Socio-demographic differences in food habits and preferences of school adolescents in Jiangsu Province, China

Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review

Objectives

To review associations between the family environment and young people’s fruit and vegetable consumption.

Design

A systematic review. Published English-language (n60) papers were identified using electronic databases and manual searches of personal files and reference lists. Observational research reporting a measure of fruit/vegetable intake for children (aged 6–11 years) and/or adolescents (aged 12–18 years) and at least one potential family correlate of dietary intake was included.

Results

Parental modelling and parental intake were consistently and positively associated with children’s fruit and fruit, juice and vegetable (FJV) consumption. There were also positive associations between home availability, family rules and parental encouragement and children’s fruit and vegetable consumption. Parental intake was positively associated with adolescents’ fruit and vegetable consumption. There were also positive associations between parental occupational status and adolescent fruit consumption and between parental education and adolescents’ FJV consumption.

Conclusions

Our findings highlight the importance of targeting the family environment for the promotion of healthy eating behaviours among children and adolescents. Future interventions should encourage parents to be positive role models by targeting parental intake and to create a supportive home environment through increased encouragement and availability of fruits and vegetables and employing rules to govern eating behaviours. For adolescents, indicators of family circumstances (e.g. parental education) should be used to identify target groups for interventions aimed at promoting healthy eating.

Cross-cultural differences in the macronutrient intakes of women with anorexia nervosa in Australia and Singapore

AIM

To compare the macronutrient intakes of women with and without anorexia nervosa (AN) across cultures.

METHOD

Participants were women with AN (n = 39) and without AN (n = 89) of North European and East Asian backgrounds recruited in Australia and Singapore. Energy and the percentage energy contributed by protein (%protein), fat (%fat) and carbohydrate (%CHO) were assessed from participant's diet histories and analysed in terms of cultural group, acculturation, socio-economic status (SES) and education level.

RESULTS

AN status was associated with lower energy and higher %CHO. Greater %protein was associated with greater acculturation to Western culture and lower SES, but not AN. Greater %fat was associated with lower SES and lower acculturation in women with AN, but with higher acculturation in controls. Greater %CHO was also associated with higher SES.

CONCLUSION

The findings may represent Western diets' higher protein and fat contents, 'Western' knowledge of weight-loss diets, and affordability of low fat foods.

Understanding eating behaviours in Spanish women enrolled in a weight-loss treatment

AIM

To identify the beliefs and attitudes of a sample of obese and overweight Spanish women undertaking a weight-loss treatment.

BACKGROUND

Obesity is a global epidemic. Weight-loss treatments focus on changing eating behaviours; however, many patients fail to adhere to the diet. This suggests that more effective behaviour-change interventions are required to help people change their eating behaviours. According to the theory of planned behaviour (TPB) human behaviour is influenced by beliefs. Identification of people's beliefs is an essential step in the design of behaviour-change interventions.

DESIGN

A qualitative approach was employed using semi-structured interviews to interview participants. Seventeen obese and overweight Spanish women enrolled in a weight-loss treatment were recruited using a criterion sample strategy.

FINDINGS

Participants' reported beliefs referring to the benefits of losing weight and the emotions related to dieting. The more positive these beliefs were the more positive their attitude towards the diet seemed to be. Findings highlight the importance of follow-ups in creating a subjective norm to maintain a diet. Perceived behavioural control to diet seemed to be related to beliefs about social support; whereas beliefs about lack of willpower to overcome temptations seemed to decrease perceived control over eating behaviours.

CONCLUSIONS

Participants reported several beliefs and attitudes that offer plausible explanations of their eating behaviours. Data from this study seemed to fit the propositions of the TPB and could be used in further research to develop effective eating behaviour-change interventions.

RELEVANCE TO CLINICAL PRACTICE

Nurses could use the TPB to assess individuals' attitudes, beliefs and expectations when following a diet. That assessment would provide insight into what aspects are relevant for individual patients when dieting, which could lead to more effective diet behaviour-change interventions being designed.

Relationships between physical activity, obesity and meal frequency in adolescents

OBJECTIVE

The purpose of this study was to assess the associations and impact of increased meal frequency, physical activity and 'skipping' breakfast on obesity levels in a sample of urban adolescents, aged 13-17 years old, from Porto, Portugal.

METHODS

Overweight and obesity were defined according to age- and sex-specific BMI cut-points. Daily meal frequency was assessed by questionnaire. Self-reported physical activity was recalled.

