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Background Current WHO's recommendation for optimal infant feeding advises exclusive breastfeeding for 6 months. After this initial period, infants should receive nutritionally adequate and safe complementary food starting from the age of 6 months with continued breastfeeding up to 2 years of age or beyond. Purpose This study examined the timing and types of fluids and foods first introduced in a representative sample of toddlers (n = 1051) from 79 daycares across Lebanon. Questionnaires were self-administered to parents of toddlers (12–36 months) with a participation rate of 67%. Results Results showed that more than half of toddlers (55.7%) were introduced to infant formula within their first month of life. Around two-thirds received water as the first type of additional fluid (62.5%) with a mean age of 3.86 ± 2.15 months and fruits or cooked vegetables (69.7%) as the first types of food introduced with a mean age of 5.73 ± 1.56 months. Unfortunately, two-third (67.3%) were not breastfed after solid food introduction. Practice implications Our data on current suboptimal feeding practices in Lebanon shows the need to reinforce BF and CF practices recommendations and guidelines at the community, social and health system levels. Conclusions In the absence of specific recommendations and with the poor involvement of the various stakeholders, it was noted that more than half of the parents were not following the WHO recommendation concerning unnecessary fluid supplementation of infants and were introducing food before the recommended age of 6 months; moreover, only a minority of mothers continued breastfeeding after introducing food to their infants.

Background Associations between sugar consumption and cardiometabolic health, taking into account the physical form of sugar-containing foods (liquid vs. solid) and the type of sugars consumed [free sugars (FSs) vs. naturally occurring sugars (NOSs)], remain to be thoroughly documented. Objective The objective was to examine whether FS and NOS intakes from drinks and solid foods are associated with cardiometabolic risk factors in a sample of French-speaking adults from the province of Quebec, Canada. Methods Data were collected as part of the cross-sectional PREDISE (PREDicteurs Individuels, Sociaux et Environnementaux) study (n = 1019, 18-65 y old; 50% women). FS and NOS intakes were assessed by three 24-h dietary recalls using a self-administered, web-based application. Diet quality was assessed using the Alternative Healthy Eating Index-2010. Participants underwent on-site clinical assessment of cardiometabolic risk factors, including blood pressure, waist circumference, BMI, and fasting blood sampling (glucose, insulin, C-reactive protein, blood lipids). Multivariable linear regression models were performed to examine the associations between sugar intake and cardiometabolic risk factors with sociodemographic characteristics, lifestyle variables, and diet quality entered as covariates. Results In fully adjusted models, FS intake from drinks was associated with fasting insulin (1.06%; 95% CI: 0.30%, 1.84%; P = 0.006) and with insulin resistance as estimated using the HOMA model (1.01%; 95% CI: 0.19%, 1.84%; P = 0.02). All metabolic variables that were significantly associated with NOS intake from solid foods in minimally adjusted models were no longer significant after entering sociodemographic and lifestyle variables (e.g., educational and income levels, smoking, physical activity, daily energy intake) and diet quality in the models. Conclusions Our data from an adult sample showed that unfavorable and favorable associations with cardiometabolic risk factors observed, respectively, for FS intake from drinks and NOS intake from foods are mostly explained by sociodemographic and lifestyle variables, as well as by diet quality.

Objective: To explore differences between mothers’ and fathers’ complementary feeding practices. Methods: An online survey of UK parents with a healthy child in complementary feeding age. Timing of introducing solid foods and adherence to feeding guidelines were assessed. Dietary quality was measured using the Complementary Feeding Utility Index. Results: In a sample of 60 mothers and fathers (nondyads), there were no differences between fathers and mothers in the timing of introduction of solid foods, compliance with complementary feeding guidelines, or dietary quality. Most fathers who participated had a male child, whereas mothers had an equal number of male and female children (P < 0.001). The proportion of mothers who followed baby-led weaning was higher compared with fathers (P = 0.02). Conclusions and Implications: Study findings reveal no gender differences in parental complementary feeding practices apart from the use of baby-led weaning. Future studies with bigger male samples are warranted to explore the paternal role during complementary feeding.

SUMMARY Purpose The purpose of this study was to evaluate a mobile-based maternal feeding education program for overweight prevention in infants based on breastfeeding attitude, breastfeeding self-efficacy, breastfeeding duration, recognition of hunger and satiety cues of infants, and knowledge regarding providing solids foods. Methods A nonequivalent control group pretest-posttest design was used for the study. Participants included 15 primiparas in the experimental group and 14 primiparas in the control group in all the follow-up tests. Using self-reported questionnaires in electronic format, data were collected four times (before the intervention, 1 month after childbirth, 3 months after childbirth, and 6 months after childbirth). Using SPSS 24 version, independent t-test and repeated-measures analysis of variance were used to test the effects of the mobile-based maternal feeding education program. Results The experimental group showed significantly more positive breastfeeding attitude (F = 5.28, p = .008), higher breastfeeding self-efficacy (F = 3.50, p = .041), and increased breastfeeding duration (t = −2.09, p = .046) than the control group. In addition, the experimental group showed significantly improved knowledge regarding providing solid foods to the infants (F = 4.86, p = .009) in comparison with the control group. However, for education on recognizing hunger and satiety cues of infants, the mobile-based maternal feeding education program was not effective (F = 0.23, p = .878). Conclusion According to the results of this study, the mobile-based maternal feeding education program has the potential to contribute to overweight prevention in infants.

Smoothies are a popular breakfast option. However, liquids may evoke weaker satiation than nutritionally comparable semi-solid and solid foods. This study examined consumption of cereal and milk (CM) or a nutritionally comparable fruit smoothie (FS) for breakfast on subsequent dietary behaviours, in a controlled laboratory setting. Twenty-five participants (age 25 ± 6 y) completed three trials, receiving either CM or FS for breakfast. Afterwards, participants remained isolated for 4 h with

Chewing disorders (CD) may cause restrictions in solid food intake and can be seen in 37% of children with esophageal atresia-tracheoesophageal fistula (EA-TEF). The Functional Chewing Training (FCT) is a holistic approach to improve chewing function (CF) in children. The study aimed to evaluate the effects of FCT on CF in children with EA-TEF.Twenty children with CD were included. Patients received 12 weeks FCT including impairment-based and adaptive components. Chewing performance level was scored with Karaduman Chewing Performance Scale (KCPS), and tolerated food texture was determined by the International Dysphagia Diet Standardization Initiative (IDDSI). The baseline and final levels of KCPS and IDDSI were compared to evaluate the effects of FCT on CF.Forty-five percent of cases were isolated-EA, and 55% were EA-distal TEF with a median age of 31 (min = 25, max = 84) months, of which 65% (n = 13) were male. Baseline evaluation showed that 12 cases were in level-1, 6 cases in level-3 and 2 cases in level-4 according to KCPS. Eight children with CD (40%) had IDDSI level-3 and 12 (60%) had level-7. There was a significant improvement in KCPS scores and IDDSI scores after 12 weeks of training (p 0.01, p = 0.005,respectively). KCPS scores showed level-0 in 15 cases, and level-1 in 5 cases. All children had IDSSI level-7.The FCT is an effective method to improve chewing function in children EA-TEF who had CD.Single group treatment study.Level 4.

