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Vidal R, Rivera-Navarro J, Gravina L, Díez J, Franco M. Correlates of eating behaviors in adolescence: a systematic review of qualitative studies. Nutr Rev 2024; 82:749-776. [PMID: 37432794 DOI: 10.1093/nutrit/nuad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
CONTEXT Nutrition plays a critical role in adolescence. Adolescents are vulnerable to the impact of different factors that distance them from healthy habits, increasing their risk of chronic diseases in adulthood. Qualitative methodologies allow for a better understanding of these factors. OBJECTIVE This systematic review aims to consolidate qualitative research evidence from the past 10 years to analyze the facilitators and barriers influencing adolescents' eating behaviors. DATA SOURCES Databases searched for relevant studies were Scopus, Medline/PubMed, PsycINFO, and Web of Science. DATA EXTRACTION A total of 4176 records were identified. The authors used the GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative Research) quality-assessment tool. RESULTS Fifty articles with qualitative or mixed methodologies were finally included. The most applied techniques were focus groups and semi-structured interviews. The factors influencing adolescents' diets were classified into 4 dimensions: individual, social, community, and macrosystem factors. The most influential were the following-(1) at the individual level: gender (facilitator or barrier), taste and appearance of food (barrier), and lack of time (barrier); (2) at the social level: parents' and caregivers' influence (facilitator or barrier), peer group influence (barrier), and socioeconomic position (barrier); (3) at the community level: school food environment (facilitator or barrier), neighborhood food environment (barrier), household food environment (facilitator or barrier), food insecurity (barrier), and availability and affordability of ultra-processed foods (barrier); and (4) at the macrosystem level: digital tools (facilitator or barrier). CONCLUSIONS This systematic review identified several facilitators and barriers influencing eating behaviors among adolescents. Qualitative research provides a rich source of knowledge to inform interventions aimed at improving adolescents' diets. Qualitative research is very useful for collecting researches that help to implement intervention programs that improve adolescent nutrition.
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Affiliation(s)
- Raquel Vidal
- Sociology and Communication Department, Social Sciences Faculty, Salamanca University, Salamanca, Spain
| | - Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Salamanca University, Salamanca, Spain
| | - Leyre Gravina
- Nursing I Department, Nursing and Medicine Faculty, University of the Basque Country (UPV/EHU), Leioa, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Ghimire L, Ashorn U. Exploring Adolescent girls' Food-Talk in Kathmandu Valley, Nepal: A Qualitative Study. Ecol Food Nutr 2024; 63:20-36. [PMID: 37936277 DOI: 10.1080/03670244.2023.2274528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
This study aimed to analyze how adolescent girls residing in Kathmandu valley, Nepal, talk about food within the context of their everyday experiences. We conducted 10 in-depth and four focus group interviews. Qualitative thematic analysis based on the constructivist paradigm was used to organize the interviews. The Utilitarian domain contained health statements using biomedical language and lay theories on health. Hedonic talk emphasized the taste of food, but notions about enjoyment were limited. Collective talk constructed an ideal family. In agency talk, the interviewees described their active role in achieving a slim body. Participants were not concerned about food insecurity but about eating too much.
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Affiliation(s)
| | - Ulla Ashorn
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
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Deslippe AL, Bergeron C, Cohen TR. Boys and girls differ in their rationale behind eating: a systematic review of intrinsic and extrinsic motivations in dietary habits across countries. Front Nutr 2023; 10:1256189. [PMID: 37841404 PMCID: PMC10570531 DOI: 10.3389/fnut.2023.1256189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/01/2023] [Indexed: 10/17/2023] Open
Abstract
Background Boys' and girls' food habits diverge in adolescence (13-18 years). This contributes to unequal risks of adverse health outcomes based on sex and gender in adulthood (e.g., heart diseases in men vs. disorder eating in women). Though multi-factorial, why these dietary differences occur is unclear. Purpose To identify the reasons why adolescents' motivation behind dietary habits differs among genders. Methods Four databases were searched following PRISMA guidelines. Eligible studies had to use qualitative methodology and report at least one gender unique theme. Reported themes were thematically analyzed, with a sub-analysis by country where the studies were conducted. Quality appraisals were assessed using the Critical Appraisal Skills Programme checklist. Results In the 34 eligible articles (n = 1,694 returned) two overarching themes emerged that dictated dietary habits in adolescents: Self-motivators and Uncontrollable factors. Gender differences arose whereby girls highlighted more external motivators (e.g., eat healthier, change dietary habits around boys and be thin to fit traditional norms) over their dietary habits. In contrast, boys focused on more internal motivators (e.g., gain autonomy, eat for enjoyment and pursue gains in physical performance). This suggests that motivation underlying how boys and girls eat differs. These trends were largely consistent across countries. Conclusion Boys' and girls' food habits are not motivated by the same factors. To create more effective dietary interventions targeting health promotion, unique motivations behind food habits need to be understood and incorporated. Systematic review registration Identifier: CRD42022298077.
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Affiliation(s)
- Alysha L. Deslippe
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
- Healthy Starts, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Coralie Bergeron
- Healthy Starts, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tamara R. Cohen
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
- Healthy Starts, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
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Rivera-Navarro J, de Loyola González-Salgado I, Ramos-Truchero G, Gravina L, Díez J, Caballero S, Franco M. Factors influencing dietary inequalities among adolescents in Madrid and Bilbao: a qualitative research project. GACETA SANITARIA 2023; 37:102325. [PMID: 37598578 DOI: 10.1016/j.gaceta.2023.102325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To describe the design and methodology of a qualitative study to explore the main factors influencing dietary inequalities in adolescents in Madrid and Bilbao, Spain. METHOD The study area included six neighborhoods (three in each city) of different socioeconomic status (SES): low, medium, and high. We sampled 12 secondary schools (six in each city: two per socioeconomic level). Our methodology comprised: 1) developing an ad hoc index to classify all neighborhoods according to their SES; 2) selecting the study area and sample; 3) conducting semi-structured interviews (n=36) and focus groups (n=24). Grounded theory and phenomenological analysis will be employed in data analysis. Initially, we found factors influencing in adolescents' diet such as gender, family environment, and SES. CONCLUSIONS Systematizing the selection of neighborhoods and secondary schools, along with using appropriate methods, could serve as a foundation for future studies on health inequalities among adolescents.
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Affiliation(s)
- Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Salamanca University, Salamanca, Spain.
| | | | - Guadalupe Ramos-Truchero
- Sociology and Social Work Department, Education and Social Work Faculty, Valladolid University, Valladolid, Spain
| | - Leyre Gravina
- Nursing I Department, Nursing and Medicine Faculty, University of the Basque Country, País Vasco University, Bilbao, Spain; Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Alcalá University, Madrid, Spain
| | - Silvia Caballero
- Nursing I Department, Nursing and Medicine Faculty, University of the Basque Country, País Vasco University, Bilbao, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Alcalá University, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Vera-Ponce VJ, Guerra Valencia J, Torres-Malca JR, Zuzunaga-Montoya FE, Zeñas-Trujillo GZ, Cruz-Ausejo L, Loayza-Castro JA, De La Cruz-Vargas JA. Factors associated with adherence to the Mediterranean diet among medical students at a private university in Lima, Peru. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
<b>Introduction:</b> The Mediterranean diet (MedD)is a characteristic eating pattern of the countries of the Mediterranean region. Nonetheless, is unknown its adherence in medical students. We aimed to determine the prevalence of adherence to the Mediterranean diet (AMedD) and associated factors in medical students from Peru.<br />
<b>Material and methods</b>: Analytical cross-sectional study carried out by means of a virtual survey. PREDIMED scale was used to evaluate AMedD. The factors assessed were age, sex, academic year, body mass index (BMI), place of lunch consumption, cigarette smoking, and physical activity. Poisson regression with robust variance was used to present it in crude and adjusted prevalence ratios (PRa).<br />
<b>Results:</b> High AMedD was present in 38.50%. Statistically significant association was found for sex (PRa: 0.623; 95%CI 0.488-0.796); for overweight (PRa: 0.417; 95%CI 0.270-0.644), obesity (PRa: 0.591; 95%CI 0.400-0.874) versus normopese; cigarette smoking (PRa: 0.450; 95%CI 0.263-0.773); and high physical activity (PRa: 1.652; 95%CI 1.233-2.215).<br />
<b>Conclusions</b>: AMedD was low. The related factors were sex, BMI, consumption of lunch outside the home, cigarette smoking, and a high level of physical activity. If this is confirmed in future studies, it would be necessary to consider these elements to encourage greater consumption of MedD components by students, which would help to improve their long-term health.
