The impact of a rural or urban context in eating awareness and self-regulation strategies in children and adolescents from eight European countries

Facilitators and barriers to healthful eating among adolescents in high-income countries: A mixed-methods systematic review

Adolescent obesity continues to be a public health challenge with poor quality diets contributing to its etiology. As part of the process to plan health promotion and policy interventions, understanding adolescents perceived facilitators and barriers to healthful eating is important. An integrative convergent mixed-methods systematic review was used to synthesize qualitative and quantitative evidence from studies among adolescents aged 10-19 years in high-income countries. Medline, Embase, PsycInfo, and Scopus were searched for peer-reviewed articles published between 2010 and 2023 and exploring adolescents' perspectives on healthful eating and contemporary contextual factors. Transformed quantitative data were integrated with qualitative data. Text was coded into subthemes and themes using an inductive approach. Key facilitators included health and physical appearance; motivation; taste; nutrition knowledge, awareness, and skills; nutrition education access; availability and accessibility of healthful foods; family; and social influences and digital media. Key barriers included taste and cravings for unhealthful foods; mood; lack of motivation, awareness, knowledge, and skills; high availability and low cost of unhealthful foods; peers and social influences; ineffective school policies; high density of fast-food outlets; unhealthful food advertising; digital influences; and time constraints. Social, behavioral, digital, and food environmental factors should be considered from an adolescent perspective in the design of education, health promotion, and policy interventions.

Influence of adolescents' and parental dietary knowledge on adolescents' body mass index (BMI), overweight/obesity in 2004-2015: a longitudinal study

OBJECTIVE

The global epidemic of overweight/obesity in children and adolescents poses a significant public health threat. This longitudinal study aims to investigate the relationship between adolescents' and their parents' dietary knowledge and overweight/obesity among adolescents in China.

METHODS

Data were collected from the China Health and Nutrition Survey (CHNS) in 2004, 2006, 2009, 2011 and 2015. Overweight/obesity was defined according to the International Obesity Task Force (IOTF) cut-off for body mass index (BMI). A set of questions were used to assess the dietary knowledge scores of both adolescents and their parents during face-to-face interviews. Mixed effect models were used to analyze the data.

RESULTS

A total of 2035 adolescents aged 12-17 years were included in the data analysis. The mean BMI increased from 19.2 in 2004 to 20.5 in 2015, with a significant increase in the prevalence of overweight and obesity from 6.8% and 0.5% in 2004 to 15.1% and 7.8% in 2015, respectively. Adolescents with medium-score dietary knowledge were less likely to be overweight/obese compared to those with low-score dietary knowledge (OR (95% CI): 0.20 (0.05-0.80), P < 0.05). However, there was no association between parental dietary knowledge and adolescents' BMI or overweight/obesity (P > 0.05). Additionally, a significant interaction between adolescents' dietary knowledge score and education in relation to adolescents' BMI (P for interaction < 0.05).

CONCLUSION

Adolescents with medium dietary knowledge were less likely to be overweight/obese than those with low knowledge, but no association was found with parental knowledge. Promoting nutritional education and healthy eating habits is vital to prevent overweight/obesity.

Promoting Self-Regulation in Health Among Vulnerable Brazilian Children: Protocol Study

