ORCID Profile
0000-0001-9029-1718
Current Organisation
Deakin University - Melbourne Burwood Campus
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Publisher: American Academy of Pediatrics (AAP)
Date: 04-2013
Abstract: To assess the effectiveness of a parent-focused intervention on infants’ obesity-risk behaviors and BMI. This cluster randomized controlled trial recruited 542 parents and their infants (mean age 3.8 months at baseline) from 62 first-time parent groups. Parents were offered six 2-hour dietitian-delivered sessions over 15 months focusing on parental knowledge, skills, and social support around infant feeding, diet, physical activity, and television viewing. Control group parents received 6 newsletters on nonobesity-focused themes all parents received usual care from child health nurses. The primary outcomes of interest were child diet (3 × 24-hour diet recalls), child physical activity (accelerometry), and child TV viewing (parent report). Secondary outcomes included BMI z-scores (measured). Data were collected when children were 4, 9, and 20 months of age. Unadjusted analyses showed that, compared with controls, intervention group children consumed fewer grams of noncore drinks (mean difference = –4.45 95% confidence interval [CI]: –7.92 to –0.99 P = .01) and were less likely to consume any noncore drinks (odds ratio = 0.48 95% CI: 0.24 to 0.95 P = .034) midintervention (mean age 9 months). At intervention conclusion (mean age 19.8 months), intervention group children consumed fewer grams of sweet snacks (mean difference = –3.69 95% CI: –6.41 to –0.96 P = .008) and viewed fewer daily minutes of television (mean difference = –15.97: 95% CI: –25.97 to –5.96 P = .002). There was little statistical evidence of differences in fruit, vegetable, savory snack, or water consumption or in BMI z-scores or physical activity. This intervention resulted in reductions in sweet snack consumption and television viewing in 20-month-old children.
Publisher: Springer Science and Business Media LLC
Date: 23-01-2021
Publisher: Oxford University Press (OUP)
Date: 13-03-2016
Abstract: Intervention programs to prevent childhood obesity are more likely to be successful when mothers are involved and engaged. Yet programs that involve mothers do not often employ process evaluation to identify aspects of the intervention that participants enjoyed or viewed as useful. The aims of this study were to describe how participants of the Melbourne InFANT Program-an early childhood obesity prevention intervention-engaged in the program and perceived its usefulness. Process evaluation data were collected at multiple time points during and after the intervention, using mixed methods drawing upon both quantitative and qualitative data. Results from short surveys (n = 271) and interview transcripts (n = 26) revealed that the Melbourne InFANT Program was perceived as useful and relevant by most (82-93%) participants. The formats through which the knowledge and skills were delivered were considered concise and effective, and aspects considered particularly useful included group sessions and advice on practical strategies to minimize stress around mealtimes. Findings from this study are important to inform future practice and the development of interventions which are well received by participants.
Publisher: Springer Science and Business Media LLC
Date: 19-12-2021
DOI: 10.1186/S12966-021-01231-7
Abstract: Recommendations to define eating occasions (EO) currently exist for research in adults, but not for children or adolescents. We examined how varying EO definitions affect the characterization of eating patterns in children and adolescents. Cross-sectional dietary data collected using a 24-h recall data during the 2011–12 Australian National Nutrition and Physical Activity Survey (1364 boys and 1337 girls aged 2–18 years) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (EO separated by 15- or 60-min and/or an additional energy criterion of 21 or 210 kJ). Frequency of and total energy intake from meals, snacks, and all EO were estimated. F tests stratified by gender and age-group, were used to assess differences between definitions. Agreement between definitions of meal and snack frequencies was assessed using intraclass correlation coefficients (ICC). Linear regression was used to estimate the proportion of variance in total energy intake (kJ) and BMI z-score predicted by each definition. Mean frequencies of meals and snacks differed between the participant-identified and time-of-day definitions, in boys and girls and for all age groups ( P 0.01). Across the six neutral definitions, there were differences between mean frequencies of EO with the largest mean difference observed for children aged 2–3 y (boys: 2.3, girls: 2.5 P 0.003). Between the participant-identified and time-of-day definitions, there was good agreement for frequencies of snacks (ICC for both genders: 0.93) but not meals (boys: 0.36 girls: 0.38). The 15-min time interval plus 210 kJ definition of an EO consistently predicted the most variance in total energy intake (R 2 range = 8.1–34.8). Definitions that delineated meals and snacks better predicted variance in BMI z-score, when compared to the neutral definitions. How eating patterns are characterized vary depending on the EO definitions employed, particularly in young children. Variance in total energy intake was best predicted by a variation of the neutral definition whereas definitions that delineated meals and snacks performed better in relation to predicting BMI variance. Further international research that compares EO definitions in children will help inform a standard approach.
