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Lanham AR, van der Pols JC. Toward Sustainable Diets-Interventions and Perceptions Among Adolescents: A Scoping Review. Nutr Rev 2024:nuae052. [PMID: 38809755 DOI: 10.1093/nutrit/nuae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
Adolescence is an important life stage during which shifts toward more healthy and sustainable diets can be promoted. Adolescents have increasing influence over their food choices, informed by their developing personal knowledge and values, affecting long-term dietary behaviors into adulthood. The recent literature regarding adolescents' (1) perceptions of environmentally sustainable diets and (2) interventions to support adolescents to eat sustainably was reviewed in this study. We reviewed published literature that focused on adolescent participants and their perceptions of, or interventions to support, sustainable dietary habits. Five electronic databases were searched to include studies published since 2012 that met the inclusion criteria, including reporting of participants aged between 11 and 18 years, reporting on adolescents' perceptions of sustainable diets or interventions implemented to improve the sustainability of adolescents' diets, and framed in the context of sustainability. Data were extracted, including study and participant characteristics, methodology, and results in relation to each of the 2 research focus areas. Twenty-eight articles were included in the review. Findings suggest that adolescents' understanding of what constitutes sustainable eating is poor. Adolescents who had previously received education regarding sustainable diets valued nature and health, or were from a rural or indigenous community, were more likely to value environmentally sustainable-food choices. Interventions which target adolescents' understanding of and aspiration to make sustainable-food choices appears to improve their attitudes toward sustainable food, whereas interventions to increase the availability of sustainable foods improved the environmental sustainability of adolescents' dietary intake. Multicomponent, tailored, and community-based interventions were most effective; however, the long-term effect of these interventions remains unclear. More research is needed in low- and middle-income countries, with consideration of adolescents' level of autonomy in food choice in local food environments and the long-term effectiveness of interventions. Systematic Review Registration: Open Science Framework identifier osf.io/h3jz6.
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Affiliation(s)
- Adeline R Lanham
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
- Centre for Agriculture and the Bioeconomy, Queensland University of Technology, Brisbane, Queensland, 4000, Australia
| | - Jolieke C van der Pols
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, 4059, Australia
- Centre for Agriculture and the Bioeconomy, Queensland University of Technology, Brisbane, Queensland, 4000, Australia
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Allcott-Watson H, Chater A, Troop N, Howlett N. A systematic review of interventions targeting physical activity and/or healthy eating behaviours in adolescents: practice and training. Health Psychol Rev 2024; 18:117-140. [PMID: 36722423 DOI: 10.1080/17437199.2023.2173631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 01/23/2023] [Indexed: 02/02/2023]
Abstract
Despite the many health benefits of physical activity (PA) and healthy eating (HE) most adolescents do not meet current guidelines which poses future health risks. This review aimed to (1) identify whether adolescent PA and HE interventions show promise at promoting behaviour change and maintenance, (2) identify which behaviour change techniques (BCTs) are associated with promising interventions, and (3) explore the optimal approaches to training deliverers of adolescent PA/HE interventions. Nine databases were searched for randomised controlled, or quasi-experimental, trials targeting 10-19 year olds, with a primary aim to increase PA/HE, measured at baseline and at least six months post-intervention, in addition to papers reporting training of deliverers of adolescent PA/HE interventions. Included were seven PA studies, three HE studies and four studies targeting both, with two training papers. For PA studies, two were promising post-intervention with two promising BCTs, and five were promising for maintenance with two promising BCTs. For HE studies, three were promising at post-intervention and four at maintenance, both with four promising BCTs. There is preliminary evidence that interventions support adolescents to improve their PA and HE behaviours over a period of at least six months.
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Affiliation(s)
- Hannah Allcott-Watson
- Department of Psychology, Sport, and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedfordshire, UK
- University College London Centre for Behaviour Change, London, UK
| | - Nick Troop
- Department of Psychology, Sport, and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Neil Howlett
- Department of Psychology, Sport, and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
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Busch V, Steenkamer I, van Nassau F, van Opdorp P, van Houtum L, Verhoeff A, Twisk J. The Effects of the Jump-In Whole-School Intervention on the Weight Development of Children in Amsterdam, the Netherlands. THE JOURNAL OF SCHOOL HEALTH 2024; 94:37-46. [PMID: 37518834 DOI: 10.1111/josh.13363] [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: 10/17/2022] [Revised: 06/13/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND This study assessed the effects of the "Jump-in" whole-school intervention in Amsterdam, the Netherlands, on children's weight development by comparing children exposed to the intervention and controls from 3 other large Dutch cities. Jump-in is a comprehensive intervention that aims to stimulate healthy nutrition and physical activity in children at primary schools in Amsterdam. In addition, the relationship between the intervention's implementation degree and its effectiveness was studied. METHODS Demographic and anthropometric data, collected by youth health care professionals via routine health checks at T0 (2014) and T1 (2019), were used to analyze possible intervention effects by comparing the weight development of children exposed to the Jump-in intervention versus unexposed controls. Implementation logs from health promotion professionals were used to determine intervention effects per implementation degree. Multilevel regression analyses were used for all analyses. RESULTS In total, 4299 children were included mean age ± 5.5 years (T0), 10.6 years (T1), and ≈50% boys/girls at both times. Receiving the fully implemented intervention resulted in a decline in standardized body-mass index (zBMI) compared to the controls (-0.23, confidence interval [CI] -0.33, -0.13). It also led to higher odds to move into a healthier weight category over time (odds ratio [OR] 1.36, CI 1.06, 1.74), yet no statistically significant shift towards a healthy weight was found. CONCLUSIONS Relative to the controls, children exposed to the intervention showed positive zBMI developments, with stronger effects when the implementation degree was higher. Despite positive results, creating more impact might require the further integration of school-based programs into whole-systems approaches that include other energy-balance behaviors.
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Affiliation(s)
- Vincent Busch
- Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Ilona Steenkamer
- Department of Healthy Living, Public Health Service (GGD), Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Vrije Universiteit, De Boelelaan 1089a, 1081 HV Amsterdam, Amsterdam, The Netherlands
| | - Paul van Opdorp
- Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Arnoud Verhoeff
- Department of Sociology, University of Amsterdam, Nieuwe Achtergracht 166, 1018WV, Amsterdam, the Netherlands; Director, Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
- Department of Sociology, University of Amsterdam. Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands
| | - Jos Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
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Ahmed KR, Kolbe-Alexander T, Khan A. Efficacy of a school-based education intervention on the consumption of fruits, vegetables and carbonated soft drinks among adolescents. Public Health Nutr 2023; 26:3112-3121. [PMID: 37781771 PMCID: PMC10755403 DOI: 10.1017/s1368980023002094] [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: 10/19/2022] [Revised: 07/21/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To evaluate the efficacy of a school-based education intervention on the consumption of fruit, vegetables and carbonated soft drinks among adolescents. DESIGN Cluster-randomised controlled trial. SETTING Eight secondary schools from Dhaka, Bangladesh, participated in this trial and were randomly allocated to intervention (n 160) and control groups (n 160). PARTICIPANTS A total of 320 students from 8th to 9th grades participated and completed the self-reported questionnaires at baseline, and at 8 and 12 weeks. The intervention included weekly classroom-based nutrition education sessions for students and healthy eating materials for students and parents. Repeated measures ANCOVA was used to assess the effects of the intervention. RESULTS Daily fresh fruit intake was more frequent in the intervention (26 %) compared to the control group (3 %) at 12 weeks (p = 0·006). Participants from the intervention group also reported a significantly (P < 0·001) higher (49 %) proportion of fresh vegetable intake compared to the control group (2 %) at 12 weeks. Frequency of daily carbonated soft drinks intake decreased (25 %) in the intervention group at 12 weeks compared to baseline, while it remained unchanged in the control group; the interaction effect was observed significant (P = 0·002). CONCLUSION Our school-based education intervention increased the daily frequency of fresh vegetables and fruit intake and decreased carbonated soft drink consumption among adolescents in the intervention group. There is a need for scaling up the intervention to engage students and empower them to develop healthy dietary habits.
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Affiliation(s)
- Kazi R Ahmed
- Department of Health Promotion and Health Education, Bangladesh University of Health Sciences, Darus Salam, Mirpur, Dhaka1216, Bangladesh
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Tracy Kolbe-Alexander
- School of Health and Wellbeing, University of Southern Queensland, Toowoomba, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Australia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
| | - Asaduzzaman Khan
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Li M, Ma S, Shi Y. Examining the effectiveness of gamification as a tool promoting teaching and learning in educational settings: a meta-analysis. Front Psychol 2023; 14:1253549. [PMID: 37876838 PMCID: PMC10591086 DOI: 10.3389/fpsyg.2023.1253549] [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: 07/05/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023] Open
Abstract
The integration of gamification into educational settings has gained recognition for its potential to boost student motivation, engagement, interest, and learning outcomes. Despite its popularity, research on gamification has produced mixed results regarding student learning outcomes. This meta-analysis aims to synthesize the existing empirical evidence on the effectiveness of gamification as a tool for promoting teaching and learning in educational settings. Forty-one studies with 49 independent samples involving more than 5,071 participants were included in our analysis. Results from random effects models showed an overall significant large effect size (g = 0.822 [0.567 to 1.078]). The research performed the moderator analysis to scrutinize the effects of a number of factors on the relationship between gamification and student learning outcomes. The study uncovered significant moderating effects for user type, educational discipline, design principles for educational gamification, duration of "gameful" experience, and learning environment. However, measurement of student outcomes and publication type did not appear to have any significant moderating effect. Those findings hold important implications for improving and implementing gamification to promote teaching and learning in future research.