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Affiliation(s)
- Victor Juan Vera-Ponce
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Santiago de Surco, Lima, PERU
- Universidad Tecnológica del Perú, Lima, PERU
| | - Jamee Guerra Valencia
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Santiago de Surco, Lima, PERU
- Universidad Privada del Norte, Lima, PERU
| | - Jenny Raquel Torres-Malca
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Santiago de Surco, Lima, PERU
| | - Fiorella E Zuzunaga-Montoya
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Santiago de Surco, Lima, PERU
| | | | - Liliana Cruz-Ausejo
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Santiago de Surco, Lima, PERU
| | - Joan A Loayza-Castro
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Santiago de Surco, Lima, PERU
| | - Jhony A De La Cruz-Vargas
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Santiago de Surco, Lima, PERU
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Demilew YM, Nigussie AA, Almaw H, Sewasew B. Diet quality of preparatory school students in Awi Zone, Ethiopia: a cross-sectional study. BMJ Open 2023; 13:e067852. [PMID: 37085317 PMCID: PMC10124249 DOI: 10.1136/bmjopen-2022-067852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE The study aimed to assess diet quality and associated factors among preparatory school students in Awi Zone, Ethiopia. DESIGN A school-based cross-sectional study design was used in this study. SETTING The study was carried out in Awi Zone, Amhara Region, Ethiopia. PARTICIPANTS A total of 834 preparatory school students participated in the study. OUTCOME MEASURES Diet quality was the outcome variable, and it was computed using the dietary diversity score, food variety score and consumption of animal-source foods. Students with high dietary diversity scores, appropriate animal-source food consumption and adequate food variety scores were labelled as having good-quality diets. Data were collected using a pretested structured self-administered questionnaire. Bivariate and multivariable logistic regressions were employed to analyse the data. Variables with p≤0.2 in the bivariate logistic regression analysis were included in the multivariable logistic regression model. Multivariable logistic regression analysis was done to determine the strength of the association. Statistical significance was determined at p value less than 0.05. RESULTS Only 24.7% (95% CI: 21.7%, 27.7%) of preparatory school students had good-quality diets. Being female (adjusted OR (AOR)=2.88, 95% CI: 2.0, 4.1), residing in an urban setting (AOR=1.90, 95% CI: 1.1, 3.2), having an educated mother (AOR=1.78, 95% CI: 1.1, 2.7), having pocket money (AOR=1.83, 95% CI: 1.2, 2.6) and nutrition information (AOR=1.90, 95% CI: 1.2, 3.1), and family monthly income >8000 Ethiopian birrs (AOR=3.90, 95% CI: 2.2, 7.1) were factors significantly associated with having good-quality diet. CONCLUSION The majority of the preparatory school students had poor-quality diets. These findings highlight the necessity of nutrition education that considers the sociodemographic characteristics of the students and their families. Implementing income-generating interventions for low-income households was also recommended by the findings.
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Affiliation(s)
| | | | - Hunegnaw Almaw
- Department of Nutrition and Dietetics, Bahir Dar University, Bahir Dar, Ethiopia
| | - Belete Sewasew
- Department of Pediatrics, Bahir Dar University, Bahir Dar, Ethiopia
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A Review of the Risk Factors for Iron Deficiency Anaemia among Adolescents in Developing Countries. Anemia 2023; 2023:6406286. [PMID: 36636253 PMCID: PMC9831712 DOI: 10.1155/2023/6406286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/15/2022] [Accepted: 12/24/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction Identifying the root causes of iron deficiency anaemia is a prerequisite for effective management and prevention in adolescents. This systematic review assessed risk factors of iron deficiency anaemia among adolescents living in developing countries. Method Electronic databases such as PubMed, Cochrane Library, Science Direct, Google Scholar, and SCOPUS were comprehensively searched for studies published between 1990 and 2020 that involved risk factors of iron deficiency anaemia among adolescents living in developing countries. The quality of the included studies was assessed using the American Dietetic Association Quality Criteria Checklist. Results A total of 2,252 publications were reviewed, and only fifteen cross-sectional studies were eligible for inclusion, eight of which focused on female adolescents and seven on both genders. Direct risk factors contributing to anaemia among adolescents included food intake practices (n = 10 studies), female adolescents (n = 8 studies), menstruation (n = 5 studies), and parasitic infection (n = 6 studies). Indirect risk factors found to be associated with anaemia among adolescents included low educational status (n = 4 studies) and low socioeconomic status (n = 3 studies). All fifteen studies were of good quality. Conclusion Food intake practices, female adolescents, menstruation, parasitic infection, and low educational status were the leading risk factors of iron deficiency anaemia among adolescents. Further research should concentrate on assessing the effectiveness and efficacy of existing interventions aimed at preventing iron deficiency among vulnerable groups in developing countries.
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Hawks M, Bratton A, Mobley S, Barnes V, Weiss S, Zadinsky J. Early adolescents’ physical activity and nutrition beliefs and behaviours. Int J Qual Stud Health Well-being 2022; 17:2050523. [PMID: 35289233 PMCID: PMC8928855 DOI: 10.1080/17482631.2022.2050523] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Obesity in early adolescents is a public health concern and presents a risk for poor health outcomes later in life. Early adolescents’ beliefs and behaviours of physical activity and healthy eating are not well understood. The purpose of this ethnographic inquiry was to explore the physical activity and healthy eating beliefs and behaviours of early adolescents (n = 15) who attended a community organization in an urban cluster in the Southeastern USA. Data from semi-structured interviews, participant observations and artefact collection were analysed using constant comparative analysis. We learned that five main influences on the early adolescents’ healthy eating and physical activity included recognizing benefits of physical activity and healthy eating, family influences, connecting with the community, peer influences, and developing a sense of self. Findings highlight community influences on early adolescents’ physical activity and healthy eating beliefs and behaviours that should be taken into account when developing health promotion strategies.
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Affiliation(s)
- Miranda Hawks
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia, USA
| | - Angela Bratton
- Katherine Reese Pamplin College of Arts, Humanities, and Social Sciences, Augusta University, Augusta, Georgia, USA
| | - Sandra Mobley
- Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Vernon Barnes
- Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Steven Weiss
- Katherine Reese Pamplin College of Arts, Humanities, and Social Sciences, Augusta University, Augusta, Georgia, USA
| | - Julie Zadinsky
- College of Nursing, Augusta University, Augusta, Georgia, USA
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"Good Food Causes Good Effects and Bad Food Causes Bad Effects": Awareness, Meanings and Perceptions of Malnutrition among Pakistani Adolescents Living in Slums through Photodiaries and Interviews. Nutrients 2022; 15:nu15010033. [PMID: 36615691 PMCID: PMC9824795 DOI: 10.3390/nu15010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Around 30% of the urban population of Southern Asia lives in a slum setting where basic necessities such as sanitation, education, employment, infrastructure are lacking, and people are more exposed to health problems. Children living in slums are at high risk of malnutrition. However, there is limited knowledge on adolescents living in slums. We explored awareness and meanings of malnutrition (under and over-nutrition) as well as examining malnutrition risk factors among adolescents living in a slum. A qualitative approach was undertaken using photodiaries and semi-structured interviews with 14 adolescents (13-16 years old) living in a slum in Karachi (Pakistan). An inductive strategy was used moving from open-ended data to patterns using reflexive thematic analysis. We identified widespread malnutrition awareness amongst these adolescents. Food consistently underpinned participants' narratives and photodiaries, which was reflected in how they made sense of malnutrition: undernutrition was understood as lack of food, while overnutrition as excess of food. This study identified malnutrition drivers: sanitation, exercise, families, peers, wellbeing, gender, nutritional knowledge, media, and most importantly, food. People's responsibility to eat healthily was highlighted by the participants, implying that people are to be blamed for their poor lifestyle choices. Following this responsibility discourse, most participants contemplated merely individually focused health interventions in order to overcome the problem of malnutrition in their area. It is necessary to study slum food environments better to implement effective nutrition programs and interventions to reduce malnutrition in slum settings.
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de Camargo AM, Botelho AM, Irmão GB, Fiates GMR. Analysis of Recipes Shared as 'Healthy' in a Popular Brazilian Website: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13914. [PMID: 36360804 PMCID: PMC9653976 DOI: 10.3390/ijerph192113914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Cooking is crucial to the achievement of healthy eating habits, and the internet, as host of culinary recipes websites, is a medium for the dissemination of cooking-related content. Research has revealed that most recipes available on internet sites do not have healthy characteristics when compared to recommendations for healthy eating, even the ones promoted as 'healthy'. This study investigated culinary recipes available on the 'healthy eating' section of a popular Brazilian recipe-sharing website. Recipes (n = 814) were analyzed with a validated framework based on national dietary guidelines. Ingredients (n = 5887) were classified according to the extension and purpose of their industrial processing. The recipes' titles were content analyzed to identify the health-related words and phrases used. Recipes contained ultra-processed foods and not enough unprocessed or minimally processed foods, such as legumes (4.7%, n = 380), nuts and seeds (18.4%, n = 150), and fruits (n = 32.7%, n = 263). The recipes' titles mentioned 564 health-related terms, appealing to physical characteristics, including weight loss, and fads, such as gluten-free, dukan, low-carb, detox, fitness, ripped body, and belly burner. Therefore, the 'healthy' recipes available on the Brazilian recipe-sharing website presented many aspects not in accordance with national dietary guidelines.
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A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities. Nutrients 2022; 14:nu14142797. [PMID: 35889754 PMCID: PMC9322165 DOI: 10.3390/nu14142797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/12/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023] Open
Abstract
This study examined the longitudinal associations between parental feeding practices and child weight status, and their potential modification effects by child sex, age, and maternal and paternal educations among children. Data were collected from 2015 to 2017 of 2139 children aged 6−17 years and their parents in five Chinese mega-cities. Parental feeding practices were assessed using 11-items from Child Feeding Questionnaire. Waist-to-height ratio (WHtR), body mass index (BMI), and general and central obesity were measured and analyzed using a mixed-effects model. Three parental feeding patterns were identified by factor analysis including “concern”, “pressure to eat”, and “control”. Concern was associated with higher BMI z-score, WHtR (βs ranged from 0.01 to 0.16), and general obesity (ORs ranged from 1.29 to 6.41) among children aged ≤12 years and >12 years, regardless of child sex and parental educations. Pressure to eat was associated with lower BMI z-score (β = −0.08, p < 0.001), WHtR (β = −0.004, p < 0.01), and general (OR = 0.53, 95%CI = 0.42, 0.66) and central obesity (OR = 0.72, 95%CI = 0.58, 0.90) among children aged ≤12 years. Further analyses showed that significant associations were found for children with maternal or paternal education of college and above. Control was associated with increased risk of general and central obesity among children with maternal education of college and above, regardless of age. Our study indicates that higher concern and lower pressure to eat were associated with increased risk of obesity among children. Control was associated with increased risk of obesity among children with maternal education of college and above. Future childhood obesity preventions may optimize parental feeding practices.