Publisher: Springer Science and Business Media LLC
Date: 04-11-2014
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.APPET.2013.07.006
Abstract: Evidence suggests that mothers' nutrition knowledge and home food availability (HFA) are directly and independently associated with children's food intakes. In this study we test the hypothesis that HFA mediates the association between maternal nutrition knowledge and child diet. In this cross-sectional study of Australian women living in socioeconomically disadvantaged neighbourhoods in Melbourne, Australia, mothers with dependent children (aged 5-12 years) provided data on their child's diet, HFA, nutrition knowledge and a range of sociodemographic characteristics. To test our hypothesis we assessed associations between nutrition knowledge and HFA, and between HFA and child food intake (adjusting for nutrition knowledge and child age). In all instances significant associations were found. HFA was found to mediate relationships between mother's nutrition knowledge and children's intake of fruit, vegetables, salty foods and soft drink. Our analyses showed that HFA was a mediator of the associations between maternal nutrition knowledge and child's diet in this population. This supports a focus on nutrition education that expands mothers' understanding of what foods to buy, prepare and serve. Further exploration of these associations will provide a stronger evidence base upon which to inform 'best bets' for parent-focussed nutrition promotion seeking to promote children's healthy eating.
Publisher: MDPI AG
Date: 23-06-2022
DOI: 10.3390/NU14132606
Abstract: Background: Mealtime television use has been cross-sectionally associated with suboptimal diets in children. This study aimed to assess the two-year prospective association between baseline mealtime television use and subsequent diets in young children, and identify socioeconomic differences. Methods: Parents reported their child’s television use at meals, and fruit, vegetable, and discretionary food intakes. Multivariable linear and logistic regression analyses assessed the association between baseline mealtime television use and follow-up diet outcomes. Differences were assessed by socioeconomic position. Results: Participants were 352 Australian parents of children aged six months to six years. Daily mealtime television use (average frequency/day) was associated with higher daily frequency of discretionary food intakes (β 0.2, 95% confidence interval (CI) 0.07–0.67) at the 2-year follow-up. In idually, television use during breakfast and dinner (1–2 days/week compared to never) predicted higher daily intake frequency of discretionary food, β 0.36 (95% CI 0.12–0.60) and β 0.19 (95% CI 0.00–0.39), respectively. Similarly, 3–7 days/week of television use during breakfast and lunch predicted higher frequency of discretionary food intake, β 0.18 (95% CI 0.02–0.37) and β 0.31 (95% CI 0.07–0.55), respectively. Associations were not socioeconomically patterned. Conclusions: Investigating mealtime television use motivators across the socioeconomic spectrum could inform interventions targeting the high consumption of discretionary foods in children.
Publisher: Elsevier BV
Date: 10-2013
Abstract: Initiatives to promote children's nutrition and prevent childhood obesity are vital. Dietary patterns are a useful way to characterize whole diets, though no previous early childhood health promotion trial to our knowledge has assessed intervention impact using this approach. This research aimed to assess the effect of a healthy eating and physical activity intervention on young children's dietary patterns. The Melbourne Infant Feeding Activity and Nutrition Trial Program was a health promotion, cluster-randomized controlled trial involving 542 families. Child diets were assessed by multiple 24-h recalls postintervention at ~18 mo of age. An Obesity Protective Dietary Index (OPDI) was created and dietary patterns were also assessed by principal components analysis (PCA). These outcomes were used to compare intervention and control participants to test the effectiveness of the intervention. Children in the intervention arm scored higher (15.6 ± 5.9) than those in the control arm (14.5 ± 6.7) for the OPDI (scores out of 30, P = 0.01). Three dietary patterns were identified by PCA however, the scores did not substantially differ between the intervention and control arms. In conclusion, this paper presents novel results in both the evaluation of an early childhood health promotion intervention and the assessment of child dietary patterns. The results highlight the capacity for such an initiative to improve child diets and the need for further research in this area.
