Children's Dietary Intake Research Articles

The diet behavior of children in vegetarian families: The care of health or cruel treatment?

The article considers the issue of alternative dietary intake in children of vegetarian families, both in Russia and abroad. The types of vegetarianism, its advantages and limitations are highlighted on the basis of empirical studies of national and foreign researchers. The emphasis is made on the risks to physical and mental health of children in case of unbalanced diet and on the need for regular consultations with pediatricians and nutritionists as well.

P97 Reducing Obesogenic Behaviors Through a Culturally-Tailored Family-Based Program: “Abriendo Caminos”

<h3>Introduction</h3> Hispanic children in the U.S. exhibit the highest rates of obesity compared to other racial/ethnic groups. Effective interventions to reduce the burden of this growing epidemic are needed. Obesity prevention interventions can improve weight outcomes by targeting modifiable lifestyle factors such as dietary patterns and physical activity. Furthermore, there is evidence that culturally-tailored interventions increase fruit and vegetable consumption and decrease sugar-sweetened beverage (SSB) consumption among Hispanic children. <h3>Objective</h3> To evaluate the effect of Abriendo Caminos 2 (AC2) on Hispanic children's dietary behaviors. <h3>Methods</h3> AC2 is a multi-state randomized-control trial that aims to prevent childhood obesity among Hispanic families by providing culturally-tailored nutrition, physical activity, and family wellness education. Families of Mexican or Puerto Rican origin with a child between the ages of 6–18 years were recruited from Illinois, California, Iowa, and Texas. Parents' reported their child's dietary intake of SSB, fruit juice, fruits, French fries, vegetables, fast food, sweets, and salty snacks using items from the U.S. Department of Education's Early Childhood Longitudinal Study, Birth Cohort protocol. Pre/post dietary changes were evaluated using Generalized Estimating Equation models adjusted for site, child sex, age, and mother's education using SAS 9.4 (SAS Institute, Cary, NC, USA). <h3>Results</h3> Children randomized to the intervention arm reduced their consumption of SSB (OR 0.35, 95% CI 0.15, 0.84, <i>P</i> = 0.003), fast food (OR 0.53, 95% CI 0.30, 0.92, <i>P</i> = 0.03), and increased consumption of vegetables (OR 1.95, 95% CI 1.13, 3.36, <i>P</i> = 0.02) after 6 weeks of participating in the program. Children in the control group reportedly decreased SSB consumption frequency (OR 0.40, 95% CI 0.17, 0.97, <i>P</i> = 0.04). There were no changes in the frequency of consumption of the other food items for either group. <h3>Conclusion</h3> Culturally-tailored family-based interventions can help improve dietary behaviors among Hispanic children. Future research should address methods to help Hispanic children transition short-term changes into lifestyle habits.

Dietary Antioxidant Micronutrient Intake and Toxicity during Remission Induction in Children with Acute Lymphoblastic Leukemia (ALL): Results from Dana-Farber Cancer Institute (DFCI) ALL Consortium Trial 05-001

