Diet quality during early childhood is a strong predictor of mental and physical outcomes, as well as future diet quality. Although many factors determine diet quality during childhood, food insecurity is a significant predictor of lower diet quality. On the other hand, participation in nutrition assistant programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a significant predictor of higher diet quality. In addition, specific feeding practices, including timing of complementary food and beverage (CFB) introduction, types of CFB introduced early, and diversity of dietary exposures (DD), in the first year may predict future diet quality, and all of these feeding practices may be affected by both food insecurity and WIC participation. A limited number of studies have explored associations between food insecurity, WIC participation, and early-life feeding practices with a focus on initiation of the complementary feeding and diversity of dietary exposures in the first year of life. The present study is a secondary analysis of the WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS 2) aimed at exploring associations between food insecurity, WIC participation, timing of CFB introduction, types of CFB introduced early, DD by 13 months, and diet quality at 2 years. The WIC ITFPS is a longitudinal, nationally representative study of mothers and children under 6 years old which examined feeding practices, associations between WIC services and feeding practices, and the health status of children participating in WIC. Data was collected via phone interviews and questionnaires. Logistic regression analysis was used to assess whether the presence of food insecurity predicted timing of CFB introduction and types of CFB introduced early. Multivariate linear regression analysis was used to assess whether the diversity of dietary exposures (DD) score at age 13 months and diet quality at 2 years was predicted by the combination of food insecurity, timing of CFB introduction, and WIC participation. The results showed that food insecurity was not significantly associated with timing of CFB introduction or types of CFB introduced before 4 months of age. Food insecurity was not a significant predictor of DD score at 13 months, but significant interactions between food insecurity and WIC participation were noted. Among families participating in WIC, infants in families with low or very low food security had significantly higher DD scores compared to families with high or marginal food security. Food insecurity was not associated with diet quality at 24 months, but higher diet quality scores were predicted by the combination of later introduction of CFB (after 4 months), higher DD scores at 13 months, and WIC participation at 24 months. The findings of this study point to the benefits of supporting parents in participating in WIC, introducing CFB on-time, and maximizing diversity of dietary exposures during infancy. Future research should aim to verify causality, include longitudinal studies, focus on exploring WIC recruitment and retention, and continue to add the limited research on the preceding relationships between the above mentioned factors, specifically during the first two years of life.
| Identifer | oai:union.ndltd.org:CALPOLY/oai:digitalcommons.calpoly.edu:theses-4558 |
| Date | 01 July 2024 |
| Creators | Drewelow, Vivian M |
| Publisher | DigitalCommons@CalPoly |
| Source Sets | California Polytechnic State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Master's Theses |
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