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Little is known about Se intakes and status in very young New Zealand children. However, Se intakes below recommendations and lower Se status compared with international studies have been reported in New Zealand (particularly South Island) adults. The Baby-Led Introduction to SolidS (BLISS) randomised controlled trial compared a modified version of baby-led weaning (infants feed themselves rather than being spoon-fed), with traditional spoon-feeding (Control). Weighed 3-d diet records were collected and plasma Se concentration measured using inductively coupled plasma mass spectrometry (ICP-MS). In total, 101 (BLISS n 50, Control n 51) 12-month-old toddlers provided complete data. The OR of Se intakes below the estimated average requirement (EAR) was no different between BLISS and Control (OR: 0·89; 95 % CI 0·39, 2·03), and there was no difference in mean plasma Se concentration between groups (0·04 μmol/l; 95 % CI −0·03, 0·11). In an adjusted model, consuming breast milk was associated with lower plasma Se concentrations (–0·12 μmol/l; 95 % CI −0·19, −0·04). Of the food groups other than infant milk (breast milk or infant formula), 'breads and cereals' contributed the most to Se intakes (12 % of intake). In conclusion, Se intakes and plasma Se concentrations of 12-month-old New Zealand toddlers were no different between those who had followed a baby-led approach to complementary feeding and those who followed traditional spoon-feeding. However, more than half of toddlers had Se intakes below the EAR. [ABSTRACT FROM AUTHOR]

The Eating Assessment in Toddlers FFQ (EAT FFQ) has been shown to have good reliability and comparative validity for ranking nutrient intakes in young children. With the addition of food items (n 4), we aimed to re-assess the validity of the EAT FFQ and estimate calibration factors in a sub-sample of children (n 97) participating in the Growing Up Milk – Lite (GUMLi) randomised control trial (2015–2017). Participants completed the ninety-nine-item GUMLi EAT FFQ and record-assisted 24-h recalls (24HR) on two occasions. Energy and nutrient intakes were assessed at months 9 and 12 post-randomisation and calibration factors calculated to determine predicted estimates from the GUMLi EAT FFQ. Validity was assessed using Pearson correlation coefficients, weighted kappa (κ) and exact quartile categorisation. Calibration was calculated using linear regression models on 24HR, adjusted for sex and treatment group. Nutrient intakes were significantly correlated between the GUMLi EAT FFQ and 24HR at both time points. Energy-adjusted, de-attenuated Pearson correlations ranged from 0·3 (fibre) to 0·8 (Fe) at 9 months and from 0·3 (Ca) to 0·7 (Fe) at 12 months. Weighted κ for the quartiles ranged from 0·2 (Zn) to 0·6 (Fe) at 9 months and from 0·1 (total fat) to 0·5 (Fe) at 12 months. Exact agreement ranged from 30 to 74 %. Calibration factors predicted up to 56 % of the variation in the 24HR at 9 months and 44 % at 12 months. The GUMLi EAT FFQ remained a useful tool for ranking nutrient intakes with similar estimated validity compared with other FFQ used in children under 2 years. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the effectiveness of consuming iodine-fortified toddler milk for improving dietary iodine intakes and biochemical iodine status in toddlers. Methods: In a 20-week parallel randomised controlled trial, healthy 12–20-month-old children were assigned to: Fortified Milk [n = 45; iodine-fortified (21.1 µg iodine/100 g prepared drink) cow's milk], or Non-Fortified Milk (n = 90; non-fortified cow's milk). Food and nutrient intakes were assessed with 3-day weighed food records at baseline, and weeks 4 and 20. Urinary iodine concentration (UIC) was measured at baseline and 20 weeks. Results: At baseline, toddlers' median milk intake was 429 g/day. There was no evidence that milk intakes changed within or between the groups during the intervention. Toddlers' baseline geometric mean iodine intake was 46.9 µg/day, and the median UIC of 43 µg/L in the Fortified Milk group and 55 µg/L in the Non-Fortified Milk group indicated moderate and mild iodine deficiency, respectively, with this difference due to chance. During the intervention, iodine intakes increased by 136% (p < 0.001) and UIC increased by 85 µg/L (p < 0.001) in the Fortified Milk group compared to the Non-Fortified Milk group. The 20-week median UIC was 91 µg/L in the Fortified Milk group and 49 µg/L in the Non-Fortified Milk group. Conclusions: Consumption of ≈ 1.7 cups of iodine-fortified toddler milk per day for 20 weeks can increase dietary iodine intakes and UIC in healthy iodine-deficient toddlers. This strategy alone is unlikely to provide sufficient intake to ensure adequate iodine status in toddlers at risk of mild-to-moderate iodine deficiency. [ABSTRACT FROM AUTHOR]

