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Song S, Tabares E, Ishdorj A, Crews M, Dave J. The Quality of Lunches Brought from Home to School: A Systematic Review and Meta-Analysis. Adv Nutr 2024:100255. [PMID: 38876395 DOI: 10.1016/j.advnut.2024.100255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/13/2024] [Accepted: 06/07/2024] [Indexed: 06/16/2024] Open
Abstract
This systematic review and meta-analysis, spanning studies published between 1995 and 2021, investigates various aspects of lunches brought from home (LBFH) to school by children. These meals, in contrast to those provided by the National School Lunch Program (NSLP), lack strict nutritional standards. Despite the availability of NSLP lunches, ∼40% of US children opt for LBFH. This review aims to assess the food content and nutritional quality of LBFH, their adherence to NSLP standards in terms of nutrition and cost, effectiveness of intervention programs designed to enhance their nutritional quality and parental and student perceptions of LBFH. The comprehensive literature search yielded 28 eligible papers, with 16 included in meta-analysis. LBFH commonly include fruits (50%), yet vegetables (17%) and dairy (25%) are less prevalent. They frequently contain snacks (50%), sweets (48%), and sugar-sweetened beverages (31%). Compared with school lunches, LBFH exhibit lower levels of calcium, protein, iron, fiber, and vitamin A, and higher levels of carbohydrates and saturated fat. Intervention programs had no effect on quality of LBFH. On average, LBFH ($1.81) cost slightly less than lunches served at school ($1.98), without accounting for free/reduced-price meals in the calculation. The cost of school lunch for pre-k and kindergarten children became $11.32, nearly 4 times higher than that of LBFH ($2.92), after replicating the meal at home and accounting for meal preparation time. Parents preferred LBFH over school lunches because of concerns related to the quality of school meals served. This study concludes that LBFH are generally less nutritious compared with lunches provided by NSLP. Future research needs to further explore ways to improve parent perception of NSLP. Especially with many states making free meals available to all children, identifying effective ways in promoting and increasing NSLP participation can ensure more children have access to nutritionally balanced and affordable lunches.
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Affiliation(s)
- Siwan Song
- Department of Agricultural and Applied Economics, University of Wisconsin-Madison, Madison, WI, United States.
| | - Elizabeth Tabares
- Norman Borlaug Institute for International Agriculture and Development, Texas A&M University, College Station, TX, United States
| | - Ariun Ishdorj
- Norman Borlaug Institute for International Agriculture and Development, Texas A&M University, College Station, TX, United States; Department of Agricultural Economics, Texas A&M University, College Station, TX, United States
| | - Molly Crews
- School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Jayna Dave
- USDA/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
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Wolfson JA, Martinez-Steele E, Tucker AC, Leung CW. Greater Frequency of Cooking Dinner at Home and More Time Spent Cooking Are Inversely Associated With Ultra-Processed Food Consumption Among US Adults. J Acad Nutr Diet 2024:S2212-2672(24)00113-8. [PMID: 38462128 DOI: 10.1016/j.jand.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/28/2023] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Cooking at home has been promoted as a strategy to improve diet quality; however, the association between cooking behavior and ultra-processed food intake is unknown. OBJECTIVE The objective of this study was to examine associations between frequency of cooking dinner at home and time spent cooking dinner with ultra-processed food intake. DESIGN Cross-sectional, nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey were analyzed. PARTICIPANTS/SETTING Participants were 9,491 adults (20 years and older) in the United States. MAIN OUTCOME MEASURES The main outcome measure was the proportion of energy intake (averaged from two 24-hour dietary recalls) from the following 4 Nova food-processing groups: (1) unprocessed or minimally processed foods, (2) processed culinary ingredients, (3) processed foods, and (4) ultra-processed foods. STATISTICAL ANALYSES PERFORMED Separate linear regression models examined associations between cooking frequency and time spent cooking dinner and proportion of energy intake from the 4 Nova food-processing groups, adjusting for sociodemographic characteristics and total energy intake. RESULTS Ultra-processed foods comprised >50% of energy consumed independent of cooking frequency or time spent cooking. Higher household frequency of cooking dinner and greater time spent cooking dinner were both associated with lower intake of ultra-processed foods (P trends < .001) and higher intake of unprocessed or minimally processed foods (P trends < .001) in a dose-response manner. Compared with cooking 0 to 2 times/wk, adults who cooked dinner 7 times/wk consumed a mean of 6.30% (95% CI -7.96% to -4.64%; P < .001) less energy from ultra-processed foods. Adults who spent more than 90 minutes cooking dinner consumed 4.28% less energy from ultra-processed foods (95% CI -6.08% to -2.49%; P < .001) compared with those who spent 0 to 45 minutes cooking dinner. CONCLUSIONS Cooking at home is associated with lower consumption of ultra-processed foods and higher consumption of unprocessed or minimally processed foods. However, ultra-processed food intake is high among US adults regardless of cooking frequency.
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Affiliation(s)
- Julia A Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Policy and Management, Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Euridice Martinez-Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Anna Claire Tucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Fernandez MA, Maximova K, Fulkerson JA, Raine KD. Associations between cooking skills, cooking with processed foods, and health: a cross-sectional study. Appl Physiol Nutr Metab 2024; 49:330-339. [PMID: 37931241 DOI: 10.1139/apnm-2023-0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
To improve health outcomes, home cooking has been suggested as a solution to reduce intakes of processed foods. However, little is known about how cooking skills or cooking with processed foods influence health. This cross-sectional study examined associations between diet and health outcomes with cooking skills and cooking with processed foods. The dataset included a nationally representative sample of 18 460 adults from Canadian Community Health Survey (CCHS) annual component rapid response modules on food skills. In the CCHS rapid response modules, diet and health outcomes (fruit and vegetable intake, general health, mental health, and obesity) and data related to cooking skills and cooking with processed foods were collected through self-report. Separate logistic regression models were fitted for each outcome, controlling for age, income, and education, and stratified by sex. Adults with poor cooking skills were less likely to have adequate fruit and vegetable intake (≥5 servings per day) (p < 0.001), very good general health (p < 0.001) or mental health (p < 0.001), and obesity (p = 0.02) compared to advanced cooking skills. Adults who cooked with highly processed foods were less likely to have adequate fruit and vegetable intake (p < 0.001), very good general health (p = 0.002) or mental health (p < 0.001), but more likely to have obesity (p = 0.03) compared to cooking with minimally processed foods. Cooking skills alone appear insufficient to protect against obesity. Results suggest that not only are cooking skills important, but the quality of ingredients also matter. Limiting the use of processed foods in addition to improving cooking skills are potential intervention targets to promote better health and diet outcomes.
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Affiliation(s)
- Melissa A Fernandez
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON, Canada
- School of Public Health, University of Alberta, Edmonton, AB, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Katerina Maximova
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Nirmala IR, Februhartanty J, Agustina R, Sekartini R. Cooking behavior among mothers of children aged 2-5 years old in Kendari, Southeast Sulawesi, Indonesia. BMC Public Health 2024; 24:391. [PMID: 38321429 PMCID: PMC10848546 DOI: 10.1186/s12889-024-17826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Cooking at home was associated with parental feeding practices. This study aimed to explore the interplay of components in cooking behavior of mothers with young children aged 2-5 years old in Kendari city of Southeast Sulawesi, Indonesia. METHODS This qualitative study involved 33 mothers from Kendari city, which was represented by each two sub-districts in coastal and mainland areas that were randomlyselected. Six focus group discussions (FGDs) were carried out using 20-item guide questions. The guide questions were developed following the Model of Goal-Directed Behavior (MGDB) theory approach exploring the components of cooking behavior i.e., skill, intention, desire, confidence, and attitude in cooking. Data analysis was performed in the field to assist decision on data saturation, followed by data analysis at desk through multilevel coding from the verbatim transcripts using NVivo R1 software. The data was analyzed thematically using pre-determined themes according to the MGDB theory. Emerging topics on enabling factors and constraints were captured to enhance our understanding of the complexity of cooking behavior. RESULTS The mothers' mean age was about 30 years old with a comparable representation of younger and older mothers. Most mothers were housewives and accomplished secondary school level. The mothers' intention was shown as they frequently cooked at home and allocated time for cooking. The enabling factors included their knowledge about food and nutrition, food source availability, their confidence in cooking meals and following recipes, and their motivation to keep their children healthy representing some intrinsic factors. The main constraint was the lack of skill to make snacks. The other extrinsic barriers were dependence on mobile food sellers and the availability of food kiosks that facilitated children's snack preferences. CONCLUSION The study obtained some insights that mothers had favorable cooking intention and desire, were supported with a confidence in some basic cooking skills. However, the existing constraints that encouraged the development of unfavorable children's snacking habit were beyond the mothers' control. A cookbook specifically for snack recipes that utilizes local ingredients may assist mother in preparing more healthier options for the children.
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Affiliation(s)
- Intan R Nirmala
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Department of Nutrition, Health Polytechnic of Kendari, Ministry of Health, Kendari, Indonesia
| | - Judhiastuty Februhartanty
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO-RECFON)/PKGR Universitas Indonesia, Jakarta, Indonesia.
| | - Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia , Jakarta, Indonesia
| | - Rini Sekartini
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Department of Pediatric, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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Barton JM, McMath AL, Montgomery SP, Donovan SM, Fiese BH. Longitudinal changes in home food availability and concurrent associations with food and nutrient intake among children at 24-48 months. Public Health Nutr 2024; 27:e62. [PMID: 38305130 PMCID: PMC10897571 DOI: 10.1017/s1368980024000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES To describe changes in home food availability during early childhood, including modified, developmentally sensitive obesogenic scores, and to determine whether home food availability is associated with food and nutrient intakes of children concurrently, over time. DESIGN Data were drawn from the STRONG Kids 2 longitudinal, birth cohort to achieve the study objectives. Home food availability was assessed with the Home Food Inventory (HFI) and included fifteen food groups (e.g. fruit and vegetables) and three obesogenic scores (one original and two modified). Food and nutrient intakes were measured using the Block FFQ and included twenty-seven food groups and eighteen nutrients (e.g. vitamins A and C, protein). HFI and FFQ were completed by trained researchers or mothers, respectively, at 24, 36 and 48 months. Repeated-measures ANOVA and Spearman's correlations were used to achieve the study objectives. SETTING Central Illinois, USA. PARTICIPANTS Participants were 468 children at 24, 36 and 48 months of age. RESULTS Availability of less nutritious foods and obesogenic foods and beverages increased as children aged, and availability of both nutritious and less nutritious foods were associated with child food and nutrient intake. The three obesogenic scores demonstrated similar, positive associations with the intake of energy, saturated fat, added sugars and kilocalories from sweets. CONCLUSION These findings offer novel insight into changes in home food availability and associations with food and nutrient intake during early childhood. Additional attention is needed examining antecedents (e.g. built environments, purchasing behaviours) and consequences (e.g. child diet quality and weight) of home food availability.
