Children's Dietary Habits Research Articles

Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur.

AimTo determine possible associations of early childhood caries (ECC) with risk factors such as feeding and dietary habits of children and oral hygiene practices by the parents or caregiver in rural and urban school children in Jaipur, India.Materials and methodsAn observational cross-sectional study was designed with a dental examination and a standardized questionnaire. A total of 1,824 children, that is, 848 (46%) rural, and 976 (54%) urban school children were enrolled in the study. The data regarding their diet and feeding habits of children, oral hygiene practices of the parents or caregivers were collected with the help of a standardized questionnaire. The caries status of rural and urban school children was recorded using the decayed, missing, filled teeth (DMFT) index. Data thus collected were compiled, analyzed and were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS v 26.0, IBM). Comparison of frequencies of categories of variables with groups was done using Chi-square test with p < 0.05 was considered to be statistically significant.ResultsThe prevalence of ECC was 34.7% in rural and 45.5% in urban school children of Jaipur (p < 0.01). Caries risk increased with the use of both bottle and breast feeding, habit of milk at night, eating snacks between meals with no habit of rinsing teeth, and decrease in parental supervision during oral hygiene practices. In urban school children there is an increased access to junk food and refined sugar daily as compared to rural school children with more than two times in a week was found statistically highly significant in the study (p < 0.01).ConclusionThe prevalence of ECC was higher in urban school children as compared to rural school children in Jaipur. It was found that risk factors such as diet and feeding habits of children and oral hygiene practices by the parents or caregiver are strongly associated with the prevalence of ECC. It was concluded that the epidemiological data, which have been collected in a very comprehensive way can be utilized more effectively to eliminate the root cause of the disease by improving oral health services in the rural and urban school children in Jaipur, India.How to cite this articleYadav SP, Meghpara M, Marwah N, et al. Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur. Int J Clin Pediatr Dent 2022;15(3):273-279.

Assessment of oral health problems, dietary, and lifestyle changes among pediatric dental patients during the COVID 19 pandemic - A cross sectional pilot study

Abstract Introduction: The COVID-19 pandemic has affected the routine lives of people worldwide because of lockdowns/restrictions. Children have been largely confined to home due to the suspension of schools, which may lead to potential behavioral changes. Routine dental services have been nonfunctional, and oral health problems have been frequently neglected. Aims: The present study aimed to assess oral health problems, dietary, and lifestyle changes among pediatric dental patients during the COVID-19 pandemic. Materials and Methods: This is a cross-sectional study that employed a structured 38-item questionnaire through teledentistry to 121 children who previously visited the dental department of a tertiary hospital in Delhi. The Dental Problems and Treatment Needs (DPTN-COVID-19) Questionnaire and Dietary Habits Lifestyle Changes (DHLC-COVID19) Questionnaire, customized and validated for the study, were administered for the assessment of oral needs of children and how they were managed during the pandemic. We also evaluated their dietary/lifestyle changes. Results and Discussion: Participants were interviewed telephonically; as a general trend, oral health was observed to be significantly affected among children. A majority of the children (83.47%) suffered from toothache, 34.71% had tooth-related swelling, and 18.1% experienced dental trauma. More than half of the parents of the participants (54.5%) preferred the management of dental problems with self-medication. Oral hygiene of the children was affected primarily due to decreased brushing frequency during the COVID-19 pandemic (43.8%). A considerable proportion of parents (44.6%) believed that the COVID-19 infection could spread by dental treatment and perceived the dental environment to be more dangerous than other places. A significant number of parents (59.5%) observed the changes in their children's dietary habits, with a drastic reduction in the consumption of high-carbohydrate snacks in children during the COVID-19 pandemic. Many parents (67.8%) observed a change in their children's hunger and satiety levels during the COVID-19 lockdown, with decreased appetite in 38.8% of the children. Moreover, a significant increase in screen time and changes in sleeping patterns was also observed during the pandemic. Multivariate logistic regression analysis was found to be significant predictors for brushing frequency, carbohydrates intake, and lifestyle changes before and during COVID-19. It was a good fit as analyzed on Pearson goodness-of-fit Chi-square test. The likelihood ratio of during COVID-19 model was statistically significant. The model was able to explain variance in the outcome measure before and during COVID-19, respectively, as analyzed on Nagelkerke pseudo R 2. Conclusion: In the present pandemic situation, amid the burden of increased biological and financial needs, oral health needs of children may have been neglected. This has been accompanied by associated dietary and lifestyle changes, leading to a vicious cycle demonstrating a need for appropriate strategies to address the issue.

