Children's Intake Research Articles

An Analysis of MyPlate FoodGroup Intake in Children with Autism Spectrum Disorder

An Analysis of MyPlate FoodGroup Intake in Children with Autism Spectrum Disorder

Associations between feeding practices and child dietary quality, and the moderating effect of child eating behaviours on these associations

BackgroundParents' feeding practices are associated with children's food intake. Little is known about how children's eating behaviours (fussiness, enjoyment of food, food responsiveness, satiety responsiveness) moderate these associations. This study examines the relationships between feeding practices and pre-school children's dietary quality and whether children's eating behaviours moderate these relationships. MethodsIn 2018, 1349 Australian mothers of children aged 2–5 years completed an online survey including validated measures of feeding practices (n = 9), child eating behaviours (n = 4) and dietary quality. Thirteen items from a food frequency questionnaire were summed as a measure of dietary quality. Linear regression assessed associations between feeding practices and dietary quality, including interactions between feeding practices and child eating behaviours. ResultsThe feeding practices positively associated with dietary quality were structured meal timing, monitoring, covert restriction, modelling healthy eating and structured meal setting (B coefficients: 0.63 to 2.70). The feeding practices inversely associated with dietary quality were overt restriction, persuasive feeding, reward for eating and reward for behaviour (B coefficients: −0.88 to −1.85). Child eating behaviours moderated associations between three feeding practices and dietary quality. ConclusionsThis exploratory study showed that some associations between feeding practices and child dietary quality were moderated by children's eating behaviours. The potential for tailoring nutrition promotion strategies for parents of children with differing eating behaviours should be further investigated.

Fathers' daily intake of fruit and vegetables is positively associated with children's fruit and vegetable consumption patterns in Europe: The Feel4Diabetes Study.

Past research has focused on the relationship between mothers' and children's eating habits, although little is known about fathers as potential agents. The present study aimed to investigate the relationship between fathers' and children's fruit and vegetable (FV) intake in the context of fathers' education level and family income insecurity. Cross-sectional analysis using baseline data from the multicentre Feel4Diabetes Study were collected in 2016. Participants were parent-dyads (fathers, n = 10,038) and school children (n = 12,041) from six European countries. Socio-demographic and dietary data were collected using questionnaires. Associations were assessed applying the multinomial logistic regression model. Overall, European children have low FV intake, especially in Southern European countries (Greece, Spain and Hungary). Children with fathers consuming FV daily were more likely to consume fresh fruit (odds ratio [OR] = 2.75; 95% confidence interval [CI] = 1.95-3.88) and vegetables (OR = 2.55; 95% CI = 1.80-3.60) 1-2 times per day. After adjusting for paternal educational level and family income insecurity significant associations remained for fresh fruit (ORadj = 2.59; 95% CI = 1.82-3.69) and vegetables (ORadj = 1.98; 95% CI = 1.38-2.86). Country differences showed that fathers' educational level and income insecurity might be important factors worth considering for FV intake in Greece. The present study showed that fathers' FV intake was positively associated with children's daily intake of these foods. Implementation of future population-based strategies promoting FV intake not only in mothers, but also in fathers could be an effective public health initiative to increase FV intake in children. Policy-makers should give special attention to families dwelling in Southern European regions.

Evaluation of the Validity of a Food Frequency Questionnaire and 24-Hour Dietary Recall to Assess Dietary Iron Intake in Children and Adolescents from the South American Youth/Child Cardiovascular and Environmental Study

