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De Visser HS, Dufault B, Brunton N N, McGavock J. Early life adversity and obesity risk in adolescence: a 9-year population-based prospective cohort study. Pediatr Res 2024; 96:216-222. [PMID: 38267708 DOI: 10.1038/s41390-024-03040-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND There are few prospective studies of factors that mediate the association between exposure to adverse childhood experiences (ACEs) and obesity in adolescence. Our aim was to address this limitation. METHODS We used prospective data from the Growing up in Ireland cohort study, with measurements at 9, 13, and 18 years old. The exposures were 14 adverse experiences before age 9. The main outcome was body mass index (BMI) at 18 years. Mediators were daily activity, diet quality, self-image and behavioural difficulties at 13 years. RESULTS Among the 4561 adolescents in the final cohort, 77.2% experienced any adversity, 50.5% were female and 26.7% were overweight/obese at 18 years. BMI Z was higher at ages 9 (0.54 vs 0.43, p < 0.05, 95% CI of difference: -0.22, -0.01) and 13 years (0.50 vs 0.35, p < 0.05, 95% CI of difference: -0.25, -0.06), in those exposed to an ACE, compared to those unexposed. Structural equation models revealed that behavioural difficulties (β = 0.01; 95% CI: 0.007-0.018, p < 0.001) and self-concept (β = 0.0027; 95% CI: 0.0004-0.0050, p = 0.026) indirectly mediate the association between exposure to ACEs and BMI at 18 years. CONCLUSIONS The association between ACEs and BMI in adolescence is mediated by behavioural difficulties and self-concept. IMPACT In a previous study, we found modest associations between exposure to a range of adverse childhood experiences and weight gain at 13 years of age. The strength of the association between adverse childhood experiences and weight gain was lower at 18 years of age compared to the association observed at 13 years and was no longer significant after controlling for confounding and including possible mediators. The association between adverse childhood experiences and BMI in adolescence is indirectly mediated by behavioural difficulties and self-concept.
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Affiliation(s)
- Hannah Steiman De Visser
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme of the Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Brenden Dufault
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
| | - Nicole Brunton N
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme of the Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
- The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme of the Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB, Canada.
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Dowda M, Saunders RP, Dishman RK, Pate RR. Association of physical activity, sedentary behavior, diet quality with adiposity: a longitudinal analysis in children categorized by baseline weight status. Int J Obes (Lond) 2024; 48:240-246. [PMID: 37932409 DOI: 10.1038/s41366-023-01405-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND/OBJECTIVES Childhood obesity rates have increased in recent years. The effectiveness of future public health interventions to reduce childhood obesity will be enhanced by a better understanding of behavioral factors that influence adiposity in children as they transition from childhood to adolescence. The purpose of this study was to examine whether initial weight status modifies the longitudinal associations of physical activity, sedentary behavior, and diet quality with changes in adiposity over time. SUBJECTS/METHODS A total of 658 children (45% boys) were stratified into 3 groups based on 5th grade BMI percentiles ( < 85th, 85-95th, > 95th) and followed from 5th grade to 6th and/or 7th grade. Study variables, including fat-mass-index (FMI), moderate-to-vigorous physical activity (MVPA), diet quality, and sedentary behavior, were measured at 5th, 6th, and/or 7th grades. Separate growth curve models were conducted within each weight status group to examine the associations between MVPA, sedentary behavior, diet quality and adiposity, operationalized as FMI. All models controlled for sex, maturity offset, race, and parent education. RESULTS Of the 658 children, 53% were classified with normal weight at baseline, 18% with overweight, and 29% with obesity. Associations between MVPA, sedentary behavior, diet quality and FMI varied within each weight status group. MVPA was negatively associated with adiposity (FMI) for all weight status groups. Diet quality and sedentary behavior were associated with adiposity only in children with obesity at baseline; neither diet quality nor sedentary behavior was associated with FMI for those with overweight. CONCLUSIONS MVPA was negatively associated with adiposity (FMI) in all weight status groups, suggesting that MVPA may protect against higher adiposity. Sedentary behavior and diet quality were associated with adiposity only in children with obesity at baseline; neither sedentary behavior nor diet quality was associated with FMI for children with overweight.
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Affiliation(s)
- Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA.
| | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
| | - Rod K Dishman
- Department of Kinesiology, The University of Georgia, Ramsey Student Center, 330 River Road, Athens, GA, 30602-6554, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
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Said FA, Khamis AG, Salmin AH, Msellem SN, Mdachi K, Noor R, Leyna G, Mchau GJ. Influence of diet quality on nutritional status of school-aged children and adolescents in Zanzibar, Tanzania. PLoS One 2023; 18:e0293316. [PMID: 37862346 PMCID: PMC10588882 DOI: 10.1371/journal.pone.0293316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Malnutrition among young children and adolescents poses a serious health challenge in developing countries which results in many health problems during adulthood. Poor diet quality is known as the root cause of malnutrition which is caused by unhealthy food choices and bad eating habits among young children and adolescents. However, limited evidence is available on diet quality and its association with nutrition status among young children and adolescents in Zanzibar. This study examined the diet quality and its relationship with the nutritional status of school-aged children and adolescents in Zanzibar. METHODS Data for this study was obtained from the cross-sectional survey of School Health and Nutrition (SHN) conducted in Zanzibar. The survey recruited children aged 5-19 years from 93 schools in Zanzibar. A seven-day food frequency questionnaire (FFQ) was used to assess dietary intake. Prime Dietary Quality Score (PDQS) consisted of 21 food groups was then constructed to assess the diet quality of school-aged children and adolescents. Body mass index (BMI-for-age Z-score) was used as the indicator of nutrition status. Both linear and logistic regression analysis techniques were used to determine the associations between BMI and PDQS. RESULTS A total data of 2,556 children were enrolled in the survey. The prevalence of thinness was 8.1%, normal 82.1%, overweight 7.2% and obesity 2.6%. The mean (SD) PDQS score was 18.8 (3.2) which ranged from 8 to 33. Consumptions of green leafy vegetables (49.3%), yellow or red fruits (37.8%), legumes (38.3%), fish (36.3%), and vegetable oil (31.5%) were up to three times per week, whereas consumptions of white vegetables (77.3%), cooked vegetables (32.6%), citrus fruits (66.8%), other types of fruits (66.2%), nuts (46.4%), poultry (49.6%), whole grains (61%) and eggs (67.8%) were less than once per week. In terms of unhealthy foods, eating fried foods was reported by 26.3% up to three times per week, and 31.5% reported consuming sweets and ice cream up to three times in the past week. High PDQS was significantly associated with a reduction in BMI of children (p< 0.005). For each unit increase in the consumption of unhealthy foods such as fried foods, cooked vegetables and refined grains there is a significant increase in BMI. The odds of being obese decrease significantly as diet quality increases from the first to third quintile of PDQS (AOR = 0.2, 0.04-0.89 95% CI, p = 0.035). CONCLUSION Consumption of high quality diet was found to be associated with a reduction in excessive weight among school-aged children and adolescents in Zanzibar. There is a need for interventions targeting to reduce unhealthy food consumption in school environment. Further research should be conducted to assess diet quality using PDQS among young children and adolescents.
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Affiliation(s)
- Fatma Ali Said
- Department of Preventive Services and Health Promotion, Ministry of Health Zanzibar, Zanzibar, Tanzania
| | | | - Asha Hassan Salmin
- Department of Preventive Services and Health Promotion, Ministry of Health Zanzibar, Zanzibar, Tanzania
| | | | - Kombo Mdachi
- Office of the Chief Government Statistician, Zanzibar, Tanzania
| | | | - Germana Leyna
- Tanzania Food and Nutrition Centre, Dar-es-salaam, Tanzania
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Grove G, Ziauddeen N, Roderick P, Vassilev I, Appleton JV, Smith D, Alwan NA. Mixed methods feasibility and usability testing of a childhood obesity risk estimation tool. BMC Public Health 2023; 23:1719. [PMID: 37667235 PMCID: PMC10478378 DOI: 10.1186/s12889-023-16500-2] [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: 03/30/2023] [Accepted: 08/10/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND A Childhood Obesity Risk Estimation tool (SLOPE CORE) has been developed based on prediction models using routinely available maternity and early childhood data to estimate risk of childhood obesity at 4-5 years. This study aims to test the feasibility, acceptability and usability of SLOPE CORE within an enhanced health visiting (EHV) service in the UK, as one context in which this tool could be utilised. METHODS A mixed methods approach was used to assess feasibility of implementing SLOPE CORE. Health Visitors (HVs) were trained to use the tool, and in the processes for recruiting parents into the study. HVs were recruited using purposive sampling and parents by convenience sampling. HVs and parents were invited to take part in interviews or focus groups to explore their experiences of the tool. HVs were asked to complete a system usability scale (SUS) questionnaire. RESULTS Five HVs and seven parents took part in the study. HVs found SLOPE CORE easy to use with a mean SUS of 84.4, (n = 4, range 70-97.5) indicating excellent usability. Five HVs and three parents took part in qualitative work. The tool was acceptable and useful for both parents and HVs. Parents expressed a desire to know their child's risk of future obesity, provided this was accompanied by additional information, or support to modify risk. HVs appreciated the health promotion opportunity that the tool presented and felt that it facilitated difficult conversations around weight, by providing 'clinical evidence' for risk, and placing the focus of the conversation onto the tool result, rather than their professional judgement. The main potential barriers to use of the tool included the need for internet access, and concerns around time needed to have a sensitive discussion around a conceptually difficult topic (risk). CONCLUSIONS SLOPE CORE could potentially be useful in clinical practice. It may support targeting limited resources towards families most at risk of childhood obesity. Further research is needed to explore how the tool might be efficiently incorporated into practice, and to evaluate the impact of the tool, and any subsequent interventions, on preventing childhood obesity.
