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Dominguez-Viera ME, de Vries Mecheva M, Nguyen T, van den Berg M. Relaxed minds for healthier food choice at school: A field experiment in southern Mexico. Appetite 2024; 200:107529. [PMID: 38801995 DOI: 10.1016/j.appet.2024.107529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/12/2024] [Accepted: 05/24/2024] [Indexed: 05/29/2024]
Abstract
Stress leads to unhealthy food choices since the school-age stage. Yet, there is limited evidence particularly in low- and middle-income countries regarding the impact of stress-reduction strategies on school-age children's food choices. Such aspects were crucial during the recent COVID-19 pandemic, which exacerbated psychological distress and unhealthier food choices among children. Two years after the pandemic began, we conducted a field experiment in southern Mexico to assess the impact of stress-reduction strategies on the food choices of over 1400 children aged 9-12. Half of the school-classes in the sample were randomly assigned to a stress reduction strategy namely meditation, which comprised six audios with basic relaxation techniques and intuitive messages to guide food choices. Additionally, all participants received information signalling that an amaranth snack was nutritious (i.e., the healthy snack), which was paired with a chocolate bar (i.e., the unhealthy snack) as part of a snack choice experiment. Students that practiced meditation were slightly more likely to choose the healthy snack than those in the control group, but the effect was not statistically significant. Upon collecting their snack, students had the chance to exchange their original choice for the other snack. Students that meditated were more likely to exchange their originally chosen "unhealthy snack" towards the healthy snack than students in the control group. The meditation program effectively reduced chronic stress among treated children. The effect was larger among students attending schools in lower-income areas. Our study sheds some light on the challenges to translate an improved psychological well-being into healthier food choices at school.
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Affiliation(s)
- Marcos E Dominguez-Viera
- Development Economics Group, Wageningen University & Research, Droevendaalsesteeg 4, 6708 PB, Wageningen, Netherlands.
| | - Margarita de Vries Mecheva
- The International Institute of Social Studies, Erasmus University Rotterdam, Kortenaerkade 12, 2518 AX, Den Haag, Netherlands
| | - Trang Nguyen
- Development Economics Group, Wageningen University & Research, Droevendaalsesteeg 4, 6708 PB, Wageningen, Netherlands
| | - Marrit van den Berg
- Development Economics Group, Wageningen University & Research, Droevendaalsesteeg 4, 6708 PB, Wageningen, Netherlands
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Smith TA, Lin BH, Guthrie J. School Meal Nutrition Standards Reduce Disparities Across Income and Race/Ethnicity. Am J Prev Med 2024; 67:249-257. [PMID: 38521131 DOI: 10.1016/j.amepre.2024.03.012] [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: 10/23/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Children's diets in the U.S. typically fail to meet dietary recommendations, contributing to associated adverse health outcomes. The Healthy, Hunger-Free Kids Act (HHFKA) of 2010 required the U.S. government to update nutrition standards for school meals to align with the Dietary Guidelines for Americans (DGAs). This study estimates the evolving impact of substituting school-prepared food for home-prepared food on overall daily diet quality and by subcomponents of diet quality. Subgroup analyses are performed by race/ethnicity and income. METHODS Two, nonconsecutive days of dietary recall data from the National Health and Nutrition Examination Survey (2005-March 2020) are used to calculate schoolchildren's Healthy Eating Index (HEI)-2020 scores. The study includes children with complete two-day dietary intakes who attend kindergarten through twelfth grade in a school offering lunch. An individual-level fixed effects regression is employed to examine the relationship of school food consumption on HEI-2020 scores before and after HHFKA-mandated changes in nutrition standards. Analyses were conducted on September 23, 2023. RESULTS Prior to changes in standards (2005-2008), school food did not impact diet quality within the overall group of children. In 2009-2012, positive associations between school food and diet quality emerged for low-income students and for non-Hispanic Black students. By 2013-2020, improvements were seen across all groups. The association between school food and diet quality was most attributable to more favorable consumption of dairy, fruit, whole grains, refined grains, added sugars and saturated fats. CONCLUSIONS HHFKA-based nutrition standards were associated with beneficial dietary changes and reduced dietary disparities for children across diverse backgrounds.
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Affiliation(s)
- Travis A Smith
- Department of Agricultural and Applied Economics, University of Georgia, Athens, GA.
| | - Biing-Hwan Lin
- Economic Research Service, U.S. Department of Agriculture, Washington DC
| | - Joanne Guthrie
- Economic Research Service, U.S. Department of Agriculture, Washington DC
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Mederer-Hengstl B, Núñez-Delgado P, Bueno-Cavanillas A. Evaluation of Problem-Based Learning Experiences Addressing Health Promotion in the Fourth Grade of Primary School. CHILDREN (BASEL, SWITZERLAND) 2024; 11:807. [PMID: 39062257 PMCID: PMC11275087 DOI: 10.3390/children11070807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/03/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND The global issues of overweight and sedentary lifestyles require comprehensive responses from health systems. Despite this, health education remains fragmented and sporadic. This study aims to target primary school children to instil healthy habits using active learning strategies, with a specific focus on promoting a healthy diet and physical activity. METHODS This study employed problem-based learning (PBL) projects with fourth-grade primary students to encourage the acquisition of healthy habits. Conducted over four consecutive years at a two-line school, the study utilised an opportunity sample, evaluating intervention and control groups by comparing their corresponding scores. The control groups consisted of 54 students, while the intervention group included 159 students. Data collection involved pre-test and post-test questionnaires to measure outcomes. RESULTS Differential evaluation scores revealed significantly higher results in the intervention groups compared to the control groups, with an average score increase of 3.62 points in control groups and 6.94 points in intervention groups, particularly in attitudinal competencies. The strategies employed facilitated the development of crucial skills such as information search, synthesis, representation, analysis, decision making, teamwork, and intrapersonal awareness. Additionally, they significantly broadened the knowledge acquired regarding healthy habits. CONCLUSIONS The problem-based learning approach proved effective in helping children understand the importance of making healthy choices and encouraged the integration of such habits into their daily lives. These findings suggest that active learning strategies can significantly enhance health education and promote long-term healthy behaviours among primary school children.
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Affiliation(s)
| | - Pilar Núñez-Delgado
- Department of Didactics of Language and Literature, University of Granada, 18011 Granada, Spain;
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP-Spain), 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Granada (IBS-Granada), 18012 Granada, Spain
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Ge R, You S, Zheng D, Zhang Z, Cao Y, Chang J. Global, regional, and national temporal trends of diet-related ischemic stroke mortality and disability from 1990 to 2019. Int J Stroke 2024; 19:665-675. [PMID: 38415357 DOI: 10.1177/17474930241237932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND Stroke is the second leading cause of death and the third leading cause of disability in the general population worldwide. However, the changing trend of ischemic stroke burden attributable to various dietary risk factors has not been fully revealed and may contribute to a better understanding of stroke epidemiology. AIMS Our article aimed to evaluate the temporal trend of diet-related ischemic stroke burden to inform future research and policy-making. METHODS This analysis was based on the data from the Global Burden of Disease (GBD) Study 2019 (spanning years 1990 to 2019), and we used the joinpoint regression to model temporal trends in diet-related ischemic stroke burden across countries and regions of the world during the study period. Six specific dietary factors known to influence stroke risk, including sodium, red meat, fiber, vegetables, whole grains, and fruits, were evaluated in the GBD study to determine their individual and joint impact on ischemic stroke. The changing trend was primarily measured by the average annual percent change (AAPC). Age-standardized rates (ASRs) of mortality and years lived with disability (YLD) per 100,000 population were used to evaluate disease burden. Finally, the socioeconomic background, which was quantified as sociodemographic index (SDI), and its association with diet-related ischemic stroke burden were also explored with the Pearson correlation coefficient. RESULTS During the study period, the ischemic stroke ASR of mortality attributable to overall dietary risk decreased by an average of 1.6% per year, while the ASR of YLD decreased by an average of 0.2% per year. High sodium diet was still a key driver of diet-related ischemic stroke, accounting for 8.4% and 11.0% of deaths and disabilities, respectively, in 2019. In addition, we found a negative association between temporal evolution of stroke burden and socioeconomic background (r = -0.6603 for mortality and r = -0.4224 for disability, P < 0.001), which suggested that the developing countries with weak social and economic foundation faced greater challenges from the ongoing burden of diet-related strokes compared with developed countries. CONCLUSIONS Our study found declining trends and revealed the current status of diet-related ischemic stroke mortality and disability. Interdisciplinary countermeasures involving the development of effective food policies, evidence-based guidelines, and public education are needed in the future to combat this global epidemic. DATA ACCESS STATEMENT The data used for analysis were open-access and can be obtained from https://vizhub.healthdata.org/gbd-results/.
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Affiliation(s)
- Rongguang Ge
- Department of Neurology and Clinical Research Center of Neurological Disease, Soochow Medical College, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shoujiang You
- Department of Neurology and Clinical Research Center of Neurological Disease, Soochow Medical College, The Second Affiliated Hospital of Soochow University, Suzhou, China
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Danni Zheng
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Zengli Zhang
- Department of Occupational and Environmental Health, School of Public Health, Soochow Medical College, Soochow University, Suzhou, China
| | - Yongjun Cao
- Department of Neurology and Clinical Research Center of Neurological Disease, Soochow Medical College, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Chang
- Department of Occupational and Environmental Health, School of Public Health, Soochow Medical College, Soochow University, Suzhou, China
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Yu X, Huang X, Liang X, Ou Q, Sun L, Ren J, Wu Q, Chen H, Huang Q, Zhao H, Wei J, Wu F, Huang S, Wang L. The effects of nutrition education on nutritional knowledge and dietary behaviours in primary school students in Zhongshan city. J Hum Nutr Diet 2024. [PMID: 38944880 DOI: 10.1111/jhn.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/09/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Adequate nutritional knowledge and healthy dietary behaviours are essential for promoting rational nutrition for children. However, lack of nutritional knowledge and unhealthy dietary behaviours are common among Chinese children. Therefore, we developed a school-based nutrition education (NE) program to assess its impacts on nutritional knowledge and dietary behaviours in pupils. METHODS In this trial, one school was assigned as an intervention group (n = 199) and the other two schools were designated as a control group (n = 140). Children in the intervention group received the NE program in addition to their regular health curriculum, whereas the control group continued with their usual health curriculum without any NE program materials. RESULTS Concerning nutritional knowledge, the mean difference (follow-up minus baseline) of average knowledge scores in the intervention group was significantly higher than that in the control group (1.99 ± 3.22 vs. 0.66 ± 3.60, p = 0.001). However, subgroup analysis revealed that this difference disappeared among boys and students with malnutrition status. Regarding dietary behaviours, the NE program significantly increased the proportion of children exhibiting high frequencies of meat and nuts consumption in the intervention group, along with diverse food choice at breakfast. Additionally, it markedly reduced the proportion of children exhibiting high frequencies of sugar-sweetened beverages and fast food consumption. Structural equation modelling analyses indicated a significant direct effect of NE intervention on nutritional knowledge and an indirect effect on dietary behaviours. CONCLUSIONS The NE program effectively enhanced nutritional knowledge scores and further improved dietary behaviours among Chinese primary school students. Future NE programs should pay more attention to boys and children with malnutrition.
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Affiliation(s)
- Xinxue Yu
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaoxia Huang
- Jiahe Community Health Service Centre of Baiyun District, Guangzhou, China
| | - Xiaoping Liang
- Health Care Centre for Primary and Secondary School of Zhongshan, Zhongshan, China
| | - Qian Ou
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Liuqiao Sun
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Jieru Ren
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Qiongmei Wu
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Hangjun Chen
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Qiaoli Huang
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Hanqing Zhao
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Jun Wei
- Department of Science and Technology, Guangzhou Customs, Guangzhou, China
| | - Feng Wu
- Jiahe Community Health Service Centre of Baiyun District, Guangzhou, China
| | - Sizhe Huang
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
| | - Lijun Wang
- Department of Nutrition, School of Medicine, Jinan University, Guangzhou, China
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Mogre V, Sefogah PE, Adetunji AW, Olalekan OO, Gaa PK, Ayettey Anie HNG, Tayo B. A school-based food and nutrition education intervention increases nutrition-related knowledge and fruit consumption among primary school children in northern Ghana. BMC Public Health 2024; 24:1739. [PMID: 38951824 PMCID: PMC11218303 DOI: 10.1186/s12889-024-19200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 06/19/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Providing children with the opportunity to learn about nutrition is critical in helping them establish a healthy lifestyle and eating behaviours that would remain with them till adulthood. We determined the effect of a school-based food and nutrition education (SFNE) intervention on the nutrition-related knowledge, attitudes, dietary habits, physical activity levels and the anthropometric indices (BMI-for-age z scores, %Body fat and waist circumference) of school-age children in northern Ghana. METHODS Following a controlled before-and-after study design, we recruited school-age children in primary 4 and 5 from public and private schools and assigned them non-randomly to intervention and control groups (4 schools total). A SFNE intervention called 'Eat Healthy, Grow Healthy (EHGH)' was implemented in intervention schools. Components of the intervention included children, teachers, school officials, and the school environment. Nutrition education didactic sessions, active discussions, nutrition games, charades, art work, and physical activity sessions were among the teaching and learning activities implemented. At 0 and 6 months, primary (anthropometry) and secondary (fruit, vegetable, and breakfast consumption) outcomes were obtained. RESULTS Mean BMI-for-age z-scores did not differ significantly between intervention and control groups (F1,261 = 0.45, P = 0.503, η2 = 0.01). However, significantly greater nutrition-related knowledge scores were recorded in the intervention group than in the control group at post-intervention (M = 6.07 SD = 2.17 vs. M = 5.22 SD = 1.92; p = 0.002). Mean number of days intervention children consumed fruits differed across time (F1, 263 = 33.04, p = 0.002, η2 = 0.04) but not between the control and intervention groups (F1, 263 = 0.28, p = 0.60, η2 = 0.00). CONCLUSIONS The EHGH intervention had positive effects on the nutrition-related knowledge and the consumption of fruits among children although it did not impact their anthropometric indices.
