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Myers KP, Temple JL. Translational science approaches for food insecurity research. Appetite 2024; 200:107513. [PMID: 38795946 PMCID: PMC11227396 DOI: 10.1016/j.appet.2024.107513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
Food insecurity is a pervasive problem that impacts health and well-being across the lifespan. The human research linking food insecurity to poor metabolic and behavioral health outcomes is inherently correlational and suffers from a high degree of variability both between households and even within the same household over time. Further, food insecurity is impacted by societal and political factors that are largely out of the control of individuals, which narrows the range of intervention strategies. Animal models of food insecurity are being developed to address some of the barriers to mechanistic research. However, animal models are limited in their ability to consider some of the more complex societal elements of the human condition. We believe that understanding the role that food insecurity plays in ingestive behavior and chronic disease requires a truly translational approach, and that understanding the health impacts of this complex social phenomenon requires understanding both its psychological and physiological dimensions. This brief review will outline some key features of food insecurity, highlighting those that are amenable to investigation with controlled animal models and identifying areas where integrating animal and human studies can improve our understanding of the psychological burden and health impacts of food insecurity. In the interest of brevity, this review will largely focus on food insecurity in the United States, as the factors that contribute to food insecurity vary considerably across the globe.
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Affiliation(s)
- Kevin P Myers
- Department of Psychology, Animal Behavior & Neuroscience Programs, Bucknell University, Lewisburg, PA, USA.
| | - Jennifer L Temple
- Departments of Exercise and Nutrition Sciences, Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
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Gance-Cleveland B, Frenn M, Browne N, Greenberg CS, Snethen JA, Hodges EA, Fial AV, Small L, Irving SY. A scoping review of the role of policy in mitigating childhood obesity in underserved populations using the RE-AIM framework. Worldviews Evid Based Nurs 2024; 21:445-453. [PMID: 38584314 DOI: 10.1111/wvn.12725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Childhood obesity is an escalating crisis in the United States. Health policy may impact this epidemic which disproportionally affects underserved populations. AIM The aim was to use the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework to assess health policy impact on preventing or treating school-aged children (5 > 18 years) with obesity in underserved populations. METHODS A scoping review of 842 articles was conducted. Twenty-four articles met the inclusion criteria and underwent data extraction. RESULTS Twelve studies included subgroup analysis, with four suggesting an impact of policy on at-risk groups. None of the 24 studies fully applied the RE-AIM framework. Policies positively impacted childhood obesity in 12 studies across the sample. LINKING EVIDENCE TO ACTION Our review revealed inconsistent evidence for the effectiveness of policy on childhood obesity, perhaps due to the lack of focus on the social determinants of health. In addition, many studies did not evaluate the outcomes for underserved populations. Therefore, we propose more attention to social determinants in future legislation and evaluation of policy effectiveness on underserved populations. Findings identify an urgent need for the design, implementation, and evaluation of policies specifically directed to address the inequities of racism, social injustices, and social determinants of health that impact childhood obesity in the United States. Future work needs to identify who was reached by the policy, who benefitted from the policy, and how policies were implemented to address obesity-related health disparities. Nurses should advocate for the evaluation of childhood obesity policies, particularly in underserved populations, to determine effectiveness. Nurses, particularly those trained in population and community health and research, should advocate for policy research that considers inequities rather than controls for these variables. Multi-layered interventions can then be tailored to sub-populations and evaluated more effectively.
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Affiliation(s)
- Bonnie Gance-Cleveland
- University of Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marilyn Frenn
- Marquette University College of Nursing, Milwaukee, Wisconsin, USA
| | | | | | - Julia A Snethen
- University of Wisconsin-Milwaukee, School of Nursing, Milwaukee, Wisconsin, USA
| | - Eric A Hodges
- The University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, North Carolina, USA
| | - Alissa V Fial
- Marquette University, Raynor Memorial Libraries, Milwaukee, Wisconsin, USA
| | - Leigh Small
- Michigan State University College of Nursing, East Lansing, Michigan, USA
| | - Sharon Y Irving
- University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania, USA
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Xavier JFDS, Feuerstein SC, De Moraes ACF, de Oliveira TA, da Silva Gomes ER, de Almeida Silva MIA, de Oliveira LF, de Carvalho HB, Marin KA, Nascimento-Ferreira MV. Development of a User-Friendly Self-Screening Tool for Assessing Metabolic Syndrome Risk in Youths from Economically Challenged Regions. J Pers Med 2024; 14:810. [PMID: 39202001 PMCID: PMC11355849 DOI: 10.3390/jpm14080810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Metabolic syndrome increases the risk of heart disease and diabetes. Early identification and management are crucial, especially in economically challenged regions with limited healthcare access. AIMS To develop nomograms for individualized risk estimation for metabolic syndrome in young people from low-income regions. METHODS We assessed 496 college students from two Brazilian cities with Gini indices ≤0.56. Of these, 69.9% were female, 65.1% were younger than 20 years, 71.8% were non-white, and 64.3% were enrolled in health-related courses. For external validity, we assessed metabolic syndrome in a subset of 375 students. RESULTS We found 10 variables associated with abdominal obesity by logistic regression: age, biological sex, physical education facilities, enrollment in sports competitions during elementary school, grade retention, physical education as the preferred subject, physical education classes per week, and enrollment in sports training in secondary school (score A); adherence to 24 h movement behaviors (B score); and body weight (score C). We designed three nomograms (for scores A, B, and C), all of which showed acceptable performance according to the area under the receiver operating characteristic curve (≥0.70) and calibration (Hosmer-Lemeshow test, p > 0.05). In the external validation, we observed higher predictive capability for the A and B scores, while the C score had lower but still acceptable predictive ability. CONCLUSIONS User-friendly self-reported data accurately predict metabolic syndrome among youths from economically challenging areas.
