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McMath AL, Barton JM, Cai T, Khan NA, Fiese BH, Donovan SM. Western, Healthful, and Low-Preparation Diet Patterns in Preschoolers of the STRONG Kids2 Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:219-229. [PMID: 38402478 PMCID: PMC10999342 DOI: 10.1016/j.jneb.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 02/26/2024]
Abstract
OBJECTIVE Identify and describe diet patterns of children during early childhood using confirmatory factor analysis (CFA). DESIGN Longitudinal data were drawn from the STRONG Kids 2 program. PARTICIPANTS Mothers were surveyed about their child's diet at 24 (n = 337), 36 (n = 317), and 48 (n = 289) months old. VARIABLES MEASURED The Block Food Frequency Questionnaire for children aged 2-7 years was used to derive diet patterns; 23 food groups were created for analyses. ANALYSIS Principal component analysis was used to obtain preliminary factor loadings, and loadings were used to form a priori hypotheses for CFA-derived diet patterns. Independent samples t tests were used to compare food groups, nutrient intakes, and child and family characteristics by CFA pattern scores above vs at/below the median. RESULTS Three diet patterns consistently emerged: (1) processed meats, sweets, and fried foods; (2) vegetables, legumes, and starchy vegetables; and (3) grains, nuts/seeds, and condiments (only 24 and 36 months). Patterns were related to differences in added sugars, dietary fiber and potassium intakes, maternal education, and household income. CONCLUSIONS AND IMPLICATIONS Opposing healthful vs Western patterns, extant in child and adult literature, were observed across all ages. The third pattern differed between 24/36 and 48 months, representing a potential shift in food choices or offerings as children age.
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Affiliation(s)
- Arden L McMath
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Jennifer M Barton
- Family Resiliency Center, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Tianying Cai
- Family Resiliency Center, University of Illinois, Urbana-Champaign, Urbana, IL; Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Naiman A Khan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL; Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, Urbana, IL; Neuroscience Program, University of Illinois Urbana-Champaign, Champaign, IL; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, IL
| | - Barbara H Fiese
- Family Resiliency Center, University of Illinois, Urbana-Champaign, Urbana, IL; Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, Urbana, IL
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL; Department of Food Science and Human Nutrition, University of Illinois Urbana-Champaign, Urbana, IL.
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Mazonde N, Goldstein S. Online Health Communities' Portrayal of Obesity on Social Media Platforms in South Africa. JOURNAL OF HEALTH COMMUNICATION 2023; 28:15-24. [PMID: 38146160 DOI: 10.1080/10810730.2023.2231374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
The rapidly increasing prevalence of obesity in South Africa, intertwined with extensive changes in diet, life expectancy, and nutritional status has led to a complex framing of obesity on social media. This has prompted the prioritization of media-based social and behavior change communication interventions leveraging social media for obesity prevention. This study was conducted to understand how obesity is constructed and represented on social media in South Africa. A media review of Facebook and Twitter platforms in South Africa was conducted over a six-month period using Meltwater software for data collection. The search yielded 13 500 posts and tweets. Data were cleaned and coded in Microsoft Excel. Content and framing analysis were performed to add insight into the nature of obesity discourse on social media. Portrayals of obesity on social media were dominated by stigmatizing imagery blaming individuals for unhealthy lifestyles, poor diets, and lack of physical activity. Future media-based social and behavior change communication interventions for obesity prevention can leverage social media to reach the broader public and insights into media portrayals of obesity have the potential to influence the shape and development of these behavioral interventions.
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Affiliation(s)
- Natasha Mazonde
- SAMRC/Wits Centre for Health Economics & Decision Science- PRICELESS-SA, University of Witwatersrand, Faculty of Health Sciences, School of Public Health, Parktown Johannesburg, South Africa
| | - Susan Goldstein
- SAMRC/Wits Centre for Health Economics & Decision Science- PRICELESS-SA, University of Witwatersrand, Faculty of Health Sciences, School of Public Health, Parktown Johannesburg, South Africa
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Enriquez JP, Gollub E. Snacking Consumption among Adults in the United States: A Scoping Review. Nutrients 2023; 15:nu15071596. [PMID: 37049435 PMCID: PMC10097271 DOI: 10.3390/nu15071596] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Snacks are a staple of the American diet, contributing to approximately 20% of energy intake. Most U.S. adults consume one to three snacks/day, yet few reviews have focused on snacking among this population. This scoping review was conducted to characterize snacks and snacking occasions among U.S. adults to further inform healthy eating practices. The protocol was prepared following the PRISMA-Extension for Scoping Reviews. Three web databases were used to identify articles using snacking or eating occasions as primary or secondary outcomes among U.S. adults. A search strategy was developed using subject headings, truncation, and phrase searching in the title and abstract of articles published between 2010 and 2022. A two-stage, multi-step screening process identified 31 of 4795 publications as meeting the inclusion criteria. Findings included identification of snacking themes, e.g., cues and motivations; diet composition; and weight management. Food quality, time of consumption, and convenience emerged as characteristics of snacking; time of day was found to influence food choice. Snacks contribute to or detract from a healthy diet. Strategic selection of healthy snack options can improve diet quality. Applied to nutrition education, this information can help strengthen programs or policies, ultimately contributing to health and wellbeing.
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Ganpule A, Dubey M, Pandey H, Srinivasapura Venkateshmurthy N, Green R, Ann Brown K, Maddury AP, Khatkar R, Jarhyan P, Prabhakaran D, Mohan S. Snacking Behavior and Association with Metabolic Risk Factors in Adults from North and South India. J Nutr 2023; 153:523-531. [PMID: 36894244 PMCID: PMC7616315 DOI: 10.1016/j.tjnut.2022.12.032] [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: 09/22/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Snacks are increasingly contributing to daily diets around the world. Studies from high-income countries have demonstrated the link between snack consumption and metabolic risk factors, but there are very few studies from low- and middle-income countries. OBJECTIVES The objective of this study was to assess snack behavior and its associations with metabolic risk factors in Indian adults. METHODS Adults from the UDAY study (October 2018-February 2019, n = 8762) from rural and urban Sonipat (North) and Vizag (South) India were studied for snack consumption (food frequency questionnaire), demographic factors, including age, sex, etc. and metabolic risk factors, including BMI, waist circumference, fat percentage, plasma glucose, and blood pressure. We compared snack consumption by categories of sociodemographic factors (Mann-Whitney U test, Kruskal-Wallis test) and studied the likelihood for metabolic risk (logistic regression analysis). RESULTS Half of the study participants were women and resided in rural locations. Savory snacks were the most preferred; 50% of the participants consumed them 3-5 times/wk. Participants preferred to purchase out-of-home prepared snacks and eat them at home (86.6%) while watching television (69.4%) or with family/friends (49.3%). The reasons for snacking were hunger, craving, liking, and availability. Snack consumption was higher in Vizag (56.6%) than in Sonipat (43.4%), among women (55.5%) than men (44.5%), and the wealthiest; it was similar in rural-urban locations. Frequent consumers of snacks had 2 times higher likelihood for having obesity (OR: 2.22; 95% CI: 1.51, 3.27) central obesity (OR: 2.35; 95% CI: 1.60, 3.45), and higher fat percentage (OR: 1.92; 95% CI: 1.31, 2.82) and higher fasting glucose levels (r=0.12 (0.07-0.18) than consumers who consumed snacks rarely (all P ≤ 0.05). CONCLUSIONS Snack (savory and sweet) consumption was high among adults from sexes in both urban and rural locations of north and south India. This was associated with higher risk of obesity. There is a need to improve the food environment by promoting policies for ensuring healthier food options to reduce snacking and associated metabolic risk.
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Affiliation(s)
| | - Manisha Dubey
- Centre for Chronic Disease Control, New Delhi, India
| | | | | | - Rosemary Green
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | - Dorairaj Prabhakaran
- Centre for Chronic Disease Control, New Delhi, India; Public Health Foundation of India, New Delhi, India; London School of Hygiene and Tropical Medicine, London, UK
| | - Sailesh Mohan
- Centre for Chronic Disease Control, New Delhi, India; Public Health Foundation of India, New Delhi, India; Deakin University, Melbourne, Australia
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Patel D, Butzer D, Williams BD, Dev DA, Horm D, Finneran D, Lowery B, Campbell JE, Sisson SB. Food Waste, Preference, and Cost: Perceived Barriers and Self-Reported Food Service Best Practices in Family Child Care Homes. Child Obes 2022; 18:548-555. [PMID: 35333611 DOI: 10.1089/chi.2021.0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Family Child Care Homes (FCCHs) are a setting where providers care for children at their own residence. FCCHs face unique challenges and children may not always receive optimal nutrition and have higher risk of obesity compared to other programs. The objective of this study was to determine differences in food service best practices scores between FCCHs who did/did not perceive barriers to serving healthy meals. Methods: FCCHs (n = 167) self-reported demographics, and perceived barriers to serving healthy foods. Nutrition and Physical Activity Self-Assessment for Child Care was used to assess food served with 1 (indicating poor practice) to 4 (indicating best practice). Means, standard deviations, and t-tests were conducted to determine differences in scores between FCCHs with and without perceived barriers. Adjusted alpha was 0.013. Results: FCCHs perceiving food waste as a barrier had significantly lower scores for total food and beverage (p = 0.006, 3.2 ± 0.3 vs. 3.4 ± 0.3); fruits and vegetables (p = 0.003, 3.1 ± 0.5 vs. 3.3 ± 0.5), whole fruits (p = 0.048, 3.1 ± 1.2 vs. 3.4 ± 0.9), and nonstarchy vegetables (p = 0.007, 2.8 ± 0.9 vs. 3.2 ± 0.9). Providers perceiving food preferences as a barrier had significantly lower scores compared to those who did not (p = 0.008, 2.9 ± 0.9 vs. 3.3 ± 0.9). No significant differences found in best practices among providers with vs. without perceived barrier of food costs. Conclusion: Food waste is an understudied barrier in FCCHs to serve healthy meals. Research is needed to explore these perceived barriers in FCCHs to improve best practices around meals.
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Affiliation(s)
- Divya Patel
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Daisy Butzer
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Bethany D Williams
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Department of Nutrition and Exercise Physiology, Washington State University Health Sciences Spokane, Spokane, WA, USA
| | - Dipti A Dev
- Department of Child, Youth, and Family studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Diane Horm
- Instructional Leadership and Academic Curriculum, and University of Oklahoma, Norman, OK, USA
| | - Denise Finneran
- Department Speech Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Bryce Lowery
- Department of Regional and City Planning, University of Oklahoma, Norman, OK, USA
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Susan B Sisson
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Bailey RL, Leidy HJ, Mattes RD, Heymsfield SB, Boushey CJ, Ahluwalia N, Cowan AE, Pannucci T, Moshfegh AJ, Goldman JD, Rhodes DG, Stoody EE, de Jesus J, Casavale KO. Frequency of Eating in the US Population: A Narrative Review of the 2020 Dietary Guidelines Advisory Committee Report. Curr Dev Nutr 2022; 6:nzac132. [PMID: 36110105 PMCID: PMC9469881 DOI: 10.1093/cdn/nzac132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background A person's daily nutrient intake and overall nutritional status are determined by a complex interplay of the types and amounts of foods ingested in combination with the timing and frequency of eating. Objectives The aim was to summarize frequency of eating occasion data examined by the 2020 Dietary Guidelines Advisory Committee, the macronutrient contributions they provide, and meal frequency relative to dietary quality among the US population (≥2 y), with a focus on sex, age, race/Hispanic origin, and income. Methods Demographic and 24-h recall data from the 2013-2016 NHANES were examined. An eating occasion was defined as "any ingestive event (e.g., solid food, beverage, water) that is either energy yielding or non-energy yielding"; all eating occasions were further divided into discrete meals and snacks. Frequency of meals and snacks was defined as "the number of daily EOs [eating occasions]," respectively. Diet quality was assessed via the Healthy Eating Index (HEI)-2015. Results Most Americans consume 2 (28%) to 3 (64%) meals on a given day and >90% consume 2 to 3 snacks on that day. Adult, Hispanic, and non-Hispanic Black and lower-income (<131% family poverty-to-income ratio) Americans had a lower frequency of eating than children or adolescents, non-Hispanic White, and non-Hispanic Asian Americans and higher-income Americans, respectively. Americans who reported 3 meals on a given day consumed a diet higher in dietary quality than Americans who consumed 2 meals on a given day (HEI-2015: 61.0 vs. 55.0), regardless of population subgroup. Conclusions The frequency of the types of eating occasions differs according to age, race and Hispanic origin, and income. Dietary quality is associated with the number of meals consumed. Healthy dietary patterns can be constructed in a variety of ways to suit different life stages, cultural practices, and income levels; improved diet quality and careful consideration of nutrient density when planning meals are warranted.
