Intergenerational relations and the family food environment in families with a child with obesity

Dietary diversity and nutritional status of children attending early childhood development centres in Vhembe District, Limpopo province, South Africa

The present study assessed dietary diversity and anthropometric status of children attending early development centres in South Africa. In the Vhembe District of Limpopo province, South Africa, 273 children were conveniently chosen from 8 randomly selected early childhood development centres for a cross-sectional study. Data were gathered via a questionnaire administered by the interviewer in June 2021. Height, body weight and mid-upper arm circumference were measured to assess anthropometric status. A 24-h dietary recall was obtained to provide information on dietary diversity. The prevalence of underweight, wasting and stunting was 9, 4 and 26 %, respectively. More than half of the children had a low dietary diversity score, according to the Food and Agriculture Organization scoring system for children. Grains, roots, tubers, dairy products, other fruits and vegetables, and flesh-based foods were the highest consumed food groups. The lowest consumption was for eggs, vitamin A-rich fruits and vegetables, legumes and nuts. Height for age and weight for age were significantly associated with dietary diversity score, but not weight for height. Children who did not meet the reference value of greater than 4 for dietary diversity had a significant risk of being underweight (AOR 0⋅25, 95 % CI 0⋅08, 0⋅75) and stunted (AOR 0⋅32, 95 % CI 0⋅14, 0⋅74). The nutritional status of the children was impacted by a lack of adequate dietary diversity. Young children in rural areas need to receive a wide range of food to promote greater diversification of diets in order to diminish the risk of undernutrition.

Fulfilling food practices: Applying the capability approach to ethnographic research in the Northern Netherlands

Often, food practices are evaluated in terms of their healthiness or lack thereof, but fulfilling food practices based on other values and influenced by family members' capabilities are overlooked. This study analyses food practices in families with low socio-economic status, and aims to explain how family households come to prioritise one food practice over another. We conducted an ethnographic study using the capability approach as an analytical framework. In-depth interviews and observations concerning food patterns and health-related choices with family members from three generations were analysed. Two dimensions of fulfilling food practices which emerged from our study are having a healthy as well as harmonious meal. The families under study tended to prioritise having harmonious meals over having healthy meals, despite the attempts by mothers to serve healthy meals. This choice can be understood from the perspective of capabilities, such as being able to enjoy meals, eating what everybody else eats in the region, avoiding conflicts, creating good relationships with children and serving and organising meals with ease. Within the cultural environment, there prevailed a tendency not to care too much about nutritional outcomes, which also supported the preference for harmonious over healthy meals. In the decision about whether to have a healthy or a harmonious meal, children's agency often outweighed the voices of parents and grandparents. The capability approach helped unravel the complexity of family food practices and the role of intergenerational family dynamics in a setting of low socio-economic status. Acknowledging the multi-dimensional nature of food practices, and including dimensions beyond the food domain, such as harmony at the dinner table, contribute to a better understanding of this complexity. It also helps to shed new light on opportunity deprivation in households, for example in relation to agency, which should be accounted for in health interventions.

A qualitative study of the day-to-day lives of obese Mexican-American adolescent females

OBJECTIVE

In an effort to develop more effective weight-loss interventions, this study examined the daily experiences and personal struggles of Mexican-American adolescent females with morbid obesity.

METHODS

Twenty self-identified, morbidly obese Mexican-American adolescent females and their families were interviewed about their food choices, personal and family barriers to weight loss, sources of support, previous weight-loss experience, and weight-related beliefs. Qualitative responses were coded by using framework analysis.

RESULTS

Four themes emerged from the adolescent and family responses: the impact of normal adolescent development, multiple sources of excess calories, the physical and emotional burden of excess weight for the adolescent, and the magnitude of the family's personal struggle with weight management. Multiple subthemes were also identified.

CONCLUSIONS

Responses by the adolescents and their families highlighted the intersection of adolescence and Mexican-American culture and the daily challenges of obesity. Recommendations for providers include incorporating knowledge of adolescent development and culturally sensitive care into treatment recommendations.