Family dinner and diet quality among older children and adolescents

Clustering of obesity and dental health with lifestyle factors among Turkish and Finnish pre-adolescents

BACKGROUND

This study aims to assess any clustering between obesity, number of decayed, missing, and filled teeth (DMFT), television (TV) viewing, and lifestyle factors among pre-adolescents living in 2 countries with different developmental status and oral health care systems - Turkey and Finland.

PATIENTS AND METHODS

A cross-sectional study of Finnish (n = 338) and Turkish (n = 611) preadolescents, 10-12 years old, was undertaken with preadolescent oral health data and health behavior questionnaires for pre-adolescents and their mothers. The parameters examined were DMFT, body mass index (BMI), leisure time activities (TV viewing), and lifestyle factors (family dinners and dietary habits) of pre-adolescents. Data analysis included factor analysis, Student's t-test, and Chi-square tests by cross tabulation.

RESULTS

Turkish pre-adolescents were more obese and had poorer dental health than their Finnish counterparts (p < 0.05). Turkish and Finnish pre-adolescents drinking fizzy drinks more than 3 times a week were more likely to watch TV for >or= 2 h/school day (odds ratio (OR) = 1.51, 95% confidence interval (CI) 1.00-2.28) than those consuming them once a week or less (OR = 3.06, 95% CI 1.39-6.75; p < 0.05). Factor analysis revealed that DMFT and obesity shared the same cluster among Turkish and Finnish pre-adolescents.

CONCLUSION

Both medical and dental examination of any pediatric patient should include BMI, leisure time activities, and dietary habits as well as socio-economic status.

Recommendations for prevention of childhood obesity

The majority of US youth are of healthy weight, but the majority of US adults are overweight or obese. Therefore, a major health challenge for most American children and adolescents is obesity prevention-today, and as they age into adulthood. In this report, we review the most recent evidence regarding many behavioral and practice interventions related to childhood obesity, and we present recommendations to health care providers. Because of the importance, we also suggest approaches that clinicians can use to encourage obesity prevention among children, including specific counseling strategies and practice-based, systems-level interventions. In addition, we suggest how clinicians may interact with and promote local and state policy initiatives designed to prevent obesity in their communities.

Low-income, overweight and obese mothers as agents of change to improve food choices, fat habits, and physical activity in their 1-to-3-year-old children

OBJECTIVE

To examine the effects of a weight loss program for mothers on the diet and activity of mothers and their 1-3 year old children.

DESIGN

Overweight and obese mothers participated in an 8-week weight loss intervention encompassing diet, physical activity, and behavioral modification. Anthropometrics, demographic, dietary, and physical activity questionnaires were administered at weeks 0 and 8; anthropometrics were re-evaluated at week 24.

SUBJECTS

Mothers (N=91) of a 1-3 year old child; body mass index (BMI) >or= 25 kg/m2; non-breastfeeding; age 18-45 years; income < 200% of federal poverty index; Hispanic, African American, or white; and English-speaking were recruited from Special Supplemental Program for Women Infants and Children (WIC) and public health clinics. INTERVENTION MEASURES OF OUTCOME: Weight loss in mothers and improvements in diet (reduction in calories, fat, snacks/desserts, sweetened beverages, and increases in fruit, vegetables) and activity in mothers and children.

RESULTS

Weight loss in mothers was modest (-2.7 kg, p < 0.001) and sustained at week 24 (-2.8 kg, p < 0.001), and children gained in height and weight as expected for normal growth (p < 0.001). Initial energy intakes of children exceeded Estimated Energy Requirements (123%) and were reduced to acceptable levels post-intervention (102%, p < 0.001); additional beneficial changes in children's diets were decreased total (47.7 to 39.9 g/day) and saturated fat (19.2 to 16.6 g/day), high-fat snacks/desserts (1.6 to 0.9 servings/day), added fats (81.8 to 40.9% using), sweetened beverages (0.8 to 0.4 servings/day), and fast food consumption (11.6 to 6.6% of meals), and increased home-prepared meals (63.2 to 71.6% of meals) (p < 0.01 for all). Physical activity scores improved by 7% in children (p < 0.05). Comparable changes in food choices and activity also were seen in mothers.

CONCLUSION

Offering weight loss classes was a successful method of enticing low-income women to participate in an educational intervention that benefited their children. Overweight and obese mothers who modified their food choices and fat habits made comparable changes for their child.

Atherosclerosis risk factors in children of parents with the metabolic syndrome

BACKGROUND

Metabolic syndrome is a constellation of disorders that produces a high risk of atherosclerosis. Endothelial dysfunction is the key event in atherosclerosis and already present even in the childhood. The aim of the present study is to investigate inflammatory and radiological signs of atherosclerosis in children who have parents with the metabolic syndrome.

DESIGN AND METHODS

Fifty children of parents with the metabolic syndrome and 38 age- and sex-matched controls were studied. Anthropometric measurements, blood pressure assessment, echocardiography, flow-mediated vasodilatation (FMD) which is a non-invasive test for the evaluation of endothelial function and fasting blood measurements including blood glucose, insulin, total cholesterol, HDL cholesterol, triglyceride, hsCRP and soluble CD40 ligand were performed.

RESULTS

Serum sCD40L and hsCRP levels were significantly higher in the study group compared to the controls. FMD values did not differ between the study and control groups. Increased serum sCD40L levels were positively correlated with body mass index, waist hip ratio, LDL/HDL cholesterol ratio, and the number of metabolic syndrome components in parents, whereas showed negative correlation with the serum HDL cholesterol levels. High hsCRP levels were positively correlated with body mass index and the number of metabolic syndrome components. Multiple regression analysis demonstrated that the number of metabolic syndrome components in parents presented as being a significant predictor of the serum sCD40L and hsCRP levels of their children.

CONCLUSION

Our results suggest that children of patients with metabolic syndrome have higher values of the serum markers of inflammation, which may be associated with increased risk for development of cardiovascular disease.

Associations between watching TV during family meals and dietary intake among adolescents

OBJECTIVE

To examine associations between watching television during family meals and dietary intake among adolescents.

DESIGN

Cross-sectional study using survey data from a diverse sample of adolescents.

SETTING

Data were collected from a school-based survey during the 1998-1999 school year.

PARTICIPANTS

Middle and high school students (N = 4746) from 31 public schools in the Minneapolis-St. Paul area. Response rate was 81.5%.

VARIABLES MEASURED

Intake of fruits, total vegetables, dark green/yellow vegetables, calcium-rich food, grains, soft drinks, fried food, snack food, calories, family meal frequency, and watching television during meals.

