Objective: To describe patterns of feeding difficulties and behaviors of Filipino children diagnosed with Autism Spectrum Disorder (ASD). Methods: An electronic mealtime survey was administered to caregivers of 3- to 9-year-old children diagnosed with ASD in a Philippine tertiary government hospital. Descriptive statistics and correlation analyses between feeding difficulties measured as Mealtime Survey Score, sociodemographic data, and early feeding history were performed. The impact of the COVID-19 pandemic to these was analyzed through a binomial test. Results: All of the 115 study subjects reported at least one problematic feeding behavior, with picky eating being the most frequent (61.74%). Significantly, more feeding difficulties were observed among the children with reported early feeding difficulties during their 2nd and 3rd year of life. There were no documented statistically significant changes in feeding behaviors during the past six months of the COVID-19 pandemic. Conclusion There is a high prevalence of feeding difficulties and problematic feeding behavior among Filipino children with ASD, however no significant changes to these during the past six months of the COVID-19 pandemic were documented. Present feeding difficulties and behaviors were associated with history of early feeding difficulties, highlighting the need to include feeding difficulties in screening tools, and early training programs and interventions for children with ASD.
Autism Spectrum Disorder: Child ; Feeding Behavior ; COVID-19

Academic stressors can hinder the wellbeing of students and impact their eating habits. In this study, we apply the socio-ecological model to academic stressors and explore the influence they have on eating behaviour among university students. This cross-sectional study was set in a private health sciences university in Malaysia among a sample of 183 pre-university students, which was obtained using systematic random sampling technique. The academic stressors of the participants were assessed using the Academic Stress Questionnaire while eating behaviour was determined using The Three Eating Factor Questionnaire Revised-18 Items. Significant association (p ≤ 0.05) was found between academic stressors and eating habits. The increase in academic stressors increased the unhealthy eating behaviours: Cognitive Restraint, Uncontrolled Eating, and Emotional Eating. The findings illustrate that academic stressors should be taken into consideration for future university health interventions to promote healthy eating behaviour.
Feeding Behavior ; Students

Objective: To explore the obesity-related factors among primary and middle school students in Hangzhou. Methods: A stratified random cluster sampling cross-sectional study was conducted using Hangzhou city's 2016-2020 annual school health survey data. Finally, 9 213 primary and secondary school students with complete data were selected as the research objects. The standard of Overweight and Obesity Screening for School-age Children and Adolescents (WS/T 586-2018) was used to verify students' obesity. SPSS 25.0 software was applied to conduct statistical analysis on the related factors of obesity. Results: The overall obesity detection rate among primary and middle school students in Hangzhou was 8.52%. The results of logistic regression analysis showed that inadequate sleep (OR=6.507, 95%CI: 2.371-17.861, P<0.001), 3- hours (OR=5.666, 95%CI: 2.164-14.835, P<0.001) and ≥4 hours (OR=7.530, 95%CI: 2.804-20.221, P<0.001) of watching video every day in the past week, being beaten and scolded by parents in the past week (OR=1.627, 95%CI: 1.161-2.280, P=0.005), parents often reduce students' exercise time in order to let students have more time to study in the past week (OR=3.310, 95%CI: 1.243-8.819, P=0.017), age 16-18 years old (OR=0.137, 95%CI: 0.050-0.374, P<0.001), often suffering from campus violence in the past week (OR=0.332, 95%CI: 0.141-0.783, P=0.012), 1 hour of watching video every day in the past week (OR=0.023, 95%CI: 0.006-0.083, P<0.001), sometimes having breakfast (OR=0.151, 95%CI: 0.058-0.397, P<0.001) and eating breakfast every day (OR=0.020, 95%CI: 0.005-0.065, P<0.001) in the past week, eating vegetables and fruits sometimes (OR=0.015, 95%CI: 0.010-0.023, P<0.001) and every day (OR=0.020, 95%CI: 0.008-0.053, P<0.001) in the past week, eating sweet food sometimes (OR=0.089, 95%CI: 0.035-0.227, P<0.001) and every day (OR=2.568, 95%CI: 1.632-4.041, P<0.001) in the past week, eating fried food sometimes (OR=0.274, 95%CI: 0.094-0.800, P=0.018) in the past week, and having three physical education classes every week (OR=0.156, 95%CI: 0.057-0.423, P<0.001) were the main related factors affecting the occurrence of obesity in primary and secondary school students. Conclusions: With the higher obesity prevalence among primary and middle school students in Hangzhou, parents and teachers should strengthen health education for primary and middle school students, help children develop scientific eating behavior, develop positive and healthy living habits of children, and effectively prevent overweight/obesity in primary and middle school students.
Child ; Adolescent ; Humans ; Overweight/epidemiology* ; Cross-Sectional Studies ; Obesity/epidemiology* ; Feeding Behavior ; Students

