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Results suggest that the current national survey item may not adequately measure cigar use. Accordingly, prevalence of cigar use among adolescents may be greatly underestimated, especially among Black youth.

Paralleling the works of Cambourne's Conditions of Literacy Learning (The Reading Teacher, 54(4), [414][415][416][417][418][419][420][421][422][423][424][425][426][427][428][429] 2001), Copple and Bredekamp's (Developmentally appropriate practice in early childhood programs serving children from birth though age. National Association for the Education of Young Children, Washington, 2009) Developmentally Appropriate Practices and the findings from the field of Neuroscience this article explores the important components of creating an active, stimulating learning environment; one purposely designed to actively engage the minds of young children in order to help strengthen their neurological networks. The article concludes its exploration with the role of ''mirror neurons'' in the learning environment and how they affect the young child's mood, emotions, and empathy.

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Background Child eating behaviours can negatively contribute to the development of childhood obesity. This study investigated associations between breastfeeding habits, maternal eating behaviours and child eating behaviours, in 5-year-old children. Methods Secundigravida women were recruited to the ROLO dietary randomised controlled trial (Dublin, Ireland) and were followed up with their children to 5 years of age. Breastfeeding exposure and duration were obtained at postnatal and infant follow-up at 2 and 6 months and 2 and 5 years. At 5 years, maternal and child eating behaviours were measured using the Three Factor Eating Questionnaire and the Child Eating Behaviour Questionnaire, respectively. Regression determined associations between breastfeeding habits and maternal eating behaviours with child eating behaviours, controlling for RCT group, maternal education level, maternal BMI at 5 years, childcare exposure and child BMI centile at 5-year follow-up. Results There were 230 mother and child pairs analysed. One hundred and fifty-eight mothers had initiated breastfeeding. Median breastfeeding duration was 22 (IQR 33) weeks. Children who were never breastfed were more likely to express a desire to drink (B = −1.01, p = 0.022). Longer breastfeeding duration was associated with lower food responsiveness (B = −1.71, p = 0.003). Maternal uncontrolled eating was positively associated with child food responsiveness, emotional overeating and emotional undereating (B = 0.21, p < 0.001; B = 0.14, p = 0.005; B = 0.14, p = 0.005, respectively). Maternal emotional eating was associated with child emotional overeating and undereating (B = 0.27, p < 0.001, B = 0.29, p = 0.004, respectively). Conclusion Not breastfeeding and short breastfeeding duration may contribute to the development of obesogenic eating behaviours in children, alongside maternal eating behaviours including uncontrolled and emotional eating. These ‘food approach’ eating behaviours may increase risk of overweight/obesity as they are associated with increased energy intake, hence the importance of research surrounding eating behaviours.

Infant protein intake has been associated with child growth, however, research on maternal protein intake during pregnancy is limited. Insulin-like growth factors (IGF) play a role in early fetal development and maternal protein intake may influence child body composition via IGF-1. The aim of this study was to investigate the association of maternal protein intake throughout pregnancy on cord blood IGF-1 and child body composition from birth to 5 years of age. Analysis was carried out on 570 mother–child dyads from the Randomised cOntrol trial of LOw glycaemic index diet study. Protein intake was recorded using 3-d food diaries in each trimester of pregnancy and protein intake per kg of maternal weight (g/d per kg) was calculated. Cord blood IGF-1 was measured at birth. Infant anthropometry was measured at birth, 6 months, 2 and 5 years of age. Mixed modelling, linear regression, and mediation analysis were carried out. Birth weight centiles were positively associated with early-pregnancy protein intake (g/d per kg), while weight centiles from 6 months to 5 years were negatively associated (B=−21·6, P<0·05). These associations were not mediated by IGF-1. Our findings suggest that high protein intake in early-pregnancy may exert an in utero effect on offspring body composition with a higher weight initially at birth but slower growth rates into childhood. Further research is needed to elucidate the exact mechanisms by which dietary protein modulates fetal growth.

Summary Introduction Childhood obesity remains a significant global health concern. Early intervention through maternal diet during pregnancy represents a possible mode of improving childhood adiposity. Aim To examine the impact of a low glycaemic index diet during pregnancy on offspring anthropometry at 5 years of age. Methods This is a secondary analysis of 387 children from the ROLO pregnancy study 5 years' post‐intervention. At the follow‐up, BMI, circumferences and skinfold thickness were obtained. A subgroup of 103 children had a DXA scan completed. Statistical analyses included Independent sample t tests, Mann Whitney‐U tests and chi‐square tests to compare the intervention and control groups. Adjusted analysis using linear regression controlled for significant confounders between participants who returned at follow‐up and those that did not. Results There were no significant differences in BMI (16.05 kg/m2 vs 16.16 kg/m2, P = 0.403), general adiposity (36.60 mm vs 36.00 mm, P = 0.920), central adiposity (0.61 mm vs 0.60 mm, P = 0.540), total fat mass (4.91 kg vs 4.71 kg, P = 0.377) or total lean mass (14.29 kg vs 14.56 kg, P = 0.386) between the intervention and control groups, respectively. No associations were observed in 5‐year outcomes in adjusted analyses when controlling for maternal age at delivery, maternal early pregnancy BMI, maternal education and gestational age. Conclusion Our study found no evidence that a low glycaemic index diet in pregnancy impacts offspring anthropometry 5 years' post‐intervention. Therefore, modulating maternal carbohydrate quality in pregnancy may not be an appropriate approach to improving weight status in childhood. Future research should investigate the impact of other dietary practices in pregnancy on child health.

Objective To determine whether a dietary intervention in pregnancy had a lasting effect on maternal outcomes of diet, HbA1c and weight retention 5 years post‐intervention; and to establish whether modifiable maternal behaviours were associated with these outcomes. Design Randomised control trial of low glycaemic index (GI) diet in pregnancy with longitudinal follow up to 5 years post‐intervention. Setting Dublin, Ireland (2007–2016). Population In all, 403 women of 759 (53.1%) were followed up at 5 years. A total of 370 (intervention n = 188; control n = 182) were included in this analysis. Methods Fasting glucose was measured at 13 and 28 weeks’ gestation and HbA1c (mmol/mol) at 5‐year follow up. Weight retention (kg) from early pregnancy to 5 years post‐intervention was calculated. Dietary intakes, anthropometry, and lifestyle factors were measured in pregnancy and 5 years post‐intervention. Multiple linear regression models, controlling for confounders, were used for analysis. Outcome Maternal diet, HbA1c, and weight retention at 5 years post‐intervention. Results There was no difference between the intervention and control at 5 years post‐intervention for any long‐term maternal outcomes measured. HbA1c at 5 years post‐intervention was associated with early‐pregnancy fasting glucose (B 1.70, 95% CI 0.36–3.04) and parity ≥3 (B 1.04, 95% CI 0.09–1.99). Weight retention was associated with change in well‐being from pregnancy to 5 years (B −0.06, 95% CI −0.11 to −0.02), gestational weight gain (B 0.19, 95% CI 0.00–0.38), and GI (B 0.26, 95% CI 0.06–0.46) at 5 years. Conclusions The ROLO low‐GI dietary intervention in pregnancy had no impact on maternal dietary intakes, HbA1c or body composition 5 years post‐intervention. Maternal factors and lifestyle behaviours in pregnancy have long‐term effects on glucose metabolism and weight retention up to 5 years later. Tweetable abstract Pregnancy factors are associated with maternal glucose metabolism and weight retention 5 years later—findings from the ROLO Study.