Midlife vulnerability and food insecurity: Findings from low-income adults in the US National Health Interview Survey.

BACKGROUND: Food insecurity, limited access to adequate food, in adulthood is associated with poor health outcomes that suggest a pattern of accelerated aging. However, little is known about factors that impact food insecurity in midlife which in turn could help to identify potential pathways of accelerated aging. METHODS: Low-income adults (n = 17,866; 2014 National Health Interview Survey), ages 18 to 84, completed a 10-item food security module and answered questions regarding health challenges (chronic conditions and functional limitations) and financial worry. We used multinomial logistic regression for complex samples to assess the association of health challenges and financial worry with food insecurity status and determine whether these associations differed by age group, while adjusting for poverty, sex, race/ethnicity, education, family structure, social security, and food assistance. RESULTS: Food insecurity rates were highest in late- (37.5%) and early- (36.0%) midlife, relative to younger (33.7%) and older (20.2%) age groups and, furthermore, age moderated the relationship between food insecurity and both risk factors (interaction p-values < .05, for both). The effects of poor health were stronger in midlife relative to younger and older ages. Unlike younger and older adults, however, adults in midlife showed high levels of food insecurity regardless of financial worry. CONCLUSIONS: Findings suggest that food insecurity in midlife may be more severe than previously thought. Greater efforts are needed to identify those at greatest risk and intervene early to slow premature aging.

Influence of pre-schooler and parent nutrition education on carotenoid levels of Mexican-heritage children.

OBJECTIVE: To determine the mediating effect of direct preschool and parent nutrition education on changes in skin carotenoids scores over 2 years in children of Mexican heritage. DESIGN: In a quasi-experimental, community-based study, two school districts were randomly assigned to either a comparison group (parent workshops unrelated to nutrition) or a childhood obesity prevention intervention group which included nutrition education at family nights for parents and at school for children. Changes in skin carotenoid intensity scores (diffCAROT, year 2015 minus 2013) were measured in children as a proxy for fruit and vegetable consumption using Resonance Raman Spectroscopy. SETTING: Two rural, low-income, school districts from a county in California's Central Valley. PARTICIPANTS: 316 Mexican heritage families with children aged 3-8 years. RESULTS: Intervention group children improved over 2 years in skin carotenoid scores relative to comparison group children (diffCAROT mean +1419 (sd 9540) v. -3473 (sd 9272), P = 0·0001). Parent attendance at nutrition education classes partially mediated the intervention effect on diffCAROT (P = 0·02). Controlling for child's age and other covariates, participation in preschool during the study had a significant positive effect on diffCAROT among intervention children compared with controls (P < 0·03), whereas no significant difference by group was observed among those not enrolled in preschool or already enrolled in elementary school. CONCLUSIONS: Programmes that combine direct parent and preschool nutrition education may be effective in low-income Mexican heritage families to improve children's intake of fruit and vegetables.

A three-year multifaceted intervention to prevent obesity in children of Mexican-heritage.

BACKGROUND: Obesity and overweight have increased dramatically in the United States over the last decades. The complexity of interrelated causal factors that result in obesity needs to be addressed within the cultural dynamic of sub-populations. In this study, we sought to estimate the effects of a multifaceted, community-based intervention on body mass index (BMI) among Mexican-heritage children. METHODS: Niños Sanos, Familia Sana (Healthy Children, Healthy Family) was a quasi-experimental intervention study designed to reduce the rate of BMI growth among Mexican-heritage children in California's Central Valley. Two rural communities were matched based on demographic and environmental characteristics and were assigned as the intervention or comparison community. The three-year intervention included parent workshops on nutrition and physical activity; school-based nutrition lessons and enhanced physical education program for children; and a monthly voucher for fruits and vegetables. Eligible children were between 3 and 8 years old at baseline. Intent-to-treat analyses were estimated using linear mixed-effect models with random intercepts. We ran a series of models for each gender where predictors were fixed except interactions between age groups and obesity status at baseline with intervention to determine the magnitude of impact on BMI. RESULTS: At baseline, mean (SD) BMI z-score (zBMI) was 0.97 (0.98) in the intervention group (n = 387) and 0.98 (1.02) in the comparison group (n = 313) (NS). The intervention was significantly associated with log-transformed BMI (ß = 0.04 (0.02), P = 0.03) and zBMI (ß = 0.25 (0.12), P = 0.04) among boys and log-transformed BMI among obese girls (ß = - 0.04 (0.02), P = 0.04). The intervention was significantly and inversely associated with BMI in obese boys and girls across all age groups and normal weight boys in the oldest group (over 6 years) relative to their counterparts in the comparison community. CONCLUSIONS: A community-based, multifaceted intervention was effective at slowing the rate of BMI growth among Mexican-heritage children. Our findings suggest that practitioners should consider strategies that address gender disparities and work with a variety of stakeholders to target childhood obesity. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01900613 . Registered 16th July 2013.