BackgroundA food frequency questionnaire (FFQ) for South American children and adolescents was developed, but its validity for assessing dietary iron intake has not been evaluated. ObjectiveTo evaluate the validity of the FFQ and 24-hour dietary recalls (24h-DR) for assessing dietary iron intake in children and adolescents. DesignThe South American Youth/Child Cardiovascular and Environmental study is a multicenter observational study, conducted in five South American cities: Buenos Aires (Argentina), Lima (Peru), Medellin (Colombia), Sao Paulo, and Teresina (Brazil). The FFQ assessed dietary intake over the previous 3 months, and the 24h-DR was completed three times (2 weekdays and 1 weekend day) with a minimum 5-day interval between recalls. Blood samples were collected to assess serum iron, ferritin, and hemoglobin levels. Participants and settingData of 99 children (aged 3 to 10 years) and 50 adolescents (aged 11 to 17 years) from public and private schools were collected during 2015 to 2017. Main outcome measuresDietary iron intake calculated from the FFQ (using the sum of daily iron intake in all food/food groups) and 24h-DR (mean of 3 days using the multiple source method). Statistical analyses performedDietary iron intake in relation to blood biomarkers were assessed using Spearman rank correlations adjusted for sex, age, and total energy intake, and the quadratic weighted κ coefficients for agreement. ResultsSpearman correlations showed very good coefficients (range = 0.78 to 0.85) for the FFQ in both age groups; for the 24h-DR, the coefficients were weak in children and adolescents (range = 0.23 to 0.28). The agreement ranged from 59.9% to 72.9% for the FFQ and from 63.9% to 81.9% for the 24h-DR. ConclusionThe South American Youth/Child Cardiovascular and Environmental study FFQ exhibited good validity to rank total dietary iron intake in children and adolescents, and as well as the 24h-DR, presented good strength of agreements when compared with serum iron and ferritin levels.

Factors associated with feeding practices of black immigrant mothers of African and Caribbean origin living in Ottawa, Canada

In Canada, Black immigrant women and their children are at higher risk of developing obesity. Factors that could influence children's weight status include parental feeding practices. Feeding practices such as monitoring, restriction and pressure to eat, are well studied among non-Hispanic White and Latinos groups, however, little is known about the feeding practices of Black immigrant parents of African and Caribbean origin. The aim of this study was to identify factors associated with feeding practices of Black immigrant mothers in Ottawa, Canada. The sample includes 188 Black mothers of African and Caribbean origin and their 6-12-year-old children. The Child Feeding Questionnaire was used to assess mothers' feeding practices. Demographic and socioeconomic data were collected using questionnaires. All participants' weight status was determined from measured weight and height. Pearson Chi-square tests and multivariate logistic regressions were performed. Results showed that mothers who felt responsible for feeding their children were more likely to monitor their children's food intake (p < 0.05). While mothers of children with underweight or normal weight were more like to use pressure to eat (p < 0.01), mothers of children with overweight or obesity were more like to use restriction (P < 0.05). Recent immigrant mothers were also more likely to use pressure to eat (P < 0.05). This study also provides evidence for associations between maternal feeding practices and mothers' weight status, household income and food security status. Findings build on previous research suggesting that parental feeding practices vary based on parents' and children's characteristics. Longitudinal studies are needed to assess the directionality of the association between mothers' feeding practices, and children's weight, diet quality and health in this population.

Children's inhibitory control abilities in the presence of rewards are related to weight status and eating in the absence of hunger

The Reflective-Impulsive Dual Processes Model suggests that overeating occurs when the temptation to consume food overrides inhibitory control processes. However, how rewards interact with inhibitory control and their relation to children's weight status and food intake is not understood. Here, 7-to-11-year-old children (n = 66; 32 overweight/obese) completed two versions (baseline [i.e., non-reward incentivized/control] and reward incentivized [food, money, no reward]) of a Go/Nogo task. Intake of palatable foods in the absence of hunger (i.e., eating in the absence of hunger-EAH) was measured following a standardized meal. A drift diffusion model was used to characterize children's performance parameters on the Go/Nogo. On the baseline Go/Nogo, children with higher weight status responded more cautiously, but on reward trials for food/money children were more cautions and made more false alarms relative to the no reward condition. Energy intake during EAH positively correlated with FA errors for food and money vs. no reward, but sex moderated this effect such that FA positively associated with EAH in girls but not boys. Independent of sex, FA for money vs. no reward and food vs. money were both positively associated with energy consumed during EAH. These results suggest that the presence of food and money rewards impair inhibitory control processing, especially in children with higher weight status. Further, increased inhibitory control impairment in response to food rewards, specifically, may be a risk factor for disinhibited eating in girls. Though preliminary, results may be useful in the development of targeted treatments to help moderate excess consumption in children.