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Affiliation(s)
- Minzi Li
- Center for Linguistics and Applied Linguistics, Guangdong University of Foreign Studies, Guangzhou, China
| | - Siyu Ma
- Center for Linguistics and Applied Linguistics, Guangdong University of Foreign Studies, Guangzhou, China
| | - Yuyang Shi
- Law School, Peking University, Beijing, China
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Zurc J, Laaksonen C. Effectiveness of Health Promotion Interventions in Primary Schools-A Mixed Methods Literature Review. Healthcare (Basel) 2023; 11:1817. [PMID: 37444651 DOI: 10.3390/healthcare11131817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
School-based health promotion interventions (HPIs) are commonly used in schools, but scientific evidence about the structures of effective interventions is lacking. Therefore, we conducted a mixed methods systematic literature review to recognize the HPI structures related to their effectiveness. Based on the inclusion criteria, 49 articles were selected for the literature review. The articles, published in 2011-2022, described 46 different school-based interventions conducted in 20 different countries. The average duration of the interventions was 12 months, and they were implemented mostly with an RCT study design (61.2%) and by targeting children (69.4%). Three main groups of interventions were identified and explained: (1) extensive and long-term interventions; (2) school policy-changing interventions; and (3) highly effective interventions. Effective school-based HPIs included multiple target groups, multiple providers with external experts, and an efficient duration and timing of follow-ups. The implications for educational research and school practice are presented. Evidence on the effectiveness of health-related interventions is still lacking and needs to be addressed in further studies.
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Affiliation(s)
- Joca Zurc
- Department of Pedagogy, Faculty of Arts, University of Maribor, 2000 Maribor, Slovenia
| | - Camilla Laaksonen
- Faculty of Health and Well-Being, Turku University of Applied Sciences, 20520 Turku, Finland
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Varì R, Silenzi A, d’Amore A, Catena A, Masella R, Scazzocchio B. MaestraNatura Reveals Its Effectiveness in Acquiring Nutritional Knowledge and Skills: Bridging the Gap between Girls and Boys from Primary School. Nutrients 2023; 15:nu15061357. [PMID: 36986085 PMCID: PMC10055962 DOI: 10.3390/nu15061357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
MaestraNatura (MN) is a nutrition education program developed to both enhance awareness about the importance of healthy eating behaviour and skills on food and nutrition in primary school students. The level of knowledge about food and nutritional issues was assessed by a questionnaire administered to 256 students (9–10 years old) attending the last class of primary school and was compared with that of a control group of 98 students frequenting the same schools that received traditional nutrition education based on curricular science lessons and one frontal lesson conducted by an expert nutritionist. The results indicated that students in the MN program showed a higher percentage of correct responses to the questionnaire when compared with the control group (76 ± 15.4 vs. 59 ± 17.7; p < 0.001). Furthermore, the students attending the MN program were requested to organise a weekly menu before (T0) and when finished (T1) the MN program. The results evidenced an overall significant improvement in the score obtained at T1 with respect to those at T0 (p < 0.001), indicating a strong improvement in the ability to translate the theoretical concepts of nutrition guidelines in practice. In addition, the analysis revealed a gender gap between boys and girls, with boys showing a worse score at T0 that was ameliorated after the completion of the program (p < 0.001). Overall, MN program is effective in improving nutrition knowledge amongst 9–10-year-old students. Furthermore, students showed an increased ability to organise a weekly dietary plan after completing the MN program, a result which also bridged gender gaps. Thus, preventive nutrition education strategies specifically addressed to boys and girls, and involving both the school and family, are needed to make children aware of the importance of a healthy lifestyle and to correct inadequate eating habits.
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Affiliation(s)
- Rosaria Varì
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Annalisa Silenzi
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Antonio d’Amore
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Alice Catena
- Postgraduate School of Hygiene and Preventive Medicine, University of Brescia, 25123 Brescia, Italy
| | - Roberta Masella
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
- Correspondence:
| | - Beatrice Scazzocchio
- Center for Gender-Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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Lin CA, Vosburgh KL, Roy D, Duffy VB. Usability Testing an mHealth Program with Tailored Motivational Messages for Early Adolescents. Nutrients 2023; 15:nu15030574. [PMID: 36771281 PMCID: PMC9921541 DOI: 10.3390/nu15030574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/24/2023] Open
Abstract
Obesity among children is a rising concern throughout the world. In the U.S., rates of childhood obesity are the highest among children from diverse and economically disadvantaged households. Obesity in adolescence increases the risk of negative physical and psychological health consequences. Mobile-app-based health interventions have been found to be an effective tool to encourage children to adopt a healthier living style. A novel mobile app prototype was developed for early adolescents to communicate with and engage them interactively about healthy eating and active living. To test the app's usability, students from a U.S. middle school, with a majority of children from low-income families, were recruited to use the app and report their feedback. The usability testing results confirmed that the app was equally well received by participants of different genders, normal weight versus overweight/obesity, and amounts of screen time. Study participants also provided overwhelming positive feedback for the embedded and tailored motivational messages that encourage healthy eating and active living. The conceptualization of the app prototype was guided by the self-determination theory, social cognitive theory, and priming theory, in addition to incorporating evidence-based obesity prevention principles. This prototype, hence, provides a valid platform for building theory-based behavioral interventions.
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Affiliation(s)
- Carolyn A. Lin
- Department of Communication, University of CT, Storrs, CT 06269, USA
- Correspondence: ; Tel.: +1+860-486-3984
| | - Kayla L. Vosburgh
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269, USA
| | - Deya Roy
- Department of Communication, California State University San Marcos, 333 S. Twin Oaks Valley Rd, San Marcos, CA 92096, USA
| | - Valerie B. Duffy
- Department of Allied Health Sciences, University of CT, Storrs, CT 06269, USA
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Ma J, Chen Y, Zhu H, Gan Y. Fighting COVID-19 Misinformation through an Online Game Based on the Inoculation Theory: Analyzing the Mediating Effects of Perceived Threat and Persuasion Knowledge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:980. [PMID: 36673733 PMCID: PMC9859504 DOI: 10.3390/ijerph20020980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/29/2022] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic was accompanied by the rapid spread of misinformation through social media platforms. This study attempted to develop an online fake news game based on the inoculation theory, applicable to the pandemic context, and aimed at enhancing misinformation discrimination. It also tested whether perceived threat and persuasion knowledge serve as underlying mechanisms of the effects of the intervention on misinformation discrimination. In Study 1, we used online priming to examine the influence of inoculation on misinformation discrimination. In Study 2, we developed an online fake-news-game-based intervention and attempted to validate its effectiveness through a randomized controlled trial while also exploring the mediating roles of perceived threat and persuasion knowledge. In Study 1, brief inoculation information priming significantly enhanced the ability to recognize misinformation (F(2.502) = 8.321, p < 0.001, ηp2 = 0.032). In Study 2, the five-day game-based intervention significantly enhanced the ability to recognize misinformation (F(2.322) = 3.301, p = 0.038, ηp2 = 0.020). The mediation effect of persuasion knowledge was significant (β = 0.025, SE = 0.016, 95% CI = [0.034, 0.075]), while that of perceived threat was not significant. Online interventions based on the inoculation theory are effective in enhancing misinformation discrimination, and one of the underlying mechanisms of this effect lies in its promotion of persuasion knowledge.
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Affiliation(s)
- Jinjin Ma
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China
| | - Yidi Chen
- Department of Psychology, School of Humanities and Social Sciences, Beijing Forestry University, Beijing 100083, China
| | - Huanya Zhu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China
| | - Yiqun Gan
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing 100871, China
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The Impact of Modifying Food Service Practices in Secondary Schools Providing a Routine Meal Service on Student's Food Behaviours, Health and Dining Experience: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14173640. [PMID: 36079897 PMCID: PMC9460342 DOI: 10.3390/nu14173640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022] Open
Abstract
The education sector is recognised as an ideal platform to promote good nutrition and decision making around food and eating. Examining adolescents in this setting is important because of the unique features of adolescence compared to younger childhood. This systematic review and meta-analysis examine interventions in secondary schools that provide a routine meal service and the impact on adolescents’ food behaviours, health and dining experience in this setting. The review was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist and Cochrane Handbook recommendations. Studies published in English searched in four databases and a hand search yielded 42 interventions in 35 studies. Risk of bias was assessed independently by two reviewers. Interventions were classified using the NOURISHING framework, and their impact analysed using meta-analysis, vote-counting synthesis or narrative summary. The meta-analysis showed an improvement in students selecting vegetables (odds ratio (OR): 1.39; 1.12 to 1.23; p = 0.002), fruit serves selected (mean difference (MD): 0.09; 0.09 to 0.09; p < 0.001) and consumed (MD: 0.10; 0.04 to 0.15; p < 0.001), and vegetable serves consumed (MD: 0.06; 0.01 to 0.10; p = 0.024). Vote-counting showed a positive impact for most interventions that measured selection (15 of 25; 41% to 77%; p = 0.002) and consumption (14 of 24; 39% to 76%; p = 0.013) of a meal component. Interventions that integrate improving menu quality, assess palatability, accessibility of healthier options, and student engagement can enhance success. These results should be interpreted with caution as most studies were not methodologically strong and at higher risk of bias. There is a need for higher quality pragmatic trials, strategies to build and measure sustained change, and evaluation of end-user attitudes and perceptions towards intervention components and implementation for greater insight into intervention success and future directions (PROSPERO registration: CRD42020167133).
