Intake Of Young Children Research Articles

Skin Carotenoids Measured by Reflection Spectroscopy Correlate With Dietary Carotenoid Intake in Racially and Ethnically Diverse US Toddlers From Houston, Texas

BackgroundMethods to objectively assess fruit and vegetable (FV) intake in young children are needed in order to support rigorous assessments of policies and interventions. Noninvasive skin carotenoid concentration measurements may provide a rapid assessment of toddler carotenoid and carotenoid-rich FV intake. ObjectiveThe aim of this study was to evaluate the relationship between pressure-mediated reflection spectroscopy-measured skin carotenoid score (SCS) with proxy-reported carotenoid and FV intake in racially and ethnically diverse US toddlers. DesignThis study was a secondary analysis of data obtained from a randomized controlled 10-week study of the effect of an interactive healthy playgroup intervention vs classroom parent education on the diet and physical activity of toddlers. This study collected skin carotenoid and 1-week dietary intake using a 31-item semi-quantitative food frequency questionnaire analyzed by the Nutrient Data System for Research nutrient database. The current study determined dietary predictors of toddler SCS. Participants/settingParticipants were racially and ethnically diverse US toddlers (12 to 36 months) and adult guardian dyads (n = 50) recruited from the community in Houston, TX from fall 2018 to spring 2019. Main outcome measuresAt baseline and 10 to 12 weeks after baseline, SCS was measured by means of pressure-mediated reflection spectroscopy (Veggie Meter, Longevity Link Corporation), guardians reported toddler diet using a food frequency questionnaire, and carotenoid intake was estimated from the food frequency questionnaire responses using a nutrient database. Statistical analysisThe relationship between toddler SCS and intake of total and individual carotenoid species and FV servings was tested using generalized linear mixed models, controlling for body mass index-for-age percentiles, group assignment, and age. ResultsSCS was positively and significantly predicted by estimated intakes of total carotenoids (P = .002), β-carotene (P ≤ .001), and lutein and zeaxanthin (P = .003). Reported intakes of α-carotene, β-cryptoxanthin, and lycopene were not predictors of SCS. SCS was predicted by estimated total FV intake (P = .047) and vegetable intake (P = .006), but not fruit intake (P = .580). ConclusionsThese results showed that reported dietary carotenoid intake is a significant predictor of SCS in an ethnically and racially diverse population of US toddlers. Toddler skin carotenoid measurement holds promise as a rapid, objective, noninvasive biomarker of dietary carotenoid intake.

Choice-induced tasting. Evaluating the effect of choice on children's acceptance of an unfamiliar vegetable

Children's vegetable intake is in general below recommendations. It is known that self-selection of vegetables out of multiple options can increase intake in children. However, it is not clear if this effect is driven by a pre-existing preference for the selected food, or purely by having a choice. Allowing children to choose could create a positive bias and endorse feelings of autonomy, which could increase acceptance of the food and promote intake. The aim of the present pre-registered study was to investigate the effect of choice in promoting the acceptance of an unfamiliar vegetable during a blind-choice task. Children aged 4–5 years old (n = 161) were randomly assigned to the choice or no-choice condition. Each child was presented with three closed cups, containing a vegetable. The children were unaware that the cups contained the same vegetable, a piece of raw celeriac. In the choice condition, the children were able to choose a cup themselves whereas in the no-choice condition, the experimenter made the decision. We hypothesized that children in the choice condition would show more acceptance of the vegetable compared to children in the no-choice condition and that higher levels of picky eating would lead to less vegetable acceptance. The results demonstrated that choice indeed significantly increased vegetable acceptance (4.7 ± 1.7 versus 4.0 ± 1.9 on a 6-point scale), irrespective of pickiness in eating. In addition, picky children showed less acceptance of the vegetable compared to non-picky children. The results of this study imply that choice is an important factor in promoting unfamiliar vegetable intake in young children. Including children in the decision process may be a practical strategy for educators and caregivers to increase children's vegetable intake.

Dynamic Interplay between Social Brain Development and Nutrient Intake in Young Children.

