Breakfast consumption trends among young Australian children aged up to 5 years: results from InFANT program.

Breakfast is considered a healthy dietary habit which can track over time from childhood to adulthood. The breakfast meal has the potential to improve daily dietary quality, particularly if it includes a range of food groups and adequate nutrient intakes. However, research on breakfast consumption trends among young Australian children aged up to 5 years is currently limited. This study assessed children's usual breakfast food group and nutrient intakes at ages 1.5 (n = 369), 3.5 (n = 242), and 5.0 (n =240) years using three 24-hour dietary recalls from the Melbourne InFANT program. Tracking of food groups at breakfast across the three ages was assessed by Pearson correlation of energy-adjusted food intake residuals. The main food groups consumed at breakfast were grains, milk/alternatives and discretionary items, with vegetables rarely consumed at any age. Our study found that while breakfast contributed about 20% of total daily energy, this provided 20%-29.1% of total daily intake across all ages for carbohydrates, total sugars, calcium and potassium. For the contribution to daily recommendations, breakfast contributed more than about a third of daily recommended intakes for some micronutrients (e.g., iron, calcium and zinc), and a large proportion (over 40%) of sodium intake. Children consumed 11.9% -15.2% of their energy at breakfast from saturated fat, which is higher than the recommended total energy contribution of saturated fat (no more than 10% from saturated fat). For tracking of most food groups and nutrients, tracking was found to be low or moderate over time. Given the contribution that breakfast can make to ensure children achieve their daily dietary intakes, early interventions for young Australian children should focus on practical strategies to increase vegetable intake while reducing sodium and saturated fat intake at breakfast.

Mothers' descriptions of their feeding strategies in response to fussy eating with children of different levels of trait fussiness.

Parent feeding practices influence a child's dietary intake. Many studies examining how parents react to children's fussy eating behaviours have been limited to questionnaire measures, which assess a limited number of feeding practices. There is a lack of research exploring the range of strategies parents use when their child is being fussy and/or refusing to eat. Therefore, the aims of this study are to describe the strategies used by mothers when their child is being fussy or refusing to eat, and to assess differences in the strategies depending on the child's trait fussiness levels. In 2018, 1504 mothers of children aged 2-5 years completed an online survey. Trait fussiness was assessed using the Children's Eating Behaviour Questionnaire. Mothers were also asked the open-ended question "What are the strategies you use when your child is being fussy or refusing to eat?". Inductive thematic analysis was conducted using NVivo. Themes were compared by child trait fussiness levels. Seven main themes were identified: child-led feeding/trust in child's appetite, spectrum of pressure, home or family strategies, different types of food offerings, communication, avoid certain strategies, and never or rarely fussy. Mothers of children with severe trait fussiness levels reported more pressuring or persuasive strategies. This study provides novel information regarding the diverse range of feeding practices parents use in response to children's fussy eating behaviours. Mothers used more feeding strategies typically associated with unhealthy dietary intake for children of high levels of trait fussiness. It is important that future interventions tailor the information to provide support to parents of children with high levels of trait fussiness regarding the use of feeding practices recommended to support healthy dietary intake.

Nutritional and Behavioral Countermeasures as Medication Approaches to Relieve Motion Sickness: A Comprehensive Review.

The mismatch in signals perceived by the vestibular and visual systems to the brain, also referred to as motion sickness syndrome, has been diagnosed as a challenging condition with no clear mechanism. Motion sickness causes undesirable symptoms during travel and in virtual environments that affect people negatively. Treatments are directed toward reducing conflicting sensory inputs, accelerating the process of adaptation, and controlling nausea and vomiting. The long-term use of current medications is often hindered by their various side effects. Hence, this review aims to identify non-pharmacological strategies that can be employed to reduce or prevent motion sickness in both real and virtual environments. Research suggests that activation of the parasympathetic nervous system using pleasant music and diaphragmatic breathing can help alleviate symptoms of motion sickness. Certain micronutrients such as hesperidin, menthol, vitamin C, and gingerol were shown to have a positive impact on alleviating motion sickness. However, the effects of macronutrients are more complex and can be influenced by factors such as the food matrix and composition. Herbal dietary formulations such as Tianxian and Tamzin were shown to be as effective as medications. Therefore, nutritional interventions along with behavioral countermeasures could be considered as inexpensive and simple approaches to mitigate motion sickness. Finally, we discussed possible mechanisms underlying these interventions, the most significant limitations, research gaps, and future research directions for motion sickness.