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de Medeiros GCBS, de Azevedo KPM, Garcia D, Oliveira Segundo VH, Mata ÁNDS, Fernandes AKP, dos Santos RP, Trindade DDBDB, Moreno IM, Guillén Martínez D, Piuvezam G. Effect of School-Based Food and Nutrition Education Interventions on the Food Consumption of Adolescents: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710522. [PMID: 36078238 PMCID: PMC9518323 DOI: 10.3390/ijerph191710522] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 05/05/2023]
Abstract
The school is a favorable environment for the development of interventions to prevent obesity. The objective of this systematic review is to evaluate the effects of school-based food and nutrition education interventions on adolescent food consumption. The literature search was conducted on databases: MEDLINE/PubMed, Embase, Scopus, ERIC, Science Direct, Web of Science, Cochrane, LILACS, and ADOLEC. The following research strategies were focused on: population (adolescents), intervention (food and nutrition education), outcome (food consumption), and study design (clinical trial). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement guidelines were followed and all stages of this review were performed by two researchers and, when necessary, a third researcher resolved discrepancies. Included studies are randomized clinical trials (RCT). A total of 24 articles were included for review and 11 articles in meta-analysis. In the evaluation of the general effects, there was a significant effect (mean difference (MD) for fruit consumption (MD = 0.09, CI 0.05, 0.14) in serving/day; and for vegetables (MD = 0.59, IC 0.15, 1.03) at times/week. In the consumption of FV (fruits and vegetables), there was no significant effect (standardized mean difference (SMD) of interventions in their consumption (SMD = 0.00, 95% C1 -0.11, 0.11). The evidence available in this review and meta-analysis concludes that food and nutrition education interventions in schools presented favorable results in the food consumption of adolescents. Registered on the PROSPERO database (CRD42019116520).
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Affiliation(s)
- Gidyenne Christine Bandeira Silva de Medeiros
- Systematic Review and Meta-Analysis Laboratory (Lab-Sys), CNPq-UFRN, Department of Nutrition, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
- Correspondence: ; Tel.: +55-84-9880-42405
| | | | - Daniel Garcia
- Department of Physiotherapy, UCAM Universidad Católica de Murcia, 30107 Murcia, Spain
| | - Victor Hugo Oliveira Segundo
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | - Ádala Nayana de Sousa Mata
- Multicampi School of Medical Sciences of RN, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
| | | | | | | | | | | | - Grasiela Piuvezam
- Systematic Review and Meta-Analysis Laboratory (Lab-Sys), CNPq-UFRN, Postgraduate Program in Public Health, Federal University of Rio Grande do Norte (UFRN), Natal 59078-970, Brazil
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The Impact of School-Based Nutrition Interventions on Parents and Other Family Members: A Systematic Literature Review. Nutrients 2022; 14:nu14122399. [PMID: 35745127 PMCID: PMC9231235 DOI: 10.3390/nu14122399] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022] Open
Abstract
Little is known about the impact of school-based nutrition interventions on parents and other family members. This systematic review aims to explore the impact of school-based nutrition interventions on different parental/family outcomes, mainly dietary intake, nutrition knowledge, and health outcomes. PubMed, Web of Science, PsycINFO, EconLit, Cochrane Reviews, and Google Scholar were systematically searched for controlled trials or natural experiments measuring the impact of school-based nutrition interventions, with or without parental involvement, on parents/families of school children. Twenty-two studies met the inclusion criteria. Of which, 15 studies assessed the impact of school-based nutrition interventions on parental/family dietary intake, 10 on parental/family nutrition knowledge, and 2 on parental/family health outcomes. Inconsistent results were found for parental dietary intake with six studies reporting favorable effects. Most studies found improved parental nutrition knowledge. Positive impacts were seen by both studies that assessed the impact on a parental health outcome. Overall, we found that there is potential for school-based nutrition interventions to result in positive effects for parents, in particular for nutrition knowledge. More research is needed to assess the impacts of school-based nutrition interventions on parents and other family members and to assess important intervention characteristics in creating a positive impact.
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Nagy-Pénzes G, Vincze F, Bíró É. A School Intervention's Impact on Adolescents' Health-Related Knowledge and Behavior. Front Public Health 2022; 10:822155. [PMID: 35359760 PMCID: PMC8963932 DOI: 10.3389/fpubh.2022.822155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundMany factors can influence health behavior during adolescence, and the lifestyle of adolescents is associated with health behavior during adulthood. Therefore, their behavior can determine not only present, but also later health status.ObjectiveWe aimed to develop an intervention program to improve high school students' health behavior and to evaluate its effectiveness.MethodsWe performed our study at a secondary school in a rural town in East Hungary between 2016 and 2020. Sessions about healthy lifestyles were organized regularly for the intervention group to improve students' knowledge, to help them acquire the right skills and attitudes, and to shape their behavior accordingly. Data collection was carried out via self-administered, anonymous questionnaires (n = 192; boys = 49.5%; girls = 50.5%; age range: 14–16). To determine the intervention-specific effect, we took into account the differences between baseline and post-intervention status, and between the intervention and control groups using individual follow-up data. We used generalized estimating equations to assess the effectiveness of our health promotion program.ResultsOur health promotion program had a positive effect on the students' health-related knowledge and health behavior in the case of unhealthy eating, moderate to vigorous physical activity, and alcohol consumption.ConclusionOur findings suggest that school health promotion can be effective in knowledge transfer and lifestyle modification. To achieve a more positive impact on health behavior, preventive actions must use a complex approach during implementation.
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Affiliation(s)
- Gabriella Nagy-Pénzes
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- *Correspondence: Gabriella Nagy-Pénzes
| | - Ferenc Vincze
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Éva Bíró
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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14
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Sutherland RL, Jackson JK, Lane C, McCrabb S, Nathan NK, Yoong SL, Lum M, Byaruhanga J, McLaughlin M, Brown A, Milat AJ, Bauman And AE, Wolfenden L. A systematic review of adaptations and effectiveness of scaled-up nutrition interventions. Nutr Rev 2021; 80:962-979. [PMID: 34919715 PMCID: PMC8907487 DOI: 10.1093/nutrit/nuab096] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Context Public health nutrition interventions shown to be effective under optimal research conditions need to be scaled up and implemented in real-world settings. Objectives The primary aim for this review was to assess the effectiveness of scaled-up public health nutrition interventions with proven efficacy, as examined in a randomized controlled trial. Secondary objectives were to: 1) determine if the effect size of scaled-up interventions were comparable to the prescale effect, and; 2) identify any adaptations made during the scale-up process. Data sources Six electronic databases were searched and field experts contacted. Study selection An intervention was considered scaled up if it was delivered on a larger scale than a preceding randomized controlled trial (“prescale”) in which a significant intervention effect (P ≤ 0.05) was reported on a measure of nutrition. Data extraction Two reviewers independently performed screening and data extraction. Effect size differences between prescale and scaled-up interventions were quantified. Adaptations to scale-up studies were coded according to the Adaptome model. Results Ten scaled-up nutrition interventions were identified. The effect size difference between prescale trials and scaled-up studies ranged from –32.2% to 222% (median, 50%). All studies made adaptations between prescale to scaled-up interventions. Conclusion The effects of nutrition interventions implemented at scale typically were half that achieved in prior efficacy trials. Identifying effective scale-up strategies and methods to support retainment of the original prescale effect size is urgently needed to inform public health policy. Systematic Review Registration PROSPERO registration no.CRD42020149267.
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Affiliation(s)
- Rachel L Sutherland
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jacklyn K Jackson
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Cassandra Lane
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sam McCrabb
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Nicole K Nathan
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sze Lin Yoong
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Lum
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Judith Byaruhanga
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Matthew McLaughlin
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Alison Brown
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J Milat
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Adrian E Bauman And
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Luke Wolfenden
- R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, A.E. Bauman, and L. Wolfenden are with the School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia. R.L. Sutherland, J.K. Jackson, C. Lane, S. McCrabb, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia. R.L. Sutherland, C. Lane, N.K. Nathan, S.L. Yoong, M. Lum, J. Byaruhanga, M. McLaughlin, A. Brown, and L. Wolfenden are with the Hunter New England Population Health Unit, Hunter New England Local Health District, Wallsend, New South Wales, Australia. S.L. Yoong is with the School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia. A.J. Milat and A.E. Bauman are with the School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Mingay E, Hart M, Yoong S, Hure A. Why We Eat the Way We Do: A Call to Consider Food Culture in Public Health Initiatives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11967. [PMID: 34831723 PMCID: PMC8623951 DOI: 10.3390/ijerph182211967] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 01/12/2023]
Abstract
The way we eat has changed dramatically in only a few decades. While definitions of food culture have previously existed, a clear description of modern food culture that can be used for health promotion is lacking. In this paper, we propose a concept of food culture for application within public health, what a positive food culture looks like compared to negative elements that have dominated in developed countries and the consequences for physical and mental health and wellbeing. We support calls to action from the international community to reconsider the way we eat. All segments of society have a role to play in building a positive food culture, and it is critical that macro (policy and systems) and meso (community) level environmental factors align and provide supportive environments that promote health-enhancing behaviours. Defining food culture is a necessary step towards articulating the complexities that influence food behaviours and impact health. The ultimate goal is collective action to enable population-wide and sustained improvements to the way we eat, and how we think and feel about food.
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Affiliation(s)
- Edwina Mingay
- School of Medicine and Public Health, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia; (S.Y.); (A.H.)