Attitudes and Social Norms Are Related to Attendance at Childhood Obesity Prevention Classes in a Rural Mexican-Heritage Community.

OBJECTIVE: To examine factors related to attendance of Mexican-heritage parents at community-based nutrition classes to prevent childhood obesity. METHODS: Starting in 2011, interviewers collected baseline data from Niños Sanos Familia Sana (Healthy Children, Healthy Families) participants in rural California. Educators maintained attendance logs from 2012 to 2014. Informed by the Theory of Planned Behavior, interviewers administered an exit survey in 2015 to collect data on attitudes, subjective norms, health motivations, and perceived control related to attendance. Multivariable ordinal logistic regression analysis examined the correlates of attendance (n = 194, intervention group only). RESULTS: Controlling for mother's age, marital status, acculturation, and employment, attitudes and subjective norms were significantly related to attendance (odds ratio = 1.27; 95% confidence interval [CI], 1.18-1.37; P < .001). CONCLUSIONS AND IMPLICATIONS: In these Mexican-heritage participants, attitudes and subjective norms were significant correlates of attendance. The Theory of Planned Behavior may shed light on attendance of high-risk groups but further testing of instruments is needed.

Prevalence and predictors of overweight and obesity among Cameroonian women in a national survey and relationships with waist circumference and inflammation in Yaoundé and Douala.

Information on the distribution and predictors of obesity in Africa is needed to identify populations at risk and explore intervention options. Our objectives were to (a) examine the prevalence and geographic distribution of overweight and obesity among Cameroonian women; (b) evaluate change in anthropometric indicators among urban women between 2009 and 2012; (c) examine associations between household and individual characteristics and overweight and obesity; and (d) examine relationships between body mass index (BMI), abdominal obesity, and inflammation. We analysed data from a nationally representative survey conducted in 3 geographic strata (North, South, and Yaoundé/Douala) in Cameroon in 2009 and a survey in Yaoundé/Douala in 2012. Participants selected for this analysis were nonpregnant women, ages 15-49 years (n = 704 in 2009; n = 243 in 2012). In 2009, ~8% of women were underweight (BMI < 18.5) and 32% overweight or obese (BMI ≥ 25.0). Underweight was most common in the North (19%) and overweight and obesity in the South (40%) and Yaoundé/Douala (49%). Prevalence of BMI ≥ 25.0 in Yaoundé/Douala did not differ in 2012 compared with 2009 (55.5% vs. 48.7%; P = 0.16). Residence in urban areas, greater maternal age, and TV ownership were independently related to overweight and obesity in national and stratified analyses. In Yaoundé/Douala in 2012, 48% (waist-to-hip ratio > 0.85) to 73% (waist circumference > 80 cm) had abdominal obesity. Body mass index was positively associated with abdominal obesity and inflammation. Though causal inferences cannot be drawn, these findings indicate population subgroups at greatest risk for overweight and associated health consequences in Cameroon.

Purchases Made with a Fruit and Vegetable Voucher in a Rural Mexican-Heritage Community.

Recent recommendations for US food assistance programs are intended to ensure foods provided through these programs help households consume a varied, healthful diet. From a policy viewpoint, it is important to examine the impact of economic incentives to purchase healthy foods across subpopulations, particularly low-income Latinos, who comprise 40% of the WIC program nationwide. Our aim was to determine how rural, Mexican-heritage households (N = 227) residing in California's Central Valley distributed fruit and vegetable (F/V) voucher spending among F/V subgroups and specific items over a 1-year period. Households contained at least one child who was between 3 and 8 years old at baseline and had a parent of Mexican-heritage. F/V voucher purchase data were collected via grocery store scanners. Expenditure and frequency shares of subgroups and individual items were analyzed to determine purchasing habits. Fruits were the most commonly purchased subgroup, representing 55% of spending and 45% of frequency. Households allocated low percentages of their voucher to dark green and red/orange vegetables-7 and 9% respectively. Approximately 20% of purchases were good potassium sources and 30% of purchases were good fiber sources. Many of the most frequently purchased items were of cultural significance (tomatillo, chayote, chili/jalapeño pepper, and Mexican squash). This study suggests that economic incentives can contribute important nutrients to participants' diets and targeted vouchers provided by food assistance programs should continue to include culturally important foods and be aware of the cultural values of their participants.

