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Quirke-McFarlane S, Carstairs SA, Cecil JE. 'You just eyeball it': Parent and nursery staff perceptions and influences on child portion size: A reflexive thematic analysis. Nutr Health 2024:2601060241245255. [PMID: 38623628 DOI: 10.1177/02601060241245255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Background: Childhood obesity is one of the most serious public health epidemics of the 21st century. Observational studies report that increases in portion size (PS) have occurred in parallel with levels of obesity. Increased PSs of high-energy-dense foods can promote overeating, and without compensatory behaviours, can contribute to childhood obesity. Caregivers make decisions about PSs for children in the home and nursery environment, thus are gatekeepers to child food intake. Understanding caregiver PS decisions can aid in the best practice of PS provision to young children. The aim of this study was to explore parent and nursery staff influences on child PS selection and their suggestions for useful tools/strategies in PS decisions. Methods: A qualitative design was employed using focus group discussions (FGDs) with parents and nursery staff of children aged 3-5 years. FGDs were employed given their ability to generate rich data, as well as permit the exploration of collective perceptions, attitudes, behaviours and experiences. Data were analysed using an inductive, semantic approach to reflexive thematic analysis. Results: Four FGDs were conducted: two with parents (n = 13), two with nursery staff (n = 17). Four overarching themes were derived: (i) awareness of PS guidelines; (ii) control over PS; (iii) social influences on children's eating behaviours; (iv) child-specific, social and external factors influencing parent and nursery staff PS decisions. Additionally, participants discussed tools/strategies they believe would be useful in PS decisions. Conclusion: Data from the themes suggest that caregiver control, social, child-specific and external factors are more influential than PS guidelines in both parent and nursery staff PS decisions for young children aged 3-5 years. These findings can inform future childhood obesity prevention initiatives focussed on improving parent and nursery staff provision/use of age-appropriate PSs.
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Affiliation(s)
- Sophia Quirke-McFarlane
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Sharon A Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Joanne E Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
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Acolatse L, Pourshahidi LK, Logue C, McCann MT, Kerr MA. Child food portion sizes in the home environment: how do parents decide? Proc Nutr Soc 2023; 82:386-393. [PMID: 36866645 DOI: 10.1017/s0029665123000071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The consumption of larger portion sizes (PS) of food has been implicated in the increased prevalence of childhood obesity. The home is usually the first place children learn about food, however, little is known about how parents determine child PS in the home environment. This narrative review aimed to explore parental beliefs, decisions, strategies and barriers to the provision of appropriate food PS for children in the home environment. Results indicate that parental decisions on child food PS are based on the amounts they serve themselves, personal intuition and knowledge of child appetite. Owing to the habitual nature of food provision, parental decisions on child PS may be taken without conscious thought and/or could be part of a complex decision-making process influenced by several interlinked factors, including parental childhood mealtime experiences, other family members and child weight status. Strategies to determine child-appropriate PS include modelling the desired PS behaviour, use of unit-based food packaging and PS estimation aids, and providing the child with a degree of autonomy to rely on their own appetite cues. A lack of knowledge/awareness of PS guidance is a key barrier identified by parents to the provision of age-appropriate PS, warranting the inclusion of salient child-appropriate PS guidance within national dietary recommendations. Further home-based interventions to improve the provision of appropriate child PS are required, leveraged on parental strategies already in use, as outlined in this review.
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Affiliation(s)
- Lena Acolatse
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - L Kirsty Pourshahidi
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Caomhan Logue
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Mary T McCann
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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3
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Mahmood L, Moreno LA, Flores-Barrantes P, Mavrogianni C, Schwarz P, Makrilakis K, Liatis S, Cardon G, Willems R, Rurik I, Radó S, Tankova T, Iotova V, Usheva N, Manios Y, Gonzalez-Gil EM. Parental food consumption and diet quality and its association with children's food consumption in families at high risk of type 2 diabetes: the Feel4Diabetes-study. Public Health Nutr 2022; 25:1-12. [PMID: 36217747 PMCID: PMC9991723 DOI: 10.1017/s1368980022002245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/19/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine the parental food consumption and diet quality and its associations with children's consumption in families at high risk for developing type 2 diabetes mellitus across Europe. Also, to compare food frequency consumption among parents and children from high-risk families to the European Dietary guidelines/recommendations. DESIGN Cross-sectional study using Feel4diabetes FFQ. SETTING Families completed FFQ and anthropometric measures were obtained. Linear regression analyses were applied to investigate the relations between parental food consumption and diet quality and their children's food consumption after consideration of potential confounders. PARTICIPANTS 2095 European families (74·6 % mothers, 50·9 % girls). The participants included parent and one child, aged 6-8 years. RESULTS Parental food consumption was significantly associated with children's intake from the same food groups among boys and girls. Most parents and children showed under-consumption of healthy foods according to the European Dietary Guidelines. Parental diet quality was positively associated with children's intake of 'fruit' (boys: β = 0·233, P < 0·001; girls: β = 0·134, P < 0·05) and 'vegetables' (boys: β = 0·177, P < 0·01; girls: β = 0·234, P < 0·001) and inversely associated with their 'snacks' consumption (boys: β = -0·143, P < 0·05; girls: β = -0·186, P < 0·01). CONCLUSION The present study suggests an association between parental food consumption and diet quality and children's food intake. More in-depth studies and lifestyle interventions that include both parents and children are therefore recommended for future research.
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Affiliation(s)
- Lubna Mahmood
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Paloma Flores-Barrantes
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Peter Schwarz
- Department of Medicine III, Technical University of Dresden, Dresden, Germany
| | - Konstantinos Makrilakis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Liatis
- Department of Propaedeutic Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
| | - Ruben Willems
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Imre Rurik
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Sándorné Radó
- Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Tsvetalina Tankova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Violeta Iotova
- Department of Diabetology, Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Natalya Usheva
- Department of Social Medicine and Health Care Organization, Medical University of Varna, Varna, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Esther M Gonzalez-Gil
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, University of Zaragoza, Zaragoza50009, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain
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4
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Liu Q, Wang L, Allman-Farinelli M, Rangan A. Systematic review of the portion size norm of discretionary foods. Nutr Rev 2022; 81:531-554. [PMID: 36137249 DOI: 10.1093/nutrit/nuac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Portion size norm is described as the perception of how much of a given food people choose to eat. Reducing the portion size norm of foods that are high in saturated fat, added sugar, and added salt toward smaller sizes might be a potential strategy to promote appropriate portion size selections. However, an overview of existing portion size norms for discretionary foods has yet to be established. OBJECTIVE The aim of this systematic review was to examine the portion size norm of discretionary foods and assess the methodologies used to investigate the norm. DATA SOURCES The literature search was conducted in 6 databases following the PRISMA guidelines (from inception to January 2022). DATA EXTRACTION Forty studies were eligible and grouped into 3 categories by portion size norm measures: normal (n = 26), appropriate (n = 8), and preferred portion sizes (n = 3). Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. DATA ANALYSIS A wide range of portion sizes were considered normal for each food type, with means/medians varying from 2- to 4-fold among studies. Studies differed considerably in design, with variables including the setting, food type, food presentation, the manner in which portion-size-related questions were formulated, and the range and number of displayed serving size options. The quality of reviewed studies was mixed (25 studies had low or moderate risk of bias, 15 had high risk of bias), and the method of assessing portion size was not validated in 15 of 33 quantitative studies. CONCLUSION The assessment of portion size in future studies should be conducted using tools that are validated for the population of interest so that more definitive conclusions can be drawn regarding portion size norms for discretionary foods. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021249911.
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Affiliation(s)
- Qingzhou Liu
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Leanne Wang
- the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,the Faculty of Medicine and Health, Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
| | - Margaret Allman-Farinelli
- the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,the Faculty of Medicine and Health, Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
| | - Anna Rangan
- the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia.,the Faculty of Medicine and Health, Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
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5
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Bekelman TA, Martin CK, Johnson SL, Glueck DH, Sauder KA, Harrall KK, Steinberg RI, Hsia DS, Dabelea D. A comparison of the remote food photography method and the automated self-administered 24-h dietary assessment tool for measuring full-day dietary intake among school-age children. Br J Nutr 2022; 127:1269-1278. [PMID: 34085613 PMCID: PMC8642460 DOI: 10.1017/s0007114521001951] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The limitations of self-report measures of dietary intake are well-known. Novel, technology-based measures of dietary intake may provide a more accurate, less burdensome alternative to existing tools. The first objective of this study was to compare participant burden for two technology-based measures of dietary intake among school-age children: the Automated-Self-Administered 24-hour Dietary Assessment Tool-2018 (ASA24-2018) and the Remote Food Photography Method (RFPM). The second objective was to compare reported energy intake for each method to the Estimated Energy Requirement for each child, as a benchmark for actual intake. Forty parent-child dyads participated in two, 3-d dietary assessments: a parent proxy-reported version of the ASA24 and the RFPM. A parent survey was subsequently administered to compare satisfaction, ease of use and burden with each method. A linear mixed model examined differences in total daily energy intake between assessments, and between each assessment method and the Estimated Energy Requirement (EER). Reported energy intake was 379 kcal higher with the ASA24 than the RFPM (P = 0·0002). Reported energy intake with the ASA24 was 231 kcal higher than the EER (P = 0·008). Reported energy intake with the RFPM did not differ significantly from the EER (difference in predicted means = -148 kcal, P = 0·09). Median satisfaction and ease of use scores were five out of six for both methods. A higher proportion of parents reported that the ASA24 was more time-consuming than the RFPM (74·4 % v. 25·6 %, P = 0·002). Utilisation of both methods is warranted given their high satisfaction among parents.
