The prediction of preschool children's weight from family environment factors: gender-linked differences

Mealtime emotional climate and child health: A systematic review

BACKGROUND

Positive mealtime emotional climate (MEC) has been linked to better nutrition, psychosocial, literacy and academic outcomes, and fewer behavior problems. However, MEC has been defined in a variety of ways across studies, limiting the ability to synthesize findings and plan future research.

OBJECTIVE

To identify which child characteristics are associated with MEC and to determine how previous studies have measured MEC.

METHODS

We searched three databases (1980-2020) for peer-reviewed articles measuring MEC. Inclusion criteria required at least one child-level outcome related to physical, nutritional, or developmental health; children aged 0-18 years old; and quantitative data using cohort, case-control, intervention, or experimental designs. We used a previously published taxonomy to categorize child/adolescent characteristics as correlates, non-correlates, unclear, or as having insufficient evidence, according to the amount of evidence linking them to MEC. Additionally, we extracted data about the measures and definitions of MEC from each included article.

RESULTS

Out of 668 unique studies identified in the initial search after duplicates removed, 14 met inclusion criteria, and only three used the same measure of MEC. Healthful dietary intake, disordered eating behaviors, and weight/BMI were categorized as correlates of MEC, but links to unhealthy dietary intake are unclear. Several characteristics (e.g. temperament, academic success) were examined in one study only.

CONCLUSIONS

Future research should examine the relationship between MEC and child psychosocial child outcomes and utilize a preschool age group. These findings aid in conceptualizing how MEC has been defined and measured and illuminate the importance of MEC on children's health.

Measurement of screen time among young children aged 0-6 years: A systematic review

The impact of screen-based devices on children's health and development cannot be properly understood without valid and reliable tools that measure screen time within the evolving digital landscape. This review aimed to summarize characteristics of measurement tools used to assess screen time in young children; evaluate reporting of psychometric properties; and examine time trends related to measurement and reporting of screen time. A systematic review of articles published in English across three databases from January 2009 to April 2020 was undertaken using PROSPERO protocol (registration: CRD42019132599) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included articles measured screen time as outcome, exposure, or confounder in children 0-6 years. The search identified 35,868 records, 1035 full-text articles were screened for eligibility, and 622 met inclusion criteria. Most measures (60%) consisted of one to three items and assessed duration of screen time on a usual day. Few measures assessed content (11%) or coviewing (7%). Only 40% of articles provided a citation for the measure, and only 69 (11%) reported psychometric properties-reliability n = 58, validity n = 19, reliability and validity n = 8. Between 2009 and 2019, the number of published articles increased from 28 to 71. From 2015, there was a notable increase in the proportion of articles published each year that assessed exposure to mobile devices in addition to television. The increasing number of published articles reflects increasing interest in screen time exposure among young children. Measures of screen time have generally evolved to reflect children's contemporary digital landscape; however, the psychometric properties of measurement tools are rarely reported. There is a need for improved measures and reporting to capture the complexity of children's screen time exposures.

Weekday-Weekend Sedentary Behavior and Recreational Screen Time Patterns in Families with Preschoolers, Schoolchildren, and Adolescents: Cross-Sectional Three Cohort Study

Background: Excessive recreational screen time (RST) has been associated with negative health consequences already being apparent in preschoolers. Therefore, the aim of this study was to reveal parent-child sedentary behavior, and RST patterns and associations with respect to the gender, age category of children, and days of the week. Methods: Our cross-sectional survey included 1175 parent-child dyads with proxy-reported RST data collected during a regular school week during the spring and fall between 2013 and 2019. The parent-child RST (age and RST) relationship was quantified using Pearson’s (r_P) correlation coefficient. Results: Weekends were characterized by longer RST for all family members (daughters/sons: +34/+33 min/day, mothers/fathers: +43/+14 min/day) and closer parent-child RST associations than on weekdays. The increasing age of children was positively associated with an increase in RST on weekdays (+6.4/+7.2 min per year of age of the daughter/son) and weekends (+5.8/+7.5 min per year of age of the daughter/son). Conclusions: Weekends provide a suitable target for implementation of programs aimed at reducing excessive RST involving not only children, but preferably parent-child dyads.