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Affiliation(s)
- Regan L Bailey
- Institute for Advancing Health through Agriculture, Texas A&M University, College Station, TX, USA
| | - Heather J Leidy
- Departments of Nutritional Sciences and Pediatrics, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Richard D Mattes
- Institute for Advancing Health through Agriculture, Texas A&M University, College Station, TX, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Carol J Boushey
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Namanjeet Ahluwalia
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD, USA
| | - Alexandra E Cowan
- Institute for Advancing Health through Agriculture, Texas A&M University, College Station, TX, USA
| | - TusaRebecca Pannucci
- Center for Nutrition Policy and Promotion, Food and Nutrition Services, US Department of Agriculture, Alexandria, VA, USA
| | - Alanna J Moshfegh
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Joseph D Goldman
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Donna G Rhodes
- Agricultural Research Service, US Department of Agriculture, Beltsville, MD, USA
| | - Eve E Stoody
- Center for Nutrition Policy and Promotion, Food and Nutrition Services, US Department of Agriculture, Alexandria, VA, USA
| | - Janet de Jesus
- Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, MD, USA
| | - Kellie O Casavale
- Office of Nutrition and Food Labeling, Center for Food Safety and Applies Nutrition, Food and Drug Administration, US Department of Health and Human Services, College Park, MD, USA
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Does Internet Use Connect Us to a Healthy Diet? Evidence from Rural China. Nutrients 2022; 14:nu14132630. [PMID: 35807811 PMCID: PMC9268265 DOI: 10.3390/nu14132630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
Dietary patterns in China have changed dramatically over the past few decades as the Internet has become rapidly available. Based on data from the China Health and Nutrition Survey (2006–2011), we use a two-way fixed effects model and an instrumental variable approach to determine the impact of Internet use on the dietary quality of rural residents. The results indicate that Internet use could significantly improve the dietary quality of Chinese rural residents, with an increase of about 10.4% in the China Food Pagoda Score (CFPS), mainly due to the increase in the dietary quality score for five food groups: fruits, meats, eggs, oil, and salt. We also found that Internet use significantly increased the consumption amounts of milk and its products (4 g), fruits (31 g), eggs (8 g), and vegetables (34 g), while also decreasing the intake of salts (2 g) and oil (6 g). A possible mechanism is that Internet use improves the dietary knowledge of rural residents, thus optimizing their dietary structure. Moreover, the effect of the Internet was greater among females and those who prepare food for a family. Rural residents without a college degree enjoyed more benefits. In summary, governments should further promote Internet penetration in rural areas for health purposes.
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Effects of Developmental Failure of Swallowing Threshold on Obesity and Eating Behaviors in Children Aged 5-15 Years. Nutrients 2022; 14:nu14132614. [PMID: 35807794 PMCID: PMC9268440 DOI: 10.3390/nu14132614] [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: 05/15/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background: The aim of the present study was to identify factors related to developmental failure of swallowing threshold in children aged 5−15 years. Methods: A total of 83 children aged 5−15 years were included in this study. A self-administered lifestyle questionnaire was completed, along with hand grip strength and oral function tests. Swallowing threshold was determined based on the concentration of dissolved glucose obtained from gummy jellies when the participants signaled that they wanted to swallow the chewed gummy jellies. Developmental failure of swallowing threshold was defined as glucose concentrations in the lowest 20th percentile. After univariate analysis, multivariate binary logistic regression analysis was used to identify factors associated with developmental failure of swallowing threshold. Results: Hand grip strength was significantly correlated with masticatory performance (r = 0.611, p < 0.01). Logistic regression analysis revealed factors related to developmental failure of swallowing threshold, i.e., overweight/obesity (Odds ratio) (OR) = 5.343, p = 0.031, 95% CI = 1.168−24.437) and eating between meals at least once a day (OR = 4.934, p = 0.049, 95% CI = 1.004−24.244). Conclusions: Developmental failure of swallowing threshold was closely associated with childhood obesity in 5- to 15-year-old children.
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Damen FW, Luning PA, Fogliano V, Steenbekkers BL. Mothers choose a snack for their 2–3-year-old children based on different health perceptions. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Nogueira T, Ferreira RJ, Dias da Silva V, Liñan Pinto M, Damas C, Sousa J. Analytical Assessment and Nutritional Adequacy of School Lunches in Sintra's Public Primary Schools. Nutrients 2021; 13:1946. [PMID: 34198879 PMCID: PMC8228420 DOI: 10.3390/nu13061946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/19/2022] Open
Abstract
School meals present several cost benefits overtime at the short, medium, and long term for individuals and society. This cross-sectional study aims to analyse the nutritional composition and evaluate the adequacy of school lunches. One hundred and fifty-eight samples were collected and analysed from 10 primary schools in Sintra's municipality, served during one week. On average, energy (27.7% daily energetic requirements) and carbohydrate (48.1%) contents did not reach the reference values, and the content of protein (19.5%) exceeded the reference value (p < 0.05). The mean total fat (28.8%) and saturated fatty acids (5.4%) content complied with the recommendations. The mean salt (1.7 g) and dietary fibre (8.3 g) content exceeded the reference value but did not differ significantly from the recommendations. Addressing school canteens is crucial, not only in a nutritional approach, but also as an opportunity to achieve healthier, sustainable, and accessible food systems, aligned with the Sustainable Development Goals 2030. We highlighted the importance of evaluating evidence-based practices and disseminated practice-based evidence regarding the adequacy of school lunches.
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Affiliation(s)
- Telma Nogueira
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (V.D.d.S.); (M.L.P.); (J.S.)
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Raquel J. Ferreira
- Câmara Municipal de Sintra, 2714-501 Sintra, Portugal;
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal;
| | - Vitória Dias da Silva
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (V.D.d.S.); (M.L.P.); (J.S.)
| | - Mariana Liñan Pinto
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (V.D.d.S.); (M.L.P.); (J.S.)
| | - Carlos Damas
- Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal;
- Direção de Qualidade e Ambiente, Indústria e Comércio Alimentar, S.A, 1000-203 Lisboa, Portugal
| | - Joana Sousa
- Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (V.D.d.S.); (M.L.P.); (J.S.)
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
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Healthy snacking in the school environment: Exploring children and mothers' perspective using projective techniques. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2020.104173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Liao HE, Deng YM. The Role of Caregiver's Feeding Pattern in the Association between Parents' and Children's Healthy Eating Behavior: Study in Taichung, Taiwan. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8050369. [PMID: 34066688 PMCID: PMC8151811 DOI: 10.3390/children8050369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/21/2022]
Abstract
While parenting style has been linked with parent feeding behavior (FB), little is known about the role FB plays in the relationship between parents’ eating behavior (PEB) and children’s eating behavior (CEB). Based on social learning theory, we hypothesized that children learn to develop healthy CEB by obeying and imitating parents’ healthy eating and feeding behaviors, and that FB is the mediator between PEB and CEB. In total, 257 survey responses from parents of children up to 5 years old were included in the study. Results indicated that CEB did not differ by children’s age, gender, or birth order; for parents, older age and lower educational levels were associated with less healthy unhealthier FB and PEB. Healthy PEB and FB explained 46.8% and 21.7% of the variance in healthy CEB, respectively. The model confirmed that FB reduced the coefficient of healthy PEB from 0.563 to 0.468 and increased the variance explained from 35.0% to 38.5%. FB was a mediator for PEB and CEB. Discussion covers the complexity of ideal parenting styles and child feeding and their associated effects on CEB in varied environments, including different cultures. We concluded that PEB was the main predictor of CEB, and healthy feeding acted as a mediator.
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Olczak-Kowalczyk D, Gozdowski D, Turska-Szybka A. Protective Factors for Early Childhood Caries in 3-Year-Old Children in Poland. Front Pediatr 2021; 9:583660. [PMID: 33791255 PMCID: PMC8005648 DOI: 10.3389/fped.2021.583660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Early childhood caries (ECC) remains highly prevalent in preschool children worldwide. Dental caries affects every second 3-year-olds in Poland. The aim of the study was to assess protective factors for ECC in 3-year-olds. Methods: A cross-sectional survey was conducted in 2017 among 3-year-olds attending kindergartens in all 16 provinces of Poland. The questionnaire included socioeconomic factors, and oral health behaviors. Decayed, missing due to caries and filled teeth and surfaces were assessed. Caries indices (dmft and dmfs), percentage of caries-free and severe ECC (S-ECC) were calculated. The Student's t-test, Spearman correlation, univariate and multivariate logistic regression (the odds ratios (OR) and adjusted odds ratios (AOR): confounding factors: socioeconomic conditions, oral health behaviors) were performed; p < 0.05. Results: A total of 1,638 children were included. ECC was confirmed in 41.1%; S-ECC in 23.4%. The dmft index was 1.85 ± 3.14, dmfs = 2.99 ± 6.56. Spearman correlation [socioeconomic factors, especially mother's education (r = -0.148, p < 0.001) and family's economic status (r = -0.071, p = 0.004)], despite were statistically significant, indicate very weak relationships with dmft index. After 12th month of life not giving any beverages before bedtime and at night, but water or unsweetened milk only, healthy snacking (sandwiches, fresh fruit), or water on a daily basis decreases the probability of caries development (for S-ECC: OR = 0.37, AOR = 0.47, AOR2 = 0.37; p < 0.01), even if inappropriate dietary behaviors or hygiene practices were simultaneously present. Brushing of a child's teeth twice a day lowered the odds of caries (for S-ECC: OR = 0.78, p = 0.031; AOR = 0.81, p = 0.081; AOR2 = 0.84, p = 0.131), but this effect was less intense when inappropriate dietary behaviors were accounted for. Children of parents with good self-assessment of their teeth were more often caries-free (61.4 vs. 42.9%; p = 0.006) and had lower dmft indices (1.67 vs. 2.93; p = 0.002). Conclusions: Preventing a child after 12th month of life from getting any beverages before bedtime, water or unsweetened milk only, sandwiches and fresh fruit as snacks, or water given to on a daily basis, tooth brushing twice a day decrease the odds of caries in 3-year-olds. Diet appears to have primary significance in the etiology of ECC, since tooth brushing can only partly attenuate the impact of inappropriate dietary behaviors on dental caries. Children are more often caries-free and have lower severity of caries if their parents' dentition is self-assessed as healthy.
