Observations of feeding practices of US parents of young children with Down syndrome.

Parental behaviours influence food acceptance in young children, but few studies have measured these behaviours using observational methods, especially among children with Down syndrome (CWDS). The overall goal of this study was to understand parent feeding practices used during snack time with young CWDS (N = 111, aged 11-58 months). A coding scheme was developed to focus on feeding practices used by parents of CWDS from a structured home-use test involving tasting variously textured snack products. Behavioural coding was used to categorise parental feeding practices and quantify their frequencies (N = 212 video feeding sessions). A feeding prompt was coded as successful if the child ate the target food product or completed the prompt within 20 s of the prompt being given without a refusal behaviour. CWDS more frequently consumed the test foods and completed tasks in response to Autonomy-Supportive Prompts to Eat (49.3%), than to Coercive-Controlling Prompts to Eat (24.2%). By exploring the parent-CWDS relationship during feeding, we can identify potentially desirable parent practices to encourage successful feeding for CWDS. Future research should build upon the knowledge gained from this study to confirm longitudinal associations of parent practices with child behaviours during feeding.

The influence of food sensory properties on eating behaviours in children with Down syndrome.

Developing new food products for children is challenging, particularly in vulnerable groups including children with Down syndrome (DS). Focusing on children with DS, the aim of this study was to study the influence of parent liking on acceptance of food products by children with DS and demonstrate the influence of food sensory properties on indicators of food acceptance, food rejection, and challenging eating behaviours. Children (ages 1158 months) with DS (n = 111) participated in a home use test evaluating snack products with varying sensory properties as profiled by a trained sensory panel. Parents recorded their children's reactions to each food product; trained coders coded videos for eating behaviours. To understand the influence of each sensory modality on eating behaviour, ordered probit regression models were run. Results found a significant correlation between the parent liking and overall child disposition to the food (p < 0.05). From the regression analysis, the inclusion of all food sensory properties, including texture, flavour, taste, product shape and size, improved the percentage of variance explained in child mealtime behaviours and overall disposition over the base model (containing no sensory modalities), with texture having the largest influence. Overstuffing the mouth, a challenging eating behaviour, was most influenced by product texture (children ≥ 30 months), and product texture and size (children < 30 months). In both age groups, coughing/choking/gagging was most influenced by food texture and was associated with a product that was grainy and angular (sharp corners). In both age groups, product acceptance was associated with a product that was dissolvable, crispy, and savoury while rejection was associated with a dense, gummy and fruity product. These results suggest that a dissolvable, crispy texture, with a cheesy or buttery flavour are the sensory properties important in a desirable flavoured commercial snack product for children with DS; however, overall disposition must be balanced against mouth overstuffing.

Eating behaviors in children with Down syndrome: Results of a home-use test.

Children with Down syndrome (DS) display a disproportionate number of health challenges, including feeding and swallowing difficulties and food texture sensitivities. To start addressing food texture challenges early in life, the aim of this research was to understand mealtime behaviors and identify preferred food textures of children with DS. Children (aged 11 to 58 months) with DS (n = 111) and without (typically developing, TD; n = 107) participated in a home use test evaluating snack products of varying textures. Parents recorded their children's reactions to each food product; a panel of trained coders coded videos for mealtime behaviors. Children were also identified as food texture sensitive (TS) or non-texture sensitive (NTS). Results showed that age, TS, the presence of a DS diagnosis and the TS*DS interaction influenced the child's behaviors to the food products. Children with DS were more likely to increase distance from the food, mouth/suck on the food, and less likely to chew/much on the food compared to children TD. Children with DS also ate significantly less than typically developing children. Similar mealtime behaviors were observed between the children with TD/<30 months of age and children with DS regardless of age (p < .05). While children with DS/TS had a higher disposition for the dissolvable texture, along with products that were salty and cheesy, children with DS/NTS had a greater tolerance for more textures in general, including crunchy and grainy. Overall, this research identified mealtime behaviors in children with DS, determined overall disposition of children with DS to foods of differences sensory properties, and demonstrated the influence of TS on a child's disposition to a food. This research will be extended to develop acceptable and innovative food products for children with DS/TS.

Food texture experiences across age groups in 4- to 36-month-old children in the United States.

The question of what to feed becomes a new challenge as an infant reaches the transition to complementary foods. Limited information is available that provides a texture progression map for complementary food introduction. Thus, the objective of this study was to determine the relationship between age and food texture experiences (FTE) in young children aged 4-36 months in the United States. A parent-reported survey was fielded with 328 children categorized into five age groups (AGs): 4-8 months (AG1), 9-12 months (AG2), 13-18 months (AG3), 19-24 months (AG4), and 25-36 months (AG5). The present study analyzed four questions focused on FTE, with statistical analyses including probit and logit models, and analysis of variance. Results showed that all 16 food textures were tried at least once (>50%) by AG3. The question answered by participants, "How well does your child manage a specific texture," showed that significant differences existed among AGs for the management of 10 food textures (including chewy, hard, soft), whereas teething alone had no effect. The most refused textures by the children were AG1-crispy (27%), AG2-leafy (23%), AG3-leafy (40%), AG4-tough meat (52%), and AG5-leafy (51%). With increasing AG, the refusal probability of nine food textures, including chewy, leafy, and rubbery, also increased (p < .05). The refusal probability of cold food temperatures decreased with increasing age (p < .05). This study observed FTE in children across AGs and provides useful information to parents and practitioners as they introduce food textures into children's diets.

