Associations between family structure and adolescents' food habits

The influence of family characteristics on food parenting practices among parents with school-age children and adolescents: A systematic review

Family characteristics can influence parents' implementation of food parenting practices. However, with a growing body of research on family characteristics and food parenting practices, a systematic review of the related topic has yet to be found in the current literature. Hence, the study aimed to review existing studies on family characteristics and food parenting practices among parents with school-age children and adolescents. Family characteristics refer to the family background or demographics that involve race/ethnicity, family income, parents' education levels, food security, culture, acculturation, and family structure. The study used Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the review process. The data was collected from EBSCOhost Discovery, PubMed, and Scopus databases. Forty-five relevant articles were analyzed and summarized, and the findings were presented in three themes, including (1) culture, races/ethnicities, and acculturation, (2) socioeconomic status and food security, and (3) family structure. The results showed that the family characteristics identified in this study can influence the engagement of food parenting practices among parents with school-age children and adolescents. Several issues have been addressed for the advancement of future research, which can lead to better suggestions and implementation of food parenting practices among parents. Therefore, parents can improve their food parenting experiences and enhance their children's health, growth, and development.

Sociodemographic characteristics on behavioural risk factors of noncommunicable diseases in adolescents in Luxembourg

BACKGROUND

Non-communicable diseases (NCDs) accounted for 89% of deaths in Luxembourg in 2019, aligning with Europe's figures but exceeding the global average of 74%. Behaviours play a critical role in NCD management, with unhealthy lifestyles-like poor diets, physical inactivity, tobacco use, and alcohol consumption-posing significant risks, especially when combined. The present study aims to explore sociodemographic characteristics of adolescents presenting behavioural risks for NCDs in Luxembourg.

METHODS

A representative sample of 8117 adolescents (11-to-18-years-old) took part in the 2022 Health Behaviour in School-aged Children (HBSC) Luxembourg survey. We measured physical inactivity, daily sugar consumption, cigarette use and alcohol consumption, and their combination (1, 2 or 3 ≥ risks). The sociodemographic characteristics investigated were sex, age, migration background, family structure and perceived wealth. Binomial logistic regression crude and adjusted were performed with sociodemographic characteristics for each risk behaviour. In addition, multinomial logistic regression crude and adjusted were used to analyse the association between the combination of risk behaviours and the sociodemographic information of the adolescents in Luxembourg.

RESULTS

Girls had higher odds of physical inactivity (OR = 2.06) than boys, and older age groups exhibited elevated odds of physical inactivity (OR = 2.99), cigarette smoking (OR = 25.00), and alcohol consumption (OR = 35.56). Migration background emerged as a protective factor against alcohol consumption (parents' migration OR = 0.60; self-immigrated OR = 0.45) but a risk factor for physical inactivity (parents' migration OR = 1.50; self-immigrated OR = 1.72). Adolescents who did not live with both parents were more likely to be physically inactive (OR = 1.37), consume sugar daily (OR = 1.33), smoke cigarettes (OR = 1.26) and consume alcohol (OR = 1.80). Adolescents that reported their families were not well off had higher odds to be physically inactive (OR = 2.12) and to consume sugar daily (OR = 1.39). The simultaneity of risk behaviours reveals a worrying trend of increasing risk with age, highlighting the need for preventive interventions throughout adolescence. Furthermore, the results in relation to family structure and perceived wealth highlights the complexity and interrelationship of these factors in adolescent behavioural health.  CONCLUSIONS: The study provides guidance to create more effective interventions aiming to promote healthy behaviours in adolescents.

Food consumption and mental health in children and adolescents: A systematic review protocol

Mental illnesses are prevalent among children and adolescents worldwide and may be associated with food consumption. This protocol aims to evaluate the association between food consumption and mental health in children and adolescents through a systematic review and meta-analysis. The electronic search will include keywords related to childhood, adolescence, mental health issues (e.g., anxiety, stress, depression), and food consumption (e.g., in natura or minimally processed foods and ultra-processed foods ultra-processed foods), verified using MeSH terms. The systematic review will follow the PRISMA-2020 guidelines, employing the PECOS strategy, and will include quantitative observational and mixed-methods studies. A search will be conducted in the following databases: Scopus, CINAHL, SPORTDiscus, LILACS, Web of Science, APA-PsycArticles, PubMed/Medline, and EMBASE. Identifying the association between mental health and food consumption will contribute to the development of preventive and intervention strategies aimed at improving the health and well-being of children and adolescents. The analysis of the data will provide results on how psychological factors are linked to the consumption of various food groups, implying the updating of public policies. These guidelines can assist managers and researchers in creating effective interventions to promote mental health and healthy eating behaviors, ultimately leading to long-term positive impacts on public health.