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Affiliation(s)
| | - Dariusz Gozdowski
- Department of Experimental Statistics and Bioinformatics, Warsaw University of Life Science, Warsaw, Poland
| | - Anna Turska-Szybka
- Department of Paediatric Dentistry, Medical University of Warsaw, Warsaw, Poland
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Gearan EC, Monzella K, Jennings L, Fox MK. Differences in Diet Quality between School Lunch Participants and Nonparticipants in the United States by Income and Race. Nutrients 2020; 12:E3891. [PMID: 33352695 PMCID: PMC7765856 DOI: 10.3390/nu12123891] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 12/14/2022] Open
Abstract
Prior research has shown that participation in the United States' National School Lunch Program (NSLP) is associated with consuming higher-quality lunches and diets overall, but little is known about differences by income and race/ethnicity. This analysis used 24 h dietary recall data from the School Nutrition and Meal Cost Study to examine how NSLP participation affects the diet quality of students in different income and racial/ethnic subgroups. Diet quality at lunch and over 24 h was assessed using the Healthy Eating Index (HEI)-2010, where higher scores indicate higher-quality intakes. HEI-2010 scores for NSLP participants and nonparticipants in each subgroup were estimated, and two-tailed t-tests were conducted to determine whether participant-nonparticipant differences in scores within each subgroup were statistically significant. NSLP participants' lunches received significantly higher total HEI-2010 scores than those of nonparticipants for lower-income, higher-income, non-Hispanic White, and non-Hispanic Black students, suggesting that participating in the NSLP helps most students consume healthier lunches. These significantly higher total scores for participants' lunch intakes persisted over 24 h for higher-income students and non-Hispanic White students but not for lower-income students or students of other races/ethnicities. For NSLP participants in all subgroups, the nutritional quality of their 24 h intakes was much lower than at lunch, suggesting that the positive influence of the NSLP on their overall diet quality was negatively influenced by foods consumed the rest of the day (outside of lunch).
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Affiliation(s)
- Elizabeth C. Gearan
- Mathematica Policy Research Inc., 955 Massachusetts Avenue, Suite 801, Cambridge, MA 02139, USA; (K.M.); (L.J.); (M.K.F.)
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15
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Athavale P, Khadka N, Roy S, Mukherjee P, Chandra Mohan D, Turton B(B, Sokal-Gutierrez K. Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228629. [PMID: 33233797 PMCID: PMC7699964 DOI: 10.3390/ijerph17228629] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 12/18/2022]
Abstract
In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with mothers of 959 children, ages six-months through six-years, addressed maternal-child nutrition and oral health, and children received dental exams and anthropometric assessments. Focus groups with community health workers and mothers explored experiences and perceptions of oral health, nutrition, and ECC. Descriptive and logistic regression analyses of quantitative data, and content analysis of qualitative data were performed. Eighty percent of children lived 5 min from a junk-food store, over 50% consumed junk-food and sugary tea daily, 50% experienced ECC, 19% had severe deep tooth decay, 27% experienced mouth pain, and 56% experienced chronic and/or acute malnutrition. In children ages 3–6, each additional tooth with deep decay was associated with increased odds of undernutrition (Odds Ratio [OR] 1.10, Confidence Interval [CI] 1.02–1.21). Focus groups identified the junk-food environment, busy family life, and limited dental care as contributors to ECC. Policy interventions include limits on junk-food marketing and incorporating oral health services and counseling on junk-food/sugary drinks into maternal–child health programs.
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Affiliation(s)
- Priyanka Athavale
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
- School of Medicine, University of California, San Francisco, CA 94143, USA
- Correspondence: ; Tel.: +1-(408)-647-0477
| | - Nehaa Khadka
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
- Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, CA 90095, USA
| | - Shampa Roy
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
| | | | - Deepika Chandra Mohan
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
| | | | - Karen Sokal-Gutierrez
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
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16
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Engle-Stone R, Guo J, Ismaily S, Addo OY, Ahmed T, Oaks B, Suchdev PS, Flores-Ayala R, Williams AM. Intraindividual double burden of overweight and micronutrient deficiencies or anemia among preschool children. Am J Clin Nutr 2020; 112:478S-487S. [PMID: 32743648 PMCID: PMC7396269 DOI: 10.1093/ajcn/nqaa101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/16/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Child overweight prevalence is increasing globally, but micronutrient deficiencies persist. OBJECTIVES We aimed to 1) describe the prevalence and distribution of intraindividual double burden of malnutrition (DBM), defined as coexistence of overweight or obesity (OWOB) and either micronutrient deficiencies or anemia, among preschool children; 2) assess the independence of DBM components, e.g., whether the prevalence of DBM is greater than what would be expected by chance; and 3) identify predictors of intraindividual DBM, to guide intervention targeting. METHODS We analyzed data from 24 population-based surveys from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia project (separately by survey; n = 226 to n = 7166). We defined intraindividual DBM as coexisting OWOB and ≥1 micronutrient deficiency [e.g., Micronutrient Deficiency Index (MDI) > 0; DBM-MDI] or anemia (DBM-Anemia). We assessed independence of DBM components with the Rao-Scott chi-square test and examined predictors of DBM and its components with logistic regression. RESULTS DBM prevalence ranged from 0% to 9.7% (median: 2.5%, DBM-MDI; 1.4%, DBM-Anemia), reflecting a lower prevalence of OWOB (range: 0%-19.5%) than of micronutrient deficiencies and anemia, which exceeded 20% in most surveys. OWOB was generally not significantly associated with micronutrient deficiencies or anemia. In more than half of surveys, children 6-23 mo of age, compared with ≥24 mo, had greater adjusted odds of DBM-Anemia, anemia, and micronutrient deficiencies. Child sex and household socioeconomic status, urban location, and caregiver education did not consistently predict DBM or its components. CONCLUSIONS Intraindividual DBM among preschool children was low but might increase as child OWOB increases. The analysis does not support the hypothesis that DBM components cluster within individuals, suggesting that population-level DBM may be addressed by programs to reduce DBM components without targeting individuals with DBM.
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Affiliation(s)
| | - Junjie Guo
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Sanober Ismaily
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - O Yaw Addo
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA,McKing Consulting Corporation, Atlanta, GA, USA
| | - Tahmeed Ahmed
- Nutrition & Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Brietta Oaks
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Parminder S Suchdev
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA,Emory Global Health Institute and Department of Pediatrics, Emory University, Atlanta, GA, USA,Division of Nutrition, Physical Activity and Obesity, US CDC, Atlanta, GA, USA
| | - Rafael Flores-Ayala
- Division of Nutrition, Physical Activity and Obesity, US CDC, Atlanta, GA, USA
| | - Anne M Williams
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA,McKing Consulting Corporation, Atlanta, GA, USA
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17
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Folta SC, Anzman-Frasca S, Tsai M, Johnson SK, Rossi M, Cash SB. Snack It Up for Parents: Brief Videos and Tip Sheets for Promoting Vegetable Snacks to School-Aged Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:565-567. [PMID: 31917130 DOI: 10.1016/j.jneb.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/27/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY
| | | | | | | | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
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18
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Marino LV, Valla FV, Beattie RM, Verbruggen SCAT. Micronutrient status during paediatric critical illness: A scoping review. Clin Nutr 2020; 39:3571-3593. [PMID: 32371094 PMCID: PMC7735376 DOI: 10.1016/j.clnu.2020.04.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 01/06/2023]
Abstract
Background No evidence based recommendations for micronutrient requirements during paediatric critical illness are available, other than those arising from recommended nutrient intakes (RNI) for healthy children and expert opinion. Objectives The objective of this review is to examine the available evidence from micronutrient status in critically ill children considering studies which describe 1) micronutrient levels, 2) associations between micronutrient levels and clinical outcome, and 3) impact on clinical outcome with micronutrient supplementation during PICU admission. Design Scoping review. Eligibility criteria Any study which used a qualitative and quantitative design considering causes and consequences of micronutrient levels or micronutrient supplementation during paediatric critical illness. Sources of evidence NICE Healthcare Databases Advanced Search website (https://hdas.nice.org.uk/) was used as a tool for multiple searches, with a content analysis and charting of data extracted. Results 711 records were identified, 35 were included in the review. Studies evaluated serum micronutrient status was determined on admission day in majority of patients. A content analysis identified (n = 49) initial codes, (n = 14) sub-categories and (n = 5) overarching themes during critical illness, which were identified as: i) low levels of micronutrients, ii) causes of aberrant micronutrient levels, iii) associations between micronutrients levels and outcome, iv) supplementation of micronutrients. Conclusion During critical illness, micronutrients should be provided in sufficient amounts to meet reference nutrient intakes for age. Although, there is insufficient data to recommend routine supplementations of micronutrients at higher doses during critical illness, the ‘absence of evidence should not imply evidence of absence’, and well designed prospective studies are urgently needed to elucidate paediatric micronutrient requirements during critical illness. The absence of reliable biomarkers make it challenging to determine whether low serum levels are reflective of a true deficiency or as a result redistribution, particularly during the acute phase of critical illness. As more children continue to survive a PICU admission, particularly those with complex diseases micronutrient supplementation research should also be inclusive of the recovery phase following critical illness.
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Affiliation(s)
- L V Marino
- Department of Dietetics/Speech & Language Therapy, NIHR Biomedical Research Centre Southampton, University Hospital Southampton NHS Foundation Trust and School of Health Sciences, University of Southampton, Southampton, UK.
| | - F V Valla
- Paediatric Intensive Care Unit, Hôpital Femme Mère Enfant, CarMEN INSERM UMR 1060 Hospices Civils de Lyon, Lyon-Bron, France
| | - R M Beattie
- Department of Paediatric Gastroenterology, Southampton Children's Hospital, NIHR Biomedical Research Centre Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - S C A T Verbruggen
- Intensive Care, Department of Paediatrics and Paediatric Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands
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19
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Herman DR, Rhoades N, Mercado J, Argueta P, Lopez U, Flores GE. Dietary Habits of 2- to 9-Year-Old American Children Are Associated with Gut Microbiome Composition. J Acad Nutr Diet 2020; 120:517-534. [PMID: 31668602 PMCID: PMC7089824 DOI: 10.1016/j.jand.2019.07.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 07/29/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND The human gut microbiome is recognized as an important determinant of human health, yet little is known about how dietary habits are related to the microbiome in post-weaned, pre-pubescent children. OBJECTIVE The goal of this work was to link quantitative dietary intake with microbiome features in a diverse population of children consuming a predominantly Western diet. DESIGN This was a cross-sectional study. PARTICIPANTS/SETTINGS English- or Spanish-speaking families with healthy children between the ages of 2 and 9 years were recruited from a community-based, early childhood learning center in suburban Los Angeles, California between June and September 2014. MAIN OUTCOME MEASURES Children included in the analyses (n=75) contributed three fecal samples and three quantitative 24-hour dietary recalls using the multiple-pass method with an average of 5.7 days between samples. Microbial communities of each fecal sample were characterized using Illumina sequencing of the 16S ribosomal RNA gene. Dietary recalls were analyzed using the Automated Self-Administered 24-Hour Recall Dietary Assessment Tool. STATISTICAL ANALYSIS PERFORMED Associations between dietary factors and microbiome features were assessed using the Kruskal-Wallis test, Spearman rank correlations, or permutational multivariate analysis of variance. For demographic and health-related variables, χ2 analyses were used to test for differences between age groups for categorical variables. RESULTS Our results show that age is correlated with three metrics of microbiome diversity (P<0.05) and is associated with both community structure (P=0.0488) and membership (P=0.0002). Several dietary food groups and nutrients were likewise associated with microbiome features. For example, consumption of non-whole-grain foods was associated with community structure (P=0.0089) and membership (P=0.0057), but not diversity (P>0.05). Likewise, the relative abundance of several bacterial taxa were linked to consumption of particular food groups and/or nutrients, as illustrated by the positive associations between total fruit (Pfalsediscovery rate<0.05) and fiber (Pfalsediscovery rate<0.05) consumption with the relative abundance of the Lachnospira genera. CONCLUSIONS This hypothesis-generating study demonstrates that the composition of the child gut microbiome remains dynamic beyond the age of 3 years and responds to dietary differences across individuals. In particular, non-whole-grain foods fortified with vitamins and minerals appear to be associated with the composition of the microbiome. Future interventional or model organism-based studies will be needed to test these associations between diet and microbiome composition.