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Affiliation(s)
- Grace Grove
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.
- NIHR Applied Research Collaboration Wessex, Southampton, UK.
| | - Nida Ziauddeen
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton, UK
| | - Paul Roderick
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration Wessex, Southampton, UK
| | - Ivaylo Vassilev
- NIHR Applied Research Collaboration Wessex, Southampton, UK
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Jane V Appleton
- Formerly Professor of Primary and Community Care, Oxford Brookes University (Retired), Oxford, UK
| | - Dianna Smith
- NIHR Applied Research Collaboration Wessex, Southampton, UK
- School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Nisreen A Alwan
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.
- NIHR Applied Research Collaboration Wessex, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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Dhondt N, Staines L, Healy C, Cannon M. Childhood adversity and recurrence of psychotic experiences during adolescence: the role of mediation in an analysis of a population-based longitudinal cohort study. Psychol Med 2023; 53:4046-4054. [PMID: 35311635 PMCID: PMC10317802 DOI: 10.1017/s003329172200071x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/15/2022] [Accepted: 02/22/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) are relatively common in childhood and adolescence and are associated with increased risk of functional issues and psychiatric illness in young adulthood, and PEs that recur are associated with increased risk of poorer psychiatric and functional outcomes. Childhood adversity is a well-established risk factor for PEs. The aim of this study was to investigate (1) the relationship between childhood adversity and recurring PEs in adolescence and (2) candidate mediators of that relationship. METHODS We used data from Cohort '98 of the Growing Up in Ireland study (n = 6039) at three time points (ages 9, 13 and 17) to investigate the relationship between childhood adversity (parent-reported at age 9), recurring PEs (measured using a subset of the Adolescent Psychotic-like Symptoms Screener at ages 13 and 17). The mediating roles of parent-child relationship, internalising and externalising difficulties, self-concept, physical activity, dietary quality, perceived neighbourhood safety and friendship quantity were investigated using the KHB path decomposition method. RESULTS Childhood adversity was associated with an increased risk of recurring PEs with a population attributable fraction of 23%. Internalising difficulties and self-concept explained 13% of the relationship between childhood adversity and PEs suggesting a partial mediation. A significant direct effect remained between childhood adversity and recurring PEs. CONCLUSIONS The established relationship between childhood adversity and PEs may be mainly driven by the relationship between childhood adversity and recurring PEs. Internalising difficulties and self-concept together mediate part of the relationship between childhood adversity and recurring PEs.
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Affiliation(s)
- N. Dhondt
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
- St James's Hospital, Dublin 8, Dublin, Ireland
| | - L. Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
| | - C. Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
| | - M. Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Dublin, Ireland
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Thompson D, Mirabile Y, Islam N, Callender C, Musaad SMA, Miranda J, Moreno JP, Dave JM, Baranowski T. Diet Quality among Pre-Adolescent African American Girls in a Randomized Controlled Obesity Prevention Intervention Trial. Nutrients 2023; 15:2716. [PMID: 37375620 DOI: 10.3390/nu15122716] [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: 05/15/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Consuming an unhealthy diet increases health risks. This study assessed the impact of a culturally adapted behaviorally innovative obesity prevention intervention (The Butterfly Girls and the Quest for Founder's Rock) on diet quality in pre-adolescent non-Hispanic Black/African American girls. The RCT consisted of three groups (experimental, comparison, and waitlist control); block randomization allocated participants to each group. The two treatment groups varied in terms of whether or not they set goals. Data were collected at baseline (prior to receiving the intervention), post 1 (3 months post-baseline), and post 2 (6 months post-baseline). Two dietitian-assisted 24 h dietary recalls were collected at each timepoint. Healthy Eating Index 2015 (HEI-2015) was used to determine diet quality. A total of 361 families were recruited; 342 completed baseline data collection. No significant differences in overall HEI score or component scores were observed. To attain more equitable health outcomes, future efforts to promote dietary intake change among at-risk children should explore other behavior change procedures and employ more child-friendly dietary assessment methods.
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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
| | - Yiming Mirabile
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Noemi Islam
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Chishinga Callender
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Salma M A Musaad
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Julie Miranda
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jennette P Moreno
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
| | - Tom Baranowski
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, USA
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Koester BD, Sloane S, Chusid S, Simon J. Informing State-Wide Coalition Efforts to Implement and Integrate Nutrition Best Practices in Early Care and Education: Focus Group Insights from Child Care Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10025. [PMID: 36011660 PMCID: PMC9408123 DOI: 10.3390/ijerph191610025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
A healthy diet in early childhood is an important contributor to ensuring lifelong health and in reducing risk for obesity. The child care environment is critical to supporting nutrition as a majority of young children less than 5 years of age are enrolled in out-of-home care. In order to better understand barriers to implementing and integrating nutrition best practices, we conduced focus groups with child care providers (n = 25) in Illinois. Providers from low-income communities, rural communities, and communities of color were prioritized. Focus group participants reported several challenges including the high cost of nutritious food, picky eating, and their perception that parents did not set good examples at home. Many providers identified the Child and Adult Care Food Program (CACFP) as a critical resource in helping them implement best practices. Providers discussed needing and wanting more training, more money for food, and more parental support. These results indicate support for additional resources and sustained training and technical assistance to address perceived challenges. The evidence of the importance of CACFP in helping providers engage in nutrition best practices indicates support for expansion and strengthening of the program.
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Affiliation(s)
- Brenda D. Koester
- Family Resiliency Center, Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
- Department of Communication, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Stephanie Sloane
- Family Resiliency Center, Department of Human Development and Family Studies, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Sarah Chusid
- Illinois Public Health Institute, Chicago, IL 60607, USA
| | - Janna Simon
- Illinois Public Health Institute, Chicago, IL 60607, USA
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Association between Diet Quality and Health Outcomes among Children in Rural Areas of Northwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137803. [PMID: 35805462 PMCID: PMC9265919 DOI: 10.3390/ijerph19137803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022]
Abstract
This study aims to examine the relationship between diet quality and health outcomes among children in rural remote areas of China. We draw on a cross-sectional dataset of 1216 children from two counties in the Gansu Province in Northwest China. Child health outcomes were assessed with both anthropometric measurements and reports by primary caregivers of the children. Child diet quality was assessed with the diet quality score (DQS) using information from a food frequency questionnaire (FFQ). Our data show the prevalence of stunting and underweight among sample children were 12% and 11%, respectively; 27% of children were reported by their caregivers as unhealthy, and 60% of children had at least one of the seventeen selected non-communicable diseases (NCDs) over the past 14 days. Overall, 780 (72%) children have at least one of the four above-mentioned health problems. Results from logistic regression models show that a higher DQS was significantly associated with a lower likelihood of being stunted and a higher likelihood of being reported healthy after adjusting for confounders. These findings imply that improving child diet quality might be an option when designing interventions to improve child health.
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Usage of Mobile Applications or Mobile Health Technology to Improve Diet Quality in Adults. Nutrients 2022; 14:nu14122437. [PMID: 35745167 PMCID: PMC9230785 DOI: 10.3390/nu14122437] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/06/2023] Open
Abstract
The use of mobile applications for dietary purposes has dramatically increased along with the consistent development of mobile technology. Assessing diet quality as a dietary pattern or an indicator across key food groups in comparison to those recommended by dietary guidelines is useful for identifying optimal nutrient intake. This systematic review aims to explore mobile applications and their impact on the diet quality of the user. The electronic databases of The Cumulative Index to Nursing and Allied Health Literature (Cinahl), The American Psychological Association’s (APA Psycinfo), and PubMed were systematically searched for randomised and non-randomised controlled trials to retrieve papers from inception to November 2021. Ten studies with 1638 participants were included. A total of 5342 studies were retrieved from the database searches, with 10 articles eligible for final inclusion in the review. The sample sizes ranged from 27 to 732 participants across the included studies, with 1638 total participants. The ratio of female to male participants in the studies was 4:1. The majority of the mobile applications or M-health interventions were used to highlight dietary health changes (six studies), with the remainder used to reduce weight or blood sugar levels (four studies). Each study used a different measure to quantify diet quality. Studies were either assessed by diet quality scoring or individual dietary assessment, of the ten studies, six studies reported an improvement in diet quality following diet-related mobile application use. Mobile applications may be an effective way to improve diet quality in adults; however, there is a need for more targeted and longer-term studies that are expressly designed to investigate the impact using mobile applications has on diet quality.
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The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Caferoglu Z, Erdal B, Hatipoglu N, Kurtoglu S. The effects of diet quality and dietary acid load on insulin resistance in overweight children and adolescents. ENDOCRINOL DIAB NUTR 2022; 69:426-432. [PMID: 35817547 DOI: 10.1016/j.endien.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/28/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION This study aimed to investigate the association of diet quality (DQ) and dietary acid load (DAL) with insulin resistance (IR) in overweight children and adolescents. MATERIALS AND METHODS The study was conducted on 135 overweight participants aged 6-17 years. DQ was assessed using the Healthy Eating Index 2015 (HEI-2015) and the HEI-2015-TUBER, revised in accordance with the Turkey Dietary Guidelines (TUBER). Estimation of DAL was made calculating the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. RESULTS The HEI-2015-TUBER score was lower in those with IR than in those without IR (p=0.021). Higher PRAL and NEAP scores were found in those with IR (p=0.060 and p=0.044, respectively). Moreover, a one-unit increase in the HEI-2015-TUBER score and the DAL score was associated with a reduction of 4.2% and a rise of approximately 3% in IR risk, respectively. CONCLUSIONS Healthy eating habits in overweight paediatric groups may help to reduce the IR risk, improving DQ and decreasing DAL.
