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Masztalerz-Kozubek D, Zielinska-Pukos MA, Plichta M, Hamulka J. The influence of early and current feeding practices, eating behaviors, and screen time on dietary patterns in Polish toddlers - A cross-sectional study. Appetite 2024; 201:107580. [PMID: 38936700 DOI: 10.1016/j.appet.2024.107580] [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: 11/09/2023] [Revised: 06/21/2024] [Accepted: 06/24/2024] [Indexed: 06/29/2024]
Abstract
Early nutrition has an important influence on a child's proper health and development, and understanding factors that may be related to desirable dietary patterns is key to improving the diet of future generations. The aim of this study was to assess whether early and current feeding practices, eating behaviors, and screen time viewing are associated with toddlers' dietary patterns. A cross-sectional sample of 467 mothers of toddlers (aged 1 year to 3) was surveyed between 2020 and 2022. Food consumption was evaluated by the Food Frequency Questionnaire (FFQ). The k-means algorithm was used to define dietary patterns on the basis of data collected from the FFQ and mealtime environment patterns, based on the data about practices during meals consumption. The odds of following a prohealth dietary pattern among early feeding factors were lower when infants ate commercial complementary foods more often. Distracted mealtime environment pattern increased the odds of following a non-eaters pattern, and commercial complementary foods pattern increased the odds of following a processed pattern. Currently, the odds of following a processed dietary pattern were higher when children were not breastfed and had higher screen time. Toddlers who ate during distraction and were more fussy had lower odds of following a prohealth dietary pattern, whereas higher enjoyment of food and satiety responsiveness increased the odds. The results indicate the need to increase parents' awareness about the importance of early factors in establishing dietary patterns.
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Affiliation(s)
- Daria Masztalerz-Kozubek
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Monika A Zielinska-Pukos
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Marta Plichta
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland.
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Hodder RK, O'Brien KM, Wyse RJ, Tzelepis F, Yoong S, Stacey FG, Wolfenden L. Interventions for increasing fruit and vegetable consumption in children aged five years and under. Cochrane Database Syst Rev 2024; 9:CD008552. [PMID: 39312396 PMCID: PMC11418976 DOI: 10.1002/14651858.cd008552.pub8] [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] [Indexed: 09/25/2024]
Abstract
BACKGROUND Insufficient consumption of fruits and vegetables in childhood increases the risk of future non-communicable diseases, including cardiovascular disease. Testing the effects of interventions designed to increase children's consumption of fruit and vegetables, including those focused on specific child-feeding strategies or broader multicomponent interventions targeting the home or childcare environment, is required to assess the potential to reduce this disease burden. OBJECTIVES To assess the benefits and harms of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and two clinical trials registries to identify eligible trials on 25 March 2023. We searched Proquest Dissertations and Theses in December 2022. We reviewed reference lists of included trials and contacted authors of the included trials to identify further potentially relevant trials. SELECTION CRITERIA We included randomised controlled trials (RCTs), including cluster-randomised controlled trials (C-RCTs) and cross-over trials, of any intervention primarily targeting consumption of fruit, vegetables or both amongst children aged five years and under compared to no-intervention control, and incorporating a dietary or biochemical assessment of fruit or vegetable consumption. Two review authors independently screened titles and abstracts of identified papers; a third review author resolved disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risks of bias of included trials; a third review author resolved disagreements. We used random-effects models in meta-analyses for the primary review outcomes where we identified sufficient trials. We calculated standardised mean differences (SMDs) to account for the heterogeneity of fruit and vegetable consumption measures. We conducted assessments of risks of bias and evaluated the certainty of evidence (GRADE approach) using Cochrane procedures. MAIN RESULTS We included 53 trials with 120 trial arms and 12,350 participants. Sixteen trials examined the impact of child-feeding practice interventions only (e.g. repeated food exposure) in increasing child vegetable intake. Twenty trials examined the impact of multicomponent interventions primarily conducted in the childcare setting (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. Seventeen trials examined the impact of parent nutrition education only in increasing child fruit and vegetable intake. Two trials examined the effect of a nutrition education intervention delivered to children only in increasing child fruit and vegetable intake and one each examined a child-focused mindfulness intervention or providing families with fruit and vegetable interventions. We judged nine of the 53 included trials as free from high risks of bias across all domains. Performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining trials. There is moderate-certainty evidence that child-feeding practice interventions versus no-intervention control probably have a small positive effect on child vegetable consumption, equivalent to an increase of 15.5 grams as-desired consumption of vegetables (SMD 0.44, 95% confidence interval (CI) 0.24 to 0.65; 15 trials, 1976 participants; mean post-intervention follow-up = 12.3 weeks). No trials in this comparison reported information about intervention costs. One trial reported no harms or serious unintended adverse consequences (low-certainty evidence). Multicomponent interventions versus no-intervention control probably have a small effect on child consumption of fruit and vegetables (SMD 0.27, 95% CI 0.11 to 0.43; 14 trials, 4318 participants; moderate-certainty evidence; mean post-intervention follow-up = 4.0 weeks), equivalent to an increase of 0.34 cups of fruit and vegetables a day. One trial, which tested a multicomponent garden-based intervention, reported the installation of the garden as part of the intervention to be USD 1500 per childcare centre (low-certainty evidence). No trials in this comparison reported information about unintended adverse consequences of interventions. Parent nutrition education interventions may have little to no short-term impact on child consumption of fruit and vegetables versus no-intervention control (SMD 0.10, 95% CI -0.02 to 0.22; 14 trials, 4122 participants; low-certainty evidence; mean post-intervention follow-up = 6.4 weeks). One trial reported the total estimated cost of delivering a parent nutrition education intervention for infant feeding, physical activity and sedentary behaviours delivered by a dietitian as approximately AUD 500 per family (low-certainty evidence). One trial reported no unintended adverse consequences on family food expenditure following implementation of an intervention delivered over the telephone to improve parental knowledge and skills about the home food environment (low-certainty evidence). Trials reported receiving governmental or charitable funds, except for one trial reporting industry funding. AUTHORS' CONCLUSIONS There was moderate-certainty evidence that child-feeding practice interventions and multicomponent interventions probably lead to only small increases in fruit and vegetable consumption in children aged five years and under. Parent nutrition education interventions may have little or no effect on increasing fruit and vegetable consumption in children aged five years and under. Future research should be prioritised on assessment and reporting of both intervention cost and adverse effects, and development and evaluation of interventions in research gaps, including in a broader range of settings and in low- and middle-income countries. This review continues to be maintained as a living systematic review with monthly searches for new evidence and incorporation of relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.
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Affiliation(s)
- Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Kate M O'Brien
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Rebecca J Wyse
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
| | - Serene Yoong
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
- Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, Deakin University, Melbourne, Australia
| | - Fiona G Stacey
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
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de Gooijer FJ, Lasschuijt M, van der Heijden ZS, de Wild VWT, Brouwer-Brolsma EM, Feskens EJM, Camps G. "Miffy eats the rainbow!" - A colorful modeling- and reward-based intervention to increase willingness to taste fruit and vegetables in 3-7-year-old children. Appetite 2024; 203:107654. [PMID: 39218038 DOI: 10.1016/j.appet.2024.107654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 08/23/2024] [Accepted: 08/29/2024] [Indexed: 09/04/2024]
Abstract
Diets rich in fruit and vegetables (F&Vs) improve cognitive functioning and reduce the risk of non-communicable diseases in children. Nevertheless, 59% of Dutch children do not meet recommended intake levels. Given the importance of color in children's food choices, the concept of "eat the rainbow" presents a promising approach. This project aimed to evaluate the effects of a modeling- and reward-based intervention to stimulate the consumption of colorful foods to increase willingness to taste different F&Vs among children aged 3-7 years. 164 children from Dutch elementary schools participated in a nested cluster randomized multi-arm parallel design study. During two morning school breaks, children were invited to choose from ten F&Vs in five different colors. Their willingness to taste and ad libitum intake were recorded. The first session served as a baseline with no intervention, while the second session involved either the Miffy intervention (modeling- and reward-based), a reward-only intervention (reward-based), or a control session. In the Miffy intervention, children listened to a story about Miffy eating the rainbow before tasting F&Vs and they received colored stickers (e.g., red sticker for tomatoes, green sticker for celery) upon tasting them. In the reward-only intervention, children received a sticker upon tasting a food. The Miffy group showed a higher probability (P(tasted) = 0.39) of tasting a food product compared to the control group (P(tasted) = 0.29; OR = 0.63, p = .04). No significant differences were observed between the Miffy and reward-only groups or between the reward-only and control groups. Both interventions did not significantly impact intake or liking of the foods. The Miffy-themed intervention demonstrates potential to enhance children's willingness to taste F&Vs, primarily due to the use of non-food incentives.
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Affiliation(s)
- Femke J de Gooijer
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, the Netherlands; OnePlanet Research Centre, Bronland 10, 6708 WE Wageningen, the Netherlands.
| | - Marlou Lasschuijt
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, the Netherlands.
| | - Zoë S van der Heijden
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, the Netherlands.
| | - Victoire W T de Wild
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, the Netherlands.
| | - Elske M Brouwer-Brolsma
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, the Netherlands.
| | - Edith J M Feskens
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, the Netherlands.
| | - Guido Camps
- Division of Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, the Netherlands; OnePlanet Research Centre, Bronland 10, 6708 WE Wageningen, the Netherlands.
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Achak D, Azizi A, El-Ammari A, Marfak IY, Saad E, Nejjari C, Hilali A, Peltzer K, Marfak A. The health behaviors differences among male and female school-age adolescents in the Middle East and North Africa region countries: a meta-analysis of the Global School-based Student Health Survey data. Front Public Health 2024; 12:1448386. [PMID: 39253282 PMCID: PMC11381380 DOI: 10.3389/fpubh.2024.1448386] [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: 06/13/2024] [Accepted: 08/06/2024] [Indexed: 09/11/2024] Open
Abstract
Background Understanding gender disparities in adolescent health behaviors is crucial for developing targeted health promotion strategies. This study uses data from the Global School-based Student Health Survey (GSHS) across 17 MENA countries to analyze gender differences in adolescent health behaviors, aiming to provide a comprehensive overview for both boys and girls. Methods This meta-analysis incorporates data from recent years of the GSHS, covering 17 MENA countries. The objective was to assess and compare health behaviors between adolescent girls and boys. A random-effects model was employed to calculate odds ratios for gender comparisons in these behaviors. Statistical analyses and modeling were performed using JAMOVI software. Results In most MENA countries, boys consumed more vegetables compared to girls. Girls were less likely to frequent fast food establishments (OR = 0.82, 95% CI: 0.69-0.98) and generally exhibited better self-care behaviors. Boys reported a higher prevalence of physical altercations (OR = 2.18, 95% CI: 1.88-2.51) and were more involved in fights (OR = 3.00, 95% CI: 2.46-3.67). Girls were more likely to miss school without permission and were consistently described as kinder and more helpful across various income levels. However, in some countries such as Oman and Tunisia, boys missed school more frequently. There were no significant gender differences in parental oversight of homework or knowledge of students' activities, but girls were reported to have stronger parental relationships and better parental understanding of their problems and free time, with exceptions in Morocco and the Palestinian Territory-Gaza. Boys were more likely to engage in smoking (OR = 3.57, 95% CI: 2.69-4.76) and other substance use. Conversely, girls reported higher levels of physical inactivity and loneliness, but also demonstrated greater kindness and helpfulness in school settings and stronger parental relationships. Conclusion Policymakers in the MENA region should develop and implement gender-specific interventions targeting key areas such as hygiene practices, physical activity, and substance use. By focusing on these targeted strategies, they can address the distinct health behaviors and needs of both boys and girls. Effective interventions in these areas are crucial for improving overall health outcomes and promoting healthier lifestyles, thereby enhancing adolescent health and well-being across the region.
