Girls feeling good at school: School gender environment, internalization and awareness of socio-cultural attitudes associations with self-esteem in adolescent girls.

As society continues to advocate an unrealistically thin body shape, awareness and internalization of appearance and its consequent impact upon self-esteem has become increasingly of concern, particularly in adolescent girls. School gender environment may influence these factors, but remains largely unexplored. This study aimed to assess differences between two different school environments in appearance attitudes, social influences and associations with self-esteem. Two hundred and twelve girls (M = 13.8 years) attending either a single-sex or co-educational school completed measures on socio-cultural attitudes towards appearance, social support and self-esteem. Though marginal differences between school environments were found, significantly higher internalization was reported among girls at the co-educational school. School environment moderated relations between internalization and self-esteem such that girls in co-educational environments had poorer self-esteem stemming from greater internalization. Thus, in a single-sex school environment, protective factors may attenuate negative associations between socio-cultural attitudes towards appearance and self-esteem in adolescent girls.

Dietary patterns in UK adolescents obtained from a dual-source FFQ and their associations with socio-economic position, nutrient intake and modes of eating.

OBJECTIVE: To derive dietary patterns using principal components analysis from separate FFQ completed by mothers and their teenagers and to assess associations with nutrient intakes and sociodemographic variables. DESIGN: Two distinct FFQ were completed by 13-year-olds and their mothers, with some overlap in the foods covered. A combined data set was obtained. SETTING: Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK. SUBJECTS: Teenagers (n 5334) with adequate dietary data. RESULTS: Four patterns were obtained using principal components analysis: a 'Traditional/health-conscious' pattern, a 'Processed' pattern, a 'Snacks/sugared drinks' pattern and a 'Vegetarian' pattern. The 'Traditional/health-conscious' pattern was the most nutrient-rich, having high positive correlations with many nutrients. The 'Processed' and 'Snacks/sugared drinks' patterns showed little association with important nutrients but were positively associated with energy, fats and sugars. There were clear gender and sociodemographic differences across the patterns. Lower scores were seen on the 'Traditional/health conscious' and 'Vegetarian' patterns in males and in those with younger and less educated mothers. Higher scores were seen on the 'Traditional/health-conscious' and 'Vegetarian' patterns in girls and in those whose mothers had higher levels of education. CONCLUSIONS: It is important to establish healthy eating patterns by the teenage years. However, this is a time when it is difficult to accurately establish dietary intake from a single source, since teenagers consume increasing amounts of foods outside the home. Further dietary pattern studies should focus on teenagers and the source of dietary data collection merits consideration.

Sources of vitamin A in the diets of pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC).

Vitamin A is essential for growth and development. We investigated whether high consumption of energy-dense nutrient-poor foods in the diets of pre-school children is detrimental to diet quality with respect to vitamin A. Data were collected from 755 children at 18-months and 3½-years, from the Avon Longitudinal Study of Parents and Children, using 3-day unweighed dietary records completed by parents in 1994 and 1996, respectively. Energy, carotene and retinol intakes were calculated. The quality of the diet declined from 18-months to 3½-years with respect to vitamin A. Preformed retinol intakes decreased by -54 µg/day on average (p = 0.003). Carotene intakes were similar at each age although there was a 23% increase in energy intake by 3½-years. Longitudinally those in the highest quartile of intake at 18-months were twice as likely to remain in the highest quartile at 3½-years for retinol (OR 2.21 (95% CI 1.48-3.28)) and carotene (OR 1.66 (95% CI 1.11-2.50)) than to change quartiles. Nutrient-rich core foods provided decreasing amounts of carotene and preformed retinol over time (both p < 0.001). Vegetables and milk contributed the highest proportion of carotene at both ages, but milk's contribution decreased over time. Milk and liver were the largest sources of retinol. Nutrient-poor foods provided an increased proportion of energy (p < 0.001) with low proportions of both nutrients; however fat spreads made an important contribution. It is recommended that pre-school children should take vitamin supplements; only 19% at 18-months did this, falling to 11% at 3½-years. Care should be taken to choose nutrient-rich foods and avoid energy-dense, nutrient-poor foods when feeding pre-school children.

Estimating trajectories of energy intake through childhood and adolescence using linear-spline multilevel models.

BACKGROUND: Methods for the assessment of changes in dietary intake across the life course are underdeveloped. METHODS: We demonstrate the use of linear-spline multilevel models to summarize energy-intake trajectories through childhood and adolescence and their application as exposures, outcomes, or mediators. The Avon Longitudinal Study of Parents and Children assessed children's dietary intake several times between ages 3 and 13 years, using both food frequency questionnaires (FFQs) and 3-day food diaries. We estimated energy-intake trajectories for 12,032 children using linear-spline multilevel models. We then assessed the associations of these trajectories with maternal body mass index (BMI), and later offspring BMI, and also their role in mediating the relation between maternal and offspring BMIs. RESULTS: Models estimated average and individual energy intake at 3 years, and linear changes in energy intake from age 3 to 7 years and from age 7 to 13 years. By including the exposure (in this example, maternal BMI) in the multilevel model, we were able to estimate the average energy-intake trajectories across levels of the exposure. When energy-intake trajectories are the exposure for a later outcome (in this case offspring BMI) or a mediator (between maternal and offspring BMI), results were similar, whether using a two-step process (exporting individual-level intercepts and slopes from multilevel models and using these in linear regression/path analysis), or a single-step process (multivariate multilevel models). Trajectories were similar when FFQs and food diaries were assessed either separately, or when combined into one model. CONCLUSIONS: Linear-spline multilevel models provide useful summaries of trajectories of dietary intake that can be used as an exposure, outcome, or mediator.