Publisher: Cambridge University Press (CUP)
Date: 23-07-2021
DOI: 10.1017/S1368980021003062
Abstract: To examine associations between parenting style and changes in dietary quality score across childhood. This longitudinal analysis included the child’s frequency of consumption for twelve food and drink items reported by mothers of children (aged 4–8 years) and children (aged 10–14 years) during face-to-face interviews biennially. These items were combined into dietary scores based on the Australian Dietary Guidelines. Parenting styles were classified at baseline as authoritative, authoritarian, permissive and disengaged. Multilevel modelling was used to examine changes in diet quality score over time by maternal parenting styles. The Longitudinal Study of Australian Children. A total of 4282 children aged 4 to 14 years. Children’s diet quality score declined over time between 4 and 14 years of age ( β = –0·10, 95 % CI (–0·11, –0·08)). There was strong evidence to suggest that change in diet quality differed dependent on baseline maternal parenting style, although diet quality declined for all groups. Children with authoritative mothers had the greatest decline in diet quality score over time ( β = –0·13 95 % CI (–0·18, –0·08)), while children with disengaged mothers had the lowest decline ( β = –0·03 95 % CI (–0·07, 0·01)). However, it is important to note that children with authoritative mothers had a better dietary quality score than children of permissive or disengaged mothers for most of their childhood. These findings question the previous assumptions that early exposure to an authoritative parenting style has lasting positive effects on the dietary intake of children.
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.EATBEH.2021.101569
Abstract: Parents' feeding practices are associated with children's food intake. Little is known about how children's eating behaviours (fussiness, enjoyment of food, food responsiveness, satiety responsiveness) moderate these associations. This study examines the relationships between feeding practices and pre-school children's dietary quality and whether children's eating behaviours moderate these relationships. In 2018, 1349 Australian mothers of children aged 2-5 years completed an online survey including validated measures of feeding practices (n = 9), child eating behaviours (n = 4) and dietary quality. Thirteen items from a food frequency questionnaire were summed as a measure of dietary quality. Linear regression assessed associations between feeding practices and dietary quality, including interactions between feeding practices and child eating behaviours. The feeding practices positively associated with dietary quality were structured meal timing, monitoring, covert restriction, modelling healthy eating and structured meal setting (B coefficients: 0.63 to 2.70). The feeding practices inversely associated with dietary quality were overt restriction, persuasive feeding, reward for eating and reward for behaviour (B coefficients: -0.88 to -1.85). Child eating behaviours moderated associations between three feeding practices and dietary quality. This exploratory study showed that some associations between feeding practices and child dietary quality were moderated by children's eating behaviours. The potential for tailoring nutrition promotion strategies for parents of children with differing eating behaviours should be further investigated.
Publisher: Springer Science and Business Media LLC
Date: 2012
Publisher: Springer Science and Business Media LLC
Date: 24-01-2017
Publisher: Cambridge University Press (CUP)
Date: 11-2012
DOI: 10.1017/S0007114511005757
Abstract: The objectives of the present study were to identify dietary patterns independently in first-time mothers and fathers, and to examine whether these patterns were correlated within families. Dietary intakes were collected at baseline in the Melbourne Infant Feeding Activity and Nutrition Trial Program using a validated FFQ in 454 pairs of first-time mothers and fathers. Education level was reported in associated questionnaires. Principal components analyses included frequencies of fifty-five food groups and were performed independently in mothers and fathers. Spearman's correlation coefficients were used to assess associations between dietary pattern scores. A total of four dietary patterns were identified in mothers and fathers. Of these, three dietary patterns had similar characteristics between these two populations, namely ‘Fruits and vegetables’, ‘High-energy snack and processed foods’, ‘High-fat foods’ in mothers and ‘Fruits’, ‘High-energy snack and processed foods’, ‘High-fat foods’ in fathers. The following two additional patterns were identified: ‘Cereals and sweet foods’ in mothers and ‘Potatoes and vegetables’ in fathers. Patterns incorporating healthier food items were found to be positively associated with parent education. An inverse association with education was found for the ‘High-fat foods’ and ‘High-energy snack and processed foods’ dietary patterns. Qualitatively similar patterns between corresponding mothers and fathers were the most strongly correlated (ρ = 0·34–0·45, P 0·001). There were some differences in dietary patterns between mothers and fathers, suggesting that it is worth deriving patterns separately when considering couples, and more generally between men and women. Exploring how these various patterns correlate within households provides important insights to guide the development and implementation of family-based interventions.
