Eating habits and eating behaviors by family dinner frequency in the lower-grade elementary school students

Prevalence of Overweight and Obesity and Association with Risk Factors in Secondary School Children in Croatia

BACKGROUND

Childhood and adolescent overweight and obesity represent significant global health concerns. The primary objective of this study was to assess the prevalence and associations of some potential risk factors with overweight and obesity among Croatian adolescents aged 15 to 18.

METHODS

This cross-sectional study included 344 secondary school students from Croatia's Mediterranean region, with data collected through an anonymous questionnaire. The questionnaire gathered sociodemographic information, adherence to the Mediterranean diet of both children and their parents, and the children's dietary habits and physical activity levels.

RESULTS

Weight status data revealed that 2.6% of participants were underweight, 82% had normal weight, 11% were overweight, and 4.4% were classified as obese. The results indicated that boys (p < 0.001), children who skip breakfast (p = 0.031), those with less active lifestyles compared to their peers (p = 0.001), children whose mothers have a higher BMI (p < 0.001), and children from smaller families (p = 0.034) are at greater risk of being overweight or obese.

CONCLUSIONS

This study provides valuable insights into the risk factors associated with overweight and obesity in this age group, which can support the development of targeted strategies for this population.

Meal Duration and Obesity-Related Indicators among Adolescents: Insights from the EHDLA Study

PURPOSE

This paper aims to examine the association between meal duration and obesity indicators among Spanish adolescents.

METHODS

We conducted a cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) project involving 755 adolescents aged 12 to 17 years (54.8% girls) from three secondary schools in the Valle de Ricote Region of Murcia, Spain. To evaluate overall meal duration, participants were asked how long (on average) breakfast, morning snacks, lunch, afternoon snacks, and dinner typically last. Subsequently, global meal duration was measured, and the participants were categorized into tertiles. Obesity-related indicators, including body mass index (BMI) z score, waist circumference (WC), and skinfold thickness, were assessed. The analyses were adjusted for potential confounders such as sex, age, socioeconomic status, physical activity, sedentary behavior, diet quality, and energy intake.

RESULTS

Concerning meal duration status, adolescents with long meal durations had the lowest estimated marginal means of BMI z score, WC, and body fat percentage (using the sum of triceps and calf skinfolds). However, significant differences between adolescents with a long meal duration and those with a short meal duration were observed only for BMI z score (p = 0.008), and WC (p = 0.020). Furthermore, significant differences in BMI z score (p = 0.017) between adolescents with a long meal duration and those with a moderate meal duration were identified.

CONCLUSIONS

These findings underscore the importance of promoting slower eating habits as part of obesity prevention strategies. Future studies should explore the causality of this association and its potential for behavioral interventions.

Is family meal frequency associated with obesity in children and adolescents? A cross-sectional study including 155 451 participants from 43 countries

OBJECTIVE

This study tried to examine the association between the frequency of family meals and excess weight using large and representative samples of children and adolescents from 43 countries.

METHODS

This cross-sectional study used data from the Health Behaviour in School-aged Children (HBSC), which included nationally representative samples of children and adolescents aged 10-17 years, involving a total of 155 451 participants (mean age = 13.6 years; standard deviation [SD] = 1.6; 51.4% girls). Family meal frequency was gauged through the following question: 'How frequently do you and your family typically share meals?' The possible responses were: 'never', 'less often', 'approximately once a week', 'most days' and 'every day'. The body weight and height of the participants were self-reported and utilized to calculate body mass index (BMI). Subsequently, BMI z-scores were computed based on the International Obesity Task Force criteria, and the prevalence of excess weight was defined as +1.31 SD for boys and + 1.24 SD for girls, with obesity defined as +2.29 SD for boys and + 2.19 SD for girls. Generalized linear mixed models were conducted to examine the associations between the frequency of family meals and excess weight or obesity.

RESULTS

The lowest predicted probabilities of having excess weight and obesity were observed for those participants who had family meals every day (excess weight: 34.4%, 95% confidence interval [CI] 31.4%-37.5%; obesity: 10.8%, 95% CI 9.0%-13.0%).

CONCLUSIONS

A higher frequency of family meals is associated with lower odds of having excess weight and obesity in children and adolescents.

The centrality of food in Norwegian adolescents' life; a photo elicitation study among Norwegian youth

The purpose of the study was to explore how adolescents from a high school in Viken county define and interact with food systems in their immediate environments to understand if and how health and sustainability affect their food choices. A qualitative case study design and a participatory approach were employed. Data were collected through photo elicitation combined with group interviews. Pictures were analyzed in collaboration with participants, and the group interview through systematic text condensation. Results indicate that adolescents perceive food systems as being a substantial part of their everyday life, that they care about their health and that of the planet, and they wish to take sustainability and health into consideration when making food choices. Their food choices are affected by aspects such as family, friends, marketing, price, time, availability and accessibility. They perceive that their agency to influence their own diet and food systems is limited. Adolescents hold unique and important knowledge of their food-related behaviors and value their autonomy to make food choices. Future research and policies aiming to help adolescents make healthy and sustainable food choices should therefore actively include adolescents.