Background Gut microbiota data obtained by DNA sequencing are complex and compositional because of large numbers of detectable taxa, and because microbiota characteristics are described in relative terms. Nutrition researchers use principal component analysis (PCA) to derive dietary patterns from food data. Although compositional PCA methods are not commonly used to describe patterns from complex microbiota data, this approach would be useful for identifying gut microbiota patterns associated with diet and body composition. Objectives To use compositional PCA to describe the principal components (PCs) of gut microbiota in 5-y-old children and explore associations between microbiota components, diet, and BMI z -score. Methods A fecal sample was provided by 319 children aged 5 y. Their primary caregiver completed a validated 123-item quantitative FFQ. Body composition was determined using DXA, and a BMI z -score was calculated. Compositional PCA identified characterizing taxa and weightings for calculation of gut microbiota PC scores at the genus level, and was examined in relation to diet and body size. Results Three gut microbiota PCs were found. PC1 (negative loadings on uncultured Christensenellaceae and Ruminococcaceae) was related to lower BMI z -scores and longer duration of breastfeeding (per month) (β = −0.14; 95% CI: −0.26, −0.02; and β = 0.02; 95% CI: 0.003, 0.34, respectively). PC2 (positive loadings on Fusicatenibacter and Bifidobacterium ; negative loadings on Bacteroides) was associated with a lower intake of nuts, seeds, and legumes (β = −0.05 per gram; 95% CI: −0.09, −0.01). When adjusted for fiber intake, PC2 was also associated with higher BMI z -scores (β = 0.12; 95% CI: 0.01, 0.24). PC3 (positive loadings on Faecalibacterium, Eubacterium , and Roseburia) was associated with higher intakes of fiber (β = 0.02 per gram; 95% CI: 0.003, 0.04) and total nonstarch polysaccharides (β = 0.02 per gram; 95% CI: 0.003, 0.04). Conclusions Our results suggest that specific gut microbiota components determined using compositional PCA are associated with diet and BMI z -score. This trial was registered at clinicaltrials.gov as NCT00892983. [ABSTRACT FROM AUTHOR]