Systematic review of the relationships between sedentary behaviour and health indicators in the early years (0-4 years)

Background

The purpose of this systematic review was to examine the relationships between sedentary behaviour (SB) and health indicators in children aged 0 to 4 years, and to determine what doses of SB (i.e., duration, patterns [frequency, interruptions], and type) were associated with health indicators.

Methods

Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, 1 month to 4.99 years), intervention/exposure and comparator (durations, patterns, and types of SB), and outcome/health indicator (critical: adiposity, motor development, psychosocial health, cognitive development; important: bone and skeletal health, cardiometabolic health, fitness, risks/harm). The quality of the evidence was assessed by study design and outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

Results

Due to heterogeneity, meta-analyses were not possible; instead, narrative syntheses were conducted, structured around the health indicator and type of SB. A total of 96 studies were included (195,430 participants from 33 countries). Study designs were: randomized controlled trial (n = 1), case-control (n = 3), longitudinal (n = 25), longitudinal with additional cross-sectional analyses (n = 5), and cross-sectional (n = 62). Evidence quality ranged from “very low” to “moderate”. Associations between objectively measured total sedentary time and indicators of adiposity and motor development were predominantly null. Associations between screen time and indicators of adiposity, motor or cognitive development, and psychosocial health were primarily unfavourable or null. Associations between reading/storytelling and indicators of cognitive development were favourable or null. Associations between time spent seated (e.g., in car seats or strollers) or in the supine position, and indicators of adiposity and motor development, were primarily unfavourable or null. Data were scarce for other outcomes.

Conclusions

These findings continue to support the importance of minimizing screen time for disease prevention and health promotion in the early years, but also highlight the potential cognitive benefits of interactive non-screen-based sedentary behaviours such as reading and storytelling. Additional high-quality research using valid and reliable measures is needed to more definitively establish the relationships between durations, patterns, and types of SB and health indicators, and to provide insight into the appropriate dose of SB for optimal health in the early years.

Electronic supplementary material

The online version of this article (10.1186/s12889-017-4849-8) contains supplementary material, which is available to authorized users.

Associations between adverse childhood experiences, student-teacher relationships, and non-medical use of prescription medications among adolescents

OBJECTIVE

Few studies have investigated associations between adverse childhood experiences (ACE) and nonmedical use of prescription medication (NMUPM) in population-based samples of adolescents, and even fewer have examined whether promotive factors might buffer these effects. The present study assesses the direct effects of ACE and positive student-teacher relationships on NUMPD and whether positive student-teacher relationships moderate this association.

DESIGN

Data were from the 2013 Minnesota Student Survey (MSS), an in-school survey administered every three years to students throughout Minnesota. The analytic sample (n=104,332) was comprised of 8th, 9th, and 11th graders.

RESULTS

Approximately 3% of students acknowledged past year NMUPM, the majority of whom reported at least one ACE. The most frequently used prescription drug was Ritalin/ADHD medications (1.71%) followed by opiate-based painkillers (1.67%), tranquilizers (0.92%), and stimulants (0.75%). Students who reported any use tended to use more than one medication. For every additional ACE, there was a 56%, 51%, 47%, and 52% increase in the odds of past year stimulant use, ADHD medication, pain reliever, and tranquilizer use, respectively. The estimated rate of the number of prescription drugs used increased by 62% for every additional ACE. Positive student- teacher relationships buffered the association between ACE and NMUPD, especially at higher levels of ACEs.

CONCLUSION

Our findings have important implications for prevention work. Training educators to recognize trauma symptomology and cultivating strong student-teacher relationships are important considerations for future school-based substance use prevention initiatives.

Association between maternal lifestyle and preschool nutrition

Introduction:

Many of the health behaviors involved in the emergence of chronic non-communicable diseases (CNCD) are originated in childhood under parental influence. Mothers are the ones most involved in the education and health care of children. Lifestyle (LS) is a social determinant of health. Very few studies tried to understand the influence of maternal LS on child nutrition.

Objective:

To verify the association between maternal behavioral and non-behavioral LS and nutritional aspects in preschool children.

Method:

From January 2010 to December 2010, we performed a cross-sectional study with 255 mothers of preschool children who were residents of five different sub-districts in southwestern São Paulo. A proportional stratified random sample was selected using two layers ("schools" and "children"). From the mother, sociodemographic and LS information were collected. From the child, data on anthropometry, sedentary behavior and food intake were collected. The association was calculated using chi-square test and logistic regression.

