title: Association of maternal characteristics and behaviours with 4-year-old children's dietary patterns.
abstract: This study examined the association of family and maternal characteristics with preschool children's dietary patterns. Trained interviewers evaluated subsample 3422 mothers and children enrolled in the population-based birth cohort Generation XXI (Porto, Portugal, 2005-2006). Maternal characteristics and behaviours (exercise, smoking habits, diet and child-feeding practices) and family characteristics were evaluated. Maternal diet was classified by a dietary score, and children's dietary patterns were identified by latent class analysis. Odds ratios (OR) and confidence intervals (95% CI) were estimated by multinomial regression models. The analysis was based on a framework with four conceptual levels: maternal socio-economic position (SEP) at 12 years, maternal socio-economic and demographic characteristics at child's delivery, family characteristics and maternal behaviours at child's 4 years. Three dietary patterns were identified in children: high in energy-dense foods (EDF); low in foods typically consumed at main meals and intermediate in snacks (Snacking); higher in healthy foods; and lower in unhealthy ones (Healthier, reference). Lower maternal SEP had an overall effect on children's diet (low vs. high SEP; EDF, OR = 1.76, 95% CI: 1.42-2.18; Snacking, OR = 1.73, 95% CI: 1.27-2.35), while maternal education was directly associated with it (≤9 vs. >12 schooling years, EDF, OR = 2.19, 95% CI: 1.70-2.81; Snacking, OR = 2.22, 95% CI: 1.82-3.55). Children whose mothers had worse dietary score were significantly more likely to follow unhealthier patterns (first vs. fourth quartile; EDF, OR = 9.94, 95% CI: 7.35-13.44, P-trend < 0.001; Snacking, OR = 4.21, 95% CI: 2.94-6.05, P-trend < 0.001). Maternal diet was the key factor associated with children's diet, above and beyond socio-economic and demographic characteristics, accounting for one-third of the determination coefficient of the fully adjusted model. At preschool age, interventions should give a particular focus on maternal diet and low SEP groups.
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.
authors.forename: Catarina
authors.identifier: 0000-0002-3619-5095
authors.initials: C
authors.lastname: Durão
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.|Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors.forename: Milton
authors.initials: M
authors.lastname: Severo
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.|Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors.forename: Andreia
authors.initials: A
authors.lastname: Oliveira
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.|Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Moreira
authors.affiliation: Department of Pediatrics, University of Porto Medical School, Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Guerra
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.|Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors.forename: Henrique
authors.initials: H
authors.lastname: Barros
authors.affiliation: EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal.|Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Lopes
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D015444:Exercise; D005191:Family Characteristics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008425:Maternal Behavior; D039382:Maternal Nutritional Physiological Phenomena; D015999:Multivariate Analysis; D011174:Portugal; D012907:Smoking; D012959:Socioeconomic Factors; D044465:White People
keywords: demographic factors; dietary habits; family characteristics; maternal behaviours; preschool children; socio-economic factors