Introduction: Treatment related toxicities are a major contributor to morbidity during induction therapy in childhood ALL. Our prior study in 103 children with ALL suggested that low intakes of antioxidant micronutrients were associated with toxicity and delays in chemotherapy administration (Am J Clin Nutr 79:1029, 2004). The objective of this study was to examine whether inadequate antioxidant micronutrient dietary intake in children with ALL is associated with episodes of infection or ≥grade 3 mucositis during Remission Induction.Methods: Assessment of dietary intake was collected in patients (pts) ages 1-17.9 years enrolled on the DFCI ALL Consortium Protocol 05-001 from 2005-2011. Institutional review board approval was obtained by each of the 9 participating centers. Grade 3 or higher (NCI CTCAEvs) mucositis, culture positive bacteremia and fungemia, and radiographic invasive fungal disease were prospectively collected. Dietary intake was assessed with the Harvard Service Food Frequency Questionnaire (FFQ) for children ages 1-5 years and the Youth and Adolescent Harvard FFQ for children ages 5-18 years and queried about intake in the past 30 days at the end of induction. Dietary antioxidant intake from food sources ± supplementation was examined by comparing consumption above and below recommended intake for age and sex as per the Dietary Reference Intake (DRI). Micronutrient intake was summarized with descriptive statistics and plotted by the presence/absence of a given toxicity in induction. Categorical and continuous variables were compared between group with the Fisher's exact test and the Wilcoxon rank sum test respectively. Logistic regression was used to model the probability of a given toxicity univariately and with a multivariable adjustment for sex and age.Results: Among 794 eligible pts, 561 (71%) had analyzable FFQs. The sample with dietary surveys responses was marginally younger (p=0.06) and more often classified as initial standard risk (p=0.01) than those with no end of induction survey. DRI recommendations were not met for vitamin C (18%), vitamin E (67%) and zinc (12%); 39% of pts reported zinc overconsumption. 141 (25%) of pts with dietary data had ≥1 bacterial and/or fungal infection, 131 (23%) had ≥1 bacterial infection, and 19 (3%) had ≥1 fungal infection. 24 (4%) pts experienced at least 1 event of ≥grade 3 mucositis. Female sex was associated with overall and bacterial infection (p=0.02) and marginally with mucositis (p=0.06). The proportion of patients with ≥Grade 3 mucositis was marginally higher (p=0.06) for those not meeting the vitamin C recommendation (OR=2.3; 95% CI 1.0-5.5), but was not significant (p=0.10) in a multivariable model. Supplementation was reported by 88 (16%) for zinc, vitamins C, E, and A in combination, 16 (3%) for β-carotene and total carotene, and 87 (15%) for vitamin E alone. Intake levels of vitamins C, E, and A, zinc and total carotenoids from food sources and total (food + supplementation) were compared for pts with and without infection and mucositis (unadjusted for age/sex) (Figure 1). Bacterial infection was associated with low intake from food only of zinc (p=0.02), vitamin A (p=0.01), and vitamin E (p=0.049). Mucositis was associated with the following: low intakes of vitamin C from food (p=0.04), vitamin E from food (p=0.03), total lycopene (p=0.03), total α-carotene (p=0.01), total β-carotene (p=0.007) and from food (p=0.008), total carotene (p=0.005) and carotene from food (p=0.006), and total vitamin A (p=0.01) and vitamin A from food (p=0.004). Females age <10 had higher rates of bacterial infection with low β-carotene (p=0.05) and vitamin A from food (p=0.004). In males age ≥10, low vitamin E from food was observed in those with bacterial infections (p=0.05). Supplementation did not confer an added benefit for most nutrients.Conclusions: Confirming our pilot study, data from a large prospective cohort show that low dietary intakes of antioxidant vitamins, carotenoids and zinc primarily from food sources predict risk for bacterial infection or mucositis during induction therapy for childhood ALL. Dietary supplementation for most vitamins and minerals did not confer an added benefit for prevention of infection or mucositis over levels obtained from food. Our results suggest a possible modifiable dietary intervention to reduce toxicity during induction therapy for ALL. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Effects of Longer Seated Lunch Time on Food Consumption and Waste in Elementary and Middle School–age Children