Dietary patterns throughout childhood and associations with nutrient intakes.

OBJECTIVE: To examine how the dietary patterns of children at various time points throughout childhood relate to estimated nutrient intakes. DESIGN: FFQ at 3, 4, 7 and 9 years of age were completed by mothers. Dietary patterns were identified cross-sectionally using principal component analysis; 'processed', 'health conscious' and 'traditional' patterns were consistently obtained. Correlations between pattern scores and nutrient intakes and proportions of variance in nutrients explained by the patterns were calculated. SETTING: Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK. SUBJECTS: Children provided data between 3 and 9 years of age (n 8010 to 10,023). RESULTS: Dietary patterns explained substantial proportions of the variance of the absolute intake for most nutrients (>25% at 3 years of age, >40% other ages). After energy adjustment, protein, fibre, K, Mg, Fe, Zn, folate, thiamin and vitamin B6 continued to be well explained. Strong correlations were observed between the 'processed' pattern and macronutrients including energy (r=0.481-0.619), total fat (r=0.529-0.662) and total sugar (r=0.475-0.693). However correlations with most micronutrients were reversed after energy adjustment, suggesting that the 'processed' pattern is energy-dense but nutrient-poor. The 'health conscious' and 'traditional' patterns were strongly positively correlated with protein, fibre and most micronutrients, whether energy adjusted or not. Higher scores on these patterns were associated with a better nutrient profile. CONCLUSIONS: Dietary patterns explain a reasonable amount of the variation in the nutrient content of diets. Higher scores on the 'health conscious' and 'traditional' dietary patterns were related to better nutrient profiles; conversely, with higher scores on the 'processed' pattern the nutrient profile was poorer.

Is maternal education level associated with diet in 10-year-old children?

OBJECTIVE: To examine the associations between maternal education level and diet in 10-year-old children. DESIGN: Three-day diet diaries (child completed with parental help) were collected. Height and weight were measured in research clinics. Maternal education level was derived from a questionnaire completed during pregnancy and classified into low, medium or high. One-way ANOVA was undertaken to compare maternal education groups for nutrient intakes and the Kruskal-Wallis test used for food consumption. SETTING: Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK. SUBJECTS: Children (n 7474) who provided dietary data at age 10 years. RESULTS: A large proportion (60 %) of the sample was classified as plausible reporters, with under-reporting accounting for 36 %. No clear differences were found for intakes of energy or macronutrients between maternal education groups for plausible reporters. However, there were marked differences in micronutrient intakes especially for vitamin C, retinol equivalents and folate, highlighting lower diet quality with lower maternal education level. Intakes of fruit and vegetables showed a positive gradient with increasing maternal education (57 % v. 79 % consumed fresh fruit in low and high educational groups, respectively). A trend towards higher intake in the lower educated group was shown for less healthy foods (meat pies P < 0·001; sausages, burgers and kebabs P < 0·001). CONCLUSIONS: The quality of children's diet at 10 years was related to maternal education level. Lower maternal education was associated with less healthy food choices that could be detrimental to health. Further research is needed to establish if these associations can be explained by other socio-economic factors.

Maternal macronutrient and energy intakes in pregnancy and offspring intake at 10 y: exploring parental comparisons and prenatal effects.

BACKGROUND: High maternal dietary intakes in pregnancy may lead to increased fetal growth and program neuroendocrine pathways that result in greater appetite, energy intake, and adiposity in offspring later in life. Few prospective dietary studies have explored this relation. OBJECTIVE: The objective was to assess associations of maternal dietary intake in pregnancy and maternal and paternal dietary intake postnatally with child dietary intake and adiposity. DESIGN: Dietary intakes of energy, protein, total fat, and carbohydrate were assessed prospectively in mothers during pregnancy, in mothers and their partners at 47 mo postnatally, and in children at 10 y (n = 5717 mother-child pairs prenatally, 5593 mother-child pairs postnatally, and 3009 father-child pairs). Child body composition was assessed at 9 and 11 y (n = 5725). RESULTS: Maternal dietary intakes of protein, fat (when adjusted for energy intake), and carbohydrate in pregnancy were positively associated with child dietary intakes of the same nutrients, and these associations were greater than those observed for paternal dietary intake, which was not strongly associated with offspring diet. Associations of maternal prenatal-offspring intakes were stronger than those of maternal postnatal-offspring intakes for protein and fat. Greater child energy and macronutrient intakes were only associated with greater adiposity in children when adjusted for potential energy underreporting. Maternal diet during pregnancy was not associated with offspring adiposity or lean mass. CONCLUSION: The stronger prenatal maternal associations with child dietary intake, particularly protein and fat, compared with both paternal intake associations and maternal postnatal intake associations provide some evidence for in utero programming of offspring appetite by maternal intake during pregnancy.