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Affiliation(s)
- Doha Achak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
- Research, Development and Innovation Laboratory, Mundiapolis University, Casablanca, Morocco
| | - Asmaa Azizi
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Abdelghaffar El-Ammari
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
- National School of Public Health (Morocco), Rabat, Morocco
| | - Ibtissam Youlyouz Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Elmadani Saad
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Chakib Nejjari
- Euromed Research Center, Euromed University of Fes, Fes, Morocco
- Faculty of Medicine, Pharmacy, and Dentistry, Sidi Mohamed Ben Abdellah University, Fes, Morocco
| | - Abderraouf Hilali
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Karl Peltzer
- University of the Free State, Bloemfontein, South Africa
- College of Medical and Health Science, Asia University, Taichung, Taiwan
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Vonk L, Eekhout I, Huijts T, Levels M, Jansen M. School Health Promotion, the Body Mass Index z-Score, and Psychosocial Health in Primary Schools of the Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1073. [PMID: 39200682 PMCID: PMC11353774 DOI: 10.3390/ijerph21081073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/09/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024]
Abstract
Childhood overweight and psychosocial issues remain significant public health concerns. Schools worldwide implement health promotion programs to address these issues and to support the physical and psychosocial health of children. However, more insight is needed into the relation between these health-promoting programs and the Body Mass Index (BMI) z-score and psychosocial health of children, while taking into account how school factors might influence this relation. Therefore, we examined whether the variation between primary schools regarding the BMI z-score and psychosocial health of students could be explained by school health promotion, operationalized as Healthy School (HS) certification, general school characteristics, and the school population; we also examined to what extent the characteristics interact. The current study had a repeated cross-sectional design. Multilevel analyses were performed to calculate the variation between schools, and to examine the association between HS certification and our outcomes. Existing data of multiple school years on 1698 schools were used for the BMI z-score and on 841 schools for psychosocial health. The school level explained 2.41% of the variation in the BMI z-score and 2.45% of the variation in psychosocial health, and differences were mostly explained by parental socioeconomic status. Additionally, HS certification was associated with slightly lower BMI z-scores, but not with psychosocial health. Therefore, obtaining HS certification might contribute to the better physical health of primary school students in general. This might indicate that HS certification also relates to healthier lifestyles in primary schools, but further research should examine this.
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Affiliation(s)
- Lisanne Vonk
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
| | - Iris Eekhout
- Expertise Center Child Health, Netherlands Organisation for Applied Scientific Research (TNO), P.O. Box 3005, 2301 DA Leiden, The Netherlands;
| | - Tim Huijts
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (T.H.); (M.L.)
| | - Mark Levels
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; (T.H.); (M.L.)
| | - Maria Jansen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, P.O. Box 33, 6400 AA Heerlen, The Netherlands
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Mumena WA, Kutbi HA. Fruit and vegetable consumption among children in Saudi Arabia: Predictors and associations with dietary intake. J Hum Nutr Diet 2024. [PMID: 38865290 DOI: 10.1111/jhn.13339] [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: 01/08/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Data exploring factors related to the consumption of fruits and vegetables (F&V) among children in Saudi Arabia are lacking. The present study aimed to evaluate F&V consumption among Saudi children. Predictors of F&V intake and associations with dietary intake were also explored. METHODS Cross-sectional data of 424 Saudi children (6-12 years) were collected from their mothers using an online survey. Phone interviews were conducted with mothers and children to provide data on dietary intake of children. RESULTS Most children included in the study (92.2%, n = 391) consumed less than five servings of F&V per day. Region of residency (B = -0.14, SE = 0.06, 95% confidence interval [CI] = -0.25 to -0.02, p = 0.019), paternal education level (B = 0.52, SE = 0.14, 95% CI = 0.24-0.79, p < 0.001) and family monthly income (B = 0.15, SE = 0.07, 95% CI = 0.01-0.29, p = 0.034) predicted the intake of F&V. Food neophobia and food pickiness also predicted the intake of F&V (B = -0.16, SE = 0.06, 95% CI = -0.27 to -0.05, p = 0.005 and B = -0.24, SE = 0.06, 95% CI = -0.36 to -0.12, p < 0.001, respectively). Children's intake of F&V positively predicted the intake of fibre, potassium, phosphorus, magnesium, iodine and vitamin C. CONCLUSIONS Limited intake of F&V was observed among Saudi children. F&V consumption was found to be associated with a number of sociodemographic factors, including region of residency, paternal education level and family income, as well as children's food neophobia and pickiness. Children's intake of F&V predicted higher intake of fibre, potassium, phosphorus, magnesium, iodine and vitamin C, suggesting that F&V consumption may contribute to improved intake of key nutrients in children.
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Affiliation(s)
- Walaa Abdullah Mumena
- Clinical Nutrition Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia
| | - Hebah Alawi Kutbi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Nordström M, Carlsson P, Ericson D, Hedenbjörk-Lager A, Jansson H, Wolf E, Hänsel Petersson G. Some young adults can maintain good oral health despite socioeconomic challenges. Eur J Oral Sci 2024; 132:e12985. [PMID: 38520668 DOI: 10.1111/eos.12985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/03/2024] [Indexed: 03/25/2024]
Abstract
The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19-23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was 'Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health', comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.
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Affiliation(s)
| | | | - Dan Ericson
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | | | - Eva Wolf
- Faculty of Odontology, Malmö University, Malmö, Sweden
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Vonk L, Eekhout I, Huijts T, Levels M, Jansen MWJ. School health promotion and fruit and vegetable consumption in secondary schools: a repeated cross-sectional multilevel study. BMC Public Health 2024; 24:1098. [PMID: 38644493 PMCID: PMC11034157 DOI: 10.1186/s12889-024-18546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/08/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Worldwide, recommendations for fruit and vegetable consumption are not met, which can cause chronic diseases. Especially adolescence is an important phase for the development of health behaviours. Therefore, in the Netherlands, the Healthy School program was established to aid schools in promoting healthy lifestyles among their students. We examined to what extent the variation between secondary schools regarding students' fruit and vegetable consumption could be explained by differences between schools regarding Healthy School certification, general school characteristics, and the school population. Additionally, we examined whether Healthy School certification was related to the outcomes, and whether the association differed for subgroups. METHODS We performed a repeated cross-sectional multilevel study. We used data from multiple school years from the national Youth Health Monitor on secondary schools (grades 2 and 4, age ranged from approximately 12 to 18 years) of seven Public Health Services, and added data with regard to Healthy School certification, general school characteristics and school population characteristics. We included two outcomes: the number of days a student consumed fruit and vegetables per week. In total, we analysed data on 168,127 students from 256 secondary schools in the Netherlands. RESULTS Results indicated that 2.87% of the variation in fruit consumption and 5.57% of the variation in vegetable consumption could be attributed to differences at the school-level. Characteristics related to high parental educational attainment, household income, and educational track of the students explained most of the variance between schools. Additionally, we found a small favourable association between Healthy School certification and the number of days secondary school students consumed fruit and vegetables. CONCLUSIONS School population characteristics explained more variation between schools than Healthy School certification and general school characteristics, especially indicators of parental socioeconomic status. Nevertheless, Healthy School certification seemed to be slightly related to fruit and vegetable consumption, and might contribute to healthier dietary intake. We found small differences for some subgroups, but future research should focus on the impact in different school contexts, since we were restricted in the characteristics that could be included in this study.
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Affiliation(s)
- Lisanne Vonk
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, 6400 AA, Heerlen, P.O. Box 33, the Netherlands.
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD, Maastricht, P.O. Box 616, the Netherlands.
| | - Iris Eekhout
- Expertise Center Child Health, Netherlands Organisation for Applied Scientific Research (TNO), 2301 DA, Leiden, P.O. Box 3005, the Netherlands
| | - Tim Huijts
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Mark Levels
- Research Centre for Education and the Labour Market (ROA), School of Business and Economics, Maastricht University, Postbus 616, 6200 MD, Maastricht, the Netherlands
| | - Maria W J Jansen
- Academic Collaborative Center for Public Health Limburg, Public Health Service South Limburg, 6400 AA, Heerlen, P.O. Box 33, the Netherlands
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD, Maastricht, P.O. Box 616, the Netherlands
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Kelly NR, Doty KJ, Guidinger C, Folger A, Luther GM, Giuliani NR. Social desirability bias is related to children's energy intake in a laboratory test meal paradigm. Appetite 2024; 195:107235. [PMID: 38296111 PMCID: PMC10922645 DOI: 10.1016/j.appet.2024.107235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
Dietary intake is notoriously difficult to measure in children. Laboratory test meals address some of the methodological concerns of self-report methods, but may also be susceptible to social desirability bias, referring to the tendency for individuals to adjust their behaviors in order to be perceived more positively. The aim of the current study was to evaluate whether social desirability bias was associated with children's energy intake during a laboratory test meal, and whether this association varied by food type (total caloric intake, snack food intake, fruit/vegetable intake) and sex. A total of 82 children (M age = 9.45 ± 0.85; 50 % girls; 84.1 % rural; 85.4 % White) completed several surveys, including the Children's Social Desirability Scale and had their body composition measured. At lunchtime, they were granted access to a multi-array test meal (>5000 kcal). After adjusting for lean mass, fat mass, depressive symptoms, and parental food restriction, children who reported higher social desirability bias consumed fewer calories from snack foods (B = -11.58, p = .009, semi-partial correlation = -0.28). Boys with higher social desirability bias consumed less calories from fruits and vegetables (B = -6.47, p = .010, semi-partial correlation = -0.411); this association was not significant in girls. The desire to be perceived in a positive manner may influence children's eating behaviors in experimental paradigms. Replication studies with larger, more diverse pediatric samples are needed, as are strategies to reduce the effects of social desirability bias on test meal intake in order to enhance the validity of this dietary assessment approach.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR, United States; The Prevention Science Institute, University of Oregon, 6217 University of Oregon, Eugene, OR, United States.
| | - Kelly Jean Doty
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR, United States; The Prevention Science Institute, University of Oregon, 6217 University of Oregon, Eugene, OR, United States
| | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR, United States; The Prevention Science Institute, University of Oregon, 6217 University of Oregon, Eugene, OR, United States
| | - Austin Folger
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR, United States; The Prevention Science Institute, University of Oregon, 6217 University of Oregon, Eugene, OR, United States
| | - Gabriella M Luther
- Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR, United States; The Prevention Science Institute, University of Oregon, 6217 University of Oregon, Eugene, OR, United States
| | - Nicole R Giuliani
- The Prevention Science Institute, University of Oregon, 6217 University of Oregon, Eugene, OR, United States; Special Education and Clinical Sciences, University of Oregon, 1215 University of Oregon, Eugene, OR, United States
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10
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Noiman A, Lee SH, Marks KJ, Grap ME, Dooyema C, Hamner HC. Factors Associated with Daily Fruit and Vegetable Intakes among Children Aged 1-5 Years in the United States. Nutrients 2024; 16:751. [PMID: 38474879 DOI: 10.3390/nu16050751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
To describe child, caregiver, and household characteristics associated with fruit and vegetable intakes among US children aged 1-5 years, we examined fruit and vegetable intakes (less than daily vs. daily) using data from the 2021 National Survey of Children's Health among children aged 1-5 years. Multiple logistic regression provided adjusted odds ratios for factors associated with (1) daily fruit and (2) daily vegetable intakes. Among children aged 1-5 years, 68% (n = 11,124) consumed fruit daily, and 51% (n = 8292) consumed vegetables daily. Both daily fruit and daily vegetable intake were associated with child age, child race and ethnicity, and frequency of family meals. For example, children who ate a family meal 4-6 days/week (aOR 0.69; 95% CI 0.57, 0.83) or 0-3 days/week (aOR 0.57; 95% CI 0.46, 0.72) were less likely to consume fruit daily compared to children who had a family meal every day. Participation in food assistance programs, food insufficiency, and household income were not significantly associated with odds of daily fruit or daily vegetable intake in the adjusted models. Several factors were associated with daily fruit and vegetable intake among children aged 1-5. Strategies aimed at increasing fruit and vegetable consumption in early childhood may consider these child, caregiver, and household characteristics. Pediatric healthcare providers, early childhood education centers, and families of young children may be important partners in this work.
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Affiliation(s)
- Adi Noiman
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Seung Hee Lee
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Kristin J Marks
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
- US Public Health Service Commissioned Corps, Rockville, MD 20852, USA
| | - Mary Ellen Grap
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830, USA
| | - Carrie Dooyema
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Heather C Hamner
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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11
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Raudeniece J, Vanags E, Justamente I, Skara D, Fredriksen PM, Brownlee I, Reihmane D. Relations between the levels of moderate to vigorous physical activity, BMI, dietary habits, cognitive functions and attention problems in 8 to 9 years old pupils: network analysis (PACH Study). BMC Public Health 2024; 24:544. [PMID: 38383413 PMCID: PMC10882845 DOI: 10.1186/s12889-024-18055-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Physical activity (PA) and dietary habits (DH) play a crucial role on quality of life and health outcomes from various aspects. METHODS This study aims to investigate the relations between recommended daily levels of moderate to vigorous physical activity (MVPA) in 8 to 9 year old pupils, and their body mass index (BMI), DH, cognitive functions and attention problem scores by network analysis. Study participants were split into two groups based on their MVPA levels on weekdays. RESULTS Our findings suggest that children who reach recommended MVPA levels consume more vegetables and fruits, eat breakfast more frequently, have better motor speed and lower impulsivity score. CONCLUSIONS The number of interlinkages between various parameters in network structure for children who do not reach recommended MVPA levels is greater and more intense, highlighting the differences between the groups and suggesting that different interventions and approaches to improve/change lifestyle habits might be used.