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Affiliation(s)
- Jennifer M Barton
- Family Resiliency Center, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, USA
| | - Arden L McMath
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Stewart P Montgomery
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, Urbana, IL, USA
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Tucker AC, Martinez-Steele E, Leung CW, Wolfson JA. Associations Between Household Frequency of Cooking Dinner and Ultraprocessed Food Consumption and Dietary Quality Among US Children and Adolescents. Child Obes 2024; 20:11-22. [PMID: 36795986 PMCID: PMC10790553 DOI: 10.1089/chi.2022.0200] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Introduction: Dietary quality is poor and intake of ultraprocessed foods (UPFs) is high among children and adolescents in the United States. Low dietary quality and high UPF intake are associated with obesity and higher risk of diet-related chronic diseases. It is unknown whether household cooking behavior is related to improved dietary quality and lower consumption of UPFs among US children and adolescents. Methods: Nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey (n = 6032 children and adolescents ≤19 years of age) were used to examine the relationships between household cooking frequency of evening meals and children's dietary quality and UPF intake using multivariate linear regression models adjusted for sociodemographics. Two 24-hour diet recalls were used to assess UPF intake and dietary quality [Healthy Eating Index-2015 (HEI-2015)]. Food items were categorized according to Nova classification to obtain the UPF percent of total energy intake. Results: A higher household frequency of cooking dinner was associated with lower UPF intake and higher overall dietary quality. Compared to children in households cooking dinner 0-2 times per week, children in households cooking dinner 7 times/week had lower intake of UPFs [β = -6.30, 95% confidence interval (CI) -8.81 to -3.78, p < 0.001] and marginally higher HEI-2015 scores (β = 1.92, 95% CI -0.04 to 3.87, p = 0.054). The trends toward lower UPF intake (p-trend <0.001) and higher HEI-2015 scores (p-trend = 0.001) with increasing cooking frequency were significant. Conclusions: In this nationally representative sample of children and adolescents, more frequent cooking at home was associated with lower intake of UPFs and higher HEI-2015 scores.
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Affiliation(s)
- Anna Claire Tucker
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Euridice Martinez-Steele
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, São Paulo, Brazil
| | - Cindy W. Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Julia A. Wolfson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health Policy and Management, Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Fraser K, Johnson BJ, Love P, Spence A, Laws R, Campbell KJ. Mapping the behaviour change potential of meal kits to positively influence parental food literacy. Public Health Nutr 2023; 27:e16. [PMID: 38037708 PMCID: PMC10825774 DOI: 10.1017/s136898002300263x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE This study aimed to examine the theoretical potential of meal kit subscription services in Australia to promote parental food literacy using the retrospective application of behaviour change frameworks. DESIGN A one-week subscription was purchased for all Australian-based meal kit subscription services (n 9) to access content and features available to subscribers. Behaviour change techniques (BCTs) identified in the subscription and meal planning features, meal kit delivery (i.e. ingredients and recipes) and website were coded using the behaviour change technique taxonomy (BCTTv1) and associated behaviour change frameworks. Identified BCTs were mapped to the theoretical domains framework to identify potential mechanisms of action for influencing parental food literacy development. SETTING Australia. RESULTS Thirty-five BCTs were identified across the nine meal kit services reviewed, ranging from nineteen to twenty-nine BCTs per company. Sixteen BCTs were common to all meal kits services, from the hierarchical clusters of 'goals and planning', 'shaping knowledge', 'social support', 'natural consequences', 'comparison of behaviour', 'repetitions and substitution', 'associations', 'reward and threat', 'antecedents' and 'regulation'. Across the meal kit services, the most frequently identified mechanisms of action were motivation (n 27) and capability (n 19). CONCLUSION These findings support the applicability of behaviour change frameworks to commercial meal kit subscription services and provide a theory-informed process for identifying BCTs that may be relevant for promoting parental food literacy within this context. Further research is required to explore how families engage with meal kit subscription services to determine the exposure and delivery of identified BCT content and to evaluate the potential influence on food literacy development.
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Affiliation(s)
- Kylie Fraser
- School of Exercise & Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
| | - Brittany J Johnson
- Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Penelope Love
- School of Exercise & Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
| | - Alison Spence
- School of Exercise & Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
| | - Rachel Laws
- School of Exercise & Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
| | - Karen J Campbell
- School of Exercise & Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC3125, Australia
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Baltaci A, Laska MN, Horning M, Hearst M, Lee J, Fulkerson JA. Parent meal self-efficacy and practices in households with healthy home food environments in the face of economic hardship. Appetite 2023; 190:107029. [PMID: 37683896 PMCID: PMC10543555 DOI: 10.1016/j.appet.2023.107029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023]
Abstract
Some families who experience economic hardship demonstrate remarkable strength and resourcefulness to sustain a healthy home food environment. This ability to navigate economic barriers could be associated with parent meal practices that promote children's healthful dietary intake. Therefore, this study aimed to examine 1) whether parent meal self-efficacy and practices were associated with economic assistance status and home fruit and vegetable (FV) availability and 2) how parent meal self-efficacy and practices differed by home FV availability and economic assistance status. Analyses utilized baseline data from 274 parent/child dyads from two childhood obesity prevention trials: HOME Plus (urban) and NU-HOME (rural). Parents in households with high FV availability (regardless of economic assistance) had significantly higher self-efficacy in preparing healthy foods, family dinner routines, frequency of child's plate being half filled with FV, frequency of family dinner and breakfast, and lower frequency of purchasing dinner from fast food restaurants. Economic assistance was not associated with parent meal self-efficacy and practices. Four family groups were created and defined by economic assistance (yes/no) and home FV availability (high/low). About 31% of families that received economic assistance and had high home FV availability were food insecure. Families (n = 39) receiving economic assistance and having high home FV availability had greater frequency of family dinners compared to those in households with economic assistance and low home FV availability (n = 47) (p = 0.001); no other parent meal self-efficacy or practices differed between groups. Our findings suggest some families can maintain healthy home food environments despite economic hardship and frequent family dinners may be an important strength for these families. More research is needed to investigate asset-based models to understand the family strengths that enable them to thrive during difficult times.
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Affiliation(s)
- Aysegul Baltaci
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa N Laska
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa Horning
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Mary Hearst
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Jiwoo Lee
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
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Xiong Y, Lin X, Wen X, Wang Y, Liang W, Xing T. The Analysis of Residents' Intention to Consume Pre-Made Dishes in China: A Grounded Theory. Foods 2023; 12:3798. [PMID: 37893691 PMCID: PMC10606755 DOI: 10.3390/foods12203798] [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: 09/20/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
The demand for pre-made dishes has increased in China. However, a detailed understanding of residents' intention to consume pre-made dishes is lacking in the existing studies. This research aims to investigate the consumer motives and intention to consume pre-made dishes. Through in-depth interviews and analysis, this research explores the factors influencing the residents' intention along the research steps of grounded theory. Fifty-one residents participated in semi-structured interviews via face-to-face or online interviews. Three motives for purchasing pre-made dishes were attitude, subjective norm, and perceived control. These were influenced by external factors, including environmental features and product features. Subjective characteristics are pre-existing characteristics of individuals themselves, including cooking skills, food skills, housework allocation, and eating attitudes, which play a moderating role in the relationship between external factors and consumer motives. Based on the six major categories, this study built a model of the formation mechanism of the consumer intention to consume pre-made dishes. It revealed the psychological attribution of residents' consumption of pre-made dishes. The finding of this study contributes to the understanding of the internal logic of PMDs' consumer intention formation. It would be a guide for researchers to map out appropriate business development strategies, and provide evidence for the government in formulating management policies.
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Affiliation(s)
- Yanling Xiong
- College of Economics and Management, South China Agricultural University, Wushan Road 483, Tianhe District, Guangzhou 510642, China
| | - Xiaoxi Lin
- College of Economics and Management, South China Agricultural University, Wushan Road 483, Tianhe District, Guangzhou 510642, China
| | - Xiaowei Wen
- Research Institute of Rural Development of Guangdong Province, South China Agricultural University, Wushan Road 483, Tianhe District, Guangzhou 510642, China
| | - Yiqin Wang
- College of Economics and Management, South China Agricultural University, Wushan Road 483, Tianhe District, Guangzhou 510642, China
| | - Wenwen Liang
- College of Economics and Management, South China Agricultural University, Wushan Road 483, Tianhe District, Guangzhou 510642, China
| | - Tianyang Xing
- College of Economics and Management, South China Agricultural University, Wushan Road 483, Tianhe District, Guangzhou 510642, China
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Moore AM, Fisher JO, Burgess B, Morris KS, Croce CM, Kong KL. Caregiver feeding decisions and sociodemographic characteristics are associated with snack food intake during infancy and toddlerhood. Appetite 2023; 186:106551. [PMID: 37024055 PMCID: PMC10213156 DOI: 10.1016/j.appet.2023.106551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
Snacking starts early in childhood, yet little is known about child versus family influences on snacking during infancy and toddlerhood. This secondary analysis of baseline data examined associations of child characteristics (e.g., appetitive traits, temperament), caregiver feeding decisions, and sociodemographic characteristics with the mean frequency of (times/day) and mean energy from (kcal/day) child snack food intake. Caregivers and their children (ages 9-15 months) were recruited in Buffalo, NY from 2017 to 2019. Caregivers reported on sociodemographics, child appetitive traits (Baby Eating Behaviour Questionnaire), and child temperament (Infant Behavior Questionnaire-Revised). Three 24-h dietary recalls were collected, and USDA food categories were used to categorize snack foods (e.g., cookies, chips, and puffs). Hierarchical multiple linear regression models examined associations of child characteristics (Step 1: age, sex, baseline weight-for-length z-score, appetitive traits, and temperament), caregiver feeding decisions (Step 2: breastfeeding duration and age of solid food introduction), and caregiver sociodemographic characteristics (Step 3: caregiver age, prepregnancy BMI, education, and household size) with mean child snack food intake. Caregivers (n = 141) were on average 32.6 years of age, predominantly white (89.1%), and college-educated (84.2%). Age of solid food introduction (B = -0.21, p = 0.03), prepregnancy BMI (B = 0.03, p = 0.04), and household size (B = 0.23, p = 0.02) were significantly associated with the mean frequency of (times/day) snack food intake, over and above other variables of interest. Child age (B = 15.96, p = 0.002) was significantly associated with mean energy from (kcal/day) snack food intake. Household size (B = 28.51, p = 0.006) was significantly associated with mean energy from (kcal/day) snack food intake, over and above other variables of interest. There were no significant associations of other child characteristics with snack food intake. Findings show that child snack food intake is more closely associated with caregiver feeding decisions and sociodemographic characteristics than child characteristics. TRIAL REGISTRATION: National Institute on Child Health and Human Development, Grant/Award Number R01HD087082-01.
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Affiliation(s)
- Amy M Moore
- Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Jennifer Orlet Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Brenda Burgess
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14203, USA
| | - Katherine S Morris
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, 14203, USA.
| | - Christina M Croce
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, 64108, USA; Center for Children's Healthy Lifestyles and Nutrition, University of Kansas Medical Center Kansas City, KS, USA; Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA.