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Melissa Hart
- School of Health Sciences, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia;
- Hunter New England Mental Health Service, Waratah, Newcastle, NSW 2298, Australia
| | - Serene Yoong
- School of Medicine and Public Health, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia; (S.Y.); (A.H.)
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
- Hunter New England Population Health, Wallsend, Newcastle, NSW 2287, Australia
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Melbourne, VIC 3122, Australia
| | - Alexis Hure
- School of Medicine and Public Health, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia; (S.Y.); (A.H.)
- Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
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Lindquist K, Mann G, Farris A, Gordon K, Misyak S. Parent Perspectives of Packing School Lunches. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2021. [DOI: 10.1080/19320248.2021.1994081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kayla Lindquist
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Georgianna Mann
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Alisha Farris
- Nutrition and Foods Program, Appalachian State University, Boone, USA
| | - Kymberle Gordon
- Department Nutrition and Hospitality Management, University of Mississippi, University, MS, USA
| | - Sarah Misyak
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Indriasari R, Nadjamuddin U, Arsyad DS, Iswarawanti DN. School-based nutrition education improves breakfast-related personal influences and behavior of Indonesian adolescents: a cluster randomized controlled study. Nutr Res Pract 2021; 15:639-654. [PMID: 34603611 PMCID: PMC8446687 DOI: 10.4162/nrp.2021.15.5.639] [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: 12/20/2019] [Revised: 09/10/2020] [Accepted: 09/23/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND/OBJECTIVES Many adolescents in developing countries skip breakfast. Innovative nutrition education (NE) strategies are needed to enhance knowledge and skills related to the breakfasts of adolescents in a low socioeconomic setting. The objective was to evaluate short- and long-term effects of a multi-strategy, school-based NE intervention on adolescents' breakfast-related personal influences and behaviors. SUBJECTS/METHODS An intervention study with a cluster randomized controlled trial design was conducted in 4 senior high schools in Makassar, Indonesia. The multi-strategy NE intervention was delivered for 3 months. Data were collected using a self-administered questionnaire and a 3-day breakfast recall (face-to-face interview). Wilcoxon, McNemar, and Mann-Whitney tests were used to determine intra- and intergroup differences. RESULTS Unlike knowledge, improvement was observed in attitude and self-efficacy scores in the intervention groups (IGs) (P < 0.01); however, no significant changes were observed in the control group (CG). More students showed improved motivation in the IG than in the CG (P > 0.05). Changes in breakfast frequency and macronutrient intake from breakfast were greater in the IG than in the CG (P < 0.05). CONCLUSIONS A multi-strategy NE intervention is effective in producing positive changes in breakfast-related attitude, self-efficacy, and motivation of adolescents from a low-middle socioeconomic setting. The intervention improved breakfast frequency and nutrient intake. This intervention has promise for sustaining the observed changes over the long-term.
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Affiliation(s)
- Rahayu Indriasari
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia.,Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, DKI Jakarta 10430, Indonesia
| | - Ulfah Nadjamuddin
- Department of Nutrition Science, Faculty of Public Health, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia
| | - Dian Sidik Arsyad
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, South Sulawesi 90245, Indonesia
| | - Dwi Nastiti Iswarawanti
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia, DKI Jakarta 10430, Indonesia.,Institute of Health Science of Kuningan, Kuningan, West Java 45561, Indonesia
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Concordance Between the Weight of Spanish Adolescent Soccer Players, Their Self-Perceived Weight, and Their Weight as Perceived by Their Parents. J Pediatr Nurs 2021; 60:e13-e18. [PMID: 33618980 DOI: 10.1016/j.pedn.2021.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE In the context of soccer clubs, to analyze the concordance between players' actual weight, their self-perceived weight, and their weight as perceived by their parents; to determine which variables might explain the presence of concordance between parents' perception of adolescents' weight and their actual weight. Design and study: A cross-sectional study involving 330 soccer players aged between 13 and 16. Data on personal characteristics of adolescents and parents were analyzed, as well as parents' perceptions of adolescents' weight status and their self-perception. A descriptive analysis of the personal characteristics of the sample (adolescents and parents) and an analysis of the variables explaining the presence of concordance between the parents' perception of adolescents' weight and their actual weight were performed. RESULTS 19% of the adolescents were overweight and 3.4% were obese. The concordance between parents' perceptions of players' weight and players' actual weight was weak. The concordance between adolescents' self-perceived weight and their actual weight was moderate. The difference in BMI scores according to presence or absence of concordance was statistically significant: these scores were higher in the absence of concordance. Discordance between adolescents' weight and their parents' perception of their weight was associated with parents having lower levels of education. CONCLUSION A high percentage of parents and players misperceived their actual weight. This discrepancy was associated with higher BMI scores for adolescents. PRACTICE IMPLICATIONS Nurses should include promotion of accurate weight perception in educational interventions on excess weight.
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Calvert S, Dempsey RC, Povey R. Normative misperceptions of unhealthy snacking amongst 11- to 12-year-old secondary school students. Appetite 2021; 166:105462. [PMID: 34119560 DOI: 10.1016/j.appet.2021.105462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Abstract
Younger adolescents are at an age where they have increasing control of their diet, and where peers become an important social reference for acceptable and normative dietary behaviours. These normative perceptions are often inaccurate and can lead to the development of unhealthy eating practices; although, the role of normative misperceptions of peers' unhealthy snacking behaviours in younger adolescents' personal snacking behaviours is not clear. The current study was a cross-sectional analysis of baseline data from a social norms-based healthy eating intervention sampling two secondary schools in deprived areas of England. Students aged 11-12 years (n = 252) completed self-report measures of their demographic characteristics and personal behaviours, attitudes, intentions, and normative perceptions (descriptive and injunctive norms), relating to unhealthy snacking. Results indicated students overestimated peers' daily unhealthy snacks consumption by approximately 3.2 portions, misperceived peers to have more positive attitudes towards unhealthy snacking and more negative attitudes towards reducing snacking. The greater these misperceptions of peers' behaviours and attitudes, the more likely students were to consume unhealthy snacks and have positive attitudes about unhealthy snacking. Girls had a stronger intention to reduce their snacking behaviours if they had more positive attitudes to reducing snacking behaviours and misperceived peers to also have a positive attitude. In summary, 11- to 12-year-olds misperceive the snacking behaviour and attitudes of their peers, and such normative misperceptions are associated with students' own snacking behaviours and attitudes. Interventions which challenge these misperceptions may assist in reducing the social acceptability of unhealthy snacking and in reducing unhealthy snacking amongst young adolescents.
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Affiliation(s)
- Sian Calvert
- The Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, ST4 2DF, UK.
| | - Robert C Dempsey
- Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, M15 6GX, UK
| | - Rachel Povey
- The Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, ST4 2DF, UK
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Mental Health and Wellbeing at Schools: Health Promotion in Primary Schools with the Use of Digital Methods. CHILDREN-BASEL 2021; 8:children8050345. [PMID: 33925744 PMCID: PMC8145101 DOI: 10.3390/children8050345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/25/2022]
Abstract
Mental health disorders among primary school children remain a crucial issue. Early health promotion interventions can positively affect and prevent the onset of mental disorders. Promising digital mental health methods have been implemented for adolescents and youths with scarce evidence among younger ages. Therefore, the aim of the current systematic review was to identify health promotion interventions on mental health and wellbeing, with the use of digital methods, delivered in primary school settings. Six digital interventions have been identified, three of which were targeting teachers and the others students. Regardless of the limited number of studies, the effectiveness of the web-based interventions upon teachers’ knowledge and attitudes and the positive impact on children’s behavioral improvements has been documented. The lack of adequate evidence highlights the need for further research in the field. The current review provides information for professionals working in primary schools useful for the design and implementation of effective mental health and wellbeing interventions.
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Martín-Payo R, Fernández-Álvarez MDM, Zabaleta-del-Olmo E, García-García R, González-Méndez X, Carrasco-Santos S. Feasibility Study of an Educational Intervention to Improve Water Intake in Adolescent Soccer Players: A Two-Arm, Non-Randomized Controlled Cluster Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031339. [PMID: 33540715 PMCID: PMC7908608 DOI: 10.3390/ijerph18031339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to assess the feasibility of an educational intervention on hydration behavior in adolescent soccer players. A pilot study of a two-arm, non-randomized controlled cluster trial was conducted. A total of 316 players aged 13-16 agreed to participate. The response variables were the players' participation in the intervention, their perception of the knowledge acquired, the usefulness and the overall assessment of the intervention. Hydration patterns and acquisition of knowledge on hydration behavior were also assessed. The intervention involved two elements: posters and a web app. A total of 259 adolescents completed the study (intervention group (IG) = 131; control group (CG) = 128). 80.6% of the players responded to the survey assessing the feasibility of the intervention. The mean number of correct answers regarding behavior was significantly higher in the IG (3.54; SD = 1.162) than in the CG (2.64; SD = 1.174) (p < 0.001). The water consumption pattern at all the clubs was ad libitum. Of the players, 10% did not drink any water at all during the game. In conclusion, this intervention has been shown to be feasible for implementation with adolescent soccer players. It suggests that hydration guidelines should be informed by personal factors and that ad libitum water consumption should be avoided.
