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

Exploring unequal class logics of mealtime food socialisation. An ethnography of family meals in France and Australia

Regular family mealtimes are occasions to model food consumption and have been associated with health and well-being benefits for children. This study aimed to investigate children's mealtime food socialisation in socially diverse households. Nine families from France and five from Australia were recruited, ranging from lower middle-class to upper-class positions, with children mostly between the ages of five to eight. The data is composed of the observations of 47 mealtimes and semi-directive interviews with both parents. The results showed that food socialisation and parents' understanding of children's taste development were linked to the household's social class position as well as to the temporal, cognitive and emotional resources parents possessed at mealtimes, in a similar manner across France and Australia. The more capital and resources the parents had, the more they were able to perform an intensive food socialisation style, which led them to prepare balanced menus and get children to eat the food served. The less capital and resources the parents had, the more they engaged in a hands-off food socialisation style, leading them to serve more child-oriented and less diverse menus. Importantly, all parents strived to serve healthy food, but limited resources prevented some of them from doing so. These food socialisation styles were also connected to the development of different social skills in children: with the intensive model, children were closely managed by their parents at the table but also learnt negotiation skills, whereas with the hands-off style, children learnt to be quite autonomous in their eating. The findings presented here contribute to Hays' intensive mothering concept and to Lareau's class-based parenting models. They also challenge Bourdieu's differentiation between a taste of necessity and a taste of luxury.

Associations Between Household Frequency of Cooking Dinner and Ultraprocessed Food Consumption and Dietary Quality Among US Children and Adolescents

Introduction: Dietary quality is poor and intake of ultraprocessed foods (UPFs) is high among children and adolescents in the United States. Low dietary quality and high UPF intake are associated with obesity and higher risk of diet-related chronic diseases. It is unknown whether household cooking behavior is related to improved dietary quality and lower consumption of UPFs among US children and adolescents. Methods: Nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey (n = 6032 children and adolescents ≤19 years of age) were used to examine the relationships between household cooking frequency of evening meals and children's dietary quality and UPF intake using multivariate linear regression models adjusted for sociodemographics. Two 24-hour diet recalls were used to assess UPF intake and dietary quality [Healthy Eating Index-2015 (HEI-2015)]. Food items were categorized according to Nova classification to obtain the UPF percent of total energy intake. Results: A higher household frequency of cooking dinner was associated with lower UPF intake and higher overall dietary quality. Compared to children in households cooking dinner 0-2 times per week, children in households cooking dinner 7 times/week had lower intake of UPFs [β = -6.30, 95% confidence interval (CI) -8.81 to -3.78, p < 0.001] and marginally higher HEI-2015 scores (β = 1.92, 95% CI -0.04 to 3.87, p = 0.054). The trends toward lower UPF intake (p-trend <0.001) and higher HEI-2015 scores (p-trend = 0.001) with increasing cooking frequency were significant. Conclusions: In this nationally representative sample of children and adolescents, more frequent cooking at home was associated with lower intake of UPFs and higher HEI-2015 scores.

Considering the role of integration experiences in shaping immigrants' post-migration food choices and eating practices

This article draws on data collected from qualitative interviews with 38 recent immigrants in two Ontario cities to provide an overview of recent immigrants' general dietary acculturation experiences. With insights from both Cockerham's health lifestyle theory and Berry's acculturation model, this article explores how structural inequalities related to integration and settlement may shape recent immigrants' post-migration food choices and eating practices. The results of this study revealed that immigrants from non-Western countries experienced greater challenges in healthy eating. Findings are in line with Cockerham's health lifestyle theory: immigrants' post-migration food choices and dietary acculturation strategies were not only bounded by socioeconomic status and cultural differences but were also shaped by various structural inequalities, especially those related to systematic barriers during the integration and settlement process. Overall, this paper provides a more holistic understanding of the multifaceted nature of immigrants' dietary acculturation experiences.

Do 20-minute neighbourhoods moderate associations between work and commute hours with food consumption?

OBJECTIVE

To examine associations between work and commute hours with food consumption and test whether neighbourhood type (20-minute neighbourhood (20MN)/non-20MN) moderate associations.

DESIGN

Cross-sectional analysis of the Places and Locations for Activity and Nutrition study (ProjectPLAN). Exposures were work hours (not working (0 h), working up to full-time (1-38 h/week), working overtime (> 38 h/week)), and among those employed, combined weekly work and commute hours (continuous). Outcomes were usual consumption of fruit, vegetables, takeaway food, snacks and soft drinks, and number of discretionary food types (takeaway, snacks and soft drinks) consumed weekly. Generalised linear models were fitted to examine associations between each exposure and outcome. The moderating role of neighbourhood type was examined through interaction terms between each exposure and neighbourhood type (20MN/non-20MN).

SETTING

Melbourne and Adelaide, Australia, 2018-2019.

PARTICIPANTS

Adults ≥ 18 years old (n 769).

RESULTS

Although all confidence intervals contained the null, overall, patterns suggested non-workers and overtime workers have less healthy food behaviours than up-to-full-time workers. Among those employed, analysis of continuous work and commute hours data suggested longer work and commute hours were positively associated with takeaway consumption (OR = 1·014, 95 % CI 0·999, 1·030, P-value = 0·066). Patterns of better behaviours were observed across most outcomes for those in 20MN than non-20MN. However, differences in associations between work and commute hours with food consumption across neighbourhood type were negligible.

CONCLUSIONS

Longer work and commute hours may induce poorer food behaviours. There was weak evidence to suggest 20MN moderate associations between work and commute hours with food consumption, although behaviours appeared healthier for those in 20MN.

In-Store Marketing and Supermarket Purchases: Associations Overall and by Transaction SNAP Status

INTRODUCTION

In-store placement promotions are used widely in supermarkets, but their effects on customer purchases remain largely unknown. This study examined associations of supermarket placement promotions with customer purchases overall and by Supplemental Nutrition Assistance Program (SNAP) benefit use.

METHODS

Data on in-store promotions (e.g., endcaps, checkout displays) and transactions (n=274,118,338) were obtained from a New England supermarket chain with 179 stores from 2016 to 2017. Product-level analyses examined multivariable-adjusted changes in products' sales when they were promoted (versus not) across all transactions and stratified by whether the transaction was paid for with SNAP benefits. Food group-level analyses examined the extent to which a 20% increase from the mean number of weekly promotions for a food group (e.g., increasing the number of candy promotions from 17.0 to 20.4) was associated with total food group sales. Analyses were conducted in 2022.

