{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T21:56:40Z","timestamp":1761429400969,"version":"build-2065373602"},"reference-count":57,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["450153"],"award-info":[{"award-number":["450153"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Chronic stress is known to influence dietary choices, and stressed families often report poorer diet quality; however, little is known about how family-based stress is linked with dietary patterns that promote inflammation. This study investigated associations between family-based stress and the inflammatory potential of the diet among preschool-aged children and their parents. Parents (n = 212 mothers, n = 146 fathers) and children (n = 130 girls, n = 123 boys; aged 18 months to 5 years) from 241 families participating in the Guelph Family Health Study were included in the analyses. Parents reported levels of parenting distress, depressive symptoms, household chaos, and family functioning. The inflammatory potential of parents\u2019 and children\u2019s diets was quantified using the Dietary Inflammatory Index (DII\u00ae), adjusted for total energy intake (i.e., the E-DIITM). E-DII scores were regressed onto family stress using generalized estimating equations to account for shared variance among family clusters. Compared to those in homes with low chaos, parents in chaotic homes had significantly more proinflammatory dietary profiles (\u03b2 = 0.973; 95% CI: 0.321, 1.624, p = 0.003). Similarly, compared to those in well-functioning families, parents in dysfunctional families had significantly more proinflammatory dietary profiles (\u03b2 = 0.967; 95% CI: 0.173, 1.761, p = 0.02). No significant associations were found between parents\u2019 E-DII scores and parenting distress or depressive symptoms, nor were any associations found for children\u2019s E-DII scores. Results were not found to differ between males and females. Parents in chaotic or dysfunctional family environments may be at increased risk of chronic disease due to proinflammatory dietary profiles. Children\u2019s dietary inflammatory profiles were not directly associated with family stress; however, indirect connections through family food-related behaviours may exist. Future research should prioritize elucidating these mechanisms.<\/jats:p>","DOI":"10.3390\/nu13051464","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T06:19:11Z","timestamp":1619504351000},"page":"1464","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Associations between Family-Based Stress and Dietary Inflammatory Potential among Families with Preschool-Aged Children"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8282-5839","authenticated-orcid":false,"given":"Valerie","family":"Hruska","sequence":"first","affiliation":[{"name":"Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitin","family":"Shivappa","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0677-2672","authenticated-orcid":false,"given":"James R.","family":"H\u00e9bert","sequence":"additional","affiliation":[{"name":"Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison M.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jess","family":"Haines","sequence":"additional","affiliation":[{"name":"Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1165-5972","authenticated-orcid":false,"given":"David W. L.","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bremner, J.D., Moazzami, K., Wittbrodt, M.T., Nye, J.A., Lima, B.B., Gillespie, C.F., Rapaport, M.H., Pearce, B.D., Shah, A.J., and Vaccarino, V. (2020). Diet, stress and mental health. Nutrients, 12.","DOI":"10.3390\/nu12082428"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1017\/S1041610212001986","article-title":"Patterns of dietary intake and psychological distress in older Australians: Benefits not just from a Mediterranean diet","volume":"25","author":"Hodge","year":"2013","journal-title":"Int. Psychogeriatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1136\/jnnp-2012-304792","article-title":"Mediterranean diet improves cognition: The PREDIMED-NAVARRA randomised trial","volume":"84","author":"Clavero","year":"2013","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_4","first-page":"1821","article-title":"Adherence to the Mediterranean diet is associated with better mental and physical health","volume":"101","author":"Marrugat","year":"2009","journal-title":"Br. J. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1038\/s41380-018-0237-8","article-title":"Healthy dietary indices and risk of depressive outcomes: A systematic review and meta-analysis of observational studies","volume":"24","author":"Lassale","year":"2019","journal-title":"Mol. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.jad.2017.09.022","article-title":"Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies","volume":"226","author":"Molendijk","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1192\/bjp.bp.108.058925","article-title":"Dietary pattern and depressive symptoms in middle age","volume":"195","author":"Akbaraly","year":"2009","journal-title":"Br. J. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1017\/S1368980011001856","article-title":"Fast-food and commercial baked goods consumption and the risk of depression","volume":"15","author":"Toledo","year":"2012","journal-title":"Public Health Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1080\/10715762.2018.1475733","article-title":"The role of oxidative stress in anxiety disorder: Cause or consequence?","volume":"52","author":"Ferreira","year":"2018","journal-title":"Free Radic. Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Berk, M., Williams, L.J., Jacka, F.N., O\u2019Neil, A., Pasco, J.A., Moylan, S., Allen, N.B., Stuart, A.L., Hayley, A.C., and Byrne, M.L. (2013). So depression is an inflammatory disease, but where does the inflammation come from?. BMC Med., 11.","DOI":"10.1186\/1741-7015-11-200"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1017\/S1461145709009924","article-title":"A potential role for pro-inflammatory cytokines in regulating synaptic plasticity in major depressive disorder","volume":"12","author":"Khairova","year":"2009","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.it.2005.11.006","article-title":"Cytokines sing the blues: Inflammation and the pathogenesis of depression","volume":"27","author":"Raison","year":"2006","journal-title":"Trends Immunol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fpsyt.2019.00350","article-title":"What is the role of dietary inflammation in severe mental illness? A review of observational and experimental findings","volume":"10","author":"Firth","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1080\/01494929.2016.1204406","article-title":"Understanding single mothers\u2019 parenting stress trajectories","volume":"53","author":"Berryhill","year":"2017","journal-title":"Marriage Fam. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S0190-7409(98)00022-X","article-title":"Multiple sources of stress and parenting behavior","volume":"20","author":"Rodgers","year":"1998","journal-title":"Child. Youth Serv. Rev."},{"key":"ref_16","first-page":"255","article-title":"Stress and eating behaviors","volume":"38","author":"Yau","year":"2013","journal-title":"Minerva Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.nut.2007.08.008","article-title":"Relationship between stress, eating behavior, and obesity","volume":"23","author":"Torres","year":"2007","journal-title":"Nutrition"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0031-9384(98)00322-9","article-title":"Perceived effects of stress on food choice","volume":"66","author":"Oliver","year":"1999","journal-title":"Physiol. Behav."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1139\/apnm-2016-0659","article-title":"Examination of associations between chaos in the home environment, serum cortisol level, and dietary fat intake among parents of preschool-age children","volume":"42","author":"MacRae","year":"2017","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1002\/oby.22710","article-title":"Stress is associated with adiposity in parents of young children","volume":"28","author":"Hruska","year":"2020","journal-title":"Obesity"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.socscimed.2012.03.026","article-title":"Parental employment and work-family stress: Associations with family food environments","volume":"75","author":"Bauer","year":"2012","journal-title":"Soc. Sci. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1017\/S1368980012004594","article-title":"What\u2019s for dinner? Types of food served at family dinner differ across parent and family characteristics","volume":"17","author":"MacLehose","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e1096","DOI":"10.1542\/peds.2012-0895","article-title":"Influence of stress in parents on child obesity and related behaviors","volume":"130","author":"Parks","year":"2012","journal-title":"Pediatrics"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/obr.12262","article-title":"Do stressed mothers have heavier children? A meta-analysis on the relationship between maternal stress and child body mass index","volume":"16","author":"Tate","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/obr.12522","article-title":"Associations of maternal stress with children\u2019s weight-related behaviours: A systematic literature review","volume":"18","author":"Maher","year":"2017","journal-title":"Obes. Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.foodqual.2004.02.010","article-title":"A prospective study of food preferences in childhood","volume":"15","author":"Nicklaus","year":"2004","journal-title":"Food Qual. Prefer."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"549","DOI":"10.17269\/s41997-018-0072-3","article-title":"Guelph Family Health Study: Pilot study of a home-based obesity prevention intervention","volume":"109","author":"Haines","year":"2018","journal-title":"Can. J. Public Health"},{"key":"ref_28","unstructured":"Abidin, R.R. (2012). Parenting Stress Index Professional Manual, Par Inc.. [4th ed.]."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"205031211351457","DOI":"10.1177\/2050312113514576","article-title":"Performance of the 10-item Center for Epidemiologic Studies Depression scale for caregiving research","volume":"1","author":"Andresen","year":"2013","journal-title":"SAGE Open Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0749-3797(18)30622-6","article-title":"Screening for depression in well older adults: Evaluation of a short form of the CES-D","volume":"10","author":"Andresen","year":"1994","journal-title":"Am. J. Prev. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/0193-3973(95)90028-4","article-title":"Bringing order out of chaos: Psychometric characteristics of the Confusion, Hubbub, and Order Scale","volume":"16","author":"Matheny","year":"1995","journal-title":"J. Appl. Dev. Psychol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/j.1752-0606.1983.tb01497.x","article-title":"The McMaster Family Assessment Device","volume":"9","author":"Epstein","year":"1983","journal-title":"J. Marital Fam. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1037\/h0080547","article-title":"A psychometric study of the McMaster Family Assessment Device in psychiatric, medical, and nonclinical samples","volume":"3","author":"Kabacoff","year":"1990","journal-title":"J. Fam. Psychol."},{"key":"ref_34","unstructured":"(2020, September 27). National Cancer Institute ASA24\u00ae Dietary Assessment Tool | EGRP\/DCCPS\/NCI\/NIH, Available online: https:\/\/epi.grants.cancer.gov\/asa24\/."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3945\/ajcn.114.083238","article-title":"Performance of the Automated Self-Administered 24-hour Recall relative to a measure of true intakes and to an interviewer-administered 24-h recall","volume":"100","author":"Kirkpatrick","year":"2014","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Wallace, A., Kirkpatrick, S., Darlington, G., and Haines, J. (2018). Accuracy of parental reporting of preschoolers\u2019 dietary intake using an online self-administered 24-h recall. Nutrients, 10.","DOI":"10.3390\/nu10080987"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1017\/S1368980013002115","article-title":"Designing and developing a literature-derived, population-based dietary inflammatory index","volume":"17","author":"Shivappa","year":"2014","journal-title":"Public Health Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/advances\/nmy071","article-title":"Perspective: The Dietary Inflammatory Index (DII)\u2014Lessons learned, improvements made, and future directions","volume":"10","author":"Shivappa","year":"2019","journal-title":"Adv. