Children's Diets Research Articles

Breastfeeding duration, children’s diet and physical activity in immigrant children living in Lisbon

Abstract Background In 2023, 25% of children born in the Lisbon metropolitan area were from foreign mothers. Children of immigrant parents often face an unbalanced diet and unhealthy lifestyle, preventing them from reaching their full potential. The aim of this study was to analyse the associations between migrant status and breastfeeding duration, fruit and vegetable consumption and physical activity in children living in the Lisbon metropolitan area, Portugal. Methods Cross-sequential cohort study in Lisbon Region. Between May 2022 and April 2024, 729 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study. Data were collected in a face-to-face interview with the parents using a structured questionnaire with information on children’s diet (fruit and vegetable consumption) and physical activity. We used X2, Mann-Whitney U and t-tests to compare immigrant and non-immigrant children. Adjusted odds ratios (aOR) with a 5% level were estimated by logistic regression. Results Immigrant children (49.4%) live in socio-economically disadvantaged families. Breastfeeding practices are more common among migrant mothers with a higher median duration of exclusive breastfeeding (6 versus 4 months, p < 0.001) and a higher median duration of breastfeeding (14 versus 8 months, p < 0.001). Parental migration background is associated with the frequency of fruit (p = 0.039) and vegetable (p < 0.01) consumption and with the practice of physical activity (p < 0.01). The odds of consuming three or more portions of fruit are 1.37 times higher for non-immigrant children, and the odds of consuming two portions of vegetables are higher for non-immigrants than immigrants (aOR=2.04, p < 0.01). Practicing sports is most frequent in non-immigrants (aOR =2.25; p < 0.01). Conclusions Migrant status was associated with a less healthy lifestyle in childhood for children living in the Lisbon metropolitan area. Key messages • Breastfeeding is an essential source of nutrition for children, especially in socio-economically disadvantaged families. • The migrant status is often associated with inequalities in childhood, challenging immigrant children to achieve their full potential.

Health disparities continue to report in DEIS schools: Irish COSI Round 6 study

Abstract Background Previous reports have identified clear differences in the prevalence of overweight and obesity among children living with disadvantaged compared to those living in advantaged circumstances. Childhood obesity is influenced by factors in the home environment, including lifestyle behaviours and socio-economic status. The Childhood Obesity Surveillance Initiative (COSI) family survey provides insights into these factors, particularly in children that attend disadvantaged (DEIS) and non-disadvantaged (non-DEIS) schools. Aim This study aims to compare various demographic and socioeconomic factors within the home environment of primary school children across DEIS and non-DEIS schools in Ireland, elucidating the differences in their performance with implications for health policy. Methods Parents of 1st and 2nd class children (mean age 7) from 121 sentinel schools invited to participate in the family survey, returned it by post or online using Lime Survey. Ethical approval was secured for COSI R6, with consent from families. Data on demographics, diet, transportation, activities, and clinical characteristics of children in Ireland were collected, anonymised and analysed in SPSS, comparing children from DEIS (n = 147) and non-DEIS (n = 1014) schools. Results Around 88% of respondents of returned surveys included in the study (n = 1161) were mothers. Significant disparity in families with diabetes diagnosis or treatment observed between DEIS and non-DEIS schools (10.6% vs. 5.4%, p = 0.016). Breastfeeding rates were higher in non-DEIS schools (57.0% vs. 46.9%, p = 0.015). Children consuming at least 3 portions of fruits and vegetables daily were also higher in non-DEIS schools (58.9% vs. 46.0%, p < 0.001). More children in non-DEIS schools engaged in physical activities outside of school hours (93.7% vs. 74.5%, p < 0.001). Conclusions The findings underscore the significant socioeconomic disparities between families whose children attend DEIS and non-DEIS schools in Ireland. Key messages • Irish COSI R6 reveals disparities in health-related factors between disadvantaged and advantaged schools. • Targeted interventions and policies are necessary to address factors influencing child health.

Food insecurity impacts diet quality and adherence to the gluten-free diet in youth with celiac disease.