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Affiliation(s)
- Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO80045, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Susan L Johnson
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO80045, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO80045, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kylie K Harrall
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO80045, USA
| | - Rachel I Steinberg
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO80045, USA
| | - Daniel S Hsia
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, Aurora, CO80045, USA
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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6
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Tang T, Chawner LR, Chu R, Nekitsing C, Hetherington MM. Downsizing by design – Investigating acceptance, choice and willingness to pay for portion control design concepts. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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7
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Lanza HI. Weighing the Risk: Developmental Pathways and Processes Underlying Obesity to Substance Use in Adolescence. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2022; 32:337-354. [PMID: 34490962 PMCID: PMC8897223 DOI: 10.1111/jora.12610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Research on co-occurring obesity and substance use in adolescence has grown substantially in the past decade, but questions on the pathways and processes underlying co-occurrence remain. This review first synthesizes empirical findings on the relationship between obesity and substance use (e.g., alcohol, cannabis, tobacco use). Multidisciplinary theoretical frameworks referencing behavioral medicine, neuroscience, psychology, and public health are then used to inform an interdisciplinary, conceptual model focused on pathways and processes by which obesity increases risk of substance use. Recommendations for future research underscore the importance of prospective studies that encompass multiple domains of development. Recommendations for practice include family-based interventions that promote adaptive self-regulation, targeted antibullying or victimization interventions, and increased attention by health professionals on risky behavior associated with adolescent obesity.
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8
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Porter A, Toumpakari Z, Kipping R, Summerbell C, Johnson L. Where and when are portion sizes larger in young children? An analysis of eating occasion size among 1·5-5-year-olds in the UK National Diet and Nutrition Survey (2008-2017). Public Health Nutr 2021; 25:1-12. [PMID: 34955105 PMCID: PMC9991682 DOI: 10.1017/s1368980021005024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify eating occasion-level and individual-level factors associated with the consumption of larger portions in young children and estimate their relative importance. DESIGN Cross-sectional. SETTING Data from parent-reported 4-d food diaries in the UK National Diet and Nutrition Survey (2008-2017) were analysed. Multilevel models explored variation in eating occasion size (kJ) within (n 48 419 occasions) and between children (n 1962) for all eating occasions. Eating contexts: location, eating companion, watching TV, and sitting at a table and individual characteristics: age, gender, ethnicity and parental socio-economic status were explored as potential correlates of eating occasion size. PARTICIPANTS Children aged 1·5-5 years. RESULTS Median eating occasion size was 657 kJ (IQR 356, 1117). Eating occasion size variation was primarily attributed (90 %) to differences between eating occasions. Most (73 %) eating occasions were consumed at home. In adjusted models, eating occasions in eateries were 377 kJ larger than at home. Eating occasions sitting at a table, v. not, were 197 kJ larger. Eating in childcare, with additional family members and friends, and whilst watching TV were other eating contexts associated with slightly larger eating occasion sizes. CONCLUSIONS Eating contexts that vary from one eating occasion to another are more important than demographic characteristics that vary between children in explaining variation in consumed portion sizes in young children. Strategies to promote consumption of age-appropriate portion sizes in young children should be developed, especially in the home environment, in eating contexts such as sitting at the table, eating with others and watching TV.
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Affiliation(s)
- Alice Porter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BristolBS8 2BN, UK
| | - Zoi Toumpakari
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BristolBS8 2BN, UK
| | - Ruth Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
- Fuse, NIHR Centre for Translational Research in Public Health, London, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BristolBS8 2BN, UK
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9
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Mori S, Asakura K, Sasaki S, Nishiwaki Y. Relationship between maternal employment status and children's food intake in Japan. Environ Health Prev Med 2021; 26:106. [PMID: 34711169 PMCID: PMC8555293 DOI: 10.1186/s12199-021-01026-z] [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: 07/08/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022] Open
Abstract
Background Although long maternal working hours are reported to have a negative effect on children’s dietary habits, few studies have investigated this issue in Japan. Healthy dietary habits in childhood are important because they may reduce the risk of future disease. Here, we examined the relationship between maternal employment status and children’s dietary intake in 1693 pairs of Japanese primary school 5th and 6th graders and their mothers. Methods The survey was conducted using two questionnaires, a brief-type self-administered diet history questionnaire and a lifestyle questionnaire. The analysis also considered mothers’ and children’s nutrition knowledge, attitudes toward diet, and some aspects of family environment. Results Longer maternal working hours were associated with children’s higher intake of white rice (g/1000kcal) (β 11.4, 95%CI [1.0, 21.9]; working ≥8h vs. not working), lower intake of confectioneries (g/1000kcal) (β −4.0 [−7.6, −0.4]), and higher body mass index (BMI) (kg/m2) (β 0.62 [0.2, 1.0]). Although maternal employment status was not significantly associated with lower intake of healthy food (e.g., vegetables) or higher intake of unhealthy food (e.g., sweetened beverages) in the children, in contrast with previous studies, it may have affected children’s energy intake through their higher intake of white rice. Further, children’s nutrition knowledge and attitudes toward diet, mothers’ food intake, and some family environment factors were significantly associated with intakes of vegetables and sweetened beverages in the children. Conclusions Longer maternal working hours were significantly associated with higher intake of white rice and lower intake of confectioneries, as well as higher BMI among children. Even when a mother works, however, it may be possible to improve her child’s dietary intake by other means such as nutrition education for children or enhancement of food environment.
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Affiliation(s)
- Sachie Mori
- Department of Environmental and Occupational Health, Toho University Graduate School of Medicine, Tokyo, Japan
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Omori-Nishi 5-21-16, Ota-ku, Tokyo, 143-8540, Japan.
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Omori-Nishi 5-21-16, Ota-ku, Tokyo, 143-8540, Japan
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10
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Philippe K, Issanchou S, Roger A, Feyen V, Monnery-Patris S. How Do French Parents Determine Portion Sizes for Their Pre-Schooler? A Qualitative Exploration of the Parent-Child Division of Responsibility and Influencing Factors. Nutrients 2021; 13:nu13082769. [PMID: 34444929 PMCID: PMC8399289 DOI: 10.3390/nu13082769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/28/2021] [Accepted: 08/09/2021] [Indexed: 01/28/2023] Open
Abstract
Large portion sizes can make children overeat, alter their self-regulation abilities and induce weight gain. However, little is known about how parents determine portion sizes for their children. Using semi-structured interviews with 5 fathers and 32 mothers of pre-schoolers, this study examined French parents' food portioning practices. The division of responsibility between parent and child in deciding portion sizes was explored, as well as the influencing factors and possible sources of information. Parents described a wide range of practices. For most, determining portion sizes is an intuitive action that depends on habits and mainly arises from experiences with feeding their child and his/her appetitive traits. Few parents grant autonomy to their child for portioning and serving food, especially for the first serving. Many influencing factors were identified, including child-related (e.g., appetite, food preferences), parent-related (e.g., avoiding food waste), and external factors (e.g., influence of siblings, French food culture). Most parents do not search for information/recommendations to guide their practices. Stimulating optimal self-regulation of eating in children is important and parents can play a crucial role in this. This study identified barriers and facilitators to guide parents in providing appropriate portion sizes and help include children in this decision process.
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11
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Heller RL, Chiero JD, Trout N, Mobley AR. A qualitative study of providers' perceptions of parental feeding practices of infants and toddlers to prevent childhood obesity. BMC Public Health 2021; 21:1276. [PMID: 34193104 PMCID: PMC8243475 DOI: 10.1186/s12889-021-11305-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background With a recent focus on establishing US Dietary Guidance for children ages 0 to 2 years old, the objective of this qualitative study was to determine misconceptions and barriers that prevent parents from implementing early childhood feeding and obesity prevention practices as reported by healthcare, community-based, and education providers. Methods Trained researchers conducted one-on-one qualitative phone interviews, using a semi-structured script, with early childhood health and education providers working with families of young children. Interviews were audiotaped, transcribed verbatim, and analyzed using the classic analysis approach. Transcripts were coded by researchers and analyzed for themes. Results Providers (n = 21) reported commonly observed obesogenic practices including overfeeding tendencies, early initiation of solids or less optimal feeding practices, lack of autonomy and self-regulation by child, and suboptimal dietary patterns. Sources of parental misconceptions about feeding were often related to cultural, familial, and media influences, or lack of knowledge about optimal feeding practices for infants or toddlers. Conclusions Providers indicated a need for engaging and consistent child feeding and obesity prevention education materials appropriate for diverse cultural and literacy levels of parents, with detailed information on transitioning to solid foods. Early education and community-based providers reported limited access to evidence-based educational materials more so than healthcare providers. It is an opportune time to develop reputable and evidence-based child feeding guidance that is readily available and accessible for parents of infants and toddlers to prevent early childhood obesity.