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Davis AM, Befort CA, Lancaster BD, Tuck C, Polivka BJ, Carlson JA, Fleming K, Romine RS, Dean K, Murray M. Rationale and design of integrating a parents first obesity intervention with a pediatric weight management intervention for rural families - Evaluating the ripple effect. Contemp Clin Trials 2023; 128:107140. [PMID: 36893988 DOI: 10.1016/j.cct.2023.107140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
Rural families are disproportionately affected by obesity. Obesity often runs in families and is impacted by hereditary components, the shared home environment, and parent modeling/child observational learning. Moreover, parent changes in weight predict child changes in weight. Thus, targeting the family unit has the potential to enhance outcomes for adults and children simultaneously. Additionally, engaging rural nurses in medical clinics and schools may be important in determining whether rural telehealth programs are successfully implemented and sustained. This paper describes the rationale and design of a randomized control trial (RCT) evaluating the effectiveness of an integrated adult- and child-focused obesity treatment tailored for rural participants. Outcomes of this study include participant weight loss from baseline to 9-months, device-measured physical activity, and dietary intake. This project will additionally compare reach between clinic and school settings and evaluate the impact of nurse engagement. This study will include 240 participants from eight rural communities who will be randomized to either a Parent +Family-based group or a Newsletter +Family-based group. Parents in the Parent +Family-based group will receive a 3-month adult obesity treatment designed for adult behavior change as a first step. Then, parents and children together will enter the family-based program (iAmHealthy), allowing for potential enhancement of a theorized ripple effect. Parents in the Newsletter +Family-based group will receive 3 monthly newsletters and then participate in the 6-month family-based intervention designed for child behavior change. This study is the first RCT to examine the effectiveness of an integrated adult- and child-focused obesity treatment program. Registered with ClinicalTrials.gov NCT ID NCT05612971.
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Affiliation(s)
- Ann M Davis
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS 66160, United States.
| | - Christie A Befort
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Brittany D Lancaster
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS 66160, United States
| | - Chris Tuck
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States
| | - Barbara J Polivka
- School of Nursing, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Jordan A Carlson
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO 64108, United States
| | - Kandace Fleming
- Lifespan Institute, University of Kansas, Lawrence, KS 66045, United States
| | | | - Kelsey Dean
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO 64108, United States
| | - Megan Murray
- Center for Children's Healthy Lifestyles & Nutrition, 610 E 22nd St, Kansas City, MO 64108, United States; Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 4004, Kansas City, KS 66160, United States
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Oliver T, Diewald L, McKeever A, Shenkman R. Achieving a healthy home food environment: perspectives on parents' nutrition education needs when living with food insecurity. NUTRIRE : REVISTA DE SOCIEDADE BRASILEIRA DE ALIMENTACAO E NUTRICAO = JOURNAL OF THE BRAZILIAN SOCIETY OF FOOD AND NUTRITION 2023; 48:17. [PMID: 38625126 PMCID: PMC10062277 DOI: 10.1186/s41110-023-00203-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
Purpose The familial food environment is influenced by many factors, including food insecurity, food accessibility, and foods accepted by the family. These factors can facilitate or hinder caregivers' ability to support a healthy home food environment. The aim of this research was to explore the barriers to, perspectives on, and nutrition education needs identified by food-insecure parents which would then inform a community-based nutrition education program. Methods A qualitative study used focus group data that were recorded, transcribed verbatim, and analyzed using a constant comparison approach to categorize the emerging themes. Results Emergent themes: (1) Cooking confidence deficit; (2) Healthy meal preparation barriers; (3) Healthy meal acceptance barriers; (4) Meal planning, management, and adaptability. These themes suggest that supporting a healthy home food environment is connected to both food knowledge and competencies, known as food literacy. Conclusion Food literacy competency should be assessed before nutrition education program implementation within community settings.
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Associations of cooking practices and healthy eating habits among young Korean adults in their 20s. Int J Gastron Food Sci 2022. [DOI: 10.1016/j.ijgfs.2022.100644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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14
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Befort CA, Ross KM, Janicke DM, Perri MG. Parents of minor children lose less weight during a behavioral weight loss intervention: Findings from the Rural LEAP trial. Obes Sci Pract 2022; 8:728-734. [PMID: 36483125 PMCID: PMC9722455 DOI: 10.1002/osp4.604] [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: 12/10/2021] [Revised: 03/11/2022] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
Objective The transition to parenthood is associated with worsening health behaviors, yet the impact of parental status on successful weight loss has rarely been examined. The purpose of this study was to examine the effect of parental status of minor children on weight loss and behavioral adherence in a rural community-based weight loss intervention. Methods Five hundred and twenty-eight adults (age 21-75 years, body mass index [BMI] 30-45 kg/m2) were enrolled in a group-based weight loss intervention consisting of 16 weekly sessions delivered in face-to-face group sessions at Cooperative Extension Service (CES) offices. Participants who were parents with at least one minor child (≤18 years old) in the home were compared to participants with no minor children in the home. Measures included percent weight loss, session attendance, adherence to self-monitoring, and achieving calorie and physical activity goals. Results Compared to participants without minor children, parents with minor children lost significantly less weight (7.5% vs. 6.2%, respectively; p = 0.01), and were less likely to lose ≥5% of baseline weight (59.2% vs. 70.2%, respectively; p = 0.02). In addition, parents with minor children attended significantly fewer sessions, had lower adherence to self-monitoring, and met calorie and step goals less often (all ps < 0.001). The association between parental status and percent weight loss was not significantly moderated by gender of the parent. Conclusions Parents of minor children had greater difficulty adhering to intervention goals and lost less weight than participants without minor children. Future research should investigate whether tailoring intervention to meet the unique needs of parents can enhance outcomes, especially given the large segment of the population represented by this group.
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Affiliation(s)
- Christie A. Befort
- Department of Population HealthUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Kathryn M. Ross
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - David M. Janicke
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - Michael G. Perri
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
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Significantly different roles of economic affluence in sex-specific obesity prevalence rates: understanding more modifications within female body weight management. Sci Rep 2022; 12:15757. [PMID: 36130963 PMCID: PMC9492695 DOI: 10.1038/s41598-022-19633-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/31/2022] [Indexed: 11/08/2022] Open
Abstract
Socioeconomic status has been associated with obesity prevalence increase in both males and females worldwide. We examined the magnitude of the difference between the two relationships and explored the independence of both relationships. Country specific data on gross domestic product (GDP) per capita, sex-specific obesity prevalence rates, urbanisation, total calories availability and level of obesity, genetic background accumulation (measured by the Biological State Index, Ibs) were obtained for 191 countries. Curvilinear regressions, bivariate and partial correlations, linear mixed models and multivariate linear regression analyses were used to examine the relationship between GDP and obesity prevalence rates in males and females respectively. Fisher’s r-to-z transformation, F-test and R2 increment in multivariate regression were used to compare results for males and females. GDP significantly correlated with sex-specific obesity prevalence rates, but significantly more strongly with male obesity prevalence in bivariate correlation analyses. These relationships remained independent of calories availability, Ibs and urbanization in partial correlation model. Stepwise multiple regression identified that GDP was a significant predictor of obesity prevalence in both sexes. Multivariate stepwise regression showed that, when adding GDP as an obesity prevalence predictor, the absolute increment of R2 in male fit model (0.046) was almost four (4) times greater than the absolute increment in female model fit (0.012). The Stepwise analyses also revealed that 68.0% of male but only 37.4% of female obesity prevalence rates were explained by the total contributing effects of GDP, Ibs, urbanization and calories availability. In both Pearson’s r and nonparametric analyses, GDP contributes significantly more to male obesity than to female obesity in both developed and developing countries. GDP also determined the significant regional variation in male, but not female obesity prevalence. GDP may contribute to obesity prevalence significantly more in males than in females regardless of the confounding effects of Ibs, urbanization and calories. This may suggest that aetiologies for female obesity are much more complex than for males and more confounders should be included in the future studies when data are available.
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Patel C, Walasek L, Karasouli E, Meyer C. Content and Validity of Claims Made about Food Parenting Practices in United Kingdom Online News Articles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095053. [PMID: 35564446 PMCID: PMC9105157 DOI: 10.3390/ijerph19095053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
The objective of this study was to qualitatively summarise the content of online news articles pertaining to food parenting practices and determine whether this content is substantiated by the scientific literature. News article data were identified and collected from United Kingdom online news published during 2010–2017 period using the News on the Web corpus. A coding framework was used to categorise the content of news articles to identify information related to food parenting practices. Then, claims made about food parenting practices were extracted from relevant news articles. Each claim was evaluated to determine the extent to which any claims were supported by the available scientific research evidence. The study identified ten claims across thirty-two relevant online news articles. Claims made across the news articles reported on the following food parenting practices: food restrictions, food-based threats and bribes, pressure to eat, use of food to control negative emotions, food availability, food preparation, and meal and snack routines. Eight out of the ten claims identified did not refer to scientific research evidence. News articles frequently lacked detail and information to explain to readers why and how the use of certain food parenting practices could have a lasting impact on children’s health outcomes. Considering the influence that news media has on parents, the reporting of food parenting practices in news articles should aim to provide a balanced view of the published scientific evidence and recognise the difficulties and barriers that prevent the use of helpful and healthy food parenting practices. The study results in this paper could be used to aid and structure of the dissemination of food parenting practice research findings in the media, inform public health education to influence perceptions of unhelpful food parenting practices, and promote parental use of responsive food parenting practices.
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Affiliation(s)
- Chloe Patel
- Warwick Manufacturting Group, Behaviour and Wellbeing Science, University of Warwick, Coventry CV4 7AL, UK;
- Correspondence:
| | - Lukasz Walasek
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
| | - Eleni Karasouli
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
| | - Caroline Meyer
- Warwick Manufacturting Group, Behaviour and Wellbeing Science, University of Warwick, Coventry CV4 7AL, UK;
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Rees J, Fu SC, Lo J, Sambell R, Lewis JR, Christophersen CT, Byrne MF, Newton RU, Boyle S, Devine A. How a 7-Week Food Literacy Cooking Program Affects Cooking Confidence and Mental Health: Findings of a Quasi-Experimental Controlled Intervention Trial. Front Nutr 2022; 9:802940. [PMID: 35369083 PMCID: PMC8970183 DOI: 10.3389/fnut.2022.802940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/14/2022] [Indexed: 12/30/2022] Open
Abstract
Obesity and mental health disorders are rising simultaneously with shifting dietary behavior away from home cooking, toward typically nutrition-poor and energy-dense convenience meals. Food literacy strongly influences nutrition choices. Community-based cooking interventions target barriers to healthy eating and facilitate development of food literacy skills, thereby potentially increasing preparation of home-cooked meals and positively influencing health. This study of 657 healthy Australian adults explored the efficacy of a 7-week cooking program in improving cooking confidence, whether this transferred to behavior surrounding food, and/or affected mental health. Significant post-program improvements in cooking confidence and satisfaction (all p < 0.001, ηp2 1.12 large), ability to change eating habits (p < 0.001) and overcome lifestyle barriers (p = 0.005) were observed for the intervention group but not control. Participation also improved mental and general health (all p < 0.05, ηp2 0.02 small). No changes were observed for acquisition and consumption of food, or nutrition knowledge in either group. This 7-week cooking program built cooking confidence and improved general and mental health but did not change dietary behavior. To further improve nutrition related behaviors associated with better mental health, more effort is needed to recruit those with below-average nutrition knowledge and interest in cooking.