Health experts recommend at least 20 minutes of seated lunch time for children, but no federal policy for lunch period duration exists in the United States. Additional strategies in the National School Lunch Program for mitigating food waste are needed to maintain the viability of the Healthy, Hunger-Free Kids Act. To assess the effect of a longer seated lunch time on food consumption and waste among elementary and middle school-age children. This randomized within-participant crossover trial was conducted from June 3 to June 28, 2019, for a total of 20 study days. All attendees of a summer camp held at the University of Illinois at Urbana-Champaign, were invited to participate in the study. Participants were elementary and middle school-age children and were provided every study day with lunch prepared according to the National School Lunch Program nutrition standards. Five menus were served throughout the study. A 20-minute or 10-minute seated lunch condition was randomly assigned to each day within the 5 menus. The primary outcomes were food consumption, waste, and dietary intake, which were analyzed separately for each meal component (fruit, vegetable, entree [protein plus grain], beverage [both milk and water], and milk alone). Dietary intake was assessed for calories, fat, carbohydrates, fiber, protein, vitamin D, calcium, iron, and potassium. Participant behaviors were observed during the meal, including seated time as well as level of talking and phone use. A total of 38 children with 241 lunch trays were observed. The 38 children had a mean (SD) age of 11.86 (1.23) years and 23 were female participants (61%); 30 had a non-Hispanic/non-Latino ethnicity (79%) and 23 were White individuals (61%). During 10 minutes of seated lunch time, participants consumed significantly less fruit (-11.3 percentage points; 95% CI, -18.1 to -4.5) and vegetables (-14.1 percentage points; 95% CI, -22.7 to -5.7) compared with 20 minutes of seated lunch time. Entree and beverage consumption and waste did not differ between the 10-minute and 20-minute seated lunch conditions. Participants also consumed significantly more and wasted significantly less calories (-22.03 kcal; 95% CI, -39.47 to -4.61 kcal), carbohydrates (-3.81 g; 95% CI, -6.20 to -1.42 g), dietary fiber (-0.51 g; 95% CI, -0.81 to -0.19 g), protein (-1.11 g; 95% CI, -2.17 to -0.04 g), iron (-0.20 mg; 95% CI, -0.38 to -0.02 mg), and potassium (-53.49 mg; 95% CI, -84.67 to -22.32 mg) during the 20-minute seated lunch condition. This study found that fruit and vegetable consumption increased in school-age children during a 20-minute seated lunch condition. This finding supports policies that require children to receive at least 20 minutes of seated lunch time; such policies could have favorable implications for children's dietary intake and food waste. ClinicalTrials.gov Identifier: NCT04191291.

Associations between advertisement-supported media exposure and dietary quality among preschool-age children

Foods of low nutritional quality are heavily marketed to children, and exposure to food ads shapes children's preferences and intake towards advertised foods. Whether food ad exposure independently relates to an overall lower diet quality among children remains unclear. We examined the association between ad-supported media use, a proxy for food ad exposure, and diet quality using the baseline data (2014–2015) from 535 3-5-year-olds in a community-based cohort study. Parents reported their child's dietary intake over 3 days via a diary, and diet quality was assessed with the Healthy Eating Index (HEI-2015) where higher scores reflect greater adherence to USDA dietary guidelines. Children's media exposure was measured through online parent surveys. Mean HEI score was 54.5 (SD = 9.4). In models adjusted for sociodemographic characteristics and metrics of parent diet quality, children's HEI scores were 0.5 points lower (adjusted beta = −0.5 [95% CI: 0.8, −0.1]; P < 0.01) for each 1-h increment in weekly viewing of ad-supported children's TV networks. Children's use of media that may have food ads (e.g., apps, online games) also related to a lower diet quality yet to a lesser extent (adjusted beta −0.2 [-0.2, −0.1]; P < 0.01). In contrast, children's ad-free media use was not associated with diet quality (P = 0.21). Findings support the premise that exposure to food advertisements via media may result in a lower quality diet among children independently of other risk factors.

Automated Self-Administered 24-H Dietary Assessment Tool (ASA24) recalls for parent proxy-reporting of children\u2019s intake (> 4 years of age): a feasibility study

BackgroundRobust measurement of dietary intake in population studies of children is critical to better understand the diet–health nexus. It is unknown whether parent proxy-report of children’s dietary intake through online 24-h recalls is feasible in large cohort studies.ObjectivesThe primary objective of this study was to describe the feasibility of the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24) to measure parent proxy-reported child dietary intake. A secondary objective was to compare intake estimates with those from national surveillance.MethodsParents of children aged 4–15 years participating in the TARGet Kids! research network in Toronto, Canada were invited by email to complete an online ASA24-Canada-2016 recall for their child, with a subsample prompted to complete a second recall about 2 weeks later. Descriptive statistics were reported for ASA24 completion characteristics and intake of several nutrients. Comparisons were made to the 2015 Canadian Community Health Survey (CCHS) 24-h recall data.ResultsA total of 163 parents completed the first recall, and 46 completed the second, reflecting response rates of 35% and 59%, respectively. Seven (4%) first recalls and one (2%) second recall were excluded for ineligibility, missing data, or inadvertent parental self-report. The median number of foods reported on the first recall was 18.0 (interquartile range (IQR) 6.0) and median time to complete was 29.5 min (IQR 17.0). Nutrient intakes for energy, total fat, protein, carbohydrates, fiber, sodium, total sugars, and added sugars were similar across the two recalls and the CCHS.ConclusionsThe ASA24 was found to be feasible for parent proxy-reporting of children’s intake and to yield intake estimates comparable to those from national surveillance, but strategies are needed to increase response rate and support completion to enhance generalizability.