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Abstract
OBJECTIVE To explore and provide contextual meaning around issues surrounding food insecurity, namely factors influencing food access, as one domain of food security. DESIGN A community-based, qualitative inquiry using semi-structured face-to-face interviews was conducted as part of a larger sequential mixed-methods study. SETTING Cayo District, Belize, May 2019-August 2019. PARTICIPANTS Thirty English-speaking individuals (eight males, twenty-two females) between the ages of 18-70, with varying family composition residing within the Cayo District. RESULTS Participants describe a complex interconnectedness between family- and individual-level barriers to food access. Specifically, family composition, income, education and employment influence individuals' ability to afford and access food for themselves or their families. Participants also cite challenges with transportation and distance to food sources and educational opportunities as barriers to accessing food. CONCLUSION These findings provide insight around food security and food access barriers in a middle-income country and provide avenues for further study and potential interventions. Increased and sustained investment in primary and secondary education, including programmes to support enrollment, should be a priority to decreasing food insecurity. Attention to building public infrastructure may also ease burdens around accessing foods.
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Neufeld LM, Andrade EB, Ballonoff Suleiman A, Barker M, Beal T, Blum LS, Demmler KM, Dogra S, Hardy-Johnson P, Lahiri A, Larson N, Roberto CA, Rodríguez-Ramírez S, Sethi V, Shamah-Levy T, Strömmer S, Tumilowicz A, Weller S, Zou Z. Food choice in transition: adolescent autonomy, agency, and the food environment. Lancet 2022; 399:185-197. [PMID: 34856191 DOI: 10.1016/s0140-6736(21)01687-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023]
Abstract
Dietary intake during adolescence sets the foundation for a healthy life, but adolescents are diverse in their dietary patterns and in factors that influence food choice. More evidence to understand the key diet-related issues and the meaning and context of food choices for adolescents is needed to increase the potential for impactful actions. The aim of this second Series paper is to elevate the importance given to adolescent dietary intake and food choice, bringing a developmental perspective to inform policy and programmatic actions to improve diets. We describe patterns of dietary intake, then draw on existing literature to map how food choice can be influenced by unique features of adolescent development. Pooled qualitative data is then combined with evidence from the literature to explore ways in which adolescent development can interact with sociocultural context and the food environment to influence food choice. Irrespective of context, adolescents have a lot to say about why they eat what they eat, and insights into factors that might motivate them to change. Adolescents must be active partners in shaping local and global actions that support healthy eating patterns. Efforts to improve food environments and ultimately adolescent food choice should harness widely shared adolescent values beyond nutrition or health.
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Affiliation(s)
| | - Eduardo B Andrade
- Brazilian School of Public and Business Administration (EBAPE), Getulio Vargas Foundation (FGV), Rio de Janeiro, Brazil
| | | | - Mary Barker
- NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK; MRC Lifecourse Epidemiology Centre, Southampton General Hospital, Southampton, UK; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Ty Beal
- Global Alliance for Improved Nutrition, Washington, DC, USA
| | - Lauren S Blum
- Global Alliance for Improved Nutrition, Washington, DC, USA
| | | | - Surabhi Dogra
- Lancet Standing Commission on Adolescent Health and Wellbeing, Noida, India
| | - Polly Hardy-Johnson
- MRC Lifecourse Epidemiology Centre, Southampton General Hospital, Southampton, UK
| | | | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Christina A Roberto
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | - Sofia Strömmer
- NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK; MRC Lifecourse Epidemiology Centre, Southampton General Hospital, Southampton, UK
| | | | - Susie Weller
- Clinical Ethics and Law at Southampton (CELS), Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing, China; National Health Commission Key Laboratory of Reproductive Health, Beijing, China
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Cateriano-Arévalo E, Saavedra-Garcia L, Ponce-Lucero V, Miranda JJ. Applying Customer Journey Mapping in Social Marketing to Understand Salt-Related Behaviors in Cooking. A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413262. [PMID: 34948870 PMCID: PMC8701153 DOI: 10.3390/ijerph182413262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
Worldwide, salt consumption exceeds the World Health Organization’s recommendation of a daily intake of 5 g. Customer journey mapping is a research method used in market research to understand customer behaviors and experiences and could be useful in social marketing as well. This study aimed to explore the potential of customer journey mapping to better understand salt-related behaviors performed during the preparation of household cooking. We tracked the journey of four women in their kitchens for approximately two hours to observe the preparation of lunch. Individual journey maps were created, one for each woman, that were composited into a single journey map. We found that customer journey mapping was a suitable research method to understand how food preparers made decisions around adding salt and artificial seasonings at each stage of the journey. In contrast to the interviewee’ responses, it was observed that the four women added salt and artificial seasonings consistently and incrementally with little control and without any standard measure. In this study, we demonstrate the utility of customer journey mapping in a novel context and nudge social marketers to include this tool in their repertory of research methods to understand human behavior.
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Affiliation(s)
- Erik Cateriano-Arévalo
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru; (E.C.-A.); (L.S.-G.); (J.J.M.)
| | - Lorena Saavedra-Garcia
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru; (E.C.-A.); (L.S.-G.); (J.J.M.)
| | - Vilarmina Ponce-Lucero
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru; (E.C.-A.); (L.S.-G.); (J.J.M.)
- Correspondence: ; Tel.: +511-241-69-78
| | - J. Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima 15074, Peru; (E.C.-A.); (L.S.-G.); (J.J.M.)
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
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Viñuela A, Criado-Álvarez JJ, Aceituno-Gómez J, Durantez-Fernández C, Martín-Conty JL, Martín-Rodríguez F, Cano Martín LM, Maestre Miquel C, Polonio-López B, Mohedano-Moriano A. How Relevant Is the Place Where First-Year College Students Live in Relation to the Increase in Body Mass Index? Healthcare (Basel) 2021; 9:healthcare9121638. [PMID: 34946364 PMCID: PMC8700919 DOI: 10.3390/healthcare9121638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/22/2023] Open
Abstract
(1) Objective: This study analyzes the evolution of the body mass index (BMI) throughout the academic year associated with changes in the lifestyle associated with the place where students live during the course, lifestyle design, and health strategies for the university community. (2) Methods: A total of 93 first-year nursing students participated in this study. Data were collected throughout the course by administering self-reported questionnaires about eating habits and lifestyles, weight, and height to calculate their BMI and place of residence throughout the course. Data were analyzed using statistical analysis (Mann–Whitney, chi-square, Student’s t-test, repeated-measures analysis of variance, and least significant difference tests). (3) Results: We found that the mean BMI increases significantly throughout the course among all students regardless of sex, age, eating habits, or where they live during the course. At the beginning of the course, the mean BMI was 22.10 ± 3.64. The mean difference between the beginning of the course and the middle has a value of p-value < 0.015 and between the middle of the course and the end a p-value < 0.009. The group that increased the most is found among students who continue to live in the family nucleus rather than those who live alone or in residence. Students significantly changed their eating and health habits, especially those who live alone or in residence. (4) Conclusions: There is an increase in BMI among students. It is necessary to carry out seminars or talks that can help students understand the importance of good eating practices and healthy habits to maintain their weight and, therefore, their health, in the short, medium, and long term and acquire a good quality of life.
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Affiliation(s)
- Antonio Viñuela
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.A.-G.); (C.D.-F.); (J.L.M.-C.); (C.M.M.); (B.P.-L.)
- Correspondence:
| | - Juan José Criado-Álvarez
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Avenida Real Fábrica de las Sedas, s/n, 45600 Talavera de la Reina, Spain; (J.J.C.-Á.); (A.M.-M.)
| | - Javier Aceituno-Gómez
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.A.-G.); (C.D.-F.); (J.L.M.-C.); (C.M.M.); (B.P.-L.)
- Management of Integrated Attention of Talavera de la Reina, SESCAM, 45600 Talavera de la Reina, Spain
| | - Carlos Durantez-Fernández
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.A.-G.); (C.D.-F.); (J.L.M.-C.); (C.M.M.); (B.P.-L.)
| | - José Luis Martín-Conty
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.A.-G.); (C.D.-F.); (J.L.M.-C.); (C.M.M.); (B.P.-L.)
| | - Francisco Martín-Rodríguez
- Center for Advanced Clinical Simulation, Advanced Life Support Unit, Emergency Medical Services, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain;
| | | | - Clara Maestre Miquel
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.A.-G.); (C.D.-F.); (J.L.M.-C.); (C.M.M.); (B.P.-L.)
| | - Begoña Polonio-López
- Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.A.-G.); (C.D.-F.); (J.L.M.-C.); (C.M.M.); (B.P.-L.)
| | - Alicia Mohedano-Moriano
- Department of Medical Sciences, School of Health Sciences, University of Castilla-La Mancha, Avenida Real Fábrica de las Sedas, s/n, 45600 Talavera de la Reina, Spain; (J.J.C.-Á.); (A.M.-M.)
