 children (79% Hispanic) aged 3 to 5 years from low-income families who completed a cluster randomized controlled trial from September 2017 to June 2020. Weight and height were used to calculate BMI percentiles. Sweet (animal crackers) and salty (pretzels) snacks were used to conduct a validated classroom-based EAH assessment. A generalized estimating equation (GEE) approach investigated associations between the grams of snacks consumed and BMI percentiles. A set of nested multivariable GEEs were estimated, while adjusting for potentially important covariates. Results: Boys significantly consumed more snacks than girls (13.34 ± 9.71 g vs. 8.13 ± 7.36 g; p < 0.001). Children who indicated greater preference for sweet snacks consumed more sweet snacks (r = 0.19; b = 2.05, p < 0.001) and total grams of total snacks (r = 0.18; b = 2.42, p = 0.004) but not salty snacks (pretzels). Consuming more sweet snacks was significantly associated with higher BMI percentiles (b = 0.55; p = 0.024). Conclusions: The findings suggest that a preference for sweet snacks is associated with EAH, and eating sweet snacks in the absence of hunger is related to higher BMI percentiles. Obesity prevention programs may focus on addressing eating sweet snacks in the absence of hunger starting in early childhood. Full article

Background: Childhood nutrition plays an important role in the promotion of long-term health. Introducing solid foods in alignment with the Mediterranean Diet during weaning fosters a preference for healthy foods early in life. However, access to nutritious diets remains a challenge in underserved communities. Scampia, a socioeconomically disadvantaged district in Naples, Italy, exemplifies a community where barriers to healthy eating persist. This research reports a trial protocol that plans for a study to evaluate the impact of the Mediterranean Diet on child health and to establish preventive strategies for chronic diseases. Methods: The PEMED (PrEventive effect of MEditerranean Diet in Children) trial is a Bayesian Sequential Pragmatic Cluster Randomized Clinical Trial. Family Pediatricians (FPs) are randomized to deliver either Mediterranean Diet-based dietary guidance starting at weaning or standard dietary practices using typical baby foods. Children will be followed up for six years, with regular assessments of growth, microbiome composition, and adherence to the Mediterranean Diet, using validated tools. Interim analyses will be conducted at three-year intervals to evaluate the efficacy and monitor adverse events. Saliva and stool samples will be collected for genetic and microbiome analyses, and adherence will be monitored through quarterly dietary recalls and biomarkers. Results: This trial will consider Italy’s established FP network for implementing innovative dietary intervention in a real-world setting. Conclusions: This study will address nutritional disparities in the underserved Scampia community and provide a scalable model for early dietary interventions. The results will shed light on the role of the Mediterranean Diet in improving childhood health and informing public health strategies globally. Full article

Background/Objectives: Complementary feeding (CF), is defined as the process of providing foods in addition to milk when breast milk or milk formula alone are no longer adequate to meet nutritional requirements. CF affects not only growth but also the subsequent development of the child’s dietary preferences. The Mediterranean diet (MedDiet) is one of the most studied dietary patterns worldwide. The main purpose of this article is to provide practical guidance for CF to caregivers introducing the Greek MedDiet, summarizing the current different approaches. The evidence-based information provided could be used by developers to create a reliable digital app for CF based on Mediterranean foods and traditional dishes. Methods: An in-depth literature review of the existing guidelines and recently published research data on CF using PubMed, national recommendations, and grey literature were undertaken. Results: Practical, simple, evidence-based, comprehensive tables are presented. The tables serve as a guide to simplify the process of introducing Mediterranean foods in CF. Τhe tables consist of a total of more than 90 foods and day-to-day guidance for the first 13 weeks of CF. Furthermore, specific dietary guidance and suggestions regarding the order and content of meals during CF are given. Discussion: The tables are based on updated recommendations, summarizing the optimal feeding practices in a MedDiet-based perspective. Conclusions: Conclusively, there are significant contradictions among different organizations that present practical issues and cause confusion among caregivers. An effort was carried out to provide practical evidence-based guidance for caregivers introducing MedDiet during CF. Full article

