INTRODUCTION
N-3 polyunsaturated fatty acids (PUFA) from fish and seafood play a critical role in early development and long-term disease prevention [
1]; however, intakes remain low in many Western countries. Despite recommendations to consume at least two servings of fish or seafood per week [
2–
4], studies in North American children suggest that >70% of children consume less than one serving of fish and seafood per week [
4,
5]. This is concerning, given that early nutrition influences long-term dietary habits [
6–
8].
Studies in adults have shown that a number of factors impact frequency of fish and seafood intake, including taste, food skills, perceived health benefits, age, education level, and geographic location [
9–
13]; these factors have not yet been explored in children. However, it is known that parents play a primary role influencing early dietary habits and perceptions in their children [
8,
14], suggesting that parental preference and perception of fish and seafood consumption may contribute to fish and seafood consumption by their children. Understanding the factors that influence fish and seafood consumption in children will help support the development of strategies to improve their children’s intake of n-3 PUFA [
9,
15]. The purpose of this study was to investigate how parental perceptions of fish and seafood consumption influence the frequency of fish and seafood consumption in Canadian children.
METHODS
This study used cross-sectional data collected from 28 parents (of 40 children) participating in the Guelph Family Health Study pilot, a longitudinal family-based cohort. These parents responded to an online survey administered between March 2019 and May 2020 that assessed parental perceptions and history of fish and seafood consumption, confidence in preparing fish and seafood dishes, and parental and childhood intakes of fish and seafood (Supplemental Table 1
1). Survey questions were adapted from a variety of sources [
13,
16–
18]. Surveys were completed by one parent per household. Families were eligible to participate in the Guelph Family Health Study pilot if they had at least one child aged 18 months to 5 years at the time of enrolment (children were aged 5–10 years at the time of this study), lived in Wellington County (an inland region located in Ontario, Canada), and had a parent who could respond to questionnaires and surveys in English. This study received approval by the University of Guelph Research Ethics Board (REB14AP008).
Statistical analysis
Parent age and child age were reported as mean ± standard deviation (minimum–maximum). Ethnicity, household income, and parent highest level of education were reported as frequency (percent). Logistic regression analyses assessed associations between parental variables (Likert scale score) and whether children consumed at least one type of fish and seafood at least once per month (yes or no). Odds ratio estimates (OR) and 95% confidence intervals (CI) were calculated using generalized estimating equations to account for potential correlations among siblings. Statistical analyses were performed using SAS OnDemand for Academics (SAS Institute Inc., Cary, North Carolina, USA).
DISCUSSION
This pilot study examined frequency of intake and parental factors associated with fish and seafood intake in Canadian children. Previous studies have shown that dietary intakes of n-3 PUFA from fish and seafood sources by North American children are low. Many children do not meet the recommendations for these fatty acids [
19] from 2 servings of fish or seafood per week [
4,
5,
20]. In this study, 80% of children in this study consumed less than one serving per week per category of fish or seafood.
This study found that 63% (n = 25) of children consumed fish and seafood at least once per month. Of these children, 20 parents also reported consuming fish and seafood at least once per month (Supplemental Table 1
1), suggesting that parental intakes of fish and seafood are reflective of child intake. Previous studies have shown that parents’ modelling of healthy food behaviours improves nutrition outcomes in children [
21]; thus, modelling of fish and seafood consumption by parents may be an effective strategy to increase fish and seafood intake by children.
Additionally, this study found that parental cooking confidence was positively associated with child intakes of fish and seafood (OR = 1.91, 95% CI [1.21, 3.03]). This agrees with earlier findings which have shown that cooking competency when preparing fish and seafood meals is a driver of fish and seafood consumption [
9,
22]. These findings suggest that to increase fish and seafood consumption, families may require support and education around recipes and food skills to increase their cooking confidence when preparing these dishes at home.
Our findings shed light on possible new research directions. However, there are some limitations, including low variability in parental age, ethnic diversity, education level, and socioeconomic status, as well as low sample size and focused geographic location, as Wellington County is an inland region located in Ontario, Canada. Additionally, parents were not asked if any family members had fish or seafood allergies, which may impact intake.