Rachael Taylor

• University of Otago

Objectives: Many teenagers suffer chronic sleep loss, which could potentially be mitigated by later school start times to accommodate the natural shift in their circadian timekeeping system favoring later bedtimes. This study explored experiences of senior students from a school in Aotearoa New Zealand with later school start times. Method: Semi...

Background Early childhood obesity prevention interventions that aim to change parent/caregiver practices related to infant (milk) feeding, food provision and parent feeding, movement (including activity, sedentary behaviour) and/or sleep health (i.e. target parental behaviour domains) are diverse and heterogeneously reported. We aimed to 1) system...

Objective To determine whether BMI differences observed at 5 years of age, from early intervention in infancy, remained apparent at 11 years. Methods Participants (n = 734) from the original randomized controlled trial (n = 802) underwent measures of body mass index (BMI), body composition (DXA), sleep and physical activity (24‐h accelerometry, qu...

Background Although evening screen time is thought to impair subsequent sleep, current measures are limited to questionnaires which seem unlikely to accurately assess screen time in youth. Given the ubiquitous nature of digital devices, improving measurement of screen time is required before related health effects can be appropriately determined. T...

Objective: Most wet commercial infant foods are now sold in squeezable ‘pouches’. While multiple expert groups have expressed concern about their use, it is not known how commonly they are consumed and whether they impact energy intake or body mass index (BMI). The objectives were to describe pouch use, and determine associations with energy intake...

Importance Although questionnaire-based cross-sectional research suggests that screen time before bed correlates with poor sleep, self-reported data seem unlikely to capture the complexity of modern screen use, requiring objective night-by-night measures to advance this field. Objective To examine whether evening screen time is associated with sle...

Optimal nutrition during infancy is critical given its influence on lifelong health and wellbeing. Two novel methods of infant complementary feeding, commercial baby food pouch use and baby‐led weaning (BLW), are becoming increasingly popular worldwide. Household food insecurity may influence complementary feeding practices adopted by families, but...

Background Although inadequate sleep increases the risk of obesity in children, the mechanisms remain unclear. The aims of this study were to assess how sleep loss influenced dietary intake in children while accounting for corresponding changes in sedentary time and physical activity; and to investigate how changes in time use related to dietary in...

Objective To determine if performing regular 3-min bouts of resistance exercise spread over 4 hours in an evening will impact subsequent sleep quantity and quality, sedentary time and physical activity compared with prolonged uninterrupted sitting. Methods In this randomised crossover trial, participants each completed two 4-hour interventions com...

Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at “around 6 m...

Background Actigraphy is often used to measure sleep in pediatric populations, despite little confirmatory evidence of the accuracy of existing sleep/wake algorithms. The aim of this study was to determine the performance of 11 sleep algorithms in relation to overnight polysomnography in children and adolescents. Methods One hundred thirty-seven p...

This chapter discusses childhood and adolescent nutrition. Childhood and adolescence are periods of rapid growth, learning, and development. Nutritional needs are high and differ in many respects from those of adults. Ensuring adequate food intake remains the challenge for many of the world's children. In contrast, for most children in high income...

This chapter highlights infant feeding and the importance of eating well for toddlers. Nutrition during infancy and the second year of life (the first 1,000 days) is an important determinant of short- and long-term health. Exclusive breastfeeding provides the only nutrition a healthy infant needs for the first six months of life, and is recommended...

Infant feeding guidelines provide evidence-based recommendations to support optimal infant health, growth, and development, and exploring adherence to guidelines is a useful way of assessing diet quality. The aim of this study was to determine adherence to the recently updated Ministry of Health “Healthy Eating Guidelines for New Zealand Babies and...

Objective: The aim of this study was to determine which growth indicator (weight, weight-for-length, BMI) and time frame (6- or 12-month intervals between 0 and 24 months) of rapid infant weight gain (RIWG) best predicted obesity risk and body composition at 11 years of age. Methods: RIWG (increase ≥0.67 z scores between two time points) was cal...

The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual pa...