Celiac disease (CD) is an autoimmune gastrointestinal disorder that requires a strict lifelong gluten-free diet (GFD). Gluten-free (GF) foods are more expensive and less readily accessible than gluten-containing foods, contributing to an increased risk for food insecurity (FI). The study aimed to determine associations between GF-FI, sociodemographic risk factors and child dietary adherence and diet quality (DQ). A 26-item, cross-country online survey was administered through social media to parents of children with CD on the GFD. The survey elicited household and CD child sociodemographic and clinical characteristics (e.g., duration of CD), measures of household FI, child DQ and GFD adherence, and parents' concerns related to GF food. Household GF-FI was evaluated using the validated Hunger Vital Sign™ and the US Department of Agriculture Six-Item Short Form Household Food Security Survey Module. GF-FI occurred in 47% of households with children with CD with >30% reporting low to very low food security. Sociodemographic risk factors identified included lower income, renters, rural residency, single-parental households, and having children with additional dietary restrictions (p < 0.001). Regardless of FI status, a majority of households reported experiencing significantly higher GF food expenditure. GF-FI was associated with reduced adherence to the GFD, increased consumption of processed GF food, and lower intakes of fresh fruits and vegetables and GF grains among children with CD (p < 0.05). GF-FI is prevalent in this multiethnic cohort of households with CD children and is associated with worsening DQ and GFD adherence. Policy interventions are urgently needed to address GF-FI.

Dietary patterns among European children and their association with adiposity-related outcomes: a multi-country study.

Children's diets in school-age are inherently unhealthy, with few meeting dietary recommendations. Yet, little is known about similarities and differences on dietary patterns across countries and their association with obesity. We aimed to derive dietary patterns in childhood and explore their association with adiposity-related outcomes in childhood and adolescence. This study included data from six European countries (Spain, France, UK, Greece, Lithuania and Norway) during childhood (n = 1597) and adolescence (n = 803). Using a food frequency questionnaire, we derived data-driven dietary patterns through exploratory factor analyses and calculated the Mediterranean KIDMED index. We assessed body mass index z-score (zBMI), fat mass proportion and waist-to-height ratio at both visits. Associations were estimated using generalized linear regressions, adjusted for key-confounders. "Meat", "Dairy", "Western", "Healthy" and "Sweets and fats" dietary patterns were derived. Norwegian children showed better diet quality, with higher consumption of fruits and vegetables, and highest "Healthy pattern" adherence, and Lithuanian children, the worst, with higher sweets consumption, and highest "Western pattern" adherence. Children with lower intake of healthy foods (vegetables, fruits, fish) tended to have higher adiposity, e.g., children with average or low "Healthy pattern" adherence (vs. high) had higher fat mass proportion in childhood (average: β (95% CI) 1.44 (0.48; 2.39), low: 1.10 (0.09; 2.12)). Low adherence to a "Healthy pattern" (vs. high) was associated with increased adolescent zBMI, and child and adolescent waist-to-height ratio. Low "Dairy pattern" adherence (vs. high), was associated with lower zBMI and fat mass in childhood, but not in adolescence. No significant associations were seen with the KIDMED index. Many European children have poor diets and a low adherence to a healthy diet pattern may be of concern for adiposity-related outcomes. Assessment of children's dietary patterns can help tailor dietary advice and provide support for families aiming to prevent future excess weight gain.

Food purchase diversity is associated with market food diversity and diets of children and their mothers but not fathers in rural Tanzania: Results from the EFFECTS baseline survey.

Rural households in East Africa rely on local markets, but the influence of market food diversity and household food purchase diversity on diets has not been well-characterized. We quantify the associations among market food diversity, household food purchase diversity and dietary diversity of mothers, fathers and children in rural Tanzania. This study uses baseline data from a randomized controlled trial, Engaging Fathers for Effective Child Nutrition and Development in Tanzania. We used the 10 food groups for women's dietary diversity to assess the seasonal availability of nutritious foods in 79 markets. Using data from 957 rural households in two districts in Mara, Tanzania, we measured household food purchase diversity over the previous month and dietary diversity among children (6-23 months), mothers and fathers. Overall, 63% of markets sold all 10 food groups throughout the year, indicating high-market food diversity and minimal seasonality. However, only 33% of women and 35% of children met dietary diversity recommendations. Households that reported higher purchasing power (0.14, p < 0.001), lived within 30 min of a market (0.36, p = 0.001) and had access to a highly diverse market (0.37, p = 0.01) purchased a higher diversity of foods. In turn, food purchase diversity was positively associated with the dietary diversity of mothers (p < 0.001) and children 9-23 months (p < 0.001) but not fathers (p = 0.56). Interventions must account for food availability and access in local markets, and promoting diverse food purchases may be an effective strategy to improve women's and children's diets in rural areas.

