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Fisberg M, Gioia N, Maximino P. Transgenerational transmission of eating habits. J Pediatr (Rio J) 2024; 100 Suppl 1:S82-S87. [PMID: 38142715 PMCID: PMC10960189 DOI: 10.1016/j.jped.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
OBJECTIVE To investigate the relationship between the biopsychosocial environment and eating habits and behaviors that lead to the selection and consumption of certain food from the earliest stages of life. To clarify whether there is an interaction between genetic and epigenetic factors, and how they shape eating habits. DATA SOURCE A narrative review based on research in PubMed and Web of Science electronic databases was carried out over the last 10 years, searching the title and summary fields using the keywords Children OR adolescents Feeding Behavior eating OR Dietary Habits OR Eating Behavior OR Eating Habits OR Children obesity. DATA SYNTHESIS The generational transmission of eating habits is related to the home, community, and school environments, mainly during the first years of life, and can exert the modulation of habits during all stages of life. During childhood, the family's role in consolidating eating habits is very broad and ranges from choosing foods to prioritizing family meals, including the lifestyle. CONCLUSIONS Eating habits are transmitted from parents to children in different ways: environmental, emotional, social, and educational. In cases of obesity, a greater association of genetic influence can be observed.
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Affiliation(s)
- Mauro Fisberg
- Instituto de Pesquisa Pensi - Sabará Hospital Infantil, Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), São Paulo, SP, Brazil
| | - Nathalia Gioia
- Instituto de Pesquisa Pensi - Sabará Hospital Infantil, Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), São Paulo, SP, Brazil
| | - Priscila Maximino
- Instituto de Pesquisa Pensi - Sabará Hospital Infantil, Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), São Paulo, SP, Brazil.
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Ervina E, Berget I, Skeie SB, L. Almli V. Basic taste sensitivity, eating behaviour, food propensity and BMI of preadolescent children: How are they related? Open Res Eur 2024; 1:127. [PMID: 38433733 PMCID: PMC10904958 DOI: 10.12688/openreseurope.14117.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 03/05/2024]
Abstract
Background Taste sensitivity has been reported to influence children's eating behaviour and contribute to their food preferences and intake. This study aimed to investigate the associations between taste sensitivity, eating behaviour, food frequency and BMI (Body Mass Index) in preadolescents. Methods Preadolescents' taste sensitivity was measured by detection threshold of sweetness (sucrose), sourness (citric acid), saltiness (sodium chloride), bitterness (caffeine, quinine), and umami (monosodium glutamate). In addition, the Child Eating Behaviour Questionnaire (CEBQ), the Food Propensity Questionnaire (FPQ) measuring food frequency, and the children's body weight and height were completed by the parents. A total of 69 child-parent dyads participated (preadolescents mean age =10.9 years). Results Taste sensitivity to caffeine bitterness was significantly associated with eating behaviour in food responsiveness, emotional overeating, and desire to drink. The preadolescents who were less sensitive to caffeine bitterness had higher food responsiveness scores. Those who were less sensitive to caffeine bitterness and to sweetness had higher emotional overeating scores. In addition, preadolescents who were less sensitive to sourness and bitterness of both caffeine and quinine demonstrated to have higher scores in desire to drink. There was no association between taste sensitivity and FPQ, but significant differences were observed across preadolescents' BMI for FPQ of dairy food items, indicating higher consumption of low-fat milk in the overweight/obese compared to the underweight/normal-weight subjects. There was no significant difference in taste sensitivity according to BMI. Preadolescents' eating behaviour differed across BMI, demonstrating a positive association between BMI and food approach, and a negative association between BMI and food avoidance. Conclusions This study contributes to the preliminary understanding of the relationships between taste sensitivity and eating behaviour in preadolescents. The results may be used to develop effective strategies to promote healthy eating practices by considering taste sensitivity in preadolescents.
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Affiliation(s)
- Ervina Ervina
- Department of Sensory and Consumer Sciences, Nofima, Norwegian Institute of Food, Fisheries and Aquaculture Research, Ås, 1430, Norway
- Department of Chemistry, Biotechnology and Food Science (KBM), The Norwegian University of Life Science, Ås, 1433, Norway
- Food Technology Department, Faculty of Engineering, Bina Nusantara University, Jakarta, 11480, Indonesia
| | - Ingunn Berget
- Department of Raw Materials and Process Optimization, Nofima, Norwegian Institute of Food, Fisheries and Aquaculture Research, Ås, 1430, Norway
| | - Siv Borghild Skeie
- Department of Chemistry, Biotechnology and Food Science (KBM), The Norwegian University of Life Science, Ås, 1433, Norway
| | - Valérie L. Almli
- Department of Sensory and Consumer Sciences, Nofima, Norwegian Institute of Food, Fisheries and Aquaculture Research, Ås, 1430, Norway
- Department of Chemistry, Biotechnology and Food Science (KBM), The Norwegian University of Life Science, Ås, 1433, Norway
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Czarniecka-Skubina E, Hamulka J, Gutkowska K. How Can We Increase the Nutrition-Related Knowledge in Children Aged 7-12 Years: Results of Focus Groups Interviews with Parents-Junior-Edu-Żywienie (JEŻ) Project. Nutrients 2023; 16:129. [PMID: 38201959 PMCID: PMC10780913 DOI: 10.3390/nu16010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Nutrition education is a long-term process that should cover various population groups. A special focus should be placed on children, adolescents and their parents. The aim of this research was to find out the opinions of parents of primary school pupils aged 7-12 on their expectations towards school education in the areas of food and nutrition, addressed to both pupils and their parents. The research was conducted among 101 parents of primary school pupils with the use of the Focus Group Interview (FGI) method. It demonstrated that what is most needed are hands-on activities relating to basic theoretical issues. While parents see the need for nutrition education for their children, educating pupils in this area is of interest to only some of the respondents for whom nutrition aspects are quite important. All parents would like formal nutrition education at school, but at the same time, they do not want classes to take up too much of their children's time, due to the already excessive number of school subjects. It seems appropriate to include everyone in regard to nutrition education, regardless of their declared interest in this issue. The need for consistent presentation of educational content addressed to teachers and parents is very important, so that they can, in a uniform way, shape the attitudes towards food and nutrition of children and adolescents.
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Affiliation(s)
- Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
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Au LE, Arnold CD, Ritchie LD, Lin SK, Frongillo EA. Differences in Infant Diet Quality Index by Race and Ethnicity Predict Differences in Later Diet Quality. J Nutr 2023; 153:3498-3505. [PMID: 37858725 PMCID: PMC10843900 DOI: 10.1016/j.tjnut.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/15/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in infant-feeding practices may negatively influence diet quality and health. OBJECTIVES This study investigated the racial, ethnic, and language (English or Spanish) differences in infant diet quality, later diet quality, and weight status at 2-5 y, and whether these differences were explained through infant diet quality among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS Using the WIC Infant and Toddler Feeding Practices Study-2 (unweighted n = 2663; weighted n = 362,712), relationships between the Infant Dietary Quality Index (IDQI; range 0-1) and Healthy Eating Index-2020 (HEI-2020; range 0-100) and BMI z-score (BMIz) at 2-5 y were analyzed by race, ethnicity, and language preference [Hispanic Spanish-speaking, Hispanic English-speaking, non-Hispanic (NH) White, and NH Black participants]. Statistical interaction between IDQI and each group was evaluated in multivariable models. The mediation of each group through the IDQI was assessed using causal mediation methods. RESULTS Differences in IDQI [mean (standard deviation)] were observed between Hispanic Spanish-speaking participants [0.41 (0.10)], Hispanic English-speaking participants [0.37 (0.10)], NH White participants [0.36 (0.10)], and NH Black participants [0.35 (0.09)], P < 0.001. Differences in HEI-2020 occurred at 2-5 y, with the Hispanic Spanish-speaking participants having consistently higher HEI-2020 scores. Differences in BMIz were observed at 5 y, with higher scores among Hispanic Spanish-speaking participants. Interaction between race, ethnicity, and IDQI was observed for all outcomes except for BMIz at 3 y. Through mediation, IDQI explained 13%-20% of the difference in HEI-2020 scores between Hispanic Spanish-speaking and NH White participants at 2-5 y. IDQI explained 22%-25% of the difference in HEI-2020 scores between the Hispanic Spanish-speaking and NH Black participants at 4 y and 5 y. CONCLUSIONS Higher infant diet quality scores observed in Hispanic Spanish-speaking participants explain some of the racial and ethnic differences observed in later diet quality, suggesting that improving infant diet quality may help reduce diet disparities during early childhood.
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Affiliation(s)
- Lauren E Au
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States.
| | - Charles D Arnold
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA, United States
| | - Sarina K Lin
- Meyer Hall, Department of Nutrition, University of California, Davis, CA, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, United States
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Padhani ZA, Das JK, Siddiqui FA, Salam RA, Lassi ZS, Khan DSA, Abbasi AMA, Keats EC, Soofi S, Black RE, Bhutta ZA. Optimal timing of introduction of complementary feeding: a systematic review and meta-analysis. Nutr Rev 2023; 81:1501-1524. [PMID: 37016953 DOI: 10.1093/nutrit/nuad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
CONTEXT The timing of introducing complementary feeding (CF) is crucial because premature or delayed CF can be associated with adverse health outcomes in childhood and adulthood. OBJECTIVE This systematic review aims to evaluate the impact of the timing of CF introduction on health, nutrition, and developmental outcomes among normal-term infants. DATA SOURCES Electronic databases and trial registries were searched, along with the reference lists of the included studies and relevant systematic reviews. DATA EXTRACTION Two investigators independently extracted data from the included studies on a standardized data-extraction form. DATA ANALYSIS Data were meta-analyzed separately for randomized controlled trials (RCTs) and observational studies on the basis of early introduction of CF (< 3 months, < 4 months, < 6 months of age) or late introduction of CF (> 6 months, > 8 months of age). Evidence was summarized according to GRADE criteria. In total, 268 documents were included in the review, of which 7 were RCTs (from 24 articles) and 217 were observational studies (from 244 articles). Evidence from RCTs did not suggest an impact of early introduction, while low-certainty evidence from observational studies suggested that early introduction of CF (< 6 months) might increase body mass index (BMI) z score and overweight/obesity. Early introduction at < 3 months might increase BMI and odds of lower respiratory tract infection (LRTI), and early introduction at < 4 months might increase height, LRTI, and systolic and diastolic blood pressure (BP). For late introduction of CF, there was a lack of evidence from RCTs, but low-certainty evidence from observational studies suggests that late introduction of CF (> 6 months) might decrease height, BMI, and systolic and diastolic BP and might increase odds of intestinal helminth infection, while late introduction of CF (> 8 months) might increase height-for-age z score. CONCLUSION Insufficient evidence does suggest increased adiposity with early introduction of CF. Hence, the current recommendation of introduction of CF should stand, though more robust studies, especially from low- and middle-income settings, are needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020218517.
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Affiliation(s)
- Zahra A Padhani
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Jai K Das
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Faareha A Siddiqui
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
| | - Rehana A Salam
- Centre of Research Excellence, Melanoma Institute Australia, University of Sydney, Sydney, New South Wales, Australia
| | - Zohra S Lassi
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | | | - Ammaar M A Abbasi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Emily C Keats
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sajid Soofi
- Division of Women and Child Health, Aga Khan University, Karachi, Sindh, Pakistan
| | - Robert E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Zulfiqar A Bhutta
- Institute of Global Health and Development, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
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Varela P, De Rosso S, Ferreira Moura A, Galler M, Philippe K, Pickard A, Rageliene T, Sick J, van Nee R, Almli VL, Ares G, Grønhøj A, Spinelli S, van Kleef E. Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system. Nutr Res Rev 2023:1-21. [PMID: 37746804 DOI: 10.1017/s0954422423000203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.
