Validation testing of a short food‐group‐based questionnaire to assess dietary risk in preschoolers aged 3–5 years

This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for self-archiving'. Copyright (2018) Dietitians Association of Australia. All rights reserved. This author accepted manuscript is made available following 12 month embargo from date of publication (February 2018) in accordance with the publisher’s archiving policy.Background: Short questionnaire-style dietary assessment methods are useful for monitoring compliance with dietary guidelines. A reliable and valid short food-based questionnaire for assessing dietary risk in toddlers aged 1-3 years was recently adapted for use in pre-schoolers. This study aimed to determine the reliability and validity of this 19-item Preschooler Dietary Questionnaire (PDQ) that assesses dietary risk of 3-5 year-olds. Methods: Primary caregivers of preschoolers completed a two-stage online survey: 1) a demographic questionnaire and the PDQ; 2) a second PDQ and a validated 54-item semi-quantitative food frequency questionnaire (FFQ). Dietary risk scores (0-100; higher score=higher risk) derived from the two PDQ administrations (2.1±1.0 weeks apart) were compared and average scores assessed against the FFQ. Cross-classification into dietary risk categories (low, 0-24; moderate, 25-49; high, 50-74; very high, 75- 100) was determined. The relationship of dietary risk scores with BMI z-score was assessed using standard linear regression. Results: Preschoolers’ (n=74) risk scores were highly correlated yet statistically different for reliability (ICC=0.87; mean bias 1.51, 95% CI 0.07, 2.95, p=0.040) and validity (r=0.85; mean bias -1.64, 95% CI -2.86, -0.43, p=0.009). There was no systematic bias between the two tools. All participants were classified into the same (80%) or adjacent (20%) category upon administration of each tool. Risk scores were not associated with BMIz scores (β -0.09, 95%CI -0.02,-0.04, p=0.512). Conclusion: The PDQ is a novel and useful screening instrument to rapidly identify preschooler dietary, but not obesity, risk. The tool could facilitate referral to appropriate health professionals for detailed assessment and intervention

Precision health in behaviour change interventions: A scoping review

Precision health seeks to optimise behavioural interventions by delivering personalised support to those in need, when and where they need it. Conceptualised a decade ago, progress toward this vision of personally relevant and effective population-wide interventions continues to evolve. This scoping review aimed to map the state of precision health behaviour change intervention research. This review included studies from a broader precision health review. Six databases were searched for studies published between January 2010 and June 2020, using the terms ‘precision health’ or its synonyms, and including an intervention targeting modifiable health behaviour(s) that was evaluated experimentally. Thirty-one studies were included, 12 being RCTs (39 %), and 17 with weak study design (55 %). Most interventions targeted physical activity (27/31, 87 %) and/or diet (24/31, 77 %), with 74% (23/31) targeting two to four health behaviours. Interventions were personalised via human interaction in 55 % (17/31) and digitally in 35 % (11/31). Data used for personalising interventions was largely self-reported, by survey or diary (14/31, 45 %), or digitally (14/31, 45 %). Data was mostly behavioural or lifestyle (20/31, 65 %), and physiologic, biochemical or clinical (15/31, 48 %), with no studies utilising genetic/genomic data. This review demonstrated that precision health behaviour change interventions remain dependent on human-led, low-tech personalisation, and have not fully considered the interaction between behaviour and the social and environmental contexts of individuals. Further research is needed to understand the relationship between personalisation and intervention effectiveness, working toward the development of sophisticated and scalable behaviour change interventions that have tangible public health impact

Predictors of and reasons for pacifier use in first-time mothers: an observational study

Background: The use of pacifiers is commonplace in Australia and has been shown to be negatively associated with breastfeeding duration. In order to influence behaviour related to the use of pacifiers it is important to understand the reasons for their use. The primary aim of this observational study was to investigate who (if anyone) advises first-time mothers to give a pacifier and the reasons for which they first give (or try to give) a pacifier to their infant. Additionally, this study investigated the predictors of pacifier use and the relationship between pacifier use and breastfeeding duration. Methods: In total, 670 Australian first-time mothers recruited as part of the NOURISH trial completed a questionnaire regarding infant feeding and pacifier use. Results: Pacifiers were introduced by 79% of mothers, of whom 28.7% were advised to use a pacifier by their mother/mother-in-law with a further 22.7% being advised by a midwife. The majority of mothers used a pacifier in order to soothe their infant (78.3%), to help put them to sleep (57.4%) and to keep them comforted and quiet (40.4%). Pacifiers given to infants before four weeks (adjHR 3.67; 95%CI 2.14–6.28) and used most days (adjHR 3.28; 95%CI 1.92–5.61) were significantly associated with shorter duration of breastfeeding. Conclusions: This study identifies an opportunity for educating new mothers and their support network, particularly their infant’s grandmothers, with regards to potential risks associated with the early and frequent use of a pacifier, and alternative methods for soothing their infant, in order to reduce the use of pacifiers and their potentially negative effect on breastfeeding duratio