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Affiliation(s)
- Jacqueline Fernandes de Sa Xavier
- Health, Physical Activity and Behavior Research (HEALTHY-BRA) Group, Universidade Federal do Tocantins, Miracema do Tocantins 77650-000, Brazil; (J.F.d.S.X.); (S.C.F.); (E.R.d.S.G.); (M.I.A.d.A.S.); (L.F.d.O.); (K.A.M.)
| | - Shirley C. Feuerstein
- Health, Physical Activity and Behavior Research (HEALTHY-BRA) Group, Universidade Federal do Tocantins, Miracema do Tocantins 77650-000, Brazil; (J.F.d.S.X.); (S.C.F.); (E.R.d.S.G.); (M.I.A.d.A.S.); (L.F.d.O.); (K.A.M.)
| | - Augusto Cesar Ferreira De Moraes
- Texas PARC—Texas Physical Activity Research Collaborative Lab, Michael and Susan Dell Center for Healthy Living, Department of Epidemiology, School of Public Health in Austin, The University of Texas Health Science Center at Houston, Austin, TX 78701, USA;
| | | | - Evellyn Ravena da Silva Gomes
- Health, Physical Activity and Behavior Research (HEALTHY-BRA) Group, Universidade Federal do Tocantins, Miracema do Tocantins 77650-000, Brazil; (J.F.d.S.X.); (S.C.F.); (E.R.d.S.G.); (M.I.A.d.A.S.); (L.F.d.O.); (K.A.M.)
- Instituto de Ensino Superior do Sul do Maranhão (IESMA/UNISULMA), Imperatriz 65907-070, Brazil
| | - Maria Isabela Alves de Almeida Silva
- Health, Physical Activity and Behavior Research (HEALTHY-BRA) Group, Universidade Federal do Tocantins, Miracema do Tocantins 77650-000, Brazil; (J.F.d.S.X.); (S.C.F.); (E.R.d.S.G.); (M.I.A.d.A.S.); (L.F.d.O.); (K.A.M.)
- Instituto de Ensino Superior do Sul do Maranhão (IESMA/UNISULMA), Imperatriz 65907-070, Brazil
| | - Luiz Fernando de Oliveira
- Health, Physical Activity and Behavior Research (HEALTHY-BRA) Group, Universidade Federal do Tocantins, Miracema do Tocantins 77650-000, Brazil; (J.F.d.S.X.); (S.C.F.); (E.R.d.S.G.); (M.I.A.d.A.S.); (L.F.d.O.); (K.A.M.)
| | - Heraclito Barbosa de Carvalho
- YCARE (Youth/Child and Cardiovascular Risk and Environmental) Research Group, School of Medicine, University of Sao Paulo, São Paulo 17012-900, Brazil;
| | - Kliver Antonio Marin
- Health, Physical Activity and Behavior Research (HEALTHY-BRA) Group, Universidade Federal do Tocantins, Miracema do Tocantins 77650-000, Brazil; (J.F.d.S.X.); (S.C.F.); (E.R.d.S.G.); (M.I.A.d.A.S.); (L.F.d.O.); (K.A.M.)
| | - Marcus Vinicius Nascimento-Ferreira
- Health, Physical Activity and Behavior Research (HEALTHY-BRA) Group, Universidade Federal do Tocantins, Miracema do Tocantins 77650-000, Brazil; (J.F.d.S.X.); (S.C.F.); (E.R.d.S.G.); (M.I.A.d.A.S.); (L.F.d.O.); (K.A.M.)