FREQUENCY AND RISK FACTORS OF OVERWEIGHT AND OBESE SCHOOL GOING ADOLESCENTS OF DISTRICT PESHAWAR, KHYBER PAKHTUNKHWA, PAKISTAN

ABSTRACT&#x0D; Objective:&#x0D; To assess the frequency and risk factors of overweight and obese school going children of district Peshawar.&#x0D; To determine association of these risk factors with obesity in school going children.&#x0D; Material and methods:&#x0D; This is a cross sectional descriptive study, performed in public and private schools of district Peshawar from 1st October 2020 till 30th March 2021. A pre validated questionnaire was used to assess the dietary habits of students. The listed schools were stratified according to the monthly fee structure of the schools into three strata, low SES status (fee &lt; 1000 PKR), middle SES (fee = 1000-2500 PKR), high socioeconomic status (SES) (fee &gt; 2500 PKR). Two schools were selected using stratified random technique from each stratum. Simple random sampling technique (balloting) was used to select students from each selected school. Data were analyzed using SPSS 23. Chi square test was used to determine association between obesity and socioeconomic status and between obesity and dietary habits. Kendal-tau was used to determine statistical correlation between obesity and socioeconomic status and between obesity and dietary habits.&#x0D; Results: The overall frequency of overweight and obesity was found to be 14.7 % and 8% respectively. After applying chi square test, it was found that obesity has a significant association with socioeconomic condition and dietary habits of children. Kendal-tau was applied to develop correlation. It was found that obesity has positive correlation with socioeconomic condition +0.312. However obesity has negative correlation with dietary habits -0.092.&#x0D; Conclusion: childhood obesity is rising significantly in district Peshawar where every 4th or 5th child is either overweight or obese. The major risk factors that were studied were socioeconomic status and dietary habits, which were statistically found to be associated with obesity.&#x0D; Keywords: BMI, school going children, obesity, overweight.

Evaluation of the relationship between severe early childhood caries and vitamin D

To evaluate the relationship between the factors affecting the formation of severe early childhood caries (S-ECC) in preschool children, dental caries and serum 25-hydroxyvitamin D (25(OH)D) and to contribute to the literature on this subject. ASA I-II children aged <72 months and their volunteer parents who had no apparent learning disability were included in the study. 25(OH)D, calcium and albumin levels were measured from the serum samples taken from the children. Dft, dfs and plaque scores were calculated after the oral examination of the children. Parents were asked to fill out a questionnaire assessing the child's dietary habits and family demographics. Total of 175 children (56% male) participating in the study (n = 98; ECC, n = 77; caries-free). S-ECC was present in 42.8% of children with adequate 25(OH)D levels and 63.4% of children with deficient or insufficient levels. Children with S-ECC had significantly lower mean 25(OH)D levels than those caries-free. A very weak negative correlation was detected between 25(OH)D level and dft score. It was difficult to confirm the relationship between 25(OH)D levels and S-ECC. Again, there was a weak correlation between the dft score and 25(OH)D levels.