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Affiliation(s)
| | - Sofia De Rosso
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | | | - Kaat Philippe
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, F-21000 Dijon, France
| | | | | | - Julia Sick
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Roselinde van Nee
- Wageningen University, Marketing & Consumer Behaviour Group, Wageningen, The Netherlands
| | | | - Gastón Ares
- Sensometrics and Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | | | - Sara Spinelli
- Department of Agriculture, Food, Environment and Forestry (DAGRI), University of Florence, Florence, Italy
| | - Ellen van Kleef
- Wageningen University, Marketing & Consumer Behaviour Group, Wageningen, The Netherlands
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Moura AF, Philippe K. Where is the father? Challenges and solutions to the inclusion of fathers in child feeding and nutrition research. BMC Public Health 2023; 23:1183. [PMID: 37337169 DOI: 10.1186/s12889-023-15804-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 05/02/2023] [Indexed: 06/21/2023] Open
Abstract
Despite an increasing acknowledgement of fathers' involvement in and impact on children's lives, fathers remain underrepresented in child feeding and childhood obesity prevention research, interventions, and actions. Built on our own experiences with conducting research with fathers and recent evidence on this topic, this Research in Practice article has three aims. It will first substantiate the importance of including and studying fathers in the field of child feeding and childhood obesity prevention based on recent study results. Secondly, the article will present and discuss barriers to fathers' inclusion and participation (why isn't it happening?), among other issues, by drawing on sociological and gender ideological insights. Finally, it will provide recommendations and suggestions related to recruitment, focus and methods that can facilitate fathers' involvement in future research, interventions, and practice. Taken together, this article aims to provide tools for giving fathers a voice in the field of child nutrition and by doing so, to decrease maternal-only "burden" of care. We hope our experiences and theoretical reflections will inspire and support researchers and practitioners to be as successful as possible in the realm of family care.
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Affiliation(s)
- Andreia F Moura
- Department of Food, Nutrition and Dietetics, School of Biosciences, University of Nottingham, Sutton Bonington, UK.
- Department of Management, Business and Social Sciences Faculty, MAPP Centre for Research On Value Creating in the Food Sector, Aarhus University, Aarhus, Denmark.
| | - Kaat Philippe
- Centre des Sciences du Goût et de L'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne, Dijon, F-21000, France
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Belfield, Ireland
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Weker H, Friedrich M, Zabłocka-Słowińska K, Sadowska J, Długosz A, Hamułka J, Charzewska J, Socha P, Wądołowska L. Position Statement of the Polish Academy of Sciences' Committee of Human Nutrition Science on the Principles for the Nutrition of Preschool Children (4-6 Years of Age) and Early School-Age Children (7-9 Years of Age). J Mother Child 2023; 27:222-245. [PMID: 38369720 PMCID: PMC10875211 DOI: 10.34763/jmotherandchild.20232701.d-23-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/01/2023] [Indexed: 02/20/2024]
Affiliation(s)
- Halina Weker
- Department of Nutrition, Institute of Mother and Child, Warsaw, Poland
| | - Mariola Friedrich
- Department of Applied Microbiology and Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranianu University of Technology, Szczecin, Poland
| | | | - Joanna Sadowska
- Department of Applied Microbiology and Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranianu University of Technology, Szczecin, Poland
| | - Anna Długosz
- Faculty of Chemical Technology and Engineering, University of Science and Technology, Bydgoszcz, Poland
| | - Jadwiga Hamułka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Jadwiga Charzewska
- National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Piotr Socha
- Department of Gastroenterology, Hepatology, Eating Disorders and Paediatrics, Institute ‘Monument - Children’s Health Center’, Warsaw, Poland
| | - Lidia Wądołowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Poland
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Au LE, Arnold CD, Ritchie LD, Frongillo EA. The Infant Diet Quality Index Predicts Dietary and Adiposity Outcomes in US Children 2 to 4 years old. J Nutr 2023; 153:741-748. [PMID: 36806452 PMCID: PMC10196607 DOI: 10.1016/j.tjnut.2023.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Healthy nutrition during the first year of life is critical for optimal growth and development. Limited techniques are available to assess diet quality in infancy, and few have been shown to be predictive of dietary and adiposity outcomes in low-income children. OBJECTIVE The objectives of this study were to construct an Infant Diet Quality Index (IDQI) to assess the diet quality from birth to 12 mo and to determine whether the IDQI exhibits predictive validity by estimating the longitudinal associations of IDQI scores with diet quality and weight status at 2 to 4 y. DESIGN Data were analyzed from the longitudinal Women, Infants, and Children Infant and Toddler Feeding Practices Study-2 (unweighted, n = 2858; weighted. N = 392,439) using one 24-h dietary recall and survey responses during infancy. The newly constructed IDQI consists of 16 equally-weighted components: 1) breastfeeding duration; 2) exclusive breastfeeding; age of first introduction of: 3) solids, 4) iron-rich cereals, 5) cow milk, 6) sugar-sweetened beverages, 7) salty/sweet snacks, 8) other drinks/liquids, and 9) textured foods; frequency of consuming 10) fruit or 11) vegetables; frequency of consuming different 12) fruit or 13) vegetables; 14) nonrecommended bottle-feeding practices; 15) use of commercial baby foods; and 16) number of meals and snacks. Regression analysis was used to estimate associations between the total IDQI score (range, 0-1) and Healthy Eating Index-2015 (HEI-2015) scores and body mass index z-scores (BMIz) at 2 to 4 y of age, adjusted for covariates (e.g., child age, sex and race/ethnicity; maternal education level, etc.) RESULTS: The total IDQI score was positively associated with HEI-2015 at the age of 2 y (β = 16.7; 95% CI: 12.6, 20.9; P < 0.001), 3 y (β = 14.5; 95% CI: 8.1, 21.0; P < 0.001), and 4 y (β = 15.4; 95% CI: 8.4, 22.4; P < 0.001); and negatively associated with BMIz at the age of 2 y (β = -1.24; 95% CI: -2.01, -0.47; P = 0.002) and 4 y (β = -0.92; 95% CI: -1.53, -0.30; P = 0.003). CONCLUSIONS The IDQI has predictive validity for diet quality and weight status in low-income US children.
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Affiliation(s)
- Lauren E Au
- Meyer Hall, Department of Nutrition, University of California, One Shields Avenue, Davis, CA, United States.
| | - Charles D Arnold
- Meyer Hall, Department of Nutrition, University of California, One Shields Avenue, Davis, CA, United States
| | - Lorrene D Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, 1111 Franklin Street, Oakland, CA, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Discovery 1, 915 Greene Street, Room 529, Columbia, SC, United States
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Laitinen AL, Antikainen A, Mikkonen S, Kähkönen K, Talvia S, Varjonen S, Paavola S, Karhunen L, Tilles-Tirkkonen T. Implementation of food education in school environments improves pupils' eating patterns and social participation in school dining. Public Health Nutr 2022; 25:1-11. [PMID: 36210798 PMCID: PMC9991779 DOI: 10.1017/s1368980022002154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/19/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Schools can be an effective arena for food education. The Tasty School is a tailored teacher-driven food education model that provides tools for implementing food education in primary schools. This study aimed to investigate the effects of the Tasty School model on pupils' eating patterns and experiences. We also aimed to assess the implementation strength of the Tasty School. DESIGN A quasi-experimental study was conducted during one school year 2019-2020 in fifteen intervention and ten control schools. The intervention schools implemented the Tasty School food education model. The pupils completed web-based baseline and follow-up questionnaires in class during a school day. The principals were interviewed after the intervention. The data were analysed using a mixed-effects model for repeated measures, accounting for the implementation strength and selected standardisation effects. SETTING A total of twenty-five general Finnish primary schools. PARTICIPANTS 1480 pupils from grades 3-6 (age 8-12 years) from five municipalities in Finland. RESULTS Percentages of pupils eating a balanced school meal increased in schools where food education was actively implemented (P = 0·027). In addition, pupils' experience of social participation in school dining strengthened in schools where the Tasty School model was implemented (5-point scale mean from 2·41 to 2·61; P = 0·017). CONCLUSIONS Healthy eating patterns can be promoted by the active implementation of food education in primary schools. The Tasty School model offers a promising tool for developing healthy eating patterns and increasing social participation among pupils not only in Finland, but also potentially in other countries as well.
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Affiliation(s)
- Aija L Laitinen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Amma Antikainen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Santtu Mikkonen
- Department of Applied Physics and Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Kähkönen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Sanna Talvia
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Silja Varjonen
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Saila Paavola
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Leila Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Tanja Tilles-Tirkkonen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
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Swindle T, Rutledge JM, Zhang D, Martin J, Johnson SL, Selig JP, Yates AM, Gaulden DT, Curran GM. De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies. Nutrients 2022; 14:nu14142861. [PMID: 35889818 PMCID: PMC9319894 DOI: 10.3390/nu14142861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023] Open
Abstract
This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or de-implementation strategies (i.e., Basic Support; B), (b) implementation strategies only (i.e., Enhanced Support; E), and (c) implementation and de-implementation strategies (i.e., De-implementation + Enhanced Support; D + E) and (2) a within-site pre-post comparison among sites with D + E. At nutrition lessons, the D + E group had more Positive Comments (Hedege’s g = 0.60) and higher Role Model fidelity (Hedege’s g = 1.34) compared to the E group. At meals, assistant teachers in the D + E group had higher Positive Comments than in the B group (g = 0.72). For within-group comparisons, the D + E group decreased Negative Comments (t(19) = 2.842, p = 0.01), increased Positive Comments (t(20) = 2.314, p = 0.031), and improved use of the program mascot at nutrition lessons (t(21) = 3.899, p = 0.001). At meals, lead teachers’ Negative Comments decreased (t(22) = 2.73, p = 0.01). Qualitative data identified strengths and opportunities for iteration. Despite a COVID interruption, mid-point comparisons and qualitative feedback suggest promise of the de-implementation strategy package.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
- Correspondence:
| | - Julie M. Rutledge
- College of Applied and Natural Sciences, School of Human Ecology, Louisiana Tech University, Ruston, LA 71272, USA; (J.M.R.); (A.M.Y.)
| | - Dong Zhang
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
| | - Janna Martin
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - James P. Selig
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Amy M. Yates
- College of Applied and Natural Sciences, School of Human Ecology, Louisiana Tech University, Ruston, LA 71272, USA; (J.M.R.); (A.M.Y.)
| | - Daphne T. Gaulden
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (D.Z.); (J.M.); (D.T.G.)
| | - Geoffrey M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
- Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
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12
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Wahi G, Wilson J, Burning M, George S, Hill P, Homer J, Jacobs L, Lickers A, Smoke S, Davis AD, Desai D, Jack SM, Williams N, de Souza RJ, Anand SS. Impact of Maternal Health Behaviours and Social Conditions on Infant Diet at Age 1-Year: Results from a Prospective Indigenous Birth Cohort in Ontario, Canada. Nutrients 2022; 14:nu14091736. [PMID: 35565704 PMCID: PMC9102994 DOI: 10.3390/nu14091736] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Understanding the impact of maternal health behaviours and social conditions on childhood nutrition is important to inform strategies to promote health during childhood. Objective: To describe how maternal health sociodemographic factors (e.g., socioeconomic status, education), health behaviours (e.g., diet), and traditional health care use during pregnancy impact infant diet at age 1-year. Methods: Data were collected from the Indigenous Birth Cohort (ABC) study, a prospective birth cohort formed in partnership with an Indigenous community-based Birthing Centre in southwestern Ontario, Canada. 110 mother-infant dyads are included in the study and were enrolled between 2012 and 2017. Multiple linear regression analyses were performed to understand factors associated with infant diet scores at age 1-year, with a higher score indicating a diet with more healthy foods. Results: The mean age of women enrolled during pregnancy was 27.3 (5.9) years. Eighty percent of mothers had low or moderate social disadvantage, 47.3% completed more than high school education, and 70% were cared for by a midwife during their pregnancy. The pre-pregnancy body mass index (BMI) was <25 in 34.5% of women, 15.5% of mothers smoked during pregnancy, and 14.5% of mothers had gestational diabetes. Being cared for by an Indigenous midwife was associated with a 0.9-point higher infant diet score (p = 0.001) at age 1-year, and lower maternal social disadvantage was associated with a 0.17-point higher infant diet quality score (p = 0.04). Conclusion: This study highlights the positive impact of health care provision by Indigenous midwives and confirms that higher maternal social advantage has a positive impact on child nutrition.
