Characteristics of Youth Food Preparation in Low-Income, African American Homes: Associations with Healthy Eating Index Scores

A review of dairy food intake for improving health among black children and adolescents in the US

Adequate nutrition during childhood and adolescence is crucial for proper neurological, musculoskeletal, immunological, and cardiometabolic health and development. Yet, disparities among socially underserved racial/ethnic groups in the United States (US) provide significant challenges to achieving adequate nutrition during these years of rapid growth and maturation. For example, Black children and adolescents are at greater risk for having food insecurity, lower-quality diets, obesity, and numerous associated health challenges that result from these disparities compared to their White peers. A growing body of evidence indicates that improving diet quality is critical for improving childhood and adolescent health and well-being, and that the diverse nutritional profile and bioactive compounds found within dairy foods may play multiple roles in promoting proper growth and development during these life stages. Therefore, to support overall health and development among Black youth, greater education and implementation efforts are needed to help this population meet the national dietary recommendations of 2.5 to 3 servings of dairy foods per day. Continuing to fall short of these recommendations puts Black children and adolescents at risk of multiple nutrient inadequacies and health disparities that can have lifelong impacts on disease development, mental health, and quality of life. This review presents the state of knowledge on health disparities and modifiable nutritional strategies involving milk and dairy foods to support the growth and maturation of children and adolescents, with a special focus on Black youth in the US.

Associations Between Household Frequency of Cooking Dinner and Ultraprocessed Food Consumption and Dietary Quality Among US Children and Adolescents

Introduction: Dietary quality is poor and intake of ultraprocessed foods (UPFs) is high among children and adolescents in the United States. Low dietary quality and high UPF intake are associated with obesity and higher risk of diet-related chronic diseases. It is unknown whether household cooking behavior is related to improved dietary quality and lower consumption of UPFs among US children and adolescents. Methods: Nationally representative data from the 2007-2010 National Health and Nutrition Examination Survey (n = 6032 children and adolescents ≤19 years of age) were used to examine the relationships between household cooking frequency of evening meals and children's dietary quality and UPF intake using multivariate linear regression models adjusted for sociodemographics. Two 24-hour diet recalls were used to assess UPF intake and dietary quality [Healthy Eating Index-2015 (HEI-2015)]. Food items were categorized according to Nova classification to obtain the UPF percent of total energy intake. Results: A higher household frequency of cooking dinner was associated with lower UPF intake and higher overall dietary quality. Compared to children in households cooking dinner 0-2 times per week, children in households cooking dinner 7 times/week had lower intake of UPFs [β = -6.30, 95% confidence interval (CI) -8.81 to -3.78, p < 0.001] and marginally higher HEI-2015 scores (β = 1.92, 95% CI -0.04 to 3.87, p = 0.054). The trends toward lower UPF intake (p-trend <0.001) and higher HEI-2015 scores (p-trend = 0.001) with increasing cooking frequency were significant. Conclusions: In this nationally representative sample of children and adolescents, more frequent cooking at home was associated with lower intake of UPFs and higher HEI-2015 scores.

Cooking and Its Impact on Childhood Obesity: A Systematic Review

INTRODUCTION

This systematic review aimed to study the effect of a cooking intervention on obesity among children and adolescents aged < 18 years.

METHODS

Articles that studied the effect of cooking intervention with at least 4 sessions among children and adolescents on obesity (from January, 2000 to December, 2021) were included for analysis. Of the 500 articles identified through PubMed and ScienceDirect database, 9 studies qualified to be included in this review.

RESULTS

One-third of the studies found a positive effect of a cooking intervention on obesity among children and adolescents. School-based studies conducted among elementary school students were promising. Centers for Disease Control and Prevention body mass index percentile was the most common tool used to identify children and adolescents with overweight and obesity. The majority of the studies had a strong methodology.

DISCUSSION

All studies showed improvement in diet-related factors. Active participation of parents is crucial in making childhood interventions successful. It is difficult to delineate the effect of cooking alone on obesity as almost all studies had multicomponent interventions.

IMPLICATIONS FOR RESEARCH AND PRACTICE

These diverse results highlight the need for longitudinal studies in natural settings to comprehend the effect of long-term cooking on obesity in children and adolescents.

