Dietary patterns in toddlers

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Dietary patterns in toddlers

• The Generation R Study

Jessica Kiefte-de Jong, RD, MSc Department of
Paediatrics / The Generation R Study
group Erasmus Medical Centre, Rotterdam, The
Netherlands
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Content

• Objectives
• Methods
• Dietary pattern analysis
• Results
• Conclusion
• Future perspectives

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Objectives
Aim To identify dietary patterns in toddlers and
to assess socio-demographic and lifestyle
determinants of these dietary patterns
Identifying children at potential risk for
unhealthy eating behaviour in future.
Forming a basis for future studies on dietary
patterns and health outcomes within our cohort
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Methods Generation R

• Generation R Study, Rotterdam, The Netherlands.
• Population based prospective cohort study from
  fetal life onwards.
• N5088 mothers with a delivery data between April
  2002 and January 2006 provided consent for
  follow-up and received a food frequency
  questionnaire for their child at 14 months.
• (Mean SD 14 2 months).

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Methods Food groups
Refined grains
Whole grains
Pasta and rice
Dairy
Fruit
Soy substitutes
Vegetables
Potatoes
Soups and sauces
Savoury and snacks
Confectionary
Vegetable oils
Other fats (margarines, butter)
Fish
Shellfish
Meat
Eggs
Legumes
Sugar-containing beverages
Non-sugar containing beverages
Composite dishes
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Methods statistical analyses (1)

• Food groups were entered in PCA by grams/day
  consumed.
• Dietary patterns with an Eigenvalue of gt1.5 were
  extracted.
• Explaining 24.5 of the variation in food
  consumption.
• Varimax rotation to reduce correlation between
  patterns
• Individual adherence scores on the dietary
  patterns by using regression-based factor scores.
• Multivariate analyses on dietary pattern score
• Stepwise backward elimination procedure retaining
  only the strongest predictors.

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Methods statistical analyses (2)
Variables in model

• Mother factors
• Maternal educational background
• Household income
• Marital status
• Maternal alcohol consumption
• Maternal smoking
• Folic acid supplementation
• Maternal BMI
• Maternal age
• Parity
• Parental stress
• Any history of depression or anxiety
• Any diabetes, hypertension or hypercholesterolemia
  
• Maternal macronutrient intake

• Child factors
• Age of food assessment
• Gender
• Birth weight
• Breast-feeding
• Timing of solid introduction
• Daycare attendance
• Weight and Height
• Watching TV

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Methods Dietary patterns analysis (PCA)
Western-like dietary pattern
Health conscious dietary pattern
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Mean intake grams/day Health conscious dietary pattern Western-like dietary pattern
Refined bread and breakfast cereals 15 - 0.57
Whole bread and breakfast cereals 62 - -
Pasta and rice 23 0.62 -
Dairy 626 - -
Fruit 162 0.32 -
Soy substitutes 4 - -
Vegetables 52 0.74 -
Potatoes 34 0.61 -
Soups and sauces 9 - 0.23
Savoury and snacks 4 - 0.59
Confectionary 28 - 0.72
Vegetable oils 1 0.50 -
Animal fats 11 - 0.58
Fish 8 0.22 -
Shellfish 0.3 - -
Meat 26 0.21 0.27
Eggs 2 - -
Legumes 4 0.59 -
Sugar-containing beverages 198 - 0.59
Non-sugar containing beverages 56 - -
Composite dishes 102 - -
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Results Western-like dietary pattern
Maternal indicators of a Western-like dietary
pattern
Difference in western-like dietary pattern score
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Results Western-like dietary pattern
Difference in western-like dietary pattern score
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Results Health conscious dietary pattern
Mother and child indicators of a Health conscious
dietary pattern
Difference in Health conscious dietary pattern
score
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Conclusion

• A Western-like and Health conscious dietary
  pattern can already be identified in children
  aged 14 months.
• Adherence to a Western-like dietary pattern
  clusters with early-life risk factors for
  overweight in later life.
• Determinants of a Health conscious diet may be
  less straightforward and need further elucidation

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Future perspectives (1)

• Dietary variety in toddlers
• Tracking dietary patterns?
• Consequences for later health?

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Thank you for your attention!