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Socio-demographic and lifestyle determinants of ‘Western-like’ and ‘Health conscious’ dietary patterns in toddlers

  • Jessica C. Kiefte-de Jong (a1) (a2), Jeanne H. de Vries (a3), Sacha E. Bleeker (a1) (a2), Vincent W. V. Jaddoe (a1) (a2) (a4), Albert Hofman (a4), Hein Raat (a5) and Henriette A. Moll (a2) (a4)...

Determinants of a child's diet shortly after weaning and lactation have been relatively understudied. The aim of the present study was hence to identify common dietary patterns in toddlers and to explore parental and child indicators of these dietary patterns. The study was a population-based, prospective birth-cohort study in Rotterdam, the Netherlands. Food consumption data of 2420 children aged 14 months were used. A ‘Health conscious’ dietary pattern characterised by pasta, fruits, vegetables, oils, legumes and fish, and a ‘Western-like’ dietary pattern characterised by snacks, animal fats, confectionery and sugar-containing beverages were extracted using principal component analysis. Low paternal education, low household income, parental smoking, multiparity, maternal BMI, maternal carbohydrate intake and television-watching of child were determinants of a ‘Western-like’ diet, whereas parental age, dietary fibre intake during pregnancy, introduction of solids after 6 months and female sex were inversely associated with a ‘Western-like’ diet of the child. Maternal co-morbidity, alcohol consumption during pregnancy and female sex were inversely associated with a ‘Health conscious’ dietary pattern of the child, while single parenthood, folic acid use and dietary fibre intake during pregnancy were positively associated. All aforementioned associations were statistically significant. In conclusion, both ‘Western-like’ and ‘Health conscious’ diets can already be identified in toddlers. Particularly, adherence to a ‘Western-like’ diet is associated with unfavourable lifestyle factors of the parents and child, and low socio-economic background. These findings can form a basis for future epidemiological studies regarding dietary patterns and health outcomes in young children.