Blended diets for children and young people: applying the evidence to nursing practice.

Enteral tube feeding is commonly used for children and young people with complex health and care needs. Blended diets are becoming more widely used and there is increasing evidence to show the benefits of a blended diet for children, young people and their families. This article aims to collate recent evidence on blended diets and describe the implications for nursing practice. Studies exploring blended diets have identified benefits such as improved gastrointestinal symptoms, positive engagement with families around food and mealtimes and the normalisation of enteral tube feeding. Research has also explored the nutritional and microbial content of food blends as well as the viscosity and risk of tube blockage. These are key considerations when supporting families to make informed decisions and use blended diets safely. Nurses play an important role in supporting the safe and effective use of blended diets as part of a wider multidisciplinary team. It is necessary that they have an understanding of the evidence underpinning nursing practice in this area.

The development and testing of a single-arm feasibility and acceptability study of a whole foods diet intervention for adults with prediabetes and their offspring

BackgroundDiet is considered a first-line treatment option for prediabetes, a condition that affects 96 million United States (U.S.) adults. Diet patterns that prioritize whole foods (e.g., Mediterranean) are currently recommended to treat prediabetes. However, no studies have tested whether a U.S.-style diet pattern that prioritizes whole foods can be used to treat prediabetes. The purpose of this study was to assess the feasibility and acceptability of a whole foods diet for adults with prediabetes and their offspring prior to conducting a larger clinical trial.MethodsA 2-week single-arm pre-post experimental controlled-feeding intervention of a 2020–2025 Dietary Guidelines for Americans adapted whole foods diet (e.g., primarily focused on foods that have undergone limited processing or refinement) was conducted in adults (25–59 years) with prediabetes and their biological offspring (6–17 years). Families received 2 weeks of menus and grocery delivery and weekly counseling by a registered dietitian. Families were invited to attend an optional focus group session. Feasibility was based on having a ≥ 50% family completion rate with ≥ 80% completion of study outcomes. Measures included adult–child anthropometrics (weight [kg], body mass index [BMI] including BMI% and Z-scores for offspring, waist circumference [cm]) and child diet quality estimated using the 2015 Healthy Eating Index (HEI) from a single random food record. Wilcoxon signed rank was used to compare differences between baseline and 2-week anthropometrics measures and offspring total HEI scores. Qualitative data were analyzed using thematic analysis to understand factors attributed to diet adherence and acceptability.ResultsEight families enrolled (n = 8 adults, n = 12 offspring), with 7 families completing the study (12% attrition) and completing 100% of study outcome measures. Adults experienced a median weight loss of − 1.0 kg from baseline to 2 weeks (79.5 kg to 78.5 kg). Offspring had a 24-point increase in total 2015 HEI scores (median difference 50 to 74). Focus group participants (n = 4 adults) reported being satisfied with the program and expressed a willingness to continue the diet despite identified barriers.ConclusionsA whole foods diet that provides dietary support was found to be feasible and acceptable for families at risk for T2D. Future studies are needed to test the effects of the diet on prediabetes outcomes, diet quality, and diet adherence in adults and families.Trial registrationNCT05483972 at ClinicalTrials.gov. Registered July 25, 2022. https://clinicaltrials.gov/study/NCT05483972?cond=prediabetes&term=whole%20foods%20&rank=1

Arsenic in Rice: A Call to Change Feeding Substitution Practices for Pediatric Otolaryngology Patients.