Development and application of specific questions to classify a child as food texture sensitive.

Understanding food texture sensitivity in children is important in guiding food selection. The objective of this work was to develop a short questionnaire that could be completed by parents in nonclinical settings to provide a categorization for food texture sensitivity in children. This study evaluated the distribution of children as texture sensitive (TS) or non-texture sensitive (NTS) and the predictive validity of these questions to explain rejection of specific food textures. Three sets of survey data were examined, including data from a home-use test (HUT) in children with and without Down syndrome (DS), and lingual tactile sensitivity measured by grating orientation task (GOT). From three parent-completed surveys, the use of the questionnaire yielded a similar distribution of children in the TS category (16-22%) as previously reported. TS children (4-36 months) were more likely to reject specific food textures, including chewy, hard, lumpy, and "tough meat" (p < .05). A higher percentage of children with a diagnosis of DS were TS (36.9%). Children who were TS showed increased negative behaviors to foods and ate less than NTS children. In older children (5-12 years), TS children were fussier than NTS children (p < .001). Lingual tactile sensitivity was not significantly different by TS/NTS categorization (p = .458). This study demonstrated that the use of these five questions specific to food texture provides a useful tool in categorizing a child as TS/NTS, with this information being useful in selecting preferred food textures. Future studies involving these TS questions should perform psychometric assessments and measures of criterion validity using other questionnaires.

Development of a home-use method for the evaluation of food products by children with and without Down syndrome.

This article describes the development of a method to evaluate the acceptance of different snack food textures by children with food texture sensitivities, including children with and without Down syndrome (DS). An in-home use test (HUT) was developed to reflect recent taste study and allow greater recruitment. In this study, parents with children (ages 11-60 months) with DS (CWDS) and without (typically developing, CTD) were recruited and based on responses to several questions, children were categorized as food texture sensitive (TS) or nontexture sensitive (NTS). In total, 111 CWDS (49 TS and 62 NTS) and 107 CTD (42 TS and 65 NTS) participated. To select the food products for assessment, a trained panel profiled commercially available infant and toddler solid snack foods (n = 41), from which 16 products were selected and sorted into four flavor groupings. For the HUT, participating children evaluated each food product once per day for 6 days. Parents recorded their children's reactions to each food product; a panel of trained coders coded each video for verbal and nonverbal behaviors using a novel coding scheme. Parent prompts were also coded. Several challenges were experienced during this study, including poor-quality videos, and standardization of the home environment during the feeding sessions. However, the high degree of successful completion of the HUT (96%) was attributed to the high motivation of the parents involved, as well as the close interaction between the experimenters and the participants on an individual family level.

Parent-reported ease of eating foods of different textures in young children with Down syndrome.

Food texture has been identified as a significant contributor to feeding problems in children, particularly in children with Down syndrome (DS). This study examined the open-ended survey responses of parents describing which food textures were "easy" or "difficult" for their child with DS. The open-ended responses from the parents about textures and foods they considered "easy" or "difficult" for their child (n = 157) were coded into 26 texture categories. Chewy and firm were more frequently listed as "difficult" textures by parents. Textures found to be cited more frequently as "easy" textures included creamy, crispy/crunchy, dissolvable, mushy, puree, smooth, and soft. Age influenced the citation of specific textures. As age increased, crispy/crunchy, dry, and hard were more likely to be listed as "easy" while lumpy, mushy, and gooey/soggy/wet were less likely be listed as "easy." For "difficult" textures, as age increased, juicy was more likely to be listed as "difficult" while the textures of creamy, dry, lumpy, and tender were less likely to be "difficult." While this research provides information as to the food textures children with DS find "easy" or "difficult," further research is needed to better understand how to expand the variety of textures in the diets of children with DS.

Estimating microbial growth parameters from non-isothermal data: a case study with Clostridium perfringens.