Objectives: Despite the American Academy of Pediatrics (AAP) recommending that electronic media be avoided in children under two years of age, screen use is common in infants and toddlers. The aims of this study were to determine how parenting style, infant temperament, and family type are associated with television viewing in two-year-old children. Study design: Participants were from the Prevention of Overweight in Infancy (POI) randomized controlled trial (n = 802) (Dunedin, New Zealand). Demographic information was collected at baseline (late pregnancy), and television and other screen time assessed by questionnaire at 24 months of age. Parenting style (Parenting Practices Questionnaire), infant temperament (Colorado Childhood Temperament Inventory), and family type (7 categories) were reported by both parents. Results: Data were available for 487 participants (61% of the original participants). Median television viewing was relatively low at 21 minutes per day, or 30 minutes in those watching television (82%). Children who watched television played with mobile phones (12% of children) or iPads/tablets (22% of children) more frequently than children who did not (6% of children). In terms of parenting style, children of more authoritarian mothers (β = 17, 95% CI: 6–27 minutes), more authoritarian partners (β = 14, 95% CI: 2–26 minutes), or more permissive mothers (β = 10, 95% CI: 3–17 minutes) watched significantly more television. No significant relationships were observed between child temperament and time watching television after adjustment for confounding variables. Children from “active” families (as rated by partners) watched 29 minutes less television each day (P = 0.002). Conclusions: Parenting style and family type were associated with television viewing time in young children, whereas child temperament was not. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the impact of a baby-led approach to complementary feeding on infant choking and gagging. METHODS: Randomized controlled trial in 206 healthy infants allocated to control (usual care) or Baby-Led Introduction to SolidS (BLISS; 8 contacts from antenatal to 9 months providing resources and support). BLISS is a form of baby-led weaning (ie, infants feed themselves all their food from the beginning of complementary feeding) modified to address concerns about choking risk. Frequencies of choking and gagging were collected by questionnaire (at 6, 7, 8, 9, 12 months) and daily calendar (at 6 and 8 months); 3-day weighed diet records measured exposure to foods posing a choking risk (at 7 and 12 months). RESULTS: A total of 35% of infants choked at least once between 6 and 8 months of age, and there were no significant group differences in the number of choking events at any time (all Ps > .20). BLISS infants gagged more frequently at 6 months (relative risk [RR] 1.56; 95% confidence interval [CI], 1.13-2.17), but less frequently at 8 months (RR 0.60; 95% CI, 0.42-0.87), than control infants. At 7 and 12 months, 52% and 94% of infants were offered food posing a choking risk during the 3-day record, with no significant differences between groups (7 months: RR 1.12; 95% CI, 0.79-1.59; 12 months: RR 0.94; 95% CI, 0.83-1.07). CONCLUSIONS: Infants following a baby-led approach to feeding that includes advice on minimizing choking risk do not appear more likely to choke than infants following more traditional feeding practices. However, the large number of children in both groups offered foods that pose a choking risk is concerning. [ABSTRACT FROM AUTHOR]

The present study aimed to estimate small, median and large daily quantities of frequently consumed foods and identify which food groups are important sources of key micronutrients for 12- to 24-month-old New Zealand children. A community-based cross-sectional survey was conducted in three cities in the South Island of New Zealand. Healthy toddlers (n = 188) were randomly selected using multistage sampling. Three non-consecutive 1-day weighed food records were collected from each child and the frequencies and daily quantities of foods and beverages, and important sources of iron and zinc, were determined. Fifty percent or more of the children consumed the following foods at least once over 3 days (median gram intake among toddlers who consumed the food): milk (366 g), white bread (29 g), banana (70 g), potato (34 g), cheese (12 g), apple (39 g), 'Weetbix' whole-wheat breakfast cereal (16 g), yeast extract spread ('Marmite', 'Vegemite') (2 g), carrot (17 g) and margarine (4 g). Dairy, cereals and the meat/fish/poultry/eggs/nuts food group were the most important sources of iron and zinc in the toddlers' diets, providing 69.1% of iron and 86.3% of zinc. This research provides dietitians, other health professionals, researchers and policy-makers with detailed information on daily quantities of foods and beverages frequently consumed by toddlers that can be used for dietetic counselling, dietary assessment, and to develop food-based dietary guidelines specifically for toddlers. [ABSTRACT FROM AUTHOR]

NOVA is a food classification system that categorises food items into one of four categories according to the extent and purpose of their processing: minimally processed food (MPF), processed culinary ingredient (PCI), processed food (PF), or ultra-processed food (UPF). The aim of this study was to determine the relative validity and reproducibility of a food frequency questionnaire (EAT5 FFQ) for measuring daily energy intake (EI kJ) and percentage of daily energy intake (EI%) from each NOVA group in New Zealand children. One hundred parents of five year old children completed the 123 item EAT5 FFQ on two occasions four weeks apart. A 3 day weighed diet record (WDR) was completed on non-consecutive randomly assigned days between FFQ appointments. The FFQ overestimated EI (both as kJ and %) from MPF and UPF, and underestimated intakes from PCI and PF, compared with the WDR. Bland–Altman plots indicated reasonably consistent agreement between FFQ and WDR for MPF and UPF but not PCI or PF. Correlation coefficients between the FFQ and WDR were acceptable for EI (%) for MPF (r = 0.31) and UPF (r = 0.30). The FFQ differentiated between the highest and lowest quartiles for EI (%) from MPF and UPF foods (p-values for the trends were 0.006 and 0.009 respectively), and for EI (kJ) from UPF foods (p-value for trend 0.003). Bland–Altman plots indicated consistent agreement between repeat administrations of FFQ for MPF and UPF only, while intra-class correlations suggested good reproducibility for EI (kJ and %) for all four NOVA categories (range 0.51–0.76). The EAT5 FFQ has acceptable relative validity for ranking EI (%) from MPF and UPF. It has good reproducibility for measuring EI from all four NOVA categories, in young children. [ABSTRACT FROM AUTHOR]