Estimated causal effects of complementary feeding behaviors on early childhood diet quality in a US cohort

Complementary feeding (CF) provides an opportunity to shape children's future dietary habits, setting the foundation for good nutrition and health. We estimated effects of 3 CF behaviors on early childhood diet quality using inverse probability (IP) weighting of marginal structural models (MSMs). Among 1041 children from the Boston-area Project Viva cohort, we estimated effects on the mean Youth Healthy Eating Index (YHEI) score in early childhood of 1) delayed (≥12 mo) compared with early (<12 mo) introduction of sweets and fruit juice; 2) continued compared with ceased offering of initially refused foods; and 3) early (<12 mo) compared with late (≥12 mo) introduction of flavor/texture variety. Mothers reported CF behaviors at 1 y and completed FFQs for children in early childhood (median age: 3.1 y). We estimated average treatment effects (ATEs) using IP weighting of MSMs to adjust for both confounding and selection bias due to censored outcomes and examined effect modification by child sex and breastfeeding compared with formula feeding at 6 mo. Twelve percent of mothers delayed introducing sweets/fruit juice, 93% continued offering initially refused foods, and 32% introduced flavor/texture variety early. The mean ± SD YHEI score was 52.8 ± 9.2 points. In adjusted models, we estimated a higher mean YHEI score with delayed (compared with early) sweets and fruit juice among breastfeeding children (ATE: 4.5 points; 95% CI: 1.0, 7.4 points), as well as with continued (compared with ceased) offering of refused foods among females (ATE: 5.4 points; 95% CI: 0.8, 9.1 points). The ATE for early (compared with late) flavor/texture variety was 1.7 points (95% CI: 0.3, 3.2 points) overall and stronger (2.8 points; 95% CI: 0.7, 5.1 points) among the formula-fed group. Delayed introduction of sweets/juice, continued offering of refused foods, and early flavor/texture variety may all result in higher childhood diet quality. Effects may depend on child sex and infant breastfeeding status.

Parental perception of child's weight, their attitudes towards child's dietary habits and the risk of obesity

BackgroundThe association between parental perception of child’s weight and their attitudes towards his/her dietary habits has not been reported yet. This study aimed to assess the association between parental underestimation of child’s weight and parental attitudes towards child’s dietary habits.MethodsWe conducted a cross-sectional analysis of SENDO cohort participants recruited between January 2015 and June 2020. All information was collected through online questionnaires completed by parents. We calculated crude and multivariable-adjusted odds ratio (OR) and 95% confidence intervals (CI) for unhealthy attitudes towards child’s dietary habits associated with parental underestimation of child’s weight.ResultsSixteen percent of children in the SENDO project had parents who underestimated their weight. Parents who underestimated their child’s weight status were more likely to have unhealthy attitudes toward his/her dietary habits [OR 3.35; 95% CI (1.71–6.53)].ConclusionsParental underestimation of child's weight was associated with unhealthy attitudes towards child’s dietary habits. Pediatricians and public health practitioners should pay attention to the parental perception of child’s weight to identify parents who underestimate it as an at-risk group in which to inquire about lifestyle and dietary habits.

Nutrition Literacy of Middle School Students and Its Influencing Factors: A Cross-Sectional Study in Chongqing, China.

Nutrition literacy plays an important role in children's dietary habits and nutrition. This study aimed to analyse the status of nutrition literacy and its influencing factors amongst middle school students in Chongqing, China. “Nutrition literacy scale for middle school students in Chongqing” was used in 29 districts of Chongqing in September 2020. The scores of nutrition literacy and its' three sub-domains (functional, interactive and critical nutrition literacy) were divided into low and high groups based on their median scores. Binary logistic regression was used to measure the influencing factors of nutrition literacy. A total of 18,660 middle school students were included in this study. The median of nutrition literacy of middle school students was 61.68 (IQR = 14.37). Interactive nutrition literacy had the highest score (median = 70.00, IQR = 20.00), followed by functional nutrition literacy (median = 68.69, IQR = 14.14) and critical nutrition literacy (median = 45.83, IQR = 25.00). Students who were the minority (OR = 0.71, 95% CI = 0.637–0.785), in senior high school (OR = 0.51, 95% CI = 0.477–0.548), in rural areas (OR = 0.85, 95% CI = 0.790–0.911), receiving school meal support from the government (OR = 0.63, 95% CI = 0.591–0.664), with other caregivers' parenting (OR = 0.86, 95% CI = 0.805–0.914), with parents having a low level of education and with an abnormal BMI [thin (OR = 0.91, 95% CI = 0.837–0.990), overweight (OR = 0.87, 95% CI = 0.785–0.968), and obese (OR = 0.83, 95% CI = 0.767–0.902)] presented less probability of being a high level of nutrition literacy. Our results could assist public health authorities in developing strategies of nutrition literacy promotion for references and theoretical foundations.

