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Douglas S, Darlington G, Davison K, Beaton J, Haines J. Food parenting and Children's eating behaviour: Exploring the role of coparenting. Appetite 2024; 198:107367. [PMID: 38640969 DOI: 10.1016/j.appet.2024.107367] [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] [Received: 11/13/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 04/21/2024]
Abstract
Parents have primary influence over the development of their children's eating behaviours, however less attention has been given to whether or how their coparenting plays a role in this association. The aim of this study was to investigate the cross-sectional associations between mothers' and fathers' food parenting practices and children's eating behaviour and examine whether coparenting quality moderates or confounds these associations. Parents (222 mothers and 167 fathers) with children 18 months to 5 years completed an online survey that assessed their food parenting practices and coparenting quality. One parent per family (91% mothers) also reported their children's food approach behaviours. We used linear regressions with generalized estimating equations to examine the associations between food parenting practices and children's eating behaviours. To explore moderation by coparenting quality, we included an interaction term in each model (coparenting quality x food parenting practice). To explore confounding, models were adjusted for coparenting quality. All models were stratified by parent gender and included parent educational attainment, child age, and child BMI z-scores as covariates. Among both mothers and fathers, we found that structure and autonomy support food parenting practices were inversely associated with children's food responsiveness, and desire to drink, while coercive control practices were positively associated with these food approach behaviours. We found the opposite direction of association between these food parenting practices and children's enjoyment of food. Among mothers, autonomy support was inversely associated with children's emotional overeating, while coercive control was positively associated with this eating behaviour. Coparenting quality did not moderate or confound the associations. Future studies should continue to explore these associations among families with young children and consider feeding coparenting in the association.
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Affiliation(s)
- Sabrina Douglas
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road, Guelph, Ontario N1G2W1, Canada.
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, 50 Stone Road, Guelph, Ontario N1G2W1, Canada.
| | - Kirsten Davison
- Boston College School of Social Work, Chestnut Hill, MA 02467, USA.
| | - John Beaton
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road, Guelph, Ontario N1G2W1, Canada.
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road, Guelph, Ontario N1G2W1, Canada.
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Sahye-Pudaruth S, Ma DWL, Prashad M, Haines J. Early life involvement in food skills is associated with children's cooking skills: a longitudinal analysis. Appl Physiol Nutr Metab 2024; 49:718-722. [PMID: 38224581 DOI: 10.1139/apnm-2023-0497] [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: 01/17/2024]
Abstract
Engaging young children in food skills such as food planning and preparation early in life may be an important predictor of later child cooking skills. The aim of this study was to examine whether early life involvement in food skills (mean age at baseline = 3.6 years) is prospectively associated with cooking skills among a sample of 60 children (mean age at follow-up = 10.0 years; 83% White) from the Guelph Family Health Study, an ongoing cohort study examining the effect of a home-based obesity prevention intervention. Early life involvement in food skills, i.e., child involvement in grocery shopping and meal preparation, was reported by parents at baseline. Children self-reported their cooking skills at follow-up. After adjusting for child age, child sex, parent age, household income, and intervention status, early life involvement in food skills was significantly associated with later child cooking skills (β = 0.24, 95% CI (0.02-0.45), p = 0.03). Future studies with larger and more socioeconomically, geographically, and racially diverse samples are needed to confirm these findings.
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Affiliation(s)
- Sandhya Sahye-Pudaruth
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Michael Prashad
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
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Zhang L, Dai S, Chen Y, Jin T, Li W, Wang W, Pu J, Jia P, Zhao L, Sun X. Scoping review of obesity interventions: Research frontiers and publication status. iScience 2024; 27:109240. [PMID: 38495822 PMCID: PMC10940913 DOI: 10.1016/j.isci.2024.109240] [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] [Indexed: 03/19/2024] Open
Abstract
Obesity and overweight are significant global health issues, and numerous obesity intervention studies have been conducted. Summarizing current knowledge of interventions aims to inform researchers and policymakers to keep up-to-date with the latest scientific advancements and trends. In this review, we comprehensively retrieved and screened 4,541 studies on obesity intervention published between 2018 and 2022 in the Web of Science Core Collection, and objectively presented research frontiers using bibliometric analysis. The research frontiers of intervention are mainly focused on dietary, exercise, pharmacological interventions, bariatric surgery, environmental, and cognitive interventions. Time-restricted eating is the hottest research topic, followed by probiotics and Roux-en-Y gastric bypass. Gut microbiota is located in the "Basic and transversal themes" quadrant with a high centrality and low density, which has great development potentiality. Obesity intervention is becoming increasingly common,and we advocate for researchers to undertake more focused research endeavors that consider the specific characteristics of diverse populations or patients.
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Affiliation(s)
- Longhao Zhang
- Department of Endocrinology & Metabolism, West China Hospital, Sichuan University, Chengdu, China
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Medical Discipline Construction, West China Hospital, Sichuan University, Chengdu, China
| | - Shuang Dai
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yufei Chen
- Core Facilities, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tingting Jin
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wei Li
- Department of Medical Discipline Construction, West China Hospital, Sichuan University, Chengdu, China
| | - Wen Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Pu
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Peng Jia
- School of Resource and Environmental Sciences, Wuhan University, Wuhan, China
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Johnson LG, Cho H, Lawrence SM, Keenan GM. Early childhood (1-5 years) obesity prevention: A systematic review of family-based multicomponent behavioral interventions. Prev Med 2024; 181:107918. [PMID: 38417469 DOI: 10.1016/j.ypmed.2024.107918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/06/2024] [Accepted: 02/23/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Globally 38.9 million children under age 5 have overweight or obesity, leading to type 2 diabetes, cardiovascular complications, depression, and poor educational outcomes. Obesity is difficult to reverse and lifestyle behaviors (healthy or unhealthy) can persist from 1.5 years of age. Targeting caregivers to help address modifiable behaviors may offer a viable solution. OBJECTIVE Evaluate the impact of multicomponent family interventions on weight-based outcomes in early childhood and explore related secondary behavior outcomes. METHODS Four databases were searched (1/2017-6/2022) for randomized controlled trials (RCTs) of obesity-prevention interventions for children (1-5 years). Eligible studies included an objectively measured weight-based outcome, family interventions targeting the caregiver or family, and interventions including at least two behavioral components of nutrition, physical activity, or sleep. RESULTS Eleven interventions were identified consisting of four delivery modes: self-guided (n = 3), face-to-face group instruction (n = 3), face-to-face home visits (n = 2), and multiple levels of influence (n = 3). The reviewed studies reported almost no significant effects on child weight-based outcomes. Only two studies (one was an underpowered pilot study) resulted in significant positive child weight-management outcomes. Seven of the interventions significantly improved children's dietary intake. CONCLUSION Except for one, the reviewed studies reported that family based interventions had no significant effects on child weight-based outcomes. Future studies of this type should include measurements of age and sex-based body mass index (BMI) and trajectories, and also examine other important benefits to the children and families.
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Affiliation(s)
- Lisa G Johnson
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States.
| | - Hwayoung Cho
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States
| | - Samantha M Lawrence
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States
| | - Gail M Keenan
- College of Nursing, University of Florida College of Nursing, 1225 Center Dr, Gainesville, FL 32610, United States
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Saher A, Tang L, Douglas S, Jacob R, Walton K, Sadowski A, Ma DWL, Haines J. Fathers' use of social media for social comparison is associated with their food parenting practices. Appetite 2024; 194:107201. [PMID: 38191076 DOI: 10.1016/j.appet.2024.107201] [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] [Received: 09/04/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
Over 85% of parents use social media; however, limited research has investigated the associations between parental social media use and food parenting practices. The objectives of this study were to: 1) describe how mothers and fathers use social media focused on topics related to child feeding and family meals; and 2) examine associations between parental social media use focused on child feeding and family meals and mothers' and fathers' food parenting practices. Data were obtained from 179 mothers and 116 fathers of children aged 3-8 years enrolled in a family-based obesity prevention intervention. We used descriptive statistics to describe parents' social media use in relation to child feeding and family meals and linear regressions with generalized estimating equations to explore associations between parents' social media use and food parenting practices. Models were stratified by parent gender and adjusted for household income, parent ethnicity, parent age, child sex, and intervention status. A higher percent of mothers than fathers reported using social media to seek information related to child feeding and family meals (64.8% mothers; 25.0% fathers) and to share and compare family meals and food choices (41.9% mothers; 19.8% fathers). While social media use was not associated with food parenting practices in mothers, fathers' social media use to share and compare family meals and food choices was associated with negative food parenting practices, i.e., greater use of food for emotional regulation (β = 0.37, p = 0.02) and greater use of food for reward (β = 0.34, p = 0.02). Study results can inform strategies to promote healthy social media use among parents of young children.
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Affiliation(s)
- Amina Saher
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Lisa Tang
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Sabrina Douglas
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Raphaëlle Jacob
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Kathryn Walton
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Adam Sadowski
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - David W L Ma
- Department of Human Health and Nutrition Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Jess Haines
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, N1G 2W1, Canada.