Publisher: JMIR Publications Inc.
Date: 18-07-2022
DOI: 10.2196/35553
Abstract: Early childhood is a critical period for supporting the development of healthy eating habits, which may affect lifelong health. Childcare services are important settings for promoting early childhood nutrition however, food provision in childcare frequently does not align with dietary guidelines. Web-based menu planning tools are well suited to support healthy food provision in childcare, although little is known about their use. Research is needed to understand how web-based menu planning tools are used in the childcare setting and how they can effectively support healthy menu planning and food provision for children in childcare. We aimed to explore the use of a web-based menu planning tool called FoodChecker, which is available to childcare services in Victoria, Australia. We also aimed to gain insights and perspectives from childcare staff involved in menu planning about their use of the tool to plan healthy menus and guide healthy food provision for children. We conducted a qualitative descriptive study using a cross-sectional web-based survey completed by the staff involved in menu planning in childcare services. Thematic analysis was performed using NVivo software. Emergent themes were mapped against constructs of the Technology Acceptance Model regarding perceived usefulness, perceived ease of use, and external variables influencing perceptions and use. The participants included 30 cooks and 34 directors from 53 childcare services. Participants perceived the web-based menu planning tool as useful for supporting child nutrition and health, improving organizational processes, and aiding the menu planner role. Perceptions regarding ease of use were mixed. External variables influencing perceptions and use included awareness of the tool, perceived need, time, resources, organizational support, and the food budget. Participants made recommendations to improve the tool, particularly the need to integrate functionality to make it easier and faster to use or to include more links to resources to support healthy menu planning. The web-based menu planning tool was perceived as useful for cooks and directors in childcare services. Areas for improvement were identified for ex le, the need for integrated digital features to make the tool easier and faster to use. As the first qualitative study to explore childcare staff experiences with a web-based menu planning tool, these findings inform future research and development of such tools to aid scalable and sustainable support for healthier food provision in the childcare sector.
Publisher: Springer Science and Business Media LLC
Date: 02-2019
DOI: 10.1007/S00394-019-01897-7
Abstract: To estimate the prevalence of inadequate iron intakes and identify socio-demographic factors associated with iron intakes of Australian children aged 2-5 years. Data from the 2011-2012 National Nutrition and Physical Activity Survey component of the Australian Health Survey were analysed (n = 783, 2-5 years old). Dietary intake was assessed via two non-consecutive 24-h recalls. Prevalence of inadequate iron intake was estimated using the full probability approach after estimating the distribution of usual intakes with PC-SIDE. Associations between potential socio-demographic factors and energy-adjusted iron intakes were assessed via linear regression accounting for the complex survey design. Mean (SD) iron intakes for pre-schoolers were 7.9 (1.9) mg/day and the prevalence of inadequate iron intake was 10.1% (95% CI 7.9%, 12.1%). Male sex (mean difference between boys and girls: - 0.22 (95% CI - 0.03, - 0.41) mg/day p = 0.022) and age (each additional year was associated with 0.11 (95% CI - 0.22, - 0.00) mg/day lower iron intake p = 0.048) were negatively associated with pre-schooler iron intakes. This study provides current data relating to the iron nutrition of Australian pre-schoolers. Poor iron intakes continue to be a problem for 10% of Australian children beyond the second year of life, with iron intakes being lower for boys compared to girls and declining with age. Future research should examine strategies to improve iron intakes of young children, with a focus on promoting iron-rich food sources.
Publisher: MDPI AG
Date: 17-09-2020
Abstract: Early childhood is a critical stage for nutrition promotion, and childcare settings have the potential for wide-reaching impact on food intake. There are currently no Australian national guidelines for childcare food provision, and the comparability of existing guidelines across jurisdictions is unknown. This project aimed to map and compare childcare food provision guidelines and to explore perspectives amongst early childhood nutrition experts for alignment of jurisdictional childcare food provision guidelines with the Australian Dietary Guidelines (ADG). A desktop review was conducted and formed the basis of an online survey. A national convenience s le of childhood nutrition experts was surveyed. Existing guideline recommendations for food group serving quantities were similar across jurisdictions but contained many minor differences. Of the 49 survey respondents, most (84–100%) agreed with aligning food group provision recommendations to provide at least 50% of the recommended ADG serves for children. Most (94%) agreed that discretionary foods should be offered less than once per month or never. Jurisdictional childcare food provision guidelines do not currently align, raising challenges for national accreditation and the provision of support and resources for services across jurisdictions. Childhood nutrition experts support national alignment of food provision guidelines with the ADG.
