Early-Life Diet Diversity and the Subsequent Risk of Inflammatory Bowel Disease: Findings From Two Scandinavian Birth Cohorts.

BACKGROUND: Diet diversity in early childhood promotes microbial diversity, influences the developing immune system, and has been linked to a reduced risk of immune-mediated diseases. This study aimed to determine the association between childhood diet diversity and later inflammatory bowel disease (IBD), for which data are limited. METHODS: Questionnaire data from the population-based birth cohorts All Babies in Southeast Sweden (ABIS) and the Norwegian Mother, Father, and Child Cohort (MoBa), including participants from Southeast Sweden and Norway, were used to estimate a diet diversity score at ages 1 and 3 years. This score represents the diversity of intakes across 5 food groups comprising 11 subgroups. A higher score signifies higher diet diversity. We used linked health registry data to identify IBD diagnoses up to the year 2021. Cox regression and random-effect models were used to estimate pooled hazard ratios (aHRs) adjusted for sociodemographics, breastfeeding, and early-life antibiotic use. RESULTS: Among 81 272 children with 1 304 325 person-years of follow-up, 307 developed IBD. Diet diversity at ages 1 and 3 years was in pooled analyses not associated with later IBD (per one-unit increase, aHR = 0.96 [95% CI = 0.81-1.14] and aHR = 0.96 [95% CI = 0.83-1.11]). In MoBa, but not ABIS, a higher diet diversity at 1 and 3 years of age was inversely associated with ulcerative colitis (UC) (per one-unit increase, aHR = 0.78 [95% CI = 0.66-0.94] and aHR = 0.78 [95% CI = 0.65-0.95]). Still, pooled aHRs for UC as well as Crohn's disease approximated one. CONCLUSIONS: In this prospective study of 2 Scandinavian birth cohorts, no association was observed between early-life diet diversity and the subsequent risk of IBD.

In this prospective study of over 80 000 children followed in 2 Scandinavian birth cohorts, early-life diet diversity was not associated with the subsequent risk of inflammatory bowel disease.

Benchmarking the nutrient composition and labelling practices of finger foods and snacks for older infants and young children across seven Southeast Asian countries.

Ensuring consumption of nutrient-dense, safe and appropriate complementary foods among older infants and young children (IYC) 6-36 months of age is critical for enabling optimal growth and development. The ubiquitous availability of and high demand for commercially packaged snack foods has culminated in a growing trend of snack food products specifically produced and promoted for older IYC. Commercially produced complementary foods (CPCF) that are finger foods/snacks often contain added sugars, excessive sodium content and high total sugar content, making them inappropriate for this young population. This study benchmarked the nutrient composition and labelling practices of CPCF finger foods/snacks available for purchase in seven countries in Southeast Asia. The study adapted a nutrient profiling model from the WHO Regional Office for Europe to determine the proportion of products suitable for promotion for older IYC. Of the total 606 products identified, 8.2% were automatically categorized as not suitable because they were confectionery items. Of the remaining 556 products assessed, over 85% failed to meet all nutrient composition requirements, with the presence of added sugars/sweeteners and excessive sodium and total sugar contents the primary reasons for failure. Products also demonstrated concerning labelling practices, with all of the products (98.6%) displaying an inappropriate claim on the label. These findings reveal major concerns with the nutrient composition and labelling practices of CPCF finger foods/snacks in the SEA region and should serve as an alarm bell for regulatory action. National binding legal measures, such as mandatory standards for composition and labelling are urgently needed.

Child feeding indexes measuring adherence to New Zealand nutrition guidelines: Development and assessment.