How Family Structure Can Influence Adolescents' Eating Habits: An Italian Health Behaviour in School-Aged Children (HBSC) 2022 Sample

BACKGROUND/OBJECTIVES

Adolescence is an important period of psychophysical development. In this phase of life people acquire greater self-awareness and adopt behaviors that will later shape their lifestyle in adulthood. This study aimed to assess whether family structure can influence adolescents' eating habits.

METHODS

Data were acquired from a survey titled 'Italian Health Behaviour in School-aged Children' (HBSC) given to a representative sample of Tuscan adolescents aged 11, 13, 15 and 17 years of age. Participants (3210) filled out a validated questionnaire answering questions about their eating habits and family structure. After adjusting for covariates, some interesting trends were highlighted in the survey results.

RESULTS

Adolescents living in single-mother families reported a lower intake of fruits (OR 0.68, 95% CI = 0.55-0.83) and vegetables (OR 0.66, 95% CI = 0.53-0.81) and a higher intake of sugar-added soft drinks (OR 1.33, 95% CI = 1.08-1.64). Living in a mother and stepfather family was associated with a higher intake of sugar-added soft drinks (OR 1.53, 95% CI = 1.02-2.28), whereas living in a father and stepmother family was associated only with a lower intake of fruits (OR 0.48, 95% CI = 0.26-0.87). Participants living with other family types reported a lower intake of vegetables (OR 0.68, 95% CI = 0.47-0.98).

CONCLUSIONS

The results of this study show a correlation between family structure and adolescents' eating habits.

Associations between eating habits and mental health among adolescents in five nordic countries: a cross-sectional survey

BACKGROUND

The role of eating habits in adolescent mental health has become a growing area of interest for researchers and health professionals. Recent studies suggest that healthy eating habits may play a role in the development and management of mental health. However, existing literature is largely based on clinical populations, and comparisons are challenged by sociocultural differences and methodological issues. The aim of the present study was to use nationally representative data based on standardized procedures, to explore associations between adolescents eating habits and mental health, considering the importance of age, gender, socioeconomic factors, and country.

METHODS

The study was based on data from Nordic adolescents (age 11, 13 and 15 years) who participated in the 2017/2018 Health Behavior in School-aged Children (HBSC) study (n = 22384). General linear modelling and multigroup regression analysis were used to examine the relationship between food habits (intake of fruit, vegetables, sweets, soft drinks), meal habits (intake of breakfast and having family meals together), and mental health (life satisfaction and subjective health complaints). The analyses were weighted and adjusted for age, gender, socio-economic status, and country.

RESULTS

Overall, healthier eating habits were associated with better mental health. The strongest associations were found between meal habits (breakfast consumption and having family meals together) and mental health. Gender and country differences were seen, with weaker associations found among Danish boys.

CONCLUSION

Eating habits should be considered when promoting mental health in the adolescent population. While gender differences and cross-country variations exist, even minor enhancements in eating behaviors could yield meaningful benefits.

Exploring parental secretive eating of sugary foods and drinks, and its associations with food consumption in families

As a way of modeling healthier eating habits for their children, parents may intentionally avoid consuming sugary foods and drinks (SFDs) in their presence but consume these on other occasions (later referred to as parental secretive eating). This study aimed to 1) explore the prevalence of parental secretive eating, 2) investigate the associations between parental secretive eating and SFD consumption in parents and children, and 3) qualitatively explore the reasons for parental secretive eating. Participants were Finnish mothers (n = 362), fathers (n = 123), and their 3-6-year-old children (n = 403); this data was collected in 2017 as part of the baseline assessment of the DAGIS intervention. Parents reported how often they avoided eating SFDs in the presence of their child, completed food frequency questionnaires for themselves and their child, and responded to an open-ended question of explaining reasons for secretive eating. The overall prevalence of parental secretive eating was 68%. It was more common among mothers than fathers (p < 0.001) and most prevalent in chocolate (61%) and sweets (59%). Parental secretive eating was positively associated with SFD consumption both among mothers (ꞵ = 0.274, p < 0.001) and fathers (ꞵ = 0.210, p = 0.028) in linear regression models adjusted for parents' and child's age, child's gender, parental education level, and number of household members. Mothers' or fathers' secretive eating and child's SFD consumption were not associated (ꞵ = 0.031, p = 0.562; ꞵ = -0.143; p = 0.167). Three themes describing reasons for parental secretive eating were found: family food rules, avoiding child's requests, and aspiration for healthy modeling. In conclusion, parental secretive eating may play an important role in determining SFD consumption in families with preschoolers. Additional research is needed to determine whether parents can prevent their own eating habits from influencing their child through secretive eating.

