Children's Dietary Habits Research Articles

Mothers' Perceptions and Attitudes towards Children's Vegetable Consumption-A Qualitative, Cross-cultural Study of Chilean, Chinese and American Mothers Living in Northern California.

This exploratory research focused on the cultural variables involved in children’s vegetable consumption, through the analysis of mothers’ perceptions, attitudes, and feeding practices regarding their children’s intake, using qualitative consumer research methods. Twelve focus groups of mothers with children between 2–12 years old (Euro-Americans n = 20, Chinese n = 19, and Chilean n = 19) were conducted. All participants lived in Northern California, had higher education, and incomes that did not limit their vegetable purchase. Intercultural differences in vegetable preferences and consumption habits were found. Mothers across all groups agreed on the importance of children’s vegetable consumption, the influence that mothers have over their children’s vegetable intake, and how challenging it is to get children to eat a variety of vegetables. The ethnic groups differed regarding how they perceived the level of mothers’ responsibility over children’s vegetable intake, the way that mothers defined the amount of vegetables that children should eat, the constraints that mothers had on increasing their children’s vegetable intake and mothers’ recommendations to encourage vegetable consumption. Our study suggests that under similar socio-economic and parental education levels, culture-specific strategies should be considered to foster healthy dietary habits in children.

VITAMIN D STATUS AND DIETARY HABITS OF CHILDREN WITH ADOLESCENT IDIOPATHIC SCOLIOSIS IN VARNA

Background: Adolescent idiopathic scoliosis (AIS) is a very common condition amongst adolescents in Bulgaria, as well as in Europe. Few factors play a role in the etiopathogenesis, one of which is the lifestyle, specifically the levels of some nutrients, and anthropometrics. They can be described as aspects of the nutritional status of patients with AIS. Purpose: This ongoing study aims to access the vit. D3 and dietary habits of children with AIS in Varna. Methods: Data was collected from 77 participants so far, using anthropometric measurements, food questionnaires and biochemical testing for vit. D3 levels in blood serum of all children without contraindications or objections (34 out of the 77). Results: Out of 34, 3% are sufficient, while 47% are insufficient and 50% are with moderate to severe levels of deficiency. The level of consumption of fish amongst all the participants so far is below the recommendations. The level of consumption of eggs, despite the low amount of vit. D3 in the egg yolk also has a correlation to the levels of vit. D3. Participants supplementing with vit D3 or multivitamins containing it had similar average levels to the children not supplementing. Conclusions: The data so far shows that participants might be in need of more information about fish consumption recommendations and how to properly supplement with vit D3 .

Association between parental attitudes towards their offspring's diet and children's actual dietary habits - The SENDO project.

Introduction: the preschool stage is a critical period for teaching and modeling healthy habits to positively influence children's health and wellbeing throughout their lifetime. Objectives: to evaluate the association between parental attitudes towards their offspring's dietary habits in Spanish children aged 4 to 7 years participating in the Follow-up of Children for Optimal Development (SENDO) project. Methods: we defined an index to measure information on parental attitudes towards their offspring's diet (0 to 8 points), and another one to measure children's actual dietary habits (0 to 19 points). A higher score meant healthier attitudes and healthier habits, respectively. Information was collected through an online questionnaire completed by parents. We calculated crude and multivariable-adjusted odds ratios (OR) and 95 % confidence intervals (CI) for children's healthy dietary habits associated with parental scores in the parental attitudes index. Generalized estimation equations (GEE) were used to account for intra-cluster correlation between siblings. Results: a total of 423 preschoolers (52.3 % boys, mean age 5.3 years) were included in the analyses. Half of the children (51 %) reported unhealthy dietary habits, whereas 56 % of parents reported high adherence to the healthy eating index. Compared to those in the lowest category, the children whose parents were in the highest category in the parental attitudes index showed significantly higher odds of having healthy dietary habits (OR: 2.91; 95 % CI: 1.30-6.53, p for trend = 0.004). Conclusions: our results support a direct association between parental attitudes and their offspring's dietary habits, suggesting that public health interventions aimed at improving children's dietary habits should shift from the individual- to a family-based approach.

Oral health practice and health-related quality of life of a group of children during the early stage of the COVID-19 pandemic in Istanbul.