Myelination of the brain structures underlying social behavior in humans is a dynamic process that parallels the emergence of social-emotional development and social skills in early life. Of the many genetic and environmental factors regulating the myelination processes, nutrition is considered as a critical and modifiable early-life factor for establishing healthy social brain networks. However, the impact of nutrition on the longitudinal development of social brain myelination remains to be fully understood. This study examined the interplay between childhood nutrient intake and social brain development across the first 5 years of life. Myelin-sensitive neuroimaging and food-intake data were analyzed in 293 children, 0.5 to 5 years of age, and explored for dynamic patterns of nutrient-social brain myelin associations. We found three data-driven age windows with specific nutrient correlation patterns, 63 individual nutrient-myelin correlations, and six nutrient combinations with a statistically significant predictive value for social brain myelination. These results provide novel insights into the impact of specific nutrient intakes on early brain development, in particular social brain regions, and suggest a critical age-sensitive opportunity to impact these brain regions for potential longer-term improvements in socio-emotional development and related executive-function and critical-thinking skills.

Sugar Intake among Preschool-Aged Children in the Guelph Family Health Study: Associations with Sociodemographic Characteristics.

It is crucial to develop strategies targeted to promote healthy eating patterns in vulnerable populations, especially young children from diverse sociodemographic groups. Thus, the study objective was to investigate the associations between child age, child sex, child ethnicity, parent number of years living in Canada, annual household income, parent education and parent marital status with total, free and added sugar intakes in young children. This cross-sectional study was a secondary analysis of data gathered in the Guelph Family Health Study. The study included 267 children (129M; 138F) from 210 families aged 1.5 to 5 years. Parents completed questionnaires for children on sociodemographic characteristics and an online 24-hour diet recall. The associations between sociodemographic characteristics and sugar intakes were determined using generalized estimating equations applied to linear regression models. The mean age of the children was 3.5 ± 1.2 years (mean ± std dev.). As children's age increased, there was a greater intake of free and added sugar (β^ = 8.6, p = 0.01, 95% CI = 2.4 to 14.7 and β^ = 6.5, p = 0.03, 95% CI = 0.8 to 12.2, respectively). Those children who identified as white had a higher total sugar intake than children of other ethnicities (β^ = 31.0, p = 0.01, 95% CI = 7.2 to 54.7). Additionally, higher annual household income was associated with lower was free sugar intake in children (β^ = -2.4, p = 0.02, 95% CI = -4.5 to -0.4). This study underscores the significant influence of multiple sociodemographic characteristics on sugar intake in young children, providing valuable insights for public health policy and nutrition interventions. Moreover, this study highlights the need for early behaviour interventions focusing on reducing sugar intake in young children, while considering sociodemographic factors.

Abstract P616: Implementing a Dietary Energy Density Intervention in Preschool Children

Introduction: The preschool years have been identified as a critical time to intervene on energy balance behaviors to halt the progression of obesity. In children, strategies for achieving physical activity recommendations are well established. Less clear are strategies for implementing an optimal dietary approach—one that maintains a healthy body weight and improves diet quality. Energy density (ED), the amount of energy per unit weight of food (kcal/g), may be a promising dietary approach. Hypothesis: We tested the hypothesis that a lower ED dietary approach will lower ED and energy intake and demonstrate better maintenance of body mass index (BMI z-score) than standard dietary recommendations in young children at risk for obesity. Methods: Thirty-six preschool children (3.5±1.1 years; 52.8% female; 52.8% White; 16.7% Hispanic or Latino; BMI percentile 56.8±22.2) and their parent (35.4±6.2 years; 86.1% female; 55.6% White; 13.9% Hispanic or Latino; BMI 38.2±5.4 kg/m 2 ) participated in a 6-month, 14-session, family-based behavioral intervention. Participants were randomized to a low-ED dietary approach (consume ≥10 foods/day with an ED ≤1.0 kcal/g and ≤2 foods/day with an ED ≥ 3.0 kcal/g; LOW-ED), or standard dietary recommendations (meet recommended daily servings of fruits, vegetables, and whole grains; STANDARD). Both interventions had physical activity goals of 60 minutes/day for children and 150 minutes/week for adults. Dietary and anthropometric assessments occurred at baseline and 6-months. Completer and intent-to-treat (ITT) analyses, with outliers removed, used repeated measures general linear mixed models to examine child change in ED (calculated as both all foods and beverages and food only), kcals, and BMI z-score from baseline to 6 months. Results: ITT analyses showed that the change in ED did not differ between the LOW-ED condition and STANDARD condition when calculated as for foods and beverages (LOW-ED: Δ-0.1 kcal/g vs. STANDARD: Δ+0.1 kcal/g, p = 0.12) or food only (LOW-ED: Δ-0.2 kcal/g vs. STANDARD: Δ+0.1 kcal/g, p = 0.06). There was a significant time by condition interaction with kcals/d decreasing in LOW-ED and increasing in STANDARD over time for completers (LOW-ED: Δ-98 kcals vs. STANDARD: Δ+212 kcals, p = 0.04), but not when using ITT (LOW-ED: Δ+5 kcals vs. STANDARD: Δ+211 kcals, p = 0.09). Under ITT BMI z-score had a main effect of time, with both LOW-ED and STANDARD conditions significantly increasing over time (p=0.03). Conclusion: In conclusion, these data suggest a LOW-ED dietary approach is an alternative way to lower ED and energy intake in young children at risk for obesity.

