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 (β = 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: β = -0.31 NutriSTEP® points, 95% CI = -0.54, -0.08; fathers: β = -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

Nutritional risk in early childhood and parent-reported school concerns

Objective: To determine if nutritional risk in early childhood is associated with parent-reported school concerns. Design: A prospective cohort study conducted through the TARGet Kids! primary care research network (2011-2018). Nutritional risk was measured between 18 months and 5 years of age using validated parent-completed NutriSTEP® questionnaires with eating behaviour and dietary intake subscores (0 = lowest and 68 = highest total nutritional risk score). Parent-reported school concerns were measured at school age (4-10 years of age) and included: speech and language; learning; attention; behaviour; social relationships; physical coordination; fine motor coordination and self-help skills and independence. The primary outcome was any parent-reported school concerns, and individual school concerns were used as secondary outcomes. Multiple logistic regression models were conducted adjusting for clinically relevant confounders to assess the relationship between nutritional risk and school concerns. Setting: Toronto, Canada. Participants: Children aged 18 months to 10 years. Results: The study included 3655 children, 52 % were male, mean NutriSTEP® score was 14·4 (sd 6·4). Each 1 sd increase in NutriSTEP® total score was associated with a 1·18 times increased odds of school concerns (adj OR: 1·18, 95 % CI 1·07, 1·28, P = 0·0004), and high nutritional risk was associated with a 1·42 times increased odds of school concerns (adj OR: 1·42, 95 % CI 1·13, 1·78, P = 0·002). Conclusions: Nutritional risk in early childhood was associated with school concerns. Nutritional interventions in early childhood may reveal opportunities to enhance school outcomes.</p

Nutritional Risk in Early Childhood and School Readiness

Background Nutrition in early childhood is important for healthy growth and development. Achieving school readiness is considered one of the most important developmental milestones for young children. Objectives The purpose of this study is to determine if nutritional risk in early childhood is associated with school readiness in kindergarten. Methods A prospective cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) primary care research network in Toronto, Canada, 2015–2020. Nutritional risk was measured (18 mo to 5 y) using validated parent-completed questionnaires called Nutrition Screening for Toddlers and Preschoolers (NutriSTEP). High nutritional risk was categorized as scores ≥21. School readiness was measured using the validated teacher-completed Early Developmental Instrument (EDI), which measures 5 developmental domains in kindergarten (2 y of schooling, ages 4–6 y, before they enter grade 1). Vulnerability indicates scores lower than a population-based cutoff at the 10th percentile on at least 1 domain. Multiple logistic and linear regression models were conducted adjusting for relevant confounders. Results The study included 896 children: 53% were male, 9% had high nutritional risk, and 17% were vulnerable on the EDI. A 1-SD increase in NutriSTEP total score was associated with 1.54 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P = 0.001). High nutritional risk cutoff was associated with 4.28 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P Conclusions Higher nutritional risk in early childhood is associated with lower school readiness in year 2 of kindergarten. Nutritional interventions early in life may offer opportunities to enhance school readiness. This trial was registered http://www.clinicaltrials.gov as NCT01869530.</p

Children’s screen use and school readiness at 4-6 years: prospective cohort study

Background The primary aim of this study was to determine if screen use in early childhood is associated with overall vulnerability in school readiness at ages 4 to 6 years, as measured by the Early Development Instrument (EDI). Secondary aims were to: (1) determine if screen use was associated with individual EDI domains scores, and (2) examine the association between screen use and EDI domains scores among a subgroup of high screen users. Methods This prospective cohort study was carried out using data from young children participating in a large primary care practice-based research network in Canada. Logistic regression analyses were run to investigate the association between screen use and overall vulnerability in school readiness. Separate linear regression models examined the relationships between children’s daily screen use and each separate continuous EDI domain. Results A total of 876 Canadian participants participated in this study. Adjusted logistic regression revealed an association between increased screen use and increased vulnerability in school readiness (p = 0.05). Results from adjusted linear regression demonstrated an association between higher screen use and reduced language and cognitive development domain scores (p = 0.004). Among high screen users, adjusted linear regression models revealed associations between increased screen use and reduced language and cognitive development (p = 0.004) and communication skills and general knowledge domain scores (p = 0.042). Conclusions Screen use in early childhood is associated with increased vulnerability in developmental readiness for school, with increased risk for poorer language and cognitive development in kindergarten, especially among high users.</p

Fit for School Study protocol: early child growth, health behaviours, nutrition, cardiometabolic risk and developmental determinants of a child’s school readiness, a prospective cohort

Introduction School readiness is a multidimensional construct that includes cognitive, behavioural and emotional aspects of a child’s development. School readiness is strongly associated with a child’s future school success and well-being. The Early Development Instrument (EDI) is a reliable and valid teacher-completed tool for assessing school readiness in children at kindergarten age. A substantial knowledge gap exists in understanding how early child growth, health behaviours, nutrition, cardiometabolic risk and development impact school readiness. The primary objective was to determine if growth patterns, measured by body mass index trajectories in healthy children aged 0–5 years, are associated with school readiness at ages 4–6 years (kindergarten age). Secondary objectives were to determine if other health trajectories, including health behaviours, nutrition, cardiometabolic risk and development, are associated with school readiness at ages 4–6 years. This paper presents the Fit for School Study protocol. Methods and analysis This is an ongoing prospective cohort study. Parents of children enrolled in the The Applied Health Research Group for Kids (TARGet Kids!) practice-based research network are invited to participate in the Fit for School Study. Child growth, health behaviours, nutrition, cardiometabolic risk and development data are collected annually at health supervision visits and linked to EDI data collected by schools. The primary and secondary analyses will use a two-stage process: (1) latent class growth models will be used to first determine trajectory groups, and (2) generalised linear mixed models will be used to examine the relationship between exposures and EDI results. Ethics and dissemination The research ethics boards at The Hospital for Sick Children, Unity Health Toronto and McMaster University approved this study, and research ethics approval was obtained from each school board with a student participating in the study. The findings will be presented locally, nationally and internationally and will be published in peer-reviewed journals.</p