BACKGROUND:During the pandemic period of coronavirus disease, appropriate oral health management and disease prevention of children are very important for children's oral and general health. The aim of this study was to survey to better understand in children's dental health and dietary habits and to learn about parents' attitudes toward dental treatment and clinical factors associated with their QoL using the Turkish version of KIDSCREEN-10 during the initial stage of the COVID-19 pandemic in the general public.MATERIALS AND METHODS:A two-part questionnaire, namely Part 1 addressed topics regarding changes in general and dental health, dietary habits of children under quarantine, and sociodemographic characteristics of the family and Part 2 impact of QoL was assessed by the KIDSCREEN-10 scale with 10 questions. The questionnaire was sent online using WhatsApp to a convenience sample of mothers with children between the age group of 8 and 18 years, who lived in Istanbul. Variables were statistically analyzed using the Student's t-test for independent samples and Univariate F-test, ANOVA according to the characteristics of variables which were analyzed.RESULTS:This study included 328 from 557 mothers with 58% respondent rate. The consumption of fast food, packaged food, and carbonated beverages decreased during the COVID-19 outbreak. Half of the mothers of children reported that they were anxious or fearful about their children visiting dentists during the pandemic and 64.2% of the children missed routine dental visits. The KIDSCREEN-10 scores for 13 years old or older children were influenced more by the COVID-19 pandemic than those for the 8–12 years old, who had a better QoL (P = 0.008).CONCLUSIONS:The results of this study emphasize the importance of oral health and QoL of children during the initial phase of the COVID-19 outbreak. The general perception of QoL in this group of Turkish children seemed to be substantially affected by COVID-19 outbreak.

Associations of family feeding and mealtime practices with children's overall diet quality: Results from a prospective population-based cohort

Food parenting practices are considered to have a key influence on children's dietary habits, with potential long term effects. In this study, we explored the associations of parental feeding practices and family mealtime practices in early childhood with children's overall diet quality at school age among 3626 parents and their children in a population-based cohort study in Rotterdam, the Netherlands. Parental feeding practices (monitoring, pressure to eat, and restriction) and family mealtime practices (meal skipping behaviors and family meal frequency) at age 4 years were assessed by parental questionnaires. Children's dietary intake was assessed at age 8 years using a food-frequency questionnaire, from which diet quality scores (range 0–10) were calculated, reflecting adherence to age-specific dietary guidelines. Using multivariable linear regression models, we found that monitoring was associated with higher diet quality of children (β = 0.12; 95%CI: 0.08, 0.16), whereas pressure to eat was associated with lower diet quality (β = −0.08; 95%CI: −0.12, −0.04)), both independent of child BMI. Restriction was associated with a higher child diet quality, but this association was explained by child BMI. As compared to children who did not skip meals, children who skipped meals had a lower diet quality (e.g. breakfast skipping: β = −0.32; 95%CI: −0.48, −0.17). Similarly, children who had less frequent family meals had a lower diet quality compared with those who had family meals every day (e.g. family dinner ≤2 days/week: β = −0.37; 95%CI: −0.60, −0.14). These associations were not driven by single food groups. In conclusion, parental monitoring and family mealtime routines in early childhood may provide a supportive food environment that promotes children's overall diet quality. Longitudinal studies with repeated measurements are needed to replicate our findings.

The effect of teacher-delivered nutrition education programs on elementary-aged students: An updated systematic review and meta-analysis.

Research shows that schools can make a positive impact on children’s nutritional outcomes. However, it is also reported that schools and teaching staff note many barriers, which may restrict nutritional education programming and delivery. This is concerning, considering the view that teachers are the key agents for promoting health and nutrition within schools. The purpose of the updated systematic review and meta-analysis was to ascertain the impact that nutrition education programs have on elementary-aged students’ energy intake, fruit, vegetable, sugar consumption and nutritional knowledge. A systematic literature search was conducted using electronic databases (The Cochrane Central Register of Controlled Trials (CENTRAL); A + Education; ERIC; PsycINFO; MEDLINE; ProQuest Central, Journals@Ovid and SAGE Health Sciences Full-Text Collection) from 1990 to 31st October 2018. This process yielded 34 studies for inclusion in this systematic review and meta-analysis. Of these studies, seven studies had a focus on energy intake, five had a focus on sugar consumption, 21 of the studies looked at fruit and vegetable consumption and 13 studies focused on nutritional knowledge. The results suggest that the teaching of nutrition education in elementary schools by qualified teachers can make an important contribution to the knowledge and dietary habits of children. The small and medium effect sizes indicate that prudent, evidence-based decisions need to be made by policy makers and pedagogues as to the teaching strategies employed when delivering nutrition education programs to elementary-aged students.The review is reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (van Sluijs et al., 2007).