RESULTS

Across stores, the mean (SD) number of promotions per week was highest for sweet/salty snacks (126.3 [22.6]), baked goods (67.5 [18.4]), and sugar-sweetened beverages (48.6 [13.8]) and lowest for beans (5.0 [2.6]) and fruits (6.6 [3.3]). Product sales were between 16% (low-calorie drinks) and 136% (candy) higher when promoted versus not promoted. In 14 of 15 food groups, associations were stronger among transactions made with SNAP benefits than among those not made with SNAP benefits. The number of in-store promotions was generally not associated with total food group sales.

CONCLUSIONS

In-store promotions, which were mostly for unhealthy foods, were associated with large product sales increases, particularly among SNAP purchasers. Policies limiting unhealthy in-store promotions and incentivizing healthy promotions should be explored.

Supporting early childhood routines to promote cardiovascular health across the life course

Optimal cardiovascular health is an essential component of human health and well-being across the life course. Heart healthy practices around diet, physical activity, and sleep early in childhood have the potential to greatly improve lifespan and quality (Mehta et al., 2020). Early childhood routines, defined as functional practices that are predictable and repeatable, predict positive growth and development across the lifecourse (Fiese et al., 2002; Ferretti and Bub, 2017; Spagnola and Fiese, 2007). The American Heart Association has identified key heart healthy routines, such as daily regular activities including diet, physical activity, and sleep that promote cardiovascular health (Lloyd-Jones et al., 2022). Integrating the strength-based relational aspects of routines with the acquisition of cardiovascular health development capabilities allows children to establish their own optimal cardiovascular health trajectory early on. A systematic life course approach to supporting heart healthy routines in early childhood would inform clinical, research, and policy strategies to promote long-term cardiovascular health, and contribute to reducing inequalities in cardiovascular outcomes.

Caregiving Strain, family functioning, and effort to change diet for patients with gastrointestinal cancer: A cross-sectional descriptive study

PURPOSE

Among patients with cancer, it has been found that the family system influences health-related behaviors and may promote a healthy diet. This study assessed the associations among cancer patients between family caregiver strain, family functioning, and efforts to change diet.

METHODS

This cross-sectional descriptive study was conducted in gastrointestinal outpatient units at two tertiary university hospitals in South Korea. This study included 401 main family caregivers of patients with gastrointestinal cancer. The caregivers were evaluated using structured, face-to-face questionnaires measuring family strain, family functioning, and effort to change diet.

RESULTS

Greater effort to change diet was associated with higher family functioning, having a spouse, and more caregiving time per week. Less effort to change diet was associated with greater levels of caregiving strain and with a son providing caregiving.

CONCLUSION

The efforts of family caregivers to alter diet are influenced by family strain and family functioning, as well as family caregivers' characteristics, such as marital status, health problems due to caregiving, care time and duration, and relationship with the patient. This study suggested that reducing family strain and improving family functioning in clinical settings facilitate the success to change dietary strategies for cancer families.

Adolescents' dietary behaviour: The interplay between home and school food environments

In the UK, school food standards have looked to improve the nutritional profile of school food provision and the choices made; however, adolescents' choices tend to bias towards micronutrient poor and energy dense options. This study aimed to explore how adolescents make their school food choices, along with how they engage with their environments whilst selecting food. Seven focus group interviews took place with adolescents (n = 28; 13-14 years) in a secondary school in Northern England. Discussions with participants were audio-recorded, transcribed verbatim and then analysed using an inductive thematic approach. Six themes emerged from the data: (1) parents' and adolescents' roles in the home food environment, (2) burgeoning food autonomy, (3) school food choice factors, (4) social aspects of school food, (5) home versus school, (6) food knowledge & beliefs. Adolescents identified two distinct environments during the focus group discussions: the home and school environments. Adolescents juxtaposed the two, in terms of food provision, food choices, rules and customs surrounding food choice. This juxtaposition emerged as an indirect but important influence on adolescents' school food choices. The school and home environments both (in)directly influence adolescents' school food choices, which involve an integration of multiple, often conflicting influences. Adolescents may adopt a number of unhelpful dietary rationalisations as they try to manage and reconcile these influences. Consultation, together with consideration of relevant food choice models, is required to identify opportunities to influence adolescents' food choices at school.

Influence of work hours and commute time on food practices: a longitudinal analysis of the Household, Income and Labour Dynamics in Australia Survey

OBJECTIVES

Work hours and commute time are key contributors to time scarcity, with potential detrimental implications for healthy eating. This study examined (1) associations between work and commute hours with food practices and (2) within-individual associations between changes in work and commute hours with changes in food practices.

DESIGN

Longitudinal study SETTING: Australia PARTICIPANTS: Data were from 14 807 respondents in waves 7 (2007), 9 (2009), 13 (2013) and 17 (2017) of the Household, Income and Labour Dynamics in Australia Survey. The sample for this analysis included individuals who were in paid employment in at least one of the four waves.

PRIMARY AND SECONDARY OUTCOME MEASURES

Outcomes included frequency of out-of-home food purchasing for breakfast, lunch, dinner and all three summed eating occasions, and fruit and vegetables consumption.

RESULTS

Results indicated the longer individuals spent working and commuting, the more likely they were to purchase out-of-home foods (frequency of total out-of-home food purchasing: incidence rate ratio (IRR)=1.007 (95% CI 1.007 to 1.008)), and the less they consumed fruit and vegetables, although reductions in fruit and vegetables servings were minimal (fruit: β=-0.002 (95% CI -0.003 to -0.001), vegetables: β=-0.002 (95% CI -0.003 to -0.001)). Similar results regarding associations with out-of-home food purchasing were observed when examining within-individual changes (IRR=1.006 (95% CI 1.005 to 1.007)).

CONCLUSIONS

Results suggest employment-related time demands push towards more frequent out-of-home food purchasing. In the long term, this may have negative health consequences as out-of-home foods tend to be less healthy than home-prepared foods.

The Multi-Caregiver Role and Its Relationship to Behavioral Adherence and Weight Among Treatment Engaged Black Women

PURPOSE

To examine the relationship between the multiple caregiver role and its perceived barriers to self-care on behavioral adherence in a weight loss intervention.

DESIGN

A secondary analysis of data from a behavioral weight loss intervention.

SETTING

The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill.

SUBJECTS

Eighty-one Black women with overweight/obesity (age = 48.4 ± 10.9 years [M ± SD], BMI = 36.4 ± 4.5 kg/m² [M ± SD]).

MEASURES

Identification with the multiple caregiver role and barriers was assessed with the Multiple Caregiving Measurement Instrument. Weight was measured with a digital scale and height with a stadiometer. The Block food frequency questionnaire evaluated dietary intake. Moderate-to-vigorous physical activity (MVPA) was measured objectively with an accelerometer. Study adherence was measured by session attendance, self-weighing, and self-monitoring (diet and physical activity) frequency.