Rice products are ubiquitous in the diets of American children and are often utilized to thicken feeds as part of treatments for gastroesophageal reflux disease in infants. However, a 2015 Food and Drug Administration investigation demonstrated that they contain unsafe levels of inorganic arsenic. Inorganic arsenic exposure has been linked to serious health issues including skin, lung, and bladder cancer. Smaller children are put at higher risk due to the increased arsenic-to-weight ratio compared to adults, threatening their development in multiple ways. Other thickeners offer cost-effective, safer alternatives. With this communication, we aim to raise awareness of this issue within the otolaryngology practice thereby bringing us abreast of the best practices of the pediatric and gastrointestinal medical societies who have recommended against the use of rice for thickening feeds, instead advocating for alternate natural thickening agents like wheat or oatmeal.

Media Usage and Adherence to the Mediterranean Diet in Children

Background: Increased screen time in children is significantly associated with lower adherence to the Mediterranean diet (MD). The purpose of this study was to explore the association between different types of media use and the adherence to the MD in children. Methods: The study sample included 332 children aged 10–11 years attending the fifth year of primary school in Veneto, north-east Italy. The children’s mothers were surveyed on their children’s adherence to the MD, using the KidMed questionnaire, and on the time of media use, using the Media Activity Form-Parent (MAF-P). A multivariable backward stepwise linear regression was applied, adjusting the association for other potential confounding factors. Results: Children’s primary digital activities were watching TV or streaming platforms (5.0 h/week) and video content (2.5 h/week), followed by digital games (2.3 h/week). Lower adherence to the Mediterranean diet was associated with digital games (regression coefficient −0.65, SE 0.29, p = 0.026) and time spent watching TV or streaming platforms (regression coefficient −0.60, SE 0.29, p = 0.04). Conclusion: Interventions to promote healthier diets justify an approach that includes media education. Providing parents with recommendations on children’s use of digital media devices can empower them to improve their children’s well-being.

The association between ultra-processed food consumption and low-grade inflammation in childhood: A cross-sectional study.

This study aimed to investigate the relationship between the amount of ultra-processed food (UPF) in the diet and low-grade inflammation in children. This cross-sectional study was conducted in 50 healthy children recruited from children attending the Social Paediatrics Outpatient Clinic for follow-up of normal developmental stages. Low-grade inflammation was calculated by INFLA-score, dietary intake by three 24-h dietary recalls and dietary content analyses by BeBiS™ software. The mean age of the 50 children included in our study was 10.18 ± 3.98 years (5-17 years). UPF accounted for 24.5% of the total daily energy intake of children. In children with higher inflammation scores (INFLA-score ≥ 2), the amount in grams of UPF and the percentage of total energy from UPF were found to be significantly higher (p = 0.030 and p = 0.015, respectively). A weak positive correlation was found between the INFLA-score and the percentage of daily dietary energy intake coming from UPFs (r = 0.350, p < 0.01), the average daily energy intake from UPFs (r = 0.313, p < 0.05), and the average daily amount of UPF consumed (r = 0.260, p < 0.05). The linear regression model revealed that every one-unit increase (1%) in the percentage of total daily energy intake coming from UPF caused an increase in β = 0.154-unit in the INFLA-score. It was found that obesity was not a mediator in the association between the percentages of total energy intake from UPF on the INFLA-score, instead, the energy intake from UPF had a significant direct association with the INFLA-score. The average amount of UPF consumed daily showed an increasing pattern in parallel with inflammation-score quartile classes (Q1 to Q4) with 33.3% in Q1, 38.5% in Q2, 53.8% in Q3 and 66.7% in Q4 (p = 0.049). In conclusion, a positive association was found between low-grade inflammation and UPF consumption in children, independent of obesity.

Barriers and facilitators to healthy eating during post-partum among non-Hispanic Black mothers.

