A Feasibility Study of a Music Enrichment Program on Relative Reinforcing Value of Food and Home Environmental Enrichment among Families of Low Socioeconomic Status.

BACKGROUND: Emerging evidence suggests that low socioeconomic status (SES) home environments may play a role by promoting excess energy intake through a lack of access to non-food reinforcers. Because of the deleterious effects of SES-related disparities on child health and development, feasible and culturally acceptable interventions are urgently needed. Community-based music enrichment programs may be an ideal intervention strategy. METHODS: In collaboration with a local non-profit organization and music studio, we conducted a pilot randomized controlled trial to assess the effects of a music enrichment program versus a play date control in a group of 9-24-month-old healthy infants (N = 16). The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Children's Mercy Hospital Kansas City. This study is registered with clinicaltrials.gov (NCT05868811). RESULTS: Overall, we found some intervention effects on the relative reinforcing value of food (RRVfood) and the home environmental enrichment measures (i.e., increased music use at home and the home language environment). Our intervention demonstrated large effects on the increased use of music at home. We did not find significant group differences in the RRVfood and home language environment, but some of the effect sizes were medium-to-large. Results also suggest that our intervention is feasible and acceptable. Parent feedback indicated that the intervention was well-liked and that the steps we took to help reduce barriers worked. CONCLUSIONS: Music enrichment programs may be a high-impact, low-cost strategy to address socioeconomic disparities.

A Systematic Review of Early General Parenting Interventions: Long-term Effects in Underrepresented Populations and Implications for Obesity Prevention.

PURPOSE OF REVIEW: While some parenting interventions designed for early-life obesity prevention have demonstrated short-term success, there is limited evidence of longer-term impacts and feasibility with underrepresented populations. The goal of this review was to examine existing general parenting programs for parents of children 0-5 years that were not designed to target obesity but investigated long-term effects on parenting and/or were conducted with underrepresented populations to offer recommendations for the modification or development of parenting-focused obesity prevention programs. RECENT FINDINGS: Most studies with sustained impacts on parenting in underrepresented populations were brief, group-based programs for parents of children 2-5 years. Many effective interventions included guided practice of skills and cultural adaptations. Unique intervention approaches included remote or school-based delivery models and motivational interviewing. Brief, group-based programs for parents of young children may be a promising approach to achieving longer-term impacts of parenting interventions on obesity risk among underrepresented populations.

Play With Me: Effects of a shared activities parenting intervention on parenting and relative reinforcing value of food.

This pilot randomized controlled trial evaluated impacts of a novel shared activities intervention designed to promote positive parent-child interactions, which may function as an alternative reinforcer to food. The 4-week, at-home Play With Me intervention combines didactic parenting videos and play kits with materials for parent-child activities to practice skills. Aims of the present study were to examine the intervention's acceptability and its effects on parenting and the relative reinforcing value (RRV) of food versus parent-child activity at post-intervention. Thirty-two parents of 4-to-5-year-old children at risk for obesity were randomly assigned to the intervention or a waitlist control group. The intervention was well-liked by parents and feasible. Intervention parents reported more parenting structure and demonstrated higher observed sensitive parenting than controls at post; the latter finding was driven by greater parent positive mood, warmth, positive reinforcement, and relationship quality, with large effect sizes. There were no effects on the RRV of food. Inconsistent with hypotheses, there were trends toward control group parents reporting more parenting satisfaction and efficacy at post. Possible explanations are discussed. Results suggest Play With Me shows promise as an effective and acceptable intervention to promote positive parenting. Further research is needed to examine these effects and their implications for socioemotional development and health in a larger, more diverse sample over a longer time frame.

Prenatal tobacco and tobacco-cannabis co-exposure: Relationship with attention and memory in middle childhood.