Validation testing of a short food‐group‐based questionnaire to assess dietary risk in preschoolers aged 3–5 years

This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for self-archiving'. Copyright (2018) Dietitians Association of Australia. All rights reserved. This author accepted manuscript is made available following 12 month embargo from date of publication (February 2018) in accordance with the publisher’s archiving policy.Background: Short questionnaire-style dietary assessment methods are useful for monitoring compliance with dietary guidelines. A reliable and valid short food-based questionnaire for assessing dietary risk in toddlers aged 1-3 years was recently adapted for use in pre-schoolers. This study aimed to determine the reliability and validity of this 19-item Preschooler Dietary Questionnaire (PDQ) that assesses dietary risk of 3-5 year-olds. Methods: Primary caregivers of preschoolers completed a two-stage online survey: 1) a demographic questionnaire and the PDQ; 2) a second PDQ and a validated 54-item semi-quantitative food frequency questionnaire (FFQ). Dietary risk scores (0-100; higher score=higher risk) derived from the two PDQ administrations (2.1±1.0 weeks apart) were compared and average scores assessed against the FFQ. Cross-classification into dietary risk categories (low, 0-24; moderate, 25-49; high, 50-74; very high, 75- 100) was determined. The relationship of dietary risk scores with BMI z-score was assessed using standard linear regression. Results: Preschoolers’ (n=74) risk scores were highly correlated yet statistically different for reliability (ICC=0.87; mean bias 1.51, 95% CI 0.07, 2.95, p=0.040) and validity (r=0.85; mean bias -1.64, 95% CI -2.86, -0.43, p=0.009). There was no systematic bias between the two tools. All participants were classified into the same (80%) or adjacent (20%) category upon administration of each tool. Risk scores were not associated with BMIz scores (β -0.09, 95%CI -0.02,-0.04, p=0.512). Conclusion: The PDQ is a novel and useful screening instrument to rapidly identify preschooler dietary, but not obesity, risk. The tool could facilitate referral to appropriate health professionals for detailed assessment and intervention

The Australian Feeding Infants and Toddlers Study (OzFITS) 2021: Study Design, Methods and Sample Description

(1) Background: Caregiver feeding practices during the first two years of a child’s life influence nutrition, growth, and development, as well as long term taste preferences and dietary patterns. Suboptimal feeding practices lead to poorer health outcomes, such as obesity, that persist into adulthood. Although the importance of early life nutrition is well-established, there are no Australia-wide surveys of dietary intakes of children under two years of age. The 2021 Australian Feeding Infants and Toddlers Study (OzFITS) aims to fill this gap. This paper describes the methods and study sample of OzFITS 2021. (2) Methods: OzFITS 2021 is a cross-sectional study of children aged 0 to 23.9 months of age and their caregiver across Australia. Data were collected between April 2020 and April 2021. A telephone-based survey was completed with a caregiver to obtain information on child and caregiver characteristics and feeding practices. For exclusively breastfed infants, the number of breastfeeds in a 24 h period was reported. Dietary intakes for mixed fed children were estimated using a one-day food record, with 30% of caregivers completing a second food record on a non-consecutive day. (3) Results: We enrolled 1140 caregiver and child dyads. Of those eligible to complete a food record, 853 (87%) completed the food record. Compared to the Australian population, caregivers were more likely to be university-educated (>75%), married or in a de facto relationship (94%), and have a household income >$100,000/y (60%). (4) Conclusions: OzFITS 2021 is the first national study to examine food and nutrient intake in Australian children aged under 2 years. The study will provide information on breastfeeding rates and duration, use of breast milk substitutes, and timing of solid food introduction. Dietary intake data will allow the comparison of core food groups and discretionary food intake to Australian guidelines and estimate the prevalence of inadequate intake of key nutrients, like iron. Healthcare practitioners and policymakers can use the study findings as a source of evidence to inform the next iteration of infant feeding guidelines

Usual Nutrient Intake Distribution and Prevalence of Inadequacy among Australian Children 0–24 Months: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