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Affiliation(s)
- Gita Wahi
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- Correspondence:
| | - Julie Wilson
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Melanie Burning
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Stephanie George
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Phyllis Hill
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Janet Homer
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Laurie Jacobs
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Ashley Lickers
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Sharon Smoke
- Six Nations Birthing Centre, Six Nations of the Grand River, Ohsweken, ON N0A 1M0, Canada; (J.W.); (M.B.); (S.G.); (P.H.); (J.H.); (L.J.); (A.L.); (S.S.)
| | - Albertha D. Davis
- Six Nations Health Services, Six Nations of the Grant River, Ohsweken, ON N0A 1M0, Canada;
| | - Dipika Desai
- Population Health Research Institute, Hamilton, ON L8L 2X2, Canada;
| | - Susan M. Jack
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- School of Nursing, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Natalie Williams
- Chanchlani Research Centre, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Russell J. de Souza
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- Population Health Research Institute, Hamilton, ON L8L 2X2, Canada;
| | - Sonia S. Anand
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.M.J.); (R.J.d.S.); (S.S.A.)
- Population Health Research Institute, Hamilton, ON L8L 2X2, Canada;
- Chanchlani Research Centre, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada;
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13
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Swindle T, Rutledge JM, Selig JP, Painter J, Zhang D, Martin J, Johnson SL, Whiteside-Mansell L, Almirall D, Barnett-McElwee T, Curran GM. Obesity prevention practices in early care and education settings: an adaptive implementation trial. Implement Sci 2022; 17:25. [PMID: 35303894 DOI: 10.1186/s13012-021-01185-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Despite the potential for Early Care and Education (ECE) settings to promote healthy habits, a gap exists between current practices and evidence-based practices (EBPs) for obesity prevention in childhood. Methods We will use an enhanced non-responder trial design to determine the effectiveness and incremental cost-effectiveness of an adaptive implementation strategy for Together, We Inspire Smart Eating (WISE), while examining moderators and mediators of the strategy effect. WISE is a curriculum that aims to increase children’s intake of carotenoid-rich fruits and vegetables through four evidence-based practices in the early care and education setting. In this trial, we will randomize sites that do not respond to low-intensity strategies to either (a) continue receiving low-intensity strategies or (b) receive high-intensity strategies. This design will determine the effect of an adaptive implementation strategy that adds high-intensity versus one that continues with low-intensity among non-responder sites. We will also apply explanatory, sequential mixed methods to provide a nuanced understanding of implementation mechanisms, contextual factors, and characteristics of sites that respond to differing intensities of implementation strategies. Finally, we will conduct a cost effectiveness analysis to estimate the incremental effect of augmenting implementation with high-intensity strategies compared to continuing low-intensity strategies on costs, fidelity, and child health outcomes. Discussion We expect our study to contribute to an evidence base for structuring implementation support in real-world ECE contexts, ultimately providing a guide for applying the adaptive implementation strategy in ECE for WISE scale-up. Our work will also provide data to guide implementation decisions of other interventions in ECE. Finally, we will provide the first estimate of relative value for different implementation strategies in this setting. Trial registration NCT05050539; 9/20/21.
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14
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Bélanger V, Delorme J, Napartuk M, Bouchard I, Meloche C, Curnier D, Sultan S, Laverdière C, Sinnett D, Marcil V. Early Nutritional Intervention to Promote Healthy Eating Habits in Pediatric Oncology: A Feasibility Study. Nutrients 2022; 14:nu14051024. [PMID: 35267999 PMCID: PMC8912879 DOI: 10.3390/nu14051024] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 12/21/2022] Open
Abstract
This study aims to describe the feasibility of a nutritional intervention that promotes healthy eating habits early after cancer pediatric diagnosis in patients and their parents. Participants were recruited 4 to 12 weeks after cancer diagnosis as part of the VIE study. The one-year nutritional intervention included an initial evaluation and 6 follow-up visits every 2 months with a registered dietician. The feasibility assessment included rates of retention, participation, attendance, completion of study measures, and participants' engagement. A preliminary evaluation of the intervention's impact on the participants' dietary intakes was conducted. A total of 62 participants were included in the study (51.6% male, mean age = 8.5 years, mean time since diagnosis = 13.2 weeks). The retention and attendance rates were 72.6% and 71.3%, respectively. Attendance to follow-up visits declined over time, from 83.9% to 48.9%. A majority of participants had high participation (50.8%) and high engagement (56.4%). Measures of body-mass-index or weight-for-length ratio and dietary 24-h recalls were the procedures with the highest completion rates. Participants with refractory disease or relapse were less likely to complete the intervention. Post-intervention, participants (n = 21) had a lower sodium intake compared to the initial evaluation. These results suggest that a nutritional intervention that involves patients and parents early after a pediatric cancer diagnosis is feasible.
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Affiliation(s)
- Véronique Bélanger
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Josianne Delorme
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Mélanie Napartuk
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Isabelle Bouchard
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Caroline Meloche
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
| | - Daniel Curnier
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Serge Sultan
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- Department of Psychology, Université de Montréal, Montreal, QC H2V 2S9, Canada
- Division of Hematology-Oncology, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada;
| | - Caroline Laverdière
- Division of Hematology-Oncology, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada;
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Daniel Sinnett
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- Department of Pediatrics, Université de Montréal, Montreal, QC H3T 1C5, Canada
| | - Valérie Marcil
- Department of Nutrition, Université de Montréal, Montreal, QC H3T 1A8, Canada; (V.B.); (J.D.); (M.N.)
- Research Centr, CHU Sainte-Justine, Montreal, QC H3T 1C5, Canada; (I.B.); (C.M.); (D.C.); (S.S.); (D.S.)
- Correspondence: ; Tel.: +1-514-345-4931 (ext. 3272)
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15
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López-banet L, Miguélez Rosique JA, Martínez-carmona M, Ayuso Fernández GE. Development of Food Competence in Early Childhood Education. Education Sciences 2022; 12:64. [DOI: 10.3390/educsci12020064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The increase in childhood obesity requires the incorporation of nutritional competence into school programs through appropriate activities, starting in the early years. In addition, it is important to promote scientific and cognitive skills during childhood education. The main objective of this study was the implementation of an instructional sequence focused on the learning of skills such as observation, measurement, or interpretation of data related to plants, their germination, and their growth, as well as its relation with the development of food competence. To do so, a set of differentiated activities, organized into several stages, was designed, starting from simple and concrete situations and progressively increasing in complexity and abstraction. The aims were to express ideas about known fruits, vegetables, and legumes in order to expand them by learning new information through student-centered activities, in which children were able to practice and talk about science. The activities were carried out in a class of 24 students aged 4–5 years and data were compared with a control group. The results revealed that the children were motivated in all the activities, which provided an excellent opportunity to initially develop an interest in science and to start to develop food competence in the early years.
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16
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Libuy N, Bann D, Fitzsimons E. Inequalities in body mass index, diet and physical activity in the UK: Longitudinal evidence across childhood and adolescence. SSM Popul Health 2021; 16:100978. [PMID: 34950761 PMCID: PMC8671115 DOI: 10.1016/j.ssmph.2021.100978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/05/2021] [Accepted: 11/20/2021] [Indexed: 11/20/2022] Open
Abstract
We use longitudinal data across a key developmental period, spanning much of childhood and adolescence (age 5 to 17, years 2006-2018) from the UK Millennium Cohort Study, a nationally representative study with an initial sample of just over 19,000. We first examine the extent to which inequalities in overweight, obesity, BMI and body fat over this period are consistent with the evolution of inequalities in health behaviours, including exercise and healthy diet markers (i.e., skipping breakfast) (n = 7,220). We next study the links between SES, health behaviours and adiposity (BMI, body fat), using rich models that account for the influence of a range of unobserved factors that are fixed over time. In this way, we improve on existing estimates measuring the relationship between SES and health behaviours on the one hand and adiposity on the other. The advantage of the individual fixed effects models is that they exploit within-individual changes over time to help mitigate biases due to unobserved fixed characteristics (n = 6,883). We observe stark income inequalities in BMI and body fat in childhood (age 5), which have further widened by age 17. Inequalities in obesity, physical activity, and skipping breakfast are observed to widen from age 7 onwards. Ordinary Least Square estimates reveal the previously documented SES gradient in adiposity, which is reduced slightly once health behaviours including breakfast consumption and physical activity are accounted for. The main substantive change in estimates comes from the fixed effects specification. Here we observe mixed findings on the SES associations, with a positive association between income and adiposity and a negative association with wealth. The role of health behaviours is attenuated but they remain important, particularly for body fat.
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Affiliation(s)
- Nicolás Libuy
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
- Corresponding author.
| | - David Bann
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
- Institute for Fiscal Studies, London, UK
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17
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Baranowski T, Thompson D, Hughes SO, O’Connor TM. Precision Food Parenting: A Proposed Conceptual Model and Research Agenda. Nutrients 2021; 13:3650. [PMID: 34684651 PMCID: PMC8538596 DOI: 10.3390/nu13103650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022] Open
Abstract
Precision medicine, nutrition and behavioral interventions are attempting to move beyond the specification of therapies applied to groups, since some people benefit, some do not and some are harmed by the same therapy. Instead, precision therapies are attempting to employ diverse sets of data to individualize or tailor interventions to optimize the benefits for the receiving individuals. The benefits to be achieved are mostly in the distant future, but the research needs to start now. While precision pediatric nutrition will combine diverse demographic, behavioral and biological variables to specify the optimal foods a child should eat to optimize health, precision food parenting will combine diverse parent and child psychosocial and related variables to identify the optimal parenting practices to help a specific child accept and consume the precision nutrition specified foods. This paper presents a conceptual overview and hypothetical model of factors we believe are needed to operationalize precision food parenting and a proposed research agenda to better understand the many specified relationships, how they change over the age of the child, and how to operationalize them to encourage food parenting practices most likely to be effective at promoting healthy child food choices.
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Affiliation(s)
- Tom Baranowski
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates St., Houston, TX 77030, USA; (D.T.); (S.O.H.); (T.M.O.)
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18
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Labyak CA, Kaplan LG, Johnson TM, Moholland M. Practical School Nutrition Program May Reduce Food Neophobia. Nutrients 2021; 13:3541. [PMID: 34684541 DOI: 10.3390/nu13103541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 11/15/2022] Open
Abstract
The study’s purpose was to evaluate an intervention to reduce fruit and vegetable food neophobia and influence attitudes and behaviors among children using a four-month, non-experimental, before-and-after intervention. Participants were children aged 5–11 years in an intervention school (IS) and a control school (CS). Children were offered fruit or vegetable samples weekly utilizing school-specific psychosocial and educational practices to encourage participation. The outcomes of interest included attitudes measured using a written survey-based food neophobia scale (FNS), behavioral observations, and an oral survey. The post-intervention IS FNS score was significantly lower compared to pre-intervention (p = 0.04). Repeated-measures ANOVA revealed a statistically significant overall effect of time (p = 0.006). School type-time interaction was not significant (p = 0.57). Pre-intervention observational data showed the proportions finishing and taking another fruit and vegetable sample were higher in the CS (p < 0.001 for both). Post-intervention, the proportions taking the vegetable (p = 0.007) and the fruit (p < 0.001) were higher in the IS. The percentage tasting the vegetable was higher in the CS (p = 0.009). Offering samples of produce in school lunchrooms may reduce food neophobia. This intervention is an inexpensive program that volunteers can quickly implement.
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19
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Meleleo D, Susca G, Andrulli Buccheri V, Lamanna G, Cassano L, De Chirico V, Mustica S, Caroli M, Bartolomeo N. Effectiveness of an Innovative Sensory Approach to Improve Children's Nutritional Choices. Int J Environ Res Public Health 2021; 18:6462. [PMID: 34203732 DOI: 10.3390/ijerph18126462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 12/03/2022]
Abstract
A case-control study was conducted to investigate the effectiveness of the Edueat® Method, through experiential workshops focused on the use of all 5 senses. In two different primary schools in the same city, questionnaires were administered in two months with a follow-up one year later. Participants: 119 children (age 8.2–9.0) chosen randomly; control group 66 (55.5%). Seven lessons of 2 h each were held in the schools by experts of the Edueat® method and seven extra lessons by the teachers. The main outcome measures were the children’s changes in their approach and attitude towards their eating habits. The answers were grouped with factor analysis and summarized through scores. Repeated-measures analysis of variance was conducted in order to identify the relationships between scores and treatment over time. At the end of treatment, the intervention group showed a significant appreciation towards healthy foods (+4.15 vs. −0.05, p = 0.02) and a greater capacity in identifying foods which are very good for the health (+15.6 vs. +14.4, p = 0.02). In conclusion, the Edueat® method was found to be particularly promising in transmitting knowledge of those foods which are healthy. Greater involvement of teachers and parents is crucial.
