1
|
McNeel K, Shearrer GE, Papantoni A, Nansel TR, Lipsky LM, Burger KS. Ultraprocessed Foods at Home and Children's Attentional Bias Toward Those Foods. JAMA Pediatr 2024:2821476. [PMID: 39037866 PMCID: PMC11264074 DOI: 10.1001/jamapediatrics.2024.2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/30/2024] [Indexed: 07/24/2024]
Abstract
This study examines the association between exposure to ultraprocessed foods at home and children’s attentional bias for those foods.
Collapse
Affiliation(s)
- Katherine McNeel
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Grace E. Shearrer
- Department of Family and Consumer Sciences, University of Wyoming, Laramie
| | - Afroditi Papantoni
- Department of Family and Consumer Sciences, University of Wyoming, Laramie
| | - Tonja R. Nansel
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Leah M. Lipsky
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Kyle S. Burger
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| |
Collapse
|
2
|
Laroche HH, Andino J, O'Shea AMJ, Engebretsen B, Rice S, DeJear M, Nicholson C, Yeh HW, Snetselaar L. Family-Based Motivational Interviewing and Resource Mobilization to Prevent Obesity: Living Well Together Trial. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00327-0. [PMID: 38904597 DOI: 10.1016/j.jneb.2024.05.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE Test an obesity intervention for families with low incomes. METHODS A total of 208 families were included (a parent with a body mass index [BMI] ≥ 30 and a child aged 6-12 years). A 12-month randomized controlled trial combining family health coaching (motivational interviewing) and connection to community resources. Comparison group: referrals for basic needs, written educational materials. Questionnaires, accelerometry, and anthropometrics. Intention-to-treat analysis of change in outcomes. Two-sided t test with multiple imputation. RESULTS Parents were 95% female, 31% Black, and 27% Hispanic. Children had a mean BMI-Z score of 1.15. Primary outcomes did not differ between groups at 12 months. Both groups significantly (P < 0.05) improved on the Family Nutrition and Physical Activity Scale for behaviors related to childhood obesity (mean ± SE: comparison, 2.8 ± 1.0; intervention, 2.2 ± 0.9), increased child sedentary activity (comparison, 32.5 ± 12.1; intervention, 39.9 ± 12.4 min/d), and decreased child moderate-vigorous physical activity (comparison, -9.6 ± 3.3; intervention -7.0 ± 3.0 min/d). Parents had no change in BMI. CONCLUSIONS AND IMPLICATIONS We successfully embedded screening and referral to address social needs within an obesity intervention. The coaching intervention did not provide additional benefits. Future research could explore ways to make these interventions more accessible, valuable, and effective for families.
Collapse
Affiliation(s)
- Helena H Laroche
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO; Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO; Department of Internal Medicine, University of Iowa, Iowa City, IA; Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO.
| | - Jessica Andino
- Department of Internal Medicine, University of Iowa, Iowa City, IA; Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA
| | - Amy M J O'Shea
- Department of Internal Medicine, University of Iowa, Iowa City, IA; Center for Comprehensive Access & Delivery Research & Evaluation, Iowa City VA Health Care System, Iowa City, IA
| | | | - Sarai Rice
- Des Moines Area Religious Council, Des Moines, IA
| | | | | | - Hung-Wen Yeh
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO; Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO
| | - Linda Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| |
Collapse
|
3
|
Nansel TR, Schwedhelm C, Lipsky LM, Faith MS, Siega-Riz AM. Socioeconomic Characteristics and the Home Food Environment Are Associated With Feeding Healthful and Discretionary Foods During the First Year of Life in the Pregnancy Eating Attributes Study. J Acad Nutr Diet 2024:S2212-2672(24)00249-1. [PMID: 38777149 DOI: 10.1016/j.jand.2024.05.011] [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: 11/16/2023] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Feeding of nutrient-poor foods begins in infancy and may adversely influence long-term food preferences. OBJECTIVE To examine associations of socioeconomic characteristics, childbearing parent eating behaviors, and home food environment with infant feeding characteristics. DESIGN Secondary analysis of a prospective cohort study from first trimester of pregnancy through 12 months postpartum. PARTICIPANTS/SETTING Participants with uncomplicated singleton pregnancies and no major chronic illness were enrolled from November 2014 through October 2016 from 2 university-based obstetrics clinics in Chapel Hill, NC. Of 458 enrolled, 321 were retained through 12 months postpartum. MAIN OUTCOME MEASURES Participants completed infant food frequency questionnaires indicating age at introduction and frequency of consuming multiple food groups. Exposures included childbearing parent socioeconomic characteristics, hedonic hunger, addictive-like eating, Healthy Eating Index 2015 calculated from three 24-hour diet recalls, and home food environment fruit/vegetable and obesogenic scores. STATISTICAL ANALYSES PERFORMED Multiple imputation using Heckman selection model; linear and logistic regressions examining associations with infant feeding characteristics. RESULTS Lower education and income were associated with later infant age at introduction to, and lower frequency of consuming fruits and vegetables at age 12 months. Socioeconomic characteristics were not associated with age at introduction to discretionary solid foods; however, lower education and income were associated with greater infant frequency of intake of discretionary foods and greater odds of introducing fruit juice and sweetened beverages by age 12 months. Childbearing parent Healthy Eating Index 2015, hedonic hunger, and addictive-like eating were not consistently associated with infant feeding characteristics. A more obesogenic food environment was associated with greater frequency of intake of discretionary foods, lower frequency of intake of fruit, and greater odds of fruit juice introduction by age 12 months. CONCLUSIONS Infant feeding characteristics may be important intervention targets for addressing socioeconomic disparities in child diet quality. Efforts to reduce routine feeding of discretionary foods across socioeconomic groups are needed; modifying the home food environment may promote healthful infant feeding.
Collapse
Affiliation(s)
- Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
| | - Carolina Schwedhelm
- Max-Delbrück Center for Molecular Medicine in the Helmholtz Association, Molecular Epidemiology Research Group, Berlin, Germany
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo- SUNY, Buffalo, New York
| | - Anna Maria Siega-Riz
- Epidemiology and Biostatistics, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| |
Collapse
|
4
|
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.
Collapse
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.
| |
Collapse
|
5
|
Reppas K, Papamichael MM, Usheva N, Iotova V, Chakarova N, Cardon G, Rurik I, Antal E, Valve P, Liatis S, Makrilakis K, Moreno L, Manios Y, Moschonis G. Associations between household food environment and daily intake of regular and diet soft drinks per BMI status of European children: Feel4Diabetes Study. NUTR BULL 2024; 49:82-95. [PMID: 38288678 DOI: 10.1111/nbu.12659] [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: 03/31/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 02/27/2024]
Abstract
The objective of this study was to investigate how the availability of food in the household environment is associated with a daily intake of regular and diet soft drinks in European children, considering BMI status. This cross-sectional study utilised baseline data from 12 211 schoolchildren participating in the Feel4Diabetes European lifestyle modification intervention. Sociodemographics, soft drink intake and household food availability data were collected using parent-completed questionnaires. Anthropometry was recorded, and children were classified into BMI categories according to the International Obesity Task Force cut-offs. In the multivariate logistic regression analysis controlled for children's sex, mother's BMI, and educational level, frequent household availability of fruit juice (sugar added), regular soft drinks and salty snacks compared to less frequent were positively associated with daily regular soft drink intake in children, regardless of BMI group (ORs range 1.59-6.69). Conversely, frequent availability of fruit juice (no added sugar) was inversely related to regular soft drink intake in both BMI groups, as was the availability of fresh fruit in the overweight/obesity group, and the availability of diet soft drinks in the underweight/normal-weight (ORs range 0.31-0.54). In conclusion, habitual household availability of selected energy-dense foods/beverages was positively associated with a daily intake of regular soft drinks in European children, regardless of BMI status. Contrastingly, household availability of fresh fruit, fruit juice (no added sugar) and diet soft drinks were inversely associated with regular soft drink intake. Programmes focusing on reducing children's soft drink intake should consider reducing the availability of sugar-added beverages in the household food environment and encouraging water consumption, as a practical, healthier alternative suggestion.
Collapse
Affiliation(s)
- Kyriakos Reppas
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
| | - Maria Michelle Papamichael
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Natalya Usheva
- Department of Social Medicine and Healthcare Organization, Medical University of Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Paediatrics, Medical University, Varna, Bulgaria
| | - Nevena Chakarova
- Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Imre Rurik
- Department of Family and Occupational Medicine, University of Debrecen, Budapest, Hungary
- Department of Family Medicine, Semmelweis University, Budapest, Hungary
| | - Emese Antal
- Hungarian Society of Nutrition, Budapest, Hungary
| | - Päivi Valve
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Stavros Liatis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Luis Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza, Spain
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University of Athens, Kallithea, Greece
- Institute of Agri-food and Life Sciences, (Agro-Health), Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
6
|
Acosta ME, Sanchez-Vaznaugh EV, Matsuzaki M, Barba N, Sánchez BN. Temporal Patterns in Fruit and Vegetable Intake Among Racially and Ethnically Diverse Children and Adolescents in California. Prev Chronic Dis 2024; 21:E09. [PMID: 38329921 PMCID: PMC10870998 DOI: 10.5888/pcd21.230162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Introduction Childhood dietary behaviors, including fruit and vegetable intake, are associated with adult health. Most children do not meet daily recommended servings of fruits and vegetables. Less is known about temporal patterns in fruit and vegetable consumption or if they vary by race and ethnicity. We investigated temporal patterns in fruit and vegetable intake among California school-age children and adolescents overall and by race and ethnicity. Methods We used 2-year cross-sectional datasets from the child and adolescent samples in the California Health Interview Surveys from 2011-2012 through 2019-2020 and modified Poisson regression models to estimate the likelihood of consuming 5 or more servings of fruits and vegetables in 2013-2016 and 2017-2020 compared with 2011-2012. Models controlled for age, race and ethnicity, gender, citizenship status, family income, and adult education and tested for differences by race and ethnicity. The samples included 16,125 children aged 5 to 11 years and 9,672 adolescents aged 12 to 17 years. Results Overall, 29.3% of children and 25.9% of adolescents reported intake of 5 or more fruits and vegetables per day. Among children, adjusted prevalence ratios (PR) of fruit and vegetable intake were higher in 2013-2016 (PR,1.25; 95% CI, 1.11-1.42) and 2017-2020 (PR,1.13; 95% CI, 0.99-1.30) compared with 2011-2012. Among adolescents, the adjusted prevalence did not differ significantly over time. We found no evidence of differential associations by race and ethnicity for children and adolescents. Conclusion We found favorable temporal changes in fruit and vegetable consumption among children, but not among adolescents. Monitoring temporal patterns in fruit and vegetable intake remains critical for planning population-level interventions to increase consumption.