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Affiliation(s)
- Rebecca L Heller
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA.,Rhythm Pharmaceuticals, Boston, MA, USA
| | - Jesse D Chiero
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA
| | - Nancy Trout
- Division of Primary Care, Connecticut Children's Medical Center, Department of Pediatrics, University of Connecticut School of Medicine, Hartford, CT, USA
| | - Amy R Mobley
- Department of Nutritional Sciences, Storrs, CT, USA. .,Department of Health Education and Behavior, University of Florida, PO Box 118210, Gainesville, FL, 32611-8210, USA.
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12
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Dörsam AF, Weiland A, Sauer H, Giel KE, Stroebele-Benschop N, Zipfel S, Enck P, Mack I. The Role of Dishware Size in the Perception of Portion Size in Children and Adolescents with Obesity. Nutrients 2021; 13:nu13062062. [PMID: 34208625 PMCID: PMC8235649 DOI: 10.3390/nu13062062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/02/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: The influence of dishware on portion size perception in children and adolescents is inconclusive. This study investigated how children and adolescents with both obesity and a normal weight perceived portion size in different sized and shaped dishware items. Methods: The study included 60 children and adolescents with overweight and obesity (OBE) and 27 children and adolescents with normal weight (NW) aged from 9 to 17 years. The participants estimated quantities in three pairs of drinking glasses, one pair of bowls and two pairs of plates which varied in size and shape. The children were instructed to state intuitively which portion they would choose for big or small thirst/hunger. Thereafter they were asked to determine the exact amount by answering which dishware item contained the larger/smaller portion (cognitive evaluation). Results: There were no substantial differences in the intuitive evaluation of portion sizes between OBE and NW. During the cognitive evaluation, OBE estimated the amount of water in the glasses more correctly compared to NW (61% vs. 43%; p = 0.008); OBE estimated the amount of lentils in the bowls and on the plates significantly less correctly (39%) compared to NW (56%; p = 0.013). Conclusions: Habit formation and environmental stimuli might play a greater role in estimating food amounts in dishware than the child’s and adolescent’s body weight.
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Affiliation(s)
- Annica Franziska Dörsam
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Alisa Weiland
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Helene Sauer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, 72076 Tübingen, Germany; (A.F.D.); (A.W.); (H.S.); (K.E.G.); (S.Z.); (P.E.)
- Correspondence: ; Tel.: +49-7071-29-85614
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Garemo M, Elamin A, Gardner A. Home packed food for nursery children in United Arab Emirates provides suboptimal quality. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Early childhood nutrition is associated with health outcomes later in life, hence developing health promoting habits from an early age is imperative. OBJECTIVE: The aim of this study was to assess the nutritional adequacy of home-packed food brought to the nurseries by attending children. METHODS: In a cross sectional study conducted in 7 nurseries in Abu Dhabi, United Arab Emirates 315 food-boxes were assessed through detailed food observations at the nurseries prior to mealtimes. The food content was evaluated using the Alberta Guidelines for nursery food, Canada. RESULTS: Most food boxes contained refined grains (77.5%), fruits (74.6%), sweet/full fat dairy products (77.5%), discretionary-calorie-food-items (70.6%). Emirati children were offered sweetened drinks significantly more (p < 0.001). Non-dairy protein sources, vegetables, low-fat-natural-dairy products were offered to 45.4%, 44.1% and 3.9% of children, respectively. Overall, 70.2% of the food-boxes contained not-recommended food and 63.1% of the children were served a very poor food combination. CONCLUSIONS: Despite frequent inclusion of recommended food, many food boxes were nutritionally inadequate due to their low content of whole grains, low-fat dairy products, vegetables and animal proteins and high content of sweet food and drinks. The inadequate dietary patterns necessitate developing nutrition guidelines for nurseries in Abu Dhabi.
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Affiliation(s)
- Malin Garemo
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, United Arab Emirates
| | - Amal Elamin
- Department of Health Sciences, College of Natural and Health Sciences, Zayed University, United Arab Emirates
| | - Andrew Gardner
- School of Molecular Sciences, University of Western Australia, Crawley, Perth, WA, Australia
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14
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Arlinghaus KR, Power TG, Hernandez DC, Johnston CA, Hughes SO. The association between maternal depressive symptomology and child dinner dietary quality among Hispanic Head Start families. Prev Med Rep 2020; 20:101196. [PMID: 32983852 PMCID: PMC7494499 DOI: 10.1016/j.pmedr.2020.101196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
Dietary quality is important for children’s growth and development. Poor dietary quality and maternal depression are prevalent among low-income, Hispanic families. Maternal depression likely influences child feeding before and during the meal. This secondary data analysis of an observational feeding study (2007–2008) examined how maternal depressive symptomology relates to dietary quality of dinner served to and consumed by Head Start preschoolers in Houston, TX (n = 82 mother-child dyads). A digital photography method assessed food served and consumed by the child at three separate dinner meals in families’ homes. Healthy Eating Index-2010 (HEI) was calculated and averaged across the three meals to measure dietary quality (possible range 0–100). Maternal depression was assessed by the Centers for Epidemiologic Depression Scale (CES-D, possible range 0–60). A series of linear regression models were developed, regressing the total CES-D score and all four CES-D subscales onto both the dietary quality of the meal served and consumed. Dinners served had a HEI of 45.70 ± 9.19 and dinners consumed had a HEI of 44.65 ± 7.34. Clinically significant depressive symptomology (CES-D ≥ 16) was reported by 28% of mothers. Maternal depressive symptomology and the dietary quality served were not related. Controlling for dietary quality served, total CES-D and somatic complaints subscale scores were associated with lower dietary quality consumed (respectively, β = −0.16, p < 0.05 and β = −0.23, p < 0.01). Among low-income, Hispanic families, maternal depressive symptomology was predictive of the dietary quality consumed, but not served. Together, these findings reinforce the importance of parent feeding behaviors and emotional climates during dinner.
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Affiliation(s)
- Katherine R Arlinghaus
- Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX 77204-6015, USA
| | - Thomas G Power
- Department of Human Development, Washington State University, PO Box 644852, Pullman, WA 99164, USA
| | - Daphne C Hernandez
- Cizik School of Nursing, University of Texas Health Science Center, 6901 Bertner Avenue, SON-591, Houston, TX 77030, USA
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX 77204-6015, USA
| | - Sheryl O Hughes
- Department of Pediatrics & USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Houston, TX 77030, USA
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15
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Porter A, Kipping R, Summerbell C, Dobrescu A, Johnson L. What guidance is there on portion size for feeding preschool-aged children (1 to 5 years) in the United Kingdom and Ireland? A systematic grey literature review. Obes Rev 2020; 21:e13021. [PMID: 32219990 DOI: 10.1111/obr.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/17/2020] [Accepted: 03/04/2020] [Indexed: 01/10/2023]
Abstract
Large portion sizes of food can lead to excessive energy intake and weight gain in young children. Although portion size guidance is available, parents are often unaware it exists. Our systematic grey literature review aimed to identify the portion size guidance resources in the United Kingdom and Ireland, aimed at users (e.g., parents and childcare providers) responsible for feeding preschool-aged children. We describe who the resources are aimed at, how they are informed and whether the recommended portion sizes are consistent across resources. Resources were identified via advanced Google searches, searching reference lists and contacting experts. Resources that provided quantifiable portion size information (e.g., grammes) were included. Portion sizes (g) were extracted and energy equivalents (kcal) were calculated. Portion sizes were analysed by food group and by eating occasion. Twenty-two resources were identified. Median portion sizes were consistent across resources for fruit (40 g [IQR = 40-50]) and vegetables (40 g [IQR = 30-40]). Variability was observed in portion size and/or energy content for dairy (60 g [IQR = 25-93]), protein (72 kcal [IQR = 44-106]) and starchy (41 g/71 kcal [IQR = 25-80/56-106]) food groups. The range in size of an average eating occasion was large (90-292 g). This review identifies resources that could help caregivers to choose appropriate portion sizes for preschool-aged children but also highlights how future resources could be improved.