Prevalence of early childhood caries in three regions of China: A cross-sectional study.

The burden of early childhood caries (ECC) in different regions of China with different levels of economic development has been of interest to policymakers and public health workers. To investigate regional differences in ECC prevalence in China and to identify associated risk factors. A total of 11612 three- to five-year-old children from three geographic regions of China were included in this cross-sectional study. The dmft index was assessed for each child. A questionnaire regarding children's dietary habits, oral health behaviors, parents' socioeconomic status, and attitudes toward oral health was administered. Odds ratios and 95% confidence intervals were calculated to evaluate associated factors. Caries prevalence in the Eastern, Central and Northwestern regions of China was 63.4% (95% CI: 61.4%-64.5%), 59.4% (95% CI: 58.6%-61.7%), and 59.0% (95% CI: 58.5%-61.6%), respectively. Children from the Northwestern (OR=0.83, 95% CI: 0.75-0.92) and Central (OR=0.83, CI: 0.75-0.92) regions of China had a lower risk of experiencing ECC. Dietary habits and parents' specific oral health knowledge and attitudes were associated with ECC. Differences in ECC prevalence were found in the three regions of China. Multiple factors were associated with ECC. Overall, the burden of ECC was heavy in the examined regions.

Food for thought: Eating before saliva collection and interference with SARS-CoV-2 detection.

Saliva is a promising specimen for the detection of viruses that cause upper respiratory infections including severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) due to its cost‐effectiveness and noninvasive collection. However, together with intrinsic enzymes and oral microbiota, children's unique dietary habits may introduce substances that interfere with diagnostic testing. To determine whether children's dietary choices impact SARS‐CoV‐2 molecular detection in saliva, we performed a diagnostic study that simulates testing of real‐life specimens provided from healthy children (n = 5) who self‐collected saliva at home before and at 0, 20, and 60 min after eating 20 foods they selected. Each of 72 specimens was split into two volumes and spiked with SARS‐CoV‐2‐negative or SARS‐CoV‐2‐positive clinical standards before side‐by‐side testing by reverse‐transcription polymerase chain reaction matrix‐assisted laser desorption ionization time‐of‐flight (RT‐PCR/MALDI‐TOF) assay. Detection of internal extraction control and SARS‐CoV‐2 nucleic acids was reduced in replicates of saliva collected at 0 min after eating 11 of 20 foods. Interference resolved at 20 and 60 min after eating all foods except hot dogs in one participant. This represented a significant improvement in the detection of nucleic acids compared to saliva collected at 0 min after eating (p = 0.0005). We demonstrate successful detection of viral nucleic acids in saliva self‐collected by children before and after eating a variety of foods. Fasting is not required before saliva collection for SARS‐CoV‐2 testing by RT‐PCR/MALDI‐TOF, but waiting for 20 min after eating is sufficient for accurate testing. These findings should be considered for SARS‐CoV‐2 testing and broader viral diagnostics in saliva specimens.

Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence

BackgroundThe food environment within and surrounding homes influences family dietary habits with socio-economic areas at a nutritional disadvantage. Families’ perception of the food environment and how it influences their food decisions is less clear. This rapid review aimed to synthesise qualitative evidence of parental perspectives of the food environment and their influence on food decisions among disadvantaged families.MethodQualitative and mixed-methods peer-reviewed journal articles published after 2000, that explored the perspectives of low-income parents in relation to their food environment and how this impacted food decisions for families with children aged 2-17 years, were included in this review. Embase, Scopus and PsycINFO were the databases chosen for this review. Search strategies included seven concepts related to family, food, perceptions, influences, environment, socio-economic status and study type. Two independent reviewers screened sixty-four studies. Thematic synthesis was employed.ResultsTwo thousand one hundred and forty five results were identified through database searching and 1,650 were screened. Fourteen articles that originated from the US, Australia and the UK were included in this review. No articles were excluded following quality appraisal. Child preferences, financial and time constraints, and location and access to food outlets were barriers to accessing healthy food. Parental nutrition education and feeding approaches varied but positive outcomes from interventions to address these behaviours will be short-lived if inequities in health caused by poverty and access to affordable and healthy food are not addressed. The reliance on social support from families or government sources played an important role for families but are likely to be short-term solutions to health and nutritional inequities.ConclusionsThis qualitative evidence synthesis provides an insight into the perceptions of low-income parents on the factors influencing food decisions. Findings have implications for public health and the development of effective strategies to improve the dietary habits of children of disadvantaged families. Sustainable changes to dietary habits for families on low-income requires policy responses to low income, food access and to the high cost of healthy foods.

Meals adequacy during weekdays and weekends in an Italian primary school children sample

Abstract Background Between 15 and 50% of European children aged 6-9 are overweight or obese and this number is rising dramatically over time, making it one of the most important public health challenges. Selection of healthy food and a balanced diet are key when addressing this obesity epidemic. At the same time, it is essential to consider schools' role and parents' influence on children's dietary habits. This study aims to assess the adequacy of meals during the weekdays (WD) and weekends (WE), therefore highlighting the critical moments where schools' and parents' involvement needs to be of greater impact. Methods A cross-sectional study was conducted among 428 children aged 6-11 recruited in a primary school of Calderara di Reno (Italy) in 2017. A weekly diary was administered between May and June 2017 to explore the dietary habits of the participants. Every day for each meal (breakfast, morning snack, lunch, dinner) it was required to report what types of food and beverages were consumed, and where (home/school). The adequacy of each meal was determined by using national guidelines. A McNemar test was performed to evaluate the differences in meal adequacy between the WD and WE. Results Our analysis showed that meals consumed at school, i.e. morning snacks and lunches, were more adequate during WD than WE (69.6% vs 22.2%, 53.5% vs 32.5%; P-value &amp;lt;0.001), underlying the positive influence of school. On the other hand, breakfasts and dinners were more adequate during WE than WD (64.5% vs 51.4%, 23.8% vs 15.7%; P-value &amp;lt;0.001); this difference might be partially explained by the different amount of time parents have for food preparation during workdays versus weekends. Conclusions Further preventive interventions should address childrens' and parents' home dietary routine as a tool to improve meal adequacy at home and therefore reduce childhood obesity. Parental school-based interventions could have a key role in changing childrens' dietary habits. Key messages Our study showed a significant difference of healthy dietary habits between meals served at school during weekdays and at home during weekends, highlighting a higher dietary adequacy in the first ones. The results underline the importance of implementing educational programs addressing childrens’ and their parents' home meals routine and dietary habits.

Fractional urinary fluoride excretion and nail fluoride concentrations in normal, wasted and stunted 4–5 year-old children in Nepal