ANALISIS ASUPAN ZAT GIZI BATITA BERDASARKAN TINGKAT PENDIDIKAN, STATUS BEKERJA DAN PENGETAHUAN IBU

Background: Acute malnutrition could increase mortality and morbidity indirectly in infants and toddlers. The family socio-economic characteristics including the maternal education, nutritional knowledge, and family income, are related to the incidence of stunting.Objective: To determine the relationship between maternal education, working status and knowledge on dietary intake among toddlers under 3 years old.Methods: A correlative analytic study with cross-sectional design. The populations were mothers with toddlers under 3 years old. Sample size were 70 mothers which obtained with the cluster random sampling technique. Data collection were used questionnaire and calculated with 2005 Nutria survey and 14 levels.Results: There were no significant relationship between education level and working status on dietary intake of children under 3 years old (OR: 0,88; ᵖ-value: 0,855; CI: 0,136-4,136) and (OR: 1,29 ᵖ-value: 0,674; CI: 0.298-4.987). However, there were significant relationship between maternal knowledge and dietary intake of children under 3 years, especially related with energy and protein intake (OR: 2,14 ᵖ-value: 0,043; CI: 1,043-17,045). Conclusions: Maternal knowledge level are related to dietary intake among children under 3 years old, relared with energy and protein intake.

Nutritional Quality and Dietary Intake in Children and Adolescents with Celiac Disease

Background: Gluten-free diet (GFD) may influence the nutritional quality and adequacy of celiac disease (CD) patients. The aim of the present study was to evaluate quality of diet and nutrients intake of children and adolescents with CD and compare those with healthy subjects.Methods: This cross-sectional study included 50 patients with CD (18 boys and 32 girls; mean age: 11.5 y; range:7-18 y) and 50 healthy children and adolescent matched by age, sex and body mass index (BMI). The subjects’ height, weight, body composition evaluated by bioelectrical impedance analysis were measured and a food frequency questionnaire(FFQ) was administered. Diet quality was assessed using modified healthy eating index (mHEI) and visual analog scale (VAS) was used to evaluate appetite.Results: The weight, height, fat-free mass (FFM) and body fat percentage (BF%) were not different between groups. Intake of energy, macro-nutrients and some micro-nutrients like vitamin A, vitamin D, thiamin, riboflavin, niacin, vitamin B12 and zinc was significantly lower in celiac patients. The scores of mHEI were not different between case and control groups(55.24±8.8 vs. 55.84±8.6; p=0.819). VAS results revealed no difference in sensation of hunger, satiety, fullness and prospective food consumption between the groups; but there was a higher desire to eat in celiac patients.Conclusion: Although intake of macronutrients and a few micronutrients were more than recommended dietary allowance (RDA) in both groups; but diet quality of CD patients is needed to be improved.

How Time in the US and Race/Ethnicity Shape Parents Feeding Practices and Child Diet Quality

ObjectivesChildhood obesity is a critical public health issue with short and long-term health and financial burdens. Studies show that childhood obesity is higher among children of immigrant/refugee households compared to children whose parents were born in the United States. Poor child dietary intake is a critical risk factor for elevated obesity prevalence. Nonetheless, parents feeding practices are known to be associated with child dietary intake. Thus, this study aimed to examine the associations between length of residence time in the US of migrants/refugees, parents feeding practices, and child diet quality while also taking into consideration race/ethnicity. MethodsData are from baseline measures of a longitudinal cohort study called Family Matters. The sample includes 1307 children ages 5–9 and their families from six racial/ethnic backgrounds. ResultsResults showed that feeding practices of immigrant/refugee parents changed in relation to their length of residency in the US, in particular, with regard to using directive (e.g., restriction), non-directive (e.g., modeling), and emotional feeding practices. Additionally, race/ethnicity was found to influence the relation between time length in the US and parents feeding practices. Moreover, the diet quality score changed in relation to parents’ length of time in the US. For example, Hmong children had the poorest diet quality compared to African American, Native American, Hispanic, Somali, and White children. ConclusionsFuture research should consider studying more in-depth why parent feeding practices may change when parents move to the US and explore whether there is a combination of parent feeding practices that are most useful in promoting healthful child diet quality. It is also important to further examine why child diet quality declines (e.g., Hmong children) with parents’ time living in the US as a migrant/refugee. Funding SourcesResearch is supported by grant number R01HL126171 from the National Heart, Lung, and Blood Institute (PI: Berge). Content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Sensory Processing Dysfunction and Mealtime Behavior Problems in Children With Autism

