Clustering and correlates of screen-time and eating behaviours among young adolescents

Relationship between youth cardiometabolic health and physical activity in medical records

BACKGROUND

Thers is limited research examining modifiable cardiometabolic risk factors with a single-item health behavior question obtained during a clinic visit. Such information could support clinicians in identifying patients at risk for adverse cardiometabolic health. We investigated if children meeting physical activity or screen time recommendations, collected during clinic visits, have better cardiometabolic health than children not meeting recommendations. We hypothesized that children meeting either recommendation would have fewer cardiometabolic risk factors.

METHODS AND FINDINGS

This cross-sectional study used data from electronic medical records (EMRs) between January 1, 2013 through December 30, 2017 from children (2-18 years) with a well child visits and data for ≥1 cardiometabolic risk factor (i.e., systolic and diastolic blood pressure, glycated hemoglobin, alanine transaminase, high-density and low-density lipoprotein, total cholesterol, and/or triglycerides). Physical activity and screen time were patient/caregiver-reported. Analyses included EMRs from 63,676 well child visits by 30,698 unique patients (49.3% female; 41.7% Black, 31.5% Hispanic). Models that included data from all visits indicated children meeting physical activity recommendations had reduced risk for abnormal blood pressure (odds ratio [OR] = 0.91, 95%CI 0.86, 0.97; p = 0.002), glycated hemoglobin (OR = 0.83, 95%CI 0.75, 0.91; p = 0.00006), alanine transaminase (OR = 0.85, 95%CI 0.79, 0.92; p = 0.00001), high-density lipoprotein (OR = 0.88, 95%CI 0.82, 0.95; p = 0.0009), and triglyceride values (OR = 0.89, 95%CI 0.83, 0.96; p = 0.002). Meeting screen time recommendations was not associated with abnormal cardiometabolic risk factors.

CONCLUSION

Collecting information on reported adherence to meeting physical activity recommendations can provide clinicians with additional information to identify patients with a higher risk of adverse cardiometabolic health.

The Family Environment as a Source for Creating the Dietary Attitudes of Primary School Students-A Focus Group Interview: The Junior-Edu-Żywienie (JEŻ) Project

The family environment plays a crucial role in creating the health behaviours of children and youth. This study aimed to explore the attitudes of parents with children aged 7-12 who represent an influential environment for creating the eating behaviours of children. A qualitative study was conducted using focus-group interviews (FGI) involving 101 parents from various socioeconomic backgrounds. Three categories of parents were identified based on their level of involvement and awareness of nutrition: 'aware', 'determined', and 'relaxed'. Among parents of 10-12-year-old students, an additional category, 'distanced' parents, was identified. The study revealed that parents require support in terms of providing compelling arguments and practical recommendations related to meals and reducing or eliminating their children's consumption of sweets, snacks, fast food, and, in the case of older students, energy drinks. Parents reported that their children had a moderate understanding of the principles of proper nutrition. The majority of respondents viewed this knowledge as primarily theoretical and expressed a need for practical guidance and activities, which they believe should be offered by schools. To achieve positive outcomes in educational activities related to food and nutrition, it is essential to involve children, parents, guardians, teachers, and other school staff in these efforts.

Clustering of diet, physical activity and sedentary behaviour and related physical and mental health outcomes: a systematic review

BACKGROUND

Physical activity (PA), sedentary behaviour (SB) and diet play an important role in the physical and mental health of young people. Understanding how these behaviours cluster, and the impact of clusters on health is important for the development of public health interventions. This review examines the prevalence of clusters of PA, sedentary time, and dietary behaviours, and how clusters relate to physical and mental health indicators among children, adolescents and young adults.

METHODS

Electronic (PubMed, Web of Science and Scopus) and manual searches were conducted for articles that were (i) observational studies including children, adolescents and/or young adults aged 5-24 years, (ii) examined the 'patterning', 'clustering', or 'co-existence' of each of PA, dietary behaviour and SB, and (iii) published in English up to and including July 2022. In addition to information on clustering, data on physical and mental health outcomes were extracted where reported. Included studies were assessed using the Cochrane risk of bias for observational studies. A narrative synthesis was conducted due to high heterogeneity. This review was registered with PROSPERO (CRD42021230976).

RESULTS

Forty-nine cross-sectional studies and four prospective cohort studies from eighteen countries reporting data from 778,415 individual participants were included. A broad range of clusters (n = 172) were found (healthy, unhealthy, and mixed). Mixed clusters were common (n = 98), and clusters of high diet quality, low PA and high SB were more prevalent in girls, while mixed clusters of high PA, high SB and low diet quality were more prevalent in boys. Unhealthy clusters comprising low moderate to vigorous PA, low consumption of fruits and vegetables, and high screen time were prevalent, particularly in those from lower socioeconomic status families. Compared to those with healthy behavioural clusters, those with unhealthy and mixed clusters had a higher adiposity, higher risk of cardiovascular disease, poorer mental health scores, and lower cardiorespiratory fitness.

CONCLUSIONS

PA, SB and diet cluster in healthy, unhealthy and mixed patterns in young people that differ across sociodemographic characteristics. Unhealthy clusters are associated with poorer health outcomes. Intervention strategies targeting un-clustering multiple unhealthy behaviours should be developed and evaluated for their impact on health outcomes.

The Association of Eating Behaviour with Physical Activity and Screen Time among Adolescents in the Klang Valley, Malaysia: A Cross-Sectional Study

Over the last few decades, the time adolescents spend using electronic devices has increased significantly. The aim of this study was to evaluate the impact of screen time and physical activity on eating behaviour in adolescents. This study used the Physical Activity Questionnaire for Adolescents (PAQ-A) Malay version and the Dutch Eating Behaviour Questionnaire (DEBQ) Malay version methods with secondary students around the Klang Valley. The sampling technique used was purposive sampling. With parents' consent, an online survey was conducted among adolescent school children aged between 13 and 17 years during the COVID-19 pandemic in the Klang Valley, Malaysia. There were 372 respondents participating in this study. The results showed that 99.4% of them had more than 4 h screen time a day, and that 38.5% have more than three devices at home. Moreover, there was a significant mean difference in screen time for console games without a handheld device between male and female adolescents (p < 0.05). There was also a significant mean difference in the emotional, restricted and external eating behaviour scores between male and female adolescents (p < 0.001). There was a significant relationship between physical activity and the time duration spent on a television, telephone and laptop during weekends (p < 0.05). There was a significant relationship between eating behaviour and time spent watching television and using laptops during weekends (p < 0.05). Based on the moderation model, gender as a moderator variable indicated that there was a significant relationship between screen time and interaction screen time and gender with emotional eating (p < 0.001). Female adolescents had a stronger relationship between screen time and emotional eating compared to male adolescents (p < 0.05). Meanwhile, for physical activity level as a moderator variable, the results showed that there was a significant interaction between screen time and physical activity for emotional eating behaviour (p < 0.05). In conclusion, this study indicates that screen time was higher among female adolescents and significantly related to emotional eating behaviour. Therefore, the educational sector should emphasise the motivation of adolescents to engage in physical activity, reduce their screen time and eat healthy foods such as fruits and vegetables.