Influence of engaging female caregivers in households with adolescent girls on adopting equitable family eating practices: a quasi-experimental study

Background

In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA).

Method

We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study's outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the mixed effect logistic regression model was used to examine the effect of the intervention.

Result

The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06-4.09]) after controlling selected covariates, p-value 0.033.

Conclusions

The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.

Effects of Childhood Nutrition Education from School and Family on Eating Habits of Japanese Adults

Since the Basic Law of Shokuiku (nutrition education) was established in 2005, the Japanese government has been promoting nutrition education among children to encourage better eating habits. This study analyzes the 2019 survey data on people's attitudes towards nutrition education, in order to elucidate the relationship between the results of nutrition education, attitude towards nutrition education and proper eating habits, and the experience of nutrition education. The results reveal that people who received nutrition education at elementary school and middle school tend to have a more positive attitude towards nutrition education. In addition, family conversation on foods during elementary school years has a positive effect on nutritionally balanced eating behavior.

The Moderating Effects of the Families Improving Together (FIT) for Weight Loss Intervention and Parenting Factors on Family Mealtime in Overweight and Obese African American Adolescents

Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child’s weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent’s weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.

Longitudinal association between food frequency and changes in body mass index: a prospective cohort study

OBJECTIVES

Analysing data of the Young Lives Study in Peru, we aimed at assessing the association between daily food frequency and body mass index (BMI) changes between 2006 and 2016.

DESIGN

Secondary analysis of a prospective ongoing cohort study.

SETTING

20 sentinel sites in Peru.

PARTICIPANTS

Children enrolled in the younger cohort of the Young Lives Study. We used information from the second (2006-2007), third (2009-2010), fourth (2013-2014) and fifth (2016-2017) rounds of the younger cohort in Peru.

PRIMARY AND SECONDARY OUTCOMES

BMI as well as BMI-for-age z-score, both as numerical variables.

RESULTS

Data from 1948 children, mean age 4.3 (SD: 0.3) years and 966 (49.6%) women were included at baseline. In multivariable model, lower food consumption frequency was associated with increased BMI and BMI-for-age z-scores: children reporting <4 times of food consumption per day had a greater increase in BMI (β=0.39; 95% CI 0.17 to 0.62) and BMI-for-age z-score (β=0.07; 95% CI 0.01 to 0.13) compared with those reporting 5 per day. Results were consistent for those reporting exactly eating 4 times per day (β for BMI=0.16; 95% CI 0.02 to 0.30 and β for BMI-for-age z-score=0.05; 95% CI 0.01 to 0.09).

CONCLUSIONS

Children who eat <5 times per day, gain more BMI compared with those who eat ≥5 times. Parents should receive information to secure adequate nutrition for their children, both in terms of quality and quantity.

Understanding the food-family relationship: A qualitative research in a Chilean low socioeconomic context

Our life is comprised of, among other things, many food and eating decisions. Therefore, we are in a constant relationship with food. Although many health providers and researchers have recommended having a positive relationship with food for better health and well-being, what the human relationship with food entails is still unclear. The aim of this study is to explore the relationship with food among families in Chile, a country that has the highest rate of obesity among OECD countries. In this qualitative study, we conducted eight focus groups in three regions of Chile (North, Center, and South). We recruited women living with their partners and children who represented the family point of view. For data analysis, we used the Atlas.ti program and conducted a thematic analysis. We found that the family relationship with food had five dimensions: (1) An identity dimension that allowed families to describe themselves or some of their family members; (2) an emotional dimension in which family expressed feelings and emotions through food; (3) a social dimension in which family members got together through food; (4) a health dimension in which family related to food to obtain benefits from it or to avoid enemy food; (5) a practical dimension in which families were organized around food tasks. Our findings show that the relationship that Chilean families have with food is a complex phenomenon. All the dimensions should be taken in consideration to create or improve interventions that seek to improve eating habits or prevent nutrition-related diseases from a family perspective.

