"A lot of sacrifices:" work-family spillover and the food choice coping strategies of low-wage employed parents

Effects of Latino children on their mothers' dietary intake and dietary behaviors: The role of children's acculturation and the mother-child acculturation gap

RATIONALE

Research shows that acculturation is important to Latinas' dietary intake and related behaviors. Although evidence suggests children may also play a role, it remains unclear whether children's acculturation is related to mothers' dietary intake/behaviors.

OBJECTIVES

We examined the relationship between Latino children's acculturation and mothers' dietary intake/behaviors. We also examined the mother-child acculturation gap to identify dyad characteristics associated with mothers' diet.

METHODS

Baseline surveys were collected in 2010 from 314 Latino mother-child (7-13 years old) dyads of Mexican-origin enrolled in a family-based dietary intervention in Southern California, USA. Mother's daily intake of fruits, vegetables, and sugary beverages, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were assessed via self-report. Mothers' and children's bidimensional acculturation were examined using acculturation groups (e.g., assimilated, bicultural) derived from Hispanic and non-Hispanic dimensions of language. We also assessed the acculturation gap between mothers and children with the a) difference in acculturation between mothers' and children's continuous acculturation scores and b) mother-child acculturation gap typologies (e.g., traditional mothers of assimilated children).

RESULTS

Findings show that having an assimilated versus a bicultural child was negatively associated with mothers' vegetable intake and positively associated with mothers' sugary beverage intake, percent of calories from fat, and frequency of away-from-home eating, regardless of mothers' acculturation. Traditional mothers of assimilated children reported more sugary beverage intake, calories from fat, and more frequent away-from-home eating than traditional mothers of bicultural children.

CONCLUSION

Results suggest that children's acculturation is associated with their mothers' dietary intake/behaviors and traditional mothers of assimilated children require more attention in future research.

Home food preparation practices, experiences and perceptions: A qualitative interview study with photo-elicitation

Food-related choices have an important impact on health. Food preparation methods may be linked to diet and health benefits. However, the factors influencing people's food choices, and how they are shaped by food preparation experiences, are still not fully understood. We aimed to study home food preparation practices, experiences and perceptions amongst adults in North East England. A matrix was used to purposively sample participants with diverse socio-demographic characteristics. Participants developed photographic food diaries that were used as prompts during semi-structured interviews. Data were analysed using the Framework Method. Interviews were conducted with 18 adults (five men and 13 women), aged approximately 20 to 80 years, to reach data saturation. Participants' practices varied widely, from reliance on pre-prepared foods, to preparing complex meals entirely from basic ingredients. Key themes emerged regarding the cook (identity), the task (process of cooking), and the context (situational drivers). Resources, in terms of time, money and facilities, were also underpinning influences on food preparation. Participants' practices were determined by both personal motivations to cook, and the influence of others, and generally reflected compromises between varied competing demands and challenges in life. Most people appeared to be overall content with their food preparation behaviour, though ideally aspired to cook more frequently, using basic ingredients. This often seemed to be driven by social desirability. Home food preparation is complex, with heterogeneous practices, experiences and perceptions both between individuals and within the same individual over time, according to shifting priorities and circumstances. Generalisability of these findings may be limited by the regional participant sample; however the results support and build upon previous research. Focussing interventions on life transition points at which priorities and circumstances change, with careful targeting to stimulate personal motivation and social norms, may prove effective in encouraging home food preparation.

The Struggle Is Real: A Systematic Review of Food Insecurity on Postsecondary Education Campuses

BACKGROUND

Numerous international studies have examined cross-sectional correlates of food insecurity (FI) among postsecondary education students. Research is needed to synthesize the findings of this work to support vulnerable students.

OBJECTIVE

To systematically review peer-reviewed and gray literature to assess the prevalence of FI on postsecondary education institutions, as well as factors related to FI among students and suggested/practiced solutions.

DESIGN

Systematic literature review. Medline, Web of Science, and PsycINFO databases were searched for peer-reviewed literature for FI research; a Google search (Google Inc) was conducted to obtain gray literature on FI among postsecondary education students.

PARTICIPANTS/SETTING

Undergraduate and graduate students at postsecondary institutions of higher education.

MAIN OUTCOME MEASURES

Measures included prevalence of FI; sociodemographic, health, and academic factors related to FI; and solutions to address FI on postsecondary institutions.

RESULTS

Seventeen peer-reviewed studies and 41 sources of gray literature were identified (out of 11,476 titles). All studies were cross-sectional. Rates of FI were high among students, with average rates across the gray and peer-reviewed literature of 35% and 42%, respectively. FI was consistently associated with financial independence, poor health, and adverse academic outcomes. Suggested solutions to address food security among postsecondary institutions addressed all areas of the socioecologic model, but the solutions most practiced included those in the intrapersonal, interpersonal, and institutional levels.

CONCLUSIONS

FI is a major public health problem among postsecondary education students. Studies are needed to assess the long-term influence of FI among this vulnerable population. More research is needed on the effectiveness of FI interventions.

Daily Associations of Stress and Eating in Mother-Child Dyads

BACKGROUND AND AIMS

This study used Ecological Momentary Assessment (EMA) in mother-child dyads to examine the day-level associations of stress and eating.

METHOD

Mothers and their 8- to 12-year-old children ( N = 167 dyads) completed between three (weekday) and eight (weekend) EMA survey prompts per day at random nonschool times across 8 days. EMA measured perceived stress, and past 2-hour healthy (i.e., fruit and vegetables) and unhealthy (e.g., pastries/sweets, soda/energy drinks) eating.

RESULTS

Children reported more healthy and unhealthy eating on days when their mothers also engaged in more healthy and unhealthy eating, respectively. On days when mothers' perceived stress was greater than usual, they reported more healthy eating.

DISCUSSION AND CONCLUSIONS

Eating behaviors were coupled between mothers and children at the day level. Mothers' stress was related to their own eating but not to children's eating.

Sociocultural Factors Influencing Eating Practices Among Office Workers in Urban South Korea

OBJECTIVE

To understand the sociocultural factors affecting the eating behaviors of South Korean employees.

DESIGN

In-depth individual interviews.

SETTING

Two metropolitan areas of South Korea.

PARTICIPANTS

Thirteen male and 9 female office workers.

PHENOMENON OF INTEREST

The effects of sociocultural factors on office workers' eating behaviors.

ANALYSIS

The researchers transcribed and analyzed audio-recorded interviews using thematic analysis.

RESULTS

Among social and economic factors, participants with a family described a connection between female employment and lower frequency of home-cooked family meals. Working parents felt guilty about their need to depend on eating outside the home and eating processed foods because of their schedules. In addition, competitive and stressful working environments negatively affected workers' nutritional choices. Regarding cultural factors, given the powerful influences of collectivism and Confucianism on daily life, hierarchy and group harmony clearly had an important role in workers' everyday food choices. These included choosing menus that were most suitable for group meals and having to miss dinnertime while waiting until higher-position workers to leave work in the evening.