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Affiliation(s)
- Jelena Raudeniece
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
- Department of Human Physiology and Biochemistry, Riga Stradiņš University, Dzirciema Street 16, Riga, LV-1007, Latvia
| | - Edmunds Vanags
- Department of Psychology, Faculty of Education, Psychology and Art, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
| | - Ilze Justamente
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
- Department of Human Physiology and Biochemistry, Riga Stradiņš University, Dzirciema Street 16, Riga, LV-1007, Latvia
| | - Dana Skara
- Department of Psychology, Faculty of Education, Psychology and Art, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia
| | - Per Morten Fredriksen
- Department of Biotechology, Faculty of Applied Ecology, Agricultural Sciences and Biotechnology, Inland Norway University of Applied Sciences, 2318, Hamar, Norway
| | - Iain Brownlee
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Dace Reihmane
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas Street 1, Riga, LV-1004, Latvia.
- Department of Human Physiology and Biochemistry, Riga Stradiņš University, Dzirciema Street 16, Riga, LV-1007, Latvia.
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12
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Acosta ME, Sanchez-Vaznaugh EV, Matsuzaki M, Barba N, Sánchez BN. Temporal Patterns in Fruit and Vegetable Intake Among Racially and Ethnically Diverse Children and Adolescents in California. Prev Chronic Dis 2024; 21:E09. [PMID: 38329921 PMCID: PMC10870998 DOI: 10.5888/pcd21.230162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Introduction Childhood dietary behaviors, including fruit and vegetable intake, are associated with adult health. Most children do not meet daily recommended servings of fruits and vegetables. Less is known about temporal patterns in fruit and vegetable consumption or if they vary by race and ethnicity. We investigated temporal patterns in fruit and vegetable intake among California school-age children and adolescents overall and by race and ethnicity. Methods We used 2-year cross-sectional datasets from the child and adolescent samples in the California Health Interview Surveys from 2011-2012 through 2019-2020 and modified Poisson regression models to estimate the likelihood of consuming 5 or more servings of fruits and vegetables in 2013-2016 and 2017-2020 compared with 2011-2012. Models controlled for age, race and ethnicity, gender, citizenship status, family income, and adult education and tested for differences by race and ethnicity. The samples included 16,125 children aged 5 to 11 years and 9,672 adolescents aged 12 to 17 years. Results Overall, 29.3% of children and 25.9% of adolescents reported intake of 5 or more fruits and vegetables per day. Among children, adjusted prevalence ratios (PR) of fruit and vegetable intake were higher in 2013-2016 (PR,1.25; 95% CI, 1.11-1.42) and 2017-2020 (PR,1.13; 95% CI, 0.99-1.30) compared with 2011-2012. Among adolescents, the adjusted prevalence did not differ significantly over time. We found no evidence of differential associations by race and ethnicity for children and adolescents. Conclusion We found favorable temporal changes in fruit and vegetable consumption among children, but not among adolescents. Monitoring temporal patterns in fruit and vegetable intake remains critical for planning population-level interventions to increase consumption.
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Affiliation(s)
- Maria Elena Acosta
- Department of Public Health, San Francisco State University, San Francisco, California
| | - Emma V Sanchez-Vaznaugh
- Department of Public Health, San Francisco State University, San Francisco, California
- College of Health & Social Sciences, Department of Public Health, 1600 Holloway Ave, San Francisco CA 94132
| | - Mika Matsuzaki
- Department of International Health, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland
| | - Nancy Barba
- Department of Public Health, San Francisco State University, San Francisco, California
| | - Brisa N Sánchez
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania
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13
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Garr K, Mendoza A, Mazzeo SE, Raynor HA, de Jonge L, Tatum KL, Moore B, Bean MK. School Nutrition Personnel Perceptions of School Salad Bars before and after COVID-19. Nutrients 2024; 16:488. [PMID: 38398812 PMCID: PMC10892901 DOI: 10.3390/nu16040488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Many schools have salad bars as a means to increase students' fruit and vegetable intake. School nutrition programs experienced drastic changes to the school food environment due to COVID-19. The aim of the current study was to understand cafeteria personnel's experiences related to salad bar implementation before the COVID-19 pandemic and in the current school environment to inform efforts to enhance salad bar sustainability. Seven elementary schools (N = 30 personnel) installed salad bars prior to COVID-19; three of these schools (n = 13 personnel) re-opened salad bars after COVID-19. Cafeteria personnel completed surveys assessing their experiences with salad bars at both time points. Satisfaction with salad bar implementation and training was high pre- and post-COVID-19. Most agreed that salad bars increased students' fruit and vegetable intake, yet had concerns about cleanliness and waste. Perceived job difficulty increased post-COVID-19 (p = 0.01), and satisfaction with student salad bar training decreased (p = 0.001). Additional staff support and greater student training were needed post-COVID-19. Overall, salad bars were viewed favorably; however, more challenges and lower satisfaction were reported following COVID-19. Increasing support for cafeteria personnel is needed for salad bar sustainability and improving the school food environment.
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Affiliation(s)
- Katlyn Garr
- Department of Pediatrics, School of Medicine, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23229, USA
| | - Ashley Mendoza
- Department of Pediatrics, School of Medicine, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23229, USA
| | - Suzanne E. Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Hollie A. Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN 37996, USA;
| | - Lilian de Jonge
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA;
| | - Kristina L. Tatum
- Department of Pediatrics, School of Medicine, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23229, USA
| | | | - Melanie K. Bean
- Department of Pediatrics, School of Medicine, Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond, VA 23229, USA
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14
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Daas MC, Gebremariam MK, Poelman MP, Andersen LF, Klepp KI, Bjelland M, Lien N. Mediators and moderators of the effects of a school-based intervention on adolescents' fruit and vegetable consumption: the HEIA study. Public Health Nutr 2024; 27:e50. [PMID: 38269621 PMCID: PMC10882531 DOI: 10.1017/s1368980024000260] [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] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To examine whether targeted determinants mediated the effects of the HEalth In Adolescents (HEIA) intervention on fruit and vegetable (FV) consumption and explore if these mediating effects were moderated by sex, parental education or weight status. DESIGN Cluster-randomised controlled trial. SETTING The HEIA study (2007-2009) was a Norwegian 20-month multi-component school-based intervention to promote healthy weight development. FV consumption and targeted determinants were self-reported at baseline, mid-way (8 months) and post-intervention (20 months). PARTICIPANTS Adolescents (11-13-year-old) in twenty-five control schools (n 746) and twelve intervention schools (n 375). RESULTS At post-intervention, more adolescents in the intervention group compared with the control group had knowledge of the FV recommendations (OR: 1·4, 95 % CI 1·1, 1·9) and reported a decreased availability of vegetables at home (β: -0·1, 95 % CI -0·2, 0·0). Availability/accessibility of FV at home, availability of vegetables at dinner, taste preferences for different types of FV and knowledge of the FV recommendations were positively associated with the consumption of FV. However, none of the post-intervention determinants significantly mediated the intervention effects on FV consumption. Although no moderating influences by sex, parental education or weights status were observed on the mediating effects, exploratory analyses revealed significant moderations in the b-paths. CONCLUSIONS Since none of the targeted determinants could explain the increase in FV consumption, it remains unclear why the intervention was effective. Reporting on a wide range of mediators and moderators in school-based interventions is needed to reveal the pathways through which intervention effects are achieved.
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Affiliation(s)
- Merel Celine Daas
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo0317, Norway
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen6700 AA, The Netherlands
| | - Mekdes Kebede Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo0318, Norway
| | - Maartje P Poelman
- Department of Social Sciences, Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen6700 EW, The Netherlands
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo0317, Norway
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo0213, Norway
| | - Mona Bjelland
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo0317, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo0317, Norway
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15
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Norman J, Furber S, Bauman A, Okely AD. The feasibility, acceptability and potential efficacy of a parental text message and social media program on children's vegetable consumption and movement behaviours: A pilot randomised controlled trial. Health Promot J Austr 2024. [PMID: 38200657 DOI: 10.1002/hpja.839] [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: 03/27/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
ISSUE ADDRESSED Australian children fall short of meeting the dietary, physical activity and sedentary behaviour guidelines. This study aimed to test the feasibility, acceptability and potential efficacy of a parental text message and social media program on, primarily, their school-aged children's vegetable consumption and movement behaviours, and, secondarily, their own. METHODS Between August and November 2022, we conducted a two-armed randomised controlled trial with 242 parents/caregivers of primary school-aged children in New South Wales. The 'Adventure & Veg' intervention ran for 8 weeks, promoting vegetable eating behaviours, local outdoor physical activity opportunities and ideas for reducing screen time. Feasibility and acceptability were assessed via recruitment and retention data, intervention metrics and self-reported participant data. Vegetable intake and movement behaviour data were collected via online-surveys and effect sizes were examined. RESULTS Most participants reported that they enjoyed receiving the text messages (88%) and the delivery frequency was acceptable (94%). Limitations to Facebook as a delivery platform were reported. The majority of participants used the text messages to influence the vegetable eating (65%) and movement (77%) behaviours of their child. Significant effects were observed among intervention child participants compared with control for mean daily vegetable consumption (0.45 serves, CI: .19; .71, p = .001, d = .5); weekly vegetable variety (1.85, CI: .25; 3.45, p < .001, d = .6); and weekly physical activity variety (.64 CI: .09; 1.19, p = .022, d = .3). Parents in the intervention group increased their daily vegetable intake by .44 serves (CI: .11; .78, p = .01, d = .4). CONCLUSIONS A parental text message and social media program has potential to support children's vegetable intake and movement behaviours. Further research is required to explore different online delivery methods to promote local outdoor activity options. SO WHAT?: The Adventure & Veg program holds promise as a stand-alone health promotion intervention or as a useful adjunct to current family or school-based healthy lifestyle programs.
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Affiliation(s)
- Jennifer Norman
- Health Promotion Service, Illawarra Shoalhaven Local Health District, New South Wales Health, Wollongong, New South Wales, Australia
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Susan Furber
- Health Promotion Service, Illawarra Shoalhaven Local Health District, New South Wales Health, Wollongong, New South Wales, Australia
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Adrian Bauman
- School of Public Health, and the Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Anthony D Okely
- Early Start, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
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16
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Dhawan D, McCloud R, Pinnamaneni R, Arora G, Kadam R, Dutt A, Biswas-Ramchandran N, Viswanath K. Communication and Social Determinants of Cancer Preventive Behaviors in Adolescents From Low Socio-Economic Backgrounds in India: A Cross-Sectional Study. Cancer Control 2024; 31:10732748241255538. [PMID: 38736171 PMCID: PMC11089949 DOI: 10.1177/10732748241255538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/17/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
PURPOSE Promoting cancer preventive behaviors among adolescents, especially those from lower socioeconomic backgrounds, is crucial due to the significant impact of health behaviors in adolescence on disease risk in adulthood. With India witnessing a rise in cancer incidence and mortality, adolescence becomes a pivotal stage for establishing healthy habits, emphasizing the need for early cancer prevention efforts. METHODS This cross-sectional study used survey data from 2242 adolescents attending public schools of Mumbai, India. Multiple logistic regression was conducted to determine the associations between cancer preventive behaviors and: (1) the individual and social determinants of health, and (2) media exposure. FINDINGS Merely 21.5% of the adolescents ate fruits and vegetables daily, 50% of the adolescents exercised 3 or more times a week, and 20% of the adolescents admitted having used tobacco and/or supari. Girls were found to have lower odds of exercising, as well as using tobacco and/or supari. Wealth and father's education were positively associated with all 3 cancer preventive behaviors. Media exposure was negatively associated, with television exposure linked to reduced fruits and vegetables consumption, while movies and social media exposure were associated with increased tobacco and/or supari use. INTERPRETATION Our findings suggest that individual and social determinants of health and media exposure can influence cancer preventive health behaviors in low socio-economic status (SES) adolescents. Efforts to increase awareness to promote cancer preventive behaviors among the adolescents, particularly low SES adolescents, a population more vulnerable to poor health outcomes, is critical.