A Scoping Review of Household Factors Contributing to Dietary Quality and Food Security in Low-Income Households with School-Age Children in the United States

Low-income and food-insecure households are at risk of poor dietary quality and even more severe food insecurity. Especially in childhood, consuming a nutritionally adequate diet is an essential driver of health, growth, and development. Household-level factors can present challenges to support the nutritional needs of low-income and food-insecure household members. The aim of this scoping review is to identify the contributing household factors to dietary quality and food security in US households of school-aged children 5 to 19 years and synthesize the evidence around emergent themes for application to future interventions. The scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews using search terms addressing food insecurity, low income, and dietary behaviors in the database PubMed. Screening by 3 independent reviewers of the title, abstract, and full study phases identified 44 studies. The 5 themes around which the studies grouped were: parental behaviors, child/adolescent behaviors, food procurement behaviors, food preparation behaviors, and household environment factors. Most studies were cross-sectional (n = 41, 93%) and focused on parental behaviors (n = 31, 70%), followed by food preparation and procurement behaviors. The themes identified were interrelated and suggest that incorporating education on parent and child behaviors that influence food procurement and preparation, along with strengthening organization and planning in the household environment, may hold promise to improve dietary quality and food security among food-insecure and low-income households. The findings can be used to inform future nutrition education interventions aimed at improving dietary quality and food security in households with school-aged children.

Diet Quality among Pre-Adolescent African American Girls in a Randomized Controlled Obesity Prevention Intervention Trial

Consuming an unhealthy diet increases health risks. This study assessed the impact of a culturally adapted behaviorally innovative obesity prevention intervention (The Butterfly Girls and the Quest for Founder's Rock) on diet quality in pre-adolescent non-Hispanic Black/African American girls. The RCT consisted of three groups (experimental, comparison, and waitlist control); block randomization allocated participants to each group. The two treatment groups varied in terms of whether or not they set goals. Data were collected at baseline (prior to receiving the intervention), post 1 (3 months post-baseline), and post 2 (6 months post-baseline). Two dietitian-assisted 24 h dietary recalls were collected at each timepoint. Healthy Eating Index 2015 (HEI-2015) was used to determine diet quality. A total of 361 families were recruited; 342 completed baseline data collection. No significant differences in overall HEI score or component scores were observed. To attain more equitable health outcomes, future efforts to promote dietary intake change among at-risk children should explore other behavior change procedures and employ more child-friendly dietary assessment methods.

Definitions and Assessment Methods of ‘Home Cooking’ in Studies with Dietary Variables: A Scoping Review

Home cooking is a complex idea that involves multiple skills and behaviors and can be interpreted differently. Using six databases (two of which were Japanese), this scoping review examined the definitions and methods used in studies investigating the relationship between home cooking and dietary variables. Of the 40 studies (2 in Japanese) included in this review, 8 provided definitions but did not specify the extent or level that convenience foods can be allowed in food preparation. The methods were classified into two categories, namely, perception-dependent (n = 29) if using a self-reported instrument, or perception-independent (n = 11) if based on investigators’ classification. Subsequently, indicators of home cooking were classified based on survey attributes (e.g., frequency, location). All but five studies used single indicators, primarily the preparation frequency (n = 18). Quality of analysis was also evaluated. Studies that used multiple indicators or perception-independent methods showed high or moderate overall quality. In contrast, studies that used single indicators based on perception-dependent methods tended to have a low overall quality. The consistency of the relationship between home cooking and dietary variables depended on study quality. In conclusion, the definitions of home cooking were inconsistent across studies, and lacked consensus for examining the association between dietary outcomes.

Perceptions and Impact of a Youth-led Childhood Obesity Prevention Intervention among Youth-leaders

Objective

To evaluate the impact of a youth-led nutrition intervention on youth-leaders themselves.

Design

Mixed methods, including: in-depth interviews and a quasi-experimental quantitative study comparing youth-leaders and nonparticipant comparison youth.

Analysis

Qualitative analysis using direct content analysis. Difference-in-differences analyses assessing quantitative program impact.