Dietary habits associated with growth development of children aged

BackgroundKnowing which dietary habits are associated with child growth could lead to better long-term health outcomes and improve the design of food-based interventions. We aimed to identify dietary habits that are associated with the growth development of children aged < 5 years living in rural Burkina Faso.MethodsThis study used cross-sectional baseline data from 514 children (8–59 months) within the Nouna Health and Demographic Surveillance System (HDSS) in 2018. Household socio-demographics and child dietary habits, height and weight were assessed. We constructed scores for dietary diversity (DDS) and food variety (FVS), and extracted exploratory dietary pattern scores (DPS) using principal component analysis (PCA). Child growth was measured using height-for-age (HAZ) and weight-for-height z-scores (WHZ). We used multiple-adjusted linear regressions considering for socio-economic factors to quantify associations.ResultsIn this study population (median 36 ± 14 months old), stunting (HAZ < − 2) was seen in 26% and wasting (WHZ < − 2) in 7%. The DDS (median 7 ± 2 food groups) was positively associated with WHZ, while the FVS (median 13 ± 8 food items) was inversely associated with HAZ. We identified 4 dietary patterns: leaves-based, beans and poultry-based, maize and fish-based, and millet and meat-based diets. Only the maize and fish-based diet showed a statistically significant and here positive trend for associations with WHZ.ConclusionGrowth development of children aged < 5 years continues to be a health problem in the Nouna HDSS. A higher dietary diversity and food variety and dietary patterns characterized by maize and fish and beans and poultry intake appear to be beneficial for growth of young children in this area.

A Narrow Window: Booming Gluten-free Market and Fostering Healthy Dietary Habits in Children With Celiac Disease.

An expanding gluten-free marketplace has left children with celiac disease and their families with a host of new dietary options. The quality of these foods is inconsistent and processed items may be high in caloric content while lacking nutritional value. Assessing the dietary preferences of a cohort of children with celiac disease via cross-sectional survey, we find that these processed food items have become a staple of the gluten-free diet, and in many cases, these foods are consumed to the exclusion of healthy alternatives. Furthermore, children with celiac disease and their families become less interested in dietary education over time, indicating that the greatest opportunity for imparting a healthy diet may occur at the time of diagnosis.

Correlation between Blood Pressure, Body Mass Index, Life Style and Dietary Habits in Children and Adolescents Aged 6 to 18 Years in Tabriz, Iran

Introduction: The prevalence of childhood high blood pressure is rising fast. The possibility of high blood pressure augments with increasing body mass index (BMI), inappropriate dietary intake and lifestyle problems. The aim of this study was to investigate the correlation between blood pressure, body mass index, life style and dietary habits in children and adolescents aged 6 - 18 years in Tabriz, Iran. Methods: The present study was a cross-sectional study. Using data of the Sib software (the software used in the health transformation system) were collected. This data includes anthropometric information, some demographic factors, dietary intake and lifestyle of 425 children and adolescents with overweight and obesity. The data were analyzed by STATA software (MP 4.2 potable 2017). Results: The association between systolic blood pressure and dairy products (P = 0.02), watching TV / PC (P = 0.041), BMI quarter (P &lt;0.001), BMI (P &lt;0.001), and age (P &lt;0.001) as well as the association between diastolic blood pressure with BMI quarter (P &lt;0.001), BMI (P &lt;0.001) and age (P &lt;0.001) was statistically significant and the other variables did not show a meaningful statistical relationship. Conclusion: Age, BMI, less dairy consumption, and watching TV/PC has a relationship with high blood pressure. Therefore, nutritionists and health workers should consider the above considerations when making recommendations in children and adolescents with overweight and obesity.

The Effects of Parental Emotion Regulation Ability on Parenting Self-Efficacy and Child Diet.

