The American Journal of Gastroenterology, Oct 1, 2019
INTRODUCTION: Adventurous eating in adulthood has been associated with increased dietary variety ... more INTRODUCTION: Adventurous eating in adulthood has been associated with increased dietary variety and healthy body mass index, however little is known about correlates of adventurous eating in children. METHODS: Data were collected at three time points: Baseline (age 4 years), Time point 1 (age 6 years), Time point 2 (age 8 years). At each time point mothers completed questionnaires and anthropometrics were measured. At baseline and Time point 1, children participated in observational eating tasks. Statistical analysis was done using cluster analysis. RESULTS: Two clusters were identified: Adventurous eaters and Non-adventurous eaters. Being an adventurous (vs. non) eater at time point 1 was correlated with greater child surgency, dietary variety, ability to delay gratification and maternal pressure to eat. Being an adventurous (vs. non) eater was associated with greater maternal restriction at time point 1. Adventurous eating was not associated with child body mass index z-score, or prospective weight gain. CONCLUSION: Adventurous eating is correlated with child temperamental traits that are associated with seeking novel experiences. There also may be maternal influence on child adventurous eating. Adventurous eating was not associated with cross-sectional or prospective body mass index z-score.
ImportanceThe capacity for regulation of energy intake (REI) to match energy needs is thought to ... more ImportanceThe capacity for regulation of energy intake (REI) to match energy needs is thought to contribute to differences in weight gain, and preventing excess infant weight gain is a priority.ObjectiveTo determine capacity for REI across infancy.Design, Setting, and ParticipantsFor this cohort study, a convenience sample of mother-infant dyads was recruited from the community in Michigan between 2015 and 2019. Inclusion criteria were healthy, full-term infants with weight appropriate for gestational age; biological mothers who were 18 years or older, English speaking, and a legal and custodial guardian; and infant having had consumed 2 oz or more in 1 feeding from an artificial nipple at least once per week. Infants were followed in the home setting with staff support for up to 12 months.InterventionsMother-infant dyads participated at infant age 1, 2.5, 5, 7, 10, and 12 months. In the intervention condition, mothers offered a feeding every hour for 6 hours. In the control condition, mothers fed infants as they typically would for 6 hours. Intake was recorded and kilocalories calculated.Main Outcomes and MeasuresCapacity for REI was indexed as the difference in intake in kilocalories per kilogram of body weight (intervention minus control condition); a value of 0 indicated perfect REI. Maternal and infant characteristics were obtained by questionnaire, and anthropometry was measured. Using multiple imputation, the intercept and slope for difference in kilocalories per kilogram across the 6 age points were estimated using mixed models accounting for repeated measures within participants. Statistical analyses were conducted between September 2021 and February 2023.ResultsThe sample included 175 infants (87 [49.71%] female, 88 [50.29%] male; 494 pairs of intervention and control conditions and 4630 feedings). The mean (SD) 12-month weight-for-age z score was 0.1 (0.8). Mean (SD) gestational age as 39.55 (1.05) weeks, and mean (SD) birth weight was 3.43 (0.41) kg. Mean (SD) breastfeeding duration for those who reported stopping by 12 months was 17.83 (12.03) weeks. As designed, the intervention (compared with control) condition included more feedings at shorter intervals. After collapsing the data across age points in a mixed model accounting for repeated measures within participants, the REI estimate at 1 month differed from 0. On average, infants ate 5.21 kcal/kg (95% CI, 2.89-7.54 kcal/kg) more in the frequent feeding intervention condition than in the ad lib feeding control condition. This difference did not significantly change over 12 months of infancy (REI slope = −0.01 kcal/kg per month; 95% CI, −0.02 to 0.03 kcal/kg per month).Conclusions and RelevanceThe study’s findings suggested that, on average, when offered more frequent feedings, healthy, full-term infants may overeat. The results provide support for responsive feeding as a strategy for preventing excess infant weight gain.
Behavioral responses to sucrose provide an index of positive hedonic response in newborns. In 118... more Behavioral responses to sucrose provide an index of positive hedonic response in newborns. In 118 infants, the current study used repeated assessments to explore behavioral responses to sucrose solutions (24%/50% sucrose) compared to water across the first six months of infancy. Lip smacking and bringing fingers to mouth are more likely to occur in response to 24% sucrose relative to water. Tongue protrusions are also more likely to occur for 50% sucrose relative to water. Behavioral responses to sucrose may provide an index of positive hedonic response and could be used to investigate individual differences in the first six months of infancy.
International Journal of Behavioral Nutrition and Physical Activity
Background Individual differences in eating behaviors among young children are well-established, ... more Background Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight. Methods A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3–4 years and their parents with low-income backgrounds. Children’s eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status. Results LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (2...
