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1. Temperament Is Associated With Outdoor Free Play in Young Children: A TARGet Kids! Study

Author

Julia R. Sharp, Jonathon L. Maguire, Sarah Carsley, Kawsari Abdullah, Yang Chen, Eliana M. Perrin, Patricia C. Parkin, Catherine S. Birken, Eddy Lau, Andreas Laupacis, Michael Salter, Peter Szatmari, Shannon Weir, Mary Aglipay, Yamna Ali, Laura N. Anderson, Imaan Bayoumi, Cornelia M. Borkhoff, Shiyi Chen, David W.H. Dai, Denise Darmawikarta, Cindy-Lee Dennis, Karen Eny, Stephanie Erdle, Kayla Furlong, Kanthi Kavikondala, Christine Koroshegyi, Christine Kowal, Grace Jieun Lee, Dalah Mason, Jessica Omand, Navindra Persaud, Lesley Plumptre, Meta van den Heuvel, Shelley Vanderhout, Peter Wong, Weeda Zabih, Murtala Abdurrahman, Barbara Anderson, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Nicholas Blanchette, Gary Bloch, Joey Bonifacio, Ashna Bowry, Anne Brown, Jennifer Bugera, Caroline Calpin, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Erin Culbert, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Keewai Fung, Sharon Gazeley, Donna Goldenberg, Charlie Guiang, Dan Ha, Shuja Hafiz, Curtis Handford, Laura Hanson, Leah Harrington, Hailey Hatch, Teresa Hughes, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Tara Kiran, Lauren Kitney, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Fok-Han Leung, Alan Li, Patricia Li, Jennifer Loo, Joanne Louis, Sarah Mahmoud, Roy Male, Vashti Mascoll, Rosemary Moodie, Julia Morinis, Maya Nader, Sharon Naymark, Patricia Neelands, James Owen, Jane Parry, Michael Peer, Kifi Pena, Marty Perlmutar, Andrew Pinto, Tracy Pitt, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Jesleen Rana, Alana Rosenthal, Katherine Rouleau, Janet Saunderson, Rahul Saxena, Vanna Schiralli, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Suzanne Turner, Fatima Uddin, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Anne Wormsbecker, Ethel Ying, Elizabeth Young, Michael Zajdman, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Thivia Jegathesan, Tarandeep Malhi, Sharon Thadani, Julia Thompson, Laurie Thompson, Christopher Allen, Bryan Boodhoo, Judith Hall, Peter Juni, Gerald Lebovic, Karen Pope, Jodi Shim, Kevin Thorpe, and Azar Azad

Subjects
Male, Surgency, media_common.quotation_subject, Psychological intervention, Negative affectivity, Developmental psychology, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, 030225 pediatrics, medicine, Humans, Obesity, 030212 general & internal medicine, Temperament, Association (psychology), Exercise, media_common, Extraversion and introversion, Confounding, Infant, medicine.disease, Play and Playthings, Child, Preschool, Multivariate Analysis, Pediatrics, Perinatology and Child Health, Linear Models, Female, Sedentary Behavior, Psychology, Clinical psychology
Abstract

Objective Outdoor free play is important for preschoolers' physical activity, health, and development. Certain temperamental characteristics are associated with obesity, nutrition, and sedentary behaviors in preschoolers, but the relationship between temperament and outdoor play has not been examined. This study examined whether there is an association between temperament and outdoor play in young children. Methods Healthy children aged 1 to 5 years recruited to The Applied Research Group for Kids (TARGet Kids!), a community-based primary care research network, from July 2008 to September 2013 were included. Parent-reported child temperament was assessed using the Childhood Behavior Questionnaire. Outdoor free play and other potential confounding variables were assessed through validated questionnaires. Multivariable linear regression was used to determine the association between temperament and outdoor play, adjusted for potential confounders. Results There were 3393 children with data on outdoor play. The association between negative affectivity and outdoor play was moderated by sex; in boys, for every 1-point increase in negative affectivity score, mean outdoor play decreased by 4.7 minutes per day. There was no significant association in girls. Surgency was associated with outdoor play; for every 1-point increase in surgency/extraversion, outdoor play increased by 4.6 minutes per day. Conclusions Young children's temperamental characteristics were associated with their participation in outdoor free play. Consideration of temperament could enhance interventions and strategies to increase outdoor play in young children. Longitudinal studies are needed to elucidate the relationship between children's early temperament and physical activity.