Screen time among school-aged children of aged 6-14: a systematic review

BACKGROUND

Screen time refers to the time an individual spends using electronic or digital media devices such as televisions, smart phones, tablets or computers. The purpose of this study was to conduct systematic review to analyze the relevant studies on the length and use of screen time of school-aged children, in order to provide scientific basis for designing screen time interventions and perfecting the screen use guidelines for school-aged children.

METHODS

Screen time related studies were searched on PubMed, EMBASE, Clinical Trials, Controlled Trials, The WHO International Clinical Trials Registry Platform, the Cochrane Central Register of Controlled Trials, CNKI, and Whipple Journal databases from January 1, 2016 to October 31, 2021. Two researchers independently screened the literature and extracted the data, and adopted a qualitative analysis method to evaluate the research status of the length and usage of screen time of school-aged students.

RESULTS

Fifty-three articles were included. Sixteen articles studied screen time length in the form of continuous variables. Thirty-seven articles studied screen time in the form of grouped variables. The average screen time of schoolchildren aged 6 to 14 was 2.77 h per day, and 46.4% of them had an average screen time ≥ 2 h per day. A growth trend could be roughly seen by comparing studies in the same countries and regions before and after the COVID-19 outbreak. The average rates of school-aged children who had screen time within the range of ≥ 2 h per day, were 41.3% and 59.4% respectively before and after January 2020. The main types of screen time before January 2020 were watching TV (20 literatures), using computers (16 literature), using mobile phones/tablets (4 literatures). The mainly uses of screens before January 2020 were entertainment (15 literatures), learning (5 literatures) and socializing (3 literatures). The types and mainly uses of screen time after January 2020 remained the same as the results before January 2020.

CONCLUSIONS

Excessive screen time has become a common behavior among children and adolescents around the world. Intervention measures to control children's screen use should be explored in combination with different uses to reduce the proportion of non-essential uses.

Correlation between lifestyle patterns and overweight and obesity among Chinese adolescents

Lifestyles such as physical exercise, sedentary behavior, eating habits, and sleep duration are all associated with adolescent overweight and obesity. The purpose of this study was to investigate how Chinese adolescents' lifestyles clustered into different lifestyle patterns, and to analyze the correlation between these patterns and adolescent overweight and obesity. The investigated respondents included 13,670 adolescents aged 13-18 from various administrative regions in China. Latent class analysis was employed to cluster the lifestyles of adolescents, χ2 test and Logistic regression were used to explore the relationship between lifestyle patterns and overweight and obesity in adolescents. The results identified 6 types of Chinese adolescents' lifestyle patterns, as well as the significant differences in gender and age. The adolescents with high exercise-high calorie diet had the lowest risk of overweight and obesity, and the adolescents with low consciousness-low physical activity and low consciousness-unhealthy had the highest risk of overweight and obesity, which were 1.432 times and 1.346 times higher than those with high exercise-high calorie diet, respectively. The studied demonstrated that there was a coexistence of healthy behaviors and health-risk behaviors in the lifestyle clustering of Chinese adolescents. Low physical exercise and high intake of snacks and carbonated beverages were the most common. Physical exercise and health consciousness were the protective factors of overweight and obesity in adolescents.

Contributions of Work-to-Family Enrichment to Parental Food Monitoring and Satisfaction with Food-Related Life during the COVID-19 Pandemic in Dual-Earner Parents and Their Adolescent Children

Evidence shows that numerous family-related variables influence parents’ use of different food parenting practices (FPP), but less is known about the influence of parents’ work-related variables on their use of FPP, and their own and their children’s outcomes in the food domain. To fill this gap, the present study explored intra-individual and inter-individual effects between work-to-family enrichment (WtoFE), parents’ monitoring practices, the adolescent’s perception of their parents’ monitoring practices, and the three family members’ satisfaction with food-related life (SWFoL), in different-sex dual-earner parents with adolescent children. The mediating role of monitoring between WtoFE and SWFoL was also tested. A sample of 430 different-sex dual-earner parents and one of their adolescent children (average age 13.0 years, 53.7% female) were recruited in Rancagua, Chile, during March and June 2020. The three family members answered the monitoring dimension of the Compressive Feeding Practices Questionnaire and the Satisfaction with Food-Related Life Scale. Parents answered a measure of WtoFE based on the Work−Home Interaction Survey. Analyses were conducted using the Actor−Partner Interdependence Model and structural equation modelling. Results showed a positive association between WtoFE and SWFoL, directly (p < 0.001) and through monitoring in fathers (95% confidence interval [0.010, 0.097], actor effect). The father’s (p = 0.042) and mother’s (p = 0.006) WtoFE was positively associated with their adolescent’s SWFoL (partner effects). The father’s (p = 0.002) and mother’s (p = 0.036) WtoFE were positively associated with their own monitoring (actor effect), while only the father’s WtoFE (p = 0.014) was positively associated with the adolescent’s perception of their parents’ monitoring (partner effect). The father’s (p = 0.018) and mother’s (p = 0.003) monitoring, as well as the adolescents’ perception of their parents’ monitoring (p = 0.033), were positively associated with their own SWFoL (actor effects), while the mother’s monitoring (p = 0.043) was also associated with the father’s SWFoL (partner effects). Findings suggest that both parents’ WtoFE improved their monitoring practices, which, in turn, improved their own SWFoL and their adolescent child’s SWFoL. Policymakers and organizations must aim to promote the WtoFE of working parents.

The Impact of Social Media Influencers on Food Consumption in Saudi Arabia, a Cross-Sectional Web-Based Survey

Background

Previous studies investigating the impact of social media influencers on food consumption are limited. Therefore, this study explores the influence of social media on people’s health choices to understand the consequences of food consumption among the Saudi community.

