Toward more rigorous and informative nutritional epidemiology: The rational space between dismissal and defense of the status quo.

To date, nutritional epidemiology has relied heavily on relatively weak methods including simple observational designs and substandard measurements. Despite low internal validity and other sources of bias, claims of causality are made commonly in this literature. Nutritional epidemiology investigations can be improved through greater scientific rigor and adherence to scientific reporting commensurate with research methods used. Some commentators advocate jettisoning nutritional epidemiology entirely, perhaps believing improvements are impossible. Still others support only normative refinements. But neither abolition nor minor tweaks are appropriate. Nutritional epidemiology, in its present state, offers utility, yet also needs marked, reformational renovation. Changing the status quo will require ongoing, unflinching scrutiny of research questions, practices, and reporting-and a willingness to admit that "good enough" is no longer good enough. As such, a workshop entitled "Toward more rigorous and informative nutritional epidemiology: the rational space between dismissal and defense of the status quo" was held from July 15 to August 14, 2020. This virtual symposium focused on: (1) Stronger Designs, (2) Stronger Measurement, (3) Stronger Analyses, and (4) Stronger Execution and Reporting. Participants from several leading academic institutions explored existing, evolving, and new better practices, tools, and techniques to collaboratively advance specific recommendations for strengthening nutritional epidemiology.

Person Specific Parameter Heterogeneity in the 2PL IRT Model.

Following Kelderman and Molenaar's demonstration that a factor model with person specific factor loadings is almost indistinguishable from the standard factor model in terms of overall fit, we examined person specific measurement models in Item Response Theory, person specific discrimination and difficulty parameters were created by adding random variation at the item by person level. Using standard fitting algorithms for the 2PL IRT there was modest evidence of person- or item-level misfit using common diagnostic tools. The item difficulties were well-estimated, but the item discriminations were noticeably underestimated. As found by Kelderman and Molenaar, factor scores were estimated with less than expected reliability due to the underlying heterogeneity. The person specific models considered here are basically limiting cases of IRT models with multilevel, mixture, or differential item functioning structure. We conclude with some thoughts regarding real-world sources of heterogeneity that might go unacknowledged in common testing applications.

A Cautionary Note about Having the Right Mixture Model but Classifying the Wrong People.

Mixture models can be used for explanation or individual prediction and classification. In practice, researchers are often tempted to make the class membership manifest by classifying cases according to their class of maximum posterior probability and using the "observed" class membership directly or as a variable in follow-up analyses to predict distal outcomes. This study revisits the issue of correct class assignment in latent profile analysis by providing an example where the number of classes is known (3-classes), sampling variability is eliminated, and precise estimates of classification indices are provided. This pseudo-population study design assumes the data-generating mechanism is known and provides a "best-case" scenario for evaluating correct class assignment. We use a variety of classification indices and graphical displays to show that correct classification may be poor despite relatively high entropy and overall correct class assignment metrics (e.g., percent correct). Our study serves as a reminder of the risks associated with trying to make latent class memberships manifest.

Association between social interaction and affect in nursing home residents with dementia.

BACKGROUND: Social interactions that lead to positive affect are fundamental to human well-being. However, individuals with dementia are challenged to achieve positive social interaction. It is unclear how social interactions influence affect in people with dementia. This study examined the association between social interactions and affect in nursing home residents with dementia. METHODS: This repeated measures study used baseline data from a clinical trial in which 126 residents from 12 nursing homes were enrolled. Participants were video recorded twice daily on five days. Ratings of social interaction and affect were taken from the videotapes using the Interacting with People subscale of the Passivity in Dementia and the Philadelphia Geriatric Center Apparent Affect Rating Scale. Linear mixed models were used for analysis. RESULTS: Social interaction was significantly related to higher interest and pleasure at within- and between-person levels. Social interaction significantly predicted anxiety and sadness at the between-person level only. Residents with higher cognitive function also displayed greater pleasure. Greater interest and anxiety was evident during the afternoon hours. CONCLUSIONS: This study supports the impact of social interactions on positive and negative affect. Findings can guide intervention development, aimed at promoting positive social interactions and improving affect for people with dementia.