To compare sensory processing and mealtime problem behaviors among children with autism spectrum disorder (ASD) and typically developing controls, and to examine the relationship between atypical sensory processing and eating problems in children with ASD. 50 children (4-10 years) with a diagnosis of ASD as per DSM-5 were recruited from the pediatric psychology clinic of a tertiary care center in India. The Brief Assessment of Mealtime Behavior in Children (BAMBIC) and the Short Sensory Profile (SSP) were administered to measure feeding and sensory processing problems, respectively. Parents were interviewed about their child's dietary intake using a 3-day dietary recall. The ASD group showed greater mealtime behavior problems than the control group and had significantly higher total scores on the BAMBIC (P<0.001), and on two of the three subscales including food refusal (P<0.001) and disruptive behavior (P<0.001). The ASD group, relative to the neurotypical children, showed atypical response on majority of the subscales of the short sensory profile including tactile sensitivity (P<0.001), taste sensitivity (P<0.001), movement sensitivity (P<0.001), under responsiveness (P<0.001), auditory filtering (P<0.001), low weak/energy (P=0.02), and visual/auditory sensitivity (P<0.001). The study underscores the need for detailed evaluation of sensory processing and feeding problems of children with ASD so that the interventions can be tailored to address their unique sensory characteristics.

Influence of gendered roles on legume utilization and improved child dietary intake in Malawi

The relationship between gender roles, legume production, utilization and child feeding practices in rural smallholder households of Dedza and Ntcheu districts in Malawi was investigated and analyzed. A cross-sectional research study was conducted with legume farming households with children aged 6-23 months who were part of the Africa RISING ‘mother trial’ or ‘baby trials’ for two farming seasons (2014/2015 to 2015/2016). Africa RISING project encourages smallholder farmers to grow legumes namely,groundnut (Arachis hypogaea),cowpea (Vigna unguiculata), pigeon pea (Cajanus cajan)and soya bean (Glycin max) as one way of improving the wellbeing of smallholder farmers. The key objective of the research was to assess the influence of gender roles,legume production, utilization and infant and young child dietary intake.In total, 291 households with children 6-23 months were targeted. Eight focus group discussions (FDGs) for in-depth qualitative data were conducted. Two 24-hour dietary recalls and food frequency questionnaires were used to collect data on infant and young child feeding (IYCF)practices. Data collected were extracted, arranged, recorded and analyzed by using SPSS version 21. About 18% of children aged 6-23 months received a minimum dietary diversity(the consumption of four or more food groups from the seven food groups), 2.5% received a minimum acceptable diet(indicator measures both the minimum feeding frequency and minimum dietary diversity, as appropriate for various age groups)and 37.5% of children received a minimum meal frequency(frequency of receiving solid, semi-solid, or soft foods at the minimum numbers of two and three times for children aged 6–8 months, and 9–23 months,respectively). Control on use of income by women had a positive and significant association with minimum dietary diversity (P&lt;0.05), minimum meal frequency (P&lt;0.05) and minimum acceptable diets (P&lt;0.05) among children of both sexes. Children aged 6-23 months from households where women were actively involved in partial processing and budgeting of legumes met minimum dietary diversity than children from non-participating households. Women farmers were more knowledgeable about legumes; played an important role in seed selection, storage and processing; however, the findings signal an opportunity to increase women’s income by involving them in market information. Increasing legume production at household level does not mean increasing the nutritional status among children (6-23 months). Several factors related to gender roles, markets accessibility and legume utilization have an effect on infantand young child feeding practices.