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Affiliation(s)
- Victor Mogre
- University for Development Studies, School of Medicine, Department of Health Professions Education and Innovative Learning, Tamale, Ghana.
| | | | | | | | | | | | - Bamidele Tayo
- Parkinson School of Health Sciences, Loyola University, Chicago, IL, USA
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Roccaldo R, Censi L, D’Addezio L, Berni Canani S, Gennaro L. Improvement of Adherence to the Mediterranean Diet through a Nutrition Education Teaching Pack for Teachers within the "School Fruit Scheme" Program: An Italian Long-Term Trial in School Children. Nutrients 2024; 16:2057. [PMID: 38999804 PMCID: PMC11243712 DOI: 10.3390/nu16132057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/19/2024] [Accepted: 06/23/2024] [Indexed: 07/14/2024] Open
Abstract
A previous short time span study related to the effectiveness of a teaching pack (TP) in improving the adherence to the Mediterranean Diet (MD) showed positive results. The present study was aimed at investigating and confirming those results, with a follow up data collection, in the same sample, a year after the baseline intervention. Pre- and post-intervention assessments were conducted. Weight and height were measured. Eating patterns/lifestyle were assessed by the KIDMED test and questionnaires. Thirteen schools in three areas with low, medium and high prevalence of overweight/obesity (North, Center and South respectively) were involved, with a representative baseline cluster sample of 494 fourth class children (8-10 years old) in 2015. An intervention group and a control group were recruited in each school; the intervention group (n = 395) got the intervention, the control group (n = 99) did not. The children's KIDMED score changes were the main outcome measures. Differences in percentages of adherence and in yes/no answers on the KIDMED test, at baseline and after one year, for both the intervention and the control groups, were assessed through contingency tables and statistical tests. Improvements in the high and low adherence rates to MD were observed (high adherence: 24.4% to 43.3%; low adherence: 15.0% to 3.9%, p < 0.0001). The percentages of subjects with optimal adherence improved in both sexes (females: 25.5% to 49.5%, p < 0.0001; males: 23.1% to 36.6%, p < 0.0001) in all the geographical areas and ponderal status classes. Accompanying free distribution of fruit and vegetables with a nutritional intervention led by trained teachers with a cross-curricular approach can be successful in promoting healthy eating in children.
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Affiliation(s)
- Romana Roccaldo
- Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, 00178 Rome, Italy (L.D.)
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Braga BC, Nguyen PH, Tran LM, Hoang NT, Bannerman B, Doyle F, Folson G, Gangupantulu R, Karachiwalla N, Kolt B, McCloskey P, Palloni G, Thi Tran TH, Thuy Thi Trơưng D, Hughes D, Gelli A. Feasibility of Using an Artificial Intelligence-based Telephone Application for Dietary Assessment and Nudging to Improve the Quality of Food Choices of Female Adolescents in Vietnam: Evidence from a Randomized Pilot Study. Curr Dev Nutr 2024; 8:102063. [PMID: 38817706 PMCID: PMC11137395 DOI: 10.1016/j.cdnut.2023.102063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 06/01/2024] Open
Abstract
Background Adolescent nutrition has faced a policy neglect, partly owing to the gaps in dietary intake data for this age group. The Food Recognition Assistance and Nudging Insights (FRANI) is a smartphone application validated for dietary assessment and to influence users toward healthy food choices. Objectives This study aimed to assess the feasibility (adherence, acceptability, and usability) of FRANI and its effects on food choices and diet quality in female adolescents in Vietnam. Methods Adolescents (N = 36) were randomly selected from a public school and allocated into 2 groups. The control group received smartphones with a version of FRANI limited to dietary assessment, whereas the intervention received smartphones with gamified FRANI. After the first 4 wk, both groups used gamified FRANI for further 2 wk. The primary outcome was the feasibility of using FRANI as measured by adherence (the proportion of completed food records), acceptability and usability (the proportion of participants who considered FRANI acceptable and usable according to answers of a Likert questionnaire). Secondary outcomes included the percentage of meals recorded, the Minimum Dietary Diversity for Women (MDDW) and the Eat-Lancet Diet Score (ELDS). Dietary diversity is important for dietary quality, and sustainable healthy diets are important to reduce carbon emissions. Poisson regression models were used to estimate the effect of gamified FRANI on the MDDW and ELDS. Results Adherence to the application was 82% and the percentage of meals recorded was 97%. Acceptability and usability were 97%. MDDW in the intervention group was 1.07 points (95% CI: 0.98, 1.18; P = 0.13) greater than that in the control (constant = 4.68); however, the difference was not statistically significant. Moreover, ELDS in the intervention was 1.09 (95% CI: 1.01, 1.18; P = 0.03) points greater than in the control (constant = 3.67). Conclusions FRANI was feasible and may be effective to influence users toward healthy food choices. Research is needed for FRANI in different contexts and at scale.The trial was registered at the International Standard Randomized Controlled Trial Number as ISRCTN 10681553.
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Affiliation(s)
- Bianca C Braga
- Friedman School of Nutrition Policy and Science, Tufts University, Boston, MA, United States
| | - Phuong H Nguyen
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Lan Mai Tran
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Boateng Bannerman
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Frank Doyle
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Gloria Folson
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Rohit Gangupantulu
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Naureen Karachiwalla
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | - Bastien Kolt
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | - Peter McCloskey
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Giordano Palloni
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | | | | | - David Hughes
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Aulo Gelli
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
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Irankhah K, Asadimehr S, Kiani B, Jamali J, Rezvani R, Sobhani SR. Investigating the role of the built environment, socio-economic status, and lifestyle factors in the prevalence of chronic diseases in Mashhad: PLS-SEM model. Front Public Health 2024; 12:1358423. [PMID: 38813428 PMCID: PMC11133713 DOI: 10.3389/fpubh.2024.1358423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
Background Chronic diseases remain a significant contributor to both mortality and disability in our modern world. Physical inactivity and an unhealthy diet are recognized as significant behavioral risk factors for chronic diseases, which can be influenced by the built environment and socio-economic status (SES). This study aims to investigate the relationship between the built environment, SES, and lifestyle factors with chronic diseases. Methods The current study was conducted in Mashhad's Persian cohort, which included employees from Mashhad University of Medical Sciences (MUMS). In the study, 5,357 participants from the cohort were included. To assess the state of the built environment in Mashhad, a Geographic Information System (GIS) map was created for the city and participants in the Persian Mashhad study. Food intake and physical exercise were used to assess lifestyle. A food frequency questionnaire (FFQ) was used to assess food intake. To assess food intake, the diet quality index was computed. To assess the link between variables, the structural model was created in accordance with the study's objectives, and partial least square structural equation modeling (PLS-SEM) was utilized. Results The chronic diseases were positively associated with male sex (p < 0.001), married (p < 0.001), and higher age (p < 0.001). The chronic diseases were negatively associated with larger family size (p < 0.05), higher SES (p < 0.001), and higher diet quality index (DQI) (p < 0.001). No significant relationship was found between chronic disease and physical activity. Conclusion Food intake and socioeconomic status have a direct impact on the prevalence of chronic diseases. It seems that in order to reduce the prevalence of chronic diseases, increasing economic access, reducing the class gap and increasing literacy and awareness should be emphasized, and in the next step, emphasis should be placed on the built environment.
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Affiliation(s)
- Kiyavash Irankhah
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Soheil Asadimehr
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behzad Kiani
- UQ Center for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Jamshid Jamali
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Rezvani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Reza Sobhani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Barabas A, Nagy AC, Pazmany V, Grestyak Molnarne AK, Nemeth A, Jona G, Santha A, Takacs P, Toldy-Schedel E, Javorne Erdei R. Comparative Health Behaviour of Young People with Disabilities in Hungary: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:589. [PMID: 38790584 PMCID: PMC11120086 DOI: 10.3390/children11050589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/09/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
The health status of Hungary's population is unfavorable, with significant differences in health indicators not only compared to the EU15 but also to the Visegrad countries. Unfavorable health indicators can be disproportionate and particularly affect vulnerable groups, such as people with disabilities. In this study, we set out to compare the health behavior of disabled youth and youth with typical development in Hungary. We also aimed to compare the health behavior of adolescents in the Visegrad countries. The eating habits of both groups of young people we examined are unfavorable. Adolescents with disabilities experience a significantly higher rate of school stress than children with typical development in Hungary. The prevalence of somatic complaints and parameters of poor mental well-being are significantly higher in Hungary than in the other Visegrad countries. The results indicate that additional interventions are needed in Hungary and that differentiated, professional health promotion is needed for young people with disabilities. The researchers recommend extending the study to disabled adolescents living in Visegrad countries, on the basis of which an injury-specific health promotion methodology could be developed with international interprofessional cooperation.
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Affiliation(s)
- Agota Barabas
- Department of Health Methodology and Prevention, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (V.P.); (A.K.G.M.); (R.J.E.)
| | - Attila C. Nagy
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary;
| | - Viktoria Pazmany
- Department of Health Methodology and Prevention, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (V.P.); (A.K.G.M.); (R.J.E.)
| | - Anita K. Grestyak Molnarne
- Department of Health Methodology and Prevention, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (V.P.); (A.K.G.M.); (R.J.E.)
| | - Agnes Nemeth
- Institute of Psychology, Eötvös Loránd University, 1053 Budapest, Hungary;
| | - György Jona
- Department of Social Sciences, Faculty of Health, University of Debrecen, 4400 Nyíregyháza, Hungary;
| | - Agnes Santha
- Department of Applied Social Sciences, Faculty of Technical and Human Sciences, Sapientia Hungarian University of Transylvania, 540485 Targu Mures, Romania;
| | - Peter Takacs
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary;
| | | | - Renata Javorne Erdei
- Department of Health Methodology and Prevention, Faculty of Health Sciences, University of Debrecen, 4400 Nyíregyháza, Hungary; (V.P.); (A.K.G.M.); (R.J.E.)
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11
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Chan CMJ, Müller-Riemenschneider F, Chia MYH, Hildon ZJL, Chong MFF. Promoting hEalthy Diet and Active Lifestyle (PEDAL): a protocol for the development and feasibility study of a multicomponent intervention among primary school children in Singapore. Pilot Feasibility Stud 2024; 10:52. [PMID: 38521958 PMCID: PMC10960416 DOI: 10.1186/s40814-024-01479-3] [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: 09/25/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Setting healthy lifestyle habits during the formative years of childhood is critical as habits can track to adulthood and help prevent obesity and chronic disease risks in later life. While multicomponent interventions have been shown to be effective in changing the lifestyle behaviours of children, there is a limited understanding of the feasibility of such interventions in primary schools in Singapore. A multiphase mixed method study was conducted to develop and examine the feasibility of a theory-based multicomponent school-based intervention-Promoting hEatlthy Eating and Active Lifestyle (PEDAL). METHODS Underpinned by Kincaid's ideation model, the PEDAL intervention was developed to increase fruit and vegetable consumption and decrease sedentary behaviours among children. This study consists of three phases. Phase 1 details the development of PEDAL, which consists of four components: (A) a series of interactive health education lessons, (B) actionable home activities to support habit formation, (C) parental/guardian engagement, and (D) optimising the school environment. In Phase 2, components A and B of PEDAL were implemented in two public, co-educational primary schools among Primary 5 students (aged 10-12 years) in Singapore. Data was collected quantitatively using questionnaires and qualitatively using focus group discussions (FGDs) with students and teachers. The feasibility dimensions of components A and B, including recruitment capability, data collection, social validity, and practicality were examined, and ideation on healthy eating and physical activity was explored. In Phase 3, the full PEDAL intervention was pilot-tested in two other public, co-education primary schools with the same target population, using a concurrent mixed method quasi-experimental study design. Feasibility dimensions and potential effectiveness of the intervention will be assessed. DISCUSSION This study will provide insights into the feasibility of PEDAL and inform its refinement. Findings from the pilot test will guide the planning of a larger-scale definitive trial. TRIAL REGISTRATION Registered with ISRCTN registry (ISRCTN16114046) on 16 October 2022.