Solid foods should be introduced not later than the age of six months, regardless of whether the family adheres to a traditional, vegetarian, or vegan diet. The aim of this study was to compare the knowledge on the complementary feeding of infants older than six months among mothers who adhere to traditional and vegetarian diets and to identify problems that require the assistance of a dietician. A total of 251 mothers of children aged 10–12 months participated in the study. Only 10% of vegetarian mothers declared that they had placed their children on a vegetarian diet, whereas 36 mothers adhered to a lacto-ovo-vegetarian diet during complementary feeding in the first year of life. Mothers adhering to a traditional diet were characterized by lower levels of knowledge (4.1 ± 2.3 points) than vegetarian mothers (5.3 ± 2.1 points). Mothers following a traditional diet were more likely to indicate a higher than recommended number of daily meals (OR = 1.76, Cl: 1.31–1.97, p &lt, 0.001). Significant differences were noted in the respondents’ adherence to the BLW method, which was more readily implemented by vegan (p &lt, 0.05) and lacto-vegetarian (p &lt, 0.05) mothers and was least popular among mothers following a traditional diet (OR = 0.81, CI: 0.66–1.23, p &lt, 0.04). Vegetarian mothers unnecessarily delayed the introduction of gluten and potentially allergizing foods to the children’s diets, sometimes even past the age of 12 months.

The Drosophila model is used to investigate the effects of diet on physiology as well as the effects of genetic pathways, neural systems and environment on feeding behavior. We previously showed that Blue 1 works well as a dye tracer to track consumption of agar-based media in Drosophila in a method called Con-Ex. Here, we describe Orange 4 as a novel dye for use in Con-Ex studies that expands the utility of this method. Con-Ex experiments using Orange 4 detect the predicted effects of starvation, mating status, strain, and sex on feeding behavior in flies. Orange 4 is consumed and excreted into vials linearly with time in Con-Ex experiments, the number of replicates required to detect differences between groups when using Orange 4 is comparable to that for Blue 1, and excretion of the dye reflects the volume of consumed dye. In food preference studies using Orange 4 and Blue 1 as a dye pair, flies decreased their intake of food laced with the aversive tastants caffeine and NaCl as determined using Con-Ex or a more recently described modification called EX-Q. Our results indicate that Orange 4 is suitable for Con-Ex experiments, has comparable utility to Blue 1 in Con-Ex studies, and can be paired with Blue 1 to assess food preference via both Con-Ex and EX-Q.

Suboptimal nutrient quality/quantity during complementary feeding (CF) can impact negatively on infants’ healthy growth, even with adequate energy intake. CF must supplement at best human milk (HM) or formulas, which show nutritional differences. Considering this, a differentiated CF is probably advisable to correctly satisfy the different nutritional needs. To assess whether current needs at 6–24 months of age can still be met by one single CF scheme or different schemes are needed for breastfed vs. formula/cow’s milk (CM) fed infants, protein, iron and calcium intakes were assessed from daily menus using the same type and amount of solid food, leaving same amounts of HM and follow-up formula at 9 and again 18 months of age, when unmodified CM was added. Depending on the child’s age, calcium- and iron-fortified cereals or common retail foods were used. The single feeding scheme keeps protein intake low but higher than recommended, in HM-fed children while in formula/CM-fed ones, it achieves much higher protein intakes. Iron Population Recommended Intake (PRI) and calcium Adequate Intakes (AI) are met at the two ages only when a formula is used, otherwise, calcium-fortified cereals are needed. ESPGHAN statements on the futility of proposing different CF schemes according to the milk type fed do not allow to fully meet the nutritional recommendations issued by major Agencies/Organizations/Societies for all children of these age groups.

Exclusive breastfeeding for the first 6 months and then alongside solid food for the first 2 years and beyond is the gold standard in young child nutrition. There is an abundance of literature relating to the preventative nature of breastmilk and breastfeeding against many infectious diseases and chronic conditions. However, despite medically complex infants and children being a group that could benefit most from continued breastfeeding, breastfeeding duration and exclusivity are lower among more complex paediatric populations. The reasons for this are not well known, and there is a paucity of data relating to supporting infants who have acute or chronic illness, disability or congenital anomaly to breastfeed. This systematic review aimed to understand the challenges of breast/chestfeeding the medically complex child and to establish the gaps in healthcare provision that act as barriers to optimal infant and young child feeding. The search was limited to studies published in English, focused on breastfed sick infants in hospital, with no date limits as there is no previous systematic review. Of 786 papers retrieved, 11 studies were included for review, and seven themes identified. Themes included practical and psychological challenges of continuing to breastfeed in a hospital setting, complications of the condition making breastfeeding difficult, lack of specialist breastfeeding support from hospital staff and a lack of availability of specialist equipment to support complex breastfeeding. The findings affirm the lack of consistent high‐quality care for lactation support in paediatric settings and reinforce the need for further focused research in this area.

Introduction There are several recommendations advising caregivers when and how to introduce solid food to infants. These complementary feeding guides vary in terms of the recommendations for timing and portions. The objective of this study is to determine the impact of following different guidelines on weight trajectories of infants. Methods In 2018, the study team developed a computational simulation model to capture feeding behaviors, activity levels, metabolism, and body size of infants from 6 months to 1 year. Daily food intake of virtual infants based on feeding recommendations translated to changes in body weight. Next, simulations tested the impact of the following complementary feeding recommendations that provided amount, type, and timing of foods: Children's Hospital of Philadelphia, Johns Hopkins Medicine, Enfamil, and Similac. Results When virtual caregivers fed infants according to the four different guides, none of the simulated situations resulted in normal weight at 12 months when infants were also being breastfed along average observed patterns. Reducing breast milk portions in half while caregivers fed infants according to complementary feeding guidelines resulted in overweight BMIs between 9 and 11 months for Children's Hospital of Philadelphia, Johns Hopkins Medicine, and Enfamil guidelines. Cutting breast milk portions in half also led to infants reaching unhealthy underweight BMI percentiles between 7 and 11 months for female and male infants when caregivers followed Children's Hospital of Philadelphia, Johns Hopkins Medicine, and Similac guidelines. Conclusions This study identified situations in which infants could reach unhealthy weights, even while following complementary feeding guidelines, suggesting that current recommended portion sizes should be tightened.

Food oral processing depends on food properties and consumer characteristics. The aim of this study was to determine the effect of age, gender, ethnicity and eating capability on oral processing behaviour of liquid, semi-solid and solid foods. Oral processing behaviour of 18 commercially available foods, ranging from liquids, semi-solids to solids, was compared between Dutch, Caucasian adults (18-30 yrs), Chinese, Asian adults (18-30 yrs), Dutch, Caucasian elderly (60-80 yrs), and consumers with mild swallowing problems and/or low mastication efficiency (18-80 yrs). Participants were video recorded during food consumption and six oral processing parameters extracted. Elderly consumed all foods with lower eating rates (g/s) than young adults by increasing consumption time (s). Females consumed solid foods with lower eating rates (g/s) than males by reducing bite size (g). Chinese, Asian consumers consumed liquid and solid foods with lower eating rates (g/s) than Dutch, Caucasian consumers by reducing bites size (g). Chinese, Asian consumers consumed semi-solid foods with lower eating rates (g/s) than Dutch, Caucasian consumers by reducing bite size (g) and increasing consumption time (s). Consumers with decreased mastication efficiency or mild swallowing problems showed similar oral processing behaviour than healthy consumers, probably because reduction in eating capability was limited in the group. This demonstrates that different consumer groups adapt eating rate (g/s) in different ways by modifying bite size (g), consumption time (s) or both. To conclude, age, gender and ethnicity influence oral processing behaviour of liquid, semi-solid and solid foods differently. Understanding differences in oral processing behaviour of specific consumer groups can assist in steering sensory perception, food choice and energy intake of specific consumer groups such as the elderly.