Child weight issues can be emotionally challenging for parents. The purpose of this study was to examine how parents' ability to manage negative emotions may facilitate parenting self-efficacy and healthy parenting behaviors (e.g., providing healthy food for a child). In this study, parents (N = 159) of a 6-12-year-old child completed a health-specific parenting self-efficacy questionnaire and retrospectively reported their child's daily servings of fruits and vegetables and sweets and soda. They also completed a parental emotion regulation task where they viewed film clips of families struggling with child weight challenges. During this task, parents managed their emotions by either positively reframing the situation to feel less negative (down-regulate negative emotions) or negatively reframing the situation to feel more negative (up-regulate negative emotions). We tested a mediation model examining the relations among parent emotion regulation, parenting self-efficacy, and child dietary habits. Results revealed that parents' ability to down-regulate negative emotions was associated with lower parenting self-efficacy, which in turn was associated with greater sweets and soda consumption among children. In contrast, parents' ability to up-regulate negative emotions was directly associated with lower sweets and soda consumption, regardless of parenting self-efficacy. Our findings have implications for healthcare practice and child weight interventions as they underscore the importance of helping parents consider the consequences of childhood obesity to encourage healthy eating behavior in families.

Impact of the oncological treatment on change in taste perception and dietary habits of children diagnosed with cancer – preliminary study

Purpose: Chemotherapy, which is widely used in cancer treatment in children, may cause various side effects, including impaired taste perception, thus the main aim of the presented study was a subjective assessment of changes in taste perception and dietary habits among children undergoing oncological treatment. Materials and methods: In the present study, 41 hospitalized children were examined (mean age 11.0 ± 5.1 years). Anthropometric measurements were made, and diet was assessed using a food frequency questionnaire. Results: For 85.4% of the patients, the current treatment was chemotherapy. The average Body Mass Index value was 17.8 kg/m2 . 68.3% of children declared a change in taste preferences preferred tastes were spicy (39.3%) and sour (35.7%). Determination of the way of eating showed a significant reduction in the consumption of bread, milk and dairy products, poultry, meat, fish, potatoes, vegetables, and a particularly pronounced decrease in the frequency of sweets consumption. Conclusions: Oncological treatment changes the subjective taste perception of children in favor of intense flavors, and the process of oncological treatment, especially the use of chemotherapy, affects the way of eating

Relationship Between Parental Lifestyle and Dietary Habits of Children: A Cross-Sectional Study.

BackgroundAlthough parents seek the best for their children, nutrition education for parents has attracted little attention to improve their children’s dietary habits. To address this gap, this study aimed to examine the relationship between parental lifestyle factors and children’s dietary habits.MethodsWe used data from the questionnaire survey of the Super Shokuiku School Project conducted in January 2016. The participants consisted of 1,632 elementary school children who answered questions about their lifestyle, while their parents answered parental lifestyle questions, including Breslow’s seven health practice score (BHPS). Logistic regression analysis was performed to evaluate the strength of the relationship between parental lifestyle factors and parental dietary attitudes or children’s dietary habits.ResultsCompared with good maternal BHPS (scores of 6–7), poor maternal BHPS (scores of 0–3) was significantly associated with less parental interest in Shokuiku, less parental consideration of nutrient balance, and an increased rate of children eating breakfast alone (adjusted odds ratio [aOR] 2.95; 95% confidence interval [CI], 1.82–4.78, aOR 3.86; 95% CI, 2.50–5.96, and aOR 2.42; 95% CI, 1.34–4.35, respectively). There was no significant difference between parental BHPS and the following children’s dietary habits: frequency of eating breakfast, vegetable intake, and snacking. These habits of children were associated with their personal lifestyle factors.ConclusionTwo types of dietary habits among children were associated with lifestyle factors of both parents and children. Nutrition education might be especially important for parents to improve their dietary attitude and children’s dietary habits. However, different nutrition education interventions would be needed to appropriately address each dietary habit.

Dietary Habits in Children with Respiratory Allergies: A Single-Center Polish Pilot Study.