New Zealand (NZ) lacks nationally representative or generalisable information on the dietary intakes of pre-schoolers. We used Growing Up in New Zealand cohort data to i) develop child feeding indexes (CFIs) based on National Food and Nutrition Guidelines for 2- and 4.5-year-olds; ii) describe the cohort adherence to the guidelines at 2 (n = 6046) and 4.5 years (n = 5889) and; iii) assess the CFIs' convergent construct validity, by exploring associations with maternal sociodemographic and health behaviours and with child body mass index for age (BMI/age) and the waist-to-height ratio at 4.5 years. The CFIs scores ranged from 0 to 11, with 11 representing full adherence to the guidelines. Associations were tested using multiple linear regressions and Poisson regressions with robust variance (risk ratios [RR], 95% confidence intervals, 95% CI). The CFIs mean scores (SD) at 2 and 4.5 years were, respectively, 6.13 (1.21) and 6.22 (1.26) points. Maternal characteristics explained, respectively, 27.2% and 31.9% of the variation in the CFIs scores at 2 and 4.5 years. In the adjusted model at the 4.5-year interview, in relation to girls ranked in the 5th quintile, those in the 2nd (RR, 95% CI: 1.48; 1.03; 1.24) and 4th (1.53; 1.05; 2.23) quintiles of the CFI were more likely to have BMI/age > +2z (World Health Organization growth standards) at 4.5 years. At 2 and 4.5 years, most children fell short of meeting national guidelines. The associations between the CFIs scores at both time points with maternal characteristics and with children's body size at 4.5 years were in the expected directions, confirming the CFIs' convergent construct validity among NZ pre-schoolers.

The lived experience of parenting a child with sensory sensitivity and picky eating.

"Picky eating" is a common behaviour seen in childhood in both clinical and nonclinical populations. Sensory processing difficulties have been repeatedly associated with food refusal and picky eating behaviours. The aim of this study was to explore the lived experiences of parents/caregivers who have a child displaying both sensory processing differences and picky eating behaviours utilising Interpretative Phenomenological Analysis (IPA). Participants were recruited from social media support groups for parents of picky eating children. Pre-selection criteria utilised an adapted short sensory profile questionnaire to ensure the children displayed probable/definite taste-smell, audio-visual and tactile sensory sensitivities. Twelve participants fulfilling the required criteria were interviewed face to face utilising a semi-structured interview schedule. Interviews were transcribed and analysed following IPA guidelines and three common themes are presented here: Battling for control of the sensory environment, Living with stigma and, disapproval, and Staying positive and moving forward. The findings show the very considerable day-to-day challenges of parenting a child with sensory issues with food, including a lack of support and criticism from others. It was apparent that the parents in our study gradually adopted a positive and accepting attitude to their child's eating. This acceptance allowed them to have positive interactions around food with their child such as cooking and playing with food, suggesting that experiential activities serve an important purpose in this population. Further research should examine whether parental interventions based on acceptance of child eating behaviour, and commitment to gradual positive food interactions would be the best strategy to support parents and children.

Revisión bibliográfica: alimentación vegetariana en la infancia y adolescencia / Vegetarian diet in childhood and adolescence

RESUMEN Introducción: la popularidad de las dietas vegetarianas y veganas está aumentando en países occidentales y son adoptadas por niños, niñas y adolescentes (NNyA). Las principales asociaciones de nutrición y dietética del mundo avalan este tipo de práctica alimentaria en estos grupos etáreos si son supervisados y acompañados por profesionales idóneos. Objetivo: tomar posicionamiento como Asociación Argentina de Dietistas y Nutricionistas Dietistas acerca de la implementación de dietas vegetarianas en edad pediátrica y adolescencia, considerando recomendaciones basadas en evidencias científicas. Materiales y método: revisión y actualización bibliográfica, no sistemática con búsquedas en Google Scholar, PudMed y Medline entre diciembre 2018 y marzo 2019. Resultados: la valoración nutricional, evaluando ingesta alimentaria utilizando recordatorio de 24 horas y frecuencia de consumo, orientará sobre cuáles son las potenciales deficiencias nutricionales que puede presentar para adecuar la dieta y/o suplementación de nutrientes específicos. La alimentación vegetariana tiene una densidad energética más baja que la no vegetariana, pero se logran alcanzar las recomendaciones. Las necesidades proteicas se satisfacen fácilmente cuando la dieta incluye variedad de alimentos y las calorías son adecuadas. Algunos autores sugieren aumentar un 10 a 15% la recomendación proteica. Además, considerar el aporte de ácidos grasos omega 3 (EPA y DHA) para lograr el equilibrio óptimo entre los ácidos grasos poliinsaturados omega3/omega6. Los requerimientos nutricionales de calcio no varían con respecto a los omnívoros. Es imprescindible suplementar vitamina B12 oral a todos los NNyA vegetarianos, incluso en ovolactovegetarianos o en NNyA que consuman habitualmente alimentos fortificados. La suplementación adecuada es la mejor forma de garantizar unos niveles óptimos de esta vitamina. Se recomienda evaluar el estado de la vitamina D suplementando según edad. Conclusiones: La Asociación Argentina de Dietistas y Nutricionistas Dietistas (AADYND) plantea que la alimentación vegetariana y/o vegana planificada, supervisada y suplementada por un profesional de la nutrición idóneo, son saludables en la niñez y adolescencia. Los profesionales de la alimentación y nutrición pueden desempeñar un papel clave en la educación y acompañamiento de las personas vegetarianas acerca de fuentes específicas de nutrientes, preparación de alimentos, y modificaciones dietéticas necesarias para satisfacer sus necesidades(AU)