INTRODUCTION The Australasian Society of Clinical Immunology and Allergy, the peak professional body for clinical immunology and allergy in Australia and New Zealand, develops and provides information on a wide range of immune-mediated disorders, including advice about infant feeding and allergy prevention for health professionals and families. Guidelines for infant feeding and early onset allergy prevention were published in 2016, with additional guidance published in 2017 and 2018, based on emerging evidence. MAIN RECOMMENDATIONS When the infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods. (This is not a strict window of introduction but rather a recommendation not to delay the introduction of solid foods beyond 12 months.) Introduce peanut and egg in the first year of life in all infants, regardless of their allergy risk factors. Hydrolysed (partially and extensively) formula is no longer recommended for the prevention of allergic disease. CHANGES IN MANAGEMENT A RESULT OF THE GUIDELINES The guidelines specifically recommend introducing solid foods at around 6 months of age and introducing peanut and egg in the first year of life in all infants to prevent allergy development. Hydrolysed formula is no longer recommended for prevention of allergic disease. A new document outlining the reasons for and the method of peanut introduction to high risk infants is available for health professionals.

Objective To evaluate the relationship between the timing of infant cereal introduction between 4 and 6 months of age and growth and dietary intake in later childhood. Study design A longitudinal cohort study was conducted among healthy children 0-10 years of age participating in The Applied Research Group for Kids cohort study between June 2008 and August 2019 in Toronto, Canada. Results Of 8943 children included, the mean (SD) age of infant cereal introduction was 5.7 (2.1) months. In the primary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.17 greater body mass index z score (95% CI 0.06-0.28; P = .002) and greater odds of obesity (OR 1.82; 95% CI 1.18-2.80; P = .006) at 10 years of age. In the secondary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.09 greater height-for-age z score (95% CI 0.04-0.15; P = .002) at 1 year of age, an association that was not observed at 5 or 10 years of age. Children who were introduced to infant cereal at 4 vs 6 months had greater nutrition risk which was primarily determined by a less-favorable eating behavior score at 18 months to 5 years of age (0.18 units higher; 95% CI 0.07-0.29; P = .001). Conclusions Introduction of infant cereal at 4 vs 6 months was associated with greater body mass index z score, greater odds of obesity, similar height-for-age z score, and less favorable eating behavior. These findings support recommendations for introducing solid food around 6 months of age.

Complementary feeding (CF) should start between 4–6 months of age to ensure infants’ growth but is also linked to childhood obesity. This study aimed to investigate the association of the timing of CF, breastfeeding and overweight in preschool children. Infant-feeding practices were self-reported in 2012 via a validated questionnaire by &gt, 7500 parents from six European countries participating in the ToyBox-study. The proportion of children who received breast milk and CF at 4–6 months was 51.2%. There was a positive association between timing of solid food (SF) introduction and duration of breastfeeding, as well as socioeconomic status and a negative association with smoking throughout pregnancy (p &lt, 0.005). No significant risk to become overweight was observed among preschoolers who were introduced to SF at 1–3 months of age compared to those introduced at 4–6 months regardless of the type of milk feeding. Similarly, no significant association was observed between the early introduction of SF and risk for overweight in preschoolers who were breastfed for ≥4 months or were formula-fed. The study did not identify any significant association between the timing of introducing SF and obesity in childhood. It is likely that other factors than timing of SF introduction may have impact on childhood obesity.

Food allergy affects 5-6% of Irish children with 3-6% of preschool children affected. Common food allergens in preschool children are milk, egg and peanut while peanut, tree-nut, fish and shellfish allergies are more common in older children1 . Recent studies such as LEAP2 and EAT3 reported that regular consumption of common allergy associated foods early in the complementary feeding period resulted in a protective effect on the development of food allergy2,3 . Current guidelines recommend that solid foods should be introduced into the infant diet around 6 months of age, including the common allergenic foods, and these foods should be continued on a regular basis. For children at a higher risk of developing food allergy, the early introduction (from 4 months of age) of egg and peanut may be beneficial.

Background It is shown that meeting the increased nutritional demand of preterm infants from birth is not only important for survival but essentially contributes to the infants` overall development and long-term health. While there are established guidelines for weaning term infants, evidence regarding preterm infants is scarce and less precise. The aim of this study was to identify the current practices on introducing solids to preterm infants amongst caregivers in Salzburg and determine potential reasons for early weaning. Methods Altogether 68 infants born between 24 0/7 and 36 6/7 weeks were recruited and detailed structured interviews with the caregivers were conducted at 17 weeks corrected age. Weight, height and head circumference were collected. Results 52% of the study group received solids before the recommended 17 weeks corrected age. For this group the mean age being 13.77 ± 1.11 weeks corrected age. Premature introduction of solids significantly correlates with exclusively and early formula-feeding. 34% were weaned due to recommendation by their paediatrician. 23% of the preterm infants even received solids before 12 weeks corrected age, putting them at risks for developing obesity, celiac disease and diabetes. Conclusions This study shows the necessity for clear guidelines regarding the introduction of complementary feeding in preterm infants as well as the importance of their implementation. Caregivers should receive information on this topic early enough and they should fully understand the difference between chronological and corrected age.

1. Farhan Ullah, MD* 2. Matthew Tien, MD*,† 1. *MetroHealth Medical Center, Cleveland, OH 2. †Case Western Reserve University School of Medicine, Cleveland, OH 1. Address correspondence to Matthew Tien, MD, Department of Pediatrics, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109. E-mail: mtien{at}metrohealth.org A previously healthy 12-month-old girl presents to the office for a well-child visit. Her mother mentions a recurring red blotchy facial rash that appears during or right after mealtimes. This was initially noticed around 6 months of age, shortly after introducing solid foods. At first, the blotchy rash seemed to come on several times when trying applesauce, and her mother wondered whether this might be an allergic reaction. As a result, the mother had avoided applesauce for a while. Since then, the mother has noticed the rash at mealtimes with other foods also, and it has been happening on a more frequent, daily basis. The rash is nonraised, red and blotchy—on further probing, the mother reported that it …

International audience; The gut microbiota plays a key role in intestinal development at the suckling-to-weaning transition. The objective of this study was to analyze the production of metabolites by the gut microbiota in suckling and weaned piglets. We studied piglets raised in two separate maternity farms and weaned at postnatal day 21 in the same farm. The fecal metabolome (1H nuclear magnetic resonance) and the microbiota composition (16S rRNA gene amplicon sequencing) and its predicted functions (PICRUSt2) were analyzed in the same piglets during the suckling period (postnatal day 13) and 2 days after weaning (postnatal day 23). The relative concentrations of the bacterial metabolites methylamine, dimethylamine, cadaverine, tyramine, putrescine, 5-aminovalerate, succinate, and 3-(4-hydroxyphenylpropionate) were higher during the suckling period than after weaning. In contrast, the relative concentrations of the short-chain fatty acids acetate and propionate were higher after weaning than during the suckling period. The maternity of origin of piglets also influenced the level of some bacterial metabolites (propionate and isobutyrate). The fecal metabolome signatures observed in suckling and weaned piglets were associated with specific microbiota-predicted functionalities, structure, and diversity. Gut microbiota-derived metabolites, which are differentially abundant between suckling and weaned piglets (e.g., short-chain fatty acids and biogenic amines), are known to regulate gut health. Thus, identification of metabolome signatures in suckling and weaned piglets paves the way for the development of health-promoting nutritional strategies, targeting the production of bacterial metabolites in early life.