Patients and Methods

A cross-sectional study using an online survey was conducted in Saudi Arabia between 24 June and 20 July 2021. A convenience sample of eligible participants was used to recruit the study participants. A 32-items questionnaire was distributed via social media platforms (Facebook, Twitter, Snapchat, and Instagram). In addition, significant predictors of people being affected by social media to change diet and living with obesity were determined using binary logistic regression.

Results

A total of 1124 participants were involved in this study. More than half of them (57.8%) were females and aged below 40 years (57.4%). The study participants’ median body mass index (BMI) was 27.4 kg/m² (IQR: 23.5–32.5). Around one-third of the study participants (36.6%) reported following influencers on social media. The median attitude score for the study participants was 15.00 (IQR: 1.00–27.00) out of 72, equal to 20.8%, which highlights that social media influence the diet of around one-fifth of the study participants. Males were less likely to be affected by social media than females (OR: 0.51; (95% CI: 0.40–0.65). Participants with obesity and participants who had tried a diet to lose weight were more likely to be affected by social media, with odds ratios of 2.14, and 4.83, respectively. Followers of social media influencers were 10-folds more likely to be affected by social media than others.

Conclusion

This study showed that social media might influence the food consumption manner in the Saudi population.

The coexistence of obesogenic behaviors among Brazilian adolescents and their associated factors

BACKGROUND

The prevalence of obesity in adolescents has increased significantly in recent years. The growth of obesity is motivated by the association with modifiable behaviors, however, this behavioral are commonly evaluated individually, not considering the possibility of these factors coexisting in the individual. The purpose of this essay was to identify the coexistence of obesogenic behaviors among Brazilian adolescents and to assess the factors associated with the presence of these behaviors.

METHODS

This a cross-sectional, national, school-based study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), totaling a sample of 71,552 Brazilian adolescents. To identify the coexistence of obesogenic behaviors in adolescents, the Principal Component Analysis has been performed. To assess the association between factors that influence the coexistence of modifiable behaviors in the pattern of obesogenic behavior, logistic regression was used. The magnitude of the associations was estimated by the Odds Ratio (OR), with the respective 95% confidence intervals (95%CI).

RESULTS

The component was characterized by a higher percentage of ultra-processed food intake, longer in front of screens, having a habit of snacking in front of the television, and not having the habit of eating breakfast. In the adjusted logistic model, it shows that female adolescents and who declare themselves black are more likely to belong to the third tertile of the pattern of obesogenic behavior. As for teenagers who sometimes or almost always or always have lunch or dinner with parents or guardians, who have longer hours of sleep and who live in economically disadvantaged regions have reduced chances of belonging to the third tertile of the pattern of obesogenic behavior.

CONCLUSION

The identification of obesogenic behavior patterns allows assertive interventions to eliminate or reduce these changeable behaviors, also aiming at the possibility of reducing obesity among adolescents.

Ecological factors and childhood eating behaviours at 5 years of age: findings from the ROLO longitudinal birth cohort study

Background

Individual differences in children eating behaviours have been linked with childhood overweight and obesity. The determinants of childhood eating behaviours are influenced by a complex combination of hereditary and ecological factors. This study examines if key ecological predictors of childhood overweight; maternal socio-economic status (SES), children’s screen time, and childcare arrangements, are associated with eating behaviours in children aged 5-years-old.

Methods

This is secondary, cross-sectional analysis of the ROLO (Randomized COntrol Trial of LOw glycemic diet in pregnancy) study, using data from the 5-year follow-up (n = 306). Weight, height, and body mass index (BMI) were obtained from mothers and children at the 5-year follow-up. Children’s BMI z-scores were calculated. SES was determined using maternal education level and neighborhood deprivation score. Information on children’s screen time and childcare arrangements were collected using lifestyle questionnaires. Children’s eating behaviours were measured using the Children’s Eating Behaviour Questionnaire (CEBQ). Multiple linear regression, adjusted for potential confounders, assessed associations between maternal SES, screen time and children’s eating behaviours. One-way ANOVA, independent sample t-tests and Spearman’s correlation examined childcare exposure and children’s eating behaviour.

Results

Mothers in the lowest SES group had higher BMI and were younger than those in the highest SES group (p =  < 0.001, p = 0.03 respectively). In adjusted analysis, the lowest SES group was associated with a 0.463-point higher mean score for ‘Desire to Drink’ (95% CI = 0.054,0.870, p = 0.027) and higher ‘Slowness to Eat’ (B = 0.388, 95% CI = 0.044,0.733, p = 0.027) when compared with the highest SES group. Screen time (hours) was associated with higher ‘Food Fussiness’ (B = 0.032, 95% CI = 0.014,0.051, p = 0.001). Those who attended childcare had higher scores for ‘Desire to Drink’(p = 0.046). No relationship was observed between longer duration (years) spent in childcare and eating behaviours.

Conclusions

In this cohort, the ecological factors examined had an influence on children’s eating behaviours aged 5-years-old. Our results illustrate the complexity of the relationship between the child’s environment, eating behaviour and children’s body composition. Being aware of the ecological factors that impact the development of eating behaviours, in the pre-school years is vital to promote optimal childhood appetitive traits, thus reducing the risk of issues with excess adiposity long-term.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03423-x.

Individual and family predictors of ultra-processed food consumption in Spanish children. The SENDO project

BRACKGROUND

Ultra-processed food (UPF) consumption is increasing exponentially, becoming a matter of concern for Public Health, given its adverse health effects.

OBJECTIVE

To identify individual and family factors predicting UPF consumption in childhood.

DESIGN

The SENDO project is an ongoing prospective dynamic cohort of Spanish children. In this study, we used baseline information of participants recruited between January 2015 and June 2021. Dietary information was collected with a validated semi-quantitative FFQ, and food items were classified using the NOVA classification. Individual and family factors associated with UPF consumption (p< 0.20) in univariate analyses were introduced in a model of generalized estimating equations (GEE) which accounted for intra-cluster correlations between siblings.

SETTING

The SENDO proyect (Spain), 2015-2021.

PARTICIPANTS

Spanish children are recruited at the age of 4-5 years and followed yearly through online questionnaires completed by parents.

RESULTS

In this sample of 806 participants (49% girls; mean age 5 years [SD: 0.90]), the mean UPF consumption was 37.64 % of total energy intake (sd: 9.59). Large family size and longer exposure to screens predicted higher consumption of UPF. On the other hand, better knowledge of children's dietary recommendations, healthy dietary attitudes towards child's eating habits and longer breastfeeding were associated with lower consumption of UPF. All these factors accounted for approximately 16% of the variability on the consumption of UPF in childhood.