ABSTRACT Introduction: the popularity of vegetarian and vegan diets is increasing in western countries and are adopted by children and adolescents (Ch&A). The main nutrition and dietetic associations in the world approve this type of dietary practice in these age groups if they are supervised and accompanied by qualified professionals. Objective: take a position as the Argentine Association of Dietitians and Dietitian Nutritionists about the implementation of vegetarian diets in pediatric and adolescent age, considering recommendations based on scientific evidence. Materials and Method: review and bibliographic update, non-systematic, with searches on Google Scholar, PudMed and Medline between December 2018 and March 2019. Results: The nutritional assessment, evaluating food intake using a 24-hour reminder and frequency of consumption, will provide guidance on what are the potential nutritional deficiencies that may come up, adapt the diet and/or supplementation of specific nutrients. The vegetarian diet has a lower energy density than the non-vegetarian diet but manages to meet the recommendations. Protein needs are easily met when the diet includes a variety of foods and calories are adequate. Some authors suggest increasing the protein recommendation by 10 to 15%. Considering the contribution of omega 3 fatty acids (EPA and DHA) to achieve the optimal balance between omega3/omega6 polyunsaturated fatty acids. The nutritional requirements of calcium do not vary with respect to omnivores. It is essential to supplement oral vitamin B12 to all vegetarian Ch&A, even in ovolactovegetarians or in Ch&A that habitually consume fortified foods. Proper supplementation is the best way to ensure optimal levels of this vitamin. It is recommended to evaluate the status of vitamin D by supplementing according to age. Conclusions: Argentine Association of Dietitians and Dietitian Nutritionists states that vegetarian and/or vegan food, planned, supervised and supplemented by a suitable nutrition professional, are healthy in childhood and adolescence. Food and nutrition professionals can play a key role in educating and mentoring vegetarians about specific sources of nutrients, food preparation, and dietary modifications necessary to meet their needs(AU)

Infant Feeding Practices and Subsequent Dietary Patterns of School-Aged Children in a US Birth Cohort.

BACKGROUND: Infant feeding practices are thought to shape food acceptance and preferences. However, few studies have evaluated whether these affect child diet later in life. OBJECTIVE: The study objective was to examine the association between infant feeding practices and dietary patterns (DPs) in school-aged children. DESIGN: A secondary analysis of data from a diverse prospective birth cohort with 10 years of follow-up (WHEALS [Wayne County Health Environment Allergy and Asthma Longitudinal Study]) was conducted. PARTICIPANTS/SETTING: Children from the WHEALS (Detroit, MI, born 2003 through 2007) who completed a food screener at age 10 years were included (471 of 1,258 original participants). MAIN OUTCOME MEASURES: The main outcome was DPs at age 10 years, identified using the Block Kids Food Screener. STATISTICAL ANALYSIS PERFORMED: Latent class analysis was applied for DP identification. Breastfeeding and age at solid food introduction were associated with DPs using a 3-step approach for latent class modeling based on multinomial logistic regression models. RESULTS: The following childhood DPs were identified: processed/energy-dense food (35%), variety plus high intake (41%), and healthy (24%). After weighting for loss to follow-up and covariate adjustment, compared with formula-fed children at 1 month, breastfed children had 0.41 times lower odds of the processed/energy-dense food DP vs the healthy DP (95% CI 0.14 to 1.25) and 0.53 times lower odds of the variety plus high intake DP (95% CI 0.17 to 1.61), neither of which were statistically significant. Results were similar, but more imprecise, for breastfeeding at 6 months. In addition, the association between age at solid food introduction and DP was nonsignificant, with each 1-month increase in age at solid food introduction associated with 0.81 times lower odds of the processed/energy-dense food DP relative to the healthy DP (95% CI 0.64 to 1.02). CONCLUSIONS: A significant association between early life feeding practices and dietary patterns at school age was not detected. Large studies with follow-up beyond early childhood that can also adjust for the multitude of potential confounders associated with breastfeeding are needed.