Food neophobia, defined as fear or aversion to eating new or unfamiliar foods, is a significant challenge, especially in the context of preschool children. In the scientific literature, this phenomenon is often described as a natural developmental stage, but its severity and impact on preferences and eating patterns still raise many questions. The purpose of the present study was to assess the prevalence of food neophobia in children aged 1 to 6 years and to analyze its relationship with eating habits, preferences, and eating patterns. The study was conducted using a proprietary questionnaire and validated research tools such as the Child Feeding Scale (MCH-FS) and Food Neophobia Scale (FNS). The study included 345 children, of whom 59.1% were observed to be at significant risk for food neophobia. The results of the study suggest that food neophobia is not a common phenomenon in children aged 1–2 years but becomes more pronounced later in childhood. Another important finding was that food neophobia shows a stronger association with established eating patterns than with individual taste preferences. Considering these results, this phenomenon should be considered not only as a natural part of child development, but also as a potential indicator of eating disorders that may require intervention. These findings underscore the need for further research that could deepen the understanding of the mechanisms governing food neophobia and its long-term consequences for child health. Full article

Infancy and early childhood are periods of dietary transition. Early exposure to specific foods and the establishment of dietary habits during this period can shape long-term food preferences and have lasting effects on health. This study aimed to examine the longitudinal trajectories of sugar-sweetened beverage (SSB) intake in Australian children from birth to age 3 years and identify early-life and socioeconomic factors influencing those trajectories. Mother–infant dyads (n = 934) from the Healthy Smiles Healthy Kids birth cohort study were interviewed on their weekly frequency of SSB intake at 4-month, 8-month, 1-year, 2-year, and 3-year age points. Group-based trajectory modelling analysis was performed to identify trajectories for SSB intake among Australian children. A multivariable logistic regression was performed to identify the maternal and child-related predictors of resulting trajectories. The intake of SSBs showed two distinct quadratic trajectories (high and low) with age. While the two trajectories remained distinctive throughout, the SSB consumption for both groups consistently increased between 4 months and 2 years of age and subsequently stabilised. Compared to low SSB consumers (75%), the high SSB consumers (25%) were significantly more likely to be living in households with three or more children (relative risk (RR): 1.59, 95%CI: 1.02–2.48), had low maternal education (left school < year 12—RR: 1.75, 95%CI: 1.09–2.81; completed year 12—RR: 1.57, 95%CI: 1.02–2.81), and resided in highly/the most socioeconomically disadvantaged areas (highly disadvantaged—RR: 1.89, 95%CI: 1.13–3.18; most disadvantaged—RR: 2.06, 95%CI: 1.25–3.38). Children’s SSB intake patterns are established early in life as they transition from infancy to preschool age, and the trajectories of intake established during early childhood are strongly influenced by socioeconomic factors. Hence, interventions targeted to limit SSB intake and improve nutrition amongst children should occur in early life. Full article

Responsive feeding (RF), the reciprocal feeding approach between caregiver and child that promotes child health, is understudied among low-income caregivers. This mixed methods study with low-income caregivers of 12-to-36-month-olds aimed to (1) assess variability in RF and associations with children’s dietary intake, and (2) explore caregivers’ perceptions of RF. Caregivers (n = 134) completed an online survey with RF questions (n = 25), grouped into environmental (meal environment, caregiver modeling, caregiver beliefs) and child (self-regulation, hunger/satiety cues, food for reward, food acceptance) influences scores. Children’s recent food group consumption was loaded onto healthy and less healthy intake scores. In an adjusted multiple linear regression analysis, greater RF scores for environmental and child influences were associated with greater healthy intake scores (p’s < 0.01). Greater scores for environmental influences were also associated with lower scores for unhealthy intake (p < 0.01). From focus groups with a separate sample of caregivers (n = 24), thematic analysis uncovered that two themes aligned (trust in child cues, positive strategies to encourage children to eat non-preferred foods) and two misaligned (lack of trust in child cues, use of force/bribery) with RF. Complementary integration of quantitative and qualitative findings can inform future interventions with low-income caregivers, encouraging trust in young children’s hunger/satiety cues and positive strategies for food acceptance to improve diet quality. Full article