CONCLUSION

Since most of the factors identified in this study are modifiable, they should be considered in public health strategies aimed at promoting heathy dietary habits in early life.

Validation of a Modified Version of the German Sedentary Behavior Questionnaire

Background: Physical inactivity and excessive sedentary behavior (SB) are growing public health issues that require surveillance, guidelines, and targeted interventions. In addition to a variety of sophisticated technical methods, questionnaires are still an attractive method for quick, easy, comprehensive, and cost-effective estimation of SB. The aim of this study was to validate a modified version of the widely used Sedentary Behavior Questionnaire (SBQ) compared to waist-worn accelerometers as an objective measurement. Contemporary explanations covering the use of smart devices have been added to the original instrument, and sitting while handwriting was explicated in more detail. Methods: Cross-sectional data from an adult sample (n = 64, 20−85 y, 25 m, 39 f) were used in this first validation study. Based on prior investigations of the SBQ, analyses were conducted in a gender-specific manner. Criterion validity was assessed using Spearman’s Rho coefficients. The Bland−Altman method was used to test the agreement between self-reported and accelerometer-measured SB time. Results: Using the modified SBQ (mSBQ), a significant gender difference in weekly sedentary time was found. Women estimated their sedentary time to be almost 50% higher than men (median 74.5 h vs. 51.0 h). No correlation was found between the questionnaire and accelerometer data for both subgroups (rho ≤ 0.281, p ≥ 0.174). Individual differences in daily SB estimation between both methods (in relation to accelerometry) were +3.82 h ± 4.36 h for women and +0.48 h ± 2.58 h for men (p < 0.001). Conclusion: The modifications to the SBQ did not improve the correlation between self-assessment of SB and objective determination. The reasons for the presented gender-specific overestimation of the participants’ own sedentary time, which contradicts the findings of other studies, remain unclear and need to be investigated further.

Solo Dining at Home in the Company of ICT Devices

The consumption of a solo meal is often subject to negative associations. Studies indicate that solo diners use information and communication technology (ICT) devices such as smartphones, to mitigate negative experiences such as boredom and loneliness, especially when dining in a public context. However, we know less about the motivation to use such devices and consequent meal experiences in a private context. For this exploratory qualitative study, we asked participants to fill out a cultural probe kit to capture their dining experience and use of ICT devices over a period of seven days. Once completed, the content was discussed with participants during a semi-structured interview. Data was analyzed using thematic analysis in a deductive and inductive form leading to four themes: (1) The experience of eating with others; (2) The use of electronic devices while eating; (3) The meaning of food; and (4) Relaxing features and influences. Participants indicated that eating alone can be a pleasurable experience that people enjoy and perceive as relaxing. ICT devices were named to play an essential part in the dining experience. The entertainment that devices provide can mitigate feelings of loneliness and uncomfortable silence when eating by oneself. We reflect on the findings and point out potential design avenues for future studies.

Clustering of Lifestyle Risk Factors among Algerian Adolescents: Comparison between Urban and Rural Areas: GSHS Data

Objective: Compare the clustering of LBRs between urban and rural Algerian adolescents. Design: Data of this cross-sectional study was derived from the Global School-based Health Survey (GSHS). A self-administered, anonymous questionnaire was filled out by 4532 adolescents (11–16 years), which addressed LBRs of NCDs. Life style behavioral risk factors (LBRs) clustering was measured by the ratios of observed (O) and expected (E) prevalence of one or more simultaneously occurring LBRs for urban and rural areas separately. Multivariate logistic regression was performed to examine the association of LBRs as dependent variable with demographic variables (location, age, gender). Results: The most common LBR was physical inactivity (84.6%: 50.9% for urban and 49.1% for rural). Adolescents in urban areas had a higher prevalence of two (56.8% vs. 43.2%) and three and more (61.3% vs. 38.7%) LBRs than in rural areas. In urban areas, a significant positive association was found between (low fruit and vegetable consumption + physical inactivity) [2.06 (1.61–2.64)] and (high SB + smoking) [2.10 (1.54–2.76)], while (physical inactivity + high SB) [0.70 (0.54–0.91)] showed a significant negative association. In rural areas, (high SB + overweight/obesity) [1.49 (1.09–2.04)] had a significant positive association. While, (low fruit and vegetable consumption + high SB) [0.75 (0.60–0.94)], (physical inactivity + high SB) [0.65 (0.49–0.86)], and (physical inactivity + smoking) [0.70 (0.49–0.99)] had a negative association. Conclusions: Several socio-demographic factors have been identified to play a role in LBRs clustering among Algerian adolescents. Results of the study suggest the development of intervention aiming to tackle different LBRs rather than focusing on a single LBR.

[Cooccurrence of obesogenic risk factors in Brazilian adolescents: the role of sociodemographic characteristics and parental presence]

The study aimed to estimate the prevalence of cooccurrence of obesogenic risk factors in Brazilian adolescents and associated sociodemographic and family characteristics. This is a cross-sectional study of data from the Brazilian National School Health Survey, 2009 (n = 53,274). The outcome variable (cooccurrence of obesogenic risk factors) varied from zero to five and was obtained as the sum of the risk behaviors: daily consumption of soft drinks; daily consumption of candy; insufficient consumption of fruits; insufficient consumption of vegetables; and insufficient physical activity. The explanatory variables were sex, age, skin color, region of Brazil, household goods and services score, maternal schooling, type of school, family composition, parental monitoring, and main meals shared with parents or guardians. A Venn diagram was used for exploratory analysis, plus ordinal logistic regression with partial proportional odds model for multivariate analysis. The results showed higher odds of simultaneous occurrence of the factors in adolescent girls, in teens with less parental supervision, and teens who shared fewer meals with their parents or guardians. Meanwhile, adolescents living in more developed regions of the country and those whose mothers had more schooling showed lower odds of cooccurrence of obesogenic risk factors. Actions that encourage greater family involvement and supervision in dietary behavior can have a positive impact on the prevention of obesity in Brazilian adolescents, especially in less developed regions and in homes where the mothers have less schooling.

Clustering of multiple lifestyle behaviors among migrant, left-behind and local adolescents in China: a cross-sectional study

BACKGROUND

Influence of migration on externalized behavioral problems (e.g., aggressive) among adolescents has been well assessed, yet lifestyle behaviors of migrant, left-behind and local adolescents have been largely overlooked by researchers and policy-makers. Therefore, this study aimed to identify clustering of multiple lifestyle behaviors and their associations with migrant status among Chinese adolescents.