Results

Youth-leaders perceived that the intervention impacted themselves, the youth-participants, and their respective social networks. Youth-leaders experienced greater increases in intentions to eat healthfully (p=0.04), and greater decreases in support for healthy eating from their friends (p=0.01), than the comparison group.

Conclusions/Implications

Youth-leaders reported multiple levels of intervention impact, and increased intentions for healthy eating; however, additional research is needed to enhance impact on behavioral outcomes.

Design and Development of an Instrument on Knowledge of Food Safety, Practices, and Risk Perception Addressed to Children and Adolescents from Low-Income Families

In the fight against foodborne diseases, expanding access to information for different groups is needed. In this aspect, it is crucial to evaluate the target audience’s particularities. This study constructed and validated an instrument containing three questionnaires to identify the level of knowledge, practices, and risk perception of food safety by low-income students between 11 and 14 years old. The following steps were used: systematic search of the databases; conducting and analyzing focus groups; questionnaires development; and questionnaires analysis. After two judges’ rounds, the final version was reached with 11 knowledge items, 11 practice items, and five risk perception items. The content validation index values were higher than 0.80. The adopted methodology considered the students’ understanding and perceptions, as well the appropriate language to be used. Besides, it allowed the development of questionnaires that directly and straightforwardly covers the rules set by the World Health Organization for foodborne disease control called Five Keys to Safer Food (keep clean; separate raw and cooked; cook thoroughly; keep food at safe temperatures; and use safe water and raw materials). Its use can result in a diagnosis for elaborating educational proposals and other actions against foodborne illness in the most vulnerable population.

More frequent cooking at home is associated with higher Healthy Eating Index-2015 score

Objective:

To examine the association between cooking frequency and Healthy Eating Index (HEI)-2015, overall and by income, among US adults.

Design:

Cross-sectional analysis using multivariable linear regression models to examine the association between cooking frequency and total HEI-2015 score adjusted for sociodemographic variables, overall and stratified by income.

Setting:

Nationally representative survey data from the USA.

Participants:

Adults aged ≥20 years (with 2 d of 24 h dietary recall data) obtained from the 2007 to 2010 National Health and Nutrition Examination Survey (n 8668).

Results:

Compared with cooking dinner 0–2 times/week, greater cooking frequency was associated with higher HEI-2015 score overall (≥7 times/week: +3·57 points, P < 0·001), among lower-income adults (≥7 times/week: +2·55 points, P = 0·001) and among higher-income adults (≥7 times/week: +5·07 points, P < 0·001). Overall, total HEI-2015 score was higher among adults living in households where dinner was cooked ≥7 times/week (54·54 points) compared with adults living in households where dinner was cooked 0–2 times/week (50·57 points). In households in which dinner was cooked ≥7 times/week, total HEI-2015 score differed significantly based on income status (lower-income: 52·51 points; higher-income: 57·35 points; P = 0·003). Cooking frequency was associated with significant differences in HEI-2015 component scores, but associations varied by income.

Conclusions:

More frequent cooking at home is associated with better diet quality overall and among lower- and higher-income adults, although the association between cooking and better diet quality is stronger among high-income adults. Strategies are needed to help lower-income Americans consume a healthy diet regardless of how frequently they cook at home.

Youth involvement in food preparation practices at home: A multi-method exploration of Latinx youth experiences and perspectives

Youth are frequently involved in preparing meals for themselves and family members. Latinx youth may be more likely to be involved in food preparation compared to youth from other ethnic backgrounds. Involvement in food preparation has been linked to various positive health outcomes, such as better diet quality and higher self-esteem. However, little is known about how youth come to be involved in food preparation at home. In addition, previous research has failed to explore the perspectives of youth regarding their role in food preparation. The objective of the present study was to qualitatively explore the food preparation practices of youth from im/migrant Latinx families. A multi-method study consisting of participatory focus groups embedded within an ethnographic fieldwork period was conducted. Participatory focus groups with Latinx youth featured inclusive discussions and participatory techniques, such as draw-write-tell activities, photo-elicitation activities, a decision-making chart activity, and listing activities. Twenty-three youths ages 9-17 years participated in this study. A thematic analysis uncovered themes related to gender norm expectations, specific cooking skills bound by age and food type, and food preparation as an important household contribution. Findings illustrate the diverse experiences of Latinx youth in food preparation. The investigation of youth involvement in food preparation in the home environment may identify potential targets for obesity prevention and dietary health promotion.