Impacts of an egg complementary feeding trial on energy intake and dietary diversity in Malawi.

Complementary feeding diets in low- and middle-income countries are generally inadequate to meet requirements for growth and development. Food-based interventions may prevent nutrient inadequacies provided that they do not displace other nutrient-rich foods. We conducted a randomized controlled trial in rural Malawi in which 660 children aged 6 to 9 months were provided an egg a day for 6 months or assigned to a control group. Dietary intake of complementary foods and drinks was assessed at baseline, 3-month midline and 6-month endline visits using a tablet-based multipass 24-h recall. Up to two repeat recalls were collected at each time point in a subsample of 100 children per treatment group. At midline and endline, usual energy intake from eggs was about 30 kcal/day higher in the egg group compared with controls (p < 0.0001). Compared with controls, children in the egg group were over nine times more likely to consume eggs at midline and endline. There was a comparable, but nonsignificant, greater total usual energy intake from complementary foods of 30 kcal/day at midline (p = 0.128) and 36 kcal/day at endline (p = 0.087). There also was a displacement of 7 kcal/day in legumes and nuts in children at endline (p = 0.059). At midline and endline, more than 80% of children in the egg group consumed a minimally diverse diet compared with 53% at midline and 60% at endline in the control group. This study illustrates that mothers in the egg group fed eggs to young children on a regular basis without substantial displacement of other complementary foods.

Eating Habits of Children Born after Maternal Bariatric Surgery.

Mothers who underwent bariatric surgery (BS) before pregnancy have worrisome eating habits, but little is known about the eating habits of their offspring. EFFECTOR is a cross-sectional, long-term follow-up study of 4-11-year-old children born from mothers that underwent bariatric surgery before pregnancy (n = 36), mothers with overweight/obesity (OW/OB) in a control group (n = 71), and mothers with a normal weight (NW) in a second control group (n = 35). Data on anthropometry and on eating habits obtained through a Food Frequency Questionnaire were collected prospectively. The children's body mass index (BMI) scores significantly correlated with maternal pre-pregnancy BMI. The prevalence of overweight and obesity was the highest in children of the BS group (38.9% vs. 15.5% for children of the OW/OB group and 5.7% for those of the NW group; p = 0.004). Meal-skipping behavior was comparable between the groups. There was no difference in fruit and vegetable consumption. The BS group consumed more low-calorie sweetened beverages compared to the NW group (p = 0.01) but less fruit juice compared to the NW and OW/OB groups (p = 0.01). Our results may indicate a sugar-avoiding behavior in children of the BS group, fitting dietary maternal habits in a strategy to prevent dumping syndrome. In conclusion, maternal pre-pregnancy bariatric surgery does not alter unhealthy eating behaviors and the risk of development of overweight during childhood in their children.

Validation of 24-h dietary recall for estimating nutrient intakes and adequacy in adolescents in Burkina Faso.

Data on dietary nutrient intakes of adolescents in low- and middle-income countries (LMIC) is lacking partly due to the absence of validation studies of the 24-h recall method in adolescents. We conducted a validation study of 24-h recall (24HR) compared with observed weighed records (OWR) in adolescents (n = 132, 10-11 years; n = 105, 12-14 years). Dietary data were collected for the same day by both methods by conducting the 24HR the day after the OWR. For OWR, all foods consumed by adolescents from the first to last meal of the day were weighed; for 24HR adolescents reported foods consumed using portion aids. Food intakes were converted to nutrients. Nutrient intakes by both methods were tested for equivalence by comparing the ratios (24HR/OWR) with equivalence margins of within ±10%, 15% and 20% of the ratio. Prevalences of inadequacy (POIs) were obtained using the NCI method. Mean ratios for energy were 0.88 and 0.92, for younger and older adolescents, respectively, and other nutrients ranged between 0.84 and 1.02. Energy intakes were equivalent within the 15% bound, and most nutrients fell within the 20% bound. POI was overestimated by 24HR, but differences were less than 25 percentage points for most nutrients. Half of adolescents omitted foods in recalls, mainly sweet or savoury snacks, fruits and beverages. Our study showed that adolescents underestimated intakes by 24HR; however, the degree of underestimation was generally acceptable for 12-14-year-olds within a bound of 15%. Errors could possibly be reduced with further training and targeted probing.