METHODS

A cross-sectional survey was conducted in 2015 in Beijing, and Wuhu city (Anhui province). Adolescents self-reported age, gender, family economic status, migrant situation, and lifestyle behaviors (i.e., physical activity, screen time, sleep, smoke, soft-drink, alcohol, fruit and vegetable consumption) via a battery of validated questionnaires. Latent class analysis was conducted to identify behavioral clusters using Mplus 7.1. ANOVA, and multivariable logistic regression were used to examine associations between migrant situations and behavioral clusters using SPSS 22.

RESULTS

Three distinct behavioral clusters were exhibited among 1364 students (mean age: 13.41 ± 0.84 years): "low risk" (N = 847), "moderate risk" (N = 412) and "high risk" (N = 105). The "high-risk" cluster had the highest prevalence of adolescents not meeting healthy behavioral recommendations. There were no significant differences in the prevalence of high-risk lifestyle among migrant, left-behind, rural local and urban local adolescents. But migrant adolescents had the lowest prevalence of low-risk lifestyle, followed by left-behind, rural and urban local adolescents. Moreover, compared with urban local, migrant (OR = 2.72, 95%CI: 1.88,3.94), left-behind (OR = 2.28, 95%CI: 1.46, 3.55), and rural local (OR = 1.76, 95%CI:1.03,3.01) adolescents had a higher risk of moderate-risk lifestyle.

CONCLUSIONS

Clustering of assessed lifestyle behaviors differed by the migrant status. Particularly, migrant and left-behind adolescents were more likely to have moderate-risk lifestyle compared with their counterparts. Interventions that promote moderate to vigorous physical activity and consumption of fruits and vegetables simultaneously are needed among them.

Clustering of South Korean Adolescents' Health-Related Behaviors by Gender: Using a Latent Class Analysis

Background: Health-related behaviors during adolescence could influence adolescents’ health outcomes, leading to either advantageous or deteriorative conditions. Clustering of adolescents’ health-related behaviors by gender identifies the target groups for intervention and informs the strategies to be implemented for behavioral changes. Methods: Data from 1807 adolescents in grades 7 and 10 in a city in South Korea were used. Health-related behaviors including eating habits, physical activity, hand washing, brushing teeth, drinking alcohol, smoking, and Internet use were examined. Latent class analysis (LCA) was used to identify subgroups of adolescents with regard to their health-related behaviors. Results: A four-class model was the most adequate grouping classification across genders: adolescents with (1) healthy behaviors, (2) neither health-promoting nor health-risk behaviors, (3) good hygiene behaviors, and (4) unhealthy behaviors. The majority of both male and female adolescents were classified into the healthy group. Male adolescents belonging to the healthy group were more likely to engage in vigorous physical activities, while vigorous physical activity was not important for female adolescents. The smallest group was the unhealthy group, regardless of gender; however, the proportion of boys in the unhealthy group was almost twice that of girls. Only female adolescents engaged in excessive Internet use, especially the group with neither health-promoting nor health-risk behaviors. Conclusion: To improve adolescents’ health-related behaviors, it would be more effective to develop tailored interventions considering the behavioral profiles of the target groups.

Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. Report from the ABC of Healthy Eating Study

Today, the time spent actively is increasingly being replaced by screen-based media, although in some teenagers, a high level of physical activity (PA) and longer time spent in front of a screen (screen time, ST) may coexist as a mixed behavioral pattern. This study aimed to examine the association of the pattern created as activity (low/high ST with high PA) and inactivity patterns (low/high ST with low PA) with overweight, central obesity, and muscle strength in Polish teenagers taking into consideration socioeconomic and demographic factors. Cross-sectional data were collected from elementary school children (n = 1567), aged 11–13 years. Height, weight, waist circumference, and handgrip strength were measured. Body mass index (BMI) was calculated as the overweight measure, and the waist-to-height ratio (WHtR) was calculated as the central obesity measure. Data on ST, PA, socioeconomic status, demographics, and nutrition knowledge were collected by a questionnaire. Activity–inactivity patterns were defined by an a priori approach. Multivariate logistic regression modelling was applied. The most active pattern (lowST-highPA) was found in 17% of the total sample. Teenagers with the most inactive pattern (highST-lowPA) had over four times higher chance of general overweight. No association between WHtR ≥0.5 and highST-highPA pattern was found. Higher muscle strength (>1 SD) was associated only with high physical activity. Urban residence or lower socioeconomic status increased adherence to the most inactive pattern. From a public health perspective, implementing interventions promoting active patterns in 11–13-year-old teenagers is important for obesity prevention and enhanced physical fitness, especially in girls, teenagers living in urban areas, and from families with lower socio-economic status.

[Simultaneity of risk behaviors for obesity in adults in the capitals of Brazil]

The scope of this study was to verify the association between risk behaviors and obesity in adults (18 to 59 years of age) in Brazilian capitals. It involved a cross-sectional population-based study conducted by telephone interview. The self-reported variables were obesity, defined by weight and height (BMI ≥ 30 kg/m²) and risk behaviors: physical inactivity (≤ 149 minutes/week), excess sedentarism (≥ 4 hours/day), frequent consumption of sweets (≥ 5 days/week) and meat with fat and/or chicken with skin (≥ 1 day/week). The simultaneity of risk behaviors was analyzed for reasons of observed and expected prevalence. The Poisson and multinomial logistic regressions were used in crude analyses and adjusted for sociodemographic factors. Among the 35,448 adults, the simultaneous consumption of meat with fat, excess sedentarism and physical inactivity (PR: 1.94, 95% CI: 1.45, 2.60), as well as the presence of the four risk behaviors (PR: 1.72, 95% CI: 1.16, 2.53) were associated with obesity in men. In women, the simultaneous consumption of sweets and meat with fat (PR: 1.77, 95% CI: 1.19, 2.66) was also associated with the outcome. In both sexes, there was an increase in the tendency of obesity according to the sum total of risk behaviors.

Is adherence to the 24-hour movement guidelines associated with a reduced risk of adiposity among children and adolescents?

BACKGROUND

Little is known about the combined effect of physical activity (PA), recreational screen time (ST), and sleep in preventing childhood obesity. Hence, this study aimed to analyze the associations between meeting the PA, ST, and sleep recommendations within the 24-hour movement guidelines and adiposity indicators among children and adolescents.