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Affiliation(s)
- Zeynep Caferoglu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey.
| | - Busra Erdal
- Department of Nutrition and Dietetics, Institute of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Nihal Hatipoglu
- Department of Paediatric Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Selim Kurtoglu
- Department of Paediatric Endocrinology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Ding C, Fan J, Yuan F, Feng G, Gong W, Song C, Ma Y, Chen Z, Liu A. Association between Physical Activity, Sedentary Behaviors, Sleep, Diet, and Adiposity among Children and Adolescents in China. Obes Facts 2022; 15:26-35. [PMID: 34784593 PMCID: PMC8820170 DOI: 10.1159/000519268] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 08/25/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Physical activity (PA), sedentary behaviors (SB), sleep, and diet are related to adiposity among children and adolescents. However, there may be interactions between PA, SB, sleep, and diet, and these lifestyle behaviors may work together to affect body weight. The purpose of this study was to explore the impact of multiple lifestyle behaviors of PA, SB, sleep, and diet on childhood adiposity (body mass index z-score and overweight/obesity), and to investigate the effect of meeting multiple guidelines on adiposity among children and adolescents in China. METHODS Cross-sectional results were based on 28,048 children aged 6-17 years from the China National Nutrition and Health Surveillance in 2010-2012. Information about PA, SB, and sleep was measured through interview-administered questionnaire. Dietary intake was assessed with food frequency questionnaire. The associations between multiple lifestyle behaviors and BMI z-score and overweight/obese were examined. RESULTS The prevalence of overweight/obesity in the participants was 19.2%. The average time of moderate-to-vigorous PA (MVPA), leisure SB, and sleep was 76.7 ± 45.5 min, 2.9 ± 1.4 h, and 8.5 ± 1.1 h per day, respectively. The China Dietary Guidelines Index for Youth (CDGI-Y) score was 62.6 ± 11.0. Sleep duration and diet score were negative associated with BMI z-score (both p < 0.001). MVPA and SB time were positive associated with BMI z-score (p = 0.041, 0.004). Meeting the SB, sleep, and diet guidelines had a lower BMI z-score (all p < 0.01) and lower odds of overweight/obesity (all p < 0.05). There were significant interactions between PA and diet. Compared with meeting no guidelines, those who met multiple guidelines had a lower risk of overweight/obesity (all p < 0.01). The more guidelines the participants met, the lower odds of overweight/obesity (p for trend <0.001). CONCLUSIONS PA, SB, sleep, and diet are important behaviors associated with adiposity among children and adolescents. Attaining adequate amounts of appropriate multiple behaviors provided an additional benefit. It is important for children to meet recommended behavioral guidelines or recommendations. Interventions that aim to improve awareness of and compliance with these guidelines are needed in future.
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Affiliation(s)
- Caicui Ding
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China,
| | - Jing Fan
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fan Yuan
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ganyu Feng
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Weiyan Gong
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chao Song
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanning Ma
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zheng Chen
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Liu
- Department of Nutrition and Health Education, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Hernández-Ruiz Á, Díaz-Jereda LA, Madrigal C, Soto-Méndez MJ, Kuijsten A, Gil Á. Methodological Aspects of Diet Quality Indicators in Childhood: A Mapping Review. Adv Nutr 2021; 12:2435-2494. [PMID: 34192740 PMCID: PMC8634546 DOI: 10.1093/advances/nmab053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/12/2021] [Accepted: 04/02/2021] [Indexed: 01/16/2023] Open
Abstract
Diet quality indicators (DQIns) are tools that aim to assess an individual's overall diet quality. Previous reviews focused mainly on health-related outcomes but did not provide detailed information about components, assessment variables, or important methodological issues for the development and application of DQIns in the pediatric age. The current mapping review aims to provide comprehensive guidance regarding DQIns developed through a priori methodology in children aged ≤14 y that have been applied worldwide. A mapping review was conducted, whereby 1665 original articles describing the development, modifications, and updates of DQIns, published up to June 26, 2020, in English and Spanish, were retrieved. A total of 139 articles were identified and classified into 13 subgroups. There were 10 overall DQIns: Healthy Eating Indexes (n = 25), Dietary Diversity Scores (n = 20), Diet Quality Indexes (n = 16), Food Variety Scores (n = 11), Healthy and Unhealthy Scores (n = 11), Feeding and Eating Indexes (n = 10), Diet Quality Scores (n = 5), Nutritional Adequacy and Micronutrients Indexes (n = 5), Dietary Guidelines Indexes (n = 5), and Other Healthy Diet Indexes (n = 13). Three additional subgroups of dietary and lifestyle indicators found were Mediterranean Diet Indexes (n = 10), Diet-Lifestyle Indexes (n = 5), and Breakfast Quality Indexes (n = 3). This compilation of DQIns will help researchers select the most appropriate tool for future epidemiological studies by considering a careful selection of information about the assessment components, scoring methods, and key methodological issues. The main limitations of this review are that, due to its nature, a risk-of-bias assessment was not performed and the article screening was completed in 2 databases (PubMed/MEDLINE and Scopus). More research is needed to identify health-related outcomes associated with DQIns in the pediatric population, using clearer and more standardized methodological criteria.
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Affiliation(s)
| | | | - Casandra Madrigal
- Iberoamerican Nutrition Foundation (FINUT), Granada, Spain
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Granada, Spain
| | | | - Anneleen Kuijsten
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Granada, Spain
- Department of Biochemistry and Molecular Biology II, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology “José Mataix,” Biomedical Research Center, University of Granada, Granada, Spain
- Biosanitary Research Institute ibs.GRANADA, Granada University Hospital Complex, Granada, Spain
- CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain
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Parental and Child Factors Associated With 2- to 6-Year-Old Children's Diet Quality in Finland. J Acad Nutr Diet 2021; 122:129-138.e4. [PMID: 34378535 DOI: 10.1016/j.jand.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/26/2021] [Accepted: 06/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND There is limited evidence about diet quality and associated factors in a representative population-based sample of preschool-aged children in Finland. OBJECTIVE The aims of this study were to investigate (1) the extent to which child diet quality and the consumption of health indicator foods (vegetables, fruits, berries, vegetable oil-based spread, nonfat milk) are in accordance with Finnish recommendations for preschool-aged children, (2) whether diet quality differs between children with underweight or normal weight compared with children with overweight or obesity, and (3) whether parental or child factors are related to children's diet quality. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTING Healthy children aged 2 to 6 years (n = 766) were recruited from child health clinics across Finland from February to June 2016. MAIN OUTCOME MEASURES Diet quality and consumption of the health indicator foods were assessed by the Children's Index of Diet Quality (CIDQ, score 0-21, values < 10 indicate poor; 10-13.5, moderate; and ≥14, good diet quality). Parental information was collected with a self-administered questionnaire. Child weight and height were measured by child health clinic nurses. STATISTICAL ANALYSES The overweight/obesity status and diet quality of the children were compared with 1-way analysis of variance. One-way analysis of variance was used as the preliminary analysis between child and parental factors and CIDQ scores, and linear mixed model analysis to further analyze the relationship between child and parental factors and CIDQ data. RESULTS Only a small minority (13.7%) of the children had a good diet quality, 55.4% had a moderate diet quality, and 30.9% had a poor diet quality. Only 1% of the children consumed the key health indicator foods, namely vegetables, fruits, and berries, as recommended. Diet quality did not differ between children with underweight/normal weight and overweight/obesity. Instead, the child's younger age, parents' higher education, and parents' self-perceived healthy diet were related to good diet quality in the child. CONCLUSIONS The diet quality was moderate or poor in the majority of the children. Parental characteristics were the main factors related to the child's diet quality. The results suggest that future efforts to improve preschool-aged children's diet quality are needed including efforts to counsel families in pediatric care. Whether the findings from the current study also apply to Finnish school-aged children should be investigated further.
