Associations between frequency of food groups offered to toddlers and their weight status

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Health, Growth, Injury

Abstract

In the US, 13.9% of children ages 2-5 are obese (CDC, 2017). This statistic is alarming. Children who are overweight or obese are significantly more likely to be overweight as adults than children who were not (Serdula et al., 1993). Links between toddler diet and elevated weight status are not fully understood. For example, in the Feeding Infants and Toddlers Study (FITS), 75% of toddlers were given desserts and sugar-sweetened beverages in a 24-hour period (Roess et al, 2018), but it is not known whether this frequent consumption of sweet foods is linked to obesity risk. The goal of the present study is to investigate the associations between the frequency of fruits, vegetables, desserts, and sugar-sweetened beverages offered to toddlers and their weight status.

Caregivers (n= 30) reported how frequently they offered their toddlers (Mage= 22.46 months, SD= 3.65 months) different foods (fruits, vegetables, desserts, and sugar-sweetened beverages) using a food frequency questionnaire (FFQ) and a 3-day food log. The American Academy of Pediatrics (AAP) recommends that toddlers consume 2-3 servings of both fruits and vegetables per day, and no desserts or sugar-sweetened beverages. Consistent with these recommendations, toddlers who were offered fruits and vegetables less than 5-10 times per week according to the FFQ were classified as “not meeting recommendations.” The total number of fruits and vegetables offered across 3 days were calculated using the food logs. Not offering any desserts and sugar-sweetened beverages (e.g., fruit drinks, soft drinks) according to the FFQ and food log was classified as “meeting recommendations.” Toddler weight and height measurements (collected by trained researchers) were used to calculate BMI-for-age percentiles according to WHO (age< 24 months) or CDC growth standards (age 24 months+). Toddlers at or above the 85th percentile were classified as overweight/obese. To control for sociodemographic and familial risk factors, an obesity risk score was created by summing 8 factors (1= risk factor present) associated with obesity: high birth weight, not breastfed, solid foods before 6 months, low family income, less than high school education in mother or father, single-parent status, and parental obesity.

Fruit and vegetable offerings were comparable across the normal and elevated weight groups with 28 (93.3%) caregiver offering meeting recommendations for fruits and 24 (80%) meeting recommendations for vegetables. However, 27 (90%) caregivers reported offering sugar-sweetened beverages (FFQ) with 10 (100%) toddlers in the elevated weight group. A series of logistic regressions were conducted to examine associations between the frequency of food groups offered and child weight classification, controlling for the obesity risk scores. Children who were offered sugar-sweetened beverages had ten times higher odds of being overweight or obese (OR: 10.06, 95% CI: 1.25-80.69, p< 0.05). The frequencies of fruits, vegetables, and desserts offered were not significantly different across the weight classifications/groups.

The results of this study suggest that offering sugar-sweetened beverages during toddlerhood may be a risk factor for obesity. Interventions focused on reducing consumption of sugar-sweetened beverages among toddlers may reduce risk for elevated weight during this critical period of development.

Authors

• Elizabeth Irene Kielb, Purdue University, West Lafayette
  Presenting Author

• Kameron Moding, Purdue University, West Lafayette
  Non-Presenting Author

• Carly Evich, Purdue University, West Lafayette
  Non-Presenting Author

• Blake L. Jones, Brigham Young University
  Non-Presenting Author

• AJ Schwichtenberg, Purdue University, West Lafayette
  Non-Presenting Author