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Ali S, Gibbs SE, Wiseman K, Zoellner J, Montez K, Taxter A, Suarez M, Hindel L, Lewis KH. A Qualitative Study To Understand Parental, Health Care Provider and WIC Nutritionist Perspectives on Early Childhood Beverage Choices for WIC-enrolled Families in a Southeastern US Health System. Matern Child Health J 2025; 29:628-638. [PMID: 40167858 PMCID: PMC12098453 DOI: 10.1007/s10995-025-04075-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2025] [Indexed: 04/02/2025]
Abstract
OBJECTIVES Nutritionists for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), along with healthcare providers, can influence beverage choices for young children in WIC-enrolled families. Coordination of messaging about beverages and between-provider communication may be important for facilitating behavior change. METHODS In preparation for a planned intervention, during Spring through Fall of 2021, we conducted a qualitative study to understand perceptions around family beverage choice discussions across three groups: parents of WIC-enrolled children, WIC nutritionists and practicing clinicians. Semi-structured interviews were conducted with 25 individuals, with sample size determined a priori. Thematic content analysis was used to summarize transcribed data. RESULTS There was broad agreement that children should not consume sugar-sweetened beverages (SSB), but disagreement on tap water safety. Both clinicians and WIC nutritionists reported educating families about healthy drink choices, and parents recalled similar messages during these conversations. Parents were very supportive of fruit juice as part of the WIC package, with near universal opposition among clinicians. Many parents expressed concerns about tap water. Both provider groups perceived difficulty in reaching out to each other, and felt more communication would be helpful. CONCLUSIONS FOR PRACTICE Our findings highlight a need for more regular communication between WIC nutritionists and children's healthcare providers within our system, and more consistent parental education on juice and tap water safety. Future studies could evaluate whether these types of communication gaps and perceptions are regional or more widespread across the US.
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Affiliation(s)
- Sophia Ali
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston Salem, NC, USA
| | - Sydney-Evelyn Gibbs
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston Salem, NC, USA
| | - Kimberly Wiseman
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston Salem, NC, USA
| | - Jamie Zoellner
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Kimberly Montez
- Department of Pediatrics, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Alysha Taxter
- Department of Rheumatology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Mallory Suarez
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston Salem, NC, USA
| | - Leah Hindel
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston Salem, NC, USA
| | - Kristina H Lewis
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston Salem, NC, USA.
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Cuy Castellanos D, Miller B, Zoellner J. Contributing Factors of Sugar-Sweetened Beverage Intake in the Latinx Population: A Narrative Review Using the Social-Ecological Model. HEALTH EDUCATION & BEHAVIOR 2022; 49:10901981221097053. [PMID: 35677964 DOI: 10.1177/10901981221097053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sugar-sweetened beverage (SSB) consumption in the Latinx population has been a topic of increasing interest due to higher rates of consumption in this population, as well as higher prevalence of chronic health conditions, such as diabetes and obesity. SSB behaviors are influenced by multiple factors across the socio-ecological model. Understanding these factors can inform future intervention development and improve SSB consumption and overall health. Therefore, this narrative review identifies factors contributing to SSB consumption, as well as interventions conducted to address SSB consumption in the Latinx population residing in the United States. Contributing factors that are not currently addressed in published interventions are highlighted with the intent to inform the development of future comprehensive interventions.
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Affiliation(s)
| | | | - Jamie Zoellner
- University of Virginia, Charlottesville, VA, USA
- UVA Cancer Center, Charlottesville, VA, USA
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Dietary Intake and Sources of Added Sugars in Various Food Environments in Costa Rican Adolescents. Nutrients 2022; 14:nu14050959. [PMID: 35267934 PMCID: PMC8912352 DOI: 10.3390/nu14050959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
Consumption of added sugars, especially from sugar-sweetened beverages (SSBs), has been associated with several negative health outcomes during adolescence. This study aimed to identify dietary intake and food sources of added sugars in the home, school, and neighborhood environments of Costa Rican adolescents. Dietary intake of added sugars was determined using 3-day food records in a cross-sectional study of 818 adolescents aged 12 to 19 and enrolled in rural and urban schools in the province of San José. On average, 90% of adolescents consumed more than 10% of their total energy intake from added sugars. Furthermore, 74.0% of added sugars were provided at home, 17.4% at school, and 8.6% in the neighborhood. Added sugars were primarily provided by frescos (29.4%), fruit-flavored still drinks (22.9%), and sugar-sweetened carbonated beverages (12.3%), for a total contribution of 64.6%. Our findings suggest that Costa Rican adolescents have a plethora of added sugar sources in all food environments where they socialize. However, it is relevant for public health to consider the home and school environments as fundamental units of interventions aimed at reducing added sugars in the adolescent diet. Frescos prepared at home and school and fruit-flavored still drinks must be the focus of these interventions.
