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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.

Author information

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

Abstract

OBJECTIVE:

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

DESIGN:

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.

SUBJECTS:

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

SETTING:

Urban and suburban Maryland, USA.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

Diet; Ecological momentary assessment; Home environment; Toddlers

PMID:
29526170
DOI:
10.1017/S1368980018000186

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