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Affiliation(s)
- Alice Porter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Ruth Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
- The National Institute for Health Research Centre for Translational Research in Public Health (Fuse), Newcastle upon Tyne, UK
| | - Anca Dobrescu
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
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16
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Tang T, Wang W, Croden F, Vazirian M, Hetherington MM. “Wrap healthy snacks with cool packaging” - A qualitative study of mothers’ portion size strategies for their children. Appetite 2020; 147:104537. [DOI: 10.1016/j.appet.2019.104537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/23/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
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17
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Hughes SO, Power TG, Beck A, Betz D, Goodell LS, Hopwood V, Jaramillo JA, Lanigan J, Martinez AD, Micheli N, Olivera Y, Overath I, Parker L, Ramos G, Thompson YP, Johnson SL. Short-Term Effects of an Obesity Prevention Program Among Low-Income Hispanic Families With Preschoolers. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:224-239. [PMID: 31917129 DOI: 10.1016/j.jneb.2019.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To assess the short-term effects of an obesity prevention program promoting eating self-regulation and healthy food preferences in low-income Hispanic children. DESIGN Randomized controlled trial with pretest, posttest, and 6- and 12-month assessments. SETTING AND PARTICIPANTS Head Start and similar early learning institutions in Houston, TX, and Pasco, WA. A total of 255 families with preschoolers randomized into prevention (n = 136) and control (n = 119) groups. INTERVENTION Multicomponent family-based prevention program. Fourteen waves lasted 7 weeks each with 8-10 mother-child dyads in each group. MAIN OUTCOME MEASURES Parent assessments included feeding practices, styles, and knowledge. Child assessments included child eating self-regulation, willingness to try new foods, and parent report of child fruit and vegetable preferences. Parent and child heights and weights were measured. ANALYSIS Multilevel analyses were employed to consider the nested nature of the data: time points within families within waves. RESULTS The program had predicted effects on parental feeding practices, styles, and knowledge in the pre- to post-comparisons. Effects on child eating behavior were minimal; only the number of different vegetables tried showed significant pre-post differences. CONCLUSIONS AND IMPLICATIONS Short-term effects of this prevention program highlight the importance of family-focused feeding approaches to combating child overweight and obesity.
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Affiliation(s)
- Sheryl O Hughes
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Ashley Beck
- Department of Human Development, Washington State University, Pullman, WA
| | - Drew Betz
- Department of Human Development, Washington State University, Pullman, WA
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutritional Sciences, North Carolina State University, Raleigh, NC
| | - Veronica Hopwood
- Department of Human Development, Washington State University, Pullman, WA
| | - J Andrea Jaramillo
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Jane Lanigan
- Department of Human Development, Washington State University, Pullman, WA
| | | | - Nilda Micheli
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Yadira Olivera
- Department of Human Development, Washington State University, Pullman, WA
| | - Irene Overath
- Department of Human Development, Washington State University, Pullman, WA
| | - Louise Parker
- Department of Human Development, Washington State University, Pullman, WA
| | - Guadalupe Ramos
- Department of Human Development, Washington State University, Pullman, WA
| | - Yuri Peralta Thompson
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO
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18
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Reale S, Simpson RM, Marr C, Carstairs SA, Cecil JE, Hetherington MM, Caton SJ. Snack Portion Sizes for Preschool Children Are Predicted by Caregiver Portion Size, Caregiver Feeding Practices and Children's Eating Traits. Nutrients 2019; 11:E3020. [PMID: 31835571 PMCID: PMC6950396 DOI: 10.3390/nu11123020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022] Open
Abstract
Caregivers are mostly responsible for the foods young children consume; however, it is unknown how caregivers determine what portion sizes to serve. This study examined factors which predict smaller or larger than recommended snack portion sizes in an online survey. Caregivers of children aged 2 to 4 years were presented with 10 snack images, each photographed in six portion sizes. Caregivers (n = 659) selected the portion they would usually serve themselves and their child for an afternoon snack. Information on child eating traits, parental feeding practices and demographics were provided by caregivers. Most caregivers selected portions in line with recommended amounts for preschool children, demonstrating their ability to match portion sizes to their child's energy requirements. However, 16% of caregivers selected smaller than recommended low energy-dense (LED, e.g., fruits and vegetables) snacks for their child which was associated with smaller caregiver's own portion size, reduced child food liking and increased satiety responsiveness. In contrast, 28% of caregivers selected larger than recommended amounts of high energy-dense (HED, e.g., cookies, crisps) snacks for their child which were associated with larger caregiver's own portion size, greater frequency of consumption, higher child body mass index (BMI), greater pressure to eat and lower child food liking. These findings suggest that most caregivers in this study select portions adjusted to suit their child's age and stage of development. Future interventions could provide support to caregivers regarding the energy and nutrient density of foods given the relatively small portion sizes of LED and large portions of HED snacks offered to some children.
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Affiliation(s)
- Sophie Reale
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Rebecca M. Simpson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Colette Marr
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Sharon A. Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (S.A.C.); (J.E.C.)
| | - Joanne E. Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (S.A.C.); (J.E.C.)
| | | | - Samantha J. Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
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Maternal Decisions on Portion Size and Portion Control Strategies for Snacks in Preschool Children. Nutrients 2019; 11:nu11123009. [PMID: 31835341 PMCID: PMC6950145 DOI: 10.3390/nu11123009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/29/2019] [Accepted: 12/04/2019] [Indexed: 11/17/2022] Open
Abstract
Caregivers are responsible for the type and amount of food young children are served. However, it remains unclear what considerations caregivers make when serving snacks to children. The aim of the study was to explore mothers' decisions and portion control strategies during snack preparation in the home environment. Forty mothers of children aged 24-48 months participated in the study. Mothers prepared five snack foods for themselves and their child whilst verbalizing their actions and thoughts. Mothers were then asked about their portion size decisions in a semi-structured interview. Transcripts were imported into NVivo and analyzed thematically. Three key themes were identified: (1) portion size considerations, (2) portion control methods, and (3) awareness and use of portion size recommendations. Transient, food-related situational influences influenced mothers and disrupted planning and portion control. Food packaging and dishware size were used as visual cues for portion control; however, these vary widely in their size, thus emphasizing mothers' uncertainty regarding appropriate portion sizes. Mothers called for portion size information to be accessible, child-centered, and simple. These findings reveal multiple considerations when deciding on the correct snack portion sizes for children. These decisions are complex and vary across situations and time, and according to the types of snacks offered.
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20
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Blundell-Birtill P, Hetherington MM. Determinants of Portion Size in Children and Adolescents: Insights from the UK National Diet and Nutrition Survey Rolling Programme (2008-2016). Nutrients 2019; 11:nu11122957. [PMID: 31817139 PMCID: PMC6950001 DOI: 10.3390/nu11122957] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 12/18/2022] Open
Abstract
Large portion sizes have been identified as contributing to overweight and obesity, particularly in children and adolescents. This study examined predictors of portion sizes of high energy snack foods eaten by children aged 1.5–18 years. Specifically, we examined whether portion sizes were adjusted for age, and what external features of the environment might be linked to large portion sizes. Portion sizes were derived from four-day food diaries that form the UK National Diet and Nutrition Survey. Diaries from 5942 children were examined and multilevel models were used to discover whether age, gender, location, time of day, household income, and watching TV while eating predicted portion sizes of savoury snacks, chocolate, confectionery and biscuits. Portion sizes of all the target foods were predicted by age. Boys had larger portions, and portion sizes were larger when target foods were consumed later in the day. Portion sizes were larger outside the home, for example in leisure venues, but the target foods were eaten more frequently in the home. As dietary patterns change to include more snack intake outside the home, these locations could be an important space to target for interventions for portion control.
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21
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O'Connor TM, Elias C, Thompson RR, Arlinghaus KR, Vollrath K, Hernandez DC, Power TG, Hughes SO. The association of TV viewing during dinner meals with quality of dietary intake and BMI z-scores among low income, ethnic minority preschool children. Appetite 2019; 140:231-238. [PMID: 31121200 DOI: 10.1016/j.appet.2019.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 04/18/2019] [Accepted: 05/18/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND TV viewing has been associated with children's weight status and is thought to be mediated mostly through children's dietary intake. However, the mechanisms underlying this association are not understood. OBJECTIVE Assess the associations of having the TV on and the child watching TV during dinners with the dietary quality consumed at that meal and with the child's weight status. METHODS Secondary analysis of a directly-observed study of 144 preschool-aged African American and Hispanic, low-income children's dinner meals. Three home dinners were video recorded per child (428 meals observed) and what children were served and consumed measured. The Healthy Eating Index-2010 assessed dietary quality of dinners served and consumed. Child height and weight were measured and parents completed questionnaires. Videos were coded for whether the TV was on and the proportion of the dinner the child watched TV. Mixed models with meal observations nested within child assessed the associations. RESULTS 77% of children consumed at least one dinner with the TV on. The proportion of the meal the child watched TV was not associated with lower dietary quality consumed. TV on was associated with the dietary quality consumed only in the fully adjusted model (p < 0.05). The dietary quality of dinner served was most strongly associated with the dietary quality consumed (p < 0.0001). Neither having the TV on nor child watching the TV while eating were associated with the child's BMI z-score. CONCLUSION Having the TV on during meals was common, but watching TV during the meal was not associated with the dietary quality of what the children consumed. Further controlled studies should evaluate if turning the TV off during dinner directly improves the dietary quality children consume at that meal.