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Swindle T, McBride NM, Selig JP, Johnson SL, Whiteside-Mansell L, Martin J, Staley A, Curran GM. Stakeholder selected strategies for obesity prevention in childcare: results from a small-scale cluster randomized hybrid type III trial. Implement Sci 2021; 16:48. [PMID: 33933130 PMCID: PMC8088574 DOI: 10.1186/s13012-021-01119-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Together, We Inspire Smart Eating (WISE) is an intervention for the early care and education setting to support children's exposure to and intake of fruits and vegetables. WISE emphasizes 4 evidence-based practices (EBPs): (1) use of a mascot; (2) educators' role modeling; (3) positive feeding practices; and (4) hands-on exposures. The current study reports on a small-scale implementation trial aimed at improving the use of WISE EBPs by teachers. METHODS A Hybrid Type III Cluster Randomized Design compared a Basic and Enhanced implementation strategy. The Basic Strategy included training and reminders only; the Enhanced strategy was a multi-faceted package of stakeholder-selected strategies including a leadership commitment, an implementation blueprint, a local champion, an environmental reminder of the EBPs, facilitation, and tailored educational resources and incentives. All study sites were Head Starts. Sites were randomized using a balancing technique that considered site characteristics; 4 sites (20 classrooms, 39 educators, 305 children) received Enhanced support; 5 sites (18 classrooms, 36 educators, 316 children) received Basic support. RE-AIM guided the evaluation, and implementation fidelity was the primary outcome. Strategies were assessed using examination of data distributions and unadjusted comparisons (t tests) as well as general linear and mixed effects models controlling for covariates. RESULTS For the primary outcome of fidelity, the Enhanced group had significantly higher means for 3 of 4 EBPs. Multivariate models explained a significant portion of variance for both mascot use and hands-on exposure with a significant positive effect observed for treatment condition. The Enhanced group also had higher rates of Appropriateness and Organizational Readiness for Implementing Change (as indicators of implementation and adoption, respectively). There was no significant difference between groups for indicators of Reach, Effectiveness or Maintenance. Formative interviews indicated key targets for iteration and potential mechanisms. Key events were catalogued to provide context for interpretation (e.g., 61% of classrooms with turnover). CONCLUSIONS Findings were mixed but suggested promise for the Enhanced strategy, especially considering key events of the study. Implementation fidelity improvements occurred mainly in the last 3 months of the school year; additional time may be needed to translate to improvements in child outcomes. TRIAL REGISTRATION NCT03075085 Registered 20 February 2017.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Nicole M. McBride
- Embedded Preventive Behavioral Health Capability, Marine Corps Community Services, III MEF, United State Marine Corps, Okinawa, Japan
| | - James P. Selig
- College of Public Health, Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 W. Markham St., #781, Little Rock, AR 72205 USA
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue Box C225, Aurora, CO 80045 USA
| | - Leanne Whiteside-Mansell
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Janna Martin
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Audra Staley
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Geoffrey M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, 4301 W. Markham St, #522-4, Little Rock, AR 72205-7199 USA
- Central Arkansas Veterans Healthcare System, North Little Rock, AR 72114 USA
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16
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VANHELST JÉRÉMY, DEKEN VALÉRIE, BOULIC GAËLLE, DUHAMEL ALAIN, ROMON MONIQUE. Feasibility and reliability of the Self Administered Children's Lifestyle Assessment (SACLA), a new tool to measure children's lifestyle behaviors: the VIF Program. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E117-E121. [PMID: 34322626 PMCID: PMC8283655 DOI: 10.15167/2421-4248/jpmh2021.62.1.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/25/2021] [Indexed: 11/21/2022]
Abstract
Objectives To develop a self-administered children health-related behaviors assessment, and to test its feasibility and reliability in a group of French children. Methods A sample of 216 children participated in the first stage of this study, dedicated to the feasibility assessment. An independent sample of 99 children participated in the assessment of reliability via questionnaire test and retest. Results Missing or inappropriate responses on different parts of the questionnaire ranged from 0 to 35%, more evident on the drink intake and sleep areas. Some questions in fact have been modified or removed. No problems were reported on the dimensions of physical activity habits and sedentary behaviors. The mean percentage of agreement in test-retest reliability for the questionnaire dimensions was 78% (47-99%). Overall, kappa coefficients were good. Conclusions This questionnaire is an acceptable and reliable instrument for assessing lifestyle habits in French children.
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Affiliation(s)
- JÉRÉMY VANHELST
- University of Lille, Inserm, CHU Lille, U1286, INFINITE, Institute for Translational Research in Inflammation, Lille, France - Clinical Investigation Center, CHU Lille, Lille, France
- Correspondence: Jérémy Vanhelst, Antenne pédiatrique du CIC, Hôpital Jeanne de Flandre, CHU de Lille, avenue Eugène Avinée, 59000 Lille Cedex, France - Tel.: +33 3 20 44 60 58 - Fax: +33 3 20 44 66 87 - E-mail:
| | - VALÉRIE DEKEN
- University of Lille, CHU Lille, ULR 2694, METRICS: Evaluation des technologies de santé et des pratiques médicales, Lille, France
| | | | - ALAIN DUHAMEL
- University of Lille, CHU Lille, ULR 2694, METRICS: Evaluation des technologies de santé et des pratiques médicales, Lille, France
| | - MONIQUE ROMON
- Professeur émérite, University of Lille, CHU Lille, ULR 2694, METRICS: Evaluation des technologies de santé et des pratiques médicales, Lille, France
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17
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Golpour-Hamedani S, Rafie N, Pourmasoumi M, Saneei P, Safavi SM. The association between dietary diversity score and general and abdominal obesity in Iranian children and adolescents. BMC Endocr Disord 2020; 20:181. [PMID: 33308202 PMCID: PMC7733278 DOI: 10.1186/s12902-020-00662-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 12/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake. This study aimed to examine the relationship between dietary diversity score (DDS) and obesity in Iranian children. METHODS A cross-sectional study was conducted on 456 children aged 11-18 years, who were selected by random cluster sampling. The usual food intake for each participant assessed using a validated Food frequency questionnaire (FFQ). To calculate the dietary diversity score, food items were categorized into 5 broad groups and 23 subgroups based on the US Department of Agriculture Food Guide Pyramid. Participants were categorized based on the DDS tertile cut-off points. Anthropometric measurements were conducted based on standard protocols. Overweight and obesity were defined as 85th ≤ BMI < 95th, and ≥ 95th percentiles of BMI, respectively. Additionally, abdominal obesity was considered as WC ≥ 85th percentile. RESULTS Mean and standard deviation (SD) of subjects' Body Mass Index (BMI) and waist circumference were 20.88 (SD 4.22) kg/m2 and 74.27 (SD 10.31) cm, respectively. The probability of overweight and obesity was increased as tertiles of DDS increased (OR among tertiles: 1.00, 1.82 and 2.13 for overweight and 1.00, 2.60 and 3.45 for obesity; this was the same for abdominal obesity: 1.00, 2.22 and 3.45, P < 0.001 for all). However, no statistically significant results were found after adjustment for energy intake. CONCLUSION Dietary diversity positively affected obesity through higher energy intake. Despite the wide recommendation of having high dietary diversity, public health programs should emphasize to improve dietary diversity only in selective food items.
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Affiliation(s)
- Sahar Golpour-Hamedani
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran
| | - Nahid Rafie
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran
| | - Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Parvane Saneei
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran.
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sayyed Morteza Safavi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, PO Box: 81746-73461, Isfahan, Iran.
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Dalwood P, Marshall S, Burrows TL, McIntosh A, Collins CE. Diet quality indices and their associations with health-related outcomes in children and adolescents: an updated systematic review. Nutr J 2020; 19:118. [PMID: 33099309 PMCID: PMC7585689 DOI: 10.1186/s12937-020-00632-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/30/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To describe a-priori diet quality indices used in children and adolescents, appraise the validity and reliability of these indices, and synthesise evidence on the relationship between diet quality and physical and mental health, and growth-related outcomes. METHODS Five electronic databases were searched until January 2019. An a-priori diet quality index was included if it applied a scoring structure to rate child or adolescent (aged 0-18-years) dietary intakes relative to dietary or nutrient guidelines. Diagnostic accuracy studies and prospective cohort studies reporting health outcomes were appraised using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS From 15,577 records screened, 128 unique paediatric diet quality indices were identified from 33 countries. Half of the indices' scores rated both food and nutrient intakes (n = 65 indices). Some indices were age specific: infant (< 24-months; n = 8 indices), child (2-12-years; n = 16), adolescent (13-18 years; n = 8), and child/adolescent (n = 14). Thirty-seven indices evaluated for validity and/or reliability. Eleven of the 15 indices which investigated associations with prospective health outcomes reported significant results, such as improved IQ, quality of life, blood pressure, body composition, and prevalence of metabolic syndrome. CONCLUSIONS Research utilising diet quality indices in paediatric populations is rapidly expanding internationally. However, few indices have been evaluated for validity, reliability, or association with health outcomes. Further research is needed to determine the validity, reliability, and association with health of frequently utilised diet quality indices to ensure data generated by an index is useful, applicable, and relevant. REGISTRATION PROSPERO number: CRD42018107630 .
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Affiliation(s)
- Phoebe Dalwood
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Skye Marshall
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia.
- Nutrition Research Australia, Sydney, New South Wales, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Ashleigh McIntosh
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
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Patel KJ, Strait KM, Hildebrand DA, Amaya LL, Joyce JM. Variability in Dietary Quality of Elementary School Lunch Menus with Changes in National School Lunch Program Nutrition Standards. Curr Dev Nutr 2020; 4:nzaa138. [PMID: 32939439 PMCID: PMC7485789 DOI: 10.1093/cdn/nzaa138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/26/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022] Open
Abstract
National School Lunch Program (NSLP) standards recently changed significantly. The Healthy, Hunger-Free Kids Act (HHFKA) presumably improved the dietary quality (DQ) of meals, whereas Child Nutrition Program (CNP) Flexibilities appear to decrease DQ. This variability has not been quantified. Our objective was to determine differences in DQ between elementary school lunch menus meeting NSLP standards: School Meal Initiative (SMI), HHFKA, CNP Flexibilities, and evidence-based best practices (BP). A base menu was portioned per NSLP standards and analyzed for nutrient content and DQ. Statistical analyses included 1-factor ANOVA, Kruskal-Wallis, and Dunnett's test. The BP menu had higher whole fruit and whole grain Healthy Eating Index scores than SMI (Ps < 0.0083). The BP and HHFKA menus had higher refined grain and added sugars scores than SMI (Ps < 0.0083). The SMI menu had lower total vegetable and saturated fat scores than all menus (Ps < 0.0083). This study informs policy toward improving standards, positively affecting child health and academic performance through higher-DQ lunches.
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Affiliation(s)
- Kajal J Patel
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Katie M Strait
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Deana A Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Lauren L Amaya
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Jillian M Joyce
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Acceptability and Feasibility of Best Practice School Lunches by Elementary School-Aged Children in a Serve Setting: A Randomized Crossover Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176299. [PMID: 32872501 PMCID: PMC7504630 DOI: 10.3390/ijerph17176299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/22/2020] [Accepted: 08/27/2020] [Indexed: 11/22/2022]
Abstract
Background: National School Lunch Program (NSLP) standards have improved school lunch dietary quality (DQ), however, further improvements could be made. Acceptability and feasibility of higher DQ are potential barriers. Thus, the purpose is to compare acceptability and feasibility of best practice (BPSL, optimizing DQ) with typical school lunches (TSL, meeting minimum NSLP standards) served separately and concurrently. Methods: Forty elementary school-aged participants were recruited for a randomized crossover trial. Participants attended three meal conditions (MC) choosing one of two meal types—MC1) BPSL1/BPSL2, MC2) TSL1/TSL2, MC3) BPSL/TSL. Acceptability included taste test surveys, weighted plate waste assessments, and hunger scales. Feasibility included meal cost, time, and skill and equipment requirements. Results: There were no significant differences in total taste test score, average total plate waste, or change in hunger (ps > 0.017) before or after adjusting for covariates. TSL was selected significantly more often in MC3 (TSL = 83.3%, BPSL = 16.7%, p = 0.001). Meal cost (p = 0.783) and skill and equipment requirements were not significantly different between meal types. BPSL required significantly longer preparation time (TSL = 60 ± 25 min, BPSL = 267 ± 101 min, p = 0.026). Conclusions: Results indicate few differences in acceptability and feasibility between BPSL and TSL. This study could inform decision and policy-makers seeking to improve school lunch DQ and acceptance of higher DQ meals.