Effect of a Responsive Parenting Educational Intervention on Childhood Weight Outcomes at 3 Years of Age: The INSIGHT Randomized Clinical Trial.

Importance: Rapid growth and elevated weight status in early childhood increase risk for later obesity, but interventions that improve growth trajectories are lacking. Objective: To examine effects of a responsive parenting intervention designed to promote developmentally appropriate, prompt, and contingent responses to a child's needs on weight outcomes at 3 years. Design, Setting, and Participants: A single-center randomized clinical trial comparing a responsive parenting intervention designed to prevent childhood obesity vs a home safety intervention (control) among 279 primiparous mother-child dyads (responsive parenting group, 140; control group, 139) who enrolled and completed the first home visit from January 2012 through March 2014 with follow-up to age 3 years (completed by April 2017). Interventions: Research nurses conducted 4 home visits during infancy and annual research center visits. The responsive parenting curriculum focused on feeding, sleep, interactive play, and emotion regulation. The control curriculum focused on safety. Main Outcomes and Measures: The primary outcome was body mass index (BMI) z score at 3 years (z score of 0 represents the population mean; 1 and -1 represent 1 SD above and below the mean, respectively). BMI percentile at 3 years was designated previously as the primary outcome. Secondary outcomes included the prevalence of overweight (BMI ≥85th percentile and <95th percentile) and obesity (BMI ≥95th percentile) at 3 years. Results: Among 291 mother-child dyads randomized, 279 received the first home visit and were included in the primary analysis. 232 mother-child dyads (83.2%) completed the 3-year trial. Mean age of the mothers was 28.7 years; 86% were white and 86% were privately insured. At age 3 years, children in the responsive parenting group had a lower mean BMI z score (-0.13 in the responsive parenting group vs 0.15 in the control group; absolute difference, -0.28 [95% CI, -0.53 to -0.01]; P = .04). Mean BMI percentiles did not differ significantly (47th in the responsive parenting group vs 54th in the control group; reduction in mean BMI percentiles of 6.9 percentile points [95% CI, -14.5 to 0.6]; P = .07). Of 116 children in the responsive parenting group, 13 (11.2%) were overweight vs 23 (19.8%) of 116 children in the control group (absolute difference, -8.6% [95% CI, -17.9% to 0.0%]; odds ratio [OR], 0.51 [95% CI, 0.25 to 1.06]; P = .07); 3 children (2.6%) in the responsive parenting group were obese vs 9 children (7.8%) in the control group (absolute difference, -5.2% [95% CI, -10.8% to 0.0%]; OR, 0.32 [95% CI, 0.08 to 1.20]; P = .09). Conclusions and Relevance: Among primiparous mother-child dyads, a responsive parenting intervention initiated in early infancy compared with a control intervention resulted in a modest reduction in BMI z scores at age 3 years, but no significant difference in BMI percentile. Further research is needed to determine the long-term effect of the intervention and assess its efficacy in other settings. Trial Registration: ClinicalTrials.gov Identifier: NCT01167270.

The Weight-Related Eating Questionnaire offers a concise alternative to the Three-Factor Eating Questionnaire for measuring eating behaviors related to weight loss.

OBJECTIVE: During a one-year weight loss trial, we compared the Three-Factor Eating Questionnaire (TFEQ), a valid 51-item measure of restraint, disinhibition, and hunger subscales, with the newer 16-item Weight-Related Eating Questionnaire (WREQ) measuring routine and compensatory restraint and external and emotional eating. METHODS: Both questionnaires were administered to women with overweight or obesity (n = 186, mean ± SD, age 50 ± 10.6 y, BMI 34 ± 4.2 kg/m2) at five time points. Completion rates were 100% at baseline and Month 1, 94% at Month 3, 83% at Month 6, and 76% at Month 12. Confirmatory factor analysis was conducted on baseline WREQ data and correlations were calculated between TFEQ and WREQ subscales. Multilevel models evaluated the relationship between each subscale and weight change over time. RESULTS: Factor analysis revealed a WREQ structure consistent with previous research, and corresponding subscales on the TFEQ and WREQ were correlated. Lower baseline TFEQ restraint predicted greater weight loss. Across five administrations, TFEQ and WREQ restraint scores were positively related to weight loss (p < 0.01) and TFEQ disinhibition and WREQ external and emotional eating scores were negatively related (p < 0.001). Thus, with one baseline administration, only TFEQ restraint was significantly related to weight change, but multiple administrations showed relationships between all TFEQ and WREQ subscales and weight change. CONCLUSIONS: The WREQ offers a shorter alternative to the TFEQ when repeatedly assessing eating behaviors related to weight change.