ANALYSIS

General linear modeling comparing dietary intake across 3 groups.

RESULTS

33.5% of boys and 30.9% of girls reported watching television during family meals. Adolescents watching television were found to have lower intakes of vegetables, dark green/yellow vegetables, calcium-rich food, and grains and higher intakes of soft drinks compared to adolescents not watching television during meals. However, watching television during family meals was associated with a more healthful diet than not eating regular family meals.

CONCLUSIONS AND IMPLICATIONS

Watching television during family meals was associated with poorer dietary quality among adolescents. Health care providers should work with families and adolescents to promote family meals, emphasizing turning the TV off at meals.

Family Meals during Adolescence Are Associated with Higher Diet Quality and Healthful Meal Patterns during Young Adulthood

BACKGROUND

Cross-sectional research in adolescents has found that eating family meals is associated with better nutritional intake.

OBJECTIVE

To describe meal patterns of young adults and determine if family meal frequency during adolescence is associated with diet quality, meal frequency, social eating, and meal structure during young adulthood.

DESIGN

Population-based, 5-year longitudinal study in Minnesota.

SUBJECTS/SETTING

Surveys and food frequency questionnaires were completed by 946 female students and 764 male students in high school classrooms at Time 1 (1998-1999; mean age 15.9 years) and by mail at Time 2 (2003-2004; mean age 20.4 years).

STATISTICAL ANALYSES PERFORMED

Multiple linear regression models were used to predict mean levels of young adult outcomes from adolescent family meal frequency. Probability testing of trends in each outcome across ordered categories of family meal frequency used linear contrasts.

RESULTS

Family meal frequency during adolescence predicted higher intakes of fruit (P<0.05), vegetables (P<0.01), dark-green and orange vegetables (P=0.001), and key nutrients and lower intakes of soft drinks (P<0.05) during young adulthood. Frequency of family meals also predicted more breakfast meals (P<0.01) in females and for both sexes predicted more frequent dinner meals (P<0.05), higher priority for meal structure (P<0.001), and higher priority for social eating (P<0.001). Associations between Time 1 family meals and Time 2 dietary outcomes were attenuated with adjustment for Time 1 outcomes but several associations were still statistically significant.

CONCLUSIONS

Family meals during adolescence may have a lasting positive influence on dietary quality and meal patterns in young adulthood.

Use of the youth risk behavior survey to monitor trends for nutrition and physical activity in a Midwest city school district

BACKGROUND

The Youth Risk Behavior Survey (YRBS) was used by a city school district (approximately 11,000 students) in the upper Midwest to monitor trends for nutrition and physical activity (PA) behaviors both within and between years and to compare with national 2003 data.

METHODS

Independent random samples were obtained in 1999 (387 middle school [MS] and 931 high school [HS]), in 2001 (322 MS and 367 HS), and in 2003 (658 MS and 1026 HS). A two-sample test of proportions was used.

RESULTS

Within each survey year, a higher proportion of MS compared to HS reported positive behaviors with some exceptions: (1) an increased proportion of HS having daily physical education (PE) and (2) a reduced proportion of HS reporting media time. Within 2003, a lower proportion of district females compared to males (MS and HS) reported participation in many measured behaviors. District trends overtime indicated a reduced proportion: (1) drinking milk (MS and HS), (2) eating breakfast (HS), and (3) watching television (MS). Trends overtime indicated an increased proportion: (1) using computers for fun (MS and HS), (2) participating in moderate PA (MS), and (3) daily PE (HS). District HS compared to national (2003) indicated a higher proportion: (1) drinking milk, (2) getting moderate PA, and (3) taking daily PE. District HS compared to national indicated a lower proportion: (1) at risk of overweight, (2) overweight, and (3) watching television.

CONCLUSIONS

Analysis of district YRBS trends provides both a database for informed decisions by the school district and an assessment model for other districts.

Eating competence: definition and evidence for the Satter Eating Competence model

The evidence- and practice-based Satter Eating Competence Model (ecSatter) outlines an inclusive definition of the interrelated spectrum of eating attitudes and behaviors. The model is predicated on the utility and effectiveness of biopsychosocial processes: hunger and the drive to survive, appetite and the need for subjective reward and the biological propensity to maintain preferred and stable body weight. According to ecSatter, competent eaters have 1) positive attitudes about eating and about food, 2) food acceptance skills that support eating an ever-increasing variety of the available food, 3) internal regulation skills that allow intuitively consuming enough food to give energy and stamina and to support stable body weight, and 4) skills and resources for managing the food context and orchestrating family meals. Identifying these four constructs allows nutrition professionals to target interventions as well as trust and support the individual's own capabilities and tendency to learn and grow.

Childhood obesity: food, nutrient, and eating-habit trends and influences

The need has never been greater to support healthy eating and physical activity in children and youth; the numbers of overweight and obese children have doubled and tripled, respectively, over the past 3 decades. Poor eating habits, including inadequate intake of vegetables, fruit, and milk, and eating too many high-calorie snacks, play a role in childhood obesity. Grain products provide the highest percentage (31%) of daily calories, followed by “other foods,” which have limited nutritional value (22% of daily calories). Snacks account for 27% of total daily calories, which is more than the calories consumed at breakfast (18%) and lunch (24%), but not dinner (31%). For Canadians older than 4 years of age, more than 41% of daily snack calories come from other foods, such as chips, chocolate bars, soft drinks, fruit drinks, sugars, syrup, preserves, fats, and oils. Habits that protect against childhood obesity include eating more vegetables and fruit, eating meals with family, and being physically active. Children’s food habits and choices are influenced by family, caregivers, friends, schools, marketing, and the media. Successful interventions for preventing childhood obesity combine family- and school-based programs, nutrition education, dietary change, physical activity, family participation, and counseling.

Food and weight-related patterns and behaviors of Hmong adolescents

OBJECTIVE

Little is known about the food and weight-related behaviors of Hmong adolescents. This study assessed these behaviors in Hmong adolescents and determined if they differed between Hmong and white teens or by country of birth.

DESIGN

School-based cross-sectional study.

SUBJECTS/SETTING

Hmong (n=649) and white (n=2,260) adolescents from 31 public middle and high schools in the Minneapolis/St Paul, MN, metropolitan area who participated in Project EAT (Eating Among Teens).

MAIN OUTCOME MEASURES

Family meals, grocery shopping, and meal preparation; consumption of breakfast, snacks, and fast foods, physical activity and inactivity; body satisfaction, weight concern, body mass index, and weight-control behaviors.