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20
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Mahmood L, Flores-Barrantes P, Moreno LA, Manios Y, Gonzalez-Gil EM. The Influence of Parental Dietary Behaviors and Practices on Children's Eating Habits. Nutrients 2021; 13:nu13041138. [PMID: 33808337 PMCID: PMC8067332 DOI: 10.3390/nu13041138] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/12/2021] [Accepted: 03/26/2021] [Indexed: 01/09/2023] Open
Abstract
Poor dietary habits established during childhood might persist into adulthood, increasing the risk of developing obesity and obesity-related complications such as Type 2 Diabetes Mellitus. It has been found that early modifications in eating habits, especially during childhood, might promote health and decrease the risk of developing diseases during later life. Various studies found a great influence of parental dietary habits on dietary behaviors of their children regardless of demographic characteristics such as gender, age, socioeconomic status and country; however, the exact mechanism is still not clear. Therefore, in this review, we aimed to investigate both parents’ and children’s dietary behaviors, and to provide evidence for the potential influence of parents’ dietary behaviors and practices on certain children’s eating habits. Family meals were found to contribute the most in modeling children’s dietary habits as they represent an important moment of control and interaction between parents and their children. The parental practices that influenced their children most were role modeling and moderate restriction, suggesting that the increase of parental encouragement and decrease of excessive pressure could have a positive impact in their children’s dietary behaviors. This narrative review highlights that parental child-feeding behaviors should receive more attention in research studies as modifiable risk factors, which could help to design future dietary interventions and policies to prevent dietary-related diseases.
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Affiliation(s)
- Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, 50009 Zaragoza, Spain; (L.M.); (P.F.-B.); (E.M.G.-G.)
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, 50009 Zaragoza, Spain; (L.M.); (P.F.-B.); (E.M.G.-G.)
| | - Luis A. Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, 50009 Zaragoza, Spain; (L.M.); (P.F.-B.); (E.M.G.-G.)
- Instituto Agroalimentario de Aragón (IA2), 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-(97)-676-1000
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 17671 Athens, Greece;
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
| | - Esther M. Gonzalez-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), University of Zaragoza, 50009 Zaragoza, Spain; (L.M.); (P.F.-B.); (E.M.G.-G.)
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28040 Madrid, Spain
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, 18071 Granada, Spain
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Giménez-Legarre N, Santaliestra-Pasías AM, Cardon G, Imre R, Iotova V, Kivelä J, Liatis S, Makrilakis K, Mavrogianni C, Milenkovic T, Nánási A, Tankova T, Timpel P, Willems R, Manios Y, Moreno LA, On Behalf Of The Feel Diabetes-Study Group. Cross-Sectional Associations Between Mothers and Children's Breakfast Routine-The Feel4Diabetes-Study. Nutrients 2021; 13:720. [PMID: 33668380 DOI: 10.3390/nu13030720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 12/15/2022] Open
Abstract
Positive influences of family members have been associated with a high probability of children’s daily breakfast consumption. Therefore, the aim of this study was to scrutinize the association of breakfast routines between mothers and their children. The baseline data of the Feel4Diabetes-study was obtained in 9760 children (49.05% boys)–mother pairs in six European countries. A parental self-reported questionnaire gauging the frequency of breakfast consumption and of breakfast´ foods and beverages consumption was used. Agreement in routines of mothers and their children’s breakfast consumption was analyzed in sex-specific crosstabs. The relationship of breakfast routine and food groups’ consumption between mothers and their children was assessed with analysis of covariance. The highest proportion of children who always consumed breakfast were those whose mothers always consumed it. Children consuming breakfast regularly had a higher intake of milk or unsweetened dairy products and all kind of cereal products (low fiber and whole-grain) than occasional breakfast consumers (p < 0.05). The strong similarity between mothers and children suggests a transfer of breakfast routine from mothers to their children, as a high proportion of children who usually consume breakfast were from mothers also consuming breakfast. All breakfast foods and beverages consumption frequencies were similar between children and their mothers.
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Usfar AA, Budiman G, Lan MPJ, Riyanti A, Nuryanto V. Balance Nutrition Messages Are Still Implemented in Preschools One Year Postintervention: Case Studies in Subang District, West Java, Indonesia. J Nutr Sci Vitaminol (Tokyo) 2021; 66:S155-S161. [PMID: 33612586 DOI: 10.3177/jnsv.66.s155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Thirty-two teachers from 10 preschools in Cisalak subdistrict, Subang district, West Java province, Indonesia, received a two-day training on Balance Nutrition and My Plate in February 2018. The main messages underlined in the training were consume a variety of foods, drink enough water daily, wash your hands with soap, be physically active, and monitor your body weight. The training was followed by an eight-week implementation period to preschoolers aged 3 to 6 y. The knowledge of the teachers increased by up to 33 percentage points (average score: 69 to 82 pre- vs. posttest) after training, and the teachers answered correctly to the same questions 15 mo later. The mothers' knowledge increased by up to 37 percentage points after parenting sessions. All seven teaching aids provided were used by end-line, but their usage decreased after seven months (range: 2 to 7) and further decreased by 12 mo postintervention (range: 2 to 5). A teacher's handbook and a flipchart were the two aids persistently used. The practices of washing hands with soap, bringing healthy packed lunches, and monitoring weight and height continued after 12 mo postintervention. Dissemination of Balance Nutrition knowledge to fellow teachers of the same school, colleagues from different schools, or to representatives of preschool associations was evident. Training should be scaled up to the district level, using trained teachers as trainers and adopting a cascade training method. National roll-out by teachers' associations, in collaboration with the Ministry of Education and the Ministry of Health, could improve the knowledge of over 200,000 preschool teachers and potentially improve the nutrition of 19 million preschoolers.
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Ritchie LD, Keeton V, Lee DL, Gurzo K, Homel Vitale E, Au LE, Alkon A. Nutrition Standards For Infants and Young Children can be Implemented by Family Child Care Home Providers. Glob Pediatr Health 2021; 8:2333794X21989555. [PMID: 33614841 PMCID: PMC7841240 DOI: 10.1177/2333794x21989555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 11/03/2020] [Accepted: 12/31/2020] [Indexed: 11/15/2022] Open
Abstract
The study evaluated an educational intervention with family child care home (FCCH) providers to implement nutrition standards. A convenience sample of licensed California FCCH providers (n = 30) attended a 2-hour, in-person group training in English or Spanish on nutrition standards for infants and children aged 1 to 5 years. Provider surveys and researcher observations during meals/snacks were conducted pre- and 3 months post-intervention. Providers rated the training as excellent (average score of 4.9 on a scale of 1-5). Adherence, assessed by survey and observation and compared over time using paired t-tests, increased from an average of 36% pre-intervention to 44% post-intervention (P = .06) of providers (n = 12) for infant standards and from 59% to 68% (P < .001) of providers (n = 30) for child standards. One-third (39%) of providers rated infant standards and 19% of providers rated child standards as difficult to implement. Nutrition standards can be implemented by FCCH providers after an educational intervention; a larger study is warranted with a representative group of providers.
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Affiliation(s)
- Lorrene D Ritchie
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, Oakland, CA, USA
| | - Victoria Keeton
- School of Nursing, Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
| | - Danielle L Lee
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, Oakland, CA, USA
| | - Klara Gurzo
- Division of Agriculture and Natural Resources, Nutrition Policy Institute, University of California, Oakland, CA, USA.,Stockholm University, Sveaplan, Stockholm, Sweeden
| | | | - Lauren E Au
- Department of Nutrition, University of California, Davis, Davis, CA, USA
| | - Abbey Alkon
- School of Nursing, Department of Family Health Care Nursing, University of California, San Francisco, CA, USA
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24
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Hwang I, Bang KS. [Effects of Program to Promote Obesity Prevention Behaviors on Pre-Schoolers: Focused on Kindergartener in Korea]. J Korean Acad Nurs 2021; 51:188-202. [PMID: 33993125 DOI: 10.4040/jkan.20217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/03/2021] [Accepted: 03/08/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to develop a program to promote obesity prevention behaviors for pre-schoolers and to confirm the effectiveness of the program in Korea. METHODS The program comprised 8 sessions for 4 weeks including combined classroom lectures and physical activities. A non-equivalent control group pre-post test study design was used, and seventy two children, aged 5 to 6 years (experimental group: 33, control group: 39) and their parents participated in the study. To examine the effectiveness of the program, children's knowledge, intake of sugar-added beverages and fruits & vegetables, time of outdoor play and screen time, and parental self-efficacy were measured. Data were analyzed with SPSS/WIN ver. 22.0 and R 4.0.2, using descriptive analysis, chi-square test, Fisher's exact test, the independent t-test, and Analysis of covariance (ANCOVA). RESULTS The results showed that the experimental group reported significantly increased knowledge (p < .001) and longer time of outdoor play on weekends (p = .033). However, there were no significant differences in the intake of sugar-added beverages and fruits & vegetables, screen time, and parental self-efficacy in the two groups. CONCLUSION This study confirms the applicability of an obesity prevention intervention at kindergartens in Korea. The results can be used as basic data for the study of childhood obesity prevention in Korea.
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Affiliation(s)
- Inju Hwang
- Department of Nursing, Suwon Women's University, Suwon, Korea
| | - Kyung Sook Bang
- College of Nursing · The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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25
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Bédard A, Lamarche PO, Grégoire LM, Trudel-Guy C, Provencher V, Desroches S, Lemieux S. Can eating pleasure be a lever for healthy eating? A systematic scoping review of eating pleasure and its links with dietary behaviors and health. PLoS One 2020; 15:e0244292. [PMID: 33347469 PMCID: PMC7751982 DOI: 10.1371/journal.pone.0244292] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/08/2020] [Indexed: 11/18/2022] Open
Abstract
The aims of this review were to map and summarize data currently available about 1) key dimensions of eating pleasure; 2) associations of eating pleasure, and its key dimensions, with dietary and health outcomes and 3) the most promising intervention strategies using eating pleasure to promote healthy eating. Using the scoping review methodology, a comprehensive search of the peer-reviewed literature (Medline, PsycInfo, Embase, ERIC, Web of Science, CINAHL, ABI/Inform global and Sociology Abstract) and of the grey literature (ProQuest Dissertations & Theses and Google) was carried out by two independent reviewers. We included 119 of the 28,908 studies found. In total, 89 sub-dimensions of eating pleasure were grouped into 22 key dimensions. The most frequently found related to sensory experiences (in 50.9% of the documents), social experiences (42.7%), food characteristics besides sensory attributes (27.3%), food preparation process (19.1%), novelty (16.4%), variety (14.5%), mindful eating (13.6%), visceral eating (12.7%), place where food is consumed (11.8%) and memories associated with eating (10.9%). Forty-five studies, mostly cross-sectional (62.2%), have documented links between eating pleasure and dietary and/or health outcomes. Most studies (57.1%) reported favorable associations between eating pleasure and dietary outcomes. For health outcomes, results were less consistent. The links between eating pleasure and both dietary and health outcomes varied according to the dimensions of eating pleasure studied. Finally, results from 11 independent interventions suggested that strategies focusing on sensory experiences, cooking and/or sharing activities, mindful eating, and positive memories related to healthy food may be most promising. Thus, eating pleasure may be an ally in the promotion of healthy eating. However, systematically developed, evidence-based interventions are needed to better understand how eating pleasure may be a lever for healthy eating.