Associations between Meal Companions and Obesity in South Korean Adults

Dinner, considered the main meal of the day, forms a large portion of an individual’s overall food intake. Therefore, having family dinners has a significant impact on peoples’ health. This study examined the relationship between meal companions and obesity among South Korean adults. Data from 23,494 participants, from the 2013–2017 Korean National Health and Nutrition Examination Survey (KNHANES), were examined. Participants were divided into three categories: dinner with family, dinner with others, and dinner alone. Obesity was the dependent variable, using body mass index recommended by the KNHANES. A multinomial logistic regression analysis was performed to examine the target association. Compared to those that had family dinners, people who ate dinner with others or alone had a higher obesity risk (With Others: odds ratio (OR) = 1.19, 95% confidence interval (CI) = 1.04–1.36; Alone: OR = 1.15, 95% CI = 1.03–1.27). Participants who engaged in weekly heavy drinking were more likely to be obese than those who did not drink (OR = 1.34, 95% CI = 1.19–1.51). Moreover, those who had dinner with others or alone were at higher risk of obesity regardless of their breakfast companion. Further, people who had daily meals outside of their homes had a higher risk of obesity than those who had dinner with others and those who had family dinners. Having family dinners poses a significantly lower risk of obesity compared to having dinners with others or alone, as shown by this investigation. By detailing the correlation between meal companions and obesity, this study could help motivate dieters to have more frequent family dinners.

The Family as an Actor in High School Students' Eating Habits: A Qualitative Research Study

In order to discover family conceptions and their difficulties with regard to healthy eating habits during the school day, a qualitative study framed in the phenomenological, exploratory, and explanatory perspective has been carried out to detect and describe the aspects and interrelationships that shape the study phenomenon. The researchers performed triangulation techniques and information analysis support with the Atlas-ti programme. As participants, the students' parents belonging to public secondary education high schools in Huelva, and the capital and its province were included. The participants were intentionally chosen based on established selection and segmentation criteria. Four main categories were obtained from the triangulated analysis. Healthy breakfast, school snack, school cafeteria, and promotion of healthy food measures. Other subcategories were established within them. Families are well aware of the composition of a healthy breakfast, although this is often not translated into practice. Lack of time, comfort and market influence are the main challenges they encounter for their children to acquire healthy habits. The maintenance of healthy habits, their responsibility and control on behalf of the family, and promoting fruit consumption and healthy products from the part of the centre and its cafeteria were highlighted as improvement proposals.

The Associations between Body Mass Index of Seven- and Eight-Year-Old Children, Dietary Behaviour and Nutrition-Related Parenting Practices

Background and objective: Body mass index (BMI) is one of the key indicators used to measure the growth of children. It could be affected by the children’s nutrition, which is essential for the proper development of the child. Nutrition of children could be affected by many environmental factors, for example, the socioeconomic environment of the family. The aim of this study was to identify the associations between the BMI of seven- and eight-year-old children, dietary behaviour and nutrition-related parenting practices. Materials and Methods: The study was carried out as part of the World Health Organization European Childhood Obesity Surveillance Initiative (WHO COSI). Data were collected using two instruments: objective anthropometric measurements and a questionnaire. The target participant group was 3969 Lithuanian first-formers. Factor analysis was used to summarise questions from the family form. Linear regression analysis was used to identify the associations between various factors and the BMI value of the children. The association between two groups of factors was analysed using Spearman correlation. Results: Factors of dietary behaviour like unhealthy food and proteins were significantly positively associated with BMI in children, while consumption of plant-based, dairy and confectionery items was significantly negatively associated with BMI. Factors of nutrition-related parenting practices like control of unhealthy food, food as a reward or punishment, and mealtime were significantly positively associated with BMI, while encouragement, pressure to eat, and liberal attitude were significantly negatively associated with BMI. The strongest associations were between control of unhealthy food and unhealthy food; cost of and preferences for food and plant-based food; variety of food and proteins; variety of food and plant-based food compared to other associations. Conclusions: The dietary behaviour and nutrition-related parenting practices were associated with BMI in children.

The frequency of family meals and nutritional health in children: a meta-analysis

Findings on the relationship between family meal frequency and children's nutritional health are inconsistent. The reasons for these mixed results have to date remained largely unexplored. This systematic review and meta-analysis of 57 studies (203,706 participants) examines (i) the relationship between family meal frequency and various nutritional health outcomes and (ii) two potential explanations for the inconsistent findings: sociodemographic characteristics and mealtime characteristics. Separate meta-analyses revealed significant associations between higher family meal frequency and better overall diet quality (r = 0.13), more healthy diet (r = 0.10), less unhealthy diet (r = -0.04) and lower body mass index, BMI (r = -0.05). Child's age, country, number of family members present at meals and meal type (i.e. breakfast, lunch or dinner) did not moderate the relationship of meal frequency with healthy diet, unhealthy diet or BMI. Socioeconomic status only moderated the relationship with BMI. The findings show a significant relationship between frequent family meals and better nutritional health - in younger and older children, across countries and socioeconomic groups, and for meals taken with the whole family vs. one parent. Building on these findings, research can now target the causal direction of the relationship between family meal frequency and nutritional health.