Memory-guided force output is associated with self-reported ADHD symptoms in young adults.

Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed mental health disorder in childhood and persists into adulthood in up to 65 % of cases. ADHD is associated with adverse outcomes such as the ability to gain and maintain employment and is associated with an increased risk for substance abuse obesity workplace injuries and traffic accidents A majority of diagnosed children have motor deficits; however, few studies have examined motor deficits in young adults. This study provides a novel examination of visuomotor control of grip force in young adults with and without ADHD. Participants were instructed to maintain force production over a 20-second trial with and without real-time visual feedback about their performance. The results demonstrated that when visual feedback was available, adults with ADHD produced slightly higher grip force than controls. However, when visual feedback was removed, adults with ADHD had a faster rate of decay of force, which was associated with ADHD symptom severity and trait impulsivity. These findings suggest that there may be important differences in the way that adults with ADHD integrate visual feedback during continuous motor tasks. These may account for some of the motor impairments reported in children with ADHD. These deficits could result from (1) dysfunctional sensory motor integration and/or (2) deficits in short-term visuomotor memory.

Impact of imposed exercise on energy intake in children at risk for overweight.

BACKGROUND: Exercise not only has a direct effect on energy balance through energy expenditure (EE), but also has an indirect effect through its impact on energy intake (EI). This study examined the effects of acute exercise on daily ad libitum EI in children at risk for becoming overweight due to family history. METHODS: Twenty healthy-weight children (ages 9-12 years, 12 male/8 female) with at least one overweight biological parent (body mass index ≥ 25 kg/m2) participated. Children reported to the laboratory for one baseline and two experimental visits (EX = exercise, SED = sedentary) each separated by 1 week in a randomized crossover design. Two hours into the EX day session, children exercised at 70 % estimated VO2max for 30 min on a cycle ergometer. Objective EI (kcal) was measured at a standard breakfast (~285 kcal) and ad libitum lunch, snack and dinner. Meals were identical on the EX and SED days. Activity-related EE (kcal) was estimated with accelerometers worn on the non-dominant wrist and ankle. Relative EI (kcal) was computed as the difference between Total EI and Activity-related EE for each testing day. Paired t-tests were performed to test differences in Total EI, Activity-related EE and Relative EI between the EX and SED days. RESULTS: Across all meals, Total EI was not statistically different between the EX and SED days (t = 1.8, p = 0.09). Activity-related EE was greater on the EX day compared to the SED day (t = 10.1, p < 0.001). By design, this difference was predominantly driven by activity during the morning (t = 20.4, p < 0.001). Because children consumed a similar number of kcal on each day, but had greater Activity-related EE on the EX day, Relative EI was lower (t = -5.15, p < 0.001) for the EX day (1636 ± 456 kcal) relative to the SED day (1862 ± 426 kcal). CONCLUSIONS: Imposed exercise was effective in reducing Relative EI compared to being sedentary. Morning exercise may help children at risk for becoming overweight to better regulate their energy balance within the course of a day.

Bayesian Factor Analysis as a Variable-Selection Problem: Alternative Priors and Consequences.

