Parental knowledge, perceptions and consumption of milk and alternatives relates to intakes of young children 2–8 y of age
Authors: Brett Neil R , Vanstone Catherine A , Maguire Jonathon L , Rauch Frank , Weiler Hope A 
Published: November 2023

A low intake of milk and alternatives is concerning for children, since vitamin D, calcium and other nutrients in these foods are important for growth and development. Canadian research is ambiguous on how parental nutrition knowledge impacts the dietary intake of their children. Because of this, the objective was to assess the relationship between parental knowledge/perceptions of milk and alternatives and the intake of their child. This was a cross sectional analysis, during April and May 2015, of healthy participants (BMI z‐score > −2 and < 2), 2–8 y (n= 49) from a 6 month randomized vitamin D trial (clinicaltrials.gov: NCT02387892) in Montreal, Canada. The self‐reported parental knowledge and perceptions survey had 2 sections, one about general knowledge and perceptions and the second had specific questions about their child. Milk and alternatives and vitamin D intake were assessed using a validated 30 day food frequency questionnaire (FFQ). Pearson partial correlations, Bland‐Altman plots of agreement and mixed model ANOVA with Bonferroni post hoc testing were used. The participants (5.6 ± 1.9 y) were 59% (29/49) male, had mean BMI z‐scores of 0.65 ± 0.84, and only 2% (1/49) of children did not reach the recommended 2 servings/day of milk and alternatives by Canada's Food Guide (CFG). Sixty seven percent of families had incomes above $65,000 Canadian and 70% of parents had university level education. There was a significant partial correlation between parental milk and alternatives intake and FFQ child milk and alternatives intake (r = 0.59, p = 0.001). Also, when parents consumed milk and alternatives at meals with their child, children consumed significantly more servings of this food group throughout the day (Figure 1A). There was a small bias (0.314, 95% CI: −2.56 to 3.19) between the FFQ milk product intake and the perceived milk and alternatives intakes (Figure 1B). Though 82% of parents correctly identified CFG serving sizes of fluid milk, less than 25% correctly identified the serving sizes of yogurt and cheese (Table 1). Sixty three percent of parents thought the number of servings of milk and alternatives that children needed per day was higher than the CFG recommendations. Non‐white children consumed significantly more (p < 0.05) milk and alternatives than white children. Age and sex however, did not associate with milk and alternatives intake. These results suggest that parental milk and alternatives intake as well as knowledge of CFG may have a significant impact on the amount of milk and alternatives served to children. Future longitudinal research should test whether educating parents about milk and alternatives significantly changes the amount of these products they serve to their young children.Support or Funding InformationThis work was supported by funding from Dairy Farmers of Canada, the Canadian Foundation for Innovation and Canada Research Chairs. Dairy Farmers of Canada did not have a role in design, implementation, analysis or interpretation.
Proportions of parents who correctly identified Canada's Food Guide (CFG) servings and serving sizes.

Question
Proportion of parents correctly answering

CFG serving size of fluid milk
82%

CFG serving size of yogurt:
Solid
16%

Beverage
24%

CFG serving size of cheese
13%

CFG recommended servings/day of milk and alternatives*
32%

Servings/day for 2–8 year olds