Frequency and distribution of dietary energy, vegetable, fruit and discretionary food intakes in 18-month-old Australian children.

Dietary behaviours in early childhood are understudied despite links with later health. Assessing the distribution of key food groups across the day could identify opportunities for improvements. This study aimed to describe the 24-hourly distribution of dietary intakes and frequency of eating occasions for weekdays and weekend days among children aged 18 months and assess associations of eating frequency with vegetable, fruit and discretionary intakes and zBMI. Using two parent-reported 24-h recalls of child dietary intakes from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program, mean frequency of daily eating occasions and hourly intake distributions were calculated for vegetables, fruits, discretionary foods, and total foods and energy-containing beverages on weekdays (n 428) and weekend days (n 376). Multivariable regression analyses assessed associations between frequency of eating occasions, total intake of food groups and zBMI. Overall, children had 7·8 ± 1·8 (mean ± sd) eating occasions/d on weekdays, where 1·5 ± 0·8 contained vegetables, 2·2 ± 1·1 contained fruit and 2·5 ± 1·5 contained discretionary foods. Weekend day intakes were similar. Energy intakes were highest at dinner time. Intakes of total foods, fruits and discretionary foods were spread across the day (06.00-22.00). Vegetable consumption was mainly about 18.00 with minimal intake at other times. Eating frequency was associated with amount of food consumed but not consistently with zBMI. These 18-month-old children ate frequently throughout the day, with little distinction between weekdays and weekend days. Most eating occasions lacked vegetables, and frequency of discretionary foods was higher than of vegetables. Promoting vegetable consumption at occasions other than dinner could improve vegetable intake.

Describing the longitudinal breakfast quality index trajectories in early childhood: results from Melbourne InFANT program.

BACKGROUND: Breakfast quality in early childhood remains understudied. This study describes the changes in breakfast quality index (BQI) (i.e. trajectory) in early childhood and assesses its associations with obesity outcomes. METHODS: Data from children who participated in the Melbourne InFANT Program were used (n = 328). The Melbourne InFANT Program was a 15-month early obesity prevention intervention conducted from 2008 to 2013. Dietary intakes at ages 1.5, 3.5 and 5.0 years were assessed using three parent-proxy reported 24 h recalls. A revised nine-item BQI tool developed based on Australian dietary recommendations for young children was used to calculate BQI scores. Group-based trajectory modelling identified BQI trajectory groups. Multivariable linear and logistic regression examined the associations between identified BQI trajectory groups and obesity outcomes at age 5 years. RESULTS: Mean BQI at ages 1.5, 3.5 and 5.0 years was 4.8, 4.8, 2.7 points, respectively. Two BQI trajectory groups were identified, and both showed a decline in BQI. The mean BQI of most children (74%) decreased from 5.0 to 4.0 points from ages 1.5 to 5.0 years (referred as "High BQI" group). The remaining children (26%) had a mean BQI of 4.8 and 1.2 points at age 1.5 and 5.0 years, respectively (referred as "Low BQI" group). The "Low BQI" group appeared to show higher risk of overweight (OR:1.30, 95% CI: 0.60, 2.81, P = 0.66) at age 5 years than the "High BQI" group. No difference in body mass index (BMI) z-score was found between the two groups. CONCLUSIONS: Two BQI trajectory groups were identified. Both groups showed a decline in breakfast quality from ages 1.5 to 5.0 years. Our study highlights the need for early health promotion interventions and strategies to improve and maintain breakfast quality across early childhood.

Groups of mothers based on feeding practices and their associations with dietary quality of pre-school children: A latent profile analysis.