CONCLUSIONS AND IMPLICATIONS

In this sociocultural setting, targeting office workers and changing social norms for healthy eating may be more effective than providing individualized interventions. These findings may be transferable to other, similar Asian countries.

Innovative approaches to weight loss in a high-risk population: The small changes and lasting effects (SCALE) trial

OBJECTIVE

To evaluate the efficacy of a small change behavioral weight loss intervention with or without a positive affect/self-affirmation (PA/SA) component on weight loss at 12 months.

METHODS

Black and Hispanic adults (N = 405) with body mass index 25-50 kg/m² selected one of ten small change eating strategies and a physical activity goal, randomly with/without PA/SA. Participants were followed by community health workers at set intervals (weekly in months 1-3; biweekly in months 4-9; once monthly in months 10-12).

RESULTS

There was no difference in weight loss at 12 months between participants in the small change approach alone (1.1%) versus the small change PA/SA intervention (1.2%). During treatment, 9% of participants lost at least 7% of their initial body weight. Participants who reported more interval life events had a lower likelihood of losing weight (P < 0.0001). However, those randomized to the small change PA/SA intervention gained less weight (+0.3% vs. 2.3% gain; P < 0.0001).

CONCLUSIONS

The small change PA/SA intervention did not lead to a significant difference in weight loss in comparison to the small change approach alone. It did, however, decrease the negative impact of psychosocial stressors on weight gain among participants with more interval life events.

Deconstructing family meals: Do family structure, gender and employment status influence the odds of having a family meal?

OBJECTIVES

We assessed the odds of having a family dinner by parental gender, family structure and parental employment.

METHODS

This study used data from the American Time Use Survey (ATUS) (2006-2008). Multivariate analyses assessed the odds of two outcomes among parents: 1) eating at all with children and 2) having a family dinner.

RESULTS

Single men had lower odds of eating at all with children and eating a family dinner in comparison to partnered/married males. Partnered/married women had increased odds of eating at all with children and eating a family dinner compared to their partnered/married male counterparts. While single women had increased odds of eating at all with children compared to partnered/married males, no difference was detected in the odds of having a family dinner. Among dual-headed households, women had lower odds of eating a family dinner when both parents were employed compared a dual-headed household with employed male/non-employed female. There were no differences among men regardless of their employment status or that of their partner/spouse.

CONCLUSIONS

Family structure, parental gender and employment status all influence the odds of having a family dinner. Future research on family meals should consider all of these factors to better understand trends and disparities across household compositions.

Meal planning is associated with food variety, diet quality and body weight status in a large sample of French adults

BACKGROUND

Meal planning could be a potential tool to offset time scarcity and therefore encourage home meal preparation, which has been linked with an improved diet quality. However, to date, meal planning has received little attention in the scientific literature. The aim of our cross-sectional study was to investigate the association between meal planning and diet quality, including adherence to nutritional guidelines and food variety, as well as weight status.

METHODS

Meal planning, i.e. planning ahead the foods that will be eaten for the next few days, was assessed in 40,554 participants of the web-based observational NutriNet-Santé study. Dietary measurements included intakes of energy, nutrients, food groups, and adherence to the French nutritional guidelines (mPNNS-GS) estimated through repeated 24-h dietary records. A food variety score was also calculated using Food Frequency Questionnaire. Weight and height were self-reported. Association between meal planning and dietary intakes were assessed using ANCOVAs, while associations with quartiles of mPNNS-GS scores, quartiles of food variety score and weight status categories (overweight, obesity) were evaluated using logistic regression models.

RESULTS

A total of 57% of the participants declared to plan meals at least occasionally. Meal planners were more likely to have a higher mPNNS-GS (OR quartile 4 vs. 1 = 1.13, 95% CI: [1.07-1.20]), higher overall food variety (OR quartile 4 vs. 1 = 1.25, 95% CI: [1.18-1.32]). In women, meal planning was associated with lower odds of being overweight (OR = 0.92 [0.87-0.98]) and obese (OR = 0.79 [0.73-0.86]). In men, the association was significant for obesity only (OR = 0.81 [0.69-0.94]).

CONCLUSIONS

Meal planning was associated with a healthier diet and less obesity. Although no causality can be inferred from the reported associations, these data suggest that meal planning could potentially be relevant for obesity prevention.

Associations of Cooking With Dietary Intake and Obesity Among Supplemental Nutrition Assistance Program Participants

INTRODUCTION

Participation in the Supplemental Nutrition Assistance Program (SNAP) may help ease economic and time constraints of cooking, helping low-income households prepare healthier meals. Therefore, frequent cooking may be more strongly associated with improved dietary outcomes among SNAP recipients than among income-eligible non-recipients. Alternately, increased frequency of home-cooked meals among SNAP participants may be beneficial simply by replacing fast food intake. This study quantified the association between home cooking and fast food with diet intake and weight status among SNAP recipients.

METHODS

In 2016, data from low-income adults aged 19-65 years from the National Health and Nutrition Survey 2007-2010 (N=2,578) were used to examine associations of daily home-cooked dinner and weekly fast food intake with diet intake, including calories from solid fat and added sugar and key food groups (sugar-sweetened beverages, fruit, and vegetables), and prevalence of overweight/obesity. Differences in these associations for SNAP recipients versus income-eligible non-recipients were analyzed, as well as whether associations were attenuated when controlling for fast food intake.

RESULTS

Daily home-cooked dinners were associated with small improvements in dietary intake for SNAP recipients but not for non-recipients, including lower sugar-sweetened beverage intake (-54 kcal/day), and reduced prevalence of overweight/obesity (-6%) (p<0.05). However, these associations were attenuated after controlling for fast food intake. Consuming at least one fast food meal/week was associated with 9.3% and 11.6% higher overweight/obesity prevalence among SNAP recipients and non-recipients, respectively (p<0.05).

CONCLUSIONS

Strategies to improve dietary intake among SNAP recipients should consider both increasing home cooking and reducing fast food intake.

Biobehavioral Factors That Shape Nutrition in Low-Income Populations: A Narrative Review

Although evidence exists for an association between income level and diet quality, a causal relationship has not been established. A number of studies found that the price of nutritious food and the time cost to prepare foods are economically driven reasons for this relationship. However, in addition to economic constraints, low-income individuals and families face a number of additional challenges linked with food choice, eating behaviors, and diet-related chronic conditions that contribute to diet quality and health. Low-income individuals have a higher burden of employment-, food-, and housing-related insecurity that threaten the livelihood of their household. Poverty and exposure to these insecurities are hypothesized to activate biobehavioral and psychological mechanisms-endocrine, immune, and neurologic systems-that influence food choice and consumption. Examples of biobehavioral and psychological factors that influence diet are stress, poor sleep, and diminished cognitive capacity. High levels of stress, poor sleep, and cognitive overload compound the challenges of economic constraints, creating a mentality of scarcity that leads to poor diet quality.