Published
2018

2. Total Breast-Feeding Duration and Dental Caries in Healthy Urban Children

Author

Peter D. Wong, Catherine S. Birken, Patricia C. Parkin, Isvarya Venu, Yang Chen, Robert J. Schroth, Jonathon L. Maguire, Kawsari Abdullah, Laura N. Anderson, Cornelia M. Borkhoff, Sarah Carsley, Mikael Katz-Lavigne, Kanthi Kavikondala, Grace Jieun Lee, Dalah Mason, Jessica Omand, Navindra Persaud, Meta van den Heuvel, Weeda Zabih, Jillian Baker, Tony Barozzino, Joey Bonifacio, Douglas Campbell, Sohail Cheema, Brian Chisamore, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Sloane Freeman, Keewai Fung, Charlie Guiang, Curtis Handford, Hailey Hatch, Sheila Jacobson, Tara Kiran, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Fok-Han Leung, Jennifer Loo, Sarah Mahmoud, Rosemary Moodie, Julia Morinis, Sharon Naymark, Patricia Neelands, James Owen, Michael Peer, Marty Perlmutar, Andrew Pinto, Michelle Porepa, Nasreen Ramji, Noor Ramji, Alana Rosenthal, Janet Saunderson, Rahul Saxena, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Carolyn Taylor, Thea Weisdors, Sheila Wijayasinghe, Peter Wong, Ethel Ying, and Elizabeth Young

Subjects
Male, medicine.medical_specialty, Pediatrics, Time Factors, Urban Population, Cross-sectional study, Dentistry, Dental Caries, Logistic regression, Odds, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, 030225 pediatrics, medicine, Humans, Early childhood, Child, Dental Care for Children, Preventive healthcare, Ontario, business.industry, Infant, 030206 dentistry, Confidence interval, Breast Feeding, Cross-Sectional Studies, Logistic Models, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Preventive Medicine, business, Breast feeding
Abstract

Objective To determine if there is an association between longer breast-feeding duration and dental caries in healthy urban children. Methods We conducted a cross-sectional study of urban children aged 1 to 6 years recruited through The Applied Research Group for Kids (TARGet Kids!) practice-based research network between September 2011 and August 2013. The main outcome measure was parental report of dental caries. Results The adjusted predicted probability of dental caries was 7%, 8%, 11%, and 16% with total duration of breast-feeding duration of 12, 18, 24, and 36 months, respectively. In the adjusted logistic regression analyses, relative to breast-feeding 0 to 5 months, the odds of dental caries with total breast-feeding duration >24 months was 2.75 (95% confidence interval 1.61–4.72). Conclusions Among healthy urban children, longer breast-feeding duration was associated with higher odds of dental caries. These findings support heightened awareness and enhanced anticipatory guidance for preventive dental care, particularly among children who breast-feed beyond 2 years of age.