Publisher: Springer Science and Business Media LLC
Date: 26-06-2015
DOI: 10.1007/S13679-015-0168-5
Abstract: A range of important early-life predictors of later obesity have been identified. Children of lower socioeconomic position (SEP) have a steeper weight gain trajectory from birth with a strong socioeconomic gradient in child and adult obesity prevalence. An assessment of the association between SEP and the early-life predictors of obesity has been lacking. The review involved a two-stage process: Part 1, using previously published systematic reviews, we developed a list of the potentially modifiable determinants of obesity observable in the pre-natal, peri-natal or post-natal (pre-school) periods and part 2, conducting a literature review of evidence for socioeconomic patterning in the determinants identified in part 1. Strong evidence was found for an inverse relationship between SEP and (1) pre-natal risk factors (pre-pregnancy maternal body mass index (BMI), diabetes and pre-pregnancy diet), (2) antenatal eri natal risk factors (smoking during pregnancy and low birth weight) and (3) early-life nutrition (including breastfeeding initiation and duration, early introduction of solids, maternal and infant diet quality, and some aspects of the home food environment), and television viewing in young children. Less strong evidence (because of a lack of studies for some factors) was found for paternal BMI, maternal weight gain during pregnancy, child sleep duration, high birth weight and lack of physical activity in young children. A strong socioeconomic gradient exists for the majority of the early-life predictors of obesity suggesting that the die is cast very early in life (even pre-conception). Lifestyle interventions targeting disadvantaged women at or before child-bearing age may therefore be particularly important in reducing inequality. Given the likely challenges of reaching this target population, it may be that during pregnancy and their child's early years are more feasible windows for engagement.
Publisher: MDPI AG
Date: 19-03-2018
DOI: 10.3390/NU10030374
Abstract: Background: The prevalence of obesity among Australian pre-school children is a major concern with links to poor health outcomes. One contributing factor is excess energy intake. Sugar-sweetened beverages are energy-dense, nutrient-poor, readily available and have been implicated in the increasing prevalence of obesity. Furthermore, preschooler beverage consumption may develop into dietary habits that track into adulthood. There is little research on factors influencing parents’ decision-making when serving beverages to their preschoolers, or on mothers’ perceptions of preschooler’s beverages. The aim of this study was to explore mothers’ perceptions of commonly consumed preschooler beverages. Methods: The Repertory Grid Technique and the Laddering Technique methodologies were utilized in interviews with 28 mothers from Melbourne, Australia, to explore beverage perceptions. Results: A large number of erse perceptual categories (‘constructs’) (n = 22) about beverages were elicited, demonstrating the complexity of mothers’ perceptions when making beverage choices for their preschoolers. The five most common categories were related to health, sugar, dairy, packaging, and additives. Thematic analysis of responses from the laddering method identified three major themes: concerns about the types of beverages mothers would like to provide their preschoolers, the healthiness of a beverage, and the sugar content. Conclusions: Mothers’ perceptions of beverages are sophisticated and need to be included in the design of health communication strategies by health promoters and government agencies to influence mothers’ beverage selections for their preschoolers.
Publisher: Springer Science and Business Media LLC
Date: 16-01-2013
Publisher: Cambridge University Press (CUP)
Date: 21-10-2023
DOI: 10.1017/S0007114522003324
Abstract: Dietary behaviours in early childhood are understudied despite links with later health. Assessing the distribution of key food groups across the day could identify opportunities for improvements. This study aimed to describe the 24-hourly distribution of dietary intakes and frequency of eating occasions for weekdays and weekend days among children aged 18 months and assess associations of eating frequency with vegetable, fruit and discretionary intakes and zBMI. Using two parent-reported 24-h recalls of child dietary intakes from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program, mean frequency of daily eating occasions and hourly intake distributions were calculated for vegetables, fruits, discretionary foods, and total foods and energy-containing beverages on weekdays ( n 428) and weekend days ( n 376). Multivariable regression analyses assessed associations between frequency of eating occasions, total intake of food groups and zBMI. Overall, children had 7·8 ± 1·8 (mean ± sd ) eating occasions/d on weekdays, where 1·5 ± 0·8 contained vegetables, 2·2 ± 1·1 contained fruit and 2·5 ± 1·5 contained discretionary foods. Weekend day intakes were similar. Energy intakes were highest at dinner time. Intakes of total foods, fruits and discretionary foods were spread across the day (06.00–22.00). Vegetable consumption was mainly about 18.00 with minimal intake at other times. Eating frequency was associated with amount of food consumed but not consistently with zBMI. These 18-month-old children ate frequently throughout the day, with little distinction between weekdays and weekend days. Most eating occasions lacked vegetables, and frequency of discretionary foods was higher than of vegetables. Promoting vegetable consumption at occasions other than dinner could improve vegetable intake.