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Affiliation(s)
- Cindy Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
- Center for Digital Health, Berlin Institute of Health (BIH), Charité-Universitatsmedizin Berlin, Berlin, Germany
| | - Michael Yong Hwa Chia
- Physical Education & Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Zoe Jane-Lara Hildon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Tahir Foundation Building (MD1), 12 Science Drive 2, #09-01Q, Singapore, 117549, Singapore.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.
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12
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F K, A W, S S, K B, R L. Primary-school-aged children inspire their peers and families to eat more vegetables in the KiiDSAY project: a qualitative descriptive study. BMC Pediatr 2024; 24:175. [PMID: 38461327 PMCID: PMC10924354 DOI: 10.1186/s12887-024-04643-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 02/13/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND While vegetable intakes in Australia remain sub-optimal across all age groups, children are rarely consulted about their ideas on how to increase consumption. Qualitative research involving children provides an opportunity to consider their views. The aim of the Kids initiative inspires Dietary Success in Adults and Youth (KiiDSAY) project was to explore the views of school-aged children, who had participated in a school-based nutrition education program, about inspiring their peers and families to eat more vegetables. METHODS A total of 26 children (15 boys) aged 10-12 years from four primary schools in New South Wales, Australia, participated in seven focus group interviews. Purposeful sampling was used to recruit participants. The study involved open-ended semi-structured questions conducted via Zoom that were audio-recorded, transcribed verbatim and analysed using thematic analysis with deductive and inductive coding in NVivo. RESULTS Four major themes emerged: (i) taste; (ii) family environment; (iii) healthy eating; and (iv) change makers; with subthemes that were embedded within Social Cognitive Theory and Ecological Model of Health Behaviour theoretical frameworks. CONCLUSIONS Children's inputs hold great potential for informing future interventions, particularly when designing or refining school-based nutrition programs. Children offered suggestions on how to inspire increased vegetable consumption among their peers and families that could be taken into consideration for future research and practice. These included: cooking activities in the home and school settings using recipes that creatively hide/mask/enhance the flavour of vegetables, involving positive role models and supportive school environments. Additionally, children recommended a sequential approach to the delivery of recipes starting from fruit-based and transitioning to vegetable-based recipes. Given the challenges faced in increasing children's vegetable consumption, particular focus on future research in this area is warranted. TRIAL REGISTRATION FEAST Trial registered 14th December 2020 with the Australian and New Zealand Clinical Trials Registry (ACTRN12620001347954).
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Affiliation(s)
- Karpouzis F
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, 3125, Australia.
| | - Walsh A
- School of Behavioural and Health Sciences, Australian Catholic University, VIC, Melbourne, Australia
| | - Shah S
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Ball K
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, 3125, Australia
| | - Lindberg R
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, 3125, Australia
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13
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Karpouzis F, Lindberg R, Walsh A, Shah S, Abbott G, Ball K. Impact and process evaluation of a primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: pragmatic cluster non-randomized controlled trial. BMC Public Health 2024; 24:657. [PMID: 38429629 PMCID: PMC10905805 DOI: 10.1186/s12889-024-18079-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/12/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Environmentally sustainable food initiatives accompanying nutrition education, such as the Food Education and Sustainability Training (FEAST) program, have gained traction in school settings. The aim of this trial was to conduct an impact and process evaluation of FEAST, to evaluate its effect on children's fruit and vegetable (F&V) intakes, and secondary outcomes: F&V variety consumed, nutrition knowledge, food preparation/cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours, and food production knowledge. METHODS FEAST was a 10-week curriculum-aligned program, designed to educate children about healthy eating, food waste, and sustainability, while teaching cooking skills. It was implemented by classroom teachers, face-to-face and online, during COVID-19 school closures, in Australia in 2021. A custom designed survey was used to collect baseline and post-intervention data from students. Generalised linear mixed models (GLMM) estimated group differences in pre-post changes for primary and secondary outcomes. Surveys were also administered to students and teachers to evaluate intervention implementation. RESULTS Twenty schools participated and self-selected to be either intervention schools (n = 10) or wait-list control (WLC) schools (n = 10). A total of 977, 5th and 6th grade children participated in the trial with a mean age of 11.1 years (SD ± 0.7). The FEAST intervention, compared to WLC, did not result in significant increases in primary outcomes nor secondary outcomes. The process evaluation revealed FEAST was well-received by students and teachers, but COVID-19 school closures hindered implementation fidelity with a less intense program delivered under the constraints of pandemic lockdowns. CONCLUSIONS This is the first cluster non-randomized controlled trial designed to independently evaluate FEAST in the primary-school setting. No evidence was found for improved F&V intakes in children, nor secondary outcomes. However, the positive process evaluation results suggest that further trials of the program are warranted. If implemented as originally designed (pre-pandemic), with increased duration and complemented by supporting school policies, such programs have the potential to improve children's daily F&V intakes, cooking skills and food waste behaviours. This would support the Australian curriculum and contribute to: health promotion within schools and sustainable schools initiatives, the national agenda to reduce food waste and sustainable development goals. AUSTRALIAN AND NEW ZEALAND CLINICAL TRIALS REGISTRY: [ACTRN12620001347954]- Registered prospectively on 14/12/2020.
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Affiliation(s)
- F Karpouzis
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.
- , Rose Bay Nth, Australia, PO Box 2108, NSW, 2030.
| | - R Lindberg
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - A Walsh
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - S Shah
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - G Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - K Ball
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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14
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Federici G, Marcotrigiano V, Bino E, Lovat A, Padoin A, Salerno G, D’Incà P, Napoli C, Cinquetti S. Healthy Snack Project: Improving Healthy Choices through Multidisciplinary Food Education Actions. Nutrients 2024; 16:255. [PMID: 38257147 PMCID: PMC10818516 DOI: 10.3390/nu16020255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
School is one of the main settings where it is useful to guarantee health promotion actions, as it is well known that diet and eating habits that are shaped in the early stages of life are maintained through adulthood. The objective of this study was to carry out the "Healthy Snack" project to promote nutritional education in primary schools in the Province of Belluno in the 2022-2023 school year, in which 925 students were enrolled, and to evaluate the intervention in terms of changes in eating habits during their school breaks. Following the workshops performed by the healthcare workers (HCWs), medals were awarded, taking into account the quality of the participating students' mid-morning snacks, considering the food pyramid. The results collected in the annual survey period were related to the type and quantity of snacks consumed at school, and allowed students to gain a final score, comparing the period before and after the educational intervention to demonstrate the effectiveness of the actions promoted by HCWs and the increased nutritional quality of meals. In light of this evidence, public health strategies must continue to emphasize the importance of implementing health promotion interventions and actions aimed at children in order to prevent weight gain in this age group, and the potential development of cardiometabolic pathologies over their lifetime.
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Affiliation(s)
- Giuseppina Federici
- Prevention of Non-Communicable Diseases, Screening Programs and Health Promotion Service, Prevention Department, Local Health Authority “ULSS 1 Dolomiti”, 32100 Belluno, Italy; (G.F.); (A.L.); (A.P.)
| | | | - Erica Bino
- Epidemiology Service, Prevention Department, Local Health Authority “ULSS 1 Dolomiti”, 32100 Belluno, Italy;
| | - Alberto Lovat
- Prevention of Non-Communicable Diseases, Screening Programs and Health Promotion Service, Prevention Department, Local Health Authority “ULSS 1 Dolomiti”, 32100 Belluno, Italy; (G.F.); (A.L.); (A.P.)
| | - Angela Padoin
- Prevention of Non-Communicable Diseases, Screening Programs and Health Promotion Service, Prevention Department, Local Health Authority “ULSS 1 Dolomiti”, 32100 Belluno, Italy; (G.F.); (A.L.); (A.P.)
| | - Gerardo Salerno
- Department of Neurosciences, Mental Health and Sensory Organs “NESMOS”, Sapienza University of Rome, 00189 Rome, Italy;
| | - Pamela D’Incà
- Communication Office, Local Health Authority “ULSS 1 Dolomiti”, 32100 Belluno, Italy;
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00185 Rome, Italy;
| | - Sandro Cinquetti
- Prevention Department, Local Health Authority “ULSS 1 Dolomiti”, 32100 Belluno, Italy;
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15
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St Pierre C, Sokalsky A, Sacheck JM. Participant Perspectives on the Impact of a School-Based, Experiential Food Education Program Across Childhood, Adolescence, and Young Adulthood. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:4-15. [PMID: 38185490 DOI: 10.1016/j.jneb.2023.10.012] [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: 05/22/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE Explore participant perceptions of involvement in an experiential food education program during elementary school and the scope and extent of program influence on food decisions. DESIGN Focus groups with current participants and program alumni. SETTING Washington, DC. PARTICIPANTS Thirty-nine elementary school students and 39 program alumni ranging from middle school through university students. PHENOMENON OF INTEREST Participant perceptions of program impact from childhood into adolescence and young adulthood. ANALYSIS Inductive thematic analysis. RESULTS Nine emergent themes were identified, spread over 3 categories of program impact: immediate, beyond the classroom, and sustained. Immediate program impact themes came from all participants and included enjoyment, hands-on learning, and fostering connection. Beyond the classroom, older elementary students and alumni expressed perceived shifts in individual and family food intake, involvement in household food practices, and desire for fresh food options at school. Themes of sustained program impact among alumni participants were an appreciation for fresh food, openness to trying new foods, and confidence to make informed food decisions. CONCLUSIONS AND IMPLICATIONS Findings provide a deeper understanding of participant perspectives on the impact of participation in a school-based experiential food education program and a basis for further research on the role of early exposure to food education in influencing food decisions as children grow older.
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Affiliation(s)
- Christine St Pierre
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington DC.
| | - April Sokalsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington DC
| | - Jennifer M Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington DC
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16
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Czarniecka-Skubina E, Hamulka J, Gutkowska K. How Can We Increase the Nutrition-Related Knowledge in Children Aged 7-12 Years: Results of Focus Groups Interviews with Parents-Junior-Edu-Żywienie (JEŻ) Project. Nutrients 2023; 16:129. [PMID: 38201959 PMCID: PMC10780913 DOI: 10.3390/nu16010129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Nutrition education is a long-term process that should cover various population groups. A special focus should be placed on children, adolescents and their parents. The aim of this research was to find out the opinions of parents of primary school pupils aged 7-12 on their expectations towards school education in the areas of food and nutrition, addressed to both pupils and their parents. The research was conducted among 101 parents of primary school pupils with the use of the Focus Group Interview (FGI) method. It demonstrated that what is most needed are hands-on activities relating to basic theoretical issues. While parents see the need for nutrition education for their children, educating pupils in this area is of interest to only some of the respondents for whom nutrition aspects are quite important. All parents would like formal nutrition education at school, but at the same time, they do not want classes to take up too much of their children's time, due to the already excessive number of school subjects. It seems appropriate to include everyone in regard to nutrition education, regardless of their declared interest in this issue. The need for consistent presentation of educational content addressed to teachers and parents is very important, so that they can, in a uniform way, shape the attitudes towards food and nutrition of children and adolescents.
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Affiliation(s)
- Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
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17
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Pillay D, Ali A, Wham CA. Examining the New Zealand school food environment: what needs to change? Nutr Res Rev 2023; 36:406-419. [PMID: 35968693 DOI: 10.1017/s0954422422000154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Habitual dietary intakes and nutrition behaviours developed during childhood and adolescence pave the way for similar behaviours to manifest in adulthood. Childhood obesity rates have now reached a point where one in six children globally are classified as overweight or obese. Schools have the unique ability to reach almost all children during key developmental stages, making them an ideal setting for influencing children's nutrition behaviours. Evidence suggests the school food environment is not always conducive to healthy food choices and may be obesogenic. The aim of this narrative review is to explore factors that influence the healthy food and drink environment in and around schools in New Zealand. The review focused on evidence from New Zealand and Australia given the close resemblance in education systems and school food guidance. Using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework, the school food environment was categorised into the following domains: economic, political, physical and socio-cultural factors. Findings suggest that food policies are not utilised within schools, and guidelines to improve the school food environment are not well implemented. Canteen profit models, lack of staff support and resources, and higher availability of low-cost unhealthy foods are among barriers that hinder implementation. This review highlights recommendations from existing evidence, including canteen pricing strategies, restriction of unhealthy foods and using peer modelling in a time-scarce curriculum to improve the school food environment. Key areas for improvement, opportunities to enhance policy implementation and untapped avenues to improve the food and nutrition behaviours of children are highlighted.