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21
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Zhang X, Gong Y, Jia P, Zhang J, Xue H, Quan L, Tian G, Xiong J, Zhang L, Wang Y, Zhang L, Cheng G. Monetary diet cost is positively associated with diet quality and obesity: an analysis of school-aged children in Southwest China. J Public Health (Oxf) 2020; 41:250-258. [PMID: 29924330 DOI: 10.1093/pubmed/fdy100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 03/13/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is known about the relationships between diet cost, dietary intake and obesity in Chinese populations. This study explored how diet cost was related to diet quality and obesity among school-aged children in Southwest China. METHODS Data from a cross-sectional study was analysed. Diet cost was estimated based on dietary intake assessed with 24-h dietary recalls and retail food prices. Diet quality was measured using the Chinese Children Dietary Index. Body height, weight, waist circumference and skinfold thicknesses were measured, and their body mass index standard deviation score (BMISDS), waist-to-height ratio (WHtR), fat mass index (FMI) and fat-free mass index (FFMI) were calculated. Multivariate regression models were used to explore the relevance of diet cost to diet quality and obesity. RESULTS After adjustment for potential confounders, a positive association was observed between diet quality and energy-adjusted diet cost (β = 0.143, 95% confidence interval, CI: 0.014-0.285, Pfor-trend = 0.0006). Energy-adjusted diet cost also showed a positive association with FMI (β = 0.0354, 95% CI: 0.0001-0.0709, Pfor-trend = 0.01), BMISDS (β = 0.0200, 95% CI: 0.0006-0.0394, Pfor-trend = 0.002) and WHtR (β = 0.0010, 95% CI: 0.0003-0.0017, Pfor-trend = 0.02). CONCLUSIONS Energy-adjusted diet cost was independently and positively associated with diet quality and obesity among Chinese school-aged children.
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Affiliation(s)
- Xiao Zhang
- No. 4 West China Hospital, Sichuan University, 610041 Chengdu, People's Republic of China
| | - Yunhui Gong
- Department of Forensic Biology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, People's Republic of China.,Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) of Ministry of Education, Chengdu, Sichuan, People's Republic of China
| | - Peng Jia
- International Initiative on Spatial Lifecourse Epidemiology (ISLE), Enschede, The Netherlands.,Faculty of Geo-Information Science and Earth Observation, University of Twente, Enschede, The Netherlands
| | - Jieyi Zhang
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China
| | - Hongmei Xue
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China
| | - Liming Quan
- Office of Scientific Research Management, West China School of Public Health, Sichuan University, 610041, Chengdu, People's Republic of China
| | - Guo Tian
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China
| | - Jingyuan Xiong
- Research Center for Public Health and Preventive Medicine, West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Lishi Zhang
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China
| | - Yu Wang
- Department of Nutrition and Food Safety, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Lin Zhang
- Department of Forensic Biology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, People's Republic of China
| | - Guo Cheng
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and Healthy Food Evaluation Research Center, Sichuan University, Chengdu, People's Republic of China
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Burnett AJ, Lamb KE, McCann J, Worsley A, Lacy KE. Parenting styles and the dietary intake of pre-school children: a systematic review. Psychol Health 2020; 35:1326-1345. [DOI: 10.1080/08870446.2020.1743842] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Alissa J. Burnett
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Karen E. Lamb
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jennifer McCann
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Anthony Worsley
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Kathleen E. Lacy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Kroeger EN, Fernandez J, Jones P, Bertrand B. Diet Quality in Early Care and Education Centers: A Comparison of Menu, Served, and Consumed Lunch Measures. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:39-44. [PMID: 31732430 DOI: 10.1016/j.jneb.2019.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/08/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Assess if diet quality (DQ) differs among 3 lunch measures commonly used to assess DQ in early care and education (ECE) centers, which include what is listed on the menu, served, and consumed. DESIGN This quantitative observational study measured DQ of food and beverage items listed on the menu, what children were served, and what they consumed during one lunch meal. SETTING Alabama ECE centers. PARTICIPANTS ECE centers (n = 28) with attendance of ≥10 children ages 3 to 5 years and provided lunch daily. MAIN OUTCOME MEASURE(S) DQ measured through Healthy Eating Index-2015 (HEI) scores, which were calculated for the menu, served, and consumed lunch measures. ANALYSIS Menu, served, and consumed HEI scores compared using either Kruskal-Wallis or ANOVA. Dunn Bonferroni or Duncan post hoc tests identified which group differed. RESULTS Total HEI scores were significantly higher among menus, compared with served and consumed (P = .001). Served and consumed total HEI scores were not different. CONCLUSIONS AND IMPLICATIONS Menu DQ differed from both the served and consumed lunch measures. These findings support the need for nutrition education on the importance of menu adherence in ECE centers.
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Affiliation(s)
- Elizabeth N Kroeger
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL.
| | - Jose Fernandez
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Peter Jones
- Department of Political Science and Public Administration, University of Alabama at Birmingham, Birmingham, AL
| | - Brenda Bertrand
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
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Colby S, Moret L, Olfert MD, Kattelmann K, Franzen-Castle L, Riggsbee K, Payne M, Ellington A, Springer C, Allison C, Wiggins S, Butler R, Mathews D, White AA. Incorporating Technology Into the iCook 4-H Program, a Cooking Intervention for Adults and Children: Randomized Controlled Trial. JMIR Pediatr Parent 2019; 2:e11235. [PMID: 31518323 PMCID: PMC6744819 DOI: 10.2196/11235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 03/18/2019] [Accepted: 05/14/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Families who cook, eat, and play together have been found to have more positive health outcomes. Interventions are needed that effectively increase these health-related behaviors. Technology is often incorporated in health-related interventions but is not always independently assessed. OBJECTIVE The objective of this study was to describe challenges and facilitators to incorporating technology into the iCook 4-H intervention program. METHODS Dyads (n=228) composed of children (mean 9.4, SD 0.7 years old) and an adult primary meal preparer (mean 39.0, SD 8 years) were randomly assigned to a control (n=77) or treatment group (n=151). All treatment group dyads participated in 6 in-person sessions designed to increase families cooking, eating, and playing together. We incorporated Web-based between-session technological components related to the curriculum content throughout the intervention. Assessments were completed by both groups at baseline and at 4, 12, and 24 months; they included measured anthropometrics for children, and online surveys about camera and website skill and use for dyads. Session leaders and participants completed open-ended process evaluations after each session about technological components. We computed chi-square analysis for sex differences in technological variables. We tested relationships between video posting frequency and outcomes of interest (cooking frequency, self-efficacy, and skills; dietary intake; and body mass index) with Spearman correlations. Process evaluations and open-ended survey responses were thematically analyzed for beneficial and inhibiting factors, including technological components in the curriculum. RESULTS Only 78.6% (81/103) of children and 68.3% (71/104) of adults reported always being comfortable accessing the internet postintervention. Boys reported being more comfortable than girls with technological tasks (P<.05). Children who posted more videos had a higher level of cooking skills at 4 months postintervention (r=.189, P=.05). Barriers to website usage reported most frequently by children were lack of accessibility, remembering, interactivity, motivation, time, and lack of parental encouragement. CONCLUSIONS Incorporating technological supports, such as cameras and websites, into children's programs may help produce improved outcomes. Identifying barriers to and patterns of technology usage need to be considered when developing future child health promotion interventions. TRIAL REGISTRATION ISRCTN Registry ISRCTN54135351; https://www.isrctn.com/ISRCTN54135351.
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Affiliation(s)
- Sarah Colby
- Department of Nutrition, University of Tennessee, Knoxville, TN, United States
| | | | - Melissa D Olfert
- Davis College of Agriculture, Natural Resources, and Design, West Virginia University, Morgantown, WV, United States
| | - Kendra Kattelmann
- Health and Nutritional Sciences Department, South Dakota State University, Brookings, SD, United States
| | - Lisa Franzen-Castle
- College of Education and Human Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Kristin Riggsbee
- Department of Nutrition, University of Tennessee, Knoxville, TN, United States
| | - Magen Payne
- Department of Nutrition, University of Tennessee, Knoxville, TN, United States
| | - Ainsley Ellington
- Department of Nutrition, University of Tennessee, Knoxville, TN, United States
| | - Cary Springer
- Research Computing Support, University of Tennessee, Knoxville, TN, United States
| | - Chelsea Allison
- Department of Nutrition, University of Tennessee, Knoxville, TN, United States
| | - Sa'Nealdra Wiggins
- Department of Nutrition, University of Tennessee, Knoxville, TN, United States
| | - Rochelle Butler
- Research Computing Support, University of Tennessee, Knoxville, TN, United States
| | | | - Adrienne A White
- School of Food and Agriculture, University of Maine, Orono, ME, United States
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Trijsburg L, Talsma EF, de Vries JHM, Kennedy G, Kuijsten A, Brouwer ID. Diet quality indices for research in low- and middle-income countries: a systematic review. Nutr Rev 2019; 77:515-540. [PMID: 31127835 PMCID: PMC6609420 DOI: 10.1093/nutrit/nuz017] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
CONTEXT Dietary intake research has increasingly focused on improving diet quality in low- and middle-income countries (LMICs). Accompanying this is the need for sound metrics to assess diet quality. OBJECTIVE This systematic literature review aims to describe existing diet quality indices for general populations and highlights recommendations for developing such indices for food system research in LMICs. DATA SOURCES Three electronic databases were searched for papers published between January 2008 and December 2017. DATA EXTRACTION Articles published in English and describing the development of an index to measure overall diet quality, irrespective of whether they were for high-income countries or LMICs, were included. DATA ANALYSIS Eighty-one indices were identified, over two thirds were based on national dietary guidelines from high-income countries. Of the 3 key diet quality dimensions, "diversity" was included in all 18 indices developed for LMICs, "moderation" was captured by most, and "nutrient adequacy" was included 4 times. CONCLUSIONS Indices need to be developed that include all dimensions, include foods and/or food groups rather than nutrients, use an optimal range for individual components in the score, and express the intake of healthy and unhealthy components separately. Importantly, validation of the index should be part of its development.