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Affiliation(s)
- Joanna Rees
- School of Medical and Health Sciences, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- *Correspondence: Joanna Rees
| | - Shih Ching Fu
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Science, Edith Cowan University, Joondalup, WA, Australia
- School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Perth, WA, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA, Australia
| | - Ros Sambell
- School of Medical and Health Sciences, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Joshua R. Lewis
- School of Medical and Health Sciences, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, University of Western Australia, Perth, WA, Australia
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Claus T. Christophersen
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Western Australian Human Microbiome Collaboration Centre, School of Molecular and Life Sciences, Curtin University, Perth, WA, Australia
- Centre for Integrative Metabolomics and Computational Biology, Edith Cowan University, Perth, WA, Australia
| | - Matthew F. Byrne
- School of Education, Edith Cowan University, Joondalup, WA, Australia
| | - Robert U. Newton
- School of Medical and Health Sciences, Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | | | - Amanda Devine
- School of Medical and Health Sciences, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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18
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Mauch CE, Wycherley TP, Bell LK, Laws RA, Byrne R, Golley RK. Parental work hours and household income as determinants of unhealthy food and beverage intake in young Australian children. Public Health Nutr 2022; 25:1-29. [PMID: 35135652 PMCID: PMC9991677 DOI: 10.1017/s1368980022000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study examined parental work hours and household income as determinants of discretionary (energy dense, nutrient poor) food and beverage intake in young children, including differences by eating occasion. DESIGN Secondary analysis of cross-sectional data. Three hierarchical regression models were conducted with percent energy from discretionary food and beverages across the day, at main meals, and at snack times being the outcomes. Dietary intake was assessed by 1x24-hour recall and 1-2x24-hour food record(s). Both maternal/paternal work hours were included, and total household income. Covariates included household, parent and child factors. SETTING Data from the NOURISH/SAIDI studies were collected between 2008-13. PARTICIPANTS Participants included 526 mother-child dyads (median(IQR) child age 1.99(1.96,2.03) years). Forty-one percent of mothers did not work while 57% of fathers worked 35-40 hours/week. Most (85%) households had an income of ≥$50k AUD/year. RESULTS Household income was consistently inversely associated with discretionary energy intake (β= -0.12 to -0.15). Maternal part-time employment (21-35 hours/week) predicted child consumption of discretionary energy at main meals (β=0.10, p=0.04). Paternal unemployment predicted a lower proportion of discretionary energy at snacks (β= -0.09, p=0.047). CONCLUSIONS This work suggests that household income should be addressed as a key opportunity-related barrier to healthy food provision in families of young children. Strategies to reduce the time burden of healthy main meal provision may be required in families where mothers juggle longer part-time working hours with caregiving and domestic duties. The need to consider the role of fathers and other parents/caregivers in shaping children's intake was also highlighted.
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Affiliation(s)
- Chelsea E Mauch
- Caring Futures Institute, College of Nursing and Health Sciences, Level 7, SAHMRI building, North Terrace, Flinders University, Adelaide, SA5000, Australia
- Early Prevention of Obesity in Childhood Centre of Research Excellence, Sydney, Australia
| | - Thomas P Wycherley
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Lucinda K Bell
- Caring Futures Institute, College of Nursing and Health Sciences, Level 7, SAHMRI building, North Terrace, Flinders University, Adelaide, SA5000, Australia
| | - Rachel A Laws
- Early Prevention of Obesity in Childhood Centre of Research Excellence, Sydney, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Melbourne, Australia
| | - Rebecca Byrne
- Early Prevention of Obesity in Childhood Centre of Research Excellence, Sydney, Australia
- Queensland University of Technology, School of Exercise and Nutrition Sciences, Faculty of Health, Centre for Children’s Health Research, South Brisbane, Australia
| | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Level 7, SAHMRI building, North Terrace, Flinders University, Adelaide, SA5000, Australia
- Early Prevention of Obesity in Childhood Centre of Research Excellence, Sydney, Australia
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PRADO TR, MAZZONETTO AC, BOTELHO AM, FIATES GMR. Home availability of ultraprocessed foods in families who prepare meals at home. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This study characterized the degree of processing of the food items available at home and the routine of shopping for food in families with children and/or teenagers and whose meals are usually prepared at home. Methods Mixed methods (interview, questionnaires, and food inventory). Interview’s transcripts were submitted to thematic analysis and the foods identified in the inventory were classified according to the degree of processing and analyzed for their availability and access in the home food environment. Results Results revealed the high availability of ultra-processed foods; that the supermarket was the main source of food acquisition; and that purchasing food is part of an organized routine where time and control of expenses are the most valued aspects. Conclusion Actions which focus on planning and executing the acquisition of unprocessed and minimally processed foods are needed to promote greater availability and increased intake of such foods, so that the composition of homemade meals may be in line with what is recommended by the national dietary guidelines.
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Horning ML, Friend S, Lee J, Flattum C, Fulkerson JA. Family Characteristics Associated with Preparing and Eating More Family Evening Meals at Home. J Acad Nutr Diet 2022; 122:121-128. [PMID: 34399976 PMCID: PMC8688213 DOI: 10.1016/j.jand.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/03/2021] [Accepted: 07/08/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Research has demonstrated dietary quality benefits of family meals and meals prepared at home. Less is known about associations between the proportion of family evening meals made at home and key personal, behavioral, and environmental characteristics. Moreover, most studies often measure these data retrospectively. OBJECTIVE The objective of this study is to describe the proportion of evening meals made at home measured in real time and to assess associations between personal, behavioral, and environmental characteristics that are associated with a higher proportion of evening meals prepared and consumed at home. DESIGN This study is a cross-sectional secondary analysis of baseline data collected during 2017 and 2018 from the New Ulm at Home study, a randomized controlled trial conducted in rural Minnesota to evaluate the effectiveness of a childhood obesity prevention program for school-aged children. PARTICIPANTS/SETTING The present study analyzes a subset of the New Ulm at Home trial data from families (N = 108) who completed at least four evening meal screeners collected in real time with ecological momentary assessment technology over a 2-week period. MAIN OUTCOME MEASURE The main outcome measure was the proportion of family evening meals made at home, calculated using two cutpoints (≤50% of evening meals prepared at home vs >50%; ≤70% vs >70%). STATISTICAL ANALYSIS Descriptive statistics were used to describe the proportion of evening meals prepared at home. Logistic regression analyses adjusted for parent education were used to assess associations between family characteristics and the two different proportions of meals made at home. RESULTS Most family evening meals were prepared and eaten at home (62%). Logistic regression models indicated meal planning skills (odds ratio=1.19, 95% CI 1.01 to 1.39) and mealtime routines (odds ratio=1.20, 95% CI 1.03 to 1.40) were significantly associated with odds of preparing more than 50% of evening meals at home. Only meal planning skills (odds ratio=1.27, 95% CI 1.06 to 1.51) was significantly associated with odds of preparing more than 70% of evening meals at home. CONCLUSIONS Study findings indicated mealtime routines and meal planning skills were associated with preparing more than 50% of evening meals at home, but only meal planning skills were associated with preparing more than 70% of evening meals at home, which may suggest the importance of adapting interventions for families. Future research should build on these findings in randomized controlled trials.
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Affiliation(s)
- Melissa L Horning
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, Minnesota, 55455
| | - Sarah Friend
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, Minnesota, 55455
| | - Jiwoo Lee
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, Minnesota, 55455
| | - Colleen Flattum
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 300 West Bank Office Building, 1300 S 2 St, Minneapolis, Minnesota 55454
| | - Jayne A Fulkerson
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, Minnesota, 55455
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McWhorter JW, Danho MP, LaRue DM, Tseng KC, Weston SR, Moore LS, Durand C, Hoelscher DM, Sharma SV. Barriers and Facilitators of Implementing a Clinic-Integrated Food Prescription Plus Culinary Medicine Program in a Low-Income Food Insecure Population: A Qualitative Study. J Acad Nutr Diet 2021; 122:1499-1513. [PMID: 34839026 DOI: 10.1016/j.jand.2021.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/11/2021] [Accepted: 11/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Food prescription and culinary medicine programs are gaining popularity as tools for decreasing food insecurity, increasing personal agency, promoting healthy eating, and reducing the risk of chronic diseases. However, there is a gap in understanding of how health care professionals can deliver evidence-based how-to nutrition information that is tailored for culturally diverse, low-income populations. OBJECTIVE To understand the barriers and facilitators for healthy eating among a low-income, diverse population with diabetes, and the gaps in knowledge and training needed for registered dietitian nutritionists (RDN) to address patient barriers when implementing a food prescription and CM program in a healthcare setting. DESIGN A series of nine focus groups were conducted: six focus groups with patients with diabetes (n = 40) (three in English and three in Spanish) and three focus groups with RDN employees (n = 17). PARTICIPANTS/SETTING A convenience sample of 40 low-income food insecure patients with diabetes receiving care at a diverse, integrated, safety net health care system in an urban setting in Texas and convenience sample of 17 RDN employees. STATISTICAL ANALYSIS All focus group transcripts were examined by independent reviewers and blind catalogued and organized into common themes and subthemes based on constant comparative methodology. Investigator group consensus was reached on emergent themes and subthemes for the respective focus groups. RESULTS Patients reported frustration with mixed dietary messages from different health care providers, lack of culturally inclusive recommendations, and a desire for skills to prepare tasty and healthy food. RDNs desired more training and education in cultural humility, culinary nutrition skills, and behavioral change theory. CONCLUSIONS Our study describes how cultural humility, practical culinary nutrition skills, and consistent and coordinated messaging can help to improve patient nutrition care. Before implementation of a food prescription and culinary medicine program, efforts should promote training of RDN staff in culinary nutrition and related areas to increase acceptability and adherence of the program for patients.