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Affiliation(s)
- Alexandra Bédard
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC, Canada
| | | | - Lucie-Maude Grégoire
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC, Canada
- School of Nutrition, Université Laval, Québec, QC, Canada
| | - Catherine Trudel-Guy
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC, Canada
- School of Nutrition, Université Laval, Québec, QC, Canada
| | - Véronique Provencher
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC, Canada
- School of Nutrition, Université Laval, Québec, QC, Canada
| | - Sophie Desroches
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC, Canada
- School of Nutrition, Université Laval, Québec, QC, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC, Canada
- School of Nutrition, Université Laval, Québec, QC, Canada
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Swindle T, Rutledge J. Measuring feeding practices among early care and education teachers and examining relations with food insecurity. Appetite 2020; 155:104806. [PMID: 32735955 DOI: 10.1016/j.appet.2020.104806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
Early care and education teachers' (ECETs) dietary and feeding behaviors have the potential to influence children's health outcomes. This study sought to: (1) gather data on the properties and performance of the CFQ and CFSQ in an ECET sample and compare properties to published parent samples and (2) examine relations between FI experiences by ECETs and reported feeding practices, and (3) examine relations between FI experiences by ECETs and reported feeding practices. ECETs completed 506 cross-sectional surveys. Mean patterns, ranges, and internal consistency values on the adapted instruments for ECETs were consistent with those published for parents. Significant mean differences between parents and ECETs on established scales using one-sample t-tests were prevalent with medium to large effect sizes despite small, relative differences. The majority of ECETs were authoritarian (35.6%), followed by indulgent (29.2%), authoritative (17.9%), and uninvolved (17.3%). T-tests indicated that ECETs who were currently food insecure were significantly higher than teachers who were currently food secure on scales of perceived responsibility, concern about child weight, restriction, pressure to eat, monitoring, demandingness, and responsiveness (all p < .001). Chi-square tests found that food insecurity was not independent from ECET feeding style, with a greater occurrence of authoritarian and less of indulgent feeding styles for ECETs who were food insecure. Overall, analyses support that two popular measures of feeding practices function similarly in ECETs as they do in parents. Additionally, results demonstrate associations between food insecurity and ECETs' feeding practices.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199; USA.
| | - Julie Rutledge
- School of Human Ecology; Louisiana Tech University, P.O. Box 3167, Ruston, LA, 71272, USA
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Swindle T, Rutledge JM, Johnson SL, Selig JP, Curran GM. De-implementation of detrimental feeding practices: a pilot protocol. Pilot Feasibility Stud 2020; 6:181. [PMID: 33292711 PMCID: PMC7678218 DOI: 10.1186/s40814-020-00720-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early childhood educators (ECEs) often use detrimental feeding practices and are slow to implement positive feeding practices. Nevertheless, few studies have aimed to understand and change ECEs' feeding practices. This gap needs to be addressed because implementation (i.e., adding new, evidence-based practices) and de-implementation (i.e., stopping low-value or harmful practices) are distinct processes that require unique strategies. METHODS We will develop a de-implementation strategy for detrimental feeding practices using evidence-based quality improvement (EBQI) sessions to engage stakeholders and draw on the Niven process model for de-implementation. Then, we will investigate the effects of the de-implementation strategy in a proof-of-principle study. The de-implementation strategy will be evaluated in 2 partnering childcare agencies using a pre-post, within-site design. For our primary outcome, we will interview educators throughout the school year to assess the feasibility and acceptability of the intervention and survey them with standard measures for assessing feasibility and acceptability. For secondary outcomes, we will investigate its effects on the use of detrimental and evidence-based feeding practices by teachers and impacts on child BMI and diet. DISCUSSION The current study will establish the feasibility and acceptability of our de-implementation approach and will provide preliminary data toward 3 predicted secondary outcomes: (1) decreased detrimental feeding practices by ECEs, (2) increased adoption of and fidelity to nutrition promotion practices, and (3) improved child dietary outcomes. These results are expected to contribute to the uptake and sustainability of mealtime interventions to improve the diets of young children. Results will also apply to the field of implementation science by informing processes for developing de-implementation approaches in a community setting.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Julie M. Rutledge
- College of Applied and Natural Sciences, Louisiana Tech University, Ruston, USA
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, USA
| | - James P. Selig
- College of Public Health, Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Geoff M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Central Arkansas Veterans Healthcare System, Little Rock, USA
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Pietrabissa G, Rossi A, Borrello M, Manzoni GM, Mannarini S, Castelnuovo G, Molinari E. Development and Validation of a Self-Determination Theory-Based Measure of Motivation to Exercise and Diet in Children. Front Psychol 2020; 11:1299. [PMID: 32714231 PMCID: PMC7340182 DOI: 10.3389/fpsyg.2020.01299] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/18/2020] [Indexed: 01/10/2023] Open
Abstract
Objective: To develop and test the factorial structure of a new self-determination theory–based measure of behavioral regulation in children. Methods: Five hundred ninety 590 (F = 51.7%) children aged 7 to 11 years completed the Motivation to Exercise and Diet (MED-C) questionnaire, which comprises 16 items (eight for exercise and eight for diet) grouped into eight factors (five motivations and three needs). Psychometric testing included confirmatory factor analysis and internal consistency. Measurement invariance analyses were also performed to evaluate whether the factorial structure of the MED-C was equivalent for gender (male vs. female), age (≤9 vs. ≥10 years), and the perception of having at least one parent with overweight or obesity (yes vs. no). Results: Factorial analysis confirmed an acceptable factors solution for the MED-C and a good fit to the data for both the exercise and the diet subscales assessed independently. The maximal reliability coefficient revealed good reliability for the exercise and the diet subscales. Moreover, the MED-C factor structure was invariant across group comparisons. Discussion: Findings support the construct validity and reliability of the MED-C. Therefore, it represents the first validated instrument simultaneously measuring motivational regulation and psychological need satisfaction in the context of children’s exercise and diet. Considering the goodness of these results, scale percentile ranks of the total score distribution as well as the z score and the T score were provided for clinical and research purposes. Conclusion: The MED-C might support the understanding of motivations and needs of children with weight problems and assist their process of behavioral change in primary and secondary prevention programs. Psychological factors represent, in fact, potential targets for interventions to increase children’s motivation to exercise and diet.
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Affiliation(s)
- Giada Pietrabissa
- Clinical Psychology Lab, Istituto Auxologico Italiano IRCCS, Milan, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Alessandro Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padua, Italy.,Interdepartmental Center for Family Research, University of Padova, Padua, Italy
| | - Maria Borrello
- Department of Psychology, University of Bergamo, Bergamo, Italy
| | - Gian Mauro Manzoni
- Clinical Psychology Lab, Istituto Auxologico Italiano IRCCS, Milan, Italy.,Department of Psychology, eCampus University, Novedrate, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padua, Italy.,Interdepartmental Center for Family Research, University of Padova, Padua, Italy
| | - Gianluca Castelnuovo
- Clinical Psychology Lab, Istituto Auxologico Italiano IRCCS, Milan, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Enrico Molinari
- Clinical Psychology Lab, Istituto Auxologico Italiano IRCCS, Milan, Italy.,Department of Psychology, Catholic University of Milan, Milan, Italy
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Rotman SA, Fowler LA, Ray MK, Stein RI, Hayes JF, Kolko RP, Balantekin KN, Engel A, Saelens BE, Welch RR, Perri MG, Epstein LH, Wilfley DE. Family Encouragement of Healthy Eating Predicts Child Dietary Intake and Weight Loss in Family-Based Behavioral Weight-Loss Treatment. Child Obes 2020; 16:218-225. [PMID: 31829732 PMCID: PMC7099423 DOI: 10.1089/chi.2019.0119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introduction: Social support for healthy eating can influence child eating behaviors; however, little is known about the impact of social support during family-based behavioral weight-loss treatment (FBT). This study aimed to determine the impacts of both baseline and change in family support on change in child diet and weight during FBT. Methods: Children (n = 175; BMI percentile ≥85th; ages 7-11; 61.1% female; 70.9% white) and a participating parent completed 4 months of FBT. Parents were active participants and learned social support-related strategies (i.e., praise and modeling of healthy eating). Child perceived family encouragement and discouragement for healthy eating, child diet quality (via 24-hour recalls), and child weight were assessed pre- and post-FBT. Results: Family encouragement for healthy eating increased during FBT, and this increase was related to increases in child healthy vegetable intake and overall diet quality, as well as decreases in refined grains consumed. Low pre-FBT family encouragement predicted greater increases in healthy vegetable intake, greater weight reduction, and greater increases in family encouragement for healthy eating. Family discouragement for healthy eating did not change during treatment nor did it predict dietary or weight outcomes. Conclusions: FBT successfully improves family encouragement, which is associated with improvements in child diet. Furthermore, even children who began treatment with low family encouragement for healthy eating show great improvements in dietary intake and weight during treatment. Results suggest that changes in child eating behavior during treatment is influenced by active, positive parenting techniques such as praise of healthy eating rather than negative family support.
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Affiliation(s)
- Sophia A Rotman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
- Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Lauren A Fowler
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Mary Katherine Ray
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Richard I Stein
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO
| | - Jacqueline F Hayes
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Rachel P Kolko
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Alexis Engel
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Brian E Saelens
- Department of Pediatrics, University of Washington and Seattle Children's Research Institute, Seattle, WA
| | - R Robinson Welch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Michael G Perri
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | | | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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Gibson EL, Androutsos O, Moreno L, Flores-Barrantes P, Socha P, Iotova V, Cardon G, De Bourdeaudhuij I, Koletzko B, Skripkauskaite S, Manios Y. Influences of Parental Snacking-Related Attitudes, Behaviours and Nutritional Knowledge on Young Children's Healthy and Unhealthy Snacking: The ToyBox Study. Nutrients 2020; 12:nu12020432. [PMID: 32046193 PMCID: PMC7071198 DOI: 10.3390/nu12020432] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/23/2020] [Accepted: 02/04/2020] [Indexed: 12/25/2022] Open
Abstract
This study investigated parental influences on preschool children's healthy and unhealthy snacking in relation to child obesity in a large cross-sectional multinational sample. Parents and 3-5 year-old child dyads (n = 5185) in a kindergarten-based study provided extensive sociodemographic, dietary practice and food intake data. Parental feeding practices that were derived from questionnaires were examined for associations with child healthy and unhealthy snacking in adjusted multilevel models, including child estimated energy expenditure, parental education, and nutritional knowledge. Parental healthy and unhealthy snacking was respectively associated with their children's snacking (both p < 0.0001). Making healthy snacks available to their children was specifically associated with greater child healthy snack intake (p < 0.0001). Conversely, practices that were related to unhealthy snacking, i.e., being permissive about unhealthy snacking and acceding to child demands for unhealthy snacks, were associated with greater consumption of unhealthy snacks by children, but also less intake of healthy snacks (all p < 0.0001). Parents having more education and greater nutritional knowledge of snack food recommendations had children who ate more healthy snacks (all p < 0.0001) and fewer unhealthy snacks (p = 0.002, p < 0.0001, respectively). In the adjusted models, child obesity was not related to healthy or unhealthy snack intake in these young children. The findings support interventions that address parental practices and distinguish between healthy and unhealthy snacking to influence young children's dietary patterns.
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Affiliation(s)
- Edward Leigh Gibson
- Department of Psychology, University of Roehampton, London SW15 4JD, UK;
- Correspondence:
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42132 Trikala, Greece
| | - Luis Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Paloma Flores-Barrantes
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009 Saragossa, Spain; (L.M.); (P.F.-B.)