Dietary intake from birth through adolescence in relation to risk of benign breast disease in young women.

PURPOSE: Nutritional factors during different periods in life impact breast cancer risk. Because benign breast disease (BBD) is a well-established risk factor for breast cancer, we investigated childhood nutrition from birth through age 14 year and subsequent BBD. METHODS: A prospective cohort study of 9031 females, 9-15 year at baseline, completed questionnaires (including heights, weights) annually from 1996 to 2001, in 2003, 2005, 2007, 2010, 2013 and 2014. In 1996, mothers reported infant feeding practices during their daughters first year of life. Beginning in 1996, participants completed annual food frequency questionnaires. In 2005, participants (18 year +) began reporting whether they had ever been diagnosed with biopsy-confirmed BBD (N = 173 cases). Multivariable logistic regression models estimated associations between childhood nutrition and BBD, adjusted for maternal breast disease and childhood body size factors. RESULTS: Although no infant nutrition factors were associated with biopsy-confirmed BBD, certain adolescent dietary factors were. A multivariable model simultaneously included the most important diet and body size factors from different age periods: higher BBD risk was associated with greater age 10 year consumption of animal (non-dairy, energy-adjusted) fat (OR 2.27, p < .02, top vs. bottom quartiles) and with lower 14 year consumption of nuts/peanut butter (OR 0.60, p = .033, top vs. bottom quartiles). CONCLUSION: Greater intake of animal (non-dairy) fat at 10 year and lower intake of nuts/peanut butter at 14 year were independently associated with higher BBD risk. These dietary factors appeared to operate on BBD risk independent of childhood growth (gestational weight gain, childhood BMI and height, adolescent height growth velocity), young adult height and BMI, and family history.

Childhood diet and growth in boys in relation to timing of puberty and adult height: the Longitudinal Studies of Child Health and Development.

PURPOSE: To begin to explore the possible roles of childhood diet and growth in prostate cancer (PCa) development, we investigated these exposures in relation to two known/suspected PCa risk factors, earlier pubertal timing and greater attained height, in the Longitudinal Studies of Child Health and Development. METHODS: We used biannual/annual height, weight, and dietary history data to investigate childhood diet, body mass index (BMI), birth length, and childhood height in relation to PCa risk factors (age at peak height velocity (APHV), height at age 13, and adult height) for 64 Caucasian American boys. RESULTS: In adjusted models, childhood fat and animal protein intake was positively associated with height at age 13 and adult height (P < 0.05). A childhood diet high in fat and animal protein and low in vegetable protein was also associated with earlier APHV (P < 0.05), whereas no associations were observed for childhood energy intake or BMI. Birth length and childhood height were positively associated with height at age 13 and adult height, and childhood height was inversely associated with APHV (P < 0.05). CONCLUSION: Our findings suggest that both childhood diet and growth potential/growth contribute to earlier pubertal timing and taller attained height in males, supporting roles of these factors in PCa development.

Associations between children's diet quality and watching television during meal or snack consumption: A systematic review.

