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

Vitamin D Status of Anabaptist Children in Southwestern Ontario, Canada

The objective was to determine vitamin D status of Old Order Anabaptist children in rural Southwestern, Ontario, Canada, given concerns of community healthcare professionals. Fifty-two children (2.5 months - 6.5 years) (56% female) were recruited. Finger prick blood spot (BSp) samples were analyzed for 25-hydroxy (OH) vitamins D2 & D3 (BSp25(OH)D). Three-day food records were evaluated using Dietary Reference Intakes and Canada’s Food Guide (CFG) (Bush, et al. 2007). Compared to national Canadian data: mean BSp25(OH)D concentrations (78±31 nmol/L) were similar; a slightly smaller proportion (0% vs 2%) were at risk of deficiency (\u3c30 nmol/L) or had inadequate status (4% vs 7%) (\u3c40 nmol/L); and 10% vs 1% had BSp25(OH)D higher than 125 nmol/L. BSp25(OH)D was significantly associated (r2=0.358; p=0.001) with total vitamin D intake. From food alone, vitamin D intake was 68±39 IU/day, lower than the Recommended Dietary Allowance (RDA) of 600 IU/day, and intakes were all below the Estimated Average Requirement (EAR) of 400 IU. Even including supplemental vitamin D, 87% were below the EAR (total intake=213±194 IU/day). No children had vitamin D intakes greater than the Upper Limit. Servings of milk and alternates were 1.6±0.8/day (CFG=2/day). Unfortified farm milk was consumed by 88% of children and 89% received a vitamin D supplement. Results were comparable to recent Canadian data suggesting that most children have adequate vitamin D status. Nevertheless, these findings support the need to encourage appropriate vitamin D intake (from food and supplements) to achieve the RDA for Old Order Anabaptist children in these communities. [Abstract by authors.

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

Supporting Dietitians in Practice: Professional Development Activities of Dietitians of Canada in the Past 30 Years

Dietitians of Canada (DC) was established in 1997 from the Canadian Dietetic Association and the provincial associations. This project is part of a larger program of work to document the recent history of Canadian dietetic practice, including the professional development (PD) initiatives DC has provided since its inception. The aims of the present study are to synthesize a timeline of PD events since 1993, understand the context that led to their development, and understand their impact on the profession. 13 key informants were recruited by email, of which 11 semi-structured interviews were conducted, and 8 participants provided written contributions. Interview transcripts and written contributions were analyzed thematically, and a final timeline of events was developed. Six themes were found: 1) the use of technology in PD tools, e.g. online courses, Learning on Demand; 2) conferences and workshops , e.g. national conference, Coast-to-Coast workshops; 3) initiatives that placed DC as a leader in health and nutrition, e.g. Practice-based Evidence in Nutrition (PEN); 4)  informal discussion about emerging issues in dietetics, e.g. PEN Current Issues, Practice Blog; 5) DC actively sought member input to inform PD strategy, e.g. members issues forums; and, 6) DC PD events demonstrated their support for research and dietetic education, e.g. relationship with CFDR, public health online course. Key concerns for the future included: declining DC membership and funding, and dietetics not keeping pace with other professions on PD. The successes and failures of initiatives in this time period can inform the development of DC’s PD strategy for the coming decades.&nbsp

Food parenting practices and their association with child nutrition risk status: comparing mothers and fathers

In Canada, little is known about how food parenting practices are associated with young children’s dietary intakes and no studies have examined food parenting practices of Canadian fathers. This study aimed to examine associations between food parenting practices and preschool-age children’s nutrition risk. We conducted a cross-sectional analysis of 31 two-parent families; 31 mothers, 31 fathers and 40 preschool-age children. Parents completed an adapted version of the Comprehensive Feeding Practices Questionnaire. We calculated children’s nutrition risk using their NutriSTEP® score. To account for sibling association, we used generalized estimating equations, adjusting for child age, sex, household income, and parental BMI. Both mothers’ and fathers’ involvement of children in meal preparation were associated with lower child nutrition risk (mother β=-3.45, p=0.02; father β=-1.74, p=0.01), as were their healthy home environment scores (mother β=-8.36, pThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Development, Reliability and Validity Testing of Toddler NutriSTEP®: A Nutrition Risk Screening Questionnaire for Children 18-35 Months of Age

Background /Objectives Nutrition is vital for optimal growth and development of young children. Nutrition risk screening can facilitate early intervention when followed by nutritional assessment and treatment. NutriSTEP® is a valid and reliable nutrition risk screening questionnaire for preschoolers (3-5 years). A need was identified for a similar questionnaire for toddlers (18-35 months). The purpose was to develop a reliable and valid Toddler NutriSTEP®. Subjects/Methods Toddler NutriSTEP® was developed in four phases. Content and face validity were determined with a literature review, parent focus groups (n=6, 48 participants) and experts (n=13) (Phase A). A draft questionnaire was refined with key intercept interviews of 107 parents/caregivers (Phase B). Test-retest reliability (Phase C), based on intra-class correlations (ICC), Kappa (ĸ) statistics, and Wilcoxon tests was assessed with 133 parents/caregivers. Criterion validity (Phase D) was assessed using Receiver Operating Characteristic (ROC) curves by comparing scores on the Toddler NutriSTEP® to a comprehensive nutritional assessment of 200 toddlers with a registered dietitian (RD). Results The Toddler NutriSTEP® was reliable between two administrations (ICC=0.951, F=20.53, pThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Screening for marginal food security in young children in primary care

Abstract Background Household food insecurity (FI), even at marginal levels, is associated with poor child health outcomes. The Nutrition Screening Tool for Every Preschooler (NutriSTEP®) is a valid and reliable 17-item parent-completed measure of nutrition risk and includes a single item addressing FI which may be a useful child-specific screening tool. We evaluated the diagnostic test properties of the single NutriSTEP® FI question using the 2-item Hunger Vital Sign™ as the criterion measure in a primary care population of healthy children ages 18 months to 5 years. Results The sample included 1174 families, 53 (4.5%) of which were marginally food secure. An affirmative response to the single NutriSTEP® question “I have difficulty buying food I want to feed my child because food is expensive” had a sensitivity of 85% and specificity of 91% and demonstrated good construct validity when compared with the Hunger Vital Sign™. Conclusion The single NutriSTEP® question may be an effective screening tool in clinical practice to identify marginal food security in families with young children and to link families with community-based services or financial assistance programs including tax benefits. Trial registration TARGet Kids! practice-based research network (Registered June 5, 2013 at www.clinicaltrials.gov ; NCT01869530); www.targetkids.caFunding to support TARGet Kids! was provided by multiple sources including the Canadian Institutes for Health Research (CIHR), namely the Institute of Human Development, Child and Youth Health [No. FRN 114945 to JLM, No. FRN 115059 to PCP] and the Institute of Nutrition, Metabolism and Diabetes [No. FRN 119375 to CSB], as well as, the St. Michael’s Hospital Foundation. The Paediatric Outcomes Research Team (PORT) is supported by a grant from The Hospital for Sick Children Foundation