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Cobal S, Bender DV, Kljusurić JG, Rumora Samarin I, Krznarić Ž. Effect of School-Based Educational Intervention on Childhood Obesity in Croatian Urban and Rural Settings. CHILDREN (BASEL, SWITZERLAND) 2024; 11:867. [PMID: 39062316 PMCID: PMC11276343 DOI: 10.3390/children11070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based "PETICA-Play for Health" obesity prevention program in urban and rural areas in Croatia. METHODS This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. "PETICA" multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student's t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman's correlation, and heatmaps were used. RESULTS The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents' and children's physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. CONCLUSION The study shows that "PETICA" is an efficient school-based educational model that contributes to positive changes in children's knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention.
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Affiliation(s)
- Sara Cobal
- Croatian Medical Association, Šubićeva 9, 10 000 Zagreb, Croatia;
| | - Darija Vranešić Bender
- Unit of Clinical Nutrition, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia;
| | - Jasenka Gajdoš Kljusurić
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.G.K.); (I.R.S.)
| | - Ivana Rumora Samarin
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (J.G.K.); (I.R.S.)
| | - Željko Krznarić
- Croatian Medical Association, Šubićeva 9, 10 000 Zagreb, Croatia;
- Unit of Clinical Nutrition, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10 000 Zagreb, Croatia;
- School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia
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Dhanjani S, Allen H, Varman B, Callender C, Dave JM, Thompson D. Community-Based Participatory Obesity Prevention Interventions in Rural Communities: A Scoping Review. Nutrients 2024; 16:2201. [PMID: 39064643 PMCID: PMC11279648 DOI: 10.3390/nu16142201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
Child obesity is a worldwide public health concern. In America, children from rural areas have greater odds of obesity in comparison to those from urban areas. Community-engaged research is important for all communities, particularly under-represented communities. This paper reports the results of a scoping review investigating community-engaged research in obesity prevention programs tested with school-aged children in rural America. A literature search of Medline Ovid was conducted to identify interventions reporting the results of obesity prevention interventions that promoted a healthy diet or physical activity (PA) behaviors to school-age children in rural communities of the United States (US). After title and abstract review, potentially relevant citations were further examined by assessing the full text. Each stage of review was conducted by two independent reviewers. Twelve studies met the inclusionary criteria and are included in this review. Most of the studies focused on elementary school participants (n = 7) and improving both diet and PA (n = 9). Out of the twelve studies, only five included the target audience in intervention development or implementation. The most popular type of community engagement was community participation (n = 4). This review revealed that community-engaged research is under-utilized in obesity prevention interventions tested with school-aged children in rural US communities.
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Affiliation(s)
- Saagar Dhanjani
- Department of Natural Science, Rice University, Houston, TX 77005, USA; (S.D.); (H.A.)
| | - Haley Allen
- Department of Natural Science, Rice University, Houston, TX 77005, USA; (S.D.); (H.A.)
| | - Beatriz Varman
- The Texas Medical Center Library, Houston, TX 77030, USA;
| | - Chishinga Callender
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (C.C.); (J.M.D.)
| | - Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (C.C.); (J.M.D.)
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (C.C.); (J.M.D.)
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Dave JM, Chen TA, Castro AN, White MA, Onugha EA, Zimmerman S, Thompson D. Urban-Rural Disparities in Food Insecurity and Weight Status among Children in the United States. Nutrients 2024; 16:2132. [PMID: 38999879 PMCID: PMC11243017 DOI: 10.3390/nu16132132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Place of residence (urban versus rural) is a contextual determinant of health that has received less attention in the food insecurity literature. The purpose of this study was to assess the urban-rural disparity in the prevalence of food insecurity and weight status among US children. Using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 with three age groups of children (2-5, 6-11, and 12-17 years old), the associations of weight status and child and household food security status by urban-rural residence were examined using Rao-Scott Chi-square tests. Statistical significance was set at p < 0.05. Children living in urban areas were significantly more likely to experience household food insecurity (29.15%) compared to their rural counterparts (19.10%), among those aged 6-11 years. The associations between children's weight status and child and household food security status were significant for children living in urban areas overall and different age groups but not for children living in rural areas. These trends were more pronounced in older age groups. Given the link between food insecurity and higher obesity rates, particularly among urban children, this study highlights the importance of incorporating food security interventions into future obesity prevention programs.