ANALYSIS

Generalized linear models were used to examine the relationship between the multiple caregiver scales and the outcomes of interest, controlling for study arm, cohort, and income. Chi-square tests tested correlations.

RESULTS

Greater identification with the multiple caregiver role was associated with decreased session attendance (β = -.56 [SE = .27], P < .05) and a trend towards weight gain (β = .36, [SE = .19], P = .07). Greater multiple caregiver barriers score predicted a decrease in fruit/vegetable intake (β = -.17 [SE = .07], P < .05). All regression results are unstandardized. Negative correlations between multiple caregiver barriers and MVPA (r = -.24, P = .06) and daily self-weighing (r = -.19, P = .10) approached significance.

CONCLUSIONS

Participants' identification with multiple caregiving role and barriers can reduce adherence, behavior and weight change. Interventions to address Black women's multiple roles and barriers during weight loss are needed to maximize outcomes.

Typology of Work-Family Balance Among Middle-Aged and Older Japanese Adults

This study explores the clusters of work-family balance (WFB) among Japanese middle-aged and older adults and clarifies the characteristics of the derived clusters. Data on working adults (N = 1,351; age range = 40-85 years) were drawn from a pool of participants in the National Institute for Longevity Sciences-Longitudinal Study of Aging. The WFB scale consists of subscales assessing work-family conflict (WFC) and work-family facilitation (WFF). First, a cluster analysis was performed using the WFB scale, and four clusters were extracted. Second, we examined associations between the four clusters and related variables such as demographic characteristics, work, family, and lifestyle factors, social support, and mental health. Our findings showed that the clusters included high-WFC/high-WFF, high-WFC/low-WFF, low-WFC/high-WFF, and low-WFC/low-WFF. Differences were found in related variables among the clusters. Specifically, those in the Low-WFC/High-WFF cluster had a good lifestyle, received the highest levels of social support, and had the fewest mental health issues. Our findings have implications for maintaining sufficient WFB and promoting positive mental health among workers.

Marketing of sugar-sweetened children's drinks and parents' misperceptions about benefits for young children

Despite expert recommendations, US parents often serve sugar‐sweetened children's drinks, including sweetened fruit‐flavoured drinks and toddler milks, to young children. This qualitative research explored parents' understanding of common marketing tactics used to promote these drinks and whether they mislead parents to believe the drinks are healthy and/or necessary for children. We conducted nine focus groups in Washington, DC and Hartford, CT with parents of children (9–36 months) of diverse race/ethnicity and socioeconomic status (N = 50). Semistructured discussions elicited parents' responses to four concepts designed to correct common misperceptions about toddler milks and sweetened fruit‐flavoured drinks (fruit drinks and flavoured waters) by providing information about drink ingredients and potentially misleading marketing tactics. Participants expressed widespread misperceptions about sweetened fruit‐flavoured drinks and toddler milks, including perceived healthfulness and benefits for children and confusion between sweetened and unsweetened drink categories (sweetened fruit‐flavoured drinks vs. juice, toddler milk vs. infant formula). They confirmed that common marketing strategies contributed to misperceptions, including front‐of‐package claims and marketing messages that imply benefits for children and/or hide problematic ingredients; cross‐branding and product extensions from trusted brands; side‐by‐side shelf placement at retailers; lower price than healthier products; and targeted marketing to children and parents. Some parents expressed anger about deceptive marketing and supported increased regulation and consumer education campaigns. Findings support the need for policies to address potentially misleading marketing of sweetened fruit‐flavoured drinks and toddler milks and revealed opportunities to reduce parents' provision of these drinks through countermarketing campaigns communicated via trusted sources.

Marketing messages for sweetened fruit‐flavoured drinks and toddler milks can mislead parents to believe these sugar‐sweetened products are healthful options for young children.

Parents described front‐of‐package label claims, images, and other marketing messages on sugar‐sweetened children's drinks as confusing, deceptive, and misleading. They also raised issues about targeted marketing to children and parents and lower prices for less‐healthy products.

Findings support opportunities for countermarketing campaigns to correct misleading marketing messages and the need for government policies, such as restricting front‐of‐package claims and requiring consistent ingredient reporting, to assist parents in making healthier drink selections for their children.

Relationships Between Work-to-Family Conflict and the Food Domain for Dual-Earner Parents With Adolescent Children

The impact of work-to-family conflict (WtoFC) can extend beyond family and work, and to other domains that contribute to well-being, such as the food domain. This study examined associations between WtoFC, perception of atmosphere of family meals (AFM), and satisfaction with food-related life (SWFoL) in dual-earner parents with adolescent children, and tested the mediating role of AFM between WtoFC and SWFoL. Questionnaires were administered to 473 different-sex dual-earner parents and one of their adolescent children (mean age 12.5 years, 51.4% male) in Temuco, Chile. Parents responded to a measure of work-to-family conflict; the three family members answered the Project-EAT Atmosphere of family meals scale, and the Satisfaction with Food-related Life Scale. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modeling. Results showed a negative association from WtoFC to SWFoL in both parents, while a more positive perception of atmosphere of family meals was linked to higher SWFoL in the three family members. Moreover, WtoFC was negatively linked to SWFoL in parents, while only mothers' WtoFC had a negative association with their adolescent children's SWFoL. Policymakers and organizations can contribute to workers' and their families' food-related well-being by fostering policies and measures to reduce WtoFC.

Developmental Origins of Cardiovascular Disease: Understanding High Mortality Rates in the American South

While many social scientists view heart disease as the outcome of current conditions, this cannot fully explain the significant geographic disparities in cardiovascular disease (CVD) mortality rates in the USA. The developmental origins hypothesis proposes that CVD vulnerability is created by poor conditions in utero that underbuilds major organs relative to those needed to process lush nutrition later in life. The American South underwent an economic transformation from persistent poverty to rapid economic growth in the post-World War II era. We use state-level data on income growth and current conditions to explain variation in CVD mortality rates in 2010–2011. Our proxy for unbalanced physical growth, the ratio of median household income in 1980 to that in 1950, has a large systematic influence on CVD mortality, an impact that increases dramatically with age. The income ratio combined with smoking, obesity, healthcare access, and education explain more than 70% of the variance in CVD mortality rates.