Selective eating in children is commonly measured by parental report questionnaires, yet it is un... more Selective eating in children is commonly measured by parental report questionnaires, yet it is unknown if parents accurately estimate their child's selective eating behavior. The objectives of this study were to test the validity and stability of two measures of selective eating using observed child behavior. Low-income mother-child dyads participated in a videotaped laboratory eating protocol at two time points (baseline: mean child age = 5.9 years; follow-up: mean child age = 8.6 years), during which they were presented with a familiar and an unfamiliar vegetable. Videos were reliably coded for child selective eating behaviors: amount consumed, child hedonic rating of vegetables, child compliance with maternal prompts to eat, latency to first bite, number of bites, and negative utterances. Mothers completed the Child Eating Behavior Questionnaire Food Fussiness (CEBQ FF) scale and the Food Neophobia Scale (FNS) at both time points. Questionnaire validity, stability of measured...
OBJECTIVE. Household energy security has not been measured empirically or related to child health... more OBJECTIVE. Household energy security has not been measured empirically or related to child health and development but is an emerging concern for clinicians and researchers as energy costs increase. The objectives of this study were to develop a clinical indicator of household energy security and assess associations with food security, health, and developmental risk in children <36 months of age.METHODS. A cross-sectional study that used household survey and surveillance data was conducted. Caregivers were interviewed in emergency departments and primary care clinics form January 2001 through December 2006 on demographics, public assistance, food security, experience with heating/cooling and utilities, Parents Evaluation of Developmental Status, and child health. The household energy security indicator includes energy-secure, no energy problems; moderate energy insecurity, utility shutoff threatened in past year; and severe energy insecurity, heated with cooking stove, utility shu...
OBJECTIVE. The potential association between short sleep duration or sleep problems and childhood... more OBJECTIVE. The potential association between short sleep duration or sleep problems and childhood overweight has not been well described. The objective of this study was to test the independent associations of sleep duration and problems with overweight risk in children. METHODS. Data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were analyzed. In 3rd and 6th grades, sleep duration and problems were obtained by maternal report, and height and weight were measured, with overweight defined as a BMI of ≥95th percentile for age and gender. Logistic regression evaluated the association of sleep duration and problems with overweight at 6th grade cross-sectionally adjusting for gender, race, and maternal education. Additional covariates tested individually included the level of chaos at home, the quality of the home environment, the lax-parenting subscale score of the Raising Children Checklist, and the Child Behavior Chec...
The American Journal of Gastroenterology, Oct 1, 2019
INTRODUCTION: Adventurous eating in adulthood has been associated with increased dietary variety ... more INTRODUCTION: Adventurous eating in adulthood has been associated with increased dietary variety and healthy body mass index, however little is known about correlates of adventurous eating in children. METHODS: Data were collected at three time points: Baseline (age 4 years), Time point 1 (age 6 years), Time point 2 (age 8 years). At each time point mothers completed questionnaires and anthropometrics were measured. At baseline and Time point 1, children participated in observational eating tasks. Statistical analysis was done using cluster analysis. RESULTS: Two clusters were identified: Adventurous eaters and Non-adventurous eaters. Being an adventurous (vs. non) eater at time point 1 was correlated with greater child surgency, dietary variety, ability to delay gratification and maternal pressure to eat. Being an adventurous (vs. non) eater was associated with greater maternal restriction at time point 1. Adventurous eating was not associated with child body mass index z-score, or prospective weight gain. CONCLUSION: Adventurous eating is correlated with child temperamental traits that are associated with seeking novel experiences. There also may be maternal influence on child adventurous eating. Adventurous eating was not associated with cross-sectional or prospective body mass index z-score.