Healthy Lifestyle Fitness Camp: A Summer Approach to Prevent Obesity in Low-Income Youth.

OBJECTIVE: To examine the effect of participation in a summer camp focused on nutrition and fitness among low-income youth. METHODS: In 2011-2012, overweight and obese youth (n = 126) from Fresno, CA participated in a free 6-week summer program, Healthy Lifestyle Fitness Camp (HLFC), which included 3 h/wk of nutrition education provided by University of California CalFresh and 3 hours of daily physical activity through Fresno Parks and Recreation. The researchers used repeated-measures ANOVA to examine changes in weight, waist circumference, and waist-to-height ratio (WHtR) between HLFC and the comparison group (n = 29). RESULTS: Significant pre-post WHtR reductions were observed in HLFC: 0.64 to 0.61 (P < .001). In addition, WHtR reductions were maintained in HLFC 2 months afterward whereas an increase occurred in the comparison group (P < .007). CONCLUSIONS AND IMPLICATIONS: Understanding the impact of nutrition- and fitness-themed summer camps during unstructured months of summer is integral to obesity prevention among low-income youth.

Relative validity of a tool to measure food acculturation in children of Mexican descent.

The purpose of this study was to examine relative validity of a food frequency questionnaire (FFQ) to measure food acculturation in young Mexican-origin children. In 2006, Spanish-speaking staff interviewed mothers in a community-based sample of households from Ventura, California (US) (n = 95) and Guanajuato, Mexico (MX) (n = 200). Data included two 24-h dietary recalls (24-DR); a 30-item FFQ; and anthropometry of the children. To measure construct, convergent, and discriminant validity, data analyses included factor analysis, Spearman correlations, t-test, respectively. Factor analysis revealed two constructs: 1) a US food pattern including hamburgers, pizza, hot dogs, fried chicken, juice, cereal, pastries, lower fat milk, quesadillas, and American cheese and 2) a MX food pattern including tortillas, fried beans, rice/noodles, whole milk, and pan dulce (sweet bread). Out of 22 food items that could be compared across the FFQ and mean 24-DRs, 17 were significantly, though weakly, correlated (highest r = 0.62, for whole milk). The mean US food pattern score was significantly higher, and the MX food pattern score, lower in US children than in MX children (p < 0.0001). After adjusting for child's age and gender; mother's education; and household size, the US food pattern score was positively related to body mass index (BMI) z-scores (beta coefficient: +0.29, p = - 0.004), whereas the MX food pattern score was negatively related to BMI z-scores (beta coefficient: -0.28, p = 0.002). This tool may be useful to evaluate nutrition education interventions to prevent childhood obesity on both sides of the border.

Assessing Child Obesity and Physical Activity in a Hard-to-Reach Population in California's Central Valley, 2012-2013.

INTRODUCTION: In California's agricultural Central Valley, the rate of childhood obesity is higher than the national average. Adequate physical activity contributes to obesity prevention and its assessment is useful to evaluate the impact of interventions. METHODS: Niños Sanos, Familia Sana (Healthy Children, Healthy Family [NSFS]) uses community-based participatory research to implement an intervention program to reduce childhood obesity among people of Mexican origin in the Central Valley. Anthropometric measurements were conducted on more than 650 children enrolled in NSFS. Physical activity data from a subgroup of children aged 4 to 7 years (n = 134) were collected via a wearable accelerometer. RESULTS: Children were classified on the basis of age and sex-adjusted body mass index as healthy weight (57.7%); overweight (19.3%), or obese (23%). Logistic regression showed that moderate to vigorous physical activity (MVPA) was associated with a child's likelihood of having a healthy BMI (odds ratio: 1.03; 95% CI, 1.01-1.05; P = .017). CONCLUSION: NSFS's community-based participatory approach resulted in successful use of a commercial electronic device to measure physical activity quantity and quality in this hard-to-reach population. Promotion of adequate daily MVPA is an appropriate and necessary component of NSFS's childhood obesity prevention strategy.

