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
Content
 Objectives
 Methods
 Dietary pattern analysis
 Results
 Conclusion
 Future perspectives
Objectives
Aim:
To identify dietary patterns in toddlers and to assess sociodemographic 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
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).
Methods: Food groups
Refined grains
Vegetable oils
Whole grains
Other fats (margarines, butter)
Pasta and rice
Fish
Dairy
Shellfish
Fruit
Meat
Soy substitutes
Eggs
Vegetables
Legumes
Potatoes
Sugar-containing beverages
Soups and sauces
Non-sugar containing beverages
Savoury and snacks
Composite dishes
Confectionary
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.

Methods: statistical analyses (2)
Variables in model:

Mother factors:
Child factors:
 Maternal educational background
 Age of food assessment
 Household income
 Gender
 Marital status
 Birth weight
 Maternal alcohol consumption
 Breast-feeding
 Maternal smoking
 Timing of solid introduction
 Folic acid supplementation
 Daycare attendance
 Maternal BMI
 Weight and Height
 Maternal age
 Watching TV
 Parity
 Parental stress
 Any history of depression or anxiety
 Any diabetes, hypertension or
hypercholesterolemia
 Maternal macronutrient intake
Methods: Dietary patterns analysis (PCA)
‘Western-like dietary pattern’
‘Health conscious 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
4
-
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
4
0.59
-
Sugar-containing beverages
198
-
0.59
Non-sugar containing beverages
56
-
-
Composite dishes
102
-
-
Results: Western-like dietary pattern
Maternal indicators of a Western-like dietary pattern
Difference in western-like dietary pattern score
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
Results: Health conscious dietary pattern
Mother and child indicators of a Health conscious dietary pattern
Difference in Health conscious dietary pattern score
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
Future perspectives (1)
 Dietary variety in toddlers
 Tracking dietary patterns?
 Consequences for later health?
Thank you for your attention!