A multilevel, multicomponent childhood obesity prevention group-randomized controlled trial improves healthier food purchasing and reduces sweet-snack consumption among low-income African-American youth

BACKGROUND

Consumption of foods and beverages rich in sugar remains high across all races and ages in the United States. Interventions to address childhood obesity and decrease sugar intake are needed, particularly in low-income settings.

METHODS

B'more Healthy Communities for Kids (BHCK) was a group-randomized, controlled trial implemented among 9-15-year olds in 30 low-income areas of Baltimore. We increased access to low-sugar foods and beverages at wholesalers and small food stores. Concurrently, we encouraged their purchase and consumption by children through youth-led nutrition education in recreation centers, in-store promotions, text messaging and a social media program directed at caregivers. Sugar consumption (sugar sweetened beverage (SSB), sweets) in youth was assessed pre- (n = 534) and post-intervention (n = 401) using the Block Kids Food Frequency Questionnaire. Purchasing of 38 healthier and 28 less healthier food/beverage varieties in the previous 7 days was assessed via self-report. Multilevel models at the community and individual levels were used. Analyses were stratified by age (younger: 9-12-year olds (n = 339) vs older: 13-15 (n = 170)). Models were controlled for child's sex, race, total daily caloric intake, and caregiver's age and sex.

RESULTS

Overall baseline mean healthier food purchasing was 2.5 (+ 3.6; min. 0, max. 34 items per week), and unhealthier food purchasing 4.6 (+ 3.7; 0-19 items per week). Mean intake at baseline for kcal from SSB was 176 (+ 189.1) and 153 (+ 142.5), and % of calories from sweets (i.e. cookies, cakes, pies, donuts, candy, ice cream, sweetened cereals, and chocolate beverages) was 15.9 (+ 9.7) and 15.9 (+ 7.7) in comparison and intervention youth, respectively. Intervention youth increased healthier foods and beverages purchases by 1.4 more items per week than comparison youth (β = 1.4; 95% CI: 0.1; 2.8). After the intervention, there was a 3.5% decrease in kcal from sweets for older intervention youth, compared to the control group (β = - 3.5; 95% CI: -7.76; - 0.05). No impact was seen on SSB consumption.

CONCLUSION

BHCK successfully increased healthier food purchasing variety in youth, and decreased % calories from sweet snacks in older youth. Multilevel, multicomponent environmental childhood obesity programs are a promising strategy to improve eating behaviors among low-income urban youth.

TRIAL REGISTRATION

NCT02181010 (July 2, 2014, retrospectively registered).

Helping With Meal Preparation and Children’s Dietary Intake: A Literature Review

Most children and adolescents do not meet dietary recommendations that may result in poor diets contributing to obesity. This systematic literature review was conducted to examine associations between helping with meal preparation at home and dietary quality, intake of specific foods, and/or dietary-related perceptions among youth. A search of databases using key terms was conducted for studies meeting criteria. This literature review included 15 studies using a cross-sectional descriptive design, with two studies also including a longitudinal design. Data were self-reported (or parent-reported) using various surveys and/or interviews. Study findings supported positive associations between youth involvement in home meal preparation and improvement in overall dietary quality, increased consumption of fruits and vegetables, greater preference for vegetables, and higher self-efficacy for cooking and choosing healthy foods. Further research is needed to develop efficacious meal preparation interventions involving parents and their children to promote this mealtime behavior with many potential health benefits.

Exposure to a multi-level multi-component childhood obesity prevention community-randomized controlled trial: patterns, determinants, and implications

BACKGROUND

For community interventions to be effective in real-world conditions, participants need to have sufficient exposure to the intervention. It is unclear how the dose and intensity of the intervention differ among study participants in low-income areas. We aimed to understand patterns of exposure to different components of a multi-level multi-component obesity prevention program to inform our future impact analyses.

