Socio-economic position as a moderator of 9–13-year-old children’s non-core food intake

Parental work hours and household income as determinants of unhealthy food and beverage intake in young Australian children

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.

Like parent, like child: a cross-sectional study of intra-household consumption patterns of non-alcoholic beverages among British households with children

OBJECTIVE

Most research investigating sugar-sweetened beverages (SSB) and health, conducted at the individual or household level, ignores potentially important intra-household dynamics. We analysed self-reported consumption relationships between children and adults, and between children of different ages, as well as the associations between intra-household consumption, BMI and sociodemographic characteristics.

DESIGN

A cross-sectional analysis of survey data from Kantar Fast Moving Consumer Goods panellists in September 2017.

SETTING

Great Britain.

PARTICIPANTS

Random sample of 603 households with children under 18 years who regularly purchase non-alcoholic beverages.

RESULTS

Low- or no-sugar/diet beverages dominate consumption across all age categories, particularly children under 12 years. SSB consumption increased as children became older. Children's reported consumption of SSB and low- or no-sugar/diet beverages was positively associated with consumption by adults; a child in adolescence had over nine times the odds of consuming SSB (adjusted OR 9·55, (95 % CI 5·38, 17·00), P < 0·001), and eight times the odds of consuming low- or no-sugar/diet drinks (adjusted OR 8·12, (95 % CI 4·71, 13·97), P < 0·001), if adults did so. In households with multiple children, consumption patterns of older siblings were associated with those of the younger; notably a perfect correlation between children aged 0 and 6 years consuming SSB if siblings 13-18 years did so, and children aged 7-12 years had 22 times the odds of consuming SSB if siblings aged 13-18 years did so (OR 22·33, (95 % CI 8·60, 58·01), P < 0·001).

CONCLUSIONS

Multiple policies, targeting children as well as adults, such as fiscal levers and advertisement restrictions, are needed to reduce and prevent the consumption of SSB.

Nonalcoholic Fatty Liver Disease Prevalence Trends Among Adolescents and Young Adults in the United States, 2007-2016

Understanding the burden of NAFLD among adolescents and young adults has become increasingly relevant. Our aim was to estimate the prevalence of NAFLD among adolescents and young adults in the United States. Data were obtained from National Health and Nutrition Examination Survey from 2007-2016. Adolescents and young adults aged 12 to 29 years were included. NAFLD was determined by the U.S. Fatty Liver Index in the absence of secondary causes of liver disease, and the differences in prevalence trends were analyzed based on age, gender, and race. Complete data were available for 4,654 adolescents and young adults (mean age 21 years; 50.9% male; 56.8% White, 20.9% Hispanic, and 13.3% Black). The overall prevalence of NAFLD among adolescents and young adults was 18.5%, ranging from 13.2% among early and middle adolescents (12-17 years) to 18.7% among late adolescents and young adults (18-24 years), to 24.0% among older young adults (25-30 years) (trend P < 0.001). The prevalence of NAFLD was higher for boys than for girls (aged 12-17: 15.1% vs. 11.3%; aged 18-24: 21.1% vs. 16.2%; aged 25-30: 28.7% vs. 19.2%, all P < 0.030). Among all age groups, Hispanics had a higher prevalence of NAFLD than Whites and Blacks (pairwise P < 0.001). Over the study time period, the prevalence of NAFLD among early and middle adolescents and young adults did not change (trend P > 0.80). In contrast, NAFLD prevalence among late adolescents increased (trend P = 0.018). In fact, White and Hispanic late adolescents were the drivers behind this increase in the prevalence of NAFLD. Conclusion: These data indicate an increasing trend in NAFLD prevalence among 18-24-year-olds. These data have important public health and policy implications.