How (not) to feed young children: A class-cultural analysis of food parenting practices

This study unpacks how class processes shape understandings and practices of "good feeding" in families with young children. It brings a Bourdieusian class consumption focus together with food parenting studies and approaches feeding as encompassing a wide range of processes including cooking, shopping, and planning. To capture the lived experience of feeding work, the study draws on a longitudinal and ethnographic study conducted in the south-east of England over the course of two years. The analysis suggests that, regardless of their resources, parents tend to internalize the dominant discourse on "healthy" and "varied" feeding. However, closer inspection of day-to-day practices reveals a nuanced class-cultural patterning in how these terms are defined and achieved. Moreover, it reveals how different interpretations of key notions such as homemade, nutritious, and balanced generate practices that contribute to the cultivation of distinctively classed culinary agencies in children. This study also questions what potential role these understandings can play in reproducing taste hierarchies and maintaining symbolic boundaries from very early ages.

Who We Seek and What We Eat? Sources of Food Choice Inspirations and Their Associations with Adult Dietary Patterns before and during the COVID-19 Lockdown in New Zealand

Research shows the shaping of food choices often occurs at home, with the family widely recognised as significant in food decisions. However, in this digital age, our eating habits and decision-making processes are also determined by smartphone apps, celebrity chefs, and social media. The ‘COVID Kai Survey’ online questionnaire assessed cooking and shopping behaviours among New Zealanders during the 2020 COVID-19 ‘lockdown’ using a cross-sectional study design. This paper examines how sources of food choice inspirations (cooking-related advice and the reasons for recipe selection) are related to dietary patterns before and during the lockdown. Of the 2977 participants, those influenced by nutrition and health experts (50.9% before; 53.9% during the lockdown) scored higher for the healthy dietary pattern. Participants influenced by family and friends (35% before; 29% during the lockdown) had significantly higher scores for the healthy and the meat dietary patterns, whereas participants influenced by celebrity cooks (3.8% before; 5.2% during the lockdown) had significantly higher scores in the meat dietary pattern. There was no evidence that associations differed before and during the lockdown. The lockdown was related to modified food choice inspiration sources, notably an increase in ‘comforting’ recipes as a reason for recipe selection (75.8%), associated with higher scoring in the unhealthy dietary pattern during the lockdown. The lockdown in New Zealand saw an average decrease in nutritional quality of diets in the ‘COVID Kai Survey’, which could be partly explained by changes in food choice inspiration sources.

Association of Hours of Paid Work with Dietary Intake and Quality in Japanese Married Women: A Cross-Sectional Study

This study investigated the association of hours of paid work with dietary intake and diet quality among Japanese married women. This cross-sectional study was a secondary analysis of a nationwide population survey in 2013. The analytic sample included 644 married women aged 20–59 years. The participants were categorized into five groups according to hours of paid work per week: 0 (housewives), 1–14, 15–34, 35–42, and ≥43 h. Dietary intake was assessed by a self-administered diet history questionnaire. The Nutrient-Rich Food Index 9.3 (NRF9.3) was used to measure the dietary quality. The association of hours of paid work with dietary intake and NRF9.3 score was assessed using a multivariable general linear regression analysis with adjustments for confounders. Hours of paid work were associated with a higher intake of rice and lower intake of vegetables, potatoes, soy products, and seaweeds and nutrients including protein, dietary fiber, and most vitamins and minerals. Hours of paid work were negatively associated with the NRF9.3 score. This study showed that Japanese married women engaging in paid work, especially those who work long hours, have less healthy diets. Efforts to improve the dietary intake of married women with paid work might be needed.

Parental feeding practices and children's disordered eating among single parents and co-parents

OBJECTIVE

Some parental feeding practices are associated with pediatric disordered eating and weight status. Existing research, however, has focused on maternal feeding practices in co-parent households. Single parents and fathers are notably understudied in this area. The current study examined associations of parental feeding practices with child disordered eating behaviors and weight, and compared associations between single mothers and fathers with a matched sample of co-parenting mothers and fathers.

METHOD

Parents (N = 524) of youth between 5 and 16 years completed an online survey that included measures of parental feeding practices and unhealthy eating/weight-related parenting practices. Co-parents were matched to each single parent based on gender, race, ethnicity, education level, age, and BMI.

RESULTS

Single parents reported significantly greater concern about their child's weight, eating and shape, and reported engaging in more restraint and restriction of their child's eating, as well as having more perceived responsibility of their child's eating than caregivers in co-parent households. Children of single parents were significantly more likely to engage in secretive eating.

DISCUSSION

Associations between single parents' feeding practices and child weight and disordered eating parallel the broader literature. There were differences between single mothers and fathers and co-parenting mothers and fathers, particularly in their report of their unhealthy eating/weight-related parenting practices. Such differences may influence children's longer-term eating behaviors and weight status. Further research on single-parent households is needed, including longitudinal and epidemiological studies.

Picture Perfect: How Attaining the Ideal Meal is Not So Easy for Parents of Young Children

OBJECTIVE

To explore parental perspectives on the ideals and realities of family mealtimes.

DESIGN

Mini-focus groups (n = 7).

SETTING

Rural Colorado, US.

PARTICIPANTS

Parents (n = 30) were recruited at Head Start/preschool centers.

PHENOMENON OF INTEREST

Parent perspectives on mealtimes with preschool-aged children.

ANALYSIS

Transcripts were analyzed using thematic analysis.

RESULTS

Three categories of themes emerged: participant conceptions of ideal family meals, challenges to achieving their ideal family meal, and parental solutions. The theme of participant conceptions of ideal family meals composed family togetherness, children liking and eating the prepared food, healthfulness of food, and a nonchaotic mealtime. Challenges to achieving their ideal family meal included work schedules, disruptive child behaviors, child pickiness, snacking, and negative role-modeling. Finally, parental solutions to challenges incorporated having flexible meal timings, considering child preferences in premeal preparations, role-modeling, and numerous other parenting strategies.

CONCLUSIONS AND IMPLICATIONS

While parents valued many aspects of a version of the ideal meal rooted in historical standards, families faced many challenges in trying to attain that ideal. Although parents employed various strategies to combat mealtime challenges, parental expectations for preschool-aged children's mealtime behaviors may be unrealistic for the developmental stage of early childhood. Future interventions could help parents develop age-appropriate mealtime expectations.

Food Skills Education and Low-Income Adults' Healthy Food Choices

BACKGROUND

The Cooking Matters food skills education program equips low-income families with the skills and knowledge to shop for and cook healthy meals within budget and time constraints.

AIMS

To explore whether participation in Cooking Matters is associated with healthier food choices using a 6-item scale, comprised of a variety of food categories.

METHODS

Cooking Matters participants (n = 332) and a comparison group (n = 336) completed surveys at baseline, 3-, and 6-month follow-up.