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Affiliation(s)
| | | | | | | | | | | | | | - K. Viswanath
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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17
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Heikkilä L, Korpelainen R, Aira T, Alanko L, Heinonen OJ, Kokko S, Parkkari J, Savonen K, Toivo K, Valtonen M, Vasankari T, Villberg J, Vanhala M. Is health promotion in sports clubs associated with adolescent participants' fruit and vegetable consumption? Eur J Public Health 2023; 33:1102-1108. [PMID: 37665763 PMCID: PMC10710333 DOI: 10.1093/eurpub/ckad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Although sports clubs' potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs' health promotion orientation, as well as associations between sports clubs' health promotion orientation, coaches' nutritional discussions and sports club participants' (SPs') fruit and/or vegetable consumption. METHODS The cross-sectional study included 554 SPs aged 14-16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs' health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0-22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations. RESULTS Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5-21). SPs' daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23-5.42, P < 0.001], better self-rated health (OR 3.26, 95% CI 1.13-9.41, P = 0.03), higher average school grades (OR 1.67, 95% CI 1.04-2.67, P = 0.03), and SPs' responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41-3.14, P < 0.001). CONCLUSION Although sports clubs' orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches' nutritional discussions were associated with adolescents' fruit and/or vegetable consumption.
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Affiliation(s)
- Laura Heikkilä
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuula Aira
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Sports Medicine Clinic, Foundation for Sports and Exercise Clinic, Helsinki, Finland
- Sports and Exercise Medicine Clinic, Central Finland Hospital Nova, Jyväskylä, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Physical Activity and Health, University of Turku, Turku, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland
- UKK Institute of Health Promotion Research, Tampere, Finland
| | - Maarit Valtonen
- Finnish Institute of High Performance Sports KIHU, Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marja Vanhala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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18
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Capasso M, Califano G, Caracciolo F, Caso D. Only the best for my kids: An extended TPB model to understand mothers' use of food labels. Appetite 2023; 191:107040. [PMID: 37730151 DOI: 10.1016/j.appet.2023.107040] [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: 01/26/2023] [Revised: 07/21/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
Despite the evidence that mothers' food purchasing behavior impacts the quality of children's diet, few studies have explored psycho-social factors influencing how mothers choose the food to buy for their children. To fill this gap, this study tested an extended Theory of Planned Behavior (TPB) model to predict mothers' tendency to seek information on food labels before purchasing food for children. Participants included 311 Italian mothers who completed a self-report questionnaire measuring their information-seeking behavior, TPB variables, anticipated regret and healthy-eater identity. Results from a Multiple Correspondence Analysis showed that mothers' information-seeking behavior involved a continuum of choices ranging from selecting conventional or prepackaged foods to choosing to read the food label before making a purchase. Besides, a Partial Least Squares-Structural Equation Modeling analysis showed that information-seeking behavior was positively predicted by intention (β = 0.309, p < 0.001) and healthy-eater identity (β = 0.195, p < 0.001). In turn, intention was positively affected by attitude (β = 0.208, p < 0.001), subjective norms (β = 0.155, p < 0.01), perceived behavioral control (β = 0.124, p < 0.05), anticipated regret (β = 0.193, p < 0.001), and healthy-eater identity (β = 0.191, p < 0.001). These findings emphasize that future initiatives could usefully target attitude, anticipated regret and self-identity to encourage mothers' informed food choices for their children.
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Affiliation(s)
- Miriam Capasso
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | | | - Francesco Caracciolo
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Daniela Caso
- Department of Humanities, University of Naples Federico II, Naples, Italy.
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19
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Nicolas C, Rouche M, Dierckens M, Kelly C, Fismen AS, Nardone P, Castetbon K, Chatelan A. Sixteen-year trends in fruit consumption and related socioeconomic inequalities among adolescents in Western European countries. Eur J Nutr 2023; 62:3287-3296. [PMID: 37584785 DOI: 10.1007/s00394-023-03199-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/23/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE To investigate time trends in daily fruit consumption among Western European adolescents and in related socioeconomic inequalities. METHODS We used nationally representative data from 18 countries participating in five rounds (2002 to 2018) of the cross-sectional "Health Behaviour in School-aged Children" (HBSC) survey (n = 458,973). The questionnaire, standardised across countries and rounds, was self-administered at school by 11-, 13- and 15-year-old adolescents. Daily fruit consumption was assessed using a short food frequency questionnaire (sFFQ). Socioeconomic inequalities were measured using the Family Affluence Scale (FAS). Multilevel logistic regressions were applied to study linear time trends in daily fruit consumption, overall, by country and by FAS. RESULTS Between 2002 and 2018, daily fruit consumption increased in 10 countries (OR range, 1.04 to 1.13, p < 0.05) and decreased in 3 (OR range 0.96 to 0.98, p < 0.05). In all survey years combined, prevalence of daily fruit consumption was significantly higher among high FAS groups (42.6%) compared to medium (36.1%) and low FAS groups (31.7%; all countries: p < 0.001). Between 2002 and 2018, socioeconomic inequalities in fruit consumption increased in Austria, Germany, Italy, Netherlands, Scotland, Sweden, and Switzerland. Only in Norway FAS inequalities decreased while the prevalence increased. CONCLUSION The prevalence of daily fruit consumption generally increased among adolescents between 2002 and 2018 in Western European countries, yet socioeconomic inequalities increased in some countries. Public health interventions should continue to promote fruit consumption with special attention to lower socioeconomic groups.
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Affiliation(s)
- Charlotte Nicolas
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles (ULB), CP 598, Route de 24 Lennik 808, 1070, Brussels, Belgium.
- Research Institute LABIRIS, Brussels, Belgium.
| | - Manon Rouche
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles (ULB), CP 598, Route de 24 Lennik 808, 1070, Brussels, Belgium
| | - Maxim Dierckens
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Colette Kelly
- Health Promotion Research Centre, School of Health Sciences, University of Galway, Galway, Ireland
| | - Anne-Siri Fismen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health (Istituto Superiore Di Sanità), Rome, Italy
| | - Katia Castetbon
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles (ULB), CP 598, Route de 24 Lennik 808, 1070, Brussels, Belgium
| | - Angeline Chatelan
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université Libre de Bruxelles (ULB), CP 598, Route de 24 Lennik 808, 1070, Brussels, Belgium
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20
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Kaur S. Barriers to consumption of fruits and vegetables and strategies to overcome them in low- and middle-income countries: a narrative review. Nutr Res Rev 2023; 36:420-447. [PMID: 36004512 DOI: 10.1017/s0954422422000166] [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] [Indexed: 11/06/2022]
Abstract
This review provides an overview of the barriers to the consumption of fruits and vegetables (FVs) as well as strategies to improve the intake of FVs in low- and middle-income countries (LMICs). The importance of the consumption of FVs and its role in disease prevention are discussed briefly. Trends in the consumption of FVs in LMICs are also summarised. The WHO recommends that every individual should consume at least five servings or 400 grams of FVs per day. Epidemiological and clinical investigations have demonstrated that FVs contain numerous bioactive compounds with health-protecting activities. Despite their health benefits, the intake of FVs in LMICs remains low. Major barriers identified were socio-demographic factors, environmental conditions, individual and cultural factors, and macrosystem influences. These barriers may be lowered at the household, school, community, and national level through multi-component interventions including behaviour change communication (BCC) initiatives, nutrition education (NE), gardening initiatives, farm to institution programs (FIPs), food baskets, cash transfers, nutrition-agriculture policy and program linkages, and food-market environment-based strategies. This review has research implications due to the positive outcomes of strategies that lower such barriers and boost consumption of FVs in LMICs.
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Affiliation(s)
- Sukhdeep Kaur
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, Punjab141004, India
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21
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Thompson D, Miranda J, Callender C, Dave JM, Appiah G, Musaad SMA. See Me, Hear Me, Know Me: Perspectives on Diet and Physical Activity Influences among Teens Living in Rural Texas Communities. Nutrients 2023; 15:4695. [PMID: 37960349 PMCID: PMC10650212 DOI: 10.3390/nu15214695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/27/2023] [Accepted: 10/29/2023] [Indexed: 11/15/2023] Open
Abstract
Teens in rural communities are at greater risk of obesity than teens in urban areas. Diet and physical activity influence obesity risk. Understanding their perspectives is an important step in intervention design. This qualitative investigation explored teen perspectives on how living in a rural community influenced their diet and physical activity choices. Forty parent-teen pairs were recruited. Data collection included surveys and telephone interviews. This paper reports teen perspectives identified in the first interview. Thematic analysis was used to code and analyze the data. Findings revealed that the primary factor driving teens' diet and physical activity behaviors was the teens themselves. They clearly understood their role in the choices they made, although they acknowledged not always making the healthiest choice. This belief was driven by their motivation to engage in healthy behaviors, which was influenced by the perceived benefits derived from making healthy choices and from the synergistic relationship between diet and physical activity. Diet and physical activity, in turn, were influenced by the environment, particularly the home, social, and community environments. Family and friends were particularly influential, as well as resource availability. These findings can serve as a foundation for designing interventions tailored to this population.
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Affiliation(s)
- Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA; (J.M.); (C.C.); (J.M.D.); (G.A.); (S.M.A.M.)
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22
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Baltaci A, Laska MN, Horning M, Hearst M, Lee J, Fulkerson JA. Parent meal self-efficacy and practices in households with healthy home food environments in the face of economic hardship. Appetite 2023; 190:107029. [PMID: 37683896 PMCID: PMC10543555 DOI: 10.1016/j.appet.2023.107029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/16/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023]
Abstract
Some families who experience economic hardship demonstrate remarkable strength and resourcefulness to sustain a healthy home food environment. This ability to navigate economic barriers could be associated with parent meal practices that promote children's healthful dietary intake. Therefore, this study aimed to examine 1) whether parent meal self-efficacy and practices were associated with economic assistance status and home fruit and vegetable (FV) availability and 2) how parent meal self-efficacy and practices differed by home FV availability and economic assistance status. Analyses utilized baseline data from 274 parent/child dyads from two childhood obesity prevention trials: HOME Plus (urban) and NU-HOME (rural). Parents in households with high FV availability (regardless of economic assistance) had significantly higher self-efficacy in preparing healthy foods, family dinner routines, frequency of child's plate being half filled with FV, frequency of family dinner and breakfast, and lower frequency of purchasing dinner from fast food restaurants. Economic assistance was not associated with parent meal self-efficacy and practices. Four family groups were created and defined by economic assistance (yes/no) and home FV availability (high/low). About 31% of families that received economic assistance and had high home FV availability were food insecure. Families (n = 39) receiving economic assistance and having high home FV availability had greater frequency of family dinners compared to those in households with economic assistance and low home FV availability (n = 47) (p = 0.001); no other parent meal self-efficacy or practices differed between groups. Our findings suggest some families can maintain healthy home food environments despite economic hardship and frequent family dinners may be an important strength for these families. More research is needed to investigate asset-based models to understand the family strengths that enable them to thrive during difficult times.
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Affiliation(s)
- Aysegul Baltaci
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa N Laska
- School of Public Health, Division of Epidemiology and Community Health, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Melissa Horning
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Mary Hearst
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
| | - Jiwoo Lee
- School of Nursing, 308 SE Harvard St, Minneapolis, MN, 55455, USA.
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23
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Drouka A, Brikou D, Causeret C, Al Ali Al Malla N, Sibalo S, Ávila C, Alcat G, Kapetanakou AE, Gurviez P, Fellah-Dehiri N, Masson M, Kontogianni MD, Yannakoulia M. Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1676. [PMID: 37892339 PMCID: PMC10605522 DOI: 10.3390/children10101676 10.3390/儿童10101676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 06/30/2024]
Abstract
The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6-10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers' training.
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Affiliation(s)
- Archontoula Drouka
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Dora Brikou
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | | | | | | | - Concha Ávila
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | - Gabriela Alcat
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | | | - Patricia Gurviez
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Nawel Fellah-Dehiri
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Marine Masson
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Meropi D. Kontogianni
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Mary Yannakoulia
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
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24
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Drouka A, Brikou D, Causeret C, Al Ali Al Malla N, Sibalo S, Ávila C, Alcat G, Kapetanakou AE, Gurviez P, Fellah-Dehiri N, Masson M, Kontogianni MD, Yannakoulia M. Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1676. [PMID: 37892339 PMCID: PMC10605522 DOI: 10.3390/children10101676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6-10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers' training.
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Affiliation(s)
- Archontoula Drouka
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Dora Brikou
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | | | | | | | - Concha Ávila
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | - Gabriela Alcat
- Federación Española de Industrias de Alimentación y Bebidas, 28001 Madrid, Spain; (C.Á.); (G.A.)
| | | | - Patricia Gurviez
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Nawel Fellah-Dehiri
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Marine Masson
- Agroparistech, INRAE, Paris-Saclay University, 91120 Palaiseau, France; (P.G.); (N.F.-D.); (M.M.)
| | - Meropi D. Kontogianni
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
| | - Mary Yannakoulia
- Department of Nutrition & Dietetics, Harokopio University, 17671 Athens, Greece; (A.D.); (D.B.); (M.D.K.)
