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Public Health Nutr. 2018 Jul;21(10):1855-1864. doi: 10.1017/S1368980018000186. Epub 2018 Mar 12.

Factors in the home environment associated with toddler diet: an ecological momentary assessment study.

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1Department of Pediatrics,University of Maryland School of Medicine,737 West Lombard Street,Room 163,Baltimore,MD 21201,USA.
2Department of Family Medicine,University of Wisconsin Eau Claire,Madison,WI,USA.



To identify home environment factors associated with toddler dietary behaviours using ecological momentary assessment (EMA).


Home environment and toddler's diet were assessed by mothers through EMA (random beeps over ≤8 d and a brief survey). Dietary outcomes were fruit/vegetable consumption, eating episode ('snack' v. 'meal') and sugar-sweetened beverage (SSB) consumption. Home environment factors included interacting with mother, eating alone/with others, eating in a high chair/chair at the table, watching television and movement/translocation. Multilevel logistic mixed-effects regression models assessed both within- (individual toddlers across time) and between- (toddlers-on-average) subject effects.


Low-income mother-toddler dyads (n 277).


Urban and suburban Maryland, USA.


EMA captured eating/drinking episodes for 249/277 (89·9 %) toddlers (883 eating episodes, 1586 drinking episodes). Toddlers-on-average were more likely (adjusted OR, P value) to eat fruit/vegetables when not moving around (0·43, P=0·043), eat with the television off (0·33, P<0·001) and eat in a high chair/chair (3·38, P<0·001); no within-subject effects were shown. For eating episodes, both toddlers-on-average and individual toddlers were more likely to eat snacks when not in a high chair/chair (0·13, P<0·001 and 0·06, P<0·001, respectively) and when eating alone (0·30, P<0·001 and 0·31, P<0·001, respectively). Also, individual toddlers were more likely to eat snacks when moving around (3·61, P<0·001). Toddlers-on-average were more likely to consume SSB when not in a high chair/chair (0·21, P=0·001), eating alone (0·38, P=0·047) or during a snacking episode (v. a meal: 3·96, P=0·012); no within-subject effects shown.


Factors in the home environment are associated with dietary behaviours among toddlers. Understanding the interplay between the home environment and toddler diet can inform future paediatric dietary recommendations.


Diet; Ecological momentary assessment; Home environment; Toddlers


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