Dietary fiber is an important nutrient for the gut microbiota, with different fiber fractions having different effects. The aim of this study was to determine the relative validity and reproducibility of a food frequency questionnaire (EAT5 FFQ) for measuring intake of fiber, and low and high fiber foods, in studies examining diet and gut microbiota in young children. One hundred parents of 5-year old children completed the 123-item EAT5 FFQ on two occasions four weeks apart. A 3-day weighed diet record (WDR) was completed on non-consecutive days between FFQ appointments. Mean correlations between the (randomly chosen) FFQ and WDR were acceptable for nutrient and food group intakes (r = 0.34 and r = 0.41 respectively). Gross misclassification was below chance (12.5%) for quartiles of nutrient (mean 5.7%) and food group (mean 5.1%) intake. 'Absolute values for surrogate categories' suggested the FFQ clearly differentiated between highest and lowest quartiles for all nutrients and food groups tested. Mean correlations between repeat administrations of the FFQ suggested very good reproducibility for nutrients (r = 0.83) and food groups (r = 0.80). The EAT5 FFQ appears to be an appropriate tool for investigating the intake of nutrients and food groups of relevance to the gut microbiota, and is the first FFQ validated to measure total, soluble and insoluble non-starch polysaccharide intakes in young children. [ABSTRACT FROM AUTHOR]

The biological succession that occurs during the first year of life in the gut of infants in Western countries is broadly predictable in terms of the increasing complexity of the composition of microbiotas. Less information is available about microbiotas in Asian countries, where environmental, nutritional, and cultural influences may differentially affect the composition and development of the microbial community. We compared the fecal microbiotas of Indonesian (n = 204) and New Zealand (NZ) (n = 74) infants 6 to 7 months and 12 months of age. Comparisons were made by analysis of 16S rRNA gene sequences and derivation of community diversity metrics, relative abundances of bacterial families, enterotypes, and cooccurrence correlation networks. Abundances of Bifidobacterium longum subsp. infantis and B. longum subsp. longum were determined by quantitative PCR. All observations supported the view that the Indonesian and NZ infant microbiotas developed in complexity over time, but the changes were much greater for NZ infants. B. longum subsp. infantis dominated the microbiotas of Indonesian children, whereas B. longum subsp. longum was dominant in NZ children. Network analysis showed that the niche model (in which trophic adaptation results in preferential colonization) of the assemblage of microbiotas was supported in Indonesian infants, whereas the neutral (stochastic) model was supported by the development of the microbiotas of NZ infants. The results of the study show that the development of the fecal microbiota is not the same for infants in all countries, and they point to the necessity of obtaining a better understanding of the factors that control the colonization of the gut in early life. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The few existing early-life obesity prevention initiatives have concentrated on nutrition and physical activity, with little examination of sleep. METHODS: This community-based, randomized controlled trial allocated 802 pregnant women (≥16 years, <34 weeks' gestation) to: control, FAB (food, activity, and breastfeeding), sleep, or combination (both interventions) groups. All groups received standard well-child care. FAB participants received additional support (8 contacts) promoting breastfeeding, healthy eating, and physical activity (antenatal-18 months). Sleep participants received 2 sessions (antenatal, 3 weeks) targeting prevention of sleep problems, as well as a sleep treatment program if requested (6-24 months). Combination participants received both interventions (9 contacts). BMI was measured at 24 months by researchers blinded to group allocation, and secondary outcomes (diet, physical activity, sleep) were assessed by using a questionnaire or accelerometry at multiple time points. RESULTS: At 2 years, 686 women remained in the study (86%). No significant intervention effect was observed for BMI at 24 months (P= .086), but there was an overall group effect for the prevalence of obesity (P = .027). Exploratory analyses found a protective effect for obesity among those receiving the "sleep intervention" (sleep and combination compared with FAB and control: odds ratio, 0.54 [95% confidence interval, 0.35-0.82]). No effect was observed for the "FAB intervention" (FAB and combination compared with sleep and control: odds ratio, 1.20 [95% confidence interval, 0.80-1.81]). CONCLUSIONS: A well-developed food and activity intervention did not seem to affect children's weight status. However, further research on more intensive or longer running sleep interventions is warranted. [ABSTRACT FROM AUTHOR]