STATISTICAL ANALYSES PERFORMED

Variables were compared across race/ethnicity and by country of birth using chi(2) tests and general linear model regression.

RESULTS

Hmong students reported greater participation in family meals and more involvement with food purchasing and preparation. Fast-food consumption was similar among groups. Hmong teens reported less frequent breakfast consumption. The prevalence of overweight was higher in Hmong male adolescents than white male adolescents, but similar among female adolescents. Hmong students reported higher levels of weight concern, body dissatisfaction, dieting, unhealthful weight-control behaviors, less physical activity, and more inactivity than white students. Hmong male adolescents participated in extreme unhealthful weight-control behaviors four times more often than white male adolescents.

CONCLUSIONS

Hmong adolescents appear to be at increased risk for obesity, body dissatisfaction, and unhealthful weight-control behaviors compared to white adolescents. There is a need for culturally tailored interventions to address these nutrition and weight issues among Hmong adolescents.

Examination of Weight Status and Dietary Behaviors of Middle School Students in Kentucky

OBJECTIVE

There is growing interest in understanding the roles that fruit, vegetable, milk, breakfast, and soft drink consumption play in relation to adolescents' weight status. This study examines the relationship between weight status and dietary practices of middle school students.

DESIGN

This study consists of secondary analysis of a cross-sectional survey given to 4,049 middle school students in central Kentucky.

METHODS

Students' self-reported height and weight data, as well as 7-day recall of fruits, vegetables, milk, soft drinks, and breakfast consumption prior to completion of the survey, were collected. Self-reported height and weight were converted to body mass index (BMI) percentile according to Centers for Disease Control and Prevention's classification criteria.

OUTCOME MEASURES

Measures included dietary consumption of fruits, vegetables, milk, soft drinks, and breakfast in relation to students' BMI percentile.

STATISTICAL ANALYSES PERFORMED

Descriptive statistics were extracted on demographics, BMI percentile, and food consumption. Bivariate analyses included chi2 tests of association and Spearman rank correlation.

RESULTS

Healthy weight was associated with consuming fruits, vegetables, breakfast, and milk. Underweight and healthy-weight students consumed more fruits than students who were at risk of being overweight and overweight. Healthy-weight students consumed more "other vegetables" than students who were at risk of being overweight and more "other vegetables" and carrots than overweight students. Underweight students consumed breakfast more often than all other students, and healthy-weight students consumed breakfast significantly more frequently than students at risk of being overweight and overweight. Finally, overweight students had a significantly lower consumption of milk than all other students.

CONCLUSIONS

Parents and school foodservice personnel should take these factors into consideration by developing menu strategies and tactics to encourage more healthful eating behaviors in children.

Dietary risk factors for development of childhood obesity

PURPOSE OF REVIEW

Controversial information exists on the contribution of several dietary factors for overweight development in childhood, but there is no doubt that obesity prevalence is increasing. We review the most up-to-date information in order to clarify the evidence-based dietary aspects influencing obesity development in children and adolescents.

RECENT FINDINGS

Longitudinal studies are the preferred method for analysing the relationship between dietary factors and obesity development. With the exception of infants, there are no conclusive associations between energy intake or diet composition and later overweight development in children. Among formula or mixed-fed infants, the increase in energy intake has been associated with an increased risk of being overweight during childhood. Breastfeeding seems to be a protective factor for later obesity development. In terms of food intake, longitudinal studies have only found a clear and positive association between obesity development and sugar-sweetened beverage consumption; this is not the case with snacking, fast food or food portion sizes. Cross-sectional studies have found correlations between being overweight in childhood and buying lunch at school, eating supper while watching television or without family supervision, consuming less energy at breakfast or more at dinner, and missing breakfast.

SUMMARY

Results from longitudinal studies must be taken into account in order to design preventive strategies to counteract the increased prevalence of obesity and its consequences in children. Lack of breastfeeding, high early energy intake and high intake of sugar-sweetened beverages seem to be the main dietary factors contributing to obesity development.

Positive effects of family dinner are undone by television viewing

The purpose of this cross-sectional study was to test the independent associations of eating dinner as a family and having the television on during dinner with child feeding behaviors. Parents/guardians of children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in New York state were surveyed (n=1,336). Main outcome variables were frequencies of serving fruits, vegetables, and milk. Main exposure variables were the number of days per week the family ate dinner together and the number of days per week the television was on during dinner. Multiple logistic regressions assessed the association between the exposure variables and each of the main outcome measures controlling for race/ethnicity and parental educational attainment. Each night the family ate dinner together was positively associated with serving fruits (odds ratio [OR]=1.14, 95% confidence interval [CI] 1.07 to 1.21) or vegetables (OR=1.15, 95% CI 1.08 to 1.23). Serving fruits (OR= 0.95, 95% CI 0.91 to 0.99) or vegetables (OR=0.94, 95% CI 0.90 to 0.98) decreased with each night the television was on during dinner. Neither family dinner nor television on during dinner was significantly associated with serving milk. Family dinners and dinners without television on are independent predictors of servings of fruits or vegetables offered to preschool children. Because dietary habits and preferences are established early in life, parents should be counseled to promote family meal environments that support healthful eating.

[Food choice and place of eating for Quebec children]

PURPOSE

The relationships are explored between food choices of school-aged children and eating in the bedroom, while watching television, or in front of the computer.

METHODS

Data were collected using a self-administered questionnaire that 534 subjects completed in class. Participants were ten- to 12-year-old children from Québec.

RESULTS

Significant positive correlations were found between the act of eating in the bedroom and eating in front of the television or the computer (p<0.05). Significant positive correlations were also found between eating in the bedroom, or eating in front of the television or the computer, and the consumption of low-density food, foods high in sugar and fat, and foods low in fibre (p<0.05). Data also revealed more negative food habits for boys than for girls (p<0.05).

CONCLUSIONS

Because of the prevalence of childhood obesity, these findings support the need to document children's food consumption patterns and gender differences.

Associations between the home food environment and obesity-promoting eating behaviors in adolescence

OBJECTIVE

This study examines relationships between multiple aspects of the home food environment and obesity-promoting characteristics of 12- to 13-year-old adolescents' diets, specifically frequency of consumption of high-energy fluids, sweet snacks, savory snacks, and take-out foods.

RESEARCH METHODS

This was a cross-sectional study including 347 adolescents 12 to 13 years of age and their parents. Data were collected via self-completed surveys. The adolescents' diets were assessed using a Food Frequency Questionnaire derived from existing age-appropriate National Nutrition Survey data. An extensive range of domains within the home food environment were assessed. Bivariate linear regression analyses were run split by gender. Forced entry multiple linear regression analyses (adjusting for all variables significant in bivariate analyses as well as for maternal education) were also performed, stratified by the sex of the child.