Results:

Children who ate minimally processed food were born from mothers with more socially aware non-behavioral LS, while children that ate more processed food were born from mothers with more consumerist non-behavioral LS. No association was found between nutritional characteristics of preschoolers and types of maternal behavioral LS. Children presenting "sedentary behavior" and the habit of eating "ultra-processed foods" had 113% and 84% higher chances, respectively, of being born to mothers that belonged to the "consumerist" cluster.

Conclusion:

Mothers living a consumerist lifestyle can promote negative influences on child nutrition.

Family Resiliency: A Neglected Perspective in Addressing Obesity in Young Children

BACKGROUND

Traditional research primarily details child obesity from a risk perspective. Risk factors are disproportionately higher in children raised in poverty, thus negatively influencing the weight status of low-income children. Borrowing from the field of family studies, the concept of family resiliency might provide a unique perspective for discussions regarding childhood obesity, by helping to identify mediating or moderating protective mechanisms that are present within the family context.

METHODS

A thorough literature review focusing on (1) components of family resiliency that could be related to childhood obesity and (2) factors implicated in childhood obesity beyond those related to energy balance was conducted. We then conceptualized our perspective that understanding resiliency within an obesogenic environment is warranted.

RESULTS

Both family resiliency and childhood obesity prevention rely on the assumptions that (1) no one single answer can address the multifactorial nature involved with adopting healthy lifestyle behaviors and (2) the pieces in this complex puzzle will differ between families. Yet, there are limited holistic studies connecting family resiliency measures and childhood obesity prevention. Combining mixed methodology using traditional measures (such as general parenting styles, feeding styles, and parent feeding behaviors) with potential family resiliency measures (such as family routines, family stress, family functioning, and family structure) might serve to broaden understanding of protective strategies.

CONCLUSIONS

The key to future success in child obesity prevention and treatment may be found in the application of the resiliency framework to the exploration of childhood obesity from a protective perspective focusing on the family context.

Oral Fat Sensing and CD36 Gene Polymorphism in Algerian Lean and Obese Teenagers

Growing number of evidences have suggested that oral fat sensing, mediated by a glycoprotein CD36 (cluster of differentiation 36), plays a significant role in the development of obesity. Indeed, a decreased expression of CD36 in some obese subjects is associated with high dietary fat intake. In the present study, we examined whether an increase in body mass index (BMI) is associated with altered oleic acid lingual detection thresholds and blood lipid profile in young Algerian teenagers (n = 165). The obese teenagers (n = 83; 14.01 ± 0.19 years; BMI z-score 2.67 ± 0.29) exhibited higher lingual detection threshold for oleic acid than lean participants (n = 82, 13.92 ± 0.23 years; BMI z-score 0.03 ± 0.0001). We also studied the association between rs1761667 polymorphism of CD36 gene and obesity. The AA and AG genotypes were more frequent in obese teenagers, whereas GG genotype was more common in lean participants. The A-allele frequency was higher in obese teenagers than that in lean children. We report that rs1761667 polymorphism of CD36 gene and oro-gustatory thresholds for fat might play a significant role in the development of obesity in young teenagers.

Gender differences in home environments related to childhood obesity in Nanchang, China

BACKGROUND

Childhood obesity is rapidly increasing in China, with rates doubling between 2000 and 2010. Several large, epidemiological studies have shown boys to be consistently more likely to be obese than girls. The aim of this study was to investigate gender differences in the home environment and parenting practices related to childhood obesity.

METHODS

A cross-sectional survey using a convenience sampling of 522 (86.1% response rate) primary caregivers of children ages 2-10 years was conducted in four locations in Nanchang, China, in the spring of 2013 using face-to-face, anonymous questionnaires.

RESULTS

Boys were significantly (p<0.05) more likely than girls to watch more television (TV) per week, be allowed to have snacks/sweets or soft drinks without permission, and to have sugary drinks at snacks and meals. Girls were significantly more likely than boys to have parental encouragement and support for physical activity, participate in organized sports/group activities, and have fresh fruits accessible. Parents also believed that boys eat too much junk foods or their favorite foods if not controlled. Few differences were noted in the actual physical environment in the home, including access to sports equipment, junk food availability, and access to media.