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Affiliation(s)
- Danika Pillay
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Ajmol Ali
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Carol A Wham
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand
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18
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Kalimuthu I, Karpudewan M, Baharudin SM. An Interdisciplinary and Immersive Real-Time Learning Experience in Adolescent Nutrition Education Through Augmented Reality Integrated With Science, Technology, Engineering, and Mathematics. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:914-923. [PMID: 37921797 DOI: 10.1016/j.jneb.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/04/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Ilavarasi Kalimuthu
- School of Educational Studies, Universiti Sains Malaysia, George Town, Penang, Malaysia
| | - Mageswary Karpudewan
- School of Educational Studies, Universiti Sains Malaysia, George Town, Penang, Malaysia.
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19
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Czarniecka-Skubina E, Gutkowska K, Hamulka J. 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. Nutrients 2023; 15:4930. [PMID: 38068788 PMCID: PMC10708071 DOI: 10.3390/nu15234930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/21/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
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.
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Affiliation(s)
- Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland
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20
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Gutkowska K, Hamułka J, Czarniecka-Skubina E. The Attitudes of 7-9 Year Old Primary School Students towards Food and Nutrition: Insights from Qualitative FGI Research-The Junior-Edu-Żywienie (JEŻ) Project. Nutrients 2023; 15:4732. [PMID: 38004126 PMCID: PMC10674932 DOI: 10.3390/nu15224732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Optimal nutrition is one of the most significant environmental factors affecting human health. The aim of this study was to assess the attitudes of primary school students aged 7-9 towards nutrition considering three fundamental components: knowledge, emotional disposition, and dietary behaviors. The research was conducted using the Focus Group Interview (FGI) technique among 78 children. Considering their attitudes towards food and nutrition, four profiles were identified: "engaged", "obedient", "reluctant", and "indifferent". Children who were "engaged" and "obedient" due to their parents' involvement in creating their dietary attitudes exhibited the most alignment with the principles of optimal nutrition. Regardless of profile type, it was observed that children were familiar with recommended and unrecommended food products, as well as the role of water in proper nutrition. It was demonstrated that parents wield the most substantial influence on children's nutrition. As a result, initiatives promoting the proper nutrition and a healthy lifestyle should commence with parents. Children of nutritionally conscious parents tend to eat more healthily and demonstrate a high nutritional awareness. Conversely, the children of busy parents who lack time for meal preparation more frequently replicate their parents' nutritional mistakes. These findings emphasize the importance of the family environment in shaping the dietary behaviors of children and youth.
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Affiliation(s)
- Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Jadwiga Hamułka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland
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21
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Younossi ZM, Zelber-Sagi S, Henry L, Gerber LH. Lifestyle interventions in nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 2023; 20:708-722. [PMID: 37402873 DOI: 10.1038/s41575-023-00800-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 07/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a dynamic chronic liver disease that develops in close association with metabolic irregularities. Between 2016 and 2019, the global prevalence among adults was reported as 38% and among children and adolescents it was about 10%. NAFLD can be progressive and is associated with increased mortality from cardiovascular disease, extrahepatic cancers and liver complications. Despite these numerous adverse outcomes, no pharmacological treatments currently exist to treat nonalcoholic steatohepatitis, the progressive form of NAFLD. Therefore, the main treatment is the pursuit of a healthy lifestyle for both children and adults, which includes a diet rich in fruits, nuts, seeds, whole grains, fish and chicken and avoiding overconsumption of ultra-processed food, red meat, sugar-sweetened beverages and foods cooked at high heat. Physical activity at a level where one can talk but not sing is also recommended, including leisure-time activities and structured exercise. Avoidance of smoking and alcohol is also recommended. Policy-makers, community and school leaders need to work together to make their environments healthy by developing walkable and safe spaces with food stores stocked with culturally appropriate and healthy food items at affordable prices as well as providing age-appropriate and safe play areas in both schools and neighbourhoods.
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Affiliation(s)
- Zobair M Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA.
- Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA.
- Inova Medicine, Inova Health System, Falls Church, VA, USA.
| | | | - Linda Henry
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
- Inova Medicine, Inova Health System, Falls Church, VA, USA
| | - Lynn H Gerber
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
- Inova Medicine, Inova Health System, Falls Church, VA, USA
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22
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Fathi LI, Walker J, Dix CF, Cartwright JR, Joubert S, Carmichael KA, Huang YS, Littlewood R, Truby H. Applying the Integrated Sustainability Framework to explore the long-term sustainability of nutrition education programmes in schools: a systematic review. Public Health Nutr 2023; 26:2165-2179. [PMID: 37548226 PMCID: PMC10564612 DOI: 10.1017/s1368980023001647] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 04/27/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes. DESIGN Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programmes aimed at school-age (5-14 years) children that had been running for ≥ 2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework (ISF), which involved deductive coding of programme enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. SETTING International school-based nutrition programmes. SUBJECTS Individuals involved with the implementation of school-based nutrition programmes. RESULTS From the 7366 articles identified, thirteen studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of eleven different nutrition-related programmes were analysed. Thirty-four factors across the five domains of the ISF were identified that influenced the sustained implementation of programmes. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment. CONCLUSIONS These findings have application during the initiation and implementation phases of school-based nutrition programmes. Paying attention to the 'outer contextual factors' of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies are crucial for programme sustainment.
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Affiliation(s)
- Leila Isabella Fathi
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
| | - Jacqueline Walker
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
- Health and Wellbeing Queensland, Brisbane, Australia
| | - Clare Frances Dix
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
| | - Jessica Rose Cartwright
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
| | - Suné Joubert
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
| | - Kerri Amelia Carmichael
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
| | - Yu-Shan Huang
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
| | - Robyn Littlewood
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
- Health and Wellbeing Queensland, Brisbane, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD4067, Australia
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23
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Di Salvo G, Cattapan I, Fumanelli J, Pozza A, Moscatelli S, Sabatino J, Avesani M, Reffo E, Sirico D, Castaldi B, Cerutti A, Biffanti R, Pergola V. Childhood Obesity and Congenital Heart Disease: A Lifelong Struggle. J Clin Med 2023; 12:6249. [PMID: 37834891 PMCID: PMC10573337 DOI: 10.3390/jcm12196249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Congenital heart disease (CHD) affects approximately one in every one hundred infants worldwide, making it one of the most prevalent birth abnormalities globally. Despite advances in medical technology and treatment choices, CHD remains a significant health issue and necessitates specialized care throughout an individual's life. Childhood obesity has emerged as a novel global epidemic, becoming a major public health issue, particularly in individuals with lifelong conditions such as CHD. Obesity has profound effects on cardiac hemodynamics and morphology, emphasizing the importance of addressing obesity as a significant risk factor for cardiovascular health. Obesity-induced alterations in cardiac function can have significant implications for cardiovascular health and may contribute to the increased risk of heart-related complications in obese individuals. Moreover, while diastolic dysfunction may be less apparent in obese children compared to adults, certain parameters do indicate changes in early left ventricular relaxation, suggesting that obesity can cause cardiac dysfunction even in pediatric populations. As most children with CHD now survive into adulthood, there is also concern about environmental and behavioral health risk factors in this particular patient group. Addressing obesity in individuals with CHD is essential to optimize their cardiovascular health and overall quality of life. This review aims to succinctly present the data on the impact of obesity on CHD and to enhance awareness of this perilous association among patients, families, and healthcare providers.
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Affiliation(s)
- Giovanni Di Salvo
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
| | - Irene Cattapan
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Jennifer Fumanelli
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Alice Pozza
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Sara Moscatelli
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
- Inherited Cardiovascular Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Jolanda Sabatino
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
| | - Martina Avesani
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
- Working Group on Congenital Heart Disease and Cardiovascular Prevention in Children, Italian Society of Cardiology (SIC), 00198 Rome, Italy;
| | - Elena Reffo
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Domenico Sirico
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Biagio Castaldi
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Alessia Cerutti
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Roberta Biffanti
- Paediatric Cardiology and Congenital Heart Disease Complex Unit, Department of Women’s and Child’s Health, University of Padua, 35122 Padua, Italy; (I.C.); (J.F.); (A.P.); (J.S.); (M.A.); (E.R.); (D.S.); (B.C.); (A.C.); (R.B.)
| | - Valeria Pergola
- Cardiology Unit, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35122 Padua, Italy;
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24
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McInnes C, Carstairs SA, Cecil JE. A qualitative study of young peoples' thoughts and attitudes to follow a more plant-based diet. Front Psychol 2023; 14:1196142. [PMID: 37727744 PMCID: PMC10506079 DOI: 10.3389/fpsyg.2023.1196142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/31/2023] [Indexed: 09/21/2023] Open
Abstract
Plant-based diets (PBDs) refer to dietary habits that reduce the consumption of animal-based products and increase the consumption of nutritionally rich plant foods. PBD's have been shown to provide significant health benefits, such as reducing obesity and improving psychological wellbeing, and are environmentally friendly. However, few studies have investigated factors that influence young people's thoughts and attitudes toward following a PBD in western societies, particularly in the United Kingdom. Understanding these factors may benefit public health interventions that encourage the consumption of more fruit and vegetables. The aim of this study was to explore the factors that affect young people's intentions toward following a PBD. Twenty-one young people (18-24 years) participated in this qualitative study. Participants were asked about their views of PBDs in a semi-structured interview. Thematic analysis was utilized to explore views and the barriers and facilitators to following a PBD. The Theory of Planned Behavior (TPB) was used as a framework to organise the findings. Within attitudes, the sub-themes identified were an awareness of a healthy diet, environmental concerns, health concerns and distrust, perceptions of PBDs and associated stereotypes, perceived restriction and lack of enjoyment, and need for education. Within subjective norms, the sub-themes identified were cultural and familial norms, peer influence, and exposure through social media. Within perceived behavioral control (PBC), the sub-themes identified were a lack of independence and parental control, lack of knowledge and perceived difficulty, lack of inclusiveness and accessibility, and inconvenience. Overall, the findings suggest that increased provision of education and knowledge about PBDs to young people, and widening access to PBDs, could encourage and help improve their understanding and intention to follow this dietary style. Tailored health promotion strategies, which also consider additional barriers and facilitators found within this study, could motivate young people to consume a more PBD.
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Affiliation(s)
- Catherine McInnes
- School of Medicine, University of St Andrews, St Andrews, Fife, Scotland, United Kingdom
| | - Sharon A. Carstairs
- School of Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom
| | - Joanne E. Cecil
- School of Medicine, University of St Andrews, St Andrews, Fife, Scotland, United Kingdom
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25
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Ilić A, Rumbak I, Brečić R, Colić Barić I, Bituh M. Three-Year School-Based Multicomponent Intervention May Change Fruit and Vegetable Preferences in Primary School Children-A Quasi-Randomized Trial. Nutrients 2023; 15:3505. [PMID: 37630695 PMCID: PMC10457900 DOI: 10.3390/nu15163505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Preference could be the trigger for fruit and vegetable (FV) consumption in children and could be modified by appropriate intervention to increase the acceptance of FVs. The primary objective of this study was to investigate the effects of the three-year school-based multicomponent intervention "Nutri-školica" on the FV preferences of primary school children. It also aimed to explore whether a positive change in FV preferences could lead to an increase in actual FV consumption. The study was conducted in 14 primary schools from the city of Zagreb on 193 children (52.3% boys; age, 7.7 ± 0.4 years; n = 85 in the control group and n = 108 in the intervention group) who completed a preference questionnaire before and after the intervention with a 5-point hedonic smiley-face scale, where 5 means "I like it a lot." The per-protocol approach was used for data analysis (28.3% of children from the study sample). After the intervention, children in the intervention group (before: 3.1 ± 0.8; after: 3.5 ± 0.8) increased their FV preferences significantly more than children in the control group (before: 3.2 ± 0.8; after: 3.3 ± 0.7). Children's FV preferences changed most toward the varieties for which they had the least preferences at the beginning of the study. Participation in the intervention had a stronger effect on changing FV intake than change in FV preferences among primary school children. In summary, the present study highlighted that a targeted intervention can increase children's FV preferences, but that participation in the intervention is substantial for increasing FV intake.
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Affiliation(s)
- Ana Ilić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
| | - Ivana Rumbak
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
| | - Ružica Brečić
- Department of Marketing, Faculty of Economics and Business, University of Zagreb, Trg J.F. Kennedy 6, 10000 Zagreb, Croatia;
| | - Irena Colić Barić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
| | - Martina Bituh
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Pijerottijeva 6, 10000 Zagreb, Croatia; (A.I.); (I.C.B.); (M.B.)