Poor eating habits have been correlated with an increased probability of developing chronic health problems, including weight gain. In particular, dietary choices during the first years of life can have a lasting impact on dietary preferences and habits. Parents strongly influence the child’s relationship with food which will be maintained for the rest of their life; in particular, a greater sense of maternal self-efficacy is correlated with healthier eating habits and the child being less overweight. To date, there are few studies investigating the relationship between parental eating habits, self-efficacy in promoting healthy behaviors and the use of social media (SM). The general purpose of our study is to investigate the eating habits of families, food awareness and choices and the use of SM to search for pediatric nutrition content. The habits were collected through a questionnaire administered online on the most popular SM platforms. Data show that parents take care of their children’s food choices (96.1%) and rarely comply with their requests (77.9%). More than half read product labels (56.1%) and the origin (43.9%) before purchasing. Overall, 44.1% are influenced by TV and newspapers regarding their purchases, while 39.4% are influenced by the opinions of their friends and relatives. Food style correlates positively with the influence of TV and newspapers (r = 0.238) and the influence of friends and relatives (r = 0.231). Overall, 77.1% aim to follow a healthy diet, even if fish (24.5%) and vegetables (36.3%) are difficult to include in the child’s diet. Instagram (50.2%) and Facebook (36.3%) are the SM platforms most used to search for information on pediatric nutrition. Health professionals’ (60.3%) and institutions’ (24.9%) profiles are the most followed for reading articles and blogs (59.4%), but without direct interactions (78.9%). Only 20% are satisfied with the content found. Parental self-efficacy in promoting a healthy diet for their children correlates positively and moderately with encouragement to follow a healthy diet (r = 0.340) and control over the amount of snacks and sweets consumed (r = 0.302). The data demonstrate parents’ interest in using SM to search for information on pediatric nutrition but indicates that few (33.3%) are satisfied with what they find online. Therefore, future educational interventions need to be refined to help parents to better influence children’s eating habits. Full article

Diet is an essential element of treating and managing type 1 diabetes (T1D). However, limited research has examined food behaviour in children and adolescents with T1D and their relationship to glycaemic control. This study evaluated food behaviour, metabolic characteristics and their impact on the glycaemic control of children and adolescents with T1D. Two hundred and fifty-eight participants with T1D (6–15 years, duration of diabetes >1 year) were recruited. Demographic, anthropometric and clinical data were collected. Questionnaires on food neophobia and food preferences were administered. The Child Food Questionnaire (CFQ) also assessed parental feeding practices. An analysis of food behaviour showed that food neophobia was inversely associated with the liking of vegetables, fruits, fish, sweets and carbohydrates. Moreover, by analysing parental feeding practices, an inverse association of “Pressure to eat”, “Monitoring” and “Restriction” with liking for vegetables and carbohydrates emerged. Considering glycaemic control, increased food neophobia and the parent practices “Restriction”, “Pressure to eat” and “Concern about weight” were found in participants with glycated haemoglobin (HbA1c) values >8.5%. Finally, higher body mass index (BMI) and total cholesterol values were observed in subjects with HbA1c values >8.5%. These findings contribute to a better understanding of eating behaviour, metabolic status and their complex relationship with glycaemic control. Full article

The phenomenon of overweight and obesity constitutes a threat for health and children’s lives at preschool age. Eating habits formed during this period seriously affect not only future dietary preferences but also the development of diet-related diseases. The purpose of the present study was the assessment of the relationship between the state of knowledge of children’s nutrition and parents’ eating behaviour and the prevalence of overweight and obesity in children aged 4–6 years. The study was conducted using 200 parent–child pairs. The behaviour and nutritional knowledge of parents was assessed using a questionnaire method. In contrast, anthropometric measurements were taken among the children. Nutritional disorders were noted in 46.5% of children of whom 39.0% struggled with overweight and 7.5% with obesity. The study showed that the children of parents with higher levels of nutritional knowledge were more likely to develop overweight and obesity. It also proved that irregularity of parental food intake predisposed the development of excessive body weight in children (p = 0.0049). Therefore, it is reasonable to undertake further investigation into factors implying the development of nutritional disorders among those youngest. Early recognition of dietary mistakes can contribute to their elimination at an early age. Full article