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Affiliation(s)
- Rubén Martín-Payo
- Faculty of Medicine and Health Sciences, University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain;
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
| | - María del Mar Fernández-Álvarez
- Faculty of Medicine and Health Sciences, University of Oviedo, Campus del Cristo s/n, 33006 Oviedo, Spain;
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Correspondence:
| | - Edurne Zabaleta-del-Olmo
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain;
- Gerència Territorial de Barcelona, Institut Català de la Salut, 08007 Barcelona, Spain
- Nursing Department, Nursing Faculty, Universitat de Girona, 17004 Girona, Spain
- Campus Bellaterra, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Rebeca García-García
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Hospital Universitario Central de Asturias, Avenida Roma s/n, 33011 Oviedo, Spain
| | - Xana González-Méndez
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Hospital Universitario San Agustín de Avilés, Camino de Heros 6, 33401 Avilés, Spain
| | - Sergio Carrasco-Santos
- PRECAM Research Team, Health Research Institute of the Principality of Asturias, Avenida Roma s/n, 33011 Oviedo, Spain; (R.G.-G.); (X.G.-M.); (S.C.-S.)
- Hospital Universitario San Agustín de Avilés, Camino de Heros 6, 33401 Avilés, Spain
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Hayba N, Rissel C, Allman Farinelli M. Effectiveness of lifestyle interventions in preventing harmful weight gain among adolescents: A systematic review of systematic reviews. Obes Rev 2021; 22:e13109. [PMID: 32725749 DOI: 10.1111/obr.13109] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/08/2020] [Accepted: 07/08/2020] [Indexed: 12/20/2022]
Abstract
Obesity in adolescence is associated with stigma during school years, early emergence of co-morbidities in adulthood and premature mortality. Adolescence presents a key window of opportunity to intervene for building healthy eating and physical activity routines and prevent weight gain. This review of reviews assesses the evidence on the effectiveness of prevention interventions conducted with adolescents. Nine reviews assessing the effects of lifestyle interventions in adolescents (defined as age 10 to 19 years old) on weight gain were identified from the 10 health databases searched. Only four reviews conducted meta-analyses, of which, three (two exercise-focused) demonstrated positive changes in primary outcomes of body mass index (BMI) and/or BMI z-score (range of decrease in BMI from 0.06 to 0.47 kg/m2) ). Most were conducted in school settings, and all but two reviews were of low quality. Few reviews reported external validity components that would enable clearer directions for policy makers to implement in real-world settings. More than 140 distinct interventions were included in the reviews, but there remains a serious gap in evidence for effective interventions in adolescents.
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Affiliation(s)
- Nematullah Hayba
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Rissel
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman Farinelli
- Nutrition and Dietetics Group, School of Life and Environmental Science, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
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Verdonschot A, de Vet E, van Seeters N, Warmer J, Collins CE, Bucher T, Haveman-Nies A. Caregivers' Role in the Effectiveness of Two Dutch School-Based Nutrition Education Programmes for Children Aged 7-12 Years Old. Nutrients 2021; 13:nu13010140. [PMID: 33401470 PMCID: PMC7824262 DOI: 10.3390/nu13010140] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 11/24/2022] Open
Abstract
Childhood eating behaviours can track into adulthood. Therefore, programmes that support early healthy eating, including school-based nutrition education programmes, are important. Although school-based programmes may be beneficial in improving nutrition knowledge, impact on actual fruit and vegetable (FV) intake is generally limited as FV intake is also influenced by the home environment. The current study includes secondary analyses of data from an evaluation study on Dutch nutrition education and examined the role of caregivers’ health promotion behaviours (HPB) in influencing healthy eating behaviours in primary school children (n = 1460, aged 7–12 years) and whether caregivers’ HPB contribute to programme effectiveness. Children’s nutrition knowledge, FV intake and caregivers’ HPB (FV/sugar-sweetened beverages/sweets provision to take to school, cooking together and talking about healthy food at home) were measured by child-reported questionnaires at baseline, during, and 6 months post-programme. Results indicated that caregivers’ HPB was positively associated with children’s healthy eating behaviours and that programme effectiveness was highest in those in the lower HPB subcategory. In conclusion, children with less encouragement to eat healthily at home potentially benefit more from school-based nutrition education programmes than children receiving more encouragement. This highlights the important role of the home environment in supporting healthy eating behaviour in children.
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Affiliation(s)
- Angeliek Verdonschot
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
- Priority Research Center for Physical Activity and Nutrition (PRCPAN), The University of Newcastle, Callaghan, NSW 2308, Australia; (C.E.C.); (T.B.)
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
- Correspondence: ; Tel.: +31-317-483401
| | - Emely de Vet
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
| | - Natalie van Seeters
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
| | - Jolieke Warmer
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
| | - Clare E. Collins
- Priority Research Center for Physical Activity and Nutrition (PRCPAN), The University of Newcastle, Callaghan, NSW 2308, Australia; (C.E.C.); (T.B.)
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Tamara Bucher
- Priority Research Center for Physical Activity and Nutrition (PRCPAN), The University of Newcastle, Callaghan, NSW 2308, Australia; (C.E.C.); (T.B.)
- School of Environmental and Life Sciences (SELS), Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Annemien Haveman-Nies
- Consumption and Healthy Lifestyles Group, Wageningen University & Research, 6700 EW Wageningen, The Netherlands; (E.d.V.); (N.v.S.); (J.W.); (A.H.-N.)
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Importance of Self-Efficacy in Eating Behavior and Physical Activity Change of Overweight and Non-Overweight Adolescent Girls Participating in Healthy Me: A Lifestyle Intervention with Mobile Technology. Nutrients 2020; 12:nu12072128. [PMID: 32709005 PMCID: PMC7400873 DOI: 10.3390/nu12072128] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 02/08/2023] Open
Abstract
Very little is known about how multicomponent interventions directed to entire populations work in selected groups of adolescents. The aim was to evaluate the effectiveness of the Healthy Me one-year program on changes in healthy eating and physical activity among overweight and non-overweight female students. Randomization involved the allocation of full, partial or null intervention. The randomized field trial was implemented in 48 secondary schools (clusters) all over Poland among 1198 15-year-old girls. In this study, a sample of N = 1111 girls who participated in each evaluation study was analyzed. Using multimedia technologies, efforts were made to improve health behaviors and increase self-efficacy. The main outcome was a health behavior index (HBI), built on the basis of six nutritional indicators and one related to physical activity. HBI was analyzed before and immediately after intervention and at three months' follow-up, and the HBI change was modeled. Statistical analysis included nonparametric tests and generalized linear models with two-way interactions. Comparing the first and third surveys, in the overweight girls, the HBI index improved by 0.348 (SD = 3.17), while in the non-overweight girls it had worsened. After adjusting for other factors, a significant interaction between body weight status and level of self-efficacy as predictors of HBI changes was confirmed. The program turned out to be more beneficial for overweight girls.
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Effectiveness of Interventions to Promote Healthy Eating Habits in Children and Adolescents at Risk of Poverty: Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12061891. [PMID: 32630502 PMCID: PMC7353268 DOI: 10.3390/nu12061891] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 01/05/2023] Open
Abstract
The objective of this review was to provide an up-to-date review of trials that include behavioral intervention on the eating habits of children and adolescents at risk of poverty, applying meta-analysis to estimate the size of the intervention effect. A systematic literature search was performed in the following databases: MEDLINE via Pubmed and via EBSCOhost, LILACS and IBECS via VHL. The MeSH terms were used: "social class", "poverty", "diet", "health promotion" (PROSPERO ID: 183900). A total of 14 articles were finally included in this systematic review. The primary results of the included studies were meta-analyzed with the RevMan 5.3 program, assuming a random effects model. Analysis of the overall effect showed combined standardized mean differences (SMD) of 0.16 (CI 95%: [0.03, 0.30], I2 = 76%). The p-value for the Z statistic was 0.02, which reflects accuracy in the effect estimation. When establishing subgroups based on the intervention tracking time points, studies that provided longer-term follow-up data showed a combined SMD of 0.15 (CI 95%: [-0.02, 0.32], I2 = 81%]). Small effects of behavioral interventions were found to promote healthy eating habits, but better effects were shown in cases where the invention was followed up in the long term.
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Impact of a teacher-led school handwashing program on children's handwashing with soap at school and home in Bihar, India. PLoS One 2020; 15:e0229655. [PMID: 32106240 PMCID: PMC7046199 DOI: 10.1371/journal.pone.0229655] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/11/2020] [Indexed: 12/20/2022] Open
Abstract
Handwashing with soap is an important preventive health behavior, and yet promoting this behavior has proven challenging. We report the results of a program that trained teachers to deliver a handwashing with soap behavior change program to children in primary schools in Bihar, India. Ten intervention schools selected along with ten nearby control schools, and intervention schools received the “School of Five” program promoting handwashing with soap using interactive stories, games, and songs, behavioral diaries to encourage habit formation, and public commitment. Households with children aged 8–13 attending the nearby school were enrolled in the study. Handwashing with soap was measured using sticker diaries before eating and after defecation 4 weeks after the intervention was completed. Children in the treatment reported 15.1% more handwashing with soap on key occasions (35.2%) than those in the control group (20.1%) (RR: 1.77, CI: (1.22, 2.58), p = .003). There was no evidence that handwashing with soap after defecation was higher in the treatment group than the control group (RR: 1.18, CI: (0.88, 1.57), p = .265), but there was strong evidence that handwashing with soap was greater in the treatment than in the control before eating (RR: 2.68, 95% CI: (1.43, 5.03), p = .002). Rates of handwashing increased both at home (RR: 1.63, CI: 1.14, 2.32), p = .007) and at school (RR: 4.76, 95% CI: (1.65, 17.9), p = .004), though the impact on handwashing with soap at key occasions in schools was much higher than at home. Promoting handwashing with soap through teachers in schools may be an effective way to achieve behavior change at scale.