Collapse
Affiliation(s)
- Maria Elena Acosta
- Department of Public Health, San Francisco State University, San Francisco, California
| | - Emma V Sanchez-Vaznaugh
- Department of Public Health, San Francisco State University, San Francisco, California
- College of Health & Social Sciences, Department of Public Health, 1600 Holloway Ave, San Francisco CA 94132
| | - Mika Matsuzaki
- Department of International Health, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland
| | - Nancy Barba
- Department of Public Health, San Francisco State University, San Francisco, California
| | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania
| |
Collapse
|
7
|
Hartson KR, King KM, O'Neal C, Brown AA, Olajuyigbe T, Elmore S, Perez A. Testing the Effects of Two Field-to-Fork Programs on the Nutritional Outcomes of Elementary School Students From Diverse and Lower-Income Communities. J Sch Nurs 2023; 39:444-455. [PMID: 34351238 DOI: 10.1177/10598405211036892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this quasi-experimental study was to evaluate the effects of two farm-to-school programs, specifically the Field-to-Fork Multi-visit Program (N = 264) and the Field-to-Fork After-school Club (N = 56), on nutritional outcomes of elementary school students (third to fifth grade) from urban, diverse, and lower-income communities. Data were collected via self-report surveys measuring: (a) knowledge of recommendations for daily fruit and vegetable intake; (b) fruit and vegetable consumption; (c) knowledge of cooking a healthy recipe using vegetables; and (d) desire for farm fresh foods at school. Statistical analyses included McNemar's and Wilcoxon signed rank tests. The proportion of students knowing how to cook a vegetable rich recipe increased with both programs (Multi-visit Program p < .001; After-school Club p = .002). Vegetable consumption increased with the After-school Club (p = .002). Farm-to-school programming can increase knowledge of cooking vegetable rich recipes and vegetable intake among elementary school students from diverse, urban, and lower-income communities.
Collapse
Affiliation(s)
| | - Kristi M King
- Department of Health and Sports Sciences, Student Activity Center-East (SAC-E) 105G, Louisville, KY, USA
| | - Carol O'Neal
- Department of Health and Sports Sciences, Student Activity Center-East (SAC-E) 105G, Louisville, KY, USA
| | - Aishia A Brown
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | | | - Shakeyrah Elmore
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | | |
Collapse
|
8
|
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.
Collapse
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.
| | | |
Collapse
|
9
|
Anderson CE, Au LE, Yepez CE, Ritchie LD, Tsai MM, Whaley SE. Increased WIC Cash Value Benefit is Associated with Greater Amount and Diversity of Redeemed Fruits and Vegetables among Participating Households. Curr Dev Nutr 2023; 7:101986. [PMID: 37662701 PMCID: PMC10469066 DOI: 10.1016/j.cdnut.2023.101986] [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: 05/31/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages for children ages 1 to 4 y include a cash value benefit (CVB) redeemable for fruits and vegetables (FVs) with participating vendors. The CVB value was increased beginning in June 2021. Objectives This study evaluated associations of the augmented CVB with the amount and diversity of redeemed FVs. Methods Price look-up codes (PLUs) in redemption data determined outcomes including any redemption (any, none), amount redeemed (United States dollars [USD]/mo), and percent of total CVB redemption (percent) in 54 FV commodity groups among a cohort of 1770 WIC-participating children in Southern California. Outcomes across all commodity groups for fresh fruits, fresh vegetables, and all FVs were evaluated including dollar amount redeemed, percentage of redemption, and diversity of produce redeemed (variety and balance among items redeemed). Comparisons were made between augmented CVB periods (35 USD/mo in June-September 2021, 24 USD/mo October 2021-June 2022) and the preaugment period (9 USD/mo in June 2020-May 2021). Associations were tested in multivariable generalized estimating equation Poisson (any redemption) and linear (amount, percent, diversity) regression models. Results The augmented CVB was associated with higher any redemption prevalence and amount redeemed for 53 of 54 commodity groups at both 35 USD/mo and 24 USD/mo compared with 9 USD/mo. Redemption diversity increased for both fruits, vegetables, and all produce during both augment periods, and modestly greater increases in redeemed fruits relative to vegetables were observed at 35 USD/mo. The most commonly redeemed vegetables were tomatoes, onions, cucumbers, peppers, and avocados and the most commonly redeemed fruits were bananas, apples, grapes, limes, and melons. Conclusions The augmented CVB was associated with greater redeemed FV amount and greater redeemed FV diversity. Data on FV intake diversity among WIC-participating children are needed to understand dietary impacts of the CVB increase.
Collapse
Affiliation(s)
- Christopher E. Anderson
- Division of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, a program of Heluna Health, Irwindale, CA, United States
| | - Lauren E. Au
- Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Catherine E. Yepez
- Division of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, a program of Heluna Health, Irwindale, CA, United States
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA, United States
| | - Marisa M. Tsai
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA, United States
| | - Shannon E. Whaley
- Division of Research and Evaluation, Public Health Foundation Enterprises (PHFE) WIC, a program of Heluna Health, Irwindale, CA, United States
| |
Collapse
|
10
|
Serasinghe N, Vepsäläinen H, Lehto R, Abdollahi AM, Erkkola M, Roos E, Ray C. Associations between socioeconomic status, home food availability, parental role-modeling, and children's fruit and vegetable consumption: a mediation analysis. BMC Public Health 2023; 23:1037. [PMID: 37259139 DOI: 10.1186/s12889-023-15879-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. METHODS Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. RESULTS The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51-4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10-1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35-1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 - -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06-1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40-1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. CONCLUSIONS Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
Collapse
Affiliation(s)
- Nithya Serasinghe
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Reetta Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, P.O. Box 63, Helsinki, FI-00014, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| |
Collapse
|
11
|
Greene E, Murrin C. Parental influences on children's dairy products consumption: a narrative review. Public Health Nutr 2023; 26:976-993. [PMID: 36459073 PMCID: PMC10346067 DOI: 10.1017/s1368980022002555] [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: 09/21/2021] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To review research on the influence of parent-related factors on children's dairy products consumption. DESIGN A search of electronic databases and a narrative synthesis of the literature were conducted. English-language articles were included if they reported data relating to parental influences on children's consumption of dairy products and if statistical significance was reported. SETTING Studies were carried out in the USA (n 8) and in a range of countries across Europe (n 12) and Asia (n 5). PARTICIPANTS The subjects of this research were children aged between 2 and 12 years of age, from a range of geographical locations. RESULTS Twenty-five studies met the inclusion criteria. The studies examined children's dairy products consumption in relation to parental socio-economic status (education level and income) (n 12), home availability (n 2), home food environment (n 3), parental dairy products consumption (n 4), parent feeding practices (n 3), parents' beliefs and attitudes (n 3) and parental nutrition knowledge (n 3). Results on the association between socio-economic status and children's dairy products consumption varied; however, studies reporting a significant association generally observed a positive relationship. Fifteen studies reported children's total dairy products intake as an outcome measure, with the remaining studies reporting intake of milk or other dairy products as individual foods. CONCLUSIONS This review identified literature exploring a range of parental factors in relation to children's dairy products intake. However, there were limited numbers of studies published within each category of modifiable factors. Further research on the parent-related determinants of dairy products consumption in children is required in order to identify potential intervention targets in this age group.
Collapse
Affiliation(s)
- Ellen Greene
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| |
Collapse
|
12
|
Longitudinal association between density of retail food stores and body mass index in Mexican school children and adolescents. Int J Obes (Lond) 2023; 47:365-374. [PMID: 36792910 PMCID: PMC10147568 DOI: 10.1038/s41366-023-01273-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Obesity is rapidly increasing in Mexican children and adolescents, while food environments are rapidly changing. We evaluated the association between changes in retail food stores and change in body mass index (BMI) in Mexican children and adolescents. METHODS Data on 7507 participants aged 5-19 years old came from the Mexican Family Life Survey 2002-2012. Density of food stores at the municipal-level (number of food stores/area in km2) came from the Economic Censuses of 1999, 2004 and 2009. We categorized food stores as small food retail (small neighborhood stores, tiendas de abarrotes in Mexico), specialty foods, fruit/vegetables, convenience foods, and supermarkets. Associations between change in food stores and change in BMI were estimated using five longitudinal linear fixed-effects regression models (one per type of food store) adjusted for age, parental education, municipal-level socioeconomic deprivation and population density. Density of each food store type was operationalized as quartiles. Analyses were stratified by urbanization. RESULTS There was an inverse dose-response association between increases in fruit/vegetable store density and BMI (β = -0.455 kg/m2, β = -0.733 kg/m2, and β = -0.838 kg/m2 in the second, third, and fourth quartile). In non-urban areas, children living in municipalities with the highest density of small food retail stores experienced a reduction in BMI (β = -0.840 kg/m2). In urban areas, there was an inverse association between specialty food stores with BMI (β = -0.789 kg/m2 in third quartile, and β = -1.204 kg/m2 in fourth quartile). We observed dynamic associations with age; results suggested stronger associations in adolescents. CONCLUSIONS The availability of fruit/vegetable stores may influence a reduction in children and adolescents BMI. These results indicate that policy approaches could be tailored by type of food store - with some consideration for level of urbanization and children's age.
Collapse
|
13
|
Impacts of a Multi-Professional Family versus Isolated Intervention on Food Level Processing in Overweight Adolescents: A Randomized Trial. Nutrients 2023; 15:nu15040935. [PMID: 36839292 PMCID: PMC9962466 DOI: 10.3390/nu15040935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 02/15/2023] Open
Abstract
The food consumption of adolescents has changed nowadays, with an increase in ultra-processed food that in general shows higher calories and lower nutrients. Because of this, the objective of this study was to investigate the impacts of a 12-week multi-professional family versus isolated intervention on the food level processing of overweight adolescents. A randomized clinical trial study was carried out in which adolescents (n = 43; mean aged 13.73 years) who were divided into FG-family group (n = 21; the adolescents performed the activities with their parents) and IG-isolated group (n = 22; the adolescents performed the activities alone). The parameters measured before and after 12 weeks of multi-professional intervention (physical exercise, nutrition and psychoeducation) were: body mass, height and body mass index-BMI. The level of food processing was analyzed using a three-day food recall (24hR), classified according to the Food Guide for the Brazilian Population (fresh, minimally, processed and ultra-processed foods). The main results show that there was only a significant reduction in the consumption of processed foods (FG: 7.93%; IG: 49.73%) and ultra-processed foods (FG: 35.06%; IG: 67.16%) in grams (FG: 22.29%; IG: 65.23%) and calories (p < 0.05; for all comparisons). The consumption of fresh foods in grams (FG:61.97%; IG: 147.13%) and calories (FG: 147.13%; IG: 118.03%) and minimally processed foods (FG: 27.45%; IG: 14.64%) in grams increased significantly (p < 0.05; for all comparisons). However, no significant differences were observed between all variables analyzed for the groups, nor any interaction (p > 0.05). In conclusion, both groups who participated in the activities showed positive changes with increased consumption of fresh foods and reduced consumption of processed foods, without difference between them.