Background: The rising trend in allergic diseases has developed in parallel with the increasing prevalence of obesity, suggesting a possible association. The links between eating habits and allergies have not been sufficiently clarified. Aim: To evaluate the nutritional status, eating habits, and risk factors of obesity and pulmonary function in children with allergic rhinitis. Materials and methods: We evaluated 106 children with allergic rhinitis (mean age 12.1 ± 3.4 years; M/F 60/46) from the Department of Allergology. Clinical data were collected regarding allergies, physical activity, nutritional status (Bodystat), dietary habits (Food Frequency Questionnaire validated for the Polish population), skin prick test with aeroallergens (Allergopharma), and spirometry (Jaeger). Results: All children suffered from allergic rhinitis; among them, 43 (40.6%) presented symptoms of asthma. There were differences between children with only allergic rhinitis (AR group) and children with both rhinitis and asthma (AA group) in pulmonary function (forced expiratory volume in one second (FEV1) 100 ± 11 vs. 92.1 ± 15.0; p < 0.05). A total of 84 children (79%) presented a normal body mass index (BMI) (10–97 percentile), 8 (7.5%) were underweight, and 14 (13.5%) were overweight or obese. There were no differences in body composition between the AR and AA groups. Incorrect eating habits were demonstrated by most of the children, e.g., consumption of three or fewer meals in a day (38%), sweets every day (44%), snacking between meals every day (80%), and eating meals less than 1 h before bedtime (47%). Compared to the AR group, the AA group was more likely to eat more meals a day (p = 0.04), snack more often (p = 0.04), and eat before sleeping (p = 0.005). Multiple regression analysis showed a significant association between high BMI and snacking between meals and low physical activity (adjusted R2 = 0.97; p < 0.05). Conclusions: The risk factors for obesity in children with allergies include snacking and low physical activity. Most children with respiratory allergies, especially those with asthma, reported incorrect eating habits such as snacking and eating before bedtime. A correlation between pulmonary function and body composition or dietary habits was not found.

Association between dental caries risk indicators and various stages of caries in newly erupted permanent teeth

Background/Aim. Identification of caries risk indicators involved in the disease development is of great importance. The aim of this study was to assess the association between distinctive risk indicators and different stages of caries disease process in children. Methods. The cross-sectional study was conducted on a sample (n = 327) of school children ages 7?11. A questionnaire submitted to parents was used to record the data regarding demographic characteristics, children's dietary habits, oral hygiene habits and oral health behaviors. Caries was assessed using the International Caries Detection and Assessment System (ICDAS) II and subjects were stratified according to the highest and most prevalent caries lesion stage. The data obtained were analyzed using the ?2 or Fisher`s exact test and multinomial logistic regression. Results. Caries lesions were detected in 56.6% of examinees observed in the study. Compared to caries-free subjects, appearance of initial caries lesions was statistically significantly influenced by maternal education level (p = 0.021), paternal occupational status (p = 0.023), toothbrushing frequency (p &lt; 0.001), and caries status of deciduous teeth (p = 0.027). Maternal educational level (p = 0.026), paternal occupational status (p = 0.003), sweets and snacks taking frequency (p = 0.005), toothbrushing frequency (p &lt; 0.001), and fluoridate dentifrice usage (p = 0.027) were associated with moderate caries lesions. Maternal educational level (p &lt; 0.001), sweets and snacks taking frequency (p = 0.022) and toothbrushing frequen-cy (p &lt; 0.001) were associated with extensive caries lesions. Maternal educational level (p = 0.02) and brushing frequency (p &lt; 0.001) were statistically significantly associated with the highest prevalence of initial caries lesions. Maternal educational level (p = 0.025), toothbrushing frequency (p &lt; 0.001) and frequency of dental check-ups (p = 0.016) were statistically significantly associated with the highest prevalence of moderate caries lesions. Conclusion. Parental socioeconomic indicators and children's behavior related to oral health were involved in the changes from caries-free status to different caries stages.

Nutrition in developmental age: few rules to stay healthy

The first 1000 days of life represent a critical window for infants' and children's development. Overweight and insulin resistance, at the basis of non-communicable diseases (NCDs), are linked to various risk factors that begin in childhood, including children's diet. Italian data on infants' and children's dietary habits show higher intake of proteins, simple sugars, unhealthy fats and salt than recommended, while the iron intake is below requirement. We reviewed current literature analyzing observational studies, meta-analysis, systematic review and randomized clinical trials of the last 10 years (from 2009) on nutrition in developmental age, providing some few rules to abide by. Exclusive breastfeeding is recommended by World Health Organization for the first 6 months of life and it should be continued alongside the complementary feeding period until 12 months, or even afterward. Complementary feeding should not be started before the 17th week of age with energetically adequate foods, paying attention to limit protein intake and favoring iron-rich foods. Intake of simple sugars should be limited or avoided at all; it has been demonstrated that substituting sugar-sweetened beverages with water decreases body fatness development in adolescence. Quality of the ingested fats is more important than their quantity: polyunsaturated fatty acids should be preferred. Sodium intake should be limited in the first 24 months of life, as first prevention measure of arterial hypertension later in adulthood. Healthy eating habits are the first important step toward the prevention of NCDs.