Objective: To explore the relationship between nutrient-related dietary pattern and mild cognitive impairment (MCI) in middle-aged and elderly people. Methods: A total of 6 444 middle-aged and elderly people aged ≥55 years were selected in 2018 China Health and Nutrition Survey. MCI was evaluated by Mini-Mental State Examination, and the intakes of various foods were obtained by consecutive 3-day 24-hour dietary survey and weighing method. The intakes of various nutrients and total dietary energy were calculated based on the food composition table. Demographic and social information, lifestyle and health status of the respondents were obtained through questionnaire survey and physical measurements. In this study, vitamin C, vitamin E, zinc, iron, copper and selenium were selected as dependent variables. Nutrient-related dietary patterns were extracted by reduced rank regression method, and the relationship between dietary patterns and MCI was analyzed by multivariate logistic regression model. Results: Six dietary patterns were extracted in this study, and dietary pattern 1 with the highest explanatory degree was selected for subsequent analysis. Dietary pattern 1 was characterized by higher intakes of legume products, vegetables, fruits, nuts, pork, aquatic products and plant oil. Multivariate logistic regression analysis showed that the risk of MCI was lower in Q₄ dietary score group than in Q₁ dietary score group (OR=0.69, 95%CI: 0.49-0.98) in the 55-64 age group. In people with sleep duration of 8 hours per day, the risk of MCI was reduced in Q₂, Q₃ and Q₄ dietary score groups compared with the Q₁ dietary score group, with OR values of 0.68 (95%CI: 0.51-0.92), 0.67 (95%CI: 0.49-0.92) and 0.65 (95%CI: 0.45-0.92), respectively. Interaction analysis showed that the risk for MCI increased in those aged 65-74 years and ≥75 years compared with those aged 55-64 years in Q₁ dietary score group. However, the risk for MCI decreased in both age groups as dietary pattern scores increased. Compared with those with sleep duration less or more than 8 hours per day in Q₁ dietary score group, those with sleep duration of 8 hours per day in Q₂ and Q₃ dietary score groups had a reduced risk for MCI. Conclusion: Dietary patterns with higher intakes of legume products, vegetables, fruits, nuts, pork, aquatic products, and plant oil are negatively associated with MCI in people aged 55-64 years and those who slept 8 hours per day, and may reduce the risk of MCI with aging.
Aged ; Middle Aged ; Humans ; Feeding Behavior/psychology* ; Diet ; Cognitive Dysfunction/epidemiology* ; Nutrients ; Vegetables ; China/epidemiology*