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Khan, S., Wirth, M., Ortaglia, A., Alvarado, C., Shivappa, N., Hurley, T., and H\u00e9bert, J. (2018). Design, development and construct validation of the Children\u2019s Dietary Inflammatory Index. Nutrients, 10.","DOI":"10.3390\/nu10080993"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1093\/ajcn\/75.3.453","article-title":"Body-composition assessment via air-displacement plethysmography in adults and children: A review","volume":"75","author":"Fields","year":"2002","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_41","unstructured":"Myatt, M., and Guevarra, E. (2019, October 19). R package version 0.3.1. Available online: https:\/\/CRAN.R-project.org\/package=zscorer."},{"key":"ref_42","unstructured":"SAS Institute Inc. (2015). SAS\/IML\u00ae14.1 User\u2019s Guide, SAS Institute Inc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/biomet\/73.1.13","article-title":"Longitudinal data analysis using generalized linear models","volume":"73","author":"Liang","year":"1986","journal-title":"Biometrika"},{"key":"ref_44","first-page":"1","article-title":"Relationships of family conflict, cohesion, and chaos in the home environment on maternal and child food-related behaviours","volume":"14","author":"Quick","year":"2018","journal-title":"Matern. Child. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.nutres.2015.11.009","article-title":"Anti-inflammatory Dietary Inflammatory Index scores are associated with healthier scores on other dietary indices","volume":"36","author":"Wirth","year":"2016","journal-title":"Nutr. Res."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Kim, Y., Chen, J., Wirth, M.D., Shivappa, N., and Hebert, J.R. (2018). Lower dietary inflammatory index scores are associated with lower glycemic index scores among college students. Nutrients, 10.","DOI":"10.3390\/nu10020182"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1055\/a-0596-8204","article-title":"Dietary Inflammatory Index and its association with the risk of cardiovascular diseases, metabolic syndrome, and mortality: A systematic review and meta-analysis","volume":"50","author":"Namazi","year":"2018","journal-title":"Horm. Metab. Res."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Ruiz-Canela, M., Bes-Rastrollo, M., and Mart\u00ednez-Gonz\u00e1lez, M.A. (2016). The role of dietary inflammatory index in cardiovascular disease, metabolic syndrome and mortality. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17081265"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1024\/0300-9831\/a000648","article-title":"The association between dietary inflammatory index and risk of central obesity in adults: An updated systematic review and meta-analysis","volume":"90","author":"Farhangi","year":"2020","journal-title":"Int. J. Vitam. Nutr. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1002\/ijc.30922","article-title":"Meta-analysis of the association between dietary inflammatory index (DII) and cancer outcomes","volume":"141","author":"Fowler","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"104391","DOI":"10.1016\/j.appet.2019.104391","article-title":"A healthful home food environment: Is it possible amidst household chaos and parental stress?","volume":"142","author":"Fulkerson","year":"2019","journal-title":"Appetite"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.ssresearch.2016.04.001","article-title":"Home sweet home? Home physical environment and inflammation in children","volume":"60","author":"Schmeer","year":"2016","journal-title":"Soc. Sci. Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1016\/j.clnu.2019.09.004","article-title":"Predictors of the dietary inflammatory index in children and associations with childhood weight status: A longitudinal analysis in the Lifeways Cross-Generation Cohort Study","volume":"39","author":"Navarro","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1752-0606.1988.tb00748.x","article-title":"Family Assessment Device: Reports from mothers, fathers, and adolescents in community and clinic families","volume":"14","author":"Sawyer","year":"1988","journal-title":"J. Marital Fam. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.ypmed.2018.02.029","article-title":"The forgotten parent: Fathers\u2019 representation in family interventions to prevent childhood obesity","volume":"111","author":"Davison","year":"2018","journal-title":"Prev. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1093\/oxfordjournals.aje.a009233","article-title":"Gender differences in social desirability and social approval bias in dietary self-report","volume":"146","author":"Ma","year":"1997","journal-title":"Am. J. Epidemiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1353\/cpr.2015.0028","article-title":"Considering the role of stress in populations of high-risk, underserved community networks program centers","volume":"9","author":"Braun","year":"2015","journal-title":"Prog. Community Health Partnerships Res. Educ. Action"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1464\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:52:47Z","timestamp":1760161967000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/5\/1464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,26]]},"references-count":57,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["nu13051464"],"URL":"https:\/\/doi.org\/10.3390\/nu13051464","relation":{},"ISSN":["2072-6643"],"issn-type":[{"type":"electronic","value":"2072-6643"}],"subject":[],"published":{"date-parts":[[2021,4,26]]}}}