Relationships Among the Physical and Social Home Food Environments, Dietary Intake, and Diet Quality in Mothers and Children

BackgroundBoth the physical and social home food environment (HFE) are believed to influence dietary intake and diet quality, but few studies have examined both aspects together. ObjectiveThe purpose of this study was to examine the relationships among the physical and social HFE, dietary intake, and diet quality in mothers and children. DesignThis was a cross-sectional substudy of a larger study. Participants/settingThe study included 24 mothers (aged ≥30 years) with a biological child aged 6 to 12 years living in the Newark, DE, area between June and November 2018. Main outcome measuresThe outcome measures of interest included the physical HFE (ie, home food availability); aspects of the social HFE (ie, parenting styles, family meal frequency, and policies); maternal and child intake of fruits, vegetables, sugar-sweetened beverages, and snacks; and diet quality using the 2015 Healthy Eating Index total score. Statistical analysisPearson correlations were used to examine the relationship between physical HFE and dietary intake as well as social HFE and dietary intake in both mothers and children. The relationships were further examined through exploratory regression analyses. ResultsIn mothers, fruit availability in the physical HFE was correlated with fruit intake (r = 0.50; P = 0.02). Fruit and vegetable availability in the physical HFE were correlated with 2015 Healthy Eating Index total score in both the mother and child. Family meals participation was correlated with dietary intake (vegetable intake in children, r = 0.44; P = 0.04; and snack intake in mothers, r = –0.74; P < .001). Exploratory regression analysis showed vegetables in the HFE was associated with vegetable intake and 2015 Healthy Eating Index total score in mothers, and fruits and vegetables in the HFE were associated with child 2015 Healthy Eating Index total score. Family meals participation was negatively associated with maternal snack intake and child sugar-sweetened beverages intake. Authoritative parenting was negatively associated with child snack intake and permissive parenting was negatively associated with mother’s fruit intake. ConclusionsBoth the physical and social HFE are associated with maternal and child dietary intake, but only the physical HFE was associated with dietary quality. Although preliminary, these data indicate the importance of future studies that include measures to assess both the physical and social HFE to better elucidate the influences of the HFE on dietary intake.

Longitudinal Associations between Food Parenting Practices and Dietary Intake in Children: The Feel4Diabetes Study.

Food parenting practices (FPPs) have an important role in shaping children’s dietary behaviors. This study aimed to investigate cross-sectional and longitudinal associations over a two-year follow-up between FPP and dietary intake and compliance with current recommendations in 6- to 11-year-old European children. A total of 2967 parent-child dyads from the Feel4Diabetes study, a randomized controlled trial of a school and community-based intervention, (50.4% girls and 93.5% mothers) were included. FPPs assessed were: (1) home food availability; (2) parental role modeling of fruit intake; (3) permissiveness; (4) using food as a reward. Children’s dietary intake was assessed through a parent-reported food frequency questionnaire. In regression analyses, the strongest cross-sectional associations were observed between home availability of 100% fruit juice and corresponding intake (β = 0.492 in girls and β = 0.506 in boys, p < 0.001), and between parental role modeling of fruit intake and children’s fruit intake (β = 0.431 in girls and β = 0.448 in boys, p < 0.001). In multilevel logistic regression models, results indicated that improvements in positive FPPs over time were mainly associated with higher odds of compliance with healthy food recommendations, whereas a decrease in negative FPP over time was associated with higher odds of complying with energy-dense/nutrient-poor food recommendations. Improving FPPs could be an effective way to improve children’s dietary intake.

Dietary intake and growth in children with Prader-Willi syndrome.