Collapse
|
14
|
Tripicchio GL, Kubik MY, Lee J, Fisher JO. More-To-Less Home Healthful Foods Ratio is Associated With Diet Quality in Preadolescents With Elevated Body Mass Index. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:939-946. [PMID: 35909037 PMCID: PMC10434829 DOI: 10.1016/j.jneb.2022.04.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To examine home food availability (HFA) and the association with diet quality in preadolescents with elevated body mass index. METHODS A cross-sectional analysis examined HFA and diet quality (using the 2015-Health Eating Index [HEI] derived from 1 or 2 24-hour dietary recalls) among preadolescents (n = 111; aged 8-12 years; body mass index ≥ 75th percentile). A novel ratio of more-to-less healthful items was created to represent HFA. Multivariate linear regression models examined the HFA ratio and individual food and beverage groups as correlates of HEI. RESULTS The HFA ratio was associated with higher HEI (β = 5.3 [1.3]; P < 0.001). Home food availability of sweets (β = -2.6 [0.9]; P = 0.003) and sugar-sweetened beverages (β = -2.3 [1.0]; P = 0.02) were associated with lower HEI. Home food availability of fruits was associated with higher HEI (β = 1.3 [0.7]; P = 0.05). CONCLUSIONS AND IMPLICATIONS Structuring the HFA so that more healthful choices are available relative to less healthful foods could be an effective approach for improving diet quality in preadolescents at risk for obesity.
Collapse
Affiliation(s)
- Gina L Tripicchio
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA.
| | | | - Jiwoo Lee
- School of Nursing, University of Minnesota, Minneapolis, MN
| | - Jennifer Orlet Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
| |
Collapse
|
15
|
Laroche HH, Park-Mroch J, O'Shea A, Rice S, Cintron Y, Engebretsen B. Resource mobilization combined with motivational interviewing to promote healthy behaviors and healthy weight in low-income families: An intervention feasibility study. SAGE Open Med 2022; 10:20503121221102706. [PMID: 35707344 PMCID: PMC9189556 DOI: 10.1177/20503121221102706] [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: 05/14/2021] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: This non-randomized pilot trial examined the feasibility and acceptability of an intervention for low-income families with one parent with obesity, glucose intolerance and/or diabetes. Methods: The 12-month intervention combined health coaching using motivational interviewing to promote lifestyle behavior change and community resource mobilization to assist with basic needs plus diet quality and physical activity. Outcome measures included process measures, open-ended questions, and the Family Nutrition and Physical Activity scale. Results: Forty-five families completed an average of 2.1 health coach in-person visits, including 15 families lost to follow-up. Parents who stayed in the intervention reported the intervention was helpful. Some families and the health coach had difficulties contacting one another, and some of these families reported they would have liked more sessions with the coach. The Family Nutrition and Physical Activity scores improved significantly for all children (6 months: 2.9; p < .01; 12 months: 3.2; p < .05) and at 6 months for index children (6 months: 3.5; p < .01; 12 months: 2.9; p = .09). There was variation in the FNPA and other outcome changes between families. Conclusion: This intervention was feasible in terms of recruitment and delivery of family sessions and community referrals and acceptable to participants, but maintaining contact with participants was difficult. Findings warrant improvements to help retention and logistical aspects of communication between families and coaches and testing in a randomized, controlled trial.
Collapse
Affiliation(s)
- Helena H Laroche
- Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, USA.,Children's Mercy Hospital and Clinics, Kansas City, MO, USA.,Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA.,Department of Internal Medicine, The University of Iowa, Iowa City, IA, USA
| | - Jennifer Park-Mroch
- Department of Internal Medicine, The University of Iowa, Iowa City, IA, USA.,Health & Well-Being, University of Wisconsin-Extension, Madison, WI, USA
| | - Amy O'Shea
- Department of Internal Medicine, The University of Iowa, Iowa City, IA, USA.,Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, IA, USA
| | - Sarai Rice
- Des Moines Area Religious Council (DMARC), Des Moines, IA, USA
| | - Yolanda Cintron
- Department of Internal Medicine, The University of Iowa, Iowa City, IA, USA
| | | |
Collapse
|
16
|
Dugas C, Brassard D, Bélanger M, Perron J, Weisnagel SJ, Marc I, Robitaille J. Determinants of Healthy Diet Among Children Exposed and Unexposed to Gestational Diabetes. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:378-387. [PMID: 35151604 DOI: 10.1016/j.jneb.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To evaluate the association between individual and environmental determinants of diet quality with diet quality of children exposed to gestational diabetes mellitus (GDM+) and unexposed (GDM-); to study the association between mother and child vegetables and fruit (VF) intakes. DESIGN Cross-sectional study. PARTICIPANTS One hundred forty-two children (104 GDM+; 38 GDM-) aged 6.2 ± 2.5 years. VARIABLES Canadian Healthy Eating Index 2007 (HEI-C) and VF were obtained with 2 24-hour dietary recall questionnaires in children. Maternal VF was obtained by a validated food frequency questionnaire, and weight and height were measured. Sociodemographic determinants were obtained by questionnaires. ANALYSIS Linear regression models were used to evaluate the association between individual and environmental determinants and the HEI-C score with interaction for GDM status. RESULTS Family meals were associated with HEI-C among GDM- but not GDM+ children (β = 9.97, P = 0.01 and β = -0.41, P = 0.84, respectively; P for interaction = 0.02). Children's age (β = -1.45; 95% confidence interval, -2.19 to -0.72; P < 0.001) was a determinant of HEI-C among all children. Maternal VF intakes were positively associated with children's VF intake (r = 0.30, P < 0.001, r2 = 0.09), with association of larger variance among GDM- children (r = 0.38, r2 = 0.14, P = 0.02) than GDM+ children (r = 0.23, r2 = 0.05, P = 0.02). CONCLUSIONS The food environment at home was associated differently with the diet quality of GDM+ and GDM- children. Whether targeting family meals and maternal diet quality is a good strategy to improve children's diet quality among GDM+ children needs to be further investigated.
Collapse
Affiliation(s)
- Camille Dugas
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada; School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, University Hospital of Quebec-Laval University Research Center, Quebec City, Canada
| | - Didier Brassard
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada; School of Nutrition, Laval University, Quebec City, Canada
| | - Mélissa Bélanger
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada; School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, University Hospital of Quebec-Laval University Research Center, Quebec City, Canada
| | - Julie Perron
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - S John Weisnagel
- Endocrinology and Nephrology Unit, University Hospital of Quebec-Laval University Research Center, Quebec City, Canada
| | - Isabelle Marc
- Department of Pediatrics, University Hospital of Quebec-Laval University Research Center, Laval University, Quebec City, Canada
| | - Julie Robitaille
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada; School of Nutrition, Laval University, Quebec City, Canada; Endocrinology and Nephrology Unit, University Hospital of Quebec-Laval University Research Center, Quebec City, Canada.
| |
Collapse
|
17
|
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.
Collapse
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;
| |
Collapse
|
18
|
A randomized controlled trial of a community-based obesity intervention utilizing motivational interviewing and community resource mobilization for low-income families: Study protocol and baseline characteristics. Contemp Clin Trials 2022; 112:106626. [PMID: 34801731 PMCID: PMC8805455 DOI: 10.1016/j.cct.2021.106626] [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: 05/09/2021] [Revised: 10/21/2021] [Accepted: 11/11/2021] [Indexed: 01/03/2023]
Abstract
Low-income, racially diverse families with one parent with obesity are at high risk for child obesity. Effective approaches to promote healthy behaviors and prevent additional weight gain in family members are needed. Motivational interviewing (MI) may assist families to engage, identify motivations for change and establish goals. However, families with limited resources face other barriers to goal achievement that may be addressed through connection with community organizations. This paper describes a unique protocol combining MI and community connection. This randomized controlled trial includes low-income families with one parent with obesity and at least one child aged 6 to 12 years. Families in the intervention group receive an innovative, 12-month intervention combining health coaching using MI to promote lifestyle behavior change goals and community resource mobilization to assist with basic needs and resources to aid goals. The study protocol is modeled on community-based participatory research principles. Data is collected at baseline, 6 months, 12 months, and 18 months include questionnaires, body measurements, and accelerometer data. For adults, primary outcomes are Body Mass Index (BMI), minutes of moderate to vigorous physical activity (MVPA), and hours of sedentary time per day. For children, primary outcomes are sedentary time, MVPA, and the Family Nutrition and Physical Activity Score. From this hard-to-reach population, 236 diverse families were recruited. If the study is deemed effective, it has the potential to demonstrate that the combination of MI, resource mobilization, and utilization of existing community organizations is a sustainable model to assist families at risk for obesity.
Collapse
|
19
|
Monroe-Lord L, Jones BL, Richards R, Reicks M, Gunther C, Banna J, Topham GL, Anderson A, Lora KR, Wong SS, Ballejos M, Hopkins L, Ardakani A. Parenting Practices and Adolescents' Eating Behaviors in African American Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010110. [PMID: 35010370 PMCID: PMC8750164 DOI: 10.3390/ijerph19010110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 01/09/2023]
Abstract
Parents play an important role in developing the eating behaviors of their children by adopting specific parenting practices. As the prevalence of obesity is high amongst African American adolescents, investigations into associations of specific parenting practices and adolescents’ eating behaviors are essential. In this exploratory study, 14 African American parent–adolescent dyads were interviewed to characterize the influence of eight different parenting practices on the consumption of three main food categories (dairy, fruits and vegetables, and unhealthy snacks). The results revealed that authoritarian parenting practices were correlated with a higher BMI percentile in adolescents, whereas modeling and monitoring are correlated with a higher parent BMI. In addition, reasoning, monitoring, modeling, and authoritative parenting practices were associated with less unhealthy snack consumption among adolescents. Reasoning and monitoring were the only parenting practices associated with higher fruit and vegetable consumption. Finally, a significant correlation was found between eating fruits and vegetables and unhealthy snacks and the location of eating. In conclusion, different parenting practices and environmental factors may impact BMI and food consumption of African American dyads. The results of this study can be used to guide improvement in, and/or development of, nutritional education interventions considering the cultural differences of racial minorities.