RESULTS

The influence of mothers, either as models for eating behaviors or as the providers of food, was pervasive. Mothers' intake of high-energy fluids (p = 0.003), sweet snacks (p = 0.010), savory snacks (p = 0.008), and take-out food (p = 0.007) was positively associated with boys' intake of all these foods. In addition, mothers' intake of high-energy fluids was positively associated with daughters' consumption of these drinks (p = 0.025). Furthermore, availability of unhealthy foods at home was positively associated with girls' sweet snack (p = 0.001), girls' savory snack (p < 0.001), boys' savory snack (p = 0.002), and, in the bivariate analyses, girls' high-energy fluid consumption (p = 0.002).

DISCUSSION

This study of home food environment influences on adolescent diet highlights the pervasive influence of mothers in determining adolescents' obesity-promoting eating, providing direction for obesity prevention strategies and future research.

Differences between parents' and adolescents' perceptions of family food rules and availability

OBJECTIVE

To test the hypotheses that adolescents have different perceptions of family-environmental factors than do their parents, and that dietary intake of adolescents is more highly associated with the adolescent's own perceptions than those of their parents.

DESIGN

Data from self-administered questionnaires were used.

PARTICIPANTS

Five-hundred two students aged 12 to 14 years, and one of each student's parents.

MAIN OUTCOME MEASURES

Two types of family-environmental factors (ie, family food rules and home availability and accessibility of food) for 3 self-reported dietary behaviors (ie, fruit, snack, and breakfast intake).

ANALYSIS

Unpaired t tests, chi-square tests, percentage (gross) disagreement, standardized regression coefficients, and linear regression analyses.

RESULTS

For most rules and most perceptions of availability and accessibility, considerable disagreement was found between parents and students. Self-reported intake of fruit and snacks was more highly associated with student measures, but breakfast intake was more highly associated with parent measures of rules and availability.

IMPLICATIONS FOR RESEARCH AND PRACTICE

The findings might explain mixed results on the associations between family-environmental factors and children's dietary intake that were found in earlier studies. Researchers need to be aware that in studies into family-environmental determinants of dietary habits using self-reports, the results are possibly influenced by whether the data were reported by parents or by children.

Association between family variables and Mexican American children's dietary behaviors

OBJECTIVE

To examine the association between family variables and children's diets.

DESIGN

Cross-sectional study with households sampled using random-digit dialing. Children completed a one-time, self-administered survey, and mothers participated in a face-to-face structured interview.

SETTING

Data collection occurred in southern San Diego County on the U.S.-Mexico border.

PARTICIPANTS

One hundred sixty-seven Mexican American children between 8 and 18 years of age and their mothers.

MAIN OUTCOME MEASURES

Diet: number of snacks, candies and sweets, and sodas consumed daily; dietary fat and fiber; and money spent weekly on fast food and snacks. Family variables: household size, family support for healthful eating, number of meals eaten together, availability of fast food in the home, food ads seen on television, and parent purchasing food products that children saw advertised on television.

DATA ANALYSES

Regression analyses were used to examine the independent contributions of family variables on dietary intake. Statistical significance was set at P < .05.

RESULTS

Greater family support for healthful eating was associated with fewer snacks and more fiber consumed. Children of parents who purchased food products that their children had seen advertised on television reported consuming more snacks and more fat, and they spent more money on fast food and snacks.

CONCLUSIONS AND IMPLICATIONS

Family-based interventions are needed to moderate the potential influence of television-advertised food products on children's requests for these food products.

The contribution of psychosocial and home environmental factors in explaining eating behaviours in adolescents

OBJECTIVE

The present study aimed at investigating the influence of food availability, rules and television viewing habits on eating behaviours in adolescents.

DESIGN

Cross-sectional study.

SETTING

Four randomly selected middle schools.

SUBJECTS

A sample of 534 seventh and eighth graders.

INTERVENTIONS

Validated questionnaires were used to measure the family environment and fat, soft drink and fruit consumption. Hierarchical regression analyses on fat, soft drink and fruit consumption, with demographic and psychosocial variables entered as the first and environmental factors as the second block were conducted in boys and girls.

RESULTS

Boys with more unhealthy products available at home consumed more fat (P< or =0.001, 95% CI: 8.2-29.4) and more soft drinks (P< or =0.01, 95% CI: 0.2-1.4). Boys who reported better television viewing habits ate more fruit (P< or =0.001, 95% CI: -1.7 to -0.5). Girls who reported better television viewing habits consumed less fat (P< or =0.01, 95% CI: 1.4-9.0) and more fruit (P< or =0.05, 95% CI: -1.0 to -0.1). Girls who reported higher availability of healthy products at home (P< or =0.05, 95% CI: 0.3-3.1) and more food rules (P< or =0.001, 95% CI: -1.8 to -0.5), consumed more fruit. Environmental factors were poor predictors of soft drink consumption among girls.

CONCLUSION

Availability of (un)healthy food products, family food rules and TV viewing habits were related to one or more eating behaviours in boys or girls. Although home environmental factors can play an important role in influencing adolescents' eating behaviours, these factors were generally less predictive than demographic and psychosocial variables.

Trends in adolescent fruit and vegetable consumption, 1999-2004: project EAT

BACKGROUND

Diets abundant in fruits and vegetables are associated with reduced risk for chronic disease, but intakes of adolescents are often inadequate. To design effective interventions it is important to understand how dietary intake changes longitudinally during adolescence and to monitor progress in the population toward fruit and vegetable consumption recommendations. The objective of this study was to examine longitudinal and secular trends in fruit and vegetable intake among two cohorts of Minnesota adolescents over the period 1999-2004.

METHODS

Measures of fruit and vegetable intake and demographics were completed by 944 boys and 1161 girls who were Project EAT participants in 1999 and 2004. In 2005, mixed linear regression models were used to estimate (1) longitudinal trends among two cohorts of young people during developmental transitions and (2) age-matched secular trends between the two cohorts of young people at middle adolescence.

RESULTS

Longitudinal trends indicated that adolescents decreased their daily intake of fruit and vegetables by an average of 0.7 servings during the transition from early to middle adolescence and by 0.6 servings from middle to late adolescence. Analyses of age-matched secular trends at middle adolescence showed a mean daily decrease of 0.7 servings among girls and 0.4 servings among boys between 1999 and 2004.