Autistic traits and eating behaviors in Chinese preschoolers: Role of sensory profiles and home environment

OBJECTIVE

This study aims to 1) explore the association between autistic traits and eating behaviors in Chinese preschoolers; 2) explore the mediating role of sensory processing patterns on the relation of autistic traits and eating-related behaviors; and 3) examine home nurturing environment as a moderator between autistic traits and eating-related behaviors. We hypothesize that there is a significant association between autistic traits and eating behaviors, which is mediated by sensory processing patterns and moderated by the home nurturing environment.

METHOD

509 children aged 3-4 years participated in this cross-sectional research. They were assessed using the Social Responsiveness Scale-Second Edition (SRS-2) for autistic traits, the Chinese Preschoolers' Eating Behavior Questionnaire (CPEBQ) for eating-related behaviors, the Short Sensory Profile-Second Edition (SSP-2) for sensory processing patterns, and the Children Home Nurture Environment Questionnaire (CHNEQ) for home nurturing environment. Mediation regression analyses were used to examine the role of sensory processing patterns, while moderation analyses to examine the role of home nurturing environment.

RESULTS

We observed a positive association between autistic traits and eating behavior problems among typically developed children. Sensory processing patterns significantly mediated the impact of autistic traits on children's eating-related behaviors and home nurturing environment also moderated this relationship.

DISCUSSION

Our research suggests that Chinese preschoolers with higher autistic traits may face more eating challenges when they possess more heightened sensory processing patterns, while living in supportive home environments helps to improve their eating behaviors. These findings contribute to the understanding of how and to what extent eating problems are influenced by autistic traits, and they offer insight into the alleviation of eating problems from the perspectives of sensory patterns and family nurturing environments.

Family structure and the association with physical activity-Findings from 40 countries participating in the Health Behaviour in School-aged Children (HBSC) study

BACKGROUND

The family has been acknowledged as central to developing physical activity (PA) beliefs and behaviours. However, increased diversity in family structures has developed over the last decades. This study examines the association between family structure and PA among adolescents and cross-national variations in the associations.

METHODS

The data are from the 2013/14 Health Behaviours in School-Aged Children study, involving nationally representative samples of 11-, 13- and 15-year-olds (n = 211,798) from 40 countries. Multilevel Poisson regression analysis was used to examine the associations between family structure and moderate to vigorous physical activity (MVPA) and vigorous physical activity (VPA) by age, gender, socioeconomic status (SES), and geographic region.

RESULTS

Living with one versus two parents was associated with a reduced likelihood of daily 60 min MVPA for boys (IRR = 0.96, 95% CI: 0.92, 0.99) and ≥ 4 times/week VPA (IRR 0.93, 95% CI: 0.91, 0.95). This impact on MVPA differed across individual-level SES (high SES; IRR = 0.92, (p <0.05), low SES; IRR = 1.04, (ns)), and was for VPA only significant for those with siblings (IRR = 0.93, 95% CI: 0.91, 0.96). Cross-country variations in the association between living with one versus two parents were observed, most pronounced for VPA. These differences varied by region, primarily explained by country-level SES differences between regions. The likelihood of daily 60 min MVPA also increased with siblings in the main house (IRR 1.11, 95% CI: 1.07, 1.14), and ≥ 4 times/week VPA decreased with grandparents in the main house (IRR 0.91, 95% CI: 0.89,0.94).

CONCLUSIONS

Family structure correlated with PA, but cross-country differences exist. The findings are relevant for the development of policies and programs to facilitate PA, especially in countries where living with one versus two parents was unfavourable. Additional country-specific research is needed to identify challenges for engaging in PA related to family structure.

Sixteen-year trends in fruit consumption and related socioeconomic inequalities among adolescents in Western European countries

PURPOSE

To investigate time trends in daily fruit consumption among Western European adolescents and in related socioeconomic inequalities.