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Burns JL, Bhattacharjee A, Darlington G, Haines J, Ma DWL, The Guelph Family Health Study. Parental Cooking Confidence is Associated with Children's Intake of Fish and Seafood. CAN J DIET PRACT RES 2024; 85:54-57. [PMID: 37403973 DOI: 10.3148/cjdpr-2023-012] [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: 07/06/2023]
Abstract
Purpose: Fish and seafood consumption by North American children is low. This is concerning, given the critical role of n-3 polyunsaturated fatty acids (eicosapentaenoic acid and docosahexaenoic acid), found in fish and seafood, in early development. This study aimed to determine whether parental factors related to fish and seafood consumption are associated with frequency of fish and seafood consumption in Canadian children.Methods: A subgroup of parents (n = 28) participating in the Guelph Family Health Study Pilot reported their perceptions and history of fish and seafood consumption, confidence in preparing fish and seafood dishes, and the frequency of intake for their children (n = 40).Results: This study found that 20% of children consumed one serving of saltwater fish, freshwater fish, or shellfish weekly and 63% consumed at least one type of fish or seafood monthly. Parental cooking confidence preparing fish and seafood was positively associated with at least monthly fish and seafood intake in children.Conclusions: These findings suggest that some children may have low intakes of fish and seafood due to a lack of parental cooking confidence when preparing fish and seafood dishes. Therefore, future research and interventions focused on addressing this barrier may aid in improving fish and seafood intake.
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Affiliation(s)
- Jessie L Burns
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Aritra Bhattacharjee
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
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Ashraf R, Duncan AM, Darlington G, Buchholz AC, Haines J, Ma DWL. The degree of food processing contributes to sugar intakes in families with preschool-aged children. Clin Nutr ESPEN 2024; 59:37-47. [PMID: 38220399 DOI: 10.1016/j.clnesp.2023.11.010] [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] [Received: 02/16/2022] [Revised: 11/08/2023] [Accepted: 11/17/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIMS Evidence implicates ultra-processed food intake as a major contributor of excess dietary sugars. However, little research exists on the relationship between the degree of food processing and sugar intake in families with young children. We investigated associations between the degree of food processing and sugar intake (total and free sugars) in Canadian preschool-aged children and parents. METHODS This cross-sectional study of 242 families included preschool-aged children (n = 267) and parents (n = 365) participating in the Guelph Family Health Study. Dietary intake was assessed via the web-based Automated Self-Administered 24-h Dietary Assessment Tool (ASA24-Canada-2016) and classified according to the NOVA Food Classification System including, unprocessed or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods. Linear regression models with generalized estimating equations were used to examine associations between the energy contribution of each NOVA classification category and sugar intake (% kcal of total and free sugars). Pearson correlation coefficient estimates were used to assess dietary relationships between parents and children. RESULTS Ultra-processed foods were the greatest source of energy (44.3%) and energy from total (8.7%) and free sugars (7.3%) in the parents' diets, and the greatest source of energy (41.3%) and energy from free sugars (7.6%) in the children's diet. Ultra-processed food intake was positively associated with sugar intake in parents (total sugars: B = 0.05, 95% CI: 0.02-0.09, p = 0.01; free sugars: B = 0.11, 95% CI: 0.08-0.15, p < 0.001) and children (total sugars: B = 0.10, 95% CI: 0.04-0.16, p = 0.001; free sugars: B = 0.16, 95% CI: 0.12-0.21, p < 0.001). Unprocessed or minimally processed food intake was negatively associated with free sugar intake in parents (B = -0.08, 95% CI: -0.12 to -0.05, p < 0.001) and children (B = -0.15, 95% CI: -0.19 to -0.10, p < 0.001). Weak correlations were found between parents and children for processed culinary ingredients and ultra-processed processed food intake (p < 0.001). CONCLUSIONS This study highlights the associations between degree of food processing and sugar intake in parents and children, whereby ultra-processed foods were positively, and unprocessed or minimally processed foods were negatively, associated with sugar intake. These are important considerations in the development of policy and recommendations for foods to potentially promote or limit.
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Affiliation(s)
- Rahbika Ashraf
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, N1G 2W1, Canada.
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Mahajan A, Haines J, Yu J, Darlington G, Buchholz AC, Duncan AM, Ma DWL. Sugar Intake among Preschool-Aged Children in the Guelph Family Health Study: Associations with Sociodemographic Characteristics. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1459. [PMID: 37761420 PMCID: PMC10530220 DOI: 10.3390/children10091459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND It is crucial to develop strategies targeted to promote healthy eating patterns in vulnerable populations, especially young children from diverse sociodemographic groups. Thus, the study objective was to investigate the associations between child age, child sex, child ethnicity, parent number of years living in Canada, annual household income, parent education and parent marital status with total, free and added sugar intakes in young children. METHODS This cross-sectional study was a secondary analysis of data gathered in the Guelph Family Health Study. The study included 267 children (129M; 138F) from 210 families aged 1.5 to 5 years. Parents completed questionnaires for children on sociodemographic characteristics and an online 24-hour diet recall. The associations between sociodemographic characteristics and sugar intakes were determined using generalized estimating equations applied to linear regression models. RESULTS The mean age of the children was 3.5 ± 1.2 years (mean ± std dev.). As children's age increased, there was a greater intake of free and added sugar (β^ = 8.6, p = 0.01, 95% CI = 2.4 to 14.7 and β^ = 6.5, p = 0.03, 95% CI = 0.8 to 12.2, respectively). Those children who identified as white had a higher total sugar intake than children of other ethnicities (β^ = 31.0, p = 0.01, 95% CI = 7.2 to 54.7). Additionally, higher annual household income was associated with lower was free sugar intake in children (β^ = -2.4, p = 0.02, 95% CI = -4.5 to -0.4). CONCLUSIONS This study underscores the significant influence of multiple sociodemographic characteristics on sugar intake in young children, providing valuable insights for public health policy and nutrition interventions. Moreover, this study highlights the need for early behaviour interventions focusing on reducing sugar intake in young children, while considering sociodemographic factors.
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Affiliation(s)
- Anisha Mahajan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (A.C.B.)
| | - Jessica Yu
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G2 W1, Canada;
| | - Andrea C. Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (A.C.B.)
| | - Alison M. Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
| | - David W. L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (J.Y.); (A.M.D.)
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Yu J, Mahajan A, Darlington G, Buchholz AC, Duncan AM, Haines J, Ma DWL. Free sugar intake from snacks and beverages in Canadian preschool- and toddler-aged children: a cross-sectional study. BMC Nutr 2023; 9:44. [PMID: 36890595 PMCID: PMC9996946 DOI: 10.1186/s40795-023-00702-3] [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: 07/08/2022] [Accepted: 03/03/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Excess consumption of free sugar (FS) increases the risk of dental caries and unhealthy weight gain. However, the contribution of snacks and beverages to young children's FS intake is not well understood. The purpose of this study was to determine FS intake from snacks and beverages among preschool-aged Canadian children. METHODS This cross-sectional study examined baseline data from 267 children 1.5 to 5 y enrolled in the Guelph Family Health Study. Dietary assessment was completed over a 24-h period using ASA24-Canada-2016 to, 1) estimate the proportion of children whose FS intake from snacks and beverages consumed exceeded 5% total energy intake (TE) and 10% TE, and 2) identify the top snack and beverage sources of FS. RESULTS FS contributed 10.6 ± 6.9% TE (mean ± SD). 30 and 8% of children consumed ≥ 5% TE and ≥ 10% TE from snack FS, respectively. Furthermore, 17 and 7% of children consumed ≥ 5% TE and ≥ 10% TE from beverages FS, respectively. Snacks and beverages accounted for 49 ± 30.9% of FS energy. Top snack sources of FS (% children, children's %TE from FS) were bakery products (55%, 2.4%), candy and sweet condiments (21%, 3.0%), and sugar-containing beverages (20%, 4.1%). Top sugar-containing beverage sources of FS (48%, 5.3%) were 100% fruit juice (22%, 4.6%) and flavored milk (11%, 3.1%). CONCLUSIONS Snacks and beverages contributed nearly half of FS intake among a sample of young children in Canada. Thus, long-term monitoring of snacking behavior and consumption of FS is warranted. These findings may help inform nutritional strategies and public policies to improve diet quality and FS intake in preschool-aged children. TRIAL REGISTRATION The Clinical Trial Registry number is NCT02939261 from clinicaltrials.gov. Date of Registration: October 20, 2016.