Dietary Protein Intake in Young Children in Selected Low-Income Countries Is Generally Adequate in Relation to Estimated Requirements for Healthy Children, Except When Complementary Food Intake Is Low

Background Previous research indicates that young children in low-income countries (LICs) generally consume greater amounts of protein than published estimates of protein requirements, but this research did not account for protein quality based on the mix of amino acids and the digestibility of ingested protein.Objective: Our objective was to estimate the prevalence of inadequate protein and amino acid intake by young children in LICs, accounting for protein quality.Methods: Seven data sets with information on dietary intake for children (6–35 mo of age) from 6 LICs (Peru, Guatemala, Ecuador, Bangladesh, Uganda, and Zambia) were reanalyzed to estimate protein and amino acid intake and assess adequacy. The protein digestibility–corrected amino acid score of each child's diet was calculated and multiplied by the original (crude) protein intake to obtain an estimate of available protein intake. Distributions of usual intake were obtained to estimate the prevalence of inadequate protein and amino acid intake for each cohort according to Estimated Average Requirements.Results The prevalence of inadequate protein intake was highest in breastfeeding children aged 6–8 mo: 24% of Bangladeshi and 16% of Peruvian children. With the exception of Bangladesh, the prevalence of inadequate available protein intake decreased by age 9–12 mo and was very low in all sites (0–2%) after 12 mo of age. Inadequate protein intake in children <12 mo of age was due primarily to low energy intake from complementary foods, not inadequate protein density.Conclusions Overall, most children consumed protein amounts greater than requirements, except for the younger breastfeeding children, who were consuming low amounts of complementary foods. These findings reinforce previous evidence that dietary protein is not generally limiting for children in LICs compared with estimated requirements for healthy children, even after accounting for protein quality. However, unmeasured effects of infection and intestinal dysfunction on the children's protein requirements could modify this conclusion.

Evaluation of a Food Frequency Questionnaire for Capturing Free Sugars Intake in Australian Young Children: The InFANT FFQ.

Excess free sugars intake contributes to dental caries and obesity in children. Food frequency questionnaires (FFQ) that assess free sugars intake in young children are limited. This study evaluated the utility of a 68-item FFQ to assess free sugars intake in Australian young children against three 24-h recalls at ages 1.5, 3.5, and 5.0 years. Free sugars intakes estimated from two methods were compared using group- and individual-level validation tests. Group-level tests revealed that mean free sugars intakes estimated from two methods were similar and Bland-Altman tests revealed no presence of proportional bias at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ underestimated the free sugars intake compared to the recalls, and Bland-Altman tests revealed proportional bias. For individual-level tests, the deattenuated correlation (R) between free sugars intakes estimated from two methods exhibited good agreement across three time-points (R: 0.54-0.62), as were the percentage agreement (68.5-73.6%) and weighted kappa (Kw: 0.26-0.39). The FFQ showed good validity at age 1.5 years. For ages 3.5 and 5.0 years, the FFQ showed good validity for individual-level tests only. The FFQ provided stronger validity in the ranking of individuals according to free sugars intake than comparing absolute free sugars intake at group level.

