Children's Dietary Intake Research Articles

The myth and reality of familial resemblance in dietary intake: a systematic review and meta-analysis on the resemblance of dietary intake among parent and offspring.

There is a strong societal belief that parents are role models for their child's dietary behaviours in early life that may persist throughout the life course. Evidence has shown inconclusive dietary resemblance in parent-child (PC) pairs. This systematic review and meta-analysis aimed to examine dietary resemblance between parent and children. We systematically searched for studies on PC dietary resemblance, via six electronic databases (PubMed, Ovid MEDLINE, Embase, APA PsycNet, CINAHL, and Web of Science) and other grey sources of literature between 1980 and 2020. We performed quality effect meta-analysis model on transformed correlation coefficients (z) to examine the resemblance in dietary intakes including nutrient intakes, food group intakes and whole diet. Finally, the Fisher's transformed coefficient (z) was used for meta-regression analysis to identify potential moderators. Heterogeneity and inconsistency were examined using the Q and I2 statistic. The study is registered on PROSPERO, CRD42019150741. A total of 61 studies met the inclusion criteria for systematic review, 45 were included in the meta-analysis. Pooled analyses showed weak to moderate PC dietary intake associations for energy: (r: 0.19; 95% CI: 0.16, 0.22), fat (% energy): (r: 0.23; 95% CI: 0.16, 0.29), protein (% energy): (r: 0.24; 95% CI: 0.20, 0.27), carbohydrate (% energy): (r: 0.24; 95% CI: 0.19, 0.29), fruits and vegetable (g/d): (r: 0.28; 95% CI: 0.25, 0.32), confectionary food (g/d): (r: 0.20; 95% CI: 0.17, 0.23), and whole diet (r: 0.35; 95% CI: 0.28, 0.42). Dietary intakes associations by study characteristics, including population, study year, dietary assessment method, person reporting dietary intake, quality of the study, and study design were highly variable, but associations were similar between PC pairs. The resemblance among parent-child pairs was weak to moderate for most aspects of dietary intakes. These findings challenge the social myth that parental dietary intake behaviour shapes their child's dietary intake. None.

Assessments of energy, macro and micronutrient intakes in children and adolescents with type 1 diabetes mellitus

Objective: This study aims at examining dietary intake in children and adolescents with type 1 diabetes mellitus (DM) and comparing
 the results with national dietary intake recommendations.
 Patients and Methods: One hundred fifty children and adolescents (52.7% female) with an average age of 12.2±3.1 years and with
 type 1 DM who were followed by the Pediatric Endocrinology Polyclinic participated in the study. Three-day food intake records and
 clinical information regarding the type 1 DM condition of the participants were obtained.
 Results: No gender-related significant difference was found among the participants regarding food intake. The percentage of energy
 derived from fat (average 39.6%) and saturated fat (16.1%) were higher than the recommended levels in both gender groups. The
 percentage of energy derived from carbohydrates (female 44.1±5.7%, male 43.0±6.8%) was below the recommended levels. The dietary
 fiber intake in children aged 6-10 years with type 1 DM met recommendations, whereas, it was below the recommended levels in other
 age groups. Micronutrient inadequacy was common in children and adolescents with type 1 DM.
 Conclusions: The authors believe that guidelines and programs are needed for children and adolescents with type 1 DM to reduce
 total fat and saturated fat intake, increase carbohydrate and dietary fiber intake up to the recommended levels, and prevent multiple
 micronutrient inadequacies.