METHODS

B'more Healthy Communities for Kids (BHCK) was a community-randomized controlled trial implemented in 28 low-income zones in Baltimore in two rounds (waves). Exposure to three different intervention components (corner store/carryout restaurants, social media/text messaging, and youth-led nutrition education) was assessed via post-intervention interviews with 385 low-income urban youths and their caregivers. Exposure scores were generated based on self-reported viewing of BHCK materials (posters, handouts, educational displays, and social media posts) and participating in activities, including taste tests during the intervention. For each intervention component, points were assigned for exposure to study materials and activities, then scaled (0-1 range), yielding an overall BHCK exposure score [youths: mean 1.1 (range 0-7.6 points); caregivers: 1.1 (0-6.7), possible highest score: 13]. Ordered logit regression analyses were used to investigate correlates of youths' and caregivers' exposure level (quartile of exposure).

RESULTS

Mean intervention exposure scores were significantly higher for intervention than comparison youths (mean 1.6 vs 0.5, p < 0.001) and caregivers (mean 1.6 vs 0.6, p < 0.001). However, exposure scores were low in both groups and 10% of the comparison group was moderately exposed to the intervention. For each 1-year increase in age, there was a 33% lower odds of being highly exposed to the intervention (odds ratio 0.77, 95% confidence interval 0.69; 0.88) in the unadjusted and adjusted model controlling for youths' sex and household income.

CONCLUSION

Treatment effects may be attenuated in community-based trials, as participants may be differentially exposed to intervention components and the comparison group may also be exposed. Exposure should be measured to provide context to impact evaluations in multi-level trials. Future analyses linking exposure scores to the outcome should control for potential confounders in the treatment-on-the-treated approach, while recognizing that confounding and selection bias may exist affecting causal inference.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02181010 . Retrospectively registered on 2 July 2014.

Utility of eButton images for identifying food preparation behaviors and meal-related tasks in adolescents

BACKGROUND

Food preparation skills may encourage healthy eating. Traditional assessment of child food preparation employs self- or parent proxy-reporting methods, which are prone to error. The eButton is a wearable all-day camera that has promise as an objective, passive method for measuring child food preparation practices.

PURPOSE

This paper explores the feasibility of the eButton to reliably capture home food preparation behaviors and practices in a sample of pre- and early adolescents (ages 9 to 13).

METHODS

This is a secondary analysis of two eButton pilot projects evaluating the dietary intake of pre- and early adolescents in or around Houston, Texas. Food preparation behaviors were coded into seven major categories including: browsing, altering food/adding seasoning, food media, meal related tasks, prep work, cooking and observing. Inter-coder reliability was measured using Cohen's kappa and percent agreement.

RESULTS

Analysis was completed on data for 31 participants. The most common activity was browsing in the pantry or fridge. Few participants demonstrated any food preparation work beyond unwrapping of food packages and combining two or more ingredients; actual cutting or measuring of foods were rare.

CONCLUSIONS

Although previous research suggests children who "help" prepare meals may obtain some dietary benefit, accurate assessment tools of food preparation behavior are lacking. The eButton offers a feasible approach to food preparation behavior measurement among pre- and early adolescents. Follow up research exploring the validity of this method in a larger sample, and comparisons between cooking behavior and dietary intake are needed.

Breakfast Consumption Frequency and Its Relationships to Overall Diet Quality, Using Healthy Eating Index 2010, and Body Mass Index among Adolescents in a Low-Income Urban Setting

The aim of this study was to describe the relationship of breakfast frequency to diet quality and BMI among low-income, predominantly African American adolescents aged 9-15 (n = 239). Mean frequency of breakfast consumption was 5.0 ± 0.15 times per week. A significant, positive relationship was seen between HEI scores and frequency of breakfast consumption (p = .01). Dairy (p = .02) and whole grains (p < .01) HEI component scores were significantly related to breakfast frequency. No relationship was seen between breakfast frequency and BMI. Research with more rigorous designs should be conducted to assess the potential effects of breakfast consumption on diet quality in this population.