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Affiliation(s)
- Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA; Public Health and Primary Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| | - Cindy Elias
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Ralf Richard Thompson
- Public Health and Primary Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Katherine R Arlinghaus
- Department of Health and Human Performance and HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Kristin Vollrath
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Daphne C Hernandez
- Department of Health and Human Performance and HEALTH Research Institute, University of Houston, Houston, TX, USA
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
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22
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Food portion at ages 8–11 and obesogeny: The amount of food given to children varies with the mother's education and the child's appetite arousal. Soc Sci Med 2019; 228:111-116. [DOI: 10.1016/j.socscimed.2019.03.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/23/2019] [Accepted: 03/15/2019] [Indexed: 11/21/2022]
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23
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The effect of food type on the portion size effect in children aged 2-12 years: A systematic review and meta-analysis. Appetite 2019; 137:47-61. [PMID: 30779929 DOI: 10.1016/j.appet.2019.01.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 01/21/2019] [Accepted: 01/28/2019] [Indexed: 01/13/2023]
Abstract
Visual cues such as plate size, amount of food served and packaging are known to influence the effects of portion size on food intake. Unit bias is a well characterised heuristic and helps to determine consumption norms. In an obesogenic environment where large portions are common place, the unit or segmentation bias may be overridden promoting overconsumption of both amorphous or unit foods. The aim of this review was to investigate the impact of offering unit or amorphous food on the portion size effect (PSE) in children aged 2-12 years. A systematic search for literature was conducted in Medline, PsycInfo and Web of Science in February 2018. A total of 1197 papers were retrieved following the searches. Twenty-one papers were included in the systematic review, of which 15 provided requisite statistical information for inclusion in a random effects meta-analysis. Increasing children's food portion size by 51-100% led to a significant increase in intake (SMD = 0.47, 95% CI: 0.39-0.55). There was no evidence to suggest that increases in consumption were related to food type (p = 0.33), child age (p = 0.47) or initial portion size served (p=0.14). Residual heterogeneity was not significant (p=0.24). The PSE was demonstrated in children aged 2-12 years when offered both unit and amorphous food items. The effect was not restricted by food type, child age or influenced by initial portion size served. Of the studies included in the meta-analysis between study heterogeneity was low suggesting minimal variation in treatment effects between studies, however, more research is required to understand the mechanisms of the PSE in preschool children. Future research should determine feasible methods to downsize portion sizes served to children.
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24
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Kairey L, Matvienko-Sikar K, Kelly C, McKinley MC, O'Connor EM, Kearney PM, Woodside JV, Harrington JM. Plating up appropriate portion sizes for children: a systematic review of parental food and beverage portioning practices. Obes Rev 2018; 19:1667-1678. [PMID: 30160009 DOI: 10.1111/obr.12727] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/10/2018] [Accepted: 06/04/2018] [Indexed: 12/20/2022]
Abstract
Consumption of larger portion sizes is associated with higher energy intake and weight status in children. As parents play a pivotal role in child feeding, we synthesized literature on 'parental portioning practices' using a mixed methods systematic design to inform future strategies addressing portion sizes served to children. Electronic databases PubMed, EMBASE, SCOPUS, PsycINFO and CINAHL Plus were searched. Two reviewers independently screened 385 abstracts and assessed 71 full-text articles against eligibility criteria: studies assessing portioning of foods or beverages by parent(s) with ≥1 child aged 2-12 years. Narrative synthesis of 14 quantitative studies found that portion sizes parents serve vary substantially and are influenced by amounts parents serve themselves, perceived child hunger and parent and child body size. Thematic synthesis of 14 qualitative studies found that parents serve the portion sizes they learn to be appropriate for their child to be fed. Portioning is influenced by parents' desires for a healthy child with a balanced diet. Future guidance on appropriate portion sizes for children would ideally present recommended portion sizes for first serving, incremental with age. Future research is however needed to assess the adoption and efficacy of providing such guidance to families.
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Affiliation(s)
- L Kairey
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - K Matvienko-Sikar
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - C Kelly
- Health Promotion Research Centre, School of Health Sciences, NUI Galway, Galway, Ireland
| | - M C McKinley
- Northern Ireland Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - E M O'Connor
- Department of Biological Sciences, and Health Research Institute, University of Limerick, Limerick, Ireland
| | - P M Kearney
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - J V Woodside
- Northern Ireland Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - J M Harrington
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
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Lanza HI, Pittman P, Hser YI. Parenting With a Substance Abuse History: The Moderating Role of Parenting Behaviors on Obesity and Internalizing Symptoms in Adolescence. YOUTH & SOCIETY 2018; 52:1436-1458. [PMID: 33678918 PMCID: PMC7932061 DOI: 10.1177/0044118x18815274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although numerous studies have shown that child obesity is associated with internalizing symptoms, relatively few studies have examined the role of parenting behaviors on this relationship. Youth meeting obesity status may be at higher risk of psychosocial maladjustment when exposed to more vulnerable parenting contexts. The current study interviewed mothers with a history of substance abuse to assess whether parenting behaviors moderated the relationship between obesity and internalizing symptoms among adolescents (N = 160; 51% girls; M = 12.76 years). Hierarchical regression analyses identified physical discipline as a moderator; girls meeting obesity status displayed higher levels of internalizing symptoms when exposed to higher versus lower levels of physical discipline. Prevention/intervention efforts targeting mothers with substance abuse histories should aim to not only improve physical and emotional health but also highlight the connections between physical and emotional health and the influence of parenting behaviors on associations.
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McCrickerd K. Cultivating self-regulatory eating behaviours during childhood: The evidence and opportunities. NUTR BULL 2018. [DOI: 10.1111/nbu.12355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- K. McCrickerd
- Clinical Nutrition Research Centre (CNRC); Singapore Institute for Clinical Sciences (SICS); Agency of Science, Technology and Research (A*STAR); Singapore
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Drewnowski A, Caballero B, Das JK, French J, Prentice AM, Fries LR, van Koperen TM, Klassen-Wigger P, Rolls BJ. Novel public-private partnerships to address the double burden of malnutrition. Nutr Rev 2018; 76:805-821. [PMID: 30203056 PMCID: PMC6236421 DOI: 10.1093/nutrit/nuy035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Public–private partnerships are an effective way to address the global double burden of malnutrition. While public–private partnerships operate in multiple forms, their leadership usually falls to governments, public health agencies, or nongovernmental organizations, with the private sector taking a subordinate role. The rapid ascent of social media and mass communications worldwide has provided a disruptive technology for new nutrition intervention programs. A new model, provisionally called private–public engagement, takes advantage of social media, mass media, and integrated social marketing to reach parents, families, and communities directly. These new private–public engagement initiatives need to be managed in ways suggested for public–private partnerships by the World Health Organization, especially if the private sector is in the lead. Once the rationale for engagement is defined, there is a need to mobilize resources, establish in-country partnerships and codes of conduct, and provide a plan for monitoring, evaluation, and accountability. Provided here is an example consistent with the private–public engagement approach, ie, the United for Healthier Kids program, which has been aimed at families with children aged less than 12 years. Materials to inspire behavioral change and promote healthier diets and lifestyle were disseminated in a number of countries through both digital and physical channels, often in partnership with local or regional governments. A description of this program, along with strategies to promote transparency and communication among stakeholders, serves to provide guidance for the development of future effective private–public engagements.
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Affiliation(s)
- Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Benjamin Caballero
- Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jai K Das
- Division of Woman and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jeff French
- Brighton Business School, Brighton University, Brighton, United Kingdom.,Strategic Social Marketing Ltd, Concord, Hampshire, United Kingdom
| | - Andrew M Prentice
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Keneba, Gambia.,MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Lisa R Fries
- Corporate Nutrition, Health and Wellness Unit, Nestlé, Vevey, Switzerland.,Behavioral Science Group, Nestlé Research Center, Lausanne, Switzerland
| | | | - Petra Klassen-Wigger
- Corporate Nutrition, Health and Wellness Unit, Nestlé, Vevey, Switzerland.,Nutrition, Health and Wellness Unit, Nestlé Research Center, Lausanne, Switzerland
| | - Barbara J Rolls
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
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Reale S, Kearney CM, Hetherington MM, Croden F, Cecil JE, Carstairs SA, Rolls BJ, Caton SJ. The Feasibility and Acceptability of Two Methods of Snack Portion Control in United Kingdom (UK) Preschool Children: Reduction and Replacement. Nutrients 2018; 10:E1493. [PMID: 30322090 PMCID: PMC6212871 DOI: 10.3390/nu10101493] [Citation(s) in RCA: 14] [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: 09/12/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 01/23/2023] Open
Abstract
Large portions of high energy dense (HED) snacks are offered to children from a young age and are pervasive in our food environment. This study aimed to explore the feasibility, acceptability, and preliminary efficacy of two strategies of snack portion control: reduction and replacement. Forty-six mother-child dyads aged 22⁻56 months (36.6 ± 9.5 m, 48% female) completed a three-week intervention. In week 1 (baseline) no changes were made to the child's diet; week 2 (acclimation) children received a standardised selection of HED snacks, and in week 3 (intervention) participants were randomly assigned to snack replacement (n = 24) or snack reduction (n = 22). Snack replacement involved swapping HED snacks for fruits and vegetables, whilst snack reduction involved reducing the size of HED snacks by 50%. Food and energy intake were measured using a weighed food diary for four consecutive days. Snack replacement resulted in more positive changes to children's diets; vegetable intake increased (p < 0.01), and total daily energy intake decreased when compared to snack reduction (p < 0.05). Mothers expressed a more favourable attitude to snack replacement, although snack reduction was also well received by mothers. Despite increased preliminary efficacy of snack replacement on dietary intake, both strategies were feasible and acceptable. The current pilot study provides the necessary information to inform the design of future interventions.