Effects of the Preschool-Based Family-Involving DAGIS Intervention on Family Environment: A Cluster Randomised Trial

Interventions promoting young children’s healthy energy balance-related behaviours (EBRBs) should also examine changes in the family environment as this is an important determinant that may affect the effectiveness of the intervention. This study examines family environmental effects of the Increased Health and Wellbeing in Preschools (DAGIS) intervention study, and whether these effects differed when considering three parental educational level (PEL) groups. The DAGIS intervention was conducted in preschools and involving parents in Southern Finland from September 2017 to May 2018. It was designed as a randomised trial, clustered at preschool-level. Parents of 3–6-year-olds answered questionnaires recording PEL, parental role modelling for EBRBs, and the family environment measured as EBRBs availability and accessibility. Linear Mixed Models with Repeated Measures were used in order to detect intervention effects. Models included group by time interactions. When examining intervention effects separated by PEL groups, models with three-level interactions (group × time-points × PEL) were evaluated. There was an interaction effect for the availability of sugary everyday foods and drinks (p = 0.002). The analyses showed that the control group increased availability (p = 0.003), whereas in the intervention group no changes were detected (p = 0.150). In the analysis separated by PEL groups, changes were found only for the accessibility of sugary treats at home; the high PEL control group increased the accessibility of sugary treats (p = 0.022) (interaction effect: p = 0.027). Hence, results suggest that the DAGIS multicomponent intervention had a limited impact on determinants for children’s healthy EBRBs, and no impact was found in the low PEL group.

High-risk environments for eating foods surplus to requirements: a multilevel analysis of adolescents' non-core food intake in the National Diet and Nutrition Survey (NDNS)

OBJECTIVE

Interventions to reduce adolescents' non-core food intake (i.e. foods high in fat and sugar) could target specific people or specific environments, but the relative importance of environmental contexts v. individual characteristics is unknown.

DESIGN

Cross-sectional.

SETTING

Data from 4d food diaries in the UK National Diet and Nutrition Survey (NDNS) 2008-2012 were analysed. NDNS food items were classified as 'non-core' based on fat and sugar cut-off points per 100g of food. Linear multilevel models investigated associations between 'where' (home, school, etc.) and 'with whom' (parents, friends, etc.) eating contexts and non-core food energy (kcal) per eating occasion (EO), adjusting for variables at the EO (e.g. time of day) and adolescent level (e.g. gender).ParticipantsAdolescents (n 884) aged 11-18 years.

RESULTS

Only 11 % of variation in non-core energy intake was attributed to differences between adolescents. In adjusted models, non-core food intake was 151 % higher (ratio; 95 % CI) in EO at 'Eateries' (2·51; 2·14, 2·95) and 88 % higher at 'School' (1·88; 1·65, 2·13) compared with 'Home'. EO with 'Friends' (1·16; CI 1·03, 1·31) and 'Family &amp; friends' (1·21; 1·07, 1·37) contained 16-21 % more non-core food compared with eating 'Alone'. At the individual level, total energy intake and BMI, but not social class, gender or age, were weakly associated with more non-core energy intake.

CONCLUSIONS

Regardless of individual characteristics, adolescents' non-core food consumption was higher outside the home, especially at eateries. Targeting specific eating contexts, not individuals, may contribute to more effective public health interventions.

In Search of Consistent Predictors of Children's Physical Activity

Physical activity is pivotal for children's health and well-being, yet participation declines across teenage years. Efforts to increase physical activity need to be strengthened to combat this, however, evidence for the design and planning of physical activity promotion in children is lacking. The aim was to identify predictors of physical activity that were relatively consistent across three different measures of physical activity, in pre- and early adolescent South Australians. This is the first study to compare correlates of physical activity across three measures of physical activity in a single sample, in this age group. Children (n = 324) aged 9-13 years and their parents were surveyed on personal, interpersonal and environmental correlates of physical activity. Child physical activity was objectively measured using pedometers (7 days). Self-reported physical activity was determined from organised sport participation and the Physical Activity Questionnaire for Adolescents. Regression models were used to identify consistent predictors of three physical activity measures. Consistent predictors across multiple physical activity measures were: parent support for physical activity, having appropriate clothing for sport, enjoyment of physical activity and perceived availability of sporting clubs. These predictors identify potential avenues for directing intervention efforts to increase physical activity in early adolescents.