[Unhealthy dietary habits among toddlers in Rome (Italy): a cross sectional study].

Objective: To explore the nutrition and food habits of toddlers, in order to develop interventions to promote healthy eating starting from the early years of life.

Methods: We conducted a cross-sectional study among 204 children aged from 3 months to 3 years, registered in 10 nursery schools in Rome, Italy. Children's diet-related behaviors and parent's food attitudes were evaluated using a 10-item questionnaire for parents. After administering the questionnaire, pediatricians of the local health authority conducted motivational interviews with parents to encourage them to make their children adopt healthy behaviors at home. Descriptive and analytical statistical methods were used to evaluate dietary habits in children, after stratifying by nursery school grade attended.

Results: The data showed that unhealthy dietary habits occur even in nursery schoolaged children. In particular, over 50% of children were reported to watch TV while eating meals at home every day and to drink fruit juices at least 1-2 times per week. Unhealthy dietary habits were found to be more common among older children: there were significant differences in the proportions of older and younger children who consumed fruit juices or snacks more than twice per week (35.7% and 8.9% respectively of older children vs 3.3% and 3.3% respectively of younger children), who watched TV during meals (26.8% of older children versus 16.9% of younger children) and whose parents attribute a moral value to food as a reward more than twice a week (almost 14.3% of older children's parents vs 0.0% of small children's parents). On the contrary, older children were found to eat fruit significantly more frequently compared to younger children (51.8% vs 24.6% of young children ate fruit >2 times a week). Parents of children with at least one unhealthy behavior had low awareness of healthy dietary choices: 86.7% believed that their children's diets were healthy.

Conclusion: This study showed that unhealthy dietary habits occur among Italian toddlers. These should be prevented by promoting specific interventions. Parents should be made aware of the possible consequences of their own behavior, considering that home food habits influence the development of dietary attitudes in children. Preventive interventions aimed at preschoolers may also be beneficial for parents themselves and for other family members.