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Affiliation(s)
- John Wesley McWhorter
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas; Nourish Program, UTHealth School of Public Health, Houston, Texas.
| | - Melisa P Danho
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas
| | - Denise M LaRue
- Population Health Transformation, Harris Health System, Houston, Texas
| | - Karen C Tseng
- Population Health Transformation, Harris Health System, Houston, Texas
| | - Shannon R Weston
- Nourish Program, UTHealth School of Public Health, Houston, Texas
| | - Laura S Moore
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas; Nourish Program, UTHealth School of Public Health, Houston, Texas
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, Texas
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, Austin, Texas
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Houston, Texas
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Fismen AS, Buoncristiano M, Williams J, Helleve A, Abdrakhmanova S, Bakacs M, Bergh IH, Boymatova K, Duleva V, Fijałkowska A, García-Solano M, Gualtieri A, Gutiérrez-González E, Hejgaard T, Huidumac-Petrescu C, Hyska J, Kelleher CC, Kierkegaard L, Kujundžić E, Kunešová M, Milanović SM, Nardone P, Nurk E, Ostojic SM, Ozcebe LH, Peterkova V, Petrauskiene A, Pudule I, Rakhmatulleoeva S, Rakovac I, Rito AI, Rutter H, Sacchini E, Stojisavljević D, Farrugia Sant'Angelo V, Shengelia L, Spinelli A, Spiroski I, Tanrygulyyeva M, Usupova Z, Weghuber D, Breda J. Socioeconomic differences in food habits among 6- to 9-year-old children from 23 countries-WHO European Childhood Obesity Surveillance Initiative (COSI 2015/2017). Obes Rev 2021; 22 Suppl 6:e13211. [PMID: 34235830 DOI: 10.1111/obr.13211] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Socioeconomic differences in children's food habits are a key public health concern. In order to inform policy makers, cross-country surveillance studies of dietary patterns across socioeconomic groups are required. The purpose of this study was to examine associations between socioeconomic status (SES) and children's food habits. METHODS The study was based on nationally representative data from children aged 6-9 years (n = 129,164) in 23 countries in the World Health Organization (WHO) European Region. Multivariate multilevel analyses were used to explore associations between children's food habits (consumption of fruit, vegetables, and sugar-containing soft drinks) and parental education, perceived family wealth and parental employment status. RESULTS Overall, the present study suggests that unhealthy food habits are associated with lower SES, particularly as assessed by parental education and family perceived wealth, but not parental employment status. We found cross-national and regional variation in associations between SES and food habits and differences in the extent to which the respective indicators of SES were related to children's diet. CONCLUSION Socioeconomic differences in children's food habits exist in the majority of European and Asian countries examined in this study. The results are of relevance when addressing strategies, policy actions, and interventions targeting social inequalities in children's diets.
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Affiliation(s)
- Anne-Siri Fismen
- Department of Health Promotion and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Bergen, Norway
| | - Marta Buoncristiano
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Julianne Williams
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Arnfinn Helleve
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Health, Oslo, Norway
| | - Shynar Abdrakhmanova
- Department of Science and Professional Development, National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Almaty, Kazakhstan.,Kazakhstan School of Public Health, Kazakhstan's Medical University, Almaty, Kazakhstan
| | - Márta Bakacs
- Department of Nutrition and Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - Ingunn Holden Bergh
- Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Khadichamo Boymatova
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Country Office for Tajikistan, Dushanbe, Tajikistan
| | - Vesselka Duleva
- Department Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria
| | - Anna Fijałkowska
- Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
| | - Marta García-Solano
- Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain
| | | | | | - Tatjana Hejgaard
- Health Promotion and Inequality, Danish Health Authority, Copenhagen, Denmark
| | - Constanta Huidumac-Petrescu
- National Center for Health Assessment and Promotion, National Institute of Public Health, Bucharest, Romania
| | - Jolanda Hyska
- Nutrition and Food Safety Sector, Institute of Public Health, Tirana, Albania
| | - Cecily C Kelleher
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Lene Kierkegaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Enisa Kujundžić
- Center for Health Ecology, Institute of Public Health, Podgorica, Montenegro
| | - Marie Kunešová
- Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
| | - Sanja Musić Milanović
- Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Eha Nurk
- Department of Nutrition Research, National Institute for Health Development, Tallinn, Estonia
| | - Sergej M Ostojic
- Biomedical Sciences Department, Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Lütfiye Hilal Ozcebe
- Medical Faculty, Department of Public Health, Hacettepe University, Ankara, Turkey
| | - Valentina Peterkova
- Institute of Paediatric Endocrinology, National Medical Research Centre for Endocrinology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ausra Petrauskiene
- Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Iveta Pudule
- Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia
| | - Sanavbar Rakhmatulleoeva
- Department of the Organization of Medical Services for Mothers, Children and Family Planning Ministry of Health and Social Protection, Dushanbe, Tajikistan
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Ana Isabel Rito
- WHO/Europe Collaborating Center for Nutrition and Childhood Obesity - Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| | - Elena Sacchini
- Health Authority, Ministry of Health, San Marino, San Marino
| | - Dragana Stojisavljević
- Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.,Public Health Institute of Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | | | - Lela Shengelia
- Maternal, Child and Reproductive Health, National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - Angela Spinelli
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy
| | - Igor Spiroski
- Institute of Public Health, Skopje, North Macedonia.,Faculty of Medicine, SS. Cyril and Methodius University, Skopje, North Macedonia
| | - Maya Tanrygulyyeva
- Scientific Research Institute of Maternal and Child Health, Ashgabat, Turkmenistan
| | - Zhamilya Usupova
- Republican Center for Health Promotion and Mass Communication, Ministry of Health of the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - João Breda
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
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Fernandez MA, Raine KD. Digital Food Retail: Public Health Opportunities. Nutrients 2021; 13:nu13113789. [PMID: 34836044 PMCID: PMC8624168 DOI: 10.3390/nu13113789] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/23/2021] [Accepted: 10/24/2021] [Indexed: 02/03/2023] Open
Abstract
For over two decades, digital food retail services have been emerging alongside advances in mobile technology and improved access to wi-fi. Digitalization has driven changes within the food environment, complicating an already complex system that influences food-related behaviors and eating practices. Digital food retail services support an infrastructure that enhances commercial food systems by extending access to and availability of highly processed foods, further escalating poor dietary intakes. However, digital food retail services are heterogeneous–food delivery apps, online groceries, and meal kits–and can be feasibly adapted to nutrition interventions and personalized to individual needs. Although sparse, new evidence indicates great potential for digital food retail services to address food insecurity in urban areas and to support healthy eating by making it easier to select, plan, and prepare meals. Digital food retail services are a product of the digital transformation that reflect consumers’ constant need for convenience, which must be addressed in future research and interventions. This paper will discuss public health opportunities that are emerging from the global uptake of digital food retail services, with a focus on online groceries, food delivery apps, and meal kits.
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24
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The role of peers, siblings and social media for children’s healthy eating socialization: a mixed methods study. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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25
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Oono F, Matsuura N, Saito A, Fujiwara A, Takahashi O, Sasaki S, Iida K. Association of Hours of Paid Work with Dietary Intake and Quality in Japanese Married Women: A Cross-Sectional Study. Nutrients 2021; 13:nu13093005. [PMID: 34578884 PMCID: PMC8466932 DOI: 10.3390/nu13093005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/21/2022] Open
Abstract
This study investigated the association of hours of paid work with dietary intake and diet quality among Japanese married women. This cross-sectional study was a secondary analysis of a nationwide population survey in 2013. The analytic sample included 644 married women aged 20–59 years. The participants were categorized into five groups according to hours of paid work per week: 0 (housewives), 1–14, 15–34, 35–42, and ≥43 h. Dietary intake was assessed by a self-administered diet history questionnaire. The Nutrient-Rich Food Index 9.3 (NRF9.3) was used to measure the dietary quality. The association of hours of paid work with dietary intake and NRF9.3 score was assessed using a multivariable general linear regression analysis with adjustments for confounders. Hours of paid work were associated with a higher intake of rice and lower intake of vegetables, potatoes, soy products, and seaweeds and nutrients including protein, dietary fiber, and most vitamins and minerals. Hours of paid work were negatively associated with the NRF9.3 score. This study showed that Japanese married women engaging in paid work, especially those who work long hours, have less healthy diets. Efforts to improve the dietary intake of married women with paid work might be needed.
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Affiliation(s)
- Fumi Oono
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;
| | - Nozomi Matsuura
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
| | - Aki Saito
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
| | - Aya Fujiwara
- Department of Nutritional Epidemiology and Shokuiku, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan;
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Osamu Takahashi
- Department of Epidemiology, Graduate School of Public Health, St. Luke’s International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
- Department of General Internal Medicine, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kaoruko Iida
- Department of Nutrition and Food Science, Graduate School of Humanities and Sciences, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; (F.O.); (N.M.); (A.S.)
- Institute for Human Life Innovation, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan
- Correspondence: ; Tel.: +81-3-5978-5474
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26
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Fiorentino R, Chiarelli F. Treatment of Dyslipidaemia in Children. Biomedicines 2021; 9:biomedicines9091078. [PMID: 34572264 PMCID: PMC8470054 DOI: 10.3390/biomedicines9091078] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/07/2021] [Accepted: 08/21/2021] [Indexed: 01/14/2023] Open
Abstract
Childhood dyslipidaemia is one of the main traditional cardiovascular risk factors that initiate and exacerbate the atherosclerotic process. Healthcare providers may play a key role in the management of children with lipid abnormalities; however, they have to properly evaluate the normal lipid values and know the available treatment options in children and adolescents. Current guidelines recommend healthy behaviours as the first-line treatment for childhood dyslipidaemia. The therapeutic lifestyle changes should focus on dietary modifications, daily physical activity, reduction in body weight and tobacco smoking cessation. Parents play a key role in promoting their children’s healthy habits. In children with more severe forms of lipid abnormalities and in those who do not benefit from healthy behaviours, pharmacological therapy should be considered. Safe and effective medications are already available for children and adolescents. Statins represent the first-line pharmacological option, while ezetimibe and bile acid sequestrants are usually used as second-line drugs. Despite their limited use in children, other lipid-lowering agents (already approved for adults) are currently available or under study for certain categories of paediatric patients (e.g., familial hypercholesterolemia). Further studies are needed to evaluate the long-term efficacy, safety and tolerability of novel lipid-lowering drugs, especially in children.
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27
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Stankov I, Useche AF, Meisel JD, Montes F, Morais LM, Friche AA, Langellier BA, Hovmand P, Sarmiento OL, Hammond RA, Diez Roux AV. From causal loop diagrams to future scenarios: Using the cross-impact balance method to augment understanding of urban health in Latin America. Soc Sci Med 2021; 282:114157. [PMID: 34182357 PMCID: PMC8287591 DOI: 10.1016/j.socscimed.2021.114157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/17/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022]
Abstract
Urban health is shaped by a system of factors spanning multiple levels and scales, and through a complex set of interactions. Building on causal loop diagrams developed via several group model building workshops, we apply the cross-impact balance (CIB) method to understand the strength and nature of the relationships between factors in the food and transportation system, and to identify possible future urban health scenarios (i.e., permutations of factor states that impact health in cities). We recruited 16 food and transportation system experts spanning private, academic, non-government, and policy sectors from six Latin American countries to complete an interviewer-assisted questionnaire. The questionnaire, which was pilot tested on six researchers, used a combination of questions and visual prompts to elicit participants' perceptions about the bivariate relationships between 11 factors in the food and transportation system. Each participant answered questions related to a unique set of relationships within their domain of expertise. Using CIB analysis, we identified 21 plausible future scenarios for the system. In the baseline model, 'healthy' scenarios (with low chronic disease, high physical activity, and low consumption of highly processed foods) were characterized by high public transportation subsidies, low car use, high street safety, and high free time, illustrating the links between transportation, free time and dietary behaviors. In analyses of interventions, low car use, high public transport subsidies and high free time were associated with the highest proportion of factors in a healthful state and with high proportions of 'healthy' scenarios. High political will for social change also emerged as critically important in promoting healthy systems and urban health outcomes. The CIB method can play a novel role in augmenting understandings of complex urban systems by enabling insights into future scenarios that can be used alongside other approaches to guide urban health policy planning and action.