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Affiliation(s)
- Sophie Reale
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| | - Colette M Kearney
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
| | | | - Fiona Croden
- School of Psychology, University of Leeds, Leeds LS2 9JT, UK.
| | - Joanne E Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Sharon A Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK.
| | - Barbara J Rolls
- Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Samantha J Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK.
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Arlinghaus KR, Vollrath K, Hernandez DC, Momin SR, O'Connor TM, Power TG, Hughes SO. Authoritative parent feeding style is associated with better child dietary quality at dinner among low-income minority families. Am J Clin Nutr 2018; 108:730-736. [PMID: 30169719 PMCID: PMC6186208 DOI: 10.1093/ajcn/nqy142] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/30/2018] [Indexed: 11/13/2022] Open
Abstract
Background Parent feeding styles have been linked to child weight status across multiple studies. However, to our knowledge, the link between feeding styles and children's dietary quality, a more proximal outcome, has not been investigated. Objective The purpose of this study was to examine the relation between parent feeding styles and dietary quality of Head Start preschoolers' dinner meals. Design The amount of food served and consumed by children was measured by using a standardized digital photography method during 3 in-home dinner observations of low-income minority families in Houston, Texas. Trained dietitians entered food served and consumed into the Nutrient Data System for Research 2009 for nutrient analysis. Overall dietary quality of the food served and consumed at dinner was evaluated by using the Healthy Eating Index 2010 (HEI-2010). Parent feeding style was assessed with the use of the Caregiver's Feeding Style Questionnaire (CFSQ). On the basis of a parent's level of demandingness and responsiveness to his or her child during feeding, the CFSQ categorizes parent feeding into 4 styles: authoritative (high demandingness and high responsiveness), authoritarian (high demandingness and low responsiveness), indulgent (low demandingness and high responsiveness), or uninvolved (low demandingness and low responsiveness). Results For the overall sample, the mean ± SD HEI score for dinner served was 44.2 ± 8.4, and the mean ± SD HEI score for dinner consumed was 43.4 ± 7.0. In the fully adjusted model, ANCOVA indicated that the authoritative parent feeding style was associated with significantly higher child dietary quality compared with the authoritarian feeding style (mean ± SEE HEI consumed-authoritative 45.5 ± 0.9; authoritarian: 41.9 ± 0.7; P = 0.001). Conclusions Parent feeding style contributes to the overall dietary quality of children, and among low-income minority preschoolers an authoritative feeding style was associated with the highest dietary quality of the 4 feeding styles. Interventions to promote feeding practices that contribute to authoritative feeding are needed to improve the dietary quality of preschool children at dinner. This trial was registered at https://clinicaltrials.gov as NCT02696278.
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Affiliation(s)
| | - Kirstin Vollrath
- USDA–Agricultural Research Service, Children's Nutrition Research Center at Baylor College of Medicine, Houston, TX
| | - Daphne C Hernandez
- Department of Health and Human Performance, University of Houston, Houston, TX,Department of HEALTH Research Institute, University of Houston, Houston, TX
| | - Shabnam R Momin
- USDA–Agricultural Research Service, Children's Nutrition Research Center at Baylor College of Medicine, Houston, TX
| | - Teresia M O'Connor
- USDA–Agricultural Research Service, Children's Nutrition Research Center at Baylor College of Medicine, Houston, TX
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Sheryl O Hughes
- USDA–Agricultural Research Service, Children's Nutrition Research Center at Baylor College of Medicine, Houston, TX,Address correspondence to SOH (e-mail: )
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Hetherington MM, Blundell-Birtill P. The portion size effect and overconsumption - towards downsizing solutions for children and adolescents. NUTR BULL 2018. [DOI: 10.1111/nbu.12307] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Bauer KW, Haines J, Miller AL, Rosenblum K, Appugliese DP, Lumeng JC, Kaciroti NA. Maternal restrictive feeding and eating in the absence of hunger among toddlers: a cohort study. Int J Behav Nutr Phys Act 2017; 14:172. [PMID: 29258621 PMCID: PMC5735902 DOI: 10.1186/s12966-017-0630-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 12/07/2017] [Indexed: 01/23/2023] Open
Abstract
Background Restrictive feeding by parents has been associated with greater eating in the absence of hunger (EAH) among children, a risk factor for obesity. However, few studies have examined the association between restrictive feeding and EAH longitudinally, raising questions regarding the direction of associations between restrictive feeding and child EAH. Our objective was to examine the bidirectional prospective associations between restrictive feeding and EAH among toddlers. Methods Low-income mother-child dyads (n = 229) participated when children were 21, 27, and 33 months old. Restriction with regard to food amount and food quality were measured with the Infant Feeding Styles Questionnaire. EAH was measured as kilocalories of food children consumed after a satiating meal. A cross-lagged analysis adjusting for child sex and weight-for-length z-score was used to simultaneously test cross-sectional and bidirectional prospective associations between each type of restriction and children’s EAH. Results At 21 months, mothers of children with greater EAH reported higher restriction with regard to food amount (b = 0.17, p < .05). Restriction with regard to food amount at age 21 months was inversely associated with EAH at 27 months (b = −0.20, p < .05). Restriction with regard to food amount at 27 months was not associated with EAH at 33 months and restriction with regard to food quality was not associated with EAH. EAH did not prospectively predict maternal restriction. Conclusions Neither restriction with regard to food amount nor food quality increased risk for EAH among toddlers. Current US clinical practice recommendations for parents to avoid restrictive feeding, and the potential utility of restrictive feeding with regard to food amount in early toddlerhood, deserve further consideration. Electronic supplementary material The online version of this article (10.1186/s12966-017-0630-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, Macdonald Stewart Hall, University of Guelph, Room, Guelph, ON, 226, Canada
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI, 48109, USA
| | - Katherine Rosenblum
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | | | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI, 48109, USA
| | - Niko A Kaciroti
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI, 48109, USA
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Evaluation of food photographs assessing the dietary intake of children up to 10 years old. Public Health Nutr 2017; 21:888-895. [PMID: 29199628 DOI: 10.1017/s1368980017003354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Young children lack basic skills related to recognizing the types of foods they consume and dietary surveys often rely on parents' response. The present study aimed to evaluate how well parents of children aged from 3 months to 10 years perceive images of portions of foods commonly consumed by young children. DESIGN Pre-weighed, actual food portions (n 2314) were shown to the study participants who were asked to indicate the picture that corresponded to the food in view. Mean differences between picture numbers selected and shown were estimated and compared using unpaired t tests or Tukey-Cramer pairwise comparisons. SETTING Real-time testing of parents' perception of food images presenting portion sizes consumed by children up to 10 years old. SUBJECTS A convenience sample of 138 parents/caregivers of young children (69 % females). RESULTS Individuals selected the correct or adjacent image in about 97 % of the assessments. Images presenting amorphous solids (i.e. pies and pastries with a filling), liquid or semi-liquid dishes (i.e. soups, porridges, fruit and vegetable purées) were more prone to bias. There was no indication that personal characteristics (gender, age, educational background, age, number of offspring) were associated with differences in the way parents/caregivers perceived the food pictures. CONCLUSIONS Food pictures may not be appropriate to quantify the intake of liquid, semi-liquid or amorphous solid foods in surveys addressing young children and studies evaluating their performance as food portion anchors should ensure the inclusion of several and various amorphous foods in the assessment.
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McCrickerd K, Leong C, Forde CG. Preschool children's sensitivity to teacher-served portion size is linked to age related differences in leftovers. Appetite 2017; 114:320-328. [DOI: 10.1016/j.appet.2017.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/24/2017] [Accepted: 04/03/2017] [Indexed: 01/12/2023]
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Assari S, Caldwell CH. Low Family Support and Risk of Obesity among Black Youth: Role of Gender and Ethnicity. CHILDREN (BASEL, SWITZERLAND) 2017; 4:E36. [PMID: 28498351 PMCID: PMC5447994 DOI: 10.3390/children4050036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 01/22/2023]
Abstract
Most studies on the role of family environment in developing risk of obesity among youth have focused on parenting behaviors that are directly involved in energy balance in regional, non-representative White samples. Using a national sample of ethnically diverse Black youth, the current study tested the association between low family support and risk of obesity. We also tested the heterogeneity of this association based on gender, ethnicity, and their intersection. We used data from the National Survey of American Life-Adolescent Supplement (NSAL-A), a national survey of Black adolescents in the United States. The study enrolled 1170 African American and Caribbean Black 13-17 year old youth. Obesity was defined based on the cutoff points of body mass index (BMI) appropriate for age and gender of youth. Family support was measured using a five-item measure that captured emotional and tangible social support. Age, gender, and ethnicity were also measured. Logistic regressions were utilized in the pooled sample, and also based on gender, ethnicity, and their intersection, to test the link between low family support and risk for obesity. RESULTS In the pooled sample, low family support was not associated with an increased risk of obesity (OR = 1.35, 95% Confidence Interval (CI) = 0.96-1.89). The association between low family support and risk of obesity was, however, significant among African American females (OR = 1.60, 95% CI = 1.01-2.55). There was no association for African American males (OR = 1.26, 95% CI = 0.82-1.92), Caribbean Black males (OR = 0.68, 95% CI = 0.01-54.85), and Caribbean Black females (OR = 0.78, 95% CI = 0.42-1.44). In conclusion, policies and programs that enable African American families to provide additional family support may prevent obesity among African American female youth. Future research should test the efficacy of promoting family support as a tool for preventing obesity among African American female youth.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA.