RESULTS

Cooking Matters participants experienced greater improvements in healthy choices overall (p < 0.0001) and for each of the six underlying items at 3 month follow-up. Improvements were sustained at 6-month follow-up overall and for all categories, except low-fat milk (p = 0.1168).

DISCUSSION

Participation in Cooking Matters was associated with improvements in overall healthy food choices across a variety of food groups and maintained at 6-month follow-up. Enabling healthy food choices is an important step toward improved diet quality.

Fulfilling food practices: Applying the capability approach to ethnographic research in the Northern Netherlands

Often, food practices are evaluated in terms of their healthiness or lack thereof, but fulfilling food practices based on other values and influenced by family members' capabilities are overlooked. This study analyses food practices in families with low socio-economic status, and aims to explain how family households come to prioritise one food practice over another. We conducted an ethnographic study using the capability approach as an analytical framework. In-depth interviews and observations concerning food patterns and health-related choices with family members from three generations were analysed. Two dimensions of fulfilling food practices which emerged from our study are having a healthy as well as harmonious meal. The families under study tended to prioritise having harmonious meals over having healthy meals, despite the attempts by mothers to serve healthy meals. This choice can be understood from the perspective of capabilities, such as being able to enjoy meals, eating what everybody else eats in the region, avoiding conflicts, creating good relationships with children and serving and organising meals with ease. Within the cultural environment, there prevailed a tendency not to care too much about nutritional outcomes, which also supported the preference for harmonious over healthy meals. In the decision about whether to have a healthy or a harmonious meal, children's agency often outweighed the voices of parents and grandparents. The capability approach helped unravel the complexity of family food practices and the role of intergenerational family dynamics in a setting of low socio-economic status. Acknowledging the multi-dimensional nature of food practices, and including dimensions beyond the food domain, such as harmony at the dinner table, contribute to a better understanding of this complexity. It also helps to shed new light on opportunity deprivation in households, for example in relation to agency, which should be accounted for in health interventions.

A positive deviance-based qualitative study of stress, coping, and feeding practices among low-income, Hispanic mothers whose children do versus do not meet guidelines for fruit and vegetable intake

Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being 'high-risk' for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one's attention away from stressors; comparison group mothers tended to report stress about managing their child's eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.

Food security and alternative food acquisition among US low-income households: results from the National Food Acquisition and Purchasing Survey (FoodAPS)

OBJECTIVE

To determine the characteristics of US low-income households that use alternative food acquisition strategies and to examine the association between food security and alternative food acquisition.

DESIGN

Cross-sectional analysis. The ten-item Adult Food Security Survey Module was used to determine food security status. Self-reported data were used to determine food acquisition from community food sources, social networks and household food production.

SETTING

The National Food Acquisition and Purchasing Survey (FoodAPS), 2012.

PARTICIPANTS

The sample consisted of 2534 low-income households (≤185 % of the federal poverty line) in the USA.

RESULTS

Households using alternative food acquisition strategies were more likely to have a primary respondent who was non-Hispanic White, born in the USA, and female, and more likely to live in a rural area, have higher income and own a home than households not using alternative acquisition strategies. Very low food security was positively associated with the use of community food sources (aOR = 2·26 (95 % CI 1·15, 4·46)). There was no association between food security and food acquisition from social networks or household food production.

CONCLUSIONS

Use of alternative food acquisition strategies varied by specific demographic characteristics among low-income households, suggesting opportunities for outreach and promotion of alternative acquisition strategies in specific subpopulations in the USA. Future research should examine whether quantity and quality of food received from these sources are associated with food security.

Results of the 3 Pillars Study (3PS), a relationship-based programme targeting parent-child interactions, healthy lifestyle behaviours, and the home environment in parents of preschool-aged children: A pilot randomised controlled trial

BACKGROUND

Early childhood is a critical period for the development of obesity, with new approaches to prevent obesity in this age group needed. We designed and piloted the 3 Pillars Study (3PS), a healthy lifestyle programme informed by attachment theory for parents of preschool-aged children.

METHODS

A 2-arm, randomised controlled pilot study was conducted to assess the effectiveness of 3PS, a 6-week programme involving a half-day workshop plus 6-week access to a study website. The programme was designed to promote routines around healthy lifestyle behaviours, including sleep, limited screen use, and family meals, within the context of positive, reciprocal parent-child interactions. Parents (n = 54) of children aged 2-4 years who regularly exceeded screen use recommendations (≥1 hour per day), were randomised to the 3PS programme (n = 27) or a wait-list control group (n = 27). Child screen time at 6 weeks was the primary endpoint. Frequency of family meals, parent feeding practices, diet quality, sleep, Child Routine Inventory (to assess predictability of commonly occurring routines), and household chaos were also assessed. Study data were collected online at baseline, 6 weeks, and 12 weeks via REDCap.

RESULTS

No group differences were observed for changes from baseline in screen time (primary endpoint), feeding behaviour scores, Child Routine Inventory scores, or total night time sleep duration at 6 and 12 weeks, although all measures improved in the hypothesised direction in the 3PS group. Compared with controls, the intervention group demonstrated significant improvements from baseline in household chaos scores (i.e. a reduction in chaos) and a number of measures of sleep outcomes, indicating improved sleep continuity. The programme was highly acceptable to parents.

CONCLUSIONS AND RECOMMENDATIONS

A relational approach appears promising as a novel way to promote healthy lifestyle behaviours associated with the prevention of childhood obesity in children aged 2-4 years. A larger study is warranted.

Family Mealtime Communication in Single- and Dual-Headed Households Among Hispanic Adolescents With Overweight and Obesity

OBJECTIVE

To investigate the association of adolescent self-report of family mealtime communication on obesity-related behaviors in single- and dual-parent households and by sex in a sample of overweight and obese Hispanic adolescents.

DESIGN

Cross-sectional analysis of a randomized control trial SETTING: Eighteen middle schools in Miami-Dade County, Florida.

PARTICIPANTS

Two-hundred and eighty Hispanic seventh- and eighth-grade students MAIN OUTCOME MEASURES: Physical activity, fruit and vegetable intake, and added sugar intake.

ANALYSIS

Structural equation modeling.

RESULTS

The findings indicate that mealtime communication was associated with fruit and vegetable consumption in boys (β = .30; P = .001; 95% confidence interval [CI], 0.52-2.68) and physical activity in girls (β = .26; P = .010; 95% CI, 0.16-1.30). Moreover, a single-parent household was associated with dietary consumption in boys (fruit and vegetable intake [β= .18; P = .039; 95% CI, 0.02-2.60] but had a moderating effect on fruit and vegetable consumption in girls (β = .21; P = .015; 95% CI, 0.14-2.19).