RESULTS

The proportion of overweight/obese girls (p < or = 0.05) and boys (p < or = 0.001) that consumed fewer than three meals was significantly higher than those reported from normal-weight counterparts. While no statistically significant differences were reported in girls, obese boys skipped breakfast significantly more (13% vs 5.6%; p < or = 0.05) than normal-weight counterparts did. Normal-weight boys but not girls were significantly more active (p < or = 0.01) than obese peers. An additional meal in boys (OR: 2.75; p < or = 0.05) and girls (OR: 1.97; p < or = 0.05) reduced the risk of being overweight/obese. Regardless of gender, breakfast skipping is not seen as a predictor of being overweight/obese. However, boys (OR: 2.10; p < 0.003), but not girls, who were moderately active were more likely to be of normal weight.

CONCLUSION

The data indicate that increased meal frequency may have a beneficial effect on a reduced BMI. Physical activity and breakfast skipping may be candidate targets for prevention programmes aimed at reducing overweight/obesity among adolescents.

Children's body mass index and nutrition intake in HIV/AIDS

HIV/AIDS in China poses many challenges for caregivers and their children. A total of 154 caregivers of HIV/AIDS-affected families were interviewed to examine the children's nutrition intake and body mass index (BMI) in the context of HIV/AIDS in the family. The results showed that 25% of children in HIV/AIDS-affected families were underweight or at risk of being underweight according to US criteria. More than half the children reported that their consumption of protein such as meat, eggs or milk ranged from not at all to two times during the past month. About 40% of the children sometimes or often went hungry due to insufficient food. The study findings underscore the need to improve the nutrition and general health of children of people living with HIV/AIDS.

Convergence of obesity and high glycemic diet on compounding diabetes and cardiovascular risks in modernizing China: an emerging public health dilemma

As China is undergoing dramatic development, it is also experiencing major societal changes, including an emerging obesity epidemic, with the prevalence of overweight and obesity doubling in the past decade. However, the implications of a high glycemic index (GI) and glycemic load (GL) traditional Chinese diet are adversely changing in modern times, as a high-glycemic diet is becoming a greater contributor to diabetes and cardiovascular risks in a population with rising obesity and decreasing physical activity. Specifically, a high GI diet adversely impacts metabolism and appetite control regulation, and notably confers substantially greater risk of weight gain, type 2 diabetes, cardiovascular disease, and certain cancers among overweight and obese individuals (P<0.05 for all); leading to an emerging vicious cycle of compounding adverse health risks. Notably, while no elevated risk of cardiovascular disease and type 2 diabetes were observed with higher GL intake among normal weight individuals, among overweight individuals, higher GL was strongly associated with higher risk of coronary heart disease (RR=2.00, 95%CI: 1.31-2.96), stroke (RR=2.13, 1.28-3.53), and type 2 diabetes (RR=1.52, 1.22-1.89 among Chinese). Additionally, the influx of Western-diets rich in saturated fats and high-glycemic sugar-sweetened beverages also threaten the health of the population. This review highlights the emerging adverse convergence of a high-glycemic Asian diet with a Chinese society experiencing an emerging obesity epidemic, and the important implications of these combined factors on compounding cardiometabolic risks. Potential policy directions in China are also discussed.

The Influence of Sociodemographic Factors on Patterns of Fruit and Vegetable Consumption in Canadian Adolescents

BACKGROUND

Poor dietary habits may increase risk for obesity and chronic diseases among Canadian adolescents.

OBJECTIVES

The aims of the present study were to: (a) establish the patterns of fruit and vegetable intake by Canadian adolescents, and (b) identify the impact of sociodemographic factors-including age, household income, household education, ethnicity, living arrangement, and location-on the pattern of fruit and vegetable intake in this population.

DESIGN

This is a cross-sectional study using the data from the Canadian Community Health Survey, Cycle 2.1, Public Use File. The survey used questions similar to a food frequency questionnaire.

METHODS

Total fruit and vegetable intake of 18,524 Canadian adolescents (12 to 19 years old) was cross-tabulated between two age groups (12 to 14 years old [n=7,410] and 15 to 19 years old [n=11,114]) by sex, level of household education, total household income, ethnicity, living arrangement, and geographical location.

RESULTS

The data revealed that a 38.3% of Canadian adolescents in this study consumed fruits and vegetables five to 10 times per day; fewer older adolescents (15- to 19-year-olds) reported eating fruits and vegetables at that frequency as compared with the younger subgroup (12- to 14-year-olds) (P<0.001). Household education and income independently had a significant (P<0.001) positive impact on fruit and vegetable consumption. Females reported a significantly (P<0.05) higher frequency of intake than did males. Adolescents living in homes with only one parent reported a significantly (P<0.005) lower frequency of intake, as compared with adolescents living with two parents.