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20
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Drewnowski A, Richonnet C. Dairy and Fruit Listed as Main Ingredients Improve NRF8.3 Nutrient Density Scores of Children's Snacks. Front Nutr 2020; 7:15. [PMID: 32211416 PMCID: PMC7075804 DOI: 10.3389/fnut.2020.00015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/04/2020] [Indexed: 01/13/2023] Open
Abstract
Background: The US Food and Drug Administration has modified its regulations on nutrient content claims by considering healthy dietary ingredients as well as nutrients. Objective: To assess the relation between dairy and fruit as main ingredients in children's snacks and the Nutrient Rich Food (NRF8.3) nutrient density score. Methods: Commonly consumed children's snacks in the United States, Canada, France, and the United Kingdom (n = 261) were assigned into USDA What We Eat in America (WWEI) categories. Nutrient composition data came from industry websites, open-source government databases (USDA Standard Reference SR28; CIQUAL), and back-of-pack food labels. Nutrient density was calculated using the Nutrient Rich Food Index NRF8.3. Snacks with dairy or fruit as the first listed ingredient (n = 115) were compared to those that listed neither (n = 146). Snacks that contained fruits-vegetables-nuts (FVN) (n = 88) were compared to those that did not (n = 173). Results: NRF8.3 scores were higher for snacks listing dairy or fruit as main ingredients. Dairy or fruit when listed as the first ingredient were associated with higher percent daily values of protein, fiber, calcium, vitamin A, vitamin C, and vitamin D, lower saturated fat content and a 30-point increment in NRF8.3 scores. The presence of FVN was associated with a 22-point increment in NRF8.3 scores. Conclusion: The correspondence between back-of-pack food ingredients and the nutrient based NRF8.3 scores suggests that ingredients can also be used to communicate the nutritional value of foods to the consumer. Dairy and fruit, when listed as first ingredients, were an important component of the NRF8.3 nutrient density score.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, United States
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21
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Economos CD, Hennessy E, Chui K, Dwyer J, Marcotte L, Must A, Naumova EN, Goldberg J. Beat osteoporosis - nourish and exercise skeletons (BONES): a group randomized controlled trial in children. BMC Pediatr 2020; 20:83. [PMID: 32093625 PMCID: PMC7038625 DOI: 10.1186/s12887-020-1964-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 02/07/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Lifelong healthy habits developed during childhood may prevent chronic diseases in adulthood. Interventions to promote these habits must begin early. The BONES (Beat Osteoporosis - Nourish and Exercise Skeletons) project assessed whether early elementary school children participating in a multifaceted health behavior change, after-school based intervention would improve bone quality and muscular strength and engage in more bone-strengthening behaviors. METHODS The 2-year BONES (B) intervention included bone-strengthening physical activity (85 min/week), educational materials (2 days/week), and daily calcium-rich snacks (380 mg calcium/day) delivered by after-school program leaders. BONES plus Parent (B + P) included an additional parent education component. From 1999 to 2004, n = 83 after-school programs (N = 1434 children aged 6-9 years) in Massachusetts and Rhode Island participated in a group randomized trial with two intervention arms (B only, n = 25 programs; B + P, n = 33) and a control arm (C, n = 25). Outcome measures (primary: bone quality (stiffness index of the calcaneus) and muscular strength (grip strength and vertical jump); secondary: bone-strengthening behaviors (calcium-rich food knowledge, preference, and intake; and physical activity level (metabolic equivalent time (MET) score, and weight-bearing factor (WBF) score)) were recorded at baseline, and after years one and two. Analyses followed an intent-to-treat protocol, and focused on individual subjects' trajectories along the three time points adjusting for baseline age and race via a mixed-effects regression framework. Analyses were performed with and without sex stratification. RESULTS Children in B + P increased bone stiffness compared to C (p = 0.05); No significant changes were observed in muscle strength, food knowledge, or vertical jump. Children in B + P showed significant improvement in their MET and WBF scores compared to C (p < 0.01) with a stronger effect in boys in both B and B + P (all p < 0.01). CONCLUSION After-school programs, coupled with parental engagement, serving early elementary school children are a potentially feasible platform to deliver bone-strengthening behaviors to prevent osteoporosis in adulthood, with some encouraging bone and physical activity outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT00065247. Retrospectively registered. First posted July 22, 2003.
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Affiliation(s)
- Christina D. Economos
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Kenneth Chui
- Tufts University School of Medicine, Boston, MA USA
| | - Johanna Dwyer
- Frances Stern Nutrition Center, Tufts Medical Center, Boston, MA USA
- Jean Mayer USDA Human Nutrition Research Center on Aging and Tufts University School of Medicine, Boston, MA USA
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD USA
| | | | - Aviva Must
- Tufts University School of Medicine, Boston, MA USA
| | - Elena N. Naumova
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Jeanne Goldberg
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111 USA
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Loth KA, Tate AD, Trofholz A, Fisher JO, Miller L, Neumark-Sztainer D, Berge JM. Ecological momentary assessment of the snacking environments of children from racially/ethnically diverse households. Appetite 2020; 145:104497. [PMID: 31669580 PMCID: PMC8996165 DOI: 10.1016/j.appet.2019.104497] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/05/2019] [Accepted: 10/21/2019] [Indexed: 11/17/2022]
Abstract
Children consume nearly one-third of their daily energy intake as snacks (i.e., eating occasions that occur between meals); thus there is a growing interest in understanding what snacking occasions look like in the homes of young children. This study makes use of ecological momentary assessment (EMA) to 1) examine differences in the contextual factors, including location, food preparation style, people present, presence of media devices, and overall atmosphere, between meal and snack occasions; and 2) explore differences in the context of snacking occasions across children's gender and weight status. Data for the current study came from the Family Matters Study, which included 150 families with children aged 5-7 years old (n = 25 from each of the following groups: Black/African American, Hispanic, Hmong, Native American, Somali, White). Parents completed an 8-day EMA observation period, during which they were surveyed after each eating occasion with the study child; questions explored contextual factors including location, food preparation style, people present, presence of media devices, and the overall atmosphere of each eating occasion. Differences between meals and snacks were observed; a smaller percentage of snacks (compared to meals) were prepared by the parent, consisted of only homemade food, and were planned ahead of time, as opposed to being served in response to a child's request. Snacks were more likely than other meals to be eaten on the couch and in the presence of a screen. Furthermore, important differences in snacking context were observed by child gender and weight status. Findings illuminate opportunities to improve children's overall dietary intake via interventions focused on improving the quality of foods served during snacks, as well as the contextual environment in which snacks are eaten.
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Affiliation(s)
- Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Allan D Tate
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Laura Miller
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Herrán OF, Villamor E, Quintero-Lesmes DC. Adherence to a snacking dietary pattern is decreasing in Colombia among the youngest and the wealthiest: results of two representative national surveys. BMC Public Health 2019; 19:1702. [PMID: 31856781 PMCID: PMC6921475 DOI: 10.1186/s12889-019-8057-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 12/09/2019] [Indexed: 12/11/2022] Open
Abstract
Background A common recommendation is to reduce the consumption of snack food and replace this consumption with nutrient-dense foods. The objective was to assess whether in Colombian children and adults there were changes in the consumption of the snack dietary pattern (SP) in the 5 years 2010–2015. In addition, this study aimed to establish the relationship between the SP and some biological, socioeconomic, and geographic variables in Colombia, South America. Methods Based on a Food Frequency Questionnaire (FFQ) applied both in 2010 and 2015 in the national nutritional situation surveys, the adherence to the snack consumption pattern was established through factor analysis. The change in the adherence of consumption to the SP was established for the five-year period [2015 minus 2010], using multiple linear regression models. Crude and adjusted differences were estimated by the following covariables: sex, age, marital status, food security, wealth index, ethnicity, education of the head of the household, area and region. In total, 37,981 subjects were analyzed. In 2010, 10,150 children (5 to 17 years old) and 5145 adults (18 to 64 years old) were included, and in 2015, 13,243 children and 9443 adults. Results In children, the adjusted difference in the adherence to SP was − 0.37 (95% CI: − 0.42, − 0.32). In adults, the adjusted difference in the adherence to SP was − 0.27 (95% CI: − 0.31, − 0.24). In all categories of covariables, consumption decreased, for all p < 0.0001. In children, the decrease in consumption was inversely associated with height-age. The decrease was smaller at the extremes of the BMI distribution, Z < -2 and Z > 2. The decrease in consumption was directly associated with the level of food security in the home and the wealth index. In adults, the decrease in consumption was inversely related to age and was directly related to the level of food security of the household, wealth index, and education level. The BMI decrease was greater in subjects with 18.5–24.9. In subjects with 30+, it was lower than in subjects with 25.0–29.9. Conclusions In the 5 years 2010–2015, snack consumption is decreasing. The region, the richest subjects, those with adequate BMI, and in households with more educated heads of household, achieved a greater decrease in SP.
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Affiliation(s)
- Oscar F Herrán
- Facultad de Salud (UIS), Escuela de Nutrición y Dietética, Universidad Industrial de Santander, Carrera 32 No. 29-31, Santander, Bucaramanga, 680002, Colombia.
| | - Eduardo Villamor
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Benjamin-Neelon SE, Hecht AA, Burgoine T, Adams J. Perceived Barriers to Fruit and Vegetable Gardens in Early Years Settings in England: Results from a Cross-Sectional Survey of Nurseries. Nutrients 2019; 11:nu11122925. [PMID: 31816838 PMCID: PMC6949897 DOI: 10.3390/nu11122925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 12/13/2022] Open
Abstract
Garden-based interventions may increase child intake of fruits and vegetables and offset food costs, but few have been conducted in early care and education (ECE). This study assessed whether nurseries were interested in and perceived any barriers to growing fruits and vegetables. Surveys were mailed to a cross-sectional sample of nurseries in 2012–2013 throughout England. Nurseries were stratified based on socioeconomic status as most, middle, or least deprived areas. We fit logistic regression models to assess the odds of nurseries interested in growing fruits and vegetables and perceiving any barriers, by deprivation tertile. A total of 851 surveys were returned (54% response). Most nurseries (81%) were interested in growing fruits and vegetables. After adjustment, there was no difference in interest in the middle (OR 1.55; CI 0.84, 2.78; p = 0.16) or most (OR 1.05; CI 0.62, 1.78; p = 0.87) deprived areas, compared to the least deprived. Nurseries reported barriers to growing fruits and vegetables, including space (42%), expertise (26%), and time (16%). Those in the most deprived areas were more likely to report space as a barrier (OR 2.02; 95% CI 1.12, 3.66; p = 0.02). Nurseries in the most deprived areas may need creative solutions for growing fruits and vegetables in small spaces.
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Affiliation(s)
- Sara E Benjamin-Neelon
- Department of Health, Behavior and Society, 615 North Wolfe Street, Johns Hopkins University, Baltimore, MD 21205, USA
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; (T.B.); (J.A.)
- Correspondence:
| | - Amelie A Hecht
- Department of Health Policy and Management, 624 North Broadway, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Thomas Burgoine
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; (T.B.); (J.A.)
| | - Jean Adams
- UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; (T.B.); (J.A.)