Studies have identified an association between watching television (TV) and childhood obesity. This review adds context to existing research by examining the associations between TV viewing, whilst eating, and children's diet quality. Web of Science and PubMed databases were searched from January 2000 to June 2014. Cross-sectional trials of case control or cohort studies, which included baseline data, measuring the associations between eating whilst watching TV and children's food and drink intake. Quality of selected papers was assessed. Thirteen studies, representing 61,674 children aged 1-18 yrs, met inclusion criteria. Of six studies reporting overall food habits, all found a positive association between TV viewing and consumption of pizza, fried foods, sweets, and snacks. Of eight studies looking at fruit and vegetable consumption, seven identified a negative association with eating whilst watching TV (p < .0001). Four out of five studies identified a positive association between watching TV whilst eating and servings of sugar-sweetened beverages (p < .0001). Four studies identified an association between low socioeconomic status and increased likelihood of eating whilst watching TV (p ≤ .01). Family meals did not overcome the adverse impact on diet quality of having the TV on at mealtimes. Eating whilst watching television is associated with poorer diet quality among children, including more frequent consumption of sugar-sweetened beverages and high-fat, high-sugar foods and fewer fruits and vegetables. Although these differences in consumption are small, the cumulative effect may contribute to the positive association between eating whilst watching TV and childhood obesity.

Association of maternal and index child's diet with subsequent leukemia risk: A systematic review and meta analysis.

BACKGROUND: Exploring the effect of maternal and/or childhood diet on offspring leukemogenesis is challenging, given differences in food group categories, their potentially variable impact depending on time window of exposure and the multiple leukemia subtypes. We opted to quantitatively synthesize published data on the association of maternal/child diet with leukemia risk. METHODS: Medline was searched until June 30th, 2016 for eligible articles on the association of childhood leukemia with consumption of (i) food groups, excluding alcoholic and non-alcoholic beverages, and (ii) specific dietary supplements before/during index pregnancy and childhood. RESULTS: Eighteen studies of case-control design (N=11,720 cases/18,721 controls) were included, of which nine assessed maternal dietary components, five index child's and four both, mainly focusing on acute lymphoblastic leukemia (ALL). Statistically significant inverse estimates for ALL were found (2 studies, 413 cases, 490 controls) for fruit (OR: 0.81, 95% CI: 0.67, 0.99); vegetables (OR: 0.51, 95% CI: 0.28, 0.94); legumes (OR: 0.76, 95% CI: 0.62, 0.94); fish (OR: 0.27, 95% CI: 0.14, 0.53, among the 0-4year old; 2 studies 215 cases, 215 controls); preconception folic acid supplementation (OR: 0.69, 95%CI: 0.50-0.95; published meta analysis plus 2 studies, 3511 cases, 6816 controls); and use of vitamins during pregnancy (OR: 0.81, 95%CI: 0.74-0.88; published meta analysis plus one study, 5967 cases, 8876 controls). The associations (2 studies) of the remaining food groups and maternal dietary supplements consumption during pregnancy as well as of childhood diet and supplements intake (2-4 studies) were non significant. CONCLUSIONS: Maternal consumption of specific food groups comprising"healthy" items of the Mediterranean diet, preconception use of folic acid and intake of vitamins during pregnancy were associated with decreased ALL risk. Further research is needed, however preferably with homogeneous dietary information and data on immunophenotypic/cytogenetic subtypes to also explore the interaction of specific macro- and micronutrients intake with gene polymorphisms.

Parental perspectives regarding primary-care weight-management strategies for school-age children.

To identify parental perspectives regarding weight-management strategies for school-age children, focus groups were conducted of parents of overweight and obese (body mass index ≥ 85th percentile) 6-12-year-old children recruited from primary-care clinics. Questions focused on the role of the primary-care provider, effective components of weight-management strategies and feasibility of specific dietary strategies. Focus groups were recorded, transcribed and analysed using margin coding and grounded theory. Six focus groups were held. The mean age (in years) for parents was 32, and for children, eight; 44% of participants were Latino, 33%, African-American and 23%, white. Parents' recommendations on the primary-care provider's role in weight management included monitoring weight, providing guidance regarding health risks and lifestyle changes, consistent follow-up and using discretion during weight discussions. Weight-management components identified as key included emphasising healthy lifestyles and enjoyment, small changes to routines and parental role modelling. Parents prefer guidance regarding healthy dietary practices rather than specific weight-loss diets, but identified principles that could enhance the acceptability of these diets. For dietary guidance to be feasible, parents recommended easy-to-follow instructions and emphasising servings over counting calories. Effective weight-management strategies identified by parents include primary-care provider engagement in weight management, simple instructions regarding healthy lifestyle changes, parental involvement and deemphasising specific weight-loss diets. These findings may prove useful in developing primary-care weight-management strategies for children that maximise parental acceptance.