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Affiliation(s)
- Jessica Yu
- Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Anisha Mahajan
- Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
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Tovar A, Fox K, Gans KM, Markham Risica P, Papandonatos GD, Ramirez A, Gorin AA, von Ash T, Jennings E, Bouchard K, McCurdy K. Results from the Strong Families Start at Home/Familias Fuertes Comienzan en Casa: feasibility randomised control trial to improve the diet quality of low-income, predominantly Hispanic/Latinx children. Public Health Nutr 2023; 26:1-15. [PMID: 36691686 PMCID: PMC10131154 DOI: 10.1017/s1368980023000174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/21/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention. DESIGN Pilot randomised controlled trial. SETTING Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials. PARTICIPANTS Parents and their 2-5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups. RESULTS Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group (n 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (-1·35, -0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (-1·52, -0·19)), using food as a reward (PE = -0·54, 95 % CI (-1·35, -0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)). CONCLUSION Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.
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Affiliation(s)
- Alison Tovar
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | - Katelyn Fox
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kim M Gans
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Patricia Markham Risica
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | | | - Andrea Ramirez
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Amy A Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Tayla von Ash
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | - Ernestine Jennings
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Kelly Bouchard
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI, USA
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11
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Fidjeland TG, Øen KG. Parents' Experiences Using Digital Health Technologies in Paediatric Overweight and Obesity Support: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010410. [PMID: 36612733 PMCID: PMC9819819 DOI: 10.3390/ijerph20010410] [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: 11/10/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 05/08/2023]
Abstract
This study aimed to explore parents' perspectives regarding the use of digital health technologies in paediatric overweight and obesity weight support. A systematic search in 'Academic Search Premier', 'British Nursing Index', 'Cumulative Index to Nursing and Allied Health', and 'Health Research Premium Collection' was conducted in November 2021. Inclusion criteria were English or Nordic peer-reviewed articles published after 2010, overweight and obese children aged 2-10, weight support using digital health technologies, and parental experiences examined. An integrative review was conducted using Joanna Briggs Institute quality appraisal checklists and a constant comparison analysis method. In total, 14 articles were analysed that included SMS, telephone, apps, websites, and social media as the main technology groups. A limitation of this review was the heterogenicity of the studies. The results indicate that parents, mostly mothers, had a positive experience, finding technologies helpful and easy to use, and expressed optimism toward future use. An option for interacting with others and the possibility of personalising support were enjoyed or requested. In conclusion, digital health technologies can be a suitable tool to empower the parents of children with overweight and obesity concerns, whose perspective should be considered during the design and support phases.
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12
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Ashraf R, Duncan AM, Darlington G, Buchholz AC, Haines J, Ma DWL. The degree of food processing is associated with anthropometric measures of obesity in Canadian families with preschool-aged children. Front Nutr 2022; 9:1005227. [PMID: 36211496 PMCID: PMC9537364 DOI: 10.3389/fnut.2022.1005227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022] Open
Abstract
Adopting a healthy diet remains central for the prevention of obesity. In adults, higher intake of ultra-processed food is associated with a greater risk of overweight and obesity. However, little is known about the degree of food processing and its association with anthropometric measures in families with preschool-aged children, a critical period for the development of dietary patterns. This cross-sectional study included preschool-aged children (n = 267) between 1.5 and 5 years of age and their parents (n = 365) from 242 families enrolled in the Guelph Family Health Study. Dietary assessment was completed using ASA24-Canada-2016. Foods and beverages were classified based on their degree of food processing using the NOVA Classification (unprocessed or minimally processed foods, processed culinary ingredients, processed foods, and ultra-processed foods). Associations between the energy contribution (% kcal) of each NOVA category and anthropometric measures were examined using linear regression models with generalized estimating equations, adjusted for sociodemographic variables. The energy contribution of ultra-processed foods was the highest relative to the other NOVA categories among parents (44.3%) and children (41.3%). The energy contribution of unprocessed or minimally processed foods was 29.1% for parents and 35.3% for children, processed foods was 24.0% for parents and 21.3% for children, and processed culinary ingredients was 2.6% for parents and 2.1% for children. Ultra-processed foods (% kcal) were positively associated with BMI (β = 0.04, 95% CI: 0.01–0.07, P = 0.02), waist circumference (β = 0.11, 95% CI: 0.03–0.18, P = 0.008) and body weight (β = 0.13, 95% CI: 0.03–0.22, P = 0.01) in parents, but not children. Unprocessed foods (% kcal) were negatively associated with waist circumference in parents (β = −0.09, 95% CI: 0.18–0.01, P = 0.03) and children (β = −0.03, 95% CI: 0.05–0.01, P = 0.01), as well as body weight (β = −0.12, 95% CI: 0.23–0.00, P = 0.04) in parents. The degree of food processing primarily influenced anthropometric outcomes in parents. Nevertheless, diets of children were similar, suggesting that such exposure in families may eventually lead to outcomes observed in parents.
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Affiliation(s)
- Rahbika Ashraf
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Alison M. Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON, Canada
| | - Andrea C. Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - David W. L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
- *Correspondence: David W. L. Ma,
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13
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Moss S, Gu X. Home- and Community-Based Interventions for Physical Activity and Early Child Development: A Systematic Review of Effective Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911968. [PMID: 36231271 PMCID: PMC9565703 DOI: 10.3390/ijerph191911968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 06/09/2023]
Abstract
This systematic review examined the effects of home/family and community-based interventions on physical activity (PA) and developmental outcomes in early childhood. A search strategy was employed using four electronic databases (Academic Search Complete, CINAHL Complete, MEDLINE, and SPORTDiscus). Interventions investigating weight status (i.e., BMI), physical activity, sedentary behavior, and/or motor proficiency that took place in home, family, or community settings were assessed. Studies were eligible if they were peer-reviewed, available in English, published between 2011 and 2021, and if samples consisted of healthy young children (2-5 years old). There were 24 studies retained (8351 participants) spanning from the United States (n = 12), Australia (n = 3), Canada (n = 2), Switzerland (n = 2), Finland (n = 2), Netherlands (n = 1), and other Eastern European countries (n = 2). There were 19 studies that incorporated home/family-based approaches and 14 studies that incorporated community-based approaches. Studies ranged in intervention duration from 6 weeks to 24 months. It suggests that improving PA participation in young children was especially challenging to solicit improvement (only 25% of all studies found significant improvement in PA after intervention). Distributing educational material to parents/families, consistent, direct contact with parents, and encouraging community engagement were identified as effective strategies to promote physical activity, healthy weight status, and motor skills in young children.
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Affiliation(s)
- Samantha Moss
- Department of Kinesiology, State University of New York at Cortland, Cortland, NY 13090, USA
| | - Xiangli Gu
- Department off Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA
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14
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Flynn AC, Suleiman F, Windsor‐Aubrey H, Wolfe I, O'Keeffe M, Poston L, Dalrymple KV. Preventing and treating childhood overweight and obesity in children up to 5 years old: A systematic review by intervention setting. MATERNAL & CHILD NUTRITION 2022; 18:e13354. [PMID: 35333450 PMCID: PMC9218326 DOI: 10.1111/mcn.13354] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 01/01/2023]
Abstract
The prevalence of childhood obesity is increasing worldwide with long-term health consequences. Effective strategies to stem the rising childhood obesity rates are needed but systematic reviews of interventions have reported inconsistent effects. Evaluation of interventions could provide more practically relevant information when considered in the context of the setting in which the intervention was delivered. This systematic review has evaluated diet and physical activity interventions aimed at reducing obesity in children, from birth to 5 years old, by intervention setting. A systematic review of the literature, consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed. Three electronic databases were searched from 2010 up to December 2020 for randomised controlled trials aiming to prevent or treat childhood obesity in children up to 5 years old. The studies were stratified according to the setting in which the intervention was conducted. Twenty-eight studies were identified and included interventions in childcare/school (n = 11), home (n = 5), community (n = 5), hospital (n = 4), e-health (n = 2) and mixed (n = 1) settings. Thirteen (46%) interventions led to improvements in childhood obesity measures, including body mass index z-score and body fat percentage, 12 of which included both parental/family-based interventions in conjunction with modifying the child's diet and physical activity behaviours. Home-based interventions were identified as the most effective setting as four out of five studies reported significant changes in the child's weight outcomes. Interventions conducted in the home setting and those which included parents/families were effective in preventing childhood obesity. These findings should be considered when developing optimal strategies for the prevention of childhood obesity.