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Affiliation(s)
- Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St, Philadelphia, PA, 19104, USA; South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.
| | - Andres Felipe Useche
- Department of Industrial Engineering, Universidad de Los Andes, Bogotá, Colombia; Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
| | - Jose D Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Carrera 22 Calle 67, Ibagué, 730001, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, Universidad de Los Andes, Bogotá, Colombia; Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
| | - Lidia Mo Morais
- Observatory for Urban Health in Belo Horizonte, Belo Horizonte, Brazil; School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Amelia Al Friche
- Observatory for Urban Health in Belo Horizonte, Belo Horizonte, Brazil; School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Peter Hovmand
- Center for Community Health Integration, Case Western Reserve University, Cleveland, OH, USA
| | - Olga Lucia Sarmiento
- Department of Public Health, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Ross A Hammond
- Brown School at Washington University in St. Louis, One Brookings Drive, St Louis, MO, 36130, USA; Center on Social Dynamics and Policy, The Brookings Institution, 1775 Massachusetts Ave NW, Washington, DC, 20036, USA; Santa Fe Institute, 1399 Hyde Park Rd, Santa Fe, NM, 87501, USA
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St, Philadelphia, PA, 19104, USA
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Growth of Ready Meals in Australian Supermarkets: Nutrient Composition, Price and Serving Size. Foods 2021; 10:foods10071667. [PMID: 34359537 PMCID: PMC8304220 DOI: 10.3390/foods10071667] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/18/2022] Open
Abstract
Pre-prepared, or ready meals (frozen, chilled and shelf-stable) are increasingly available in supermarkets in developed countries. This study aimed to investigate how the range of ready meals in Australian supermarkets has changed from 2014 to 2020, and how products vary by price, serving size, nutrient composition and Health Star Rating. Product information was obtained from the FoodTrack™ packaged food database for the years 2014 to 2019 and from an instore audit of products available in Adelaide, Australia for 2020. There was a 13% annual average increase in the number of ready meals available in supermarkets. Serving size did not change (median 350 g, p-trend = 0.100) and price increased modestly from 2014 to 2020 (median $1.67 to $1.79/100 g, p-trend < 0.001), with chilled ready meals being the most expensive. A modest decrease in sodium density from 2014 to 2020 (median 275 to 240 mg/100 g, p-trend < 0.001) was seen. However, the category has a wide range in Health Star Ratings and nutrient composition, highlighting the importance of appropriate consumer choice to optimise health benefits. With the increasing availability of ready meals, global improvements within this category should be encouraged and consumers guided to choose healthier products.
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Trentinaglia MT, Parolini M, Donzelli F, Olper A. Climate change and obesity: A global analysis. GLOBAL FOOD SECURITY 2021. [DOI: 10.1016/j.gfs.2021.100539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Zachary M, Sisley S. The Pediatric Obesity Encounter: Literature and Resources to Help with 4 Common Issues. Curr Nutr Rep 2021; 9:94-100. [PMID: 32350815 DOI: 10.1007/s13668-020-00308-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW We review here best practices and resources for pediatricians providing pediatric obesity management in 4 key areas: how to assess all of the relevant factors contributing to obesity, how to provide nutrition education, how to counsel families who eat out regularly, and what to do with patients who frequently make poor eating choices. RECENT FINDINGS While there are many resources indicating recommendations for the physical exam and laboratory tests, there are very few resources that give pragmatic advice on the counseling aspects of the pediatric obesity encounter. We note new nutrition research showing the importance of avoiding ultra-processed foods. Most importantly, we list several resources regarding useful questionnaires, nutrition guidance, and even further training for pediatricians. There is a need for more curation of resources in different aspects of obesity care. We hope that this review and list of resources are helpful for pediatricians and will empower families and can be expanded in the future.
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Affiliation(s)
- Montgomery Zachary
- Department of Pediatrics, Baylor College of Medicine, 1100 Bates St. #10068, Houston, TX, 77030, USA
| | - Stephanie Sisley
- Department of Pediatrics, Baylor College of Medicine, 1100 Bates St. #10068, Houston, TX, 77030, USA.
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Horning ML, Hill T, Martin CL, Hassan A, Petrovskis A, Bohen L. The East Side Table Make-at-Home Meal-Kit Program is feasible and acceptable: A pilot study. Appetite 2020; 160:105087. [PMID: 33359465 DOI: 10.1016/j.appet.2020.105087] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 11/15/2022]
Abstract
Drawing from marketing literature, shopper solutions and food bundles (that group items to be used together) can promote purchase intention, efficacy, and related outcomes. Similarly, meal kits boxes (food bundles with step-by-step instructions to prepare home-cooked meals) have potential to be an accessible intervention to facilitate healthy, at-home food preparation and intake. This manuscript describes the feasibility, acceptability, and preliminary outcomes of a community-designed and -led program promoting healthy food skills, accessibility, and intake through meal kits. This pilot study was designed using community-based participatory research principles and 60 participants enrolled in the study. Participating families received a free meal kit weekly during the 10-week program. Meal-kit boxes also included language-appropriate recipe cards, step-by-step instructions, and supplemental educational material including links to videos with related food preparation tips and fact sheets about the meal. Data were collected at baseline, post-program, and follow-up (3 months post-program). Specifically, validated measures were used to assess food insecurity, food availability, cooking preparation techniques, self-efficacy, and fruit/vegetable intake. Process data were also collected. Descriptive statistics, paired t-tests, and Wilcoxon sign-ranked tests were used to describe data and evaluate outcomes. Content analysis was used to code open-ended survey responses into categories. Study findings indicated retention rates were high (≥90%); 83% made eight or more meal kits. At post-program, significant increases were observed in cooking/meal preparation self-efficacy, cooking techniques, and healthy food availability. At follow-up, only healthy food availability remained significantly higher. Findings suggest that meal-kit programs are feasible and acceptable, and there is a potential for these programs to influence factors important to increasing healthy home-cooked meals and dietary intake. Future research should use more rigorous designs and explore meal-kit dosage.
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Affiliation(s)
- Melissa L Horning
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, MN, 55414, USA.
| | - Terese Hill
- East Side Table, M Health Fairview, 1690 University Avenue West, Suite 250, Saint Paul, MN, 55104, USA.
| | - Christie L Martin
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, MN, 55414, USA.
| | - Abdirahman Hassan
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, Minneapolis, MN, 55414, USA.
| | - Anna Petrovskis
- School of Nursing, Box 357260, University of Washington, Seattle, WA, 98195, USA.
| | - Laura Bohen
- Health & Nutrition Programs, University of Minnesota Extension, Coffey Hall 1420 Eckles Ave, St Paul, MN, 55108, USA.
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Johnson BJ, Golley RK, Zarnowiecki D, Hendrie GA, Huynh EK. Understanding the influence of physical resources and social supports on primary food providers' snack food provision: a discrete choice experiment. Int J Behav Nutr Phys Act 2020; 17:155. [PMID: 33256737 PMCID: PMC7706064 DOI: 10.1186/s12966-020-01062-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/23/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Snack eating occasions contribute approximately a third of children's energy intake, with approximately half of all unhealthy foods consumed during snack times. Therefore, it is critical to understand the drivers of primary food providers' snack provision. The study aims were to determine the relative importance of physical resources and social supports when primary food providers are choosing snacks to provide to their child, and to investigate how these attributes differ in social versus non-social occasions, and between subgroups of primary food providers based on socio-economic position. METHODS Primary food providers of three to seven-year olds completed an online discrete choice experiment, by making trade-offs when completing repeated, hypothetical choice tasks on the choice of snacks to provide to their child in: 1) non-social and 2) social condition. Choice tasks included two alternatives consisting of varying attribute (i.e. factor) levels, and an opt-out option. The order of conditions shown were randomized across participants. Multinomial logit model analyses were used to determine utility weights for each attribute. RESULTS Two-hundred and twenty-five primary food providers completed the study, providing 1125 choice decisions per condition. In the non-social condition, the top three ranked attributes were type of food (utility weight 1.94, p < 0.001), child resistance (- 1.62, p < 0.001) and co-parent support (0.99, p < 0.001). In the social condition, top ranking attributes were child resistance (utility weight - 1.50, p < 0.001), type of food (1.38, p < 0.001) and co-parent support (1.07, p < 0.001). In both conditions, time was not a significant influence and cost was of lowest relative importance. Subgroup analyses revealed cost was not a significant influence for families from higher socio-economic backgrounds. CONCLUSIONS Type of food, child resistance and co-parent support were of greatest relative importance in primary food providers' snack provision decision-making, regardless of social condition or socio-economic position. In designing future interventions to reduce unhealthy snacks, researchers should prioritize these influences, to better support primary food providers in changing their physical and social opportunity. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry no. ACTR N12618001173280.
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Affiliation(s)
- Brittany J Johnson
- Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia.
| | - Rebecca K Golley
- Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia
- Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, New South Wales, Australia
| | - Dorota Zarnowiecki
- Caring Futures Institute, College of Nursing & Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia
- Early Prevention of Obesity in Childhood Centre for Research Excellence, Sydney, New South Wales, Australia
| | - Gilly A Hendrie
- Health & Biosecurity Flagship, Commonwealth Scientific Industrial Research Organisation, Adelaide, South Australia, Australia
| | - Elisabeth K Huynh
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Acton, Australian Capital Territory, Australia
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Martins CA, Andrade GC, Oliveira MFBD, Rauber F, Castro IRRD, Couto MT, Levy RB. "Healthy", "usual" and "convenience" cooking practices patterns: How do they influence children's food consumption? Appetite 2020; 158:105018. [PMID: 33166600 DOI: 10.1016/j.appet.2020.105018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/24/2020] [Accepted: 10/31/2020] [Indexed: 10/23/2022]
Abstract
This study identified adults' cooking practices patterns and tested their associations with children's consumption of ultra-processed foods. Cross-sectional study conducted with 551 adult-child pairs from São Paulo, Brazil. Children's food consumption was collected through dietary recalls. Adults' cooking practices were identified using a questionnaire developed for the Brazilian's context. Principal Component Analysis has been employed to identify cooking patterns and linear regression models (crude and adjusted for sociodemographic variables) have been used to test associations between pattern's scores and contribution of ultra-processed foods to total energy at dinners. Three cooking patterns were identified: "Healthy", "Usual" and "Convenience". The first two patterns reflected behaviors of people who mostly cook "from scratch". Only the Healthy pattern (confidence to cook several meals using fresh foods and natural seasonings; healthier cooking techniques) was inversely associated with ultra-processed food consumption (β = -4.1; p = 0.002), whereas the Convenience pattern (less frequency and time to cook, using microwave and ready-to-heat meals) was positively associated with (β = 3.6; p = 0.008). Our results suggest that cooking at home, as an isolated action, is not enough to protect the consumption of ultra-processed foods. To promote healthy eating among children, the adults' cooking practices should be aligned with the preparation of meals made "from scratch", taking into account the healthiness of what is being cooked.