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Hetherington MM. Nutrition in the early years - laying the foundations for healthy eating. NUTR BULL 2016. [DOI: 10.1111/nbu.12232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Hughes SO, Power TG, Beck A, Betz D, Calodich S, Goodell LS, Hill LG, Hill R, Jaramillo JA, Johnson SL, Lanigan J, Lawrence A, Martinez AD, Nesbitt M, Overath I, Parker L, Ullrich-French S. Strategies for Effective Eating Development-SEEDS: Design of an Obesity Prevention Program to Promote Healthy Food Preferences and Eating Self-Regulation in Children From Low-Income Families. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:405-418.e1. [PMID: 27288192 DOI: 10.1016/j.jneb.2016.04.388] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To develop a scientifically based childhood obesity prevention program supporting child eating self-regulation and taste preferences. This article describes the research methods for the Strategies for Effective Eating Development program. A logic model is provided that depicts a visual presentation of the activities that will be used to guide the development of the prevention program. DESIGN Randomized, controlled prevention program, pretest, posttest, 6 months, and 12 months. SETTING Two sites: Houston, TX and Pasco, WA. Each trial will last 7 weeks with 8-10 mother-child dyads in each arm (prevention and control). PARTICIPANTS Recruitment at Head Start districts (Texas; n = 160) and Inspire Child Development Center including Early Childhood Education and Head Start (Washington; n = 160). Sixteen trials with 16-20 parent-child dyads per trial will provide adequate power to detect moderate effects. INTERVENTION Multicomponent family-based prevention program incorporating a dialogue approach to adult learning and self-determination theory. MAIN OUTCOME MEASURES Child assessments will include observed taste preferences, caloric compensation, and eating in the absence of hunger. Parent assessments will include parent-reported feeding, feeding emotions, acculturation, child eating behaviors, child food preferences, and child dietary intake. Heights and weights will be measured for parent and child. ANALYSIS A multilevel growth modeling analysis will be employed to consider the nested nature of the data: time points (level 1) within families (level 2) within trials (level 3).
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Affiliation(s)
- Sheryl O Hughes
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Ashley Beck
- Department of Human Development, Washington State University, Pullman, WA
| | - Drew Betz
- Department of Human Development, Washington State University, Pullman, WA
| | - Shirley Calodich
- Department of Human Development, Washington State University, Pullman, WA
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutritional Sciences, North Carolina State University, Raleigh, NC
| | - Laura G Hill
- Department of Human Development, Washington State University, Pullman, WA
| | - Rachael Hill
- Department of Human Development, Washington State University, Pullman, WA
| | - J Andrea Jaramillo
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO
| | - Jane Lanigan
- Department of Human Development, Washington State University, Pullman, WA
| | - Adair Lawrence
- Department of Human Development, Washington State University, Pullman, WA
| | | | | | - Irene Overath
- Department of Human Development, Washington State University, Pullman, WA
| | - Louise Parker
- Department of Human Development, Washington State University, Pullman, WA
| | - Sarah Ullrich-French
- Department of Educational Leadership, Sport Studies, and Educational/Counseling Psychology, Washington State University, Pullman, WA
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37
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McCrickerd K, Forde CG. Parents, portions and potential distortions: Unpicking children's meal size. NUTR BULL 2016. [DOI: 10.1111/nbu.12190] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K. McCrickerd
- Clinical Nutrition Research Centre; Centre for Translational Medicine; Yong Loo Lin School of Medicine; Singapore
- Singapore Institute for Clinical Sciences; Agency for Science Technology and Research (A*STAR); Singapore
| | - C. G. Forde
- Clinical Nutrition Research Centre; Centre for Translational Medicine; Yong Loo Lin School of Medicine; Singapore
- Singapore Institute for Clinical Sciences; Agency for Science Technology and Research (A*STAR); Singapore
- Department of Physiology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
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Brown CL, Skelton JA, Perrin EM, Skinner AC. Behaviors and motivations for weight loss in children and adolescents. Obesity (Silver Spring) 2016; 24:446-52. [PMID: 26718021 PMCID: PMC4779651 DOI: 10.1002/oby.21370] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/21/2015] [Accepted: 09/11/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To examine the association between weight loss behaviors and motivations for weight loss in children and adolescents and the association of weight status with these behaviors and motivations in a nationally representative sample. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) was examined, focusing on children in the United States aged 8-15 years, in repeated cross-sections from 2005 to 2011. RESULTS Half of participants (N = 6,117) reported attempting to lose weight, and children with obesity attempted to lose weight more frequently (76%) than children who were a healthy weight (15%). Children reported attempting to lose weight by both healthy and unhealthy means: "exercising" (92%), "eating less sweets or fatty foods" (84%), "skipping meals" (35%), and "starving" (18%). The motivation to be better at sports was more likely to be associated with attempting weight loss through healthy behaviors, whereas children motivated by teasing were more likely to engage in unhealthy behaviors. Motivations for losing weight differed by weight status. CONCLUSIONS Many children and adolescents attempt to lose weight, using either or both healthy and unhealthy behaviors, and behaviors differed based on motivations for weight loss. Future research should examine how physicians, parents, and teachers can inspire healthy behavior changes.
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Affiliation(s)
- Callie Lambert Brown
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, North Carolina, USA
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Eliana M Perrin
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Asheley Cockrell Skinner
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Health Policy and Administration, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Johnson SL. Developmental and Environmental Influences on Young Children's Vegetable Preferences and Consumption. Adv Nutr 2016; 7:220S-231S. [PMID: 26773030 PMCID: PMC4717879 DOI: 10.3945/an.115.008706] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Food intake patterns begin to be shaped at the earliest points in life. Early exposures and experiences are critical for the acceptance of some foods, particularly healthful foods such as vegetables, which often have a bitter component in their flavor profiles. In addition to repeated exposure to these foods, the quality and emotional tone of parent-child interactions are important in facilitating children's acceptance of vegetables. During early childhood, parents are challenged by children's developmental characteristics related to eating, such as the emergence of child neophobia, and by individual characteristics of the child that are more biologically based, including genetic predispositions to bitter taste and sensory sensitivities. Experimental studies consistently show that repeated exposure to novel and rejected familiar foods is the most powerful method to improve acceptance. However, the manner and persistence with which these exposures are performed are critical. Research investigating influences on children's vegetable acceptance and ingestion has focused on associations among availability, parent intakes, child neophobia, and the parental feeding response to children's reluctance to try and consume vegetables. Because young children's dietary intakes are low and below dietary recommendations, investigations have focused more on factors that impede children's vegetable acceptance, such as controlling feeding practices, than on positive influences. Research that addresses the multifaceted nature of these interactions among different levels of social-ecological environment, individual traits, parental feeding styles and practices, and socioeconomic influences and that uses longitudinal designs and complex statistical approaches is called for to ascertain more effective methods to improve children's vegetable acceptance.
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Affiliation(s)
- Susan L Johnson
- University of Colorado Anschutz Medical Campus, Department of Pediatrics/Section of Nutrition, The Children's Eating Laboratory, Aurora, CO
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Examining the relationship between vegetable intake of mothers and that of their children: a cross-sectional study of 10- to 12-year-old schoolchildren in Japan. Public Health Nutr 2015; 18:3166-71. [PMID: 26388453 DOI: 10.1017/s1368980015002591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study aimed to investigate the correlation between mothers' and children's vegetable intake and whether children are conscious about their vegetable intake. DESIGN Cross-sectional study. Self-administered questionnaires for mothers and children, consisting of items regarding diet history, were distributed to children via homeroom teachers. We created dummy exposure variables for each quartile of mothers' vegetable intake. Multiple regression analysis was performed with children's vegetable intake as the outcome variable. SETTING Two public elementary schools in a residential district of Tokyo, Japan. SUBJECTS Study participants were upper-grade children (aged 10-12 years) and their mothers (332 pairs of mothers and children). RESULTS The mean vegetable intake in mothers and children was 310 (sd 145) g/d and 276 (sd 105) g/d, respectively. A positive linear relationship was found between mothers' and children's vegetable intake even after adjustment for considerable covariates (P<0·001). When stratified by children's consciousness, the positive linear relationship was more pronounced in children who were conscious of eating all their vegetables (P<0·001 for interaction with children's consciousness). CONCLUSIONS Mothers' vegetable intake was significantly correlated with children's vegetable intake. However, this correlation was stronger in children who were conscious of eating all their vegetables. Our findings suggest that enhancing mother's vegetable intake and health consciousness of children are indispensable prerequisites for increasing vegetable intake among children.