Food insecurity reported by children, but not by mothers, is associated with lower quality of diet and shifts in foods consumed.

Household food security shows little indication of nutrient inadequacy among children, according to reports made by parents. We examined the associations of food insecurity as reported by children and mothers with children's consumption of energy, macronutrients such as vitamin A, calcium, iron and zinc, and selected foods, and whether these associations differed by child's gender. This cross-sectional study had non-probabilistic 128 Venezuelan mother-child pairs. We assessed food insecurity and management strategies in children using 10- and nine-item instruments, respectively. Mothers' report of food insecurity came from a previously validated 12-item instrument. Nutrient intake of children was assessed with a 67-item food frequency questionnaire. Comparisons were made using chi-square test for contingency tables and t-tests for trends (P < 0.05). Linear regression models were used for intakes of nutrients and selected foods. We tested for interactions with gender. Prevalence of child- and mother-reported food insecurity was 83.6 and 61.7%, respectively (P < 0.01). Greater food insecurity or management strategies reported by boys was associated with lower calcium, iron and zinc intake (P < 0.05), but reported intakes were low in girls who are even food secure. Rice and corn flour consumption was higher with higher food insecurity in children. Papaya and banana were less consumed by food-insecure children. We found shifts in 13 of 67 foods consumed, with less quality in those food insecure, as reported by children. Mother-reported food insecurity was associated only with rice intake of children. In contrast to mothers' reports, food insecurity reported by children was associated with children's lower quality of diet and shifts in foods consumed.

Isotopic evidence of human mobility and diet in a prehistoric/protohistoric Fijian coastal environment (c. 750-150 BP).

OBJECTIVES: Bourewa, on the southwest coast of Viti Levu in Fiji, is a multi-period site that contained burials dated to the later Vuda Phase (750-150 BP), a period of climatic fluctuations that potentially impacted the availability of food resources. We aim to investigate diet and movement at this site during a time of possible ecological pressure and political change. MATERIALS AND METHODS: We analyzed δ(13) C, δ(15) N, and (87) Sr/(86) Sr of these Vuda Phase individuals (n = 25) interred at the site. By analyzing dentin and bone, both childhood diet and the diet within the past few years of adults' lives were examined. RESULTS: The paleodietary results suggested that adult diets consisted largely of low trophic level marine organisms. Dentin and bone isotopic values differed significantly: childhood diet involved consumption of more higher trophic level terrestrial foods. Most individuals displayed (87) Sr/(86) Sr ratios expected of people living along a marine coastline. However, a few individuals displayed (87) Sr/(86) Sr ratios and paleodietary values (δ(13) Cdentin , δ(15) Ndentin ) suggestive of living further inland or consuming a more terrestrial-based childhood diet. DISCUSSION: The results are compared with past studies of sites from Fiji and nearby archipelagoes, placing our interpretations into a wider regional context. The Bourewa community appears to have consumed more low trophic level marine foods than any nearby site, possibly because terrestrial foods were more difficult to acquire. Interpreting the childhood diet is challenging due to the paucity of ethnohistoric literature on Fijian childhood; small meals outside of communal mealtimes or feeding children terrestrial animal protein as a means of cultural buffering are potential explanations.

Pregnancy diet and associated outcomes in the Avon Longitudinal Study of Parents and Children.

All publications covering diet during pregnancy that stemmed from the Avon Longitudinal Study of Parents and Children were reviewed. Diet was assessed using a food frequency questionnaire. Socioeconomic background, maternal mental health, and the health and development of the offspring were assessed using a variety of methods, such as direct measurement, self-completion questionnaires, and assays of biological samples. Differences in diet, including specific food and nutrient intakes and dietary patterns, were associated with maternal educational attainment, smoking habits, and financial difficulty. There were marginal intakes, compared with recommendations, of the key nutrients iron, magnesium, potassium, and folate. Maternal diet during pregnancy was predictive of offspring diet during childhood. There were independent associations between prenatal fish consumption and lower frequency of maternal depressive and anxiety symptoms, as well as lower frequency of intrauterine growth retardation. Consistent evidence that fish consumption during pregnancy benefited the neurocognitive development of the child was also found. Two constituents of fish, n-3 polyunsaturated fatty acids and iodine, were associated with these benefits in children. The findings from the Avon Longitudinal Study of Parents and Children strengthen the recommendation to eat fish regularly during pregnancy.