Objective: To demonstrate how distributional cost-effectiveness analyses of childhood obesity interventions could be conducted and presented for decision makers. Methods: We conducted modelled distributional cost-effectiveness analyses of three obesity interventions in children: an infant sleep intervention (POI-Sleep), a combined infant sleep,...

Introduction: Screen time is predominantly measured using questionnaires assessing a limited range of activities. This project aimed to develop a coding protocol that reliably identified screen time, including device type and specific screen behaviours, from video camera footage. Methods: Screen use was captured from wearable and stationary Patr...

Background Data on body mass index (BMI) in infants and toddlers worldwide are lacking, relative to older age groups. Objectives To describe the growth (weight, length/height, head circumference, and BMI z‐score) of New Zealand children under the age of 3 years, and examine differences by sociodemographic characteristics (sex, ethnicity, and depri...

The majority of children and young people in Aotearoa New Zealand (NZ) experience good health and wellbeing, but there are key areas where they compare unfavourably to those in other rich countries. However, current measures of wellbeing are critically limited in their suitability to reflect the dynamic, culture-bound, and subjective nature of the...

Background: Insufficient sleep duration increases obesity risk in children, but the mechanisms remain unclear. Objectives: This study seeks to determine how changes in sleep influence energy intake and eating behavior. Methods: Sleep was experimentally manipulated in a randomized, crossover study in 105 children (8-12 y) who met current sleep...

Background Good quality sleep, regular physical activity, and limited time spent sedentary are all considered individually important in promoting good mental health in children. However, few studies have examined the influence of each behaviour simultaneously, using compositional analysis which accounts for the closed nature of the 24-h day. Our ai...

Objective: This study aimed to describe how mild sleep deprivation in children changes time spent physically active and sedentary. Methods: In 2018 through 2020, children (n = 105) with normal sleep were randomized to go to bed 1 hour earlier (extension) or 1 hour later (restriction) than their usual bedtime for 1 week, each separated by a 1-wee...

Objective: This study aimed to determine whether the cost-effectiveness of an infant sleep intervention from the Prevention of Overweight in Infancy (POI) trial was influenced by socioeconomic position (SEP). Methods: An SEP-specific economic evaluation of the sleep intervention was conducted. SEP-specific intervention costs and effects at age 5...

Rapid weight gain (RWG) during infancy is a known risk factor for later childhood obesity. It can be measured using a range of definitions across various time periods in the first 2 years of life. In recent years, some early childhood obesity prevention trials have included a focus on preventing RWG during infancy, with modest success. Overall, RWG...

Background Good quality sleep, regular physical activity, and limited time spent sedentary are all considered individually important in promoting good mental health in children. However, few studies have examined the influence of each behaviour simultaneously, using compositional analysis which accounts for the closed nature of the 24-hour day. Our...

Background Heterogeneity in the outcomes collected and reported in trials of interventions to prevent obesity in the first five years of life highlights the need for a core outcome set to streamline intervention evaluation and synthesis of effects. This study aimed to develop a core outcome set for use in early childhood obesity prevention interven...

Little is known about selenium intakes and status in very young New Zealand children. However, selenium intakes below recommendations and lower selenium status compared to international studies have been reported in New Zealand (particularly South Island) adults. The Baby-Led Introduction to SolidS (BLISS) randomised controlled trial compared a mod...

Objective To examine whether the prevalence of age- and sex-adjusted BMI at, or above, the 85th, 95th and 99.7th percentiles continues to decline in New Zealand preschool children, over time. Methods As part of a national screening programme, 438,972 New Zealand 4-year-old children had their height and weight measured between 2011 and 2019. Age- a...

Background Although early childhood obesity prevention has become an important issue internationally, little evidence exists regarding longer term effects (i.e., sustainability) of early interventions. Objective To determine whether intervention benefits at 2 years of age were sustained at 3.5 and 5 years. Methods Follow‐up of the Early Preventio...

