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Screti C, Edwards K, Blissett J. Understanding family food purchasing behaviour of low-income urban UK families: An analysis of parent capability, opportunity and motivation. Appetite 2024; 195:107183. [PMID: 38182053 DOI: 10.1016/j.appet.2023.107183] [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: 09/29/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVE Family food purchasing decisions have a direct influence on children's food environments and are powerful predictors of obesity and dietary quality. This study explored parents' capability, opportunities, and motivations regarding food purchasing for their families, as well as barriers and facilitators of healthy food purchasing behaviour, in an ethnically diverse, low-income area. DESIGN Semi-structured interviews with parents of under-11-year-old children were conducted to investigate family food purchases, both when eating inside and outside the home. Interviews were analysed using framework analysis mapped against the COM-B model (Michie et al., 2011). SETTING An ethnically diverse, low-income area in Birmingham, UK. PARTICIPANTS Sixteen parents (13F, 3M) of under-11-year-old children. 75% Pakistani, 12.5% White British, 6.3% White and Black Caribbean, and 6.3% "Other". RESULTS Four themes were identified: i) I know how to provide healthy meals for my family, ii) Family food purchase decisions are complex, iii) I want what they are eating and iv) Healthy eating is important but eating outside of the home is a treat. The barriers of healthy family food purchasing were predominantly at family and community levels, including time, cost, and both parents' and children's food enjoyment and preferences. Facilitators of healthy family food purchasing were primarily identified at an individual level, with high levels of capability and motivation for healthy food provision. CONCLUSIONS Attempts to enhance parental capability to improve healthy food purchasing through nutrition education is not likely to be a useful intervention target in this group. Emphasis on enjoyment, palatability and value for money could be key to increasing parental motivation to purchase healthy family foods.
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Affiliation(s)
- Cassandra Screti
- School of Psychology and Institute of Health and Neurodevelopment, College of Health & Life Sciences, Aston University, Birmingham, UK
| | - Katie Edwards
- School of Psychology and Institute of Health and Neurodevelopment, College of Health & Life Sciences, Aston University, Birmingham, UK
| | - Jacqueline Blissett
- School of Psychology and Institute of Health and Neurodevelopment, College of Health & Life Sciences, Aston University, Birmingham, UK.
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Zhang K, Xu X, You H. Social causation, social selection, and economic selection in the health outcomes of Chinese older adults and their gender disparities. SSM Popul Health 2023; 24:101508. [PMID: 37720820 PMCID: PMC10500472 DOI: 10.1016/j.ssmph.2023.101508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/26/2023] [Accepted: 09/02/2023] [Indexed: 09/19/2023] Open
Abstract
Background The economic selection hypothesis, which argues that the initial economic situation determines both subsequent health and economic conditions, has been drawn into the debate on causation-selection issues. This study aims to construct a path model with self-rated health and depression score of older adults as health outcomes to measure and compare the social causation forces of wealth accumulation, social selection forces of adulthood health, and economic selection forces of childhood economics, and to examine their gender disparities. Methods Data was obtained from a sample of 19613 older adults aged 45 years or above from the 2014 life history survey and the 2015 routine follow-up survey of the China Health and Retirement Longitudinal Study. Structural equation modeling analysis was conducted employing the full information maximum likelihood estimation method. Results The presence of social causation, social selection, and economic selection were all statistically supported. In self-rated health, social selection forces held the dominant position, while social causation forces were comparable to economic selection forces. In depression score, social selection still exhibited stronger forces than economic selection, but social causation had forces close to social selection and greater than economic selection. The forces of the three hypotheses in self-rated health did not significantly change with gender, but social causation exerted mightier forces than economic selection within the male group, unlike the female group. The forces of economic selection in depression score were greater in females than males and no significant differences were observed among the forces of the three hypotheses in the female group. Conclusions Social causation, social selection, and economic selection operate simultaneously on the self-rated health and depression score of older adults. However, the force magnitudes of the three hypotheses and/or their rankings differ by health outcomes and gender.