IntroductionIt has been suggested that undernourished children are more likely to develop dental fluorosis. We investigated the effects of nutritional status on systemic fluoride metabolism including the proportion of ingested fluoride excreted through urine (i.e. fractional urinary fluoride excretion - FUFE) and fluoride concentration in nail clippings in children, aged 4−5 years, in Nepal. MethodsNutritional status was evaluated using weight-for-age (wasting) and height-for-age (stunting) indices. Total daily fluoride intake (TDFI) was estimated from diet and toothpaste ingestion and 24 -h urine collected to assess daily urinary fluoride excretion (DUFE). FUFE was calculated by dividing DUFE by TDFI. Nail clippings (finger and toe) were collected and analysed for fluoride concentration. ResultsOf the 100 children who participated, 89 provided information to assess FUFE and 51 children provided nail samples. Overall, 86.5 % of the 89 children were wasted and 39.3 % were stunted.When the samples were pooled into binary (affected and non-affected) categories, mean TDFI and mean DUFE were statistically significantly higher in the 77 wasted children (57.7 and 29.7 μg/kgbw/d, respectively) than the 12 non-wasted children (39.4 and 17.0 μg/kgbw/d, respectively). TDFI and DUFE were also statistically significantly higher in the 35 stunted children (65.1 and 34.5 μg/kgbw/d, respectively) than in the 54 non-stunted children (48.8 and 23.7 μg/kgbw/d, respectively). However, mean FUFE was similar in all groups. There were no statistically significant differences in fluoride concentration of either fingernails or toenails among the different categories of wasting, while mean fingernail fluoride concentration was statistically significantly higher in stunted (5.4 μg/g) than in non-stunted children (3.5 μg/g). ConclusionOur study found no significant effect of nutritional status on the proportion of ingested fluoride excreted in urine (and consequently the proportion retained in the body). These findings suggest that nutritional status may be less likely to be a main risk factor for the development of dental fluorosis than children's dietary habits or total fluoride intake.

Are Physical Activity and Sedentary Screen Time Levels Associated With Food Consumption in European Adolescents? The HELENA Study

Objective One of the current main public health problems is the prevalence of obesity in children. Unhealthy lifestyle behaviors such as poor dietary habits, high sedentary screen time (SST), and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The aim of this manuscript is to assess the association between meeting or not meeting the PA and SST recommendations and the consumption of different food groups. Method Data were obtained from a sample of European adolescents from the multicenter cross-sectional HELENA study. In all, 1448 adolescents from 8 cities were included. PA was objectively measured by accelerometry and dietary intake by 24-hour dietary records. Adolescents were grouped according to PA and SST recommendations. Results In both sexes, intake of savory snacks was higher in those groups who did not meet any of the recommendations (p < 0.05). For males, those who met both recommendations were more likely to drink/eat milk, yogurt, and water (p < 0.05). Those not meeting recommendations were more likely to drink sugar-sweetened beverages (p < 0.05). For females, those not meeting recommendations were less likely to eat fruits and vegetables and more likely to have a higher intake of fats and oils (p < 0.05). Conclusions Those adolescents meeting PA and SST recommendations had a higher intake of healthy foods, like fruit and vegetables and dairy products. However, the negative relationship unhealthier food and SST is stronger in males independently of PA. More studies assessing the combined effect of both PA and SST regarding dietary habits in children and adolescents are needed.

Cariogenic Risk and COVID-19 Lockdown in a Paediatric Population.

The Severe Acute Respiratory Syndrome Coronavirus 2 disease COVID-19 pandemic caused several lifestyle changes, especially among younger people. The study aimed to describe the impact of eating habits, lifestyle, and home oral hygiene during the COVID-19 pandemic, on the cariogenic risk in the Italian paediatric population, by using an online survey. The survey was conducted through a virtual questionnaire divided into four parts: child personal and anthropometric data; oral health; child dietary habits (KIDMED test); and child lifestyle, before and during COVID-19 lockdown. During the lockdown, only 18.6% of the participants had high adherence to a Mediterranean diet, recording an increase in sweets consumption and the number of meals (p < 0.001). In terms of lifestyle, the percentage of moderately and vigorously active children decreased (41.4% and 5.0%, respectively) (p = 0.014). The percentage of children sleeping more than 9 h increased (p < 0.001). They watched more television programs (p < 0.001). Regarding oral hygiene, children did not change their brushing habits (p = 0.225). The percentage of children using non-fluoridated toothpaste was higher (6.4%), and no changes were observed (p > 0.05). In some cases, dental pain and abscesses were declared (10% and 2.7%, respectively). This study confirms the need for campaigns to promote hygiene and dental care in combination with food education for a correct habit and promotion of a healthy and sustainable dietary style.

Association Between Food Insecurity and Diet Quality Among Early Care and Education Providers in the Pennsylvania Head Start Program.