Parents' feeding practices are associated with children's food intake. However, little is known about the patterns of feeding practices used by groups of mothers or how these groupings of practices influence children's dietary intake. Therefore, the aims of this study are to classify and describe groups of mothers according to their patterns of feeding practices and to examine the associations between the groups of maternal feeding practices and pre-school children's dietary quality. In 2018, 1349 mothers based in Australia of children aged 2-5 years completed an online survey including validated measures of nine feeding practices and dietary quality, measured using thirteen summed dietary items. Latent profile analysis was used to identify distinct groups of mothers who shared similar feeding practices. Linear regression models were fitted to examine associations between the feeding practice profiles and child dietary quality. A three-profile model was chosen based on interpretation, profile size and statistical model fit criteria. Profile 1 had lower mean scores of structure-related feeding practices than the other profiles; profile 2 had mean scores reflecting slightly higher use of most structure-related feeding practices and lower mean scores of some non-responsive feeding practices; profile 3 had higher mean scores of non-responsive feeding practices than the other profiles. Profile 1 (-2.95, CI: 3.97; -1.92) and profile 3 (-2.81, CI: 3.49; -2.13) had lower mean child dietary quality scores compared with profile 2. Profile 2, which reflected the most engagement in structure-related feeding practices combined with least non-responsive feeding practices, was associated with higher child diet quality, compared with the other two profiles. The identification of these unique profiles could help to tailor future interventions to consider patterns of feeding practices used by groups of mothers.

Characterizing children's eating patterns: does the choice of eating occasion definition matter?

BACKGROUND: Recommendations to define eating occasions (EO) currently exist for research in adults, but not for children or adolescents. We examined how varying EO definitions affect the characterization of eating patterns in children and adolescents. METHODS: Cross-sectional dietary data collected using a 24-h recall data during the 2011-12 Australian National Nutrition and Physical Activity Survey (1364 boys and 1337 girls aged 2-18 years) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (EO separated by 15- or 60-min and/or an additional energy criterion of 21 or 210 kJ). Frequency of and total energy intake from meals, snacks, and all EO were estimated. F tests stratified by gender and age-group, were used to assess differences between definitions. Agreement between definitions of meal and snack frequencies was assessed using intraclass correlation coefficients (ICC). Linear regression was used to estimate the proportion of variance in total energy intake (kJ) and BMI z-score predicted by each definition. RESULTS: Mean frequencies of meals and snacks differed between the participant-identified and time-of-day definitions, in boys and girls and for all age groups (P < 0.01). Across the six neutral definitions, there were differences between mean frequencies of EO with the largest mean difference observed for children aged 2-3 y (boys: 2.3, girls: 2.5; P < 0.003). Between the participant-identified and time-of-day definitions, there was good agreement for frequencies of snacks (ICC for both genders: 0.93) but not meals (boys: 0.36; girls: 0.38). The 15-min time interval plus 210 kJ definition of an EO consistently predicted the most variance in total energy intake (R2 range = 8.1-34.8). Definitions that delineated meals and snacks better predicted variance in BMI z-score, when compared to the neutral definitions. CONCLUSIONS: How eating patterns are characterized vary depending on the EO definitions employed, particularly in young children. Variance in total energy intake was best predicted by a variation of the neutral definition whereas definitions that delineated meals and snacks performed better in relation to predicting BMI variance. Further international research that compares EO definitions in children will help inform a standard approach.

Associations between feeding practices and child dietary quality, and the moderating effect of child eating behaviours on these associations.

BACKGROUND: Parents' feeding practices are associated with children's food intake. Little is known about how children's eating behaviours (fussiness, enjoyment of food, food responsiveness, satiety responsiveness) moderate these associations. This study examines the relationships between feeding practices and pre-school children's dietary quality and whether children's eating behaviours moderate these relationships. METHODS: In 2018, 1349 Australian mothers of children aged 2-5 years completed an online survey including validated measures of feeding practices (n = 9), child eating behaviours (n = 4) and dietary quality. Thirteen items from a food frequency questionnaire were summed as a measure of dietary quality. Linear regression assessed associations between feeding practices and dietary quality, including interactions between feeding practices and child eating behaviours. RESULTS: The feeding practices positively associated with dietary quality were structured meal timing, monitoring, covert restriction, modelling healthy eating and structured meal setting (B coefficients: 0.63 to 2.70). The feeding practices inversely associated with dietary quality were overt restriction, persuasive feeding, reward for eating and reward for behaviour (B coefficients: -0.88 to -1.85). Child eating behaviours moderated associations between three feeding practices and dietary quality. CONCLUSIONS: This exploratory study showed that some associations between feeding practices and child dietary quality were moderated by children's eating behaviours. The potential for tailoring nutrition promotion strategies for parents of children with differing eating behaviours should be further investigated.