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Affiliation(s)
- Carla Adriano Martins
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil.
| | - Giovanna Calixto Andrade
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil
| | | | - Fernanda Rauber
- Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil
| | - Inês Rugani Ribeiro de Castro
- Nutrition Institute, Rio de Janeiro State University. R. São Francisco Xavier, 524, Maracanã, Rio de Janeiro, RJ, Brazil
| | - Marcia Thereza Couto
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil
| | - Renata Bertazzi Levy
- Department of Preventive Medicine, School of Medicine, University of São Paulo, Av. Dr Arnaldo 455, Cerqueira César, São Paulo, SP, 01246-903, Brazil; Center for Epidemiological Studies in Health and Nutrition, University of São Paulo, Av. Dr Arnaldo 715, São Paulo, SP, 01246-904, Brazil
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Blondin SA, AlSukait R, Bleiweiss-Sande R, Economos CD, Tanskey LA, Goldberg JP. Processed and Packed: How Refined Are the Foods That Children Bring to School for Snack and Lunch? J Acad Nutr Diet 2020; 121:883-894. [PMID: 33023852 DOI: 10.1016/j.jand.2020.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/14/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Increasing consumption of highly processed foods has been associated with adverse health outcomes among children. In the US, children consume up to half of their daily energy intake at school. OBJECTIVES We sought to characterize foods that children bring from home to school according to processing level and to evaluate the effectiveness of a school-based intervention, Great Taste Less Waste (GTLW), in reducing the proportion of energy brought from highly processed foods from home compared with control. DESIGN Secondary data analysis of a 7-month school-based, cluster-randomized trial. PARTICIPANTS/SETTING Third- and fourth-grade students (n = 502, mean age: 9.0 ± 0.62 years) at 10 public elementary schools in Eastern Massachusetts (school year 2012-2013). INTERVENTION GTLW included a 22-lesson classroom curriculum, homework activities, monthly parent newsletters, a food shopping and packing guide for parents, food demonstrations, school-wide announcements, and a poster contest. MAIN OUTCOME MEASURES The energy content of foods brought to school was estimated from digital photographs, and foods were assigned to 1 of 3 processing levels (less processed or unprocessed, moderately processed, or highly processed) based on an established classification system. STATISTICAL ANALYSES PERFORMED The percentage of energy brought from foods categorized into each processing level was calculated and compared pre- and postintervention using hierarchical linear models. RESULTS Most of the food brought from home to school was highly processed (70% of food energy brought). Foods categorized as snack foods and desserts contributed the greatest percentage of total energy to the highly processed category at baseline and follow-up (72% and 69%, respectively). Energy from foods brought for snack tended to be more highly processed than those brought for lunch. No significant differences were observed from pre- to postintervention in the GTLW group compared with control for the percentage of energy brought from highly processed foods in adjusted models (β: -1.1, standard error: 2.2, P = .6) or any other processing level. CONCLUSIONS Highly processed foods were prevalent in home-packed lunches and snacks, and these patterns persisted after a targeted intervention. Further research is needed to identify strategies to improve the healthfulness of foods brought from home to school.
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Carbonneau E, Lamarche B, Provencher V, Desroches S, Robitaille J, Vohl MC, Bégin C, Bélanger M, Couillard C, Pelletier L, Bouchard L, Houle J, Langlois MF, Corneau L, Lemieux S. Associations Between Nutrition Knowledge and Overall Diet Quality: The Moderating Role of Sociodemographic Characteristics—Results From the PREDISE Study. Am J Health Promot 2020; 35:38-47. [DOI: 10.1177/0890117120928877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose: To assess how nutrition knowledge is associated with global diet quality and to investigate whether sociodemographic characteristics (ie, sex, age, education, income, marital status, and living with children or not) moderate this association. Design: Cross-sectional web-based study. Participants: The PREDISE study aims at identifying correlates of adherence to healthy eating guidelines in French-speaking adults from the Province of Quebec, Canada. Subjects: A probability sample of 1092 participants (50% female). Measures: The Nutrition Knowledge Questionnaire and 24-hour food recalls from which the Canadian Healthy Eating Index (C-HEI) was calculated. Analysis: Multiple linear regressions performed to assess how nutrition knowledge is associated with the C-HEI. Interaction terms tested to evaluate whether sociodemographic characteristics moderate the association between nutrition knowledge and the C-HEI. Results: Nutrition knowledge (B = 0.141 [95% CI: 0.075-0.208], P < .0001) was identified as a significant correlate of the C-HEI. Education significantly moderated the association between nutrition knowledge and the C-HEI ( P interaction = .0038), with a significative association among participants with a lower education level (B = 0.295 [95% CI: 0.170-0.421], P < .0001) but not among participants with a higher education level (B = 0.077 [95% CI: −0.004 to 0.157], P = .06). Whether participants lived with or without children also significantly moderated the association ( P interaction = 0.0043); nutrition knowledge was associated with the C-HEI only in participants who were not living with children (B = 0.261 [95% CI: 0.167 to 0.355], P < .0001). Conclusion: This study suggests that the association between nutrition knowledge and adherence to healthy eating guidelines is not the same in different subgroups of the population. Interventions aiming at increasing nutrition knowledge may be a promising approach to improve diet quality, especially among individuals with a lower education.
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Affiliation(s)
- Elise Carbonneau
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Véronique Provencher
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Sophie Desroches
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Julie Robitaille
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Marie-Claude Vohl
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Catherine Bégin
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Psychology, Université Laval, Québec, Canada
| | - Mathieu Bélanger
- Department of Family Medicine, Université de Sherbrooke, Moncton, New Brunswick, Canada
| | - Charles Couillard
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Luc Pelletier
- School of Psychology, University of Ottawa, Ontario, Canada
| | - Luigi Bouchard
- Department of Medical Biology, CIUSSS du Saguenay-Lac-St-Jean, Saguenay, Quebec, Canada
- Department of Biochemistry, Université de Sherbrooke, Quebec, Canada
| | - Julie Houle
- Nursing Department, Université du Québec à Trois-Rivières, Quebec, Canada
| | - Marie-France Langlois
- Division of Endocrinology, Department of Medicine, Université de Sherbrooke, Quebec, Canada
| | - Louise Corneau
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, Canada
- School of Nutrition, Université Laval, Québec, Canada
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Parents' cooking skills confidence reduce children's consumption of ultra-processed foods. Appetite 2020; 144:104452. [DOI: 10.1016/j.appet.2019.104452] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/05/2019] [Accepted: 09/11/2019] [Indexed: 02/08/2023]
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The relationship between perceived time pressure and food practices among UK adults in employment. Proc Nutr Soc 2020. [DOI: 10.1017/s0029665120007417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Meal Planning Program to Reduce Barriers and Improve Diet Quality in Worksite Wellness Center Members. J Occup Environ Med 2019; 60:998-1004. [PMID: 29995649 DOI: 10.1097/jom.0000000000001390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Many adults struggle with eating healthfully. To address this problem, dietitians and a physician at a worksite wellness center designed and implemented a healthy eating program to identify and reduce barriers and to improve nutrition knowledge, confidence, and eating habits. METHODS A single cohort study design of members of a worksite wellness center who attended the program. RESULTS Eight-six participants demonstrated significant improvement in reducing perceived barriers (P < 0.001), improving nutritional knowledge (P = 0.001), increasing confidence (P < 0.001), and increasing the frequency of preparing healthy meals (P < 0.001) and intake of fruits and vegetables (P < 0.001). These improvements were maintained at the 6-month follow-up. CONCLUSION These results suggest that participation in a 6-week nutrition education program at a worksite wellness center decreases barriers to healthy eating and improves dietary intake.
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Smith SL, Ramey E, Sisson SB, Richardson S, DeGrace BW. The Family Meal Model: Influences on Family Mealtime Participation. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2019; 40:138-146. [PMID: 31631755 DOI: 10.1177/1539449219876878] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The family meal affords benefits such as positive nutritional habits, trust building, connecting, parent modeling, and teaching. During the school-aged years, families can support children's development of health behaviors and family routines. This interdisciplinary study examined families' experiences of mealtimes and the factors that support or hinder mealtime participation. Grounded theory methods guided data collection and analysis. Semi-structured interviews were conducted with 21 families with at least one school-aged child (n = 68). Interviews were audio recorded and transcribed. Researchers coded and categorized data, identified themes, and generated a model. Families defined family mealtime as all family members being together at the kitchen or dining room table eating a meal. Families enjoyed being together, conversing, and connecting through family mealtime participation. The Family Meal Model proposes relationships between factors that support or hinder a family's mealtime participation. Discussion includes support for a broadened role of occupational therapy in promoting family occupation through family meals.
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Affiliation(s)
| | | | - Susan B Sisson
- The University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Sandra Richardson
- The University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Beth W DeGrace
- The University of Oklahoma Health Sciences Center, Oklahoma City, USA
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41
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Association between hours worked in paid employment and diet quality, frequency of eating out and consuming takeaways in the UK. Public Health Nutr 2019; 22:3368-3376. [PMID: 31407640 DOI: 10.1017/s1368980019002222] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine associations between hours worked and diet quality, frequency of eating out and consuming takeaways. DESIGN Data were taken from the National Diet and Nutrition Survey (2008-2014). Associations between hours worked in paid employment and diet quality, assessed using the Diet Quality Index (DQI) and selected foods and nutrients, were tested using linear regression models. Associations between hours worked and frequency of eating out and consuming takeaways were tested using ordinal logistic regression models. All models were adjusted for sex, age, equivalised household income, household composition and household food role. SETTING UK. PARTICIPANTS Adults (n 2154) aged 19-64 years in employment. RESULTS Mean (95 % CI) hours worked per week was 36·1 (35·6, 36·6) and mean DQI score was 41·9 (41·2, 42·5) %. Hours worked was not associated with DQI score, frequency of eating out or consuming takeaways. Hours worked was positively associated with consuming red meat, processed meat and alcohol intake. Adults working more hours had lower intake of fibre but higher total fat and saturated fat intakes if they lived in households with children. CONCLUSIONS Working hours may not be the main factor driving poor-quality diets among this sample of UK adults in employment. Focusing on consumption of foods prepared outside the household may not be the most efficient way to improve diet quality as effort is needed at all levels. Although it is unclear what is driving the differences in nutrient intakes according to household composition, they are important to consider when developing interventions to improve healthy eating.
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Fulkerson JA, Telke S, Larson N, Berge J, Sherwood NE, Neumark-Sztainer D. A healthful home food environment: Is it possible amidst household chaos and parental stress? Appetite 2019; 142:104391. [PMID: 31377322 DOI: 10.1016/j.appet.2019.104391] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/22/2019] [Accepted: 07/30/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE This study examines how household chaos and unmanaged parental stress are associated with and contribute to variance in markers of the home food environment (family meal frequency, perceived barriers to cooking, healthful home food availability). Obtaining a better understanding of these relationships could guide more effective family-based interventions to promote healthful home food environments. METHODS The analytic sample included 819 households with children in the population-based Project EAT-IV cohort with survey data from 2015 to 2016. Multiple linear regression was used to generate means and 95% confidence intervals of home food environment variables, and estimates for the contribution of household chaos (defined by frenetic activity, loud noises and disorder), and quartiles of unmanaged parental stress (ratio of perceived stress and ability to manage stress). Model fit was also examined. RESULTS/FINDINGS Both household chaos and quartiles of unmanaged parental stress were independently and inversely associated with family meal frequency (p's < 0.001) and positively associated with perceived mealtime preparation barriers (p's < 0.001). Unmanaged parental stress was also inversely associated with healthful home food availability (p = 0.004). Models including demographic characteristics, household chaos scores, and quartiles of unmanaged parental stress index showed significantly improved model fit for all outcomes compared to less comprehensive models. Among families with high chaos, those having 7 + family meals/week were significantly more likely to have lower mealtime preparation barrier scores, younger children and higher healthful home food availability scores than families eating together less often. CONCLUSIONS Interventions to assist with parental management of stress and chaos within the home environment (e.g., establishing routines) may increase family meal frequency and the quality of children's home food environments.