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16
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How Does the Family Influence Adolescent Eating Habits in Terms of Knowledge, Attitudes and Practices? A Global Systematic Review of Qualitative Studies. Nutrients 2021; 13:nu13113717. [PMID: 34835973 PMCID: PMC8624651 DOI: 10.3390/nu13113717] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022] Open
Abstract
Promoting healthy eating habits can prevent adolescent obesity in which family may play a significant role. This review synthesized findings from qualitative studies to identify family barriers and facilitators of adolescent healthy eating in terms of knowledge, attitudes, and practices (KAP). A literature search of four databases was completed on 31 July 2020; qualitative studies that explored family factors of adolescent (aged 10 to 19 years) eating habits were included. A total of 48 studies were identified, with the majority being from North America and sampled from a single source. Ten themes on how family influences adolescent dietary KAP were found: Knowledge—(1) parental education, (2) parenting style, and (3) family illness experience; Attitudes—(4) family health, (5) cultivation of preference, and (6) family motivation; Practices—(7) home meals and food availability, (8) time and cost, (9) parenting style, and (10) parental practical knowledge and attitudes. This review highlights five parental characteristics underlying food parenting practices which affect adolescents’ KAP on healthy eating. Adolescents with working parents and who are living in low-income families are more vulnerable to unhealthy eating. There is a need to explore cultural-specific family influences on adolescents’ KAP, especially regarding attitudes and food choices in Asian families.
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Qiu N, Moore JB, Wang Y, Fu J, Ding K, Li R. Perceived Parental Attitudes Are Indirectly Associated with Consumption of Junk Foods and Sugar-Sweetened Beverages among Chinese Adolescents through Home Food Environment and Autonomous Motivation: A Path Analysis. Nutrients 2021; 13:nu13103403. [PMID: 34684401 PMCID: PMC8541436 DOI: 10.3390/nu13103403] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to use path analysis to determine the association between perceived parental attitudes toward restricting junk food (JF)/sugar-sweetened beverage (SSB) intake and JF/SSB consumption among Chinese adolescents, and whether JF/SSB availability in the home environment and autonomous motivation of adolescents mediated the association. A cross-sectional survey was conducted using questionnaires adapted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study to collect data on 3819 participants with an average age of 14.7 years (SD = 1.7). Spearman correlations and path analysis were performed. It was found that perceived parental attitudes were not directly associated with adolescents’ JF/SSB consumption frequency, but indirectly related to them through JF/SSB availability in the home environment and autonomous motivation of adolescents. When parents held a less positive attitude toward JF/SSB consumption and kept less JFs/SSBs at home, youth displayed more autonomous motivation for restricting JF/SSB intake and consumed fewer JFs/SSBs.
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Affiliation(s)
- Nan Qiu
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430071, China; (N.Q.); (Y.W.); (J.F.); (K.D.)
| | - Justin B. Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA;
| | - Yechuang Wang
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430071, China; (N.Q.); (Y.W.); (J.F.); (K.D.)
| | - Jialin Fu
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430071, China; (N.Q.); (Y.W.); (J.F.); (K.D.)
| | - Kai Ding
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430071, China; (N.Q.); (Y.W.); (J.F.); (K.D.)
| | - Rui Li
- Department of Healthcare Management, School of Health Sciences, Wuhan University, Wuhan 430071, China; (N.Q.); (Y.W.); (J.F.); (K.D.)
- Correspondence: ; Tel.: +86-27-68759901; Fax: +86-27-68758648
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Association between Food Preferences and Food Habits in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study. Nutrients 2021; 13:nu13093003. [PMID: 34578881 PMCID: PMC8471474 DOI: 10.3390/nu13093003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022] Open
Abstract
Food preferences are among the most influential factors of food habits in the vulnerable period of adolescence; in addition, gender-dependent differences in food preferences are also observed. The aim of the present study was to analyze differences in food habits between individuals stratified based on their food preferences in a population-based sample of adolescents aged 15–20. The study was conducted within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population in a group of 2419 secondary school students who were randomly chosen to participate in the study using a random quota sampling procedure. The food preferences were determined on the basis of a validated Food Preference Questionnaire (FPQ) (which enables assessing preference of vegetables, fruit, meat/fish, dairy, snacks, and starches), whereas food habits were determined on the basis of the Adolescents’ Food Habits Checklist (AFHC) (which enables assessing food purchase, preparation, and consumption habits). The analysis involved three homogenous clusters (‘low-preferring’, ‘hedonists’, and ‘high-preferring’), which were identified using the k-means algorithm. It was found that for a number of the assessed food purchase, preparation, and consumption habits, there were statistically significant differences between the ‘low-preferring’, ‘hedonists’, and ‘high-preferring’ clusters. Within food purchase habits, the food preference influenced frequency of buying pastries/cakes and frequency of eating takeaway meals for all the respondents, while for female respondents, it influenced also choice of desserts in restaurants, and for male respondents, it influenced choosing a low-fat lunch away from home (p < 0.05). Within food preparation habits, the food preference influenced the fat content in desserts at home, the frequency of eating at least one serving of vegetables/salad with an evening meal, the frequency of spreading butter/margarine on bread thinly, and the frequency of having cream on desserts for all the respondents; meanwhile, for female respondents, it also influenced the frequency of avoiding fried foods and the frequency of including chocolate/biscuits in their packed lunch (p < 0.05). Within food consumption habits, the food preference influenced the frequency of eating a dessert/pudding, eating at least one serving of fruit a day, eating at least one serving of vegetables/salad a day, avoiding sausages/burgers, trying to ensure they eat plenty of fruit and vegetables, and frequency of choosing fruit as a snack for all the respondents; meanwhile, for male respondents, it also influenced the frequency of eating sweet snacks and eating at least three servings of fruit most days (p < 0.05). Taking into account that some improper food habits may be typical for the specific clusters, there is an urgent need to analyze and address them for the purposes of public health and to bear in mind that some of those habits are gender-dependent.
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Roshita A, Riddell-Carre P, Sjahrial R, Jupp D, Torlesse H, Izwardy D, Rah JH. A Qualitative Inquiry into the Eating Behavior and Physical Activity of Adolescent Girls and Boys in Indonesia. Food Nutr Bull 2021; 42:S122-S131. [PMID: 34282656 DOI: 10.1177/0379572121990948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the rising double burden of malnutrition, adolescent nutrition has received little attention in Indonesia. Eating and physical activity behaviors established in adolescence are known to track into adulthood and may contribute to chronic diseases in later life. This study aimed to explore the eating behaviors and physical activity of Indonesian adolescents, and their influencing factors. METHODS The study, designed as a qualitative study, was conducted in 2 selected districts in Indonesia: Klaten and Lombok Barat. Data were collected through immersion, open and informal discussions, and participant observations with 302 adolescent girls and boys. RESULTS The eating and physical activity behaviors of adolescent boys and girls are influenced by contextual changes in their family lifestyles and environment. The adolescents in this study only conflate physical activity with participation in sport. Even when a wider view of physical activity is cast, their level of physical activity remains low, especially for adolescent girls. Adolescents and their families generally eat 3 meals a day, with schools an important source of food for adolescents. Adolescents skip breakfast at home, and breakfast and lunch are usually purchased and eaten at school. Fewer families cook and families rarely eat together due to increasingly busy lives, increased mobility, and digital connectivity. CONCLUSIONS The rapid contextual shifts taking place in Indonesia influence the home, school, and peer environment to shape eating behaviors and physical activity among adolescent boys and girls. Gender-responsive multicomponent school-based interventions have the potential to serve as an important entry point for influencing adolescent nutrition.
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Affiliation(s)
| | | | | | - Dee Jupp
- Reality Check Approach Plus, Jakarta, Indonesia
| | | | - Doddy Izwardy
- Center of Public Health Efforts, Research and Development Agency, Ministry of Health, Jakarta, Indonesia
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Kaveh MH, Moradi L, Morowatisharifabad MA, Najarzadeh A, Fallahzadeh H. Motivation System of Healthy and Safe Nutrition in Iranian Adolescent Girls: A Qualitative Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5556759. [PMID: 34337025 PMCID: PMC8292067 DOI: 10.1155/2021/5556759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Motivation determines the possibility of an individual's intention to accept health-related behaviors. Despite the important role of the motivational system in conducting healthy and safe nutrition behavior, this issue has not been adequately addressed. The purpose of this qualitative study was to explain the healthy and safe nutrition motivation system among Iranian adolescent girls. METHOD In this qualitative study, conventional content analysis was used and participants were selected using the purposive sampling method. Semistructured in-depth interviews were conducted with 42 adolescent girls in Shiraz, Iran. The interviews continued until data saturation was obtained. Qualitative data were analyzed using the Graneheim and Lundman qualitative content analysis by MAX-Q-DA (version 10) software. RESULTS The data analysis resulted in three main categories for the participants' motivational factors for healthy and safe nutrition: (1) maintaining health and social functions, (2) maintaining the family's mental and economic health, and (3) achieving goals and success in life. The first category included two subcategories: "desire to have an appropriate look and appearance" and "fear of diseases and their complications." The second category included two subcategories of "maintaining the family's mental health" and "maintaining the family's economic health." The third category consisted of two subcategories: "desire to form a family and be successful in life" and "achieving the future career goals." CONCLUSION The motivation to maintain health and social functions, to maintain the family's mental and economic health, and to achieve goals and be successful in life has a powerful impact on the decisions and behaviors of adolescent girls to have safe and healthy nutrition. Therefore, recognizing the motivational system, as a key and determinative factor in developing the adolescents' intention to adopt health-related behaviors, is an effective step to design and develop successful interventions in promoting nutritional behaviors.