Parenting style as a predictor of dietary score change in children from 4 to 14 years of age. Findings from the Longitudinal Study of Australian Children.

OBJECTIVE: To examine associations between parenting style and changes in dietary quality score across childhood. DESIGN: This longitudinal analysis included the child's frequency of consumption for twelve food and drink items reported by mothers of children (aged 4-8 years) and children (aged 10-14 years) during face-to-face interviews biennially. These items were combined into dietary scores based on the Australian Dietary Guidelines. Parenting styles were classified at baseline as authoritative, authoritarian, permissive and disengaged. Multilevel modelling was used to examine changes in diet quality score over time by maternal parenting styles. SETTING: The Longitudinal Study of Australian Children. PARTICIPANTS: A total of 4282 children aged 4 to 14 years. RESULTS: Children's diet quality score declined over time between 4 and 14 years of age (ß = -0·10, 95 % CI (-0·11, -0·08)). There was strong evidence to suggest that change in diet quality differed dependent on baseline maternal parenting style, although diet quality declined for all groups. Children with authoritative mothers had the greatest decline in diet quality score over time (ß = -0·13; 95 % CI (-0·18, -0·08)), while children with disengaged mothers had the lowest decline (ß = -0·03; 95 % CI (-0·07, 0·01)). However, it is important to note that children with authoritative mothers had a better dietary quality score than children of permissive or disengaged mothers for most of their childhood. CONCLUSION: These findings question the previous assumptions that early exposure to an authoritative parenting style has lasting positive effects on the dietary intake of children.

Energy Density of New Food Products Targeted to Children.

High dietary energy density (ED) is linked to childhood obesity and poor diet quality. The Australian Health Star Rating (HSR) system aims to assist consumers in making healthful food choices. This cross-sectional study used 2014-2018 data from the Mintel Global New Products Database to describe the ED of new food products targeted to children (5-12 years) released after the introduction of HSR and examine relationships between ED and HSR. Products were categorised by ED (low < 630 kJ/100 g, medium 630-950 kJ/100 g, high > 950 kJ/100 g) and HSR (no, HSR < 2.5 low, HSR ≥ 2.5 high). Non-parametric statistics were used to examine ED and HSR. A total of 548 products targeted children: 21% low, 5% medium, 74% high ED. One hundred products displayed an HSR: 24% low, 76% high; 53 products with both high HSR and ED. The EDs of products differed by HSR (p < 0.05), but both group's medians (HSR < 2.5: 1850 kJ/100 g, HSR ≥ 2.5: 1507 kJ/100 g) were high. A high proportion of new products had a high ED, and the HSR of these foods did not consistently discriminate between ED levels, particularly for high ED foods. Policies to promote lower ED foods and better alignment between ED and HSR may improve childhood obesity and diet quality.

Parenting styles and the dietary intake of pre-school children: a systematic review.

Objective: The prevalence of childhood overweight and obesity has been increasing globally, with poor diet a key contributor. Parents play an influential role over the food intake of young children. This review explores whether parenting styles (authoritative, authoritarian, permissive and disengaged) or parenting dimensions (warmth and control) are associated with pre-school children's dietary intake.Design: Following the PRISMA guidelines, a systematic search of six electronic databases was conducted. Included articles were based on children aged 2-5 years and reported associations between parenting styles or dimensions and children's food intake. Two independent reviewers extracted the data and assessed the quality of the articles.Main outcome measures: Pre-school children's dietary intake.Results: Seven articles met the inclusion criteria. Six of the seven articles found evidence of at least one association between parenting styles or parenting dimensions and children's dietary intake. Several different measurement tools were used to identify parenting styles (n = 3) and dietary intake (n = 6), with reliability and validity reported in varying ways. The quality score of the articles ranged from 33% to 58%.Conclusion: Overall, an authoritative parenting style or higher levels of warmth appear to be associated with healthier dietary intakes among pre-school children.