Microbial growth parameters are usually calculated from the fit of a growth model to a set of isothermal growth data gathered at several temperatures. In principle at least, it is also possible to derive them from non-isothermal ('dynamic') growth data. This requires the numerical solution of a rate model whose coefficients are nested terms that include the temperature profile. The methodology is demonstrated with simulated non-isothermal growth data on which random noise had been superimposed to emulate the scatter found in experimental microbial counts. The procedure has been validated by successful retrieval of the known generation parameters from the simulated growth curves. The method was then applied to experimental non-isothermal growth data of C. perfringens cells in cooled ground beef. The growth data collected under one cooling regime were used to predict the organism's growth patterns under different temperature histories. The practicality of the method is currently limited because of the relatively large scatter found in experimental microbial growth data and the relatively low frequency at which they are collected. But if and when the scatter could be reduced and the counts taken at short time intervals, the method could be used to determine the growth model in situ thus enabling to translate the changing temperature during processing, transportation or storage into a corresponding growth curve of the organism in question.

Associations between Parenting Style and Parent and Toddler Mealtime Behaviors.

Background: By the time a child is 24 mo old, 50% of parents report experiencing picky eating behaviors with their child. These behaviors include consuming an inadequate dietary variety, eating the same foods repeatedly, and an unwillingness to try either new or familiar foods. Previous research has established relations with regard to the impact of parent feeding strategies on child mealtime behaviors and how parent feeding strategies are influenced by parenting style; however, to our knowledge, no studies have investigated whether there is an association between parenting style and perceived child mealtime behaviors specifically related to picky eating. Objective: The purpose of this study was to investigate whether a relation exists between general parenting style and both parent feeding strategies and perceived picky eater and non-picky eater (NPE) behaviors. Methods: Parents of 2- to 5-y-old children (n = 525) completed 2 online surveys: 1) the Mealtime Assessment Survey, which measures the frequency of parent and child mealtime behaviors, and 2) the Parenting Styles and Dimensions Questionnaire, which measures authoritative, authoritarian, and permissive parenting styles. Spearman's correlation analysis was conducted to determine the relations between parenting style and mealtime behavior. Results: Positive correlations were found between an authoritative parenting style and NPE behaviors, as well as parent mealtime strategies that promote positive eating habits. Authoritarian and permissive parenting styles were positively correlated with child behaviors associated with picky eating and parent mealtime strategies that can negatively influence child feeding. Conclusions: These findings suggest that a relation exists between general parenting style and both parent and child mealtime behaviors; however, the directionality of the relation remains unknown. The positive correlations seen within the authoritative parenting style with regard to NPE behaviors suggest the use of authoritative feeding methods to overcome feeding difficulties.

Development of a model to predict growth of Clostridium perfringens in cooked beef during cooling.

The objective of this work was to develop a new model to predict the growth of Clostridium perfringens in cooked meat during cooling. All data were collected under changing temperature conditions. Individual growth curves were fit using DMFit. Germination outgrowth and lag (GOL) time was modeled versus temperature at the end of GOL using conservative assumptions. Each growth curve was used to estimate a series of exponential growth rates at a series of temperatures. The squareroot model was used to describe the relationship between the square root of the average exponential growth rate and effective temperature. Predictions from the new model were in close agreement with the data used to create the model. When predictions from the model were compared with new observations, fail-dangerous predictions were made a majority of the time. When GOL time was predicted exactly, many fail-dangerous predictions shifted toward the fail-safe direction. Two important facts regarding C. perfringens should impact future modeling research with this organism and may have broader food safety policy implications: (i) the normal variability in the response of the organism from replicate to replicate may be quite large (1 log CFU) and may exceed the current U.S. Food Safety Inspection Service performance standard, and (ii) the accuracy of the GOL time model has a profound influence upon the overall prediction, with small differences in GOL time prediction (approximately 1 h) having a very large effect on the predicted final concentration of C. perfringens.

Mealtime behaviors and food consumption of perceived picky and nonpicky eaters through home use test.

Picky eating has been investigated through numerous surveys and food recalls, but few studies have applied in-home meal evaluations as a method to investigate behaviors and food preferences of children perceived by their parent to be a picky eater (PE) or nonpicky eater (NPE). A 2-wk in-home meal study was completed to investigate differences in PE and NPE mealtime behaviors and food selections using real-time parental observations. Parents (n = 170) and their 2- to 4-y-old children (83 PE and 87 NPE) evaluated 5 standardized meals in-home. Parents recorded their child's and their own hedonic liking of the products and completed an assessment of their child's behavior and consumption at each meal. Significant differences were found between perceived PE and NPE children for all 16 behaviors assessed. On average, perceived NPE were assessed to consume a higher percentage of the meal served and to have higher acceptance scores for most of the foods evaluated. Some foods, though, like breaded chicken and plain pasta, were liked equally by PE and NPE. Several significant differences in hedonic liking were revealed when PE children were compared to their parents. Yet, few differences in liking occurred between NPE children and their parents or between the 2 parental groups. Because study participants evaluated meals real-time rather than memory recall, the differences and similarities found between perceived PE and NPE may be considered direct experiential evidence with reduced subjective bias as created when subjects recall past experiences. Thus, findings from this study can provide the foundation to establish an objective definition and classification of PE and NPE.