- Instituto Agroalimentario de Aragón (IA2), 50013 Saragossa, Spain
- Fundación Instituto de Investigación Sanitaria Aragón (IIS Aragón), 50009 Saragossa, Spain
| | - Piotr Socha
- The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - Violeta Iotova
- Department of Pediatrics, Medical University of Varna, 9002 Varna, Bulgaria;
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium; (G.C.); (I.D.B.)
| | - Berthold Koletzko
- Dr von Hauner Children’s Hospital, LMU-Ludwig-Maximilians-University at Munich, D-80337 Munich, Germany;
| | | | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
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Swindle T, Johnson SL, Davenport K, Whiteside-Mansell L, Thirunavukarasu T, Sadasavin G, Curran GM. A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start. J Nutr Educ Behav 2019; 51:1067-1079.e1. [PMID: 31350198 PMCID: PMC6788974 DOI: 10.1016/j.jneb.2019.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To identify positive and negative deviant cases using quantitative fidelity data from a previous implementation of a nutrition intervention, Together, We Inspire Smart Eating (WISE), and to determine barriers and facilitators to fidelity by conducting qualitative interviews with deviant cases. DESIGN Explanatory sequential mixed methods. SETTING Head Start Program agencies in 2 southern US states. PARTICIPANTS Quantitative fidelity data were collected in 42 Head Start classrooms. Recruitment for qualitative interviews prioritized those who were positive or negative deviants across fidelity components (African American, n = 21; white, n = 19; and Hispanic, n = 3). INTERVENTION WISE introduces children to fruits and vegetables using evidence-based practices of role modeling, positive feeding, mascot use, and hands-on exposure. ANALYSIS A directed content analysis approach informed by the integrated Promoting Action on Research Implementation in Health Service framework. PHENOMENON OF INTEREST Barriers and facilitators to WISE evidence-based practices implementation. RESULTS Qualitative analyses identified themes of culture, leadership support, and mechanisms for embedding change as key contextual factors. Key findings related to recipient characteristics were beliefs about what works, personalized strategies to use WISE, and classroom management. Primary themes for the innovation construct were time and preparation, degree of fit, and WISE advantage. Finally, findings relative to the construct of facilitation included trainer support and desire for additional training. CONCLUSIONS AND IMPLICATIONS The study of cases at the extreme ends of the fidelity spectrum can provide unique perspectives on barriers and facilitators to implementation of interventions.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
| | - Karen Davenport
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Gireesh Sadasavin
- Regional Family Medicine Center, University of Arkansas for Medical Sciences, Pine Bluff, AR
| | - Geoffrey M Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR
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Hollis-Hansen K, Seidman J, O'Donnell S, Epstein LH. Episodic future thinking and grocery shopping online. Appetite 2019; 133:1-9. [PMID: 30342066 PMCID: PMC6312505 DOI: 10.1016/j.appet.2018.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/09/2018] [Accepted: 10/15/2018] [Indexed: 02/01/2023]
Abstract
Grocery shopping shapes the home food environment, which can contribute to the development of obesity. Episodic future thinking (EFT) helps adults make healthier decisions by initiating prospective thinking, which guides one to forego smaller immediate rewards in favor of larger delayed rewards. EFT could help parents improve grocery purchases thereby improving the home food environment and family eating behaviors. The effect of EFT on food shopping was evaluated in two studies with mothers who were overweight/obese and primary household shoppers. In Study 1, 24 mothers were randomized to goal-directed process EFT versus a money saving control. In Study 2, 33 mothers were randomized to goal-directed process EFT, general EFT, or an episodic recent thinking (ERT) control. Following cue generation, participants completed a task where they purchased one week of groceries from an online store. Food purchases were analyzed for calories purchased per family member. In Study 1 the goal-directed process EFT group purchased fewer calories per person (F(1, 23) = 25.16, p < .001; ηp2 = 0.522). In Study 2 the goal-directed process EFT purchased fewer calories (F(1, 30) = 5.98, p = .02; ηp2 = 0.166) than the ERT control as did the EFT general group (F(1, 30) = 4.61, p = .04; ηp2 = 0.133). The two EFT groups did not differ from each other (F(1, 30) = 0.16, p = .69; ηp2 = 0.005). EFT may be an effective intervention for reducing the energy intake of foods purchased while grocery shopping.
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Affiliation(s)
- Kelseanna Hollis-Hansen
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, USA.
| | - Jennifer Seidman
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, USA
| | - Sara O'Donnell
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, USA
| | - Leonard H Epstein
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, USA
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Whiteside-Mansell L, Swindle TM. Evaluation of Together We Inspire Smart Eating: pre-school fruit and vegetable consumption. Health Educ Res 2019; 34:62-71. [PMID: 30590452 PMCID: PMC6315109 DOI: 10.1093/her/cyy048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 11/19/2018] [Indexed: 05/04/2023]
Abstract
This study examined nutrition intervention curriculum, Together We Inspire Smart Eating (WISE). WISE is a research-based, nutrition promotion curriculum specifically designed for pre-school children from families with limited resources. The design was non-randomized treatment/control with standardized pre-/post-test assessments. Children (n = 268) in six Head Start centers received weekly food experiences from educators trained in WISE. Children (n = 258) in nine Head Start centers received weekly food experiences structured at the discretion of the educators untrained in WISE. Parents in both conditions (n = 268 WISE classroom, n = 258 comparison) were interviewed by educators twice over the school year using a data collection tool, The Family Map Inventory. Analyses using full information maximum likelihood controlling for pre-intervention consumption and key demographic characteristics was used to predict consumption at post-intervention assessment. Results indicated children in WISE centers consumed healthier food at home than children in non-WISE classrooms. The study suggested that WISE curriculum is an effective method to improve children's diets in at-risk environments.
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Affiliation(s)
- Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, #530, Little Rock, AR, USA
| | - Taren M Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 West Markham Street, #530, Little Rock, AR, USA
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Winn S, Chakrabarty S. Interactions between low-socioeconomic status, adult influences on macronutrient intakes and childhood obesity. Aust N Z J Public Health 2018; 42:591-592. [PMID: 30238594 DOI: 10.1111/1753-6405.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Stephen Winn
- School of Teacher Education and Early Childhood, University of Southern Queensland
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Kracht CL, Swyden KJ, Weedn AE, Salvatore AL, Terry RA, Sisson SB. A Structural Equation Modelling Approach to Understanding Influences of Maternal and Family Characteristics on Feeding Practices in Young Children. Curr Dev Nutr 2018; 2:nzy061. [PMID: 30283915 PMCID: PMC6163107 DOI: 10.1093/cdn/nzy061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/11/2018] [Accepted: 07/09/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The family environment is influential for a child's healthy development through parent and sibling influences on feeding practices. Multiple-child households may protect against unhealthy feeding practices, but additional children contribute to higher maternal stress. Households of married parents may decrease maternal stress by sharing parental demands. OBJECTIVE We aimed to evaluate the collective influence of maternal stress, marital status, and number of children on feeding practices. METHODS Mothers of 2- to 5-y-old children (n = 278) were recruited mainly on a university campus and completed an online survey to examine associations between maternal stress (Depression, Anxiety, Stress Scale), number of children, marital status, and feeding practices (restriction and pressure to eat; Child Feeding Questionnaire). Relationships were examined through the use of multivariate regression and structural equation modelling. RESULTS A mainly married (85%) and Caucasian (73%) sample participated, with most mothers reporting multiple children [2 children (45%) or ≥3 children (24%)]. Marital status was not associated with either feeding practice, i.e., restriction and pressure to eat (P < 0.05). In adjusted models, maternal stress (β = 0.04, SE = 0.01, P = 0.003) and number of children (β = 0.24, SE = 0.08, P = 0.003) in the household individually contributed to higher feeding restriction; their interaction resulted in lower feeding restriction (β = -0.01, SE = 0.05, P = 0.005). In stratified models, maternal stress was associated with restriction in single-child households (β = -0.03, SE = 0.009, P = 0.002), but not multiple-child households (β = -0.004, SE = 0.005, P = 0.40). CONCLUSIONS Number of children had no effect on feeding practices individually, but may contribute to a less restrictive feeding environment. Additional investigation into creating less stressful and more positive feeding environments for all mothers can lead to healthier mothers and families.
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Affiliation(s)
- Chelsea L Kracht
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Katheryn J Swyden
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Ashley E Weedn
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Alicia L Salvatore
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Robert A Terry
- Department of Psychology, University of Oklahoma, Norman, OK
| | - Susan B Sisson
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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Swindle T, Selig JP, Rutledge JM, Whiteside-Mansell L, Curran G. Fidelity monitoring in complex interventions: a case study of the WISE intervention. ACTA ACUST UNITED AC 2018; 76:53. [PMID: 30181874 PMCID: PMC6114253 DOI: 10.1186/s13690-018-0292-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 06/20/2018] [Indexed: 11/10/2022]
Abstract
Background Researchers face many decisions in developing a measurement tool and protocol for monitoring fidelity to complex interventions. The current study uses data evaluating a nutrition education intervention, Together, We Inspire Smart Eating (WISE), in a preschool setting to explore issues of source, timing, and frequency of fidelity monitoring. Methods The overall study from which these data are drawn was a pre/post design with an implementation-focused process evaluation. Between 2013 and 2016, researchers monitored fidelity to evidence-based components of the WISE intervention in 49 classrooms in two Southern states. Data collectors obtained direct assessment of fidelity on a monthly basis in study classrooms. Research staff requested that educators provide indirect assessment on a weekly basis. We used mean comparisons (t-tests), correlations (Pearson's r), and scatterplots to compare the direct and indirect assessments. Results No mean comparisons were statistically different. Correlations of direct and indirect assessments of the same component for the same month ranged between - 0.51 (p = 0.01) and 0.54 (p = 0.001). Scatterplots illustrate that negative correlations can be driven by individuals who are over reporting (i.e., self-report bias) and that near zero correlations approximate the ideal situation (i.e., both raters identify high fidelity). Conclusion Our findings illustrate that, on average, observed and self-reports may seem consistent despite weak correlations and individual cases of extreme over reporting by those implementing the intervention. The nature of the component to which fidelity is being monitored as well as the timing within the context of the intervention are important factors to consider when selecting the type of assessment and frequency of fidelity monitoring. Trial registration NCT03075085 Registered 20 February 2017. Trial registration corresponds to the funding that supported the writing of this manuscript, not the data collection. The original study was not a trial and was collected without registration. However, the data reported here provided foundational preliminary data for the trial.
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Affiliation(s)
- Taren Swindle
- 1Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - James P Selig
- 2College of Public Health, University of Arkansas for Medical Sciences, 220 UAMS Campus Dr, #781, Little Rock, AR 72205 USA
| | - Julie M Rutledge
- 3College of Applied and Natural Sciences, Louisiana Tech University, 305 Wisteria St, #3167, Ruston, LA 71272 USA
| | - Leanne Whiteside-Mansell
- 1Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Geoff Curran
- 4Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham St, #522-4, Little Rock, AR 72205-7199 USA
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Reeves S, Poh BK, Essau C, Summerbell C, Cheah WL, Koh D, Lee JAC, Ruzita AT, Gibson EL. ToyBox Study Malaysia: Improving healthy energy balance and obesity-related behaviours among pre-schoolers in Malaysia. NUTR BULL 2018. [DOI: 10.1111/nbu.12340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
| | - B. K. Poh
- Universiti Kebangsaan Malaysia; Kuala Lumpur Malaysia
| | - C. Essau
- University of Roehampton; London UK
| | - C. Summerbell
- Department of Sport and Exercise Sciences; University of Durham; Durham UK
| | - W. L. Cheah
- Universiti Malaysia Sarawak; Kota Samarahan Malaysia
| | - D. Koh
- Universiti Kebangsaan Malaysia; Kuala Lumpur Malaysia
| | - J. A. C. Lee
- Universiti Malaysia Sarawak; Kota Samarahan Malaysia
| | - A. T. Ruzita
- Universiti Kebangsaan Malaysia; Kuala Lumpur Malaysia
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Swindle T, Phelps J. How Does Context Relate to Nutrition Promotion and Mealtime Practice in Early Care and Education Settings? A Qualitative Exploration. J Acad Nutr Diet 2018; 118:2081-2093. [PMID: 30064879 DOI: 10.1016/j.jand.2018.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/01/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Early childhood educators have the potential to influence children's dietary outcomes through daily interactions. However, existing research suggests that educator practices are often suboptimal. Previous research has often focused on individual characteristics that affect practices. There is less study of contextual influences of practices of early childhood educators. OBJECTIVE The purpose of this study was to understand and describe contextual factors evident in narratives of early childhood educators influencing mealtime and nutrition promotion practices. We use the Promoting Action on Research Implementation in Health Services framework to consider how contextual factors related to practices of early childhood educators. DESIGN This cross-sectional, qualitative study collected data through in-depth interviews with early childhood educators. Analyses of the data reflected a factist perspective and semantic approach to complete thematic content analysis of in-depth interviews. PARTICIPANTS The study used a stratified purposive sampling approach to recruit 28 educators to balance across educator role, agency type (Head Start vs state-funded), and obesity prevalence in the community. Early childhood educators were mostly lead teachers (62%), between the ages of 30 and 49 (82.1%), and white (75%) or African American (14.3%). RESULTS The coders identified three primary themes: Mealtime Structures, Resources, and Classroom/Center Atmosphere. Mealtime Structures associated with detrimental practices included cafeteria meals with rigid schedules. Mealtime Structures associated with evidence-based practices (EBPs) included classroom meal service. Resources associated with detrimental practices included limited funding. Resources associated with EBPs included meals paid for early childhood educators and classroom food experiences. Classroom/Center Atmosphere factors associated with detrimental practices included poor food offerings and policies that conflicted (eg, allowing children to bring in outside foods). Classroom/Center Atmosphere factors associated with EBPs included clarity around meal service rules and healthy, appealing food offerings. CONCLUSIONS This study highlighted that it may be difficult for an early childhood educator to adopt and maintain EBPs in certain contexts.