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26
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Abu Shihab KHN, Dodge E, Benajiba N, Chavarria EA, Aboul-Enein BH, Faris MAIE. Effectiveness of school-based nutrition interventions promoted in the League of Arab States: a systematic review. Health Promot Int 2023; 38:daad094. [PMID: 37611160 PMCID: PMC10446142 DOI: 10.1093/heapro/daad094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Arab countries are doubly burdened with undernutrition as well as overweight and obesity. To provide guidance to those looking to address concerns of obesity and overweight among children in this region, the current review bridges an existing knowledge gap and systematically characterizes and evaluates the available scientific evidence pertaining to school-based nutrition interventions completed to date across the Arab world. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and relevant keywords, terms and phrases, a search of the literature across 14 databases for school-based nutrition interventions implemented in this region was conducted. Out of 1568 articles from 14 databases, 38 full-text articles meeting the inclusion criteria were retrieved. Further assessment for eligibility excluded 23 articles and included one article from hand-searching references, leaving 16 articles in the final analysis. Most articles (n = 7) with the implementation of 5 months or longer found strong positive and significant impacts on limiting sweets consumption, increased dietary knowledge, self-efficacy, breakfast and fruit and vegetable consumption, among others. We also found evidence (n = 5) that teachers trained by experts such as dietitians and pediatricians can effectively implement nutrition interventions that achieve the intended outcomes. Training teachers to implement theory-based nutrition and health promotion curricula serves as a potential solution to improving nutrition knowledge, health behaviors and dietary practices among children living in Arab countries. Appropriately designed and implemented nutrition interventions can positively impact nutrition knowledge, health and diet-related behaviors in children and adolescents in this region.
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Affiliation(s)
- Katia Hazim N Abu Shihab
- Department of Clinical Nutrition and Dietetics Sharjah, University of Sharjah College of Health Sciences, Sharjah, United Arab Emirates
| | - Elizabeth Dodge
- Applied Nutrition Graduate Program, University of New England College of Professional Studies, 716 Stevens Ave. Portland, ME 04103, USA
| | - Nada Benajiba
- Ibn Tofail University-CNESTEN Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Rabat, 14000 Kenitra, Morocco
| | - Enmanuel A Chavarria
- Department of Behavioral, Social, and Health Education Science, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Basil H Aboul-Enein
- London School of Hygiene & Tropical Medicine, Faculty of Public Health and Policy, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Moez Al-Islam E Faris
- Department of Clinical Nutrition and Dietetics Sharjah, University of Sharjah College of Health Sciences, Sharjah, United Arab Emirates
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27
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Jayasinghe S, Hills AP. Strategies to Improve Physical Activity and Nutrition Behaviours in Children and Adolescents: A Review. Nutrients 2023; 15:3370. [PMID: 37571307 PMCID: PMC10420868 DOI: 10.3390/nu15153370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
Despite widespread acknowledgement of the multifarious health benefits of physical activity (PA), including prevention and control of obesity, an overwhelming majority of children and adolescents are not sufficiently active to realise such benefits. Concurrently, young people are significantly impacted by the rapid global rise of sedentarism, and suboptimal dietary patterns during key phases of development. Regrettably, the cumulative effects of unhealthy behaviours during the growing years predisposes young people to the early stages of several chronic conditions, including obesity. Clear and consistent approaches are urgently needed to improve eating and activity behaviours of children and adolescents. Based on existing evidence of "best bets" to prevent and control obesity and its comorbidities, we present a set of non-negotiable strategies as a 'road map' to achieving prevention and improving the health of children and adolescents.
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Affiliation(s)
| | - Andrew P. Hills
- College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia;
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28
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Jeans MR, Landry MJ, Vandyousefi S, Hudson EA, Burgermaster M, Bray MS, Chandra J, Davis JN. Effects of a School-Based Gardening, Cooking, and Nutrition Cluster Randomized Controlled Trial on Unprocessed and Ultra-Processed Food Consumption. J Nutr 2023; 153:2073-2084. [PMID: 37116658 PMCID: PMC10375509 DOI: 10.1016/j.tjnut.2023.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND School-based gardening and nutrition education interventions report improvements in dietary intake, notably through fruit and vegetables. However, gardening, cooking, and nutrition randomized controlled trials are limited in evaluating dietary quality, and none have examined processed food consumption to date. OBJECTIVES The study examined the effects of Texas Sprouts (TX Sprouts), a gardening, cooking, and nutrition education intervention, compared with control on unprocessed and ultra-processed food (UPF) consumption in predominately low-income Hispanic children. METHODS TX Sprouts was a school-based cluster randomized controlled trial that consisted of 16 elementary schools randomly assigned to either the TX Sprouts intervention (n = 8 schools) or control (delayed intervention; n = 8 schools) over 3 y (2016-2019). TX Sprouts schools received an outdoor teaching garden and 18 1-h lessons taught by trained educators throughout the school year. Dietary intake data via 2 24-h dietary recalls were collected on a random subsample (n = 468) at baseline and postintervention. All foods and beverages were categorized using the NOVA food classification system (e.g., unprocessed, processed, ultra-processed). Generalized linear mixed effects modeling tested changes in percent calories and grams of NOVA groups between the intervention and control estimates with schools as random clusters. RESULTS Of the sample, 63% participated in the free and reduced-price lunch program, and 57% were Hispanic, followed by non-Hispanic White (21%) and non-Hispanic Black (12%). The intervention, compared to the control, resulted in an increase in consumption of unprocessed foods (2.3% compared with -1.8% g; P < 0.01) and a decrease in UPF (-2.4% compared with 1.4% g; P = 0.04). In addition, Hispanic children in the intervention group had an increase in unprocessed food consumption and a decrease in UPF consumption compared to non-Hispanic children (-3.4% compared with 1.5% g; P < 0.05). CONCLUSIONS Study results suggest that school-based gardening, cooking, and nutrition education interventions can improve dietary intake, specifically increasing unprocessed food consumption and decreasing UPF consumption. This trial was registered at clinicaltrials.gov as NCT02668744.
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Affiliation(s)
- Matthew R Jeans
- Department of Nutritional Sciences, College of Natural Sciences, the University of Texas at Austin, Austin, TX, United States
| | - Matthew J Landry
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Sarvenaz Vandyousefi
- Department of Medicine, New York University Grossman Medical Center, New York, NY, United States
| | - Erin A Hudson
- Department of Nutritional Sciences, College of Natural Sciences, the University of Texas at Austin, Austin, TX, United States
| | - Marissa Burgermaster
- Department of Nutritional Sciences, College of Natural Sciences, the University of Texas at Austin, Austin, TX, United States
| | - Molly S Bray
- Department of Nutritional Sciences, College of Natural Sciences, the University of Texas at Austin, Austin, TX, United States
| | - Joya Chandra
- Division of Pediatrics, Department of Pediatrics-Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jaimie N Davis
- Department of Nutritional Sciences, College of Natural Sciences, the University of Texas at Austin, Austin, TX, United States.
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Outzen M, Thorsen AV, Davydova A, Thyregod C, Christensen T, Grønborg I, Trolle E, Sabinsky M, Ravn-Haren G. Effect of School-Based Educational Intervention on Promoting Healthy Dietary Habits in Danish Schoolchildren: The FOODcamp Case Study. Nutrients 2023; 15:2735. [PMID: 37375639 PMCID: PMC10304401 DOI: 10.3390/nu15122735] [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: 03/10/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
The present study aimed to evaluate the effect of the school-based educational intervention "FOODcamp" on dietary habits among 6th-7th graders (aged 11-13 years), focusing on the food groups: fruits and vegetables, fish, meat, discretionary food, and sugar-sweetened beverages. In this cluster-based quasi-experimental controlled intervention study, 16 intervention classes (322 children) and 16 control classes (267 children) from nine schools were recruited during the school year 2019-2020. The children were asked to record their food intake for four consecutive days (Wednesday to Saturday) before (baseline) and after (follow-up) attending FOODcamp, using a validated self-administered web-based dietary record. Eligible dietary intake registrations from 124 and 118 children from the control and interventions classes, respectively, were included in the final statistical analysis. Hierarchical mixed model analysis was used to evaluate the effect of the intervention. No statistically significant effects of participating in FOODcamp were found on the average food intake of the food groups eaten regularly (vegetables, fruit, vegetables/fruit/juice combined, or meat) (p > 0.05). Among the food groups not eaten regularly (fish, discretionary foods, and sugar-sweetened beverages), a non-significant tendency to lower odds of consuming sugar-sweetened beverages from baseline to follow-up (OR = 0.512; 95% CI: 0.261-1.003; p = 0.0510) was seen among FOODcamp participants compared to control participants. In conclusion, this study found no effect of the educational intervention FOODcamp on the dietary intake of vegetables, fruit, vegetable/fruit/juice combined, meat, fish, or sugar-sweetened beverages. The intake frequency of sugar-sweetened beverages tended to decrease among FOODcamp participants.
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Affiliation(s)
- Malene Outzen
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Anne-Vibeke Thorsen
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Aleksandra Davydova
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Camilla Thyregod
- DTU Compute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Tue Christensen
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Ida Grønborg
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Ellen Trolle
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Marianne Sabinsky
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
- Danish Veterinary and Food Administration, Ministry of Food, Agriculture and Fisheries of Denmark, 2600 Glostrup, Denmark
| | - Gitte Ravn-Haren
- National Food Institute, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
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30
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Hasan F, Nguyen AV, Reynolds AR, You W, Zoellner J, Nguyen AJ, Swift D, Kranz S. Preschool- and childcare center-based interventions to increase fruit and vegetable intake in preschool children in the United States: a systematic review of effectiveness and behavior change techniques. Int J Behav Nutr Phys Act 2023; 20:66. [PMID: 37268953 DOI: 10.1186/s12966-023-01472-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Fruit and vegetable (FV) consumption in children in the United States (US) is very low. Adequate FV consumption is required for proper development during childhood, and dietary habits are established during preschool-age and tend to persist into adulthood. As most U.S. preschool-aged children attend childcare or preschool, this may be an opportune time and setting to conduct interventions to improve FV intake. These interventions should be based in theory and use behavior change techniques (BCTs) to explain mechanisms for expected change. To date, no published reviews have examined the effectiveness of childcare- or preschool-based FV interventions in preschoolers and their use of theoretical frameworks and BCTs. METHODS This systematic review was completed adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were randomized controlled trials (RCTs) published between 2012 and 2022 of interventions to improve diet or FV intake in preschoolers (aged 2-5 years) in childcare or preschool-settings. A search of four databases was conducted between in September 2022 using search terms pertaining to the study's primary aim (FV consumption), age group (preschool-aged), settings (US childcare or preschool settings), and study design (RCT). Additional criteria were objective measures of FV consumption or skin carotenoids, as a proxy for FV intake. Included studies were narratively synthesized based on intervention type, measured effect, and use of theory and BCTs. RESULTS The search resulted in six studies that reported on nine interventions. Overall, six interventions increased FV intake, of which five used nutrition education and one manipulated the feeding environment. Among the three interventions with no measured effect, two manipulated the feeding environment and one used peer modeling. Effective studies used at least three BCTs, though no pattern was observed between use of theory or BCTs and intervention effect. CONCLUSIONS While several studies have shown promising results, the limited number of studies identified in this review highlights key gaps in this field: there is a need for studies to test FV interventions in US childcare settings that use objective measures of FV intake, directly compare intervention components and BCTs, are theory-based, and assess long-term behavior change.
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Affiliation(s)
- Faten Hasan
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA
| | - Andy V Nguyen
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Amaya R Reynolds
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Wen You
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22903, USA
| | - Jamie Zoellner
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22903, USA
| | - Amanda J Nguyen
- Department of Human Services, University of Virginia, Charlottesville, VA, 22903, USA
| | - Damon Swift
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA
| | - Sibylle Kranz
- Department of Kinesiology, University of Virginia, Charlottesville, VA, 22903, USA.
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Haddad J, Vasiloglou MF, Scheidegger-Balmer F, Fiedler U, van der Horst K. Home-based cooking intervention with a smartphone app to improve eating behaviors in children aged 7-9 years: a feasibility study. DISCOVER SOCIAL SCIENCE AND HEALTH 2023; 3:13. [PMID: 37275348 PMCID: PMC10233529 DOI: 10.1007/s44155-023-00042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/18/2023] [Indexed: 06/07/2023]
Abstract
Objective To develop and evaluate the feasibility of a mobile application in Swiss households and assess its impact on dietary behavior and food acceptability between children who cooked with limited parental support (intervention group) with children who were not involved in cooking (control group). Methods A ten-week randomized controlled trial was conducted online in 2020. Parents were given access to a mobile-app with ten recipes. Each recipe emphasized one of two generally disliked foods (Brussels sprouts or whole-meal pasta). Parents photographed and weighed the food components from the child's plate and reported whether their child liked the meal and target food. The main outcome measures were target food intake and acceptability analyzed through descriptive analysis for pre-post changes. Results Of 24 parents who completed the baseline questionnaires, 18 parents and their children (median age: 8 years) completed the evaluation phase. Mean child baseline Brussel sprouts and whole-meal pasta intakes were 19.0 ± 24.2 g and 86.0 ± 69.7 g per meal, respectively. No meaningful differences in intake were found post-intervention or between groups. More children reported a neutral or positive liking towards the whole-meal pasta in the intervention group compared to those in the control group. No change was found for liking of Brussel sprouts. Conclusions for practice The intervention was found to be feasible however more studies on larger samples are needed to validate feasibility. Integrating digital interventions in the home and promoting meal preparation may improve child reported acceptance of some healthy foods. Using such technology may save time for parents and engage families in consuming healthier meals.