Published
2016

3. The Association of Breastfeeding Duration and Early Childhood Cardiometabolic Risk

Author

Peter D. Wong, Laura N. Anderson, David D.W. Dai, Patricia C. Parkin, Jonathan L. Maguire, Catherine S. Birken, Eddy Lau, Andreas Laupacis, Michael Salter, Peter Szatmari, Shannon Weir, Charmaine Camacho, Arthana Chandraraj, Dharma Dalwadi, Ayesha Islam, Thivia Jegathesan, Tarandeep Malhi, Megan Smith, Laurie Thompson, Christopher Allen, Bryan Boodhoo, Judith Hall, Peter Juni, Gerald Lebovic, Karen Pope, Jodi Shim, Kevin Thorpe, Azar Azad, Kawsari Abdullah, Yamna Ali, Imaan Bayoumi, Cornelia M. Borkhoff, Sarah Carsley, Shiyi Chen, Yang Chen, Denise Darmawikarta, Cindy-Lee Dennis, Karen Eny, Stephanie Erdle, Kayla Furlong, Kanthi Kavikondala, Christine Koroshegyi, Christine Kowal, Grace Jieun Lee, Dalah Mason, Jessica Omand, Navindra Persaud, Lesley Plumptre, Meta van den Heuvel, Shelley Vanderhout, Weeda Zabih, Murtala Abdurrahman, Barbara Anderson, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Nicholas Blanchette, Gary Bloch, Joey Bonifacio, Ashna Bowry, Anne Brown, Jennifer Bugera, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Ellen Culbert, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Keewai Fung, Sharon Gazeley, Charlie Guiang, Dan Ha, Curtis Handford, Laura Hanson, Hailey Hatch, Teresa Hughes, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Tara Kiran, Lauren Kitney, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Fok-Han Leung, Alan Li, Jennifer Loo, Joanne Louis, Sarah Mahmoud, Roy Male, Vashti Mascoll, Rosemary Moodie, Julia Morinis, Maya Nader, Sharon Naymark, Patricia Neelands, James Owen, Jane Parry, Michael Peer, Kifi Pena, Marty Perlmutar, Andrew Pinto, Tracy Pitt, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Jesleen Rana, Alana Rosenthal, Katherine Rouleau, Janet Saunderson, Rahul Saxena, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Suzanne Turner, Fatima Uddin, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Anne Wormsbecker, Ethel Ying, Elizabeth Young, Michael Zajdman, and Ian Zenlea

Subjects
Male, Pediatrics, medicine.medical_specialty, Time Factors, Waist, Heart disease, Cross-sectional study, Breastfeeding, 030209 endocrinology & metabolism, Standard score, 03 medical and health sciences, 0302 clinical medicine, Metabolic Diseases, Risk Factors, 030225 pediatrics, Humans, Medicine, Early childhood, Child, business.industry, Age Factors, Infant, Newborn, Infant, Protective Factors, medicine.disease, Breast Feeding, Cross-Sectional Studies, Blood pressure, Cardiovascular Diseases, Child, Preschool, Pediatrics, Perinatology and Child Health, Linear Models, Female, business, Breast feeding
Abstract

Objective To evaluate the association between breastfeeding duration and early childhood cardiometabolic risk. Study design A cross-sectional study of 1539 healthy children, 3-6 years of age, recruited through The Applied Research Group for Kids! practice-based research network between October 2009 and August 2015. Adjusted multivariable linear regression was used to examine the association between breastfeeding duration and cardiometabolic risk z score and individual cardiometabolic risk factors of waist circumference, systolic blood pressure, glucose, high-density lipoprotein cholesterol, and triglycerides. Results The mean breastfeeding duration was 12.5 months (SD = 8.4). Breastfeeding duration was associated with lower cardiometabolic risk z score (beta = −0.03; 95% CI −0.05, −0.01). In analysis of cardiometabolic risk factors, each additional 3 months of breastfeeding was associated with a 0.13 cm (95% CI −0.20, −0.05) lower waist circumference and 0.16 mm Hg (95% CI −0.30, −0.02) lower systolic blood pressure. Compared with children who breastfed for 6-12 months, those who breastfed for 12-24 months had a lower systolic blood pressure of 1.07 mm Hg (95% CI −2.04, −0.10). There was no association between breastfeeding duration and cardiometabolic risk for those who breastfed beyond 24 months. Conclusions Breastfeeding duration is associated with lower cardiometabolic risk, although the magnitude of association is small. Causation cannot be inferred. Breastfeeding beyond 24 months may not have an added benefit for cardiometabolic health.