CONCLUSIONS

The large longitudinal and secular declines in fruit and vegetable intakes of adolescents indicate a strong need for further research to understand why consumption is decreasing among adolescents and to develop more effective interventions for increasing fruit and vegetable consumption during this critical developmental period.

Associations between parental report of the home food environment and adolescent intakes of fruits, vegetables and dairy foods

Objective:

This study examines parental report of household food availability, parent dietary intake and associations with adolescent intakes of fruits, vegetables and dairy foods.

Design:

Cross-sectional study. Adolescents completed the Project EAT survey and the Youth Adolescent Food Frequency Questionnaire at school. Parents of adolescents were interviewed by telephone about the home food environment, eating habits and weight-related behaviours. General linear modelling was used to compare dietary intakes of adolescents across different levels of household food availability and parental intakes.

Subjects/setting:

The study sample included 902 adolescents and their parent or guardian.

Results:

Many parents were not consuming the minimum number of daily recommended fruit (44.5%), vegetable (69.9%) or dairy (46.9%) servings. While most parents reported that fruits and vegetables were available at home (90.3%) and vegetables were usually served at dinner (87.0%), fewer parents reported milk was served at meals (66.6%). Soft drinks were usually available at home (56.8%). Among girls, household availability was positively associated with fruit and vegetable intake (ttrend= 2.70,P< 0.01) and soft drink availability was inversely associated with dairy intake (ttrend= 2.08,P= 0.04). Among boys, serving milk at meals was positively associated with dairy intake (ttrend= 3.65,P< 0.01). Parental intakes were positively associated with dairy intake for boys (ttrend= 2.04,P= 0.04), and with dairy (ttrend= 2.43,P= 0.01), vegetable (ttrend= 3.72,P< 0.01) and fruit (ttrend= 3.17,P< 0.01) intakes for girls.

Conclusions/applications:

Interventions designed to help adolescents improve consumption of fruits, vegetables and dairy foods may be enhanced by including a parental component aimed at increasing household availability and parents' intake of healthful food choices.

Are dietary intakes and eating behaviors related to childhood obesity? A comprehensive review of the evidence

The purpose of this article is to comprehensively review studies that have examined the relation between diet and childhood obesity. The review specifically considers the roles of total energy intake and energy density; dietary composition; individual foods, food groups, and dietary patterns; beverage consumption; and eating behaviors. The paper also discusses methodological considerations and future research directions and concludes by summarizing the evidence presented and highlighting the ethical issues surrounding providing dietary advice.

Frequency of family dinner and adolescent body weight status: evidence from the national longitudinal survey of youth, 1997

OBJECTIVE

To explore associations between overweight status and the frequency of family dinners (FFD) for adolescents and how those associations differ across race and ethnicity.

RESEARCH METHODS AND PROCEDURES

A sample of 5014 respondents between 12 and 15 years of age from the 1997 wave of the National Longitudinal Survey of Youth 1997 (NLSY97) was used. BMI was calculated using self-reported height and weight; 13.3% of respondents qualified as overweight, 16.4% qualified as at-risk-of-overweight, and 1.9% qualified as underweight. The remainder were normal weight. FFD was defined as the number of times respondents had dinner with their families in a typical week in the past year. Multinomial logistic regression models were estimated separately for non-Hispanic whites vs. blacks and Hispanics for odds of belonging to the other weight categories compared with normal weight. A supplementary longitudinal analysis estimated the odds of change in overweight status between 1997 and 2000.

RESULTS

In 1997, the FFD distribution was as follows: 0, 8.3%; 1 or 2, 7.3%; 3 or 4, 13.4%; 5 or 6, 28.1%; 7, 42%. For whites, higher FFD was associated with reduced odds of being overweight in 1997, reduced odds of becoming overweight, and increased odds of ceasing to be overweight by 2000. No such associations were found for blacks and Hispanics.

DISCUSSION

Reasons for racial and ethnic differences in the relationship between FFD and overweight may include differences in the types and portions of food consumed at family meals. More research is needed to verify this.

Calcium and dairy intakes of adolescents are associated with their home environment, taste preferences, personal health beliefs, and meal patterns

OBJECTIVE

To identify correlates of calcium, dairy, and milk intakes among male and female adolescents.

DESIGN

Cross-sectional study design. Adolescents self-reported measures pertaining to correlates on the Project EAT (Eating Among Teens) survey and completed a food frequency questionnaire at school.

SUBJECTS/SETTING

Subjects were a total of 4,079 middle and high school students from Minneapolis/St Paul, MN, public schools.

STATISTICAL ANALYSES PERFORMED

Multiple linear regression models based on social cognitive theory were examined by sex.

RESULTS

Male adolescents reported higher daily intakes of calcium (male: 1,217+/-663 mg; female: 1,035+/-588 mg; P<0.001), dairy servings (male: 2.9+/-1.9; female: 2.4+/-1.7; P<0.001), and milk servings (male: 2.0+/-1.5; female: 1.5+/-1.4; P<0.001) than female adolescents. Calcium intakes of male adolescents were significantly and positively related to availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, and social support for healthful eating; intakes were significantly and inversely related to consumption of soft drinks and fast food. Among female adolescents, availability of milk at meals, taste preference for milk, eating breakfast, higher socioeconomic status, personal health/nutrition attitudes, and self-efficacy to make healthful food choices were significantly and positively related to intakes; intakes were significantly and inversely related to fast-food consumption. Models of calcium intake explained 71% of the variance in male adolescents and 72% of the variance in female adolescents.

CONCLUSIONS

Multicomponent interventions with a focus on the family environment are likely to be most effective in increasing calcium intakes among adolescents.

Predictors of Nutritional Adequacy in Mother–Toddler Dyads from Rural Families with Limited Incomes

OBJECTIVE

To predict the mean adequacy ratio (MAR) scores of mothers and toddlers from intakes of fruits, vegetables, and dairy group foods and being seated during mealtimes.

DESIGN/SUBJECTS

This was a regression analysis of cross-sectional data of the diet quality and being seated during mealtimes of 100 rural mother-toddler dyads from limited-income families using two 24-hour dietary recalls. Children were 11 to 25 months of age and at or below 100% of the poverty index.

MEASURES OF OUTCOME

Dietary quality for mothers and toddlers was assessed using a MAR score for eight different nutrients (vitamin A, vitamin C, vitamin D, folate, calcium, zinc, iron, and magnesium), and a score of 85 or above was considered nutritionally adequate. The main food groups of interest were servings from the fruits, vegetables, and dairy group foods. Mealtime sitting behavior was the percentage of times the toddler remained seated while eating.