Dietary intake, weight status, pulmonary function, and metabolic profile in children with cystic fibrosis with or without pancreatic sufficiency

ObjectiveNutritional status and growth is well associated with disease outcomes and lung function in patients with cystic fibrosis (CF). Current dietary guidelines for the management of CF suggest a high-calorie, high-fat diet. Pancreatic insufficiency (PI) is present in most patients and contributes to malabsorption and malnutrition, but a considerable number of patients have pancreatic sufficiency (PS). The aim of this study was to compare weight status, clinical characteristics, and dietary intake of children with CF, with PS or PI. MethodsPatients with a diagnosis of CF (sweat test ≥60 mmol/L) and/or two known mutations for CF, ages 1 to 19 y were included in the study. Weight status, pulmonary characteristics, and blood lipid concentrations were evaluated. Dietary intake was evaluated through four 24-h recalls and energy, macronutrient intake, and intake in terms of food groups were assessed. ResultsIncluded in the present analyses were 134 patients with CF (30 with PS and 104 with PI). The percentage of overweight/obesity (47%) was higher in children with PS than in those with PI (22%). Overall, children with PS had higher body mass index, blood lipid levels, and pulmonary function levels than those with PI (all P < 0.05). Total energy intake was lower in children with PS than in those with PI (P < 0.001), even after adjustment for age and sex (Padj < 0.001). ConclusionsWeight status, dietary intake, pulmonary function, and lipid profile differed significantly in children with CF by pancreatic status. Nevertheless, the percentage of overweight and obesity was higher in children with PS than in those with PI. To avoid obesity, dietary recommendations for a high-calorie, high-fat diet should be reconsidered in patients with CF regarding their pancreatic status.

Knowledge Improvement After Dental Health Education for Elementary School Students in Surabaya, East Java

Background: During the coronavirus disease-19 (COVID-19) pandemic, many people were afraid to go to the dentist, which affected their dental and oral health conditions. Dental cavities may hamper children's growth and development; if this condition continues, it will affect the children's dietary intake, which may impact their quality of life and, if allowed to, cause stunting. Although in this condition, we still have to take preventive precautions with dental health education in school-age children. This required increasing dental health knowledge and understanding of dental disorders, particularly. Purpose: To describe oral and dental health knowledge improved following dental health education at Muhammadiyah 4 Elementary School, which is located in Pucang, Surabaya City, East Java. Methods: Two surveyors were responsible for data collecting. This study's sample size was 105 people ranging from third to fifth grade. The seminar covered dental and oral health via a hybrid method. The participants were asked to fill out a questionnaire form for the pre-and post-test to determine the improvement of oral and dental health knowledge for the dental health education evaluation. Results: Most oral and dental health participants understood the presentation on oral and dental health education. The post-test percentage was higher (89.14%) than the pre-test rate (60.29%). Conclusion: The program findings demonstrated that oral and dental health education with a hybrid method effectively increased elementary school children's understanding of dental and oral health status.

Mothers' descriptions of their feeding strategies in response to fussy eating with children of different levels of trait fussiness

Parent feeding practices influence a child's dietary intake. Many studies examining how parents react to children's fussy eating behaviours have been limited to questionnaire measures, which assess a limited number of feeding practices. There is a lack of research exploring the range of strategies parents use when their child is being fussy and/or refusing to eat. Therefore, the aims of this study are to describe the strategies used by mothers when their child is being fussy or refusing to eat, and to assess differences in the strategies depending on the child's trait fussiness levels. In 2018, 1504 mothers of children aged 2–5 years completed an online survey. Trait fussiness was assessed using the Children's Eating Behaviour Questionnaire. Mothers were also asked the open-ended question “What are the strategies you use when your child is being fussy or refusing to eat?“. Inductive thematic analysis was conducted using NVivo. Themes were compared by child trait fussiness levels. Seven main themes were identified: child-led feeding/trust in child's appetite, spectrum of pressure, home or family strategies, different types of food offerings, communication, avoid certain strategies, and never or rarely fussy. Mothers of children with severe trait fussiness levels reported more pressuring or persuasive strategies. This study provides novel information regarding the diverse range of feeding practices parents use in response to children's fussy eating behaviours. Mothers used more feeding strategies typically associated with unhealthy dietary intake for children of high levels of trait fussiness. It is important that future interventions tailor the information to provide support to parents of children with high levels of trait fussiness regarding the use of feeding practices recommended to support healthy dietary intake.

