USDA Nutrition Evidence Systematic Review's collaborative approach for conducting systematic reviews: Promoting diversity of expertise while managing potential conflicts of interest.

U.S. Department of Agriculture's (USDA) Nutrition Evidence Systematic Review (NESR) Branch develops food-and nutrition-related systematic reviews and other evidence synthesis products. NESR has established itself as a key resource for the Federal government when making evidence-informed decisions related to public health nutrition, such as the development of the Dietary Guidelines for Americans. NESR's systematic review methodology is rigorous, protocol-driven, and highly collaborative. NESR's systematic reviews examine the complex interplay between diet and health with input and support from various collaborators, including Federal stakeholders, expert groups, and public stakeholders. Implementing NESR's rigorous methodology ensures that the appropriate steps are taken to minimize conflict of interest, producing systematic reviews that are high-quality, trustworthy, and useful to end users who make decisions based on their findings. This article describes how NESR's systematic review process leverages a diversity of expertise and experience, while managing potential conflicts of interest. It describes the groups who collaborate to conduct NESR systematic reviews, their expertise, and why their involvement is critical for ensuring the rigor and utility of NESR's work.

Strengthening Research that Answers Nutrition Questions of Public Health Importance: Leveraging the Experience of the USDA Nutrition Evidence Systematic Review Team.

The Nutrition Evidence Systematic Review (NESR) team conducts nutrition- and public health-related systematic reviews and is within the USDA's Center for Nutrition Policy and Promotion. NESR has collaborated with scientific experts to conduct systematic reviews on nutrition and public health topics for more than a decade and is uniquely positioned to share recommendations with the research community to strengthen research quality and impact, especially the evidence base that supports public health nutrition guidance, including future editions of the Dietary Guidelines for Americans. Leveraging the expertise of NESR and its systematic review process resulted in the following recommendations for the research community: a) use the strongest study design feasible with sufficient sample size(s); b) enroll study participants who reflect the diversity of the population of interest and report participant characteristics; c) use valid and reliable dietary assessment methods; d) describe the interventions or exposures of interest and use standard definitions to promote consistency; e) use valid and reliable health outcome measures; f) account for variables that may impact the relationship between nutrition-related interventions or exposures and health outcomes; g) carry out studies for a sufficient duration and include repeated measures, as appropriate; and h) report all relevant information to inform accurate interpretation and evaluation of study results. Implementing these recommendations can strengthen nutrition and public health evidence and increase its utility in future public health nutrition systematic reviews. However, implementation will require additional support from the entire research community, including scientific journals and funding agencies.

Child attachment behavior as a moderator of the relation between feeding responsiveness and picky eating behavior.

BACKGROUND: Picky eating (PE) behavior is common in early childhood, but persistent PE is associated with unhealthy development and caregiver-child stress during feeding. Identifying modifiable feeding and parent-child relationship factors that impact PE is important for decreasing risks associated with PE. OBJECTIVE: This study examined associations between caregiver Feeding Responsiveness (FR) and child PE behaviors using caregiver reports and observations of family mealtimes. An additional aim examined whether children's attachment behavior moderates this association. METHODS: The analysis sample consisted of 110 families participating in a larger longitudinal study of nutrition and child health. Home observations were conducted when children were 18-24 months (52% females) to assess caregiver-child interactions. Caregivers were, on average, 30.9 years old and mostly White (73.6%). Family mealtimes were videotaped and coded for FR and child PE behaviors. Caregivers completed surveys regarding FR and PE behaviors. RESULTS: Caregiver-reported FR was significantly correlated with observed FR, r (107) = 0.26, p = 0.007; and caregiver-reported PE was associated with observed PE, r (107) = 0.21, p = 0.029. Caregiver-reported FR was inversely related to observed PE, but only when children were characterized by observers to have more positively toned and smooth interactions with caregivers. Using observational data, child attachment significantly moderated the relationship between FR and PE behaviors. CONCLUSIONS: The quality of caregiver-child interactions may impact the degree to which FR is effective in reducing PE. Future longitudinal studies that include more diverse populations, multiple caregivers, and potential mechanisms accounting for these associations are needed.

Home feeding environment and picky eating behavior in preschool-aged children: A prospective analysis.

OBJECTIVE: Picky eating is prevalent in young children and is associated with poor dietary quality and nutrient deficiencies. Identifying predictors of picky eating could inform the development of anticipatory feeding guidance for parents and caregivers of young children. This study identified the association between factors of the home feeding environment with picky eating behavior in a cohort of preschool-aged children. METHODS: Parents of preschool-aged children (n = 497) completed questionnaires including measures of the home feeding environment (i.e., television during mealtime, family mealtime routines, and feeding practices) and child picky eating behavior. The questionnaire was repeated one year later, in which 326 parent-child dyads participated. Logistic regression was used to determine the cross-sectional and prospective associations between home feeding environment measures and child picky eating behavior outcomes. RESULTS: Child control over feeding and watching television during mealtime were associated with higher odds of picky eating behavior in both cross-sectional and prospective analyses. A higher sense of positive climate during family meals and mealtime ritualization was associated with lower odds of picky eating behavior one year later. CONCLUSION: The home feeding environment plays a role in the development of young children's picky eating behavior. Avoiding the television and maintaining parent control of food choices during mealtimes could lead to improvements in children's food preferences and dietary intake.

Variants in Chemosensory Genes Are Associated with Picky Eating Behavior in Preschool-Age Children.

BACKGROUND/AIMS: Picky eating is prevalent among preschoolers and is associated with risk of both underweight and overweight. Although differences in taste perception may be due to genetic variation, it is unclear whether these variations are related to picky eating behavior. The aim of this study was to investigate the association of 6 single nucleotide polymorphisms (SNPs) in 5 candidate genes related to chemosensory perception with picky eating behavior and adiposity in a cohort of preschool-aged children. METHODS: Parents of 2- to 5-year-old non-Hispanic white preschoolers (n = 153) responded to survey questions on demographics, and information regarding their child's breastfeeding history and picky eating behavior. Height and weight were measured to calculate body mass index (BMI) z-scores using standard growth charts, and saliva was collected for genotyping. Generalized linear models were used to examine associations between picky eating behavior and BMI z-scores with genetic variation. RESULTS: When controlling for child age, sex, breastfed status, and parent education level, SNPs in TAS2R38 (rs713598) and CA6 (rs2274327) were associated with picky eating behavior in children. There was no association between SNPs and BMI z-scores. CONCLUSION: Genes related to chemosensory perception may play a role in children's picky eating behavior.

Correlates of picky eating and food neophobia in young children: a systematic review and meta-analysis.

CONTEXT: Picky eating behavior is prevalent among toddlers and may negatively impact their growth and development. This article summarizes the correlates of picky eating and food neophobia in young children, which were identified using a socio-ecological framework. A literature search was conducted in 4 electronic databases. Inclusion criteria were English-language peer-reviewed publications that investigated correlate(s) of picky eating or food neophobia in children aged ≤30 months. Correlates were categorized into 4 levels: cell, child, clan (family), and community/country. Thirty-two studies, which examined 89 correlates, were identified from the keyword searches of the databases and manual searches of the reference lists of included articles. The most examined correlates were characteristics related to the child (sex, weight, and dietary intake) and parent (feeding beliefs and practices). A meta-analysis estimated the prevalence of picky eating to be 22%. Each additional month of a child's age was associated with a 0.06 U increase in the Children's Eating Behavior Questionnaire food fussiness score. This review highlights the importance of investigating child-parent dyads and bidirectional feeding interactions and draws attention to the lack of picky eating research at the level of the cell and the community/country.