Collapse
Affiliation(s)
- Lillie Monroe-Lord
- Center for Nutrition, Diet and Health, University of the District of Columbia, Washington, DC 20008, USA
- Correspondence: ; Tel.: +202-274-7125
| | - Blake L. Jones
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA;
| | - Rickelle Richards
- Department of Nutrition, Dietetics & Food Science, Brigham Young University, Provo, UT 84602, USA;
| | - Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108, USA;
| | - Carolyn Gunther
- Human Nutrition Program, Department of Human Sciences, Ohio State University, Columbus, OH 43210, USA;
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii-Manoa, Honolulu, HI 96822, USA;
| | - Glade L. Topham
- Department of Applied Human Sciences, Kansas State University, Manhattan, KS 66506, USA;
| | - Alex Anderson
- Department of Nutritional Sciences, University of Georgia, Athens, GA 30602, USA;
| | - Karina R. Lora
- Department of Exercise and Nutrition Sciences, The George Washington University, Washington, DC 20052, USA;
| | - Siew Sun Wong
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR 97331, USA;
| | - Miriam Ballejos
- Nutrition & Exercise Physiology, Washington State University, 412 E. Spokane Falls Blvd, Spokane, WA 99202, USA;
| | - Laura Hopkins
- Department of Public Health and Prevention Sciences, Baldwin Wallace University, 275 Eastland Rd., Berea, OH 44017, USA;
| | - Azam Ardakani
- Department of Nutritional Sciences, Howard University, Washington, DC 20059, USA;
| |
Collapse
|
20
|
Burton M, Wood JM, Booth AO, Worsley A, Larsson C, Margerison C. Enough time for lunch? The duration and governance of lunch eating times in Australian primary schools: A mixed-methods study. Appetite 2021; 169:105817. [PMID: 34826526 DOI: 10.1016/j.appet.2021.105817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/11/2021] [Accepted: 11/17/2021] [Indexed: 01/01/2023]
Abstract
Developing healthy eating behaviours is important to assist children in maintaining good health and decrease the risk of chronic health conditions. Recent nutrition promotion efforts in Australian primary schools have mainly focused on canteen guideline compliance and obesity prevention interventions. The aim of this study was to investigate the primary school food environment, specifically, allocated lunch eating duration and the governance of children's lunch breaks. Parents (n = 402) and teachers (n = 123) were asked via an online survey, about school allocated lunch eating duration and its adequacy. Respondents were asked about the supervision, monitoring and feedback of children's lunches, as well as how they felt about these practices. Parents (n = 308) and teachers (n = 102) also responded to the open-ended question "What could be done to improve the school food environment at your school?". Ten minutes was the allocated lunch eating duration reported by most parents and teachers and 58% of those parents and 30% of those teachers rated this as inadequate. Increasing the allocated lunch eating duration was frequently cited as a way to improve the school food environment. A similar proportion of parents and teachers agreed with teachers monitoring food intake, not providing feedback on food brought to school, and that parents should decide what children eat. More parents (44%) than teachers (23%) believed that teachers should eat their own lunch with the children. These findings provide an insight into the primary school lunch environment and the views of two key stakeholder groups. School food policies should consider these findings in future revisions, particularly with regards to eating times.
Collapse
Affiliation(s)
- Melissa Burton
- Deakin University, School of Exercise and Nutrition Sciences, Geelong, Australia.
| | - Julie Maree Wood
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Alison O Booth
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Anthony Worsley
- Deakin University, School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Christel Larsson
- Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Claire Margerison
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Geelong, Australia
| |
Collapse
|
21
|
Nowicka P, Keres J, Ek A, Nordin K, Sandvik P. Changing the Home Food Environment: Parents' Perspectives Four Years after Starting Obesity Treatment for Their Preschool Aged Child. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11293. [PMID: 34769810 PMCID: PMC8583698 DOI: 10.3390/ijerph182111293] [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] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 01/22/2023]
Abstract
Changing the home food environment is key to childhood obesity treatment. However, new challenges arise as the child grows older. This study investigates parents' views on the longer-term management of the home food environment, 4 years after starting obesity treatment for their preschool-aged child. Semi-structured interviews were conducted with 33 parents (85% mothers, 48% with a university degree) of 33 children (mean age 9.3 (SD 0.7), 46% girls) from Sweden. The interviews were analyzed using thematic analysis. Two main themes were developed. Making changes in the home food environment illustrates the types of changes families make over time in relation to child development. It consists of three subthemes: covert changes, overt changes and child-directed changes. The second theme, an ongoing negotiation, captures parents' experiences of managing the home food environment as a continuous process of balancing and recalibrating in relation to present challenges and concerns about the future. It includes three subthemes: concern and care, two steps forward one back and maintaining everyday balance. Managing the home food environment is a constant process affected by everyday life, parents' strategies and the child's development. Our findings can strengthen childhood obesity treatment and help prepare parents for challenges that lie ahead.
Collapse
Affiliation(s)
- Paulina Nowicka
- Department of Food Studies Nutrition and Dietetics, Uppsala University, 752 37 Uppsala, Sweden;
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institute, 141 57 Huddinge, Sweden; (A.E.); (K.N.)
| | - Johan Keres
- Dietitian Unit, Region Sörmland, 611 88 Nyköping, Sweden;
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institute, 141 57 Huddinge, Sweden; (A.E.); (K.N.)
| | - Karin Nordin
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institute, 141 57 Huddinge, Sweden; (A.E.); (K.N.)
| | - Pernilla Sandvik
- Department of Food Studies Nutrition and Dietetics, Uppsala University, 752 37 Uppsala, Sweden;
| |
Collapse
|
22
|
Moffat LF, Ritchie LD, Gosliner W, Plank KR, Au LE. Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study. Nutrients 2021; 13:3681. [PMID: 34835936 PMCID: PMC8619213 DOI: 10.3390/nu13113681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022] Open
Abstract
Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children's diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children's fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013-2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents' perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = -0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households.
Collapse
Affiliation(s)
- Laurel F. Moffat
- Youth and Families Unit, Extension, Washington State University, Spokane, WA 99202, USA;
| | - Lorrene D. Ritchie
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA; (L.D.R.); (W.G.); (K.R.P.)
| | - Wendi Gosliner
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA; (L.D.R.); (W.G.); (K.R.P.)
| | - Kaela R. Plank
- Nutrition Policy Institute, Division of Agriculture and Natural Resources, University of California, Oakland, CA 94607, USA; (L.D.R.); (W.G.); (K.R.P.)
| | - Lauren E. Au
- Department of Nutrition, University of California, Davis, CA 95616, USA
| |
Collapse
|
23
|
Parental Feeding Practices and Child-Related Factors are Associated with Overweight and Obesity in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:3655-3667. [PMID: 34453670 DOI: 10.1007/s10803-021-05247-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 10/20/2022]
Abstract
Atypical eating behaviors displayed by children with autism spectrum disorder (ASD) predispose them to unhealthy weight gain. We determined the factors associated with body weight status among 261 children with ASD (3-18 years) at nine autism intervention centers. Their mothers completed a self-administered questionnaire on sociodemographic background, parenting style, parental feeding practices, parenting stress, sleep habits, eating behaviors, and autism severity. Children with older age, non-full term gestational age, high maternal perceived weight, high maternal concern about child weight, and low pressure to eat were more likely to be overweight and obese. Obesity is a major concern among children with ASD. Healthy weight management programs for parents should incorporate appropriate feeding practices and a healthy perception of body weight.
Collapse
|
24
|
van Nee RL, van Kleef E, van Trijp HCM. Dutch Preadolescents' Food Consumption at School: Influence of Autonomy, Competence and Parenting Practices. Nutrients 2021; 13:nu13051505. [PMID: 33946949 PMCID: PMC8145952 DOI: 10.3390/nu13051505] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 02/07/2023] Open
Abstract
Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents' eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents' food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents' food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents' perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents' healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents' healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.
Collapse
|
25
|
Rozga M, Handu D. Current Systems-Level Evidence on Nutrition Interventions to Prevent and Treat Cardiometabolic Risk in the Pediatric Population: An Evidence Analysis Center Scoping Review. J Acad Nutr Diet 2021; 121:2501-2523. [PMID: 33495106 DOI: 10.1016/j.jand.2020.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/07/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
Improving and maintaining cardiometabolic health remains a major focus of health efforts for the pediatric population. Recent research contributes understanding of the systems-level nutrition factors influencing cardiometabolic health in pediatric individuals. This scoping review examines current evidence on interventions and exposures influencing pediatric cardiometabolic health to inform registered dietitian nutritionists working at each systems level, ranging from individual counseling to public policy. A literature search of MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, and other databases was conducted to identify evidence-based practice guidelines, systematic reviews, and position statements published in English from January 2017 until April 2020. Included studies addressed nutrition interventions or longitudinal exposures for participants 2 to 17 years of age who were healthy or had cardiometabolic risk factors. Studies were categorized according level of the social-ecological framework addressed. The databases and hand searches identified 2614 individual articles, and 169 articles were included in this scoping review, including 6 evidence-based practice guidelines, 141 systematic reviews, and 22 organization position statements. The highest density of systematic reviews focused on the effects of dietary intake (n = 58) and interventions with an individual child or family through counseling or education (n = 54). The least frequently examined levels of interventions or exposures were at the policy level (n = 12). Registered dietitian nutritionists can leverage this considerable body of recent systematic reviews to inform a systems-level, collaborative approach to prevention and treatment of pediatric cardiometabolic risk factors.
Collapse
|
26
|
Abstract
Introduction Objective: to analyze the impact of front-of-pack warning labeling (FOP-L) on food purchase patterns in Chilean families with children under 14 years of age after the implementation of the Law on nutritional labeling in Chile. Methods: a cross-sectional study in 468 parents/tutors from 11 schools in Santiago. The questionnaire investigated FOP-L perception, food purchase patterns, and the influence of children on the selection of foods purchased by the family. Results: mostly mothers are responsible for household food purchases (62.0 %). Parents with a higher schooling level had a greater knowledge of the regulation (p < 0.05). In all, 66.3 % did not consider label information before the law was implemented. The FOP-L considered most important was "High in sugars" (18.0 %); 49.5 % stopped buying some foods due to the presence of a FOP-L; 75.0 % of parents reported that their children accompanied them at the supermarket. A lower probability of food purchase pattern change was observed in families that did not consider the FOP-L an important tool (OR: 5.85; p < 0.001), did not understand the meaning of the FOP-L (OR: 2.99; p = 0.020), had not the habit of reading nutritional labeling prior to law implementation (OR: 2.63; p < 0.001), or had a child who requested specific foods (OR: 2.91; p = 0.009). Conclusion: factors associated with buying food with FOP-L included: not considering their presence important, lack of understanding, not having the habit of reading labels on packaged foods prior to the Law, and having a child requesting food at the supermarket.