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Fulgoni VL, Gaine PC, Scott MO, Ricciuto L, DiFrancesco L. Association of Added Sugars Intake with Micronutrient Adequacy in US Children and Adolescents: NHANES 2009-2014. Curr Dev Nutr 2019; 3:nzz126. [PMID: 32154496 PMCID: PMC7053577 DOI: 10.1093/cdn/nzz126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/15/2019] [Accepted: 11/04/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A concern about the excessive consumption of added sugars is the potential for micronutrient dilution, particularly in children and adolescents; however, the evidence is inconsistent. OBJECTIVE We examined the associations between added sugars intake and micronutrient adequacy in US children and adolescents using data from NHANES 2009-2014. METHODS Children and adolescents aged 2-18 (n = 7754), 2-8 (n = 3423), and 9-18 y (n = 4331) were assigned to deciles of added sugars intake based on the average of 2 d of dietary recall. Usual intake of micronutrients was determined using 2 dietary recalls and the National Cancer Institute method. Within each age group, regression analyses were used to assess the relationship between added sugars intake decile and percentage of the population below the estimated average requirements (EARs) for 17 micronutrients. RESULTS Deciles of added sugars intake (percentage of calories) ranged from <6.4 to >22.8 among children and adolescents aged 2-18 y, with a median intake of 13.3% of calories. Significant positive associations (P < 0.01) between added sugars intake and percentage of the population (aged 2-18 y) below the EAR were found only for calcium, magnesium, and vitamin D. These associations virtually disappeared after dropping the 2 highest and lowest deciles of intake, suggesting a threshold effect; intakes below approximately 19% of calories from added sugars were generally not associated with micronutrient inadequacy. CONCLUSIONS As added sugars intake increased, there was a threshold above which an increase in the prevalence of inadequate intakes for calcium, magnesium, and vitamin D among US children and adolescents was observed. However, even at the lower deciles of added sugars, large percentages of the population were below the EAR for these nutrients, suggesting that adequate intakes of these nutrients are difficult to achieve independent of added sugars intake.
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Loth KA, Tate A, Trofholz A, Orlet Fisher J, Neumark-Sztainer D, Berge JM. The Contribution of Snacking to Overall Diet Intake among an Ethnically and Racially Diverse Population of Boys and Girls. J Acad Nutr Diet 2019; 120:270-279. [PMID: 31780383 DOI: 10.1016/j.jand.2019.08.173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 08/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Children in low-income and minority populations are at risk for poor dietary quality. At least one-third of the calories consumed by children are eaten between meals (ie, snacks). The contribution of snacking to diet quality among children is poorly understood. OBJECTIVE The current study examined associations between snacking and children's diet quality along with differences across ethnicity or race, sex, and weight status. DESIGN Cross-sectional data came from Phase I of the Family Matters Study, an observational study. PARTICIPANTS/SETTING This study included 150 families with children aged 5 to 7 years old from six ethnic or racial groups (n=25 from each: African American, Hispanic, Hmong, Native American, Somali, non-Hispanic white); data were collected in Minneapolis-Saint Paul, MN in 2017-2018. MAIN OUTCOME MEASURES Total daily energy (kilocalories), overall diet quality using the Healthy Eating Index (HEI-2010), and food group intakes (eg, fruit, vegetables, refined grains, sugar-sweetened beverages [SSB]) were assessed using three 24-hour dietary recalls. STATISTICAL ANALYSES PERFORMED Conditional fixed effects estimators (within-child variation) were used in regression analyses to characterize the relationship between daily snacking and dietary intake relative to dietary intake at all other daily meal occasions. Mean (±standard deviation) overall dietary intake including all meals and snacks was compared with mean (±standard deviation) intake of meals only. RESULTS Among boys, snacking was found to contribute positively to HEI-2010 scores (HEI-2010=57.6, HEI-2010 without snacks=55.0; effect size [ES]=0.28, P=0.03). Snacking was an important source of fruit (ES=0.71) and dairy (ES=0.53), but also contributed to children's consumption of refined grains (ES=0.68) and SSB (ES=0.31). Very few vegetables were consumed as snacks. Furthermore, snacks contributed more to the overall diet quality (HEI-2010) of Native American (ES=0.30) and Somali (ES=0.35) youth as compared with youth from other ethnic or racial backgrounds. CONCLUSIONS Findings suggest that snacks have the potential to improve diet quality in children. Future research should examine influences on children's food choices at snack times and barriers to serving more healthful foods as snacks that are faced by ethnically or racially diverse families.
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Subhan FB, Chan CB. Diet quality and risk factors for cardiovascular disease among South Asians in Alberta. Appl Physiol Nutr Metab 2019; 44:886-893. [DOI: 10.1139/apnm-2018-0868] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
South Asians have a higher prevalence of early onset cardiovascular disease risk compared with other populations. Dietary intake is a modifiable risk factor for cardiovascular disease. Dietary patterns in immigrants and successive generations of South Asians settled in Western countries undergo adaptions. Little is known about the dietary intake of South Asians in Alberta, thus the objective of the present study was to describe the dietary patterns among South Asians and their risks for cardiovascular diseases. A retrospective analysis of data collected from 140 South Asian adults participating in the Alberta’s Tomorrow Project was conducted. Dietary intake was assessed using a food frequency questionnaire and the Healthy Eating Index (HEI) was used an indicator of overall diet quality and adherence to dietary recommendations made by Health Canada. Central obesity (70%), hypercholesterolemia (27%), and hypertension (14%) were predominant health conditions observed in the study participants. About 56% and 44% of participants obtained moderate and poor HEI scores, respectively. The diet quality of the majority of participants was inadequate to meet macro- and micronutrient intake recommendations. The high prevalence of poor/moderate diet quality and pre-existing chronic health conditions across all body mass index groups is a cause for concern in this population.
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Affiliation(s)
- Fatheema B. Subhan
- Department of Agriculture, Food and Nutritional Sciences, University of Alberta, AB T6G 2E1, Canada
| | - Catherine B. Chan
- Department of Agriculture, Food and Nutritional Sciences, University of Alberta, AB T6G 2E1, Canada
- Department of Physiology, University of Alberta, AB T6G 2H7, Canada
- Diabetes, Obesity and Nutrition Strategic Clinical Network, Alberta Health Services. Edmonton, AB T5J 3E4, Canada
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Kachurak A, Bailey RL, Davey A, Dabritz L, Fisher JO. Daily Snacking Occasions, Snack Size, and Snack Energy Density as Predictors of Diet Quality among US Children Aged 2 to 5 Years. Nutrients 2019; 11:nu11071440. [PMID: 31247959 PMCID: PMC6683020 DOI: 10.3390/nu11071440] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 01/02/2023] Open
Abstract
Whether snacks help young children meet nutritional needs or merely contribute to excessive intakes is debated. This research evaluated associations of snacking with dietary quality among US preschoolers (two to five years, n = 4217) in the 2005–2016 National Health Examination Survey (NHANES). Snacking occasions, size, and energy density (ED) were estimated from two 24-hr dietary recalls. Diet quality indices included the 2015 Healthy Eating Index (HEI-2015, 0–100), the mean adequacy ratio (MAR, 0–100) for five shortfall nutrients (vitamin D, calcium, fiber, potassium, and iron), and the mean % of recommended limits for added sugars, saturated fat, and sodium. Linear regressions included snacking parameters, demographics, and dietary reporting accuracy. Children had a mean HEI-2015 of 53.0, a MAR of 67.7, and intake of 121.4% of nutrients to limit. Daily snacking occasions were positively associated with HEI-2015 scores, whereas mean snack size and ED were negatively associated with HEI-2015 and MAR scores (all p < 0.05). Snack ED was positively associated with daily intakes of added sugar, saturated fat, and sodium (p < 0.001). These nationally representative findings reveal that more frequent, smaller, and less energy-dense snacks are associated with higher diet quality among US preschoolers.
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Affiliation(s)
- Alexandria Kachurak
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA 19140, USA
| | - Regan L Bailey
- Department of Nutrition Science, College of Health and Human Services, Purdue University, 700 West State Street, West Lafayette, IN 47907, USA
| | - Adam Davey
- Department of Behavioral Health and Nutrition, University of Delaware, 016 Carpenter Sports Building, Newark, DE 19716, USA
| | - Lauren Dabritz
- Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA 19140, USA
| | - Jennifer Orlet Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA 19140, USA.
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Snacking characteristics and patterns and their associations with diet quality and BMI in the Childhood Obesity Prevention and Treatment Research Consortium. Public Health Nutr 2019; 22:3189-3199. [PMID: 31112114 DOI: 10.1017/s1368980019000958] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe snacking characteristics and patterns in children and examine associations with diet quality and BMI. DESIGN Children's weight and height were measured. Participants/adult proxies completed multiple 24 h dietary recalls. Snack occasions were self-identified. Snack patterns were derived for each sample using exploratory factor analysis. Associations of snacking characteristics and patterns with Healthy Eating Index-2010 (HEI-2010) score and BMI were examined using multivariable linear regression models. SETTING Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, USA: NET-Works, GROW, GOALS and IMPACT studies. PARTICIPANTS Predominantly low-income, racial/ethnic minorities: NET-Works (n 534, 2-4-year-olds); GROW (n 610, 3-5-year-olds); GOALS (n 241, 7-11-year-olds); IMPACT (n 360, 10-13-year-olds). RESULTS Two snack patterns were derived for three studies: a meal-like pattern and a beverage pattern. The IMPACT study had a similar meal-like pattern and a dairy/grains pattern. A positive association was observed between meal-like pattern adherence and HEI-2010 score (P for trend < 0⋅01) and snack occasion frequency and HEI-2010 score (β coefficient (95 % CI): NET-Works, 0⋅14 (0⋅04, 0⋅23); GROW, 0⋅12 (0⋅02, 0⋅21)) among younger children. A preference for snacking while using a screen was inversely associated with HEI-2010 score in all studies except IMPACT (β coefficient (95 % CI): NET-Works, -3⋅15 (-5⋅37, -0⋅92); GROW, -2⋅44 (-4⋅27, -0⋅61); GOALS, -5⋅80 (-8⋅74, -2⋅86)). Associations with BMI were almost all null. CONCLUSIONS Meal-like and beverage patterns described most children's snack intake, although patterns for non-Hispanic Blacks or adolescents may differ. Diets of 2-5-year-olds may benefit from frequent meal-like pattern snack consumption and diets of all children may benefit from decreasing screen use during eating occasions.
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Kachurak A, Davey A, Bailey RL, Fisher JO. Daily Snacking Occasions and Weight Status Among US Children Aged 1 to 5 Years. Obesity (Silver Spring) 2018; 26:1034-1042. [PMID: 29656571 PMCID: PMC6001698 DOI: 10.1002/oby.22172] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 02/20/2018] [Accepted: 02/23/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To characterize associations of snacking frequency with weight status among US children aged 1 to 5 years. METHODS Participants were children (n = 4,669) aged 1 to 5 years in the 2005 to 2014 National Health and Nutrition Examination Survey (NHANES). Snacking was assessed by two 24-hour dietary recalls using definitions that considered "snack" occasions as well as other foods/beverages consumed between meals. Overweight/obesity (OW/OB) was defined using percentile cutoffs: ≥ 97.7th weight-for-length (< 2 years) cutoff and the ≥ 85th BMI-for-age (≥ 2 years) cutoff. Linear/logistic regressions evaluated snacking based on daily occasions and relative to current recommendations (two to three snacks per day). RESULTS During 2005 to 2014, US children aged 1 to 5 years consumed, on average, two to three snacks daily. Children with normal weight in both age groups tended to snack less frequently than children with OW/OB when considering all foods/beverages eaten between meals (P < 0.01-0.12). Across most snacking definitions, children < 2 years who snacked more frequently than recommended had greater odds of having OW/OB (P < 0.01-0.12) and consumed greater daily snack energy than those who snacked within recommendations (all P < 0.01). Recommendations did not clearly delineate weight status among children aged 2 to 5 years. CONCLUSIONS Snacking frequency and weight are positively associated among US children 1 to 5 years old, with most consistent associations seen among children < 2 years old and when considering all foods/beverages consumed between meals.