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Affiliation(s)
- Joyce Haddad
- Bern University of Applied Sciences, School of Health Professions, Nutrition and Dietetics, Murtenstrasse 10, 3008 Bern, Switzerland
| | - Maria F. Vasiloglou
- AI in Health and Nutrition Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Franziska Scheidegger-Balmer
- Bern University of Applied Sciences, School of Health Professions, Nutrition and Dietetics, Murtenstrasse 10, 3008 Bern, Switzerland
| | - Ulrich Fiedler
- Institute ICE, School of Engineering and Computer Science, Bern University of Applied Sciences, Biel/Bienne, Switzerland
| | - Klazine van der Horst
- Bern University of Applied Sciences, School of Health Professions, Nutrition and Dietetics, Murtenstrasse 10, 3008 Bern, Switzerland
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Bel-Serrat S, Klingenstein P, Marques-Previ M, Hennessy E, Murrin C. Perceived barriers to vegetable intake among urban adolescents from socioeconomically disadvantaged backgrounds: A qualitative study from the perspective of youth workers and teachers. Physiol Behav 2023; 262:114074. [PMID: 36623744 DOI: 10.1016/j.physbeh.2023.114074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
Eating habits established during adolescence have been shown to track into adulthood. Adolescents from lower socioeconomic status groups tend to have lower intakes of vegetables as compared with their more affluent peers. However, there is limited evidence about the determinants of vegetable intake in this population group. Therefore, this study aimed to explore the barriers to vegetable intake in adolescents living in socioeconomically disadvantaged areas through the perspective of school teachers and youth workers. A total of 20 semi-structured interviews were conducted with post-primary school teachers and youth workers from disadvantaged areas in Dublin, Ireland. Thematic analysis was applied to analyze the data. Eleven themes were identified and fitted within the Socioecological Model of Health: adolescent's food preferences, lack of early exposure and familiarity with vegetables, lack of interest, knowledge and skills at the individual and family level, parenting practices around nutrition, living difficulties, peers' influence and social norms around nutrition, dual role of social media, lack of resources and support to promote healthy eating, competition between unhealthy food vs. vegetables, lack of adequate approaches & initiatives at the community and at the public policy levels, and lack of State support to promote healthy eating. Although several actions could be taken at the personal and interpersonal levels, more efforts are needed at the organizational, community and public policy levels to improve dietary choices and vegetable intake among adolescents in socioeconomically deprived areas. These findings will inform the development of tailored intervention strategies and policies for these vulnerable youths.
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Affiliation(s)
- Silvia Bel-Serrat
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | - Pauline Klingenstein
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Maria Marques-Previ
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eilis Hennessy
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Celine Murrin
- National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Labbé C, Ward Chiasson S, Dupuis JB, Johnson C. Effectiveness of a School-Based Culinary Programme on 9- and 10-Year-Old Children's Food Literacy and Vegetable, Fruit, and Breakfast Consumption. Nutrients 2023; 15:nu15061520. [PMID: 36986250 PMCID: PMC10057530 DOI: 10.3390/nu15061520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
School-based culinary courses may increase children's food literacy and improve their eating behaviours. This study assessed the impact of a school-based culinary programme on 9- and 10-year-old students' food literacy and vegetable, fruit, and breakfast consumption. This cluster quasi-experimental trial compared 88 grade 4 and 5 students who participated in the Apprenti en Action programme to 82 students who did not. Students' food literacy and eating behaviours were assessed with a self-administered questionnaire. The programme's impact on vegetable and fruit consumption, cooking skills, food skills, and food knowledge was measured using MANOVA, and the odds of eating breakfast at least five times per week were assessed with logistic regression. Students who participated in the programme reported a greater increase in their cooking skills (p = 0.013) and food knowledge (p = 0.028) than students in the control group. No effect was found on food skills and vegetables, fruit, and breakfast consumption (p-values > 0.05). Boys improved their cooking skills (p = 0.025) and food knowledge (p = 0.022), but girls did not. The programme improved students' cooking skills and food knowledge, especially among boys; however, modifications are needed to improve students' food skills and eating behaviours.
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Affiliation(s)
- Charlotte Labbé
- École des Sciences des Aliments, de Nutrition et d'Études Familiales, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Stephanie Ward Chiasson
- École des Sciences des Aliments, de Nutrition et d'Études Familiales, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Jérémie B Dupuis
- Vice-Rectorat à l'Enseignement et à la Recherche, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Claire Johnson
- École des Hautes Études Publiques, Université de Moncton, Moncton, NB E1A 3E9, Canada
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Collado-Soler R, Alférez-Pastor M, Torres FL, Trigueros R, Aguilar-Parra JM, Navarro N. A Systematic Review of Healthy Nutrition Intervention Programs in Kindergarten and Primary Education. Nutrients 2023; 15:nu15030541. [PMID: 36771248 PMCID: PMC9921877 DOI: 10.3390/nu15030541] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
Childhood obesity and overweight rates are increasing in an exponential way. This type of diet-related health problem has consequences, not only at present but also for children's future lives. For these reasons, it is very important to find a solution, which could be nutrition intervention programs. The main objective of this article is to investigate the effectiveness of nutrition intervention programs in children aged 3-12 around the world. We used SCOPUS, Web of Science, and PubMed databases to carry out this systematic review and we followed the PRISMA statement. Two authors conducted literature searches independently, finding a total of 138 articles. Finally, after a thorough screening, a total of 19 articles were selected for detailed analysis. The results show that, in general, nutrition intervention programs are effective in improving knowledge and behaviors about healthy habits, and, consequently, that the body mass index value is reduced. However, it is true that we found differences between the incomes of families and geographical areas. In conclusion, we encourage school centers to consider including these types of programs in their educational program and bring awareness of the importance of families too.
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Affiliation(s)
- Rocio Collado-Soler
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Marina Alférez-Pastor
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Francisco L. Torres
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
| | - Rubén Trigueros
- Department of Language and Education, University of Antonio de Nebrija, 28015 Madrid, Spain
- Correspondence: (R.T.); (J.M.A.-P.)
| | - Jose M. Aguilar-Parra
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
- Correspondence: (R.T.); (J.M.A.-P.)
| | - Noelia Navarro
- Hum-878 Research Team, Health Research Centre, Department of Psychology, University of Almería, 04120 Almería, Spain
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Pfister F, Pozas C. The influence of Chile's food labeling and advertising law and other factors on dietary and physical activity behavior of elementary students in a peripheral region: a qualitative study. BMC Nutr 2023; 9:11. [PMID: 36631817 PMCID: PMC9832755 DOI: 10.1186/s40795-023-00671-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In 2016, Chile implemented the Food Labeling and Advertising Law to fight childhood obesity through front-of-package food labelling, marketing restrictions and school activities and programs. Nevertheless, little is known on its influence on key stakeholders in vulnerable peripheral regions of the country. This study aimed at identifying important influencing factors including the Food Labeling and Advertising Law on dietary habits and physical activity patterns of second graders in Chile, as perceived by school representatives and the children themselves. METHODS Semi-structured interviews with four school directors and 17 groups of three second graders, informal interviews with 9 key teachers and 4 food services staff complemented with documented observations were carried out in four primary schools of the Chilean city of Punta Arenas, in the Magallanes Punta Arenas region. The different sources allowed for triangulation of results. RESULTS FLAL seems to have a negligible influence on young children's diet and physical activity in the study region. Barriers are children's deeply rooted dietary habits, excessive screen-time, the parents' lacking problem awareness, limited time for parenting practices and bad role modeling. Environmental barriers are overloaded schools due to insufficient coordination between governmental entities, lacking funds for sound teacher training and unsafe neighborhoods limiting children's play. CONCLUSIONS Policy interventions aimed at reducing childhood obesity need to include and empower schools, families and local communities as active partners and consider their framework conditions for greater influence on dietary habits and physical activity.
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Affiliation(s)
- Franziska Pfister
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
| | - Claudia Pozas
- grid.424060.40000 0001 0688 6779School of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008 Bern, Switzerland
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Cunningham-Sabo L, Lohse B, Clifford J, Burg A, Nigg C. Fuel for Fun Process Evaluation Reveals Strong Implementation and Approval with Varied Parent Engagement. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:16-29. [PMID: 36621265 DOI: 10.1016/j.jneb.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To describe the implementation and process characteristics of Fuel for Fun: Cooking with Kids Plus Parents and Play (FFF). DESIGN Mixed methods. SETTING Elementary schools in 2 Northern Colorado school districts. PARTICIPANTS Fourth graders (aged 9-11 years), parents, school staff, and implementation researchers; measured over 2 consecutive years in 8 schools (851 students, 45 classrooms). INTERVENTION(S) Social Cognitive and active learning theory-based classroom cooking with tasting lessons, active recess games, cooking with tasting food promotion during school lunch, family nights, and take-home intervention reinforcements. A 7-month program delivered by a trained intervention team. MAIN OUTCOME MEASURE(S) Implementation measures (observations and debriefings) assessed context, reach, dose delivered, fidelity, and dose received; process measures (surveys) assessed student and parent perceptions and intervention participation. ANALYSIS Descriptive statistics for quantitative and themes for qualitative data. RESULTS Minor adjustments in program delivery plans were required to accommodate changes in school schedules and policies. Process measures demonstrated > 90% achievement of goals for nearly all child-centered activities. One-quarter of eligible families participated in evening events, with strong parent and student approval. Fifty out of 116 parents (43%) completing an online survey reported preparing ≥ 1 of 5 recipes with their child. Fifty-nine percent of eligible students completed >1 of 10 take-home activity sheets with their parents. CONCLUSIONS AND IMPLICATIONS Engagement and commitment of the intervention team and school staff supported strong implementation. Participant responses were positive, but improvement in parent engagement requires investigation.
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Affiliation(s)
- Leslie Cunningham-Sabo
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
| | - Barbara Lohse
- Wegmans School of Health and Nutrition, Rochester Institute of Technology, Rochester, NY
| | - Jessica Clifford
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Alixanna Burg
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Claudio Nigg
- Department of Health Science, Institute of Sport Science, University of Bern, Bern, Switzerland
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Kelly RK, Peralta L, Nash R. Promoting food literacy in primary school classrooms through the HealthLit4Kids Program in Australia. Health Promot Int 2022; 37:6823569. [DOI: 10.1093/heapro/daac166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lay Summary
Food literacy (FL) refers to the knowledge, skills, and behaviours associated with healthy eating. Schools are recognised as an important setting for FL promotion during childhood. HealthLit4Kids is an Australian primary school intervention that engages students, families, and educators to promote health literacy. This study aimed to assess the promotion of FL, a subtype of health literacy, in primary school classrooms across five schools. Teachers planned and implemented classroom activities over a 12-month period. Researchers examined lesson plans created by teachers and ‘artefacts’ (e.g. drawings, models) created by students during activities. Most classroom activities considered the nutritional knowledge and interpersonal communication skills associated with healthy eating, whereas fewer activities addressed students’ ability to critically analyse and apply information relating to food. The FL themes considered most frequently in classroom activities were ‘food and health choices’, ‘knowledge’, and ‘skills and behaviour’. Whereas the FL themes considered less frequently were ‘food systems’, ‘emotion’, and ‘culture’. The delivery of classroom activities was supported by the integration of other curriculum areas (e.g. The Arts and English). Future studies are required to understand how school-based interventions can promote the areas of FL that were less frequently addressed in this intervention in the classroom and beyond.
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Affiliation(s)
- Rebecca K Kelly
- School of Medicine, College of Health and Medicine, University of Tasmania , Hobart , Australia
- Nuffield Department of Population Health, University of Oxford , Oxford , UK
| | - Louisa Peralta
- School of Education and Social Work, Faculty of Arts and Social Sciences, University of Sydney , Sydney , Australia
| | - Rosie Nash
- School of Medicine, College of Health and Medicine, University of Tasmania , Hobart , Australia
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Beresford SA, Ornelas IJ, Bauer MC, Garrity GA, Bishop SK, Francis B, Rillamas-Sun E, Garcia LV, Vecenti FS, Lombard KA. Group Randomized Trial of Healthy Eating and Gardening Intervention in Navajo Elementary Schools (Yéego!). AJPM FOCUS 2022; 1:100033. [PMID: 37791240 PMCID: PMC10546586 DOI: 10.1016/j.focus.2022.100033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Few healthy eating, school-based interventions have been rigorously evaluated in American Indian communities. Gardening and healthy eating are priorities in the Navajo Nation. Collaborations between researchers and local partners supported the design and implementation of this project. Design The Yéego! Healthy Eating and Gardening Study was a group-randomized controlled trial to evaluate a school-based healthy eating and gardening intervention in 6 schools in the Navajo Nation. Schools were randomized 1:2 to intervention or comparison. Setting/participants The Shiprock and Tsaile/Chinle areas in the Navajo Nation were selected. Elementary schools were screened for eligibility. All students in third and fourth grades were invited to participate in the assessments. Intervention Delivered during 1 school year in the intervention schools, the intervention included a culturally relevant nutrition and gardening curriculum and a school garden. Main outcome measures Student self-efficacy for eating fruits and vegetables, student self-efficacy for gardening, and student healthy foods score from a modified Alternative Healthy Eating Index were assessed in third and fourth graders at the beginning and end of a school year affected by the COVID-19 pandemic. Primary analyses used repeated measures linear mixed models accounting for students nested within schools to estimate the intervention effect and 95% CIs. Results Students in the intervention schools had self-efficacy scores for eating fruits and vegetables that were 0.22 points greater (95% CI=0.04, 0.41) than those in the comparison schools, although the student healthy foods score increased in the intervention schools by 2.0 (95% CI=0.4, 3.6); the differential change was modest at 1.7 (95% CI=-0.3, 3.7). The self-efficacy to grow fruits and vegetables in the school garden increased among those in the intervention schools (OR=1.92; 95% CI=1.02, 3.63) but not significantly more than it increased in the comparison schools (OR=1.29; 95% CI=0.60, 2.81). Conclusions The intervention was efficacious in improving self-efficacy for eating fruits and vegetables among third- and fourth-grade students over a school year. The findings warrant further evaluation of the intervention in larger-group randomized trials with schools in Navajo communities. Trial registration This study is registered at clinicaltrials.gov NCT03778021.