Collapse
|
27
|
Mâsse LC, O'Connor TM, Lin Y, Hughes SO, Tugault-Lafleur CN, Baranowski T, Beauchamp MR. Calibration of the food parenting practice (FPP) item bank: tools for improving the measurement of food parenting practices of parents of 5-12-year-old children. Int J Behav Nutr Phys Act 2020; 17:140. [PMID: 33198790 PMCID: PMC7670656 DOI: 10.1186/s12966-020-01049-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/02/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE There has been a call to improve measurement rigour and standardization of food parenting practices measures, as well as aligning the measurement of food parenting practices with the parenting literature. Drawing from an expert-informed conceptual framework assessing three key domains of food parenting practices (autonomy promotion, control, and structure), this study combined factor analytic methods with Item Response Modeling (IRM) methodology to psychometrically validate responses to the Food Parenting Practice item bank. METHODS A sample of 799 Canadian parents of 5-12-year-old children completed the Food Parenting Practice item bank (129 items measuring 17 constructs). The factorial structure of the responses to the item bank was assessed with confirmatory factor analysis (CFA), confirmatory bi-factor item analysis, and IRM. Following these analyses, differential Item Functioning (DIF) and Differential Response Functioning (DRF) analyses were then used to test invariance properties by parents' sex, income and ethnicity. Finally, the efficiency of the item bank was examined using computerized adaptive testing simulations to identify the items to include in a short form. RESULTS Overall, the expert-informed conceptual framework was predominantly supported by the CFA as it retained the same 17 constructs included in the conceptual framework with the exception of the access/availability and permissive constructs which were respectively renamed covert control and accommodating the child to better reflect the content of the final solution. The bi-factor item analyses and IRM analyses revealed that the solution could be simplified to 11 unidimensional constructs and the full item bank included 86-items (empirical reliability from 0.78 to 0.96, except for 1 construct) and the short form had 48 items. CONCLUSION Overall the food parenting practice item bank has excellent psychometric properties. The item bank includes an expanded version and short version to meet various study needs. This study provides more efficient tools for assessing how food parenting practices influence child dietary behaviours. Next steps are to use the IRM calibrated item bank and draw on computerized adaptive testing methodology to administer the item bank and provide flexibility in item selection.
Collapse
Affiliation(s)
- Louise C Mâsse
- BC Children's Hospital Research Institute, School of Population and Public Health University of British Columbia, F508-4490 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates St, Houston, TX, 77030, USA
| | - Yingyi Lin
- BC Children's Hospital Research Institute, School of Population and Public Health University of British Columbia, F508-4490 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates St, Houston, TX, 77030, USA
| | - Claire N Tugault-Lafleur
- BC Children's Hospital Research Institute, School of Population and Public Health University of British Columbia, F508-4490 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates St, Houston, TX, 77030, USA
| | - Mark R Beauchamp
- School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC, V6T 1Z1, Canada
| |
Collapse
|
28
|
Kral TVE, Moore RH, Chittams J, O'Malley L, Jones E, Quinn RJ, Fisher JO. Does eating in the absence of hunger extend to healthy snacks in children? Pediatr Obes 2020; 15:e12659. [PMID: 32548966 DOI: 10.1111/ijpo.12659] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 04/24/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To assess if eating in the absence of hunger (EAH) extends to healthier snacks and examine the relationship between the home food environment and EAH in children with normal weight (NW) or overweight/obesity (OB) who are at low risk (LR) or high risk (HR) for obesity based on maternal obesity. METHODS EAH was assessed after lunch and dinner when children received either low energy dense fruit snacks or high energy dense sweet/savoury snacks. The availability of obesogenic foods in the home was assessed by the Home Food Inventory. RESULTS Data showed significant main effects of risk group (P=.0003) and snack type (P < .001). EAH was significantly greater in HR-OB (284±8 kcal) than LR-NW (249±9 kcal) or HR-NW (251±8 kcal) children. Serving fruit rather than sweet/savoury snacks reduced energy intake, on average, by 60% (223 kcal) across risk groups. For each unit increase in the obesogenic home food environment, EAH of sweet/savoury snacks decreased by 1.83 calories. CONCLUSIONS Offering low energy dense snacks after a meal can moderate EAH and increase children's intake of healthy foods. Increased access to obesogenic foods in the home may reduce the salience of high energy dense snacks when they become available in other settings.
Collapse
Affiliation(s)
- Tanja V E Kral
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jesse Chittams
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lauren O'Malley
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Elizabeth Jones
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ryan J Quinn
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer O Fisher
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
29
|
Tay Z, Whitton C, van Dam RM, Chia KS, Swinburn B, Vandevijvere S, Rebello SA. Identifying implementation gaps and priorities for the Singapore government to improve food environment policies: perspectives from a local expert panel. Public Health Nutr 2020; 24:1-8. [PMID: 33046170 DOI: 10.1017/s1368980020003468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Singapore, an urbanised, developed nation, with a high reliance on food importation and a high prevalence of eating out is facing rising rates of obesity and diabetes. The objective of the current study was to characterise and evaluate the Singapore government's policies to improve the food environment and to identify and prioritise concrete actions. DESIGN The Healthy Food Environment Policy Index tool and process were used. An expert panel rated the Singapore government's implementation of forty-seven indicators compared with international best practice in 2018. Indicators were prioritised, and specific recommendations were proposed by panel. SETTING Singapore. PARTICIPANTS Twenty experts primarily from academia. RESULTS As compared with international benchmarks, the level of implementation of most indicators (thirty-three indicators, 70 %) by the Singapore government was evaluated as being at least moderate. Highly rated indicators included those related to provision of healthier meals at school, supporting the use of healthier ingredients by food vendors and governmental leadership. More policy indicators (6, 26 %) as compared with infrastructure support indicators (2, 8 %) received a 'very little or no implementation' rating. After rating, the experts prioritised eleven indicators and proposed thirty-one actions informed by several considerations including those of effectiveness, political acceptability, feasibility and unique characteristics of food retail in Singapore. CONCLUSIONS Supported by documented evidence, an independent expert panel identified areas of strengths and provided specific recommendations to meaningfully improve the Singapore food environment to facilitate healthier eating. Fundamental recommendations including improving nutrition profiling and strengthening monitoring systems have the potential to positively influence environments across policy domains.
Collapse
Affiliation(s)
- Zoey Tay
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building, 10-01V, 117549, 65-65168557, 65-67791489, Singapore
| | - Clare Whitton
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building, 10-01V, 117549, 65-65168557, 65-67791489, Singapore
- School of Public Health, Curtin University, Perth, Australia
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building, 10-01V, 117549, 65-65168557, 65-67791489, Singapore
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building, 10-01V, 117549, 65-65168557, 65-67791489, Singapore
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Victoria Street West, Auckland, New Zealand
| | - Stefanie Vandevijvere
- Department of Epidemiology and Public Health, Sciensano (Scientific Institute of Public Health), Brussels, Belgium
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, 12 Science Drive 2, MD1 Tahir Foundation Building, 10-01V, 117549, 65-65168557, 65-67791489, Singapore
| |
Collapse
|
30
|
Bassul C, A. Corish C, M. Kearney J. Associations between the Home Environment, Feeding Practices and Children's Intakes of Fruit, Vegetables and Confectionary/Sugar-Sweetened Beverages. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134837. [PMID: 32635599 PMCID: PMC7370037 DOI: 10.3390/ijerph17134837] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/20/2022]
Abstract
Within the home environment, parents influence their children’s dietary intakes through their parenting and dietary practices, and the foods they make available/accessible. The aim of this cross-sectional study was to examine the associations between home environmental characteristics and children’s dietary intakes. Three hundred and thirty-two children aged three–five years and their parents participated in the study. Home environmental characteristics, including parental control feeding practices, were explored using validated and standardized questionnaires such as the Child Feeding Questionnaire (CFQ), the Physical and Nutritional Home Environment Inventory (PNHEI) and the Healthy Home Survey (HHS). Parent and child food consumption was also measured. Pressure to eat from parents was associated with lower fruit intake in children (OR 0.67, 95% CI 0.47–0.96, p = 0.032). Greater variety of fruit available in the home increased the likelihood of fruit consumption in children (OR 1.35 95% CI 1.09–1.68, p = 0.005). Watching television for ≥1 h per day was associated with a decreased probability of children eating vegetables daily (OR 0.38, 95% CI 0.20–0.72, p = 0.003) and doubled their likelihood of consuming confectionary/sugar-sweetened beverages more than once weekly (OR 2.15, 95% CI 1.06–4.38, p = 0.034). Children whose parents had lower vegetable consumption were 59% less likely to eat vegetables daily. This study demonstrates that modifiable home environmental characteristics are significantly associated with children’s dietary intakes.
Collapse
Affiliation(s)
- Carolina Bassul
- School of Biological and Health Sciences, Technological University Dublin, City Campus, Kevin Street, Dublin 8, Ireland
- Correspondence: (C.B.); (J.M.K.); Tel.: +353-(0)-1-402-2837 (C.B.); +353-(0)-1-402-2837 (J.M.K.)
| | - Clare A. Corish
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland;
| | - John M. Kearney
- School of Biological and Health Sciences, Technological University Dublin, City Campus, Kevin Street, Dublin 8, Ireland
- Correspondence: (C.B.); (J.M.K.); Tel.: +353-(0)-1-402-2837 (C.B.); +353-(0)-1-402-2837 (J.M.K.)
| |
Collapse
|
31
|
Mekonnen T, Havdal HH, Lien N, O'Halloran SA, Arah OA, Papadopoulou E, Gebremariam MK. Mediators of socioeconomic inequalities in dietary behaviours among youth: A systematic review. Obes Rev 2020; 21:e13016. [PMID: 32162413 DOI: 10.1111/obr.13016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 02/02/2023]
Abstract
Children and adolescents with a lower socioeconomic position have poorer dietary behaviours compared to their counterparts with a higher socioeconomic position. A better understanding of the mechanisms behind such socioeconomic inequalities is vital to identify targets for interventions aimed at tackling these inequalities. This systematic review aimed to summarize existing evidence regarding the mediators of socioeconomic differences in dietary behaviours among youth. A systematic literature search of MEDLINE, Embase, PsycINFO, and Web of Science databases yielded 20 eligible studies. The dietary behaviours included in the reviewed studies were the intake of fruit and vegetables, sugar-sweetened beverages, unhealthy snacks/fast food and breakfast. The consistent mediators of the effects of socioeconomic position on dietary behaviours among youth were: self-efficacy, food preferences and knowledge at the intrapersonal level; and availability and accessibility of food items at home, food rules and parental modelling at the interpersonal level. Few studies including mediators at the organisational, community or policy levels were found. Our review found several modifiable factors at the intrapersonal and interpersonal levels that could be targeted in interventions aimed at combating inequalities in dietary behaviours among youth. Rigorous studies exploring organisational, community and policy level mediators are warranted.