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Affiliation(s)
- Mohammad Hossein Kaveh
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz 71557, Iran
| | - Leila Moradi
- Social Determinants of Health Research Center, Department of Health Promotion, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
| | - Mohammad Ali Morowatisharifabad
- Elderly Health Research Center, Department of Health Promotion, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
| | - Azadeh Najarzadeh
- Nutrition and Food Security Research Center, Department of Nutrition, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
| | - Hossein Fallahzadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd 89151, Iran
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Hasan AMR, Smith G, Rashid MH, Selim MA, Rasheed S. Promoting healthy foods among urban school children in Bangladesh: a qualitative inquiry of the challenges and opportunities. BMC Public Health 2021; 21:1029. [PMID: 34074273 PMCID: PMC8168019 DOI: 10.1186/s12889-021-11085-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Bangladesh overweight and obesity among urban school children are on the rise. Urban school children tend to consume foods dense in calories and few fruits and vegetables which is associated with overweight and obesity. The current study explored the barriers and opportunities for promoting healthy diets among school children from the perspective of teachers and parents in Dhaka, Bangladesh. METHODS We conducted 14 key informant interviews with teachers and principals, six focus group discussions with 31 mothers of school children (5 to 15 year old) and 14 structured observations of the school food environment. Inductive thematic analysis was performed manually. RESULTS Schools were important for development of food preferences of children, however, most school cafeterias provided foods based on profit rather than health considerations. A shift in food culture resulted in making eating out acquire many meanings beyond convenience. Mothers, especially those who were employed, struggled to prepare healthy foods due to time pressure. Mothers were generally concerned about chemicals added to raw foods in markets which led to limited fruit and vegetable consumption. CONCLUSIONS There were many challenges to promoting healthy foods to school children within and outside the school. It is important to formulate policies and guidance to create a supportive environment for healthy foods in and in the proximity of schools. It is also important to educate consumers about identifying and choosing healthy foods. Laws related to food safety should be adequately implemented to boost the population's confidence in safety of available healthy foods in the food system.
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Affiliation(s)
- A M Rumayan Hasan
- Universal Health Coverage, Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | | | - Md Harunor Rashid
- Universal Health Coverage, Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mohammad Abdus Selim
- Universal Health Coverage, Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Sabrina Rasheed
- Universal Health Coverage, Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
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Radwan A, Radwan E, Radwan W. Eating habits among primary and secondary school students in the Gaza Strip, Palestine: A cross-sectional study during the COVID-19 pandemic. Appetite 2021; 163:105222. [PMID: 33798621 DOI: 10.1016/j.appet.2021.105222] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/05/2021] [Accepted: 03/17/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The COVID-19 pandemic has a great impact on the eating habits, dietary intake, and purchasing behaviours of students. At this critical moment, there is an urgent need to identify the eating habits of school students, in particular, who live in low-income countries, during the lockdown period. Therefore, the present study aims to identify the influence of COVID-19 on the eating habits, quality and quantity of food intake among school students in the Gaza Strip, Palestine. METHODS A cross-sectional study was carried out among 2398 primary and secondary school students aged 6-18 year old through an online questionnaire which included questions on socio-demographic, eating habits as well as quality and quantity of food intake. Students over the age of 11 years completed the questionnaire on their own, whereas for students under the age of 12 years, the students' guardians were instructed to answer the questionnaire on their behalf. A Wilcoxon Signed-Rank and McNemar tests were applied to perform a comparison between general dietary habits before and during COVID-19. Also, a Wilcoxon Signed Rank test was used to compare the median scores of food quality and quantity before and during the COVID-19 pandemic based on student's sociodemographic. RESULTS During the COVID-19 pandemic, there was a significant increase in eating home-cooked foods (91.6%), avoiding ordering food from outside per week (93.3%) and buying groceries online (7.7%) (p < 0.001). There was a marked increase in the students reporting fear about food hygiene outside the home from 20.8% before COVID-19 to 72.9% during the COVID-19 period (p < 0.001). The results showed that the median score for food quality during the COVID-19 pandemic (11.0/6.0) was significantly higher than the before COVID-19 period (10.0, IQR = 8.0) (p < 0.001). The results revealed that the median score for food quantity before the COVID-19 pandemic (15.0, IQR = 5.0) was significantly higher than the during COVID-19 pandemic (14.0, IQR = 7.0) (p < 0.001). The results showed significant differences between the before and during COVID-19 period for food quality and quantity across socio-demographic variables (gender, age group, parent's highest level of education, monthly household income, and household size). During the COVID-19 pandemic, students from a high-income and a small size family had the highest score in terms of food quality and quantity among other counterparts when compared to other counterparts. CONCLUSION Eating habits have significantly altered among school students during the COVID-19 pandemic. In spite of some good healthy habits enhanced among students, the quantity and the quality of the food was compromised. Therefore, the responsible officials at the Ministry of Education must focus on enhancing school students' awareness towards increased intake of healthy food and adopting good eating habits during the spread of pandemics and health diseases to avoid its negative effects on students.
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Affiliation(s)
- Afnan Radwan
- Faculty of Education, Islamic University of Gaza, Gaza Strip, Palestine
| | - Eqbal Radwan
- Department of Biology, Faculty of Science, Islamic University of Gaza, Gaza Strip, Palestine; Directorate of Education-East Gaza, Ministry of Education and Higher Education, Gaza Strip, Palestine.
| | - Walaa Radwan
- Faculty of Education, Ummah Open University, Gaza Strip, Palestine
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How Minority Parents Could Help Children Develop Healthy Eating Behaviors: Parent and Child Perspectives. Nutrients 2020; 12:nu12123879. [PMID: 33353032 PMCID: PMC7766451 DOI: 10.3390/nu12123879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/05/2020] [Accepted: 12/15/2020] [Indexed: 11/18/2022] Open
Abstract
Minority children and children living in under-resourced households are at the greatest risk for obesity and diet-related disparities. Identifying effective strategies to reduce these risks is an important step in child obesity prevention. Parents influence the home environment and play a critical role in child obesity prevention. Eighteen parent–child dyads living in under-resourced Houston area communities participated in a mixed methods study (online surveys, telephone interviews). The purpose of the research reported here was to conduct a secondary analysis of the qualitative data to explore Black/African American and Hispanic parent and child perspectives of the ways in which parents could help their children make healthy food choices. Descriptive statistics were calculated for parent and child demographic characteristics; hybrid thematic analysis was used to code and analyze the interview transcripts. Frequencies were calculated for children’s interview responses to rating scales and the grade they gave their eating habits. Mothers’ responses were grouped into two broad categories: facilitators (modeling, availability, and teaching) as ways parents could help their child eat healthy, and barriers (lack of time, cost of healthy foods, and lack of knowledge) to helping their child eat healthy. Alternatively, child responses focused on ways in which parents could provide support: environmental support (home availability, home cooking, and introducing new foods) and personal support (providing child choice, teaching, and encouragement). Most children reported that eating healthy was easy, and most rated their personal eating habits as an A or B. These findings suggest that understanding the perspectives of Black/African American and Hispanic parent–child dyads can provide insight into the development of culturally and economically relevant healthy eating strategies and interventions for families living in under-resourced communities.
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Fox EL, Timmer A. Children's and adolescents' characteristics and interactions with the food system. GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT 2020. [DOI: 10.1016/j.gfs.2020.100419] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Correa-Matos N, Rodríguez MC, Rodríguez-Pérez R. Development and Application of Interactive, Culturally Specific Strategies for the Consumption of High-fiber Foods in Puerto Rican Adolescents. Ecol Food Nutr 2020; 59:639-655. [DOI: 10.1080/03670244.2020.1763980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Nancy Correa-Matos
- Nutrition and Dietetics Program, College of Natural Sciences, University of Puerto Rico, Rio Piedras, Puerto Rico
| | - María C. Rodríguez
- Department of Agricultural Education, College of Agricultural Sciences, University of Puerto Rico, Mayagüez, Puerto Rico
| | - Robinson Rodríguez-Pérez
- Department of Agricultural Economics and Rural Sociology, College of Agricultural Sciences, University of Puerto Rico, Mayagüez, Puerto Rico
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Al-Jawaldeh A, Taktouk M, Nasreddine L. Food Consumption Patterns and Nutrient Intakes of Children and Adolescents in the Eastern Mediterranean Region: A Call for Policy Action. Nutrients 2020; 12:E3345. [PMID: 33143163 PMCID: PMC7693485 DOI: 10.3390/nu12113345] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 11/17/2022] Open
Abstract
The Eastern Mediterranean Region (EMR) has witnessed significant social and economic changes that may have influenced the diet of children and adolescents, and increased the risk for obesity and malnutrition in this age group. This review aims to characterize and assess food consumption patterns and nutrient intakes amongst school-aged children (5-10 years) and adolescents (10-19 years) in countries of the EMR. Electronic databases (MedLine, PubMed, Scopus, and Google Scholar) were searched for relevant articles published between 2005 and 2020; international organizations and governmental websites were also searched. Available studies documented low intakes of fruits, vegetables and fiber, inadequate consumption of water, milk and dairy products, coupled with high intakes of fat, saturated fat, and sugar sweetened beverages, as well as a frequent consumption of energy-dense, nutrient poor foods such as sweet and savory snacks. Micronutrient inadequacies were also observed, particularly for calcium, iron, zinc and vitamins A, D, C, and folate. Acknowledging the impact that nutrition may have on building societies and transforming the lives of children, adolescents and their families, there is a crucial need for a food system approach in developing and implementing national and regional policies and interventions aimed at improving the diet of children and adolescents.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo 7608, Egypt;
| | - Mandy Taktouk
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
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Rasyidah G, Wafa SW. A quantitative assessment of school environment as viewed by teachers. Heliyon 2020; 6:e04059. [PMID: 32551377 PMCID: PMC7292914 DOI: 10.1016/j.heliyon.2020.e04059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/15/2019] [Accepted: 05/20/2020] [Indexed: 11/25/2022] Open
Abstract
Background There is evidence suggesting that the school environment does have prominent contributions to the rise of childhood obesity. Aim The objective of this study was to assess the school environment by interviewing the teachers and compare the school environment score between rural and urban schools in Terengganu, Malaysia. Methods Thirty-two teachers from 16 primary schools in Terengganu were interviewed using a set of validated Malay version “School Environmental Mapping” questionnaire. A total of 76 items consisting of four domains of school environment factor: physical (what is available) with 41 items; economic (what the costs are) with nine items; political (what the rules are) with nine items; and socio-cultural (what the attitudes and beliefs are) with 17 items. Every item was questioned using an initial closed question followed by an open question when the criteria were not met or need further information regarding those particular items. Results The present study revealed that the school environment of school in state of Terengganu is still low and not satisfied. Based on the schoolteacher's information and observation, there are significant barriers to promoting healthy eating and physical activity at school e.g. limited financial and budget allocation; lack of school facilities; lack of manpower to organise and monitor the programme; lack of participation and cooperation from parents; and no enforcement and serious action from authorized personnel on street hawkers near the school. This is reflected by the score achieved for 16 schools in Terengganu was only 63.05%. The political environment indicated the highest score among the domains, which was 77.78%, whereas, the lowest score was an economic environment (50.00%). Upon comparing between the urban and rural areas, the present study reported that there was a significant difference between school settings (p < 0.001) for an overall school environment, in which the rural areas had a significantly higher score than urban counterparts (64.86% vs 59.34%, p < 0.001). For each domain of the school environment, the findings showed that only two domains (physical and political environment) were significantly different between school settings. Conclusion This study revealed that the level of a healthy school environment among schools in both settings is still not satisfied. Addressing the obesogenic elements of school environments is one of the strategies in prevention since the school environments exert a great influence on children's behaviour.