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Katsagoni CN, Apostolou A, Georgoulis M, Psarra G, Bathrellou E, Filippou C, Panagiotakos DB, Sidossis LS. Schoolteachers' Nutrition Knowledge, Beliefs, and Attitudes Before and After an E-Learning Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1088-1098. [PMID: 31402288 DOI: 10.1016/j.jneb.2019.07.001] [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: 02/08/2019] [Revised: 06/11/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Το explore teachers' nutrition knowledge, beliefs, and attitudes and to examine the effectiveness of an electronic learning (e-learning) program in teachers' nutrition knowledge. DESIGN Cross-sectional and experimental design. SETTING The study took place in Greece, while schoolteachers were invited by e-mail. PARTICIPANTS Teachers of primary and secondary education, with no exclusion criteria, were enrolled in the study between March, 2015 and 2016. MAIN OUTCOME MEASURES Schoolteachers' nutrition knowledge, beliefs, and attitudes. INTERVENTION Teachers completed a 36-item nutrition questionnaire and then a subgroup participated in an e-learning program. After the intervention, teachers completed the same questionnaire. ANALYSIS Principal component analysis and multivariate logistic regression were used for data analysis. RESULTS A total of 1,094 teachers completed the questionnaire; 619 participated in the e-learning program. Teachers showed moderate nutrition knowledge scores (ie, 65% correct answers) before the intervention, whereas their attitudes regarding acting as role models and their belief in the importance of the role of nutrition were associated with 74% (odds ratio, 1.28; 95% confidence interval, 1.13-1.45) and 79% (odds ratio, 1.21; 95% confidence interval, 1.07-1.37) increased possibility of having good nutrition knowledge, respectively. The e-learning program was effective in strengthening teachers' nutrition knowledge (P < .001) and improving their beliefs and attitudes (P < .05). CONCLUSIONS AND IMPLICATIONS Future research is needed to validate the current results, which can be used to design and implement similar educational programs to teachers as a means of creating health-promoting schools.
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Affiliation(s)
- Christina N Katsagoni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ
| | - Aris Apostolou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Glykeria Psarra
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ
| | - Eirini Bathrellou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Christina Filippou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ
| | - Labros S Sidossis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ.
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de Medeiros GCBS, de Azevedo KPM, Garcia DÁ, de Oliveira Segundo VH, de Sousa Mata ÁN, de Siqueira KSDP, Fernandes AKP, Santos RPD, de Brito Trindade DDB, de Oliveira Lyra C, Piuvezam G. Protocol for systematic reviews of school-based food and nutrition education intervention for adolescent health promotion: Evidence mapping and syntheses. Medicine (Baltimore) 2019; 98:e16977. [PMID: 31464944 PMCID: PMC6736443 DOI: 10.1097/md.0000000000016977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Nutrition is an important modifiable factor in combating overweight and obesity among adolescents. School has been indicated as an effective environment for influencing eating behavior; however, recent reviews assessing school-based interventions specifically for adolescents are scarce. Therefore, we propose the present systematic review with the aim to comprehensively review the quantitative and qualitative literature on the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits. METHODS We will search MEDLINE/PubMed, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, and ADOLEC. We will include randomized controlled trials (RCT), non-RCT, and controlled before-after studies. Risk of bias will be assessed using the EPOC Risk of Bias Tool for RCT, Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCT or controlled before-after, as well as the Critical Appraisal Skills Program (CASP) checklist for qualitative studies. We will analyze the overall strength of the evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Two independent researchers will conduct all evaluations and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed by the RevMan 5.3 software. We will conduct the study in accordance with the guideline of the Preferred Reporting Items for Systematic Review and Meta-analyses Protocols. RESULT This review will evaluate the effects of school-based food and nutrition education interventions on adolescent health promotion through healthy eating habits. The primary outcome will be changes in adolescent food consumption. Secondary outcomes will be biological parameters (e.g., body mass index (BMI), waist circumference (WC), body composition, etc); biochemical parameters (e.g., glycemia, triglycerides, total cholesterol, etc); qualitative evidences that support or explain the effect of school-based food and nutrition education interventions on adolescent food consumption. CONCLUSION The findings of this systematic review will summarize the latest evidence of the effects of school-based food and nutrition education interventions on adolescent health promotion. The findings will be an available reference for school-based interventions and other further research. REGISTRATION PROSPERO CRD42019116520.
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Affiliation(s)
| | | | - Daniel Ángel Garcia
- Department of Physiotherapy, San Antonio de Murcia Catholic University, Spain
| | | | | | | | | | | | | | - Clélia de Oliveira Lyra
- Department of Nutrition, Federal University of Rio Grande do Norte
- Graduate Program in Public Health, UFRN, Natal, Brazil
| | - Grasiela Piuvezam
- Graduate Program in Public Health, UFRN, Natal, Brazil
- Department of Public Health, UFRN, Natal, Brazil
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Newton G, Racey M, Marquez O, McKenney A, Preyde M, Wosnick D. A Systematic Review of Tools Measuring Nutrition Knowledge of Pre-Adolescents and Adolescents in a School-Based Setting. THE JOURNAL OF SCHOOL HEALTH 2019; 89:402-416. [PMID: 30895628 DOI: 10.1111/josh.12752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 04/30/2018] [Accepted: 05/12/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Measurement of nutrition knowledge is common in interventions targeting dietary modifications in a school-based setting. Previous research has noted a general lack of disclosure regarding the details and psychometric properties of nutrition knowledge tools, which makes uptake of previously used instruments extremely difficult. METHODS Our systematic literature review sought to identify interventions measuring nutrition knowledge in school settings to students aged 9 to 18. Studies were categorized according to content subject and relevant descriptive characteristics and psychometric properties were extracted. RESULTS Following the initial screening of 16,868 articles, 308 papers were evaluated for eligibility. Sixty-seven studies consistent with the inclusion criteria were included in the review. A minority of studies reported analysis of validity (31.3%) and/or reliability (40.3%), and 73.1% of studies had at least one unknown relevant descriptive characteristic. The majority (68.7%) of studies were custom developed, of which only 13 reproduced the tool in the publication. CONCLUSION Overall, there was an alarming lack of reporting across studies, both in terms of the description of knowledge tools as well as their psychometric properties. These omissions make the selection of appropriate instruments for use in novel contexts difficult, and highlight the need for greater disclosure and pre-intervention testing.
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Affiliation(s)
- Genevieve Newton
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Megan Racey
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Olivia Marquez
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Andrew McKenney
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - Michèle Preyde
- Department of Family Relations and Applied Human Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
| | - David Wosnick
- Department of Human Health & Nutritional Science, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada
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Srbely V, Janjua I, Buchholz AC, Newton G. Interventions Aimed at Increasing Dairy and/or Calcium Consumption of Preschool-Aged Children: A Systematic Literature Review. Nutrients 2019; 11:nu11040714. [PMID: 30934755 PMCID: PMC6521222 DOI: 10.3390/nu11040714] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/20/2019] [Accepted: 03/22/2019] [Indexed: 11/16/2022] Open
Abstract
Dairy product consumption is important during childhood, as dairy products provide nutrients to support growth and development. However, a high proportion of children globally are not meeting recommended daily intakes, which may have long-term health implications. Accumulating evidence suggests that interventions aimed at instilling healthy lifestyle habits are most effective when initiated during the preschool years. Therefore, the purpose of the review was to identify the characteristics of effective dairy and/or calcium interventions targeting preschool-aged children. A systematic literature review identified 14 intervention studies published between 1998⁻2018 addressing dairy/calcium intakes in the preschool population (1.5 to 5 years). Intervention reporting was assessed using intervention intensity, behavior change techniques and Workgroup for Intervention Development and Evaluation Research (WIDER), with the quality of studies evaluated using risk of bias and Grades of Recommendation, Assessment, Development and Evaluation (GRADE). Five of the 14 studies included in the review reported significant improvements in children's dairy (4/5) or calcium (1/5) intake. Characteristics that may enable intervention effectiveness include the delivery of interventions in one setting (preschool facility), using specific behavior change techniques (environmental restructuring and teach to use prompts/cues), and targeting both parent and child. Overall, the interventions assessed demonstrated variable success and highlighted the need for developing effective interventions designed to increase dairy and/or calcium intakes in preschool-aged children.
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Affiliation(s)
- Victoria Srbely
- Department of Human Health & Nutritional Science, University of Guelph, Guelph, ON N1G2W1, Canada.
| | - Imtisal Janjua
- Department of Biomedical Sciences, University of Guelph, Guelph, ON N1G2W1, Canada.
| | - Andrea C Buchholz
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G2W1, Canada.
| | - Genevieve Newton
- Department of Human Health & Nutritional Science, University of Guelph, Guelph, ON N1G2W1, Canada.
