Religious/spiritual beliefs and behaviours (RSBB) have been associated with health outcomes, with diet a potential mediator of this relationship. We therefore explored whether RSBB were associated with differences in diet.

Dietary patterns and nutrient intakes were derived from food frequency questionnaire completed by pregnant women in 1991–1992 (mean age = 28·3 years, range = 15–46) and by the mothers and partners 4 years post-partum (mothers mean age = 32·3, range = 19–49; partners mean age = 34·5, range = 18–74). RSBB exposures measured in pregnancy included religious belief, affiliation and attendance. We first explored whether RSBBs were associated with dietary patterns in confounder-adjusted linear regression models. If associations were found, we examined whether RSBB were associated with nutrient intake (linear regression) and following nutrient intake guidelines (logistic regression).

Prospective birth cohort study in Southwest England (Avon Longitudinal Study of Parents and Children; ALSPAC).

13 689 enrolled mothers and their associated partners.

In pregnant women, RSBB were associated with higher ‘traditional’ (i.e. ‘meat and two veg’) and lower ‘vegetarian’ dietary pattern scores. Religious attendance and non-Christian religious affiliation were associated with higher ‘health-conscious’ dietary pattern scores. Religious attendance was associated with increased micronutrient intake and following recommended micronutrient intake guidelines, with weaker effects for religious belief and affiliation. Comparable patterns were observed for mothers and partners 4 years post-partum, although associations between RSBB and nutrient intakes were weaker for partners.

RSBBs are associated with broad dietary patterns and nutrient intake in this cohort. If these reflect causal relationships, diet may potentially mediate the pathway between RSBB and health.

To explore the effect of maternal BMI class pre-pregnancy (overweight/obese v. healthy weight/underweight) on childhood diet quality and on childhood overweight/obesity risk.

Dietary data were collected using 3-d parental-completed food records for their children at ages 18 and 43 months. An index of diet quality was derived by classification of food items into core and non-core foods. Adjusted multiple linear regression analyses were used to explore the effect of maternal BMI class on diet quality in their children.

Avon, UK.

A 10% subsample of the Avon Longitudinal Study of Parents and Children. Nine-hundred and eighty children provided complete dietary data at 18 months and 769 at 43 months.

Children with overweight/obese mothers consumed greater amounts of energy from non-core foods than children with healthy weight/underweight mothers (0·20 MJ (48 kcal)/d more at 18 months (P < 0·001); 0·19 MJ (45 kcal)/d more at 43 months (P = 0·008)) in adjusted models. Diet quality deteriorated between 18 and 43 months (children reduced their dietary energy intake from core foods (P < 0·001) and increased intake from non-core foods (P < 0·001)). However, this change was not associated with maternal BMI class in adjusted models. Having an overweight/obese mother was associated with an increased odds of the child being overweight/obese at 43 months (OR 1·74 (1·17, 2·58)).

Children aged 18 and 43 months with overweight/obese mothers are likely to have a poorer quality diet than those with healthy/underweight mothers. Parents should be supported in discouraging the consumption of non-core foods in children at these ages.

Public health messages to reduce Hg exposure for pregnant women have focused exclusively on advice on fish consumption to limit Hg exposure, with little account being taken of the positive contribution of fish to nutritional quality. The aim of the present review was to compare and contrast the content and presentation of national guidelines on fish consumption in pregnancy, and comment on their evidence base and impact on consumption.

We searched for national and international guidelines on fish consumption in pregnancy using Internet search strategies. The detailed content and style of presentation of the guidelines were compared. The evidence base for the guidelines, and evidence for the impact of the guidelines on fish consumption levels, were assessed.

We identified nineteen national guidelines and three international guidelines. There was great variation in the content, complexity and presentation style. The guidelines were based largely on the Hg content of fish with far less consideration being given to the positive beneficial effects of nutrients provided by fish. The complexity of the guidelines may lead to pregnant women reducing their fish intake, or not eating fish at all.

Guidelines on fish consumption in pregnancy should take the beneficial effects of fish into account. Guidelines need to be clear and memorable, and appropriately disseminated, to achieve impact. Guidelines could include visual rather than narrative content. Use of technology, for example apps, could enable women to record their fish consumption in real time and log compliance with guidance over a week or other time period.

There is evidence to suggest that individual components of dietary intake are associated with depressive symptoms. Studying the whole diet, through dietary patterns, has become popular as a way of overcoming intercorrelations between individual dietary components; however, there are conflicting results regarding associations between dietary patterns and depressive symptoms. We examined the associations between dietary patterns extracted using principal component analysis and depressive symptoms, taking account of potential temporal relationships.

