Externalizing behavior is prospectively associated with intake of added sugar and sodium among low socioeconomic status preschoolers in a sex-specific manner

Abstract

BackgroundHigh intake of added sugar and sodium is a public health concern for preschool-aged children living in the US. Externalizing behavior may predict higher consumption of added sugar and/or sodium; however, previous studies have mostly been cross-sectional. The aim was to evaluate whether externalizing behavior is prospectively related to added sugar and intake in a sex-specific manner among preschoolers.MethodsThis was a secondary analysis of 524 preschool children (48% male) from Michigan who participated in an obesity prevention trial that occurred during one school year from 2011 to 2015. Teacher-assessed externalizing behaviors and three 24-h dietary recalls were completed at baseline and follow-up. We used linear mixed effects regression to evaluate the association between externalizing behavior at baseline and added sugar (% of total Calories) and sodium intake (mg/1000 Calories) at follow-up. In adjusted analysis, we included baseline income-to-needs ratio, child race/ethnicity, and baseline overweight status. All models were adjusted for total energy intake and accounted for clustering by classroom.ResultsBaseline externalizing behavior was positively associated with added sugar intake at follow-up among boys; after adjustment for confounders, every 5 points lower externalizing T-score (corresponding to higher externalizing behavior) was associated with a 0.6 higher percentage of added sugar per total Calories (95% CI 0.2 to 1.1; P value = 0.004). In contrast, girls with higher levels of externalizing behavior had lower consumption of added sugars; after confounder adjustment, every 5 points lower externalizing T-score was related to 0.6 lower percentage intake (95% CI -1.0 to −0.1; P value = 0.01). Baseline externalizing behavior was inversely associated with sodium intake at follow-up among boys. After potential confounder adjustment, for every 5 points lower externalizing behavior T-score, there was a 22 mg/1000 Cal lower sodium intake (95% CI -45 to 1; P value = 0.06). In contrast, after adjustment for confounders, every 5 points lower externalizing T-score among girls was related to 24 mg/1000 Cal higher sodium intake (95% CI 1 to 46; P value = 0.04).ConclusionsExternalizing behavior among preschool-aged children was prospectively related to added sugar and sodium intake in a sex-dependent manner.Trial registration NCT01398358 Registered 19 July 2011.Electronic supplementary materialThe online version of this article (10.1186/s12966-017-0591-y) contains supplementary material, which is available to authorized users.

Association of blood leukocyte DNA methylation at LINE-1 and growth-related candidate genes with pubertal onset and progression

“…The socioeconomic status (SES) information was collected, using a validated questionnaire consisting of thirteen questions on housing quality, services, material goods and education of the head of household by AMAI (Asociación Mexicana de Agencias de Investigación de Mercados y Opinión Pública, version 13 × 6). With the use of fourteen hierarchical trees this scale classified households into six SES categories (A/B, C+, C, D+, D, E; with A/B being the highest category) [8,65]. This scale was validated using the results of the National Survey of Household Income and Expenditure 2005, Mexico (ENIGH, Encuesta Nacional de Ingresos y Gastos de los Hogares 2004), classifying households into seven SES categories (A/B, C+, C, C-, D+, D, E; with A/B being the highest category) using a point based system [8,65].…”

“…With the use of fourteen hierarchical trees this scale classified households into six SES categories (A/B, C+, C, D+, D, E; with A/B being the highest category) [8,65]. This scale was validated using the results of the National Survey of Household Income and Expenditure 2005, Mexico (ENIGH, Encuesta Nacional de Ingresos y Gastos de los Hogares 2004), classifying households into seven SES categories (A/B, C+, C, C-, D+, D, E; with A/B being the highest category) using a point based system [8,65]. [8,65].…”

“…This scale was validated using the results of the National Survey of Household Income and Expenditure 2005, Mexico (ENIGH, Encuesta Nacional de Ingresos y Gastos de los Hogares 2004), classifying households into seven SES categories (A/B, C+, C, C-, D+, D, E; with A/B being the highest category) using a point based system [8,65]. [8,65]. Weight and height of the child were measured by trained nurses, following standardized protocols we have previously described [66]; BMI was calculated as weight over height squared (kg/m 2 ) [66].…”

“…Moreover, they may negatively affect adult psychosocial functioning, educational achievement, height, and bone mineral density [1,6]. Over recent decades, the risk factors of earlier or later puberty, including chemical exposures, unbalanced diet, and abnormal hormone levels caused by diseases and psychological stress, have been discussed [7,8]. However, the underlying biological mechanisms that lead to early or delayed puberty remain unclear.…”

Childhood emotional and behavioral characteristics are associated with soda intake: A prospective study in Mexico City

“…One area that remains underexplored is whether emotional and behavioral difficulties could predispose youth to higher SSB intake. An association is plausible, as recent studies in children <6 years have linked internalizing behavior (acting withdrawn, depressed, anxious) and externalizing behaviors (showing aggression, anger, impulsivity) with greater consumption of foods high in added sugar and/or sodium 18,19 . One potential explanation is through parental behaviors, as parents may use food to calm or pacify children when distressed or when they show disruptive behavior 20 .…”