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Affiliation(s)
- Laura Trijsburg
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Elise F Talsma
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Jeanne H M de Vries
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | | | - Anneleen Kuijsten
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - Inge D Brouwer
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
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26
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Gelberg L, Rico MW, Herman DR, Belin TR, Chandler M, Ramirez E, Love S, McCarthy WJ. Comparative effectiveness trial comparing MyPlate to calorie counting for mostly low-income Latino primary care patients of a federally qualified community health center: study design, baseline characteristics. BMC Public Health 2019; 19:990. [PMID: 31340800 PMCID: PMC6651946 DOI: 10.1186/s12889-019-7294-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/10/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Primary care-based behavior change obesity treatment has long featured the Calorie restriction (CC), portion control approach. By contrast, the MyPlate-based obesity treatment approach encourages eating more high-satiety/high-satiation foods and requires no calorie-counting. This report describes study methods of a comparative effectiveness trial of CC versus MyPlate. It also describes baseline findings involving demographic characteristics and their associations with primary outcome measures and covariates, including satiety/satiation, dietary quality and acculturation. METHODS A comparative effectiveness trial was designed to compare the CC approach (n = 130) versus a MyPlate-based approach (n = 131) to treating patient overweight. Intervenors were trained community health workers. The 11 intervention sessions included two in-home health education sessions, two group education sessions, and seven telephone coaching sessions. Questionnaire and anthropometric assessments occurred at baseline, 6- and 12 months; food frequency questionnaires were administered at baseline and 12 months. Participants were overweight adult primary care patients of a federally qualified health center in Long Beach, California. Two measures of satiety/satiation and one measure of post-meal hunger comprised the primary outcome measures. Secondary outcomes included weight, waist circumference, blood pressure, dietary quality, sugary beverage intake, water intake, fruit and vegetable fiber intake, mental health and health-related quality of life. Covariates included age, gender, nativity status (U.S.-born, not U.S.-born), race/ethnicity, education, and acculturation. ANALYSIS Baseline characteristics were compared using chi square tests. Associations between covariates and outcome measures were evaluated using multiple regression and logistic regression. RESULTS Two thousand eighty-six adult patients were screened, yielding 261 enrollees who were 86% Latino, 8% African American, 4% White and 2% Other. Women predominated (95%). Mean age was 42 years. Most (82%) were foreign-born; 74% chose the Spanish language option. Mean BMI was 33.3 kg/m2; mean weight was 82 kg; mean waist circumference was 102 cm. Mean blood pressure was 122/77 mm. Study arms on key baseline measures did not differ except on dietary quality and sugary beverage intake. Nativity status was significantly associated with dietary quality. CONCLUSIONS The two treatment arms were well-balanced demographically at baseline. Nativity status is inversely related to dietary quality. TRIAL REGISTRATION NCT02514889 , posted on 8/4/2015.
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Affiliation(s)
- Lillian Gelberg
- Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, 10880 Wilshire Blvd, Ste 1800, Los Angeles, CA 90024 USA
| | - Melvin W. Rico
- Charles R. Drew/UCLA Medical Education Program, Los Angeles, USA
| | - Dena R. Herman
- Family and Consumer Sciences, College of Health and Human Development, SQ 200M 18111 Nordhoff Street, Northridge, CA 91330 USA
| | - Thomas R. Belin
- UCLA Fielding School of Public Health, 51-267 CHS, mc 177220, 650 Charles Young Drive, Los Angeles, CA 90095 USA
| | - Maria Chandler
- TCC, 701 East 28th Street, Suite 200, Long Beach, CA 90806 USA
| | - Evangelina Ramirez
- The Children’s Clinic of Long Beach Patient Representative, 1715 E. Anaheim St., Apt. 2, Long Beach, CA 90813 USA
| | | | - William J. McCarthy
- UCLA Fielding School of Public Health, A2-125 CHS, mc 690015, 650 Charles Young Drive, Los Angeles, CA 90095 USA
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Prevalence of Dietary Behavior and Determinants of Quality of Diet among Beneficiaries of Government Welfare Assistance in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030501. [PMID: 30754683 PMCID: PMC6388226 DOI: 10.3390/ijerph16030501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/24/2019] [Accepted: 01/31/2019] [Indexed: 11/16/2022]
Abstract
Diet, as a modifiable factor for good health maintenance, reduces the risk of numerous non-communicable chronic diseases and prevents premature death. The aim of the study was to examine the prevalence of a dietary behavior and to find out what the determinants of diet quality among the low socio-economic status population are. The studied sample consisted of 1710 respondents. Only 3% of the beneficiaries had healthy dietary habits. Unhealthy dietary habits dominated in all the study group regardless of the subjects' level of education (p < 0.001). Higher odds of unhealthy dietary habits were reported among the respondents with primary, vocational, and secondary education than among the respondents with high education (for the primary education OR = 11.10; 95% CI: 5.86⁻21.01; p ≤ 0.001; for vocational education OR = 10.54; 95% CI: 5.79⁻19.18; p ≤ 0.001 and for secondary education OR = 5.83; 95% CI: 3.48⁻9.79; p ≤ 0.001). The unhealthy dietary behavior prevalence among beneficiaries of government welfare assistance in Poland is much higher than in the general population. Since only educational level is a determinant which is significantly correlated with the unhealthy dietary behavior, promotion of a healthy diet among disadvantaged individuals should be focused on this factor.
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Bidirectional associations between diet and body composition measures from 2 to 15 years: Longitudinal Study of Australian Children. Br J Nutr 2018; 121:212-220. [PMID: 30375296 DOI: 10.1017/s0007114518003173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study investigates how dietary patterns and scores are associated with subsequent BMI and waist:height ratio (WHtR), and how BMI and WHtR are associated with subsequent dietary patterns or scores, from 2-3 to 10-11 and 4-5 to 14-15 years of age. In the Longitudinal Study of Australian Children, height, weight and waist circumference were measured biennially in children, yielding BMI z-score and WHtR. Parents, latterly children, reported frequency of child consumption of 12-16 food/drink items during the previous 24 h. At each wave, we empirically derived dietary patterns using factor analyses, and dietary scores based on the 2013 Australian Dietary Guidelines. We used structural-equation modelling to investigate cross-lagged associations (n 1972-2882) between diet and body composition measures in univariable and multivariable analyses. Dietary scores/patterns did not consistently predict WHtR and BMI z-score in the next wave, nor did BMI z-score and WHtR consistently predict diet in the next wave. The few associations seen were weak and often in the opposite direction to that hypothesised. The largest effect, associated with each standard deviation increase in BMI in wave 5 of the K cohort (age 12-13 years), was a 0·06 standard deviation estimated mean increase in dietary score (higher quality diet) in the subsequent wave (95 % CI 0·02, 0·11, P=0·003). Associations between dietary patterns/scores and body composition were not strongly evident in either direction. Better quantitative childhood dietary tools feasible for large-scale administration are needed to quantify how dietary patterns, energy intake and anthropometry co-develop.
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29
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Albataineh SR, Badran EF, Tayyem RF. Dietary factors and their association with childhood obesity in the Middle East: A systematic review. Nutr Health 2018; 25:53-60. [PMID: 30282516 DOI: 10.1177/0260106018803243] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND: Childhood obesity is a global epidemic that is related to environmental and genetic factors and has adverse consequences throughout life, being obese is a serious health problem in childhood and increases the risk of many co-morbidities. AIM: The purpose of this systematic review is to illustrate that dietary factors correlate with obesity among children studied in the Middle East area. METHODS: Studies were screened by searching two databases in August 2017 and considered as eligible for inclusion if they: (a) are observational studies, (b) define at least one dietary factor for obese children aged 6-12 years, (c) are undertaken in the Middle East area, and (d) are written in English. The search dependent words and terms used are: diet, nutrition, pediatric obesity, physical activity, Middle East, overweight, children, excess weight, childhood, obesity and dietary factors. Papers were initially evaluated for eligibility based on title and abstract. The full text of articles of studies that met, or appeared to meet, the inclusion criteria, were saved. Quality assessment was conducted using the NIH tool for observational cohort and cross-sectional studies. Out of 730 studies, 4 papers met the inclusion criteria and rated as good quality. These studies were from Iran ( n=2), Saudi Arabia ( n=1) and Lebanon ( n=1) during 2008 and 2016. RESULTS: Dietary factors identified were breakfast intake, junk-food consumption, energy intake and micronutrient intake. The present systematic review shows that several dietary behaviors such as missing breakfast, excessive fat and refined carbohydrate intake with low micronutrient intake due to low consumption of fruits, vegetables and milk/diary, are associated with obesity in children in the Middle East. CONCLUSIONS: A healthy diet during childhood to control weight and prevent obesity is recommended for a healthy, lifelong adulthood.
