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Mixed-method assessment of caregiver feeding practices in early care and education centres during COVID-19. Public Health Nutr 2022; 26:12-22. [PMID: 36345562 PMCID: PMC9744446 DOI: 10.1017/s1368980022002452] [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] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The COVID-19 pandemic changed early care and education (ECE) mealtimes. Feeding practices that support children's emerging autonomy may support children's healthy eating, but it is unknown whether and how COVID-19 changed feeding practices. This paper describes caregiver feeding practices in ECE centres in Florida during COVID-19. DESIGN A mixed-methods design was used to understand mealtime feeding practices. Survey and interview questions were developed based on the Trust Model. More than 7000 surveys were sent to ECE centres. Analysis included descriptive statistics for survey data and thematic analysis for interview data. SETTING This statewide study included teachers in all licensed and license-exempt ECE centres. PARTICIPANTS Four hundred and thirty-one teachers completed a survey, and twenty-nine participated in follow-up interviews. RESULTS Surveys showed most teachers engaged in autonomy-supportive behaviours, such as letting children eat until they were finished (90 %). The most common controlling behaviour was praising children for cleaning their plates (70 %). The most common responses about changes to mealtimes were keeping physical distance and serving healthy food. Interview themes were Autonomy Support, Controlling Feeding Practices, Interactions are the Same, Interactions are Different, Physical Distancing and Healthy Eating. CONCLUSIONS Mealtimes are a central part of the day for young children and teachers in ECE environments. COVID-19 continues to influence ECE routines as behaviour change remains the primary method of reducing the risk of COVID-19 in the absence of a vaccine for young children. Understanding teachers' practices and perspectives is important for reducing the risk of COVID-19 and supporting children's autonomy and healthy eating.
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Farrer Mackie J, Marshall J, Alkon A, Gray H, Himmelgreen D, Kirby RS. Mealtime best practices and infection control in early care and education centres during COVID-19. Child Care Health Dev 2022; 48:990-1000. [PMID: 35102591 DOI: 10.1111/cch.12979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Most young children in the United States attend early care and education (ECE) programmes, where they consume the majority of daily calories. Best practices to support children's healthy eating include teachers sitting together with children, eating the same food, and appropriately supporting children in serving and feeding themselves. To understand how the COVID-19 pandemic changed mealtime practices in ECE, this study (1) describes what adaptations ECE directors and teachers made to mealtimes to include best practices, and (2) identifies common adaptations made to comply with COVID-19 infection control guidelines. METHODS This cross-sectional, mixed-methods study utilized survey and interview questions based on the trust model and social cognitive theory. More than 7000 surveys were distributed to ECE directors and teachers in Florida. Surveys were completed by 759 directors and 431 teachers. Also, 29 follow-up interviews with teachers were completed. Participants were asked to describe their mealtimes before and during COVID-19. Descriptive statistics and frequencies were used to analyse survey data, and thematic analysis was applied to interview data. RESULTS Less than 5% of survey respondents reported children serving themselves, a pre-COVID best practice. Interviews identified three common adaptations: (1) modification-best practices were incorporated into new routines, such as eating together but sitting farther away, (2) elimination-routines changed so that best practices were no longer possible, such as teachers wearing masks and standing during meals, and (3) minimal change-minimal changes due to COVID-19 occurred and consequently mealtime practices did not change. CONCLUSIONS Current recommendations do not allow children to self-serve, which previously was a key best practice. ECE centres that have successfully integrated COVID-19 modifications and maintained mealtime best practices-perhaps in a new form-can serve as examples for others. These findings are generalizable to ECE centres in Florida and could be compared with other states.
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Affiliation(s)
- Joanna Farrer Mackie
- Health Sciences Research Institute, University of California, Merced, California, USA
| | - Jennifer Marshall
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Abbey Alkon
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Heewon Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - David Himmelgreen
- Department of Anthropology, University of South Florida, Tampa, Florida, USA
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, Florida, USA
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Exploring Feeding Practices and Food Literacy in Parents with Young Children from Disadvantaged Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041496. [PMID: 33557440 PMCID: PMC7915516 DOI: 10.3390/ijerph18041496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
Early childhood provides an opportunity to optimize growth and development and parents play a fundamental role in forming healthy eating habits in their children. A healthy diet improves quality of life and wellbeing and reduces the risk of chronic disease. The aim of this research was to explore parents' experiences of feeding 0-5-year-old children and food literacy behaviors. This qualitative study employed a general inductive inquiry approach. Participants were recruited through community-based parenting organizations in disadvantaged areas. Eight focus groups were conducted with 67 parents (92.5% female) living in socially disadvantaged areas within metropolitan Perth of Western Australia. Ten themes emerged from the preliminary analysis and were aligned with domains of relatedness, autonomy, and competence within the self-determination theory. Themes included relatedness (1) feeding is emotional, (2) variations in routine and feeding structures, (3) external influences, autonomy (4) power struggles, (5) it must be quick and easy, (6) lack of strategies for feeding autonomy, competency (7) whatever works, (8) healthy is important but for some unattainable, (9) improvements in food literacy skills, and (10) conflicting information overload. This research informed the development of a food literacy program for parents. Parents faced many challenges when trying to provide healthy food. This research has shown parents would benefit from support to achieve healthy eating practices for their families.