Objective To investigate the status of exclusive breastfeeding and bottle feeding in remote rural areas of Sichuan province and explore the relationship between negative emotions of mothers and feeding patterns of infants.Methods Multistage cluster sampling was employed to select the infants aged 0-6 months and their mothers in remote rural areas of Sichuan province.A self-designed questionnaire was used to collect the demographic characteristics of mothers and infants and the basic family information.The Chinese version of Depression Anxiety Stress scale was used to evaluate mothers' negative emotions,and the Breastfeeding Self-efficacy scale to assess the confidence level of mothers' behavior of adhering to exclusive breastfeeding.Results Totally 723 pairs of infants and their mothers were included.The exclusive breastfeeding and bottle feeding rates were 34.16% (247/723) and 57.54% (416/723),respectively.Mothers with depression tendency were less likely to adopt exclusive breastfeeding (OR=0.532,95%CI=0.291-0.974,P=0.041) and more likely to adopt bottle feeding (OR=1.877,95%CI=1.054-3.344,P=0.033).Further subgroup analysis of breastfeeding self-efficacy showed that in the group of low self-efficacy,the mothers with depression tendency were less likely to adopt exclusive breastfeeding (OR=0.461,95%CI=0.236-0.902,P=0.024) and more likely to adopt bottle feeding (OR=1.968,95%CI=1.047-3.701,P=0.036) than the mothers without depression tendency.In the group of high self-efficacy,mothers' depression,anxiety,and stress tendency had no significant correlation with infant feeding patterns (all P>0.05).Conclusions The mothers in the remote rural areas of Sichuan province are more likely to employ bottle feeding than exclusive breastfeeding.The mothers with stronger depression tendency demonstrate lower possibility of exclusive breastfeeding and higher possibility of bottle feeding.Breastfeeding self-efficacy may affect the association between maternal depression and infant feeding patterns.
Humans ; Infant ; Anxiety ; China ; Feeding Behavior ; Self Efficacy ; East Asian People ; Mothers/psychology* ; Depression/epidemiology*

Objective: To examine the purchase behaviors of prepackaged food and its determinants among primary and middle school students in 6 provinces of China. Methods: A multi-stage sampling strategy was adopted to select 2 499 primary and middle school students and their parents from the eastern region of China(Beijing, Jiangsu Province, Guangdong Province), the northeast region(Heilongjiang Province), the central region(Henan Province) and the western region(Sichuan Province) from July 2020 to March 2021. Socio-demographic characteristics of students and their parents, eating-related behaviors and the purchase behaviors of prepackaged food of students, and parents' attitudes towards students' eating behavior were collected through questionnaire towards students and their parents. The χ² test was conducted to compare the purchase behaviors in different groups of students, and multivariate logistic stepwise regression analysis was used to analyze the determinants among primary and middle school students. Results: The age of 2 499 participants was(12.7±2.5) years. There were 1 272(50.9%) females and 1 279(51.2%) middle school students. About 1 404(56.2%) students bought prepackaged food. The top 6 prepackaged foods bought at least once a week were milk and dairy products(74.6%), baked food(58.7%), beverages(42.8%), puffed food(40.8%), chocolate and candy(39.8%), and nuts and dried fruits(37.5%). The multivariate logistic regression model analysis results showed that compared with primary school students, rural students, non-boarding students, students who did not like snacks and students whose parents paid attention to their children eating snacks, middle school students(OR=3.36, 95%CI:2.73-4.12), urban students(OR=1.33, 95%CI:1.11-1.61), boarding students(OR=2.15, 95%CI:1.66-2.79), students who liked snacks(OR=2.01, 95%CI:1.66-2.43), students whose parents did not pay attention to their children eating snacks(OR=1.27, 95%CI:1.05-1.54) were more likely to buy prepackaged food by themselves. Compared with students whose parents had education level of junior high school and below, students whose parents had education level of undergraduate and above(OR=0.70, 95%CI:0.53-0.92) were less likely to buy prepackaged food by themselves. Compared with students whose family monthly income was less than 5 000 yuan, students whose family monthly income was over 10 000 yuan(OR=0.67, 95%CI:0.52-0.87) were less likely to buy prepackaged food by themselves. Conclusion: Many primary and middle school students buy prepackaged food by themselves in 6 provinces of China. Individual characteristics such as grade, place of residence, boarding status, as well as family environment such as parents' education level, monthly income and concern about children eating snacks are the influencing factors of purchasing prepackaged food.
Child ; Female ; Humans ; Adolescent ; Male ; Schools ; China ; Feeding Behavior ; Students ; Surveys and Questionnaires