RESULTS

Servings of fruits, vegetables, and dairy foods predicted 0.62 of the variance in the mother's MAR score, whereas vegetable and dairy intakes along with being seated while eating indicated nutritional adequacy for toddlers. Mothers with low MAR scores were most likely to have toddlers with poor diets, although few toddlers had poor diet quality.

CONCLUSIONS

Adequate intakes of dairy, vegetables, and whole fruits along with being seated while eating could be quick assessment tools to screen toddlers for nutritional risk. Mothers with poor diet quality were likely to have toddlers with poor diets; low intakes of fruits, vegetables, and dairy foods were markers for poor diet quality in mothers.

Family and home correlates of television viewing in 12-13 year old adolescents: the Nepean Study

BACKGROUND

Few young people meet television viewing guidelines.

PURPOSE

To determine the association between factors in the family and home environment and watching television, including videos and DVDs, in early adolescence.

METHODS

Cross-sectional, self-report survey of 343 adolescents aged 12-13 years (173 girls), and their parents (338 mothers, 293 fathers). Main measures were factors in the family and home environment potentially associated with adolescents spending >or= 2 hours per day in front of the television. Factors examined included family structure, opportunities to watch television/video/DVDs, perceptions of rules and regulations on television viewing, and television viewing practices.

RESULTS

Two-thirds of adolescents watched >or= 2 hours television per day. Factors in the family and home environment associated with adolescents watching television >or= 2 hours per day include adolescents who have siblings (Adjusted Odds Ratio [95%CI] AOR = 3.0 [1.2, 7.8]); access to pay television (AOR = 2.0 [1.1, 3.7]); ate snacks while watching television (AOR = 3.1 [1.8, 5.4]); co-viewed television with parents (AOR = 2.3 [1.3, 4.2]); and had mothers who watched >or= 2 hours television per day (AOR = 2.4 [1.3, 4.6]).

CONCLUSION

There are factors in the family and home environment that influence the volume of television viewed by 12-13 year olds. Television plays a central role in the family environment, potentially providing a means of recreation among families of young adolescents for little cost. Interventions which target family television viewing practices and those of parents, in particular, are more likely to be effective than interventions which directly target adolescent viewing times.

Reconceptualizing feeding and feeding disorders in interpersonal context: the case for a relational disorder

The feeding of young children is fundamentally a relational and multisystemic process. Successful treatment of clinically significant feeding problems involves careful assessment of the full range of influences on the feeding relationship and integrated treatment approaches. However, current diagnostic approaches to feeding disorders tend to be reductionistic, exclusively focused on the child as an individual, and overly concerned with exclusionary criteria. Criteria are proposed for "Feeding Disorder Between Parent and Child" that address these limitations and embrace the complexity of feeding problems. A multiaxial diagnosis that describes the child (including medical, developmental, and behavioral characteristics); the parent; the parent-child relationship; and the social and nutritional context of feeding will more accurately speak to treatment planning in this population. The proposed diagnostic criteria were developed and refined on the basis of the available literature and many years of treatment experience across the authors of this article. The proposed diagnosis will support the development and evaluation of treatment packages with components specifically targeted to issues of the child, parent, parent-child interaction, and the broader environment.

Family dinner meal frequency and adolescent development: relationships with developmental assets and high-risk behaviors

PURPOSE

To examine associations between family meal frequency and developmental assets and high-risk behaviors among a national sample of adolescents.

METHODS

Anonymous surveys were distributed to 99,462 sixth to 12th grade students from public and alternative schools in 213 cities and 25 states across the United States. Logistic regression analyses tested differences in assets and high-risk behaviors by family dinner frequency.

RESULTS

Consistent positive associations were found between the frequency of family dinners and all developmental assets, including both external (e.g., support, boundaries and expectations; odds ratio [OR] 2.1-3.7) and internal assets (e.g., commitment to learning, positive values, social competencies, and positive identity; OR 1.8-2.6); relationships were attenuated, but remained significant after adjusting for demographics and general family communication and support. Consistent inverse relationships were found between the frequency of family dinners and all high-risk behaviors measured (i.e., substance use, sexual activity, depression/suicide, antisocial behaviors, violence, school problems, binge eating/purging, and excessive weight loss; OR .36-.58), relationships were attenuated, but remained significant after adjusting for demographics and family factors.

CONCLUSIONS

The findings of the present study suggest that the frequency of family dinner is an external developmental asset or protective factor that may curtail high-risk behaviors among youth. Creative and realistic strategies for enhancing and supporting family meals, given the context within which different families live, should be explored to promote healthy adolescent development. Family rituals such as regular mealtimes may ease the stress of daily living in the fast-paced families of today's society.

Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: Quantitative studies

BACKGROUND

In order to more effectively promote fruit and vegetable intake among children and adolescents, insight into determinants of intake is necessary. We conducted a review of the literature for potential determinants of fruit and vegetable intake in children and adolescents.

METHODS

Papers were identified from Medline and PsycINFO by using all combinations of the search terms: "fruit(s) or vegetable(s)" and "children or adolescents". Quantitative research examining determinants of fruit and/or vegetable intake among children and adolescents aged 6-18 years were included. The selection and review process was conducted according to a four-step protocol resulting in information on country, population, design, methodology, theoretical basis, instrument used for measuring intake, statistical analysis, included independent variables, and effect sizes.

RESULTS

Ninety-eight papers were included. A large number of potential determinants have been studied among children and adolescents. However, for many presumed determinants convincing evidence is lacking, mostly because of paucity of studies. The determinants best supported by evidence are: age, gender, socio-economic position, preferences, parental intake, and home availability/accessibility. Girls and younger children tend to have a higher or more frequent intake than boys and older children. Socio-economic position, preferences, parental intake, and home availability/accessibility are all consistently positively associated with intake.

CONCLUSION

The determinants most consistently supported by evidence are gender, age, socio-economic position, preferences, parental intake and home availability/accessibility. There is a need for internationally comparative, longitudinal, theory-based and multi-level studies taking both personal and environmental factors into account. This paper is published as part of the special Pro Children series in the International Journal of Behavioral Nutrition and Physical Activity. Please see [http://www.ijbnpa.org/content/3/1/26] for the relevant editorial.