The introduction of solid foods is an important dietary event during infancy that causes profound shifts in the gut microbial composition towards a more adult-like state. Infant gut bacterial dynamics, especially in relation to nutritional intake remain understudied. Over 2 weeks surrounding the time of solid food introduction, the day-to-day dynamics in the gut microbiomes of 24 healthy, full-term infants from the Baby, Food &amp, Mi and LucKi-Gut cohort studies were investigated in relation to their dietary intake. Microbial richness (observed species) and diversity (Shannon index) increased over time and were positively associated with dietary diversity. Microbial community structure (Bray–Curtis dissimilarity) was determined predominantly by individual and age (days). The extent of change in community structure in the introductory period was negatively associated with daily dietary diversity. High daily dietary diversity stabilized the gut microbiome. Bifidobacterial taxa were positively associated, while taxa of the genus Veillonella, that may be the same species, were negatively associated with dietary diversity in both cohorts. This study furthers our understanding of the impact of solid food introduction on gut microbiome development in early life. Dietary diversity seems to have the greatest impact on the gut microbiome as solids are introduced.

Condiments are rarely consumed on their own. Although addition of condiments to carrier foods is known to affect oral processing behavior and sensory perception, an understanding of how different condiment properties impact oral processing behavior and sensory perception of solid carrier foods is lacking. This study aimed to understand the role of condiments varying in composition and/or rheological properties in bolus formation facilitation, and how they influence oral processing behavior and sensory perception of solid carrier foods. Two carriers (bread, cooked potato) were combined with mayonnaises differing in fat content and viscosity. Addition of mayonnaises changed bolus properties of solid carrier foods considerably (i.e. decreased bread firmness, increased potato cohesiveness, increased lubrication of both bread and potato bolus) and, consequently, facilitated faster bolus formation. While addition of mayonnaises to bread and potatoes decreased the number of chewing cycles before swallowing, consumers did not change muscle activities or jaw movements per chew. No effect of mayonnaise fat content on oral processing behavior of composite foods was observed. Low viscosity mayonnaise resulted in faster bolus formation and swallowing compared to high viscosity mayonnaise. Low viscosity mayonnaise penetrated faster into bread boli leading to faster softening of bread boli. Also in the case of potato, low viscosity mayonnaise lead to faster bolus formation than for high viscosity mayonnaise. The low viscosity mayonnaise mixed more easily with potato bolus pieces, enhancing adhesion between pieces. Both mayonnaise fat content and viscosity influenced sensory perception of composite foods considerably, especially in terms of fattiness and creaminess. We conclude that oral processing behavior, bolus formation and sensory perception of solid carrier foods can be modified considerably by condiments. While composition and rheological properties of condiments have a large effect on bolus formation and sensory perception of solid carrier foods, these aspects have a limited effect on oral processing behavior of composite foods. Oral processing behavior is dominated by the properties of the solid carrier food. Tailoring condiment-carrier combinations could be an effective strategy to increase healthy eating, alter food intake for populations such as the elderly, and increase food appreciation.

An exploration of physiological correlates of subjective hedonic responses while eating food has practical and theoretical significance. Previous psychophysiological studies have suggested that some physiological measures, including facial electromyography (EMG), may correspond to hedonic responses while viewing food images or drinking liquids. However, whether consuming solid food could produce such subjective&ndash, physiological concordance remains untested. To investigate this issue, we assessed participants&rsquo, subjective ratings of liking, wanting, valence, and arousal while they consumed gel-type food stimuli of various flavors and textures. We additionally measured their physiological signals, including facial EMG from the corrugator supercilii. The results showed that liking, wanting, and valence ratings were negatively correlated with corrugator supercilii EMG activity. Only the liking rating maintained a negative association with corrugator supercilii activity when the other ratings were partialed out. These data suggest that the subjective hedonic experience, specifically the liking state, during food consumption can be objectively assessed using facial EMG signals and may be influenced by such somatic signals.

Infant feeding experiences are important for the development of healthy weight gain trajectories. Evidence surrounding milk feeding and timing of introduction to solids is extensive; however, the impact of the method of introducing solids on infant growth has been relatively underexplored. Baby‐led weaning (where infants self‐feed family foods) is proposed to improve appetite regulation, leading to healthier weight gain and a reduced risk of obesity. However, the evidence is mixed and has methodological inconsistencies. Furthermore, despite milk being a large part of the infant diet during the period infants are introduced to solid foods, its influence and interaction with introductory style have not been considered. The aim of this study was to explore growth among infants aged 3–12 months according to both style of introduction to solid foods and milk feeding; 269 infants were weighed and measured, and body mass index (BMI) computed. The results showed that overall, infants who were spoon‐fed (compared with self‐fed) at introduction to complementary feeding (CF) had greater length (but not weight or BMI). However, when milk feeding was accounted for, we found that infants who were both spoon‐fed and fully formula fed had greater weight compared with spoon‐fed, breastfed infants. There was no significant difference in weight among self‐fed infants who were breastfed or formula fed. The results highlight the importance of considering infant feeding as a multicomponent experience in relation to growth, combining both milk feeding and method of CF. This relationship may be explained by differences in maternal feeding style or diet consumed.

In recent years, so-called baby food pouches and other novel packaging and devices have been marketed for complementary feeding. To date, no experimental studies have been conducted to determine health and nutrition effects or the safety of baby food pouches and related feeding devices. Yet, these products hold the potential to fundamentally change the ways in which infants and children consume solid foods in infancy and early childhood. In this review, a selection of complementary feeding devices and their potential effects on breastfeeding, formula-feeding, safe and appropriate complementary feeding, and the timely transition to family foods are explored. Because manufacturers have innovated older designs of traditional feeding bottles and pacifiers for complementary feeding, perspectives on potential health effects and the safety of devices are drawn from research on feeding bottles and pacifiers. Recommendations include scaling up research on the safety, nutrition, and health impacts of commercial packaging and devices. In addition, manufacturers should ensure that devices conform to consumer product safety commission specifications and that instructions for use are in line with policies protecting pediatric dental health. Marketing of commercial devices and packaging should conform to the International Code of Marketing of Breastmilk Substitutes.

Item does not contain fulltext In the weaning period, infants are introduced to solid food after being fed solely on milk, which involves a deliberate reorganization of the infant-caregiver feeding interaction. This multiple case study, involving 5 dyads with 10 repeated observations, analyzed its dynamical structure using Cross-Recurrence Quantification Analysis. The results showed that an optimal interaction occurs when the caregiver is leading by roughly 1-2 seconds. During the weaning period, all dyads showed signs of increased synchronization, although there are interesting differences between dyads. These findings indicate that infant-caregiver dyads co-regulate their behavior within a relatively short period. 7 p.

Background Baby-led weaning (BLW) where infants self-feed family foods during the period that they are introduced to solid foods is growing in popularity. The method may promote healthier eating patterns, although concerns have been raised regarding its safety. The present study therefore explored choking frequency amongst babies who were being introduced to solid foods using a baby-led or traditional spoon-fed approach. Methods In total, 1151 mothers with an infant aged 4–12 months reported how they introduced solid foods to their infant (following a strict BLW, loose BLW or traditional weaning style) and frequency of spoon-feeding and puree use (percentage of mealtimes). Mothers recalled if their infant had ever choked and, if so, how many times and on what type of food (smooth puree, lumpy puree, finger food and specific food examples). Results In total, 13.6% of infants (n = 155) had ever choked. No significant association was found between weaning style and ever choking, or the frequency of spoon or puree use and ever choking. For infants who had ever choked, infants following a traditional weaning approach experience significantly more choking episodes for finger foods (F2,147 = 4.417, P = 0.014) and lumpy purees (F2,131 = 6.46, P = 0.002) than infants following a strict or loose baby-led approach. Conclusions Baby-led weaning was not associated with increased risk of choking and the highest frequency of choking on finger foods occurred in those who were given finger foods the least often. However, the limitations of noncausal results, a self-selecting sample and reliability of recall must be emphasised.