CONCLUSIONS

RESULTS indicate that parents tend to be more permissive with boys than girls, allowing them access to unhealthy foods and more TV time. These differences may contribute to the higher prevalence of obesity in boys in China.

Come and get it! A discussion of family mealtime literature and factors affecting obesity risk

The L.E.A.D. (Locate, Evaluate, and Assemble Evidence to Inform Decisions) framework of the Institute of Medicine guided the assembly of transdisciplinary evidence for this comprehensive, updated review of family meal research, conducted with the goal of informing continued work in this area. More frequent family meals are associated with greater consumption of healthy foods in children, adolescents, and adults. Adolescents and children who consume fewer family meals consume more unhealthy food. School-aged children and adolescents who consume more family meals have greater intakes of typically underconsumed nutrients. Increased family meal frequency may decrease risk of overweight or obesity in children and adolescents. Frequent family meals also may protect against eating disorders and negative health behaviors in adolescents and young adults. Psychosocial benefits include improved perceptions of family relationships. However, the benefits of having a family meal can be undermined if the family consumes fast food, watches television at the meal, or has a more chaotic atmosphere. Although these findings are intriguing, inconsistent research methodology and instrumentation and limited use of validation studies make comparisons between studies difficult. Future research should use consistent methodology, examine these associations across a wide range of ages, clarify the effects of the mealtime environment and feeding styles, and develop strategies to help families promote healthful mealtime habits.

Measuring parent food practices: a systematic review of existing measures and examination of instruments

During the last decade, there has been a rapid increase in development of instruments to measure parent food practices. Because these instruments often measure different constructs, or define common constructs differently, an evaluation of these instruments is needed. A systematic review of the literature was conducted to identify existing measures of parent food practices and to assess the quality of their development. The initial search used terms capturing home environment, parenting behaviors, feeding practices and eating behaviors, and was performed in October of 2009 using PubMed/Medline, PsychInfo, Web of knowledge (ISI), and ERIC, and updated in July of 2012. A review of titles and abstracts was used to narrow results, after which full articles were retrieved and reviewed. Only articles describing development of measures of parenting food practices designed for families with children 2-12 years old were retained for the current review. For each article, two reviewers extracted data and appraised the quality of processes used for instrument development and evaluation. The initial search yielded 28,378 unique titles; review of titles and abstracts narrowed the pool to 1,352 articles; from which 57 unique instruments were identified. The review update yielded 1,772 new titles from which14 additional instruments were identified. The extraction and appraisal process found that 49% of instruments clearly identified and defined concepts to be measured, and 46% used theory to guide instrument development. Most instruments (80%) had some reliability testing, with internal consistency being the most common (79%). Test-retest or inter-rater reliability was reported for less than half the instruments. Some form of validity evidence was reported for 84% of instruments. Construct validity was most commonly presented (86%), usually with analysis of associations with child diet or weight/BMI. While many measures of food parenting practices have emerged, particularly in recent years, few have demonstrated solid development methods. Substantial variation in items across different scales/constructs makes comparison between instruments extremely difficult. Future efforts should be directed toward consensus development of food parenting practices constructs and measures.

Television viewing associated with adverse dietary outcomes in children ages 2-6

The aim of this paper was to systematically review the evidence for the association between television viewing and diet in children ages 2-6. Data sources included PubMed, PsycINFO, EMBASE, ERIC, SportDISCUS, Sociological Abstracts, Web of Science and hand searches of reference lists of relevant articles. Twelve studies were reviewed in which the relationship between television viewing and diet was assessed in children between the ages of 2 and 6. All but one study reported significant relationship between television viewing time and adverse dietary outcomes. Parent-reported television viewing time was used to assay child television viewing in all included studies. Food frequency survey was the most frequent method of dietary assessment, and parent served as proxies for children in all studies. Lower fruit and/or vegetable intake was the most frequently reported dietary outcome, followed by increased energy intake with increased television viewing. The majority of studies reported adverse dietary outcomes with as little as 1 h of daily television exposure. While these results are consistent with recommendations from child health advocates to limit television viewing in young children, they also suggest that further efforts to limit television viewing in young children may be needed to aid in obesity prevention.