Family Food Preparation and Its Effects on Adolescent Dietary Quality and Eating Patterns

PURPOSE

The purpose of the study was to describe parent and adolescent involvement in food preparation for the family and to examine whether adolescents' food preparation involvement was related to their dietary quality (e.g., fruit and vegetable intake, sugar-sweetened beverage consumption, and various common nutrients) and eating patterns (e.g., frequency of breakfast, family meals, fast food intake).

METHODS

Data from two linked population-based studies, Eating and Activity in Teens 2010 and Families and Eating and Activity among Teens were used in cross-sectional analyses. Mothers (n = 1,875), stepmothers (n = 18), fathers (n = 977), stepfathers (n = 105), and adolescents (n = 2,108) from socioeconomically and racially/ethnically diverse households participated in the study. Adolescents completed food frequency questionnaires and surveys in school. Parents individually completed surveys by mail or phone. Linear regression was used to estimate differences in adolescent dietary quality and eating patterns between those who do and do not engage in meal preparation.

RESULTS

Parent and adolescent report of "usually preparing food for the family" was related to several sociodemographic characteristics, including race/ethnicity (minority populations), parent education (college or higher), parent employment status (part time or stay-at-home caregiver), household size (≤3 children), and adolescent gender (female). Adolescent involvement in food preparation for the family was significantly associated with several markers of better dietary quality and better eating patterns. In contrast, parent involvement in food preparation for the family was unrelated to adolescent dietary intake.

CONCLUSIONS

Results suggest that involving adolescents in food preparation for the family is related to better adolescent dietary quality and eating patterns. Public health interventions and health care providers may want to encourage adolescents to help with food preparation for the family. Additionally, adolescents may benefit from interventions/programs that teach cooking skills in order to increase the likelihood of participating in food preparation for the family.

Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth

BACKGROUND

Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD.

METHODS

Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10-14 y) dyads participating in the baseline evaluation of the B'More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income.

RESULTS

On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth's healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06-1.41, ORvegetable 1.31; 1.15-1.51 and ORfiber 1.46; 1.23-1.74, Self-efficacy: ORfruit 1.07; 1.03-1.12, ORvegetable 1.04; 1.01-1.09, ORfiber 1.10; 1.04-1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable and fiber intake (OR 1.26; 1.06-1.50; OR 1.28; 1.03-1.58, respectively). Also, youth with parents who shopped more frequently at fast-food stores had 7 % lower odds for higher vegetable intake (95 % CI: 0.88-0.99).

CONCLUSION

In this study, both, youth and household factors were associated with youth FV and fiber intake, underscoring the need for a multi-level approach to increasing youths' diet quality. These results will inform and shape an effective intervention program for improving youth dietary intakes.

Perceived Social Support From Friends and Parents for Eating Behavior and Diet Quality Among Low-Income, Urban, Minority Youth

OBJECTIVE

Evidence of associations between social support and dietary intake among adolescents is mixed. This study examines relationships between social support for healthy and unhealthy eating from friends and parents, and associations with diet quality.

DESIGN

Cross-sectional analysis of survey data.

SETTING

Baltimore, MD.

PARTICIPANTS

296 youth aged 9-15 years, 53% female, 91% African American, participating in the B'More Healthy Communities for Kids study.

MAIN OUTCOME MEASURE(S)

Primary dependent variable: diet quality measured using Healthy Eating Index 2010 (HEI) overall score, calculated from the Block Kids Food Frequency Questionnaire.

INDEPENDENT VARIABLES

Social support from parents and friends for healthy eating (4 questions analyzed as a scale) and unhealthy eating (3 questions analyzed individually), age, gender, race, and household income, reported via questionnaire.

ANALYSIS

Adjusted multiple linear regressions (α, P < .05).

RESULTS

Friend and parent support for healthy eating did not have statistically significant relationships with overall HEI scores. Youth who reported their parents offering high-fat foods or sweets more frequently had lower overall HEI scores (β = -1.65; SE = 0.52; 95% confidence interval, -2.66 to -0.63).

CONCLUSIONS AND IMPLICATIONS

These results are novel and demonstrate the need for additional studies examining support for unhealthy eating. These preliminary findings may be relevant to researchers as they develop family-based nutrition interventions.