We examined associations between prenatal tobacco exposure (with and without cannabis exposure) and children's performance on laboratory measures of sustained attention, attentional set shifting, and working memory in middle childhood (9-12 years of child age). Participants were recruited in the first trimester of pregnancy and oversampled for prenatal tobacco exposure; with a smaller sample (n = 133; n = 34 non-substance exposed, n = 37 exposed to tobacco only, n = 62 co-exposed) invited (oversampled for co-exposure) to participate in the middle-childhood assessment (M age = 10.6, SD = 0.77; 68% Black, 20% Hispanic). Results for sustained attention indicated lower attention (percent hits) at the first epoch for tobacco only exposed compared to non-exposed and co-exposed; a trend (p = .07) towards increases in impulsive responding across time (a total of 8 epochs) for tobacco exposed (with and without cannabis) compared to non-exposed children; and a significant association between higher number of cigarettes in the first trimester and greater increases in impulsive responding across epochs. However, children prenatally exposed to tobacco (with and without cannabis) demonstrated greater short-term memory compared to children not prenatally exposed, and this difference was driven by higher scores for children prenatally co-exposed to tobacco and cannabis compared to those who were non-exposed. Overall, results suggest that prenatal tobacco exposure, especially in the first trimester, may increase risk for impulsive responding on tasks requiring sustained attention, and that co-use of cannabis did not exacerbate these associations. The higher short-term memory scores among children who were co-exposed compared to non-exposed are perplexing and need replication, particularly in studies with larger sample sizes and samples exposed only to cannabis to examine this more closely.

The impact of a music enrichment program during infancy and early toddlerhood on effortful control at age 3: A preliminary investigation.

Effortful control (EC), a self-regulation skill, is associated with long-term developmental outcomes. Music has been associated with infant self-regulation and may be an intervention strategy for enhancing EC during toddlerhood. This investigation included 32 parent-child dyads from a previously conducted randomized controlled trial (RCT). Participants (9-15-months old at baseline) attended either a music enrichment program or a playdate control once a week for 1 year and monthly for an additional year. At age 3, participants completed snack and gift delay effortful control tasks. Groups were compared using one-way ANOVA. We found that participants in the music group had a significantly higher score during snack delay (music mean = 3.47 ± 0.94; control mean = 2.45 ± 1.51; p = 0.03; Cohen's d = 0.84). We did not find a significant group difference for latency to peek (music mean = 39.10 ± 20.10; control mean = 30.90 ± 19.88; p = 0.25; d = 0.57) or latency to touch (music mean = 105.73 ± 417.69; control mean = 98.35 ± 28.84; p = 0.38; d = 0.29) for the gift task. This study provides initial evidence that early participation in a music enrichment program may benefit later development of EC. This study is registered at ClinicalTrials.gov (NCT02936284).

The impact of a community-based music program during infancy on the quality of parent-child language interactions.

The early language environment, especially high-quality, contingent parent-child language interactions, is crucial for a child's language development and later academic success. In this secondary analysis study, 89 parent-child dyads were randomly assigned to either the Music Together® (music) or play date (control) classes. Children were 9- to 15-month old at baseline, primarily white (86.7%) and female (52%). Measures of conversational turns (CTs) and parental verbal quality were coded from parent-child free play episodes at baseline, mid-intervention (month 6), and post-intervention (month 12). Results show that participants in the music group had a significantly greater increase in CT measures and quality of parent verbalization post-intervention. Music enrichment programs may be a strategy to enhance parent-child language interactions during early childhood.

Early exposure to added sugars via infant formula may explain high intakes of added sugars during complementary feeding beyond maternal modeling.

Background: Research has shown that early exposure to added sugars from table food is related to increased intake of added sugars in later childhood. The earliest window of exposure to added sugars may be in infancy via infant formula. However, beyond the well-established factors of maternal lifestyle and modeling, there is a lack of research examining how exposure to added sugars from infant formula influences infant/toddler added sugar intakes from table foods and sugar sweetened beverages (SSB). Objective: While accounting factors previously associated with infant/toddler added sugar intakes and maternal SSB consumption (proximal measure of maternal modeling), this study aims to examine if there is an association between added sugars in infant formula and added sugar intakes from table foods and SSB during the complementary feeding period. Methods: This is a secondary, cross-sectional analysis using three-day caregiver-reported 24-h dietary recalls in a cohort of infant/toddlers (n = 95), ages 9- < 16 mos., enrolled in a music intervention trial. Hierarchical stepwise regression was used to estimate the association between exposure to added sugars from infant formula and (1) intake of added sugars from table food and (2) SSB consumption. Infant/toddler SSB consumption was transformed to account for distributional properties. We performed incremental F-tests to determine whether the addition of each step improved model fit (R2). Results: Early exposure to added sugars via infant formula was associated with infant/toddler SSB (ΔR2 = 0.044, Finc (1, 87) =6.009, p = 0.016) beyond sociodemographic and maternal SSB consumption, but not with infant/toddler added sugar intakes from table foods (ΔR2 = 0.02, Finc (1, 87) =3.308, p = 0.072). Conclusion: While past studies have identified circumstantial (i.e., sociodemographic), or indirect (i.e., maternal lifestyle and modeling), mechanisms contributing to higher infant/toddler added sugar intakes, this study identifies exposure to added sugars from infant formula as a possible direct mechanism explaining why some infants/toddlers consume more added sugars.