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Affiliation(s)
- Kangkang Zhang
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Xinpeng Xu
- School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
| | - Hua You
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
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Tripicchio GL, Croce CM, Coffman DL, Pettinato C, Fisher JO. Age-related differences in eating location, food source location, and timing of snack intake among U.S. children 1-19 years. Int J Behav Nutr Phys Act 2023; 20:90. [PMID: 37495996 PMCID: PMC10369691 DOI: 10.1186/s12966-023-01489-z] [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: 02/24/2023] [Accepted: 06/30/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Snacking is nearly universal and contributes significant energy to U.S. children's diets. Little is known, however, about where and when snacking intake occurs and if such patterns change with age. This research evaluated age-related differences in eating location, food source location, and timing of snacking among U.S. children aged 1-19 years (y). METHODS A cross-sectional analysis of snacking among 14,666 children in the 2007-2018 U.S. National Health and Nutrition Examination Survey was conducted using a single 24-hour dietary recall. Snacking was participant-defined and included all eating occasions outside of meals. Linear regression and analysis of covariance were used to examine the effects of age (toddler 1-2 y, preschooler 3-5 y, school-age 6-11 y, adolescent 12-19 y) on the percentage of daily snack energy consumed by eating location (at home vs. away from home), food source location (grocery store, convenience store, school/childcare, restaurant, from someone else (i.e. "socially"), and other), and time of day (morning, 6am-12pm; early afternoon, 12pm-3pm; late afternoon/afterschool 3pm-6pm; evening 6pm-9pm, late-night 9pm-12am, and overnight 12am-6am). RESULTS On average, U.S. children consumed most of their daily snacking energy at home (71%), from foods and beverages obtained from grocery stores (75%), and in the late afternoon/afterschool (31%). Toddlers and preschoolers consumed a greater percentage of their daily snack energy during the morning hours compared to school-age children and adolescents (both p < 0.001); school-age children consumed the most in the evening (27%, p < 0.001), and adolescents consumed the most in the late-night period (22%, p < 0.001). Age-related increases were seen in the percentage of daily snacking energy eaten outside the home (p < 0.001), and obtained socially (p < 0.001), from restaurants (p < 0.001), and convenience stores (p < 0.001). CONCLUSION Findings reveal age-related differences in eating location, food source location, and timing of snack intake among U.S. children aged 1-19 y. Younger children consume a greater percentage of snacking calories in the morning and at home relative to older children. School-age children and adolescents show greater snacking in the evening and at night and from foods obtained and eaten outside the home. Efforts to promote healthy snacking behaviors among children should consider developmental differences in snacking patterns.
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Affiliation(s)
- Gina L Tripicchio
- 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.
| | - 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
| | - Donna L Coffman
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, SC, USA
| | - Cameron Pettinato
- 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
| | - Jennifer O 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
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Croce CM, Tripicchio GL, Coffman DL, Fisher JO. Association of Snacking Frequency, Size, and Energy Density with Weight Status among Preschool-Aged Children in the United States. J Acad Nutr Diet 2023; 123:309-317. [PMID: 35809782 DOI: 10.1016/j.jand.2022.07.001] [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: 10/06/2021] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Snacking (ie, eating between meals) is common among US preschool-aged children, but associations with weight status are unclear. OBJECTIVE This research evaluated associations of snack frequency, size, and energy density as well as the percent of daily energy from snacking with weight status and sociodemographic characteristics among US children aged 2 to 5 years. DESIGN Cross-sectional analysis of 2007-2018 National Health and Nutrition Examination Survey data using two, caregiver proxy, 24-hour dietary recalls. PARTICIPANTS/SETTING US children aged 2 to 5 years (n = 3,313) with at least one snack occasion over 2 days of intake. MAIN OUTCOME MEASURES Snacking parameters included frequency (number of occasions per day), size (kilocalories per occasion), and energy density (kilocalories per gram per occasion) as well as percent of daily energy from snacking. STATISTICAL ANALYSES Generalized linear regression models evaluated associations of snacking with child weight status (ie, normal weight and overweight/obesity), adjusting for survey weights, energy misreporting, mean meal size, and sociodemographic covariates. RESULTS Children with overweight/obesity consumed more frequent snacks (2.8 [0.06] vs 2.5 [0.03] snacks/day, respectively; P < 0.001), larger snacks (188 [4] vs 162 [23] kcal/occasion, respectively; P < 0.001), and a greater percent of daily energy from snacking (29.80% [1.00%] vs 26.09% [0.40%], respectively; P < 0.001) than children with normal weight. Mean snack frequency and size as well as percentage of daily energy from snacking varied with child age, gender, and head of household education. Associations of snacking with child race and ethnicity were less consistent. CONCLUSIONS These nationally representative findings provide evidence that the consumption of larger, more frequent snacks is associated with overweight/obesity among US children aged 2 to 5 years and snacking varies by sociodemographic characteristics.
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Affiliation(s)
- Christina M Croce
- Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Gina L Tripicchio
- Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Donna L Coffman
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Jennifer Orlet Fisher
- Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania.