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.APPET.2021.105754
Abstract: Parents' feeding practices are associated with children's food intake. However, little is known about the patterns of feeding practices used by groups of mothers or how these groupings of practices influence children's dietary intake. Therefore, the aims of this study are to classify and describe groups of mothers according to their patterns of feeding practices and to examine the associations between the groups of maternal feeding practices and pre-school children's dietary quality. In 2018, 1349 mothers based in Australia of children aged 2-5 years completed an online survey including validated measures of nine feeding practices and dietary quality, measured using thirteen summed dietary items. Latent profile analysis was used to identify distinct groups of mothers who shared similar feeding practices. Linear regression models were fitted to examine associations between the feeding practice profiles and child dietary quality. A three-profile model was chosen based on interpretation, profile size and statistical model fit criteria. Profile 1 had lower mean scores of structure-related feeding practices than the other profiles profile 2 had mean scores reflecting slightly higher use of most structure-related feeding practices and lower mean scores of some non-responsive feeding practices profile 3 had higher mean scores of non-responsive feeding practices than the other profiles. Profile 1 (-2.95, CI: 3.97 -1.92) and profile 3 (-2.81, CI: 3.49 -2.13) had lower mean child dietary quality scores compared with profile 2. Profile 2, which reflected the most engagement in structure-related feeding practices combined with least non-responsive feeding practices, was associated with higher child diet quality, compared with the other two profiles. The identification of these unique profiles could help to tailor future interventions to consider patterns of feeding practices used by groups of mothers.
Publisher: Hindawi Limited
Date: 11-2022
DOI: 10.1111/HSC.14106
Abstract: Fostering the growth, development, health, and wellbeing of children is a global priority. The early childhood period presents a critical window to influence lifelong trajectories, however urgent multisectoral action is needed to ensure that families are adequately supported to nurture their children's growth and development. With a shared vision to give every child the best start in life, thus helping them reach their full developmental potential, we have formed the International Healthy Eating Active Living Matters (HEALing Matters) Alliance. Together, we form a global network of academics and practitioners working across child health and development, and who are dedicated to improving health equity for children and their families. Our goal is to ensure that all families are free from structural inequality and oppression and are empowered to nurture their children's growth and development through healthy eating and physical activity within the context of responsive emotional support, safety and security, and opportunities for early learning. To date, there have been disparate approaches to promoting these objectives across the health, community service, and education sectors. The crucial importance of our collective work is to bring these priorities for early childhood together through multisectoral interventions, and in so doing tackle head on siloed approaches. In this Policy paper, we draw upon extensive research and call for collective action to promote equity and foster positive developmental trajectories for all children. We call for the delivery of evidence-based programs, policies, and services that are co-designed to meet the needs of all children and families and address structural and systemic inequalities. Moving beyond the "what" is needed to foster the best start to life for all children, we provide recommendations of "how" we can do this. Such collective impact will facilitate intergenerational progression that builds human capital in future generations.
Publisher: Cambridge University Press (CUP)
Date: 06-2022
DOI: 10.1017/S1368980022001343
Abstract: To explore government support service access, perceived barriers/enablers to menu planning and menu compliance in long day care (LDC) centres in Victoria, Australia, where the Victorian Government-funded Healthy Eating Advisory Service (HEAS) is available to provide free LDC menu planning support. This is a cross-sectional study design. Data were collected from online surveys with the option of uploading 2 weeks of menus and recipes. Menu compliance was scored for quantity, quality and variety. Barriers/enablers to menu planning guideline implementation were determined using the Theoretical Domains Framework (TDF). Independent t tests, one-way ANOVA and chi-square tests assessed relationships between characteristics, barriers/enablers and menu scores. Eighty-nine LDC centres that prepare food onsite. LDC staff responsible for menu planning ( n 89) and menus from eighteen centres. Fifty-five per cent of centres had accessed HEAS. Of eighteen provided menus, only one menu was compliant with menu planning guidelines. HEAS access was associated with higher average scores in four of seven TDF domains, namely knowledge/awareness, skills/role, reinforcement/influence and optimism/intent. There were no correlations between menu score and barriers/enablers however, menu quality scores were higher for those accessing HEAS. Childcare-specific government support services may be an important public health nutrition strategy and may improve menu planning guideline implementation as well as menu quality however, this does not necessarily translate into menu compliance. Research should confirm these findings in larger studies to ascertain uptake of these services. Public health efforts should focus on exploring barriers and enablers to uptake of government support services to increase reach and acceptability.