Optimization using response surface methodology of the soaking and germination time of two rice varieties (Nerica 3 and Nerica L56) grown in the locality of Dschang (West-Cameroon).

One of the solutions to increase children's energy intake is the use of amylase-rich flours. This led us to optimize the fluidification capacity of two paddy rice varieties. For that, the Doehlert plane-type response surface methodology was used to optimize the germinating ability of paddy rice flour (varieties Nerica 3 and Nerica L56) to fluidize cassava-based gruels by using two factors: soaking and germination time. The evaluated response was the flow velocity of the gruels. The optimization result showed that, the optimal soaking time was 48h for the variety Nerica L56 and 12h for Nerica 3. Concerning the optimal germination time, it was 135h for both varieties. These conditions have been found to have the best fluidifying capacities for cassava flour-based gruels. The incorporation of 3g germinated paddy rice flour (Nerica L56 and Nerica 3) and at optimal conditions, allowed us to obtain high flow velocities of the gruels. They were 100.00mm/30s and 210.66mm/30s respectively for the varieties Nerica L56 and Nerica 3. These flow velocities were similar to the flow velocities predicted by the model for desirabilities of 0.99 and 1.00. In view of all these results, we could therefore recommend the use of these two varieties of rice produced under these conditions to improving flow velocities, dry matter concentrations and energy bulk of the gruels.

Associations between mother-child dyad dietary patterns and child anthropometric measures among 6-year-old children.

The goals of this study were to study relationships between maternal and children's dietary patterns (DPs) and to assess how children's DP was associated with child anthropometry. This cross-sectional study included 788 pairs of 6-year-old girls and mothers in health centers in Tehran, Iran. Information on dietary intake was collected with a 168-item food frequency questionnaire. Principal component factor analysis was performed to label different data-driven dietary patterns. Three different binary logistic regression models were used to evaluate the associations between child's DPs and child anthropometry. A positive correlation was found between all maternal patterns and child's Western DP (p < 0.001). Maternal prudent and Western DPs were correlated with child's high-protein DP (p < 0.001). Children's high-protein DP was negatively correlated with maternal high fat DP (p < 0.001). Maternal prudent and high fat DPs were correlated with prudent DP in children (p < 0.001). In adjusted models, a child being in the highest compared to the first quartile of the high-protein DP was associated with decreased odds of underweight and wasting (OR 0.43; 95% CI 0.23-0.80).Conclusion: The present study showed inverse associations between a high-protein DP in children and being underweight and wasted. Also, a positive correlation was found between all maternal DPs and children's Western DPs. This correlation should be taken into account while managing child nutrition by means of educating parents on the influence of their own dietary pattern on their children. Moreover, getting enough protein through a balanced diet should be considered in children. What is Known: • Some research exists on the intake of specific foods in relation to risk of abnormal growth in children. • Less is known about the relationship between mothers' and children's food intake. What is New: • Better adherence to a high-protein dietary pattern was significantly associated with lower risk of being both underweight and wasted. • This study suggests that correlation between mothers' and their children's dietary patterns exists, which should be taken into consideration when managing child nutrition.

Parents experience a sense of guilt when their newborn is diagnosed small for gestational age, SGA. A grounded theory study in Sweden

BackgroundTo become a parent of a child who is born small for gestational age can lead to challenges in addition to the newly acquired parenting role. There is currently a lack of knowledge regarding parents' experiences of having a child born small for gestational age. PurposeThe purpose of this study was to describe the experience of becoming a parent of a child small for gestational age Design and methodA qualitative inductive approach was chosen with grounded theory as a method, a strategic selection was used and individual interviews with open questions were performed. ResultsThe results showed that the parents expressed guilt over the child's size and focused on the ability to nourish their child to keep their unexpectedly small child alive. An experienced concern about the child's food intake could be seen throughout the entire interview material and the need for information was great. A common experience of the parents was that constant feeding of the child dominates their lives. ConclusionThe conclusion is that the unexpectedly small size of the child awakens the parent's instinct to provide life-sustaining care and the parents need increased support and more information around the child's condition. This requires well-trained professionals, because parents to children born SGA often harbour feelings of unpreparedness and guilt. Practice implicationsIncreased understanding and knowledge about the parents' experience of having a child born SGA, healthcare services can optimize the potential for better attachment between parent and child as well as offer appropriate support.