Nutrient Supplementation during the Prenatal Period in Substance-Using Mothers: A Narrative Review of the Effects on Offspring Development.

Substance use during pregnancy increases the risk for poor developmental outcomes of the offspring, and for substance-dependent mothers, abstaining from substance use during pregnancy is often difficult. Given the addictive nature of many substances, strategies that may mitigate the harmful effects of prenatal substance exposure are important. Prenatal nutrient supplementation is an emerging intervention that may improve developmental outcomes among substance-exposed offspring. We provide a narrative review of the literature on micronutrient and fatty acid supplementation during pregnancies exposed to substance use in relation to offspring developmental outcomes. We first discuss animal models exposed to ethanol during pregnancy with supplementation of choline, zinc, vitamin E, iron, and fatty acids. We follow with human studies of both alcohol- and nicotine-exposed pregnancies with supplementation of choline and vitamin C, respectively. We identified only 26 animal studies on ethanol and 6 human studies on alcohol and nicotine that supplemented nutrients during pregnancy and reported offspring developmental outcomes. There were no studies that examined nutrient supplementation during pregnancies exposed to cannabis, illicit substances, or polysubstance use. Implementations and future directions are discussed.

The effects of a music enrichment program on parent-infant interactions during mealtime: A randomized controlled trial.

BACKGROUND: Parent-child interactions are linked to childhood obesity. Music enrichment programs enhance parent-child interactions and may be a strategy for early childhood obesity prevention. OBJECTIVE: We implemented a 2-year randomized, controlled trial to assess the effects of a music enrichment program (music, n = 45) vs. active play date control (control, n = 45) on parent-child interactional quality and infant weight status. METHODS: Typically developing infants aged 9-to 15-months were enrolled with a primary caregiver in the Music Together ® or a play date program. Participants attended once per week group meetings for 12 months and once per month group meetings for an additional 12 months. Parent-child interaction was measured using the Parent Child Early Relational Assessment (PCERA) at baseline, month 6, 12, and 24. We used a modified intent-to-treat mixed model regression to test group differences in parent-child interactions and Weight for length z-score (zWFL) growth trajectories were modeled. RESULTS: There were significant differential group changes across time for negative affect during feeding (group*month; p = 0.02) in that those parents in the music group significantly decreased their negative affect score compared with the control group from baseline to month 12 (music change = -0.279 ± 0.129; control change = +0.254 ± 0.131.; p = 0.00). Additionally, we also observed significant differential group changes across time for parent intrusiveness during feeding (group*month; p = 0.04) in that those parents in the music group significantly decreased their intrusiveness score compared with the control group from month 6 to month 12 (music change = -0.209 ± 0.121; control change = 0.326 ± 0.141; p = 0.01). We did not find a significant association between any of the changes in parental negative affect and intrusiveness with child zWFL trajectories. CONCLUSION: Participating in a music enrichment program from an early age may promote positive parent-child interactions during feeding, although this improvement in the quality of parent-child interactions during feeding was not associated with weight gain trajectories.

Caregiver feeding decisions and sociodemographic characteristics are associated with snack food intake during infancy and toddlerhood.