(1) Background: Breastmilk provides all the nutrition an infant requires between 0–6 months. After that, complementary foods are needed to meet the child’s increasing energy and nutrient requirements. Inadequate energy and nutrient intake may lead to growth faltering, impaired neurodevelopment, and increased disease risk. While the importance of early life nutrition is well recognized, there are few investigations assessing the nutritional adequacy of Australian children <24 months. Here, we describe usual energy and nutrient intake distributions, including the prevalence of inadequate intakes and exceeding the upper limit (UL), in a national sample of Australian children 6– 24 months and infants < six months who had commenced solids and/or formula. (2) Methods: Dietary intakes were assessed using a one-day food record for 976 children with a repeat one-day record in a random subset. (3) Results: Based on the Nutrient Reference Values for Australia and New Zealand, children’s intakes were above the Adequate Intake or Estimated Average Requirement for most nutrients. Exceptions were iron and zinc where the prevalence of inadequacy was estimated to be 90% and 20%, respectively, for infants aged 6–11.9 months. Low iron intake was also observed in one quarter of toddlers 12–24 months. On average, children consumed 10% more energy than predicted based on Estimated Energy Requirements, and ~10% were classified as overweight based on their weight for length. One third of toddlers exceeded the tolerable upper limit for sodium and consumed > 1000 mg/day. Of the children under six months, 18% and 43% exceeded the UL for vitamin A (retinol) and zinc. (4) Conclusions: Compared to nutrient reference values, diets were sufficient for most nutrients; however, iron was a limiting nutrient for infants aged 6–11.9 months and toddlers 12–24 months potentially putting them at risk for iron deficiency. Excessive sodium intake among toddlers is a concern as this may increase the risk for hypertension

Does Food Intake of Australian Toddlers 12–24 Months Align with Recommendations: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

(1) Background: Food-based dietary guidelines promote population health and well-being through dietary patterns that reduce chronic disease risk while providing adequate energy and nutrients. In Australia, recommended dietary patterns based on servings per day from the five food groups—fruits, vegetables, cereals and grains, meats and alternatives, and dairy—have been developed for toddlers 1–2 years of age. However, no study has assessed the intake of the five food groups in this age group nationally. (2) Aim: To compare daily servings and the percentage of energy from the five food groups and discretionary foods in toddlers 1–2 years old to the Australian Dietary Guidelines. (3) Methods: Dietary intake was assessed using a one-day food record for 475 toddlers. (4) Results: Apart from fruit and dairy, servings of the five food groups were below the recommendations. Two-thirds of toddlers did not consume enough vegetables, and only 10% consumed the recommended number of servings for cereals and grains. On average, toddlers consumed only half the recommended servings of meat and alternatives. Nearly all toddlers (89%) consumed discretionary foods, which accounted for ~12% of total energy. Forty-five percent of toddlers received breastmilk. On average, breastfed toddlers consumed fewer servings from the five food groups than non-breastfed toddlers. Dairy contributed 20% of daily energy in all toddlers; however, this food group accounted for 13% in breastfed and 32% in non-breastfed toddlers on the day of the food record. (4) Conclusions: Compared to the recommendations, alignment with the servings of the five food group foods was not achieved by most toddlers, except for fruit and dairy. Discretionary foods may have displaced nutritious family foods. Consistent with Australian Infant Feeding Guidelines, many toddlers in this study continued to receive breastmilk but the recommended dietary patterns do not include breastmilk. Dietary modeling, including breastmilk as the primary milk source, is urgently needed, along with practical advice on incorporating breastmilk in a toddler’s diet while optimizing food consumption

Parental work hours and household income as determinants of unhealthy food and beverage intake in young Australian children

OBJECTIVE: This study examined parental work hours and household income as determinants of discretionary (energy dense, nutrient poor) food and beverage intake in young children, including differences by eating occasion.DESIGN: Secondary analysis of cross-sectional data. Three hierarchical regression models were conducted with percent energy from discretionary food and beverages across the day, at main meals, and at snack times being the outcomes. Dietary intake was assessed by 1x24-hour recall and 1-2x24-hour food record(s). Both maternal/paternal work hours were included, and total household income. Covariates included household, parent and child factors.SETTING: Data from the NOURISH/SAIDI studies were collected between 2008-13.PARTICIPANTS: Participants included 526 mother-child dyads (median(IQR) child age 1.99(1.96,2.03) years). Forty-one percent of mothers did not work while 57% of fathers worked 35-40 hours/week. Most (85%) households had an income of ≥$50k AUD/year.RESULTS: Household income was consistently inversely associated with discretionary energy intake (β= -0.12 to -0.15). Maternal part-time employment (21-35 hours/week) predicted child consumption of discretionary energy at main meals (β=0.10, p=0.04). Paternal unemployment predicted a lower proportion of discretionary energy at snacks (β= -0.09, p=0.047).CONCLUSIONS: This work suggests that household income should be addressed as a key opportunity-related barrier to healthy food provision in families of young children. Strategies to reduce the time burden of healthy main meal provision may be required in families where mothers juggle longer part-time working hours with caregiving and domestic duties. The need to consider the role of fathers and other parents/caregivers in shaping children's intake was also highlighted.</p

E-&mHealth interventions targeting nutrition, physical activity, sedentary behavior, and/or obesity among children: A scoping review of systematic reviews and meta-analyses

info:eu-repo/semantics/publishe