Depressive symptoms in parents were assessed using the Edinburgh Postnatal Depression Scale (EPDS) when the study child was 3 and 5 years of age. Scores >12 were considered indicative of the presence of clinical depressive symptoms. Diet was assessed via FFQ when the study child was 4 years of age.

Longitudinal population-based birth cohort.

Mothers and fathers taking part in the Avon Longitudinal Study of Parents and Children when their study child was 3–5 years old.

Unadjusted results suggested that increased scores on the ‘processed’ and ‘vegetarian’ patterns in women and the ‘semi-vegetarian’ pattern in men were associated with having EPDS scores ≥13. However, after adjustment for confounders all results were attenuated. This was the case for all those with available data and when considering a sub-sample who were ‘disease free’ at baseline.

We found no association between dietary patterns and depressive symptoms after taking account of potential confounding factors and the potential temporal relationship between them. This suggests that previous studies reporting positive associations may have suffered from reverse causality and/or residual confounding.

The present study examined whether maternal diet and early infant feeding experiences relating to being breast-fed and complementary feeding influence the range of healthy foods consumed in later childhood.

Data from four European birth cohorts were studied. Healthy Plate Variety Score (HPVS) was calculated using FFQ. HPVS assesses the variety of healthy foods consumed within and across the five main food groups. The weighted numbers of servings consumed of each food group were summed; the maximum score was 5. Associations between infant feeding experiences, maternal diet and the HPVS were tested using generalized linear models and adjusted for appropriate confounders.

The British Avon Longitudinal Study of Parents and Children (ALSPAC), the French Etude des Déterminants pre et postnatals de la santé et du développement de L’Enfant study (EDEN), the Portuguese Generation XXI Birth Cohort and the Greek EuroPrevall cohort.

Pre-school children and their mothers.

The mean HPVS for each of the cohorts ranged from 2·3 to 3·8, indicating that the majority of children were not eating a full variety of healthy foods. Never being breast-fed or being breast-fed for a short duration was associated with lower HPVS at 2, 3 and 4 years of age in all cohorts. There was no consistent association between the timing of complementary feeding and HPVS. Mother’s HPVS was strongly positively associated with child’s HPVS but did not greatly attenuate the relationship with breast-feeding duration.

Results suggest that being breast-fed for a short duration is associated with pre-school children eating a lower variety of healthy foods.

To derive dietary patterns using principal components analysis from separate FFQ completed by mothers and their teenagers and to assess associations with nutrient intakes and sociodemographic variables.

Two distinct FFQ were completed by 13-year-olds and their mothers, with some overlap in the foods covered. A combined data set was obtained.

Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK.

Teenagers (n 5334) with adequate dietary data.

Four patterns were obtained using principal components analysis: a ‘Traditional/health-conscious’ pattern, a ‘Processed’ pattern, a ‘Snacks/sugared drinks’ pattern and a ‘Vegetarian’ pattern. The ‘Traditional/health-conscious’ pattern was the most nutrient-rich, having high positive correlations with many nutrients. The ‘Processed’ and ‘Snacks/sugared drinks’ patterns showed little association with important nutrients but were positively associated with energy, fats and sugars. There were clear gender and sociodemographic differences across the patterns. Lower scores were seen on the ‘Traditional/health conscious’ and ‘Vegetarian’ patterns in males and in those with younger and less educated mothers. Higher scores were seen on the ‘Traditional/health-conscious’ and ‘Vegetarian’ patterns in girls and in those whose mothers had higher levels of education.

It is important to establish healthy eating patterns by the teenage years. However, this is a time when it is difficult to accurately establish dietary intake from a single source, since teenagers consume increasing amounts of foods outside the home. Further dietary pattern studies should focus on teenagers and the source of dietary data collection merits consideration.

To examine how the dietary patterns of children at various time points throughout childhood relate to estimated nutrient intakes.

FFQ at 3, 4, 7 and 9 years of age were completed by mothers. Dietary patterns were identified cross-sectionally using principal component analysis; ‘processed’, ‘health conscious’ and ‘traditional’ patterns were consistently obtained. Correlations between pattern scores and nutrient intakes and proportions of variance in nutrients explained by the patterns were calculated.

Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK.

Children provided data between 3 and 9 years of age (n 8010 to 10 023).