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25
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Dewi NU, Khomsan A, Dwiriani CM, Riyadi H, Ekayanti I, Hartini DA, Bohari B, Aiman U, Nurulfuadi, Fadjriyah RN. The combination of nutrition education at school and home visits to improve adolescents' nutritional literacy and diet quality in food-insecure households in post-disaster area (De-Nulit study): A study protocol of cluster randomized controlled trial (CRCT). Contemp Clin Trials Commun 2023; 35:101185. [PMID: 37529067 PMCID: PMC10387559 DOI: 10.1016/j.conctc.2023.101185] [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: 07/13/2022] [Revised: 06/28/2023] [Accepted: 07/02/2023] [Indexed: 08/03/2023] Open
Abstract
Nutrition education is selected as a method which often used to change eating behaviour, yet, the effectiveness of this method in adolescents who live in household with food insecurity status is rarely investigated. The purpose of this study was to assess the impact of a combination of nutritional education held at school and home visits for increasing the nutritional literacy and its effect on the quality of adolescent diet, so that the result can be used as a strategy to improve nutritional literacy dan diet quality in those adolescents who live in food-insecure households in post-disaster areas. The De-Nulit Study is a Cluster Randomized Controlled Trial (CRCT) with an intervention from a combination of nutritional education given at school and home visits conducted for three months for adolescents who live in food-insecure households with ages ranging from 15 to 17 years old. A randomization sampling was carried out at four schools located the nearest locations which were affected heavily by the major natural disasters in 2018. The nutritional education intervention groups in schools were given in eight sessions, whereas home visits with an interview approach for students with a motivational interview approach were carried out four times. The control group will receive leaflets three times a month for three months, and each group will receive a food stamp $ 7.6 per month for three months. The trial research has been recorded in Thai Clinical Trials Registry (TCTR) with identification number of TCTR 20220203003 issued on 03 February 2022.
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Affiliation(s)
- Nikmah Utami Dewi
- Department of Nutrition, Faculty of Public Health, University of Tadulako, Indonesia
| | - Ali Khomsan
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Cesilia Meti Dwiriani
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Hadi Riyadi
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Ikeu Ekayanti
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Indonesia
| | - Diah Ayu Hartini
- Department of Nutrition, Health Polytechnic of Palu, Palu, Indonesia
| | - Bohari Bohari
- Department of Nutrition, Faculty of Medicine, Sultan Ageng Tirtayasa University, City of Serang, Indonesia
| | - Ummu Aiman
- Department of Nutrition, Faculty of Public Health, University of Tadulako, Indonesia
| | - Nurulfuadi
- Department of Nutrition, Faculty of Public Health, University of Tadulako, Indonesia
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26
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Emke H, Dijkstra C, Kremers S, Chinapaw MJM, Altenburg T. Is the transition from primary to secondary school a risk factor for energy balance-related behaviours? A systematic review. Public Health Nutr 2023; 26:1754-1774. [PMID: 37138344 PMCID: PMC10478069 DOI: 10.1017/s1368980023000812] [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: 05/24/2022] [Revised: 03/20/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The substantial changes in the physical and social environment during the transition from primary to secondary school may significantly impact adolescents' energy balance-related behaviours (i.e. dietary behaviour, sedentary behaviour, sleep behaviour and physical activity (PA)). This is the first review systematically summarising evidence on changes in four energy balance-related behaviours of adolescents across the school transition from primary to secondary school. DESIGN For this systematic review, the electronic databases Embase, PsycINFO and SPORTDiscus were searched for relevant studies from inception to August 2021. PubMed was searched for relevant studies from inception to September 2022. Inclusion criteria were: (i) longitudinal studies reporting; (ii) one or more energy balance-related behaviours; and (iii) across the school transition, that is, with measurement(s) during both primary and secondary school. SETTING Transition from primary to secondary school. PARTICIPANTS Adolescents across the transition from primary to secondary school. RESULTS Thirty-four studies were eligible. We found strong evidence for an increase in sedentary time, moderate evidence for a decrease in fruit and vegetable consumption, and inconclusive evidence for a change in total, light, and moderate-to-vigorous PA, active transport, screen time, unhealthy snack consumption, and sugar-sweetened beverages consumption among adolescents across the school transition. CONCLUSIONS During the transition from primary to secondary school, sedentary time and fruit and vegetable consumption tend to change unfavourably. More high-quality, longitudinal research is needed specifically on changes in energy balance-related behaviour across the school transition, especially regarding sleep behaviour. (Prospero registration: CRD42018084799).
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Affiliation(s)
- Helga Emke
- Vrije Universiteit Amsterdam, Department of Health Sciences, Faculty of Science, De Boelelaan 1117Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Coosje Dijkstra
- Vrije Universiteit Amsterdam, Department of Health Sciences, Faculty of Science, De Boelelaan 1117Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
| | - Stef Kremers
- Maastricht University Medical Centre, Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, P. Debyelaan 25, Maastricht, The Netherlands
| | - Mai JM Chinapaw
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Teatske Altenburg
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases and Methodology, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, De Boelelaan 1117, Amsterdam, The Netherlands
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27
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Jindarattanaporn N, Rittirong J, Phulkerd S, Thapsuwan S, Thongcharoenchupong N. Are exposure to health information and media health literacy associated with fruit and vegetable consumption? BMC Public Health 2023; 23:1554. [PMID: 37582748 PMCID: PMC10428547 DOI: 10.1186/s12889-023-16474-1] [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: 01/08/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Health information promotes a healthy lifestyle; however, media health literacy (MHL) is essential to personal intake, especially fruit and vegetables (F&V). This study aimed to determine how exposure to health information and MHL affect F&V consumption among Thai youth aged 10-14 years. Health behavior at this age can be an important determinant of consumption habits when transitioning into adulthood. METHODS A stratified two-stage sample survey was conducted to recruit 1,871 youth across regions to be nationally representative. Qualtrics offline survey application was used for data collection face-to-face with all respondents. Multiple linear regression was used to analyze the explanatory variables on fruit consumption and vegetable consumption. RESULTS This study found that almost 70% of Thai youth were exposed to health-related content via the Internet, and had low analytical skills to process that information. Grade Point Average (GPA), exposure to health information, various media types, frequency of exposure to health information, and MHL influenced the frequency of F&V intake. Health status related to fruit intake, age, place of residence, amount of pocket money, and body mass index (BMI) were associated with F&V consumption. CONCLUSION Exposure to health information and MHL are associated with F&V intake. Therefore, exposure to health information and MHL should be addressed for policy formulation in Thai schools and the health system.
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Affiliation(s)
| | - Jongjit Rittirong
- Institute for Population and Social Research, Mahidol University, Nakorn Pathom, 73170, Thailand.
| | - Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Nakorn Pathom, 73170, Thailand
| | - Sasinee Thapsuwan
- Institute for Population and Social Research, Mahidol University, Nakorn Pathom, 73170, Thailand
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28
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Ilić A, Rumbak I, Brečić R, Colić Barić I, Bituh M. Three-Year School-Based Multicomponent Intervention May Change Fruit and Vegetable Preferences in Primary School Children-A Quasi-Randomized Trial. Nutrients 2023; 15:3505. [PMID: 37630695 PMCID: PMC10457900 DOI: 10.3390/nu15163505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Preference could be the trigger for fruit and vegetable (FV) consumption in children and could be modified by appropriate intervention to increase the acceptance of FVs. The primary objective of this study was to investigate the effects of the three-year school-based multicomponent intervention "Nutri-školica" on the FV preferences of primary school children. It also aimed to explore whether a positive change in FV preferences could lead to an increase in actual FV consumption. The study was conducted in 14 primary schools from the city of Zagreb on 193 children (52.3% boys; age, 7.7 ± 0.4 years; n = 85 in the control group and n = 108 in the intervention group) who completed a preference questionnaire before and after the intervention with a 5-point hedonic smiley-face scale, where 5 means "I like it a lot." The per-protocol approach was used for data analysis (28.3% of children from the study sample). After the intervention, children in the intervention group (before: 3.1 ± 0.8; after: 3.5 ± 0.8) increased their FV preferences significantly more than children in the control group (before: 3.2 ± 0.8; after: 3.3 ± 0.7). Children's FV preferences changed most toward the varieties for which they had the least preferences at the beginning of the study. Participation in the intervention had a stronger effect on changing FV intake than change in FV preferences among primary school children. In summary, the present study highlighted that a targeted intervention can increase children's FV preferences, but that participation in the intervention is substantial for increasing FV intake.
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Affiliation(s)
- Ana Ilić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
| | - Ivana Rumbak
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
| | - Ružica Brečić
- Department of Marketing, Faculty of Economics and Business, University of Zagreb, Trg J.F. Kennedy 6, 10000 Zagreb, Croatia;
| | - Irena Colić Barić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
| | - Martina Bituh
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
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Hahnraths MTH, Winkens B, van Schayck OCP. Effects of School-Based Health-Promoting Activities on Children's Health: A Pragmatic Real-World Study. Nutrients 2023; 15:3349. [PMID: 37571286 PMCID: PMC10420810 DOI: 10.3390/nu15153349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
More insight into the health effects of scaled-up school-based interventions in real-world settings is vital to sustainably integrate health in all schools. This study investigated the effectiveness of the scaled-up Healthy Primary School of the Future (HPSF) initiative in real-world school contexts on children's health (behaviours). From 2019 to 2022, eleven Dutch primary schools implemented HPSF-related activities. In 315 children from study years four to six (aged 7-11 years) from these schools, anthropometric measurements were performed, and questionnaires assessing the children's dietary behaviours and physical activity were administered. COVID-19 greatly limited the implementation of HPSF-related activities. Therefore, the results were compared between schools categorised as medium implementers and schools categorised as low implementers. After correction for baseline, waist circumference in the medium implementer group was significantly higher at one-year follow-up (B = 1.089, p = 0.003) and two-year follow-up (B = 1.665, p < 0.001) compared with waist circumference in the low implementer group. No significant effects were observed for other outcomes. This study showed hardly any effects of the scaled-up HPSF initiative, mainly due to the limited implementation caused by COVID-19. More research investigating the real-world effectiveness of HPSF and comparable programmes is greatly encouraged to advance the field of school-based health promotion.
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Affiliation(s)
- Marla T. H. Hahnraths
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
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Olsson C, Hörnell A, Waling M. High availability of vegetables and fruit through government-funded school lunch is not reflected in 4th grade pupils' intake. Food Nutr Res 2023; 67:9405. [PMID: 37533447 PMCID: PMC10392862 DOI: 10.29219/fnr.v67.9405] [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: 02/13/2023] [Revised: 04/26/2023] [Accepted: 05/01/2023] [Indexed: 08/04/2023] Open
Abstract
Background An increased intake of vegetable and fruit (VF) through school meals can contribute to the prevention of non-communicable diseases. Objective The purpose of this study was to investigate what types of VF 4th grade pupils (10-11 years old) choose, how much they eat when they are given the opportunity to serve themselves from the daily vegetable buffet available at lunch, and whether this varies with socioeconomic background and gender. Design A cross-sectional study design was used where pupils' VF intake was measured during 5 days with a photographic method. In total, 196 pupils from nine public schools participated. Results The results show that pupils on average ate less than one type of VF per day from the vegetable buffet. Girls, pupils with a higher socio-economic status (SES) and those with a more frequent VF intake at home, ate more types of VF per day from the vegetable buffet than their counterparts. The median intake of VF from the vegetable buffet was generally low, 20.4 g/day. The intake was two thirds higher for pupils with higher SES in comparison with pupils with lower SES; 25 g/day versus14 g/day (P = 0.001). No gender differences in grams per day of VF were identified (P = 0.123). Discussion This study indicates that a well-stocked vegetable buffet as part of government-funded school lunch does not automatically contribute substantially to the recommended daily intake of VF among a sample of 4th grade pupils in a high-income country like Sweden. Conclusions The results of the study can be interpreted as a missed opportunity to increase the intentional consumption of VF among pupils in a way that would have implications for public health as well as attenuating differences between socioeconomic groups.
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Affiliation(s)
| | | | - Maria Waling
- Maria Waling Department of Food, Nutrition and Culinary Science, SE-901 87 Umeå, Sweden.