Fast food consumption among 12- to 17-year-olds in Germany - Results of EsKiMo II.

Consuming high amounts of fast food can lead to an excessive intake of energy and subsequently promote obesity. Obesity increases a person’s risk for diabetes and cardiovascular diseases. The second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014–2017) included the Eating study as a KiGGS Module (EsKiMo II, 2015–2017) which assessed the self-reported dietary habits of children and adolescents in Germany. The analysis of the data permits an overview of the fast food consumption of 12- to 17-year-olds (n=1,353). Girls consume 57.5 grams and boys 86.3 grams of fast food per day on average (around 400 grams and 600 grams per week, respectively). Pizza is the most consumed fast food product, followed by filled pita and sausage/meat products such as curry sausage. Adolescent girls on average get 6.5% and boys 7.8% of total daily energy intake from fast food. 23% of 12- to 17-year-olds get at least 10% of their daily energy intake from fast food (high consumers). Significant differences between the proportion of high consumers exist regarding sex, age, socioeconomic status, community size, type of school and media consumption. Compared to EsKiMo I (2006), girls’ daily energy intake from fast food has remained nearly constant, whereas that of boys has dropped substantially. From a nutrition physiology perspective, the aim should be to further reduce fast food consumption.

Association Between Caregiver's Perception of "Good" Dietary Habits and Food Group Intake Among Preschool Children in Tokyo, Japan.

Given that parents are mainly responsible for a preschooler's dietary management, they need to understand a child's diet. However, few studies have examined the association between parental perception of a preschool child's “good” dietary habits and actual food intake. We conducted a cross-sectional study investigating whether a child's food intake would differ depending on the caregiver's perception of their child's dietary habits among 4-year-old nursery school children at Adachi City, Tokyo, Japan. Children's dietary data were collected using the brief-type self-administered diet history questionnaire for children Aged 3–6 Years (BDHQ3y), while caregivers' perceptions of their child's dietary habits (good, normal, and poor) were inquired (N = 136). The percentage of caregivers who perceived their child's dietary habit as good, normal, and poor was 41.2, 40.4, and 18.4%, respectively. Multiple linear regression analysis revealed that children whose caregivers perceived their diet as poor showed lower intakes of vegetables [β = −48.7, 95% confidence interval (CI): −86.1 to −11.2], beans (β = −13.2, 95% CI: −26.1 to −0.3), and fish and shellfish (β = −9.2, 95% CI: −17.5 to −1.0) and higher intakes of fat and oil (β = 1.7, 95% CI: 0.4 to 3.1), confectionaries (β = 11.9, 95% CI: 3.6 to 20.3), and soft drinks (β = 31.2, 95% CI: 3.5 to 59.0) compared to children whose caregivers perceived their diet as good (all measures are in g/1,000 kcal per day). No significant difference was observed in other food groups, such as dairy products, an important source of protein and calcium for children. The current study may therefore guide future nutritional education programs for parents of preschool children.

Influence of Parents' Oral Health Knowledge and Attitudes on Oral Health Practices of Children (5-12 Years) in a Rural School in KwaZulu-Natal, South Africa.

ABSTRACTContext:Oral health knowledge, beliefs, and attitudes of parents have a direct influence on their child’s oral health maintenance, dietary habits, and oral health behaviors.Aim:The aim of this study was to assess the knowledge, and attitude of parents with regard to the oral health practice of their children and its associated factorsMaterial and Methods:A self-administered structured questionnaire was administered to parents or guardians of learners aged 5–12 years at a low socioeconomic rural primary school in the Ugu district, KwaZulu-Natal, South Africa. In addition to demographic variables, knowledge of dental health, use of toothbrush, use of toothpaste, dietary practices, and dental visits; practice with respect to dental care; and attitudes toward oral health were requested.Results:One hundred and forty-four completed survey instruments were received with an 80% (118) representation of mothers. Ninety-five percent of the parents (136) had a positive attitude toward oral health with 86% (124) of the children brushed their tongue and 89% (128) of the children brushed their teeth happily. The mean knowledge score was 70%. Children were significantly more likely to brush their tongues (adjusted odds ratio [AOR]: 3.20 95% confidence interval [CI]: 1.06–9.66 P < 0.001), be happier when brushing their teeth (AOR: 4.65 95% CI: 1.41–15.38 P < 0.001) when the caregivers were their mothers, had an above-average knowledge score (AOR: 1.86 95% CI: 0.72–4.85) and positive attitudes (AOR: 3.20 95%CI: 0.46–22.00).Conclusion:Parents in the rural community have satisfactory knowledge and a positive attitude toward oral health and children display good practices; however, there are a number of gaps noted in overall parental knowledge.