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Affiliation(s)
- Angela C. Flynn
- Department of Women and Children's HealthKing's College LondonLondonUK
- Department of Nutritional Sciences, School of Life Course SciencesKing's College LondonLondonUK
| | - Fatma Suleiman
- Department of Nutritional Sciences, School of Life Course SciencesKing's College LondonLondonUK
| | - Hazel Windsor‐Aubrey
- Department of Nutritional Sciences, School of Life Course SciencesKing's College LondonLondonUK
| | - Ingrid Wolfe
- Department of Women and Children's HealthKing's College LondonLondonUK
- Institute for Women and Children's HealthKing's Health Partners'LondonUK
| | - Majella O'Keeffe
- School of Food and Nutritional SciencesUniversity College CorkCorkIreland
| | - Lucilla Poston
- Department of Women and Children's HealthKing's College LondonLondonUK
- Institute for Women and Children's HealthKing's Health Partners'LondonUK
| | - Kathryn V. Dalrymple
- Department of Women and Children's HealthKing's College LondonLondonUK
- Institute for Women and Children's HealthKing's Health Partners'LondonUK
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15
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Burns JL, Mirotta JA, Duncan AM, Darlington G, Haines J, Shivappa N, Hebert JR, Ma DWL. Intakes of PUFA are Low in Preschool-aged Children in the Guelph Family Health Study Pilot Cohort. Appl Physiol Nutr Metab 2022; 47:973-978. [PMID: 35649282 DOI: 10.1139/apnm-2021-0618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated intakes of total, n-3, and n-6 polyunsaturated fatty acids (PUFA) in 109 preschool-aged children who participated in the Guelph Family Health Study pilot. Intakes of total, n-3, and n-6 PUFA did not meet recommendations. This study highlights the need for additional monitoring and potential interventions to improve PUFA intake in preschool-aged children. Clinical trial #NCT02223234. Novelty: Canadian preschool-aged children are not consuming enough n-3 and n-6 polyunsaturated fatty acids.
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Affiliation(s)
- Jessie L Burns
- University of Guelph, 3653, Human Heath and Nutritional Sciences, Guelph, Ontario, Canada;
| | - Julia A Mirotta
- University of Guelph, 3653, Human Health and Nutritional Sciences, Guelph, Ontario, Canada;
| | - Alison M Duncan
- University of Guelph, 3653, Human Health and Nutritional Sciences, Guelph, Ontario, Canada;
| | - Gerarda Darlington
- University of Guelph, 3653, Mathematics and Statistics, Guelph, Ontario, Canada;
| | - Jess Haines
- University of Guelph, 3653, Family Relations and Applied Nutrition , Guelph, Ontario, Canada;
| | - Nitin Shivappa
- University of South Carolina, 2629, Epidemiology and Biostatistics, Columbia, South Carolina, United States;
| | - James R Hebert
- University of South Carolina, 2629, Epidemiology and Biostatistics, Columbia, South Carolina, United States;
| | - David W L Ma
- University of Guelph, 3653, Human Health and Nutritional Sciences, Guelph, Ontario, Canada;
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16
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Mahajan A, Haines J, Carriero A, Hogan JL, Yu J, Buchholz AC, Duncan AM, Darlington G, Ma DWL. Non-Nutritive Sweetener Intake Is Low in Preschool-Aged Children in the Guelph Family Health Pilot Study. Nutrients 2022; 14:nu14102091. [PMID: 35631232 PMCID: PMC9145788 DOI: 10.3390/nu14102091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 01/27/2023] Open
Abstract
There is limited research on the intake of non-nutritive sweeteners (NNS) among preschool-aged children. Canada’s Food Guide suggests limiting intake of NNS for all population groups and Health Canada recommends that young children (<2 years) avoid consuming beverages containing NNS. The aim of this study was to investigate the frequency and type of non-nutritive sweetener (NNS) intake in preschool-aged children participating in the Guelph Family Health Study pilots. Parents (n = 78 families) completed 3-day food records (n = 112 children; n = 55 females, n = 57 males; 3.6 years ± 1.3). Nineteen children (17%) reported consumption of foods or beverages containing NNS. Food sources with NNS included: freezies, oral nutritional supplements, flavored water, carbonated drinks, sugar free jam and protein powder. The majority of NNS contained in these foods were identified as stevia leaf extract, acesulfame K, sucralose, monk fruit extract and aspartame. Future research should continue to study NNS intake patterns longitudinally in children and examine the association of NNS intake with diet quality and health outcomes.
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Affiliation(s)
- Anisha Mahajan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (A.C.); (J.L.H.); (J.Y.); (A.M.D.)
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (A.C.B.)
| | - Alex Carriero
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (A.C.); (J.L.H.); (J.Y.); (A.M.D.)
| | - Jaimie L. Hogan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (A.C.); (J.L.H.); (J.Y.); (A.M.D.)
| | - Jessica Yu
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (A.C.); (J.L.H.); (J.Y.); (A.M.D.)
| | - Andrea C. Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (J.H.); (A.C.B.)
| | - Alison M. Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (A.C.); (J.L.H.); (J.Y.); (A.M.D.)
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G 2W1, Canada;
| | - David W. L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.M.); (A.C.); (J.L.H.); (J.Y.); (A.M.D.)
- Correspondence: ; Tel.: +1-519-824-4120 (ext. 52272)
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17
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Massara P, Spiegel-Feld C, Hamilton J, Maguire JL, Birken C, Bandsma R, Comelli EM. Association between gut MIcrobiota, GROWth and Diet in peripubertal children from the TARGet Kids! cohort (The MiGrowD) study: protocol for studying gut microbiota at a community-based primary healthcare setting. BMJ Open 2022; 12:e057989. [PMID: 35534076 PMCID: PMC9086606 DOI: 10.1136/bmjopen-2021-057989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION The gut microbiota interacts with diet to affect body health throughout the life cycle. Critical periods of growth, such as infancy and puberty, are characterised by microbiota remodelling and changes in dietary habits. While the relationship between gut microbiota and growth in early life has been studied, our understanding of this relationship during puberty remains limited. Here, we describe the MIcrobiota, GROWth and Diet in peripubertal children (The MiGrowD) study, which aims to assess the tripartite growth-gut microbiota-diet relationship at puberty. METHODS AND ANALYSIS The MiGrowD study will be a cross-sectional, community-based study involving children 8-12 years participating in the TARGet Kids! COHORT TARGet Kids! is a primary healthcare practice-based research network in Canada. Children will be asked to provide a stool sample, complete two non-consecutive 24-hour dietary recalls and a pubertal self-assessment based on Tanner Stages. Anthropometry will also be conducted. The primary outcome is the association between gut microbiota composition and longitudinal growth from birth until entry into the study. Anthropometrics data from birth will be from the data collected prospectively through TARGet Kids!. Body mass index z-scores will be calculated according to WHO. The secondary outcome is the association between gut microbiota, diet and pubertal stage. ETHICS AND DISSEMINATION Ethics approval has been obtained by the Hospital for Sick Children and St. Michael's Hospital-Unity Health, and the University of Toronto. Results will be disseminated in the public and academic sector, including participants, TARGet Kids! primary healthcare physicians teams, scientists via participation in the TARGet Kids! science and physician meetings, conferences and publications in peer-reviewed journals. The MiGrowD study results will help researchers understand the relationships underlying growth, gut microbiota and pubertal maturation in children.
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Affiliation(s)
- Paraskevi Massara
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Translational Medicine Program, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Carolyn Spiegel-Feld
- Translational Medicine Program, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Jill Hamilton
- Department of Pediatrics, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Division of Endocrinology, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Jonathon L Maguire
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Li Ka Shing Knowledge Institute, Unity Health Toronto, Ontario, Toronto, Canada
| | - Catherine Birken
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Joannah and Brian Lawson Center for Child Nutrition, University of Toronto, Ontario, Toronto, Canada
- Pediatric Outcomes Research Team, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Robert Bandsma
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Translational Medicine Program, The Hospital for Sick Children, Ontario, Toronto, Canada
| | - Elena M Comelli
- Department of Nutritional Sciences, University of Toronto, Temerty Faculty of Medicine, Ontario, Toronto, Canada
- Joannah and Brian Lawson Center for Child Nutrition, University of Toronto, Ontario, Toronto, Canada
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18
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Sheremeta J, Ma DWL, Haines J, Duncan AM, Darlington G, Newton G, Buchholz AC. Cheese Intake is Inversely Associated with LDL Cholesterol in Young Children. CAN J DIET PRACT RES 2022; 83:208-211. [PMID: 35503897 DOI: 10.3148/cjdpr-2022-012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To determine if intake (servings/day) of total dairy and/or dairy subtypes (milk, cheese, and yogurt) were associated with biomarkers related to dyslipidemia, insulin sensitivity and inflammation in a sample of cardio-metabolically healthy young children from the Guelph Family Health Study at the University of Guelph, Guelph, Ontario, Canada.Methods: Baseline data from 42 children (aged 2.0-6.2 years) from 33 families who provided a dietary assessment and a fasted blood sample were included in this cross-sectional analysis. Linear and logistic regressions using generalized estimating equations were used for analysis and models were adjusted for age, gender, and household income.Results: In total, 42 children (3.74 ± 1.23 years old; mean (± SD)) consumed median (25th percentile, 75th percentile) servings/day of 1.70 (1.16, 2.81) for total dairy, 0.74 (0.50, 1.70) for milk, 0.63 (0.00, 1.16) for cheese, and 0.00 (0.00, 0.38) for yogurt. Cheese intake was significantly inversely associated with LDL cholesterol (-0.16 (95% CI: -0.29, -0.03) mmol/L per serving; P = 0.02)). No other associations between dairy intake and biomarkers were significant.Conclusions: Cheese intake was inversely associated with LDL cholesterol in this preliminary study of cardio-metabolically healthy young children, thereby warranting further research on dairy intake and cardiometabolic risk factors.