The Health and Education Ministries of Brazil launched the Health in School Program (Programa Saúde na Escola - PSE) in 2007. The purpose of the PSE is two-fold: articulate the actions of the education and health systems to identify risk factors and prevent them; and promote health education in the public elementary school system. In the health field, the self-regulation (SR) construct can contribute to the understanding of life habits which can affect the improvement of individuals' health. This research aims to present a program that promotes SR in health (SRH). This program (PSRH) includes topics on healthy eating and oral health from the PSE; it is grounded on the social cognitive framework and uses story tools to train 5th grade Brazilian students in SRH. The study consists of two phases. In Phase 1, teachers and health professionals participated in a training program on SRH, and in Phase 2, they will be expected to conduct an intervention in class to promote SRH. The participants were randomly assigned into three groups: the Condition I group followed the PSE program, the Condition II group followed the PSRH (i.e., PSE plus the SRH program), and the control group (CG) did not enroll in either of the health promotion programs. For the baseline of the study, the following measures and instruments were applied: Body Mass Index (BMI), Simplified Oral Hygiene Index (OHI-S), Previous Day Food Questionnaire (PFDQ), and Declarative Knowledge for Health Instrument. Data indicated that the majority are eutrophic children, but preliminary outcomes showed high percentages of children that are overweight, obese and severely obese. Moreover, participants in all groups reported high consumption of ultraprocessed foods (e.g., soft drinks, artificial juices, and candies). Oral health data from the CI and CII groups showed a prevalence of regular oral hygiene, while the CG presented good oral hygiene. The implementation of both PSE and PSRH are expected to help reduce health problems in school, as well as the public expenditures with children's health (e.g., Obesity and oral diseases).

Lack of parental rule-setting on eating is associated with a wide range of adolescent unhealthy eating behaviour both for boys and girls

Background

Unhealthy eating habits in adolescence lead to a wide variety of health problems and disorders. The aim of this study was to assess the prevalence of absence of parental rules on eating and unhealthy eating behaviour and to explore the relationships between parental rules on eating and a wide range of unhealthy eating habits of boys and girls. We also explored the association of sociodemographic characteristics such as gender, family affluence or parental education with eating related parental rules and eating habits of adolescents.

Methods

The data on 2765 adolescents aged 13–15 years (mean age: 14.4; 50.7 % boys) from the Slovak part of the Health Behaviour in School-Aged Children (HBSC) study 2014 were assessed. The associations between eating-related parental rules and unhealthy eating patterns using logistic regression were assessed using logistic regression.

Results

Unhealthy eating habits occurred frequently among adolescents (range: 18.0 % reported skipping breakfast during weekends vs. 75.8 % for low vegetables intake). Of all adolescents, 20.5 % reported a lack of any parental rules on eating (breakfast not mandatory, meal in front of TV allowed, no rules about sweets and soft drinks). These adolescents were more likely to eat unhealthily, i.e. to skip breakfast on weekdays (odds ratio/95 % confidence interval: 5.33/4.15–6.84) and on weekends (2.66/2.12–3.34), to report low consumption of fruits (1.63/1.30–2.04) and vegetables (1.32/1.04–1.68), and the frequent consumption of sweets (1.59/1.30–1.94), soft drinks (1.93/1.56–2.38) and energy drinks (2.15/1.72–2.70).

Conclusions

Parental rule-setting on eating is associated with eating behaviours of adolescents. Further research is needed to disentangle causality in this relationship. If causal, parents may be targeted to modify the eating habits of adolescents.

Social support influences on eating awareness in children and adolescents: the mediating effect of self-regulatory strategies

The impact of the social environment on healthy eating awareness results from complex interactions among physical, economic, cultural, interpersonal and individual characteristics. This study investigated the impact of social support and social influence on healthy eating awareness, controlling for socio-economic status, gender and age. Additionally, the mediating effect of self-regulation strategies was examined. A total of 2764 children and adolescents aged 10-17 from four European countries completed self-report measures on healthy eating awareness, social influence and the use of self-regulation strategies. Healthy eating awareness and the use of self-regulation strategies were more likely to occur among younger participants. An interaction between gender and age was related to the use of some self-regulation strategies; compared to girls, boys decreased the use of self-regulation strategies more from pre-adolescence to adolescence. Peer social influence was associated with more unhealthy eating in older participants. Results suggest a need to promote self-regulatory competences among young people in order to assist them with regulating their eating behaviours, especially in the presence of peers. Both school-based interventions and family-based interventions, focusing on self-regulation cognitions and social (peer) influence, could help children and adolescents to use self-regulatory strategies which are essential to eat healthier.