CONCLUSIONS AND IMPLICATIONS

Family mealtime communication may impact dietary and physical activity outcomes in Hispanic adolescents with overweight and obesity, but differentially across gender and household parent makeup. These findings, together with the prevalence of single parents, point to the importance of targeting Hispanic single parents as agents of change to promote healthy lifestyle behaviors in their children via positive mealtime interactions.

Low-Income Parents' Use of Front-of-Package Nutrition Labels in a Virtual Supermarket

OBJECTIVE

To examine the impact front-of-package nutrition labels (FOPLs) have on decision-making abilities among low-income parents in a virtual supermarket.

DESIGN

A 4-by-2 experimental design with 3 FOPLs (summary, nutrient-specific, hybrid) and a no-FOPL comparison. Within the FOPL condition, participants either shopped with a time limit (10 minutes) or with no time limit.

SETTING

A web-based, 3-dimensional virtual supermarket.

PARTICIPANTS

Parents (n = 1,452) from low-income households with at least 1 child aged 4-12 years.

MAIN OUTCOMES MEASURED

Index derived from the United Kingdom's Nutrient Profiling Model that summarized the overall nutrient profile of the participant's shopping basket.

ANALYSIS

Analysis of covariance with post hoc estimations (pairwise) of condition means adjusted for multiple comparisons.

RESULTS

All FOPLs led to healthier nutrient profiles than the no-FOPL condition (P < .001). Simple FOPLs (ie, summary, hybrid) led to healthier nutrient profiles than nutrient-specific FOPLs (P = .02 and P < .001, respectively). Among parents exposed to simple FOPLs, those under time pressure made less healthy choices than those who were not under time pressure (P = .05 and P = .03, respectively). Time pressure did not affect parents exposed to nutrient-specific FOPLs (P = .69).

CONCLUSIONS AND IMPLICATIONS

Front-of-package nutrition labels can aid parents in selecting healthier products. Simple FOPLs provide greater utility for selecting healthier products than FOPLs that present an array of nutrient information. Time pressure can influence how parents interact with different types of label information.

Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association

A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.

Mothers' food choices and consumption of ultra-processed foods in the Brazilian Amazon: A grounded theory study

In recent decades, an increase in consumption of ultra-processed foods (UPF), a type of product frequently associated with diet-related obesity, chronic diseases, decrease of eating traditions and loss of culinary diversity, has been observed in middle-income countries. However, there is lack of information on factors related to choosing UPF. In this study, we aimed to understand the factors promoting UPF choices and consumption among mothers living in an urban context in the Brazilian Amazon, and to present a conceptual model grounded on their experiences that illustrates the dynamics between the observed factors. For this qualitative study, we used a constructive grounded theory approach, with a theoretical sampling of 40 women, to choose mothers with high and low consumption of ultra-processed foods. Data production and the first steps of analysis were performed concomitantly, followed by four steps of coding focused on creating conceptual categories and explaining the interactions between them. Our findings highlighted the importance of context in promoting UPF choice and consumption, particularly the "food environment", physical and virtual, and the "sociocultural environment". These contextual aspects interacted with the two main personal aspects influencing participants' UPF consumption, one concerning practices, "cooking behaviors", and the other concerning preferences, "food tastes". Factors such as economic and time constraints were also important and competed to shape eating practices through interactions with participants' health valorization. Findings are discussed in relation to food choice theories, social roles and the food environment. Implications for public health initiatives include the importance of considering environmental changes, sociocultural and economic influences, the reliance on UPF, and the role of women in the home, when promoting healthy diets.

Association between hours worked in paid employment and diet quality, frequency of eating out and consuming takeaways in the UK

OBJECTIVE

To examine associations between hours worked and diet quality, frequency of eating out and consuming takeaways.

DESIGN

Data were taken from the National Diet and Nutrition Survey (2008-2014). Associations between hours worked in paid employment and diet quality, assessed using the Diet Quality Index (DQI) and selected foods and nutrients, were tested using linear regression models. Associations between hours worked and frequency of eating out and consuming takeaways were tested using ordinal logistic regression models. All models were adjusted for sex, age, equivalised household income, household composition and household food role.

SETTING

UK.

PARTICIPANTS

Adults (n 2154) aged 19-64 years in employment.

RESULTS

Mean (95 % CI) hours worked per week was 36·1 (35·6, 36·6) and mean DQI score was 41·9 (41·2, 42·5) %. Hours worked was not associated with DQI score, frequency of eating out or consuming takeaways. Hours worked was positively associated with consuming red meat, processed meat and alcohol intake. Adults working more hours had lower intake of fibre but higher total fat and saturated fat intakes if they lived in households with children.

CONCLUSIONS

Working hours may not be the main factor driving poor-quality diets among this sample of UK adults in employment. Focusing on consumption of foods prepared outside the household may not be the most efficient way to improve diet quality as effort is needed at all levels. Although it is unclear what is driving the differences in nutrient intakes according to household composition, they are important to consider when developing interventions to improve healthy eating.

A healthful home food environment: Is it possible amidst household chaos and parental stress?

PURPOSE

This study examines how household chaos and unmanaged parental stress are associated with and contribute to variance in markers of the home food environment (family meal frequency, perceived barriers to cooking, healthful home food availability). Obtaining a better understanding of these relationships could guide more effective family-based interventions to promote healthful home food environments.

METHODS

The analytic sample included 819 households with children in the population-based Project EAT-IV cohort with survey data from 2015 to 2016. Multiple linear regression was used to generate means and 95% confidence intervals of home food environment variables, and estimates for the contribution of household chaos (defined by frenetic activity, loud noises and disorder), and quartiles of unmanaged parental stress (ratio of perceived stress and ability to manage stress). Model fit was also examined.

RESULTS/FINDINGS

Both household chaos and quartiles of unmanaged parental stress were independently and inversely associated with family meal frequency (p's < 0.001) and positively associated with perceived mealtime preparation barriers (p's < 0.001). Unmanaged parental stress was also inversely associated with healthful home food availability (p = 0.004). Models including demographic characteristics, household chaos scores, and quartiles of unmanaged parental stress index showed significantly improved model fit for all outcomes compared to less comprehensive models. Among families with high chaos, those having 7 + family meals/week were significantly more likely to have lower mealtime preparation barrier scores, younger children and higher healthful home food availability scores than families eating together less often.

CONCLUSIONS

Interventions to assist with parental management of stress and chaos within the home environment (e.g., establishing routines) may increase family meal frequency and the quality of children's home food environments.