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Jensen ML, Choi YY, Fleming-Milici F, Harris JL. Caregivers' Understanding of Ingredients in Drinks Served to Young Children: Opportunities for Nutrition Education and Improved Labeling. Curr Dev Nutr 2022; 6:nzab151. [PMID: 35047722 PMCID: PMC8760421 DOI: 10.1093/cdn/nzab151] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Against expert recommendations, sugar-sweetened beverages, especially fruit drinks, are consumed by young children. Misperceptions about drink ingredients and healthfulness can contribute to caregivers' provision. OBJECTIVES To assess caregivers' reasons for serving sweetened fruit-flavored drinks and unsweetened juices to their young children (1-5 y) and perceptions of product healthfulness and drink ingredients. METHODS A cross-sectional online survey assessed participants' (n = 1614) perceptions of sweetened fruit-flavored drinks (fruit drinks and flavored water) and unsweetened juices (100% juice and water/juice blends) provided to their child in the past month, including product healthfulness, reasons for providing, and knowledge of product ingredients [added sugar, nonnutritive sweeteners (NNSs), percentage juice]. One-factor ANOVA compared perceived healthfulness of drink categories and types of sugar and NNSs, and differences between participants who could compared with those who could not accurately identify drink ingredients. RESULTS Participants' top reasons for providing sweetened drinks included child liking it, being inexpensive, child asking for it, and being a special treat. Participants perceived 100% juice as healthiest, followed by juice/water blends, flavored waters, and, lastly, fruit drinks (P < 0.05). Many participants inaccurately believed the fruit drink or flavored water they served their child most often did not contain NNSs (59.0% and 64.9%) and/or added sugars (20.1% and 42.2%), when in fact they did, and 81.3-91.1% overestimated the percentage juice in the drink. Perceived healthfulness of fruit drinks was associated with caregivers' belief that the drink contained added sugar (P < 0.05), but not with their belief that it contained NNS; increased accuracy was associated with decreased perceived healthfulness (P < 0.05). CONCLUSIONS Inaccurate understanding of added sugar, NNSs, and percentage juice in drinks served to young children was common and could contribute to sugary drink provision. Public health efforts should seek to improve labeling practices and revise nutrition education messages.
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Affiliation(s)
- Melissa L Jensen
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
- School of Nutrition, University of Costa Rica, San José, Costa Rica
| | - Yoon Y Choi
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Frances Fleming-Milici
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Jennifer L Harris
- UConn Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
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Interventions Targeting Bottle and Formula Feeding in the Prevention and Treatment of Early Childhood Caries, Overweight and Obesity: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312304. [PMID: 34886023 PMCID: PMC8656950 DOI: 10.3390/ijerph182312304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/21/2022]
Abstract
Overweight, obesity and early childhood caries (ECC) are preventable conditions affecting infants and young children, with increased prevalence in those formula-fed. Previous research has focused on distinct outcomes for oral health and healthy weight gain. However, the aetiology may be linked through overlapping obesogenic and cariogenic feeding behaviours, such as increased sugar exposure through bottle propping and overfeeding. Best-practice bottle feeding and transition to cup use may concurrently reduce overweight, obesity and ECC. This integrative review aimed to identify interventions supporting best-practice formula feeding or bottle cessation and examine the intervention effects on feeding, oral health and weight outcomes. The reviewers searched nine databases and found 27 studies that met the predetermined inclusion criteria. Eighteen studies focused on populations vulnerable to ECC or unhealthy weight gain. All studies focused on carer education; however, only 10 studies utilised behaviour change techniques or theories addressing antecedents to obesogenic or cariogenic behaviours. The outcomes varied: 16 studies reported mixed outcomes, and eight reported worsened post-intervention outcomes. While some studies reported improvements, these were not maintained long-term. Many study designs were at risk of bias. Effective intervention strategies for preventing ECC and child obesity require the holistic use of interdisciplinary approaches, consumer co-design and the use of behavioural change theory.