Children's Dietary Intake by Early Care and Education Setting in the US Affiliated Pacific

ObjectiveExamine differences in dietary intake of children aged 2–5 years in early care and education (ECE) setting in the US Affiliated Pacific (USAP). DesignSecondary analysis of cross-sectional data collected by the Children's Healthy Living program. ParticipantsChildren (n = 1,423) with complete dietary records and information on the ECE setting. Main Outcome MeasuresDietary intake by ECE setting; Head Start (HS), other ECE (OE), and no ECE. AnalysisComparison of mean dietary intake across ECE settings and multivariate logistic regression to evaluate ECE setting and likelihood for meeting dietary reference intake (DRI). ResultsChildren in HS and OE settings had a significantly higher intake of several food groups and nutrients, compared with no ECE; vegetables (0.4 cup-equivalents per thousand kcals [CETK] vs 0.3 CETK; P < 0.001), fruits (0.8 CETK vs 0.6 CETK; P = 0.001), milk (0.9 CETK for HS and 1.0 CETK for OE vs 0.8 CETK; P < 0.001). Sixty-five percent of the HS group met DRI and had greater odds of meeting calcium DRI (odds ratio, 1.8; 95% confidence interval, 1.2–2.7) compared with other groups. The OE group had the lowest proportion of children meeting recommended intakes for 19 out of 25 nutrients. Conclusions and ImplicationsMean intakes of foods and nutrients for children across the USAP meet some, but not all, recommendations and intakes vary across children attending various ECE setting types. Additional research on the clinical importance of these differences and the impact of the complex food systems in the USAP may identify systematic strategies for improving diet among children.

Ethiopia National Food and Nutrition Survey to inform the Ethiopian National Food and Nutrition Strategy: a study protocol

IntroductionEthiopia has made significant progress in reducing malnutrition in the past two decades. Despite such improvements, a substantial segment of the country’s population remains chronically undernourished and suffers from micronutrient...

Processed Food–Sweets Patterns and Related Behaviors with Attention Deficit Hyperactivity Disorder among Children: A Case–Control Study

Previous studies have focused on the associations between core symptoms and dietary intake in children with attention deficit hyperactivity disorder (ADHD). However, few studies have explored how dietary patterns and behaviors relate to the risk of ADHD. The aim of our study is to explore the associations between dietary patterns and behaviors and the risk of ADHD, which could provide evidence for follow-up and treatments for children with ADHD. We conducted a case-control study, including 102 children diagnosed with ADHD and 102 healthy children. The food frequency questionnaire (FFQ) and the children's eating behavior questionnaire (CEBQ) were used to investigate food consumption and eating behaviors. We applied exploratory factor analysis for constructing dietary patterns, and the factor scores were adopted for log-binomial regression to assess the associations between how dietary patterns and eating behaviors affect the risk of ADHD. We extracted five dietary patterns with a cumulative contribution rate of 54.63%. Processed food-sweets scores revealed positive associations with an increased risk of ADHD (OR = 1.451, 95% CI: 1.041-2.085). Moreover, processed food-sweets tertile 3 was associated with an increased risk of ADHD (OR = 2.646, 95% CI: 1.213-5.933). In terms of eating behaviors, the group with a higher score relating to a desire to drink was also positively correlated with the risk of ADHD (OR = 2.075, 95% CI: 1.137-3.830). In the treatment and follow-up of children with ADHD, dietary intake and eating behaviors should be considered.