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Lumeng JC, Miller AL, Appugliese D, Rosenblum K, Kaciroti N. Picky eating, pressuring feeding, and growth in toddlers. Appetite 2018; 123:299-305. [PMID: 29331364 PMCID: PMC5817026 DOI: 10.1016/j.appet.2017.12.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 12/16/2017] [Accepted: 12/17/2017] [Indexed: 10/18/2022]
Abstract
Several common theoretical frameworks have posited causal pathways between picky eating, pressuring feeding, and growth in early childhood. The evidence to support these pathways is limited. This observational cohort study sought to examine the cross-lagged associations between mother-reported pressuring feeding, mother-reported child picky eating, and measured weight-for-length z-score (WLZ) across child ages 21, 27, and 33 months (n = 244). Cross-lagged analysis was used to evaluate longitudinal associations between these three constructs. The sample was 50.5% white, 52.3% male and 37.8% of mothers had a high school education or less. Mean WLZ was 0.52, 0.41, and 0.38 at each age, respectively. Pressuring feeding, picky eating, and WLZ each tracked strongly from 21 to 33 months. There were concurrent associations between pressuring feeding and picky eating. However, there were no prospective associations between pressuring feeding and future WLZ; WLZ and future pressuring feeding; pressuring feeding and future picky eating; picky eating and future pressuring feeding; or picky eating and future WLZ. Our results do not support causal relationships between picky eating, pressuring feeding, and growth in toddlerhood. Future work that examines alternative mechanisms shaping growth in early childhood is needed.
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Affiliation(s)
- Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | | | - Katherine Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Alexander GL, Lindberg N, Firemark AL, Rukstalis MR, McMullen C. Motivations of Young Adults for Improving Dietary Choices: Focus Group Findings Prior to the MENU GenY Dietary Change Trial. Health Educ Behav 2017; 45:492-500. [PMID: 29068724 DOI: 10.1177/1090198117736347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Young adulthood is often associated with poor dietary habits that may increase risk of obesity and chronic diseases. As independence grows, little is known about strategies to help balance social, work, and education commitments that may override desires to incorporate healthful food choices. OBJECTIVE In advance of a randomized trial to test an online intervention targeting young adults, we sought to identify views and experiences with healthy eating, and specifically, eating more fruits and vegetables. METHODS We conducted 13 focus groups with 68 young adults in metropolitan Detroit (Henry Ford Health System) and rural Pennsylvania (Geisinger Health System). Randomly selected adults aged 21 to 30 years, using health system automated data, were sent recruitment letters. Questions were grounded in social cognitive theory and self-determination theory. Audiotapes were transcribed, content themes identified, coded, verified for reliability, and analyzed qualitatively. RESULTS Young adults' efforts to eat healthfully included three major themes of (1) motivations to create a healthy lifestyle, teach by example, feel better, and manage weight and future health problems; (2) learning to eat well from childhood, independent living, and peers; and (3) strategies to eat better through planning, tracking, and commitment. DISCUSSION We uncovered theory-based factors that facilitate healthy dietary behavior change among young adults, including managing their behavior through self-monitoring, goal-setting, small steps, meaningful reinforcements, and social opportunities. CONCLUSIONS Targeted interventions encouraging reflection on personal values related to meaningful contemporary health benefits are likely to resonate with young adults, as will opportunities to receive and share new information.
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Affiliation(s)
| | - Nangel Lindberg
- 2 Kaiser Permanente Northwest, Center for Health Research, Portland, OR, USA
| | - Alison L Firemark
- 2 Kaiser Permanente Northwest, Center for Health Research, Portland, OR, USA
| | | | - Carmit McMullen
- 2 Kaiser Permanente Northwest, Center for Health Research, Portland, OR, USA
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Swindle T, Rutledge JM, Dix B, Whiteside-Mansell L. Table Talk: development of an observational tool to assess verbal feeding communications in early care and education settings. Public Health Nutr 2017; 20:2869-77. [PMID: 28803584 DOI: 10.1017/S1368980017001896] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Children's dietary intake impacts weight status and a range of short- and long-term health outcomes. Accurate measurement of factors that influence children's diet is critical to the development and evaluation of interventions designed to improve children's diets. The purpose of the current paper is to present the development of the Table Talk observational tool to measure early care and education teachers' (ECET) verbal feeding communications. DESIGN An observational tool to assess ECET verbal communication at mealtimes was deigned based on the extant literature. Trained observers conducted observations using the tool during lunch for both lead and assistant ECET. Descriptive statistics, test-retest for a subgroup, interclass correlations for each item, and comparisons between leads and assistants were conducted. SETTING Head Start centres, Southern USA. SUBJECTS Seventy-five Head Start educators. RESULTS On average, 17·2 total verbal feeding communications (sd 8·9) were observed per ECET. For lead ECET, the most prevalent Supportive Comment was Exploring Foods whereas for assistants Making Positive Comments was the most prevalent. Overall, lead ECET enacted more Supportive Comments than assistant ECET (F(2,72)=4·8, P=0·03). The most common Unsupportive Comment was Pressuring to Eat, with a mean of 3·8 (sd 4·3) and a maximum of 25. There was no difference in Unsupportive Comments between lead and assistant ECET. CONCLUSIONS Table Talk may be a useful tool to assess verbal feeding communications of ECET, with potential applications such as informing ECET training and assessing intervention efforts.
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Rachmi CN, Hunter CL, Li M, Baur LA. Perceptions of overweight by primary carers (mothers/grandmothers) of under five and elementary school-aged children in Bandung, Indonesia: a qualitative study. Int J Behav Nutr Phys Act 2017; 14:101. [PMID: 28750666 PMCID: PMC5531021 DOI: 10.1186/s12966-017-0556-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/19/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The prevalence of childhood overweight has increased in the past two decades in Indonesia. Even though prevalence is escalating, there is a lack of qualitative evidence to assist in the design and implementation of strategies to tackle this issue. This study aimed to explore the view of primary carers (mothers and grandmothers) from different socio-economic-status groups, on childhood overweight in the Greater Bandung Area, Indonesia. METHODS We conducted 12 focus groups discussions with a total of 94 carers of under-five and 7-12 years children, from June to October 2016. We used the grounded theory approach in our analysis. RESULTS Three main categories emerged: the concept of overweight, factors contributing to overweight, and awareness and feelings towards overweight children. Most carers from all SES groups defined overweight subjectively, while a few from the low SES group defined it objectively. Most carers from low and high SES groups agreed with the concept "chubbier is healthier". All carers had some knowledge of the main factors that contribute to childhood overweight: dietary factors, activity levels and sedentary behavior, and hereditary factors. Carers from all SES groups described similar characteristics of overweight; carers from low and intermediate SES groups had mixed feelings while all high SES carers have negative feelings about overweight children, mostly related to stigma. However, carers who identified their own children as being overweight expressed sensitivity about this weight status, especially their physical abilities. Almost all carers knew their children's current weight while less than two thirds knew their children's height. CONCLUSIONS There are several policy implications. Firstly, health-related knowledge of the primary carers is of great importance and needs augmenting. To increase that knowledge, there is a role for front-line health practitioners (doctors/midwives/nurses) to be more active in educating the community. Secondly, simpler and more effective ways to disseminate healthy lifestyle messages to carers is required. Thirdly, by placing more emphasis on carers monitoring their children's growth may encourage carers to take steps to keep their children in the healthy weight and height ranges. Fourthly, the Department of Education may need to improve the quality and quantity of physical activity in schools.
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Affiliation(s)
- Cut Novianti Rachmi
- Discipline of Child & Adolescent Health, The Children’s Hospital at Westmead, University of Sydney Clinical School, Locked Bag 4001, Westmead, NSW 2145 Australia
| | - Cynthia Louise Hunter
- School of Social and Political Sciences, The University of Sydney, RC Mills Building (A26), Sydney, NSW 2006 Australia
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Rd, Sydney, NSW 2006 Australia
| | - Mu Li
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Rd, Sydney, NSW 2006 Australia
| | - Louise Alison Baur
- Discipline of Child & Adolescent Health, The Children’s Hospital at Westmead, University of Sydney Clinical School, Locked Bag 4001, Westmead, NSW 2145 Australia
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Rd, Sydney, NSW 2006 Australia
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Swindle T, Johnson SL, Whiteside-Mansell L, Curran GM. A mixed methods protocol for developing and testing implementation strategies for evidence-based obesity prevention in childcare: a cluster randomized hybrid type III trial. Implement Sci 2017; 12:90. [PMID: 28720140 PMCID: PMC5516351 DOI: 10.1186/s13012-017-0624-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/10/2017] [Indexed: 01/29/2023] Open
Abstract
Background Despite the potential to reach at-risk children in childcare, there is a significant gap between current practices and evidence-based obesity prevention in this setting. There are few investigations of the impact of implementation strategies on the uptake of evidence-based practices (EBPs) for obesity prevention and nutrition promotion. This study protocol describes a three-phase approach to developing and testing implementation strategies to support uptake of EBPs for obesity prevention practices in childcare (i.e., key components of the WISE intervention). Methods Informed by the i-PARIHS framework, we will use a stakeholder-driven evidence-based quality improvement (EBQI) process to apply information gathered in qualitative interviews on barriers and facilitators to practice to inform the design of implementation strategies. Then, a Hybrid Type III cluster randomized trial will compare a basic implementation strategy (i.e., intervention as usual) with an enhanced implementation strategy informed by stakeholders. All Head Start centers (N = 12) within one agency in an urban area in a southern state in the USA will be randomized to receive the basic or enhanced implementation with approximately 20 classrooms per group (40 educators, 400 children per group). The educators involved in the study, the data collectors, and the biostastician will be blinded to the study condition. The basic and enhanced implementation strategies will be compared on outcomes specified by the RE-AIM model (e.g., Reach to families, Effectiveness of impact on child diet and health indicators, Adoption commitment of agency, Implementation fidelity and acceptability, and Maintenance after 6 months). Principles of formative evaluation will be used throughout the hybrid trial. Discussion This study will test a stakeholder-driven approach to improve implementation, fidelity, and maintenance of EBPs for obesity prevention in childcare. Further, this study provides an example of a systematic process to develop and test a tailored, enhanced implementation strategy. Trial registration ClinicalTrials.gov, NCT03075085
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199, USA.