Adaptation of a culturally relevant nutrition and physical activity program for low-income, Mexican-origin parents with young children.

Latino children experience higher rates of obesity than do non-Latino white children. Family-centered nutrition interventions can slow the rate of weight gain in this population. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a 5-year, community-based, participatory research study that targets rural Mexican-origin farmworker families with children aged 2 to 8 years in California's Central Valley. Adaptation of a culturally relevant obesity prevention program involved qualitative research to tailor key obesity prevention messages, pilot testing and implementation of key messages and activities at family nights, and continual modification to incorporate culturally innovative elements. Of the 238 families enrolled, 53% (125) attended the recommended minimum of 5 (of 10 possible) classes during the first year. A university and community partnership can guide development of a culturally tailored obesity prevention program that is suitable for reaching a high-risk Mexican-origin audience through cooperative extension and other public health programs.

Food Resource Management Education With SNAP Participation Improves Food Security.

OBJECTIVE: To determine the influence of Supplemental Nutrition Assistance Program (SNAP) and participant demographics on nutrition education outcomes. METHODS: At program enrollment (pre) and 1 month later (post), a statewide convenience sample of adults, who participated in the Plan, Shop, Save, and Cook program, completed a 7-item questionnaire to evaluate change in resource management skills (RMS) and running out of food before the end of the month. RESULTS: Percent of participants (n = 3,744) who reported behavioral improvements in RMS ranged from 38.8% in comparing prices to 54% in reading labels. Female gender and Hispanic ethnicity were positively related to pre-post RMS change (P = .001). Participants who received SNAP food assistance and made greater pre-post improvement in RMS reported the greatest decrease in running out of food (P = .001). CONCLUSIONS AND IMPLICATIONS: Both food assistance and education on nutrition and resource management are needed to reduce food insecurity in SNAP-eligible audiences.

Correlates of food patterns in young Latino children at high risk of obesity.

OBJECTIVE: The present paper examines the influence of age and gender on food patterns of Latino children. DESIGN: Data are from baseline of a 5-year, quasi-experimental obesity prevention study: Niños Sanos, Familia Sana (NSFS; Healthy Children, Healthy Families). In 2012, the researchers interviewed Latino parents, using a thirty-item questionnaire to ask about their children's food consumption and feeding practices. Statistical tests included t tests and ANCOVA. SETTING: Rural communities in California's Central Valley, USA. SUBJECTS: Two hundred and seventeen parents (87-89% born in Mexico) and their children (aged 2-8 years). RESULTS: Fifty-one per cent of the children were overweight or obese (≥85th percentile of BMI for age and gender). Mean BMI Z-scores were not significantly different in boys (1·10 (SD 1·07)) and girls (0·92 (SD 1·04); P=0·12). In bivariate analysis, children aged 2-4 years consumed fast and convenience foods less often (P=0·04) and WIC (Supplemental Nutrition Program for Women, Infants, and Children)-allowable foods more often than children aged 5-8 years (P=0·01). In ANCOVA, neither age nor gender was significantly related to food patterns. Mother's acculturation level was positively related to children's consumption of fast and convenience foods (P=0·0002) and negatively related to consumption of WIC foods (P=0·01). Providing role modelling and structure in scheduling meals and snacks had a positive effect on the vegetable pattern (P=0·0007), whereas meal skipping was associated with more frequent fast and convenience food consumption (P=0·04). CONCLUSIONS: Acculturation and child feeding practices jointly influence food patterns in Latino immigrant children and indicate a need for interventions that maintain diet quality as children transition to school.

Child feeding practices and overweight status among Mexican immigrant families.

The purpose was to compare maternal perceptions, feeding practices, and overweight status of children in immigrant households in California (US) with a cohort in Guanajuato, Mexico (MX). In 2006, staff interviewed mothers and weighed and measured their children, 1-6 years (US: n = 95 and MX: n = 200). Prevalence of overweight [body mass index z-score (BMIZ) >1.0 and <1.65] and obesity (BMIZ > 1.65) was 21.1 and 28.4% in the US respectively, compared to 11.5 and 12.9% in MX (p < 0.001). No differences were observed in maternal ability to identify correctly the child's weight status or ever being told the child was overweight. US children ate away from home more often (p < 0.0001), had fewer family meals (p < 0.0001), and played outdoors less often than MX children (p < 0.0002). Further analyses should examine how differences in eating and activity patterns explain the disparity in childhood obesity across the countries.