Positive experiences with the introduction of solid food in infancy may lead to positive associations with feeding in both parent and infant. During this transitional period, parental feeding behavior and infant eating behavior might mutually reinforce each other. A feeding style that is found to be associated with positive child eating behavior, is sensitive feeding. In the present study we tested bidirectional prospective relations between mother and infant behavior in a cross-lagged model using observations of two feeds on two consecutive days on which the first bites of solid food were offered. The sample consisted of 246 first-time mothers and their infants, whose feeding interactions were videotaped during two home visits. Maternal sensitive feeding behavior (consisting of responsiveness to child feeding cues, general sensitivity and non-intrusiveness) and maternal positive and negative affect were coded. In addition, infant vegetable intake was weighed and vegetable liking was reported by mother. Results showed at least some stability of maternal feeding behavior and infant vegetable intake and liking from the first to the second feed. In addition, during the second feed maternal sensitive feeding and positive affect were associated with infant vegetable intake (r=.34 and r=.14) and liking (r=.33 and r=.39). These associations were mostly absent during the first feed. Finally, infant vegetable liking during the first feed positively predicted maternal sensitive feeding behavior during the second feed (β=.25), suggesting that the infant's first response might influence maternal behavior. Taken together, mother and infant seem more attuned during the second feed than during the first feed. Future studies might include multiple observations over a longer time period, or micro-coding. Such insights can inform prevention programs focusing on optimizing feeding experiences during the weaning period.

The COVID-19 pandemic and stay-at-home orders across the nation have had substantial consequences on access to food and dietary behaviors. We investigated the dietary intake of adults in NYC, before and during the COVID-19 period. A subset of participants (n = 31) from an NIH-funded multi-level discount supermarket study were assessed. In this study, the experimental groups received a 0% (control), 15%, or 30% discount on fruits, vegetables, and noncaloric beverages for 8 months. The discount level for the participants who were selected for this study did not change from the pre-COVID to during COVID periods. Dietary intake data was collected using three unannounced 24-h dietary recalls (2 weekdays, 1 weekend) during each period. Changes in total daily kcal of food and beverages, total g of solid food, energy density of solid food (kcal/g), and g of fruit and vegetables, soda, non-caloric beverages, and snack foods were analyzed using multivariate linear regression. Energy density (ED) increased during COVID (+0.02 ± 0.5 [SD], F[4,26] = 3.0, p = 0.038). There was an interaction by gender (t = -3.2, p = 0.0035) such that ED increased for females (+0.27 ± 0.46, p = 0.037) and decreased for males (-0.22 ± 0.32, p = 0.012). The change in ED is likely due to the circumstances surrounding COVID-19, e.g. being at home, stress, and food shortages.

Background: The aim of this systematic review is to analyze the available literature on the introduction of allergenic foods and gluten among preterm infants. Methods: A systematic review of published studies concerning the introduction of gluten and allergenic foods in preterm infants was performed on PubMed and on the Cochrane Library. Results: Of the 174 PubMed results, 15 papers were considered suitable for the review. A total of 83 records were identified through the Cochrane Library search; eight papers were included in the review. Additional papers were identified from the reference lists of included studies. A secondary search was conducted on the same databases to find recommendations and advice regarding healthy full-term infants that could be translated to preterm infants. Therefore, 59 additional papers were included in the review. Conclusions: Current guidelines for the introduction of solid food cannot be directly transposed to preterm infants. Further research is needed to provide evidence-based guidelines regarding weaning in preterm infants. To date, we can suggest that in preterm infants allergenic foods and gluten may be introduced when complementary feeding is started, any time after 4 months of corrected age, avoiding delayed introduction and irrespective of infants’ relative risk of developing allergy. Avoiding large amounts of gluten during the first few weeks after gluten introduction and during infancy is advised, despite limited evidence to support this recommendation.

Background Diet is a major source of human exposure to hazardous environmental chemicals, including many perfluoroalkyl acids (PFAAs). Several assessment methods of dietary exposure to PFAAs have been used previously, but there is a lack of comparisons between methods. Aim To assess human exposure to PFAAs through diet by different methods and compare the results. Methods We studied the dietary exposure to PFAAs in 61 Norwegian adults (74% women, average age: 42 years) using three methods: i) by measuring daily PFAA intakes through a 1-day duplicate diet study (separately in solid and liquid foods), ii) by estimating intake after combining food contamination with food consumption data, as assessed by 2-day weighted food diaries and iii) by a Food Frequency Questionnaire (FFQ). We used existing food contamination data mainly from samples purchased in Norway and if not available, data from food purchased in other European countries were used. Duplicate diet samples (n=122) were analysed by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) to quantify 15 PFAAs (11 perfluoroalkyl carboxylates and 4 perfluoroalkyl sulfonates). Differences and correlations between measured and estimated intakes were assessed. Results The most abundant PFAAs in the duplicate diet samples were PFOA, PFOS and PFHxS and the median total intakes were 5.6 ng/day, 11 ng/day and 0.78 ng/day, respectively. PFOS and PFOA concentrations were higher in solid than liquid samples. PFOS was the main contributor to the contamination in the solid samples (median concentration 14 pg/g food), while it was PFOA in the liquid samples (median concentrations: 0.72 pg/g food). High intakes of fats, oils, and eggs were statistically significantly related to high intakes of PFOS and PFOA from solid foods. High intake of milk and consumption of alcoholic beverages, as well as food in paper container were related to high PFOA intakes from liquid foods. PFOA intakes derived from food diary and FFQ were significantly higher than those derived from duplicate diet, but intakes of PFOS derived from food diary and FFQ were significantly lower than those derived from duplicate diet. We found a positive and statistically significant correlation between the PFOS intakes derived from duplicate diet with those using the food diary (rho=0.26, p-value=0.041), but not with the FFQ. Additionally, PFOA intakes derived by duplicate diet were significantly correlated with estimated intakes from liquid food derived from the food diary (rho=0.34, p=0.008) and estimated intakes from the FFQ (rho=0.25, p-value=0.055). Conclusions We provide evidence that a food diary or a FFQ-based method can provide comparable intake estimates to PFOS and PFOA intakes derived from a duplicate diet study. These less burdensome methods are valuable and reliable tools to assess dietary exposure to PFASs in human studies.

Objectives Primates have an extended period of juvenility before adulthood. Although dietary complexity plays a prominent role in hypotheses regarding the evolution of extended juvenility, the development of feeding behavior is still poorly understood. Indeed, few studies have investigated the timing and nature of feeding transitions in apes, including chimpanzees. We describe general patterns of feeding development in wild chimpanzees and evaluate predictions of the needing-to-learn hypothesis. Materials and Methods We analyzed 4 years of behavioral data (2010–2013) from 26 immature chimpanzees and 31 adult chimpanzees of the Kanyawara community in Kibale National Park, Uganda. Specifically, we examined milestones of nutritional independence (first consumption of solid food and cessation of suckling) as well as developmental changes in feeding time, diet composition, diet breadth, and ingestion rates. Results Chimpanzees first fed on solid food at 5.1 months and, on average, suckled until 4.8 years. Daily feeding time of immature individuals reached adult levels between 4 and 6 years, while diet composition showed minor changes with age. By juvenility (5–10 years), individuals had a complete adult diet breadth. Ingestion rates for five ripe fruit species remained below adult levels until juvenility but continued to show absolute increases into adolescence. Discussion Chimpanzees acquired adult-like patterns on all feeding measures by infancy or juvenility. These data are inconsistent with the needing-to-learn hypothesis; moreover, where delays exist, alternatives hypotheses make similar predictions but implicate physical constraints rather than learning as causal factors. We outline predictions for how future studies might distinguish between hypotheses for the evolution of extended juvenility.