Pilot Study of the Applicability, Usability, and Accuracy of the Nutricate© Online Application, a New Dietary Intake Assessment Tool for Managing Infant Cow’s Milk Allergy

The mainstay treatment of cow's milk allergy (CMA) is to remove cow's milk proteins from children's dietary intake. In this context, dietary intake of children with CMA should be particularly checked and monitored. The objective of this study was to assess the applicability, usability, and accuracy of a new dietary intake (DI) assessment online tool (Nutricate© online application) for managing CMA in children. This study used a pre-existing database of DI from the Nutricate© online application. DIs from 30 CMA children were used to compare micro/macronutrients (energy, protein, calcium, and iron intakes) calculated by Nutricate© and NutriLog© as the reference method. Comparisons were performed using the Pearson correlation analysis and the Bland-Altman plot. The Nutricate© tool usability was assessed via a System Usability Scale questionnaire (SUSq). Correlation coefficient between the levels of micro/macronutrients obtained by Nutrilog© and Nutricate© software were highly significant (p = 0.0001) and were well-correlated (R coefficient > 0.6), indicating a very good concordance between the two methods. This observation was reinforced by the Bland-Altman plot, indicating the absence of proportional or fixed bias for energy, protein, calcium, and iron intakes. The mean SUSq score obtained was 81 ± 14, which is considered to be an excellent score. Nutricate© online application is a reliable method to assess micro/macronutrient (energy, protein, calcium, and iron intakes) intake in CMA children. Applicability and usability of this new dietary intake assessment online tool is excellent.

Associations Between Household Frequency of Cooking Dinner and Ultraprocessed Food Consumption and Dietary Quality Among US Children and Adolescents.

Introduction: Dietary quality is poor and intake of ultraprocessed foods (UPFs) is high among children and adolescents in the United States. Low dietary quality and high UPF intake are associated with obesity and higher risk of diet-related chronic diseases. It is unknown whether household cooking behavior is related to improved dietary quality and lower consumption of UPFs among US children and adolescents. Methods: Nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey (n = 6032 children and adolescents ≤19 years of age) were used to examine the relationships between household cooking frequency of evening meals and children's dietary quality and UPF intake using multivariate linear regression models adjusted for sociodemographics. Two 24-hour diet recalls were used to assess UPF intake and dietary quality [Healthy Eating Index-2015 (HEI-2015)]. Food items were categorized according to Nova classification to obtain the UPF percent of total energy intake. Results: A higher household frequency of cooking dinner was associated with lower UPF intake and higher overall dietary quality. Compared to children in households cooking dinner 0-2 times per week, children in households cooking dinner 7 times/week had lower intake of UPFs [β = -6.30, 95% confidence interval (CI) -8.81 to -3.78, p < 0.001] and marginally higher HEI-2015 scores (β = 1.92, 95% CI -0.04 to 3.87, p = 0.054). The trends toward lower UPF intake (p-trend <0.001) and higher HEI-2015 scores (p-trend = 0.001) with increasing cooking frequency were significant. Conclusions: In this nationally representative sample of children and adolescents, more frequent cooking at home was associated with lower intake of UPFs and higher HEI-2015 scores.

Effects of a mobile health nutrition intervention on dietary intake in children who have autism spectrum disorder.

Children who have Autism Spectrum Disorder (ASD) show preferences for processed foods, such as salty and sugary snacks (SSS) and sugar-sweetened beverages (SSB), while healthier foods, such as fruits and vegetables (FV), are consumed less. Innovative tools are needed that can efficiently disseminate evidence-based interventions and engage autistic children to improve their diet. The aim of this 3-month randomized trial was to test the initial efficacy of a mobile health (mHealth) nutrition intervention on changing consumption of targeted healthy (FV) and less healthy foods/beverages (SSS, SSB) in children who have ASD, ages 6-10, who were picky eaters. Thirty-eight parent-child dyads were randomly assigned to either an intervention (technology) group or a wait list control (education) group. The intervention included behavioral skills training, a high level of personalization for dietary goals, and involved parents as "agents of change." Parents in the education group received general nutrition education and the dietary goals but did not receive skills training. Children's intake was assessed at baseline and at 3 months using 24-hour dietary recalls. While there were no significant group-by-time interactions (P > 0.25) for any of the primary outcomes, we found a significant main effect of time for FV intake (P = 0.04) indicating that both groups consumed more FV at 3 months (2.58 ± 0.30 servings/day) than at baseline (2.17 ± 0.28 servings/day; P = 0.03). Children in the intervention group who consumed few FV at baseline and showed high engagement with the technology increased their FV intake by 1.5 servings/day (P < 0.01). Children's taste/smell sensitivity significantly predicted their FV intake (P = 0.0446); for each unit of lower taste/smell sensitivity (indicating greater sensory processing abnormalities), FV intake increased by 0.13 ± 0.1 servings/day. This mHealth intervention did not yield significant between-group differences for changing consumption of targeted foods/beverages. Only children who consumed few FV at baseline and highly engaged with the technology increased their FV intake at 3 months. Future research should test additional strategies to expand the intervention's impact on a wider range of foods while also reaching a broader group of children who have ASD. This trial was registered at clinicaltrials.gov as NCT03424811.Clinical Trial Registration: This study was registered at clinicaltrials.gov as NCT03424811.