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Social Representations of Drinking Water in Schoolchildren and Parents from Two Schools in Zapopan, Mexico. Nutrients 2021; 13:nu13061871. [PMID: 34070874 PMCID: PMC8229986 DOI: 10.3390/nu13061871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 12/12/2022] Open
Abstract
Childhood obesity and children being overweight has increased recently; although they are multi-causal problems, an unhealthy diet is a critical component. In Mexico, drinking water consumption in children from 9 to 18 years only reaches 30% of total fluid consumption. The aim of our study was to describe the social representations (SR) of drinking water in school-children and parents of two schools in Zapopan, Mexico. Associative free listing was used as an information gathering technique. Schoolchildren aged 8 to 12 years (n = 50) and parents (n = 23) from two elementary schools were selected by a convenience sampling from April to June 2015. A similarity analysis was performed using the co-occurrence index; with this, a similarity graph was obtained. Prototypical analysis was performed to explore the structure of the SR. Three dimensions were described in the children’s SR: a functional dimension related to health and nutrition, a practical dimension that describes the instruments used for its consumption, and a theoretical dimension that specifies the characteristics of water and its relationship with nature. In the parents’ SR, a functional dimension was also found; another dimension was described regarding the integral well-being that drinking water provides. A practical dimension describes the features related to its consumption. The investigation describes the structure of the water SR, which help to contextualize and explain the actions of schoolchildren and their parents regarding drinking water consumption.
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Delaney CL, Spaccarotella K, Quick V, Byrd-Bredbenner C. A Comparison of Weight-Related Behaviors of Hispanic Mothers and Children by Acculturation Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E503. [PMID: 33435478 PMCID: PMC7827543 DOI: 10.3390/ijerph18020503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 12/13/2022]
Abstract
Hispanic mothers and children in the United States experience a high prevalence of obesity, which may be affected by maternal acculturation level. Little is known about the association of acculturation on weight-related behaviors. This study describes differences in weight-related behaviors by acculturation level of Hispanic mothers residing in the U.S. and compares them to behaviors of White mothers. Acculturation level was determined using personal acculturation and acculturation environment variables. Cluster analysis of acculturation variables identified three groups of Hispanic mothers: low personal and environmental acculturation (n = 46), high personal and low environmental acculturation (n = 65), and high personal and environmental acculturation (n = 38). Results indicate that, compared to White mothers (n = 340), the least acculturated cluster of Hispanic mothers tended to model physical activity less often and the most acculturated exerted more pressure on children to eat. Mothers in the least acculturated cluster tended to rate children's health status lower, indicate that children had greater fruit juice and less milk intakes, have more meals in locations associated with less healthy meals, and have the least space and supports for physical activity. Findings highlight relationships between maternal acculturation level and weight-related behaviors and suggest strategies for helping acculturating Hispanic mothers create healthier lifestyles and home environments.
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Affiliation(s)
- Colleen L. Delaney
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08901-8554, USA; (V.Q.); (C.B.-B.)
| | - Kim Spaccarotella
- Department of Biological Sciences, Kean University, Union, NJ 07083-7131, USA;
| | - Virginia Quick
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08901-8554, USA; (V.Q.); (C.B.-B.)
| | - Carol Byrd-Bredbenner
- Department of Nutritional Science, Rutgers University, New Brunswick, NJ 08901-8554, USA; (V.Q.); (C.B.-B.)
