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

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

Diet Quality of Canadian Preschool Children: Associations with Socio-demographic Characteristics.

Purpose: To examine associations between preschoolers' diet quality and parent and child socio-demographic variables.Methods: Cross-sectional analysis with 117 preschoolers. Parents reported socio-demographics and their children's diet using 3-day food records. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. Linear regression models were used to analyze associations between socio-demographics and HEI scores.Results: A total of 86% of children had an HEI-2015 score in the "needs improvement" category (51-80 out of a maximum of 100). Children's overall HEI-2015 score was inversely associated with children's age (ß = -0.19, 95% CI -0.37, -0.02). Parental education was positively associated with children's overall HEI score (ß = 9.58, 95% CI 3.81, 15.35) and with scores for total fruit (ß = 1.00, 95% CI 0.39, 1.76), vegetables (ß = 1.11, 95% CI 0.03, 2.18), total protein (ß = 1.06, 95% CI 0.28, 1.84), and seafood/plant protein (ß = 1.67, 95% CI 0.43, 2.89) components. Children who identified as Caucasian (ß = 4.29, 95% CI 2.46, 6.14), had a Caucasian parent (ß = 3.01, 95% CI 0.78, 5.25), or parents who were born in Canada (ß = 2.32, 95% CI 0.53, 4.11) had higher scores for dairy.Conclusion: Our results suggest that preschoolers' diet quality needs improvement and that children's diet quality varies by children's age and parental education level.

Food Skills: Associations With Diet Quality and Food Waste Among Canadian Parents.

OBJECTIVE: To examine the association between self-reported food skills and diet quality along with measured food waste among a sample of Canadian parents. DESIGN: Cross-sectional data from surveys to assess food skills, 3-day food records to assess the Healthy Eating Index (HEI)-2015, and food waste measured by household waste audits. SETTING: Guelph-Wellington, Ontario. PARTICIPANTS: Parents (n = 130) with children aged 2-8 years. MAIN OUTCOME MEASURES: HEI-2015 scores, daily per capita avoidable and unavoidable food waste (grams). ANALYSIS: Linear regression using generalized estimating equations to determine unstandardized ß estimates of associations between food skills and dependent variables. Models were adjusted for multiple testing, gender, and level of education. RESULTS: Food safety knowledge for cooking hot foods (ß = 4.3, P = 0.05), planning (ß = 4.5, P = 0.001), and conceptualizing food (ß = 4.0, P = 0.03) were positively associated with HEI-2015 scores. Knowledge related to best before dates (ß = 25.3, P = 0.05; ß = 12.1, P = 0.04), conceptualizing food (ß = 34.1, P = 0.01; ß = 13.8, P = 0.02), and mechanical techniques (ß = 39.2, P = 0.01; ß = 20.5, P = 0.004) were associated with more avoidable and unavoidable food waste, respectively. CONCLUSIONS AND IMPLICATIONS: Addressing higher-level food skills with a focus on efficient food preparation practices that make use of all edible portions of foods could play an important role in minimizing food waste and improving diet quality. Additional research in other countries and in a larger, more socioeconomically diverse sample is needed to confirm these findings.

Dishing on dinner: a life course approach to understanding the family meal context among families with preschoolers.

OBJECTIVE: Family meals promote healthful dietary intake and well-being among children. Despite these benefits, family meal participation typically declines as children age. This study utilises life course theory to explore parents' perceptions of family meals in order to understand how parents' past experiences with family meals (in childhood and earlier in adulthood) influence their current beliefs and practices regarding mealtimes with their own children. DESIGN: Semi-structured qualitative interviews. SETTING: In-person interviews were conducted in participants' homes. PARTICIPANTS: Twenty families (twenty-one mothers and fifteen fathers) with a child aged between 18 months and 5 years. RESULTS: Thematic analysis revealed that families seemed to primarily approach mealtimes from one of three overarching orientations: meals for (1) Togetherness, (2) Nutrition Messaging or (3) Necessity. These orientations were informed by parents' own mealtime experiences and significant life transitions (e.g. parenthood). The current family meal context, including the messages parents shared with their children during mealtimes and the challenges experienced with mealtimes, characterised the orientations and families' approaches to mealtimes. CONCLUSIONS: Parents' own early life experiences and significant life transitions influence why families eat meals together and have important implications for the intergenerational transmission of mealtime practices. Results may help to inform the content and timing of intervention strategies to support the continuation of frequent family meals beyond the preschool years.