Development and Evaluation of a Diet Quality Index for Preschool-Aged Children in an Asian population: The Growing Up in Singapore Towards Healthy Outcomes cohort.

Diet quality indexes are useful tools to measure diet quality because they compare dietary intakes against recommendations. A dietary quality index for Asian preschool-aged children is lacking. The aims of this study were to develop and evaluate a dietary quality index for preschool-aged children (ie, the DQI-5) based on Singapore dietary recommendations and to examine diet quality in a cohort of 5-year-old children. An additional aim was to assess associations between sociodemographic characteristics and DQI-5 scores. A secondary analysis was conducted using dietary intake of children from the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort assessed in 2015-2016 using a validated food frequency questionnaire. The sociodemographic data were assessed at recruitment between June 2009 and September 2010. The DQI-5 was evaluated using a construct validity approach, whereby nutrition parameters associated with diet quality were studied. Participants were 767 Singaporean children aged 5 years of Chinese, Malay, or Indian ethnicity. The main outcome measures were the DQI-5 scores and the sociodemographic characteristics associated with diet quality. Kruskal-Wallis tests were used to evaluate differences in adherence to dietary recommendations across DQI-5 tertiles. Linear multiple regression analysis was performed to identify sociodemographic characteristics that were associated with diet quality in the children. The DQI-5 consists of 12 food and nutrient components, with a minimum score of zero and a maximum score of 110 points. The higher scores indicate a healthier diet, the mean ± SD DQI-5 score for the children was 61.6 ± 13.2. DQI-5 components with low scores included whole grains, vegetables, and fatty acid ratio, whereas total rice and alternatives and milk and dairy products components were overconsumed by 18% and 24.4% of children, respectively. Children with higher scores were more likely to meet dietary recommendations and had higher intake of nutrients such as dietary fiber, iron, vitamin A, and beta carotene. Children whose mothers were of Malay ethnicity and whose mothers had low income, an education below university, and shared primary caregiver responsibilities were more likely to have lower DQI-5 scores. The DQI-5 scores revealed diets to be low for several components and excessive for a few. The DQI-5 developed for preschool-aged children in Singapore had adequate construct validity.

Dietary Protein Intake in Young Children in Selected Low-Income Countries Is Generally Adequate in Relation to Estimated Requirements for Healthy Children, Except When Complementary Food Intake Is Low