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Semagn BE, Abubakari A. Zero fruits/vegetables consumption and associated factors among Children aged 6-23 months in Ethiopia: Mixed effect logistic regression analysis. PLoS One 2023; 18:e0288732. [PMID: 37450483 PMCID: PMC10348598 DOI: 10.1371/journal.pone.0288732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The first two years of life is a vital period for promoting optimal growth, development and health. The lifelong nutritional habit and overall health of children is influenced by their early age feeding practice. Ethiopia is among the top five countries in Sub-Saharan Africa with the highest burden of zero fruits/vegetables consumption. This study aims to access factors associated with zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia. METHODS The study analyzed Ethiopian Mini Demographic and Health Survey 2019 dataset with a total weighted sample of 1459 young children aged between 6-23 months and who were living with their mothers. Data cleaning, coding and labeling were done using STATA version 14 software. Multilevel mixed effect logistic regression model was employed to identify associated factors. RESULTS Exactly 69.3% of children aged 6-23 months in Ethiopia had zero fruits/vegetables consumption. In the multivariable multilevel binary logistic regression analysis a child from household with middle (AOR = 0.55, 95% CI: 0.35, 0.86) and rich (AOR = 0.37, 95% CI: 0.23, 0.60) wealth index, mothers who aged between 25-34 years old (AOR = 0.44; 95%CI = 0.29-0.69), mothers who were married/living with partner (AOR = 3.21; 95%CI: 1.58-6.52), children of mothers who follow Islamic religion (AOR = 0.34, 95% CI: 0.19, 0.61), mothers who had more than four ANC visits during their most recent pregnancy (AOR = 0.57; 95%CI: 0.39-0.83), children in age group of 12-18 month(AOR = 0.41, 95% CI: 0.28, 0.59), and 19-23 months (AOR = 0.26, 95% CI: 0.17, 0.40), health facility delivery (AOR = 1.52, 95% CI; 1.00-2.30), and small peripheral regions (AOR = 4.40, 95% CI; 1.39-13.97) were found to be significant factors associated with children's zero fruits /vegetables consumption. The Interclass correlation coefficient (ICC) value in the null model was 0.34, which indicates that 34% of the variation in children's zero fruits /vegetables consumption was attributed to the variation between clusters. CONCLUSION This study found that zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia is high. Therefore, efforts should be made by stakeholders who are concerned about optimal diet and health of children to improve fruits/vegetables consumption of children particularly those from poor households, young mothers (15-24), and peripheral regions of Ethiopia. This could be done during ANC follow up visits and during nutrition counseling.
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Affiliation(s)
- Birhan Ewunu Semagn
- Department of Public Health, Asrat Weldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abdulai Abubakari
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
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Snuggs S, Harvey K. Family Mealtimes: A Systematic Umbrella Review of Characteristics, Correlates, Outcomes and Interventions. Nutrients 2023; 15:2841. [PMID: 37447168 PMCID: PMC10346164 DOI: 10.3390/nu15132841] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 07/15/2023] Open
Abstract
Systematic reviews have examined the multitude of studies investigating family mealtimes and their importance to child/adolescent health and psychosocial outcomes, but the focus of each is limited to specific aspects of family meals (e.g., frequency) and/or specific outcomes (e.g., nutrition). Their findings require synthesis and so a systematic umbrella review was undertaken. Databases were searched to identify systematic reviews (with or without meta-analysis/meta-synthesis) addressing at least one of the following questions: what are the characteristics and/or correlates of family mealtimes; what outcomes are associated with family mealtimes; are interventions aimed at promoting family mealtimes effective? Forty-one eligible reviews were retrieved. Their findings demonstrate that families with children/adolescents typically eat together at least a few days each week. More frequent family meals are predicted by a more positive mealtime environment, more positive attitudes towards family meals, the presence of younger children, and families having more time. Greater family meal frequency protects children/adolescents against a poorer diet, obesity, risk behaviours, poorer mental health and wellbeing, and poorer academic outcomes. Findings from interventions seeking to promote family mealtimes are mixed. This umbrella review provides a comprehensive and integrated understanding of research into family mealtimes, establishing where evidence is sound and where further research is needed.
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Affiliation(s)
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading RG6 6AH, UK;
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Jenkins D, Juba N, Crawford B, Worthington M, Hummel A. Regulation of plants developed through new breeding techniques must ensure societal benefits. NATURE PLANTS 2023; 9:679-684. [PMID: 37156859 DOI: 10.1038/s41477-023-01403-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
| | - Nicole Juba
- Pairwise Plants Services, Inc., Durham, NC, USA.
| | | | | | - Aaron Hummel
- Pairwise Plants Services, Inc., Durham, NC, USA.
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Kiosses S, Garrett A. Lifestyle Medicine Programmes for Children and Young People in Residential Care. Am J Lifestyle Med 2023; 17:365-370. [PMID: 37304749 PMCID: PMC10248375 DOI: 10.1177/15598276221120234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Affiliation(s)
- Stelios Kiosses
- Instructor and Faculty-Harvard University Extension
School, Research Collaborator-Computational Psychopathology Research Group, University of Oxford, Boston, MA, USA (SK); and Edison Young People, Stoke-on-Trent, UK (SK, AG)
| | - Abbie Garrett
- Instructor and Faculty-Harvard University Extension
School, Research Collaborator-Computational Psychopathology Research Group, University of Oxford, Boston, MA, USA (SK); and Edison Young People, Stoke-on-Trent, UK (SK, AG)
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Karimi E, Haghighatdoost F, Mohammadifard N, Najafi F, Farshidi H, Kazemi T, Solati K, Shahdadian F, Arab A, Sarrafzadegan N, Mansourian M. The influential role of parents' socioeconomic status and diet quality on their children's dietary behavior: results from the LIPOKAP study among the Iranian population. BMC Pediatr 2023; 23:188. [PMID: 37085814 PMCID: PMC10120167 DOI: 10.1186/s12887-023-04000-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/09/2023] [Indexed: 04/23/2023] Open
Abstract
PURPOSE There is a paucity of evidence regarding the influential factors on Iranian children's diet quality. To assess this issue, we explore the relationship between parental diet quality, socioeconomic status (SES), and nutritional knowledge with their children's diet quality using a cross-sectional sample of the Iranian population. METHODS In this study, paired parents along with one of their children (aged 6-18 years old) who lived with them were included. Dietary intake was assessed using a food frequency questionnaire (FFQ) and diet quality was determined using an Alternative Healthy Eating Index-2010 (AHEI). Nutritional knowledge and SES were also explored using validated questionnaires. Multiple linear regression analysis was used and beta (β) and corresponding 95% confidence interval (CI) were reported. RESULTS After controlling for potential confounders, the parents' AHEI was significantly associated with their children's diet quality (β = 12.34, 95% CI: 10.75, 13.93; P < 0.001). The nutritional knowledge of parents was significantly associated with children's AHEI after controlling for potential confounders (β = 1.63, 95% CI: 0.14, 3.11; P = 0.032). Moreover, the parents' SES was inversely associated with the AHEI of children (β=-3.76, 95% CI: -5.40, -2.11; P < 0.001); however, further adjustment for confounders attenuated this relationship (Model 3: β = 0.87, 95% CI: -0.76, 2.34; P = 0.269). CONCLUSIONS We found that the children's diet quality could be influenced by their parents' SES, nutritional knowledge, and diet quality. Our findings suggest that improving the nutritional knowledge of parents not only may improve the healthy eating pattern of parents but also could influence their children's diet quality.
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Affiliation(s)
- Elham Karimi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Haghighatdoost
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Farshidi
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandarabbas, Iran
| | - Tooba Kazemi
- Cardiovascular Disease Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Kamal Solati
- Department of Psychiatry, Shahrekord University of Medical Science, Shahrekord, Iran
| | - Farnaz Shahdadian
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Naylor Metoyer B, Chuang RJ, Lee M, Markham C, Brown EL, Almohamad M, Dave JM, Sharma SV. Fruit and Vegetable Intake and Home Nutrition Environment among Low-Income Minority Households with Elementary-Aged Children. Nutrients 2023; 15:nu15081819. [PMID: 37111037 PMCID: PMC10145522 DOI: 10.3390/nu15081819] [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: 02/15/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/Latino and African American families. Through a cross-sectional study design, self-reported surveys (n = 6074) were obtained from adult-child dyad participants enrolled in Brighter Bites, an evidence-based health promotion program, in the fall of 2018. For every once/day increase in frequency of parent FV intake, there was an increase in child FV intake by 0.701 times/day (CI: 0.650, 0.751, p < 0.001) and 0.916 times/day (CI: 0.762, 1.07; p < 0.001) among Hispanic/Latinos and African Americans, respectively. In Hispanic/Latino participants, significant positive associations were found between fruits as well as vegetables served at mealtimes ≥3 times/week (p < 0.001), family mealtimes 7 times/week (p = 0.018), parent-child communication about healthy eating and nutrition at least sometimes during the past 6 months (p < 0.05), and frequency of child FV intake, after adjusting for covariates. In African American participants, a significant positive association was found in fruits served at mealtimes ≥1 times/week (p < 0.05), and vegetables served at mealtimes ≥5 times/week (p < 0.05). Meals cooked from scratch a few times a day/all the time were significantly positively associated with frequency of child FV intake for both Hispanic/Latino (p = 0.017) and African American (p = 0.007) groups. The relationship between home nutrition environment and child FV intake varied by race and ethnicity. Future programs should consider designing culturally tailored interventions to address racial/ethnic-specific influences that match the child's race, culture, and ethnicity.
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Affiliation(s)
- Brittni Naylor Metoyer
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Ru-Jye Chuang
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - MinJae Lee
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center (UTSW), 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 7000 Fannin Street, Houston, TX 77030, USA
| | - Eric L Brown
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Maha Almohamad
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA
| | - Shreela V Sharma
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler Street, Houston, TX 77030, USA
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Moraes CHDC, Alvarenga MDS, Silva WRD, Cyrillo DC. [Psychosocial Influence Scale of Fruit and Vegetable Consumption among Adolescents: Adaptation and Factorial Validity]. CIENCIA & SAUDE COLETIVA 2023; 28:1199-1218. [PMID: 37042900 DOI: 10.1590/1413-81232023284.12702022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 10/06/2022] [Indexed: 04/13/2023] Open
Abstract
Instruments to evaluate psychosocial determinants of fruit and vegetable (F&V) consumption among adolescents are scarce, and there appears to be only one instrument - unnamed and unvalidated - that investigates determinants derived from theories of social psychology targeting the frequency of F&V consumption among adolescents. The scope of this paper was to present the process of cultural adaptation and factor validation of this instrument al-lowing its use in studies with Brazilian adolescents. The cross-cultural adaptation process was accomplished and the final version - named Psychosocial Influence Scale for Fruit and Vegetable Consumption among Adolescents (PSI-FAVES) - was tested with 429 students (58% female) using McDonald's omega (ω) reliability and Confirmatory Factor Analysis (CFA) as analytical methods. The final version required refinement and the instrument showed adequate overall reliability (ω=0.86) and good fit of the data to the previously elaborated model (CFI=0.955; TLI=0.951 and RMSEA (90%CI) =0.043 (0.038-0.049)), being the first systematically validated instrument to investigate psychosocial determinants of F&V consumption among adolescents.
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Affiliation(s)
- César Henrique de Carvalho Moraes
- Programa de Pós-Graduação em Nutrição em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo (USP). Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
- Departamento de Economia, Faculdade de Economia, Administração e Contabilidade, USP. São Paulo SP Brasil
| | - Marle Dos Santos Alvarenga
- Programa de Pós-Graduação em Nutrição em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo (USP). Av. Dr. Arnaldo 715, Cerqueira César. 01246-904 São Paulo SP Brasil.
| | - Wanderson Roberto da Silva
- Programa de Pós-Graduação em Nutrição e Longevidade, Universidade Federal de Alfenas. Alfenas MG Brasil
- Programa de Pós-Graduação em Alimentos, Nutrição e Engenharia de Alimentos, Universidade Estadual Paulista. São Paulo SP Brasil
| | - Denise Cavallini Cyrillo
- Departamento de Economia, Faculdade de Economia, Administração e Contabilidade, USP. São Paulo SP Brasil
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Bel-Serrat S, Klingenstein P, Marques-Previ M, Hennessy E, Murrin C. Perceived barriers to vegetable intake among urban adolescents from socioeconomically disadvantaged backgrounds: A qualitative study from the perspective of youth workers and teachers. Physiol Behav 2023; 262:114074. [PMID: 36623744 DOI: 10.1016/j.physbeh.2023.114074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
Eating habits established during adolescence have been shown to track into adulthood. Adolescents from lower socioeconomic status groups tend to have lower intakes of vegetables as compared with their more affluent peers. However, there is limited evidence about the determinants of vegetable intake in this population group. Therefore, this study aimed to explore the barriers to vegetable intake in adolescents living in socioeconomically disadvantaged areas through the perspective of school teachers and youth workers. A total of 20 semi-structured interviews were conducted with post-primary school teachers and youth workers from disadvantaged areas in Dublin, Ireland. Thematic analysis was applied to analyze the data. Eleven themes were identified and fitted within the Socioecological Model of Health: adolescent's food preferences, lack of early exposure and familiarity with vegetables, lack of interest, knowledge and skills at the individual and family level, parenting practices around nutrition, living difficulties, peers' influence and social norms around nutrition, dual role of social media, lack of resources and support to promote healthy eating, competition between unhealthy food vs. vegetables, lack of adequate approaches & initiatives at the community and at the public policy levels, and lack of State support to promote healthy eating. Although several actions could be taken at the personal and interpersonal levels, more efforts are needed at the organizational, community and public policy levels to improve dietary choices and vegetable intake among adolescents in socioeconomically deprived areas. These findings will inform the development of tailored intervention strategies and policies for these vulnerable youths.