Maternal diet is a key predictor of child diet, yet an in-depth inquiry into the barriers and facilitators for the adoption of healthy eating behaviours during the post-partum period is lacking, specifically for non-Hispanic Black mothers. This study used qualitative research methods to investigate healthy eating practices among a sample of non-Hispanic Black mothers participating in a family-based obesity prevention intervention. In-depth interviews were conducted with 22 mothers who participated in the Mothers and Others: Family-based Obesity Prevention for Infants and Toddlers intervention trial. Interviews were audio-recorded and transcribed verbatim. A deductive and inductive process was used to develop a consensus codebook; once the data were coded, matrices were developed to explore the data and identify similarities and differences between respondents. Relevant themes were identified, and salient quotes were used to illustrate each theme. Mothers believed that time and taste were significant barriers to eating healthy. Social influence and social support had both positive and negative influences on mothers' ability to adopt healthy eating behaviours. Despite their children often being a facilitator to healthy eating, many mothers struggled with finding the time, energy and desire to focus on themselves when it came to healthy eating. Many mothers were intent on preparing healthy meals and snacks for their children but did not prepare them for themselves. Future interventions should focus on the importance of role-modelling healthy eating behaviours for their children and include behaviour change strategies that incorporate skill-building activities emphasizing time-saving methods for planning and preparing healthy meals and snacks for the whole family to eat.

Early ultra-processed foods consumption and hyperactivity/inattention in adolescence.

To investigate the relationship between childhood consumption of ultra-processed foods and symptoms of hyperactivity/inattention in adolescents from São Leopoldo, a city in southern Brazil. Data were collected at four distinct stages: when participants were 12-16 months old in 2001 and 2002 and later when they were 3-4, 7-8, and 12-13 years old. During the interview at 12-16 months, mothers were asked about the introduction of sugar in their child's diet. Two 24-hour recall surveys were conducted with children aged 3-4, 7-8, and 12-13 years to assess their consumption of ultra-processed foods. At the age of 12-13 years, the participants completed the Hyperactivity/Inattention subscale of the Strengths and Difficulties Questionnaire (SDQ), which screens for mental health problems. Among the 173 adolescents, 22.5% exhibited hyperactivity symptoms. The consumption of ultra-processed foods in grams, kilocalories, and as a percentage of energy intake at 3-4 years old were found to be predictors of hyperactivity/inattention symptoms (RR: 0.81, 95%CI: 0.69-0.95; RR: 1.01, 95%CI: 1.00-1.02; RR: 1.02, 95%CI:1.01-1.02; RR: 1.25, 95%CI:1.04-1.51, respectively). The consumption of ultra-processed foods at an early age was associated with hyperactivity and inattention symptoms in adolescence.

The impact of a positive discipline group intervention on parenting self-efficacy among mothers of young children.

Instilling healthy behaviors in early childhood is crucial as they can have lifelong impacts. However, many Chinese mothers lack effective parenting strategies, resulting in low self-efficacy. Positive Discipline, a non-punitive and non-indulgent approach, can help enhance maternal parenting self-efficacy and promote healthy lifestyle behaviors in children. This study explores the impact of a Positive Discipline group intervention on the parenting self-efficacy of Chinese mothers and how it can contribute to promoting diet and healthy lifestyle behaviors in early childhood. We randomly selected 70 mothers with low parenting self-efficacy from a kindergarten in China, dividing them into an intervention group (35 participants) and a control group (35 participants). The intervention group received a 6-week Positive Discipline intervention, while the control group received no intervention. The intervention aimed at helping mothers nurture their children in a kind and firm manner. We used paired samples t-tests and independent samples t-tests to compare changes in parenting self-efficacy scores before and after the intervention. Results showed that the intervention group's parenting self-efficacy scores significantly improved after the intervention, from an average score of 25.00 ± 4.08 to 36.29 ± 2.99 (p < 0.05, Cohen's d = 3.156). Significant improvements were observed in areas like "believing their parenting style benefits their child's growth" and "knowing how to effectively parent their children." The control group's average scores showed no significant changes between pre- and post-intervention (pre: 25.07 ± 5.33; post: 24.86 ± 5.75, p > 0.05, Cohen's d = 0.076). Furthermore, 3 months post-intervention, the intervention group's scores remained significantly higher than pre-intervention (p < 0.05), demonstrating the intervention's lasting effect. This study demonstrates that the Positive Discipline group intervention significantly enhances parenting self-efficacy in Chinese mothers, promoting healthy lifestyle behaviors in early childhood. Providing continuous support and guidance to mothers can help solidify their parenting confidence, ensuring long-term intervention success. Future research should explore how group interventions can effectively integrate healthy behaviors into early childhood routines and impact children's diet and lifestyle behaviors.