Optimal breastfeeding practices entail the early initiation of breastfeeding soon after delivery of the baby, exclusive breastfeeding for the first six months of life and the continuation of breastfeeding complemented by solid food up until two years of age. Breastfeeding has wide-ranging health benefits for both the mother and her child; however, many factors contribute to low rates of exclusive breastfeeding. This article highlights the benefits of optimal breastfeeding as well as trends and determinants associated with breastfeeding both worldwide and in Gulf Cooperation Council (GCC) countries. Strategies to optimise breastfeeding and overcome breastfeeding barriers in the GCC region are recommended, including community health and education programmes and 'baby-friendly' hospital initiatives. Advocates of breastfeeding are needed at the national, community and family levels. In addition, more systematic research should be conducted to examine breastfeeding practices and the best strategies to promote breastfeeding in this region.

As part of the aging process, multiple oral physiologic changes occur and these changes may cause individuals to reduce food intake or switch the types of food texture. Thus, the need to develop food products for the elderly has increased. To evaluate the suitability of the food products for the elderly, the evaluation method should be verified and it is important to identify the parameters of mastication and swallowing. Therefore, the purpose of this study was to compare the differences of mastication and swallowing parameters between the young adults and the elderly depending on the varying hardness of rice food product. Subjects included 20 young adults and 40 elderly and bolus transit times of video-fluoroscopic swallowing study (VFSS) were used. Four types of rice products with different hardness were provided including cooked rice, soft-boiled rice, rice gruel and thin rice gruel. In the elderly group, the chewing number, oral processing time, post-faucial aggregation time, valleculae aggregation time (VAT), first subsequence duration and total duration were significantly different according to the changes in food hardness. Of the bolus transit times, the VAT and the second subsequence duration (S-S2) were significantly different between the two groups. These results suggest that VAT and S-S2, key VFSS parameters, as well as the chewing number and total duration are useful tools for evaluating the effect of aging on mastication and swallowing of solid foods. Practical applications In Korea, the aging population is rapidly increasing. According to recent surveys, a large number of elderly Koreans have reported chewing difficulties and many of them are in the state of under-nutrition. As aging progresses, multiple physiologic changes occur in mastication and swallowing functions. These changes may cause individuals to reduce their food intake or switch to soft food products. Therefore, the development of texture-modified food products for the elderly is needed and they should be developed based on the understandings of the physiology of mastication and swallowing according to different rheological properties of food products consumed in Korea, which are quite different from those of the western countries. In this study, we compared the differences of mastication and swallowing parameters between the young adults and the elderly depending on the varying hardness of rice food product.

Background and purpose The impact of treatment accuracy on NTCP-based patient selection for proton therapy is currently unknown. This study investigates this impact for oropharyngeal cancer patients. Materials and methods Data of 78 patients was used to automatically generate treatment plans for a simultaneously integrated boost prescribing 70 Gy RBE /54.25 Gy RBE in 35 fractions. IMRT treatment plans were generated with three different margins; intensity modulated proton therapy (IMPT) plans for five different setup and range robustness settings. Four NTCP models were evaluated. Patients were selected for proton therapy if NTCP reduction was ≥10% or ≥5% for grade II or III complications, respectively. Results The degree of robustness had little impact on patient selection for tube feeding dependence, while the margin had. For other complications the impact of the robustness setting was noticeably higher. For high-precision IMRT (3 mm margin) and high-precision IMPT (3 mm setup/3% range error), most patients were selected for proton therapy based on problems swallowing solid food (51.3%) followed by tube feeding dependence (37.2%), decreased parotid flow (29.5%), and patient-rated xerostomia (7.7%). Conclusions Treatment accuracy has a significant impact on the number of patients selected for proton therapy. Therefore, it cannot be ignored in estimating the number of patients for proton therapy.

OBJECTIVE: Assess pediatrician practices around growth and nutrition for children under 2 years. DESIGN: 2017 cross-sectional survey of a national random sample of the American Academy of Pediatrics members. SETTING: US. PARTICIPANTS: Practicing primary care pediatricians and residents (n = 698). MAIN OUTCOME MEASURES: World Health Organization growth chart use, solid food introduction recommendations, healthy behaviors discussion. ANALYSIS: Descriptive statistics were calculated for nutrition-related questions. McNemar tests compared recommendations on the introduction of different solid foods at

Purpose: During the transition from ingesting milk to ingesting solid food, infants substantiate their eating habits. The present study focuses on this transition. Specifically, it aimed to explore first-time parents’ lived experiences of their infants’ transition from milk to solid foods.Method: The study is based on the descriptive phenomenological approach Reflective Lifeworld Research (RLR). Ten mothers and ten fathers were interviewed twice; when the infants were aged four to five months and again at seven to eight months of age. Data were analysed according to RLR principles.Results: The findings show that the transition from milk to solid food is a demanding in-between phase. The physically intimate feeding situation is replaced by unfamiliar situations in which parents and infant are physically separated and new types of food are introduced. The process of feeding requires parents’ full attention and sensitivity towards the infant’s reactions.Conclusion: The study highlights how shared parental experiences were reflected in frames for how a meal should normally proceed, including parents’ desire to create healthy eating habits and uphold harmony duringfamily mealsWe suggest for health professionals to present parents with a wider frame of normality, especially as concerns the concept of what constitutes “normal” eating patterns.

Infants experience a dramatic change in their food in the first year after birth when they shift from breast milk to solid food. This results in a large change in presence of indigestible polysaccharides, a primary energy resource of gut microbes. How the gut microbiota adapts to this dietary shift has not been well examined. Here, by using metagenomics data, we studied carbohydrate-active enzymes (CAZymes) of gut microbiota, which are essential enzymes catalyzing the breakdown of polysaccharides, during this dietary shift. We developed a new approach to categorize CAZyme families by food intake and found CAZyme families associated with milk or solid food. We also found CAZymes with most abundance in 12 months infants that are not associated with solid food or milk but may be related to modulating carbohydrates in the mucus. Additionally, the abundance of gut CAZymes were found to be affected by many other factors, including delivery modes and life style in adults. Taken together, our findings provide novel insights into the dynamic change of gut CAZymes in early human life and provide potential markers for food interference or gut microbiota restoration.

Objective:The present study compared the age of first solid foods in a cohort of preterm infants with term infants and identified factors influencing timing of solid food introduction.Design:Structured interviews on infant feeding practices, growth and medical status at term equivalence and at 3, 6, 9 and 12 months corrected postnatal age. The age of solid food introduction was compared between term and preterm infants, and the influence of maternal, infant and milk feeding factors was assessed.Setting:This prospective longitudinal study recruited primary carers of preterm and term infants from a regional metropolitan referral hospital in eastern Australia.Participants:One hundred and fifty infants (preterm, n 85; term, n 65).Results:When corrected for prematurity, preterm infants received solid foods before the recommended age for the introduction of solid foods for term infants. Median introduction of solid foods for preterm infants was 14 weeks corrected age (range 12–17 weeks). This was significantly less than 19 weeks (range 17–21 weeks) for term infants (P < 0·001). Lower maternal education and male gender were associated with earlier introduction of solid foods among preterm infants.Conclusions:Preterm infants are introduced to solid foods earlier than recommended for term infants, taking account of their corrected age. Further research is needed to assess any risk or benefit associated with this pattern and thus to develop clear evidence-based feeding guidelines for preterm infants.