Background Previous research indicates that young children in low-income countries (LICs) generally consume greater amounts of protein than published estimates of protein requirements, but this research did not account for protein quality based on the mix of amino acids and the digestibility of ingested protein.Objective: Our objective was to estimate the prevalence of inadequate protein and amino acid intake by young children in LICs, accounting for protein quality.Methods: Seven data sets with information on dietary intake for children (6–35 mo of age) from 6 LICs (Peru, Guatemala, Ecuador, Bangladesh, Uganda, and Zambia) were reanalyzed to estimate protein and amino acid intake and assess adequacy. The protein digestibility–corrected amino acid score of each child's diet was calculated and multiplied by the original (crude) protein intake to obtain an estimate of available protein intake. Distributions of usual intake were obtained to estimate the prevalence of inadequate protein and amino acid intake for each cohort according to Estimated Average Requirements.Results The prevalence of inadequate protein intake was highest in breastfeeding children aged 6–8 mo: 24% of Bangladeshi and 16% of Peruvian children. With the exception of Bangladesh, the prevalence of inadequate available protein intake decreased by age 9–12 mo and was very low in all sites (0–2%) after 12 mo of age. Inadequate protein intake in children <12 mo of age was due primarily to low energy intake from complementary foods, not inadequate protein density.Conclusions Overall, most children consumed protein amounts greater than requirements, except for the younger breastfeeding children, who were consuming low amounts of complementary foods. These findings reinforce previous evidence that dietary protein is not generally limiting for children in LICs compared with estimated requirements for healthy children, even after accounting for protein quality. However, unmeasured effects of infection and intestinal dysfunction on the children's protein requirements could modify this conclusion.

Momentary predictors of a broad range of food parenting practices within a population-based sample of parents of preschool-aged children.

The current study sought to understand the influence of momentary factors within the home and family environment, including parent stress, parent and child mood and child behaviors, on parents' use of a broad range of food parenting practices later that same day. Ecological Momentary Assessment (EMA) was used to evaluate parents' use of coercive, indulgent, structured and autonomy support food parenting practices, as well as numerous potentially salient momentary predictors, including parental stress, parent and child mood, and child behavior. Data were collected from 109 parents of preschool aged children multiple times per day over the course of a ten-day data collection period, allowing for temporal sequencing of momentary predictors and use of food parenting practices. With some notable exceptions, study findings align with study hypotheses in that parent stress, parent and child low mood, and child negative behaviors early in the day were found to be associated with the use of less supportive food parenting practices later that same day. For example, greater parent negative mood earlier in the day was associated with a decrease in use of feeding practices from within the structure domain later on that same day (-2.5%, p < 0.01), whereas greater parent positive mood earlier in the day was associated with an increase in use of structure later on that same day (+3.7%, p < 0.01). Greater parent stress earlier in the day was associated with an increase in the use of coercive control (+3.2%, p < 0.01) and indulgent (+3.0%, p < 0.01) practices later that same day; surprisingly, a similar increase in stress earlier in the day was also found to be associated with an increase in the use of autonomy support (5.6%, p < 0.01) feeding practices later on that same day. Developing an understanding of the types of momentary factors that influence a parent's use of particular food parenting practices across multiple contexts is a crucial next step toward developing effective interventions aimed at teaching parents to use food parenting practices that are supportive of healthful child dietary intake and eating behaviors in a way that is responsive to shifting factors.

Exploring the understanding of how parenting influences the children's nutritional status, physical activity, and BMI.

Parental behaviors and the home environment are two of the most effective ways to adopt healthy eating and active lifestyles. For this reason, it is crucial to understand children's nutritional habits, analyze the dynamics related to parental factors, diagnose and treat childhood obesity in the early period, and prevent adulthood obesity. This study aimed to explore how parenting influences children's nutritional status, physical activity, and BMI. The study involved 596 children with their parents. The data were collected through face-to-face interviews using the survey method. The survey consists of descriptive information (age, gender, educational status), anthropometric measurements, nutritional habits, Family Nutrition and Physical Activity Scale (FNPA), International Physical Activity Questionnaire, and 24-h dietary recall. The Mean Adequacy Ratio (MAR) was applied to assess dietary adequacy. Most mothers and fathers were overweight or obese (61.6 and 68.7%, respectively). 38.6% of boys and 23.1% of girls were overweight or obese. The FNPA score was positively correlated with MAR (p < 0.05). Multiple linear regression analysis revealed that children's BMI was negatively correlated with FNPA score, while maternal BMI and father's BMI were positively correlated (p < 0.05). Furthermore, dietary energy was not associated with the child's BMI but with dietary adequacy (p < 0.05). There was no evidence that family impacted children's physical activity. This study supports that parenting influences children's dietary intake and BMI. Adequate and balanced nutrition, regardless of dietary energy, may affect children's body weight. Family plays a significant role in influencing and forming children's lifestyle-related behaviors. Children's healthy eating and physical exercise habits can be encouraged through school-based programs involving families.