Reasons Parents Buy Prepackaged, Processed Meals: It Is More Complicated Than "I Don't Have Time"

OBJECTIVE

To investigate reasons why parents purchase prepackaged, processed meals and associations with parental cooking self-efficacy, meal-planning ability, and home food availability.

METHODS

This secondary data analysis uses Healthy Home Offerings via the Mealtime Environment Plus study data from parents of children aged 8-12 years (n = 160). Associations between reasons why parents purchase prepackaged, processed meals and the outcomes were assessed with chi-square, Fisher exact, and t tests.

RESULTS

The most frequently endorsed reasons for purchasing prepackaged, processed meals included lack of time (57%) and family preferences (49%). Five of 6 reasons were associated with lower parental cooking self-efficacy and meal-planning ability. Some reasons were associated with less-healthful home food environments; few reasons varied by socio-demographic characteristics.

CONCLUSIONS AND IMPLICATIONS

Because lower cooking self-efficacy and meal-planning ability are associated with most reasons reported for purchasing prepackaged, processed meals, strategies to increase these attributes for parents of all backgrounds may reduce reliance on prepackaged processed meals for family mealtimes.

Can Families Eat Better Without Spending More? Improving Diet Quality Does Not Increase Diet Cost in a Randomized Clinical Trial among Youth with Type 1 Diabetes and Their Parents

BACKGROUND

Although cost is a frequently cited barrier to healthful eating, limited prospective data exist.

OBJECTIVE

To examine the association of diet cost with diet quality change.

DESIGN

An 18-month randomized clinical trial evaluated a dietary intervention.

PARTICIPANTS AND SETTING

Youth with type 1 diabetes duration ≥1 year, age 8.0 to 16.9 years, receiving care at an outpatient tertiary diabetes center in Boston, MA, participated along with a parent from 2010 to 2013 (N=136). Eighty-two percent of participants were from middle- to upper-income households.

INTERVENTION

The family-based behavioral intervention targeted intake of whole plant foods.

MAIN OUTCOME MEASURES

Diet quality as indicated by the Healthy Eating Index 2005 (HEI-2005) (which measures conformance to the 2005 Dietary Guidelines for Americans) and whole plant food density (cup or ounce equivalents per 1,000 kcal target food groups) were calculated from 3-day food records of youth and parent dietary intake at six and four time points, respectively. Food prices were obtained from two online supermarkets common to the study location. Daily diet cost was calculated by summing prices of reported foods.

STATISTICAL ANALYSES PERFORMED

Random effects models estimated treatment group differences in time-varying diet cost. Separate models for youth and parent adjusted for covariates examined associations of time-varying change in diet quality with change in diet cost.

RESULTS

There was no treatment effect on time-varying diet cost for either youth (β -.49, 95% CI -1.07 to 0.08; P=0.10) or parents (β .24, 95% CI -1.61 to 2.08; P=0.80). In addition, time-varying change in diet quality indicators was not associated with time-varying change in diet cost for youth. Among parents, a 1-cup or 1-oz equivalent increase in whole plant food density was associated with a $0.63/day lower diet cost (β -.63, 95% CI -1.20 to -0.05; P=0.03).

CONCLUSIONS

Improved diet quality was not accompanied by greater cost for youth with type 1 diabetes and their parents participating in a randomized clinical trial. Findings challenge the prevailing assumption that improving diet quality necessitates greater cost.

Understanding Multiple Behavioral Risk Factors for Cancer in Rural Women

OBJECTIVES

To examine the demographic and health-related factors associated with risk behaviors that have been linked to cancer including smoking, high BMI, and low physical activity.

DESIGN AND SAMPLE

A secondary analysis was conducted using data from Rural Families Speak about Health, a multistate, epidemiologic study of rural American women and their families (N = 444).

MEASURES

Validated measures for various demographic and health-related items including tobacco use, BMI, physical activity, and depression were used.

RESULTS

Of the total sample with complete data (n = 399), the mean age was 32 years and the majority were White (64%), married (67%), had a high school education or higher (73%), and had an annual household income of less than $40,000 (90%). Regarding cancer risk behaviors, 36% of the sample were smokers, 39% reported low levels of physical activity, and 45% had a calculated BMI over 30. Thirty-five percent of participants reported engaging in two or more risk behaviors. There were significant differences in income, perceived health status, and depression depending on the number of risk behaviors reported.

CONCLUSIONS

Understanding combinations of risk behaviors can assist nurses and other health professionals in tailoring multiple health behavior change interventions to prevent cancer among rural women.

Occupational Physical Activity and Weight-Related Outcomes in Immigrant Mothers

INTRODUCTION

New immigrants are likely to be employed in occupations that provide physical activity; however, these positions may place workers at risk for adverse health outcomes. Relationships between occupational physical activity (OPA); weight-related behaviors; obesity; and depression remain underexplored among recent immigrants.

METHODS

Participants (N=385) were Brazilian, Haitian, and Latino mothers enrolled in a community-based participatory research lifestyle intervention among immigrant mothers (<10 years in U.S.). Baseline BMI was calculated using objectively measured height and weight. Self-reported baseline data included sociodemographics; physical activity (Pregnancy Physical Activity Questionnaire); depressive symptoms (Center for Epidemiological Studies-Depression Scale); and prepared food purchasing frequency. Logistic regression models estimated the odds of obesity (BMI ≥30.0); high depressive symptoms (score ≥16); and purchasing prepared foods (≥1 times/week) by OPA quartile. Models adjusted for covariates, including household composition, origin group, maternal age, education, household income, and recruitment year (2010, 2011). Data were analyzed in 2013.

RESULTS

Employed participants (49%) primarily worked as domestic workers, nursing assistants, and food service staff. In adjusted models, women in the highest OPA quartile versus lowest had 65% lower obesity odds (95% CI=0.16, 0.76) and approximately twice the odds of presenting high depressive symptoms (2.01, 95% CI=1.02, 4.27) and purchasing takeout food (1.85, 95% CI=0.90, 3.90), which was attenuated after adjusting for income and education (unadjusted OR=1.98, 95% CI=1.10, 3.52).

CONCLUSIONS

OPA contributes to energy expenditure and may protect against obesity among new immigrant mothers; however, it is also associated with high depressive symptoms. Implications for physical and psychosocial well-being are mixed.

Dietary intake of working women with children does not appear to be influenced by hours of employment: A secondary analysis of the Australian Health Survey (2011-2013)

Women with children often fulfil multiple roles of running a household, raising a family and working outside the home. Good nutrition during this time is important to optimise their performance and prevent lifestyle diseases. Women also act as nutritional gatekeepers for their family. The dual burden of paid employment and unpaid family work may be associated with time scarcity in mothers which can impact food preparation and therefore nutritional adequacy. The aim of this study was to examine the diet of women who lived with children by comparison of hours worked.

