Family dinner and diet quality among older children and adolescents

Individual and environmental influences on adolescent eating behaviors

Food choices of adolescents are not consistent with the Dietary Guidelines for Americans. Food intakes tend to be low in fruits, vegetables, and calcium-rich foods and high in fat. Skipping meals is also a concern among adolescents, especially girls. Factors influencing eating behaviors of adolescents need to be better understood to develop effective nutrition interventions to change eating behaviors. This article presents a conceptual model based on social cognitive theory and an ecological perspective for understanding factors that influence adolescent eating behaviors and food choices. In this model, adolescent eating behavior is conceptualized as a function of individual and environmental influences. Four levels of influence are described: individual or intrapersonal influences (eg, psychosocial, biological); social environmental or interpersonal (eg, family and peers); physical environmental or community settings (eg, schools, fast food outlets, convenience stores); and macrosystem or societal (eg, mass media, marketing and advertising, social and cultural norms).

Helping to promote healthy diets and lifestyles: the role of the food industry

In order to be successful, public health nutrition strategies require the active collaboration of all stakeholders in the promotion of healthy diet and lifestyle patterns. The food industry plays an important role both in providing products that meet consumers' needs in terms of taste, convenience, quality, nutrition and value as well as in communicating to consumers about the importance of good nutrition, including the contribution of specific foods to a balanced diet. The food industry contributes to educational efforts regarding healthy diets and lifestyles both directly--through product labelling, advertising, educational materials, on-line communications and information provided by Consumer Services departments--and indirectly, through active involvement and participation in educational programmes pursued in collaboration with nutrition and health education authorities. Through ongoing dialogue with its consumers and research conducted on consumer knowledge and attitudes towards diet, the food industry can ensure that communications developed are motivating and relevant to consumers' lives. In this paper, the specific contribution of the food industry will be illustrated through the promotion of healthy eating habits among children, focusing in particular on the importance of the breakfast meal.

Eating patterns, dietary quality and obesity

Obesity among children has reached epidemic proportions. Today, an estimated one in four children in the United States is overweight. while 11% arc obese. Children who are overweight tend to remain so up to 20 years of age; in general, they have a 1.5- to twofold higher risk for becoming overweight as adults. The prevalence of overweight has increased approximately twofold in the 20-year period from 1974 to 1994, with the largest increases observed among 19- to 24-year-olds. The annual increases in weight and obesity that occurred from 1983 to 1994 were 50% higher than those from 1973 to 1982. Overweight youth are 2.4 times as likely to have a high serum total cholesterol level, and 43.5 times as likely to have three cardiovascular risk factors. Although the total energy intake of children has remained the same, and the macronutrient density of the diet has changed, the percentage of energy from fat has decreased, while that from carbohydrates and protein has increased. Children have been consuming lower amounts of fats/oils, vegetables/soups, breads/grains, mixed meats, desserts, candy, and eggs. and increasing amounts of fruits/fruit juices, beverages. poultry, snacks, condiments, and cheese. Changes in specific eating patterns may explain the increase in adiposity among children; e.g., increases have occurred in the number of meals eaten at restaurants, food availability, portion sizes, snacking and meal-skipping. Successful prevention and treatment of obesity in childhood could reduce the adult incidence of cardiovascular disease. Because substantial weight loss is difficult to maintain, the prevention of obesity by promoting healthier lifestyles should be one of our highest priorities in the new millennium.

Prevention and treatment of childhood obesity

Obesity has reached epidemic proportions among children and youth in the United States. Surveys indicate that the number of overweight children aged 6 to 17 years has doubled within three decades. In the decade between the late 1970s and the late 1980s, the prevalence of overweight increased from 7.6% to 10.9% for children aged 6 to 11 years, and from 5.7% to 10.8% for adolescents aged 12 to 19 years. Data for 1999 indicates that the epidemic is continuing to increase, so that 13% of 6- to 11-year-old children and 14% of 12- to 19-year- old children are currently overweight (body mass index > or = 95th percentile for age/gender). This article reviews newer concepts related to etiologic factors, comorbidities, and strategies for prevention and treatment.

Preventing obesity in children and adolescents

In this review, we address the natural history of obesity in children, the most promising family- and school-based approaches to the prevention of obesity, and the barriers and opportunities associated with secondary prevention. In childhood, the most important periods of risk appear to be the periods of adiposity rebound and adolescence. Caution regarding the period of adiposity rebound is still warranted, because it is not yet clear that early rebound is attributable to changes in body fat. Families and schools represent the most important foci for preventive efforts in children and adolescents. One productive approach is to proceed from an examination of factors that affect energy balance to the identification of more proximal influences on those factors. This approach may help to narrow the strategies necessary to prevent or treat childhood obesity. For example, television viewing affects both energy intake and energy expenditure, and therefore represents a logical target for interventions. Anticipatory guidance by pediatricians may offer an effective mechanism by which to change parental attitudes and practices regarding television viewing. A similar process is used to emphasize the potential influence of school-based interventions directed at changes in food choices and sedentary behavior.

