1. Dietary patterns in toddlers
The Generation R Study
Jessica Kiefte-de Jong, RD, MSc
Department of Paediatrics / The Generation R Study group
Erasmus Medical Centre, Rotterdam, The Netherlands

2. Content Objectives Methods Dietary pattern analysis Results Conclusion
Future perspectives

3. Objectives
Aim:
To identify dietary patterns in toddlers and to assess socio-demographic and lifestyle determinants of these dietary patterns
Identifying children at potential risk for unhealthy eating behaviour in future.
Forming a basis for future studies on dietary patterns and health outcomes within our cohort
Percentage of mothers who breastfed during their child's first 6 months of life, according to mother's educational level (N = 2914).

4. Methods: Generation R Generation R Study, Rotterdam, The Netherlands.
Population based prospective cohort study from fetal life onwards.
N=5088 mothers with a delivery data between April 2002 and January 2006 provided consent for follow-up and received a food frequency questionnaire for their child at 14 months.
(Mean; SD: 14; 2 months).

5. Methods: Food groups Refined grains Whole grains Pasta and rice Dairy
Fruit
Soy substitutes
Vegetables
Potatoes
Soups and sauces
Savoury and snacks
Confectionary
Vegetable oils
Other fats (margarines, butter)
Fish
Shellfish
Meat
Eggs
Legumes
Sugar-containing beverages
Non-sugar containing beverages
Composite dishes

6. Methods: statistical analyses (1)
Food groups were entered in PCA by grams/day consumed.
Dietary patterns with an Eigenvalue of >1.5 were extracted.
Explaining 24.5% of the variation in food consumption.
Varimax rotation to reduce correlation between patterns
Individual ‘adherence scores’ on the dietary patterns by using regression-based factor scores.
Multivariate analyses on dietary pattern score
Stepwise backward elimination procedure retaining only the strongest predictors.

7. Methods: statistical analyses (2)
Variables in model:
Mother factors:
Maternal educational background
Household income
Marital status
Maternal alcohol consumption
Maternal smoking
Folic acid supplementation
Maternal BMI
Maternal age
Parity
Parental stress
Any history of depression or anxiety
Any diabetes, hypertension or hypercholesterolemia
Maternal macronutrient intake
Child factors:
Age of food assessment
Gender
Birth weight
Breast-feeding
Timing of solid introduction
Daycare attendance
Weight and Height
Watching TV

8. Methods: Dietary patterns analysis (PCA)
‘Western-like dietary pattern’
‘Health conscious dietary pattern’

9. Health conscious dietary pattern Western-like dietary pattern
Mean intake
grams/day
Health conscious dietary pattern
Western-like dietary pattern
Refined bread and breakfast cereals 15 -
0.57
Whole bread and breakfast cereals 62
Pasta and rice 23
0.62
Dairy
626
Fruit
162
0.32
Soy substitutes 4
Vegetables 52
0.74
Potatoes 34
0.61
Soups and sauces 9
0.23
Savoury and snacks
0.59
Confectionary 28
0.72
Vegetable oils 1
0.50
Animal fats 11
0.58
Fish 8
0.22
Shellfish
0.3
Meat 26
0.21
0.27
Eggs 2
Legumes
Sugar-containing beverages
198
Non-sugar containing beverages 56
Composite dishes
102

10. Results: Western-like dietary pattern
Maternal indicators of a Western-like dietary pattern
Difference in western-like dietary pattern score

11. Results: Western-like dietary pattern
Child indicators of a Western-like dietary pattern
Introduction of solids after the age of 6 months
Difference in western-like dietary pattern score

12. Results: Health conscious dietary pattern
Mother and child indicators of a Health conscious dietary pattern
Difference in Health conscious dietary pattern score

13. Conclusion
A Western-like and Health conscious dietary pattern can already be identified in children aged 14 months.
Adherence to a Western-like dietary pattern clusters with early-life risk factors for overweight in later life.
Determinants of a Health conscious diet may be less straightforward and need further elucidation

14. Future perspectives (1)
Dietary variety in toddlers
Tracking dietary patterns?
Consequences for later health?

15. Thank you for your attention!