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Affiliation(s)
- Alexandria Kachurak
- Department of Social and Behavioral Sciences, College of Public Health, Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvaniaUSA
| | - Adam Davey
- Department of Behavioral Health and Nutrition, College of Health SciencesUniversity of DelawareNewarkDelawareUSA
| | - Regan L. Bailey
- Department of Nutrition Science, College of Health and Human SciencesPurdue UniversityWest LafayetteIndianaUSA
| | - Jennifer O. Fisher
- Department of Social and Behavioral Sciences, College of Public Health, Center for Obesity Research and EducationTemple UniversityPhiladelphiaPennsylvaniaUSA
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Nicholson JS, Barton JM, Simons AL. Ability to Categorize Food Predicts Hypothetical Food Choices in Head Start Preschoolers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:238-246.e1. [PMID: 29170058 DOI: 10.1016/j.jneb.2017.09.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 09/17/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate whether preschoolers are able to identify and categorize foods, and whether their ability to classify food as healthy predicts their hypothetical food choice. DESIGN Structured interviews and body measurements with preschoolers, and teacher reports of classroom performance. SETTING Six Head Start centers in a large southeastern region. PARTICIPANTS A total of 235 preschoolers (mean age [SD], 4.73 [0.63] years; 45.4% girls). INTERVENTION(S) Teachers implemented a nutrition education intervention across the 2014-2015 school year in which children were taught to identify and categorize food as sometimes (ie, unhealthy) and anytime (ie, healthy). MAIN OUTCOME MEASURES Preschooler responses to a hypothetical snack naming, classifying, and selection scenario. ANALYSIS Hierarchical regression analyses to examine predictors of child hypothetical food selection. RESULTS While controlling for child characteristics and cognitive functioning, preschoolers who were better at categorizing food as healthy or unhealthy were more likely to say they would choose the healthy food. Low-contrast food pairs in which food had to be classified based on multiple dimensions were outside the cognitive abilities of the preschoolers. CONCLUSIONS AND IMPLICATIONS Nutrition interventions may be more effective in helping children make healthy food choices if developmental limitations in preschoolers' abilities to categorize food is addressed in their curriculum. Classification of food into evaluative categories is challenging for this age group. Categorizing on multiple dimensions is difficult, and dichotomous labeling of food as good or bad is not always accurate in directing children toward making food choices. Future research could evaluate further preschoolers' developmental potential for food categorization and nutrition decision making and consider factors that influence healthy food choices at both snack and mealtime.
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Affiliation(s)
- Jody S Nicholson
- Department of Psychology, University of North Florida, Jacksonville, FL.
| | - Jennifer M Barton
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX
| | - Ali L Simons
- Department of Psychology, University of North Florida, Jacksonville, FL
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Davison KK, Blake CE, Kachurak A, Lumeng JC, Coffman DL, Miller AL, Hughes SO, Power TG, Vaughn AF, Blaine RE, Younginer N, Fisher JO. Development and preliminary validation of the Parenting around SNAcking Questionnaire (P-SNAQ). Appetite 2018; 125:323-332. [PMID: 29475073 DOI: 10.1016/j.appet.2018.01.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/22/2017] [Accepted: 01/28/2018] [Indexed: 01/03/2023]
Abstract
Snacking makes significant contributions to children's dietary intake but is poorly understood from a parenting perspective. This research was designed to develop and evaluate the psychometrics of a theoretically grounded, empirically-informed measure of snack parenting. The Parenting around SNAcking Questionnaire (P-SNAQ) was developed using a conceptual model derived from current theory and mixed-methods research to include 20 hypothesized snack parenting practices along 4 parenting dimensions (autonomy support, structure, coercive control and permissiveness). Expert panel evaluation and cognitive interviews were used to refine items and construct definitions. The initial instrument of 105 items was administered to an ethnically diverse, low-income sample of 305 parents (92% mothers) of children aged 1-6 y participating in three existing cohort studies. The sample was randomly split into two equal samples. Exploratory factor analysis was conducted with the first sample to identify snack parenting practices within each parenting dimension, followed by confirmatory factor analysis with the second sample to test the hypothesized factor structure. Internal consistency of sub-scales and associations with existing measures of food parenting practices and styles and child weight status were evaluated. The final P-SNAQ scale included 51 items reflecting 14 snack parenting practices across four parenting dimensions. The factor structure of the P-SNAQ was consistent with prior theoretical frameworks. Internal consistency coefficients were good to very good for 12 out of 14 scales and subscale scores were moderately correlated with previously validated measures. In conclusion, initial evidence suggests that P-SNAQ is a psychometrically sound measure for evaluating a wide range of snack parenting practices in young children.
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Affiliation(s)
- K K Davison
- Harvard T.H. Chan School of Public Health, Department of Nutrition, 665 Huntington Ave, Boston, MA 02445, USA; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 665 Huntington Ave, Boston, MA 02445, USA.
| | - C E Blake
- University of South Carolina, Department of Health Promotion, Education and Behavior, 915 Greene Street, Columbia, SC 29208, USA
| | - A Kachurak
- Temple University, Center for Obesity Research and Education, 3323 N Broad St, Suite 175, Philadelphia, PA 19140, USA
| | - J C Lumeng
- University of Michigan, Department of Pediatrics, Medical School, Department of Nutritional Sciences, School of Public Health, 300 North Ingalls Street, 10th Floor, Ann Arbor, MI, 48109, USA
| | - D L Coffman
- Temple University, Center for Obesity Research and Education, 3323 N Broad St, Suite 175, Philadelphia, PA 19140, USA
| | - A L Miller
- University of Michigan, Department of Health Behavior and Health Education, School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - S O Hughes
- USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine, Department of Pediatrics, 1100 Bates Ave, Houston, TX 77030, USA
| | - T G Power
- Washington State University, Department of Human Development, PO Box 644852, Pullman, WA 99164-4852, USA
| | - A F Vaughn
- University of North Carolina at Chapel Hill, Center for Health Promotion and Disease Prevention, 1700 Martin L. King Jr. Blvd, CB 7426, Chapel Hill, NC 27599-7426, USA
| | - R E Blaine
- California State University, Long Beach, Department of Family and Consumer Sciences, 1250 Bellflower Blvd, Long Beach, CA 90840-0501, USA
| | - N Younginer
- University of South Carolina, Department of Health Promotion, Education and Behavior, 915 Greene Street, Columbia, SC 29208, USA
| | - J O Fisher
- Temple University, Center for Obesity Research and Education, 3323 N Broad St, Suite 175, Philadelphia, PA 19140, USA
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Snacking Patterns in Children: A Comparison between Australia, China, Mexico, and the US. Nutrients 2018; 10:nu10020198. [PMID: 29439472 PMCID: PMC5852774 DOI: 10.3390/nu10020198] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 02/03/2018] [Accepted: 02/07/2018] [Indexed: 11/16/2022] Open
Abstract
Snacking is common in children and influenced by many factors. The aim of this study is to provide insight of both common and country-specific characteristics of snacking among 4–13 year old children. We analyzed snacking prevalence, energy and nutrient contributions from snacking across diverse cultures and regions, represented by Australia, China, Mexico, and the US using data from respective national surveys. We found that the highest prevalence of snacking was in Australia and the US (over 95%) where snacking provided one-third and one-quarter of total energy intake (TEI), respectively, followed by Mexico (76%, provided 15% TEI) and China (65%, provided 10% TEI). Compared to 4–8 year-olds, the consumption of fruits and milk was lower in 9–13 year-old children, with a trend of increasing savory snacks consumption in China, Mexico, and the US. The nutrient density index of added sugars and saturated fat was higher, especially in Australia, Mexico, and the US. Results suggested that snacking could be an occasion to promote fruit and vegetable consumption in all countries, especially for older children. Snacking guidelines should focus on reducing consumption of snacks high in saturated fat and added sugars for Australia, Mexico, and the US, whereas improving dairy consumption is important in China.
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Ribeiro CCC, Silva MCBD, Nunes AMM, Thomaz EBDAF, Carmo CDS, Ribeiro MRC, Silva AAMD. Overweight, obese, underweight, and frequency of sugar consumption as risk indicators for early childhood caries in Brazilian preschool children. Int J Paediatr Dent 2017; 27:532-539. [PMID: 28222484 DOI: 10.1111/ipd.12292] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND A possible association between being overweight or obese and early childhood caries (ECC) remains controversial. AIM To investigated this association in a developing country testing the confounding effects of socioeconomic factors and frequency of sugar consumption. METHODS Historical cohort study, 388 children (aged 24-71 months) living in São Luís, Brazil. A theoretical model adjusted according to income, birthweight, and nutritional status at twelve months and frequency of sugar consumption was generated with directed acyclic graphs to analyze this association. Caries were considered a discrete variable in the Poisson regression models; incidence density ratios (IRs) and 95% confidence intervals (95% CIs) were estimated. RESULTS Being overweight or obese (IR = 1.52; 95% CI: 1.03-2.22) was independently associated with ECC. Being thin or very thin (IR = 1.97; 95% CI: 1.52-2.54), a high frequency of sugar consumption (IR = 1.83; 95% CI: 1.42-2.38), and age (IR = 3.62; 95% CI: 2.58-5.08) were associated with ECC. CONCLUSIONS Children overweight or obese, as well as children exhibiting being thin/very thin, were associated with ECC independent of socioeconomic variables and a high frequency of sugar consumption.