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Affiliation(s)
- Silvia Bel-Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | - Pauline Klingenstein
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Maria Marques-Previ
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eilis Hennessy
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Celine Murrin
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Labbé C, Ward Chiasson S, Dupuis JB, Johnson C. Effectiveness of a School-Based Culinary Programme on 9- and 10-Year-Old Children's Food Literacy and Vegetable, Fruit, and Breakfast Consumption. Nutrients 2023; 15:nu15061520. [PMID: 36986250 PMCID: PMC10057530 DOI: 10.3390/nu15061520] [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: 02/27/2023] [Revised: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
School-based culinary courses may increase children's food literacy and improve their eating behaviours. This study assessed the impact of a school-based culinary programme on 9- and 10-year-old students' food literacy and vegetable, fruit, and breakfast consumption. This cluster quasi-experimental trial compared 88 grade 4 and 5 students who participated in the Apprenti en Action programme to 82 students who did not. Students' food literacy and eating behaviours were assessed with a self-administered questionnaire. The programme's impact on vegetable and fruit consumption, cooking skills, food skills, and food knowledge was measured using MANOVA, and the odds of eating breakfast at least five times per week were assessed with logistic regression. Students who participated in the programme reported a greater increase in their cooking skills (p = 0.013) and food knowledge (p = 0.028) than students in the control group. No effect was found on food skills and vegetables, fruit, and breakfast consumption (p-values > 0.05). Boys improved their cooking skills (p = 0.025) and food knowledge (p = 0.022), but girls did not. The programme improved students' cooking skills and food knowledge, especially among boys; however, modifications are needed to improve students' food skills and eating behaviours.
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Affiliation(s)
- Charlotte Labbé
- École des Sciences des Aliments, de Nutrition et d'Études Familiales, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Stephanie Ward Chiasson
- École des Sciences des Aliments, de Nutrition et d'Études Familiales, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Jérémie B Dupuis
- Vice-Rectorat à l'Enseignement et à la Recherche, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Claire Johnson
- École des Hautes Études Publiques, Université de Moncton, Moncton, NB E1A 3E9, Canada
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Silva A, Astorga A, Durán-Agüero S, Domper A. Revisiting fruit and vegetable determinants: Evidence from Latin America. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2022.1001509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
IntroductionIn the past decade, the public health discussion regarding fruit and vegetable (FV) consumption has been dominated by economic and physical accessibility.MethodsUsing an online survey in four Latin American countries, we applied a set of tobit models to compare the determinants of desirable and current consumption of FV levels for satisfied and unsatisfied respondents.ResultsWe found that, even when consuming less than five FV portions a day, most of the respondents were satisfied with their current FV consumption level. Satisfied respondents consumed significantly more FV than unsatisfied ones. In general, the desirable and current consumption of FV levels were associated with different sets of determinants, while years of education were relevant in both cases. Finally, in a hypothetical case where unsatisfied respondents would not face any physical or economic access restrictions, unsatisfied respondents would not reach the goal of five FV portions a day.DiscussionAssuming that physical and economic access improved, this would automatically increase FV to reach the five-a-day recommendation may be inaccurate in some cases. We also need to take mental access into account. We may ask how to improve the desirable level of FVs and then how to close the gap between the current and desirable FV levels.
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Markert J, Herke M, Kühn S, Healy K, Richter M. Food practices among adolescents in German residential care. Findings from a quantitative survey. Appetite 2023; 181:106397. [PMID: 36473581 DOI: 10.1016/j.appet.2022.106397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/07/2022]
Abstract
Food is of great importance for socialization. So far, there are few quantitative studies analysing food practices in residential care. The aim of this paper was to describe individual food practices in these homes. Associations with sociodemographic and home-related characteristics as well as attitudes towards food were examined to identify differences between adolescents following different food practices. 400 young people aged between 12 and 21 years living in 67 residential care homes in Germany completed a standardized questionnaire. Food practices were operationalized by questions on the regularity of meals, company at meals and the eating location. Cluster analysis for types of food practices were conducted. Differences by home-related and sociodemographic characteristics as well as attitudes towards food were tested by logistic regression analyses. Two types of food practices were identified which differed regarding to age, duration of stay, and the importance as well as impact of eating on well-being: the independents (29%) and the embedded (71%). In comparison to the embedded, the independents ate fewer regular meals and eat in the homes less often, but more often alone. Furthermore, the independents were older, give less meaning to food and have more money available for food. Age was found to be an important variable that indicated increasing independence of adolescents. Food practices should therefore be discussed and reflected pedagogically in the care homes.
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Affiliation(s)
- Jenny Markert
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute of Medical Sociology, Germany.
| | - Max Herke
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute of Medical Sociology, Germany
| | - Sabine Kühn
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute of Medical Sociology, Germany
| | - Karl Healy
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute of Medical Sociology, Germany
| | - Matthias Richter
- Martin-Luther-University Halle-Wittenberg, Medical Faculty, Institute of Medical Sociology, Germany; Technical University of Munich, Department of Sport and Health Sciences, Social Determinants of Health, Germany
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Leite RO, Pavia V, Kobayashi MA, Kyoung Lee T, Prado G, Messiah SE, St. George SM. The Effects of Parent-Adolescent Acculturation Gaps on Adolescent Lifestyle Behaviors: Moderating Role of Family Communication. JOURNAL OF LATINX PSYCHOLOGY 2023; 11:21-39. [PMID: 37519909 PMCID: PMC10374166 DOI: 10.1037/lat0000215] [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: 08/01/2023]
Abstract
Objectives This study examined 1) associations between parent-adolescent acculturation gaps in Americanism and Hispanicism and adolescents' lifestyle behaviors (fruit and vegetable intake and physical activity), and 2) the moderating roles of adolescent- and parent-reported family communication on these associations. Methods Hispanic adolescents who have overweight or obesity (n=280; 52% female, 13.0±0.8 years old) and their parents (88% female, 44.9±6.5 years old) completed baseline measures on acculturation, family communication, weekly physical activity, and daily fruit and vegetable intake as part of their participation in a family-based health promotion efficacy trial. Acculturation gaps were calculated by taking the product of adolescent and parent scores for each subscale (Americanism and Hispanicism). We conducted multiple linear regression analyses with three-way interaction terms (e.g., parent Americanism x adolescent Americanism x family communication) to assess for moderation. Results Family communication significantly moderated the association between parent-adolescent acculturation gaps in Americanism and adolescent fruit and vegetable intake. For families with low adolescent-reported family communication, parent-adolescent discrepancies in Americanism were associated with lower adolescent fruit and vegetable intake whereas there were no significant associations for families with high family communication. There were no effects on weekly minutes of physical activity. Acculturation gaps in Hispanicism were not significantly associated with either outcome. Conclusions Findings highlight the importance of parent-adolescent acculturation gaps and family communication on fruit and vegetable intake for Hispanic adolescents. Targeting parent-adolescent acculturation gaps for families with low levels of communication may be important to improve dietary behaviors in Hispanic adolescents, who are already disproportionately affected by obesity.
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Affiliation(s)
- Rafael O. Leite
- Department of Psychology, University of Miami, Coral Gables, FL
| | - Vanina Pavia
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | | | - Tae Kyoung Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL
| | - Sarah E. Messiah
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX
- Center for Pediatric Population Health, UTHealth School of Public Health and Children’s Health System of Texas, Dallas, TX
| | - Sara M. St. George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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Richardsen HK, Bere ET, Stea TH, Klepp KI, Engeset D. Effect of Ending the Nationwide Free School Fruit Scheme on the Intake of Fruits, Vegetables, and Unhealthy Snacks in Norwegian School Children Aged 10-12 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2489. [PMID: 36767855 PMCID: PMC9915852 DOI: 10.3390/ijerph20032489] [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: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
The Norwegian authorities started a nationwide free school fruit program in 2007, implemented in all secondary schools (grades 8-10) and combined schools (grades 1-10) in Norway. The program ended in 2014. This study evaluates the effect of ending the nationwide free school fruit program on the consumption of fruit, vegetables, and unhealthy snacks among Norwegian sixth and seventh graders. The study sample consists of pupils at 18 schools that participated in all data collections in the Fruits and Vegetables Make the Marks project (FVMM), initiated in 2001, with new data collections in 2008 and 2018. Four of the schools were combined schools, therefore children in sixth and seventh grade at these schools received free fruit in 2008 (intervention schools), and fourteen schools did not (control schools). Between 2008 and 2018, pupils at the intervention schools ate a lower proportion of fruits and vegetables per school week, and the consumption of unhealthy snacks increased compared to the control schools. Completion of the free fruit program was not significantly different for boys and girls, or low and high parental education. The results indicate that the end of the free school fruit program resulted in less healthy eating habits among children.
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Affiliation(s)
| | - Elling Tufte Bere
- Department of Sport Science and Physical Education, University of Agder, 4630 Kristiansand, Norway
- Department of Health and Inequality, Norwegian Institute of Public Health, 0213 Oslo, Norway
| | - Tonje Holte Stea
- Department of Health and Nursing Sciences, University of Agder, 4630 Kristiansand, Norway
| | - Knut-Inge Klepp
- Division of Mental and Physical Health, Norwegian Institute of Public Health, 0213 Oslo, Norway
- Department of Nutrition, Faculty of Medicine, University of Oslo, 0315 Oslo, Norway
| | - Dagrun Engeset
- Department of Nutrition and Public Health, University of Agder, 4630 Kristiansand, Norway
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Bel-Serrat S, von der Schulenburg A, Marques-Previ M, Mullee A, Murrin CM. What are the determinants of vegetable intake among adolescents from socioeconomically disadvantaged urban areas? A systematic review of qualitative studies. Int J Behav Nutr Phys Act 2022; 19:158. [PMID: 36572889 PMCID: PMC9793665 DOI: 10.1186/s12966-022-01396-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/01/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Evidence available on the determinants of vegetable intake in young populations is inconsistent. Vegetable intake is particularly low in adolescents from less-affluent backgrounds, yet no systematic review of qualitative studies investigating determinants for vegetable intake specifically has been conducted to date in this group. This systematic review aimed to identify determinants of vegetable intake in adolescents from socioeconomically disadvantaged urban areas located in very high-income countries reported in qualitative studies. METHODS Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO and ERIC) were searched until August 2022. The search strategy used combinations of synonyms for vegetable intake, adolescents, and qualitative methodologies. Main inclusion criteria were studies exploring views and experiences of motivators and barriers to vegetable intake in a sample of adolescents aged 12-18 years from socioeconomically disadvantaged urban areas in very high income countries. Study quality assessment was conducted using criteria established in a previous review. RESULTS Sixteen studies were included out of the 984 screened citations and 63 full texts. The synthesis of findings identified the following determinants of vegetable intake: sensory attributes of vegetables; psychosocial factors (nutrition knowledge, preferences/liking, self-efficacy, motivation); lifestyle factors (cost/price, time, convenience); fast food properties (taste, cost, satiety); home environment and parental influence; friends' influence; school food environment, nutrition education and teachers' support; and availability and accessibility of vegetables in the community and community nutrition practices. Studies attained between 18 and 49 out of 61 quality points, with eleven of 16 studies reaching ≥ 40 points. One main reason for lower scores was lack of data validation. CONCLUSION Multiple determinants of vegetable intake were identified complementing those investigated in quantitative studies. Future large scale quantitative studies should attempt to examine the relative importance of these determinants in order to guide the development of successful interventions in adolescents from socioeconomically disadvantaged backgrounds.