Understanding Attitudes and Practices of Low-Income Caregivers Toward Sugar-Sweetened Beverage Consumption in Preschool-Aged Children

Sugar-sweetened beverage (SSB) consumption during early childhood has been linked to adverse health outcomes across the lifespan. Caregivers of young children are often unaware of the potential health harms of SSB and may lack knowledge, skills and environmental supports to limit SSB. The objectives of this study were to determine study caregivers’ attitudes and practices with regard to SSB and to identify themes that may inform future policies and interventions to limit these beverages. Guided by the Social Ecological Model (SEM), the research team interviewed low-income caregivers of children ages two to five at a health clinic in urban New York State. Interviews were recorded, transcribed, and coded for themes and further analyzed for determinants of behavior with regard to providing SSB. Five major themes emerged: Greater SSB knowledge led to healthier choices; confusion about the healthfulness of some SSB; SSB affordability, accessibility and cultural acceptability; children’s “pester power” to obtain SSBs; and, lack of SSB information from healthcare providers. Determinants such as perceived barriers to action, self-efficacy, cues to action, and perceived threat emerged from the themes. SSB are widely available, affordable and palatable. Healthcare providers seldom discuss children’s SSB intake specifically at well visits. SSB are frequently marketed and labeled as “healthy.” SSB are a significant source of empty calories and added sugars. Helping parents limit SSBs may reduce child overweight and obesity and minimize lifelong chronic disease risks. Heathcare providers, health campaigns and nutrition assistance programs may collaborate to help parents limit SSB intake in young children.

232 Increase in weight-for-age and vegetable intake in young children with cystic fibrosis treated with lumacaftor/ivacaftor for 24 weeks

232 Increase in weight-for-age and vegetable intake in young children with cystic fibrosis treated with lumacaftor/ivacaftor for 24 weeks

An agent-based model of child sugar-sweetened beverage consumption: implications for policies and practices

A strong body of evidence links young children's intake of sugar-sweetened beverages (SSBs) with myriad negative outcomes. Our research provides insight into whether and to what extent potential intervention strategies can reduce young children's consumption of SSBs. We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 y. In addition to extensive data from Project Viva, our model used nationally representative data as well as recent, high-quality literature. We tested the explanatory power of the model through comparison to consumption patterns observed in the Project Viva cohort. Then, we applied the model to simulate the potential impact of interventions that would reduce SSB availability in 1 or more settings or affect how families receive and respond to pediatrician advice. Our model produced age-stratified trends in beverage consumption that closely match those observed in Project Viva cohort data. Among the potential interventions we simulated, reducing availability in the home-where young children spend the greatest amount of time-resulted in the largest consumption decrease. Removing access to all SSBs in the home resulted in them consuming 1.23 (95% CI: 1.21, 1.24) fewer servings of SSBs per week on average between the ages of 2 and 7 y, a reduction of ∼60%. By comparison, removing all SSB availability outside of the home (i.e., in schools and childcare) had a smaller impact (0.77; CI: 0.75, 0.78), a reduction of ∼40%. These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption.

Parental work hours and household income as determinants of unhealthy food and beverage intake in young Australian children.

This study examined parental work hours and household income as determinants of discretionary (energy dense, nutrient poor) food and beverage intake in young children, including differences by eating occasion. Secondary analysis of cross-sectional data. Three hierarchical regression models were conducted with percent energy from discretionary food and beverages across the day, at main meals, and at snack times being the outcomes. Dietary intake was assessed by 1x24-hour recall and 1-2x24-hour food record(s). Both maternal/paternal work hours were included, and total household income. Covariates included household, parent and child factors. Data from the NOURISH/SAIDI studies were collected between 2008-13. Participants included 526 mother-child dyads (median(IQR) child age 1.99(1.96,2.03) years). Forty-one percent of mothers did not work while 57% of fathers worked 35-40 hours/week. Most (85%) households had an income of ≥$50k AUD/year. Household income was consistently inversely associated with discretionary energy intake (β= -0.12 to -0.15). Maternal part-time employment (21-35 hours/week) predicted child consumption of discretionary energy at main meals (β=0.10, p=0.04). Paternal unemployment predicted a lower proportion of discretionary energy at snacks (β= -0.09, p=0.047). This work suggests that household income should be addressed as a key opportunity-related barrier to healthy food provision in families of young children. Strategies to reduce the time burden of healthy main meal provision may be required in families where mothers juggle longer part-time working hours with caregiving and domestic duties. The need to consider the role of fathers and other parents/caregivers in shaping children's intake was also highlighted.