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Affiliation(s)
- Samah R Albataineh
- 1 Department of Nutrition and Food Technology, The University of Jordan, Jordan
| | | | - Reema F Tayyem
- 1 Department of Nutrition and Food Technology, The University of Jordan, Jordan
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30
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Joyce JM, Rosenkranz RR, Rosenkranz SK. Variation in Nutritional Quality of School Lunches With Implementation of National School Lunch Program Guidelines. THE JOURNAL OF SCHOOL HEALTH 2018; 88:636-643. [PMID: 30133780 DOI: 10.1111/josh.12665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/18/2017] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND School lunches must meet National School Lunch Program (NSLP) requirements to receive reimbursement. In this study, we sought to determine whether there are significant differences in nutrient content and nutritional quality between 2 menus meeting NSLP requirements. METHODS A cross-sectional content analysis compared 6 weeks of a typical school lunch menu (TM) from an actual school district to a best practice school lunch menu (BPM) created by a registered dietitian based on Child and Adult Care Food Program (CACFP) best practices and Dietary Guidelines for Americans (DGA) healthy meal pattern recommendations. Daily nutrient content was determined using nutrient analysis software. Nutritional quality was computed using Healthy Eating Index (HEI) 2010. RESULTS For nutrients required for analysis, the BPM was lower in calories, saturated fat, and sodium and higher in protein, carbohydrate, and fiber (ps < .01). For other nutrients of concern, the BPM was higher in vitamin A, vitamin D, phosphorus, and magnesium (ps < .01). The BPM had higher HEI scores for nutritional quality (p < .001). CONCLUSIONS Results indicate the possibility for significant variation in nutritional quality of NSLP-qualifying lunches. Using CACFP best practices and DGA recommendations may significantly impact school lunch dietary quality.
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Affiliation(s)
- Jillian M Joyce
- Department of Food, Nutrition, Dietetics and Health, College of Human Ecology, Kansas State University; Physical Activity and Nutrition Clinical Research Consortium, Kansas State University, Lafene Student Health Center, 1105 Sunset Avenue, Room 324, Manhattan, KS 66506
| | - Richard R Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, College of Human Ecology, Kansas State University; Physical Activity and Nutrition Clinical Research Consortium, Kansas State University, Lafene Student Health Center, 1105 Sunset Avenue, Room 321, Manhattan, KS 66506
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, College of Human Ecology, Kansas State University; Physical Activity and Nutrition Clinical Research Consortium, Kansas State University, Lafene Student Health Center, 1105 Sunset Avenue, Room 322, Manhattan, KS 66506
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31
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Kunaratnam K, Halaki M, Wen LM, Baur LA, Flood VM. Reliability and comparative validity of a Diet Quality Index for assessing dietary patterns of preschool-aged children in Sydney, Australia. Eur J Clin Nutr 2017; 72:464-468. [PMID: 29249825 DOI: 10.1038/s41430-017-0020-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 09/08/2017] [Accepted: 09/08/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To report on the reliability and validity of a Diet Quality Index (DQI) to assess preschoolers dietary patterns using a short food frequency questionnaire (sFFQ) and 3-day food records (3d-FR). SUBJECTS/METHODS Seventy-seven preschool carers/parents completed a telephone interview on preschoolers (2-5-year olds) dietary habits in metropolitan Sydney. Agreement in scores was assessed using intraclass correlation (ICC) and paired t-tests for repeated sFFQ-DQI scores and Bland-Altman methods and paired t-tests for sFFQ-DQI and 3d-FR-DQI scores. RESULTS Mean-total sFFQ-DQI ICC scores was high = 0.89, 95% CI (0.81, 0.93). There was weak agreement between sFFQ-DQI and 3d-FR-DQI scores (r = 0.36, p < 0.01). The 3d-FR-DQI scores were positively associated with carbohydrate, folate, ß-carotene, magnesium, calcium, protein, total fat and negatively associated with sugar, starch, niacin, vitamin C, phosphorus, polyunsaturated fat, and monounsaturated fat. CONCLUSIONS The sFFQ-DQI demonstrated good reliability but weak validity. Associations between nutrients and 3d-FR-DQI scores indicate promising usability and warrants further investigation. Further research is needed to establish its validity in accurately scoring children's diet quality using sFFQ compared to 3d-FR before the tool can be implemented for use in population settings.
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Affiliation(s)
- Kanita Kunaratnam
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Mark Halaki
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Li Ming Wen
- Health Promotion Service, Sydney Local Health District, Sydney, NSW, 2006, Australia.,School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Louise A Baur
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Discipline of Pediatrics and Child Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Victoria M Flood
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia. .,Westmead Hospital (Western Sydney Local Health District), Sydney, NSW, 2145, Australia.
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Vollmer RL, Adamsons K, Foster JS, Mobley AR. How Are Fathers' Demographic Characteristics Related to Preschool-Age Children's Weight and Obesity Risk Factors? Ecol Food Nutr 2017; 56:381-392. [PMID: 28704093 DOI: 10.1080/03670244.2017.1343726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Fathers (n = 149) of preschool children were interviewed using the Child Feeding, Role of the Father (ROF), and ROF at Mealtimes (ROFM) questionnaires to determine whether fathers' demographic characteristics are associated with child overweight. Low-income was associated with higher pressure to eat (p = .006) and perceived their child as higher weight (p = .001). Higher education level was associated with lower ROF (p = .018) and ROFM (p = .002) and higher child diet quality (p = .002). Father's BMI was positively associated with ROFM (p = .008). Certain fathers may be important targets in childhood obesity prevention programs.
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Affiliation(s)
- Rachel L Vollmer
- a Department of Family and Consumer Sciences , Bradley University , Peoria , Illinois , USA
| | - Kari Adamsons
- b Department of Human Development and Family Studies , University of Connecticut , Storrs , Connecticut , USA
| | - Jaime S Foster
- c Department of Nutritional Sciences , University of Connecticut , Storrs , Connecticut , USA
| | - Amy R Mobley
- c Department of Nutritional Sciences , University of Connecticut , Storrs , Connecticut , USA
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33
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Stability and change in dietary scores and patterns across six waves of the Longitudinal Study of Australian Children. Br J Nutr 2017; 117:1137-1150. [DOI: 10.1017/s0007114517000897] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AbstractThis study aimed to derive and compare longitudinal trajectories of dietary scores and patterns from 2–3 to 10–11 years and from 4–5 to 14–15 years of age. In waves two to six of the Baby (B) Cohort and one to six of the Kindergarten (K) Cohort of the population-based Longitudinal Study of Australian Children, parents or children reported biennially on the study child’s consumption of twelve to sixteen healthy and less healthy food or drink items for the previous 24 h. For each wave, we derived a dietary score from 0 to 14, based on the 2013 Australian Dietary Guidelines (higher scores indicating healthier diet). We then used factor analyses to empirically derive dietary patterns for separate waves. Using group-based trajectory modelling, we generated trajectories of dietary scores and empirical patterns in 4504 B and 4640 K Cohort children. Four similar trajectories of dietary scores emerged for the B and K Cohorts, containing comparable proportions of children in each cohort: ‘never healthy’ (8·8 and 11·9 %, respectively), ‘moderately healthy’ (24·0 and 20·7 %), ‘becoming less healthy’ (16·6 and 27·3 %) and ‘always healthy’ (50·7 and 40·2 %). Deriving trajectories based on dietary patterns, rather than dietary scores, produced similar findings. For ‘becoming less healthy’ trajectories, dietary quality appeared to worsen from 7 years of age in both cohorts. In conclusion, a brief dietary measure administered repeatedly across childhood generated robust, nuanced dietary trajectories that were replicable across two cohorts and two methodologies. These trajectories appear ideal for future research into dietary determinants and health outcomes.
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Golpour-Hamedani S, Mohammadifard N, Khosravi A, Feizi A, Safavi SM. Dietary approaches to stop hypertension diet and obesity: A cross-sectional study of Iranian children and adolescents. ARYA ATHEROSCLEROSIS 2017; 13:7-13. [PMID: 28761449 PMCID: PMC5515185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Few studies have investigated the effects of dietary approaches to stop hypertension (DASH) diet on obesity in children. The present study was conducted to examine adherence to the DASH diet in relation to obesity in children and adolescents, Isfahan, Iran. METHODS A cross-sectional study was carried out among 456 children aged 11-18 years who were selected by random cluster sampling method. Dietary intakes were assessed using a validated Food Frequency Questionnaire (FFQ). The DASH score was constructed based on food items emphasized or minimized in the DASH diet. Anthropometric measurements were conducted based on standard protocols. General and abdominal obesity were defined based on body mass index ≥ 95th percentiles and waist: height ratio of more than 0.5, respectively. RESULTS Higher adherence to DASH diet was inversely associated with general obesity (odds ratioT1 vs. T3 3.34, 95% confidence interval 1.28-8.75); however, after controlling for confounding factors, this association disappeared. Furthermore, higher adherence to DASH diet was negatively associated with central obesity in children, but the relation was not statistically significant. CONCLUSION We concluded that there was an inverse nonsignificant association between adherence to DASH diet and general obesity indices after adjustment for potential confounders. Further, well-designed randomized clinical trial studies are suggested to find out the effect of DASH diet on obesity obviously.