P64 Tap Water Safety and Connection to the Flint Water Crisis Associated with Beverage Intake Among Low-Income Michigan Families

<h3>Background</h3> Many Michigan communities have experienced threats to the safety of their tap water; the most well-known being the Flint Water Crisis. Little is known about how Michigan families perceive tap water and the extent to which beliefs about tap water safety influence beverage intake. <h3>Objective</h3> To identify perceptions of tap water safety among low-income mothers residing in Michigan and examine associations between these perceptions, mothers' beverage intake, infant feeding practices, and young children's beverage intake. <h3>Study Design, Settings, Participant</h3> In fall 2020, 3,881 low-income women who had given birth at the University of Michigan hospital between fall 2016 and fall 2020 were invited to complete a one-time online survey. Sixteen percent of women responded; 13% (N = 503) were eligible to participate and provided valid data. <h3>Measurable Outcome/Analysis</h3> Bivariate analyses and multivariable regression were used to examine associations between perceptions of tap water safety and mother-reported self and child beverage intake. <h3>Results</h3> Eleven percent of mothers reported that their tap water is unsafe to drink and 22% were unsure if their water is safe to drink. Negative perceptions of home tap water and tap water in general were associated with greater consumption of bottled water, using bottled water (vs tap) to make infant formula, and young children's bottled water intake. Mothers with friends or family in Flint during the Flint Water Crisis also drank more bottled water and gave their children bottled water more often than mothers without. Mothers' negative perceptions of tap water in general were associated with greater sugar-sweetened beverage intake among mothers and young children. On average, mothers spent $27/month on bottled water. <h3>Conclusion</h3> Distrust of tap water is common among low-income Michigan mothers. This distrust creates an economic and health burden due to reliance on bottled water and may increase socioeconomic inequalities in nutrition. Community-based interventions that improve trust and increase knowledge of tap water safety among low-income women are needed.

P25 Fruit and Vegetable Intake, Intention, and Healthy Food Choice Self-Efficacy Among Second and Third Grade EFNEP Youth in Guam

<h3>Objective</h3> To examine the effectiveness of the Health Kids Club (HKC) curriculum on fruit and vegetable (FV) intake and dietary behaviors among the Expanded Food and Nutrition Education Program (EFNEP) youth participants in Guam. <h3>Use of Theory or Research</h3> Guam EFNEP implements the HKC curriculum and applies the Experiential Learning Model; therefore, the constructs of the Social Cognitive Theory is the framework to evaluate this study's objective. <h3>Target Audience</h3> Study participants were Guam EFNEP youth in grades 3-5 (N = 2,569) during 2015-2019 from different community-based sites throughout Guam. Majority of youth were Asian and/or Native Hawaiian or Other Pacific Islander race and males (53%). <h3>Program Description</h3> The HKC curriculum consists of 6 interactive lessons on food safety, diet quality, portion control, and moving more and each has 2 activities. A lesson is added to gather exit data and celebrate program completion. <h3>Evaluation Methods</h3> Only data from youth who self-reported dietary behaviors using the nutrition education survey at entry and exit were analyzed (N = 1,714). Surveys consisted of 14 total questions for both periods 2015-2017 (n = 776) and 2017-2019 (n = 938). A paired <i>t</i> test and Wilcoxon signed rank test were performed to determine program effectiveness. Questions from each survey period were selected to examine FV intake, FV intention, and healthy food choice (HFC) self-efficacy behavior categories. <h3>Results</h3> Youth reported a significantly higher exit score for all behavior categories in both study periods. In 2015-2017, the mean increase in FV intake, FV intention, and HFC self-efficacy scores at exit were 0.45 (95% CI: 0.35-0.55), 0.18 (95% CI: 0.10-0.27), and 0.55 (95% CI: 0.45-0.65), respectively. In 2017-2019, the mean increase in FV intake and HFC self-efficacy scores at exit were 0.20 (95% CI: 0.05-0.35) and 0.37 (95% CI: 0.29-0.45), respectively, and a statistically significant median increase in FV intention score, z=2.27, <i>P</i> = 0.023. <h3>Conclusion</h3> Guam EFNEP youth curriculum is effective in improving children's FV intake, FV intention, and HFC self-efficacy.

