Maternal anxiety and diet quality among mothers and toddlers from low-income households.

Angela C B Trude, Maureen M Black, Pamela J Surkan, Kristen M Hurley, Yan Wang

Journal: Maternal & child nutrition 2021;16(4):e12992

PMID: 32147951

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Plain Language Summary

Childhood obesity is increasing and is an indicator that obesity may develop in adulthood. Mothers have a large influence on children’s weight-related behaviours and diet quality, but mental well-being of the mother in relation to this is understudied. Mothers from low-income households may be susceptible to lower mental well-being and low diet quality potentially influencing their children. This observational study of 277 low-income mother-toddler relationships aimed to examine the association of maternal anxiety and toddler diet quality over six months. The results showed that higher maternal anxiety was associated with lower maternal diet quality and lower toddler diet quality. It was concluded that high anxiety in mothers with toddlers from low-income households is associated with poorer diet quality in both the mother and toddler. However, it should be noted that whether anxiety is causing poor diet or poor diet is causing anxiety cannot be determined. This study could be used by healthcare professionals to include nutritional recommendations with anxiety management to improve parental and toddler diet.

Abstract

We evaluated the association between maternal anxiety score and diet quality over time among mothers and toddlers in low-income families. Longitudinal data were collected from 267 mother-toddler dyads in an obesity prevention trial. Participants were recruited from the Special Supplemental Nutrition Program for Women, Infants and Children and paediatric clinics between 2007 and 2010. Dyads were assessed at study enrolment (Time 1), 6-month (Time 2), and 12-month follow-up (Time 3). On the basis of a 1-day 24-hr dietary recall, we estimated maternal and toddler diet quality using the Healthy Eating Index 2015. Anxiety, a time-varying variable, was assessed via the State-Trait Anxiety Inventory. Associations between maternal anxiety score and maternal and toddler diet quality over time were assessed in adjusted mixed models. Maternal and toddler diet quality were positively correlated (r = .48, p < .001). Higher maternal anxiety scores were related to lower toddler Healthy Eating Index scores (b = -0.51, 95% confidence interval, CI [-0.87, -0.15]) with no significant variation over time. The relation between maternal diet quality and anxiety score varied over time (b = 0.28, p = .03, for time-anxiety interaction). Higher maternal anxiety scores were associated with lower maternal diet quality at Time 1 (b = -0.71, 95% CI [-1.09, 0.34]) and at Time 2 (b = -0.51, 95% CI [-0.97, -0.05]), but not at Time 3 (b = -0.14, 95% CI [-0.54, 0.26]). Findings suggest that mothers and toddlers exhibited similar low-quality dietary patterns and that lower diet quality was associated with higher maternal anxiety scores. Approaches to enhance diet quality may consider incorporating anxiety-reducing strategies into maternal and toddler care and feeding behaviour guidelines.

Address: Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.; RTI International, Research Triangle Park, North Carolina, USA.; Social and Behavioral Intervention Program, International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Center for Human Nutrition, International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

DOI: 10.1111/mcn.12992