Sweetened food purchases and indulgent feeding are associated with increased toddler anthropometry.

OBJECTIVE: To explore the role of feeding practices and food purchases in toddler dietary intake and anthropometry. METHODS: A convenience sample of Latino mother and toddler pairs were interviewed at baseline and at 6-month follow-up. Data on feeding practices, toddler dietary intake, anthropometry, and food purchases were collected using the Toddler-Feeding Questionnaire; 24-hour recalls; measurements of weight, height, and/or length; and food purchase receipts. RESULTS: Indulgent feeding scores and high intake of sweetened beverage were associated with a 0.52 increase (P = .03) and 0.46 increase in toddler weight-for-height z-score (P = .05), respectively. Households with 10 percentage points of more sweetened food and beverage expenditures were associated with increases in weight indicator z-scores. CONCLUSIONS AND IMPLICATIONS: Indulgent feeding, high intake, and purchase of sweetened beverage are associated with weight gain in Latino toddlers. Programs should target food purchasing decisions and provide concrete guidance for the division of responsibility around feeding.

Practice paper of the Academy of Nutrition and Dietetics abstract: nutrition and lifestyle for a healthy pregnancy outcome.

It is the position of the Academy of Nutrition and Dietetics that women of childbearing age should adopt a lifestyle optimizing health and reducing risk of birth defects, suboptimal fetal development, and chronic health problems in both mother and child.Components leading to healthy pregnancy outcome include healthy pre-pregnancy weight, appropriate weight gain and physical activity during pregnancy, consumption of a wide variety of foods, appropriate vitamin and mineral supplementation, avoidance of alcohol and other harmful substances, and safe food handling. Nutrition assessment needs to encompass changes in anthropometric,biochemical, and clinical indicators throughout pregnancy. Pregnant women should gain weight according to the 2009 Institute of Medicine Guidelines. Energy needs are no higher than the Estimated Energy Requirement for nonpregnant women until the second trimester; thereafter, the extra energy need per day is 340 kcal and 452 kcal in the second and third trimesters,respectively. Using the 2010 Dietary Guidelines for Americans, registered dietitian nutritionists and dietetics technicians, registered,can help pregnant women select a food plan based on age, physical activity, trimester, weight gain, and other considerations.Women are encouraged to participate in at least 150 minutes of moderate-intensity aerobic activity spread throughout the week or 30 minutes of moderately intense exercise on most days of the week.When good food choices are made, food consumption to meet extra energy needs and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy are generally adequate to meet most nutrient needs. However, vitamin and mineral supplementation may be important in vulnerable cases including food insecurity; alcohol, tobacco, or other substance dependency; anemia; strict vegetarian (vegan) diet; or poor eating habits. Multiple strategies are needed to support healthy lifestyles for all women, from preconception through the postpartum period. This practice paper supports the Academy of Nutrition and Dietetics' position paper "Nutrition and Lifestyle for a Healthy Pregnancy Outcome" published in the July 2014 Journal of the Academy of Nutrition and Dietetics.

Niños Sanos, Familia Sana: Mexican immigrant study protocol for a multifaceted CBPR intervention to combat childhood obesity in two rural California towns.

BACKGROUND: Overweight and obese children are likely to develop serious health problems. Among children in the U.S., Latino children are affected disproportionally by the obesity epidemic. Niños Sanos, Familia Sana (Healthy Children, Healthy Family) is a five-year, multi-faceted intervention study to decrease the rate of BMI growth in Mexican origin children in California's Central Valley. This paper describes the methodology applied to develop and launch the study. METHODS/DESIGN: Investigators use a community-based participatory research approach to develop a quasi-experimental intervention consisting of four main components including nutrition, physical activity, economic and art-community engagement. Each component's definition, method of delivery, data collection and evaluation are described. Strategies to maintain engagement of the comparison community are reported as well. DISCUSSION: We present a study methodology for an obesity prevention intervention in communities with unique environmental conditions due to rural and isolated location, limited infrastructure capacity and limited resources. This combined with numerous cultural considerations and an unstable population with limited exposure to researcher expectations necessitates reassessment and adaptation of recruitment strategies, intervention delivery and data collection methods. Trial registration # NCT01900613. TRIAL REGISTRATION: NCT01900613.