METHODS

This was a secondary analysis of the Australian National Nutrition and Physical Activity Survey 2011-12. Subjects were women aged 18-65 years who resided with ≥1 child (<18 years). Women were grouped according to hours of employment: not working; working <25 h a week; and working ≥25 hours a week. Data from two 24-h dietary recalls were used to compare differences between groups in nutrient intake and proportion of energy from discretionary foods. Covariates included were age, education, smoker status, Socio-Economic Indexes for Areas (SEIFA), number of persons in household, week or weekend day of the survey and the sequence of recalls.

RESULTS

Analyses included 1869 women. Dietary intakes varied minimally between groups with intakes of fibre, vitamin C, and calcium lowest in the group not working. Overall diet quality was poor with >30% of energy coming from discretionary foods in all groups.

CONCLUSIONS

Usual hours of employment per week have a minimal effect on diet quality in women with children. It is likely that different factors specific to each group contribute to the poor dietary intakes and should be further investigated.

Exploring the dynamics of a free fruit at work intervention

Background

The workplace has been identified as an ideal setting for health interventions. However, few UK-based workplace intervention studies have been published. Fewer still focus on the practicalities and implications when running an intervention within the workplace setting.

The objective of this paper was to qualitatively determine the perceived behaviour changes of participants in a free fruit at work intervention. Understanding the dynamics of a workplace intervention and establishing any limitations of conducting an intervention in a workplace setting were also explored.

Methods

Twenty-three face-to-face interviews were conducted with individuals receiving free fruit at work for 18 weeks (74 % female). The worksite was the offices of a regional local government in the North East of England. Analysis was guided theoretically by Grounded Theory research and the data were subjected to content analysis. The transcripts were read repeatedly and cross-compared to develop a coding framework and derive dominant themes.

Results

Topics explored included: the workplace food environment; the effect of the intervention on participants and on other related health behaviours; the effect of the intervention on others; participant’s fruit consumption; reasons for not taking part in the intervention; expectations and sustainability post-intervention; and how to make the workplace healthier. Five emergent themes included: the office relationship with food; desk based eating; males and peer support; guilt around consumption of unhealthy foods; and the type of workplace influencing the acceptability of future interventions.

Conclusion

Exploring the perceptions of participants offered valued insights into the dynamics of a free fruit workplace intervention. Findings suggest that access and availability are both barriers and facilitators to encouraging healthy eating in the workplace.

Changing maternal perceptions of healthy feeding: a novel intervention

OBJECTIVE

This study sought to better understand factors influencing mothers' perceptions about healthy feeding. Additionally, a social consensus intervention was used to try to change mothers' likelihood to serve healthy foods.

METHODS

Mothers saw photographs of healthy and unhealthy snacks and meals and rated them on several factors that were hypothesized to predict the likelihood of serving the foods. Then, mothers were randomly assigned to the experimental or control condition. Those in the experimental condition received social consensus information about these foods, whereas the control condition did not. The change in perceptions in the control and experimental conditions was examined.

RESULTS

Mothers rated healthy meals and snacks less favourably than unhealthy meals and snacks on factors including cost, preparation time and difficulty, and child preference. Furthermore, mothers' perceptions of foods as liked by their child, easy to prepare and 'kid-friendly' predicted higher likelihood to serve those foods. Finally, mothers were more likely to describe the healthy snack as kid-friendly and indicated being more likely to serve it after receiving favourable social norm information about the food.

CONCLUSIONS

The use of social consensus interventions to change parents' perceptions of healthy snacks may be one means of increasing the quality of children's diets.

Dietary and economic effects of eliminating shortfall in fruit intake on nutrient intakes and diet cost

Background

Children in the United States do not consume the recommended amounts of fruit. The economic and dietary consequences of meeting the shortfall in fruit consumption have not been evaluated.

Methods

Analyses were based on a nationally representative sample of 4–18 year-old children (n = 2,647) from the 2009–2010 National Health and Nutrition Examination Survey (NHANES). The shortfall in total fruit consumption for each child was estimated based on the USDA MyPlate recommendations. The potential impact of filling the shortfall in total fruit consumption was projected with whole fruit alone (WF model) or a combination of 100 % fruit juice and whole fruit (FJ + WF model). Juice consumption was capped using American Academy of Pediatrics (AAP) standards. The USDA national food prices database was used to estimate the cost of meeting the dietary recommendations for fruit. Selected nutrient and mineral intakes, as well as daily diet cost were estimated after eliminating the shortfall in fruit consumption.

Results

Among all children, vitamin C (+22.8 mg [95 % CI 21.4, 24.1] in the WF model and +48.1 mg [95 % CI 45.2, 51.1] in the FJ + WF model) and potassium intakes (+203 mg [95 % CI 190, 215] in WF and +263 mg [95 % CI 248, 280] in FJ + WF) were increased in both models. The FJ + WF model resulted in a marginal increase in dietary fiber (e.g., a relative change less than 10 %), while the WF model resulted in a meaningful increase in dietary fiber (e.g., a relative change greater than 10 %; +2.2 g [95 % CI 2.1, 2.3]). Conversely, the WF model resulted in only a marginal increase in calcium, while the FJ + WF model resulted in a meaningful increase in calcium (+85 mg [95 % CI 79, 89]). Calories were increased in all models (+4.5 % [95 % CI 4.1, 4.9 %] for FJ + WF and +3.5 % [95 % CI 3.2, 3.7 %] for WF). Meeting the fruit shortfall with whole fruit alone increased estimated diet costs by 9.9 % (+$0.44/d [95 % CI 0.42, 0.47]), while the fruit juice/whole fruit combination increased diet costs by 5.2 % (+$0.23/d [95 % CI 0.22, 0.25]).

Conclusions

Meeting fruit consumption guidelines without a substantial increase in diet costs may be a challenge. Combining whole fruit with 100 % fruit juice capped at AAP standards may be one approach to meeting fruit recommendations within cost constraints. Identifying approaches to increasing whole fruit consumption in as cost-neutral a fashion as possible should be a priority.

Association between Motives for Dish Choices during Home Meal Preparation and Weight Status in the NutriNet-Santé Study

Although home cooking has been associated with a lower body mass index in a few studies, no data exists on the motives behind food dish choices during home meal preparation and on their association with overweight. This study aimed to evaluate this association in 50,003 participants from the NutriNet-Santé cohort. Dimensions underlying the importance of 27 criteria possibly influencing dish choices were determined using an exploratory factor analysis. The association between dish choice motives and overweight (including obesity) was estimated using logistic regression models adjusted for sociodemographic and lifestyle characteristics. Five dimensions of dishes choice motives emerged: healthy diet (e.g., "nutritional balance of the dish"), constraints (e.g., "my cooking skills"), pleasure (e.g., "originality of the dish"), specific diets (e.g., "my health status"), and organization (e.g., "what I planned to eat"). A negative association was observed between the healthy diet factor and being overweight (OR = 0.65 (95% CI (confidence interval): 0.62-0.67)), whereas a positive association appeared for factors regarding pleasure (OR = 1.14 (95% CI: 1.10-1.19)) and specific diets (OR = 1.19 (95% CI: 1.17-1.22)). No significant associations were observed for constraints and organization. The significant associations between dish choice motives and overweight suggested the interest of focusing on these motives in order to promote healthier food choices during home cooking.