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Innella N, Breitenstein S, Hamilton R, Reed M, McNaughton DB. Determinants of Obesity in the Hispanic Preschool Population: An Integrative Review. Public Health Nurs 2015; 33:189-99. [DOI: 10.1111/phn.12215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy Innella
- College of Nursing; Rush University; Chicago Illinois
| | | | | | - Monique Reed
- College of Nursing; Rush University; Chicago Illinois
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Assari S, Caldwell CH, Zimmerman MA. Low parental support in late adolescence predicts obesity in young adulthood; Gender differences in a 12-year cohort of African Americans. J Diabetes Metab Disord 2015; 14:47. [PMID: 26029673 PMCID: PMC4449598 DOI: 10.1186/s40200-015-0176-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/17/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Most studies that have investigated the link between parenting behaviors and risk of obesity among offsprings have mostly used a cross-sectional design, enrolled Caucasian samples, focused on childhood obesity, and covered aspects of parenting behaviors that directly influence energy balance and food intake of the children. Thus, more longitudinal research is needed on how more general aspects of parenting influence obesity in young ethnic minority adults. The current longitudinal study aimed to test if baseline parental support predicts change in body mass index (BMI) of African Americans, and if this prediction varies based on gender of offspring. METHODS The current study followed 227 young African American adults (109 male and 118 female) for 12 years from year 2000 (mean age 20) to year 2012 (mean age 32). All participants were enrolled from a disadvantaged urban area in the Midwest of the United States. Baseline demographics (age, gender), socio-economics (family structure, and parental employment), psychological symptoms (anxiety and depression), general parental support (maternal support, and paternal support) were measured. BMI was measured at baseline and at follow up. We used gender-specific linear regressions to test the predictive role of baseline paternal and maternal support (year 2000) on change in BMI (from 2000 to 2012). RESULTS Regression analysis showed that among female African American young adults, high baseline maternal support was predictive of a lower increase in BMI from 2000 to 2012. The association remained significant while all covariates were in the model. We could not find such an association for male African American young adults. CONCLUSION High maternal support appears to be protective against increases in BMI among African American female young adults. As parental support is a modifiable factor within available evidence-based interventions that enhance parenting, it should be included in obesity prevention programs for African American women. Policies and programs should support African American mothers in disadvantaged neighborhoods to enable them to provide high levels of parental support for their young adult daughters. Future research should test the efficacy of such programs and policies for reducing obesity among African American women.
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Affiliation(s)
- Shervin Assari
- />Department of Psychiatry, School of Medicine, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700 USA
- />Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI USA
- />Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 2846 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
| | - Cleopatra Howard Caldwell
- />Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI USA
- />Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 2846 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
| | - Marc A. Zimmerman
- />Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 2846 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029 USA
- />Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI USA
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Johnson SL, Goodell LS, Williams K, Power TG, Hughes SO. Getting my child to eat the right amount. Mothers' considerations when deciding how much food to offer their child at a meal. Appetite 2014; 88:24-32. [PMID: 25510530 DOI: 10.1016/j.appet.2014.12.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 12/03/2014] [Indexed: 10/24/2022]
Abstract
Feeding young children successfully requires parenting skills, trust that children will eat, and nutrition and child development knowledge to ensure that foods and the amounts offered are developmentally appropriate. Mothers are often responsible for determining how much food is offered to their children; however, the influences on mothers' decisions regarding how much to offer their children--their motivations, goals for feeding and child consumption--have not been investigated. Study aims included gathering qualitative data regarding mothers' decisional processes related to preparing a dinner meal plate for her preschooler. Low income mothers (n = 15 African American and n = 15 Latina mothers) were recruited from preschools in the Denver, CO metropolitan area to participate in semi-structured interviews. Mothers prepared a plate for their preschooler and were asked about influences on their decisions about portion sizes and their expectations for children's eating. Data were coded by 2 independent coders using a consensus coding process and analyzed by investigators. Three themes emerged: (1) portion sizes differ for children who are "good" eaters and "picky" eaters; (2) mothers know the "right amounts" to serve their child; and (3) mothers have emotional investments in their children's eating. Some influencing factors were child-centered (e.g. child's likes and dislikes, "picky" and "good" eaters, and foods previously eaten in the day) and some related to adult expectations and concerns (nutrient content and waste). Interventions focusing on portion size may be more effective if tailored to the mothers' perceptions regarding her child's eating characteristics.
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Affiliation(s)
- Susan L Johnson
- Department of Pediatrics, Section of Nutrition, The University of Colorado - Anschutz Medical Campus, Denver, CO, USA.
| | - L Suzanne Goodell
- Department of Food, Bioprocessing, and Nutrition Sciences, North Carolina State University, Raleigh, NC, USA
| | - Kimberly Williams
- Department of Pediatrics, Section of Nutrition, The University of Colorado - Anschutz Medical Campus, Denver, CO, USA
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Sheryl O Hughes
- Baylor College of Medicine, The Children's Nutrition Research Center, Houston, TX, USA
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Right sizing prevention. Food portion size effects on children's eating and weight. Appetite 2014; 88:11-6. [PMID: 25464022 DOI: 10.1016/j.appet.2014.11.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/17/2014] [Accepted: 11/18/2014] [Indexed: 02/03/2023]
Abstract
Experimental findings provide consistent evidence that increasing the portion size of palatable, energy dense entrees relative to an age appropriate reference portion increases children's energy intake of the entree and the meal. Most of these studies have been conducted on preschool aged children between 2 and 6 years of age, in childcare or laboratory settings, using repeated measures designs. In these studies, children's intake is compared across a series of meals, where the size of the entrée portion is varied and other aspects of the meal, including the portion size of other items on the menu, are held constant. This paper provides an overview of what we know from this research, what is not known about the effects of portion size on children's intake and weight status, and points to some of the important unanswered questions and gaps in the literature. Lastly, we discuss how individual characteristics may make someone more or less susceptible to large portions of foods and how the palatability of foods may moderate observed associations among portion size, children's intake, and weight status. Future studies that address the gaps identified in this paper are needed to inform policy and to develop effective and efficient interventions to prevent childhood obesity.
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Kral TVE, Hetherington MM. Variability in children's eating response to portion size. A biobehavioral perspective. Appetite 2014; 88:5-10. [PMID: 25305465 DOI: 10.1016/j.appet.2014.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 08/21/2014] [Accepted: 10/03/2014] [Indexed: 12/25/2022]
Abstract
The portion size of foods and beverages offered at meals has been shown to significantly affect human food intake. While portion size effects appear to be fairly robust across studies in adults, findings from studies in children are generally more variable and do not reliably predict a significant portion size effect. Eating behaviors are still forming at a young age and individual differences in children's response to portion size will depend upon genetic predisposition interacting with the child's environment. The aim of this review is to present and discuss evidence that innate controls of appetite and eating, which involve genes that encode key hormones and neuropeptides implicated in processes of satiety and satiation, may differentially affect meal size. We also present evidence that children's response to portion size is learned and this is in turn shaped by upbringing, the early family and home environment. The review will conclude with a conceptual model that illustrates how biological and environmental factors may interact to shape child eating traits including a behavioral susceptibility to overeating when large portion sizes are available.
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Affiliation(s)
- Tanja V E Kral
- Department of Behavioral Health Sciences, University of Pennsylvania School of Nursing and Perelman School of Medicine, Philadelphia, PA, USA.
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Influencing and modifying children's energy intake: the role of portion size and energy density. Proc Nutr Soc 2014; 73:397-406. [PMID: 24886909 DOI: 10.1017/s0029665114000615] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Childhood obesity is of concern worldwide. The portion size (PS) and energy density (ED) of food are two major determinants of children's energy intake (EI). Trends towards increasing PS are most apparent and best documented in the USA, where PS of numerous food products have increased in the marketplace over the past three decades, particularly high-energy dense foods. Analyses of population-level dietary surveys have confirmed this trend in children for both in- and out-of-home eating, and a plethora of observational evidence positively associates PS, ED and adiposity in children. A limited number of intervention studies provide clear evidence that children, even as young as 2 years, respond acutely to increasing PS, with some studies also demonstrating the additive effects of increased ED in promoting excessive EI. However, most of the evidence is based on children aged 3-6 years and there is a paucity of data in older children and adolescents. It is unclear whether decreasing PS can have the opposite effect on children's EI but recent acute studies have demonstrated that the incorporation of lower energy dense foods, such as fruit and vegetables, into children's meals down-regulates EI. Although a direct causal link between PS and obesity remains to be established, the regular consumption of larger PS of energy dense foods do favour obesity-promoting eating behaviours in children. Further research is required to establish the most feasible and effective interventions and policies to counteract the deleterious impact of PS and ED on children's EI.
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