Snacking starts early in childhood, yet little is known about child versus family influences on snacking during infancy and toddlerhood. This secondary analysis of baseline data examined associations of child characteristics (e.g., appetitive traits, temperament), caregiver feeding decisions, and sociodemographic characteristics with the mean frequency of (times/day) and mean energy from (kcal/day) child snack food intake. Caregivers and their children (ages 9-15 months) were recruited in Buffalo, NY from 2017 to 2019. Caregivers reported on sociodemographics, child appetitive traits (Baby Eating Behaviour Questionnaire), and child temperament (Infant Behavior Questionnaire-Revised). Three 24-h dietary recalls were collected, and USDA food categories were used to categorize snack foods (e.g., cookies, chips, and puffs). Hierarchical multiple linear regression models examined associations of child characteristics (Step 1: age, sex, baseline weight-for-length z-score, appetitive traits, and temperament), caregiver feeding decisions (Step 2: breastfeeding duration and age of solid food introduction), and caregiver sociodemographic characteristics (Step 3: caregiver age, prepregnancy BMI, education, and household size) with mean child snack food intake. Caregivers (n = 141) were on average 32.6 years of age, predominantly white (89.1%), and college-educated (84.2%). Age of solid food introduction (B = -0.21, p = 0.03), prepregnancy BMI (B = 0.03, p = 0.04), and household size (B = 0.23, p = 0.02) were significantly associated with the mean frequency of (times/day) snack food intake, over and above other variables of interest. Child age (B = 15.96, p = 0.002) was significantly associated with mean energy from (kcal/day) snack food intake. Household size (B = 28.51, p = 0.006) was significantly associated with mean energy from (kcal/day) snack food intake, over and above other variables of interest. There were no significant associations of other child characteristics with snack food intake. Findings show that child snack food intake is more closely associated with caregiver feeding decisions and sociodemographic characteristics than child characteristics. TRIAL REGISTRATION: National Institute on Child Health and Human Development, Grant/Award Number R01HD087082-01.

Characterization of a Vigorous sucking style in early infancy and its predictive value for weight gain and eating behaviors at 12 months.

This study sought to identify sucking profiles among healthy, full-term infants and assess their predictive value for future weight gain and eating behaviors. Pressure waves of infant sucking were captured during a typical feeding at age 4 months and quantified via 14 metrics. Anthropometry was measured at 4 and 12 months, and eating behaviors were measured by parent report via the Children's Eating Behavior Questionnaire-Toddler (CEBQ-T) at 12 months. Sucking profiles were created using a clustering approach on the pressure wave metrics, and utility of these profiles was assessed for predicting which infants will have weight-for-age (WFA) percentile changes from ages 4-12 months that exceed thresholds of 5, 10, and 15 percentiles, and for estimating each CEBQ-T subscale score. Among 114 infants, three sucking profiles were identified: Vigorous (51%), Capable (28%), and Leisurely (21%). Sucking profiles were found to improve estimation of change in WFA from 4 to 12 months and 12-month maternal-reported eating behaviors above infant sex, race/ethnicity, birthweight, gestational age, and pre-pregnancy body mass index alone. Infants with a Vigorous sucking profile gained significantly more weight during the study period than infants with a Leisurely profile. Infant sucking characteristics may aid in predicting which infants may be at greater risk of obesity, and therefore sucking profiles deserve more investigation.

A pilot study of the association between maternal mid-pregnancy cholesterol and oxysterol concentrations and labor duration.

BACKGROUND: Previous animal model studies have highlighted a role for cholesterol and its oxidized derivatives (oxysterols) in uterine contractile activity, however, a lipotoxic state associated with hypercholesterolemia may contribute to labor dystocia. Therefore, we investigated if maternal mid-pregnancy cholesterol and oxysterol concentrations were associated with labor duration in a human pregnancy cohort. METHODS: We conducted a secondary analysis of serum samples and birth outcome data from healthy pregnant women (N = 25) with mid-pregnancy fasting serum samples collected at 22-28 weeks of gestation. Serum was analyzed for total-C, HDL-C, and LDL-C by direct automated enzymatic assay and oxysterol profile including 7α-hydroxycholesterol (7αOHC), 7ß-hydroxycholesterol (7ßOHC), 24-hydroxycholesterol (24OHC), 25-hydroxycholesterol (25OHC), 27-hydroxycholesterol (27OHC), and 7-ketocholesterol (7KC) by liquid chromatography-selected ion monitoring-stable isotope dilution-atmospheric pressure chemical ionization-mass spectroscopy. Associations between maternal second trimester lipids and labor duration (minutes) were assessed using multivariable linear regression adjusting for maternal nulliparity and age. RESULTS: An increase in labor duration was observed for every 1-unit increment in serum 24OHC (0.96 min [0.36,1.56], p < 0.01), 25OHC (7.02 min [1.92,12.24], p = 0.01), 27OHC (0.54 min [0.06, 1.08], p < 0.05), 7KC (8.04 min [2.7,13.5], p < 0.01), and total oxysterols (0.42 min [0.18,0.06], p < 0.01]. No significant associations between labor duration and serum total-C, LDL-C, or HDL-C were observed. CONCLUSIONS: In this cohort, mid-pregnancy concentrations of maternal oxysterols (24OHC, 25OHC, 27OHC, and 7KC) were positively associated with labor duration. Given the small population and use of self-reported labor duration, subsequent studies are required for confirmation.