METHODS

A total of 679 children and adolescents aged 8-18 years were included. The time spent in moderate-to-vigorous PA and the sleep duration were estimated from raw data from a wrist-worn accelerometer. Recreational ST was reported by the child or parent. Body mass index (BMI) z-score, fat mass percentage (FM%), and visceral adipose tissue (VAT) were used as adiposity indicators. Participants with ≥ 60 min/day of moderate-to-vigorous PA, < 2 h/day of recreational ST, and uninterrupted sleep for 9-11 h/day (for children) or 8-10 h/day (for adolescents) were considered to meet the overall 24-hour movement guidelines.

RESULTS

Meeting the ST only recommendation was associated with reduced odds of a high BMI z-score (odds ratio [OR] = 0.38, 95% confidence interval [CI]: 0.17-0.89), excess FM% (OR = 0.34, 95% CI: 0.13-0.93), and excess VAT (OR = 0.27, 95% CI: 0.10-0.74) in adolescents. Significantly reduced odds of a high BMI z-score was associated with meeting the combination of the ST and sleep recommendations (OR = 0.11, 95% CI: 0.01-0.89). Adolescents who met one recommendation (OR = 0.51, 95% CI: 0.27-0.96) or any two recommendations (OR = 0.33, 95% CI: 0.11-0.94) had reduced ORs of having a high BMI z-score. Adolescents had lower odds of having excess VAT if they met one recommendation (OR = 0.39, 95% CI: 0.19-0.81) or any two recommendations (OR = 0.25, 95% CI: 0.07-0.90). No significant associations were found in children.

CONCLUSIONS

The present study showed no associations between meeting all three recommendations within the 24-hour movement guidelines and adiposity indicators. However, meeting ST only recommendation and the combination of the ST and sleep recommendations was associated with a reduced risk of excess adiposity. This finding should be considered when designing effective strategies and interventions to prevent childhood obesity.

Clusters of Contemporary Risk and Their Relationship to Mental Well-Being Among 15-Year-Old Adolescents Across 37 Countries

PURPOSE

Adolescents' mental well-being has become a growing public health concern. Adolescents' daily lives and their engagement in risks have changed dramatically in the course of the 21st century, leading to a need to update traditional models of risk to include new exposures and behaviors. To date, studies have examined the relationship between (mainly traditional) risk behaviors and adolescent mental well-being or looked at risk factors that jeopardize mental well-being such as lack of social support but have not combined them together to highlight the most significant risks for adolescent mental well-being today. The present study included new and traditional risk behaviors and risk factors, robustly derived an empirically based model of clusters of risk, and examined the relative association of these clusters to adolescent mental well-being.

METHODS

Data from the 2017-2018 Health Behaviours in School-aged Children study were used. The sample included 32,884 adolescents (51.7% girls) aged 15 years from 37 countries and regions. The principal component analysis was used to determine the existence of clusters of risk, using 21 items related to adolescent mental well-being that included both risk behaviors (e.g., substance use) and risk factors (e.g., peer support). Analysis was conducted in both a randomly split training and test set and in gender separate models. Mixed-effects logistic regressions examined the association between clusters of risk and mental well-being indices (low life satisfaction and psychosomatic complaints).

RESULTS

Seven clusters of risk were identified: substance use and early sex, low social support, insufficient nutrition, bullying, sugary foods and drinks, physical health risk, and problematic social media use (SMU). Low social support and SMU were the strongest predictors of low life satisfaction (odds ratios = 2.167 and 1.330, respectively) and psychosomatic complaints (odds ratio = 1.687 and 1.386, respectively). Few gender differences in predictors were found. Exposure to bullying was somewhat more associated with psychosomatic complaints for girls, whereas physical health risk was associated with reduced relative odds of low life satisfaction among boys. Split-sample validation and out-of-sample prediction confirmed the robustness of the results.

CONCLUSIONS

The results highlight the importance of contemporary clusters of risk, such as low social support and SMU in the mental well-being of young people and the need to focus on these as targets for prevention. We propose that future studies should use composite risk measures that take into account both risk behaviors and risk factors to explain adolescents' mental well-being.

Screen Time and Children with Autism Spectrum Disorder

BACKGROUND

Research is increasingly raising concerns regarding the negative consequences of children's use of screens.

SUMMARY

This article reviews the literature on the benefits and risks of screen time with attention to explaining possible reasons that children with autism are more at risk for the negative effects of screen time. Based on the science of learning literature, a framework for choosing appropriate digital media for children with autism is described. The 3-component framework considers the characteristics of the child, the context in which digital media are used, and the content of the media. Key Message: Using the framework, the speech-language pathologist will be better able to select appropriate digital media content for children with autism that is engaging (while not being distracting), encourages the child to be actively involved with the media, is meaningful in the child's life, and incorporates social interactions with others.

Reducing screen-time and unhealthy snacking in 9-11 year old children: the Kids FIRST pilot randomised controlled trial

Background

Many young people form unhealthy behavioural habits, such as low intake of fruit and vegetables, high intake of energy-dense snack foods, and excessive sedentary screen-based behaviours. However, there is a shortage of parent-and home-focused interventions to change multiple health behaviours in children.

Methods

Kids FIRST was a 12-week, home- and school-based pilot randomised controlled trial to reduce screen-time and unhealthy snacking with assessments at pre- (baseline) and post-intervention. Four UK schools were randomised to control or one of three interventions targeting reductions in (1) screen-time and unhealthy snacking (ST + Sn), (2) screen-time (ST only), (3) unhealthy snacking (Sn only), and parents with children aged 9–11 years were recruited via schools. Intervention group parents received four online ‘sessions’ and four packages of resources tailored to each group. Children received four 30-min lessons during school time. Children and parents reported their own screen-time behaviours, children reported their own snacking behaviours. Descriptive analyses were undertaken using principles of intention to treat.

Results

Initial feasibility was shown in that this study successfully recruited schools and families into all four study arms and retained them over a period of 13 weeks (retention rate ≥ 74%). Seventy-five children and 64 parents provided full baseline questionnaire data. Reductions in children’s school day and weekend day TV/DVD viewing and computer game use were found in the ST + Sn and ST groups, while self-reported smartphone use increased in these groups. Similar results were found for parents’ TV/DVD, computer and smartphone use in these groups. Little to no changes were found in reports of the dietary variables assessed in any intervention group for children or parents.