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Affiliation(s)
- G Rasyidah
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Nerus, Terengganu, Malaysia
| | - S W Wafa
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Nerus, Terengganu, Malaysia
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Dietary Patterns and Associated Factors Among Adolescents in Malaysia: Findings from Adolescent Nutrition Survey 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103431. [PMID: 32423077 PMCID: PMC7277301 DOI: 10.3390/ijerph17103431] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 01/20/2023]
Abstract
Balanced diet in the early stages of life plays a role in optimum growth and maintains good health status of adolescents. Dietary habits that are established during adolescence will sustain till adulthood. Therefore, this present study aims to identify the dietary patterns and to determine factors associated with dietary patterns in terms of socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit among adolescents in Malaysia. Data from the Adolescent Nutrition Survey (ANS) 2017 was used for the present study. ANS is a population representative school-based cross-sectional study among school-going adolescents from primary four to secondary five from schools in 13 states and three federal territories registered under the Ministry of Education Malaysia. A self-administrated questionnaire was used to collect information on socio-demographic characteristics, locality of schools, ethnicity, eating habits, self-perceived weight status, and food label reading habit. A pre-tested face-to-face food frequency questionnaire (FFQ) was used to collect information on food group intake frequency. Dietary patterns were identified by using exploratory factor analysis and associated factors, using complex sample general linear model (GLM) analysis. All statistical analyses were carried out at 95% confidence interval or p-value < 0.05. The dietary patterns identified are healthy, unhealthy, and alternative proteins. The healthy dietary pattern was significantly associated with the types of school and ethnicity. The unhealthy dietary pattern was significantly associated with the locality of schools, ethnicity, frequency of snacks intake per week, frequency of eating out per week, self-perceived weight status, and food label reading habit. Significant associations were found between alternative proteins dietary pattern and locality of schools, ethnicity, and types of school. This study found that there is a disparity of dietary patterns between different ethnicity, locality of schools, and types of school. We recommend strategies of specifying ethnicity and geographical area to improve dietary patterns of adolescents in Malaysia.
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What Are the Barriers at Home and School to Healthy Eating?: Overweight/Obese Child and Parent Perspectives. J Nurs Res 2020; 27:e48. [PMID: 30958391 PMCID: PMC6752691 DOI: 10.1097/jnr.0000000000000321] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Most studies that have investigated factors influencing eating habits among obese children have focused mainly on individual or interpersonal factors and applied quantitative research methods. Purpose: This study was undertaken to identify the barriers in home and school settings that hamper healthy eating in overweight and obese children in South Korea. Methods: Focus group interviews were conducted with 15 overweight/obese children and 15 parents. A standard manual with open-ended questions was developed. Content analysis was used to identify key findings. Results: Participants were aware of the importance of home and school environments in shaping children's eating habits. Five major barriers, respectively, at home and at school emerged from the data. At home, the food preferences of parents affected the eating habits of their children. Moreover, parents worried about providing differentiated diets for siblings and about the permissiveness of grandparents toward grandsons. Furthermore, working parents preferred easy-to-prepare instant foods and said that their children ate overly quickly. At school, children cited time pressures, poor cafeteria environments, and ineffective nutrition education as barriers, whereas parents worried about inconsistent management by teachers and the unsafe food environment around the school. Conclusions: These environment-related barriers may be resolved through changes in the behavior of children, parents, and teachers as well as through the continued efforts of schools, community stakeholders, and policymakers, all of whose cooperation is essential to fostering a healthy food environment for children.
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Hidayati KF, Mahmudiono T, Buanasita A, Setiawati FS, Ramadhani N. Peer Influence dan Konsumsi Makanan Cepat Saji Remaja di SMAN 6 Surabaya. AMERTA NUTRITION 2019. [DOI: 10.20473/amnt.v3i4.2019.218-224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Adolescent have the characteristics of wanting to be accepted by their peers. Peer influence can also affect consumption, one of which is consumption of fast food, either foreign or domestic. High peer influence has the possibility to make fast food consumption high.Objectives: This research was conducted to analyze the correlation between peer influence and consumption of fast food, foreign and domestic.Methods: This study was an observational analytic study with a cross sectional design on 136 adolescents in SMAN 6 Surabaya who were selected by clustered random sampling. Data collected were the respondent's background: gender, age, and daily pocket money. Respondents also filled a peer influence scale questionnaire and a food frequency questionnaire about fast food.Results: Most respondents had low peer influence (52.21%). The chi square correlation test revealed that there was a significant correlation between peer influence and consumption of French fries (p=0.016), beef burger (p=0.029), chicken burger (p=0.025), and waffle (p=0.014). There was no significant correlation between peer influence and any food from domestic fast food group.Conclusions: There was a correlation between several types of foreign fast food consumption and peer influence. Types of fast food that had a correlation with peer influence were French fries, beef burger, chicken burger, and waffle. Whereas no food from domestic fast food groups had a significant correlation with peer influence. This revealed that peer influence only affects certain fast food that has prestige value.ABSTRAKLatar Belakang: Remaja memiliki ciri-ciri ingin diterima oleh kelompok sosialnya (peer). Peer influence juga bisa memengaruhi konsumsi, salah satunya konsumsi makanan cepat saji, modern maupun tradisional. Peer influence yang tinggi memiliki kemungkinan untuk membuat konsumsi makanan cepat saji remaja menjadi tinggi.Tujuan: Penelitian ini dilakukan untuk menganalisis hubungan antara peer influence dan konsumsi makanan cepat saji, modern maupun tradisionalMetode: Penelitian ini merupakan penelitian observasional analitik dengan studi cross sectional pada 136 remaja di SMAN 6 Surabaya yang dipilih secara clustered random sampling. Data yang dikumpulkan adalah latar belakang responden berupa tinggi badan, berat badan, jenis kelamin, usia, serta uang saku harian. Selain itu, responden diminta mengisi peer influence scale questionnaire dan food frequency questionnaire.Hasil: Sebagain besar responden berstatus gizi gemuk (14%) dan memiliki peer influence sedang (50%). Uji korelasi chi square mengungkapkan adanya hubungan yang signifikan antara peer influence dan konsumsi spaghetti (p=0,007), fried chicken (p=0,009), french fries (p=0,008), beef burger (p=0,018), chicken burger (p=0,009), dan dimsum (p=0,046). Tidak ada makanan dari kelompok makanan cepat saji tradisional yang memiliki hubungan yang signifikan dengan peer influence.Kesimpulan: Terdapat hubungan antara konsumsi beberapa jenis makanan cepat saji modern dan peer influence. Jenis makanan cepat saji yang memiliki korelasi dengan peer influence yaitu spaghetti, fried chicken, french fries, beef burger, chicken burger, dan dimsum. Sedangkan tidak ada makanan dari kelompok makanan cepat saji tradisional yang memiliki hubungan yang signifikan dengan peer influence. Hal ini mengungkapkan bahwa peer influence hanya memengaruhi makanan cepat saji tertentu yang memiliki nilai prestige.
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Schott W, Aurino E, Penny ME, Behrman JR. Time use and sexual maturity-related indicators differentially predict youth body mass indices, Peruvian girls versus boys. Ann N Y Acad Sci 2019; 1468:55-73. [PMID: 31872895 DOI: 10.1111/nyas.14292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 11/28/2022]
Abstract
Rapid development in Latin America has been accompanied by lifestyle shifts, including changes in time use and social environments. Overweight/obesity has also emerged as a public health challenge. We examined whether lifestyle changes and sexual maturity-related indicators (early pubertal development and having a child) predict increases in adiposity among Peruvian youth. Using longitudinal data from Young Lives, we examined changes in adiposity between ages 8 and 15 years old for the younger cohort and ages 15 and 22 years old for the older cohort. Boys and girls in both cohorts demonstrated substantial increases in age-adjusted adiposity measures, but predictors were different for boys versus girls. For boys, increases in time spent in work and domestic chores predicted increases in adiposity body mass index and BMI-for-age Z-score and increases in time spent sleeping were associated with decreases in adiposity (waist circumference and waist-to-height ratio). For girls, sexual maturity-related indicators (early menarche and childbearing) predicted increases in adiposity, regardless of time use. Potential mechanisms for these results may include diet, physical activity, wealth, and urban-rural residence. Time use among youth was associated with diet quality and physical activity, but in different ways for boys versus girls. Strategies for dealing with rising overweight and obesity should incorporate sex-based specificities.