The influence of minimum dietary diversity on undernutrition among children aged 6-23 months in Ethiopia: a multilevel mixed-effect analysis based on 2019 Ethiopian mini demographic and health survey.

Undernutrition persists as a critical issue in developing countries like Ethiopia due to poor feeding practices for infants and young children. The impact of dietary diversity on children's health in Ethiopia remains unclear, necessitating further investigation to develop effective prevention strategies. To examine the association between minimum dietary diversity and undernutrition among children aged 6-23 months in Ethiopia. Data from the 2019 Ethiopian Mini Demographic and Health Survey, including 1,501 women with children aged 6-23 months, were analyzed using STATA version 17 software. Child stunting, wasting, and underweight were assessed using Z-scores. Dietary diversity was measured using minimum dietary diversity. Multilevel logistic regression analysis determined associations, presenting results as crude odds ratios (COR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI). Overall, 10.99% of children had adequate minimum dietary diversity, with Addis Ababa (44.57%) and Somalia (1.47%) showing the highest and lowest prevalences, respectively. The highest stunting prevalence was in the Amhara region (45.86%), while Addis Ababa had the lowest (9.78%). Wasting was lowest in Addis Ababa (1.09%) and highest in Tigray (17.07%). Underweight prevalence ranged from 2.17% in Addis Ababa to 33.33% in Tigray. Children with adequate minimum dietary diversity (MDD) had significantly lower odds of stunting (AOR = 0.68, 95% CI = 0.45, 0.96), underweight (AOR = 0.51, 95% CI = 0.27, 0.99), and wasting (AOR = 0.40, 95% CI = 0.17, 0.97) compared to those who had inadequate minimum dietary diversity (MDD). This study highlights the association between minimum dietary diversity and stunting, wasting, and underweight among Ethiopian children aged 6-23 months. Urgent nutrition-specific interventions are needed, particularly in regions with high undernutrition rates and low dietary diversity. Targeted interventions focusing on promoting diverse and nutritious diets for children, along with improving access to essential healthcare services, are imperative to mitigate the burden of undernutrition and ensure the well-being of Ethiopia's youngest population and reinforcing existing programs is crucial to address this public health issue effectively.

Prevalence and determinants of stunting and anaemia in children aged 6-23 months: A multilevel analysis from rural Ethiopia.

Low- and middle-income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual-, household- and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6-23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147-3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate-to-zinc and phytate-to-iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non-farm income-generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18-23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6-11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273-0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6-23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.

Assessment of foods for infants and toddlers in Australia against the World Health Organization's Nutrient and Promotion Profile Model for food products for infants and young children.

Global public health agencies have recommended stronger regulation of food marketing to protect children's diets. This study assessed commercial foods for infants and toddlers available in Australian supermarkets for compliance with the World Health Organization (WHO) Regional Office for Europe's Nutrient and Promotion Profile Model: supporting appropriate promotion of food products for infants and young children 6-36 months in the WHO European Region (NPPM). Dietitians assessed a sample of commercial foods for infants and toddlers against the composition, labelling and promotion requirements of the NPPM. Australia. Commercial foods for infants and toddlers (n 45) available in two major Australian supermarkets, purposely sampled across product categories and brands. Fewer than one quarter (23 %) of the assessed products met all nutrient content requirements of the NPPM. No products met all of the labelling or promotional requirements. All products included at least one promotional marketing claim that was not permitted under the NPPM. The NPPM is useful to assess and monitor the nutritional composition and prevalence of marketing claims on commercial foods for infants and toddlers. Findings of noncompliance with the NPPM recommendations indicate an urgent need for stronger government regulation of the composition, labelling and marketing of commercial foods for infants and toddlers in Australia.

Childhood stunting in Indonesia: assessing the performance of Bayesian spatial conditional autoregressive models.