Conclusions

These preliminary findings show some promise for the Kids FIRST intervention. Based on these findings, a future full trial should recruit a more diverse sample of families and optimise the intervention and intervention resources to more fully engage parents with the dietary-based components of the intervention programme, where fewer changes were seen. Although most parents reporting receiving the intervention resources, further development work is required to achieve higher levels of engagement. This might include greater parent and child engagement work early in the development of the project.

Trial registration

Retrospectively registered in June 21st 2019 with ClinicalTrials.gov (number NCT03993652).

Eating habits and weight status in Finnish adolescents

Objective:

To investigate the association between eating habits and weight status in adolescents in Finland.

Design:

Cross-sectional study.

Setting:

The Finnish Health in Teens (Fin-HIT) study is a cohort study conducted in adolescents attending third to sixth grade in 496 schools in forty-four municipalities in Southern, Middle and Northern Finland in 2011–2014.

Participants:

Analyses included 10 569 adolescents from the Fin-HIT study aged 9–14 years (5005 boys and 5564 girls). Adolescents were categorized by their eating habits: healthy eaters (44·1 %; n 4661), unhealthy eaters (12·3 %; n 1298), and fruit and vegetable avoiders (43·6 %; n 4610); and they were grouped into weight status: underweight (11·1 %), normal weight (73·6 %) and excess weight (15·3 %).

Results:

We found an increased risk of underweight in fruit and vegetable avoiders (OR = 1·28; 95 % CI 1·12, 1·46). An irregular breakfast pattern showed an inverse association with underweight (OR = 0·70; 95 % CI 0·59, 0·84) and an increased risk of excess weight (OR = 1·56; 95 % CI 1·37, 1·77) compared with a regular breakfast pattern. An irregular dinner pattern was inversely associated with underweight (OR = 0·83; 95 % CI 0·69, 0·99) compared with a regular dinner pattern.

Conclusions:

Avoiding fruits and vegetables and following irregular breakfast and dinner patterns were associated with underweight and excess weight in adolescents.

Effects of a nutritional intervention using pictorial representations for promoting knowledge and practices of healthy eating among Brazilian adolescents

This study aimed to evaluate the effect of a nutritional intervention involving a problem-raising approach and the use of pictorial representations on the promotion of knowledge and practices of healthy eating among adolescents. This randomized study included 461 adolescents from public schools in Brasilia, Federal District, Brazil (intervention group: 273 students from four schools; control group: 188 students from three schools). Mean age was 14.8±1.0, and 52.9% were boys. The intervention consisted of three meetings with interactive activities about principles of healthy eating, food classification, importance of reading labels and analyzing food advertising critically, and representations of healthy and unhealthy meals and their sugar, salt, and fat content. Pictorial materials consisted of food drawings, food models, and a food packaging model. Controls were not exposed to any activity. Dietary knowledge, consumption, and behaviors were the variables of interest. The intervention group showed a higher mean score of correct answers to questions about dietary knowledge than the control group (p = 0.0006), with higher odds of correctly answering questions about in natura (OR: 3.7; 95% CI: 1.9–6.6), minimally processed (OR: 3.6; 95% CI: 1.9–6.4), processed (OR: 2.2; 95% CI: 1.1–4.3), and ultra-processed foods (OR: 3.5; 95% CI: 1.8–6.6) and composition of ultra-processed foods (OR: 2.4; 95% CI: 1.3–4.4). Participants in the intervention group were also 2.5 times more likely to correctly answer questions about the importance of the dietary environment (95% CI: 1.1–5.5) and caution with food advertising (95% CI: 1.2–5.3) than controls. Increased weekly consumption of vegetables (p = 0.0077; OR: 2.4; 95% CI: 1.26–4.51) and reduced consumption of soft drinks (p = 0.0212; OR: 0.36; 95% CI: 0.15–0.86) were observed in the intervention group compared to the control group. The proposed intervention increased adolescents’ knowledge and improved some of their dietary habits. Educational activities using a problem-raising approach and pictorial representations of food appear to be effective in promoting healthy eating practices among adolescents.

Lifestyle risk indices in adolescence and their relationships to adolescent disease burden: findings from an Australian national survey

BACKGROUND

The current study investigates the extent to which an adolescent-specific lifestyle risk factor index predicts indicators of the leading causes of adolescent morbidity and mortality.

METHODS

Data came from 13 to 17 year-old respondents from the 2013-2014 nationally representative Australian Child and Adolescent Survey of Mental Health and Wellbeing (n = 2314). Indicators of adolescent disease burden included Major Depressive Disorder, psychological distress, self-harm and suicide attempt. Risk factors included risky alcohol use, drug use, unprotected sex, smoking, BMI and sleep duration. The extent to which these risk factors co-occurred were investigated using tetrachoric correlations. Several risk indices were then constructed based on these risk factors. Receiver Operating Characteristic curves determined the precision with which these indices predicted the leading causes of adolescent disease burden.

RESULTS

Risky alcohol use, drug use, smoking, unprotected sex, and sleep were all highly clustered lifestyle risk factors, whereas BMI was not. A risk index comprising risky alcohol use, drug use, unprotected sex and sleep duration predicted the disease burden outcomes with the greatest precision. 31.9% of the sample reported one or more of these behaviours.

CONCLUSIONS

This lifestyle risk factor index represents a useful summary metric in the context of adolescent health promotion and non-communicable disease prevention. Lifestyle risk factors were found to cluster in adolescence, supporting the implementation of multiple health behaviour change interventions.

The Mediating Role of Family and Food-Related Life Satisfaction in the Relationships between Family Support, Parent Work-Life Balance and Adolescent Life Satisfaction in Dual-Earner Families

This study explored the associations between family support and satisfaction with life, food-related life and family life. It also assessed the associations between both parents' work-life balance and satisfaction with life, food-related life and family life among adolescent children from dual-earner families. Questionnaires were administered to 303 dual-earner families with one child between 10 and 17 years in Temuco, Chile. Adolescents answered the Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life scale (SWFoL), Satisfaction with Family Life scale (SWFaL) and the Family subscale of the Multidimensional Scale of Perceived Social Support. Both parents answered the Work-life Balance (WLB) scale. Using structural equation modelling and having controlled for adolescents' gender, age and socioeconomic status, we confirmed that adolescent life satisfaction is associated with satisfaction with family life and food-related life. Food-related life satisfaction and family life satisfaction had complete mediating roles between perceived family support and adolescents' life satisfaction. Satisfaction with food-related life also had a complete mediating role between both parents' WLB and adolescents' life satisfaction. Satisfaction with family life had a complete mediating role between mothers' WLB and adolescents' life satisfaction. In addition, mothers' WLB was positively associated with perceived family support among adolescents. These findings suggest the need to improve family support and work-life balance among mothers in order to enhance adolescents' satisfaction with different domains of life in dual-earner families.