The management of Prader-Willi Syndrome (PWS) requires strict dietary supervision to prevent obesity, avoid micronutrient deficiencies and ensure optimal growth. The present study aimed to examine the growth and dietary intake of children with PWS. All children with genetically confirmed PWS attending Children's Health Ireland (CHI) at Tallaght (n=44) were invited to participate. Anthropometry was performed and body composition measured using bioelectrical impedance analysis. Three-day food diaries were used to evaluate dietary intake and the presence of early feeding issues was assessed. Serum haemoglobin, ferritin and vitamin D levels were measured. Nineteen children participated, with a mean (range) age of 7.6(0.6-18.1)years. Most were female (n=14, 74%). Twenty-percent (n=3) were underweight, 60% (n=9) were healthy weight, n=1 was overweight and n=2 were obese. Mean (range) percentage body fat was 25.7% (10%-40%). Eigthy-three percent reported early feeding issues. Ninety-four percent (n=16) achieved ≤100% of estimated average requirement (EAR) for energy. Mean daily energy intake for ≤5years old was 722kcal (9kcalcm-1 /72-112% EAR); for those ≥12years, it was 1203kcal (8.3kcalcm-1 /41%-82% EAR). Suboptimal calcium, vitamin D, iron, zinc and fibre intake was evident. Iron deficiency anaemia and vitamin D insufficiency occurred in two children. The present study provides the first Irish data for PWS and shows that energy intake does not appear to be excessive, with four in five patients being underweight or of a normal BMI. Suboptimal dietary intake of several micronutrients was evident and biochemical nutrient deficiencies were present.

The Association between Australian Childcare Centre Healthy Eating Practices and Children's Healthy Eating Behaviours: A Cross-Sectional Study within Lunchbox Centres.

The association between healthy eating practices and child dietary intake in childcare centres where parents pack foods from home has received little attention. This study aimed to: (1) Describe the nutritional content of foods and beverages consumed by children in care; and (2) Assess the association between centre healthy eating practices and child intake of fruit and vegetable servings, added sugar(grams), saturated fat(grams) and sodium(milligrams) in care. A cross-sectional study amongst 448 children attending 22 childcare centres in New South Wales, Australia, was conducted. Child dietary intake was measured via weighed lunchbox measurements, photographs and researcher observation, and centre healthy eating practices were assessed via researcher observation of centre nutrition environments. Children attending lunchbox centres consumed, on average 0.80 servings (standard deviation 0.69) of fruit and 0.27 servings (standard deviation 0.51) of vegetables in care. The availability of foods within children’s lunchboxes was associated with intake of such foods (p < 0.01). Centre provision of intentional healthy eating learning experiences (estimate −0.56; p = 0.01) and the use of feeding practices that support children’s healthy eating (estimate −2.02; p = 0.04) were significantly associated with reduced child intake of saturated fat. Interventions to improve child nutrition in centres should focus on a range of healthy eating practices, including the availability of foods packed within lunchboxes.

Body weight status and dietary intake of Malaysian children with Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) in general, possess selective eating habits and sensory sensitivity that predispose them to the risk of poor nutritional status. Nutritional status of children is important for optimal physical and cognitive development and reduction of the risk of chronic diseases in the future. Given the limited information on the body weight status and nutrient intake of Malaysian children with ASD, this study, therefore, assessed the body weight status and dietary intake of children with ASD in an autism intervention centre in Kuala Lumpur. A total of 224 children with ASD aged 3–7 years (82.6% boys and 17.4% girls) and their mothers participated in this study. Mothers completed a self-administered questionnaire on the sociodemographic background and recorded a 3-day food diary of their children with ASD at home. The researcher measured body weight and height of the children with ASD in the centre. The prevalence rates of underweight, stunting, wasting/thinness, and overweight/obesity were 9.3%, 8.0%, 4.0%, and 21.5%, respectively. Total energy and protein intakes were adequate for most of the children with ASD but calorie from fat was higher than the recommendation. A majority of the children with ASD in this study did not meet the RNI requirements for fibre (99.6%), thiamine (67.4%), vitamin C (50.9%), vitamin D (98.2%), vitamin E (74.6%), vitamin B12 (64.3%), folate (88.8%), calcium (90.2%) and zinc (77.2%). More girls showed inadequate intakes of vitamin C, niacin and vitamin B12 than boys. Children with ASD in this study showed poor body weight status and inadequate intake of several essential nutrients. Nutritional intervention programmes in improving nutrient adequacy and regular anthropometric measurements are recommended to be carried out in order to improve nutritional status of children with ASD.

Traditional Societal Practices Can Avert Poor Dietary Habits and Reduce Obesity Risk in Preschool Children of Mothers with Low Socioeconomic Status and Unemployment.