Collapse
Affiliation(s)
- Teferi Mekonnen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Hanne Hennig Havdal
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Siobhan Anne O'Halloran
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Onyebuchi A Arah
- Department of Epidemiology and Department of Statistics, University of California, Los Angeles (UCLA), California, USA
| | - Eleni Papadopoulou
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Norway
| | - Mekdes Kebede Gebremariam
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| |
Collapse
|
32
|
Kähkönen K, Hujo M, Sandell M, Rönkä A, Lyytikäinen A, Nuutinen O. Fruit and vegetable consumption among 3–5-year-old Finnish children and their parents: Is there an association? Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2020.103886] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
33
|
Association between food availability and young people's fruits and vegetables consumption: understanding the mediation role of the theory of planned behaviour. Public Health Nutr 2020; 23:2155-2164. [PMID: 32450936 DOI: 10.1017/s1368980019005263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the relationship between fruits and vegetables (F&V) availability at home and young people's F&V consumption behaviour, and how the theory of planned behaviour (TPB) constructs could potentially mediate the relationship. DESIGN Cross-sectional face-to-face survey questionnaire to assess the TPB constructs and home food availability assessed using open inventories method. F&V availability was categorised into low and high levels based on median split. SETTING Singapore. PARTICIPANTS Two hundred and ten households (each consisting one parent-child pair) recruited via stratified cluster sampling with child participants ranging from 9 to 16 years of age. RESULTS Mediation analyses were conducted using structural equation modelling. The relationship between home F&V availability and F&V consumption behaviour did not have a significant direct association, but there were significant indirect effects through the routes of perceived behavioural control (PBC) and intention as well as attitude and intention. Specifically, higher level of F&V availability at home was related to more positive PBC and attitude towards F&V, and subsequently greater intention to consume F&V and higher consumption of F&V. CONCLUSIONS Parents should make F&V more readily available at home as increased exposure to F&V could be related to enhanced liking, sense of control and intention to consume F&V and facilitate children's healthy diet.
Collapse
|
34
|
Hermans RC, Smit K, van den Broek N, Evenhuis IJ, Veldhuis L. Adolescents' Food Purchasing Patterns in The School Food Environment: Examining the Role of Perceived Relationship Support and Maternal Monitoring. Nutrients 2020; 12:nu12030733. [PMID: 32168757 PMCID: PMC7146524 DOI: 10.3390/nu12030733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023] Open
Abstract
The school food environment plays a role in adolescents’ dietary behaviors. In this study, adolescents’ food purchasing patterns in and around school and its potential relationship with perceived maternal relationship support and maternal monitoring were examined. Data were collected in The Netherlands in 2017. A total of 726 adolescents (45.8% boys; Mage = 13.78 ± 0.49) and 713 mothers (Mage = 45.05 ± 4.45) participated. Adolescents’ frequency of bringing and purchasing foods was assessed via a Food Frequency Questionnaire (FFQ). Relationship support and monitoring were measured via self-report questionnaires. Structural Equation Modelling (SEM) was conducted to examine associations between adolescents’ food purchasing patterns, relationship support, and monitoring. Results indicated that adolescents brought food and drinks mostly from home, and infrequently purchased these products in and around school. Yet, differences exist between subgroups of adolescents. Relationship support was positively associated with bringing fruit, vegetables and salad and negatively associated with purchasing sweet snacks. No associations were found for monitoring. These findings indicate that family-home determinants of healthy and unhealthy eating are important factors to consider when examining the impact of the school food environment on adolescents’ food purchasing patterns. This has implications for policy makers who aim to develop and implement measures to improve adolescents’ eating in and around school.
Collapse
Affiliation(s)
- Roel C.J. Hermans
- The Netherlands Nutrition Centre, 2594 AC The Hague, The Netherlands; (I.J.E.); (L.V.)
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6299 AH Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-43-388-2415
| | - Koen Smit
- Behavioural Science Institute, Radboud University, 6500 HE Nijmegen, The Netherlands; (K.S.); (N.v.d.B.)
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, 3500 AS Utrecht, The Netherlands
| | - Nina van den Broek
- Behavioural Science Institute, Radboud University, 6500 HE Nijmegen, The Netherlands; (K.S.); (N.v.d.B.)
| | - Irma J. Evenhuis
- The Netherlands Nutrition Centre, 2594 AC The Hague, The Netherlands; (I.J.E.); (L.V.)
| | - Lydian Veldhuis
- The Netherlands Nutrition Centre, 2594 AC The Hague, The Netherlands; (I.J.E.); (L.V.)
| |
Collapse
|
35
|
Reicks M, Banna J, Anderson AK, Da Silva V, Gunther C, Hongu NK, Jones B, Lora K, Monroe-Lord L, Richards R, Topham G, Wong SS. Development of Parent and Adolescent Questionnaires to Assess Food Parenting Practices That Address Adolescent Consumption During Independent Eating Occasions. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:307-313. [PMID: 31780273 DOI: 10.1016/j.jneb.2019.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/24/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To develop and test parent and early adolescent questionnaires to assess food parenting practices that influence early adolescent food consumption during independent eating occasions (iEOs). METHODS Cross-sectional online questionnaires were completed by 206 and 62 low-income parent/early adolescent (11-14 years) dyads at Time 1 and 2, respectively, recruited via a Qualtrics (Provo, UT) US national panel database. Principal component analyses, internal consistency, and test-retest reliability checks were performed. RESULTS Six parallel components were identified for parents and early adolescents with acceptable internal consistency and test-retest reliability. Scales included autonomy support, monitoring, availability, indulgence, expectations, and modeling. All except indulgence were positively correlated with importance of helping early adolescents make healthy choices during iEOs. CONCLUSIONS AND IMPLICATIONS Additional research is needed to test the questionnaires' validity regarding relationships between parenting practices and early adolescent consumption during iEOs. Findings could inform development of interventions to improve consumption during these occasions.
Collapse
Affiliation(s)
- Marla Reicks
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN.
| | - Jinan Banna
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI
| | | | - Vanessa Da Silva
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Carolyn Gunther
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | - Nobuko Kay Hongu
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Blake Jones
- Psychology Department, Brigham Young University, Provo, UT
| | - Karina Lora
- Department of Exercise and Nutrition Sciences, George Washington University, Washington, DC
| | - Lillie Monroe-Lord
- Center for Nutrition, Diet and Health, University of the District of Columbia, Washington, DC
| | - Rickelle Richards
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT
| | - Glade Topham
- School of Family Studies and Human Services, Kansas State University, Manhattan, KS
| | - Siew Sun Wong
- School of Biological and Population Health Sciences, Family and Community Health, Oregon State University, Corvallis, OR
| |
Collapse
|
36
|
PEREIRA LJ, HINNIG PDF, DI PIETRO PF, ASSIS MAAD, VIEIRA FGK. Trends in food consumption of schoolchildren from 2nd to 5th grade: a panel data analysis. REV NUTR 2020. [DOI: 10.1590/1678-9865202033e190164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ABSTRACT Objective To identify trends in food consumption among schoolchildren (2nd-5th grades) from public schools in the city of Florianópolis, Brazil, in a period of three years. Methods Three cross-sectional surveys were carried out in 2013 (n=1,942), 2014 (n=1,989) and 2015 (n=2,418). Dietary intake data were obtained using the Web-Based Food Intake and Physical Activity of Schoolchildren questionnaire. Food items were aggregated to eight food groups. Kruskal-Wallis heterogeneity and trend tests were used to analyze the differences and trends among the mean intake frequency of food groups. Results There were trends to decrease the mean intake frequency of sweets in the total sample (2013: 0.72±0.91; 2014: 0.68±0.87; 2015: 0.67±0.89, p=0.03) which was determined by children between 7-9 years old (2013: 0.69±0.88; 2014: 0.64±0.85; 2015: 0.62±0.87, p=0.02), and boys (2013: 0.75±0.90; 2014: 0.70±0.86; 2015: 0.68±0.88, p=0.03). Younger children also tended to increase the mean intake frequency of fruits and vegetables (2013: 1.03±1.35; 2014: 1.16±1.45; 2015: 1.17±1.41, p=0.03) and those aged ten-12 years decreased their intake of dairy products (2013: 1.32±1.25; 2014: 1.23±1.18; 2015: 1.20±1.20, p=0.05). Conclusion The results suggest positive trends for younger children, with an increased consumption of fruits and vegetables in both sexes and decreased consumption of sweets for boys. Older children reduced their consumption of dairy products over the three-year period of this study.
Collapse
|
37
|
Zhen-Duan J, Engebretsen B, Laroche HH. Diet and physical activity changes among low-income families: perspectives of mothers and their children. Int J Qual Stud Health Well-being 2019; 14:1658700. [PMID: 31452465 PMCID: PMC6720015 DOI: 10.1080/17482631.2019.1658700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2019] [Indexed: 10/28/2022] Open
Abstract
Purpose: The current study explored how mothers and their children influence each other's diet and physical activity. Methods: We conducted semi-structured interviews with women with diabetes and their children (N = 18) from eight low-income families. Results: Two approaches to changes emerged: collaborative and non-collaborative. Families using collaborative approaches believed they could sustain positive changes through accepting family changes, encouragement, abstaining from buying certain foods, modelling and compromise. Within families using non-collaborative approaches, some challenges included using more individualistic approaches and poor communication. Lack of information and resource constraints challenged all families. Conclusion: Interventions should reinforce family collaborative approaches and teach skills for families to work together towards a healthier lifestyle.