Associations between sweet taste function, oral complex carbohydrate sensitivity, liking and consumption of ad libitum sweet and non-sweet carbohydrate milkshakes among female adults.

Excess energy intake is recognised as a strong contributing factor to the global rise of being overweight and obese. The aim of this paper was to investigate if oral sensitivity to complex carbohydrate relates to ad libitum consumption of complex carbohydrate foods in a sample group of female adults. Participants' ((n 51 females): age 23·0 (sd 0·6) years (range 20·0-41·0 years); excluding restrained eaters) sensitivity towards maltodextrin (oral complex carbohydrate) and glucose (sweet taste) was assessed by measuring detection threshold (DT) and suprathreshold intensity perception (ST). A crossover design was used to assess consumption of two different iso-energetic preload milkshakes and ad libitum milkshakes - (1) glucose-based milkshake, (2) maltodextrin-based milkshake. Ad libitum intake (primary outcome) and eating rate, liking, hunger, fullness and prospective consumption ratings were measured. Participants who were more sensitive towards complex carbohydrate (maltodextrin DT) consumed significantly more maltodextrin-based milkshake in comparison with less-sensitive participants (P = 0·01) and this was independent of liking. Participants who had higher liking for glucose-based milkshake consumed significantly more glucose-based milkshake in comparison with participants with lower hedonic ratings (P = 0·049). The results provide support regarding the role of the oral system sensitivity (potentially taste) to complex carbohydrate and the prospective to overconsume complex carbohydrate-based milkshake in a single sitting.

Home environment predictors of vegetable and fruit intakes among Australian children aged 18 months.

Suboptimal vegetable and fruit consumption by young children is common. Identifying predictors of vegetable and fruit intakes is important for informing strategies to promote sufficient intakes of these foods from early life. The aim of the present study was to examine predictors of toddlers' vegetable and fruit intakes at age 18 months. This study involved secondary analysis of data from 361 child-mother dyads participating in the Melbourne Infant Feeding, Activity and Nutrition Trial in 2008-2010 at child ages four, nine and 18 months. Children's vegetable and fruit intakes were assessed at age 18 months using multiple 24-h dietary recalls. Data on potential predictor measures were collected via parent-completed questionnaires when children were four or nine months of age. Bivariate and multivariable linear regression models were used to test associations between children's average daily vegetable or fruit intake and potential predictors controlling for treatment arm and clustering by parent group. Multivariable models also controlled for covariates and potential confounders. Home availability of vegetables at age nine months was found to predict children's vegetable intake at age 18 months and remained significant (ß = 20.19, 95% CI:7.23, 33.15, p = 0.003) in the multivariable model. Children's average daily fruit intake at age 18 months was predicted by maternal education at child age four months and the availability of fruits in their home at child age nine months. Maternal education remained significant (ß = 30.83, 95% CI:12.17, 49.48, p = 0.002) in the multivariable model. Strategies to promote adequate vegetable and fruit intakes among young children should address known barriers to the availability of vegetables and fruits in the home from early in life. Additionally, messages encouraging fruit consumption may need to be tailored to mothers with lower levels of education.

Moderation of associations between maternal parenting styles and Australian pre-school children's dietary intake by family structure and mother's employment status.

OBJECTIVE: To examine associations between maternal parenting style and pre-school children's dietary intake and to test whether perceived maternal time pressures, parenting arrangements and employment status influence these relationships. DESIGN: This cross-sectional study examined mothers' reports of their child's frequency of consumption of eight food and drink groups, including sugar-sweetened beverages (SSB), unhealthy snacks, takeaway foods, fruit and vegetables. Parenting styles were classified as authoritative, authoritarian, permissive or disengaged using two parenting dimensions (warmth and control). The moderating roles of parenting arrangements, indexed by number of parents in the home and maternal employment status, were assessed. Associations were examined using multinomial regression. SETTING: Data were from the infant and child cohorts in the Longitudinal Study of Australian Children.ParticipantsChildren aged 4-5 years from both cohorts (infant: n 3607; child: n 4661) were included. RESULTS: Compared with children of disengaged mothers, children of authoritative mothers consumed most unhealthy foods less frequently, and fruit and vegetables more frequently. Results suggested parenting arrangements and mothers' working status may moderate associations between parenting styles and SSB, takeaway foods, takeaway snacks and fruit consumption. CONCLUSIONS: These findings suggest that authoritative parenting style is associated with a higher consumption of fruit and vegetables and a lower consumption of unhealthy foods among children. However, parenting arrangements and the mothers' working status may influence these relationships. Further research is required to examine the influence of other potential moderators of parenting style/food consumption relationships such as household time and resource limitations.