Factor analysis is a popular statistical technique for multivariate data analysis. Developments in the structural equation modeling framework have enabled the use of hybrid confirmatory/exploratory approaches in which factor-loading structures can be explored relatively flexibly within a confirmatory factor analysis (CFA) framework. Recently, Muthén & Asparouhov proposed a Bayesian structural equation modeling (BSEM) approach to explore the presence of cross loadings in CFA models. We show that the issue of determining factor-loading patterns may be formulated as a Bayesian variable selection problem in which Muthén and Asparouhov's approach can be regarded as a BSEM approach with ridge regression prior (BSEM-RP). We propose another Bayesian approach, denoted herein as the Bayesian structural equation modeling with spike-and-slab prior (BSEM-SSP), which serves as a one-stage alternative to the BSEM-RP. We review the theoretical advantages and disadvantages of both approaches and compare their empirical performance relative to two modification indices-based approaches and exploratory factor analysis with target rotation. A teacher stress scale data set is used to demonstrate our approach.

The Development of Early Profiles of Temperament: Characterization, Continuity, and Etiology.

This study used a data-driven, person-centered approach to examine the characterization, continuity, and etiology of child temperament from infancy to toddlerhood. Data from 561 families who participated in an ongoing prospective adoption study, the Early Growth and Development Study, were used to estimate latent profiles of temperament at 9, 18, and 27 months. Results indicated that four profiles of temperament best fit the data at all three points of assessment. The characterization of profiles was stable over time, while membership in profiles changed across age. Facets of adoptive parent and birth mother personality were predictive of children's profile membership at each age, providing preliminary evidence for specific environmental and genetic influences on patterns of temperament development from infancy to toddlerhood.

Effects of restriction on children's intake differ by child temperament, food reinforcement, and parent's chronic use of restriction.

Parents' use of restrictive feeding practices is counterproductive, increasing children's intake of restricted foods and risk for excessive weight gain. The aims of this research were to replicate Fisher and Birch's (1999b) original findings that short-term restriction increases preschool children's (3­5 y) selection, intake, and behavioral response to restricted foods, and to identify characteristics of children who were more susceptible to the negative effects of restriction. The experiment used a within-subjects design; 37 children completed the food reinforcement task and heights/weights were measured. Parents reported on their use of restrictive feeding practices and their child's inhibitory control and approach. Overall, the findings replicated those of and revealed that the effects of restriction differed by children's regulatory and appetitive tendencies. Greater increases in intake in response to restriction were observed among children lower in inhibitory control, higher in approach, who found the restricted food highly reinforcing, and who had previous experience with parental use of restriction. Results confirm that the use of restriction does not reduce children's consumption of these foods, particularly among children with lower regulatory or higher appetitive tendencies.

Measurement of food reinforcement in preschool children. Associations with food intake, BMI, and reward sensitivity.

Progressive ratio (PR) schedules of reinforcement have been used to measure the relative reinforcing value (RRV) of food in humans as young as 8 years old; however, developmentally appropriate measures are needed to measure RRV of food earlier in life. Study objectives were to demonstrate the validity of the RRV of food task adapted for use among for preschool children (3-5 y), and examine individual differences in performance. Thirty-three children completed the RRV of food task in which they worked to access graham crackers. They also completed a snack task where they had free access these foods, liking and hunger assessments, and their heights and weights were measured. Parents reported on their child's reward sensitivity. Overall, children were willing work for palatable snack foods. Boys and older children made more responses in the task, while children with higher BMI z-scores and reward sensitivity responded at a faster rate. Children who worked harder in terms of total responses and response rates consumed more calories in the snack session. This study demonstrates that with slight modifications, the RRV of food task is a valid and developmentally appropriate measure for assessing individual differences in food reinforcement among very young children.

Dyadic concordance in mother and preschooler resting cardiovascular function varies by risk status.