"A lot of sacrifices:" work-family spillover and the food choice coping strategies of low-wage employed parents

Integrating their work and family lives is an everyday challenge for employed parents. Competing demands for parents' time and energy may contribute to fewer meals prepared or eaten at home and poorer nutritional quality of meals. Thus, work-family spillover (feelings, attitudes, and behaviors carried over from one role to another) is a phenomenon with implications for nutrition and health. The aim of this theory-guided constructivist research was to understand how low-wage employed parents' experiences of work-family spillover affected their food choice coping strategies. Participants were 69 black, white and Latino mothers and fathers in a Northeastern US city. We explored participants' understandings of family and work roles, spillover, and food choice strategies using open-ended qualitative interviews. Data analysis was based on the constant comparative method. These parents described affective, evaluative, and behavioral instances of work-family spillover and role overload as normative parts of everyday life and dominant influences on their food choices. They used food choice coping strategies to: (1) manage feelings of stress and fatigue, (2) reduce the time and effort for meals, (3) redefine meanings and reduce expectations for food and eating, and (4) set priorities and trade off food and eating against other family needs. Only a few parents used adaptive strategies that changed work or family conditions to reduce the experience of conflict. Most coping strategies were aimed at managing feelings and redefining meanings, and were inadequate for reducing the everyday hardships from spillover and role overload. Some coping strategies exacerbated feelings of stress. These findings have implications for family nutrition, food expenditures, nutritional self-efficacy, social connections, food assistance policy, and work place strategies.

Making sense of eating, weight and risk in the early teenage years: Views and concerns of parents in poorer socio-economic circumstances

This paper reports findings from a qualitative study which examined the perceptions and understandings underpinning the dietary practices in families with 'normal' weight and 'overweight' young teenagers living in poorer socio-economic circumstances. Thirty four parents/main food providers of boys and girls aged 13-14 years from socio-economically disadvantaged areas in Eastern Scotland were interviewed. Within the home there was a strong acknowledgement of these early teenagers' own food preferences; parents also saw them as having increasing responsibility for their own food choices outwith the home but these were often described as 'not healthy' choices. However, parents saw dietary issues as of fairly low priority in the hierarchy of health-relevant and other risks facing their teenagers. Equally, these interviewees felt that issues around body shape and size at this age were less potentially problematic than the risks to teenagers' mental or physical health of their becoming obsessed with weight loss. Parents often made sense of their teenager's body size and shape in terms of the variety of body types in families and inherited traits. Interviewees seemed to lack a discourse to understand weight and overweight in this age group, falling back on understandings derived from the adult lifestage.

Time scarcity and food choices: an overview

Time scarcity, the feeling of not having enough time, has been implicated in changes in food consumption patterns such as a decrease in food preparation at home, an increase in the consumption of fast foods, a decrease in family meals, and an increase in the consumption of convenience or ready-prepared foods. These food choices are associated with less healthful diets and may contribute to obesity and chronic health problems such as cardiovascular disease, diabetes, and cancer. In spite of the potential importance for health, there has been little study of how time scarcity influences people's food choices. This paper presents an overview of time issues related to food choices and discuss applications of time research for nutrition and health researchers, policy makers, and practitioners interested in food choice.

Adolescent and parent views of family meals

OBJECTIVE

To examine and compare the family mealtime environment from the perspectives of both adolescents and parents.

DESIGN

Adolescents completed a school-based survey and parents participated in a telephone interview as part of Project EAT (Eating Among Teens).

SUBJECTS/SETTING

Participants were 902 adolescent females (n=424) and males (n=478) and one of their guardians/parents.

STATISTICAL ANALYSES PERFORMED

Frequencies, chi(2) analyses, and Spearman correlations were used to assess relationships.

RESULTS

Parents were more likely than adolescents to report eating five or more family meals per week, the importance of eating together, and scheduling difficulties (P<0.001). Younger adolescents were more likely than older adolescents to report eating five or more family meals per week, higher importance of eating together, and more rule expectations at mealtime (P<0.001), whereas older adolescents were more likely to report scheduling difficulties (P<0.001). Girls reported more family meals per week and more scheduling conflicts than boys did; boys reported more rules at mealtime than girls did (P<0.001).

CONCLUSIONS

Family meals are perceived positively by both adolescents and parents. Family meals may be a useful mechanism for enhancing family togetherness, and for role modeling behaviors that parents would like their children to emulate. Dietetics professionals can capitalize on positive attitudes toward family meals to help promote their frequency. Helping families learn to cook healthful, quick meals may reduce dependency on less healthful meal options, reduce the frequency of eating outside of the home, and promote greater nutritional intake.

Promoting family meals in WIC: lessons learned from a statewide initiative

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in Washington State developed a module to be used at local WIC agencies to promote family meals. Needs assessment and formative evaluation ensured that the module met the needs of WIC staff and clients. The Promoting Family Meals module includes background information on family meals, tools for training WIC staff, outlines for group sessions, handouts tailored to each client's stage of change, children's coloring sheets, bookmarks, banners, and posters. After the first 6 months of use, there was a statistically significant (F = 26.17, df = 3, P < .001) increase in family meal participation in intervention agencies as compared to controls.

Is dietary intake able to explain differences in body fatness in children and adolescents?

Obesity is the result of an imbalance between energy intake and energy expenditure. Controversial information exists about what are the strongest energy balance aspects influencing body fatness. This article is focused on food consumption facts that could be related to the risk of being obese in children and adolescents. It reviews whether energy intake, macronutrient composition of diet, eating patterns or other dietary intake factors are able to explain differences in body composition when obesity has been already developed or even in subjects at risk to become obese. There is not enough evidence to clarify the importance of diet on overweight children and adolescents, and conclusions derived are somewhat controversial. Cross-sectional and longitudinal studies do not show clear relationships between energy intake or food composition and body fatness. To find relations between dietary factors and childhood obesity perhaps eating patterns or different types of foods must be considered: meal patterns and meal frequency, snacking and beverage consumption, fast food intake, portion sizes, etc. There is no clear association between different aspects of dietary intake and the development of obesity in children and adolescents. Longitudinal and experimental studies are needed in the future.

Understanding the food choice process of adolescents in the context of family and friends

PURPOSE

To understand from the adolescents' own perspective the decision-making processes they use to make food choices on an everyday basis and how they resolve their need for personal control over food choices with the values of family and peers.

METHODS

A sample of 108 adolescents, aged 11-18 years, were individually interviewed. They were asked in a simulated task to choose a lunch from a menu of offerings and give reasons for their choices. In addition, open-ended questions probed for meal structures, dinners, perceptions of degree of choice, role of family and peers. Interviews were audio-taped, transcribed, coded, and analyzed for emerging themes.