P56 Home Food Access and Children's Heart Healthy Dietary Intake at Home and Child Care

<h3>Background</h3> One-fifth of children and adolescents have an abnormal serum cholesterol measure. Diets higher in plant-based foods and lower in sodium, sugar, cholesterol, and saturated fat reduce cardiovascular disease risk. <h3>Objective</h3> The purpose of this study is to determine if greater home access to fruits, vegetables, and snacks is associated with cardiac dietary heath at home and Early Care and Education (ECE) centers in preschool-age children and also to determine if there is a difference in children's cardiac dietary health between home and ECE. <h3>Study Design, Settings, Participants</h3> This cross-sectional study involved children (3-5 years old, n=88) and their primary caregivers from 15 licensed ECEs across Oklahoma. Parents reported home food access using the Healthy Home Survey and child's home dinner intake using the 3-Dinner Dietary Recall. Child ECE lunch consumption was recorded using the Dietary Observation for Child Care. The cardiac dietary score was composed of 6 variables, each with a single point to be summed: consumption of fish, fruits, vegetables, fiber, and limited sodium and sugary drinks. <h3>Measurable Outcome/Analysis</h3> Outcome variables were analyzed by using means, standard deviations, median, and frequencies. Adjusted linear regression analyses examined the relationship between home food access and cardiac dietary scores at home and ECE. <h3>Results</h3> At home, total fruit and vegetable (16.2 ± 6.3) outnumbered snacks (5.5 ± 3.0) with mean ratio of total home fruits and vegetables to snacks at 3.8 ± 2.7. There was no difference in cardiac dietary score between ECE (1.50 ± 0.8) and home (1.27 ± 0.9, <i>P</i> = 0.0851). Children within both environments did not meet intake recommendations for most variables (vegetables [18.2-23.9%], fruit [5.7-10.2%], fish [4.5-10.2%], fiber [1.1%], sodium [21.6-38.6%]). There was no relationship between home food access variables and cardiac dietary scores at home or ECE. <h3>Conclusion</h3> The cardiac dietary health of children at home and ECE does not meet recommendations. Interventions might consider the ECE setting to promote healthy eating among children and educate families on healthy eating at home.

Helping parents provide vegetable snacks: Investigating price and taste as barriers

Snacks contribute nearly one-quarter of children's daily energy intake in the USA. Snack time therefore represents an opportunity for parents to provide foods with key nutrients. Instead, the most common snack foods are major contributors to children's consumption of added sugars and sodium. Parents face major barriers to providing healthier snacks, including perceptions of high cost and lack of child acceptance. We obtained both economic and qualitative data to inform and optimize interventions for parents to promote vegetable snacks for children. We conducted a survey with parents (n = 368) to estimate how much of a discount would influence vegetable snack purchases by estimating willingness-to-pay using the contingent valuation method, using baby-cut carrots as a sample product. We conducted three focus groups (n = 19) and 1 group interview (n = 2) with children to help understand how to increase the appeal of vegetable snacks. Most (70%) parents accepted the reference price for the vegetable snack. Among those who did not, contingent valuation analysis revealed that a mean discount of approximately 30% would shift consumers to purchasing the snack. Focus group results revealed that the appeal of vegetable snacks to children was influenced by how they were prepared and presented, and the child's familiarity with the vegetables and ability to choose among them. This study lays the groundwork for effective interventions to promote the provision of vegetable snacks by parents.

Fruit and vegetable intake at and away from school during participation in the FIT Game.

