Social-emotional functioning and dietary intake among children born with a very low birth weight

Very low birth weight (VLBW, <1500 g) infants are at an elevated risk of neurodevelopmental disorders, later obesity and cardiometabolic disease; if and how neurodevelopmental disorders impact chronic disease risk is poorly understood. The most common neurodevelopmental disorders experienced by VLBW children are those of social-emotional functioning. We compared dietary patterns and body composition between VLBW children with poor vs. typical social-emotional functioning using linear mixed models adjusted for sex, gestational age, cognitive impairment, parental education, and body mass index (BMI). VLBW children (n=158) attending the Donor Milk for Improved Neurodevelopmental Outcomes trial with 5.5-year follow-up participated. Poor social-emotional functioning was based on standardized parent-rated questionnaires and/or parent-reported physician diagnosis of autism spectrum or attention-deficit/hyperactivity disorders. Most children had diets categorized as needs improvement (67%) or poor (27%) and 29% of children exhibited poor social-emotional functioning. Poor social-emotional functioning was positively associated with 100% fruit juice (beta=0.3 cup equivalents/day; 95% CI 0.1, 0.5) and energy intake (beta=118.1 kcal/day; 95% CI 0.9, 235.2). Children with poor social-emotional functioning were more likely to have a limited food repertoire (p=0.02), but less likely to exceed dietary fat recommendations (p=0.04). No differences in overall diet quality or body composition were observed. Diet counselling and research are essential to improving the nutrition of VLBW children to mitigate chronic disease risk. Novelty: Overall diet quality and body composition did not differ between VLBW children with poor vs. typical social-emotional functioning. Most had diets needing improvement or poor according to the Healthy Eating Index-2010. Diet counselling may help mitigate chronic disease risk in this vulnerable population.

Automated summary

This study compared the dietary patterns and body composition of very low birth weight (VLBW) children with poor social-emotional functioning to those with typical functioning. The results showed that poor social-emotional functioning was positively associated with higher fruit juice intake and energy intake. Children with poor social-emotional functioning were more likely to have a limited food repertoire but less likely to exceed dietary fat recommendations. Overall diet quality and body composition did not differ between the two groups. Diet counselling is important to improve the nutrition of VLBW children and mitigate chronic disease risk.