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Affiliation(s)
- Sahar Golpour-Hamedani
- Food Security Research Center AND Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute AND Department of Biostatistics and Epidemiology, School of Health and Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayyed Morteza Safavi
- Food Security Research Center AND Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Sayyed Morteza Safavi,
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Keane E, Cullinan J, Perry CP, Kearney PM, Harrington JM, Perry IJ, Layte R. Dietary quality in children and the role of the local food environment. SSM Popul Health 2016; 2:770-777. [PMID: 29349188 PMCID: PMC5757931 DOI: 10.1016/j.ssmph.2016.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/08/2016] [Accepted: 10/08/2016] [Indexed: 02/08/2023] Open
Abstract
Diet is a modifiable contributor to many chronic diseases including childhood obesity. The local food environment may influence children's diet but this area of research is understudied. This study explores if distance to and the number of supermarkets and convenience stores in the local area around households are associated with dietary quality in nine year olds whilst controlling for household level socio-economic factors. This is a secondary analysis of Wave 1 (2007/2008) of the Growing Up in Ireland (GUI) Child Cohort Study, a sample of 8568 nine year olds from the Republic of Ireland. Dietary intake was assessed using a short, 20-item parent reported food frequency questionnaire and was used to create a dietary quality score (DQS) whereby a higher score indicated a higher diet quality. Socio-economic status was measured using household class, household income, and maternal education. Food availability was measured as road network distance to and the number of supermarkets and convenience stores around households. Separate fixed effects regression models assessed the association between local area food availability and dietary quality, stratified by sex. The DQS ranged from −5 to 25 (mean 9.4, SD 4.2). Mean DQS was higher in those who lived furthest (distance in quintiles) from their nearest supermarket (p<0.001), and in those who lived furthest from their nearest convenience store (p<0.001). After controlling for socio-economic characteristics of the household, there was insufficient evidence to suggest that distance to the nearest supermarket or convenience store was associated with dietary quality in girls or boys. The number of supermarkets or convenience stores within 1000 m of the household was not associated with dietary quality. Food availability had a limited effect on dietary quality in this study. Issues associated with conceptualising and measuring the food environment may explain the findings of the current study. This sample represents a large nationally representative sample of nine year old children. Distance to the nearest food outlet from the home had a limited impact on dietary quality. Having a food outlet within 1000 m of the home had a limited impact dietary quality. Household socio-economic indicators were important predictors of dietary quality.
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Affiliation(s)
- Eimear Keane
- Department Epidemiology & Public Health, University College Cork, Cork, Ireland.,Health Promotion Research Centre, National University of Ireland, Galway, Galway, Ireland
| | - John Cullinan
- Department of Economics, National University of Ireland, Galway, Galway, Ireland
| | - Catherine P Perry
- Department Epidemiology & Public Health, University College Cork, Cork, Ireland.,Health Promotion Research Centre, National University of Ireland, Galway, Galway, Ireland
| | - Patricia M Kearney
- Department Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - Janas M Harrington
- Department Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - Ivan J Perry
- Department Epidemiology & Public Health, University College Cork, Cork, Ireland
| | - Richard Layte
- Department of Sociology, Trinity College Dublin, Dublin 2, Ireland.,Economic and Social Research Institute, Sir John Rogerson's Quay, Dublin 2, Ireland
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Jampolis MB, Rothkopf MM, Li Z, Diamond SJ, Allen K, Abdelhadi RA, Kahana DD, McClave SA. Principles of Healthful Eating. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0168-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fletcher EA, McNaughton SA, Lacy KE, Dunstan DW, Carson V, Salmon J. Mediating effects of dietary intake on associations of TV viewing, body mass index and metabolic syndrome in adolescents. Obes Sci Pract 2016; 2:232-240. [PMID: 27708839 PMCID: PMC5043492 DOI: 10.1002/osp4.60] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/03/2016] [Accepted: 07/08/2016] [Indexed: 02/01/2023] Open
Abstract
Objective Evidence suggests that TV viewing is associated with body mass index (BMI) and metabolic syndrome (MetS) in adolescents. However, it is unclear whether dietary intake mediates these relationships. Methods A cross‐sectional analysis was conducted in adolescents (12–19 years) participating in the 2003–2006 United States National Health and Nutrition Examination Survey. BMI z scores (zBMI) (n = 3,161) and MetS (n = 1,379) were calculated using age‐ and sex‐specific criteria for adolescents. TV viewing (h/day) was measured via a self‐reported questionnaire, and dietary intake was assessed using two 24‐h recalls. Using the MacKinnon method, a series of mediation analyses were conducted examining five dietary mediators (total energy intake, fruit and vegetable intake, discretionary snacks, sugar‐sweetened beverages and diet quality) of the relationships between TV viewing and zBMI and MetS. Results Small positive relationships were observed between TV viewing and zBMI (β = 0.99, p < 0.001) and TV viewing and MetS (OR = 1.18, p = 0.046). No dietary element appeared to mediate the relationship between TV viewing and zBMI. However, sugar‐sweetened beverage consumption and fruit and vegetable intake partially mediated the relationship between TV viewing and MetS, explaining 8.7% and 4.1% of the relationship, respectively. Conclusions These findings highlight the complexity of the relationships between TV viewing, dietary intake and cardiometabolic health outcomes, and that TV viewing should remain a target for interventions.
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Affiliation(s)
- E A Fletcher
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - S A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - K E Lacy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - D W Dunstan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences Deakin University Geelong Australia; Baker IDI Heart and Diabetes Institute Melbourne Victoria Australia; School of Public Health and Preventive Medicine Monash University Melbourne Australia; School of Public Health The University of Queensland Brisbane Australia; Department of Medicine Monash University Melbourne Australia; School of Sport Science, Exercise and Health The University of Western Australia Perth Australia; Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Australia
| | - V Carson
- Faculty of Physical Education and Recreation University of Alberta Edmonton Alberta Canada
| | - J Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences Deakin University Geelong Australia
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Tabbakh T, Freeland-Graves JH. The home environment: A mediator of nutrition knowledge and diet quality in adolescents. Appetite 2016; 105:46-52. [PMID: 27170447 DOI: 10.1016/j.appet.2016.05.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 03/31/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
Abstract
The objective of this research was to assess adherence to the Healthy Eating Index-2010 of mothers and their adolescents (11-14 years old) and to examine the role of the home environment as a mediator of maternal nutrition knowledge and adolescent diet quality. It is hypothesized that mothers with greater knowledge impact the diet quality of their adolescents by creation of healthier home environments. A sample of 206 mother-adolescent dyads separately completed the Multidimensional Home Environment Scale, a Food Frequency Questionnaire, and a Nutrition Knowledge Scale. Body mass index-for-age percentiles were derived from weight and height measurements obtained by researcher; diet quality was estimated via the Healthy Eating Index (HEI)-2010. Percent of maximum score on nutrition knowledge for both mothers and adolescents were poor, with lowest scores on recommendations of healthy eating and physical activity (48% and 19%, respectively). A model of maternal nutrition knowledge (independent variable) and adolescent diet quality (dependent variable) indicated that greater knowledge was associated with higher scores on total fruit (p = 0.02), whole grains (p = 0.05), seafood and plant proteins (p = 0.01), and overall diet quality (p < 0.01), as well as lower scores on empty calories (p = 0.01). Inclusion of the home environment as a mediator yielded significant estimates of the indirect effect (β = 0.61, 95% CI: 0.3-1.0). Within the home environment, psychological (β = 0.46), social (β = 0.23), and environmental (β = 0.65) variables were all significant mediators of nutrition knowledge on diet quality. These results emphasize the importance of maternal nutrition knowledge and the mediating effect of the home environment on the diet quality of adolescents.
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Affiliation(s)
- Tamara Tabbakh
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX 78701, USA
| | - Jean H Freeland-Graves
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX 78701, USA.
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Tovar A, Choumenkovitch SF, Hennessy E, Boulos R, Must A, Hughes SO, Gute DM, Vikre EK, Economos CD. Low demanding parental feeding style is associated with low consumption of whole grains among children of recent immigrants. Appetite 2015; 95:211-8. [PMID: 26122753 DOI: 10.1016/j.appet.2015.06.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 05/27/2015] [Accepted: 06/08/2015] [Indexed: 11/18/2022]
Abstract
We explored the influence of immigrant mothers feeding style on their children's fruit, vegetable and whole grain intake and how this relationship differed by mother's time in the U.S. Baseline data were collected on mother-child (3-12 yrs) dyads enrolled in Live Well (n = 313), a community-based, participatory, randomized controlled lifestyle intervention (2008-2013). Socio-demographics, years of residence in the U.S., behavioral data, and responses to the Caregiver's Feeding Styles Questionnaire (CFSQ) were obtained from the mother. Measured heights and weights were obtained for both mother and child. Child dietary intake was assessed using the Block Food Screener. Separate multiple linear regression models were run, adjusting for child and mother covariates. Interactions between feeding styles and years in the U.S. (<5 and ≥ 5 years), ethnicity, and child age were tested. Sixty-nine percent of mothers were overweight or obese, 46% of the children were overweight or obese. For mothers in the U.S. for<5 years, having a low demanding/high responsive style was associated with lower child intake of whole grains in adjusted models vs. a high demanding/high responsive style (p < 0.05). This was not seen for mothers in the U.S. for≥5 years. Thus, the influence of feeding style on dietary intake may change with length of time in the U.S. These hypotheses-generating findings call for future research to understand how broader socio-cultural factors influence the feeding dynamic among immigrants.
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Affiliation(s)
- Alison Tovar
- Department of Nutrition and Food Sciences, The University of Rhode Island, 112 Ranger Hall, Kingston, RI 02881, USA.
| | - Silvina F Choumenkovitch
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Erin Hennessy
- National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Rebecca Boulos
- University of New England, Portland Campus, 716 Stevens Avenue, Portland, ME 04103, USA.
| | - Aviva Must
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA; Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111, USA.
| | - Sheryl O Hughes
- Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Houston, TX 77030, USA.
| | - David M Gute
- Civil and Environmental Engineering, School of Engineering, Tufts University, 200 College Avenue, Medford, MA 02155, USA.
| | - Emily Kuross Vikre
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
| | - Christina D Economos
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA.
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