The FIT Game is a multicomponent school-based incentive program aimed at increasing children's fruit and vegetable (FV) intake. There has been no previous report on how playing the game at school influences FV intake away from school. To examine children's (n=37) FV intake away from school while participating in the FIT Game program at school. FV intake away from school was assessed using the ASA24-Kids-2014 Dietary Assessment Tool. Paired samples t-tests and the generalized linear model repeated measures analysis of variance were used to examine the difference in children's mean FV intake away from school. During the final three days of the FIT Game intervention, we observed no change in FV consumption away from school (p=0.30). Similarly, no differences were observed between FV intake away from school before the implementation of the FIT Game and during the final three days (p=0.81). The FIT Game modestly decreased the children's FV intake in a nonstatistically significant manner away from school. Our previous report showed an increase in children's FV intake at school; thus, the net effect of the game was a significant increase in total daily FV intake.

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.

Family Education on the Quality of Children in the Covid-19 Era

The first education for children from an early age is that of the parents. This study aims to describe the role of family education that will affect the quality of children through parenting and parenting. This study used a qualitative approach with a descriptive method to obtain information related to family education about children's calories. Children's calories need to be supervised by parents to determine whether or not the child's nutrition intake is sufficient to fulfill nutrition in children so as not to excess calories in early childhood. Data collection techniques using observation, interviews, and documentation. The results showed that parents assisted children by guiding children in learning and doing assignments from educators, a series of habituation models in speech and behavior.

Level of Neighborhood Deprivation Predicts Fruit &amp; Vegetable and Sugar-Sweetened Beverage Intake in Children Aged 12–24 Months

Abstract Objectives The first USDA Dietary Guidelines for Americans for children under 2 were released in December, 2020, and recommend a diverse diet rich in fruits and vegetables (FV), whole grains and lean protein and avoidance of sugar-sweetened beverages (SSB). We analyzed data for children 12–24 months enrolled in the CDC-funded PREVAIL Cohort in Cincinnati, OH to assess adherence to FV and SSB recommendations by the socioeconomic position (SEP) of their neighborhoods. Methods Diet was assessed using a validated food frequency questionnaire and daily servings of FV and SSB were calculated. Home addresses were geocoded and merged with the Deprivation Index, a validated measure of census tract-level SEP, with residence then classified as being High SEP (least deprived), Low SEP (most deprived) or the middle quartiles of deprivation score. Comparisons of FV and SSB intake were made using logistic or Poisson regression and generalized estimating equations (GEE). Results Dietary data was available for N = 207 children from research visits at 12 (n = 155), 18 (n = 196), and 24 (n = 171) months. Residents in High SEP neighborhoods were 86% white with a median household income of ≥$50,000; residents of Low SEP neighborhoods were 86% Black with a median income of ≤$25,000. Children in High SEP consumed the most and those in Low SEP the least FV per day (mos. 12, 18, 24: High: 3.8, 3.8, 4.5; Low: 2.1, 2.7, 3.2; all P &amp;lt; 0.05). While only 16.8% of children consumed any SSB at month 12, Low SEP children were 13.4 times more likely to consume any SSB than High SEP (37.8% vs 4.4%, P = 0.001). At month 24, 27.4% of High SEP children consumed any SSB and 7.8% consumed SSB at least once daily compared to 58.4% and 27.8%, respectively, in Low SEP children (P &amp;lt; 0.05). In univariate GEE models, children in Low SEP neighborhoods averaged 1/3 fewer FV but 4.6-times more SSB (all P &amp;lt; 0.01) compared to children in High SEP neighborhoods. The middle quartiles of deprivation index were intermediate in their FV and SSB intake. Conclusions In the PREVAIL Cohort, children in more deprived neighborhoods consumed significantly fewer fruits and vegetables and more sugar-sweetened beverages than those in more affluent neighborhoods. Efforts to improve diet quality should focus on promoting and enabling healthy food and beverage consumption in low SEP neighborhoods. Funding Sources Centers for Disease Control and Prevention.