Prenatal tobacco and cannabis co-exposure and offspring obesity development from birth to mid-childhood.

BACKGROUND: Although the association between prenatal tobacco exposure and child obesity risk is well-established, less is known about co-exposure to tobacco and cannabis. OBJECTIVE: Determine the relation between prenatal substance co-exposure and obesity risk. METHODS: In a diverse sample of pregnant women, we examined the association between prenatal substance exposure (tobacco-only and co-exposure) and child BMI (kg/m2 ) trajectories from birth to mid-childhood (n = 262), overweight/obese status based on BMI percentiles from toddlerhood (24 months) to mid-childhood (9-12 years), and adiposity outcomes at mid-childhood (fat mass [kg], fat mass [%] and fat free mass [kg]; n = 128). Given that the major goal of this study was to examine the associations between prenatal substance exposure and child outcomes, we oversampled pregnant women for substance use (with tobacco as the primary focus). RESULTS: Multilevel models demonstrated that children in both exposure groups had a steeper increase in BMI trajectory from birth to mid-childhood and among co-exposed children, girls had a steeper increase than boys. Odds ratio of having obesity by mid-childhood was 12 times higher among those co-exposed than non-exposed. Co-exposure led to significantly greater fat mass and fat mass % compared with no exposure, but exposure to only tobacco was no different than no exposure. CONCLUSIONS: Results highlight potentiating effects of cannabis exposure in the context of maternal tobacco use in pregnancy on obesity risk and the importance of multi-method assessments of obesity.

Systematic Review of General Parenting Intervention Impacts on Child Weight as a Secondary Outcome.

General parenting interventions have improved parent-child relationships and child behavior, with emerging evidence that they may also reduce prevalence of pediatric overweight/obesity. We conducted a systematic review on interventions that were designed to promote positive parenting and examined child weight post-hoc. We searched for studies published through January 2022 that promoted positive parenting among parents of children ages 0-18 years and reported effects on body weight as an ancillary outcome, with no intervention content focused on energy balance (e.g., feeding, physical activity). This search was carried out within ClinicalTrials.gov, ISRCTN Registry, PubMed, PsycINFO, Web of Science, and Connected Papers. Studies were imported into EndNote X9 and assessed independently by two investigators. In total, 753 clinical trials and 723 publications were assessed, and six publications met inclusion criteria. All cohorts were low-income and interventions targeted expectant mothers up through parents of adolescents. Follow-ups occurred when participants were between 2 and 25 years. Significant improvements in weight-related outcomes were observed across all studies for the intervention arm as a whole or for certain subgroups, and reasons underlying these gains tended to differ by participants' age. The magnitude of effect sizes ranged from medium to large. Interventions focused on general positive parenting are efficacious at lowering risk of overweight/obesity without focusing on physical health. Promoting attachments among infants, restructuring a toddler's home environment, praising preschoolers, and communicating with adolescents may optimize weight outcomes in parenting interventions adapted for obesity prevention.

Change in hyper-palatable food availability in the US food system over 30 years: 1988-2018.