The relationship between parent's self-reported exposure to food marketing and child and parental purchasing and consumption outcomes in five countries: findings from the International Food Policy Study.

Food and beverage marketing influences children's food preferences and dietary intake. Children's diets are also heavily influenced by their family environment. The aim of this study was to assess the relationship between parent's self-reported exposure to unhealthy food marketing and a range of outcomes related to children's desire for and intake of unhealthy foods and beverages. The study also sought to examine whether these outcomes varied across different countries. The analysed data are from the International Food Policy Study and were collected in 2018 using an online survey. The sample included 5764 parents of children under 18, living in Australia, Canada, Mexico, the United Kingdom, or the United States. Binary logistic regressions assessed the link between the number of parental exposure locations and children's requests for and parental purchases of unhealthy foods. Generalized ordinal regression gauged the relationship between the number of exposure locations and children's consumption of such items. Interaction terms tested if these associations varied by country. Parental exposure to unhealthy food marketing was positively associated with parents reporting child purchase requests and purchase outcomes; and differed by country. Increased parental exposure to unhealthy food marketing was associated with slightly lower odds of children's weekly consumption of unhealthy foods, and this association varied by country. In conclusion, parental report of a greater range of food marketing exposure was associated with a range of outcomes that would increase children's exposure to unhealthy food products or their marketing. Governments should consider developing more comprehensive restrictions on the marketing of unhealthy foods.

Prevalence of healthy diet and activity behaviours among U.S. Latino preschool children living in an emerging Latino community.

This pilot study provides preliminary insights into whether Latino preschool children living in an emerging Latino community (ELC) are meeting recommendations for healthy diet and activity behaviours and whether those behaviours are associated with sociodemographic or home environment variables. Secondary data analysis was conducted utilising cross-sectional baseline survey data from ANDALE Pittsburgh, a home-based intervention study. Measures included parent-reported information on child dietary intake, screen time and the home environment, and objectively measured physical activity and anthropometry. χ2 and Fischer's exact tests were used to determine associations. The study was conducted in an ELC in western Pennsylvania in the US. Fifty-one Latina mothers (age: 33⋅5 ± 6⋅1 years; 63 % Mexican origin; 86 % low acculturation) and their children (age: 3⋅9 ± 1⋅3 years; 55 % male) 2-5 years of age. On average, children consumed 2⋅25 ± 1⋅44 cups of fruits/vegetables, viewed 98⋅7 ± 74⋅2 min of screen time, accumulated 12⋅9 ± 2⋅9 min/h of total physical activity and consumed 15⋅5 ± 26⋅0 kcals of sugar-sweetened beverages per day. Forty-one percent met the fruit/vegetable recommendation, 54 % met the screen time recommendation, 27 % met the physical activity recommendation and 58 % met the sugary drink recommendation. Country of origin (P = 0⋅032) and acculturation (P = 0⋅048) were significantly associated with children meeting sugary drink recommendations. No other relationships were significant. The proportion of children in this sample meeting diet and activity recommendations was mixed. More research with larger sample sizes is needed in ELCs to identify effective intervention strategies for improving health behaviours.

Children's Influence on Parents: the Bidirectional Relationship in Family Meal Selection.