The Prevention of Overweight in Infancy (POI) sleep intervention halved obesity risk at 2 years of age. However, the intervention mechanisms are unclear. Consequently, the objective of the current work was to use exploratory analyses to investigate potential moderators and mediators of the sleep intervention on obesity outcomes at age 2 years. Data...

Introduction Despite being an important period for the development of movement behaviours (physical activity, sedentary behaviour and sleep), few interventions commencing prior to preschool have been trialled. The primary aim of this trial is to assess the 12-month efficacy of the Let’s Grow mHealth intervention, designed to improve the composition...

This scoping review was undertaken as the first stage of development of the Core Outcome Sets for Early Prevention of Obesity in CHildhood (COS‐EPOCH). The aim of this review is to identify the outcomes collected and reported in randomized controlled trials of early childhood obesity prevention interventions. A systematic scoping review was underta...

Introduction Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behav...

Introduction: Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials wor...

Objectives: Children's sleep has been shown to vary by ethnicity, but little is known about children's sleep in multiethnic households. In New Zealand, Pacific families are increasingly ethnically diverse, due to intermarriage and to people identifying as more than 1 ethnicity. Thus, the objective of this work was to explore children's sleep habit...

Weight losses >10% favorably modulate biomarkers of breast cancer risk but are not typically achieved by comprehensive weight loss programs, including the Diabetes Prevention Program (DPP). Combining the DPP with hunger training (HT), an evidence-based self-regulation strategy that uses self-monitored glucose levels to guide meal timing, has potent...

Objectives: To investigate eating episodes in a group of adolescents in their home-setting using wearable electromyography (EMG) and camera, and to evaluate the agreement between the two devices. Approach: Fifteen adolescents (15.5 ± 1.3 years) had a smartphone-assisted wearable-EMG device attached to the jaw to assess chewing features over one...

This study sought to explore infant complementary feeding practices among Māori whānau and the extent to which they may be informed by traditional and culturally specific practices, knowledge, personal beliefs and values. This study also endeavoured to explore how these practices, values and beliefs may have changed across time and between generati...

The stakes for understanding sleep practices are rising as health inequalities related to sleep become more apparent. Pacific peoples in Aotearoa New Zealand face disproportionate challenges around poverty and health and sleep is one growing area of importance in addressing health inequalities. Through a qualitative study of 17 Pacific families in...

Background A recent paradigm shift has highlighted the importance of considering how sleep, physical activity and sedentary behaviour work together to influence health, rather than examining each behaviour individually. We aimed to determine how adherence to 24-h movement behavior guidelines from infancy to the preschool years influences mental hea...

The Child Eating Behaviour Questionnaire (CEBQ) is designed to measure ‘usual’ eating behaviour, with no time period attached, thus may not be suitable for assessing the effectiveness of short-term experimental studies. The aim of this study was to validate i) the CEBQ adapted to measure ‘past week’ rather than ‘usual’ eating behaviour, and ii) a c...

Introduction: Childhood overweight and obesity is prevalent in the first 5 years of life, and can result in significant health and economic consequences over the lifetime. The outcomes currently measured and reported in randomised controlled trials of early childhood obesity prevention interventions to reduce this burden of obesity are heterogeneo...

Background While insufficient sleep duration has emerged as a strong, independent risk factor for obesity, the mechanisms remain unclear. One possibility is greater “eating in the absence of hunger” (EAH) or energy intake beyond the point of satiety, when tired. Objective The aim was to determine whether mild sleep loss increases EAH in children....

Objective: This study examined the association between longitudinal trajectories of lifestyle patterns (LPs) and BMI z score in early childhood. Methods: Data of children (n = 439) who participated in the 18-, 42-, and 60-month follow-ups of the Melbourne InFANT Program were used. Multitrajectory modeling identified groups of children following...

Although excess visceral fat (VAT) is associated with numerous cardio-metabolic risk factors, measurement of this fat depot has historically been difficult. Recent dual X-ray absorptiometry approaches have provided an accessible estimate of VAT that has shown acceptable validity against gold standard methods. The aims of this study were to (i) eval...