"Choice Set" for health behavior in choice-constrained settings to frame research and inform policy: examples of food consumption, obesity and food security

Objectives

Using the nexus between food consumption, food security and obesity, this paper addresses the complexity of health behavior decision-making moments that reflect relational social dynamics in context-specific dialogues, often in choice-constrained conditions.

Methods

A pragmatic review of literature regarding social determinants of health in relation to food consumption, food security and obesity was used to advance this theoretical model.

Results and discussion

We suggest that health choice, such as food consumption, is based on more than the capacity and volition of individuals to make “healthy” choices, but is dialogic and adaptive. In terms of food consumption, there will always be choice-constrained conditions, along a continuum representing factors over which the individual has little or no control, to those for which they have greater agency. These range from food store geographies and inventories and food availability, logistical considerations such as transportation, food distribution, the structure of equity in food systems, state and non-government food and nutrition programs, to factors where the individual exercises a greater degree of autonomy, such as sociocultural foodways, family and neighborhood shopping strategies, and personal and family food preferences. At any given food decision-making moment, many factors of the continuum are present consciously or unconsciously when the individual makes a decision. These health behavior decision-making moments are mutable, whether from an individual perspective, or within a broader social or policy context. We review the construct of “choice set”, the confluence of factors that are temporally weighted by the differentiated and relationally-contextualized importance of certain factors over others in that moment. The choice transition represents an essential shift of the choice set based on the conscious and unconscious weighting of accumulated evidence, such that people can project certain outcomes. Policies and interventions should avoid dichotomies of “good and bad” food choices or health behaviors, but focus on those issues that contribute to the weightedness of factors influencing food choice behavior at a given decision-making moment and within a given choice set.

A question of balance: Explaining differences between parental and grandparental perspectives on preschoolers' feeding and physical activity

RATIONALE

Although one quarter of US and UK families rely on grandparents as the main providers of informal childcare, grandparental perspectives on the feeding and physical activity of young children remain understudied.

OBJECTIVE

The study's aim was to elucidate parents' and grandparents' perspectives on young children's feeding and physical activity, and identify how they negotiate potential differences between these perspectives.

METHODS

We interviewed 22 parents and 27 grandparents from 16 families of children aged 3-5 years in the Pacific Northwest, US. Using familial homeostasis as a novel theoretical framework, the interviews were analyzed to assess differences between parental and grandparental perspectives on feeding and physical activity.

RESULTS

The analysis yielded six thematic categories: (1) disagreements about feeding stem from parents' and grandparents' differing definitions of healthy feeding; (2) differences between parents' and grandparents' feeding practices reflect differences in perceived caretaking roles; (3) parents and grandparents negotiate differences in feeding practices through grandparental compliance and parental compromise; (4) differences in preschoolers' physical activity are influenced by parents' and grandparents' own access to and engagement in physical activity; (5) parents and grandparents express few disagreements about preschoolers' screen-time; (6) parents and grandparents rarely discuss preschoolers' physical activity. The findings suggest that parental and grandparental decision-making about feeding and exercise is informed by ideas of what constitutes familial balance and a balanced lifestyle for a preschool aged child, rather than by the child's weight status.

CONCLUSIONS

Parents and grandparents appear to engage in practices designed to preserve familial homeostasis, which may provide a compelling explanation for the persistent difficulties in implementing family-based childhood obesity interventions.

The impact of a pilot cooking intervention for parent-child dyads on the consumption of foods prepared away from home

This pilot study investigated the impact of a parent-child dyad cooking intervention on reducing eating dinner away from home. Eating away from home often results in consumption of energy-dense, nutrient-poor foods that can contribute to excess energy consumption in children. A pre-post design to evaluate a 10-week cooking intervention on reducing eating dinner away from home, energy intake, and improving diet quality was implemented. The intervention was delivered at an instructional kitchen on a university campus and assessments were completed at a children's academic medical center. Subjects included six parent-child dyads whom reported eating dinner away from home ≥3 times/week and in which the parent was overweight based on their body mass index (BMI) of ≥25 kg/m(2). Parents were a mean age of 34.7 (SD = 3.9) years, and children were a mean age of 8.7 (SD = 2.0) years. Two-thirds of parents self-identified themselves and their children as White. Results showed the proportion of dinners consumed by parent-child dyads away from home significantly decreased (F (1,161) = 16.1, p < 0.05) from 56% at baseline to 25% at post-treatment. Dyad cholesterol intake at dinner also significantly decreased over time; however, changes in energy intake, total fat, saturated fat, and sodium at dinner were not significant. A large effect size was found for changes in parent ratings of enjoyment of cooking between baseline and post-treatment. A cooking intervention that involves parent-child dyads and incorporates behavior management strategies and nutrition education may be an innovative obesity prevention intervention.

Motives for dish choices during home meal preparation: results from a large sample of the NutriNet-Santé study

Background

Although culinary practices have strongly evolved over time, few data are available on contemporary dish choices during meal preparation. We therefore sought to determine individual motives when choosing dishes to be prepared during weekdays and on weekends.

Methods

The importance of 27 criteria related to dish choices was assessed in 53,025 participants in the NutriNet-Santé study. Dimensions of dish choice motives were investigated using exploratory factor analysis. Mean ratings of motives during weekdays and on weekends were compared using Student's t-test. Association between socio-demographic and cooking practice characteristics, and dish choice motives were evaluated using logistic regression models.

Results

Five dimensions of dish choice motives emerged: healthy diet (explained variance: 48.3 %), constraints (19.0 %), pleasure (12.1 %), specific diets (11.0 %) and organization (9.6 %). The healthy diet factor was the most important on weekdays (mean rating 3.93) and weekends (3.90). Pleasure (3.61) had a higher score than constraints (3.54) on weekends (p < 0.0001) while the opposite was observed on weekdays (3.42 vs 3.77, respectively) (p < 0.0001). Organization was more important on weekdays (2.89) than on weekends (2.75) (p < 0.0001). Dish choice motives appeared to be significantly associated with socio-demographic and cooking practice characteristics.

Conclusion

This study highlighted factors involved in dish choices in meal preparation on weekdays and weekends, as well as individual characteristics which determine motives for dish choices. From a public health perspective, these findings might help to develop appropriate strategies for promoting home meal preparation.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-015-0270-9) contains supplementary material, which is available to authorized users.