This study examined concordance in heart rate (HR) and respiratory sinus arrhythmia (RSA) in a sample of 104 child-maltreating (CM) and nonCM mother-preschooler dyads (208 individuals). In a laboratory setting, mother and child cardiac physiology was simultaneously monitored via ECG in a 5-min resting period. Mothers ranged in age from 20 to 49 years; children ranged in age from 3 to 5 years. Significant within-dyad (WD) and between-dyad (BD) associations were observed for mother HR and both child HR and RSA, and the associations were moderated by CM status. Only CM dyads exhibited BD associations: Higher average maternal HR was associated with higher child HR and lower child RSA. By contrast, when the time interval was divided into 30 s epochs, nonCM dyads exhibited positive WD (dynamic) associations in mother and child HR, and both CM and nonCM dyads showed negative WD associations in mother HR and child RSA. Further, mothers' mean HR levels moderated the extent of epoch-by-epoch WD concordance observed in mother and child, such that elevated average maternal HR was associated with lower levels of WD (dynamic) concordance. No BD or WD concordance in maternal and child RSA was observed. The findings suggest that measures of intraindividual variation provide useful, alternate perspectives in the study of dyadic processes in at-risk families.

Subjective evidence evaluation survey for many-analysts studies.

Many-analysts studies explore how well an empirical claim withstands plausible alternative analyses of the same dataset by multiple, independent analysis teams. Conclusions from these studies typically rely on a single outcome metric (e.g. effect size) provided by each analysis team. Although informative about the range of plausible effects in a dataset, a single effect size from each team does not provide a complete, nuanced understanding of how analysis choices are related to the outcome. We used the Delphi consensus technique with input from 37 experts to develop an 18-item subjective evidence evaluation survey (SEES) to evaluate how each analysis team views the methodological appropriateness of the research design and the strength of evidence for the hypothesis. We illustrate the usefulness of the SEES in providing richer evidence assessment with pilot data from a previous many-analysts study.

Human face recognition ability is specific and highly heritable.

Compared with notable successes in the genetics of basic sensory transduction, progress on the genetics of higher level perception and cognition has been limited. We propose that investigating specific cognitive abilities with well-defined neural substrates, such as face recognition, may yield additional insights. In a twin study of face recognition, we found that the correlation of scores between monozygotic twins (0.70) was more than double the dizygotic twin correlation (0.29), evidence for a high genetic contribution to face recognition ability. Low correlations between face recognition scores and visual and verbal recognition scores indicate that both face recognition ability itself and its genetic basis are largely attributable to face-specific mechanisms. The present results therefore identify an unusual phenomenon: a highly specific cognitive ability that is highly heritable. Our results establish a clear genetic basis for face recognition, opening this intensively studied and socially advantageous cognitive trait to genetic investigation.

Mothers' differential treatment of adolescent siblings: predicting college attendance of sisters versus brothers.

Current estimates suggest that by 2015, 60% of college students will be women, a change since 1970 when 59% were men. We investigated family dynamics that might explain the growing gender gap in college attendance, focusing on an ethnically diverse sample of 522 mixed sex sibling dyads from the National Longitudinal Study of Adolescent Health. We examined whether the difference between sisters' and brothers' reports of their mothers' expectations for, and involvement in, their education during adolescence predicted their differential odds of college attendance seven years later. Sisters were more likely than brothers to attend college, and this gap was more pronounced among non-Whites and non-Asians. Sisters also had higher grades in school than their brothers. Although there were no gender differences overall in maternal educational expectations or involvement, brothers reported greater maternal involvement than sisters in non-White and non-Asian families. After controlling for family background factors, the average of siblings' reports of maternal treatment, and differences between siblings' grades, the results revealed that as sisters reported greater maternal educational expectations than their brothers, it became more likely that only the sister rather than only the brother in the family attended college. The difference between brothers' and sisters' reports of their mothers' educational involvement and their odds of attending college showed the same pattern of association but was not statistically significant. These results suggest that within-family social comparisons may play a role in sisters' and brothers' choices about attending college.

Effect of the INSIGHT Firstborn Parenting Intervention on Secondborn Sleep.