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Affiliation(s)
- Silvia Bel-Serrat
- grid.7886.10000 0001 0768 2743National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin, Ireland
| | - Antje von der Schulenburg
- grid.7886.10000 0001 0768 2743National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin, Ireland
| | - Maria Marques-Previ
- grid.7886.10000 0001 0768 2743National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin, Ireland
| | - Amy Mullee
- grid.516689.50000 0005 0713 0550Department of Health and Nutritional Sciences, Atlantic Technological University, Sligo, Ireland
| | - Celine M Murrin
- grid.7886.10000 0001 0768 2743National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin, Ireland
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Schuler BR, Vazquez CE, Hernandez DC. How Does Consistency of Food and Nutrition Support Effect Daily Food Consumption among Children Living in Poverty? Recession-Era Implications. Nutrients 2022; 15:29. [PMID: 36615687 PMCID: PMC9824108 DOI: 10.3390/nu15010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Underutilization of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and the Supplemental Nutrition Assistance (SNAP) food safety net programs may compromise child nutritional benefits for families with limited incomes. Using a sample of children surveyed before (2003−2006) and after the Great Recession (2007−2009), we examine whether consistent access to WIC and SNAP during times of increased economic stress moderated the association between poverty level (i.e., income-needs ratio [INR]) and fruits and vegetables (FV) or foods high in saturated fats and added sugars (SFAS). Fragile Families and Child Wellbeing Study income-eligible mothers/children (≤185% of poverty) with available FV and SFAS data at the 5- (2003−2006) and 9-year (2007−2010) waves (n = 733) were included. Main effects of INR and interaction effects of consistency of WIC, SNAP, and dual WIC and SNAP support from birth through age 5 were examined. INR was associated with decreased FV consumption frequency from age 5 to 9, conditional upon consistency of dual WIC/SNAP enrollment. FV declined when there was low consistency (<1 year) of dual support. FV consumption was stable across INR when combined WIC/SNAP support lasted at least 2 years. Results can inform strategies for optimizing the nutritional impact of WIC and SNAP by focusing on those most at risk for underutilization of multiple benefits.
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Affiliation(s)
- Brittany R. Schuler
- School of Social Work, College of Public Health, Temple University, 1301 Cecil B Moore Ave., Ritter Annex 5th Floor, Philadelphia, PA 19122, USA
| | - Christian E. Vazquez
- School of Social Work, The University of Texas at Arlington, Arlington, TX 76019, USA
| | - Daphne C. Hernandez
- Cizik School of Nursing, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX 77030, USA
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Bean MK, Raynor HA, Thornton LM, de Jonge L, Mazzeo SE. Design and rationale for evaluating the impact of salad bars on elementary school students' fruit, vegetable, and energy intake: a wait list control, cluster randomized controlled trial. BMC Public Health 2022; 22:2304. [PMID: 36494649 PMCID: PMC9733053 DOI: 10.1186/s12889-022-14744-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Most children do not consume the recommended amount of fruit and vegetable (FV) servings. Changing the school food environment can be a cost-efficient, effective approach to improving children's dietary quality. There is great popular support for school salad bars as a means to increase children's FV intake within the National School Lunch Program (NSLP), yet empirical research is limited. Further, although FV consumption can facilitate healthy weight management if these foods replace high calorie items, there is a need to enhance understanding of salad bars' influence on children's diet quality and energy intake within the NSLP. This is particularly important to investigate in schools in communities characterized by high poverty, as students they serve are particularly likely to rely on school meals. METHODS This report describes the design and rationale of a federally-funded investigation that uses validated methods to evaluate school salad bars. This district plans to install salad bars into 141 elementary schools over 5-years, facilitating the conduct of a waitlist control, cluster randomized controlled trial. Specifically, 12 pairs of matched schools will be randomly selected: half receiving a salad bar (Intervention) and half serving pre-portioned FVs only, standard under the NSLP (Control). Thus, groups will have different FV presentation methods; however, all schools will operate under a policy requiring students to take at least one FV serving. Schools will be matched on Title I status and percent of racial/ethnic minoritized students. Intake will be objectively assessed at lunch in each school pair, prior to (baseline), and 4-6 weeks after salad bars are installed (post), yielding ~ 14,160 lunch observations throughout the study duration. Cafeteria sales and NSLP participation data will be obtained to determine how salad bars impact revenues. Finally, implementation factors and cafeteria personnel's perspectives will be assessed, to identify barriers and facilitators to salad bars use and inform sustainability efforts. Proposed methods and current status of this investigation due to COVID-19 are described. DISCUSSION Results will have great potential to inform school nutrition policies and programs designed to improve dietary quality and reduce obesity. TRIAL REGISTRATION Retrospectively registered (10/28/22) in clinicaltrials.gov (NCT05605483).
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Affiliation(s)
- Melanie K. Bean
- grid.224260.00000 0004 0458 8737Department of Pediatrics, School of Medicine, Children’s Hospital of Richmond at Virginia Commonwealth University, Box 980140, Richmond, VA 23298 USA
| | - Hollie A. Raynor
- grid.411461.70000 0001 2315 1184Department of Nutrition, University of Tennessee, Knoxville, 1215 W. Cumberland Ave, Knoxville, TN 37996 USA
| | - Laura M. Thornton
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599 USA
| | - Lilian de Jonge
- Department of Nutrition and Food Studies, 10349 Democracy Ln, Suite 306, Fairfax, VA 22030 USA
| | - Suzanne E. Mazzeo
- grid.224260.00000 0004 0458 8737Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284 USA
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Zolfaghari M, Meshkovska B, Banik A, Kamphuis CBM, Kopainsky B, Luszczynska A, Murrin C, Lien N. Applying a systems perspective to understand the mechanisms of the European School Fruit and Vegetable Scheme. Eur J Public Health 2022; 32:iv107-iv113. [PMID: 36444113 PMCID: PMC9706111 DOI: 10.1093/eurpub/ckac054] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND For the past two decades, the percentage of European children who consume fruit daily has remained at around 40%, despite numerous school-based policy efforts and interventions. This study aimed to apply a systems approach to provide an integrated perspective of the mechanisms of the European School Fruit and Vegetable Scheme (the Scheme) to understand better how to increase its long-term impact on children's fruit and vegetable consumption. METHODS We developed a causal loop diagram by synthesizing peer-reviewed articles and national government documents related to the Scheme, following the conceptualization steps of system dynamics. The initial causal loop diagrams were then validated in three stages by consulting with experts (two individuals and a group) in school-based fruit and vegetable programmes, children's fruit and vegetable consumption and the Scheme, using disconfirmatory interview guidelines. RESULTS The findings suggest that a central self-reinforcing mechanism through which children socialize during fruit and vegetable consumption is critical in the habituation process. Additionally, the initial increase in children's fruit and vegetable consumption following the Scheme implementation is due to growth in three self-reinforcing loops related to motivation and capability mechanisms; however, this trend gradually slows and stops due to four balancing feedback loops with alternative goals related to opportunity mechanisms that reach their limits. CONCLUSIONS The scheme's design should incorporate activities that align the objectives of the implementers and recipients of the Scheme at all levels. This alignment should provide children with ongoing opportunities to consume fruits and vegetables and strengthen the motivation and capability mechanisms.
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Affiliation(s)
- Mahshid Zolfaghari
- Correspondence: Mahshid Zolfaghari, Department of Nutrition, University of Oslo, P.O. Box 1046 Blindern, 0317 Oslo, Norway, Tel: +47 45 91 70 38, e-mail:
| | | | - Anna Banik
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Carlijn B M Kamphuis
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Birgit Kopainsky
- Department of Geography, System Dynamics Group, University of Bergen, Bergen, Norway
| | - Aleksandra Luszczynska
- Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Celine Murrin
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
| | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
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Diet Quality and Contextual Factors Influencing Food Choice among Adolescents with Food Security and Food Insecurity in Baltimore City. Nutrients 2022; 14:nu14214573. [DOI: 10.3390/nu14214573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
This study evaluated differences in overall diet quality, diet quality components, and food-related contextual factors between adolescents with food security and those with food insecurity. Mixed methods analysis was conducted on data from three 24-h dietary recalls from 61 adolescents ages 14–19 years old living in Baltimore, Maryland, USA in 2020–2021. All adolescents were sampled from households eligible for the Supplemental Nutrition Assistance Program in 2020. There were no significant differences in overall diet quality or components between adolescents with food security and those with food insecurity in this sample, except for seafood and plant proteins, which was higher for adolescents with food insecurity. Qualitative analysis found that adolescents were largely influenced by their parents and the home food environment, and that workplace environments enabled adolescents to eat foods high in refined grains, sugar, and saturated fat. These findings provide insight about the experiences of low-income adolescents during times when they are home for prolonged periods (i.e., emergency school closures, summer, and winter breaks). Programs and policies that aim to improve healthy food access may positively impact adolescent food security and diet quality, and it is important to ensure that healthy foods are available and accessible to adolescents in the places where they spend the most time. Multilevel interventions in the home, school, and workplace may be most effective in encouraging healthy eating behaviors among adolescents.
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Contribution of home availability, parental child-feeding practices and health beliefs on children's sweets and salty snacks consumption in Europe: Feel4Diabetes-Study. Br J Nutr 2022; 128:1647-1655. [PMID: 34658332 DOI: 10.1017/s0007114521004190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Adoption of healthy dietary and snacking habits could support optimum physical and mental development in children as they define health in adulthood. This study assessed parameters associated with children's snacking such as food home availability, parenting practices, and parents' health beliefs. In this cross-sectional study 12 039 children, 49·4% boys 5-12 years, participating in the European Feel4Diabetes-Study were included. Children's weekly consumption of sweets and salty snacks, home availability of snacks, food parenting practices, and health beliefs were assessed via questionnaires. Logistic regression was applied to explore associations of a) home availability of snacks, b) food parenting practices (permissiveness and rewarding with snacks) and c) parent's opinions on deterministic health beliefs with children's consumption of sweets and salty snacks. Results showed that home availability (sweets: ORadj: 4·76, 95 % CI: 4·32, 5·23; salty snacks: ORadj: 6·56, 95 % CI: 5·64, 7·61), allowing to consume (sweets: ORadj: 3·29, 95 % CI: 2·95, 3·67; salty snacks: ORadj: 3·41, 95 % CI: 2·98, 3·90) and rewarding with sweets/salty snacks (sweets: ORadj: 2·69, 95 % CI: 2·23, 3·24; salty snacks: ORadj: 4·34, 95 % CI: 3·57, 5·28) 'sometimes/or less frequently' compared to 'always/or often' were associated with lower weekly consumption of sweets and snacks. Parents' disagreement compared to agreement with deterministic health beliefs and inattentive eating were associated with lower consumption of salty snacks and sweets in children. Overall, the findings of this study indicate that attempts to promote healthy snacking habits in children should aim to improve parental dietary habits, food parenting practices, health beliefs, and reducing home availability of unhealthy foods and snacks.
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Lightner JS, Grimes A, Rhone J, Martin K, Moss J, Wray B, Eighmy K, Valleroy E, Baughn M. Fresh Produce Delivery to Middle School Youth: Outcomes of a Case Study in Providing Fresh Fruit and Vegetables to Underserved Youth. Am J Health Promot 2022; 37:529-533. [PMID: 36301692 DOI: 10.1177/08901171221136858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this study was to evaluate a weekly school-based fruit and vegetable delivery via a mobile market on urban middle schoolers’ nutrition behaviors. Design One-group, pretest-posttest design, quasi-experimental intervention in middle schoolers (6th-8th graders, N = 158) in Kansas City, MO Intervention Weekly delivery of free produce via a mobile market over 12 weeks. Measures A self-administered survey to assess self-report consumption of fruits, vegetables, soda, and sports drinks. Analysis Univariate and bivariate analyses were used. Proportions were compared and chi-square tests were conducted to compare youth at baseline and 12 weeks. Results More youth reported consuming fresh fruit (73.8% to 83.3%; χ2 = 7.76, P = .005) and vegetables (66.4% to 71.3%; χ2 = 13.55, P = <.001) from baseline to follow-up. Less youth reported soda (49.0% to 52.8%; χ2= 6.33, P = .012) and sports drinks (41.8% to 38.2%; χ2= 12.32, P < .001) from baseline to follow-up. Conclusions A mobile produce delivery intervention, like the Healthy Harvest Mobile Market, may be an effective strategy to increase fruit and vegetable consumption for adolescents.
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Affiliation(s)
- Joseph S Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Amanda Grimes
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Janet Rhone
- Community Health Strategies and Innovation, University Health Truman Medical Center, Kansas City, MO, USA
| | - Kael Martin
- Community Health Strategies and Innovation, University Health Truman Medical Center, Kansas City, MO, USA
| | - Justin Moss
- Community Health Strategies and Innovation, University Health Truman Medical Center, Kansas City, MO, USA
| | - Bridget Wray
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Katlyn Eighmy
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Ella Valleroy
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Maya Baughn
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
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