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Prevention of Childhood Obesity: A Position Paper of the Global Federation of International Societies of Paediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN). J Pediatr Gastroenterol Nutr 2020; 70:702-710. [PMID: 32205768 DOI: 10.1097/mpg.0000000000002708] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Global childhood obesity increased more than 8-fold over 40 years, inducing a very large personal, societal, and economic burden. Effects of available treatments are less than satisfactory; therefore, effective prevention is of high priority. In this narrative review, we explore preventive opportunities. The available evidence indicates large benefits of improving nutrition and lifestyle during early life, such as promoting breast-feeding and improving the quality of infant and early childhood feeding. Promoting healthy eating patterns and limiting sugar-containing beverage consumption from early childhood onwards are of great benefit. Regular physical activity and limited sedentary lifestyle and screen time alone have limited effects but are valuable elements in effective multicomponent strategies. The home environment is important, particularly for young children, and can be improved by educating and empowering families. School- and community-based interventions can be effective, such as installing water fountains, improving cafeteria menus, and facilitating regular physical activity. Reducing obesogenic risk factors through societal standards is essential for effective prevention and limiting socioeconomic disparity; these may comprise food, drink, and physical activity standards for day cares and schools, general food quality standards, front-of-pack food labeling, taxation of unhealthy foods, restriction of food advertisements to children, and others. Effective prevention of childhood obesity is not achieved by single interventions but by integrated multicomponent approaches involving multiple stakeholders that address children, families, and societal standards. Pediatricians and their organizations should be proactive in supporting and empowering families to support their children's health, and in promoting societal measures that protect children.
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Chiatto F, Coletta R, Aversano A, Warburton T, Forsythe L, Morabito A. Messy Play Therapy in the Treatment of Food Aversion in a Patient With Intestinal Failure: Our Experience. JPEN J Parenter Enteral Nutr 2018; 43:412-418. [DOI: 10.1002/jpen.1433] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/11/2018] [Indexed: 01/27/2023]
Affiliation(s)
- Fabrizia Chiatto
- Department of Translational Medical Sciences; Section of Paediatrics; University Federico II; Naples Italy
| | - Riccardo Coletta
- Department of Paediatric Surgery; Royal Manchester Children's Hospital; Manchester United Kingdom
- Paediatric Autologous Bowel Reconstruction and Rehabilitation Unit; Royal Manchester Children's Hospital; Manchester United Kingdom
| | | | - Tracy Warburton
- Department of Therapeutic and Specialised Play; Royal Manchester Children's Hospital; Manchester United Kingdom
| | - Lynette Forsythe
- Department of Dietetics and Nutrition; Royal Manchester Children's Hospital; Manchester United Kingdom
| | - Antonino Morabito
- Department of Pediatric Surgery; Meyer Children's Hospital; University of Florence; Florence Italy
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Hopkins J, Cermak SA, Merritt RJ. Oral Feeding Difficulties in Children With Short Bowel Syndrome: A Narrative Review. Nutr Clin Pract 2017; 33:99-106. [DOI: 10.1177/0884533617707493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Judy Hopkins
- Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Sharon A. Cermak
- Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
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Plateau CR, Petrie TA, Papathomas A. Learning to eat again: Intuitive eating practices among retired female collegiate athletes. Eat Disord 2017; 25:92-98. [PMID: 27715475 DOI: 10.1080/10640266.2016.1219185] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present study used an open-ended survey to collect information about current eating practices and coping strategies among 218 retired female athletes. An inductive and deductive thematic analysis revealed three themes relevant to the intuitive eating framework-permission to eat; recognizing internal hunger and satiety cues; and eating to meet physical and nutritional needs. Athletes described feeling liberated with regards to their eating following retirement from sport, and for some this included an alleviation of disordered eating practices. These changes, however, required an effortful process of recalibration, during which athletes had to relearn and reinterpret their body's physiological signals of hunger and satiety. Additional research is needed to understand just how this process unfolds and how retired athletes can be supported in developing a healthier and more adaptive approach to eating.