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Abstract
OBJECTIVE To assess trends in consumption of soda, sweetened fruit drinks/sports drinks and any sugar-sweetened beverage (SSB) from 2013 to 2016 among all children in California aged 2-5 and 6-11 years and by racial-ethnic group. DESIGN Serial cross-sectional study using the California Health Interview Survey (CHIS). SETTING CHIS is a telephone survey of households in California designed to assess population-level estimates of key health behaviours. Previous research using CHIS documented a decrease in SSB consumption among children in California from 2003 to 2009 coinciding with state-level policy efforts targeting child SSB consumption. PARTICIPANTS Parents of children in California aged 2-11 years (n 4901 in 2013-2014; n 3606 in 2015-2016) were surveyed about the child's consumption of soda and sweetened fruit drinks/sports drinks on the day prior. RESULTS Among 2-5-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB remained stable. Sweetened fruit drink/sports drink consumption was higher than soda consumption in this age group. Latino 2-5- year-olds were more likely to consume any SSB in both 2013-2014 and 2015-2016 compared with Whites. Among 6-11-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB also remained stable over time. Latino and African-American 6-11-year-olds were more likely to consume an SSB in 2013-2014 compared with White children. CONCLUSIONS SSB consumption among children in California was unchanged from 2013 to 2016 and racial-ethnic disparities were evident. Increased policy efforts are needed to further reduce SSB consumption, particularly among children of Latino and African-American backgrounds.
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Beck AL, Iturralde E, Haya-Fisher J, Kim S, Keeton V, Fernandez A. Barriers and facilitators to healthy eating among low-income Latino adolescents. Appetite 2019; 138:215-222. [PMID: 30954634 PMCID: PMC6628719 DOI: 10.1016/j.appet.2019.04.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 04/02/2019] [Accepted: 04/02/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The objective of this study was to explore barriers and facilitators to healthy eating among low-income Latino adolescents using an intervention development framework. METHODS Semi-structured interviews (n = 30) were conducted with Latino youth ages 13-17 who had overweight or obesity at a safety-net clinic in San Francisco, CA. Adolescent beliefs and attitudes regarding healthy eating and individual, family, and community level barriers and facilitators were elicited. Interviews were analyzed using an inductive approach and the Capability-Opportunity-Motivation (COM-B) model. RESULTS Participants had capability gaps; while they demonstrated basic nutrition knowledge, they also held significant misconceptions about healthy eating, equating "organic" with healthy and failing to recognize sugar in a number of beverages and foods. Families were a source of support through role modeling and purchasing fresh produce, yet in many cases also undermined adolescents' healthy eating goals through purchases of high calorie low nutrient food, an opportunity facilitator and challenge. By contrast, peers were mostly a negative influence due to frequent consumption of high calorie low nutrient food. The school environment posed opportunity challenges as participants found school lunch unpalatable and had ready access to unhealthy options nearby. Participants were motivated to improve their eating habits but often not resilient in the face of obstacles. CONCLUSIONS Interventions to promote healthy eating among low-income Latino adolescents should address common nutritional misconceptions, target families as well as teens, consider peer influences, and advocate for policy approaches that improve the school food environment.
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Affiliation(s)
- Amy L Beck
- Department of Pediatrics, School of Medicine, University of California San Francisco, USA.
| | - Esti Iturralde
- Division of Research, Kaiser Permanente Northern California, USA.
| | - Julissa Haya-Fisher
- Department of Pediatrics, School of Medicine, University of California San Francisco, USA.
| | - Sarah Kim
- Department of Medicine, School of Medicine, University of California, San Francisco, USA.
| | - Victoria Keeton
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, USA.
| | - Alicia Fernandez
- Department of Medicine, School of Medicine, University of California, San Francisco, USA.
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Choy C, Isong IA. Assessing Preschoolers' Beverage Consumption Using the Theory of Planned Behavior. Clin Pediatr (Phila) 2018; 57:711-721. [PMID: 29090596 DOI: 10.1177/0009922817737076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Childhood obesity and caries are linked to sugar-sweetened beverage (SSB) and excessive juice consumption. We assessed psychosocial factors influencing children's beverage consumption and strategies to promote healthier choices. Using a quantitative and qualitative approach guided by the theory of planned behavior, we surveyed and interviewed 37 parents of preschool-aged children on barriers and facilitators of children's beverage consumption. Most children (83.8%) consumed SSBs, 67.6% drank >4 to 6 oz of juice per day. Parent's self-efficacy was the strongest correlate of parent's behavioral intention to limit SSB (0.72, standard error 0.08, P = .03). Parents' motivations to limit their child's SSB intake extended beyond simply preventing caries and obesity; they also considered the implications of these conditions on children's self-image, future health, and quality of life. Yet, the influence of multidimensional barriers made it difficult to reduce children's SSB consumption. Interventions that address parental attitudes, values, and self-efficacy to address external factors could help reduce children's SSB consumption.