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Affiliation(s)
- Cecilia Claudia Costa Ribeiro
- Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil.,Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Ana Margarida Melo Nunes
- Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Erika Bárbara de Abreu Fonseca Thomaz
- Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil.,Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
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Fayet-Moore F, Peters V, McConnell A, Petocz P, Eldridge AL. Weekday snacking prevalence, frequency, and energy contribution have increased while foods consumed during snacking have shifted among Australian children and adolescents: 1995, 2007 and 2011-12 National Nutrition Surveys. Nutr J 2017; 16:65. [PMID: 28974206 PMCID: PMC5627470 DOI: 10.1186/s12937-017-0288-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/21/2017] [Indexed: 11/24/2022] Open
Abstract
Background There are limited data on the evolution of eating habits, including snacking, in Australia. This study aimed to understand snacking trends among Australian children over three previous National Nutrition Surveys. Methods Data were analysed from a single weekday 24-h recall in the National Nutrition Surveys 1995, 2007, 2011–12 among children 2-16y (n = 8258). A snacking occasion was defined as an eating occasion that occurred between meals based on time of day. Results The percentage of children snacking increased over time (92.5 ± 0.5(SE) % in 1995, 98.1 ± 0.3% in 2007, and 95.8 ± 0.4% in 2011–12) (P < 0.001), particularly among those having four or more snacking occasions (7.1 ± 0.5% in 1995, 17.9 ± 0.6% in 2007, and 18.5 ± 0.8% in 2011–2) (P < 0.001). The mean number of snacking occasions increased from 2.0 ± 0.0 in 1995, to 2.5 ± 0.0 in 2007 and 2011–12 (P < 0.001). The energy contribution from snacking increased from 24.1 ± 0.3% in 1995 to 27.7 ± 0.3% in 2007 and 30.5 ± 0.4% in 2011–12 (P < 0.001), while the energy from discretionary food during snacking decreased from 56.5 ± 0.7% in 1995 to 47.3 ± 0.5% in 2007 and 47.9 ± 0.7% in 2011–12 (P < 0.001). There were differences in the top foods consumed during snacking: non-alcoholic beverages were prominent contributors in 1995 but not in 2007 or 2011, and pome fruit was the second top energy contributor during snacking in 2007 and 2011 but only fourth in 1995. Conclusions Snacking is a prominent dietary pattern that has increased over time in frequency and energy contribution. Foods and beverages consumed during snacking occasions include a mix of core foods and discretionary foods, and while the contribution of discretionary foods has decreased, there is still an opportunity to encourage consumption of more nutrient dense foods during snacking. Electronic supplementary material The online version of this article (10.1186/s12937-017-0288-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Flávia Fayet-Moore
- Nutrition Research Australia, Level 13 167 Macquarie St, Sydney, NSW, 2000, Australia.
| | | | - Andrew McConnell
- Nutrition Research Australia, Level 13 167 Macquarie St, Sydney, NSW, 2000, Australia
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Cross-sectional analysis of eating patterns and snacking in the US Feeding Infants and Toddlers Study 2008. Public Health Nutr 2017; 20:1584-1592. [DOI: 10.1017/s136898001700043x] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AbstractObjectiveTo explore eating patterns and snacking among US infants, toddlers and pre-school children.DesignThe Feeding Infants and Toddlers Study (FITS) 2008 was a cross-sectional national survey of children aged 6–47 months, weighted to reflect US age and racial/ethnic distributions. Dietary data were collected using one multiple-pass 24h recall. Eating occasions were categorized as meals, snacks or other (comprised of all feedings of breast milk and/or infant formula). The percentage of children consuming meals and snacks and their contribution to total energy, the number of snacks consumed per day, energy and nutrients coming from snacks and the most commonly consumed snacks were evaluated by age.SettingA national sample of US infants, toddlers and pre-school children.SubjectsA total of 2891 children in five age groups: 6–8 months (n 249), 9–11 months (n 256), 12–23 months (n 925), 24–35 months (n 736) and 36–47 months (n 725).ResultsSnacks were already consumed by 37 % of infants beginning at 6 months; by 12 months of age, nearly 95 % were consuming at least one snack per day. Snacks provided 25 % of daily energy from the age of 12 months. Approximately 40 % of toddlers and pre-school children consumed fruit and cow’s milk during snacks; about 25 % consumed 100 % fruit juice. Cookies were introduced early; by 24 months, 57 % consumed cookies or candy in a given day.ConclusionsSnacking is common, contributing significantly to daily energy and nutrient needs of toddlers and pre-school children. There is room for improvement, however, with many popular snacking choices contributing to excess sugar.
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Rehm CD, Drewnowski A. Replacing American snacks with tree nuts increases consumption of key nutrients among US children and adults: results of an NHANES modeling study. Nutr J 2017; 16:17. [PMID: 28270158 PMCID: PMC5341477 DOI: 10.1186/s12937-017-0238-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 02/28/2017] [Indexed: 12/21/2022] Open
Abstract
Background Replacing typical American snacks with tree nuts may be an effective way to improve diet quality and compliance with the 2015–2020 Dietary Guidelines for Americans (DGAs). Objective To assess and quantify the impact of replacing typical snacks with composite tree nuts or almonds on diet metrics, including empty calories (i.e., added sugars and solid fats), individual fatty acids, macronutrients, nutrients of public health concern, including sodium, fiber and potassium, and summary measures of diet quality. Methods Food pattern modeling was implemented in the nationally representative 2009–2012 National Health and Examination Survey (NHANES) in a population of 17,444 children and adults. All between-meal snacks, excluding beverages, were replaced on a per calorie basis with a weighted tree nut composite, reflecting consumption patterns in the population. Model 1 replaced all snacks with tree nuts, while Model 2 exempted whole fruits, non-starchy vegetables, and whole grains (>50% of total grain content). Additional analyses were conducted using almonds only. Outcomes of interest were empty calories (i.e., solid fats and added sugars), saturated and mono- and polyunsaturated fatty acids, fiber, protein, sodium, potassium and magnesium. The Healthy Eating Index-2010, which measures adherence to the 2010 Dietary Guidelines for Americans, was used as a summary measure of diet quality. Results Compared to observed diets, modeled food patterns were significantly lower in empty calories (−20.1% and −18.7% in Model 1 and Model 2, respectively), added sugars (−17.8% and −16.9%), solid fats (−21.0% and −19.3%), saturated fat (−6.6% and −7.1%)., and sodium (−12.3% and −11.2%). Modeled patterns were higher in oils (65.3% and 55.2%), monounsaturated (35.4% and 26.9%) and polyunsaturated fats (42.0% and 35.7%), plant omega 3 s (53.1% and 44.7%), dietary fiber (11.1% and 14.8%), and magnesium (29.9% and 27.0%), and were modestly higher in potassium (1.5% and 2.9%). HEI-2010 scores were significantly higher in Model 1 (67.8) and in Model 2 (69.7) compared to observed diets (58.5). Replacing snacks with almonds only produced similar results; the decrease in sodium was more modest and no increase in plant omega-3 fats was observed. Conclusion Replacing between-meal snacks with tree nuts or almonds led to more nutrient-rich diets that were lower in empty calories and sodium and had more favorable fatty acid profiles. Food pattern modeling using NHANES data can be used to assess the likely nutritional impact of dietary guidance.
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Affiliation(s)
- Colin D Rehm
- Center for Public Health Nutrition, University of Washington, Seattle, WA, 98195-3410, USA.
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA, 98195-3410, USA
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Larson N, Miller JM, Eisenberg ME, Watts AW, Story M, Neumark-Sztainer D. Multicontextual correlates of energy-dense, nutrient-poor snack food consumption by adolescents. Appetite 2017; 112:23-34. [PMID: 28082196 DOI: 10.1016/j.appet.2017.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 12/07/2016] [Accepted: 01/08/2017] [Indexed: 11/24/2022]
Abstract
Frequent consumption of energy-dense, nutrient-poor snack foods is an eating behavior of public health concern. This study was designed to inform strategies for reducing adolescent intake of energy-dense snack foods by identifying individual and environmental influences. Surveys were completed in 2009-2010 by 2540 adolescents (54% females, mean age = 14.5 ± 2.0, 80% nonwhite) in Minneapolis-St. Paul, Minnesota schools. Daily servings of energy-dense snack food was assessed using a food frequency questionnaire that asked about consumption of 21 common snack food items, such as potato chips, cookies, and candy. Data representing characteristics of adolescents' environments were collected from parents/caregivers, friends, school personnel, Geographic Information System sources, and a content analysis of favorite television shows. Linear regression was used to examine relationships between each individual or environmental characteristic and snack food consumption in separate models and also to examine relationships in a model including all of the characteristics simultaneously. The factors found to be significantly associated with higher energy-dense snack food intake represented individual attitudes/behaviors (e.g., snacking while watching television) and characteristics of home/family (e.g., home unhealthy food availability), peer (friends' energy-dense snack food consumption), and school (e.g., student snack consumption norms) environments. In total, 25.5% of the variance in adolescents' energy-dense snack food consumption was explained when factors from within each context were examined together. The results suggest that the design of interventions targeting improvement in the dietary quality of adolescents' snack food choices should address relevant individual factors (e.g., eating while watching television) along with characteristics of their home/family (e.g., limiting the availability of unhealthy foods), peer (e.g., guiding the efforts of a peer leader in making healthy choices), and school environments (e.g., establishing student norms for selecting nutrient-dense snack foods).
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Jonathan M Miller
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414, United States.
| | - Allison W Watts
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
| | - Mary Story
- Global Health and Community and Family Medicine, Duke Global Health Institute, Duke University, 112 Trent Hall, 310 Trent Drive, Box 90519, Durham, NC 27708, United States.
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Suite 300, Minneapolis, MN 55454, United States.
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Vilaro M, Barnett T, Watson A, Merten J, Mathews A. Weekday and weekend food advertising varies on children's television in the USA but persuasive techniques and unhealthy items still dominate. Public Health 2017; 142:22-30. [DOI: 10.1016/j.puhe.2016.10.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 08/14/2016] [Accepted: 10/13/2016] [Indexed: 11/16/2022]
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Fernandez MA, Marette A. Potential Health Benefits of Combining Yogurt and Fruits Based on Their Probiotic and Prebiotic Properties. Adv Nutr 2017; 8:155S-164S. [PMID: 28096139 PMCID: PMC5227968 DOI: 10.3945/an.115.011114] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Fruit and yogurt have been identified individually as indicators of healthy dietary patterns. Fruits are relatively low in energy density and are an excellent source of antioxidants and prebiotic fibers and polyphenols, which can promote digestive health. Yogurt, on the other hand, is a nutrient-dense food that is a good source of dairy protein, calcium, magnesium, vitamin B-12, conjugated linoleic acid, and other key fatty acids. In addition, it contains beneficial bacterial cultures, making it a potential source of probiotics. Yogurt's unique fermented food matrix provides added health benefits by enhancing nutrient absorption and digestion. Combining the intake of yogurt and fruit could provide probiotics, prebiotics, high-quality protein, important fatty acids, and a mixture of vitamins and minerals that have the potential to exert synergistic effects on health. Yogurt consumption has been associated with reduced weight gain and a lower incidence of type 2 diabetes, whereas fruits have established effects on reducing the risk of cardiovascular disease. Yogurt and fruits can be eaten together and may exert combined health benefits through potential prebiotic and probiotic effects. Furthermore, substituting high-energy, nutrient-deficient snacks with fruit and yogurt could reduce the intake of high-calorie obesogenic foods. In light of the positive cardiometabolic impacts of fruit and yogurt and their association with healthy dietary patterns, there is sufficient evidence to warrant further exploration into the potential synergistic health benefits of a combined intake of fruit and yogurt.
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Affiliation(s)
- Melissa Anne Fernandez
- Quebec Heart and Lung Institute, Quebec, Canada
- Institute of Nutrition and Functional Foods, Quebec, Canada; and
- School of Nutrition and
| | - André Marette
- Quebec Heart and Lung Institute, Quebec, Canada;
- Institute of Nutrition and Functional Foods, Quebec, Canada; and
- Department of Medicine, Laval University, Quebec, Canada
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Geary DC. Evolution of Sex Differences in Trait- and Age-Specific Vulnerabilities. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2016; 11:855-876. [DOI: 10.1177/1745691616650677] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Traits that facilitate competition for reproductive resources or that influence mate choice generally have a heightened sensitivity to stressors. They have evolved to signal resilience to infectious disease and nutritional and social stressors, and they are compromised by exposure to man-made toxins. Although these traits can differ from one species or sex to the next, an understanding of the dynamics of competition and choice can in theory be used to generate a priori predictions about sex-, age-, and trait-specific vulnerabilities for any sexually reproducing species. I provide a review of these dynamics and illustrate associated vulnerabilities in nonhuman species. The age- and sex-specific vulnerability of such traits is then illustrated for stressor-related disruptions of boys’ and girls’ physical growth and play behavior, as well as for aspects of boys’ and girls’ and men’s and women’s personality, language, and spatial abilities. There is much that remains to be determined, but enough is now known to reframe trait sensitivity in ways that will allow scientists and practitioners to better identify and understand vulnerable human traits, and eventually ameliorate or prevent their expression.