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Affiliation(s)
- Carolyn R Plateau
- a National Centre for Sport and Exercise Medicine , Loughborough University , Loughborough , UK
| | - Trent A Petrie
- b Department of Psychology , University of North Texas , Denton , Texas , USA
| | - Anthony Papathomas
- a National Centre for Sport and Exercise Medicine , Loughborough University , Loughborough , UK
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Tylka TL, Lumeng JC, Eneli IU. Maternal intuitive eating as a moderator of the association between concern about child weight and restrictive child feeding. Appetite 2015. [PMID: 26145275 DOI: 10.1016/j.appet.2015.06.023.maternal] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
Abstract
Mothers who are concerned about their young child's weight are more likely to use restrictive feeding, which has been associated with increased food seeking behaviors, emotional eating, and overeating in young children across multiple prospective and experimental studies. In the present study, we examined whether mothers' intuitive eating behaviors would moderate the association between their concern about their child's weight and their use of restrictive feeding. In a sample of 180 mothers of young children, two maternal intuitive eating behaviors (i.e., eating for physical reasons, trust in hunger and satiety cues) moderated this association after controlling for maternal age, body mass index, years of education, race/ethnicity, awareness of hunger and satiety cues and perceptions of child weight. More specifically, concern about child weight was unrelated to restrictive feeding for mothers with higher levels of eating for physical reasons and trust in hunger and satiety cues. However, concern about child weight was positively related to restrictive feeding among mothers with lower or average levels of eating for physical reasons and trust in hunger and satiety cues. These findings indicate that it may be important address maternal intuitive eating within interventions designed to improve self-regulated eating in children, as mothers who attend these interventions tend to be highly concerned about their child's weight and, if also low in intuitive eating, may be at risk for using restrictive feeding behaviors that interfere with children's self-regulated eating.
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Affiliation(s)
- Tracy L Tylka
- Department of Psychology, Ohio State University, 225 Psychology Building, Columbus, OH 43210, USA.
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109, USA; Department of Pediatrics, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA; Human Nutrition Program, Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 1700 SPHI, Ann Arbor, MI 48109, USA.
| | - Ihuoma U Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, Ohio State University, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
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Tylka TL, Lumeng JC, Eneli IU. Maternal intuitive eating as a moderator of the association between concern about child weight and restrictive child feeding. Appetite 2015; 95:158-65. [PMID: 26145275 DOI: 10.1016/j.appet.2015.06.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/23/2015] [Accepted: 06/29/2015] [Indexed: 11/29/2022]
Abstract
Mothers who are concerned about their young child's weight are more likely to use restrictive feeding, which has been associated with increased food seeking behaviors, emotional eating, and overeating in young children across multiple prospective and experimental studies. In the present study, we examined whether mothers' intuitive eating behaviors would moderate the association between their concern about their child's weight and their use of restrictive feeding. In a sample of 180 mothers of young children, two maternal intuitive eating behaviors (i.e., eating for physical reasons, trust in hunger and satiety cues) moderated this association after controlling for maternal age, body mass index, years of education, race/ethnicity, awareness of hunger and satiety cues and perceptions of child weight. More specifically, concern about child weight was unrelated to restrictive feeding for mothers with higher levels of eating for physical reasons and trust in hunger and satiety cues. However, concern about child weight was positively related to restrictive feeding among mothers with lower or average levels of eating for physical reasons and trust in hunger and satiety cues. These findings indicate that it may be important address maternal intuitive eating within interventions designed to improve self-regulated eating in children, as mothers who attend these interventions tend to be highly concerned about their child's weight and, if also low in intuitive eating, may be at risk for using restrictive feeding behaviors that interfere with children's self-regulated eating.
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Affiliation(s)
- Tracy L Tylka
- Department of Psychology, Ohio State University, 225 Psychology Building, Columbus, OH 43210, USA.
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109, USA; Department of Pediatrics, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA; Human Nutrition Program, Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 1700 SPHI, Ann Arbor, MI 48109, USA.
| | - Ihuoma U Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA; Department of Pediatrics, Ohio State University, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
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