Dietary Behaviours, Impulsivity and Food Involvement: Identification of Three Consumer Segments

This study aims to (1) identify consumer segments based on consumers' impulsivity and level of food involvement, and (2) examine the dietary behaviours of each consumer segment. An Internet-based cross-sectional survey was conducted among 530 respondents. The mean age of the participants was 49.2 ± 16.6 years, and 27% were tertiary educated. Two-stage cluster analysis revealed three distinct segments; "impulsive, involved" (33.4%), "rational, health conscious" (39.2%), and "uninvolved" (27.4%). The "impulsive, involved" segment was characterised by higher levels of impulsivity and food involvement (importance of food) compared to the other two segments. This segment also reported significantly more frequent consumption of fast foods, takeaways, convenience meals, salted snacks and use of ready-made sauces and mixes in cooking compared to the "rational, health conscious" consumers. They also reported higher frequency of preparing meals at home, cooking from scratch, using ready-made sauces and mixes in cooking and higher vegetable consumption compared to the "uninvolved" consumers. The findings show the need for customised approaches to the communication and promotion of healthy eating habits.

Privileging physical activity over healthy eating: 'Time' to Choose?

Physical activity and healthy eating have long been promoted as key strategies in tackling the 'wicked problem' of obesity. Both practices are assumed to go hand-in-hand, but whether one dominates the other has largely remained unexamined. Moreover, time, a dimension beyond the socio-ecological model, is a critical factor of families' busy lives, but related challenges are rarely articulated. We conducted 47 family interviews as part of a mixed methods study examining environmental influences on youth obesity in Nova Scotia, Eastern Canada. Participants were recruited from six schools at the junior high school level (grades 7-9; age range 12-14 years) based on location (urban, suburban and rural) and neighborhood socioeconomic status (high and low socioeconomic status). Time pressure to meet the demands associated with scheduled physical activity for youth was the dominant theme across interviews from all neighborhoods. Physical activity and healthy eating were valued differently, with greater value placed on physical activity than healthy eating. The pressure to engage youth in organized physical activity appeared to outweigh the importance of healthy eating, which led to neglecting family meals at home and consuming fast food and take out options. Our findings further reinforce the need to move beyond the socio-ecological model and integrate critical dimensions such as 'time', its challenges and opportunities, to allow for a more nuanced understanding of contemporary healthy living. It appears 'timely' to focus on healthy public policy in support of families, instead of unwittingly supporting a fast food industry that profits from time-pressured families.

The influence of parental encouragement and caring about healthy eating on children’s diet quality and body weights

Objective

In order to mitigate childhood obesity, evidence on what influences children’s health behaviours is needed to inform new health promotion strategies. The present study investigated the association between parental practices and their child’s diet and body weight status.

Design

Grade 5 students and their parents completed health surveys. Parents were asked how much they ‘encourage their child to eat healthy foods’ and how much they ‘personally care about healthy eating’. Children’s diet quality and vegetable and fruit intake were assessed using an FFQ. Children’s heights and weights were measured to determine body weight status. Mixed-effects regression models were used to determine the influence of parental responses on the outcomes of interest.

Setting

Elementary schools across the province of Alberta, Canada.

Subjects

Grade 5 students (aged 10 and 11 years;n8388) and their parent(s).

Results

Most parents reported caring about healthy eating and encouraging their child to eat healthy foods at least quite a lot. Children whose parents who cared or encouraged ‘very much’ compared with ‘quite a lot’ were more likely have better diet quality and were less likely to be overweight. Children whose parents both cared and encouraged ‘very much’ compared with ‘quite a lot’ scored an average of 2·06 points higher on the diet quality index (β=2·06; 95 % CI 1·45, 2·66).

Conclusions

Health promotion strategies that aim for a high level of parental interest and encouragement of their children to eat healthy foods may improve diet quality and prevent overweight among children.

Factors influencing the implementation of a school-based parental support programme to promote health-related behaviours--interviews with teachers and parents

BACKGROUND

The 'Healthy School Start' programme was developed to promote healthy dietary habits and physical activity, targeting parents of 6-year-old children in pre-school class. Knowledge of barriers and facilitators of implementation is crucial before introducing this kind of programme on a larger scale. The aim of this study was to explore the views of teachers and parents regarding factors influencing the implementation of a school-based parental support programme to promote physical activity and healthy diet.

METHODS

An inductive qualitative method was used to explore the experiences and views of teachers and parents involved in the programme. A group discussion was held with three teachers, and semi-structured interviews were conducted with 14 parents. Data were analysed using qualitative content analysis.

RESULTS

Clear communication on roles and responsibilities was identified as an overarching theme, emphasising the importance of clear information and well-functioning cooperation between project management, schools and parents when implementing the programme in a school setting. Five categories at a manifest level described aspects influencing the implementation: 1) 'The programme' underlining the importance of flexibility and feed-back; 2) 'the school' referring to management and work routines; 3) 'family conditions', implying various life situations; 4) 'group dynamics' dealing with attitudes among children and parents; and 5) 'the surrounding community' including accessibility and attitudes within society.

CONCLUSIONS

When implementing a parental support programme in a school setting it is important to facilitate communication and clearly define the division of responsibilities between project management, schools and parents. This emphasises the need for managerial support, and a professional prevention support system.

Dysbiotic drift: mental health, environmental grey space, and microbiota

Advances in research concerning the mental health implications of dietary patterns and select nutrients have been remarkable. At the same time, there have been rapid increases in the understanding of the ways in which non-pathogenic microbes can potentially influence many aspects of human health, including those in the mental realm. Discussions of nutrition and microbiota are often overlapping. A separate, yet equally connected, avenue of research is that related to natural (for example, green space) and built environments, and in particular, how they are connected to human cognition and behaviors. It is argued here that in Western industrial nations a ‘disparity of microbiota’ might be expected among the socioeconomically disadvantaged, those whom face more profound environmental forces. Many of the environmental forces pushing against the vulnerable are at the neighborhood level. Matching the developing microbiome research with existing environmental justice research suggests that grey space may promote dysbiosis by default. In addition, the influence of Westernized lifestyle patterns, and the marketing forces that drive unhealthy behaviors in deprived communities, might allow dysbiosis to be the norm rather than the exception in those already at high risk of depression, subthreshold (subsyndromal) conditions, and subpar mental health. If microbiota are indeed at the intersection of nutrition, environmental health, and lifestyle medicine (as these avenues pertain to mental health), then perhaps the rapidly evolving gut-brain-microbiota conversation needs to operate through a wider lens. In contrast to the more narrowly defined psychobiotic, the term eco-psychotropic is introduced.

The role of women in food provision and food choice decision-making in Singapore: a case study

As countries develop economically and increasing numbers of women enter the workforce, children are partly being cared for by someone other than their mother. Little is known about the impact of this shift in child-care provider on children's nutrition. This study presents findings from a case study of Singapore, a small country that has experienced phenomenal economic growth. Focus groups were conducted with 130 women of varying educational levels and ethnicities to learn about food decisions in their families. The findings showed that Singaporean working women cook infrequently, families eat out frequently, and children exert considerable influence on food choices. Implications for work-family policies and child health are discussed.