The Associations Between Oral Complex Carbohydrate Sensitivity, BMI, Liking, and Consumption of Complex Carbohydrate Based Foods.

Recent work suggests that humans may perceive complex carbohydrates and that their sensitivity to simple carbohydrates (i.e., glucose and sucrose) is independent from tasting complex carbohydrates. The aim of this study was to confirm whether humans could sense complex carbohydrates from a range of concentration levels; and if their oral sensitivity to complex carbohydrate relates to their BMI, liking, and consumption of complex carbohydrate-based foods using a large sample group of adults. Participants' (n = 92 females, age 23.7 ± 0.5 yr [range, 19 to 47 yr]) oral sensitivity towards complex carbohydrate (maltodextrin) and sweet taste function (glucose) was assessed by measuring detection threshold and suprathreshold intensity perception (gLMS). Participants were asked to complete an online version of a Food Frequency Questionnaire and a Likes and Dislikes Questionnaire. Hedonic ratings for complex carbohydrate and sweet solutions, as well as for a range of complex carbohydrate and sweet prototypical foods, were also measured. Consistent with previous findings, there was large interindividual variation in detection and intensity measures for maltodextrin and glucose. No significant associations were found between oral complex carbohydrate sensitivity, Body Mass Index (BMI), and frequency of consumption of complex carbohydrate-based foods measured. Similarly, no differences were observed between liking of complex carbohydrates, BMI, and food intake. All in, these results from a large sample group further support the proposition that complex carbohydrates are not invisible to the human palate, and can be sensed in the oral cavity even at low concentration levels.

Sodium Content of Lunches and Snacks Provided in Australian Long Day Care Centres: A Cross-Sectional Study.

We determined the average amount of sodium provided in lunches and snacks and the average amount of sodium consumed at lunch in a convenience sample of Australian preschool children attending Long Day Care (LDC). Sodium content of lunches and snacks was determined from standardised recipes. Individual children's sodium intake was estimated by a validated visual plate waste scale method. Five recipes (lunch n = 35, snacks n = 70) collected from 7 LDC centres; 95 children (50 boys) mean age 3.5 (SD) (0.2) years lunch intakes were assessed. Average total amount of sodium provided from two snacks and one lunch: 590 (146) mg, representing ~59% of the Australian Upper Level (UL) of intake (1000 mg/day sodium). Average total amount of sodium consumed: 541 (98) mg representing ~54% of the UL. Across all centres, the average sodium and energy consumed from lunch: 186 (108) mg (~19% of UL); 948 (437) kJ (38% of energy allowance); morning snacks: 63 (45) mg (6% of UL), 535 (183) kJ (21% of energy allowance); afternoon snacks: 291 (97) mg (29% of UL), 464 (171) kJ energy (46% of energy allowance). Australian LDC centres providing lunches cooked on site resulted in relatively low-sodium lunches.

Predictors of Dietary Energy Density among Preschool Aged Children.