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Affiliation(s)
- Cherry Choy
- 1 Harvard School of Dental Medicine, Boston, MA, USA
| | - Inyang A Isong
- 2 Boston Children's Hospital, Boston, MA, USA.,3 Harvard Medical School, Boston, MA, USA
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Rigo M, Willcox J, Spence A, Worsley A. Mothers' Perceptions of Toddler Beverages. Nutrients 2018; 10:nu10030374. [PMID: 29562679 PMCID: PMC5872792 DOI: 10.3390/nu10030374] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 11/25/2022] Open
Abstract
Background: The prevalence of obesity among Australian pre-school children is a major concern with links to poor health outcomes. One contributing factor is excess energy intake. Sugar-sweetened beverages are energy-dense, nutrient-poor, readily available and have been implicated in the increasing prevalence of obesity. Furthermore, preschooler beverage consumption may develop into dietary habits that track into adulthood. There is little research on factors influencing parents’ decision-making when serving beverages to their preschoolers, or on mothers’ perceptions of preschooler’s beverages. The aim of this study was to explore mothers’ perceptions of commonly consumed preschooler beverages. Methods: The Repertory Grid Technique and the Laddering Technique methodologies were utilized in interviews with 28 mothers from Melbourne, Australia, to explore beverage perceptions. Results: A large number of diverse perceptual categories (‘constructs’) (n = 22) about beverages were elicited, demonstrating the complexity of mothers’ perceptions when making beverage choices for their preschoolers. The five most common categories were related to health, sugar, dairy, packaging, and additives. Thematic analysis of responses from the laddering method identified three major themes: concerns about the types of beverages mothers would like to provide their preschoolers, the healthiness of a beverage, and the sugar content. Conclusions: Mothers’ perceptions of beverages are sophisticated and need to be included in the design of health communication strategies by health promoters and government agencies to influence mothers’ beverage selections for their preschoolers.
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Affiliation(s)
- Manuela Rigo
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | - Jane Willcox
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | - Alison Spence
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
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Beck AL, Hoeft KS, Takayama JI, Barker JC. Beliefs and practices regarding solid food introduction among Latino parents in Northern California. Appetite 2017; 120:381-387. [PMID: 28951238 DOI: 10.1016/j.appet.2017.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/06/2017] [Accepted: 09/22/2017] [Indexed: 12/19/2022]
Abstract
Latino children are more likely to be obese than non-Hispanic white children, and feeding patterns that begin in infancy may contribute to this disparity. The objective of this study was to elucidate beliefs and practices related to the introduction of solids and solid food feeding in the first year of life among low-income Latino parents residing in Northern California. We conducted 26 semi-structured interviews that explored the timing of introduction of solids, selection of foods to serve to infants, feeding strategies, sources of information on solid food feeding and concerns about infant weight. We found that most parents relied on traditional practices in selecting first foods for infants and had a strong preference for homemade food, which was often chicken soup with vegetables. Parents generally described responsive feeding practices; however a minority used pressuring practices to encourage infants to eat more. Very few parents practiced repeated gentle introduction of unfamiliar food to increase acceptance. High calorie low nutrient foods were typically introduced at around 12 months of age and parents struggled to limit such foods once children were old enough to ask for them. Parents were concerned about the possibility of infants becoming overweight and considered health care providers to be an important source of information on infant weight status. The results of this study can be used to inform the development of interventions to prevent obesity in Latino children with similar demographics to our study population.
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Affiliation(s)
- Amy L Beck
- Department of Pediatrics, School of Medicine, University of California San Francisco, 550 16th Ave. #5763, San Francisco, CA, 94158, USA.
