Family functioning and frequency of sugar consumption by 3 and 4 year old children in Outer North East London

Abstract

Dental caries is a public health problem affecting over 30% of 3.5 to 4.5 year old children in the UK. One of its most important determinants is frequent consumption of sugary foods, without which plaque bacteria cannot produce sufficient acids to demineralise tooth structure. The aim of this study was to identify the contribution of family functioning in the domains behaviour control, affective responsiveness, affective involvement, communication, problem solving and roles towards the frequent consumption of sugary foods by three and four year old children in Outer North East London. The research questions were explored with data from the Outer North East London Family Study (ONEL-FS), which collected data through home visits, by trained dentists and interviewers, from a representative sample of adults and children living in the London boroughs of Redbridge, Barking and Dagenham and Waltham Forest in 2008-10. This study analysed data (N=698) from three and four year old children and their mothers and included unadjusted and adjusted logistic regression and mediation analysis. The results showed that 17% of the sample consumed sugary foods more than 4/day which was significantly associated with behaviour-control (OR 0.25; 95% CI: 0.11, 0.57), affective-responsiveness (OR 0.29; 95% CI: 0.14, 0.58), affective-involvement (OR 0.32; 95% CI: 0.17, 0.60), communication (OR 0.34; 95% CI: 0.14, 0.85) and roles (OR 0.22; 95% CI: 0.08, 0.62), after adjusting for confounders. The significant association between mother’s education and children’s sugar consumption (OR 0.35; 95% CI: 0.21, 0.58) was partially mediated through behaviour control, affective responsiveness, affective involvement, communication and roles. The significant association between mother’s ethnicity and sugar consumption (OR 3.46; 95% CI: 1.63, 5.25) was also partially mediated through these same five domains. The study findings contribute to the literature on protective influences within the family environment and confirm current knowledge regarding mother’s education and ethnicity.