Where and when are portion sizes larger in young children? An analysis of eating occasion size among 1.5-5-year-olds in the UK National Diet and Nutrition Survey (2008-17)

Objective To identify eating occasion-level and individual-level factors associated with the consumption of larger portions in young children and estimate their relative importance. Design Cross-sectional. Setting Data from parent-reported 4-day food diaries in the UK National Diet and Nutrition Survey (2008-17) were analysed. Multilevel models explored variation in eating occasion size (kJ) within (n=48,419 occasions) and between children (n=1962) for all eating occasions. Eating contexts; location, eating companion, watching TV, and sitting at a table and individual characteristics; age, gender, ethnicity, and parental socioeconomic status were explored as potential correlates of eating occasion size. Participants Children aged 1.5-5 years. Results Median eating occasion size was 657kJ (IQR 356, 1117) Eating occasion size variation was primarily attributed (90%) to differences between eating occasions. Most (73%) eating occasions were consumed at home. In adjusted models, eating occasions in eateries were 377kJ larger than at home. Eating occasions sitting at a table, vs. not, were 197kJ larger. Eating in childcare, with additional family members and friends, and whilst watching TV were other eating contexts associated with slightly larger eating occasion sizes. Conclusions Eating contexts that vary from one eating occasion to another are more important than demographic characteristics that vary between children in explaining variation in consumed portion sizes in young children. Strategies to promote consumption of age-appropriate portion sizes in young children should be developed, especially in the home environment, in eating contexts such as sitting at the table, eating with others and watching TV.

Temporal Eating Patterns and Eating Windows among Adults with Overweight or Obesity

We aim to describe temporal eating patterns in a population of adults with overweight or obesity. In this cross-sectional analysis, data were combined from two separate pilot studies during which participants entered the timing of all eating occasions (>0 kcals) for 10–14 days. Data were aggregated to determine total eating occasions, local time of the first and last eating occasions, eating window, eating midpoint, and within-person variability of eating patterns. Eating patterns were compared between sexes, as well as between weekday and weekends. Participants (n = 85) had a median age of 56 ± 19 years, were mostly female (>70%), white (56.5%), and had a BMI of 31.8 ± 8.0 kg/m2. The median eating window was 14 h 04 min [12 h 57 min–15 h 21 min], which was significantly shorter on the weekend compared to weekdays (p < 0.0001). Only 13.1% of participants had an eating window <12 h/d. Additionally, there was greater irregularity with the first eating occasion during the week when compared to the weekend (p = 0.0002). In conclusion, adults with overweight or obesity have prolonged eating windows (>14 h/d). Future trials should examine the contribution of a prolonged eating window on adiposity independent of energy intake.

Examination of dietary intake of UK preschool children by varying carers: Evidence from the 2008-2016 UK National Diet and Nutrition Survey

Early years caregivers can play a key role in young children’s eating and the prevention of childhood obesity. The UK National Diet and Nutrition Survey (NDNS) is a large representative survey collecting detailed food and nutrition consumption data. Using these data, the aim of this study was to investigate the relationship between dietary intake of preschool children in the UK aged two to four years old and accompanying adult/s. Nutrition consumption data from 1,218 preschool children from years one to eight of the NDNS (2008 to 2016) were accessed. Dietary data was captured using three or four day estimated food diaries. Regression analyses were performed to explore the association between dietary intake and accompanying adult. There were significant differences in consumption when children were not accompanied by their parents. Compared to when children were with parents, children consumed significantly more energy (15kcal, 95% CI 7-23kcal) sodium (−19mg, 95% CI 6-32mg), added sugars (0.6g, 95% CI 0.1-1.1g), vegetables (3g, 95% CI 1-4g), total grams (12g, 95% CI 3-21g) and saturated fat (0.2g, 95% CI 0.1-0.4g) per eating occasion when accompanied by wider family. When children were accompanied by a formal carer they consumed significantly less added sugars (−1.6g, 95% CI −2.4-0.8g) and more fruit (12g, 95% CI 3-21g) per eating occasion than when they were with their parents. The results demonstrate that non-parental caregivers might be an important target to promote healthy eating in young children. Further research is needed to establish which caregivers would benefit most.

Content Validation of a Chrononutrition Questionnaire for the General and Shift Work Populations: A Delphi Study

Unusual meal timing has been associated with a higher prevalence of chronic disease. Those at greater risk include shift workers and evening chronotypes. This study aimed to validate the content of a Chrononutrition Questionnaire for shift and non-shift workers to identify temporal patterns of eating in relation to chronotype. Content validity was determined using a Delphi study of three rounds. Experts rated the relevance of, and provided feedback on, 46 items across seven outcomes: meal regularity, times of first eating occasion, last eating occasion, largest meal, main meals/snacks, wake, and sleep, which were edited in response. Items with greater than 70% consensus of relevance were accepted. Rounds one, two, and three had 28, 26, and 24 experts, respectively. Across three rounds, no outcomes were irrelevant, but seven were merged into three for ease of usage, and two sections were added for experts to rate and comment on. In the final round, all but one of 29 items achieved greater than 70% consensus of relevance with no further changes. The Chrononutrition Questionnaire was deemed relevant to experts in circadian biology and chrononutrition, and could represent a convenient tool to assess temporal patterns of eating in relation to chronotype in future studies.