BACKGROUND AND OBJECTIVES: The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention for first-time mothers improved firstborn infant sleep compared with controls. The goals of this analysis were to test intervention spillover effects on secondborn siblings and examine birth order differences in infant sleep. METHODS: Secondborns (n = 117) of INSIGHT mothers were enrolled in an observational cohort, SIBSIGHT. The Brief Infant Sleep Questionnaire was collected at 3, 16, and 52 weeks. Generalized linear mixed models assessed differences among secondborns by firstborn randomization, as well as birth order differences at 16 and 52 weeks. RESULTS: The RP group secondborns slept 42 minutes longer at night (95% confidence interval [95% CI]: 19-64) and 53 minutes longer total (95% CI: 17-90) than control secondborns. RP secondborns were more likely to self-soothe to sleep (odds ratio [OR] = 2.0, 95% CI: 1.1-3.7) and less likely to be fed back to sleep after waking (OR = 0.5, 95% CI: 0.3-0.9) than secondborns of control mothers. RP secondborns were more likely to have a bedtime ≤8 pm at 3 (OR = 2.9, 95% CI: 1.1-7.7) and 16 weeks (OR = 4.7, 95% CI: 2.0-11.0). Few differences in sleep parenting practices were observed when comparing siblings within families. Secondborns slept 37 minutes longer than firstborns at 16 weeks (CI: 7-67, P = .03). CONCLUSIONS: The INSIGHT RP intervention for first-time mothers had a spillover effect to secondborns, positively impacting sleep duration and behaviors. Intervening with first-time mothers benefits both firstborns and subsequent children.

INSIGHT responsive parenting educational intervention for firstborns is associated with growth of second-born siblings.

OBJECTIVE: The aim of this study was to test whether the Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting (RP) intervention, delivered to parents of firstborn children, is associated with the BMI of first- and second-born siblings during infancy. METHODS: Participants included 117 firstborn infants enrolled in a randomized controlled trial and their second-born siblings enrolled in an observation-only ancillary study. The RP curriculum for firstborn children included guidance on feeding, sleep, interactive play, and emotion regulation. The control curriculum focused on safety. Anthropometrics were measured in both siblings at ages 3, 16, 28, and 52 weeks. Growth curve models for BMI by child age were fit. RESULTS: Second-born children were delivered 2.5 (SD 0.9) years after firstborns. Firstborn and second-born children whose parents received the RP intervention with their first child had BMI that was 0.44 kg/m2 (95% CI: -0.82 to 0.06) and 0.36 kg/m2 (95% CI: -0.75 to 0.03) lower than controls, respectively. Linear and quadratic growth rates for BMI for firstborn and second-born cohorts were similar, but second-born children had a greater average BMI at 1 year of age (difference = -0.33 [95% CI: -0.52 to -0.15]). CONCLUSIONS: A RP educational intervention for obesity prevention delivered to parents of firstborns appears to spill over to second-born siblings.

Stability and change in snack food likes and dislikes from 5 to 11 years.

Research on the development of snack food likes and dislikes from childhood to adolescence is limited. We investigated both the stability and the change in liking (i.e., "like", "neither like nor dislike", "dislike") and rank-order liking (i.e., liking one food more than others; e.g., "I like chocolate more than cookies") of snack foods from 5 to 11 years in non-Hispanic white girls. Liking of 10 palatable snack foods was assessed biennially. Girls' liking and rank-order liking of snack foods were modestly stable from age 5 to 11, and there was a tendency for initially disliked foods to become more liked.

Rejection, feeling bad, and being hurt: using multilevel modeling to clarify the link between peer group aggression and adjustment.

The association between affiliating with aggressive peers and behavioral, social and psychological adjustment was examined. Students initially in 3rd, 4th, and 5th grade (N = 427) were followed biannually through 7th grade. Students' peer-nominated groups were identified. Multilevel modeling was used to examine the independent contributions of adolescents' typical peer context (between-person effect) and changes in peer context (within-person effects) to adolescents' adjustment. Typically affiliating with aggressive groups and affiliating with more aggressive groups than usual predicted higher aggression for all youth. Typically affiliating with aggressive groups predicted negative adjustment (lower social preference and self-worth, higher victimization) for girls but neutral or positive adjustment for boys. Although typical peer context was consistently associated with adjustment, changes in peer context predicted small changes in adjustment for several outcomes. Results underscored the need to adopt a more differentiated picture of adolescents' dynamic peer context and its association with normative development.