This observational clinical study was composed of two substudies: a non-comparative one (n = 166), testing only lysozyme-based compounds (LBCs), and a comparative substudy (n = 275), testing both LBCs and bicarbonate-based local compounds (BBCs) on the healing of oral mucositis during radio- or chemotherapy. The density of ulcerations has decreased significantly after the treatment with lysozyme in both substudies. The density of ulcerations in the radiotherapy group was lower in patients treated with LBCs compared to patients treated with BBCs (p < 0.001). In the chemotherapy group, reduction of ulceration density was similar with both LBCs and BBCs. The LBCs reduced pain intensity during the intake of solid food and speech more than BBCs in both patient cohorts (p < 0.05). In the radiotherapy cohort, pain intensity when consuming liquid foods was reduced more with LBCs than with BBCs (p < 0.05). No adverse events were recorded. This study demonstrates the advantages of treating oral mucositis during radiotherapy or chemo-therapy with LBCs.

Nordic Nutrition Recommendations (NNR) recommend exclusive breastfeeding until 6 months, partial breastfeeding until 1 year or longer and irrespective of breastfeeding, avoiding solid foods before 4 months. Strong evidence was found for benefits of breastfeeding regarding growth and infections but limited/inconclusive evidence regarding atopic disease and asthma. Vitamin D is of special interest in the Nordic diet. The aim of this prospective study was to compare infant feeding and vitamin D between immunoglobulin E (IgE) sensitized (n = 14) and non-sensitized (n = 130) children at 6 years. Information on diet and vitamin D supplement use were collected with dietary recall (&lt, 5 months), 1-d food records (5 and 6 months) and 3-d weighed food records (12 months and 6 years). Serum-specific IgE-antibodies against milk, egg, cod, wheat, soy and peanut (cut-off specific IgE &ge, 0.35 kUA/L) were measured at 6 years and serum 25-hydroxyvitamin D at 12 months and 6 years. At 4 months, 57% of IgE sensitized vs. 23% of non-sensitized children (p &lt, 0.01) had received solid food. At 12 months, IgE sensitized children had a lower intake of vitamin D (median (25th, 75th percentiles): 3.9 &mu, g/d (3.2, 7.2) vs. 8.1 &mu, g/d (4.4, 12.3), p = 0.03) and at 6 years, fewer used vitamin D supplements regularly (23% vs. 56%, p = 0.03). Introduction of solid foods prior to 4 months increased the odds of IgE-sensitization, OR = 4.9 (95%, CI = 1.4&ndash, 16.6) and vitamin D supplement at 6 years decreased the odds of IgE-sensitization, OR = 0.2 (95%, CI = 0.1&ndash, 0.98), adjusting for maternal smoking. These observations support the NNR in their recommendation against introducing complementary solid foods before the age of 4 months. Furthermore, they support encouraging vitamin D intake for young children at northern latitudes.

There is no routine data collection in the UK on infant dietary diversity during the transition to solid foods, and health visitors (HVs) (nurses or midwives with specialist training in children and family health) have the potential to play a key role in nutrition surveillance. We aimed to assess items for inclusion in routine data collection, their suitability for collecting informative data, and acceptability among HVs. A mixed-methods study was undertaken using: (i) an online survey testing potential questionnaire items among parents/caregivers, (ii) questionnaire redevelopment in collaboration with community staff, and (iii) a survey pilot by HVs followed by qualitative data collection. Preliminary online questionnaires (n = 122) were collected to identify useful items on dietary diversity. Items on repeated exposure to foods, aversive feeding behaviors, flavor categories, and sugar intake were selected to correspond to nutrition recommendations, and be compatible with electronic records via tablet. HVs surveyed 187 parents of infants aged 12 months. Semi-structured interviews indicated that HVs found the questionnaire comparable with standard nutrition conversations, which prompted helpful discussions, but questions on eating behavior did not prompt such useful discussions and, in some cases, caused confusion about what was &lsquo, normal.&rsquo, Lack of time among HVs, internet connectivity issues, and fear of losing rapport with parents were barriers to completing electronic questionnaires, with 91% submitted by paper. Routine nutrition data collection via child health records seems feasible and could inform quality improvement projects.

We explored parental feeding practices, feeding issues during the first 2 yr of life, and the relationship between feeding issues and levels of maternal distress in preterm infants. Four hundred twenty mothers (239 with preterm infants, 181 with full-term infants) participated in the study. The Behavior-Based Feeding Questionnaire for Infants With Premature History and the Parenting Stress Index–Chinese Version were used as the two outcome measures. The results indicated that preterm infants had different feeding experiences compared with their full-term counterparts. They tended to start solid food later in life and had limited experiences in food variation. Parenting stress was prevalent in parents with preterm infants and was associated with the frequency of feeding issues, especially at later ages when supplementary foods were being introduced.

A test using a solid food is relevant to measure chewing ability (CA) as (a) it includes an integrated functioning of all oral structures involved, (b) an impairment of chewing a solid food causes inevitably diet restrictions, and (c) chewing efficiency (CE) can easily be defined. CE is the number of chewing cycles, N(1/2-Xo), needed to attain a particular chewing outcome (a median particle size, X 50 , which is half the initial particle size Xo) whereas chewing performance (CP) is a state of chewing outcome (X 50 ) at an arbitrary number of chewing cycles. The use of CE is preferable for CA because inter-subject ratios are constant regardless of the initial conditions of the test food. Furthermore, the inter-subject variation is two times larger for CE values than for CP ones, yielding a better inter-subject differentiation of CA. However, a determination of CP needs only one N-value, and that of CE at least two N-values for enabling an interpolation of N(1/2-Xo). Using samples of only two half-cubes (9.6 x 9.6 x 4.8 mm; limiting test load) of Optosil (an artificial test food), and detailed previous information on log(X 50 )-log(N) relationships (Liu et al., Archives of Oral Biology, 2018, 91, 63-77) as a "gold standard," a short procedure has been developed for a priori choosing two appropriate N-numbers, and the subsequent determination of a subject's CE. This procedure has been developed using results from 20 young adults (23.7 years, SD 1.1) and was validated in 10 middle-aged and older adults (52.3 years, SD 10.1), where impairments in the dentition were reflected in the CE-values. Our short procedure to determine CE will improve studies on relationships between CA and food preference, or between CA and dental factors and/or physiological factors. The first type of relationship may be of interest for food industry whereas the second type may be of interest for population studies in rapidly aging societies and for clinical studies in dentistry. Results can be compared between subjects and studies without bias by using CE rather than CP as a measure of CA.