Development and Validation of a Sustainable Diet Index among Malaysian Adults: Protocol

Adopting a sustainable diet is an alternative to address the pandemics of obesity, undernutrition and climate change that are threatening human health. Sustainable diet considers the health aspect as well as the environmental impact of diets. There is a scarcity of research on sustainable diet and lack validated tools for its measurement. This article aimed to describe the protocol on the development and validation of a Sustainable Diet Index (SDI) among Malaysian adults. A Sustainable Diet Index (SDI) was developed based on previous studies and available dietary guidelines on sustainable diet. Five indicators (rice, animal-based food, plant-based food, food waste and packaging) were included in the SDI. The index will be validated among Malaysian adults using mobile food record as the dietary assessment tool. The index has the potential to measure the level of healthy and sustainable diet behaviour of an individual. The use of mobile food record provides images of each eating occasion for the evaluation of serving size and the information on waste management. Health and environmental impacts from the diet can be evaluated through the integration of all indicators in the SDI. The index developed is novel and expected to provide a feasible measurement to assess the level of sustainable diet of an individual.

Changes in Adolescent Meal Patterns and Processed Food Consumption Following Sleep Restriction: Results From a Randomized Crossover Trial

Objectives To evaluate if sleep restriction influences 1) meal frequency and late evening food consumption; and 2) intake of ultra-processed foods in male and female adolescents. Methods A total of 92 healthy adolescents 14–17 years old participated in a cross-over experimental sleep protocol, comparing two conditions, each lasting 5 nights: healthy sleep (HS, 9.5 h/night) and shortened sleep (SS, 6.5 h/night). The order of conditions was randomly counterbalanced, and there was a washout period of 2 days between conditions. The study team conducted 24-h dietary recalls on 3 randomly selected days during each sleep condition. For objective 1, we used the timestamps of the meals in each dietary recall to determine number of eating occasion in 24 h, number of eating occasion after 8PM, and kilocalories consumed after 8PM. For objective 2, we used the Nova food classification system to determine kilocalories and % of kilocalories consumed from ultra-processed foods (UPF) over 24 hours and after 8PM. We used general linear model analysis to compare these outcomes between HS and SS conditions. We also explored the moderating impact of individual and experimental factors, including family income and participant age, sex, age- and sex-adjusted body mass index, and the order in which they had the sleep conditions. Results There was no significant difference in number of eating occasions in 24 h across experimental conditions (SS = 4.2, HS = 4.1, P = .25). After 8PM, there was a significantly greater number of eating occasions (0.87 vs. 0.59, P &lt; .001) and higher kilocalorie consumption (354 vs. 223, P &lt; .001) during SS than HS. There was no difference in daily UPF kilocalorie consumption across conditions (SS = 1439, HS = 1397, P = .38), but UPF kilocalories after 8PM were significantly higher during SS than HS (291 vs. 172, P &lt; .001). These findings did not vary based on our exploratory individual and experimental factors. Conclusions Adolescents who are sleep restricted are more likely to eat more frequently, consume greater kilocalories, and eat highly processed foods after 8PM. Considering that these findings were not observed across the entire day, our findings suggest that sleep restriction may most negatively influence dietary patterns in the late evening. Funding Sources NIH.

People serve themselves larger portions before a social meal

One of the most powerful influences on food intake yet identified is the presence of familiar others at an eating occasion: people eat much more when they eat with friends/family than when they eat alone. But why this is the case is unclear. Across two studies (Study 1: N = 98; Study 2: N = 120), we found that the mere anticipation of social interaction is all that is needed to promote the selection of larger meals, and that this occurs even when a person is alone when they make their decision. Adult women served themselves larger portions when they knew they were going to eat socially versus when they knew they were going to eat alone. These data suggest that how other people influence our food intake reaches beyond the specific eating context to affect pre-meal portion size decisions, suggesting that a fundamental shift is required in our thinking about social influences on eating.

Temporal Eating Patterns Among U.S. Infants and Toddlers, NHANES 2011–2016

Objectives As characterization of temporal eating patterns of U.S. infants and toddlers is limited, we aimed to explore eating frequency and interval, and to reveal relevant challenges related to investigation among this age group. Methods Using a single 24-hour recall from NHANES 2011–2016, we estimated eating frequency in categories (1–4, 5–7, 8–10, and ≥11 times per day) (%, Standard Error (SE)) and eating interval (mean, SE) in hours, by age group (0–5 months, 6–11 months, and 12–23 months) among infants and toddlers younger than 2 years old (n = 1704). Eating interval was defined as the last reported consumption time minus the first reported consumption time. SAS was used to incorporate weights and the complex survey design. We also explored describing the data by parent report of eating occasion (breakfast, lunch, dinner, supper, snack, etc.). Results Among children 0–23 months, 8% (SE 0.8), 54% (SE 1.3), 32% (SE 1.1), and 6% (SE 0.6) reported eating 1–4, 5–7, 8–10, and ≥11 times per day, respectively. The mean eating interval length decreased with increasing age category: 17.6 hours (SE 0.19), 15.6 hours (0.21), and 13.1 hours (SE 0.20), among infants and toddlers 0–5, 6–11, and 12–23 months (P &lt; 0.001), respectively. Attempts to evaluate eating frequency by parent-reported eating occasion revealed misalignment of clock time with reported eating occasion. For example, a parent may report multiple eating occasions as “breakfast” in a given day between the hours of 6:00 AM and 10:00 PM, interspersed among other eating occasions reported as lunch, snack, or dinner. Conclusions There is a dearth of national data on the eating habits of infants and toddlers younger than 2 years, and even less is known about the temporal eating patterns for this group. We found that more than half of infants and toddlers reported 5–7 eating occasions on a given day and that toddlers 12–23 months had shorter eating intervals compared to infants 0–5 and 6–12 months. We also found some discordance with how eating occasions were reported among infants and toddlers, as the naming does not align with more typical classification that is used among older children and adults. Therefore, caution is advised when characterizing temporal eating patterns for this group. Funding Sources N/A