| | - Kristin S Hoeft
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, Department of Pediatrics, School of Medicine, University of California San Francisco, USA
| | - John I Takayama
- Department of Pediatrics, School of Medicine, University of California San Francisco, USA
| | - Judith C Barker
- Department of Anthropology, History and Social Medicine, School of Medicine, University of California, San Francisco, USA
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Beck AL, Fernandez A, Rojina J, Cabana M. Randomized Controlled Trial of a Clinic-Based Intervention to Promote Healthy Beverage Consumption Among Latino Children. Clin Pediatr (Phila) 2017; 56:838-844. [PMID: 28553726 PMCID: PMC5553320 DOI: 10.1177/0009922817709796] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The objective of this study was to evaluate an educational module for Latino parents about the health effects of sweet beverages. Latino parents were randomized to receive the beverage module or a control module. Child beverage consumption was assessed at baseline, 2 weeks, 2 months, and 3 months via a beverage recall survey. At 2-week follow-up, children of intervention participants had a mean reduction in 7-day total sugar-sweetened beverage and 100% fruit juice consumption of 16 ounces while controls had a mean increase of 4 ounces ( P = .01). At 2-month and 3-month follow-up, there was a reduction in mean total sugar-sweetened beverage and 100% fruit juice consumption among both intervention and control children. An educational module on beverages for Latino parents reduced child consumption of sweet beverages at 2-week follow-up. However, study participation appears to have also reduced controls' beverage consumption suggesting that frequent intensive surveys of beverage intake may be an intervention unto itself.
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Affiliation(s)
- Amy L. Beck
- Department of Pediatrics, University of California San Francisco, 3333 California St. Suite 245, San Francisco, CA 94118
| | | | - Jenssy Rojina
- Department of Pediatrics, University of California San Francisco
| | - Michael Cabana
- Department of Pediatrics, University of California San Francisco
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Luna RE, Polk S, Thompson DA. Understanding the Use of Whole Milk and Flavored Powders in Children of Low-Income, Immigrant Latina Mothers: A Descriptive Study. Clin Pediatr (Phila) 2017; 56:480-484. [PMID: 27507808 PMCID: PMC5299072 DOI: 10.1177/0009922816661505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rubi E. Luna
- University of California at San Francisco School of Medicine
| | - Sarah Polk
- Department of Pediatrics, Johns Hopkins School of Medicine
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Mazarello Paes V, Ong KK, Lakshman R. Factors influencing obesogenic dietary intake in young children (0-6 years): systematic review of qualitative evidence. BMJ Open 2015; 5:e007396. [PMID: 26377503 PMCID: PMC4577937 DOI: 10.1136/bmjopen-2014-007396] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Obesogenic dietary intake is prevalent in young children and is associated with obesity and other adverse health outcomes in childhood and later in life. OBJECTIVE To describe the barriers to and facilitators of obesogenic dietary intake in early childhood, in order to inform interventions and public health policies to prevent obesity. DESIGN Systematic review of qualitative literature on factors influencing obesogenic diets in children aged 0-6 years. DATA SOURCES MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Knowledge, British Nursing Index, ASSIA and Sociological Abstracts. REVIEW METHODS Qualitative studies meeting the inclusion criteria were synthesised. Data were analysed by creating a thematic framework, underpinned by the socioecological model, which included familiarisation of data across the studies, indexing, charting, mapping and interpretation. RESULTS 20 studies from the USA (10), Europe (6) and Australia (4) included the views of 1067 participants (901 parents/caregivers, 37 children, 87 teachers, 15 dieticians and 27 nursery staff). Study designs included focus groups (n=16), individual interviews (n=6) and ethnography (n=1) with some studies using more than one design. Despite wide differences in the study context and focus, several consistent themes emerged. Parental factors increasing young children's obesogenic diets were: negative parent/family/peer modelling, lack of knowledge, time constraints, using food as reward, affordability and concerns about child's health. Child preferences also increased intake. Environmental factors increasing intake include: availability, advertising, societal, cultural and preschool/childcare influences. CONCLUSIONS Future intervention strategies should aim to promote modelling of positive behaviours, create home and preschool environments that promote healthy diets, and simultaneously target factors at the family and preschool/childcare levels. TRIAL REGISTRATION NUMBER This review is one of a series of systematic reviews on the determinants of obesogenic behaviours in young children, registered with the International Prospective Register for Systematic Reviews (PROSPERO), CRD42012002881.
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Affiliation(s)
- Veena Mazarello Paes
- Institute of Public Health, University of Cambridge, Cambridge, UK
- Institute of Child Health, University College London, London, UK
| | - Ken K Ong
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Rajalakshmi Lakshman
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
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