A latent class analysis of family eating habits in families with adolescents

The objectives of the present study were to identify adolescent classes based on perceptions of their family's eating habits and to determine whether these classes differ in terms of family meal frequency and source, parents and adolescent diet quality, nutritional status, satisfaction with life, family life and food-related life. Questionnaires were administered to a sample of 300 two-parent families with one child between 10 and 17 years in Chile. Questionnaires included the Satisfaction with Life Scale (SWLS), the Satisfaction with Food-related Life scale (SWFoL), the Satisfaction with Family Life scale (SWFaL) and the Adapted Healthy Eating Index (AHEI). Adolescents also answered the Family Eating Habits Questionnaire (FEHQ). Latent class (LC) analysis was used to estimate the number of classes associated with the adolescent's perceptions about their family's eating habits, based on the three factors detected in the FEHQ. The LC analysis yielded three classes: "medium cohesion around family meals/healthy food-related parenting practices" (Class 1, 50.4%), "high cohesion around family meals/healthy food-related parenting practices" (Class 2, 25.9%) and "high cohesion around family meals/unhealthy food-related parenting practices" (Class 3, 23.7%). Classes also differed in the adolescents AHEI score, frequency and source of family meals; body mass index, SWLS and SWFaL scores in mothers, fathers and adolescents, adolescent sex and household financial situation. These findings suggest that frequent and cohesive family meals improve the well-being in both parents and adolescents, but are not enough to achieve healthier diets and weight statuses in adolescents.

Weight Fluctuation and Diet Concern Negatively Affect Food-Related Life Satisfaction in Chilean Male and Female Adolescents

Problematic eating behaviors and obesity are frequent problems encountered during adolescence that may potentially result in psychological, social and physical consequences that may interfere with adolescent development and well-being. The present study evaluates the relationship between satisfaction with food-related life and satisfaction with family life, and their relationship with life satisfaction in male and female adolescents. We explored the relationships between both subscales of the Revised Restraint Scale (RRS), Diet Concern (DC) and Weight Fluctuation (WF) and adolescent life satisfaction as well as satisfaction with food-related life and family life. We also explored the moderating role of socioeconomic status (SES). A questionnaire was applied to a non-probabilistic sample of 470 adolescents (mean age 13.2 years, 52.3% female) in Chile, including the RRS, Satisfaction with Life Scale (SWLS), Satisfaction with Food-related Life (SWL-Food) scale and Satisfaction with Family Life (SWL-Family) scale. Using structural equation modeling, we found that adolescent life satisfaction was related to satisfaction with family life and food-related life in both genders. In male adolescents, a negative relationship was identified between WF and food-related life satisfaction. In contrast, a negative relationship was identified in female adolescents between DC and food-related life satisfaction. DC and WF were not directly related to life satisfaction or to satisfaction with family life in either gender. SES was found to moderate the relationship between food-related life satisfaction and life satisfaction and the relationship between WF and food-related life satisfaction in female adolescents. These findings suggest that reducing DC in female adolescents and reducing WF in male adolescents and female adolescents from higher SES may improve their food-related life satisfaction.

Clustering and correlates of screen-time and eating behaviours among young children

Background

Screen-time and unhealthy dietary behaviours are highly pervasive in young children and evidence suggests that these behaviours often co-occur and are associated. Identifying clusters of unhealthy behaviours, and their influences early in childhood, can assist in the development of targeted preventive interventions. The purpose of this study was to examine the sociodemographic, behavioural, and home physical environmental correlates of co-occurring screen-time and unhealthy eating behaviours and to assess the clustering of screen-time and unhealthy dietary behaviours in young children.

Methods

Parents of 126 children, from the UK, aged 5–6 years (49% boys) completed a questionnaire which assessed their child’s screen-time (ST), fruit and vegetable (FV), and energy-dense (ED) snack consumption. Categories of health behaviours were created based on frequencies of children meeting recommendations for FV and ST and median splits of frequencies for ED snacks. Parents reported on their own behaviours (ST, FV, and ED snack consumption), how often they ate meals and watched TV with their child, and on the availability and accessibility of foods within the home. An observed over expected ratio (O/E) was used to assess behavioural clustering. Multivariable multinomial logistic regression was used to examine correlates of behaviour patterns.

Results

Approximately 25% of children had two or three health risk behaviours. Correlates consistently associated with clusters included parental income, eating meals at the TV, parental ST and ED snack food consumption, and home availability of ED snack foods. Observed over expected ratios were close to 1 and ranged from 0.78 to 1.43. The three-risk behaviour combination of insufficient FV consumption, high ED snack consumption, and excessive ST occurred more frequently than expected (1.23 (95% CI 0.89, 1.58)).

Conclusions

ST and unhealthy dietary behaviours cluster in children as young as 5 years of age and parents’ own behaviours appear to be important influencing factors. Further research into the development of behavioural clustering in young children to identify and further understand the mechanisms underlying the synergy among health behaviours is needed. Feasibility interventions promoting reductions in both screen-time and unhealthy dietary behaviours reciprocally, while simultaneously focusing on changing parental behaviours, are warranted.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5698-9) contains supplementary material, which is available to authorized users.

Factors Influencing Children's Eating Behaviours

Relevant factors involved in the creation of some children’s food preferences and eating behaviours have been examined in order to highlight the topic and give paediatricians practical instruments to understand the background behind eating behaviour and to manage children’s nutrition for preventive purposes. Electronic databases were searched to locate and appraise relevant studies. We carried out a search to identify papers published in English on factors that influence children’s feeding behaviours. The family system that surrounds a child’s domestic life will have an active role in establishing and promoting behaviours that will persist throughout his or her life. Early-life experiences with various tastes and flavours have a role in promoting healthy eating in future life. The nature of a narrative review makes it difficult to integrate complex interactions when large sets of studies are involved. In the current analysis, parental food habits and feeding strategies are the most dominant determinants of a child’s eating behaviour and food choices. Parents should expose their offspring to a range of good food choices while acting as positive role models. Prevention programmes should be addressed to them, taking into account socioeconomic aspects and education.