Introduction: Few physical activity interventions have been undertaken in infants and toddlers, despite concerns that they are insufficiently active. The Prevention of Overweight in Infancy trial encouraged parents to be physically active with their child from birth, including prone-based play ("tummy time"), while reducing time spent restrained in car seats and "strollers." Methods: A total of 802 women, recruited in late pregnancy, were randomized to a physical activity intervention, which provided information antenatally, and active group sessions with their infant at 3, 9, and 18 months of age. Questionnaires were completed at multiple time points, and toddlers wore Actical accelerometers for 5 d at 24 months of age. Results: Attendance at intervention sessions was high in infancy but declined by 18 months to 66%. Almost all parents placed their infant prone to play at least once a day (90%-95%, overall median 25 min⋅d-1), with no intervention differences observed (P = 0.445 and P = 0.350 at 4 and 6 months, respectively). Few differences were observed in other measures of restraint or parental activity at any time point. At 2 yr, children spent approximately 8 h⋅d-1 in sedentary time while awake and 3.6 h in light-to-vigorous activity. However, no group differences were apparent in counts per minute (P = 0.759) or time in light-to-vigorous activity (P = 0.960). Conclusion: An early life intervention targeting improvements in child and parent physical activity as part of a wider obesity prevention initiative had little effect on physical activity at 2 yr of age. [ABSTRACT FROM AUTHOR]

Background Dietary patterns provide insight into relationships between diet and disease. Food frequency questionnaires (FFQs) can identify dietary patterns in adults, but similar analyses have not been performed for toddlers. Objective The aim of the Eating Assessment in Toddlers study was to evaluate the relative validity and reproducibility of dietary patterns from an FFQ developed for toddlers aged 12 to 24 months. Design/setting Participants were 160 toddlers aged 12 to 24 months and their primary caregiver who completed an FFQ twice, approximately 5 weeks apart (FFQ1 and FFQ2). A 5-day weighed food record was collected on nonconsecutive days between FFQ administrations. Statistical analysis Principal component analysis identified three major dietary patterns similar across FFQ1, FFQ2, and the 5-day weighted food record. Results The sweet foods and fries pattern was characterized by high intakes of sweet foods, fries and roast potato and kumara (sweet potato), butter and margarines, processed meat, sweet drinks, and fruit or milk drinks. The vegetables and meat pattern was characterized by high intakes of vegetables, meat, eggs and beans, and fruit. The milk and fruit pattern was characterized by high intakes of milk and milk products and fruit, and low intakes of breastmilk and infant and follow-up formula. The FFQ (FFQ1) correctly classified 43.1% to 51.0% of toddlers into the same quartile of pattern score as the 5-day weighted food record, and Pearson correlations ranged from 0.56 to 0.68 for the three patterns. Reliability coefficients ranged from 0.71 to 0.72 for all three dietary patterns. Conclusions the Eating Assessment in Toddlers study FFQ shows acceptable relative validity and high reproducibility for identifying dietary patterns in toddlers. [ABSTRACT FROM AUTHOR]