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Affiliation(s)
- Jayne A Fulkerson
- School of Nursing, University of Minnesota, 5-160 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55454, USA.
| | - Susan Telke
- Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA.
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA.
| | - Jerica Berge
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, 717 Delaware St. SE, Room 425, Minneapolis, MN, 55454, USA.
| | - Nancy E Sherwood
- Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN, 55454, USA.
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Elkins C, Fruh S, Jones L, Bydalek K. Clinical Practice Recommendations for Pediatric Dyslipidemia. J Pediatr Health Care 2019; 33:494-504. [PMID: 31227123 DOI: 10.1016/j.pedhc.2019.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 12/29/2022]
Abstract
The leading cause of mortality in the United States is atherosclerotic cardiovascular disease (ASCVD). Atherosclerotic lesions begin during childhood and can place individuals at greater risk for ASCVD. Providers play an active role in preventing the progression of risk factors and future ASCVD events through appropriate clinical management of genetic and acquired dyslipidemias in the pediatric population. Health care providers need to be aware of current recommendations related to screening for dyslipidemia, lifestyle modification strategies, pharmacologic treatment, and guidelines for ongoing monitoring. Most patients with mild to moderate dyslipidemia can be managed by a primary care provider. It is imperative that providers understand the pathophysiology, screening methods, and available treatment options to effectively manage the condition. Frequent reassessment of family history and adherence to lifestyle modifications and pharmacologic interventions is essential for effective treatment.
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Mothers' Vegetable Consumption Behaviors and Preferences as Factors Limiting the Possibility of Increasing Vegetable Consumption in Children in a National Sample of Polish and Romanian Respondents. Nutrients 2019; 11:nu11051078. [PMID: 31096620 PMCID: PMC6566701 DOI: 10.3390/nu11051078] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/04/2019] [Accepted: 05/10/2019] [Indexed: 12/18/2022] Open
Abstract
Increasing the insufficient intake of vegetables in children may be difficult, due to the influence of parents and at-home accessibility. The aim of this study was to analyze the association between self-reported vegetable consumption behaviors and preferences of mothers and the behaviors and preferences of their children, as declared by them. The nationally representative Polish (n = 1200) and Romanian (n = 1157) samples of mothers of children aged 3-10 were obtained using the random quota sampling method, and interviewed for their and their children's general frequency of consumption and preferences of vegetables in years 2012-2014. A 24 h dietary recall of vegetable consumption was conducted for mothers and their children. Associations were observed for general number of servings consumed per day by mother-child pairs (p < 0.0001; R = 0.6522, R = 0.6573 for Polish and Romanian samples, respectively) and number of types indicated as preferred (p < 0.0001; R = 0.5418, R = 0.5433). The share of children consuming specific vegetables was 33.1-75.3% and 42.6-75.7% while their mothers also consumed, but 0.1-43.2% and 1.2-22.9% while their mothers did not. The share of children preferring specific vegetables was 16.7-74.1% and 15.2-100% when their mother shared the preference, but 1.3-46.9% and 0-38.3% when their mother did not. The mothers' vegetable consumption behaviors and preferences may be a factor limiting the possibility of increasing vegetable consumption in their children.
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Snuggs S, Houston-Price C, Harvey K. Development of a Parental Feeding Goal Measure: The Family Mealtime Goals Questionnaire. Front Psychol 2019; 10:455. [PMID: 30914992 PMCID: PMC6422867 DOI: 10.3389/fpsyg.2019.00455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/15/2019] [Indexed: 01/06/2023] Open
Abstract
It is well established that parents' feeding practices predict children's eating behaviors. However, there has been little research into parents' mealtime goals-their desired outcomes for family mealtimes. These goals, and potential conflicts between them, may be important both in explaining parents' feeding practices and improving children's eating behaviors, as health behavior change is more likely to be achieved by programmes and interventions that are aligned with an individual's goals. The objectives of this study were to develop a reliable and valid measure that captures parental mealtime goals, and to describe parents' endorsement of these goals. Online questionnaire methods were used to design and test the Family Mealtime Goals Questionnaire with 1,140 parents and carers of at least one child aged from 1 to 16 years. Exploratory qualitative analysis, Principal Components Analysis, Confirmatory Factor Analysis, and test-retest analysis (using intraclass correlations) were conducted to establish the psychometric properties of the instrument. An 18-item questionnaire was produced with seven dimensions: stress/conflict avoidance, homemade food, shared family food, family involvement in mealtimes, price, occasional treats, and high/low fat regulation. Some differences were found in the goal structure of parents of children of different ages but stress/conflict avoidance was the most strongly endorsed mealtime goal for all age groups. The Family Mealtime Goals Questionnaire provides a useful measure of parents' feeding motivations. It will facilitate large-scale research into the relationships between parents' feeding goals and practices and could inform the design of more effective healthy eating interventions that target specific feeding goals.
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Affiliation(s)
| | | | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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46
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47
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Utter J, Larson N, Berge JM, Eisenberg ME, Fulkerson JA, Neumark-Sztainer D. Family meals among parents: Associations with nutritional, social and emotional wellbeing. Prev Med 2018; 113:7-12. [PMID: 29746973 PMCID: PMC6309329 DOI: 10.1016/j.ypmed.2018.05.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/24/2018] [Accepted: 05/06/2018] [Indexed: 10/17/2022]
Abstract
A growing body of research suggests that children and adolescents who share frequent meals with their families report better nutrition indicators, family relationships and mental health. Yet, little research has examined whether parents who share meals with their families report the same indicators of wellbeing. The current paper addresses this question using population-based survey data and a sample of parents in the United States (n = 889, mean age 31 years) that responded to the fourth wave of the Project EAT study in 2015-16. Multiple regression models were used to examine associations between frequency of family meals and indicators of nutritional, social and emotional wellbeing, controlling for demographic and household characteristics. Analyses also examined if associations were moderated by sex, as mothers tend to be more responsible for household and childcare tasks. Results suggested that parent report of frequent family meals was associated with higher levels of family functioning, greater self-esteem, and lower levels of depressive symptoms and stress (p-value for all <0.001). Frequency of family meals was also related to greater fruit and vegetable consumption (both p < 0.05), but was unrelated to other indicators of parent body size and nutritional wellbeing. Associations between frequency of family meals and parent wellbeing were similar for both mothers and fathers. Findings from the current study suggest that frequent family meals may contribute to the social and emotional wellbeing of parents. Future strategies to promote family meals should consider the potential impacts on the health and wellbeing of the whole family.
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Affiliation(s)
- Jennifer Utter
- University of Auckland, School of Population Health, Private Bag 92019, Auckland 1142, New Zealand.
| | - Nicole Larson
- University of Minnesota, Division of Epidemiology and Community Health, 1300 South Second St, Minneapolis, MN 55454, USA.
| | - Jerica M Berge
- University of Minnesota, Department of Family Medicine and Community Health, 717 Delaware St SE, Minneapolis, MN 55414, USA.
| | - Marla E Eisenberg
- University of Minnesota, Department of Pediatrics, 717 Delaware St SE, Minneapolis, MN 55414, USA.
| | - Jayne A Fulkerson
- University of Minnesota, School of Nursing, 308 Harvard St SE, Minneapolis, MN 55455, USA.
| | - Dianne Neumark-Sztainer
- University of Minnesota, Division of Epidemiology and Community Health, 1300 South Second St, Minneapolis, MN 55454, USA.
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A latent class analysis of family eating habits in families with adolescents. Appetite 2018; 129:37-48. [PMID: 29966728 DOI: 10.1016/j.appet.2018.06.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/05/2018] [Accepted: 06/29/2018] [Indexed: 01/07/2023]
Abstract
The objectives of the present study were to identify adolescent classes based on perceptions of their family's eating habits and to determine whether these classes differ in terms of family meal frequency and source, parents and adolescent diet quality, nutritional status, satisfaction with life, family life and food-related life. Questionnaires were administered to a sample of 300 two-parent families with one child between 10 and 17 years in Chile. Questionnaires included the Satisfaction with Life Scale (SWLS), the Satisfaction with Food-related Life scale (SWFoL), the Satisfaction with Family Life scale (SWFaL) and the Adapted Healthy Eating Index (AHEI). Adolescents also answered the Family Eating Habits Questionnaire (FEHQ). Latent class (LC) analysis was used to estimate the number of classes associated with the adolescent's perceptions about their family's eating habits, based on the three factors detected in the FEHQ. The LC analysis yielded three classes: "medium cohesion around family meals/healthy food-related parenting practices" (Class 1, 50.4%), "high cohesion around family meals/healthy food-related parenting practices" (Class 2, 25.9%) and "high cohesion around family meals/unhealthy food-related parenting practices" (Class 3, 23.7%). Classes also differed in the adolescents AHEI score, frequency and source of family meals; body mass index, SWLS and SWFaL scores in mothers, fathers and adolescents, adolescent sex and household financial situation. These findings suggest that frequent and cohesive family meals improve the well-being in both parents and adolescents, but are not enough to achieve healthier diets and weight statuses in adolescents.
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Comportements, préoccupations et priorités liés à l’utilisation du temps entourant les repas familiaux au Québec. CAHIERS DE NUTRITION ET DE DIETETIQUE 2018. [DOI: 10.1016/j.cnd.2018.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Fulkerson JA. Fast food in the diet: Implications and solutions for families. Physiol Behav 2018; 193:252-256. [PMID: 29630965 DOI: 10.1016/j.physbeh.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 12/25/2022]
Abstract
Fast food is omnipresent in the United States (U.S.) and contributes to poor dietary quality and poor health among youth and adults alike. Children need adults to teach them good eating habits to attain and maintain good health by introducing them to healthful foods and being good role models. The fast food industry, through vast funds and advertising, contribute to challenges parents face to provide healthful foods for their families and thwart our best efforts to meet health goals. Research shows fast food consumption is influenced by lack of cooking confidence, time pressures, and perceptions of ease and convenience. We need practical strategies to help parents and children make healthier food choices. As a product of conference proceedings, this paper provides a non-exhaustive narrative summary of the fast food marketplace and marketing, the contributions of fast food to diet and health, struggles with healthful eating among families, and possible solutions of how we can help children and parents empower themselves to have healthier lives.
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Affiliation(s)
- Jayne A Fulkerson
- School of Nursing, University of Minnesota, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
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