Development and use of an evaluation tool for taste-testing activities by school-aged children.

We describe the development and application of a teacher-administered tool for routine program evaluation of food-tasting activities among low-income children and adolescents in a classroom or afterschool setting. This six-item evaluation tool is intended to capture student willingness to try new foods and ask for them at home. Phase 1 involved one-on-one interviews to determine the feasibility of the taste test tool among nine elementary school teachers in 2009 (168 students) and a validation pilot study in 2010 among 114 school-aged students participating in a University of California Supplemental Nutrition Assistance Program Nutrition Education (UC SNAP-Ed) summer program. Phase 2 determined instrument reliability and compared student response by grade level and food category in a convenience sample of 514 UC SNAP-Ed classrooms in 2010-2011. The mean proportion of the classroom ever having tried the foods before was 0.62 ± 0.33, and 0.77 ± 0.27 were willing to ask for the foods at home (P<0.0001). Compared with younger students (preschool through sixth grade), older students (seventh through 12th grade) were less likely to try the foods in class and less willing to try them again or ask for them at home (P<0.05). Students reported significantly greater previous exposure and willingness to try the food again for fruits than for vegetables (P<0.0001). A teacher-administered taste test tool is feasible to use in a group setting and capable of yielding valid, reliable information to evaluate student response and to guide SNAP-Ed program delivery.

Acculturation, physical activity and television viewing in Hispanic women: findings from the 2005 California Women's Health Survey.

OBJECTIVE: To assess the relationship of acculturation with physical activity and sedentary behaviours among Hispanic women in California. DESIGN: Data from the 2005 California Women's Health Survey (CWHS) - a cross-sectional telephonic survey of health indicators and health-related behaviours and attitudes - were used. SETTING: Using a random-digit dialling process, data were collected monthly from January to December 2005. SUBJECTS: A total of 1298 women aged ≥18 years in California who self-identified as Hispanic. RESULTS: Of the participants included in the analysis, 49 % were adherent to physical activity recommendations (with 150 min of weekly activity signifying adherence). There was no significant association between language acculturation and moderate or vigorous physical activity after controlling for potential confounders such as smoking, age and employment status. There was also no association between duration of residence in the USA and moderate or vigorous physical activity. Language acculturation was positively associated with television (TV) viewing, with highly acculturated women reporting more hours of TV viewing compared with women with an intermediate acculturation score (P = 0·0001), and those with an intermediate score reporting more hours of TV viewing compared with those with a low score (P = 0·003). This relationship persisted after inclusion of smoking, employment status, age and education in the model. CONCLUSIONS: Higher levels of language acculturation may be associated with increased sedentary behaviours because of the influence of US culture on those women who have assimilated to the culture. Acculturation is an important factor to be taken into account when designing health education interventions for the Hispanic female population.

Validation of an instrument to assess toddler feeding practices of Latino mothers.

This paper describes qualitative and quantitative aspects of testing a 34-item Toddler-Feeding Questionnaire (TFQ), designed for use in Latino families, and the associations between feeding practices and toddler dietary outcomes. Qualitative methods included review by an expert panel for content validity and cognitive testing of the tool to assess face validity. Quantitative analyses included use of exploratory factor analysis for construct validity; Pearson's correlations for test-retest reliability; Cronbach's alpha (α) for internal reliability; and multivariate regression for investigating relationships between feeding practices and toddler diet and anthropometry. Interviews were conducted using a convenience sample of 94 Latino mother and toddler dyads obtained largely through the Supplemental Nutrition Program for Women, Infants and Children (WIC). Data collection included household characteristics, self-reported early-infant feeding practices, the toddler's dietary intake, and anthropometric measurements. Factor analysis suggests the TFQ contains three subscales: indulgent; authoritative; and environmental influences. The TFQ demonstrated acceptable reliability for most measures. As hypothesized, indulgent practices in Latino toddlers were associated with increased energy consumption and higher intakes of total fat, saturated fat, and sweetened beverages. This tool may be useful in future research exploring the relationship of toddler feeding practices to nutritional outcomes in Latino families.