Children's acceptance of Pilot program of School meals in rural region of northern Croatia

AbstractIn the rural region of northern Croatian county Koprivnica Krizevci, new school meals program “Smart meals for smart kids” was implemented since the beginning of 2019. Analysis of nutritional quality of standard school meals served in 18 primary schools indicated high consumption of cereal products, meat, particularly meat products, pastry and sweets, and lacking of fruits, vegetables, fish and legumes. New menu was designed with the aim of improving nutritional quality of schools’ meals through a new recipes based on gastronomy heritage, dietary habits and National guidelines, but also education and testing of children's acceptance. Initial step of the project was to test new menu through Pilot program in six schools during two weeks. Process was accompanied by educational activities through originally designed leaflet about healthy diet, new meals and nutritional benefits, and was distributed among all students. Children's acceptance of Pilot menu of 10 meals was analyzed on a 9-point pictured hedonic scale and qualitative discussion through focus groups. In every school questionnaire was distributed in 4th (age 9 to 10) and 7th grade (age 12 to 13). In total, 237 children filled out the questionnaire, 104 from 4th grade and 133 from 7th grade. In focus groups, 26 participated 14 students and 12 teachers. Results show that best accepted meals were Spaghetti Bolognese, Breaded fish with cabbage savoy and potatoes, and Chicken risotto. High acceptance of this meals can be explained by familiarity to the children, often being served at school, relatively simple dishes with lesser amount of known ingredients and adequate taste profile. Least preferred meals were Chickpea with barley and corn, and Gnocchi with turnip, these meals were in most schools served for the first time, ingredients were unfamiliar, and combination of tastes was not according to the children's preferences. Qualitative discussion revealed that children noticed the difference from standard meals, particularly increase in serving of fruits and different and new varieties of vegetables, and believe that new meals are healthier. They also liked the educational leaflet and think it is a good way of communicating about healthy diet. Teachers welcome the new menus, differences were noticeable in intensity of spiciness, new varieties of vegetables and legumes, and more served fruits. For a successful and sustainable Program follow-up, school meals should be adapted to children's dietary habits gradually with careful introduction of the new food and tastes, followed by continuous nutritional education.

Evaluation of the Proximity of Singaporean Children's Dietary Habits to Food-Based Dietary Guidelines.

Dietary habits in children may not only impact current health status but could also shape future, lifelong dietary choices. Dietary intake data in Singaporean children are limited. The current study aimed to define the overall diet quality of Singaporean children using an existing cross-sectional dataset and to consider how demographic factors (i.e., body mass index (BMI) status, ethnicity, age, and sex) were associated with these scores. Existing, cross-sectional dietary data (n = 561 children aged 6–12 years, collected in 2014–2015) from duplicate 24-h recalls were assessed for diet quality using an index based on the Singaporean Health Promotion Board dietary guidelines. Total diet quality scores were calculated from ten different components (frequencies of rice and alternatives, whole grains, fruits, vegetables, meat and alternatives, dairy and alternatives, total fat, saturated fat, sodium intake, and added sugars). Association with demographic factors and BMI category was evaluated by one-way multivariate ANOVA (MANOVA) tests, with Bonferroni post hoc analyses. Median (interquartile range) total diet quality scores were 65.4 (57.1–73.0). Median scores for whole grains (0.0, 0.0–33.4), fruits (24.1, 0.0–65.3), vegetables (36.5, 10.4-89.8), and sodium (58.4, 0.0–100.0) intake were frequently sub-optimal. Children of Malay ethnic origin had statistically lower total diet quality scores ((55.3, 47.5–60.3) vs. other ethnic groups (combined median 65.4 (57.1, 73.0); p < 0.001). These findings highlight the need for continuing efforts to improve dietary intake in young Singaporeans and for longitudinal dietary monitoring in this group.