Small Changes and Lasting Effects (SCALE) Trial: the formation of a weight loss behavioral intervention using EVOLVE

Background

Obesity is a major health problem that disproportionately affects Black and Hispanic adults. This paper presents the rationale and innovative design of a small change eating and physical activity intervention (SC) combined with a positive affect and self-affirmation (PA/SA) intervention versus the SC intervention alone for weight loss.

Methods

Using a mixed methods translational model (EVOLVE), we designed and tested a SC approach intervention in overweight and/ or obese African American and Hispanic adults. In Phase I, we explored participant’s values and beliefs about the small change approach. In Phase II, we tested and refined the intervention and then, in Phase III we conducted a RCT. Participants were randomized to the SC approach with PA/SA intervention vs. a SC approach alone for 12 months. The primary outcome was clinically significant weight loss at 12 months.

Results

Over 4.5 years a total of 574 participants (67 in Phase I, 102 in Phase II and 405 in Phase III) were enrolled. Phase I findings were used to create a workbook based on real life experiences about weight loss and to refine the small change eating strategies. Phase II results shaped the recruitment and retention strategy for the RCT, as well as the final intervention. The RCT results are currently under analysis.

Conclusion

The present study seeks to determine if a SC approach combined with a PA/SA intervention will result in greater weight loss at 12 months in Black and Hispanic adults compared to a SC approach alone.

Socioeconomic gradient in consumption of whole fruit and 100% fruit juice among US children and adults

BACKGROUND

The consumption of fruit is generally associated with better health, but also higher socioeconomic status (SES). Most previous studies evaluating consumption of fruits have not separated 100% fruit juice and whole fruit, which may conceal interesting patterns in consumption.

OBJECTIVE

To estimate demographic and socioeconomic correlates of whole fruit versus 100% juice consumption among children and adults in the United States.

DESIGN

Secondary analyses of two cycles of the nationally representative National Health and Nutrition Examination Survey (NHANES) from 2007-2010, by gender, age group, race/ethnicity and SES among 16,628 children and adults.

RESULTS

Total fruit consumption (population average of 1.06 cup equivalents/d) fell far short of national goals. Overall, whole fruit provided about 65% of total fruit, while 100% juice provided the remainder. Whereas 100% juice consumption was highest among children and declined sharply with age, whole fruit consumption was highest among older adults. Total fruit and whole fruit consumption was generally higher among those with higher incomes or more education. By contrast, the highest 100% juice consumption was found among children, racial/ethnic minorities and lower-income groups.

CONCLUSIONS

Consumption patterns for whole fruit versus 100% fruit juice showed different gradients by race/ethnicity, education, and income. The advice to replace 100% juice with whole fruit may pose a challenge for the economically disadvantaged and some minority groups, whose fruit consumption falls short of national goals.

Stuck in a vicious circle of stress. Parental concerns and barriers to changing children's dietary and physical activity habits

INTRODUCTION

Dietary habits and physical activity are often the focus of obesity prevention programmes and involving parents in such programmes has proven to be effective. The aims of this study were to describe parents' concerns about their children's diet and physical activity habits and to describe barriers to change.

RESULTS

The study used archival data gathered unobtrusively in the form of memos taken after sessions of Motivational Interviewing as part of the parental support programme, A Healthy School Start. The 74 MI-sessions were conducted from October 2010 to April 2011 with either a mother or father or both, all with children in pre-school class. Thematic analysis was applied. Three themes were identified regarding children's dietary habits: amount of food consumed influenced by behaviour in the family, eating situations influenced by stressful everyday life and family interplay, and food choices influenced by stressful everyday life and family interplay. One theme appeared regarding physical activity: physical activity influenced by stressful everyday life and family interplay.

CONCLUSION

Family interplay appears to be an important link between the work-life stress perceived by parents and less healthy food and physical activity habits in the home. Both lack of parental cooperation and negative parent-child interactions may act as barriers to healthy eating and physical activity and should be addressed in future intervention studies on health-related behaviours of children.

Constrained choices? Linking employees' and spouses' work time to health behaviors

There are extensive literatures on work conditions and health and on family contexts and health, but less research asking how a spouse or partners' work conditions may affect health behaviors. Drawing on the constrained choices framework, we theorized health behaviors as a product of one's own time and spouses' work time as well as gender expectations. We examined fast food consumption and exercise behaviors using survey data from 429 employees in an Information Technology (IT) division of a U.S. Fortune 500 firm and from their spouses. We found fast food consumption is affected by men's work hours-both male employees' own work hours and the hours worked by husbands of women respondents-in a nonlinear way. The groups most likely to eat fast food are men working 50 h/week and women whose husbands work 45-50 h/week. Second, exercise is better explained if work time is conceptualized at the couple, rather than individual, level. In particular, neo-traditional arrangements (where husbands work longer than their wives) constrain women's ability to engage in exercise but increase odds of men exercising. Women in couples where both partners are working long hours have the highest odds of exercise. In addition, women working long hours with high schedule control are more apt to exercise and men working long hours whose wives have high schedule flexibility are as well. Our findings suggest different health behaviors may have distinct antecedents but gendered work-family expectations shape time allocations in ways that promote men's and constrain women's health behaviors. They also suggest the need to expand the constrained choices framework to recognize that long hours may encourage exercise if both partners are looking to sustain long work hours and that work resources, specifically schedule control, of one partner may expand the choices of the other.

Time spent on home food preparation and indicators of healthy eating

BACKGROUND

The amount of time spent on food preparation and cooking may have implications for diet quality and health. However, little is known about how food-related time use relates to food consumption and spending, either at restaurants or for food consumed at home.

PURPOSE

To quantitatively assess the associations among the amount of time habitually spent on food preparation and patterns of self-reported food consumption, food spending, and frequency of restaurant use.

METHODS

This was a cross-sectional study of 1,319 adults in a population-based survey conducted in 2008-2009. The sample was stratified into those who spent <1 hour/day, 1-2 hours/day, and >2 hours/day on food preparation and cleanup. Descriptive statistics and multivariable regression models examined differences between time-use groups. Analyses were conducted in 2011-2013.

RESULTS

Individuals who spent the least amount of time on food preparation tended to be working adults who placed a high priority on convenience. Greater amount of time spent on home food preparation was associated with indicators of higher diet quality, including significantly more frequent intake of vegetables, salads, fruits, and fruit juices. Spending <1 hour/day on food preparation was associated with significantly more money spent on food away from home and more frequent use of fast food restaurants compared to those who spent more time on food preparation.

CONCLUSIONS

The findings indicate that time might be an essential ingredient in the production of healthier eating habits among adults. Further research should investigate the determinants of spending time on food preparation.