ImportanceThe capacity for regulation of energy intake (REI) to match energy needs is thought to ... more ImportanceThe capacity for regulation of energy intake (REI) to match energy needs is thought to contribute to differences in weight gain, and preventing excess infant weight gain is a priority.ObjectiveTo determine capacity for REI across infancy.Design, Setting, and ParticipantsFor this cohort study, a convenience sample of mother-infant dyads was recruited from the community in Michigan between 2015 and 2019. Inclusion criteria were healthy, full-term infants with weight appropriate for gestational age; biological mothers who were 18 years or older, English speaking, and a legal and custodial guardian; and infant having had consumed 2 oz or more in 1 feeding from an artificial nipple at least once per week. Infants were followed in the home setting with staff support for up to 12 months.InterventionsMother-infant dyads participated at infant age 1, 2.5, 5, 7, 10, and 12 months. In the intervention condition, mothers offered a feeding every hour for 6 hours. In the control condition, mothers fed infants as they typically would for 6 hours. Intake was recorded and kilocalories calculated.Main Outcomes and MeasuresCapacity for REI was indexed as the difference in intake in kilocalories per kilogram of body weight (intervention minus control condition); a value of 0 indicated perfect REI. Maternal and infant characteristics were obtained by questionnaire, and anthropometry was measured. Using multiple imputation, the intercept and slope for difference in kilocalories per kilogram across the 6 age points were estimated using mixed models accounting for repeated measures within participants. Statistical analyses were conducted between September 2021 and February 2023.ResultsThe sample included 175 infants (87 [49.71%] female, 88 [50.29%] male; 494 pairs of intervention and control conditions and 4630 feedings). The mean (SD) 12-month weight-for-age z score was 0.1 (0.8). Mean (SD) gestational age as 39.55 (1.05) weeks, and mean (SD) birth weight was 3.43 (0.41) kg. Mean (SD) breastfeeding duration for those who reported stopping by 12 months was 17.83 (12.03) weeks. As designed, the intervention (compared with control) condition included more feedings at shorter intervals. After collapsing the data across age points in a mixed model accounting for repeated measures within participants, the REI estimate at 1 month differed from 0. On average, infants ate 5.21 kcal/kg (95% CI, 2.89-7.54 kcal/kg) more in the frequent feeding intervention condition than in the ad lib feeding control condition. This difference did not significantly change over 12 months of infancy (REI slope = −0.01 kcal/kg per month; 95% CI, −0.02 to 0.03 kcal/kg per month).Conclusions and RelevanceThe study’s findings suggested that, on average, when offered more frequent feedings, healthy, full-term infants may overeat. The results provide support for responsive feeding as a strategy for preventing excess infant weight gain.
Behavioral responses to sucrose provide an index of positive hedonic response in newborns. In 118... more Behavioral responses to sucrose provide an index of positive hedonic response in newborns. In 118 infants, the current study used repeated assessments to explore behavioral responses to sucrose solutions (24%/50% sucrose) compared to water across the first six months of infancy. Lip smacking and bringing fingers to mouth are more likely to occur in response to 24% sucrose relative to water. Tongue protrusions are also more likely to occur for 50% sucrose relative to water. Behavioral responses to sucrose may provide an index of positive hedonic response and could be used to investigate individual differences in the first six months of infancy.
International Journal of Behavioral Nutrition and Physical Activity
Background Individual differences in eating behaviors among young children are well-established, ... more Background Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight. Methods A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3–4 years and their parents with low-income backgrounds. Children’s eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status. Results LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (2...
Selective eating in children is commonly measured by parental report questionnaires, yet it is un... more Selective eating in children is commonly measured by parental report questionnaires, yet it is unknown if parents accurately estimate their child's selective eating behavior. The objectives of this study were to test the validity and stability of two measures of selective eating using observed child behavior. Low-income mother-child dyads participated in a videotaped laboratory eating protocol at two time points (baseline: mean child age = 5.9 years; follow-up: mean child age = 8.6 years), during which they were presented with a familiar and an unfamiliar vegetable. Videos were reliably coded for child selective eating behaviors: amount consumed, child hedonic rating of vegetables, child compliance with maternal prompts to eat, latency to first bite, number of bites, and negative utterances. Mothers completed the Child Eating Behavior Questionnaire Food Fussiness (CEBQ FF) scale and the Food Neophobia Scale (FNS) at both time points. Questionnaire validity, stability of measured...
OBJECTIVE. Household energy security has not been measured empirically or related to child health... more OBJECTIVE. Household energy security has not been measured empirically or related to child health and development but is an emerging concern for clinicians and researchers as energy costs increase. The objectives of this study were to develop a clinical indicator of household energy security and assess associations with food security, health, and developmental risk in children <36 months of age.METHODS. A cross-sectional study that used household survey and surveillance data was conducted. Caregivers were interviewed in emergency departments and primary care clinics form January 2001 through December 2006 on demographics, public assistance, food security, experience with heating/cooling and utilities, Parents Evaluation of Developmental Status, and child health. The household energy security indicator includes energy-secure, no energy problems; moderate energy insecurity, utility shutoff threatened in past year; and severe energy insecurity, heated with cooking stove, utility shu...
OBJECTIVE. The potential association between short sleep duration or sleep problems and childhood... more OBJECTIVE. The potential association between short sleep duration or sleep problems and childhood overweight has not been well described. The objective of this study was to test the independent associations of sleep duration and problems with overweight risk in children. METHODS. Data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were analyzed. In 3rd and 6th grades, sleep duration and problems were obtained by maternal report, and height and weight were measured, with overweight defined as a BMI of ≥95th percentile for age and gender. Logistic regression evaluated the association of sleep duration and problems with overweight at 6th grade cross-sectionally adjusting for gender, race, and maternal education. Additional covariates tested individually included the level of chaos at home, the quality of the home environment, the lax-parenting subscale score of the Raising Children Checklist, and the Child Behavior Chec...
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Papers by Danielle Appugliese