This review investigated whether randomised controlled trials attempting to improve sleep or prevent sleep problems in 0-5 year olds influenced nocturnal sleep duration, day-time naps, or 24-hour sleep. Medline (Ovid), EMBASE, and CINAHL were searched from inception until 9 July 2020 and supplemented with hand searching. Search results were screene...

BACKGROUND The complementary feeding period is a time of unparalleled dietary change for every human, during which the diet changes from one that is 100% milk to a diet that resembles that of the wider family, in less than a year. Despite this major dietary shift, we know relatively little about food and nutrient intake in infants worldwide, and vi...

Background The complementary feeding period is a time of unparalleled dietary change for every human, during which the diet changes from one that is 100% milk to one that resembles the usual diet of the wider family in less than a year. Despite this major dietary shift, we know relatively little about food and nutrient intake in infants worldwide a...

Several early childhood obesity prediction models have been developed, but none for New Zealand's diverse population. We aimed to develop and validate a model for predicting obesity in 4–5-year-old New Zealand children, using parental and infant data from the Growing Up in New Zealand (GUiNZ) cohort. Obesity was defined as body mass index (BMI) for...

There has been an important shift in the New Zealand infant food market over the past decade, with the majority of complementary foods now sold in “pouches”. Along with the increasing market share of commercial infant food pouches internationally, there have been growing concerns about their nutritional quality. However, research examining the nutr...

Context Although dietary advice has long been a cornerstone of a healthy lifestyle, how sleep quality and quantity may interact with dietary intake or eating behaviors remains unclear. Objective To consider a bidirectional relationship between sleep and diet in children aged 6–12 years via a systematic review following PRISMA guidelines. Data Sou...

Introduction Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials world...

Introduction Little is known about how early (e.g., commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to 1) characterise early obesity prevention interventions in terms of target behaviours, delivery features, and beh...

Background The Prevention of Overweight in Infancy (POI) randomized controlled trial assessed the effect of a more conventional food, physical activity, and breastfeeding intervention, with a more novel sleep intervention on weight outcomes at 2 years of age. The trial had 58% uptake at recruitment, and retention was 86% at age 2 years, 77% at age...

Background Behavioural aspects of chewing may influence food intake, nutritional status and in turn body weight. Objectives The current study aimed to study chewing features in adolescents as they naturally occur in home‐based settings, and to test for a possible association with weight status. Methods Forty‐two adolescents (15.3 ± 1.3 years) wer...

BACKGROUND The Prevention of Overweight in Infancy (POI) randomized controlled trial (RCT) assessed the effect of a more conventional food, physical activity and breastfeeding intervention, with a more novel sleep intervention on weight outcomes at 2 years of age. The trial had 58% uptake at recruitment and retention was 86% at age 2, and 77% and 6...

Importance: Typically developing children who are sensitive to sensory stimulation appear to have more sleep difficulties than children with average sensory sensitivities; however, at what age sleep difficulties emerge and whether they extend to children outside of sleep clinics are unclear. Objective: To investigate cross-sectional and longitud...

Objective: The purpose of this study was to determine, from a health funder perspective, whether a sleep intervention, delivered in infancy, either alone or in combination with food, activity, and breastfeeding advice was cost-effective compared with usual care. Methods: A cost-effectiveness analysis was conducted alongside the Prevention of Over...

Baby-led approaches to complementary feeding promote intake of family foods rather than infant specific foods, from the start of the complementary feeding period, which advocates suggest should be less expensive. However, this has never been formally examined. We recently completed a 2-year randomised controlled trial comparing baby-led (BLISS) and...

Background Children consume ultra-processed food (UPF) from a young age, but the proportional contribution of UPF to young children’s total energy intakes has not been evaluated in developed countries. Objectives To describe UPF intake and associations with demographic factors in young children from 12 to 60 months of age. Design Cohort study com...

Background Early childhood is a critical period for the development of obesity, with new approaches to prevent obesity in this age group needed. We designed and piloted the 3 Pillars Study (3PS), a healthy lifestyle programme informed by attachment theory for parents of preschool-aged children. Methods A 2-arm, randomised controlled pilot study wa...