IntroductionFood insecurity affects dietary behaviors and diet quality in adults. This relationship is not widely studied among early care and education (ECE) providers, a unique population with important influences on children’s dietary habits. Our study’s objective was to explore how food insecurity affected diet quality and dietary behaviors among ECE providers.MethodsWe used baseline data from a cluster-randomized controlled trial (January 2019−December 2020) on 216 ECE providers under the Pennsylvania Head Start Association. We used radar plots to graph scores for the Healthy Eating Index 2015 and the Alternative Healthy Eating Index (AHEI) 2010 and fitted a multivariate regression model for diet quality measures, adjusting for covariates.ResultsAmong the 216 participants, 31.5% were food insecure. ECE providers who were food insecure had a lower AHEI-2010 mean score (mean difference for food insecure vs food secure = −4.8; 95% CI, −7.8 to −1.7; P = .002). After adjusting for covariates, associations remained significant (mean difference = −3.9; 95% CI, −7.5 to −0.4; P = .03). Food insecure ECE providers were less likely to use nutrition labels (22.8% vs 39.1%; P = .046) and more likely to report cost as a perceived barrier to eating fruits and vegetables.ConclusionWe found a significant inverse association between food insecurity and the AHEI-2010 diet quality score among ECE providers after adjusting for covariates. More studies are needed to examine the effects of food insecurity on dietary behaviors of ECE providers and their response to nutrition education programs targeting their health.

Dietary practices among children with early childhood caries and the associated factors: A qualitative study.

Parents play a vital role in their children's dietary habits. A comprehensive understanding of the perspectives of parents of children with early childhood caries (ECC) is required for prevention program planning. To describe the parental perspective of the dietary habits of children with ECC. In this descriptive qualitative study, the participants were parents of children with ECC receiving routine dental care. Data were collected through focus groups using an interview guide. Data were analyzed manually using the content analysis method. Five focus groups involving 27 participants were conducted. Two main categories emerged: cariogenic food literacy and factors that affect food choices. Most of the participants knew that sugary foods are responsible for tooth decay. Parents felt that children's snacking habits were influenced by multiple factors, such as family environment, peers, commercials on television or the Internet, and affordability of food. Parents are not able to translate their knowledge into action to modify their children's diet as they may lack self-efficacy and feel pressured by their children, the media and the environment in which they live. Motivational interviewing of parents and governmental and school policies to reduce sugary food consumption may be required.

Comparison of Salivary Protein Profile and Dietary Habits in Children With and Without Early Childhood Caries

Background and objectives: The purpose of this study was to evaluate the relationship between the total salivary protein concentration and dietary habits in Caries-free, Early childhood Caries and Severe Early Childhood Caries children.&#x0D; Materials and methods: The present study included Thirty children who were divided into three groups. They were further divided into Caries-free, Early childhood Caries and Severe Early Childhood Caries with 10 children in each group. Information was collected regarding oral hygiene practices, feeding habits and dietary pattern through a face-to-face interview with the parent/caretaker of the child. Unstimulated saliva was collected and total protein concentration was estimated. Multivariate logistic regression analysis was performed to assess the relative contributions of dietary and feeding patterns between children with and without ECC. ANOVA was done to identify the difference in mean protein concentration between the groups.&#x0D; Results: Risk factors specific to the ECC group were Breast feeding &lt;24 months (OR 2.1, 95% CI, 0.35-13.0), bottle feeding (21.0, 95% CI, 2.8-15.7), snacking more than 3 times per day (OR 1.22, 95% CI 0.283-5.734), consumption of less protein diet (OR 4.1, 95% CI, 1.99-8.81), consumption of less milk products (2.33, 95% CI, 1.67-6.77). Results also revealed that there was no statistically significant difference in total protein concentration between Caries-free, Early childhood Caries and Severe Early Childhood Caries group.&#x0D; Conclusion: Within the limitation of this study, we can conclude that, Breast feeding less than 24 months, bottle feeding, snacking more than thrice per day, consuming low protein diet and low milk products had a high risk of developing ECC. There was no significant difference in the mean protein concentration between caries free, ECC and S ECC group.