Collapse
Affiliation(s)
- Jenny Zhen-Duan
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | | | - Helena H. Laroche
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| |
Collapse
|
38
|
van der Horst K, Mathias KC, Prieto Patron A, Allirot X. Art on a Plate: A Pilot Evaluation of an International Initiative Designed to Promote Consumption of Fruits and Vegetables by Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:919-925.e1. [PMID: 31047810 DOI: 10.1016/j.jneb.2019.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/18/2019] [Accepted: 03/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the 2016 International Chefs Day cooking workshops Art on a Plate. DESIGN Nonexperimental pretest-posttest design SETTING: Art on a Plate workshops with children from 14 countries in Asia, America, and Europe. PARTICIPANTS A total of 433 workshop participants aged 4-14 years (mean age, 8.6 years). INTERVENTION Instructed by a chef, children in the workshops created a self-chosen design on their plate with a spinach-fruit salad. MAIN OUTCOME MEASURES Before and after the workshop, a questionnaire assessing liking and willingness to eat or taste; hunger was assessed using the Teddy the Bear method and emotions were assessed using the Self-assessment Manikin. The event coordinator evaluated salad intake. ANALYSIS Linear and generalized linear (logit) mixed models were used to test statistical differences before and after the workshop. RESULTS The workshop resulted in a small increase in liking (n = 409; P = .02) and person control (n = 375; P < .001) and a decrease in hunger (n = 379; P < .001). A total of 30% of children increased their liking scores, 18% decreased them, and 52% did not change them. Significant associations of liking and change in liking with salad intake were in the expected direction. CONCLUSION AND IMPLICATIONS This study showed the positive effect of a cooking workshop on children's salad liking across a selection of countries worldwide. Further research and novel methods are needed to evaluate the long-term effectiveness of cooking activities in real-life settings across countries.
Collapse
Affiliation(s)
- Klazine van der Horst
- Nestec Ltd, Nestlé Research Center, Institute of Nutritional Science, Vers-Chez-Les-Blanc, Lausanne, Switzerland; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
| | - Kevin C Mathias
- Nestec Ltd, Nestlé Research Center, Institute of Nutritional Science, Vers-Chez-Les-Blanc, Lausanne, Switzerland
| | - Alberto Prieto Patron
- Nestec Ltd, Nestlé Research Center, Institute of Nutritional Science, Vers-Chez-Les-Blanc, Lausanne, Switzerland
| | | |
Collapse
|
39
|
Horning ML, Porter L. Twin Cities Mobile Market Food Delivery Model: A Preliminary Study Describing Results of A Customer Intercept Survey and Point of Sale Data for 2016. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2019. [DOI: 10.1080/19320248.2019.1654426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Leah Porter
- Twin Cities Mobile Market, Amherst Wilder Foundation, Saint Paul, MN, USA
| |
Collapse
|
40
|
Franse CB, Wang L, Constant F, Fries LR, Raat H. Factors associated with water consumption among children: a systematic review. Int J Behav Nutr Phys Act 2019; 16:64. [PMID: 31409359 PMCID: PMC6693220 DOI: 10.1186/s12966-019-0827-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 07/29/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Water is recommended as the main beverage for daily fluid intake. Previous systematic reviews have studied the consumption of sugar-sweetened beverages (SSBs) among children, but none have focused on water consumption. Insight into factors that are associated with children's water intake is needed to inform the development of interventions aimed at the promotion of water consumption. The objective of this review was therefore to summarize the current evidence on factors associated with water consumption among children aged 2 to 12 years. METHODS A systematic literature search in seven electronic databases was conducted in May, 2018 and retrieved 17,850 unique records. Two additional studies were identified by hand-searching references of included articles. Studies were selected if they had a cross-sectional or longitudinal study design, focused on children aged 2-12 years and published in an English language peer-reviewed journal. Participants from clinical populations, studies that included data of < 10 participants and non-human studies were excluded. RESULTS A total of 63 articles met inclusion criteria and were included in the analysis. We identified 76 factors that were investigated in these studies; 17/76 were investigated in a longitudinal study. There was evidence of positive associations between water consumption and child's self-efficacy, parental education level, parental self-efficacy, use of feeding practices such as restriction or encouraging healthy eating and study year. Evidence was inconsistent (< 60% of studies reported an association) for child's age, sex, BMI, consumption of SSBs and ethnic background of the parent. There was no evidence (≤33% of studies reported an association) of associations between consumption of milk or juice, parental emotional-, modelling- or instrumental feeding practices, eating school lunch or outside temperature and water consumption. The remaining 54 factors were investigated in fewer than three studies. CONCLUSIONS There is some evidence for an association between potentially modifiable parental and child-related factors and water consumption. However, most factors identified in this review were only studied by one or two studies and most studies were cross-sectional. More longitudinal research is necessary to investigate environmental, parental and child-related factors associated with water consumption that are currently under-studied and could further inform intervention strategies. TRIAL REGISTRATION PROSPERO ID# CRD42018093362 , registered May 22, 2018.
Collapse
Affiliation(s)
- Carmen B. Franse
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - L. Wang
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | | | - Lisa R. Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| |
Collapse
|
41
|
Loeb KL, Le Grange D, Celio Doyle A, Crosby RD, Glunz C, Laraque-Arena D, Hildebrandt T, Bacow T, Vangeepuram N, Gault A. Adapting family-based treatment for paediatric obesity: A randomized controlled pilot trial. EUROPEAN EATING DISORDERS REVIEW 2019; 27:521-530. [PMID: 31344751 DOI: 10.1002/erv.2699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/19/2019] [Accepted: 07/10/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This pilot study aimed to refine and test an adaption of family-based treatment (FBT) for eating disorders that addressed the distinct clinical needs of adolescents with overweight or obesity in the absence of eating disorder pathology. Our hypothesis was that FBT for paediatric obesity (FBT-PO) would be feasible to implement and superior to a nutrition education counselling (NEC) condition delivered to both parents and patients, thereby controlling for key information dissemination across groups while manipulating active therapeutic content and strategy. METHOD Seventy-seven adolescents were randomized to FBT-PO or NEC across two sites. RESULTS Results supported our core prediction, in that weight status among adolescent study participants receiving FBT-PO remained stable while increasing among participants randomized to NEC. Attrition was high in both conditions. CONCLUSIONS FBT-PO, while not seeming to yield a marked decrease in body mass index z-score, may arrest an otherwise-occurring weight-gain trajectory for these adolescents. This efficacy finding is consistent with the overall PO literature supporting parental involvement in the treatment of PO. Future research efforts should address retention in FBT-PO.
Collapse
Affiliation(s)
| | - Daniel Le Grange
- University of California, San Francisco, San Francisco, CA.,The University of Chicago, Chicago, IL
| | - Angela Celio Doyle
- Eating Disorders Center at the Evidence Based Treatment Centers of Seattle, Seattle, WA
| | - Ross D Crosby
- Sanford Research, Fargo, ND.,University of North Dakota School of Medicine and Health Sciences, Fargo, ND
| | | | | | | | - Terri Bacow
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Allison Gault
- Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
42
|
Millen L, Overcash F, Vickers Z, Reicks M. Implementation of Parental Strategies to Improve Child Vegetable Intake: Barriers and Facilitators. Glob Pediatr Health 2019; 6:2333794X19855292. [PMID: 31236434 PMCID: PMC6572880 DOI: 10.1177/2333794x19855292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 11/16/2022] Open
Abstract
Purpose. To qualitatively assess barriers and facilitators to implementing specific behavioral strategies to increase child vegetable intake during home dinner meals by low-income parents. Method. Parents (n = 49) of children (9-12 years) were asked to implement 1 behavioral strategy following each of 6 weekly cooking classes at community centers. Example strategies included serving vegetables first, serving 2 vegetables, and using a bigger spoon to serve vegetables. The following week, parents discussed how they used the strategy and barriers and facilitators to its use. Discussions were recorded, transcribed verbatim, and coded separately by strategy using NVivo Pro 11 software. Inductive, comparative thematic analyses were used to identify themes by strategy. Results. Most participants were multiethnic women aged 30 to 39 years with low food security. Time and scheduling conflicts limited involvement of children in vegetable preparation (Child Help strategy). The type of foods served and an unfamiliar serving style inhibited use of the MyPlate and Available/Visible strategies, respectively. Children's dislike of vegetables limited use of the Serve Vegetables First and Serve 2 Vegetables strategies. Ease of use promoted use of the Bigger Spoon strategy. Conclusion. Educators could tailor application of specific parent strategies for low-income families based on child and environmental characteristics.
Collapse
|
43
|
Predicting Real-Life Eating Behaviours Using Single School Lunches in Adolescents. Nutrients 2019; 11:nu11030672. [PMID: 30897833 PMCID: PMC6471169 DOI: 10.3390/nu11030672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/13/2019] [Accepted: 03/13/2019] [Indexed: 01/19/2023] Open
Abstract
Large portion sizes and a high eating rate are associated with high energy intake and obesity. Most individuals maintain their food intake weight (g) and eating rate (g/min) rank in relation to their peers, despite food and environmental manipulations. Single meal measures may enable identification of “large portion eaters” and “fast eaters,” finding individuals at risk of developing obesity. The aim of this study was to predict real-life food intake weight and eating rate based on one school lunch. Twenty-four high-school students with a mean (±SD) age of 16.8 yr (±0.7) and body mass index of 21.9 (±4.1) were recruited, using no exclusion criteria. Food intake weight and eating rate was first self-rated (“Less,” “Average” or “More than peers”), then objectively recorded during one school lunch (absolute weight of consumed food in grams). Afterwards, subjects recorded as many main meals (breakfasts, lunches and dinners) as possible in real-life for a period of at least two weeks, using a Bluetooth connected weight scale and a smartphone application. On average participants recorded 18.9 (7.3) meals during the study. Real-life food intake weight was 327.4 g (±110.6), which was significantly lower (p = 0.027) than the single school lunch, at 367.4 g (±167.2). When the intra-class correlation of food weight intake between the objectively recorded real-life and school lunch meals was compared, the correlation was excellent (R = 0.91). Real-life eating rate was 33.5 g/min (±14.8), which was significantly higher (p = 0.010) than the single school lunch, at 27.7 g/min (±13.3). The intra-class correlation of the recorded eating rate between real-life and school lunch meals was very large (R = 0.74). The participants’ recorded food intake weights and eating rates were divided into terciles and compared between school lunches and real-life, with moderate or higher agreement (κ = 0.75 and κ = 0.54, respectively). In contrast, almost no agreement was observed between self-rated and real-life recorded rankings of food intake weight and eating rate (κ = 0.09 and κ = 0.08, respectively). The current study provides evidence that both food intake weight and eating rates per meal vary considerably in real-life per individual. However, based on these behaviours, most students can be correctly classified in regard to their peers based on single school lunches. In contrast, self-reported food intake weight and eating rate are poor predictors of real-life measures. Finally, based on the recorded individual variability of real-life food intake weight and eating rate, it is not advised to rank individuals based on single recordings collected in real-life settings.