RESULTS

Primary food choice criteria were taste, familiarity/habit, health, dieting, and fillingness. Lunches had a definite structure, and lunches differed from dinners. The food choice process involved personal food decision-making rules such as trade-offs among choice criteria within a meal (e.g., taste for core items and health for secondary items), and between lunches with peers (taste) and family dinners (health); negotiation patterns with the family (autonomy versus family needs); and interactions with peers.

CONCLUSIONS

The food choice process for most adolescents seemed to involve cognitive self-regulation where conflicting values for food choices were integrated and brought into alignment with desired consequences. Educators and practitioners should recognize the dilemmas adolescents face in making food choices and help them develop strategies for balancing less healthful with more healthful food items, through: (a) personal food decision-making rules, (b) effective negotiations with family members; and (c) appropriate interaction patterns with peers.

Clustering of Health-Related Behaviors and Their Determinants: Possible Consequences for School Health Interventions

Characterizing school health promotion is its category-by-category approach, in which each separate health-related behavior is addressed independently. Such an approach creates a risk that extra-curricular activities become overloaded, and that teaching staff are distracted by continuous innovations. Within the health promotion sector there are thus increasing calls for an integrative approach to health-related behaviors. However, a meaningful integrative approach to different lifestyles will be possible only if there is some clustering of individual health-related behaviors and if health-related behaviors have a minimum number of determinants in common. This systematic review aims to identify to what extent the four health-related behaviors smoking, alcohol abuse, safe sex and healthy nutrition cluster; and how their determinants are associated. Potentially modifiable determinants that offer clues for an integrative approach of school health-promotion programs are identified. Besides, the direction in which health educators should look for a more efficient instructional design is indicated.

Feeding Infants and Toddlers Study: meal and snack intakes of Hispanic and non-Hispanic infants and toddlers

OBJECTIVE

To describe meal and snack patterns of Hispanic and non-Hispanic infants and toddlers.

DESIGN

A cross-sectional telephone survey in which mothers or other primary caregivers reported their infants' and toddlers' food and beverage intake for a 24-hour period.

SUBJECTS/SETTING

Subjects were a subset of the national random sample of children aged 4-24 months who participated in the 2002 Feeding Infants and Toddlers Study. The Feeding Infants and Toddlers Study includes a stratified random sample of 3,022 infants and toddlers aged 4-24 months. Three hundred seventy-one Hispanic and 2,637 non-Hispanic children who had 24-hour dietary recalls are included in the subset.

ANALYSES

Means+/-standard errors of daily intakes of energy, nutrients, and nutrient densities were calculated, as were percentages of children consuming foods at each eating occasion.

RESULTS

Hispanic and non-Hispanic infants and toddlers, on average, were fed seven times per day. Overall, the percentages of children who ate snacks increased with age, and more than 80% of toddlers aged 12-24 months consumed afternoon snacks, with more than 90% of Hispanic children consuming an afternoon snack. In each age group, there were significant differences between ethnic groups in nutrient intakes by eating occasion. No significant difference was seen for energy across all meal occasions. At age 6-11 months, Hispanic children had a significantly lower intake of carbohydrate at dinner and lower intake of saturated fat at afternoon snacks compared with non-Hispanic children (P<.05). The main difference between Hispanic children's and non-Hispanic children's intakes by eating occasion is at age 12-24 months. Hispanics aged 12-24 months had significantly (P<.05) lower percentages of energy from fat and saturated fat and a significantly (P<.05) higher percentage of carbohydrate at lunch compared with non-Hispanic children. For dinner, Hispanic toddlers had significantly (P<.05) lower intakes of total fat and saturated fat compared with non-Hispanic toddlers at age 12-24 months. Overall fiber intake contributed 2 g/meal for both ethnic groups. Snacks contributed, on average, less than 1 g fiber, except Hispanic toddlers had significantly higher fiber intake at afternoon snacks (1.5 g) than non-Hispanic toddlers. Foods frequently consumed at meals and snacks were lacking in whole grains, vegetables, and fruits. Most nutrients were not significantly different between Hispanics and non-Hispanics for meals and snacks.

CONCLUSIONS

Considering the sizeable contribution that snacks make toward overall energy, parents and caregivers should plan toddlers' snacks to complement meals by including additional fruits, vegetables, and whole grains that are culturally appropriate rather than fruit drinks, cookies, and crackers. This will increase fiber intake and limit fat and sugar intakes. To develop healthful eating patterns, introduce toddlers to foods eight to 10 times to increase food acceptance and the likelihood of establishing healthful eating patterns. Dietetics professionals need to consider cultural differences when developing meal and snack patterns for Hispanic and non-Hispanic infants and toddlers.

Childhood obesity: a growing public health concern

Childhood obesity has been deemed epidemic, a term usually reserved for infectious diseases that sweep populations. This review begins with guidance regarding obesity definitions and a review of the data on global prevalence. The next section details the myriad health consequences for immediate and long-term physical and psychosocial health outcomes. The authors then discuss what is known regarding distal and proximal causes and correlates at the individual and contextual levels of family, health care, schools and community. The final sections provide a summary of interventions in diverse settings and some current thinking on how the field is likely to evolve over the next several years.

Fruit, Vegetable, and Fat Intake among Non-Hispanic Black and Non-Hispanic White Adolescents: Associations with Home Availability and Food Consumption Settings

OBJECTIVE

This study sought to explore home food availability and common settings of food consumption as correlates of fruit, vegetable, and fat intake among a sample of non-Hispanic black and non-Hispanic white adolescents.

PARTICIPANTS AND DESIGN

Adolescents (n=144 black, 84 white) and their parents completed a cross-sectional survey in an urban adolescent health clinic. The adolescent survey included screening measures for fruit, vegetable, and fat intake and items on frequency of eating meals with family, while watching television, and at three types of restaurants. Parents provided information on home availability of foods.

MAIN OUTCOMES

Correlates of fruit, vegetable, and fat consumption.

STATISTICAL ANALYSIS

Spearman correlations for associations among variables, t tests for mean comparisons, and multiple stepwise regression conducted separately for black and white adolescents.

RESULTS

In multiple regression, home availability was not significantly associated with fruit, vegetable, or fat intake except for fruit intake among white adolescents only. Use of non-fast-food restaurants was the strongest positive predictor of vegetable intake. For both black and white adolescents, fast-food and buffet restaurant use and eating while watching television were the strongest predictors of fat intake.

CONCLUSIONS

Compared with restaurant use and eating while watching television, home availability had a relatively small impact on fruit, vegetable, and fat consumption for both black and white adolescents. Intervention programs on adolescent nutrition should target not just availability of healthful foods, but also ease of access, such as the preparation of fruits and vegetables so that they are flavorful and ready to eat.