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Yogurt, diet quality and lifestyle factors. Eur J Clin Nutr 2016; 71:573-579. [PMID: 27804959 DOI: 10.1038/ejcn.2016.214] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/19/2016] [Accepted: 09/26/2016] [Indexed: 01/08/2023]
Abstract
Yogurt consumption has been associated with healthy dietary patterns and lifestyles, better diet quality and healthier metabolic profiles. Studies have shown that frequent yogurt consumers do not only have higher nutrient intakes, but also an improved diet quality, which includes higher consumption of fruits and vegetables, whole grains, and dairy compared with low or non-consumers indicating better compliance with dietary guidelines. Recent epidemiological and clinical evidence suggests that yogurt contributes to better metabolic health because of its effects on the control of body weight, energy homeostasis and glycemic control. Furthermore, yogurt consumers have been shown to be more physically active (⩾ 2 h/week), smoke less, have higher education and knowledge of nutrition compared with non-consumers. Thus, yogurt consumption may be considered a signature of a healthy diet through its nutritional content, impact on metabolic health including the control of energy balance, body weight and glycemia and its relationships with healthier behaviors and lifestyle factors.
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Wang D, van der Horst K, Jacquier E, Eldridge AL. Snacking Among US Children: Patterns Differ by Time of Day. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:369-375.e1. [PMID: 27106777 DOI: 10.1016/j.jneb.2016.03.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 03/14/2016] [Accepted: 03/20/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Evaluate foods and beverages consumed, and energy and nutrient densities that constitute morning, afternoon, and evening snacking periods among children in the US. DESIGN Evaluate snacking behavior using the National Health and Nutrition Examination Survey, 2009-2012. PARTICIPANTS Children aged 4-8 and 9-13 years (n = 3,647). VARIABLES MEASURED Self-reported foods and beverages reported as snacks were aggregated into morning (0:00-12:00 hours), afternoon (12:00-18:00 hours), and evening (18:00-24:00 hour) snacking periods. ANALYSIS Intakes and amounts consumed during different snacking periods were analyzed from per capita weighted averages using SAS 9.2 and SUDAAN software. Statistical differences were detected using Student t test for means and chi-square test for prevalence data. RESULTS Snacking contributed 25% of daily energy in both age groups, with the morning snacking period contributing the least energy. The most frequently consumed food groups across all snacking periods were water, snacks and sweets, nonalcoholic beverages, milk and dairy, and fruit. Nutrient densities varied among different snacking periods; the morning snack period for 4- to 8-year-olds was the most nutrient dense. CONCLUSIONS AND IMPLICATIONS Snacking is an important contributor to energy and nutrients in children's diets, but foods and beverages selected vary by time of day and age. Modifying snacking choices, especially in the afternoon, could improve the nutritional quality of children's diets.
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Affiliation(s)
- Dantong Wang
- Public Health Nutrition, Nestlé Research Center, Lausanne, Switzerland.
| | | | - Emma Jacquier
- Public Health Nutrition, Nestlé Research Center, Lausanne, Switzerland
| | - Alison L Eldridge
- Public Health Nutrition, Nestlé Research Center, Lausanne, Switzerland
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Hess JM, Jonnalagadda SS, Slavin JL. What Is a Snack, Why Do We Snack, and How Can We Choose Better Snacks? A Review of the Definitions of Snacking, Motivations to Snack, Contributions to Dietary Intake, and Recommendations for Improvement. Adv Nutr 2016; 7:466-75. [PMID: 27184274 PMCID: PMC4863261 DOI: 10.3945/an.115.009571] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Around the world, adults consume energy outside of traditional meals such as breakfast, lunch, and dinner. However, because there is no consistent definition of a "snack," it is unclear whether those extra eating occasions represent additional meals or snacks. The manner in which an eating occasion is labeled (e.g., as a meal or a snack) may influence other food choices an individual makes on the same day and satiety after consumption. Therefore, a clear distinction between "meals" and "snacks" is important. This review aims to assess the definition of extra eating occasions, to understand why eating is initiated at these occasions, and to determine what food choices are common at these eating occasions in order to identify areas for dietary intervention and improvement. Part I of this review discusses how snacking is defined and the social, environmental, and individual influences on the desire to snack and choice of snack. The section concludes with a brief discussion of the associations of snacking with cardiometabolic health markers, especially lipid profiles and weight. Part II addresses popular snack choices, overall snacking frequencies, and the demographic characteristics of frequent snackers in several different countries. This review concludes with a recommendation for nutrition policymakers to encourage specific health-promoting snacks that address nutrient insufficiencies and excesses.
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Affiliation(s)
- Julie M Hess
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN; and
| | | | - Joanne L Slavin
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN; and
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Hess JM, Jonnalagadda SS, Slavin JL. Dairy Foods: Current Evidence of their Effects on Bone, Cardiometabolic, Cognitive, and Digestive Health. Compr Rev Food Sci Food Saf 2015; 15:251-268. [DOI: 10.1111/1541-4337.12183] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Julie M. Hess
- Dept. of Food Science and Nutrition; Univ. of Minnesota; 1334 Eckles Avenue St. Paul P.O. Box 55108 MN U.S.A
| | | | - Joanne L. Slavin
- Dept. of Food Science and Nutrition; Univ. of Minnesota; 1334 Eckles Avenue St. Paul P.O. Box 55108 MN U.S.A
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Pampaloni B, Cianferotti L, Gronchi G, Bartolini E, Fabbri S, Tanini A, Brandi ML. Growing Strong and Healthy with Mister Bone: An Educational Program to Have Strong Bones Later in Life. Nutrients 2015; 7:9985-98. [PMID: 26633485 PMCID: PMC4690062 DOI: 10.3390/nu7125510] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 01/03/2023] Open
Abstract
Optimal peak bone mass and bone health later in life are favored by a sufficient calcium intake in infancy, childhood and adolescence. The purpose of this study was to test a new educational program created to monitor and to improve calcium and vitamin D intake in children. Nutritional habits in children were evaluated through a food frequency questionnaire (FFQ) to assess the intake of calcium, vitamin D, dairy products, and total caloric energy at baseline and after seven months of exposure to a unique educational program applied between November 2013 and May 2014 in 176 schoolchildren (48% male, 52% female) attending the fourth and fifth grades of two selected primary schools in Florence, Italy. A significant increase of calcium (from 870 ± 190 to 1100 ± 200 mg/day, p < 0.05), and vitamin D (from 3.6 ± 1.53 to 4.1 ± 2 µg/day) intake in children was documented after the educational program. The amount of specific foods important for bone health consumed, such as milk and vegetables, increased significantly, both in male and female children (p < 0.05). The proposed educational program appears to be effective in modifying calcium intake in children, with a significant increase in the consumption of dairy products and vegetables, but without a significant change in the total caloric intake.
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Affiliation(s)
- Barbara Pampaloni
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Luisella Cianferotti
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Giorgio Gronchi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Elisa Bartolini
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Sergio Fabbri
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Annalisa Tanini
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
| | - Maria Luisa Brandi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, Florence 50139, Italy.
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Joseph LS, Gorin AA, Mobley SL, Mobley AR. Impact of a Short-Term Nutrition Education Child Care Pilot Intervention on Preschool Children's Intention To Choose Healthy Snacks and Actual Snack Choices. Child Obes 2015; 11:513-20. [PMID: 26280736 DOI: 10.1089/chi.2015.0028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Novel interventions within child care settings are needed for childhood obesity prevention. The aim of this study was to determine the impact of a short-term nutrition education pilot intervention on preschool-age children's snack food choices. METHODS Children ages 3-5 years (n = 49) from one child care setting participated in a short-term nutrition education intervention (nine 30-minute interactive lessons) taught over a 2-week period. Pre-post assessments included snack knowledge and snack preference questionnaires and an observed snack selection trial to allow children to choose between a healthy and unhealthy snack choice similar to the current food environment. Children's height and weight were measured and BMI z-scores calculated. Parental reports of demographics and child's food preferences were also collected at baseline. RESULTS Children significantly improved their preference of healthier snacks (p = 0.03) and the ability to distinguish them (p = 0.03) from other snacks. However, they did not significantly improve (p > 0.05) their snack choice between a healthy and unhealthy choice immediately after the short-term nutrition education program. Children who were younger (p = 0.003) or who had higher nutrition knowledge scores (p = 0.002) were more likely to select the healthy snack after the intervention. CONCLUSIONS This study provides evidence that a short-term nutrition education program improves preschool children's knowledge about healthy snacks, but does not translate to immediate healthier snack selections for all children. Future research should investigate the optimal duration of a nutrition education program in a child care setting and other external influences (parents, policy) most influential on snack choice and eventual obesity risk.
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Affiliation(s)
- Laura S Joseph
- 1 Department of Nutritional Sciences, University of Connecticut , Storrs, CT
| | - Amy A Gorin
- 2 Department of Psychology, Center for Health, Intervention, and Prevention, University of Connecticut , Storrs, CT
| | - Stacey L Mobley
- 1 Department of Nutritional Sciences, University of Connecticut , Storrs, CT
| | - Amy R Mobley
- 1 Department of Nutritional Sciences, University of Connecticut , Storrs, CT
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Madsen K, Linchey J, Gerstein D, Ross M, Myers E, Brown K, Crawford P. Energy Balance 4 Kids with Play: Results from a Two-Year Cluster-Randomized Trial. Child Obes 2015; 11:375-83. [PMID: 26061799 DOI: 10.1089/chi.2015.0002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Identifying sustainable approaches to improving the physical activity (PA) and nutrition environments in schools is an important public health goal. This study examined the impact of Energy Balance for Kids with Play (EB4K with Play), a school-based intervention developed by the Academy of Nutrition and Dietetics Foundation and Playworks, on students' PA, dietary habits and knowledge, and weight status over 2 years. METHODS This cluster-randomized, controlled trial took place in four intervention and two control schools over 2 years (n=879; third- to fifth-grade students). PA (fourth and fifth grades only), dietary knowledge and behaviors, school policies, and BMI z-score were assessed at baseline (fall 2011), midpoint (spring 2012), and endpoint (fall 2012 for accelerometers; spring 2013 for all other outcomes). RESULTS At endpoint, there were no group differences in change in PA or dietary behaviors, although BMI z-score decreased overall by -0.07 (p=0.05). Students' dietary knowledge significantly increased, as did the amount of vegetables schools served. Post-hoc analyses stratified by grade revealed that, relative to control students, fourth-grade intervention students reduced school-day sedentary time by 15 minutes (p=0.023) and third-grade intervention students reduced BMI z-score by -0.2 (0.05; p<0.05). There were no significant differences for older students. CONCLUSIONS EB4K with Play, which leverages the existing infrastructure of two national programs, increases children's dietary knowledge and may improve weight status and decrease sedentary behaviors among younger children. Future iterations should examine programming specific for different age groups.
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Affiliation(s)
- Kristine Madsen
- 1 School of Public Health, University of California Berkeley , Berkeley, CA
| | - Jennifer Linchey
- 1 School of Public Health, University of California Berkeley , Berkeley, CA
| | - Dana Gerstein
- 2 Atkins Center for Weight and Health, University of California Berkeley , Berkeley, CA
| | - Michelle Ross
- 2 Atkins Center for Weight and Health, University of California Berkeley , Berkeley, CA
| | | | - Katie Brown
- 4 Academy of Nutrition and Dietetics Foundation , Chicago, IL
| | - Patricia Crawford
- 2 Atkins Center for Weight and Health, University of California Berkeley , Berkeley, CA
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Hecht K. Editorial. Lebensm Wiss Technol 2015. [DOI: 10.1016/j.lwt.2015.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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