Karen M Switkowski1, Izzuddin M Aris1, Véronique Gingras1,2,3, Emily Oken1,4, Jessica G Young1. 1. Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. 2. Department of Nutrition, University of Montréal, Montreal, Quebec, Canada. 3. Research Center, Sainte-Justine University Hospital Center (CHU), Montreal, Quebec, Canada. 4. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND: Complementary feeding (CF) provides an opportunity to shape children's future dietary habits, setting the foundation for good nutrition and health. OBJECTIVES: We estimated effects of 3 CF behaviors on early childhood diet quality using inverse probability (IP) weighting of marginal structural models (MSMs). METHODS: Among 1041 children from the Boston-area Project Viva cohort, we estimated effects on the mean Youth Healthy Eating Index (YHEI) score in early childhood of 1) delayed (≥12 mo) compared with early (<12 mo) introduction of sweets and fruit juice; 2) continued compared with ceased offering of initially refused foods; and 3) early (<12 mo) compared with late (≥12 mo) introduction of flavor/texture variety. Mothers reported CF behaviors at 1 y and completed FFQs for children in early childhood (median age: 3.1 y). We estimated average treatment effects (ATEs) using IP weighting of MSMs to adjust for both confounding and selection bias due to censored outcomes and examined effect modification by child sex and breastfeeding compared with formula feeding at 6 mo. RESULTS: Twelve percent of mothers delayed introducing sweets/fruit juice, 93% continued offering initially refused foods, and 32% introduced flavor/texture variety early. The mean ± SD YHEI score was 52.8 ± 9.2 points. In adjusted models, we estimated a higher mean YHEI score with delayed (compared with early) sweets and fruit juice among breastfeeding children (ATE: 4.5 points; 95% CI: 1.0, 7.4 points), as well as with continued (compared with ceased) offering of refused foods among females (ATE: 5.4 points; 95% CI: 0.8, 9.1 points). The ATE for early (compared with late) flavor/texture variety was 1.7 points (95% CI: 0.3, 3.2 points) overall and stronger (2.8 points; 95% CI: 0.7, 5.1 points) among the formula-fed group. CONCLUSIONS: Delayed introduction of sweets/juice, continued offering of refused foods, and early flavor/texture variety may all result in higher childhood diet quality. Effects may depend on child sex and infant breastfeeding status.
BACKGROUND: Complementary feeding (CF) provides an opportunity to shape children's future dietary habits, setting the foundation for good nutrition and health. OBJECTIVES: We estimated effects of 3 CF behaviors on early childhood diet quality using inverse probability (IP) weighting of marginal structural models (MSMs). METHODS: Among 1041 children from the Boston-area Project Viva cohort, we estimated effects on the mean Youth Healthy Eating Index (YHEI) score in early childhood of 1) delayed (≥12 mo) compared with early (<12 mo) introduction of sweets and fruit juice; 2) continued compared with ceased offering of initially refused foods; and 3) early (<12 mo) compared with late (≥12 mo) introduction of flavor/texture variety. Mothers reported CF behaviors at 1 y and completed FFQs for children in early childhood (median age: 3.1 y). We estimated average treatment effects (ATEs) using IP weighting of MSMs to adjust for both confounding and selection bias due to censored outcomes and examined effect modification by child sex and breastfeeding compared with formula feeding at 6 mo. RESULTS: Twelve percent of mothers delayed introducing sweets/fruit juice, 93% continued offering initially refused foods, and 32% introduced flavor/texture variety early. The mean ± SD YHEI score was 52.8 ± 9.2 points. In adjusted models, we estimated a higher mean YHEI score with delayed (compared with early) sweets and fruit juice among breastfeeding children (ATE: 4.5 points; 95% CI: 1.0, 7.4 points), as well as with continued (compared with ceased) offering of refused foods among females (ATE: 5.4 points; 95% CI: 0.8, 9.1 points). The ATE for early (compared with late) flavor/texture variety was 1.7 points (95% CI: 0.3, 3.2 points) overall and stronger (2.8 points; 95% CI: 0.7, 5.1 points) among the formula-fed group. CONCLUSIONS: Delayed introduction of sweets/juice, continued offering of refused foods, and early flavor/texture variety may all result in higher childhood diet quality. Effects may depend on child sex and infant breastfeeding status.
Authors: Camille Schwartz; Petra A M J Scholtens; Amandine Lalanne; Hugo Weenen; Sophie Nicklaus Journal: Appetite Date: 2011-05-27 Impact factor: 3.868
Authors: Maureen K Spill; Kirsten Johns; Emily H Callahan; Myra J Shapiro; Yat Ping Wong; Sara E Benjamin-Neelon; Leann Birch; Maureen M Black; John T Cook; Myles S Faith; Julie A Mennella; Kellie O Casavale Journal: Am J Clin Nutr Date: 2019-03-01 Impact factor: 7.045