Dietary patterns explained substantial proportions of the variance of the absolute intake for most nutrients (>25 % at 3 years of age, >40 % other ages). After energy adjustment, protein, fibre, K, Mg, Fe, Zn, folate, thiamin and vitamin B6 continued to be well explained. Strong correlations were observed between the ‘processed’ pattern and macronutrients including energy (r = 0·481–0·619), total fat (r = 0·529–0·662) and total sugar (r = 0·475–0·693). However correlations with most micronutrients were reversed after energy adjustment, suggesting that the ‘processed’ pattern is energy-dense but nutrient-poor. The ‘health conscious’ and ‘traditional’ patterns were strongly positively correlated with protein, fibre and most micronutrients, whether energy adjusted or not. Higher scores on these patterns were associated with a better nutrient profile.

Dietary patterns explain a reasonable amount of the variation in the nutrient content of diets. Higher scores on the ‘health conscious’ and ‘traditional’ dietary patterns were related to better nutrient profiles; conversely, with higher scores on the ‘processed’ pattern the nutrient profile was poorer.

To examine the associations between maternal education level and diet in 10-year-old children.

Three-day diet diaries (child completed with parental help) were collected. Height and weight were measured in research clinics. Maternal education level was derived from a questionnaire completed during pregnancy and classified into low, medium or high. One-way ANOVA was undertaken to compare maternal education groups for nutrient intakes and the Kruskal–Wallis test used for food consumption.

Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK.

Children (n 7474) who provided dietary data at age 10 years.

A large proportion (60 %) of the sample was classified as plausible reporters, with under-reporting accounting for 36 %. No clear differences were found for intakes of energy or macronutrients between maternal education groups for plausible reporters. However, there were marked differences in micronutrient intakes especially for vitamin C, retinol equivalents and folate, highlighting lower diet quality with lower maternal education level. Intakes of fruit and vegetables showed a positive gradient with increasing maternal education (57 % v. 79 % consumed fresh fruit in low and high educational groups, respectively). A trend towards higher intake in the lower educated group was shown for less healthy foods (meat pies P < 0·001; sausages, burgers and kebabs P < 0·001).

The quality of children's diet at 10 years was related to maternal education level. Lower maternal education was associated with less healthy food choices that could be detrimental to health. Further research is needed to establish if these associations can be explained by other socio-economic factors.

To investigate associations between dietary intakes throughout childhood and age at menarche, a possible indicator of future risk of disease, in a contemporary cohort of British girls.

Diet was assessed by FFQ at 3 and 7 years of age, and by a 3 d unweighed food diary at 10 years. Age at menarche was categorised as before or after 12 years 8 months, a point close to the median age in this cohort.

Bristol, South-West England.

Girls (n 3298) participating in the Avon Longitudinal Study of Parents and Children.

Higher energy intakes at 10 years were positively associated with the early occurrence of menarche, but this association was removed on adjusting for body size. Total and animal protein intakes at 3 and 7 years were positively associated with age at menarche ≤12 years 8 months (adjusted OR for a 1 sd increase in protein at 7 years: 1·14 (95 % CI 1·04, 1·26)). Higher PUFA intakes at 3 and 7 years were also positively associated with early occurrence of menarche. Meat intake at 3 and 7 years was strongly positively associated with reaching menarche by 12 years 8 months (OR for menarche in the highest v. lowest category of meat consumption at 7 years: 1·75 (95 % CI 1·25, 2·44)).

These data suggest that higher intakes of protein and meat in early to mid-childhood may lead to earlier menarche. This may have implications for the lifetime risk of breast cancer and osteoporosis.

To describe fruit and vegetable (FV) feeding practices at 6 months, and to examine whether these practices predict children’s FV intake at 7 years of age.

A prospective, longitudinal design was adopted. The mothers completed self-reported questionnaires at 6 months and 7 years postpartum, containing questions about their child’s FV intake.

The study was carried out on a geographically representative population of infants born in Avon, UK, from 1991 to 1992, as part of the Avon Longitudinal Study of Parents and Children.

Information was collected from 7866 mothers of infants.

Hierarchical linear regressions were used to predict FV consumption at 7 years from the early feeding variables. Children who were given home-cooked fruit or vegetables more often at 6 months were more likely to be eating a higher proportion of FV at 7 years, than those who were given home-cooked FV less often. There was no positive difference found in consumption of FV at 7 years according to how often ready-prepared fruits or vegetables were given at 6 months. The age of introduction to home-cooked vegetables moderated the relationship between frequency of consumption at 6 months and 7 years.

The findings support the concept that exposure to FV is important in the early weaning period. The finding that consumption of ready-prepared FV was not positively associated with later FV consumption needs to be further investigated, with reference to theories of exposure, modelling and parental food choices. If vegetables are introduced later in weaning, they need to be fed frequently, to ensure adequate exposure.