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Croce CM, Fisher JO, Coffman DL, Bailey RL, Davey A, Tripicchio GL. Association of weight status with the types of foods consumed at snacking occasions among US adolescents. Obesity (Silver Spring) 2022; 30:2459-2467. [PMID: 36306336 DOI: 10.1002/oby.23571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/24/2022] [Accepted: 07/25/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This study aimed to evaluate snack food-group composition by weight status among United States adolescents. METHODS Cross-sectional analysis of adolescent food-group-component intake from snacking occasions using two 24-hour dietary recalls from the 2007 through 2018 National Health and Nutrition Examination Survey (NHANES; n = 5264; 12-19 years) was conducted. ANCOVA models evaluated food intakes by BMI percentile (BMI%; normal weight [NW]: <85th BMI%; overweight [OW]: 85th-95th BMI%; and obesity [OB]: ≥95th BMI%), adjusting for energy misreporting and key covariates. RESULTS Adolescents with OB consumed greater total daily energy from snacks (mean [SE]: NW = 424 [10] kcal; OW = 527 [16] kcal; OB = 603 [22] kcal; p < 0.001) than adolescents with OW and NW. Adolescents with OW or OB consumed higher amounts of refined grains, dairy, protein, oil, solid fat, and added sugar from snacks than adolescents with NW (p < 0.05-0.001). CONCLUSIONS Adolescents with OW or OB consume more calories and higher levels of overconsumed dietary components, i.e., added sugar, solid fats, and refined grains, from snacks than adolescents with NW. Age-specific snacking recommendations to inform dietary guidance are needed to prevent excess intake of overconsumed nutrients and calories.
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Affiliation(s)
- Christina M Croce
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Jennifer Orlet Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Donna L Coffman
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Regan L Bailey
- Institute for Advancing Health through Agriculture, Texas A&M University System, College Station, Texas, USA
| | - Adam Davey
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Gina L Tripicchio
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
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Hecht AA, Dunn CG, Kinsey EW, Read MA, Levi R, Richardson AS, Hager ER, Seligman HK. Estimates of the Nutritional Impact of Non-Participation in the National School Lunch Program during COVID-19 School Closures. Nutrients 2022; 14:1387. [PMID: 35406001 PMCID: PMC9003403 DOI: 10.3390/nu14071387] [Citation(s) in RCA: 2] [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: 02/04/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic resulted in widespread school closures, reducing access to school meals for millions of students previously participating in the US Department of Agriculture (USDA) National School Lunch Program (NSLP). School-prepared meals are, on average, more nutritious than home-prepared meals. In the absence of recent data measuring changes in children's diets during the pandemic, this article aims to provide conservative, back-of-the-envelope estimates of the nutritional impacts of the pandemic for school-aged children in the United States. We used administrative data from the USDA on the number of NSLP lunches served in 2019 and 2020 and nationally representative data from the USDA School Nutrition and Meal Cost Study on the quality of school-prepared and home-prepared lunches. We estimate changes in lunchtime calories and nutrients consumed by NSLP participants from March to November 2020, compared to the same months in 2019. We estimate that an NSLP participant receiving no school meals would increase their caloric consumption by 640 calories per week and reduce their consumption of nutrients such as calcium and vitamin D. Because 27 to 78 million fewer lunches were served per week in March-November 2020 compared to the previous year, nationally, students may have consumed 3 to 10 billion additional calories per week. As students return to school, it is vital to increase school meal participation and update nutrition policies to address potentially widening nutrition disparities.
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Affiliation(s)
- Amelie A. Hecht
- Institute for Research on Poverty, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Caroline Glagola Dunn
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Eliza W. Kinsey
- Department of Family Medicine & Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | | | - Ronli Levi
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA 94143, USA; (R.L.); (H.K.S.)
| | | | - Erin R. Hager
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Hilary K. Seligman
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA 94143, USA; (R.L.); (H.K.S.)
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Socioeconomic Disparities in Foods/Beverages and Nutrients Consumed by U.S. Adolescents When Snacking: National Health and Nutrition Examination Survey 2005-2018. Nutrients 2021; 13:nu13082530. [PMID: 34444690 PMCID: PMC8399168 DOI: 10.3390/nu13082530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
Snacking contributes a significant portion of adolescents’ daily energy intake and is associated with poor overall diet and increased body mass index. Adolescents from low socioeconomic status (SES) households have poorer snacking behaviors than their higher-SES counterparts. However, it is unclear if the types of food/beverages and nutrients consumed during snacking differ by SES among adolescents. Therefore, this study examines SES disparities in the aforementioned snacking characteristics by analyzing the data of 7132 adolescents (12–19 years) from the National Health and Nutrition Examination Survey 2005–2018. Results reveal that adolescents from low-income households (poverty-to-income ratio (PIR) ≤ 1.3) have lower odds of consuming the food/beverage categories “Milk and Dairy” (aOR: 0.74; 95% CI: 0.58-0.95; p = 0.007) and “Fruits” (aOR: 0.62, 95% CI: 0.50–0.78; p = 0.001) as snacks and higher odds of consuming “Beverages” (aOR: 1.45; 95% CI: 1.19-1.76; p = 0.001) compared to those from high-income households (PIR > 3.5). Additionally, adolescents from low- and middle-income (PIR > 1.3–3.5) households consume more added sugar (7.98 and 7.78 g vs. 6.66 g; p = 0.012, p = 0.026) and less fiber (0.78 and 0.77 g vs. 0.84 g; p = 0.044, p = 0.019) from snacks compared to their high-income counterparts. Future research is necessary to understand factors that influence snacking among adolescents, and interventions are needed, especially for adolescents from low-SES communities.
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