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Affiliation(s)
- Shirley A.A. Beresford
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
| | - India J. Ornelas
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
| | | | | | - Sonia K. Bishop
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
| | - Brandon Francis
- Agricultural Science Center at Farmington, College of Agricultural, Consumer, and Environmental Sciences, New Mexico State University, Farmington, New Mexico
| | - Eileen Rillamas-Sun
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, Washington
| | | | | | - Kevin A. Lombard
- Agricultural Science Center at Farmington, College of Agricultural, Consumer, and Environmental Sciences, New Mexico State University, Farmington, New Mexico
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Blanquer-Genovart M, Manera-Bassols M, Salvador-Castell G, Cunillera-Puértolas O, Castell-Abat C, Cabezas-Peña C. School Menu Review Programme (PReME): evaluation of compliance with dietary recommendations during the period 2006-2020 in Catalonia. BMC Public Health 2022; 22:2173. [PMID: 36434578 PMCID: PMC9700995 DOI: 10.1186/s12889-022-14571-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/16/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The School Menu Review Programme (PReME) has been offering complimentary revisions of meal plans to all schools in Catalonia since 2006. This study aims to assess the evolution of compliance with PReME's recommendations in the meals provided by school cafeterias in Catalonia during the period 2006-2020. METHODS Pre-post study with a sample of 6,387 meal plans from 2221 schools assessed during the period. The information was collected mainly by public health specialists within the annual technical and sanitary inspection of school kitchens and cafeterias. Meal plans were evaluated by Dietitian-Nutritionists team according to the criteria of the National Health System's "Consensus document on nutrition in schools" and the Public Health Agency of Catalonia's current guide "Healthy eating at school". Reports were sent to each participating school. A few months later, a new meal plan and another questionnaire were collected and evaluated in comparison with the first meal plan. Compliance with the recommendations was analysed based on the type of canteen management and the school category. RESULTS Compliance improved during the study period. The percentage of schools that complied with dietary recommendations in relation to the five PReME indicators (fresh fruit, pulses, daily vegetables, fresh food and olive oil for dressing) has steadily increased since PReME began, (over 70% in all indictors; p = < 0.001), with variations depending on school category and cafeteria management. Furthermore, an improvement in the levels of compliance with de recommended food frequencies was observed. with statistically significant differences for all items (p < 0.001), except for pulses whose compliance had been high since the beginning of the study (p = 0.216). CONCLUSIONS The positive evolution in compliance with PReME's recommendations provides evidence of the programme's effectiveness, with an improvement in the quality of school meals delivered in Catalonia.
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Affiliation(s)
- Maria Blanquer-Genovart
- grid.436087.ePublic Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005 Spain
| | - Maria Manera-Bassols
- grid.436087.ePublic Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005 Spain
| | - Gemma Salvador-Castell
- grid.436087.ePublic Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005 Spain
| | - Oriol Cunillera-Puértolas
- grid.436087.ePublic Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005 Spain
| | - Conxa Castell-Abat
- grid.436087.ePublic Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005 Spain
| | - Carmen Cabezas-Peña
- grid.436087.ePublic Health Agency of Catalonia, Subdirectorate General for Health Promotion, Ministry of Health, Government of Catalonia, Roc Boronat, 81-95, Barcelona, 08005 Spain
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Wells NM, Todd LE, Henderson Jr. CR, Myers BM, Barale K, Gaolach B, Ferenz G, Aitken M, Hendrix L, Taylor C, Wilkins JL. The effects of school gardens on fruit and vegetable consumption at school: a randomized controlled trial with low-income elementary schools in four U.S. states. Prev Med Rep 2022; 31:102053. [DOI: 10.1016/j.pmedr.2022.102053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
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Lorenz KA, Stylianou M, Kulinna PH, Yu H. School and Home Contributions to Dietary Behaviors of Rural Youth. Am J Health Promot 2022; 37:478-487. [PMID: 36260863 DOI: 10.1177/08901171221134792] [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: 11/15/2022]
Abstract
PURPOSE This study examined dietary behaviors of rural youth at school and at home and sociodemographic differences. DESIGN A cross-sectional design was used. SETTING The study took place in five rural schools in the Southwestern US. SAMPLE Student participants (N = 751) were in 3rd-8th grades. MEASURES Consumption of fruits, vegetables, dairy, and soda/pop, at school and at home, were measured using a modified 7-day recall Youth Risk Behavior survey for nutrition instrument (CDC, 2011); Sociodemographic data. ANALYSIS Descriptive statistics, frequency tables and MANCOVA were used. RESULTS Following a natural log transformation of the dependent variables, there were significant multivariate effects in dietary behaviors across schools (Wilks' λ = 0.962, F(16, 2539.4) = 2.05, P = 0.0082) and location (school v. home; Wilks' λ = 0.849, F(4, 831) = 36.94, P < 0.0001). Follow-up tests showed students in some schools reported higher consumption of fruit, vegetable, and soda at home than school, although most reported consuming less than one serving per day of fruit, vegetables, and dairy across settings. There were no significant main effects for gender/grade/ethnicity across behaviors. CONCLUSIONS Findings highlight poor dietary behaviors of rural youth as well as school/home differences that can help inform efforts to support optimal dietary behaviors of this population. Results should be interpreted considering limitations of the self-report nature of collected data and missing data.
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Affiliation(s)
- Kent A Lorenz
- Department of Kinesiology, San Francisco State University, San Francisco, CA, USA
| | - Michalis Stylianou
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia Campus, QLD, Australia
| | | | - Hyeonho Yu
- Metropolitan State University of Denver, Denver, CO, USA
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Verdonschot A, Follong BM, Collins CE, de Vet E, Haveman-Nies A, Bucher T. Effectiveness of school-based nutrition intervention components on fruit and vegetable intake and nutrition knowledge in children aged 4-12 years old: an umbrella review. Nutr Rev 2022; 81:304-321. [PMID: 35947869 PMCID: PMC9912007 DOI: 10.1093/nutrit/nuac057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT School-based nutrition interventions can support healthy eating in children. OBJECTIVE To identify components of school-based nutrition interventions and synthesize the impact on consumption of fruits and vegetables (FV) and nutrition knowledge (NK) in children aged 4-12 y. DATA SOURCES Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and PICOS inclusion criteria, relevant systematic reviews and/or meta-analyses, written in English, published between 2010 and August 2020, across 6 databases were identified. DATA EXTRACTION Two reviewers independently performed data extraction and assessed the study quality. DATA ANALYSIS The JBI Critical Appraisal Instrument for Systematic Reviews and Research Syntheses was used to assess review quality, and the Grading of Recommendations Assessment, Development, and Evaluation approach was used to rate strength of evidence. RESULTS From 8 included reviews, 7 intervention components were identified: FV provision, gaming/computer-delivered, curriculum, experiential learning, reward/incentives, nudging, and caregiver involvement. FV provision had the greatest effect on F intake, gaming/computer-delivered on V intake, and curriculum on NK. CONCLUSION FV provision and gaming/computer-delivered components showed, overall, some positive effect on FV intake, as did the curriculum component on NK. More evidence evaluating single-component effectiveness that considers the setting and context of nutrition interventions is required to strengthen the evidence base. SYSTEMATIC REVIEW REGISTRATION PROSPERO, registration no.: CRD42020152394.
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Affiliation(s)
- Angeliek Verdonschot
- A. Verdonschot, School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia. E-mail:
| | - Berit M Follong
- are with the School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia,are with the Priority Research Centre for Physical Activity and Nutrition (PRCPAN), University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- are with the School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia,are with the Priority Research Centre for Physical Activity and Nutrition (PRCPAN), University of Newcastle, Callaghan, New South Wales, Australia
| | - Emely de Vet
- are with the Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, The Netherlands
| | - Annemien Haveman-Nies
- are with the Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, The Netherlands
| | - Tamara Bucher
- are with the Priority Research Centre for Physical Activity and Nutrition (PRCPAN), University of Newcastle, Callaghan, New South Wales, Australia,with the School of Environmental and Life Sciences, College of Engineering, Science and Environment, University of Newcastle, Ourimbah, New South Wales, Australia
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Effect of COVID-19 outbreak on the diet, body weight and food security status of students of higher education: a systematic review. Br J Nutr 2022; 129:1916-1928. [PMID: 35946073 DOI: 10.1017/s0007114522002604] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The COVID-19 pandemic has impacted college students' lifestyles and placed them at a greater risk of obesity and food insecurity. The purpose of the systematic review was to consolidate evidence for the effect of Covid-19 on students' dietary quality, dietary habits, body weight and food security status. A comprehensive literature search was conducted utilising various databases including Google Scholar, MEDLINE, ScienceDirect, Embase and Scopus to identify relevant studies. To be incorporated in this review, studies had to include higher education students, measure the prevalence of food insecurity and assess the dietary and body weight changes during the COVID-19 pandemic. The studies showed that the diet quality of college students was compromised during the pandemic in many nations due to the decrease in the intake of whole grains, dairy products, legumes, nuts, fruits and vegetables and the increase in consumption of alcohol, confectionery products and refined grains. There was an increase in the frequency of cooking, binge eating, breakfast skipping and unhealthy snacking. These modifications, in return, were associated with body weight changes, with no less than 20 to 30 % of students gaining weight during the pandemic. The pandemic also impacted food security status of students, with over 30% being food insecure worldwide. The COVID-19 outbreak has exacerbated the students' diet quality and dietary habits and placed them under high risk of weight gain and food insecurity. Higher education institutions and governments should improve students' access to nutritious foods and incorporate nutrition education interventions in the curricula.
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Robertson D, Carins J, Rundle‐Thiele S, Harris J. Evaluation of Social Impact Within Primary School Health Promotion: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:739-764. [PMID: 35365879 PMCID: PMC9544285 DOI: 10.1111/josh.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Health promotion programs and interventions are designed to encourage behavioral changes in children, encouraging them to make safe and healthy life choices. This systematic review seeks to examine how social impact is measured in primary school health promotion interventions. METHOD A systematic search and review process was used to identify and examine primary school health promotion interventions. The PRISMA guidelines were followed to source articles from 6 electronic databases reporting school health promotion programs or interventions in Australia, Canada, New Zealand, or the United Kingdom. RESULTS A total of 77 studies were located, representing 55 health promotion interventions delivered in primary school settings. Of these interventions, only 8 (15%) measured or attempted to measure social impact, whereas another 8 (15%) alluded to social impact. The predominant theories reported were social based theories (theories which examine the social influences on people, environments, and behaviors) (n = 17, 59%), with almost a third not informed by an overt health promotion framework or model (n = 34, 59%). A systematic rating system identified some level of stakeholder engagement (n = 30, 53%). CONCLUSIONS This systematic review highlights the need for social impact measurement within health promotion to illuminate the role of school programs in delivering lasting change.