A systematic review of parental knowledge of, and compliance with, recommendations for vitamin D intake in young children in Ireland

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Nutrient intake in school-aged children with food allergies: a case-control study

Most studies assessed nutrient intake of young children with food allergy (FA) compared to healthy children. We aimed to compare macro- and micronutrient intake of school-aged children with FA to non-allergic children. This case-control study included 93 Italian children (52 with FA and 41 controls, median age 7.5 and 8.3 years, respectively). Macro- and micronutrient intake was assessed by a three-day food dietary record. Anthropometric measurements were also collected. The median height z-score was significantly lower in the FA group, despite a similar daily energy and protein intake. Calcium, iron and vitamin D intake was suboptimal in both groups, while protein intake was higher than recommended in both groups. Unexpectedly, children with FA consume more protein than controls, while having lower micronutrient intake, especially calcium. Our data suggest the importance of nutritional counseling for children with FA to ensure a balanced nutrient intake while on elimination diet.

Improving Vitamin D Intake in Young Children-Can an Infographic Help Parents and Carers Understand the Recommendations?

Vitamin D deficiency is a serious public health issue in the United Kingdom. Those at increased risk, such as pregnant women, children under 5 years and people from ethnic groups with dark skin, are not all achieving their recommended vitamin D. Effective vitamin D education is warranted. A qualitative study was undertaken to evaluate the acceptability and understanding of a vitamin D infographic, developed using recommendations from previous research. Fifteen parents/carers, recruited through local playgroups and adverts on popular parent websites, participated in focus groups and telephone interviews. The majority were female, White British and educated to degree level. A thematic analysis methodology was applied. The findings indicated that understanding and acceptability of the infographic were satisfactory, but improvements were recommended to aid interpretation and create more accessible information. These included additional content (what vitamin D is; other sources; its health benefits; methods/doses for administration and scientific symbols used) and improved presentation (eye-catching, less text, simpler language, more images and a logo). Once finalized, the infographic could be a useful tool to educate families around vitamin D supplementation guidelines, support the UK Healthy Start vitamins scheme and help improve vitamin D status for pregnant and lactating women and young children.

Dietary sugar intake among preschool-aged children: a cross-sectional study.

Background:Excessive intake of sugar in young children is a public health concern. Our study objectives were to examine intakes of total, free and added sugar among preschool-aged children and to investigate their associations with body weight, body mass index Z-scores, percent fat mass and waist circumference.Methods:The cross-sectional cohort study included preschool-aged children between 1.5 and 5 years of age, enrolled in pilot studies of the Guelph Family Health Study, Guelph, Ontario, from 2014 to 2016. Daily intake of total sugar was determined using a food processor software; daily intakes of free and added sugar, and food sources were determined through manual inspection of 3-day food records. Anthropometric measures were completed by trained research staff. We used linear regression models with generalized estimating equations to estimate associations between sugar intakes and anthropometric measures.Results:We included 109 children (55 girls and 54 boys) in 77 families. Mean daily intakes were 86 (standard deviation [SD] 26) g for total sugar, 31 (SD 15) g for free sugar and 26 (SD 13) g for added sugar. Of participants, 80% (n = 87) had intakes of free sugar greater than 5% of their daily energy intake. The most frequent food sources of free and added sugar were bakery products. A weak inverse association between free sugar intake (kcal/1000 kcal) and waist circumference (cm) (β = −0.02, 95% confidence interval −0.04 to −0.0009) was found, but no significant associations were noted between sugar intake and other anthropometric measures.Interpretation:Most of the preschool-aged children in this study had free sugar intakes greater than current recommendations; overall, their total, free and added sugar intakes were not associated with the anthropometric measures. This study can be used to inform policy development for sugar intake in young children and apprise early intervention programs.