Published
2018

4. Association Between Meat and Meat-Alternative Consumption and Iron Stores in Early Childhood

Author

Kelly Anne Cox, Patricia C. Parkin, Laura N. Anderson, Yang Chen, Catherine S. Birken, Jonathon L. Maguire, Colin Macarthur, Cornelia M. Borkhoff, Kawsari Abdullah, Imaan Bayoumi, Sarah Carsley, Mikael Katz-Lavigne, Kanthi Kavikondala, Christine Koroshegyi, Christine Kowal, Grace Jieun Lee, Dalah Mason, Jessica Omand, Navindra Persaud, Meta van den Heuvel, Peter Wong, Weeda Zabih, Jillian Baker, Tony Barozzino, Joey Bonifacio, Douglas Campbell, Sohail Cheema, Brian Chisamore, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Michael Dorey, Sloane Freeman, Keewai Fung, Charlie Guiang, Curtis Handford, Hailey Hatch, Sheila Jacobson, Tara Kiran, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Fok-Han Leung, Jennifer Loo, Sarah Mahmoud, Rosemary Moodie, Julia Morinis, Sharon Naymark, Patricia Neelands, James Owen, Michael Peer, Marty Perlmutar, Andrew Pinto, Michelle Porepa, Nasreen Ramji, Noor Ramji, Alana Rosenthal, Janet Saunderson, Rahul Saxena, Michael Sgro, Susan Shepherd, Barbara Smiltnieks, Carolyn Taylor, Thea Weisdors, Sheila Wijayasinghe, Ethel Ying, Elizabeth Young, Mark Feldman, Moshe Ipp, Kathleen Abreo, Dharma Dalwadi, Tarandeep Malhi, Antoinetta Pugliese, Megan Smith, and Laurie Thompson

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Meat, Reference Daily Intake, Body Mass Index, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Environmental health, medicine, Animals, Humans, 2. Zero hunger, Ontario, 030109 nutrition & dietetics, Anemia, Iron-Deficiency, business.industry, food and beverages, Infant, Iron deficiency, Odds ratio, medicine.disease, Confidence interval, 3. Good health, Surgery, Diet, Breast Feeding, Cross-Sectional Studies, Milk, Red Meat Consumption, Child, Preschool, Pediatrics, Perinatology and Child Health, Ferritins, Multivariate Analysis, Red meat, Female, business, Body mass index, Breast feeding
Abstract

Objective To prevent iron deficiency, 2014 Canadian recommendations for healthy term infants from 6 to 24 months recommend iron-rich complementary foods such as meat and meat alternatives 2 or more times a day. The purpose of our study was to evaluate the association between meat and meat-alternative consumption and iron status in young children and the association between red meat consumption and iron status among children meeting recommendations. Methods Healthy children aged 12 to 36 months were recruited. A cross-sectional study was conducted. Meat and meat-alternative consumption was measured using the NutriSTEP questionnaire. Adjusted multivariable regression analyses were used to evaluate an association between meat consumption and serum ferritin, and iron deficiency (serum ferritin Results A total of 1043 children were included. Seventy-three percent of children met the recommended daily intake of meat and meat alternatives, and 66% ate red meat in the past 3 days. Eating meat and meat alternatives was not associated with serum ferritin (0.13 μg/L, 95% confidence interval −0.05, 0.31, P = .16), but it was associated with a decreased odds of iron deficiency (odds ratio 0.97, 95% confidence interval 0.94, 0.99, P = .03). Associations between red meat consumption and iron status were not statistically significant. Statistically significant covariates associated with increased odds of iron deficiency included longer breast-feeding duration, daily cow's milk intake of >2 cups, and a higher body mass index z score. Conclusions Daily cow's milk intake of >2 cups, longer breast-feeding duration, and a higher body mass index z score were modifiable risk factors associated with iron deficiency. Eating meat according to recommendations may be a promising additional target for the prevention of iron deficiency in early childhood.

Published
2015

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