Family and child-care provider influences on preschool children's fruit, juice, and vegetable consumption

Children's intakes of fruit, juice, and vegetables (FJV) do not meet the recommended minimum of five daily servings, placing them at increased risk for development of cancer and other diseases. Because children's food preferences and practices are initiated early in life (e.g., 2-5 years of age), early dietary intervention programs may have immediate nutritional benefit, as well as reduce chronic disease risk when learned healthful habits and preferences are carried into adulthood. Families and child-care settings are important social environments within which food-related behaviors among young children are developed. FJV preferences, the primary predictor of FJV consumption in children, are influenced by availability, variety, and repeated exposure. Caregivers (parents and child-care providers) can influence children's eating practices by controlling availability and accessibility of foods, meal structure, food modeling, food socialization practices, and food-related parenting style. Much remains to be learned about how these influences and practices affect the development of FJV preferences and consumption early in life.

Perceptions of the family mealtime environment and adolescent mealtime behavior: do adults and adolescents agree?

The family mealtime environment has great potential to affect the eating behaviors of youth in the family. It is difficult to determine the important elements of a healthy mealtime environment because a valid assessment of the family environment is so difficult to obtain.The objective of this study is to examine the level of agreement between adult and adolescent perceptions of the family mealtime environment and adolescent mealtime behavior.A telephone survey was used to query adult and adolescent family members about how they perceive the family mealtime environment and the adolescent's mealtime behavior. A convenience sample of 282 adult/adolescent pairs from four schools in the Minneapolis/St. Paul area completed the telephone surveys. Frequencies of responses and the associations between the adult and adolescent responses are presented. Pearson correlations and regression were used to examine the level of association between adult and adolescent responses. Mixed-model regression was used for the continuous variables, and mixed-model logistic regression was used for the dichotomous variables. This study showed very little concordance between adolescent and adult responses. Only one question regarding arguments about eating during mealtime showed concordance. Adults and adolescents living in the same household seem to have different perceptions of the family mealtime environment and adolescent eating patterns. Researchers need to be aware of and concerned with the validity of the use of self-report for descriptions of family mealtime. They also need to be aware of the difference in adult and adolescent perceptions and consider these differences when designing messages for the family.

Significant increase in young adults' snacking between 1977-1978 and 1994-1996 represents a cause for concern!

BACKGROUND

Studies on children and adolescents suggest a large increase in the role of snacking; however, little is know about changes in the snacking behavior of young adults.

METHODS

USDA's nationally representative surveys from 1977-1978 to 1994-1996 are used to study snacking trends among 8,493 persons 19-29 years old.

RESULTS

Snacking prevalence increased from 77 to 84% between 1977-1978 and 1994-1996. The nutritional contribution of snacks to total daily energy intake went from 20 to 23%, primarily because energy consumed per snacking occasion increased by 26% and the number of snacks per day increased 14%. The mean daily caloric density (calorie per gram of food) of snacks increased from 1.05 to 1.32 calories. The energy contribution of high-fat desserts to the total calories from snacking decreased (22 to 14%), however, this food group remained the most important source of energy. The energy contribution of high-fat salty snacks doubled. Sweetened and alcoholic beverages remained important energy contributors.

CONCLUSION

This large increase in total energy and energy density of snacks among young adults in the United States may be contributing to our obesity epidemic.

The Importance of Meeting Calcium Needs with Foods

Calcium can be obtained from foods naturally rich in calcium such as dairy foods, from calcium-fortified foods and beverages, from supplements or from a combination of these. Recognition of calcium's many health benefits, along with Americans' low calcium intake, has led to interest in how best to meet calcium needs. Foods are the preferred source of calcium. Milk and other dairy foods are the major source of calcium in the U.S. In addition, these foods provide substantial amounts of other essential nutrients. Consequently, intake of dairy foods improves the overall nutritional quality of the diet. Other foods such as some green leafy vegetables, legumes and cereals provide calcium, but generally in lower amounts per serving than do dairy foods. Also, some components such as phytates in cereals and oxalates in spinach reduce the bioavailability of calcium. Calcium-fortified foods and calcium supplements are an option for individuals who cannot meet their calcium needs from foods naturally containing this mineral. However, their intake cannot correct poor dietary patterns of food selection which underlie Americans' low calcium intake. Considering the adverse health and economic effects of low calcium intakes, strategies are needed to optimize calcium intake. A first step is to recognize factors influencing dietary calcium consumption. Substituting soft drinks for milk and eating away from home are among the barriers to adequate calcium intake. The American public needs to understand why consuming foods containing calcium is the best way to meet calcium needs and learn how to accomplish this objective.

Remember when mom wanted you home for dinner?

Limited information exists about the relationship between family dinner and the quality of children's diets. However, several studies suggest that foods obtained at home have more fiber, calcium, and iron, and less total fat, saturated fat, cholesterol, and sodium than foods obtained away from home. The results of a recent study confirm and extend these observations by showing beneficial effects of family dinner on the diet quality of children ages 9 to 14. Nutritionists and health educators should look for ways to encourage families to increase the number of meals eaten together to improve the eating patterns of children.