The Association Between Birth Weight and Fat, Sugar, and Vegetable Consumption in a National Sample of U.S. Preschool Age Children.

Adverse prenatal development is a contributor to obesity susceptibility in children. Dietary behavior is one mechanism through which adverse prenatal development may promote obesity, but evidence for the role of prenatal overnutrition in dietary intake in young children is scant. We used data from the National Health and Nutrition Examination Survey 2009-2014. Our study sample included 1782 U.S. children 2-5years old with available birth weight and two 24-h dietary recalls. We used linear and Poisson regression to examine the association of birth weight (LBW < 2500g, HBW > 4100g) and 2-day average intake of dietary variables. We tested interactions between birthweight and breastfeeding (breastfed > 5months vs. not breastfed or breastfed 0-5months), and report breastfeeding-specific results. In multivariable regression analysis, in boys, LBW was associated with 2.4 (95% CI -4.3, -0.5) lower percent of kcal from solid fat; lower sugar intake, marginally lower saturated and total fat intake, and 0.6 cup (95% CI 0.1, 1.0) greater vegetable consumption; HBW was marginally associated with lower fat. Birth weight was unrelated to diet in girls. Breastfeeding modified associations between birth weight and dietary intake, but the direction of modification was mixed. Our findings do not support the hypothesis that LBW or HBW are associated with adverse diet consumption in preschool age U.S. children. Improved understanding of the role of early life development of dietary behavior requires further research on the development of appetitive traits and the role of the family and preschool food environments.

Healthy Default Beverages in Kids’ Meals: Evaluating Policy Adherence and Impact in California

Abstract Objectives Healthy default beverage policies for restaurant kids’ meals have been identified as a top strategy to improve beverage intake in young children and reduce obesity and diabetes risk. California passed a statewide policy (SB1192), effective January 2019, specifying kids’ meal default beverages as water, unflavored milk, or a nondairy alternative. Although other localities have adopted similar policies, there have been no studies on their effectiveness. The aim of this study was to assess changes in beverages offered with kids’ meals before and after a healthy default beverage policy took effect and to quantify policy adherence in menus and cashier orders in quick service restaurants (QSR). Methods The study employed a pre-post policy design. Baseline data on beverages offered as part of kids’ meals were collected from 111 QSR in low-income areas in California in late 2018, prior to policy implementation. Follow-up data were collected from the same restaurants one year later. Data were collected by menu observation and purchase of kids’ meals. Both walk-in and drive-through settings were assessed where available. Full policy adherence was defined as offering only SB1192-compliant beverages, and was assessed 3 ways: menu board, cashier order, and a combined metric. Results At baseline, prior to any legislative requirement, 6 (6.3%) restaurant menu boards, 5 (4.5%) cashier orders, and 0 restaurants overall were already fully adherent. At follow-up, 64 (66.0%) restaurant menu boards, 1 (0.9%) cashier order, and 0 restaurants overall were fully adherent. Generalized estimating equations, clustered by restaurant chain, were used to test pre-post policy changes. Adherence in menu boards increased (59.7%, p = &amp;lt; .0001). There were no changes in adherence in cashier orders or overall adherence. Conclusions California's healthy default beverage policy for restaurant kids’ meals was effective in changing QSR menu board offerings but did not impact cashier order processes. Additional staff training may improve policy implementation. Studies are underway to assess the impact of staff training and customer behavior change. Funding Sources University of California Division of Agriculture and Natural Resources, Robert Wood Johnson Foundation Healthy Eating Research, CA Department of Public Health/USDA.

The current state of parent feeding behavior, child eating behavior, and nutrition intake in young children with type 1 diabetes.