Objective To analyze the personality traits and nutrition package feeding behaviors of infant caregivers in remote rural areas of Sichuan province and explore the relationship between them. Methods A multi-stage random cluster sampling method was employed to select the infants of 6-24 months old and their caregivers in the remote rural areas of Sichuan province.A structured questionnaire was designed to collect the basic characteristics of infants and their caregivers,as well as the feeding behaviors of the caregivers.The Ten-Item Personality Inventory in China was used to evaluate the caregivers' personality traits in five dimensions:extraversion,agreeableness,conscientiousness,emotional stability,and openness.Multivariate Logistic regression was adopted to analyze the relationship between personality traits and nutrition package feeding behaviors of infant caregivers. Results A total of 895 pairs of infants and their caregivers were investigated.The caregivers showed the average scores of 9.01±2.64,10.60±1.99,9.41±2.06,9.01±2.38,and 8.57±2.29 in the dimensions of extraversion,agreeableness,conscientiousness,emotional stability,and openness,respectively.The effective feeding rate of nutrition package was 53.3% (477/895).The results of regression analysis showed that under the premise of controlling for other factors,the caregiver's conscientious personality (OR=1.08,95%CI=1.004-1.153,P=0.038) was the protective factor for the effective feeding of nutrition package. Conclusion The feeding behavior of infant caregivers in the remote rural areas of Sichuan province remains to be improved,and the caregivers with high conscientious personality are more likely to feed their infants effectively.
Infant ; Humans ; Child, Preschool ; Caregivers ; Infant Nutritional Physiological Phenomena ; Rural Population ; Feeding Behavior ; China ; Personality

As food preferences and eating habits form early in life, the development of healthy eating habits in early childhood is a way to prevent diet-related diseases. The dietary pattern approach examines the effect of an overall diet on health outcomes, instead of individual foods or nutrients, thereby presenting a comprehensive evaluation of children's dietary intake. This article reviews the current literature to summarize the main methods for assessing dietary patterns and explore relationships between children's dietary patterns and obesity, puberty onset, cardiovascular diseases, and neurodevelopment. The purpose of this review is to provide evidence-based support for reducing the risk of diet-related diseases in children and recommendations for future research directions.
Child ; Child, Preschool ; Diet ; Eating ; Feeding Behavior ; Food Preferences ; Humans ; Obesity/prevention & control*

Long-term poor dietary habits can cause changes in the intestinal flora, resulting in the production of a large number of lipopolysaccharide, increase intestinal mucosal permeability, and activate the entrance of a large number of inflammatory factors into the portal vein. In addition, a high carbohydrate diet can increase liver metabolic burden, increase mitochondrial oxidative phosphorylation, leading to oxidative stress, generate new fat during adenosine triphosphate synthesis, and thus resulting in ectopic fat accumulation, which further activate nuclear factor-κB signaling pathway and release inflam- matory factors such as tumor necrosis factor-α, interleukin-1β (IL-1β), IL-6, and so on. This leads to obesity and insulin resis- tance, ultimately triggering systemic low-grade inflammation. This article reviews the mechanism of poor dietary habits leading to systemic low-grade inflammation, the clinical and experimental research progress of keloids and systemic low-grade inflammation, the association between dietary habits and keloid constitution, and puts forward the hypothesis that poor dietary habits may lead to the occurrence and development of keloids.
Diet/adverse effects* ; Feeding Behavior ; Humans ; Inflammation/metabolism* ; Keloid/physiopathology* ; NF-kappa B/metabolism* ; Tumor Necrosis Factor-alpha/metabolism*

Olfaction and food intake are interrelated and regulated. In the process of feeding, the metabolic signals in the body and the feeding signals produced by food stimulation are first sensed by the arcuate nucleus of hypothalamus and the nucleus tractus solitarius of brain stem, and then these neurons project to the paraventricular nucleus of hypothalamus. The paraventricular nucleus transmits the signals to other brain regions related to feeding and regulates feeding behavior. In this process, olfactory signals can be transmitted to hypothalamus through olfactory bulb and olfactory cortex to regulate feeding behavior. At the same time, gastrointestinal hormones (ghrelin, insulin, leptin, etc.) and some neurotransmitters (acetylcholine, norepinephrine, serotonin, endocannabinoid, etc.) produced in the process of feeding act on the olfactory system to regulate olfactory function, which in turn affects the feeding itself. This review summaries the research progress of the interaction between olfaction and food intake and its internal mechanism from the aspects of neuronal and hormonal regulation.
Arcuate Nucleus of Hypothalamus/metabolism* ; Feeding Behavior/physiology* ; Hypothalamus ; Paraventricular Hypothalamic Nucleus ; Smell