CONCLUSIONS

These results may help to identify adolescent groups at risk for poor eating habits and support the implementation of programs to encourage higher fruit and vegetable intakes.

Perceptions of weight and associated factors of adolescents in Jiangsu Province, China

Objective

To describe perceptions of weight of adolescents and associated factors.

Design

Cross-sectional survey in 2002.

Setting

Eight public middle schools in two distinct socio-economic areas of Jiangsu Province, China.

Subjects

Eight hundred and twenty-four adolescents (aged 12–14 years) and 628 of their parents.

Methods

Self-administered questionnaires for students and their parents were used to collect the data. Height and weight of the students were measured.

Results

One-third of the girls perceived themselves as overweight, while only 8.9% were actually overweight or obese according to the World Health Organization definition. On the other hand, 15.0% of the girls considered themselves underweight, while 5.6% were underweight according to the definition. Among the boys, one-fifth of those defined as overweight perceived their weight as normal. Furthermore, 23.9% perceived themselves as underweight when in fact only 4.9% were classified as underweight according to the definition. About one-quarter of the students dieted in the past year. Adolescents who perceived themselves to be overweight dieted and skipped breakfast more often. They also had lower intake frequencies of animal foods, Western foods and milk/yoghurt. No disparity was observed in the intake frequency of fruits and vegetables between the groups of different weight perception. Parents' weight norms seemed to favour overweight in both genders, but especially among boys.

Conclusions

Both overweight and underweight concerns were common among girls, while a higher body weight was favoured by normal-weight boys and their parents. Distorted weight perceptions in adolescents, as well as dieting, are problems that need appropriate intervention.

Physical activity and associated socio-demographic factors among school adolescents in Jiangsu Province, China

BACKGROUND

Obesity prevalence is increasing among adolescents in China, especially in urban areas and among higher socio-economic strata. Physical inactivity may be one of the causes. We examined socio-demographic differences in physical activity among school adolescents in Jiangsu Province.

METHODS

In 2002, 824 adolescents (12-14 years) in 8 schools filled in a self administered questionnaire on physical activity, sedentary behaviors and socio-demographic characteristics. RESULTS.: In girls, low SES elicited the highest physical activity score, mainly derived from housework. More boys (49.1%) than girls (41%) had vigorous physical activity (VPA) >or=3 times/week. Associations between VPA and residence, age, SES were not significant. 88% of the adolescents were actively commuting to schools. Boys with high SES or high education fathers had the lowest percentage walking to school. The students spent daily on average 10.8 h on studying, however, little time was spent on watching TV or playing PC games.

CONCLUSIONS

Active commuting to school was common among the adolescents. However, the sedentary activity level is high. Physical activity was negatively associated with SES.

Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: Quantitative studies

BACKGROUND

In order to more effectively promote fruit and vegetable intake among children and adolescents, insight into determinants of intake is necessary. We conducted a review of the literature for potential determinants of fruit and vegetable intake in children and adolescents.

METHODS

Papers were identified from Medline and PsycINFO by using all combinations of the search terms: "fruit(s) or vegetable(s)" and "children or adolescents". Quantitative research examining determinants of fruit and/or vegetable intake among children and adolescents aged 6-18 years were included. The selection and review process was conducted according to a four-step protocol resulting in information on country, population, design, methodology, theoretical basis, instrument used for measuring intake, statistical analysis, included independent variables, and effect sizes.

RESULTS

Ninety-eight papers were included. A large number of potential determinants have been studied among children and adolescents. However, for many presumed determinants convincing evidence is lacking, mostly because of paucity of studies. The determinants best supported by evidence are: age, gender, socio-economic position, preferences, parental intake, and home availability/accessibility. Girls and younger children tend to have a higher or more frequent intake than boys and older children. Socio-economic position, preferences, parental intake, and home availability/accessibility are all consistently positively associated with intake.

CONCLUSION

The determinants most consistently supported by evidence are gender, age, socio-economic position, preferences, parental intake and home availability/accessibility. There is a need for internationally comparative, longitudinal, theory-based and multi-level studies taking both personal and environmental factors into account. This paper is published as part of the special Pro Children series in the International Journal of Behavioral Nutrition and Physical Activity. Please see [http://www.ijbnpa.org/content/3/1/26] for the relevant editorial.