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Corresponding author
*Corresponding author: Professor Dr H. A. Moll, fax +31 107036685, email
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1Robinson, SM & Godfrey, KM (2008) Feeding practices in pregnancy and infancy: relationship with the development of overweight and obesity in childhood. Int J Obes 32, Suppl. 6, S4S10.
2Ells, LJ, Campbell, K, Lidstone, J, et al. (2005) Prevention of childhood obesity. Best Pract Res Clin Endocrinol Metab 19, 441454.
3Patrick, H & Nicklas, TA (2005) A review of family and social determinants of children's eating patterns and diet quality. J Am Coll Nutr 24, 8392.
4Skinner, JD, Carruth, BR, Bounds, W, et al. (2002) Do food-related experiences in the first 2 years of life predict dietary variety in school-aged children? J Nutr Educ Behav 34, 310315.
5North, K & Emmett, P (2000) Multivariate analysis of diet among three-year-old children and associations with socio-demographic characteristics. The Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) Study Team. Eur J Clin Nutr 54, 7380.
6Aranceta, J, Perez-Rodrigo, C, Ribas, L, et al. (2003) Sociodemographic and lifestyle determinants of food patterns in Spanish children and adolescents: the enKid study. Eur J Clin Nutr 57, Suppl. 1, S40S44.
7van Rossem, L, Oenema, A, Steegers, EA, et al. (2009) Are starting and continuing breastfeeding related to educational background? The Generation R study. Pediatrics 123, e1017e1027.
8Schiess, S, Grote, V, Scaglioni, S, et al. (2010) Introduction of complementary feeding in 5 European countries. J Pediatr Gastroenterol Nutr 50, 9298.
9Hoffmann, K, Schulze, MB, Schienkiewitz, A, et al. (2004) Application of a new statistical method to derive dietary patterns in nutritional epidemiology. Am J Epidemiol 159, 935944.
10Hu, FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13, 39.
11Kjollesdal, MR, Holmboe-Ottesen, G, Mosdol, A, et al. (2010) The relative importance of socioeconomic indicators in explaining differences in BMI and waist:hip ratio, and the mediating effect of work control, dietary patterns and physical activity. Br J Nutr 104, 12301240.
12Paradis, AM, Godin, G, Perusse, L, et al. (2005) Associations between dietary patterns and obesity phenotypes. Int J Obes (Lond) 33, 14191426.
13Kant, AK (2010) Dietary patterns: biomarkers and chronic disease risk. Appl Physiol Nutr Metab 35, 199206.
14Jaddoe, VW, van Duijn, CM, van der Heijden, AJ, et al. (2010) The Generation R Study: design and cohort update 2010. Eur J Epidemiol 25, 823841.
15Feunekes, GI, Van Staveren, WA, De Vries, JH, et al. (1993) Relative and biomarker-based validity of a food-frequency questionnaire estimating intake of fats and cholesterol. Am J Clin Nutr 58, 489496.
16Hulshof, K & Breedveld, B (2002) Results of the Study on Nutrient Intake in Young Toddlers 2002. Zeist: TNO Nutrition.
17Donders-Engelen, M, Heijden van der, L & Hulshof, KF (2003) Maten, gewichten en codenummers. Wageningen: Human Nutrition of TNO and Wageningen University.
18Netherlands Nutrition Center (2006) Nevo: Dutch food composition database 2006. The Hague: Netherlands Nutrition Centre.
19Tucker, KL (2010) Dietary patterns, approaches, and multicultural perspective. Appl Physiol Nutr Metab 35, 211218.
20Swertz, O, Duimelaar, P & Thijssen, J (2004) Migrants in the Netherlands 2004. Voorburg/Heerlen: Statistics Netherlands.
21Klipstein-Grobusch, K, den Breeijen, JH, Goldbohm, RA, et al. (1998) Dietary assessment in the elderly: validation of a semiquantitative food frequency questionnaire. Eur J Clin Nutr 52, 588596.
22Brion, MJ, Ness, AR, Rogers, I, et al. (2010) Maternal macronutrient and energy intakes in pregnancy and offspring intake at 10 y: exploring parental comparisons and prenatal effects. Am J Clin Nutr 91, 748756.
23Willett, WC, Howe, GR & Kushi, LH (1997) Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 65, 4 Suppl., 1220S1228S, discussion 9S–31S.
24Hu, FB, Stampfer, MJ, Rimm, E, et al. (1999) Dietary fat and coronary heart disease: a comparison of approaches for adjusting for total energy intake and modeling repeated dietary measurements. Am J Epidemiol 149, 531540.
25Statistics Netherlands (2004) Dutch Standard Classification of Education 2003. Voorburg/Heerlen: Statistics Netherlands.
26World Heatlh Organization (2002) Global Strategy for Infant and Young Child Feeding. Unicef. 2002.
27American Academy of Pediatrics (2001) Committee on Public E. American Academy of Pediatrics: children, adolescents, and television. Pediatrics 107, 423426.
28Fredriks, AM, van Buuren, S, Burgmeijer, RJ, et al. (2000) Continuing positive secular growth change in The Netherlands 1955–1997. Pediatr Res 47, 316323.
29Kaiser, H (1958) The varimax criterion for analytic rotation in factor analysis. Psychometrika 23, 14.
30Hatcher, L (1997) A Step-by-Step Approach to Using the SAS System for Factor Analysis and Structural Equation Modeling. Cary, NC: SAS Institute, Inc.
31Gubbels, JS, Kremers, SP, Stafleu, A, et al. (2009) Clustering of dietary intake and sedentary behavior in 2-year-old children. J Pediatr 155, 194198.
32Brekke, HK, van Odijk, J & Ludvigsson, J (2007) Predictors and dietary consequences of frequent intake of high-sugar, low-nutrient foods in 1-year-old children participating in the ABIS study. Br J Nutr 97, 176181.
33Christie, L, Hine, RJ, Parker, JG, et al. (2002) Food allergies in children affect nutrient intake and growth. J Am Diet Assoc 102, 16481651.
34Hendricks, K, Briefel, R, Novak, T, et al. (2006) Maternal and child characteristics associated with infant and toddler feeding practices. J Am Diet Assoc 106, 1 Suppl. 1, S135S148.
35Dott, M, Rasmussen, SA, Hogue, CJ, et al. (2010) Association between pregnancy intention and reproductive-health related behaviors before and after pregnancy recognition, National Birth Defects Prevention Study, 1997–2002. Matern Child Health J 14, 373381.
36Sterne, JA, White, IR, Carlin, JB, et al. (2009) Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 338, b2393.
37Rubin, DB & Schenker, N (1991) Multiple imputation in health-care databases: an overview and some applications. Stat Med 10, 585598.
38Libuda, L, Alexy, U, Buyken, AE, et al. (2009) Consumption of sugar-sweetened beverages and its association with nutrient intakes and diet quality in German children and adolescents. Br J Nutr 101, 15491557.
39Collison, KS, Zaidi, MZ, Subhani, SN, et al. (2010) Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children. BMC Public Health 10, 234.
40Demory-Luce, D, Morales, M, Nicklas, T, et al. (2004) Changes in food group consumption patterns from childhood to young adulthood: the Bogalusa Heart Study. J Am Diet Assoc 104, 16841691.
41Kleber, M, Schwarz, A & Reinehr, T (2011) Obesity in children and adolescents: relationship to growth, pubarche, menarche, and voice break. J Pediatr Endocrinol Metab 24, 125130.
42Coon, KA, Goldberg, J, Rogers, BL, et al. (2001) Relationships between use of television during meals and children's food consumption patterns. Pediatrics 107, E7.
43Robinson, S, Marriott, L, Poole, J, et al. (2007) Dietary patterns in infancy: the importance of maternal and family influences on feeding practice. Br J Nutr 98, 10291037.
44Fisk, CM, Crozier, SR, Inskip, HM, et al. (2011) Influences on the quality of young children's diets: the importance of maternal food choices. Br J Nutr 105, 287296.
45Beyerlein, A, Toschke, AM & von Kries, R (2010) Risk factors for childhood overweight: shift of the mean body mass index and shift of the upper percentiles: results from a cross-sectional study. Int J Obes (Lond) 34, 642648.
46Lazarou, C, Panagiotakos, DB & Matalas, AL (2003) Level of adherence to the Mediterranean diet among children from Cyprus: the CYKIDS study. Public Health Nutr 12, 9911000.
47Northstone, K & Emmett, PM (2008) Are dietary patterns stable throughout early and mid-childhood? A birth cohort study. Br J Nutr 100, 10691076.
48Kipnis, V, Subar, AF, Midthune, D, et al. (2003) Structure of dietary measurement error: results of the OPEN biomarker study. Am J Epidemiol 158, 1421, discussion 2–6.
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British Journal of Nutrition
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