METHODS

We used nationally representative data from 18 countries participating in five rounds (2002 to 2018) of the cross-sectional "Health Behaviour in School-aged Children" (HBSC) survey (n = 458,973). The questionnaire, standardised across countries and rounds, was self-administered at school by 11-, 13- and 15-year-old adolescents. Daily fruit consumption was assessed using a short food frequency questionnaire (sFFQ). Socioeconomic inequalities were measured using the Family Affluence Scale (FAS). Multilevel logistic regressions were applied to study linear time trends in daily fruit consumption, overall, by country and by FAS.

RESULTS

Between 2002 and 2018, daily fruit consumption increased in 10 countries (OR range, 1.04 to 1.13, p < 0.05) and decreased in 3 (OR range 0.96 to 0.98, p < 0.05). In all survey years combined, prevalence of daily fruit consumption was significantly higher among high FAS groups (42.6%) compared to medium (36.1%) and low FAS groups (31.7%; all countries: p < 0.001). Between 2002 and 2018, socioeconomic inequalities in fruit consumption increased in Austria, Germany, Italy, Netherlands, Scotland, Sweden, and Switzerland. Only in Norway FAS inequalities decreased while the prevalence increased.

CONCLUSION

The prevalence of daily fruit consumption generally increased among adolescents between 2002 and 2018 in Western European countries, yet socioeconomic inequalities increased in some countries. Public health interventions should continue to promote fruit consumption with special attention to lower socioeconomic groups.

Association of household composition with dietary patterns among adolescents in Brazil

The present study identified dietary patterns (DP) and analyse their association with household composition. This is a cross-sectional school-based study, with a nationally representative sample of Brazilian adolescent students, aged 11-19 years, with data from National School Health Survey (n 102 072). Food consumption was obtained through the weekly frequency of consumption of food markers, and the confirmatory factor analysis was applied to examine the latent variables 'Healthy' (beans, legumes/vegetables and fresh fruit/fruit salad) and 'Unhealthy' (ultra-processed foods, sweets, soft drinks and snacks) DP. The association between household composition and DP was estimated considering lives with both parents as reference category. Among adolescents aged 11-14 years, adherence to healthy DP was lower for boys who lived only with mother (β = -2·1), and boys (β = -4·9) and girls (β = -4·5) who lived without any parents. Adherence to unhealthy DP was higher among boys (β = 7·6) and girls (β = 6·0) who lived only with mother, and boys (β = 4·6) and girls (β = 5·3) who lived only with father. For older adolescents (aged 15-19 years), adherence to the unhealthy DP was higher among boys who lived only with mother (β = 3·9) or only with father (β = 5·3) and girls who lived only with mother (β = 6·3). Adherence to healthy DP was lower among girls who lived only with father (β = -9·0). Thus, adolescents who lived in single-parent households had lower adherence to healthy DP and greater adherence to unhealthy DP. Among younger adolescents of both sexes, living without any parent contributed to lower adherence to healthy DP.

Clustering of Activity-Related Behaviors in Relation to Self-Reported Causes of Stress among Pre-Adolescents: Results from a National Epidemiological Study

An epidemiological study was conducted among 1728 10–12-year-old students (55.1% girls) and their parents during 2014–2016 in Greece. This study aimed to identify the dominant clusters of physical activity/sedentariness among preadolescents and investigate their association with self-reported sources of stress. Children’s physical activity levels and sources of stress were evaluated using validated questionnaires that assessed daily hours of activities, both on weekdays and on weekends, including physical activity, screen-based sedentary time, and non-screen-based sedentary time. The k-means algorithm of cluster analysis was applied. Three clusters of children’s physical activity/sedentariness were revealed. Cluster 1 was characterized as “Inactive-Non sedentary”, cluster 2 as “Active –Non-screen sedentary”, and cluster 3 as “Inactive-Sedentary”. Parental needs/expectations were associated with physical activity patterns (p = 0.009), i.e., children assigned to the third and second clusters had 36% and 51% lower odds to be stressed due to parental requirements [(OR for cluster 3 = 0.64, 95% CI = 0.41–0.99), (OR for cluster 2 = 0.49, 95% CI = 0.32–0.76)], compared with their first-cluster counterparts. Considering the need to promote physical activity in early life stages, the identification of these complex activity-related patterns along with their significant interaction with parental expectations as a cause of stress could enhance the effectiveness of targeted behavior change interventions among those parent–child dyads most in need.