The gut microbiota harvests energy from indigestible plant polysaccharides, forming short-chain fatty acids (SCFAs) that are absorbed from the bowel. SCFAs provide energy—presumably after easily digested food components have been absorbed from the small intestine. Infant night waking is believed by many parents to be due to hunger. Our objective wa...

Although 24-hour time-use data are increasingly being examined in relation to indices of health, consensus has yet to be reached about the best way to present estimates from compositional analyses. This analysis explored the impact of different presentations of results when assessing the relationship between 24-hour time-use and body mass index (BM...

Improving dietary intake early in life is a common behavioural target in obesity prevention trials. We undertook a systematic review of randomised controlled trials aiming to improve dietary intake of complementary foods during infancy (0–24 months). PubMed, Cochrane Library, EMBASE, Medline, and PsycInfo were searched for trials focussed on obesit...

Background In the absence of rigorous evidence of cost‐effectiveness for early childhood obesity prevention interventions, the next‐best option may be for decision‐makers to consider the relevant costs of interventions when allocating resources. Objectives This study aimed to estimate systematically the cost of five obesity prevention intervention...

Background Childhood obesity is a global problem. Early obesity prevention interventions are complex and differ in effectiveness. Novel frameworks, taxonomies and experience from the Early Prevention of Obesity in CHildren (EPOCH) trials were applied to unpack interventions. Objectives Deconstruct interventions into their components (target behavi...

In Baby-Led Weaning (BLW), infants are offered foods they can pick up and feed themselves from the start of complementary feeding. Infants who are fully BLW are not spoonfed at all by their parents, feeding themselves all their foods instead. The Baby-Led Introduction to SolidS (BLISS) study was a randomised controlled trial of the effect of a modi...

Gut microbiota data obtained by DNA sequencing are not only complex because of the number of taxa that may be detected within human cohorts, but also compositional because characteristics of the microbiota are described in relative terms (e.g., “relative abundance” of particular bacterial taxa expressed as a proportion of the total abundance of tax...

Insufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain w...

Background Although sleep duration is a risk factor for obesity in young children, less is known about other aspects of sleep health, including bedtime, on obesity risk. Objective To determine whether bedtime is associated with body mass index (BMI) z‐score or obesity risk in children ages 2 to 5 years, and to determine if associations are indepen...

Childhood obesity is common in New Zealand with one in three 4-5 year-old children identified as overweight or obese in the before school check (B4SC) programme. Recently, the use of BMI for assessing childhood obesity in the B4SC programme has been questioned. This article provides evidence in support of the assessment of BMI during the B4SC, incl...

Although sleep duration is well established as a risk factor for child obesity, how measures of sleep quality relate to body size is less certain. The aim of this study was to determine how objectively measured sleep duration, sleep timing, and sleep quality were related to body mass index (BMI) cross-sectionally and longitudinally in school-aged c...

Background Hunger training teaches people to eat according to their appetite using pre-prandial glucose measurement. Previous hunger training interventions used fingerprick blood glucose, however continuous glucose monitoring (CGM) offers a painless and convenient form of glucose monitoring. The aim of this randomised feasibility trial was to compa...

INTRODUCTIONPractice nurses in general practice are ideally placed to deliver weight management treatments. Teaching people to eat according to their appetite, based on measurements of blood glucose (‘hunger training’), is known to lead to weight loss and improved eating behaviour. To effectively translate this research to primary care requires und...

Background Childhood obesity is a significant global problem. Childhood obesity prevention interventions may be more effective when started very early in life before metabolic and behavioural patterns are established. Methods and findings A prospectively planned, individual participant data meta‐analysis of four randomized controlled trials. Parti...

Purpose: This study aimed to investigate (1) access to screens and screen use in the hour before bedtime and in bed; (2) attitudes and barriers to reducing screen time, and (3) perceptions of potential interventions to reduce screen time to benefit the sleep of New Zealand adolescents. Methods: Adolescents (aged 13-17 years, n = 4,811) living in...