Publisher: JMIR Publications Inc.
Date: 13-02-2022
Abstract: arly childhood is a critical period for supporting the development of healthy eating habits, which may affect lifelong health. Childcare services are important settings for promoting early childhood nutrition however, food provision in childcare frequently does not align with dietary guidelines. Web-based menu planning tools are well suited to support healthy food provision in childcare, although little is known about their use. Research is needed to understand how web-based menu planning tools are used in the childcare setting and how they can effectively support healthy menu planning and food provision for children in childcare. e aimed to explore the use of a web-based menu planning tool called i FoodChecker /i , which is available to childcare services in Victoria, Australia. We also aimed to gain insights and perspectives from childcare staff involved in menu planning about their use of the tool to plan healthy menus and guide healthy food provision for children. e conducted a qualitative descriptive study using a cross-sectional web-based survey completed by the staff involved in menu planning in childcare services. Thematic analysis was performed using NVivo software. Emergent themes were mapped against constructs of the Technology Acceptance Model regarding perceived usefulness, perceived ease of use, and external variables influencing perceptions and use. he participants included 30 cooks and 34 directors from 53 childcare services. Participants perceived the web-based menu planning tool as useful for supporting child nutrition and health, improving organizational processes, and aiding the menu planner role. Perceptions regarding ease of use were mixed. External variables influencing perceptions and use included awareness of the tool, perceived need, time, resources, organizational support, and the food budget. Participants made recommendations to improve the tool, particularly the need to integrate functionality to make it easier and faster to use or to include more links to resources to support healthy menu planning. he web-based menu planning tool was perceived as useful for cooks and directors in childcare services. Areas for improvement were identified for ex le, the need for integrated digital features to make the tool easier and faster to use. As the first qualitative study to explore childcare staff experiences with a web-based menu planning tool, these findings inform future research and development of such tools to aid scalable and sustainable support for healthier food provision in the childcare sector.
Publisher: MDPI AG
Date: 02-06-2023
DOI: 10.3390/NU15112616
Abstract: Pre-schoolers are vulnerable to iron deficiency, which, in high-resource countries, is mainly caused by suboptimal or poorly absorbable iron intakes. This review examines the prevalence of inadequate iron intakes and status, and the non-dietary factors associated with these, among children aged between 2 and 5 years within high-income countries. It then considers the quality of the pre-schooler diet in terms of dietary factors, dietary patterns, and iron intakes. Additionally, it discusses the assessment of iron bioavailability and examines the various methods used to estimate the amount of absorbable iron in pre-schooler diets. Knowledge of the adequacy of iron intakes and bioavailability of iron intakes, and dietary patterns associated with iron intakes can facilitate the design and implementation of effectively targeted community-based intervention studies to improve iron intakes and iron bioavailability to minimise the risk of iron deficiency.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.APPET.2019.04.009
Abstract: Suboptimal vegetable and fruit consumption by young children is common. Identifying predictors of vegetable and fruit intakes is important for informing strategies to promote sufficient intakes of these foods from early life. The aim of the present study was to examine predictors of toddlers' vegetable and fruit intakes at age 18 months. This study involved secondary analysis of data from 361 child-mother dyads participating in the Melbourne Infant Feeding, Activity and Nutrition Trial in 2008-2010 at child ages four, nine and 18 months. Children's vegetable and fruit intakes were assessed at age 18 months using multiple 24-h dietary recalls. Data on potential predictor measures were collected via parent-completed questionnaires when children were four or nine months of age. Bivariate and multivariable linear regression models were used to test associations between children's average daily vegetable or fruit intake and potential predictors controlling for treatment arm and clustering by parent group. Multivariable models also controlled for covariates and potential confounders. Home availability of vegetables at age nine months was found to predict children's vegetable intake at age 18 months and remained significant (β = 20.19, 95% CI:7.23, 33.15, p = 0.003) in the multivariable model. Children's average daily fruit intake at age 18 months was predicted by maternal education at child age four months and the availability of fruits in their home at child age nine months. Maternal education remained significant (β = 30.83, 95% CI:12.17, 49.48, p = 0.002) in the multivariable model. Strategies to promote adequate vegetable and fruit intakes among young children should address known barriers to the availability of vegetables and fruits in the home from early in life. Additionally, messages encouraging fruit consumption may need to be tailored to mothers with lower levels of education.