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Huys N, Cardon G, De Craemer M, Hermans N, Renard S, Roesbeke M, Stevens W, De Lepeleere S, Deforche B. Effect and process evaluation of a real-world school garden program on vegetable consumption and its determinants in primary schoolchildren. PLoS One 2019; 14:e0214320. [PMID: 30897160 PMCID: PMC6428286 DOI: 10.1371/journal.pone.0214320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/11/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the effectiveness of a school garden program on children's vegetable consumption and determinants and to gain insight into the process of the program. METHODS The "Taste Garden" is a real-world nine-week school garden program developed and implemented by a local organization. A total of 350 children (149 intervention group, 201 control group) filled out questionnaires on vegetable consumption, determinants and process of the program. Additionally, teachers filled out a process evaluation questionnaire. For effect evaluation, interaction effects (time x group) were considered, using multilevel repeated measures analyses in MLwiN 3.02. Interaction effects were repeated, taking into account quality of implementation (time x implementation group). Process evaluation was descriptively assessed with SPSS 24.0. RESULTS Overall, beside some practical concerns of teachers, the program was well perceived by teachers and children. However, an intervention effect of "The Taste Garden" was only found for knowledge (p = 0.02), with a very small effect size (0.55%). When taking into account implementation quality, only small effects were found for awareness (p between 0.005 and 0.007 and an effect size of 0.63%) and knowledge (p between 0.04 and 0.09 and an effect size of 0.65%). CCONCLUSIONS Evaluation of the real-world "Taste Garden" program, which was positively perceived by teachers, showed no effects on vegetable consumption and small effects on its determinants. Adaptations of the current format and longer follow-up periods are therefore recommended.
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Affiliation(s)
- Nele Huys
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Marieke De Craemer
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ninotchka Hermans
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Siska Renard
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | | | - Sara De Lepeleere
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Investigating the Use of an Electronic Activity Monitor System as a Component of Physical Activity and Weight-Loss Interventions in Nonclinical Populations: A Systematic Review. J Phys Act Health 2019; 16:294-302. [PMID: 30849927 DOI: 10.1123/jpah.2017-0660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Electronic activity monitor systems (EAMSs) have been readily incorporated into physical activity (PA) and weight-loss interventions to facilitate self-monitoring PA behavior. A comprehensive review is required to better understand their utility as intervention modalities in nonclinical populations. METHODS Medscape, MEDLINE, PsycINFO, and Cochrane databases were searched in February 2017, with a search update in April 2017. Citation screening, risk of bias assessment, and an intensity evaluation were conducted in duplicate by 2 investigators. RESULTS The search returned 409 unique citations. Of which, 22 citations met the inclusion criteria. Seven studies found significant between-group differences: 3 in weight loss, 3 in PA levels, and 1 in both weight loss and PA levels. Effective interventions lasted 6 weeks to 12 months. Positive health outcomes were demonstrated when users interacted with multiple features of the EAMS and had access to other services, such as personal coaching or environmental reinforcement. CONCLUSIONS When control and intervention groups have access to the same components, such as counseling or group interaction, the addition of an EAMS for self-monitoring within the intervention group may not confer more favorable results. Risk of performance bias and low sample sizes should be addressed in future trials to generate more reliable findings.
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Lepe S, Goodwin J, Mulligan KT, Balestracci K, Sebelia L, Greene G. Process Evaluation of a Policy, Systems, and Environmental Change Intervention in an Urban School District. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:307-317. [PMID: 30274727 DOI: 10.1016/j.jneb.2018.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 07/24/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To conduct a comprehensive process evaluation of a policy, systems, and environmental (PSE) change intervention. DESIGN Quasi-experimental, mixed methods. SETTING Low-income urban school district. PARTICIPANTS Fifth-grade students in 4 schools assigned to 2 intervention and 2 comparison schools (intervention, n = 142; comparison, n = 170). INTERVENTION Both groups received a nutrition curriculum delivered by classroom teachers. Intervention schools also received 10 PSE lessons taught by paraprofessional educators. MAIN OUTCOME MEASURES Quantitative data were obtained from fidelity and observation checklists, grading rubrics and self-reported student surveys. Focus group and interviews provided qualitative data. Quantitative measures included assessments of PSE and fruit and vegetable knowledge, as well as assessment of times fruits and vegetables (FV) were consumed yesterday. ANALYSES Qualitative data were analyzed using inductive content analysis. Quantitative data were analyzed using repeated measures analysis of variance and analysis of co-variance. RESULTS Fidelity, dose, reach, and acceptance of PSE intervention were high; students felt more empowered, although PSE lessons were considered lengthy and complicated. Intervention PSE and FV knowledge scores were significantly higher than comparison scores (F37.56, P < .001; and F3.94, P < .05, respectively). However, issues in communication were identified between school staff and researchers. CONCLUSIONS AND IMPLICATIONS Policy, systems, and environmental classroom interventions commented on the differences between quantitative and qualitative assessments, and this suggests the need for more sensitive quantitative assessments. Future research should look at long-term outcomes as this study only looked at short-term outcomes.
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Affiliation(s)
- Silvia Lepe
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Jennifer Goodwin
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Katie T Mulligan
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Kate Balestracci
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
| | - Linda Sebelia
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI.
| | - Geoffrey Greene
- Department of Nutrition and Food Sciences, University of Rhode Island, Providence, RI
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Effect of implementing school meals compared with packed lunches on quality of dietary intake among children aged 7-13 years. J Nutr Sci 2019; 8:e3. [PMID: 30746124 PMCID: PMC6360196 DOI: 10.1017/jns.2018.29] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/26/2018] [Accepted: 12/06/2018] [Indexed: 11/21/2022] Open
Abstract
Strategies are needed to improve the dietary habits of children. The aim of the present study was to evaluate the effect of implementing a school food programme on the dietary quality of lunches consumed by school children aged 7–13 years compared with packed lunches brought from home. A secondary objective was to investigate if a possible effect would differ between the younger children and the older. A quasi-experimental study design with four intervention schools and four matched control schools was conducted. In total, 984 school children participated. Data on packed lunches were collected at baseline. At the 1st follow-up the children in the intervention schools were offered free school meals and at the 2nd follow-up children paid for their school meals. The control group had packed lunches at all measurements. A digital photographic method combined with a Meal Index of dietary Quality (Meal IQ) was used for dietary assessment. Multilevel modelling was employed for data analyses. The quality of dietary intake was improved when free school meals were offered (P = 0·004); if the school meals were paid for the use was limited and no difference in change in dietary quality was found (P = 0·343). The school food programme had no difference in effect according to age (P = 0·083). In conclusion, offering a free school meal had a positive effect on dietary quality of the lunches consumed by school children aged 7–13 years. No effect was measured when the school meals were not provided for free. The dietary effect did not depend on age.
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Walker R, Bennett C, Blumfield M, Gwini S, Ma J, Wang F, Wan Y, Truby H. Attenuating Pregnancy Weight Gain-What Works and Why: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:E944. [PMID: 30037126 PMCID: PMC6073617 DOI: 10.3390/nu10070944] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 11/26/2022] Open
Abstract
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: -3.27; 95% CI: -4.96, -1.58, p < 0.01), physical activity (PA) (WMD: -1.02; 95% CI: -1.56, -0.49, p < 0.01), and lifestyle interventions (combining diet and PA) (WMD: -0.84; 95% CI: -1.29, -0.39, p < 0.01) gained significantly less weight than controls. The three eHealth interventions favored neither intervention nor control (WMD: -1.06; 95% CI: -4.13, 2.00, p = 0.50). Meta-regression demonstrated no optimal duration, frequency, intensity, setting, or diet type. Traditional face to face delivery of weight management interventions during pregnancy can be successful. Delivery via eHealth has potential to extend its reach to younger women but needs further evaluation of its success.
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Affiliation(s)
- Ruth Walker
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Christie Bennett
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Michelle Blumfield
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Stella Gwini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne VIC 3004, Australia.
| | - Jianhua Ma
- Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Fenglei Wang
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.
| | - Yi Wan
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.
| | - Helen Truby
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
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Bleich SN, Vercammen KA, Zatz LY, Frelier JM, Ebbeling CB, Peeters A. Interventions to prevent global childhood overweight and obesity: a systematic review. Lancet Diabetes Endocrinol 2018; 6:332-346. [PMID: 29066096 DOI: 10.1016/s2213-8587(17)30358-3] [Citation(s) in RCA: 230] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 12/31/2022]
Abstract
In view of the prevalence, health consequences, and costs of childhood obesity, there has been substantial interest in identifying effective interventions to prevent excess weight gain in young people. In this systematic review, we expand on previous reviews of obesity prevention interventions by including recent studies (until May 23, 2017) from all parts of the world. We searched MEDLINE, Embase, CINAHL Plus, Web of Science, CAB Abstracts, and PAIS Index and included randomised controlled trials, quasi-experimental studies, or natural experiments with: (1) a control group; (2) minimum follow-up of 12 months for community-based and home-based interventions or 6 months for school-based and preschool-based interventions; and (3) a primary outcome of BMI, BMI Z score, BMI percentile, body fat percentage, skinfold thickness, waist circumference, or prevalence of overweight or obesity. School-based interventions with combined diet and physical activity components and a home element (n=41) had greatest effectiveness; evidence in support of the effect of preschool-based (n=6), community-based (n=7), and home-based (n=2) interventions was limited by a paucity of studies and heterogeneity in study design. The effectiveness of school-based interventions that combined diet and physical activity components suggests that they hold promise for childhood obesity prevention worldwide. More research with rigorous evaluation and consistent reporting is needed in non-school settings and in combinations of settings.