One integral component of type 1 diabetes (T1D) management is attention to nutrition, which can be particularly challenging in young children. The current study reports on parent and child eating/feeding behavior and nutrition intake as compared with current recommendations for pediatric T1D. Participants were 46 children ages 2 to 5 diagnosed with T1D and one parent. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was used to assess parent feeding and child eating behaviors. The Remote Food Photography Method (RFPM) was used to analyze nutrition intake at breakfast. Demographic and medical information were collected via self-report and medical chart review. In the current sample, 37% of BPFAS scores were above the cutoff for problem child eating behavior. Only 28% of participants met the recommended goals for glycemic control (hemoglobin A1c, HbA1c < 7.5). Children who did not meet glycemic control targets reported higher carbohydrate intake than those meeting targets. Protein recommendations were met by 46%; 22.7% met the recommendation for carbohydrate intake, and 45.5% met fat intake recommendations. The majority of the sample did not meet body mass index percentile (BMI%) recommendations with 51% having a BMI% above the 85th percentile. Many parents of young children with T1D report problem child eating behaviors. Further, a significant number of young children are not meeting glycemic, nutritional, or BMI guidelines for T1D. Routine screening for dietary difficulties in young children is warranted. Future research should aim to examine interventions targeting families with young children not meeting nutrition, glycemic, or BMI guidelines.

Sugar-containing beverage consumption and cardiometabolic risk in preschool children

ObjectiveSugar-containing beverages (SCBs) including 100% fruit juice, fruit drinks and soda substantially contribute to total caloric intake in young children. The objective of this study was to examine whether consumption of SCB is associated with cardiometabolic risk (CMR) in preschool children, along with whether 100% fruit juice and sugar sweetened beverage (SSB) is associated with CMR.Study DesignWe used a repeated measures study design examining SCB consumption and CMR outcomes measured concurrently in children 3–6 years of age participating in TARGet Kids!, a primary-care, practice-based research network in Canada (2008–2017). To account for within-person variability, multivariable linear regression models using generalized estimating equation was used to examine the association between SCB consumption and CMR score and the individual CMR score components including systolic blood pressure, waist circumference, high-density lipoprotein cholesterol (HDL-c), triglycerides, and glucose.ResultsAfter adjusting for sociodemographic, familial and child-related covariates, higher SCB consumption was associated with elevated CMR score [0.05 (95% CI −0.0001 to 0.09), p = 0.05], including lower HDL-c [−0.02 mmol/L (95% CI −0.03 to −0.01), p = 0.01] and higher triglycerides [0.02 mmol/L (95% CI 0.004 to 0.04), p = 0.02]. When examined separately, higher 100% fruit juice [−0.02 mmol/L (95% CI −0.03 to −0.003), p = 0.02] and SSB[-0.03 mmol/L (95% CI −0.06 to −0.001), p = 0.04] consumption were each associated with lower HDL-c.ConclusionHigher SCB consumption was associated with small elevations of CMR in preschool children. Our findings support recommendations to limit overall intake of SCBs in early childhood, in effort to reduce the potential long-term burden of CMR.

Colour as a cue to eat: Effects of plate colour on snack intake in pre-school children

Environmental cues, such as the colour of food and dishware, have been shown to influence food and drink consumption in adult populations. This proof of concept study investigated whether plate colour could be utilised as a strategy to reduce intake of high energy density (HED) snacks and increase intake of low energy density (LED) snacks in pre-school children. In a between and within-subjects design, children were randomly assigned to either a control group (no colour message) or intervention group (received a colour message: red = stop, green = go) and were provided a snack at nursery on three occasions on differently coloured plates (red, green, white), for each snack type (HED, LED). Snack intake, colour preference, colour association, and anthropometrics were recorded for each child. The results showed that there was no effect of group (control vs intervention) on HED (p = 0.540) and LED intake (p = 0.575). No effect of plate colour on HED (p = 0.147) or LED snack intake (p = 0.505) was evident. Combining red and green plates for a chromatic versus achromatic comparison showed that there was no significant effect of chromatic plate on HED (p = 0.0503) and LED (p = 0.347) intakes. Despite receiving a brief learning intervention, the use of plate colour was found in the present study to be an ineffective strategy to control snack food intake in pre-school aged children. Rather, we suggest that food intake in young children may best be predicted by portion size, energy density and eating behaviour traits.