Women who have breastfed previously have significantly different breastfeeding experiences than primiparous women. Pre- and postdelivery breastfeeding support should differentially target primiparous women to improve breastfeeding outcomes.

BACKGROUND: Evidence suggests an association of breastfeeding with a maternal feeding style (MFS) that is less controlling than formula feeding, which, in turn, may improve a child' s self-regulation of eating. This study examines associations of bottle-feeding practices during infancy with MFS and children' s eating behavior (CEB) at 6 years old. METHODS:We linked data from the Infant Feeding Practices Study II to the Year 6 Follow-Up, which include 8 MFS and CEB measures adapted from previous validated instruments. Bottle-feeding practices during the first 6 months estimated by using the Infant Feeding Practices Study II were bottle-feeding intensity (BFI), mother' s encouragement of infant to finish milk in the bottle, and infant finishing all milk in the bottle. Adjusted odds ratios (aORs) for associations of bottle-feeding practices with MFS and CEB at 6 years old were calculated by using multivariable logistic regressions controlling for sociodemographic characteristics and other feeding practices (N = 1117).RESULTS: Frequent bottle emptying encouraged by mothers during infancy increased odds of mothers encouraging their child to eat all the food on their plate (aOR: 2.37; 95% confidence interval [CI]: 1.65-3.41] and making sure their child eats enough (aOR: 1.62; 95% CI: 1.14-2.31) and of children eating all the food on their plate at 6 years old (aOR: 2.01; 95% CI: 1.05-3.83). High BFI during early infancy also increased the odds of mothers being especially careful to ensure their 6-yearold eats enough.CONCLUSIONS: Bottle-feeding practices during infancy may have longterm effects on MFS and CEB. Frequent bottle emptying encouraged by mothers and/or high BFI during early infancy increased the likelihood of mothers pressuring their 6-year-old child to eat and children' s low satiety responsiveness. Pediatrics 2014;134:S70-S77

The built environment (BE) has been viewed as an important determinant of health. Numerous studies have linked BE exposure, captured using a variety of methods, to diet quality and to area prevalence of obesity, diabetes, and cardiovascular disease. First‐generation studies defined the neighborhood BE as the area around the home. Second‐generation studies turned from home‐centric to person‐centric BE measures, capturing an individual’s movements in space and time. Those studies made effective uses of global positioning system tracking devices and mobile phones, sometimes coupled with accelerometers and remote sensors. Activity space metrics explored travel paths, modes, and destinations to assess BE exposure that was both person and context specific. However, as measures of the contextual exposome have become ever more fine‐grained and increasingly complex, connections to long‐term chronic diseases with complex etiologies, such as obesity, are in danger of being lost. Furthermore, few studies on obesity and the BE have included intermediate energy balance behaviors, such as diet and physical activity, or explored the potential roles of social interactions or psychosocial pathways. Emerging survey‐based applications that identify habitual destinations and associated travel patterns may become the third generation of tools to capture health‐relevant BE exposures in the long term.

Early decisions about milk-feeding, and the types of solid foods offered in infancy can foreshadow dietary patterns and obesity risk later in childhood. Infants who were offered energy-dense foods had higher intake of these foods at 6 years of age.

Background The COVID-19 pandemic profoundly affected food systems including food security. Understanding how the COVID-19 pandemic impacted food security is important to provide support, and identify long-term impacts and needs. Objective The National Food Access and COVID research Team (NFACT) was formed to assess food security over different U.S. study sites throughout the pandemic, using common instruments and measurements. This study present results from 18 study sites across 15 states and nationally over the first year of the COVID-19 pandemic. Methods A validated survey instrument was developed and implemented in whole or part through an online survey of adults across the sites throughout the first year of the pandemic, representing 22 separate surveys. Sampling methods for each study site were convenience, representative, or high-risk targeted. Food security was measured using the USDA six-item module. Food security prevalence was analyzed using analysis of variance by sampling method to statistically significant differences. Results Respondents (n = 27,168) indicate higher prevalence of food insecurity (low or very low food security) since the COVID-19 pandemic, as compared to before the pandemic. In nearly all study sites, there is higher prevalence of food insecurity among Black, Indigenous, and People of Color (BIPOC), households with children, and those with job disruptions. The findings demonstrate lingering food insecurity, with high prevalence over time in sites with repeat cross-sectional surveys. There are no statistically significant differences between convenience and representative surveys, but statistically higher prevalence of food insecurity among high-risk compared to convenience surveys. Conclusions This comprehensive study demonstrates higher prevalence of food insecurity in the first year of the COVID-19 pandemic. These impacts were prevalent for certain demographic groups, and most pronounced for surveys targeting high-risk populations. Results especially document the continued high levels of food insecurity, as well as the variability in estimates due to survey implementation method. Summary Multi-site assessment demonstrates widespread food insecurity during COVID-19, especially on households with children, job loss, and Black, Indigenous, People of Color across multiple survey methods.