Poverty does not modify the association between perceived diet healthiness and adherence to nutritional guidelines in the Constances cohort (France)

Poor individuals have less healthy diets and seem to benefit less from nutrition information campaigns. One may wonder if they are less aware of their diets' shortcomings. The aim of this paper is to assess whether the association between perceived diet healthiness and adherence to nutritional guidelines is weaker among poor people. Data were collected from 40,000 participants from the Constances study, a large population-based observational cohort in France. Adherence to French nutritional guidelines was measured by a validated score based on a 22 item food frequency questionnaire and poverty was defined as facing material deprivation. These variables and their interaction were the variables of interest of a linear regression predicting perceived diet healthiness, with controls for confounders and 95% CI. Poor participants had lower nutrition scores and diet healthiness perceptions. Among respondents who had never faced material deprivation, for each increase in the guideline adherence score there was a +0.21 change (95% CI [0.18,0.23]) in perceived diet healthiness for men (women: +0.19 [0.17,0.22]). The coefficients were not smaller among poor respondents. Our results do not support the assumption that people facing poverty might overestimate their diet healthiness. This suggests that information campaigns are not enough: policies or interventions making healthy eating easier and more manageable are necessary.

Full-Time Employment, Diet Quality, and Food Skills of Canadian Parents

Purpose: To explore the associations between full-time employment status, food skills, and diet quality of Canadian parents.

Methods: A sample of Canadian parents (n = 767) were invited to complete a web-based survey that included sociodemographic variables, questions about food skills, and a validated food frequency questionnaire. Results were analyzed with linear and logistic regression models, controlling for sociodemographic variables and multiple testing.

Results: After controlling for covariates and multiple testing, there were no statistically significant differences in foods skills between parents’ employment status. Time was the most reported barrier for meal preparation, regardless of work status, but was significantly greater for full-time compared with other employment status (P < 0.0001). Additionally, parents who worked full-time had lower odds of reporting food preferences or dietary restrictions (P = 0.0001) and health issues or allergies (P = 0.0003) as barriers to food preparation, compared with parents with other employment status. These results remained statistically significant even after controlling for covariates and multiple testing.

Conclusions: Overall, food skills did not differ significantly between parents’ employment status. Time, however, was an important barrier for most parents, especially those working full time. To promote home-based food preparation among parents, strategies to manage time scarcity are needed.

The impact of using a closed-loop system on food choices and eating practices among people with Type 1 diabetes: a qualitative study involving adults, teenagers and parents

AIMS

We explored whether, how and why moving onto and using a hybrid day-and-night closed-loop system affected people's food choices and dietary practices to better understand the impact of this technology on everyday life and inform recommendations for training and support given to future users.

METHODS

Twenty-four adults, adolescents and parents were interviewed before commencing use of the closed-loop system and following its 3-month use. Data were analysed thematically and longitudinally.

RESULTS

While participants described preparing and/or eating similar meals to those consumed prior to using a closed-loop, many described feeling more normal and less burdened by diabetes in dietary situations. Individuals also noted how the use of this technology could lead to deskilling (less precise carbohydrate counting) and less healthy eating (increased snacking and portion sizes and consumption of fatty, energy-dense foods) because of the perceived ability of the system to deal with errors in carbohydrate counting and address small rises in blood glucose without a corrective dose needing to be administered.

CONCLUSIONS

While there may be quality-of-life benefits to using a closed-loop, individuals might benefit from additional nutritional and behavioural education to help promote healthy eating. Refresher training in carbohydrate counting may also be necessary to help ensure that users are able to undertake diabetes management in situations where the technology might fail or that they take a break from using it.

Work, worksites, and wellbeing among North American Indian women: a qualitative study

The purpose of this study was to understand what factors influenced work-family balance and related health behaviors among a sample of rural North American Indian women. We interviewed 89 women through both in-depth interviews and focus groups across four tribal communities in the American Southwest and Upper Midwest between July 2010 and August 2011. Interviews were transcribed, coded, and analyzed for emerging themes related to work- family demands placed on women and resources available to cope with those demands. Three prominent themes emerged: structural characteristics (the context of rural reservation life), role stressors (women's multiple and conflicting roles) and the influence of social support (communal nature of care in the family and institutional support in the workplace). We found that women in participating rural reservation communities often acted as primary caregivers for both immediate and extended family, and often placed the needs of others before themselves. The context of rural reservations, with high rates of unemployment, poverty, and chronic illnesses associated with the collective trauma of colonization, placed high demands on female caregivers. Social support from within the workplace, family, and cultural traditions helped some female caregivers balance the demands of home and work. Tribal worksites could be a resource for promoting health and work-life balance by being responsive to the particular demands placed on women that often interfere with engaging in positive health behaviors in general and tribal wellness programs in particular.

Lifestyle behaviours or socioeconomic characteristics? Gender differences in covariates of BMI in Hungary

Objective

Lifestyle behaviours are everyday activities that result from individual's values, knowledge, and norms shaped by broader cultural and socioeconomic context. These behaviours affect body weight as well as overall health and are influenced by a number of social characteristics. The aim of this paper was to examine the net effects of lifestyle behaviours and socioeconomic factors on body mass index (BMI), and how these differed by gender.

Methods

This study used the 2009/2010 Hungarian Time Use Survey combining behavioural records, background information, and measures of self‐reported health and weight. The sample (n = 7765) was representative for the Hungarian population. Multivariate linear OLS regression models were employed to analyse the net effects of lifestyle and sociodemographic variables.

Results

Daily behaviours were associated with BMI for women, but not for men, except for smoking. Meals frequency and duration of sleep had negative effects on female BMI, whereas duration of TV viewing had a positive effect. Occupational class was associated with male BMI, but not with female. The strong negative effect of smoking was significant for both genders.

Conclusions

Lifestyle behaviours were linked with female BMI, with socioeconomic characteristics impacting on male BMI. These results suggest that a gender‐specific approach may be appropriate to address obesity issues in the Hungarian population.