Family structure in relation to body mass index and metabolic score in European children and adolescents

BACKGROUND

Living in single parent and blended families or as an only child-compared to living in two-parent biological families or with siblings, respectively-is associated with a higher body mass index (BMI) in cross-sectional studies. However, longitudinal research addressing the children's BMI in this context is scarce. Further, little is known about the association between family structure and metabolic health.

OBJECTIVES

This study aimed at investigating the association between both aspects of family structure with BMI and a metabolic score (MetS).

METHODS

Cross-sectional data from 7804 children participating in the European multi-center I.Family study (2013/2014) and longitudinal data from 5621 children who also participated previously in the IDEFICS study (2007-2010) were used. Family structure was assessed by a detailed interview. BMI z-score and the MetS were based on measured anthropometry, blood pressure, high-density lipoprotein, blood glucose, and triglycerides. Linear regressions were performed to model associations between family structure with BMI and MetS.

RESULTS

Children from single-parent families had higher BMI z-scores in the cross-sectional (β = 0.09, 95% confidence interval [CI]: 0.001 to 0.18) and longitudinal analyses compared to those from two-parent families. Cross-sectionally, the number of siblings was associated with lower BMI z-scores (β = -0.07, 95% CI: -0.10 to -0.03) and lower MetS (β = -0.14, 95% CI: -0.26 to -0.01). Longitudinally, only children between baseline and follow-up had higher BMI z-scores at follow-up (β = 0.07, 95% CI: 0.01 to 0.14) compared to stable siblings.

CONCLUSION

Obesity prevention measures should focus on single-parent households and families with an only child.

Family Related Variables' Influences on Adolescents' Health Based on Health Behaviour in School-Aged Children Database, an AI-Assisted Scoping Review, and Narrative Synthesis

Objects

Health Behaviours in School-aged Children (HBSC) is an international survey programme aiming to investigate adolescents' health behaviours, subjective perception of health status, wellbeing, and the related contextual information. Our scoping review aimed to synthesise the evidence from HBSC about the relationship between family environmental contributors and adolescents' health-related outcomes.

Methods

We searched previous studies from six electronic databases. Two researchers identified the qualified publications independently by abstract and full-text screening with the assistance of an NLP-based AI instrument, ASReview. Publications were included if they were based on HBSC data and investigated the effects of family environment on adolescents' health outcomes. Researches addressed family-related factors as mediators or moderators were also included.

Results

A total of 241 articles were included. Family environmental contributors could be mapped into six categories: (1) Demographic backgrounds (N = 177); (2) General family's psycho-socio functions (N = 44); (3) Parenting behaviours (N = 100); (4) Parental health behaviours (N = 7); (5) Family activities (N = 24); and (6) Siblings (N = 7). Except for 75 papers that assessed family variables as moderators (N = 70) and mediators (N = 7), the others suggested family environment was an independent variable. Only five studies employed the data-driven approach.

Conclusion

Our results suggest most research studies focussed on the influences of family demographic backgrounds on adolescents' health. The researches related to parental health behaviours and siblings are most inadequate. Besides, we recommend further research studies to focus on the mediator/moderator roles of the family, for exploring the deep mechanism of the family's impacts. Also, it would be valuable to consider data-driven analysis more in the future, as HBSC has mass variables and data.

Family Structure through the Adolescent Eyes: A Comparative Study of Current Status and Time Trends over Three Decades of HBSC Study

This study aimed to investigate how family structure varies and identify its time trends in European and North American countries using data from seven surveys conducted between 1994 and 2018 according to the Health Behaviour in School-aged Children (HBSC) study. The current family structure in 44 countries was described and time trend analysis of 28 countries was performed. Adolescents were asked whom they lived with in their home to describe family structures. Family structures showed distinct patterns and dynamics between countries. In 2018, in all countries, 73% of adolescents lived with both their mother and father; 14% and 5% of adolescents lived in a single-parent family and stepfamily, respectively; and around 9% of adolescents lived in another family type. In the period 1994–2018, the proportion of young people living in intact families decreased from 79.6% to 70.0%, on average about 10 percentage points. There were no significant changes in the prevalence of single-parent families and stepfamilies, but a significant increase in the number of adolescents living without either parent was revealed. The findings have implications for cross-national adjustment of adolescent health, well-being, and behaviours, and for critical analysis of socioeconomic family resources.