Weaning is complex for children with phenylketonuria (PKU). Breastmilk/infant formula and phenylalanine (Phe)-free infant protein-substitute (PS) are gradually replaced with equivalent amounts of Phe-containing food, a semi-solid/spoonable weaning PS and special low-protein foods. In PKU, feeding patterns/practices during weaning in PKU have not been formally evaluated. In this longitudinal, prospective, case-control study (n = 20) infants with PKU transitioning to a second-stage PS, were recruited at weaning (4&ndash, 6 months) for a comparison of feeding practices and development with non-PKU infants. Subjects were monitored monthly to 12 months and at age 15 months, 18 months and 24 months for: feeding progression, food textures, motor skill development and self-feeding, feeding environment, gastrointestinal symptoms, and negative feeding behaviours. Children with PKU had comparable weaning progression to non-PKU infants including texture acceptance, infant formula volume and self-feeding skills. However, children with PKU had more prolonged Phe-free infant formula bottle-feeding and parental spoon feeding than controls, fewer meals/snacks per day, and experienced more flatulence (p = 0.0005), burping (p = 0.001), retching (p = 0.03), and less regurgitation (p = 0.003). Negative behaviours associated with PS at age 10&ndash, 18 months, coincided with the age of teething. Use of semi-solid PS in PKU supports normal weaning development/progression but parents require support to manage the complexity of feeding and to normalise the social inclusivity of their child&rsquo, s family food environment. Further study regarding parental anxiety associated with mealtimes is required.

Gradual introduction of solid foods in early childhood takes part in the maturation of mastication. The impact of any oral state alteration on food oral processing development is poorly documented for this age group. This study investigated the masticatory behavior in 3 to 6 year-old children with or without early childhood caries (ECC) for three solid foods of different textures. Twenty-one children with healthy oral state and 23 children with severe ECC were observed during complete mastication of calibrated samples of raw carrot, cheese and breakfast cereals. Food refusals and kinematic parameters (Ti: chewing time, Nc: number of cycles and Fq: chewing frequency) were used to assess children masticatory behavior. Oral Health-related Quality of Life and orofacial dysfunctions were evaluated using, respectively the early childhood oral health impact scale (ECOHIS) and the Nordic orofacial dysfunction test screening (NOT-S). Children suffering from ECC exhibited significantly higher ECOHIS and NOT-S scores, in particular for the mastication domain. Accordingly, lower chewing frequencies values were recorded in children with ECC (i.e., carrot Fq: 1.21 ± 0.20 vs 1.35 ± 0.22, p ≤ 0.01), as well as more frequent refusals for carrots. Kinematic parameters were shown to be repeatable in all children for successive samples of the same food, and tended to vary depending on the proposed food. Some masticatory behavior regulation according to food properties could already be present in preschool children. Children with ECC developed alternative behavioral strategies to overcome feeding difficulties. Further studies should investigate food bolus properties according to oral health, as well as nutritional issues. PRACTICAL APPLICATIONS: During childhood, the way solid foods are processed in the oral cavity to be safely swallowed and then digested in available nutrients, is poorly documented. In this study, preschool children have been shown to repeatedly adapt their masticatory behavior to a given food. The collection of various food boli as recorded at the moment of swallowing could then be considered in further food bolus properties research investigations. Moreover, this study suggested that children with altered dentition modified their masticatory kinematic parameters and developed alternative strategies, including food or texture selection, to overcome their feeding difficulties. The development of a mastication evaluation protocol could help medical professionals to detect children masticatory deficiencies and then propose diet adaptations. Considering the importance of food diversity in mastication development and maturation, food industries may consider to develop a range of texture adapted foods for young children, especially designed to gradually rehabilitate the masticatory function.

Background Baby-led weaning (BLW) is a method of introducing solid foods to infants, which centres around the infant self-feeding family foods. BLW has grown in popularity over the last 10 years; however, although research is starting to build around the safety and impact of the method, research examining intake is sparse. This is important because concerns have been raised by healthcare providers regarding the nutrient and energy sufficiency of BLW. The present study aimed to invstigate exposure to different food types based on different weaning approaches. Methods One hundred and eighty parents completed a 24-h recall of the foods given to their babies aged 6-12 months. Respondents were split into those following strict BLW, loose BLW and traditional spoon-feeding. Recalls were examined to ascertain the number of times in 24 h infants were given different types of foods, including iron-containing foods. The results were then compared between different weaning groups and age groups. Results Several significant differences were found between the frequency of foods eaten by different weaning and age groups: in the youngest age group, strict BLW infants were more likely to be exposed to vegetables (P = 0.000) and protein (P = 0.002) than traditionally weaned babies, whereas, at all age groups, the traditionally weaned group had the highest exposure to composite meals. However, no significant differences were found in reported exposure to iron-containing foods between weaning groups at any age. Maternal age, education and milk feeding method were controlled for throughout the analyses. Conclusions The findings add to a growing body of evidence that suggest a BLW approach may be safe and sufficient.

Background: Races and competitions over 100 miles have recently increased. Limited information exists about the effect of multiday continuous endurance exercise on blood glucose control and appropriate intake of food and drink in a female athlete. The present study aimed to examine the variation of blood glucose control and its relationship with nutritional intake and running performance in a professional female athlete during a 155.7 h ultramarathon race with little sleep. Methods: We divided the mountain course of 438 km into 33 segments by timing gates and continuously monitored the participant’s glucose profile throughout the ultramarathon. The running speed in each segment was standardized to the scheduled required time-based on three trial runs. Concurrently, the accompanying runners recorded the participant’s food and drink intake. Nutrient, energy, and water intake were then calculated. Results: Throughout the ultramarathon of 155.7 h, including 16.0 h of rest and sleep, diurnal variation had almost disappeared with the overall increase in blood glucose levels (25–30 mg/dL) compared with that during resting (p &lt, 0.0001). Plasma total protein and triglyceride levels were decreased after the ultramarathon. The intake of protein and fat directly or indirectly contributed to maintaining blood glucose levels and running speed as substrates for gluconeogenesis or as alternative sources of energy when the carbohydrate intake was at a lower recommended limit. The higher amounts of nutrient intakes from solid foods correlated with a higher running pace compared with those from liquids and gels to supply carbohydrates, protein, and fat. Conclusion: Carbohydrate, protein, and fat intake from solid foods contributed to maintaining a fast pace with a steady, mild rise in blood glucose levels compared with liquids and gels when female runner completed a multiday continuous ultramarathon with little sleep.

Premasticated food transfer, when an individual partially breaks down food through chewing and feeds it to another individual, usually mouth-to-mouth, is described widely across human cultures. This behavior plays an important role in modern humans' strategy of complementary feeding, which involves supplementing maternal milk in infant diets with processed, easily digestible versions of adult foods. The extent to which other primates engage in premasticated food transfer with infants is unclear, as premasticated food transfers have been only occasionally reported in other ape species. We investigated premasticated food transfers in 62 mother-infant pairs of wild chimpanzees at Ngogo, Uganda, as well as unresisted food taking, when mothers passively allow infants to seize food. We evaluated the presence or absence and rates of premasticated food transfer and unresisted food taking relative to maternal parity and infant age and sex and assessed the food species and part used. We found that chimpanzee mothers regularly shared premasticated food with their infants aged between 6 months and 4 years, but they were more likely to share, and more frequently shared, with younger infants. The frequency with which females shared premasticated food may relate to maternal experience, as multiparous females shared premasticated food more often than did first-time mothers, which we did not find with unresisted food taking. Both easy-to-chew, commonly eaten foods and tougher, rarely eaten foods were shared. Premasticated food transfer and unresisted food taking may be infant-rearing strategies to facilitate the transition from a diet of exclusive maternal milk to solid food during early infancy. Premasticated food transfer in particular may provide energetic, immune, or growth benefits to infants through reduced chewing effort and maternal saliva. Given our findings in chimpanzees and earlier reports in other ape species, we suggest that the foundation of complementary feeding, a uniquely hominin strategy, might have been present in a common ancestor shared with the other great apes in the form of premasticated, mouth-to-mouth food transfer by mothers with their offspring.