Early maternal feeding practices: Associations with overweight later in childhood

Background Current understanding of the impact of maternal feeding practices on weight outcomes in young children remains unclear given equivocal longitudinal study outcomes. Objectives To determine whether feeding practices used by mothers when their child was less than 2 years of age were related to overweight status at ages 3.5 and 5 years in a large cross-country sample; and investigate whether these associations were moderated by weight status in early life. Design Data from mother-child dyads participating in four childhood obesity prevention trials across Australia and New Zealand were pooled (n = 723). Each trial administered items from the Comprehensive Feeding Practices Questionnaire (CFPQ) to mothers when infants were approximately 20 months of age, measuring food as a reward, modelling, restriction for health, pressure to eat, and emotion regulation. Poisson regression was used to determine risk ratios (RR) for overweight (BMI z-score ≥85th percentile) at 3.5 and 5 years by CFPQ scores. Results Greater use of emotion regulation at 20 months of age predicted higher risk for overweight at 3.5 and 5 years (RR = 1.19 and 1.28, respectively), while restriction for health predicted lower risk for overweight at 5 years (RR = 0.88). Child's weight status at 20 months moderated the association between pressure to eat and overweight risk at 5 years, such that those who were not overweight at 20 months of age had reduced risk of overweight associated with the use of pressure to eat (RR = 0.68) but those who were overweight had an increased risk (RR = 1.09). Conclusion Early maternal feeding practices are related to a child's later risk of overweight

The Feeding Practices and Structure Questionnaire: Development and validation of age appropriate versions for infants and toddlers

Purpose: A large range of questionnaires are available to assess parental feeding practices. Most have been developed for children aged two years and older. To measure and better understand trajectories of feeding and their relationship with child eating behaviours and weight in the long term, early assessments are desirable. While questionnaires also exist to measure feeding practices of parents with infants, no questionnaire is available that allows tracking of feeding practices from infancy to later childhood. This study aimed to develop a version of the Feeding Practices and Structure Questionnaire (FPSQ) for parents with infants and toddlers.Methods: Constructs and items for the FPSQ for infants and toddlers were derived from the existing and validated FPSQ for older children and supplemented by a literature review on infant feeding questionnaires. Following expert review, two questionnaire versions were developed, one for milk feeding and one for (semi-)solid feeding parents.Data from two studies were combined (child ages 0-24 months) to test the derived constructs with Confirmatory Factor Analysis for the milk (N=731) and solid feeding (N=611) version.Results: The milk feeding version consisting of four factors (20 items) showed acceptable model fit and good internal reliability: ‘feeding on demand vs. feeding routine’ (Cronbach’s α= 0.87), ‘using food to calm’ (α= 0.86), ‘persuasive feeding’ (α= 0.71), ‘parent-focused feeding’ (α= 0.79). The same four factors showed acceptable model fit for the solid feeding version, likewise with good reliability (α= 0.74, 0.86, 0.85, 0.84 respectively). Two additional factors(19 items) were created for the solid feeding version that only appeared developmentally appropriate for children aged 12 months or older: ‘family meal environment’ (α= 0.81) and ‘using (non-)food rewards’ (α= 0.92). The majority of factor-factor correlations were in line with those of the original FPSQ.Conclusions: The FPSQ milk and solid feeding versions are the first measures specifically developed as precursors to the FPSQ to measure parental feeding practices in children <2 years, particularly those related to responsiveness and structure. Further validation in more diverse samples is required

Factors associated with adverse COVID-19 outcomes in patients with psoriasis : insights from a global registry–based study

Background: The multimorbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse outcomes of coronavirus disease 2019 (COVID-19), but the data are limited. Objective: Our aim was to characterize the course of COVID-19 in patients with psoriasis and identify factors associated with hospitalization. Methods: Clinicians reported patients with psoriasis with confirmed/suspected COVID-19 via an international registry, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection. Multiple logistic regression was used to assess the association between clinical and/or demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviors. Results: Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% were receiving a nonbiologic, and 10% were not receiving any systemic treatment for psoriasis. In all, 348 patients (93%) were fully recovered from COVID-19, 77 (21%) were hospitalized, and 9 (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted odds ratio [OR] = 1.59 per 10 years; 95% CI = 1.19-2.13), male sex (OR = 2.51; 95% CI = 1.23-5.12), nonwhite ethnicity (OR = 3.15; 95% CI = 1.24-8.03), and comorbid chronic lung disease (OR = 3.87; 95% CI = 1.52-9.83). Hospitalization was more frequent in patients using nonbiologic systemic therapy than in those using biologics (OR = 2.84; 95% CI = 1.31-6.18). No significant differences were found between classes of biologics. Independent patient-reported data (n = 1626 across 48 countries) suggested lower levels of social isolation in individuals receiving nonbiologic systemic therapy than in those receiving biologics (OR = 0.68; 95% CI = 0.50-0.94). Conclusion: In this international case series of patients with moderate-to-severe psoriasis, biologic use was associated with lower risk of COVID-19-related hospitalization than with use of nonbiologic systemic therapies; however, further investigation is warranted on account of potential selection bias and unmeasured confounding. Established risk factors (being older, being male, being of nonwhite ethnicity, and having comorbidities) were associated with higher hospitalization rates