OBJECTIVE: To quantify the change in availability of hyper-palatable foods (HPF) in the US foods system over 30 years (1988-2018). DESIGN: Three datasets considered representative of the US food system were used in analyses to represent years 1988, 2001 and 2018. A standardised definition from Fazzino et al. (2019) that specifies combinations of nutrients was used to identify HPF. SETTING: Analysis of food-item level data was conducted. Differences in the prevalence of HPF were characterised by Cochran's Q and McNemar's tests. Generalised linear mixed models with a fixed effect for time and random intercept for food item estimated change in the likelihood that a food was classified as hyper-palatable over time. PARTICIPANTS: No participant data were used. RESULTS: The prevalence of HPF increased 20 % from 1988 to 2018 (from 49 % to 69 %; P < 0·0001). The most prominent difference was in the availability of HPF high in fat and Na, which evidenced a 17 % higher prevalence in 2018 compared with 1988 (P < 0·0001). Compared with 1988, the same food items were >2 times more likely to be hyper-palatable in 2001, and the same food items were >4 times more likely to be classified as hyper-palatable in 2018 compared with 1988 (P values < 0·0001). CONCLUSIONS: The availability of HPF in the US food system increased substantially over 30 years. Existing food products in the food system may have been reformulated over time to enhance their palatability.

Reducing relative food reinforcement of infants using a music enrichment program: a randomized, controlled trial.

BACKGROUND: Food reinforcement or one's motivation to eat may be established early in life; it might not be the food reinforcement per se that drives weight gain, but rather the imbalance between food and nonfood reinforcement. OBJECTIVES: We implemented a 2-y randomized, controlled trial to assess the effects of a music enrichment program (music, n = 45) compared with an active play date control (control, n = 45) in 9- to 15-mo-old healthy infants who were strongly motivated to eat. METHODS: The 12-mo intensive intervention phase included 4 semesters of Music Together® or a play date program (Winter, Spring, Summer, and Fall), comprised of once per week group meetings, followed by a 12-mo maintenance phase with monthly meetings. Parents were encouraged to listen to the Music Together® program CD or play with the play date group's toy with their infants at home, respectively. We performed a modified intention-to-treat analysis using all randomly assigned, non-excluded subjects for the outcome measures [relative reinforcing value of food (RRVfood), food reinforcement, music reinforcement, and weight-for-length z-score (WLZ)]. RESULTS: There were significant differential group changes across time for RRVfood (group × month; P = 0.016; Cohen's f2 = 0.034). The music group had significantly greater RRVfood decreases than the control group from baseline to the end of the intensive intervention phase (music change = -0.211; control change = -0.015; P = 0.002; Cohen's D = 0.379). However, these differences were not maintained during months 12-24 (music change = -0.187; control change = -0.143; P = 0.448; D = 0.087). We observed an overall moderation effect by sex for food reinforcement and WLZ. Boys in the music group had a significant attenuation in food reinforcement and WLZ compared with boys in the control group. CONCLUSIONS: This study extends our knowledge in infant eating behavior by providing insight into the role of nonfood alternatives in altering one's motivation to eat. There may be sex differences in altering one's motivation to eat.This trial was registered at clinicaltrials.gov as NCT02936284.

The Association between Maternal Sugar-Sweetened Beverage Consumption and Infant/Toddler Added Sugar Intakes.

Intake of added sugars during early life is associated with poor health outcomes. Maternal dietary intake influences the intake of their children, but little research investigates the relationship between maternal sugar sweetened beverage (SSB) and infant/toddler added sugar intakes. Our objective was to explore the relationship between maternal total sugars and SSB intakes and infant/toddler added sugar intakes. This cross-sectional study (n = 101) of mother-infant dyads measured maternal dietary intake by food frequency questionnaire and infant intake by three 24-h dietary recalls. Pearson's correlations explored the relations between maternal total sugars and SSB intakes and infant added sugar intakes. Hierarchical stepwise regressions determined if maternal total sugars and SSB intakes explained the variation in infant added sugar intakes after accounting for known risk factors for early introduction of added sugars. Maternal total sugars (r = 0.202, p = 0.043) and SSB (r = 0.352, p < 0.001) intakes were positively correlated with infant/toddler added sugar intakes. In the hierarchical models, maternal total sugar intakes did not account for more variance in infant added sugar intakes (ß = 0.046, p = 0.060), but maternal SSB intake was a significant contributor of infant added sugar intakes (ß = 0.010, p = 0.006) after accounting for confounders. Interventions to reduced maternal SSB consumption may help reduce infant/toddler added sugar intakes.