Healthy nutritional habits are of vital importance for good health and quality of life for all individuals in all life stages. Nutritional habits shaped in early childhood set the foundation for future dietary practices applied through lifespan, hence informing risk towards chronic diseases. A key contributor to child health is maternal impact. A healthy childhood status translates into increased lifespan, health, and life-quality, as well as better family and social interactions and improved academic performance. These conditions can contribute to a healthier and more vibrant workforce, and thus extend positive impact on the economic and overall development of a country. Evidence related to maternal impact on childhood dietary habits is limited in Turkey, an emerging economy with notable disparities and a significant segment (approximately one third) of its 83 million population under the age of 30. Hence, the aim of this study was to investigate the relationship between the socioeconomic status (SES) of mothers on the dietary habits of their preschool children. A pilot cross-sectional observational study was conducted involving the mothers of 109 preschool children aged 4–6 years. Data on the nutritional status of children were collected through a food frequency questionnaire and a 24-h recall interview, while sociodemographic information was also collected, and statistical analyses conducted. An unexpected finding regarding the lack of association between the socioeconomic and employment status of mothers and the nutritional intakes of their children was observed. Interestingly, it appears that more traditional societal and nutritional practices typically undertaken in the case of lower SES, especially in more traditional settings like the case of Turkey, appear to extend a protective effect as per the nutritional habits and ensuing obesity risk in the case of children of women with lower SES. Another way to interpret our finding is that the difference in education and SES is not adequate to produce a significant effect in terms of children dietary intake. This is an interesting finding that warrants further study. Additionally, such studies serve to increase awareness about the importance of healthy nutritional practices in preschool children and the critical role of the mother on their nutritional status, particularly in the Turkish idiosyncratic setting.

Methodological aspects of the assessment of dietary intake in the Brazilian National Survey on Child Nutrition (ENANI-2019): a population-based household survey.

This manuscript aims to describe the methodological, operational, and quality control aspects of the assessment of dietary intake in children under five years of age participating in the Brazilian National Survey on Child Nutrition (ENANI-2019), a household survey in a probability sample of Brazilian households. Two instruments were developed to assess child feeding practices - a structured, current status-type questionnaire and a 24-hour dietary recall (24HR), both installed in a mobile data collection device used by previously trained interviewers. A Photographic Manual for Quantification of Children's Dietary Intake was specifically developed for and used in the survey as a support aid to identify and quantify foods reported in the 24HR. During the fieldwork, continuous quality control of the records was performed. Data errors or incomplete data in the system were corrected, and the fieldwork team was systematically contacted and informed on their performance, with reiterated orientation on data collection. All children in the sample were evaluated with the two instruments, but data were obtained from the structured questionnaire on all children in the sample (n = 14,558) and 24HR on 14,541 children. ENANI-2019 developed innovative methods and materials based on the Brazilian and international literature to address knowledge gaps on under-five children's dietary intake. Unprecedented results will be produced, which will allow updating food and nutrition guidelines for children under five years of age in Brazil.

Food intake of children and adolescents submitted to allogeneic hematopoietic stem cells transplantation

ABSTRACT Objective Describe the dietary intake of children and adolescents submitted to allogeneic hematopoietic stem cell transplantation. Methods Data from 0 to 19-year-old patients’ medical records who were submitted to the procedure from January 2012 to September 2017 were used. These medical records provided anthropometric, food intake control and symptoms data for three moments: three days before infusion (M1), the infusion day (M2), and 25 days after the cell infusion (M3). This study was approved by the Ethics in Research Committee (17-0267). Results The patients presented weight loss (p&gt;0.001) and a decrease in body mass index (p&gt;0.001) in M1 versus M2 and M3. The means of calorie intake (p=0.031), protein (p=0.006), lipid (p=0.017), dietary fiber (p=0.035), calcium (p=0.005), iron (p=0.012), and sodium (p=0.022) had a reduction from M1 to M2 and an increase from M2 to M3. There was a decrease in mean intake of carbohydrates and calories per kilo from M1 to M2 and an increase from M2 to M3. The nutritional status was related to temperature above 37ºC (p&lt;0.001) and to mucositis (p=0.001), in M1 and M2. There was a correlation of dietary intake with the presence of temperature above 37ºC (p=0.019) in M2 and M3. Conclusion Reduced intake and worsening of the patients’ previous nutritional status appear to interfere with allogeneic hematopoietic stem cell transplantation and its complications, such as the presence of temperature above 37ºC and mucositis.

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.