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Affiliation(s)
- Justin Sheremeta
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON
| | - Genevieve Newton
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
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19
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Brown V, Moodie M, Sultana M, Hunter KE, Byrne R, Zarnowiecki D, Seidler AL, Golley R, Taylor RW, Hesketh KD, Matvienko-Sikar K. A scoping review of outcomes commonly reported in obesity prevention interventions aiming to improve obesity-related health behaviors in children to age 5 years. Obes Rev 2022; 23:e13427. [PMID: 35122457 DOI: 10.1111/obr.13427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/17/2021] [Accepted: 12/17/2021] [Indexed: 12/18/2022]
Abstract
This scoping review was undertaken as the first stage of development of the Core Outcome Sets for Early Prevention of Obesity in CHildhood (COS-EPOCH). The aim of this review is to identify the outcomes collected and reported in randomized controlled trials of early childhood obesity prevention interventions. A systematic scoping review was undertaken following published guidelines. Trial registries and Medline were searched, and records retrieved were screened by two reviewers. Included trials aimed to prevent childhood obesity in the first 5 years of life and were randomized. Data were extracted using a standardized form. Outcomes were assigned to outcome domains, and similar definitions within each domain were merged, based on key literature and expert consensus. Outcome and domain frequencies were estimated and presented in outcome matrices. Eighteen outcome domains were identified from 161 included studies: "anthropometry," "dietary intake," "physical activity," "sedentary behaviour," "emotional functioning/wellbeing," "feeding," "cognitive/executive functioning," "sleep," "other," "study-related," "parenting practices," "motor skill development," "environmental," "blood and lymphatic system," "perceptions and preferences," "quality of life," and "economic," "oral health." The most frequently reported outcome domain was anthropometry (92% of studies), followed by dietary intake (77%) and physical activity (60%). 221 unique outcomes were identified, indicating a high degree of heterogeneity. Body mass index was the only outcome reported in >50% of studies. The considerable heterogeneity in outcomes supports the need for the development of COS-EPOCH.
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Affiliation(s)
- Vicki Brown
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia
| | - Marufa Sultana
- Deakin Health Economics, Institute for Health Transformation, Global Obesity Centre (GLOBE), School of Health and Social Development, Deakin University, Geelong, Australia
| | - Kylie E Hunter
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Rebecca Byrne
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
| | - Dorota Zarnowiecki
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Anna Lene Seidler
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Rebecca Golley
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Rachael W Taylor
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Kylie D Hesketh
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, Sydney, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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20
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St Laurent CW, Rodheim K, Spencer RMC. A Systematic Review of the Relationships Between Physical Activity and Sleep in Early Childhood. KINESIOLOGY REVIEW (CHAMPAIGN, ILL.) 2021; 11:121-137. [PMID: 35873529 PMCID: PMC9302480 DOI: 10.1123/kr.2020-0066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this systematic review was to examine the associations between physical activity and sleep in children aged less than 6 years. Articles were included if participants were primarily aged less than 6 years and study designs were observational or experimental. Study characteristics were extracted, and the Grading Recommendations Assessment, Development and Evaluation framework was used to assess study quality. Thirty-six studies (16 sleep, 16 physical activity, and three fitness outcomes) from 18 countries reported in 29 articles were included. The majority of sleep and physical activity outcome studies reported mixed effects with very low to low quality of evidence. Fitness outcome studies were limited, and therefore, evidence was insufficient. The high prevalence of mixed and null results could be related to study limitations. Importantly, this review points to the critical need for higher quality studies of sleep and physical activity in young children, which would support health recommendations and intervention strategies for healthier child development.
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Affiliation(s)
- Christine W St Laurent
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Katrina Rodheim
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Rebecca M C Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
- Institute of Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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21
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Mena NZ, Johnson SL, Ferrante MJ, Hobbs SJ, Zeng N, Bellows LL. The SPORKS For Kids: Integrating Movement Into Nutrition Education. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:903-906. [PMID: 34393065 DOI: 10.1016/j.jneb.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Noereem Z Mena
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Mackenzie J Ferrante
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Savannah J Hobbs
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Nan Zeng
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO; Prevention Research Center, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Laura L Bellows
- Divison of Nutritional Sciences, Cornell University, Ithaca, NY.
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22
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Mahajan A, Yu J, Hogan JL, Jewell K, Carriero A, Annis A, Sadowski A, Darlington G, Buchholz AC, Duncan AM, Haines J, Ma DWL. Dietary sugar intake among preschool-aged children: a cross-sectional study. CMAJ Open 2021; 9:E855-E863. [PMID: 34521651 PMCID: PMC8445636 DOI: 10.9778/cmajo.20200178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Excessive intake of sugar in young children is a public health concern. Our study objectives were to examine intakes of total, free and added sugar among preschool-aged children and to investigate their associations with body weight, body mass index Z-scores, percent fat mass and waist circumference. METHODS The cross-sectional cohort study included preschool-aged children between 1.5 and 5 years of age, enrolled in pilot studies of the Guelph Family Health Study, Guelph, Ontario, from 2014 to 2016. Daily intake of total sugar was determined using a food processor software; daily intakes of free and added sugar, and food sources were determined through manual inspection of 3-day food records. Anthropometric measures were completed by trained research staff. We used linear regression models with generalized estimating equations to estimate associations between sugar intakes and anthropometric measures. RESULTS We included 109 children (55 girls and 54 boys) in 77 families. Mean daily intakes were 86 (standard deviation [SD] 26) g for total sugar, 31 (SD 15) g for free sugar and 26 (SD 13) g for added sugar. Of participants, 80% (n = 87) had intakes of free sugar greater than 5% of their daily energy intake. The most frequent food sources of free and added sugar were bakery products. A weak inverse association between free sugar intake (kcal/1000 kcal) and waist circumference (cm) (β = -0.02, 95% confidence interval -0.04 to -0.0009) was found, but no significant associations were noted between sugar intake and other anthropometric measures. INTERPRETATION Most of the preschool-aged children in this study had free sugar intakes greater than current recommendations; overall, their total, free and added sugar intakes were not associated with the anthropometric measures. This study can be used to inform policy development for sugar intake in young children and apprise early intervention programs.
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Affiliation(s)
- Anisha Mahajan
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Jessica Yu
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Jaimie L Hogan
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Kira Jewell
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Alex Carriero
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Angela Annis
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Adam Sadowski
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Gerarda Darlington
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Andrea C Buchholz
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Alison M Duncan
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - Jess Haines
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont
| | - David W L Ma
- Departments of Human Health and Nutritional Sciences (Mahajan, Yu, Hogan, Carriero, Duncan, Ma), and Family Relations and Applied Nutrition (Jewell, Buchholz, Haines), and Guelph Family Health Study (Annis, Sadowski), and Department of Mathematics and Statistics (Darlington), University of Guelph, Guelph, Ont.
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23
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Lyons-Reid J, Derraik JGB, Ward LC, Tint MT, Kenealy T, Cutfield WS. Bioelectrical impedance analysis for assessment of body composition in infants and young children-A systematic literature review. Clin Obes 2021; 11:e12441. [PMID: 33565254 DOI: 10.1111/cob.12441] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 01/10/2023]
Abstract
Bioelectrical impedance analysis (BIA) is an easy to use, portable tool, but the accuracy of the technique in infants and young children (<24 months) remains unclear. A systematic literature review was conducted to identify studies that have developed and validated BIA equations in this age group. MEDLINE, Scopus, EMBASE, and CENTRAL were searched for relevant literature published up until June 30, 2020, using terms related to bioelectrical impedance, body composition, and paediatrics. Two reviewers independently screened studies for eligibility, resulting in 15 studies that had developed and/or validated equations. Forty-six equations were developed and 34 validations were conducted. Most equations were developed in young infants (≤6 months), whereas only seven were developed among older infants and children (6-24 months). Most studies were identified as having a high risk of bias, and only a few included predominantly healthy children born at term. Using the best available evidence, BIA appears to predict body composition at least as well as other body composition tools; however, among younger infants BIA may provide little benefit over anthropometry-based prediction equations. Currently, none of the available equations can be recommended for use in research or in clinical practice.