Collapse
|
44
|
Boles RE, Johnson SL, Burdell A, Davies PL, Gavin WJ, Bellows LL. Home food availability and child intake among rural families identified to be at-risk for health disparities. Appetite 2019; 134:135-141. [DOI: 10.1016/j.appet.2018.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/28/2018] [Accepted: 12/07/2018] [Indexed: 01/28/2023]
|
45
|
MacMillan Uribe AL, Olson BH. Exploring Healthy Eating and Exercise Behaviors Among Low-Income Breastfeeding Mothers. J Hum Lact 2019; 35:59-70. [PMID: 29723099 DOI: 10.1177/0890334418768792] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND: Postpartum weight retention is often a significant contributor to overweight and obesity. Lactation is typically not sufficient for mothers to return to pre-pregnancy weight. Modifiable health behaviors (e.g., healthy eating and exercise) are important for postpartum weight loss; however, engagement among mothers, especially those who are resource-limited, is low. A deeper understanding of low-income breastfeeding mothers' healthy-eating and exercise experience, a population that may have unique motivators for health-behavior change, may facilitate creation of effective intervention strategies for these women. RESEARCH AIM: To describe the healthy-eating and exercise experiences of low-income postpartum women who choose to breastfeed. METHODS: Focus group discussions were conducted with low-income mothers ( N = 21) who breastfed and had a child who was 3 years old or younger. Transcript analysis employed integrated grounded analysis using both a priori codes informed by the theory of planned behavior and grounded codes. RESULTS: Three major themes were identified from five focus groups: (a) Mothers were unable to focus on their own diet and exercise due to preoccupation with infant needs and more perceived barriers than facilitators; (b) mothers became motivated to eat healthfully if it benefited the infant; and (c) mothers did not seek out information on maternal nutrition or exercise but used the Internet for infant-health information and health professionals for breastfeeding information. CONCLUSION: Low-income breastfeeding mothers may be more receptive to nutrition education or interventions that focus on the mother-infant dyad rather than solely on maternal health.
Collapse
Affiliation(s)
| | - Beth H Olson
- 1 Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| |
Collapse
|
46
|
Ndagire CT, Muyonga JH, Nakimbugwe D. Fruit and vegetable consumption, leisure-time physical activity, and sedentary behavior among children and adolescent students in Uganda. Food Sci Nutr 2019; 7:599-607. [PMID: 30847139 PMCID: PMC6392852 DOI: 10.1002/fsn3.883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/13/2018] [Accepted: 10/19/2018] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Fruit and vegetable (FV) intake and participation in leisure-time physical activity (PA) and in sedentary behavior in accordance with the recommendations are met in a minority of populations including children and adolescents. OBJECTIVE To describe the frequency of FV intake, leisure-time PA, and sedentary behavior, assess compliance with international recommendations, and how selected factors are associated with these recommendations. METHODS The FV consumption and PA questionnaire items previously assessed for reliability in a Ugandan setting were used to gather information about FV consumption, PA, and sedentary behavior among 621 children and adolescents attending schools in Kampala Uganda. The results of FV consumption and PA were categorized as adequate or inadequate while sedentary behavior was categorized as adequate or excess. The relationship between FV consumption, PA, and sedentary behavior with selected independent variables was verified by chi-square test statistic. RESULTS Half of the participants (50%) reported inadequate fruit consumption, and 76% of them reported inadequate vegetable consumption. More children (68%) than young adolescents (52%) and older adolescents (44%) met their daily recommendation for fruit consumption. A similar trend was observed for vegetable consumption. Adequacy of FV intake was significantly associated with participant's age, level of education, school ownership, and type of school. Less of 8- to 17-year-olds (14%) than 18 years and above olds (41%) met their weekly recommendation for leisure-time PA. Majority of participants (54%) participated in acceptable levels of sedentary behaviors. Leisure-time PA was significantly associated with age category and school ownership while sedentary behavior was significantly associated with participant's age and education level. CONCLUSIONS The intake of FV and participation in leisure-time PA was not adequate in the study population. A significant proportion of participants engaged in excess sedentary behavior. Developing and implementing strategies to increase FV intake and PA among children and adolescents in schools should be a national priority.
Collapse
Affiliation(s)
- Catherine T. Ndagire
- School of Food Technology, Nutrition and Bio‐engineeringMakerere UniversityKampalaUganda
| | - John H. Muyonga
- School of Food Technology, Nutrition and Bio‐engineeringMakerere UniversityKampalaUganda
| | - Dorothy Nakimbugwe
- School of Food Technology, Nutrition and Bio‐engineeringMakerere UniversityKampalaUganda
| |
Collapse
|
47
|
Fill "half your child's plate with fruits and vegetables": Correlations with food-related practices and the home food environment. Appetite 2018; 133:77-82. [PMID: 30339784 DOI: 10.1016/j.appet.2018.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 09/25/2018] [Accepted: 10/12/2018] [Indexed: 02/03/2023]
Abstract
This study examined the prevalence of parental report of children's adherence to USDA's MyPlate guidelines of 'half of plate filled with fruits and vegetables (FV)' and associations with child and parent/guardian report of food-related practices and the home food environment. Data for this study represent the baseline assessment (n = 160 parent-child dyads) of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, a randomized controlled trial to prevent excess weight gain among 8-12 year-old children. Multiple logistic regression models examined associations between a newly created 'half plate FV' variable 'During the past seven days how many times was half of your child's plate filled with fruits and vegetables at dinner?" and personal and home food environmental factors, including food availability, child fruit/vegetable intake, and healthy eating index (HEI), adjusted for race and receipt of public assistance. Parents reported their children had half their plates filled with FV at dinner on average 2.7 times in the past week. With each reported child intake of FV, the odds of having half their plates filled with FV were almost one and a half times greater; there were significantly higher odds of children having half their plates filled with FV with greater children's HEI, parent and child cooking skills and self-efficacy to cook healthy meals, family meal frequency, and availability of more types of fruits and vegetables in the home. The findings demonstrate that the MyPlate campaign's message of "half the plate filled with FV" can be used in nutrition interventions focusing on improving the home food environment and increasing children's FV intake; the survey item used in the present study may be effective in capturing adherence to the MyPlate message.
Collapse
|
48
|
Tabak RG, Morshed AB, Schwarz CD, Haire-Joshu D. Impact of a Healthy Weight Intervention Embedded Within a National Home Visiting Program on the Home Food Environment. Front Public Health 2018; 6:178. [PMID: 29998092 PMCID: PMC6028746 DOI: 10.3389/fpubh.2018.00178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/31/2018] [Indexed: 01/16/2023] Open
Abstract
Purpose: To determine whether a lifestyle intervention embedded within Parents as Teachers (PAT), a national child development and parenting home visiting program, helped families make food-related home environment changes. Design: Secondary data analysis of a stratified randomized pragmatic trial. (Trial Registration: This study is registered at www.clinicaltrials.gov NCT01567033). Setting: Participant homes in St. Louis, Missouri. Subjects: Women (n = 179 with pre-post data, of 230 with baseline) participating in standard PAT, with overweight or obesity, and at least one preschool child with BMI percentile ≥60%. Intervention: PAT + Healthy Eating and Active Living Taught at Home (HEALTH), embedded elements of the Diabetes Prevention Program within the standard PAT curriculum. PAT + HEALTH addressed specific behaviors that impact caloric intake (e.g., sugar-sweetened beverages), focusing on behavioral and environmental strategies. Consistent with PAT practice, the frequency, number, and focus (i.e., time spent on intervention components) of home visits were determined by the family's needs; dose structure was flexible [on average intervention: 23 (SD = 9), usual care: 13 (SD = 6) visits]. Measures: Food availability/accessibility and distractions in the home were assessed with items drawn largely from the HomeSTEAD Survey. Analysis: Generalized estimating equations (GEEs) were used to test equality of changes between baseline and 24 months in the intervention and usual care groups. Results: The only significant difference in the pattern of change between usual care and intervention was soda availability/accessibility (p = 0.013). Conclusion: This embedded intervention successfully reduced availability/accessibility of sugar-sweetened beverages in the home. However, given the limited impact on other food-related home environment factors, future interventions could seek to more effectively intervene on all aspects of the home environment.
Collapse
Affiliation(s)
- Rachel G Tabak
- The Brown School, Washington University in St. Louis, St. Louis, MO, United States.,The Prevention Research Center, Washington University in St. Louis, St. Louis, MO, United States
| | - Alexandra B Morshed
- The Brown School, Washington University in St. Louis, St. Louis, MO, United States.,The Prevention Research Center, Washington University in St. Louis, St. Louis, MO, United States
| | - Cynthia D Schwarz
- The Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Debra Haire-Joshu
- The Brown School, Washington University in St. Louis, St. Louis, MO, United States
| |
Collapse
|
49
|
Polacsek M, Moran A, Thorndike AN, Boulos R, Franckle RL, Greene JC, Blue DJ, Block JP, Rimm EB. A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:217-228.e1. [PMID: 29126661 PMCID: PMC6247420 DOI: 10.1016/j.jneb.2017.09.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To carry out a pilot study to determine whether a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families. DESIGN Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention. SETTING A supermarket in a low-income rural Maine community. PARTICIPANTS A total of 401 low-income and Supplemental Nutrition Assistance Program (SNAP) supermarket customers. INTERVENTION Same-day coupon at checkout for half-off eligible fresh, frozen, or canned F&V over 4 months. MAIN OUTCOME MEASURE Weekly spending in dollars on eligible F&V. ANALYSIS A linear model with random intercepts accounted for repeated transactions by individuals to estimate change in F&V spending per week from baseline to intervention. Secondary analyses examined changes among SNAP-eligible participants. RESULTS Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared with control ($1.83; 95% confidence interval [CI], $0.29 to $3.88). The largest increase was for fresh F&V ($1.97; 95% CI, $0.49 to $3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14; 95% CI, $1.93 to $8.34) than among non-SNAP eligible participants who redeemed coupons ($3.88; 95% CI, $1.67 to $6.08). CONCLUSIONS AND IMPLICATIONS A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. Customers who were eligible for SNAP saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low-income families.
Collapse
Affiliation(s)
- Michele Polacsek
- Westbrook College of Health Professions, University of New England, Portland, ME.
| | - Alyssa Moran
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | | | - Rebecca Boulos
- Muskie School of Public Service, University of Southern Maine, Portland, ME
| | - Rebecca L Franckle
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| | | | | | - Jason P Block
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Eric B Rimm
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA
| |
Collapse
|
50
|
Madden GJ, Price J, Wengreen H. Change and Maintaining Change in School Cafeterias: Economic and Behavioral-Economic Approaches to Increasing Fruit and Vegetable Consumption. NEBRASKA SYMPOSIUM ON MOTIVATION 2018. [DOI: 10.1007/978-3-319-96920-6_4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|