Nutrition Counselling Practices among General Practitioners in Croatia

Chronic non-communicable diseases are a significant public health problem and imbalanced nutrition is one of the most significant risk factor for them. The objective of this study was to examine Croatia’s general practitioners’ nutrition counselling practice and determine the factors that influence such practice. A cross-sectional study was conducted among 444 (17.0%) randomly selected general practitioners (GPs) in Croatia from May to July 2013 via a 32-item anonymous questionnaire. Study showed that 77.0% of participants had provided nutrition counselling exclusively to patients with specific health risks; 18.7% participants had provided nutrition counselling for all patients, regardless of their individual risks, while 4.3% had not provide nutrition counselling. As the most significant stimulating factor for implementing nutrition counselling in their daily work with patients, 55.6% of the participants identified personal interest regarding nutrition and the effects it has on health. The latter factor was more frequently emphasized among female general practitioners (p < 0.001) and general practitioners without chronic diseases (p < 0.001). The most significant barrier for nutrition counselling was lack of time (81.6%). It is necessary to make additional efforts to increase the frequency of nutrition counselling provided by general practitioners in Croatia. The majority of Croatian general practitioners could increase their nutrition counselling practice in order to promote balanced nutrition and improve the overall health status of their patients.

Eating habits, physical activity, nutrition knowledge, and self-efficacy by obesity status in upper-grade elementary school students

BACKGROUND/OBJECTIVES

Childhood obesity has increased in recent decades in Korea. This study was designed to examine differences in the eating habits, physical activity (PA), nutrition knowledge, and self-efficacy of children by obesity status.

SUBJECTS/METHODS

Subjects were 5th-grade children from 70 elementary schools in 17 cities nationwide. Two-stage stratified cluster sampling was employed. Survey questionnaire included items related to general characteristics, eating habits, PA, nutrition knowledge and self-efficacy. Excluding incomplete responses, 3,531 data were analyzed using SPSS. Subjects were categorized into overweight·obesity (OW) and normal weight (NW) groups based on body mass index percentiles for age by sex.

RESULTS

A total of 21.5% of subjects was overweight or obese. There were significant differences in gender, perceived stress, perception of body shape, body satisfaction, and interest in weight control between the OW and NW groups (P < 0.001). With respect to eating habits, the OW group ate breakfast (P < 0.05) and snacks (P < 0.01) less frequently, ate bigger meals (P < 0.001), and demonstrated less desirable behaviors during meals (P <0.05 in boys) compared to the NW group. The OW group participated in less PA than the NW group, especially boys. OW boys spent less time walking during weekdays (P < 0.05) or the weekend (P < 0.001), spent more time being sedentary during weekdays or the weekend (P < 0.001), and exercised a fewer number of days (P < 0.01). For girls, the OW group spent more time being sedentary during the weekend (P < 0.01) and exercised a fewer number of days by walking or bicycle riding (P < 0.05) than the NW group. Nutrition knowledge was not significantly different between the OW and NW groups. Self-efficacy (P < 0.01 in boys), especially PA self-efficacy (P < 0.01), was significantly lower in the OW than NW group.

CONCLUSIONS

This study revealed differences in eating habits, PA, and self-efficacy between OW and NW children. Obesity management programs for children need to focus on increasing self-efficacy, modifying eating habits, and increasing PA.

Food deserts in Korea? A GIS analysis of food consumption patterns at sub-district level in Seoul using the KNHANES 2008-2012 data

BACKGROUND/OBJECTIVES

The concept of "food deserts" has been widely used in Western countries as a framework to identify areas with constrained access to fresh and nutritious foods, providing guidelines for targeted nutrition and public health programs. Unlike the vast amount of literature on food deserts in a Western context, only a few studies have addressed the concept in an East Asian context, and none of them have investigated spatial patterns of unhealthy food consumption from a South Korean perspective.

SUBJECTS/METHODS

We first evaluated the applicability of food deserts in a Korean setting and identified four Korean-specific unhealthy food consumption indicators, including insufficient food consumption due to financial difficulty, limited consumption of fruits and vegetables, excessive consumption of junk food, and excessive consumption of instant noodles. The KNHANES 2008-2012 data in Seoul were analyzed with stratified sampling weights to understand the trends and basic characteristics of these eating patterns in each category. GIS analyses were then conducted for the data spatially aggregated at the sub-district level in order to create maps identifying areas of concern regarding each of these indicators and their combinations.

RESULTS

Despite significant reduction in the rate of food insufficiency due to financial difficulty, the rates of excessive consumption of unhealthy foods (junk food and instant noodles) as well as limited consumption of fruits and vegetables have increased or remained high. These patterns tend to be found among relatively younger and more educated groups, regardless of income status.

CONCLUSIONS

A GIS-based analysis demonstrated several hotspots as potential "food deserts" tailored to the Korean context based on the observed spatial patterns of undesirable food consumption. These findings could be used as a guide to prioritize areas for targeted intervention programs to facilitate healthy food consumption behaviors and thus improve nutrition and food-related health outcomes.