Nutritional strategies of Latino farmworker families with preschool children: identifying leverage points for obesity prevention

Obesity and overweight are significant problems for children in the US, particularly for Hispanic children. This paper focuses on the children in families of immigrant Hispanic farmworkers, as farm work is the portal though which many immigrants come to the US. This paper (1) describes a model of the nutritional strategies of child feeding in farmworker families; and (2) uses this model to identify leverage points for efforts to improve the nutritional status of these children. In-depth interviews were conducted in Spanish with 33 mothers of 2-5 year old children in farmworker families recruited in North Carolina in 2010-2011. The purposive sample was balanced by farmworker status (migrant or seasonal), child age, and child gender. Interviews were transcribed and translated. Multiple coders and a team approach to analysis were used. Nutritional strategies centered on domains of procuring food, using food, and maintaining food security. The content of these domains reflected environmental factors (e.g., rural isolation, shared housing), contextual factors (e.g., beliefs about appropriate food, parenting style), and available resources (e.g., income, government programs). Environmental isolation and limited access to resources decrease the amount and diversity of household food supplies. Parental actions (parental sacrifices, reduced dietary variety) attempt to buffer children. Use of government food sources is valuable for eligible families. Leverage points are suggested that would change nutritional strategy components and lower the risk of overweight and obesity. Further prospective research is needed to verify the nutritional strategy identified and to test the ability of leverage points to prevent childhood obesity in this vulnerable population.

Insights in public health: Is the gap growing? Patterns in poverty-related disparities in nutrition and physical activity in Hawai'i

A recent Harvard study on national dietary trends found that the gap in healthy dietary behaviors between low-income and middle/upper-income Americans widened between 2000 and 2010. Hawai'i Behavioral Risk Factor Surveillance System (BRFSS) data from 2001-2009 on differences in obesity-related behaviors between moderate-high income, low-income, and poverty-level Hawai'i residents were examined to explore whether Hawai'i data on obesity-related behaviors reflected this national trend. While most differences between groups were not statistically significant, a consistent pattern was seen across all measures that suggested a growing gap between low-income and moderate/high income Hawai'i residents. Data from community studies on pedestrian injury, park use, transportation, and healthy food access were examined. This data suggests that individuals residing in low-income neighborhoods in Hawai'i experience higher barriers to the adoption of healthier behaviors. Further data is needed to document poverty-related gaps in the adoption of health behaviors among youth and within Hawai'i's ethnic groups, communities and geographic areas.

Characteristics of fast-food/takeaway-food and restaurant/café-food consumers among New Zealand adults

OBJECTIVE

To investigate: (i) the percentage of the New Zealand (NZ) population reporting fast food/takeaway food and restaurant/café food per day; (ii) examine demographic factors associated with their use; (iii) quantify their contribution to energy intake; and (iv) describe the specific types of foods reported from both sources.

DESIGN

Twenty-four hour diet recalls from the cross-sectional 2008/09 NZ Adult Nutrition Survey were used to identify fast-food and restaurant-food consumers.

SETTING

NZ households.

SUBJECTS

Adults aged 15 years and older (n 4721).

RESULTS

Overall 28 % reported consuming at least one fast food and 14 % a restaurant food within the 24 h diet recall. Fast-food consumption was not associated with level of education or an area-based measure of socio-economic status, but a higher education was positively associated with restaurant-food consumption. Individual factors such as ethnicity, household size, age, sex and marital status were found to be important influences on the use of fast food and restaurant food. Fast-food consumption was more prevalent among participants living in urban areas, young adults (19-30 years) and Māori compared with NZ European and Others. The most frequently reported fast foods were bread-based dishes, potatoes (including fries) and non-alcoholic beverages.

CONCLUSIONS

Given the high reported consumption of fast food by young adults, health promotion initiatives both to improve the nutritional quality of fast-food menus and to encourage healthier food choices would likely make a large impact on the overall diet quality of this group.

Total worker health and work-life stress

OBJECTIVE

Review relationships between work-life stress and health behaviors to advance understanding of pathways between occupational and individual risk factors and health and safety outcomes.

METHODS

A background on the Total Worker Health concept is provided, and a review of research on the relationship between work-life stress and health behaviors is presented.

RESULTS

Research evidence indicates that work-life stress serves as a negative occupational exposure relating to poor health behaviors, including smoking, poor food choices, low levels of exercise, and even decreased sleep time.

CONCLUSION

The association between work-life stress and adverse health behaviors suggests that interventions at both the occupational (health protection) and individual (health promotion) level may be helpful in mitigating effects of work-life stress, consistent with the Total Worker Health approach. Further study is needed to investigate gains from an integrated prevention strategy.

Gender role beliefs and fathers’ work-family conflict

Purpose

– The purpose of this paper is to investigate the part that gender roles play in fathers’ work-family experiences. The authors compared two models (gender role as a correlate and as a moderator) and hypothesized that gender role beliefs play an important factor related to fathers’ experiences of work-family conflict.

Design/methodology/approach

– Participants completed an online survey that consisted of questions related to work and family experiences. The final sample consisted of 264 employed, married fathers.

Findings

– Results showed a relationship between traditional gender role beliefs and number of hours spent at work and at home. Additionally, number of work hours was related to time-based work-to-family conflict, but not strain-based work-to-family conflict. The results supported the expectation that work hours mediate the relationship between a father's traditional gender role beliefs and time-based work-to-family conflict.

Research limitations/implications

– Limitations of this study include the use cross-sectional and self-report data. Future research might want to expand the theoretical model to be more inclusive of fathers of more diverse demographic backgrounds, and assess the model with a longitudinal design.

Practical implications

– A key theoretical implication gleaned from the study is that work-family researchers should include the socially constructed variable of gender roles in their work-family research. Findings provide support for the contention that organizations need to ensure that mothers’ and fathers’ unique needs are being met through family-friendly programs. The authors provide suggestions for specific workplace strategies.

Originality/value

– This is one of the first studies that focussed on fathers’ experiences of the work-family interface. The results clarify that traditional gender role beliefs give rise to fathers’ gendered behaviors and ultimately work-family conflict.

The influence of gender, age, education and household size on meal preparation and food shopping responsibilities

OBJECTIVE

To examine the extent to which the gendered division of labour persists within households in the USA in regard to meal planning/preparation and food shopping activities.

DESIGN

Secondary analysis of cross-sectional data.

SETTING

2007-2008 US National Health and Nutrition Examination Survey.

SUBJECTS

Sub-sample of 3195 adults at least 20 years old who had a spouse or partner.

RESULTS

Analyses revealed that the majority of women and men reported they shared in both meal planning/preparing and food shopping activities (meal planning/preparation: women 54 % and men 56 %; food shopping: women 60 % and men 57 %). Results from multinomial logistic regression analyses indicated that, compared with men, women were more likely to take primary responsibility than to share this responsibility and less likely to report having no responsibility for these tasks. Gender differences were observed for age/cohort, education and household size.

CONCLUSIONS

This study may have implications for public health nutritional initiatives and the well-being of families in the USA.