Feeding a child in the 21st century can be challenging. A child's diet is thought to be a parent's responsibility, and numerous studies have explored how parents influence their child's food intake through food availability, feeding practices, and modeling. However, this relationship is likely bidirectional such that the child influences the parent as well (sometimes called "pester power"). Pester power has been studied in grocery stores and restaurants. However, no research to date investigates how children influence parent's food selection when eating at home. This study addresses this gap by asking parent and child dyads (N = 79, 95% white) to create meals together and separately. Forty 6-8 and thirty-nine 13-15 year-olds participated. Most of the parents (97.5%) and children (49.4%) who participated were female; and parents reported an average annual income of over 80,000 dollars (68.3%). Mean differences in the nutrient content of the meals were analyzed using repeated measures ANOVAs to examine the strength of influence in the bidirectional relationship. Results suggested when children were present for meal selection, they exerted influence over their parents for more palatable items. When choosing foods as a dyad versus when the parent selected meals for the family, the foods contained more calories, sugar, and less fiber. Protein was the only nutrient that parents influenced in their child's selections. These findings have important implications for understanding the often-overlooked bidirectional dynamic of the feeding relationship, and the accompanying health outcomes of child dietary intake.

Accuracy of Reporting Food Intakes among Primary School Children Aged 7–9 Years

BackgroundAccurate measurement of dietary intake throughout childhood is important to monitor children’s growth and development and for their long-term health. However, measuring dietary intake in children is challenging because of misreporting, difficulties in establishing portion size, and heavy reliance on proxy reporters. ObjectivesThis study aimed to determine the accuracy of self-reported food intake by primary school children aged 7–9 y. MethodsA total of 105 children (51% boys), aged 8.0 ± 0.8 y, were recruited from three primary schools in Selangor, Malaysia. Individual meal intakes during a school break time were determined using a food photography method as the reference method. The children were then interviewed the following day to assess their recall of their meal intakes the previous day. ANOVA and Kruskal-Wallis tests were used to determine mean differences in the accuracy of reporting food items and amount by age and weight status, respectively. ResultsOn average, the children achieved 85.8% match rate, 14.2% omission rate, and 3.2% intrusion rate for accuracy in reporting food items. The children also achieved 85.9% correspondence rate and 6.8% inflation ratio for accuracy in reporting food amounts. Children living with obesity had notably higher intrusion rates compared with normal weight children (10.6% vs. 1.9%) (P < 0.05). Children aged >9 y had notably higher correspondence rates, compared with children aged 7 y (93.3% vs. 78.8%) (P < 0.05). ConclusionsThe low omission and intrusion rates and the high correspondence rate indicate that primary school children aged 7–9 y are capable of self-reporting food intake accurately for a lunch meal without proxy assistance. However, to confirm children’s abilities to report their daily food intakes, further studies should be conducted to assess the accuracy of children in reporting their food intakes for more than one meal in a day.

“That's the routine”: A qualitative exploration of mealtime screen use in lower educated Australian families with young children

BackgroundFamily meals are an opportune context for initiating healthy eating habits in young children. However, using screens at family mealtimes may negate some of the associated nutritional and social benefits. In High Income countries, frequent mealtime screen use is common, particularly in families of low socioeconomic position (SEP). This study aimed to explore experiences and acceptability of mealtime screen use in families of low SEP with young children. MethodsQualitative interviews with 25 mothers of low SEP were conducted via telephone or Zoom™ using Photo Interviewing and a semi-structured interview script. Transcripts were analysed thematically using a Constructivist paradigm. ResultsMany parents reported an eagerness for reducing family mealtime screen use. Three major themes were identified in explaining the reasons behind levels of engagement in family mealtime screen use. These included parental self-efficacy, such as parental confidence in saying no to screens at mealtimes, physical resources such as having enough space in the home for a functioning dining table without view of a television, and temporal priorities such as prioritising screen use for managing children's difficult behaviour at mealtimes over long-term health considerations. ConclusionsThis study highlights that although family mealtime screen use is likely linked with a range of child behaviours and parenting practices that may negatively influence children's dietary intake and social engagement, parents often considered screens acceptable at mealtimes. Nonetheless, parents' desire to reduce family mealtime screen use provides an important opportunity to determine how best to support parents to achieve this.