Association between diet quality and food waste in Canadian families: a cross-sectional study.

BACKGROUND: Higher diet quality has been associated with greater amounts of food waste among adults in the United States. This study aims to build on previous work by examining the association between diet quality and food waste, as assessed using detailed waste audits, among a sample of Canadian families. METHODS: This cross-sectional study used data from 85 Canadian families with young children. Parent and children diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015), calculated from 3-day food records. Household food waste was measured using detailed waste audits conducted over multiple weeks and these data were used to calculate daily per capita food waste. Linear regression was used to explore the association between parent and child HEI-2015 scores and daily per capita total avoidable and unavoidable food waste, as well as daily per capita avoidable and unavoidable food waste in the following categories: 1) fruits and vegetables, 2) milk, cheese and eggs, 3) meat and fish, 4) breads and cereals, 5) fats and sugars. RESULTS: Parent HEI-2015 scores ranged from 37 to 92 (out of 100) and 81% of parents' diets scored in the "Needs Improvement (51-80)" category. Parent and child diet quality scores were significantly correlated (r = 0.61; P < 0.0001) and 82% of children's diets scored in the "Needs Improvement" category. On average, households produced 107 g of avoidable food waste and 52 g of unavoidable food waste per person per day. Fruits and vegetables were the highest contributor for both avoidable and unavoidable food waste. Both parent and child HEI-2015 scores were not significantly associated with total daily per capita avoidable or unavoidable food waste. However, parent HEI-2015 scores were positively associated with daily per capita avoidable fruit and vegetable waste (Unstandardized ß = 1.05; 95%CI: 0.11, 1.99; P = 0.03) and daily per capita unavoidable fruit and vegetable waste (Unstandardized ß = 0.60; 95%CI: 0.03, 1.17; P = 0.04), after adjusting for household income. CONCLUSION: This is the first study to explore the association between diet quality and food waste using detailed waste audits. Future research should explore effective strategies towards improving diet quality while simultaneously reducing food waste, especially of fruits and vegetables.

The Family Mealtime Observation Study (FaMOS): Exploring the Role of Family Functioning in the Association between Mothers' and Fathers' Food Parenting Practices and Children's Nutrition Risk.

This cross-sectional study explores associations between mothers' and fathers' food parenting practices and children's nutrition risk, while examining whether family functioning modifies or confounds the association. Home observations assessed parents' food parenting practices during dinnertime (n = 73 families with preschoolers). Children's nutrition risk was calculated using NutriSTEP®. Linear regression models examined associations between food parenting practices and NutriSTEP® scores. An interaction term (family functioning × food parenting practice) explored effect modification; models were adjusted for family functioning to explore confounding. Among mothers, more frequent physical food restriction was associated with higher nutrition risk in their children (ß = 0.40 NutriSTEP® points, 95% Confidence Interval (CI) = 2.30, 7.58) and among both mothers and fathers, positive comments about the target child's food were associated with lower nutrition risk (mothers: ß = -0.31 NutriSTEP® points, 95% CI = -0.54, -0.08; fathers: ß = -0.27 NutriSTEP® points, 95% CI = -0.75, -0.01) in models adjusted for parent education and child Body Mass Index (BMI) z-score. Family functioning did not modify these associations and they remained significant after adjustment for family functioning. Helping parents to use positive encouragement rather than restriction may help to reduce their children's nutrition risk.