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Louey J, He J, Partridge SR, Allman-Farinelli M. Facilitators and barriers to healthful eating among adolescents in high-income countries: A mixed-methods systematic review. Obes Rev 2024:e13813. [PMID: 39147385 DOI: 10.1111/obr.13813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 08/17/2024]
Abstract
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.
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Affiliation(s)
- Jennifer Louey
- Nutrition and Dietetics, Sydney School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jingju He
- Nutrition and Dietetics, Sydney School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie R Partridge
- Nutrition and Dietetics, Sydney School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- Nutrition and Dietetics, Sydney School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Cai Z, Jiang K, Wang T, Li S, Xian J, Zhao Y, Shi Z. Influence of adolescents' and parental dietary knowledge on adolescents' body mass index (BMI), overweight/obesity in 2004-2015: a longitudinal study. Arch Public Health 2023; 81:188. [PMID: 37872636 PMCID: PMC10591379 DOI: 10.1186/s13690-023-01197-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023] Open
Abstract
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.
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Affiliation(s)
- Zhengjie Cai
- School of Public Health, Chongqing Medical University, Chongqing, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ke Jiang
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Tiankun Wang
- Department of Clinical Nutrition, West China Second Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China
| | - Shengping Li
- Department of Children Healthcare, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jinli Xian
- The Department of clinical nutrition, Mianyang Central Hospital, Mianyang, China
| | - Yong Zhao
- School of Public Health, Chongqing Medical University, Chongqing, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Child Nutrition and Health, Children's Hospital of Chongqing Medical University, Chongqing, China.
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, 2713, Qatar
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Mattos LB, Mattos MB, Barbosa APO, Bauer MDS, Strack MH, Rosário P, Reppold CT, Magalhães CR. Promoting Self-Regulation in Health Among Vulnerable Brazilian Children: Protocol Study. Front Psychol 2018; 9:651. [PMID: 29867636 PMCID: PMC5949717 DOI: 10.3389/fpsyg.2018.00651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 04/16/2018] [Indexed: 12/02/2022] Open
Abstract
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).
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Affiliation(s)
- Luciana B Mattos
- Education and Humanities Department, Federal University Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Marina B Mattos
- Education and Humanities Department, Federal University Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Ana P O Barbosa
- Education and Humanities Department, Federal University Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Mariana da Silva Bauer
- Education and Humanities Department, Federal University Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Maina H Strack
- Education and Humanities Department, Federal University Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Pedro Rosário
- Department of Applied Psychology, School of Psychology, University of Minho, Braga, Portugal
| | - Caroline T Reppold
- Department of Psychology, Federal University Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Cleidilene R Magalhães
- Education and Humanities Department, Federal University Health Sciences of Porto Alegre, Porto Alegre, Brazil
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Holubcikova J, Kolarcik P, Madarasova Geckova A, van Dijk JP, Reijneveld SA. Lack of parental rule-setting on eating is associated with a wide range of adolescent unhealthy eating behaviour both for boys and girls. BMC Public Health 2016; 16:359. [PMID: 27117062 PMCID: PMC4847241 DOI: 10.1186/s12889-016-3002-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 04/06/2016] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Jana Holubcikova
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia. .,Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.
| | - Peter Kolarcik
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.,Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.,Olomouc University Society and Health Institute, Palacky University Olomouc, Křížkovského 8, 771 47, Olomouc, Czech Republic
| | - Andrea Madarasova Geckova
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.,Department of Health Psychology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.,Olomouc University Society and Health Institute, Palacky University Olomouc, Křížkovského 8, 771 47, Olomouc, Czech Republic
| | - Jitse P van Dijk
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.,Olomouc University Society and Health Institute, Palacky University Olomouc, Křížkovského 8, 771 47, Olomouc, Czech Republic.,Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, Netherlands
| | - Sijmen A Reijneveld
- Graduate School Kosice Institute for Society and Health, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11, Kosice, Slovakia.,Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, Netherlands
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Gaspar de Matos M, Palmeira AL, Gaspar T, De Wit JBF, Luszczynska A. Social support influences on eating awareness in children and adolescents: the mediating effect of self-regulatory strategies. Glob Public Health 2015; 11:437-48. [PMID: 26564992 DOI: 10.1080/17441692.2015.1094106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
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.
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Affiliation(s)
- Margarida Gaspar de Matos
- a Institute for Environmental Health , University of Lisbon , Lisbon , Portugal.,b Faculty of Human Kinetics , University of Lisbon , Lisbon , Portugal.,c William James Center for Research , Instituto Superior de Psicologia Aplicada , Lisbon , Portugal
| | - Antonio L Palmeira
- d Faculty of Physical Education and Sports , Lusofona University , Lisbon , Portugal.,e Interdisciplinary Centre for the Study of Human Performance , University of Lisbon , Lisbon , Portugal
| | - Tania Gaspar
- b Faculty of Human Kinetics , University of Lisbon , Lisbon , Portugal.,f School of Psychology , Lusiada University , Lisbon , Portugal.,g Institute for Environmental Health , University of Lisbon , Lisbon , Portugal
| | - John B F De Wit
- h Centre for Social Research in Health , University of New South wales , Sydney , Australia.,i Department of Social and Organizational Psychology , Utrecht University , Utrecht , The Netherlands
| | - Aleksandra Luszczynska
- j Department in Wroclaw , University of Social Sciences and Humanities , Wroclaw , Poland.,k Trauma, Health & Hazards Center , University of Colorado , Colorado Springs , CO , USA
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