Associations of maternal lipoprotein particle distribution in mid-pregnancy with birth outcomes: a pilot study.

BACKGROUND: An excessive rise in maternal lipids during pregnancy may have detrimental impacts on maternal and fetal health leading to adverse pregnancy outcomes. However, knowledge gaps exist with respect to the association between lipid biomarkers and birth outcomes. METHODS: We conducted a secondary data analysis of healthy pregnant women (N = 25) with mid-pregnancy fasting serum samples collected at 22-28 weeks of gestation and birth outcome data. Serum was analyzed for conventional lipid profile (total-C, HDL-C, LDL-C, and triglycerides) and lipoprotein subclass distribution, including particle number (nM) and size (nm), for very low-density lipoprotein (VLDL)/chylomicron (CM), low density lipoprotein (LDL), and high-density lipoprotein (HDL), by nuclear magnetic resonance spectroscopy. Associations between maternal lipids and birth outcomes, including birth weight (g) and gestational age (weeks), were assessed using multivariable linear regression, adjusted for pre-pregnancy BMI. RESULTS: Although conventional lipids were not associated (p > 0.05) with birth outcomes, every 1-unit increment in large VLDL/CM particles (nM) and VLDL/CM size (nm) was associated with an increase in birth weight (confounder-adjusted ß-coefficient, 45.80 g [5.30, 86.20, p = 0.003] and 24.90 g [8.80, 40.90, p = 0.002], respectively). Among the HDL subclass parameters, a 1-unit (nM) increase in the concentration of total HDL-particles was associated with a reduced birth weight (confounder adjusted ß-coefficient, -19.40 g [95% confidence interval, -36.70, -2.20]; p = 0.03) after adjustment for maternal pre-pregnancy BMI. CONCLUSION: The preliminary results of this pilot study suggest that total particle concentrations of VLDL/CM and HDL in mid-pregnancy have divergent associations with birth weight, potentially reflecting the specific roles of these lipoprotein particles with respect to placental function and fetal growth.

Frequency of Sweet and Salty Snack Food Consumption Is Associated with Higher Intakes of Overconsumed Nutrients and Weight-For-Length z Scores During Infancy and Toddlerhood.

BACKGROUND: Current dietary guidelines recommend avoiding foods and beverages with added sugars and higher sodium before age 2 years. OBJECTIVE: The aim was to describe daily snack food intake (frequency and total energy) and the associations with overconsumed nutrients (added sugars, sodium, and saturated fats) and child weight-for-length z scores. DESIGN: A cross-sectional, secondary analysis of baseline data from an ongoing longitudinal intervention was conducted. PARTICIPANTS AND SETTING: A sample of 141 caregivers with infants (aged 9 to 11 months) and toddlers (aged 12 to 15 months) was recruited in Buffalo, NY, between 2017 and 2019. MAIN OUTCOME MEASURES: Three 24-hour dietary recalls were used to categorize 'sweet and salty snack foods' or 'commercial baby snack foods' based on the US Department of Agriculture What We Eat in America food group classifications and estimate nutrient intakes. Child recumbent length and weight were measured by trained researchers. STATISTICAL ANALYSIS: Daily frequency (times/day), energy (kcal/day), and overconsumed nutrients from snack food intake were calculated. Multivariable regression models examined associations between the frequency of and energy from snack food intake with overconsumed nutrients and child weight-for-length z scores. RESULTS: Infants consumed snack foods on average 1.2 times/day contributing 5.6% of total daily energy, 19.6% of added sugars, and 6.8% of sodium. Toddlers consumed snack foods on average 1.4 times/day contributing 8.9% of total daily energy, 40.0% of added sugars, and 7.2% of sodium. In adjusted models including all children, greater frequency of sweet and salty snack food intake, but not commercial baby snack foods, was associated with higher weight-for-length z scores. CONCLUSIONS: Snack foods are frequently consumed by infants and toddlers and contribute to the intake of overconsumed nutrients such as added sugars and sodium. Given the current guidelines to avoid added sugars and higher sodium before age 2 years, additional recommendations related to nutrient-dense snack intake may be beneficial.