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Factors Influencing Early Feeding of Foods and Drinks Containing Free Sugars-A Birth Cohort Study
Diep H Ha1, Loc G Do2, Andrew John Spencer3
1Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide 5005, Australia. diep.ha@adelaide.edu.au.
Insights
Introducing free sugars early to children increases sweetness preference and risk of a cariogenic diet. This study identified household income and maternal sugar-sweetened beverage (SSB) consumption as key factors influencing early introduction of free sugars.
Area of Science:
- Pediatric Nutrition
- Public Health
- Dietary Habits
Background:
- Early introduction of free sugars to infants can foster a lifelong preference for sweetness.
- This preference is linked to an increased risk of developing a cariogenic diet and associated health issues later in life.
Purpose of the Study:
- To investigate early life factors that influence the introduction of foods and drinks containing free sugars to young children.
- Identify key determinants in maternal behaviors and socioeconomic status impacting early dietary patterns.
Main Methods:
- Utilized data from an Australian population-based birth cohort study, involving maternal questionnaires up to 24 months.
- Employed log-binomial regression with robust standard errors to calculate prevalence ratios (PR) for early free sugar introduction.
- Analyzed data using complete case analysis and multiple imputation for missing data.
Main Results:
- 21% of 1479 children received foods/drinks with free sugars by 6-9 months.
- A significant income gradient was observed, with lower household income quartiles showing higher introduction rates.
- Maternal consumption of sugar-sweetened beverages (SSB) daily was associated with a 1.6 times higher PR of early introduction; breastfeeding for at least three months was associated with a 0.6 PR.
Conclusions:
- Household income at birth and maternal behaviors, particularly SSB consumption, are significant determinants of early free sugar introduction.
- Interventions targeting maternal education and socioeconomic support may help mitigate early exposure to free sugars.
- Findings highlight the importance of early life interventions for establishing healthy dietary patterns and preventing future health risks.
Abstract:
Early feeding of free sugars to young children can increase the preference for sweetness and the risk of consuming a cariogenic diet high in free sugars later in life. This study aimed to investigate early life factors influencing early introduction of foods/drinks containing free sugars. Data from an ongoing population-based birth cohort study in Australia were used. Mothers of newborn children completed questionnaires at birth and subsequently at ages 3, 6, 12, and 24 months. The outcome was reported feeding (Yes/No) at age 6-9 months of common foods/drinks sources of free sugars (hereafter referred as foods/drinks with free sugars). Household income quartiles, mother's sugar-sweetened beverage (SSB) consumption, and other maternal factors were exposure variables. Analysis was conducted progressively from bivariate to multivariable log-binomial regression with robust standard error estimation to calculate prevalence ratios (PR) of being fed foods/drinks with free sugars at an early age (by 6-9 months). Models for both complete cases and with multiple imputations (MI) for missing data were generated. Of 1479 mother/child dyads, 21% of children had been fed foods/drinks with free sugars. There was a strong income gradient and a significant positive association with maternal SSB consumption. In the complete-case model, income Q1 and Q2 had PRs of 1.9 (1.2-3.1) and 1.8 (1.2-2.6) against Q4, respectively. The PR for mothers ingesting SSB everyday was 1.6 (1.2-2.3). The PR for children who had been breastfed to at least three months was 0.6 (0.5-0.8). Similar findings were observed in the MI model. Household income at birth and maternal behaviours were significant determinants of early feeding of foods/drinks with free sugars.
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