Diet, growth, and obesity development throughout childhood in the Avon Longitudinal Study of Parents and Children.

Publications from the Avon Longitudinal Study of Parents and Children covering diet, growth, and obesity development during childhood are reviewed. Diet was assessed by food frequency questionnaires and food records. Growth data were collected by routine measurements, and in standardized clinics, body fatness was assessed by bioelectrical impedance and DXA (dual-energy X-ray absorptiometry) scans. Diets changed dramatically during the preschool period with an increase in the intake of free (added) sugars (12.3% rising to 16.4% of energy) that remained similar until adolescence. This was due to increased intake of energy-dense, nutrient-poor foods. Two periods of rapid growth were identified; infancy and mid-childhood (ages 7-11 y) and both were associated with obesity development. Diets with high energy density were associated with increasing fat mass from mid-childhood until adolescence. Genetic and dietary factors showed independent associations with increasing adiposity. At all ages studied, there were dietary inequalities related to maternal educational attainment that may influence inequalities found in obesity development. The Avon Longitudinal Study of Parents and Children has provided valuable insights into how disparities in diet and growth may affect the development of ill health in adulthood.

In utero preeclampsia exposure, milk intake and pubertal development.

Cord blood insulin-like growth factor-1 (IGF-1) concentrations are lower in preeclamptic (PE) than normotensive (NT) pregnancies. PE offspring have increased risk of cardiovascular disease and decreased risk of some cancers including breast. We examined the effects of PE exposure in utero, infant feeding and childhood diet at 3-5 years on IGF-1 and breast development in 194 female offspring who were followed from birth until follow-ups at 10.8 and 12.9 years. Diet was not associated with serum IGF-1 levels at 10.8 years. PE exposure was associated with reduced odds of thelarche at 10.8 years only among exclusively breastfed girls. Milk, butter and ice cream consumption at 3-5 years was inversely related to the OR of breast development at 10.8 years. Child's weight and maternal overweight were positively associated with breast development at 10.8 years; child's height and weight were positively associated with breast development at 12.9 years.

The effect of childhood cow's milk intake and HLA-DR genotype on risk of islet autoimmunity and type 1 diabetes: the Diabetes Autoimmunity Study in the Young.

BACKGROUND: Cow's milk intake has been inconsistently associated with islet autoimmunity (IA) and type 1 diabetes (T1D) development. Genetic and environmental factors may modify the effect of cow's milk on IA and T1D risk. METHODS: The Diabetes Autoimmunity Study in the Young (DAISY) follows children at increased T1D risk of IA (presence of autoantibodies to insulin, GAD65, or IA-2 twice in succession) and T1D development. We examined 1835 DAISY children with data on cow's milk intake: 143 developed IA, 40 subsequently developed T1D. Cow's milk protein and lactose intake were calculated from prospectively collected parent- and self-reported food frequency questionnaires (FFQ). High risk HLA-DR genotype: HLA-DR3/4,DQB1*0302; low/moderate risk: all other genotypes. We examined interactions between cow's milk intake, age at cow's milk introduction, and HLA-DR genotype in IA and T1D development. Interaction models contained the base terms (e.g., cow's milk protein and HLA-DR genotype) and an interaction term (e.g., cow's milk protein*HLA-DR genotype). RESULTS: In survival models adjusted for total calories, FFQ type, T1D family history, and ethnicity, greater cow's milk protein intake was associated with increased IA risk in children with low/moderate risk HLA-DR genotypes [hazard ratio (HR): 1.41, 95% confidence interval (CI): 1.08-1.84], but not in children with high risk HLA-DR genotypes. Cow's milk protein intake was associated with progression to T1D (HR: 1.59, CI: 1.13-2.25) in children with IA. CONCLUSIONS: Greater cow's milk intake may increase risk of IA and progression to T1D. Early in the T1D disease process, cow's milk intake may be more influential in children with low/moderate genetic T1D risk.