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Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Endocrinology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- NCD Centre of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Leigh C Ward
- Liggins Institute, University of Auckland, Auckland, New Zealand
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Timothy Kenealy
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Medicine and Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Endocrinology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
- A Better Start-National Science Challenge, University of Auckland, Auckland, New Zealand
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24
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Fangupo LJ, Haszard JJ, Reynolds AN, Lucas AW, McIntosh DR, Richards R, Camp J, Galland BC, Smith C, Taylor RW. Do sleep interventions change sleep duration in children aged 0-5 years? A systematic review and meta-analysis of randomised controlled trials. Sleep Med Rev 2021; 59:101498. [PMID: 34029803 DOI: 10.1016/j.smrv.2021.101498] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 11/25/2022]
Abstract
This review investigated whether randomised controlled trials attempting to improve sleep or prevent sleep problems in 0-5 year olds influenced nocturnal sleep duration, day-time naps, or 24-h sleep. Medline (Ovid), EMBASE, and CINAHL were searched from inception until 9 July 2020 and supplemented with hand searching. Search results were screened, eligible data were extracted, and risk of bias was assessed by at least two reviewers. Of 8571 publications considered, 32 trials which used a variety of subjective and objective sleep measurements were included in generic inverse variance random effects meta-analysis of nocturnal (n = 24), day-time (n = 14), and 24-h (n = 13) sleep duration. Overall, sleep interventions increased nocturnal sleep duration by a mean of 9 min (95% CI 4.1 to 13.8, I228%) per night when compared with no sleep intervention. Increases were predominantly seen in sleep-only, rather than multi-component interventions. Total 24-h sleep duration tended to increase by a similar amount (8.6 min (95% CI -2.7 to 19.8, I2 = 59%)), but this was mainly only seen in studies that assessed sleep using diaries. There was no evidence that interventions changed day-time sleep duration. Future studies should involve sleep-only rather than multi-component interventions, and use objective sleep measures (reviewregistry857).
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Affiliation(s)
| | | | | | - Albany W Lucas
- Centre for Pacific Health, University of Otago, New Zealand
| | | | | | - Justine Camp
- Department of Medicine, University of Otago, New Zealand
| | - Barbara C Galland
- Department of Women and Children's Health, University of Otago, New Zealand
| | - Claire Smith
- Department of Human Nutrition, University of Otago, New Zealand
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25
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Hruska V, Shivappa N, Hébert JR, Duncan AM, Haines J, Ma DWL. Associations between Family-Based Stress and Dietary Inflammatory Potential among Families with Preschool-Aged Children. Nutrients 2021; 13:nu13051464. [PMID: 33925798 PMCID: PMC8145143 DOI: 10.3390/nu13051464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/12/2021] [Accepted: 04/23/2021] [Indexed: 12/28/2022] Open
Abstract
Chronic stress is known to influence dietary choices, and stressed families often report poorer diet quality; however, little is known about how family-based stress is linked with dietary patterns that promote inflammation. This study investigated associations between family-based stress and the inflammatory potential of the diet among preschool-aged children and their parents. Parents (n = 212 mothers, n = 146 fathers) and children (n = 130 girls, n = 123 boys; aged 18 months to 5 years) from 241 families participating in the Guelph Family Health Study were included in the analyses. Parents reported levels of parenting distress, depressive symptoms, household chaos, and family functioning. The inflammatory potential of parents' and children's diets was quantified using the Dietary Inflammatory Index (DII®), adjusted for total energy intake (i.e., the E-DIITM). E-DII scores were regressed onto family stress using generalized estimating equations to account for shared variance among family clusters. Compared to those in homes with low chaos, parents in chaotic homes had significantly more proinflammatory dietary profiles (β = 0.973; 95% CI: 0.321, 1.624, p = 0.003). Similarly, compared to those in well-functioning families, parents in dysfunctional families had significantly more proinflammatory dietary profiles (β = 0.967; 95% CI: 0.173, 1.761, p = 0.02). No significant associations were found between parents' E-DII scores and parenting distress or depressive symptoms, nor were any associations found for children's E-DII scores. Results were not found to differ between males and females. Parents in chaotic or dysfunctional family environments may be at increased risk of chronic disease due to proinflammatory dietary profiles. Children's dietary inflammatory profiles were not directly associated with family stress; however, indirect connections through family food-related behaviours may exist. Future research should prioritize elucidating these mechanisms.
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Affiliation(s)
- Valerie Hruska
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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26
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Leme AC, Muszynski D, Mirotta JA, Caroll N, Hogan JL, Jewell K, Yu J, Fisberg RM, Duncan AM, Ma DWL, Haines J, On Behalf Of The Guelph Family Health Study. Diet Quality of Canadian Preschool Children: Associations with Socio-demographic Characteristics. CAN J DIET PRACT RES 2021; 82:131-135. [PMID: 33876988 DOI: 10.3148/cjdpr-2021-009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To examine associations between preschoolers' diet quality and parent and child socio-demographic variables.Methods: Cross-sectional analysis with 117 preschoolers. Parents reported socio-demographics and their children's diet using 3-day food records. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. Linear regression models were used to analyze associations between socio-demographics and HEI scores.Results: A total of 86% of children had an HEI-2015 score in the "needs improvement" category (51-80 out of a maximum of 100). Children's overall HEI-2015 score was inversely associated with children's age (β = -0.19, 95% CI -0.37, -0.02). Parental education was positively associated with children's overall HEI score (β = 9.58, 95% CI 3.81, 15.35) and with scores for total fruit (β = 1.00, 95% CI 0.39, 1.76), vegetables (β = 1.11, 95% CI 0.03, 2.18), total protein (β = 1.06, 95% CI 0.28, 1.84), and seafood/plant protein (β = 1.67, 95% CI 0.43, 2.89) components. Children who identified as Caucasian (β = 4.29, 95% CI 2.46, 6.14), had a Caucasian parent (β = 3.01, 95% CI 0.78, 5.25), or parents who were born in Canada (β = 2.32, 95% CI 0.53, 4.11) had higher scores for dairy.Conclusion: Our results suggest that preschoolers' diet quality needs improvement and that children's diet quality varies by children's age and parental education level.
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Affiliation(s)
- Ana Carolina Leme
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON.,University of São Paulo, Department of Nutrition, School of Public Health, Brazil, São Paulo, Brazil.,Center for Excellence in Nutrition and Feeding Difficulties, Children's Hospital Sabará, PENSI Institute, Brazil
| | - Dabrowka Muszynski
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Julia A Mirotta
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Nicholas Caroll
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON
| | - Jaimie L Hogan
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Kira Jewell
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Jessica Yu
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Regina Mara Fisberg
- University of São Paulo, Department of Nutrition, School of Public Health, Brazil, São Paulo, Brazil
| | - Alison M Duncan
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - David W L Ma
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Jess Haines
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON
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27
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Douglas S, Darlington G, Beaton J, Davison K, Haines J. Associations between Coparenting Quality and Food Parenting Practices among Mothers and Fathers in the Guelph Family Health Study. Nutrients 2021; 13:nu13030750. [PMID: 33652798 PMCID: PMC7996735 DOI: 10.3390/nu13030750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 11/16/2022] Open
Abstract
Coparenting quality and food parenting practices have been shown to have a strong influence on child outcomes. However, little is known about whether coparenting quality may influence food parenting practices. This study aimed to investigate how coparenting quality is associated with both mothers’ and fathers’ food parenting practices. A cross-sectional analysis was conducted of 58 mothers and 40 fathers enrolled in the Guelph Family Health Study. The Coparenting Relationship Scale and the Comprehensive Feeding Practices Questionnaire were used to measure coparenting and food parenting practices, respectively. Linear regressions using generalized estimating equations were used to examine associations between coparenting quality and food parenting practices in mothers and fathers. Among mothers, higher coparenting quality was associated with lower use of food for emotional regulation, restriction of food for health, and child control of food intake and with higher encouragement of a balanced and varied diet, provision of a healthy home environment, and modeling of healthy eating behaviors. Among fathers, higher coparenting quality was associated with lower pressure to eat and with higher encouragement of a balanced and varied diet and provision of a healthy home environment. Coparenting quality is associated with food parenting practices among both mothers and fathers. Interventions aiming to improve food parenting practices should include fathers and should consider targeting parents’ coparenting relationship.
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Affiliation(s)
- Sabrina Douglas
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G2W1, Canada; (J.B.); (J.H.)
- Correspondence:
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G2W1, Canada;
| | - John Beaton
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G2W1, Canada; (J.B.); (J.H.)
| | - Kirsten Davison
- Boston College School of Social Work, Chestnut Hill, MA 02467, USA;
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G2W1, Canada; (J.B.); (J.H.)