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Affiliation(s)
- Sara N Bleich
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Kelsey A Vercammen
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Laura Y Zatz
- Department of Nutrition and Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Johannah M Frelier
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Cara B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, USA
| | - Anna Peeters
- School of Health and Social Development, Deakin University, Burwood, VIC, Australia
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Brown EC, Buchan DS, Drignei D, Wyatt FB, Kilgore L, Cavana J, Baker JS. Primary School Children's Health Behaviors, Attitudes, and Body Mass Index After a 10-Week Lifestyle Intervention With Follow-Up. Front Pediatr 2018; 6:137. [PMID: 29868527 PMCID: PMC5954212 DOI: 10.3389/fped.2018.00137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/24/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Given the current global child obesity epidemic, testing the effectiveness of interventions in reducing obesity and its influencers is paramount. The purpose of this study was to determine immediate and long-term changes in body mass index and psychosocial variables following a 10-week lifestyle intervention. Methods: Seven hundred and seventy participants (8.75 ± 0.98 years of age, 379 boys and 391 girls) took part in the study. Participants had height, weight, and psychosocial questionnaires assessed at pre- and post-control, pre- and post-intervention, and 6-months post-intervention. Participants completed a weekly 10-week intervention consisting of healthy eating and physical activity education, physical activity, parental involvement, and behavior change techniques. Regression models were fit with correlated errors where the correlation occurred only between time points, not between subjects, and the nesting effects of school and area deprivation were controlled. Results: Regression models revealed a significant decrease in body mass index from pre- to post-intervention of 0.8512 kg/m2 (P = 0.0182). No Changes in body mass index occurred from post-intervention to 6-month follow-up (P = 0.5446). The psychosocial variables did not significantly change. Conclusions: This lifestyle intervention may be an effective means for improving body mass index in primary school children in the short-term if the duration of the intervention is increased, but these changes may not be sustained without on-going support.
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Affiliation(s)
- Elise C Brown
- Department of Public and Environmental Wellness, Oakland University, Rochester, MI, United States
| | - Duncan S Buchan
- Institute for Clinical Exercise & Health Science, University of the West of Scotland, Hamilton, United Kingdom
| | - Dorin Drignei
- Mathematics-Statistics Department, Oakland University, Rochester, MI, United States
| | - Frank B Wyatt
- Department of Exercise Physiology & Athletic Training, Midwestern State University, Wichita Falls, TX, United States
| | | | - Jonathan Cavana
- Health Improvement Department, National Health Service Lanarkshire, Carluke, United Kingdom
| | - Julien S Baker
- Institute for Clinical Exercise & Health Science, University of the West of Scotland, Hamilton, United Kingdom
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Mihrshahi S, Foley B, Nguyen B, Gander K, Tan N, Hudson N, Hughes C, Hector D, Bauman A. Evaluation of the Cancer Council NSW Eat It To Beat It Healthy Lunch Box Sessions: A short intervention to promote the intake of fruit and vegetables among families of primary school children in NSW Australia. Health Promot J Austr 2017; 30:102-107. [PMID: 30648332 DOI: 10.1002/hpja.23] [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: 06/07/2017] [Accepted: 10/20/2017] [Indexed: 11/07/2022] Open
Abstract
ISSUE ADDRESSED Children and adults in Australia are not eating the recommended amounts of fruits and vegetables. Our objective was to assess the effectiveness of a health promotion intervention to improve fruit and vegetable intake among primary school children and their families in NSW. METHODS The Cancer Council New South Wales Healthy Lunch Box sessions were a 25-minute session delivered to parents of primary school-aged children. The sessions provided information and resources about fruit and vegetables and healthy school lunch boxes. The evaluation is a quantitative uncontrolled pre-post design. Data were collected using three questionnaires, pre-intervention, 1 week post-intervention and 6 months post-intervention. RESULTS A total of 204 parents completed all three evaluation questionnaires to 6 months. Knowledge of recommended intakes and serving sizes of fruit and vegetables improved significantly after the intervention. There was an increase in parents reporting packing vegetables (often/always) in the child's lunch box at 1 week (47%) and 6 months post-intervention (40%) compared to pre-intervention (32%). The proportion of parents reporting that they were confident in packing a healthy lunch box increased from 45% pre-intervention to 62% after the intervention. CONCLUSION The Healthy Lunch Box sessions were effective in improving parental knowledge and practices related to fruit and vegetables and parental confidence with packing a healthy lunch box. SO WHAT?: This short intervention could be a useful component of a portfolio of interventions to support parents with knowledge and resources to pack a healthy lunch box for their children.
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Affiliation(s)
- Seema Mihrshahi
- Prevention Research Collaboration, Sydney Medical School & Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, Sydney Medical School & Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Bridget Foley
- Prevention Research Collaboration, Sydney Medical School & Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Binh Nguyen
- Prevention Research Collaboration, Sydney Medical School & Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Nina Tan
- Cancer Council NSW, Woolloomooloo, NSW, Australia
| | | | - Clare Hughes
- Cancer Council NSW, Woolloomooloo, NSW, Australia
| | | | - Adrian Bauman
- Prevention Research Collaboration, Sydney Medical School & Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
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Rouf AS, Grech A, Allman-Farinelli M. Assessing the efficacy and external validity of interventions promoting calcium or dairy intake in young adults: A systematic review with meta-analysis. Crit Rev Food Sci Nutr 2017; 58:2600-2616. [PMID: 28661721 DOI: 10.1080/10408398.2017.1336508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Calcium and dairy products have a role in the prevention of chronic diseases and attainment of peak bone mass, during adolescence to young adulthood. However, intakes are often suboptimal and interventions to improve consumption of food sources are needed. This systematic review aimed to investigate the efficacy and external validity of interventions promoting calcium or dairy foods among young adults. Eight databases were searched from inception to identify relevant studies. Inclusion criteria included those aged 18 to 35 years in an intervention promoting calcium or dairy food intake. The mean age of the participants was 19.9 ± 1.4 years. Of the 16 studies that met the selection criteria, five studies were included in the meta-analyses for calcium (pooled effect size 0.35, 95% CI 0.04 to 0.67) and three studies for dairy (pooled effect size 0.31, 95% CI 0.11 to 0.50). The quality of the body of evidence was determined using the GRADE system, and was of overall low quality with high risk of bias. Our review suggests young adults respond favorably to interventions but the effect size is small.
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Affiliation(s)
- Anika S Rouf
- a The University of Sydney , School of Life and Environmental Sciences, Charles Perkin Centre , Sydney , NSW 2006 Australia
| | - Amanda Grech
- a The University of Sydney , School of Life and Environmental Sciences, Charles Perkin Centre , Sydney , NSW 2006 Australia
| | - Margaret Allman-Farinelli
- a The University of Sydney , School of Life and Environmental Sciences, Charles Perkin Centre , Sydney , NSW 2006 Australia
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Watson JA, Ensink JHJ, Ramos M, Benelli P, Holdsworth E, Dreibelbis R, Cumming O. Does targeting children with hygiene promotion messages work? The effect of handwashing promotion targeted at children, on diarrhoea, soil-transmitted helminth infections and behaviour change, in low- and middle-income countries. Trop Med Int Health 2017; 22:526-538. [DOI: 10.1111/tmi.12861] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Julie A. Watson
- Department for Disease Control; London School of Hygiene and Tropical Medicine; London UK
| | - Jeroen H. J. Ensink
- Department for Disease Control; London School of Hygiene and Tropical Medicine; London UK
| | | | | | - Elizabeth Holdsworth
- Department of Health Services Research and Policy; London School of Hygiene and Tropical Medicine; London UK
| | - Robert Dreibelbis
- Department for Disease Control; London School of Hygiene and Tropical Medicine; London UK
| | - Oliver Cumming
- Department for Disease Control; London School of Hygiene and Tropical Medicine; London UK
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Lee HA, Hwang HJ, Oh SY, Park EA, Cho SJ, Kim HS, Park H. Which Diet-Related Behaviors in Childhood Influence a Healthier Dietary Pattern? From the Ewha Birth and Growth Cohort. Nutrients 2016; 9:nu9010004. [PMID: 28025537 PMCID: PMC5295048 DOI: 10.3390/nu9010004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/07/2016] [Accepted: 12/15/2016] [Indexed: 01/09/2023] Open
Abstract
This study was performed to examine how childhood dietary patterns change over the short term and which changes in diet-related behaviors influence later changes in individual dietary patterns. Using food frequency questionnaire data obtained from children at 7 and 9 years of age from the Ewha Birth and Growth Cohort, we examined dietary patterns by principal component analysis. We calculated the individual changes in dietary pattern scores. Changes in dietary habits such as eating a variety of food over two years were defined as “increased”, “stable”, or “decreased”. The dietary patterns, termed “healthy intake”, “animal food intake”, and “snack intake”, were similar at 7 and 9 years of age. These patterns explained 32.3% and 39.1% of total variation at the ages of 7 and 9 years, respectively. The tracking coefficient of snack intake had the highest coefficient (γ = 0.53) and that of animal food intake had the lowest (γ = 0.21). Intra-individual stability in dietary habits ranged from 0.23 to 0.47, based on the sex-adjusted weighted kappa values. Of the various behavioral factors, eating breakfast every day was most common in the “stable” group (83.1%), whereas consuming milk or dairy products every day was the least common (49.0%). Moreover, changes in behavior that improved the consumption of milk or dairy products or encouraged the consumption of vegetables with every meal had favorable effects on changes in healthy dietary pattern scores over two years. However, those with worsened habits, such as less food variety and more than two portions of fried or stir-fried food every week, had unfavorable effects on changes in healthy dietary pattern scores. Our results suggest that diet-related behaviors can change, even over a short period, and these changes can affect changes in dietary pattern.
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Affiliation(s)
- Hye Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hyo Jeong Hwang
- Biomaterials Research Institute, Sahmyook University, Seoul 01795, Korea.
| | - Se Young Oh
- Department of Food & Nutrition, Research Center for Human Ecology, College of Human Ecology, Kyung Hee University, Seoul 02447, Korea.
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hae Soon Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul 07985, Korea.
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