Pairwise approach for analysis and reporting of child's free sugars intake from a birth cohort study
- Authors: Nguyen, Huy , Ha, Diep , Dao, An , Golley, Rebecca , Scott, Jane , Spencer, John , Bell, Lucinda , Devenish-Coleman, Gemma , Do, Loc
- Date: 2023
- Type: Text , Journal article
- Relation: Community Dentistry and Oral Epidemiology Vol. 51, no. 5 (2023), p. 820-828
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- Description: Objectives: The prospective cohort design is an important research design, but a common challenge is missing data. The purpose of this study is to compare three approaches to managing missing data, the pairwise (n = 1386 children), the partial or modified pairwise (n = 1019) and the listwise (n = 546), to characterize the trajectories of children's free sugars intake (FSI) across early childhood. Methods: By applying the Group-based Trajectory Model Technique to three waves of data collected from a prospective cohort study of South Australian children, this study examined the three approaches in managing missing data to validate and discuss children's FSI trajectories. Results: Each approach identified three distinct trajectories of child's FSI from 1 to 5 years of age: (1) ‘low and fast increasing’, (2) ‘moderate and increasing’ and (3) ‘high and increasing’. The trajectory memberships were consistent across the three approaches, and were for the pairwise scenario (1) 15.1%, (2) 68.3% and (3) 16.6%; the partial or modified pairwise (1) 15.9%, (2) 64.1% and (3) 20.0%; and the listwise (1) 14.9%, (2) 64.9% and (3) 20.2% of children. Conclusions: Given the comparability of the findings across the analytical approaches and the samples' characteristics between baseline and across different data collection waves, it is recommended that the pairwise approach be used in future analyses to optimize the sample size and statistical power when examining the relationship between FSI in the first years of life and health outcome such as dental caries. © 2022 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.
Trajectories of child free sugars intake and dental caries - a population-based birth cohort study
- Authors: Ha, Diep , Nguyen, Huy , Bell, Lucinda , Devenish-Coleman, Gemma , Golley, Rebecca , Thomson, W. , Manton, David , Leary, Sam , Scott, Jane , Spencer, John , Do, Loc
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Dentistry Vol. 134, no. (2023), p.
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- Description: Objectives: To investigate the association between trajectories of free sugars intake during the first five years of life and dental caries experience at five years. Methods: Data from the SMILE population-based prospective birth cohort study, collected at one, two and five years old, were used. A 3-days dietary diary and food frequency questionnaire were used to estimate free sugars intake (FSI) in grams. The primary outcomes were dental caries prevalence and experience (dmfs). The Group-Based Trajectory Modelling method was used to characterize three FSI trajectories (‘Low and increasing’; ‘Moderate and increasing’; and ‘High and increasing’), which were the main exposures. Multivariable regression models were generated to compute adjusted prevalence ratios (APR) and rate ratios (ARR) for the exposure, controlling for socioeconomic factors. Results: The prevalence of caries was 23.3%, with a mean dmfs of 1.4, and a median of 3.0 among those who had caries. There were clear gradients of caries prevalence and experience by the FSI trajectories. The ‘High and increasing’ had an APR of 2.13 (95%CI 1.23-3.70) and ARR of 2.77 (95%CI 1.45-5.32) against the ‘Low and increasing’. The ‘Moderate and increasing’ group had intermediate estimates. A quarter of the caries cases could have been prevented if the whole study sample had been in the ‘Low and increasing’ FSI trajectory. Conclusion: A sustained, high trajectory of FSI from a young age was positively associated with child dental caries. Measures to minimise consumption of free sugars must commence early in life. Clinical significance: The study has provided high level evidence to inform clinicians’ decisions in promoting a healthy dietary pattern for young children. © 2023
Group-based trajectories of maternal intake of sugar-sweetened beverage and offspring oral health from a prospective birth cohort study
- Authors: Ha, Diep , Nguyen, Huy , Dao, An , Golley, Rebecca , Thomson, W. , Manton, David , Leary, Sam , Scott, Jane , Spencer, Andrew , Do, Loc
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Dentistry Vol. 122, no. (2022), p.
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- Description: Objectives: To investigate the trajectory of maternal intake of sugar-sweetened beverages (SSB) during the first five years of their child's life and its effect on the child's dental caries at five years-of-age. Methods: This is an ongoing prospective population-based birth cohort study in Adelaide, Australia. Mothers completed questionnaires on their SSB intake, socioeconomic factors and health behaviors at the birth of their child and at the ages of one, two and five years. Child dental caries measured as decayed, missing, or filled tooth surfaces was collected by oral examination. Maternal SSB intake was used to estimate the trajectory of SSB intake. The trajectories then became the main exposure of the study. Dental caries at age five years were the primary outcomes. Adjusted mean- and prevalence-ratios were estimated for dental caries, controlling for confounders. Results: 879 children had dental examinations at five years-of-age. Group-based trajectory modeling identified three trajectories of maternal SSB intake: ‘Stable low’ (40.8%), ‘Moderate but increasing’ (13.6%), and ‘High early’ trajectory (45.6%). Multivariable regression analysis found children of mothers in the ‘High early’ and ‘Moderate but increasing’ groups to have greater experience of dental caries (MR: 1.37 (95%CI 1.01–1.67), and 1.24 (95%CI 0.96–1.60) than those in the ‘Stable low’ trajectory, respectively. Conclusion: Maternal consumption of SSB during pregnancy and in the early postnatal period influenced their offspring's oral health. It is important to create a low-sugar environment from early childhood. The results suggest that health promotion activities need to be delivered to expecting women or soon after childbirth. © 2022