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28
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Fowler LA, Grammer AC, Staiano AE, Fitzsimmons-Craft EE, Chen L, Yaeger LH, Wilfley DE. Harnessing technological solutions for childhood obesity prevention and treatment: a systematic review and meta-analysis of current applications. Int J Obes (Lond) 2021; 45:957-981. [PMID: 33627775 PMCID: PMC7904036 DOI: 10.1038/s41366-021-00765-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/24/2020] [Accepted: 01/20/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Technology holds promise for delivery of accessible, individualized, and destigmatized obesity prevention and treatment to youth. OBJECTIVES This review examined the efficacy of recent technology-based interventions on weight outcomes. METHODS Seven databases were searched in April 2020 following PRISMA guidelines. Inclusion criteria were: participants aged 1-18 y, use of technology in a prevention/treatment intervention for overweight/obesity; weight outcome; randomized controlled trial (RCT); and published after January 2014. Random effects models with inverse variance weighting estimated pooled mean effect sizes separately for treatment and prevention interventions. Meta-regressions examined the effect of technology type (telemedicine or technology-based), technology purpose (stand-alone or adjunct), comparator (active or no-contact control), delivery (to parent, child, or both), study type (pilot or not), child age, and intervention duration. FINDINGS In total, 3406 records were screened for inclusion; 55 studies representing 54 unique RCTs met inclusion criteria. Most (89%) included articles were of high or moderate quality. Thirty studies relied mostly or solely on technology for intervention delivery. Meta-analyses of the 20 prevention RCTs did not show a significant effect of prevention interventions on weight outcomes (d = 0.05, p = 0.52). The pooled mean effect size of n = 32 treatment RCTs showed a small, significant effect on weight outcomes (d = ‒0.13, p = 0.001), although 27 of 33 treatment studies (79%) did not find significant differences between treatment and comparators. There were significantly greater treatment effects on outcomes for pilot interventions, interventions delivered to the child compared to parent-delivered interventions, and as child age increased and intervention duration decreased. No other subgroup analyses were significant. CONCLUSIONS Recent technology-based interventions for the treatment of pediatric obesity show small effects on weight; however, evidence is inconclusive on the efficacy of technology based prevention interventions. Research is needed to determine the comparative effectiveness of technology-based interventions to gold-standard interventions and elucidate the potential for mHealth/eHealth to increase scalability and reduce costs while maximizing impact.
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Affiliation(s)
- Lauren A. Fowler
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Anne Claire Grammer
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Amanda E. Staiano
- grid.250514.70000 0001 2159 6024LSU’s Pennington Biomedical Research Center, Baton Rouge, LA USA
| | - Ellen E. Fitzsimmons-Craft
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Ling Chen
- grid.4367.60000 0001 2355 7002Division of Biostatistics, Washington University School of Medicine, St. Louis, MO USA
| | - Lauren H. Yaeger
- grid.4367.60000 0001 2355 7002Washington University School of Medicine, St. Louis, MO USA
| | - Denise E. Wilfley
- grid.4367.60000 0001 2355 7002Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
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29
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Healthy Habits, Happy Homes Scotland (4HS) feasibility study: Translation of a home-based early childhood obesity prevention intervention evaluated using RE-AIM framework. PUBLIC HEALTH IN PRACTICE 2020; 1:100026. [PMID: 36101681 PMCID: PMC9461167 DOI: 10.1016/j.puhip.2020.100026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 11/21/2022] Open
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30
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Carroll N, Sadowski A, Laila A, Hruska V, Nixon M, Ma DW, Haines J. The Impact of COVID-19 on Health Behavior, Stress, Financial and Food Security among Middle to High Income Canadian Families with Young Children. Nutrients 2020; 12:nu12082352. [PMID: 32784530 PMCID: PMC7468859 DOI: 10.3390/nu12082352] [Citation(s) in RCA: 286] [Impact Index Per Article: 71.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic has disrupted many aspects of daily life. The purpose of this study was to identify how health behaviors, level of stress, financial and food security have been impacted by the pandemic among Canadian families with young children. Parents (mothers, n = 235 and fathers, n = 126) from 254 families participating in an ongoing study completed an online survey that included close and open-ended questions. Descriptive statistics were used to summarize the quantitative data and qualitative responses were analyzed using thematic analysis. More than half of our sample reported that their eating and meal routines have changed since COVID-19; most commonly reported changes were eating more snack foods and spending more time cooking. Screen time increased among 74% of mothers, 61% of fathers, and 87% of children and physical activity decreased among 59% of mothers, 52% of fathers, and 52% of children. Key factors influencing family stress include balancing work with childcare/homeschooling and financial instability. While some unhealthful behaviors appeared to have been exacerbated, other more healthful behaviors also emerged since COVID-19. Research is needed to determine the longer-term impact of the pandemic on behaviors and to identify effective strategies to support families in the post-COVID-19 context.
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Affiliation(s)
- Nicholas Carroll
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.S.); (A.L.); (J.H.)
- Correspondence: ; Tel.: +1-519-824-4120 (ext. 53780)
| | - Adam Sadowski
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.S.); (A.L.); (J.H.)
| | - Amar Laila
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.S.); (A.L.); (J.H.)
| | - Valerie Hruska
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (V.H.); (M.N.); (D.W.L.M.)
| | - Madeline Nixon
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (V.H.); (M.N.); (D.W.L.M.)
| | - David W.L. Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada; (V.H.); (M.N.); (D.W.L.M.)
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada; (A.S.); (A.L.); (J.H.)
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Parent Stress as a Consideration in Childhood Obesity Prevention: Results from the Guelph Family Health Study, a Pilot Randomized Controlled Trial. Nutrients 2020; 12:nu12061835. [PMID: 32575660 PMCID: PMC7353266 DOI: 10.3390/nu12061835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 01/25/2023] Open
Abstract
Parents’ stress is independently associated with increased child adiposity, but parents’ stress may also interfere with childhood obesity prevention programs. The disruptions to the family dynamic caused by participating in a behaviour change intervention may exacerbate parent stress and undermine overall intervention efficacy. This study explored how family stress levels were impacted by participation in a home-based obesity prevention intervention. Data were collected from 77 families (56 fathers, 77 mothers) participating in the Guelph Family Health Study (GFHS), a pilot randomized control trial of a home-based obesity prevention intervention. Four measures of stress were investigated: general life stress, parenting distress, depressive symptoms, and household chaos. Multiple linear regression was used to compare the level of stress between the intervention and control groups at post-intervention and 1-year follow-up, adjusted for baseline stress. Analyses for mothers and fathers were stratified, except for household chaos which was measured at the family level. Results indicate no significant differences between intervention and control groups for any stress measure at any time point, indicating a neutral effect of the GFHS intervention on family stress. Future work should investigate the components of family-based intervention protocols that make participation minimally burdensome and consider embedding specific stress-reduction messaging to promote family health and wellbeing.
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Hruska V, Ambrose T, Darlington G, Ma DWL, Haines J, Buchholz AC. Stress is Associated with Adiposity in Parents of Young Children. Obesity (Silver Spring) 2020; 28:655-659. [PMID: 32030916 DOI: 10.1002/oby.22710] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 10/15/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This study investigated associations between stress (general stress, parenting distress, and household chaos) and adiposity among parents of young children. METHODS The sample consisted of 49 mothers and 61 fathers from 70 families with young children living in Ontario, Canada. Linear regression using generalized estimating equations was used to investigate associations between stress measures and BMI, waist circumference (WC), waist to height ratio (WHtR), and percent fat mass. RESULTS General stress was significantly associated with BMI ( β ^ = 0.54; 95% CI: 0.04-1.03) and WC ( β ^ = 1.44; 95% CI: 0.10-2.77). Parenting distress was significantly associated with BMI ( β ^ = 0.16; 95% CI: 0.02-0.31), WC ( β ^ = 0.39; 95% CI: 0.04-0.75), and WHtR ( β ^ = 0.003; 95% CI: 0.001-0.005). Household chaos was significantly associated with all adiposity measures (BMI: β ^ = 0.20 [95% CI: 0.08-0.33]; WC: β ^ = 0.48 [95% CI: 0.21-0.75]; WHtR: β ^ = 0.003 [95% CI: 0.001-0.005]; percent fat mass: β ^ = 0.29 [95% CI: 0.08-0.49]). CONCLUSIONS General stress, parenting distress, and household chaos are associated with adiposity among parents of young children. Future research should elucidate mechanisms by which this occurs and elucidate how this risk may be mitigated.
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Affiliation(s)
- Valerie Hruska
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Tory Ambrose
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, Ontario, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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LEME ACBARCO, PHILIPP ST, FISBERG RM. Changes in diet quality 6 and 12 months post-intervention: the Healthy Habits, Healthy Girls: a Brazilian study. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e190184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective To determine the sustainability of food quality in an obesity-prevention strategy for adolescent girls. Methods The study is a randomized controlled trial with 253 girls (Mean=15.61, 95% Confidence Interval 15.51-15.72) enrolled in 10 vocational schools in São Paulo. The diet intake was determined using a “Food Frequency Questionnaire” and analyzed according to the Brazilian Healthy Eating Index-Revised adequacy, moderation, and overall scores. The adolescents’ dietary intake was compared to the baseline 6 months and 12 months post-intervention. Descriptive statistics and analyses of covariance were used, considering a 5% significance level. Results Significant increases were found on the components total fruits (F=6.98, p<0.01), total vegetables (F=5.76, p=0.02), beans (F=5.96, p=0.02), and whole cereals (F=12.35, p<0.001). However, there was also a significant decrease on the scores for milk and dairy (F=6.48, p=0.02), and oils (F=5.98, p=0.02). At 12-month post intervention, improvement on the overall score was found (F=3.89, p=0.05), but there was a decrease on the component whole cereals (F=11.85, p<0.001), as well as in milk and dairies (F=6.38, p=0.02). Despite no significant effect for the SoFAAS component, a moderate effect size was revealed (d=0.56). Conclusion There were significant effects on some diet quality components and for the overall scores at 6-month and 12-month post intervention. Therefore, sustainable dietary changes should be the focus of obesity prevention programs for adolescents. Socio-economic influences on diet behaviors would also need to be acknowledged.