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Affiliation(s)
- Dianne Robertson
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Julia Carins
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Sharyn Rundle‐Thiele
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
| | - Jessica Harris
- Social Marketing @ GriffithDepartment of Marketing, Griffith University170 Kessels RoadNathanQLD4111Australia
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Schmidt S, Goros MW, Gelfond JAL, Bowen K, Guttersen C, Messbarger-Eguia A, Feldmann SM, Ramirez AG. Children's Afterschool Culinary Education Improves Eating Behaviors. Front Public Health 2022; 10:719015. [PMID: 35570900 PMCID: PMC9091819 DOI: 10.3389/fpubh.2022.719015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
Objective(s) Culinary education may be one way to improve children's eating behaviors. We formatively evaluated the effect of a hands-on afterschool 12-module, registered dietitian-led culinary education program on healthy eating behaviors in a predominately Hispanic/Latino, low-socioeconomic community. Methods Of 234 children participating in the program, 77% completed both pre- and post-assessment surveys (n = 180; mean age 9.8 years; 63.3% female; 74.3% Hispanic/Latino, 88.4% receiving free/reduced lunch). In addition to program satisfaction, we assessed changes in children's self-reported fruit, vegetable, and whole-grain consumption, knowledge, and culinary skills using binary and continuous mixed effects models. We report false discovery rate adjusted p-values and effect sizes. Results 95.5% of participants reported liking the program. Improved whole grain consumption had a medium effect size, while effect sizes for whole grain servings and vegetable consumption were small, but significant (all p < 0.05). Culinary skills increased between 15.1 to 43.4 percent points (all p < 0.01), with medium to large effect sizes. Conclusion(s) The program was well-received by participants. Participants reported improved eating behaviors and culinary skills after program completion. Therefore, this hands-on afterschool culinary education program can help improve healthy eating in a predominantly Hispanic/Latino, low-socioeconomic community.
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Affiliation(s)
- Susanne Schmidt
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX, United States
| | - Martin W Goros
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX, United States
| | - Jonathan A L Gelfond
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX, United States
| | - Katherine Bowen
- Culinary Health Education for Families (CHEF), San Antonio, TX, United States
| | - Connie Guttersen
- Culinary Health Education for Families (CHEF), San Antonio, TX, United States
| | | | | | - Amelie G Ramirez
- Department of Population Health Sciences, UT Health San Antonio, San Antonio, TX, United States.,Institute for Health Promotion Research, UT Health San Antonio, San Antonio, TX, United States
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Varì R, d’Amore A, Silenzi A, Chiarotti F, Del Papa S, Giovannini C, Scazzocchio B, Masella R. Improving Nutrition Knowledge and Skills by the Innovative Education Program MaestraNatura in Middle School Students of Italy. Nutrients 2022; 14:nu14102037. [PMID: 35631178 PMCID: PMC9148077 DOI: 10.3390/nu14102037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/04/2022] Open
Abstract
Promoting a healthy diet, mainly in youths, is the most effective action to prevent and fight dietary excesses and nutritional imbalance in the population. MaestraNatura (MN) is an innovative nutritional education program aimed at promoting a healthy lifestyle in first-level secondary school students. The study evaluated the effectiveness of the MN program in improving knowledge in students following the MN program (MN group) with respect to a control group (CO group) undergoing a “traditional” nutritional education path. To this end, the nutrition knowledge of the two groups was assessed by three multi-choice questionnaires. The results showed a significant improvement in knowledge (p < 0.001) in the MN group with respect to the CO group for all the questionnaires. Furthermore, the students’ ability to transfer the principles of nutrition guidelines to the real context of daily meals was determined by asking the MN group to create a weekly food plan before (T0) and after (T1) the completion of the MN program. The MN group demonstrated improved performance in organizing the weekly menu plan at T1 with respect to T0 (p = 0.005). In conclusion, the MN nutritional education program appears to be an effective tool for improving knowledge and skills on nutritional issues, especially in those students with a lower starting level of knowledge and ability.
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Affiliation(s)
- Rosaria Varì
- Center for Gender-Specific Medicine, Italian National Institute for Health, 00161 Rome, Italy; (R.V.); (A.d.); (A.S.); (S.D.P.); (C.G.); (R.M.)
| | - Antonio d’Amore
- Center for Gender-Specific Medicine, Italian National Institute for Health, 00161 Rome, Italy; (R.V.); (A.d.); (A.S.); (S.D.P.); (C.G.); (R.M.)
| | - Annalisa Silenzi
- Center for Gender-Specific Medicine, Italian National Institute for Health, 00161 Rome, Italy; (R.V.); (A.d.); (A.S.); (S.D.P.); (C.G.); (R.M.)
| | - Flavia Chiarotti
- Reference Center for Behavioral Sciences and Mental Health, Italian National Institute for Health, 00161 Rome, Italy;
| | - Sara Del Papa
- Center for Gender-Specific Medicine, Italian National Institute for Health, 00161 Rome, Italy; (R.V.); (A.d.); (A.S.); (S.D.P.); (C.G.); (R.M.)
| | - Claudio Giovannini
- Center for Gender-Specific Medicine, Italian National Institute for Health, 00161 Rome, Italy; (R.V.); (A.d.); (A.S.); (S.D.P.); (C.G.); (R.M.)
| | - Beatrice Scazzocchio
- Center for Gender-Specific Medicine, Italian National Institute for Health, 00161 Rome, Italy; (R.V.); (A.d.); (A.S.); (S.D.P.); (C.G.); (R.M.)
- Correspondence:
| | - Roberta Masella
- Center for Gender-Specific Medicine, Italian National Institute for Health, 00161 Rome, Italy; (R.V.); (A.d.); (A.S.); (S.D.P.); (C.G.); (R.M.)
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Sánchez-Puertas R, Vaca-Gallegos S, López-Núñez C, Ruisoto P. Prevention of Alcohol Consumption Programs for Children and Youth: A Narrative and Critical Review of Recent Publications. Front Psychol 2022; 13:821867. [PMID: 35369212 PMCID: PMC8965835 DOI: 10.3389/fpsyg.2022.821867] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Youth substance use is a public health problem globally, where alcohol is one of the drugs most consumed by children, and youth prevention is the best intervention for drug abuse. Objective Review the latest evidence of alcohol use prevention programs in empirical research, oriented to all fields of action among children and youth. Methods A narrative and critical review was carried out within international databases (PsychInfo, Pubmed, Web of Science, and Scopus) in August 2021 and was limited to empirical studies that appeared in the last five years (2017-2021). A flow diagram was used according to the PRISMA statements. Empirical research articles in English with RCTs and quasi-experimental design that included alcohol, children, and young people up to 19 years of age (universal, selective, or indicated programs) were included. The authors examined the results and conceptual frameworks of the Prevention programs by fields of action. Results Twenty-two articles were found from four fields of action: school (16), family (2), community (2), and web-based (2), representing 16 alcohol prevention programs. School-based alcohol prevention programs are clinically relevant [Theory of Planned Behavior, Refuse, Remove, Reasons, Preventure, The GOOD Life, Mantente REAL, Motivational Interviewing (BIMI), Primavera, Fresh Start, Bridges/Puentes], they are effective in increasing attitudes and intentions toward alcohol prevention behavior, while decreasing social norms and acceptance of alcohol, reducing intoxication, and increasing perceptions with regards to the negative consequences of drinking. Discussion This narrative and critical review provides an updated synthesis of the evidence for prevention programs in the school, family, community, and web-based fields of action, where a more significant number of programs exist that are applied within schools and for which would have greater clinical relevance. However, the prevention programs utilized in the other fields of action require further investigation.
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Affiliation(s)
- Rafael Sánchez-Puertas
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain.,Department of Psychology, Particular Technical University of Loja, Loja, Ecuador
| | - Silvia Vaca-Gallegos
- Department of Psychology, Particular Technical University of Loja, Loja, Ecuador
| | - Carla López-Núñez
- Department of Personality, Assessment and Psychological Treatments, School of Psychology, University of Seville, Seville, Spain
| | - Pablo Ruisoto
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain
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Chan MJ, Tay GWN, Kembhavi G, Lim J, Rebello SA, Ng H, Lin C, Wang MC, Müller-Riemenschneider F, Chong MFF. Understanding children's perspectives of the influences on their dietary behaviours. Public Health Nutr 2022; 25:1-11. [PMID: 35184794 PMCID: PMC9991721 DOI: 10.1017/s1368980022000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/05/2022] [Accepted: 02/16/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to examine the intrapersonal, interpersonal, environmental and macrosystem influences on dietary behaviours among primary school children in Singapore. DESIGN A qualitative interpretive approach was used in this study. Focus group discussions guided by the socio-ecological model (sem), of which transcripts were analysed deductively using the sem and inductively using thematic analysis to identify themes at each sem level. SETTING Two co-educational public primary schools in Singapore. PARTICIPANTS A total of 48 children (n 26 girls) took part in the semi-structured focus group discussions. Their mean age was 10·8 years (sd = 0·9, range 9-12 years), and the majority of the children were Chinese (n 36), along with some Indians (n 8) and Malays (n 4). RESULTS Children's knowledge of healthy eating did not necessarily translate into healthy dietary practices and concern for health was a low priority. Instead, food and taste preferences were pivotal influences in their food choices. Parents had a large influence on children with regards to their accessibility to food, their attitudes and values towards food. Parental food restriction led to some children eating in secrecy. Peer influence was not frequently reported by children. Competitions in school incentivised children to consume fruits and vegetables, but reinforcements from teachers were inconsistent. The proximity of fast-food chains in the neighbourhood provided children easy access to less healthy foods. Health advertisements on social media rather than posters worked better in drawing children's attention. CONCLUSIONS Findings highlighted important factors that should be considered in future nutrition interventions targeting children.
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Affiliation(s)
- Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Gabrielle Wann Nii Tay
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | | | - Jubilee Lim
- Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Hazyl Ng
- Health Promotion Board, Singapore, Singapore
| | - Congren Lin
- Health Promotion Board, Singapore, Singapore
| | - May C Wang
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609 Singapore, Singapore
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Quaidoo E, Ohemeng A, Kushitor MK, Antwi J. Nutrition education incorporation into mainstream primary school curriculum in Ghana: Stakeholders' sources of nutrition information and perceived barriers. PLoS One 2022; 17:e0262359. [PMID: 34990476 PMCID: PMC8735612 DOI: 10.1371/journal.pone.0262359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/21/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Nutrition literacy has been cited as a crucial life skill. Nutrition education as a primary school subject has been treated inconsequentially when compared to other subjects. We investigated an aspect of the current state of nutrition education in Ghana by engaging stakeholders about their sources of nutrition information and the perceived barriers in implementing nutrition education in mainstream primary schools. Methods Three hundred and fifty one (351) primary school children, 121 homebased caregivers, six schoolteachers, two headteachers, two Ghana Education Service (GES) officials, and six school cooks were involved in the study. Surveys were used to collect data on nutrition information acquisition behaviors and to record perceived barriers. Key Informant Interviews were conducted among GES officials, headteachers, schoolteachers and school cooks, while Focus Group Discussions were used among homebased caregivers and children to gather qualitative information. Results Only 36.3% of the primary school children had heard about nutrition, and 71% of those got nutrition information from their family members. About 70% of homebased caregivers had heard or seen nutrition messages, and their source of nutrition information was predominantly traditional media. Schoolteachers mostly received their nutrition information from non-governmental organizations and the Internet, while most of the school cooks stated their main source of nutrition information was hospital visits. Perceived barriers included schoolteachers’ knowledge insufficiency, and lack of resources to adequately deliver nutrition education. Lack of a clear policy appeared to be an additional barrier. Conclusion The barriers to the implementation of nutrition education in the mainstream curriculum at the primary school level that were identified in this study can be resolved by: providing schoolteachers with learning opportunities and adequate nutrition education resources for practical delivery, having specific national policy framework, and including family members and school cooks in the nutrition education knowledge and information dissemination process.
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Affiliation(s)
- Esi Quaidoo
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, United States of America
| | - Agartha Ohemeng
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Mawuli K. Kushitor
- Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Janet Antwi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, Texas, United States of America
- * E-mail:
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How Primary School Curriculums in 11 Countries around the World Deliver Food Education and Address Food Literacy: A Policy Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042019. [PMID: 35206208 PMCID: PMC8871606 DOI: 10.3390/ijerph19042019] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 01/03/2023]
Abstract
(1) Background: As one of the biggest drivers of health and climate change, the food system has unrealised potential to influence consumption toward affordable, healthy, sustainable diets. A range of policy levers, including mandating food education, are needed. Schools are considered the best place for food education and childhood is a crucial period when eating habits that persist into adulthood are formed. Food education as part of the curriculum is crucial in generating population shifts in food systems improvements. The purpose of this policy analysis was to analyse mandatory curriculums in different countries to explore the ways in which primary school food education addresses food literacy. (2) Methods: This study analyses how food education within primary school education policy, in 11 countries, addresses Food Literacy (FL). It is the first study of this kind. A case study methodology was employed, and curriculum policy content analysis was conducted using a Food Literacy framework. (3) Results: Each country has a curriculum dedicated to food education, supported by food education in non-food curriculums. There is no standardized approach to primary school food education policy, no consensus in primary food education nomenclature or what curriculums constitute. Curriculums focus on cooking and health topics, but significantly less on social-cultural, equity, and sustainability issues. (4) Conclusion: How primary curriculums around the world deliver food education policy to address FL varies enormously. All 11 countries have dedicated food curriculums, supported by non-food curriculums, but there is no consensus as to what food education is called or constitutes. Countries rarely deal with FL comprehensively. The most comprehensive are single, detailed food curriculums, complemented by non-food curriculums where food knowledge and skills progress clearly and are the intended learning outcome.
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