Publisher: Wiley
Date: 08-04-2015
DOI: 10.1111/MCN.12031
Publisher: Wiley
Date: 26-08-0077
DOI: 10.1111/JHN.12399
Abstract: Short food questions are appealing to measure dietary intakes. A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. Most questions assessed foods or food groups (n = 29), with the most commonly assessed being fruit (n = 22) or vegetable intake (n = 23), dairy foods and discretionary foods (n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency (n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.JAND.2017.12.009
Abstract: Dietary intakes of young children are likely to be important determinants of their short- and long-term health, yet there are few longitudinal dietary studies of this age group, and no previous assessments of diets before age 2 years compared with national dietary guidelines. This study aimed to compare vegetable, fruit, and discretionary food intakes of children aged 9 months to 5 years to dietary guidelines, and to assess differences in intakes by socioeconomic status and tracking of intakes across early childhood. This study analyzed longitudinal data from the Melbourne Infant Feeding Activity and Nutrition Trial Program early childhood lifestyle intervention trial, and is the first study to compare diets of children younger than age 2 years to national dietary guidelines. Participants were 467 children in Melbourne, Australia, aged 4 months at baseline (study conducted 2008-2015). Multiple 24-hour recalls with parents were conducted at child ages 9 months, 1.5 years, 3.5 years, and 5 years. Intakes of vegetables, fruits, and discretionary foods were compared with Australian Dietary Guidelines. Differences by socioeconomic status and tracking of intakes of each food group were assessed by multivariable linear regression. Few children (<10%) met guidelines for discretionary food intakes at any age. Most children (≥90%) met vegetable and fruit guidelines at 9 months, but thereafter rates of adequate intakes reduced substantially. Children of higher socioeconomic status consumed diets closer to guidelines for most food groups at most ages. Tracking of intakes was apparent across ages, with the strongest and most consistent tracking for discretionary foods. This study shows that diets of Australian children participating in this lifestyle intervention trial were suboptimal from early life. The evidence of differences by socioeconomic status and tracking from age 9 months, particularly for discretionary foods, highlights the importance of research and action to support appropriate introduction of complementary foods during the first year of life, and of focusing these efforts on disadvantaged groups.
Publisher: MDPI AG
Date: 08-11-2016
Publisher: Wiley
Date: 26-04-2021
DOI: 10.1002/OBY.23136
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.APPET.2016.06.031
Abstract: Children's diets are important determinants of their health, but typically do not meet recommendations. Parents' feeding practices, such as pressure or restriction, are important influences on child diets, but reasons why parents use particular feeding practices, and malleability of such practices, are not well understood. This qualitative study aimed to explore mothers' perceptions of influences on their feeding practices, and assess whether an intervention promoting recommended feeding practices was perceived as influential. The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program was a cluster-randomised controlled trial involving 542 families aiming to improve child diets. Following the trial, when children were two years old, 81 intervention arm mothers were invited to participate in qualitative interviews, and 26 accepted (32%). Thematic analysis of interview transcripts used a tabular thematic framework. Eight major themes were identified regarding perceived influences on child feeding practices. Broadly these encompassed: practical considerations, family setting, formal information sources, parents' own upbringing, learning from friends and family, learning from child and experiences, and parents' beliefs about food and feeding. Additionally, the Melbourne InFANT Program was perceived by most respondents as influential. In particular, many mothers reported being previously unaware of some recommended feeding practices, and that learning and adopting those practices made child feeding easier. These findings suggest that a variety of influences impact mothers' child feeding practices. Health practitioners should consider these factors in providing feeding advice to parents, and researchers should consider these factors in planning interventions.
No related grants have been discovered for Alison Spence.