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Nogueira LR, Fontanelli MDM, Aguiar BSD, Failla MA, Florindo AA, Leme AC, Barbosa JPDAS, Fisberg RM. Is the local food environment associated with excess body weight in adolescents in São Paulo, Brazil? CAD SAUDE PUBLICA 2020; 36:e00048619. [DOI: 10.1590/0102-311x00048619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/02/2019] [Indexed: 11/21/2022] Open
Abstract
The obesogenic environment stimulates an inadequate diet by hampering healthy choices. This cross-sectional study evaluated the association between the local food environment and the prevalence of overweight and obesity in a representative sample population of adolescents living in the city of São Paulo, Brazil, using multilevel logistic regression models. Among the adolescents, 29.6% were overweight/obese. There were no significant differences between food environment and adolescents’ weight status. However, the presence of fast food restaurants near their home increased the chances of being overweight or obese (OR = 2.53; 95%CI: 1.02-6.27). Results suggest the need to intensify food and nutrition policies, development of culinary skills, and the reduction in prices of healthy foods to facilitate access to these foods, so that adolescents have options in locations to socialize with friends and family.
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Gillespie J, Hughes A, Gibson AM, Haines J, Taveras E, Reilly JJ. Protocol for Healthy Habits Happy Homes (4H) Scotland: feasibility of a participatory approach to adaptation and implementation of a study aimed at early prevention of obesity. BMJ Open 2019; 9:e028038. [PMID: 31175198 PMCID: PMC6561609 DOI: 10.1136/bmjopen-2018-028038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Prevention of childhood obesity is an important public health objective. Promoting healthful energy balance related behaviours (EBRBs) in the early years should be a key focus. In Scotland, one in five children are overweight or obese by age 5 years, with levels highest in deprived areas. This study protocol outlines the stages of a feasibility study to translate the highly promising North American Healthy Habits, Happy Homes (4H) a home based, preschool childhood obesity prevention intervention to Scotland (4H Scotland). First, elements of participatory and co-production approaches utilised to: (a) engage key stakeholders, (b) enable inclusive recruitment of participants and (c) adapt original study materials. Second, 4H Scotland intervention will be tested within a community experiencing health/social inequalities and high levels of deprivation in Dundee, Scotland. METHODS AND ANALYSIS 4H Scotland aims to recruit up to 40 families. Anthropometry, objective and subjective measures of EBRBs will be collected at baseline and at 6 months. The intervention consists of monthly visits to family home, using motivational interviewing and SMS to support healthful EBRBs: sleep duration, physical activity (active play), screen time, family meals. The Control Group will receive standard healthy lifestyle information. Fidelity to intervention will be assessed using recordings of intervention visits. Feasibility and acceptability of study design components will be assessed through qualitative interviews and process evaluation of recruitment, retention rates; appropriateness, practicality of obtaining outcome measures; intervention duration, content, mode of delivery and associated costs. Adaptation through participatory and co-production will support development of 4H Scotland. Process evaluation offers two future directions; advancement towards a definitive, larger trial or routine practice. ETHICS AND DISSEMINATION This study was granted ethical approval by the University of Strathclyde's School of Psychological Sciences and Health Ethics Committee. Results will be disseminated through lay summaries workshops, peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ISRCTN13385965; Pre-results.
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Affiliation(s)
- Jenny Gillespie
- Physical Activity for Health, University of Strathclyde School of Psychological Sciences and Health, Glasgow, UK
- Nutrition and Dietetics, NHS Tayside, Dundee, UK
| | - Adrienne Hughes
- University of Strathclyde School of Psychological Sciences and Health, Glasgow, UK
| | - Ann-Marie Gibson
- University of Strathclyde School of Psychological Sciences and Health, Glasgow, UK
| | - Jess Haines
- University of Guelph, Guelph, Ontario, Canada
| | - Elsie Taveras
- Massachusetts General Hospital, Boston, Massachusetts, USA
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Krystia O, Ambrose T, Darlington G, Ma DWL, Buchholz AC, Haines J. A randomized home-based childhood obesity prevention pilot intervention has favourable effects on parental body composition: preliminary evidence from the Guelph Family Health Study. BMC OBESITY 2019; 6:10. [PMID: 30873285 PMCID: PMC6398255 DOI: 10.1186/s40608-019-0231-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Background Home-based lifestyle behaviour interventions show promise for treating and preventing childhood obesity. According to family theories, engaging the entire family unit, including parents, to change their family behaviour and dynamics may be necessary to prevent the development of childhood obesity. However, little is known about how these interventions, which may change the family dynamics and weight-related behaviours of parents, affect weight outcomes in parents. Our objective was to examine the effect of a pilot home-based childhood obesity prevention intervention on measures of anthropometrics and body composition in Canadian parents. Methods Forty-four families with children aged 1.5–5 years were randomized to one of three groups: 4 home visits with a health educator, emails, and mailed incentives (4 HV); 2 home visits, emails, and mailed incentives (2 HV); or general health emails (control). Both the 2 HV and 4 HV intervention were conducted over a period of 6 months. Body composition and anthropometric outcomes were measured at baseline and at 6 months and 18 months from baseline. Results In parents with baseline body mass index (BMI) ≥ 25 kg/m2, the 2 HV group had significantly lower body mass and waist circumference at 6-month (CI = -5.85,-0.14 kg;-5.82,-0.30 respectively) and 18-month follow-up (CI = -7.57,-1.21 kg;-9.30,-2.50 cm respectively) when compared to control, and significantly lower BMI at 18-month follow-up when compared to control (CI = -2.59,-0.29 kg/m2). In parents with baseline BMI < 25 kg/m2, the 4 HV group had significantly lower percentage fat mass (CI = -3.94,-0.12%), while the 2 HV group had significantly lower body mass (CI = -2.56,-0.42 kg) and BMI (CI = -0.77,-0.08 kg/m2) at 6-month follow-up, both compared to control; these effects were not maintained at 18-month follow-up. Conclusions This study provides support that a home-based childhood obesity prevention intervention may improve weight outcomes among parents. Future research should explore how home-based interventions influence family behaviour and dynamics to impact weight outcomes in children and their parents. Trial registration Prospectively registered August 2014, clinical trial identifier NCT02223234.
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Affiliation(s)
- Owen Krystia
- 1Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Tory Ambrose
- 1Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Gerarda Darlington
- 2Department of Mathematics and Statistics, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - David W L Ma
- 3Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Andrea C Buchholz
- 1Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Jess Haines
- 1Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1 Canada
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Walton K, Ambrose T, Annis A, Ma DW, Haines J. Putting family into family-based obesity prevention: enhancing participant engagement through a novel integrated knowledge translation strategy. BMC Med Res Methodol 2018; 18:126. [PMID: 30409164 PMCID: PMC6225617 DOI: 10.1186/s12874-018-0588-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 10/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background With 1 in 4 Canadian preschoolers considered overweight or obese, identifying risk factors for excess weight gain and developing effective interventions aimed at promoting healthy weights and related behaviours among young children have become key public health priorities. Despite the need for this research, engaging and maintaining participation is a critical challenge for long-term, family-based studies. The aim of this study is to describe the implementation and evaluation of a parent-only advisory council designed to engage participants in the implementation and evaluation of a longitudinal, family-based obesity prevention intervention. Methods A Family Advisory Council (n = 14 parents, 70% mothers, 64% white), was established to engage participant stakeholders in decisions related to research protocols and strategies to engage and sustain family participation. Using a mixed methods approach, including a participant survey and focus group, we examined the council members’ perceptions of their role and the impact this novel integrated Knowledge Translation (iKT) strategy had on the Guelph Family Health Study (GFHS), a longitudinal family-based study. Results All members of the Family Advisory Council felt the topics discussed were appropriate, felt that their opinions were valued and that their suggestions have had an impact and direct benefit on the GFHS. The addition of the Family Advisory Council led to changes in study protocol (i.e. creation of more detailed intervention emails, creation of kid-friendly accelerometer bands) that may have contributed to the high retention rate of the GFHS (95% at 6-month follow-up). Conclusions Engaging parents as research partners in family-based research studies may be an effective way to increase participant engagement and study retention.
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Affiliation(s)
- Kathryn Walton
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada. .,University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada.
| | - Tory Ambrose
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada.,University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada
| | - Angela Annis
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.,University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada
| | - David Wl Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.,University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada.,University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 2W1, Canada
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