Parental phone use during mealtimes with toddlers and the associations with feeding practices and shared family meals: a cross-sectional study

BackgroundPositive parental feeding practices and a higher frequency of family meals are related to healthier child dietary habits. Parents play an essential role when it comes to the development of their child’s eating habits. However, parents are increasingly distracted by their mobile phone during mealtimes. The aim of this study was to describe the feeding practices and daily shared family meals among parents who use and do not use a mobile phone during mealtimes, and further to explore the associations between the use of a mobile phone during mealtimes and feeding practices and daily shared family meals, respectively.MethodsCross-sectional data from the Food4toddler study were used to explore the association between mobile use during meals and parental feeding practices including family meals. In 2017/2018 parents of toddlers were recruited through social media to participate in the study. In total 298 out of 404 who volunteered to participate, filled in a baseline questionnaire, including questions from the comprehensive feeding practices questionnaire (CFPQ), questions of frequency of family meals and use of mobile phone during meals.ResultsHerein, 4 out of 10 parents reported various levels of phone use (meal distraction) during mealtimes. Parental phone use was associated with lower use of positive parental feeding practices like modelling (B = − 1.05 (95% CI -1.69; − 0.41)) and family food environment (B = − 0.77 (95% CI -1.51; − 0.03)), and more use of negative parental feeding practices like emotional regulation (B = 0.73 (95% CI 0.32; 1.14)) and the use of pressure to eat (B = 1.22 (95% CI 0.41; 2.03)). Furthermore, parental phone use was associated with a lower frequency of daily family breakfast (OR = 0.50 (95% CI 0.31; 0.82)) and dinner (OR = 0.57 (95% CI 0.35; 0.93)).ConclusionsMobile phone use is common among parents during mealtimes, and findings indicate that parental phone use is associated with less healthy feeding practices and shared family meals. These findings highlight the importance of making parents aware of potential impacts of meal distractions.Trial registrationISRCTN92980420. Registered 13 September 2017. Retrospectively registered.

Physical and Sedentary Activities and Childhood Overweight/Obesity: A Cross-Sectional Study among First-Year Children of Primary Schools in Modena, Italy.

Children obesity is a serious public health issue. This study aimed to investigate physical/sedentary activities of first-year primary schools children in Modena, and their association with overweight/obesity and dietary habits of children and family characteristics to identify the risk factors for unhealthy lifestyles. Child physical/sedentary activities were gathered through an anonymous questionnaire administered to parents, as well as family characteristics and weight/height of child and parents. Logistic regression models, eventually adjusted for parents’ sociodemographic characteristics, were used to analyze data. Questionnaires were delivered by 660 families (74.2%), of which 72 without anthropometric data were excluded. Three out of four children spent in physical activities less than 7 h/week, while 63.9% dedicated to sedentary activities two or more hours/day. From multivariate analysis, the habit significantly affecting children’s overweight/obesity was spending time on tablets/Personal Computers/mobile phones/videogames. Higher parental education level resulted in a protective factor for implementing unhealthy lifestyles in terms of time dedicated to physical/sedentary activities. Our results suggest the need of interventions to increase time for physical activity and to promote a responsible use of digital media involving the entire families to reach all parents regardless of their education and nationality with a possible relapse on other family members.

IMPORTANCE OF THE DIETARY HABITS IN RELATION TO PREVENTION OF MALNUTRITION

Child malnutrition is a major public health concern worldwide, leading to higher morbidity and mortality. It is mostly preventable through public health and economic development. Malnutrition refers to the situation where there is an unbalanced diet in which some nutrients are in excess, lacking or wrong proportion. Simply put, we can categories it to be under-nutrition and over-nutrition. Nutrition effects on children’s physical, cognitive and behavioral development. Television and computer game exposure affect children’s sleep and deteriorate verbal and cognitive performance which support the hypothesis of the negative influence of media on consumption of children sleep, learning and memory. Most of the childhood obesity prevention efforts have focused on school age children and have had limited success. In the present study importance of dietary habits in children is discussed.