Parental and family predictors of fruits and vegetables in elementary school children's home-packed lunches across a school week

Home-packed lunches have been found to be of lower nutritional quality than school-bought lunches, yet little is known about family-based factors associated with lunch packing. The current exploratory study examines parental and family predictors of fruits and vegetables packed in lunches, hypothesizing parents' nutrition knowledge and authoritative parenting as well as children's involvement in lunch decisions would relate to packing more fruits and vegetables, while financial difficulties would relate to packing fewer. Ninety parent-child dyads from 4th-6th grade participated for 5 consecutive school days. Lunch contents were recorded using a digital imaging procedure to capture the number of days a fruit or vegetable was packed, and servings of fruits and vegetables in lunches each day. Parents completed family and parenting questionnaires and daily reports of child involvement in lunch decisions. Count-based regression models and longitudinal analyses within a multilevel modeling framework were used to examine predictors of lunch contents. Higher nutrition knowledge was associated with packing more fruit across the week and more vegetables on Monday. Authoritative parenting was associated with packing fewer vegetables on Monday, but more servings across the week. Financial stress was related to higher rates of never packing vegetables and when vegetables were packed including fewer servings, while child involvement in lunch decisions was associated with packing more fruits across the week, packing vegetables on more days and more servings of vegetables on Monday. Findings suggest parental and family factors impact the foods in packed lunches, with implications for children's dietary intake at school. Outreach programs can help parents pack more fruits and vegetables by providing nutrition education and suggestions for affordable, healthy lunch options as well as encouraging child involvement in the lunch packing process.

Understanding the factors influencing low-income caregivers' perceived value of a federal nutrition programme, the Special Supplemental Nutrition Program for Women, Infants and Children (WIC)

OBJECTIVE

Retention of participants has been an issue in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). It has been suggested that the perceived value of WIC may affect whether participants remain in the programme. The present study aimed to explore this phenomenon.

DESIGN

Using a constructivist approach, thirty-one individual in-depth interviews were conducted. Transcripts were analysed using constant comparative analysis. Social, cultural and environmental factors that contribute to the value of WIC were explored as the phenomenon of interest.

SETTING

Eight WIC clinics across the State of Illinois, USA.ParticipantsThirty-one caregivers of children enrolled in WIC for at least 6 months.

RESULTS

Several factors influenced perceived value of WIC at the interpersonal (level of social support), clinic (value of WIC services v. programme administration issues), vendor (shopping difficulties), community and systems levels (other programme use, stigma and restrictions on food choice). Other themes existed along continua, which overlapped several levels (continuum of perceived need and perceived value of infant formula).

CONCLUSIONS

Many caregivers value WIC, especially before their child turns 1 year old. Improvements are needed at the clinic, during shopping and within the food packages themselves in order to increase perceived value of WIC.

The Mediating Role of Family and Food-Related Life Satisfaction in the Relationships between Family Support, Parent Work-Life Balance and Adolescent Life Satisfaction in Dual-Earner Families

This study explored the associations between family support and satisfaction with life, food-related life and family life. It also assessed the associations between both parents' work-life balance and satisfaction with life, food-related life and family life among adolescent children from dual-earner families. Questionnaires were administered to 303 dual-earner families with one child between 10 and 17 years in Temuco, Chile. Adolescents answered the Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life scale (SWFoL), Satisfaction with Family Life scale (SWFaL) and the Family subscale of the Multidimensional Scale of Perceived Social Support. Both parents answered the Work-life Balance (WLB) scale. Using structural equation modelling and having controlled for adolescents' gender, age and socioeconomic status, we confirmed that adolescent life satisfaction is associated with satisfaction with family life and food-related life. Food-related life satisfaction and family life satisfaction had complete mediating roles between perceived family support and adolescents' life satisfaction. Satisfaction with food-related life also had a complete mediating role between both parents' WLB and adolescents' life satisfaction. Satisfaction with family life had a complete mediating role between mothers' WLB and adolescents' life satisfaction. In addition, mothers' WLB was positively associated with perceived family support among adolescents. These findings suggest the need to improve family support and work-life balance among mothers in order to enhance adolescents' satisfaction with different domains of life in dual-earner families.

Family meals among parents: Associations with nutritional, social and emotional wellbeing

A growing body of research suggests that children and adolescents who share frequent meals with their families report better nutrition indicators, family relationships and mental health. Yet, little research has examined whether parents who share meals with their families report the same indicators of wellbeing. The current paper addresses this question using population-based survey data and a sample of parents in the United States (n = 889, mean age 31 years) that responded to the fourth wave of the Project EAT study in 2015-16. Multiple regression models were used to examine associations between frequency of family meals and indicators of nutritional, social and emotional wellbeing, controlling for demographic and household characteristics. Analyses also examined if associations were moderated by sex, as mothers tend to be more responsible for household and childcare tasks. Results suggested that parent report of frequent family meals was associated with higher levels of family functioning, greater self-esteem, and lower levels of depressive symptoms and stress (p-value for all <0.001). Frequency of family meals was also related to greater fruit and vegetable consumption (both p < 0.05), but was unrelated to other indicators of parent body size and nutritional wellbeing. Associations between frequency of family meals and parent wellbeing were similar for both mothers and fathers. Findings from the current study suggest that frequent family meals may contribute to the social and emotional wellbeing of parents. Future strategies to promote family meals should consider the potential impacts on the health and wellbeing of the whole family.

Does physiological distribution of blood parameters in children depend on socioeconomic status? Results of a German cross-sectional study

OBJECTIVES

In the present study, we examined the relation between socioeconomic status (SES) and the physiological distribution of iron-related blood parameters.

DESIGN

This is a cross-sectional analysis of longitudinal population-based cohort study.

SETTING

Based on a sample of healthy participants from a German research centre, various blood parameters and values of clinical examinations and questionnaires were collected.

PARTICIPANTS

A total of 1206 healthy volunteers aged 2.5 to 19 years, one child per family randomly selected, were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

Associations between the SES of children by Winkler-Stolzenberg Index (WSI) and its dimensions (income, education, occupation) and iron-related blood parameters (haemoglobin, ferritin and transferrin) were analysed by linear regression analyses. Gender and pubertal stage were included as covariables. Additionally, associations between SES of children by WSI and physical activity (side-to-side jumps, push-ups) as well as body mass index (BMI) were analysed by linear regression analyses.

RESULTS

Children with high WSI or family income showed significantly increased z-scores for haemoglobin (P=0.046; P<0.001). Children with increased WSI or family income showed significantly lower z-scores for transferrin (P<0.001). There was a significant correlation between haemoglobin and gender (P<0.001) and between transferrin and pubertal stage (P=0.024). Furthermore, physical activity was positively correlated and BMI was negatively correlated with WSI (P<0.001).

DISCUSSION

Our data show an association between SES and the distribution of iron-dependent parameters. Lower SES is correlated with lower values for haemoglobin and higher values for transferrin. Furthermore, we demonstrate that physical activity and BMI are associated with SES. Whereas higher SES is correlated with higher values for physical activity and lower BMI. Our parameters are standardised as z-scores with the advantages that the results are comparable across different age groups and present physiological courses.

TRIAL REGISTRATION NUMBER

NCT02550236; Results.