Childhood obesity is a global problem with many contributing factors including dietary energy density (DED). This paper aims to investigate potential predictors of DED among preschool aged children in Victoria, Australia. Secondary analysis of longitudinal data for 209 mother-child pairs from the Melbourne Infant Feeding, Activity and Nutrition Trial was conducted. Data for predictors (maternal child feeding and nutrition knowledge, maternal dietary intake, home food availability, socioeconomic status) were obtained through questionnaires completed by first-time mothers when children were aged 4 or 18 months. Three 24-h dietary recalls were completed when children were aged ~3.5 years. DED was calculated utilizing three methods: "food only", "food and dairy beverages", and "food and all beverages". Linear regression analyses were conducted to identify associations between predictors and these three measures of children's DED. Home availability of fruits (ß: -0.82; 95% CI: -1.35, -0.29, p = 0.002 for DEDfood; ß: -0.42; 95% CI: -0.82, -0.02, p = 0.041 for DEDfood+dairy beverages) and non-core snacks (ß: 0.11; 95% CI: 0.02, 0.20, p = 0.016 for DEDfood; ß: 0.09; 95% CI: 0.02, 0.15, p = 0.010 for DEDfood+dairy beverages) were significantly associated with two of the three DED measures. Providing fruit at home early in a child's life may encourage the establishment of healthful eating behaviors that could promote a diet that is lower in energy density later in life. Home availability of non-core snacks is likely to increase the energy density of preschool children's diets, supporting the proposition that non-core snack availability at home should be limited.

The provision of ultra-processed foods and their contribution to sodium availability in Australian long day care centres.

OBJECTIVES: To categorize and assess all foods, beverages and ingredients provided over one week at Australian long day care (LDC) centres according to four levels of food processing and to assess the contribution of Na from each level of processing. DESIGN: Cross-sectional. SETTING: Menus for lunch, morning and afternoon snacks were collected from LDC centres. The level of food processing of all foods, beverages and ingredients was assessed utilizing a four-level food processing classification system: minimally processed (MP), processed culinary ingredients (PCI), processed (P) and ultra-processed (ULP). RESULTS: A total of thirty-five menus (lunch, n 35; snacks, n 70) provided to 1-5-year-old children were collected from seven LDC centres. Proportions of foodstuffs classified as MP, PCI, P and ULP were 54, 10, 15 and 21 %, respectively. All lunches were classified as MP. ULP foods accounted for 6 % of morning snacks; 41 % of afternoon snacks. Mean daily amount of Na provided per child across all centres was 633 (sd 151) mg. ULP foods provided 40 % of Na, followed by P (35 %), MP (23 %) and PCI (2 %). CONCLUSIONS: Centres provided foods resulting in a mean total daily Na content that represented 63 % of the recommended Upper Level of Intake for Na in this age group. A significant proportion of ULP snack foods were included, which were the major contributor to total daily Na intake. Replacement of ULP snack foods with MP lower-Na alternatives is recommended.

Effects of breaking up sitting on adolescents' postprandial glucose after consuming meals varying in energy: a cross-over randomised trial.

OBJECTIVES: To explore the impact of uninterrupted sitting versus sitting with resistance-type activity breaks on adolescents' postprandial glucose responses while consuming a diet varying in energy. DESIGN: Cross-over randomised trial. METHODS: Thirteen healthy participants (16.4±1.3years) completed a four-treatment cross-over trial: (1) uninterrupted sitting+high-energy diet; (2) sitting with breaks+high-energy diet; (3) uninterrupted sitting+standard-energy diet; and (4) sitting with breaks+standard-energy diet. For all four conditions, two identical meals were consumed; at 0h and 3h. A continuous glucose monitoring system (CGM) recorded interstitial glucose concentrations every five minutes. Linear mixed models examined differences in glucose positive incremental area under the curve (iAUC) and total AUC between the sitting and diet conditions for the first meal, second meal and entire trial period. RESULTS: Compared to the uninterrupted sitting conditions, the breaks condition elicited a 36.0mmol/L/h (95%CI 6.6-65.5) and 35.9mmol/L/h (95%CI 6.6-65.5) lower iAUC response after the first and second meal, respectively, but not for the entire trial period or for total AUC. Compared to the standard-energy diet, the high-energy diet elicited a 55.0mmol/L/h (95%CI 25.8-84.2) and 75.7mmol/L/h (95%CI 8.6-142.7) higher iAUC response after the first meal and entire trial, respectively. Similar response to the high-energy diet were observed for total AUC. CONCLUSIONS: According to iAUC, interrupting sitting had a significant effect on lowering postprandial glucose for both dietary conditions, however, it was not significant when examining total AUC. Larger studies are needed to confirm these findings. CLINICAL TRIAL REGISTRATION NUMBER: ACTRN12615001145594.