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Affiliation(s)
- Whitney Schott
- Population Studies Center, University of Pennsylvania, Pennsylvania, Philadelphia
| | - Elisabetta Aurino
- Department of Management and Centre for Health Economics and Policy Innovations, Imperial College London and Young Lives, University of Oxford, Oxford, United Kingdom
| | - Mary E Penny
- Instituto de Investigación Nutricional, Lima, Peru
| | - Jere R Behrman
- Population Studies Center, University of Pennsylvania, Pennsylvania, Philadelphia.,Economics Department, University of Pennsylvania, Pennsylvania, Philadelphia
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Menegassi B, de Morais Sato P, Scagliusi FB, Moubarac JC. Comparing the ways a sample of Brazilian adults classify food with the NOVA food classification: An exploratory insight. Appetite 2019; 137:226-235. [PMID: 30862456 DOI: 10.1016/j.appet.2019.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/13/2019] [Accepted: 03/05/2019] [Indexed: 11/19/2022]
Abstract
The aim of this study is to have an exploratory insight on how a sample of Brazilian adults classify food, attempting to identify the main factors involved in this process, and to compare these classifications to the NOVA food classification of the 2014 Brazilian dietary guidelines. An exploratory and qualitative approach was conducted with a selected sample of teachers, administrative technicians, and students (N = 24) from the Federal University of Grande Dourados, Brazil. First, using the pile sort method, participants were asked to freely classify 24 pictures of food (sourced from examples of the four food groups specified in NOVA) into food groups meaningful to them. Next, in semi-structured interviews, participants were asked to describe the food groups they created. The food groups created by participants were analyzed using non-metric multidimensional scaling followed by hierarchical cluster analysis, and the interviews were analyzed using content analysis. Participants had a mean age of 30 (±9.4) years. A total of 128 food groups were created by 24 participants (an average of five food groups per person); and a total of 55 non-mutually exclusive groups names were used by them to describe these food groups. Sixteen themes emerged from the content analysis. The most recurrent themes were food groups, nutrients, foods I consume, foods I do not consume, and food processing. Contrasting themes such as real food and junk foods, meals and ready-made foods, healthy foods and unhealthy foods were also noted. Six clusters emerged from the cluster analysis, each related to one or more themes. Overall, a striking similarity was observed between the ways the individuals classified food and the NOVA food classification.
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Affiliation(s)
- Bruna Menegassi
- Faculty of Health Sciences of Federal University of Grande Dourados, Rodovia Dourados-Itahum, km 12, Caixa Postal 364, CEP: 79804-970, Dourados, MS, Brazil.
| | - Priscila de Morais Sato
- School of Public Health, Department of Nutrition of the University of São Paulo, Av. Dr. Arnaldo 715, CEP: 01246-904, São Paulo, SP, Brazil.
| | - Fernanda Baeza Scagliusi
- School of Public Health, Department of Nutrition of the University of São Paulo, Av. Dr. Arnaldo 715, CEP: 01246-904, São Paulo, SP, Brazil.
| | - Jean-Claude Moubarac
- School of Public Health, Department of Nutrition of the University of São Paulo, Av. Dr. Arnaldo 715, CEP: 01246-904, São Paulo, SP, Brazil; Department of Nutrition, University of Montreal, 2405, Chemin de la Côte-Sainte-Catherine, local 1248, Montréal, H3T 1A8, Canada.
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Banna J. Obesity Prevention in Children in Latin America Through Interventions Using Technology. Am J Lifestyle Med 2019; 13:138-141. [PMID: 30800017 DOI: 10.1177/1559827618823320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The number of children in Latin America with overweight and obesity has increased markedly in recent years. However, interventions focused on prevention of childhood obesity are still in their infancy in Latin America. Leveraging the use of technology in children and adolescents to introduce or reinforce patterns of healthy eating and mobility in interventions is a priority. Though there is a low number of intervention studies focused on obesity prevention in Latin America, several studies using technology have been conducted. Further implementation of such programs as part of multilevel interventions will allow for continued prevention efforts to address increasing rates of overweight and obesity in this population.
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Affiliation(s)
- Jinan Banna
- College of Tropical Agriculture and Human Resources, Honolulu, Hawaii
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Condessa LA, Chaves OC, Silva FM, Malta DC, Caiaffa WT. Sociocultural factors related to the physical activity in boys and girls: PeNSE 2012. Rev Saude Publica 2019; 53:25. [PMID: 30810662 PMCID: PMC6390671 DOI: 10.11606/s1518-8787.2019053000516] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 04/10/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE: To verify in male and female Brazilian adolescents the association of demographic, psychosocial, behavioral and sociocultural characteristics with the regular practice of physical activity. METHODS: The sample consisted of 109,104 adolescents from all Brazilian states attending the 9th year of elementary education in 2012. The response variable was the regular practice of physical activity (300+ minutes/week). The explanatory variables were grouped into four fields: demographic, psychosocial, behavioral and sociocultural. The Poisson regression was stratified by sex to evaluate the association. RESULTS: The prevalence of active adolescents was 20.2%, higher in boys (27.9%) than in girls (13.1%). It was observed a greater practice of physical activity in boys of lower age group, children of mothers with higher schooling, who consumed healthy foods such as beans, fruits, vegetables, and milk, as well as among those with family supervision. At the same time, unhealthy habits such as insomnia and alcohol consumption were also positively associated with physical activity. In girls, greater physical activity was observed among those who lived with mothers and whose mothers had higher schooling. In addition to family supervision, the practice of physical activity in girls was also positively associated with the frequency of meals with their parents. However, as in boys, insomnia and alcohol consumption were associated with an increase in the practice of physical activity. CONCLUSIONS: One-fifth of adolescents practice physical activity regularly, demonstrating the need for specific public policies to increase the percentage of active young people in the country. Maternal schooling, healthy eating habits and family supervision were associated with regular physical activity in boys and girls, evidencing the importance of the family for the acquisition of healthy habits in this age group.
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Affiliation(s)
- Luciano Antonacci Condessa
- Instituto Federal Fluminense de Educação, Ciência e Tecnologia. Itaperuna, RJ, Brasil.,Universidade Federal de Minas Gerais. Faculdade de Medicina. Observatório de Saúde Urbana de Belo Horizonte. Belo Horizonte, MG, Brasil
| | - Otaviana Cardoso Chaves
- Universidade Federal de Minas Gerais. Faculdade de Medicina. Observatório de Saúde Urbana de Belo Horizonte. Belo Horizonte, MG, Brasil
| | - Fernanda Marcelina Silva
- Universidade Federal de Minas Gerais. Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto. Belo Horizonte, MG, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Waleska Teixeira Caiaffa
- Universidade Federal de Minas Gerais. Faculdade de Medicina. Observatório de Saúde Urbana de Belo Horizonte. Belo Horizonte, MG, Brasil
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Neves CM, Meireles JFF, Morgado FFDR, Ferreira MEC. PREOCUPAÇÕES E COMPORTAMENTOS RELACIONADOS À APARÊNCIA FÍSICA NA INFÂNCIA: UMA ABORDAGEM QUALITATIVA. PSICOLOGIA EM ESTUDO 2018. [DOI: 10.4025/psicolestud.v23i0.40289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A criança elabora mecanismos internos para formação de referências do próprio corpo, desde a tenra idade, tornando-se uma fase da vida relevante para estudiosos. Objetivou-se investigar atitudes relacionadas à imagem corporal sob o ponto de vista de crianças. Esta pesquisa qualitativa descritiva foi conduzida em quatro grupos focais. Participaram 19 crianças (10 meninas e 9 meninos), de 6 a 11 anos (M=8,36±1,42 anos), estudantes de escolas públicas da cidade de Juiz de Fora-MG. Os dados obtidos foram tratados mediante análise de conteúdo categórica. Três categorias emergiram a partir das falas das crianças: preocupações com aspectos específicos do corpo; preocupações com aspectos gerais do corpo; e comportamentos relacionados ao corpo. Conclui-se que as crianças avaliadas apresentaram atitudes que indicam preocupação com o corpo em aspectos gerais e específicos, além de comportamentos relacionados com a imagem corporal. Recomendam-se a elaboração e a adoção de estratégias de terapia e intervenção no sentido de promover uma imagem corporal positiva em crianças.
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Parents' and Teachers' Views of Food Environments and Policies in Indian Private Secondary Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071532. [PMID: 30029547 PMCID: PMC6069492 DOI: 10.3390/ijerph15071532] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/25/2022]
Abstract
School food environments and policies can play a pivotal role in inculcating healthy food habits among young people. This cross-sectional survey explored teachers’ and parents’ views of the role of school food environments and policies in promoting healthy food consumption among Indian adolescents. Thirty-two teachers and 280 parents from five private, English-speaking, secondary schools in Kolkata, India took part in a short questionnaire survey which included closed and open answer questions. Descriptive and chi-square analyses were performed to compare the responses of parents and teachers. Thematic data analysis underpinned by Template Analysis Technique was employed to examine the qualitative responses. The easy availability and accessibility of energy-dense, nutrient-poor foods, the limited availability of nutritious foods, the absence of written food policies, and inflated prices of nutritious foods were reported as problems in the Indian school food environment. However, the respondents also noted that schools restricted the sale of sugar-sweetened beverages and adopted hygienic food practices. Novel ideas for creating healthy school food environments and effective school canteen policies were also captured during the survey. These findings point to the need to create effective school food policies in Indian secondary schools to help adolescents eat healthily at school. Future research is required to test the feasibility of the implementation of school food policies.