Although children from limited-resource families in rural areas are at great risk for nutrition-related chronic diseases, few hands-on programs have been implemented that simultaneously engage both parents and children and include local produce in a single program. This study reports on the development, implementation, and evaluation of Cooking with the Seasons for Health (CwS4H). Parent–child pairs participated in six sessions (two weekly sessions during each of three growing seasons), which included food tasting, a spotlight vegetable, interactive mini nutrition lesson, a child-focused cooking lesson, hands-on meal preparation, distribution of materials as family guides, and a take-home bag of fresh produce. Pre- and postprogram survey data were collected from 23 parents and 22 children. Children reported improvements in nutrition knowledge, vegetable preference, and self-efficacy in food preparation and cooking. Parents reported gains in nutrition knowledge, nutritional behaviors, vegetable preference, attitude toward food preparation/cooking, involvement of the child in food preparation/cooking, confidence in preparing vegetables, and the child’s vegetable intake. Parents commented on the value children placed on food preparation and produce selection and how the program enhanced the parent–child relationship. By focusing CwS4H on a variety of fresh vegetables, this intervention helped to impact children’s vegetable intake behaviors by engaging children in preparing and choosing the food they eat. Full article

Background: In Lao PDR, acute malnutrition remains a public health problem, with around 9% of children under 5 being affected. Outpatient treatment of severe acute malnutrition requires ready-to-use therapeutic foods (RUTFs), but concerns have been raised about the acceptability of globally available products. Culturally acceptable RUTFs could be locally developed, but data are lacking on RUTF preferences in Lao PDR. Methods: In a crossover-designed study, four different RUTFs were tested for short-term acceptability and organoleptic qualities (two globally available: peanut-based, which is the current standard, and wheat–milk-based RUTFs; two regionally produced: a mung-bean-based and a fish–rice-based RUTF). Organoleptic properties were evaluated by 83 caretaker–child pair participants through a taste test and a 30 min consumption test. Short-term acceptability was assessed through a 3-day intake test. The study sites were in Phongsaly (North Laos) and Attapeu (South Laos). Focus group discussions were conducted at the beginning and the end of the study. Results: The mung bean RUTF was the favorite among caretakers, with an acceptability percentage of 96.2%, and scored better (p-value < 0.05) for all organoleptic variables than the other three RUTFs. Overall, 3 days after receiving take-home rations, the mean percentage of consumption was above 80% for all the RUTFs, with the mung bean product being the most consumed. Conclusions: The regionally produced mung bean RUTF was the most accepted, whereas the other regionally produced fish-based RUTF was the least accepted, showing the complexity of finding culturally acceptable solutions to fight malnutrition. For Lao PDR, a mung-bean-based RUTF seems the way forward, even if the current standard peanut-based RUTF appeared to be acceptable, albeit not the most preferred. Full article

Taste perception is a well-documented driving force in food selection, with variations in, e.g., taste receptor encoding and glucose transporter genes conferring differences in taste sensitivity and food intake. We explored the impact of maternal innate driving forces on sweet taste preference and intake and assessed whether their children differed in their intake of sweet foods or traits related to sweet intake. A total of 133 single nucleotide polymorphisms (SNPs) in genes reported to associate with eating preferences were sequenced from saliva-DNA from 187 mother-and-child pairs. Preference and intake of sweet-, bitter-, sour-, and umami-tasting foods were estimated from questionnaires. A total of 32 SNP variants associated with a preference for sweet taste or intake at a p-value < 0.05 in additive, dominant major, or dominant minor allele models, with two passing corrections for multiple testing (q < 0.05). These were rs7513755 in the TAS1R2 gene and rs34162196 in the OR10G3 gene. Having the T allele of rs34162196 was associated with higher sweet intake in mothers and their children, along with a higher BMI in mothers. Having the G allele of rs7513755 was associated with a higher preference for sweets in the mothers. The rs34162196 might be a candidate for a genetic score for sweet intake to complement self-reported intakes. Full article