Contribution of Dairy Foods to Energy and Nutrient Intakes in Children and Adults: Analysis of Nhanes 2015–2018

ObjectivesDairy foods are foundational foods in healthy eating patterns. Consumption of dairy foods helps both children and adults meet the recommendations of a variety of essential nutrients. Accordingly, the objective of this study was to determine the contribution of total dairy, milk, cheese, and yogurt to energy and nutrient intake in children and adults. MethodsTwenty-four-hour dietary recall data from children age 2–18 (n = 5038) and adults age 19–99 (n = 9813) participating in the National Health and Nutrition Examination Survey (NHANES) 2015–2016 and 2017–2018 were analyzed. Intakes (both absolute amounts and as a percentage of total intake) of energy and nutrients were determined for all food groups using the USDA food category system. Data were generated on an as consumed basis and on a disaggregated basis; the latter approach reallocated energy and nutrients from milk and cheese found in other foods (e.g., pizza) back to the respective dairy food group. Total dairy was defined as milk, cheese, and yogurt in this analysis. ResultsOn a disaggregated basis, total dairy provided 14.2% and 9.7% of total kcal/d in children and adults, respectively. At current consumption levels, milk, cheese, and yogurt contributed 61.6% of calcium, 65.8% of vitamin D, 22.8% of potassium, 23.7% of protein, 38.5% of vitamin A, 38.3% of vitamin B12, 31.1% of riboflavin, 36.3% of phosphorus, 22.7% of zinc, and 18.1% of magnesium in children, on average. Dairy foods also contributed 19% of total fat, 31.1% of saturated fat, 13.9% of sodium, and 4.7% of added sugar to the diets of children. Similarly, in adults, milk, cheese, and yogurt contributed 49.5% of calcium, 45.9% of vitamin D, 11.6% of potassium, 15.7% of protein, 26.6% of vitamin A, 24.9% of vitamin B12, 18.6% of riboflavin, 25% of phosphorus, 15.5% of zinc, and 9.4% of magnesium to the diet, on average. Total dairy also provided 14.2% of total fat, 24.8% of saturated fat, and 10.1% of sodium in adults. Milk was the top source of calcium and vitamin D in both children and adults. ConclusionsMilk, cheese, and yogurt remain significant sources of key nutrients for children and adults, including three out of the four underconsumed nutrients of public health concern (vitamin D, calcium, and potassium) as defined by the 2020 Dietary Guidelines for Americans. Funding SourcesNational Dairy Council.

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.

Five-Year Trends in Sugar-Sweetened Beverage Consumption Among Mothers, Teenagers, Children From SNAP-Ed Eligible Households Indicate Increased Intake Among Children

Abstract Objectives Previously we reported improved dietary intake from 2015 to 2017 for fruits and vegetables, water, and Healthy Eating Index-2015 scores for mothers, teenagers, and children from households eligible for Supplemental Nutrition Education Program-Education (SNAP-Ed). Sugar-sweetened beverage (SSBs) consumption was unchanged during this three-year period across age groups. Our objective was to now examine trends in SSB intake with data from 2018 and 2019. Methods Cross-sectional surveys of mothers and their teenager or child were conducted from 2015 to 2019. Respondents were randomly sampled from households with reported incomes ≤185% of the federal poverty level. A study introduction letter in English or Spanish was sent to sampled households. Next, bilingual staff confirmed by phone household eligibility, the youngest mother (or caregiver), and one teenager (12 to 17 years) or child (5 to 11 years). During the subsequent interviews, staff administered the Automated Self-administered 24-Hour Dietary Assessment Tool (ASA24) in English or Spanish. The quantity and size of each reported food or beverage item was determined by asking mothers to reference pictures in a portion-size booklet or measuring cups or spoons previously mailed to each household. The procedures were replicated to obtain 24-hour dietary information from the teenager or child. Daily SSB intake was converted to ounces and regressed on year of survey with the covariates age, education for mothers, and gender for children. Significance of difference between means was adjusted by Bonferroni. Results Participants over the five-year period were 22,827 mothers, 5855 teenagers, and 10,778 children. Most (64.2%, 69.2%, and 67.9%) survey participants were Latinx. The trend for SSB intake for children was significant, with ounces per day increasing from 5.7 in 2017 to 7.3 in 2018 and 7.9 in 2019 (P = 0.0055). Conclusions A previous study found that, despite improvements across dietary behaviors, SSB intake was unchanged among mothers and children from SNAP-Ed eligible households. This follow-up study adds two years of data and findings indicate that children's SSB intake has increased. Findings suggest a need for interventions and policy work addressing children's SSB intake. Funding Sources California Department of Social Services.