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Kabir A, Miah S, Islam A. Factors influencing eating behavior and dietary intake among resident students in a public university in Bangladesh: A qualitative study. PLoS One 2018; 13:e0198801. [PMID: 29920535 PMCID: PMC6007825 DOI: 10.1371/journal.pone.0198801] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 05/25/2018] [Indexed: 11/19/2022] Open
Abstract
Background Over the past decades, Bangladesh has made substantial progress in improving higher education, and in part, this was achieved by promoting residence based higher education in public universities. University residency is considered a crucial period for students to develop healthy eating habits and adopt nutritious intake, which comprise a strong foundation for good health throughout life. Although, there is extensive literature on eating behaviors and dietary intake internationally, there appears to be relatively scarce research and analysis concerning Bangladesh. This study aims to address this, by investigating the factors that influence eating behavior and dietary intake. Methods Adopting a qualitative approach, we conducted 25 in-depth interviews and 13 focus group discussions with students of various disciplines and semesters. We used thematic analysis to analyze the textual data, and methodological triangulation to validate the information provided. Results Student eating behavior and dietary intake are influenced by a variety of factors. Individual factors (cooking skills, food taste, food taboos, and knowledge and perceptions), societal factors (influence of peers and social norms), factors related to university (campus culture and frequency of examination), and environmental factors (availability of cooking resources and facilities and food prices) emerged as the key aspects that determine students’ eating behavior and dietary intake. Conclusion This is the first study that explored factors influencing nutritional behavior and dietary intake among resident graduates in a Bangladeshi university. The results suggest that resident students have a poor dietary intake that might have a harmful impact on their health, well-being, and academic performance. Therefore, multilevel nutritional interventions may be beneficial to promote healthy eating behavior and dietary intake among university students.
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Affiliation(s)
| | - Shahgahan Miah
- Department of Anthropology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Asraful Islam
- Department of Anthropology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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Mridha MK, Matias SL, Arnold CD, Dewey KG. Factors associated with nutritional status and dietary practices of Bangladeshi adolescents in early pregnancy. Ann N Y Acad Sci 2018; 1416:66-76. [PMID: 29457224 DOI: 10.1111/nyas.13568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 01/08/2023]
Abstract
Bangladesh has a high prevalence of adolescent pregnancy, but little is known about the nutritional status and dietary practices of Bangladeshi adolescents in early pregnancy or associated factors. We used the baseline data of 1552 pregnant adolescents from a longitudinal, cluster-randomized effectiveness trial conducted in northwest Bangladesh. Forty-four percent of the adolescents were short for their age, 36% had low body mass index, 28% were anemic, 10% had iron deficiency, and 32% had vitamin A deficiency. The mean consumption of animal-source foods was 10.3 times/week. In multivariate analysis, socioeconomic status, education, and food security were generally positively associated with anthropometric indicators and dietary practices but not with iron or vitamin A status. Our findings confirm that there is a high burden of undernutrition among these Bangladeshi adolescents in early pregnancy. Understanding factors related to undernutrition can help to identify adolescent pregnant women at higher risk and provide appropriate counseling and care.
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Affiliation(s)
- Malay K Mridha
- Department of Nutrition, University of California, Davis, Davis, California
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Susana L Matias
- Department of Nutrition, University of California, Davis, Davis, California
| | - Charles D Arnold
- Department of Nutrition, University of California, Davis, Davis, California
| | - Kathryn G Dewey
- Department of Nutrition, University of California, Davis, Davis, California
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Indian adolescents' perceptions of the home food environment. BMC Public Health 2018; 18:169. [PMID: 29357849 PMCID: PMC5778749 DOI: 10.1186/s12889-018-5083-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/16/2018] [Indexed: 11/17/2022] Open
Abstract
Background The home food environment has the potential to influence the eating behaviour of adolescents. This investigation aimed to understand Indian adolescents’ perspectives of their home food environments. Methods Adolescents aged 14–16 years (n = 1026, 65.3% girls) attending private secondary schools in Kolkata completed a paper-based questionnaire during school time which included questions about family food rules, availability and accessibility of foods at home, and domestic cooking responsibility. Boys’ and girls’ opinions and experiences were compared through cross-tabulation analyses. Results Almost all the adolescents reported that fruits (91.6%) and vegetables (95.7%) were always available in their homes. Approximately two-fifths reported that sugar-sweetened beverages (36.2%) and salty snack foods (38.0%) were readily available. In 56.1% households, adolescents were expected to follow certain food rules during mealtimes (e.g. not talking with my mouth full). The majority of the respondents (80.4%) identified mothers as the primary meal providers, only a minority reported that fathers (5.1%) were responsible for preparation of family meals. Conclusion This understanding of the family-environmental determinants of adolescent dietary habits provides useful directions for nutrition promotion interventions. Health and educational professionals associated with adolescents could communicate about the development of healthy home food environments to provide positive health benefits for adolescents and their families.
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Mokhtari F, Kazemi A, Ehsanpour S. Effect of educational intervention program for parents on adolescents'nutritional behaviors in Isfahan in 2016. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:103. [PMID: 29296604 PMCID: PMC5747237 DOI: 10.4103/jehp.jehp_155_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 09/19/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Family participation is an important element on nutritional education especially for students. Parents have a key role in instilling and understanding healthy eating habits, but yet the use of family participation strategies in the nutrition education was low. The aim of this study is determining the effect of parental educational intervention program for parents on adolescents' nutritional behaviors in Isfahan, Iran in 2016. MATERIALS AND METHODS This study was a kind of field trial that conducted on 63 girl teenagers from junior high schools of Isfahan in 2016 that were randomly divided into two groups of intervention and control. The data collection tool which was a researcher made questionnaire was completed in both groups before and 1 month after the intervention. The intervention included three training sessions for parents and giving educational compact disc and forwarding SMS. To analysis of data independent t-test and paired t-test were used. RESULTS Paired t-test showed that in intervention group the average score of fruit (P = 0.03) and in control group the average score of vegetables (P < 0.05) were significant statistical difference, but in other aspects of nutritional behaviors was not a significant difference. Independent t-test showed that after intervention, mean scores nutritional behavior of adolescent girls in both groups had no significant differences. CONCLUSIONS No significant difference was in the nutritional behaviors before and after the intervention. Hence, just educating the parents is not enough for achieving appropriate nutritional behaviors in the adolescents.
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Affiliation(s)
- Fatemeh Mokhtari
- Department of Reproductive Health, Women's Health Research Center, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Ashraf Kazemi
- Department of Reproductive Health, Women's Health Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soheila Ehsanpour
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Zobrist S, Kalra N, Pelto G, Wittenbrink B, Milani P, Diallo AM, Ndoye T, Wone I, Parker M. Results of Applying Cultural Domain Analysis Techniques and Implications for the Design of Complementary Feeding Interventions in Northern Senegal. Food Nutr Bull 2017; 38:512-527. [DOI: 10.1177/0379572117720749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Designing effective nutrition interventions for infants and young children requires knowledge about the population to which the intervention is directed, including insights into the cognitive systems and values that inform caregiver feeding practices. Objective: To apply cultural domain analysis techniques in the context of implementation research for the purpose of understanding caregivers’ knowledge frameworks in Northern Senegal with respect to infant and young child (IYC) feeding. This study was intended to inform decisions for interventions to improve infant and young child nutrition. Methods: Modules from the Focused Ethnographic Study for Infant and Young Child Feeding Manual were employed in interviews with a sample of 126 key informants and caregivers from rural and peri-urban sites in the Saint-Louis region of northern Senegal. Descriptive statistics, cluster analysis, and qualitative thematic analysis were used to analyze the data. Results: Cluster analysis showed that caregivers identified 6 food clusters: heavy foods, light foods, snack foods, foraged foods, packaged foods, and foods that are good for the body. The study also revealed similarities and differences between the 2 study sites in caregivers’ knowledge frameworks. Conclusions: The demonstration of differences between biomedical concepts of nutrition and the knowledge frameworks of northern Senegalese women with regard to IYC feeding highlights the value of knowledge about emic perspectives of local communities to help guide decisions about interventions to improve nutrition.
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Affiliation(s)
| | | | - Gretel Pelto
- Cornell University, College of Human Ecology, Ithaca, NY, USA
| | | | | | - Abdoulaye Moussa Diallo
- Helite SARL, Dakar, Senegal
- Cheikh Anta Diop University, Sociology Department, Dakar, Senegal
| | - Tidiane Ndoye
- Helite SARL, Dakar, Senegal
- Cheikh Anta Diop University, Sociology Department, Dakar, Senegal
| | - Issa Wone
- Helite SARL, Dakar, Senegal
- University Assane Seck, Health Sciences Department, Ziguinchor, Senegal
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Social Mechanisms for Weight-related Behaviors among Emerging Adults. HEALTH BEHAVIOR AND POLICY REVIEW 2017; 4:419-426. [PMID: 31867404 DOI: 10.14485/hbpr.4.5.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective The purpose of this research was to qualitatively assess young people's perceptions about how friends' impact eating and physical activity (PA) behaviors. Methods Emerging adults (N=52; mean age=18.7±0.6 years; 50% female) attending a large 4-year college campus in the southwest were enrolled in focus groups (N=10). Following saturation, the research team met to establish consensus and co-create a codebook from which two researchers independently coded each focus group. Coders continually discussed themes to ensure consistency of coding. Results Initially, youth reported that their friends' did not influence their eating/PA. The major social facilitators identified by students were encouragement, social cues, celebrations, shared experiences, pressure. Conclusion Several social facilitators impacted eating and PA. These factors should be considered when designing obesity interventions with emerging adults.
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