Stunting continues to be a significant health issue, particularly in developing nations, with Indonesia ranking third in prevalence in Southeast Asia. This research examined the risk of stunting and influencing factors in Indonesia by implementing various Bayesian spatial conditional autoregressive (CAR) models that include covariates. A total of 750 models were run, including five different Bayesian spatial CAR models (Besag-York-Mollie (BYM), CAR Leroux and three forms of localised CAR), with 30 covariate combinations and five different hyperprior combinations for each model. The Poisson distribution was employed to model the counts of stunting cases. After a comprehensive evaluation of all model selection criteria utilized, the Bayesian localised CAR model with three covariates were preferred, either allowing up to 2 clusters with a variance hyperprior of inverse-gamma (1, 0.1) or allowing 3 clusters with a variance hyperprior of inverse-gamma (1, 0.01). Poverty and recent low birth weight (LBW) births are significantly associated with an increased risk of stunting, whereas child diet diversity is inversely related to the risk of stunting. Model results indicated that Sulawesi Barat Province has the highest risk of stunting, with DKI Jakarta Province the lowest. These areas with high stunting require interventions to reduce poverty, LBW births and increase child diet diversity.

Comparison of the nutritional status and adherence to the mediterranean diet in children from 6 to 10 years-old of São Martinho Parish (autonomous region of Madeira) after one year of intervention

Comparison of the nutritional status and adherence to the mediterranean diet in children from 6 to 10 years-old of São Martinho Parish (autonomous region of Madeira) after one year of intervention

Maternal diet in pregnancy and the risk of inflammatory bowel disease in the offspring: a prospective cohort study

BackgroundDiet has been hypothesized as a risk factor for development of inflammatory bowel disease (IBD). ObjectiveTo explore associations between maternal diet diversity and quality in pregnancy and the offspring’s risk of IBD. MethodsWe used data from a nationwide cohort study on 85,129 Norwegian children followed from birth (1999–2009) with information on maternal diet in pregnancy from validated food frequency questionnaires. Hazard ratios (aHRs) for IBD, Crohn’s disease (CD), and ulcerative colitis (UC) by maternal diet diversity, quality and intake amounts of individual food groups were adjusted for maternal body mass index, parental IBD, and socio-demographic factors. Sensitivity analyses adjusted for the child's early-life diet quality and antibiotic treatment. Dietary exposures were classified into tertiles, comparing low (reference) to medium, and high levels. ResultsDuring a mean follow-up time of 16.1 years (1,367,837 person-years of follow-up), 268 children developed IBD (CD, n=119; UC, n=76; IBD-unclassified, n=73). High compared with low diet diversity in pregnancy was associated with a lower risk of UC in the offspring (aHR 0.46, 95% confidence interval 0.25-0.87), with consistent findings after further adjustment for the child's early-life diet quality and antibiotic treatment. High compared with low diet diversity in pregnancy yielded aHRs of 0.81 for CD (0.51-1.28) and 0.75 for any IBD (0.55-1.02) in the offspring. A high compared with low diet quality in pregnancy or intakes of specific food groups were not associated with the offspring’s risk of IBD or its subtypes. ConclusionsOur findings suggest that a higher maternal diet diversity in pregnancy may be associated with a lower risk of UC in the offspring.

Parental control attitudes over their pre-school children's diet.

It is during childhood that eating behaviors begin to form, with parents being the main agents in this process. Parents have eating habits that shape their children's diet, both in terms of variety and quantity of food eaten. The aim is to analyze sociodemographic factors related to parental control over their children's diet. Descriptive-correlational and cross-sectional study, with a sample of 46 parents of preschool children. An online questionnaire was used to collect data, with data processing carried out using SPSS, using descriptive and inferential statistics. The majority of respondents were mothers (89.1%), belonged to the 20-44 age group (89.1%), and were married (89.1%). The mean of the subscales of the children's food questionnaire food restriction, pressure to eat, and monitoring was 3.266 ± 0.570, 3.109 ± 1.206, and 4.268 ± 0.848, respectively. The mean rank score for the food restriction subscale differed significantly between parents with different age groups (Mann-Whitney: p < 0.014), with the 45-64 age group having the highest mean rank, i.e., they restricted their children more in food. The age group is a factor related to food restriction, making it essential to take a closer look at the parents of that age group, during the health education process.