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado School of Medicine, 12700 East 19th Avenue Box C225, Auora, CO, 80045, USA
| | - Leanne Whiteside-Mansell
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham St, #522-4, Little Rock, AR, 72205-7199, USA
| | - Geoffrey M Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham St, #522-4, Little Rock, AR, 72205-7199, USA
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Emond JA, Tovar A, Li Z, Lansigan RK, Gilbert-Diamond D. FTO genotype and weight status among preadolescents: Assessing the mediating effects of obesogenic appetitive traits. Appetite 2017; 117:321-329. [PMID: 28712975 DOI: 10.1016/j.appet.2017.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/05/2017] [Accepted: 07/11/2017] [Indexed: 12/12/2022]
Abstract
Polymorphisms in the Fat Mass and Obesity Associated (FTO) gene are robustly associated with overweight and obesity among children, although the underlying mechanisms are poorly understood. We tested if appetitive traits partially mediated the association between FTO genotype and increased BMI among a sample of US preadolescents. Data were from 178 unrelated 9-10 year olds who participated in an experimental study between 2013 and 2015. Children's DNA was isolated from buccal swabs, and the rs9939609 SNP in the FTO gene was genotyped. Children's age- and sex-adjusted BMI z-scores were computed using height and weight measured at the laboratory. Parents completed the Child Eating Behavior Questionnaire that includes three validated scales of habitual appetitive traits related to drive and regulation: satiety responsiveness, enjoyment of food and food responsiveness. Structural equation modeling was used to assess if those traits mediated the relationship between FTO and BMI z-score. The sample of children was 48.9% male and 91.0% non-Hispanic white. FTO distribution was in Hardy Weinberg equilibrium, and 16.3% of participants were homozygous for the high-risk allele. Mean BMI z-score was greatest among those with the high-risk genotype (ANOVA P < 0.01). In separate structural equation models adjusted for the child's sex and maternal education, decreased satiety responsiveness and increased food responsiveness each partially mediated the positive association between the high-risk genotype and increased BMI z-score (P-value for each indirect effect <0.05). Continued research is needed to better understand how other known genetic obesity risk factors may impact appetitive traits among children.
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Affiliation(s)
- Jennifer A Emond
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, United States; Department of Pediatrics, Geisel School of Medicine at Dartmouth College, United States.
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, United States
| | - Zhigang Li
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth College, United States
| | - Reina K Lansigan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, United States
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, United States
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Boylan S, Hardy LL, Drayton BA, Grunseit A, Mihrshahi S. Assessing junk food consumption among Australian children: trends and associated characteristics from a cross-sectional study. BMC Public Health 2017; 17:299. [PMID: 28381213 PMCID: PMC5382385 DOI: 10.1186/s12889-017-4207-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 03/30/2017] [Indexed: 01/19/2023] Open
Abstract
Background The ubiquitous supply of junk foods in our food environment has been partly blamed for the increased rates in overweight and obesity. However, consumption of these foods has generally been examined individually perhaps obscuring the true extent of their combined consumption and impact on health. An overall measure of children’s junk food consumption may prove useful in the development of child obesity prevention strategies. We describe the development of a children’s Junk Food Intake Measure (JFIM) to summarise temporal change in junk food consumption and examine the association between the JFIM and health-related behaviours. Methods Cross-sectional population surveillance survey of Australian children age 5–16 years collected in 2010 and 2015. Data were collected by questionnaire with parent’s proxy reporting for children in years K, 2 and 4 and children in years 6, 8 and 10 by self-report. Information on diet, screen-time and physical activity was collected using validated questionnaires. The JFIM comprised consumption of fried potato products, potato crisps/salty snacks, sweet and savoury biscuits/cakes/doughnuts, confectionary and, ice cream/ice blocks. Results A total of 7565 (missing = 493, 6.1%) and 6944 (missing n = 611, 8.1%) children had complete data on consumption of junk foods, in 2010 and 2015, respectively. The 2015 survey data showed that among students from high socio-economic status neighbourhoods, there were fewer high junk food consumers than low junk food consumers. Children from Middle Eastern cultural backgrounds had higher junk food consumption. High junk food consumers were more likely to consume take-away ≥3/week, eat dinner in front of the television, receive sweet rewards, be allowed to consume snacks anytime, have soft drinks available at home and a TV in their bedroom. There was a lower proportion of high junk food consumers in 2015 compared to 2010. Conclusion This is the first study to provide and examine a summary measure of overall junk food consumption among Australian children. The results indicate that junk food consumption among Australian children is lower in 2015, compared with 2010. Still, the public health workforce must continue their efforts as levels of junk food consumption remain of concern among Australian children.
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Affiliation(s)
- S Boylan
- Prevention Research Collaboration, School of Public Health, The Hub, The University of Sydney, Charles Perkins Centre D17, Level 6, Sydney, NSW, 2006, Australia.
| | - L L Hardy
- Prevention Research Collaboration, School of Public Health, The Hub, The University of Sydney, Charles Perkins Centre D17, Level 6, Sydney, NSW, 2006, Australia
| | - B A Drayton
- NSW Biostatistics Training Program, NSW Ministry of Health, Sydney, Australia
| | - A Grunseit
- Prevention Research Collaboration, School of Public Health, The Hub, The University of Sydney, Charles Perkins Centre D17, Level 6, Sydney, NSW, 2006, Australia
| | - S Mihrshahi
- Prevention Research Collaboration, School of Public Health, The Hub, The University of Sydney, Charles Perkins Centre D17, Level 6, Sydney, NSW, 2006, Australia
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Gibson EL, Cooke L. Understanding Food Fussiness and Its Implications for Food Choice, Health, Weight and Interventions in Young Children: The Impact of Professor Jane Wardle. Curr Obes Rep 2017; 6:46-56. [PMID: 28205158 DOI: 10.1007/s13679-017-0248-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW This review examines the concepts of fussy eating and food neophobia in the context of key determinants of the development of children's food preferences. We discuss the evidence for genetic versus parental and other environmental influences on the ontogeny of these behavioural traits and the implications of current knowledge for interventions that attempt to lessen the impact of these traits on children's diets. Finally, we consider whether these traits increase the risk of a child becoming obese, or alternatively, underweight and malnourished. RECENT FINDINGS Fussy eating and neophobia are related concepts with both genetic and environmental aetiologies. Parent-child correlations and heritability estimates are moderate to high for both traits, but aspects of the family environment remain influential in young children, although no longer in young adults. Parental strategies based around repeat tasting opportunities can improve acceptance of disliked foods in even the fussiest children. Fussy eating and neophobia are not risk factors for obesity but could limit growth in severe cases. Fussy eating and food neophobia are common concerns for parents, though health risks are low. Dissemination of evidence-based strategies to parents that can encourage a more varied diet in young children would be helpful.
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Affiliation(s)
- E Leigh Gibson
- Department of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, London, SW15 4JD, UK.
| | - Lucy Cooke
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK
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Larsen AL, Liao Y, Alberts J, Huh J, Robertson T, Dunton GF. RE-AIM Analysis of a School-Based Nutrition Education Intervention in Kindergarteners. J Sch Health 2017; 87:36-46. [PMID: 27917488 PMCID: PMC7822576 DOI: 10.1111/josh.12466] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 04/08/2016] [Accepted: 06/23/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Few nutrition interventions in kindergarten classes have been evaluated, and none has been tested for program effectiveness, implementation, and dissemination. Building a Healthy Me (BHM) is a nutrition intervention for kindergarteners that is classroom-based and includes a family component. This study evaluated the public health impact of BHM in California kindergarten classrooms using the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework. METHODS A quasi-experimental design assessed pre-to-post changes in nutrition knowledge, dietary consumption, and parent behaviors of 25 intervention classrooms (414 students, 264 parents); and postintervention differences in nutrition knowledge between the intervention classrooms and 4 control classrooms measured at postintervention only (103 students). RESULTS Intervention students improved in knowledge of food groups and healthy breakfast/snack options, and scored higher than control students in food group knowledge at postintervention (ps < .05). Parents of intervention group children increased their use of food labels, and intervention group children increased intake of several healthy foods and decreased intake of candy and fried potatoes (ps < .05). The BHM program reached 41% of kindergarteners attending public schools in California, and teachers implemented most lesson material. CONCLUSIONS The BHM program was effective, implemented with fidelity, and broadly disseminated, highlighting its potential public health impact for kindergarteners.
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Affiliation(s)
- Andrew L. Larsen
- Research Consultant, Department of Psychology, University of Southern California, SGM 501, 3620 South McClintock Ave, Los Angeles, CA 90089
| | - Yue Liao
- Research Consultant, Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA 90032
| | - Janel Alberts
- Research Consultant, Alberts Research Consulting, Mission Viejo, CA92691
| | - Jimi Huh
- Assistant Professor of Research, Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90032
| | - Trina Robertson
- Project Manager, Dairy Council of California, 2151 Michelson Drive, Suite 235, Irvine, CA 92612-1339
| | - Genevieve F. Dunton
- Associate Professor, Departments of Preventive Medicine and Psychology, University of Southern California, Los Angeles, CA 90032
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Swindle TM, Ward WL, Bokony P, Whiteside-Mansell L. A Cross-Sectional Study of Early Childhood Educators' Childhood and Current Food Insecurity and Dietary Intake. J Hunger Environ Nutr 2016; 13:40-54. [PMID: 29606990 DOI: 10.1080/19320248.2016.1227752] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this cross-sectional study, ECEs (N=307) completed an 18-item survey regarding their role (lead vs. assistant), Education level, Program Type, and Current and Childhood Food Insecurity (FI) and Dietary Intake. ECEs in this study reported poor dietary quality and a high rate of FI. Approximately one quarter of ECEs ate fruits and vegetables more than once per day. Of participating ECEs, 34.5% indicated Current FI and 28.7% reported experiencing FI in Childhood. Differences in prevalence of Current FI were found for ECE role, Program Type, and Education (all p ≤ .03). Regression models with Childhood Dietary Intake, Childhood FI, Education, and Program Type as predictors accounted for a significant portion of variance in Current Dietary outcomes. In both models, Childhood Dietary Intake was uniquely predictive (p < .001) although Program Type was not. Future training and education efforts for ECEs should consider including specific resources to assess and reduce ECE FI and provide practical support for healthy eating on a budget. Additional research is needed to determine the impact of ECE FI on a variety of educator and child outcomes.
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Affiliation(s)
- Taren M Swindle
- Assistant Professor, Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199; United States of America
| | - Wendy L Ward
- Professor, Department of Pediatrics, University of Arkansas for Medical Sciences, 1 Children's Way, Slot #512-21, Little Rock, AR 72202-3591; United States of America
| | - Patti Bokony
- Assistant Professor, Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199; United States of America
| | - Leanne Whiteside-Mansell
- Professor, Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199; United States of America
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Brand T, Jahn I, Pohlabeln H, Böttcher S, Hense S, Hebestreit A, Ahrens W. Comparing strategies to improve the implementation of healthy nutrition in kindergartens: a prospective observational study. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0779-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Tovar A, Vaughn AE, Fallon M, Hennessy E, Burney R, Østbye T, Ward DS. Providers' response to child eating behaviors: A direct observation study. Appetite 2016; 105:534-41. [PMID: 27328098 PMCID: PMC5067159 DOI: 10.1016/j.appet.2016.06.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 04/22/2016] [Accepted: 06/15/2016] [Indexed: 11/18/2022]
Abstract
Child care providers play an important role in feeding young children, yet little is known about children's influence on providers' feeding practices. This qualitative study examines provider and child (18 months -4 years) feeding interactions. Trained data collectors observed 200 eating occasions in 48 family child care homes and recorded providers' responses to children's meal and snack time behaviors. Child behaviors initiating provider feeding practices were identified and practices were coded according to higher order constructs identified in a recent feeding practices content map. Analysis examined the most common feeding practices providers used to respond to each child behavior. Providers were predominately female (100%), African-American (75%), and obese (77%) and a third of children were overweight/obese (33%). Commonly observed child behaviors were: verbal and non-verbal refusals, verbal and non-verbal acceptance, being "all done", attempts for praise/attention, and asking for seconds. Children's acceptance of food elicited more autonomy supportive practices vs. coercive controlling. Requests for seconds was the most common behavior, resulting in coercive controlling practices (e.g., insisting child eat certain food or clean plate). Future interventions should train providers on responding to children's behaviors and helping children become more aware of internal satiety and hunger cues.
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Affiliation(s)
- Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd, CB 7426, Chapel Hill 27599-7426, NC, USA.
| | - Megan Fallon
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI 02881, USA.
| | - Erin Hennessy
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Regan Burney
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd, CB 7426, Chapel Hill 27599-7426, NC, USA.
| | - Truls Østbye
- Duke University Medical Center, 310 Trent Drive, Durham, NC 27710, USA.
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd, CB 7426, Chapel Hill 27599-7426, NC, USA.
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