Objective This article examines relations between patterns of dietary exposures at 9 months and infant and maternal weight status at 1 year postpartum. Methods Participants were part of the Infant Feeding Practices Study II and included 1807 mothers participating through the first year postpartum. All data were self‐reported monthly by mothers. Latent class analysis was conducted to identify patterns of infant dietary exposures at 9 months. Factors that predicted dietary pattern class membership were examined including infant sleep and parity. Dietary pattern membership was used to predict child and maternal weight outcomes at 1 year postpartum. Results Five patterns of dietary exposures were identified, characterized by differences in milk‐feeding and solid foods at 9 months: “Breastfed Fruits and Vegetables,” “Breastfed Low Variety,” “Formula‐Fed Fruits and Vegetables,” “Formula‐Fed Low Variety,” and “Mixed High Energy Density.” Infants in the Mixed High Energy Density dietary pattern were more likely to be overweight at 1 year. Conclusions Dietary classes that capture different combinations of several aspects of infant feeding may be more useful than single dietary predictors, for example, breastfeeding, formula‐feeding, or early introduction to solids, to describe differences in infants' early dietary experience and risk for overweight.

Higher consumption of “ultra-processed”(UP) foods has been linked to adverse health outcomes. The present paper aims to characterize percent energy from UP foods by participant socio-economic status (SES), diet quality measures, self-reported food expenditure, and energy-adjusted diet cost. Participants in the population-based Seattle Obesity Study III (n=755) conducted in WA in 2016-17 completed socio-demographic and food expenditure surveys and the Food Frequency Questionnaire (FFQ). Education and residential property values were measures of SES. Retail prices of FFQ component foods (n=378) were used to estimate individual-level diet cost. Healthy Eating Index (HEI-2015) and Nutrient Rich Food Index (NRF9.3) were measures of diet quality. UP foods were identified following NOVA classification. Multivariable linear regressions were used to test associations between UP foods energy, socio-demographics, two estimates of food spending, and diet quality measures. Higher percent energy from UP foods was associated with higher dietary energy density, and lower HEI-2015 and NRF9.3 scores. The bottom decile of diet cost ($216.4/mo) was associated with 67.5% energy from UP foods; the top decile ($369.9/mo) was associated with only 48.7% energy from UP foods. Percent energy from UP foods was inversely linked to lower food expenditures and diet cost. In multivariate analysis, percent energy from UP foods was predicted by lower food expenditures, diet cost, and education, adjusting for covariates. Percent energy from UP foods was linked to lower food spending and lower SES. Efforts to reduce UP foods consumption, an increasingly common policy measure, need to take affordability, food expenditures and diet costs into account.

BackgroundPatterns of beverage consumption among children and adolescents can be indicative of food choices and total diet quality.MethodsAnalyses of beverage consumption patterns among 8119 children aged 4–19 y were based on the first 24-h recall of the National Health and Nutrition Examination Survey (2009–14 NHANES). Four pre-defined beverage patterns were: 1) milk pattern; 2) 100% juice pattern; 3) milk and 100% juice pattern; and 4) other caloric beverages. Food- and nutrient-based diet quality measures included the Healthy Eating Index 2010.ResultsMost children drank other caloric beverages, as opposed to milk (17.8%), 100% juice (5.6%), or milk and 100% juice (13.5%). Drinkers of milk and 100% juice had diets that did not differ from each other in total calories, total and added sugars, fiber, or vitamin E. Milk drinkers consumed more dairy and had higher intakes of calcium, potassium, vitamin A and vitamin D as compared to all other patterns. Juice drinkers consumed more total fruit, same amounts of whole fruit, and had higher intakes of vitamin C as compared to the other consumption patterns. Drinkers of both milk and 100% juice had the highest HEI 2010 scores of all the consumption patterns.ConclusionsBeverage consumption patterns built around milk and/or 100% juice were relatively uncommon. Promoting the drinking of milk and 100% juice, in preference to other caloric beverages, may be an effective strategy to improve children’s diet quality. Restricting milk and 100% juice consumption may encourage the selection of other caloric beverages.Electronic supplementary materialThe online version of this article (10.1186/s12937-018-0363-9) contains supplementary material, which is available to authorized users.