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Affiliation(s)
- Jayna M Dave
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Tzuan A Chen
- Department of Psychological, Health, and Learning Sciences, University of Houston, 3657 Cullen Boulevard, Houston, TX 77204, USA
- HEALTH Research Institute, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX 77204, USA
| | - Alexandra N Castro
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Mamie A White
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
| | - Elizabeth A Onugha
- Renal Services, Texas Children's Hospital, 1102 Bates Avenue, Houston, TX 77030, USA
- Department of Pediatrics-Nephrology, Baylor College of Medicine, 1102 Bates Avenue, Houston, TX 77030, USA
| | - Sloane Zimmerman
- Department of Pediatrics-Gastroenterology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA
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McCabe CF, Wood GC, Franceschelli-Hosterman J, Bailey-Davis L. Childhood Obesity and Early Body Mass Index Gains Associated with COVID-19 in a Large Rural Health System. Acad Pediatr 2024; 24:832-836. [PMID: 38190886 DOI: 10.1016/j.acap.2023.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To evaluate body mass index (BMI) change among a population of children with a high proportion residing in rural areas across two pandemic time periods. METHODS Electronic health records were evaluated in a rural health system. INCLUSION CRITERIA 2-17 years at initial BMI; >2 BMIs during pre-pandemic (January 1, 2018-February 29, 2020); >1 BMI in early pandemic (June 1, 2020-December 31, 2020); and >1 BMI in later pandemic (January 1, 2021-December 31, 2021). Mixed effects linear regression models were used to estimate average monthly rate of change in BMI slope (∆BMI) from pre-pandemic to pandemic and test for effect modification of sex, race/ethnicity, age, BMI, public insurance, and rural address. RESULTS Among the 40,627 participants, 50.2% were female, 84.6% were non-Hispanic white, 34.9% used public insurance, and 42.5% resided in rural areas. The pre-pandemic proportion of children with overweight, obesity, and severe obesity was 15.6%, 12.8%, and 6.3%, respectively. The ∆BMI nearly doubled during the early pandemic period compared with the pre-pandemic period (0.102 vs 0.055 kg/m2), however, ∆BMI in the later pandemic was lower (0.040 vs 0.055 kg/m2). ∆BMI remained higher in the later pandemic for all race categories compared to Non-Hispanic white. Children with public insurance had higher ∆BMI compared to those with private insurance that remained higher in the later pandemic (0.051 vs 0.035 kg/m2). There was no significant difference between ∆BMI for rural and urban children during pandemic periods. CONCLUSIONS Despite the decreased ∆BMI among children in the later pandemic, prevalence of obesity and severe obesity remain high. Efforts must continue to be made to limit excess weight gain during childhood and to assess the impact of forces like structural and social factors in both etiology and prevention.
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Affiliation(s)
- Carolyn F McCabe
- Department of Population Health Sciences (CF McCabe and L Bailey-Davis), Geisinger, Danville, Pa; Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa
| | - G Craig Wood
- Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa
| | - Jennifer Franceschelli-Hosterman
- Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa; Nutrition and Weight Management (J Franceschelli-Hosterman), Geisinger Medical Center, Danville, Pa
| | - Lisa Bailey-Davis
- Department of Population Health Sciences (CF McCabe and L Bailey-Davis), Geisinger, Danville, Pa; Center for Obesity and Metabolic Research (CF McCabe, G Craig Wood, J Franceschelli-Hosterman, and L Bailey-Davis), Geisinger, Danville, Pa.
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Gosadi IM. Body weight modification experience among adolescents from Saudi Arabia. Front Public Health 2024; 12:1323660. [PMID: 38706541 PMCID: PMC11066232 DOI: 10.3389/fpubh.2024.1323660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/10/2024] [Indexed: 05/07/2024] Open
Abstract
Background Childhood malnutrition is a public health issue in developing countries, leading to a double burden of malnutrition, which is associated with both overweight and underweight. Objective To assess body weight satisfaction and perception as well as body weight modification experiences, among adolescents from Saudi Arabia. Method This study utilized a cross-sectional design targeting adolescents who attempted to modify their body weight. A questionnaire was constructed to measure their demographics, body weight satisfaction and perception, and experience concerning their weight modification attempts. The chi-square test was used to assess the association between the ability to modify weight and maintain the modification according to the ability to set an appropriate weight target based on the age and height of the adolescents, method of weight modification, and receipt of support to modify weight. Results A total of 285 adolescents were recruited. More than half of the sample were female (58%); most respondents were secondary school students (73%). Nearly 45% had abnormal body weight where 12.6% were underweight, and 32.3% were overweight or obese. Most of the recruited sample were unsatisfied with their body weight (63%). Although 52% of the adolescents had a normal BMI, only 35% perceived their body weight as normal. Nearly 75% of the sample were able to modify their body weight. However, a smaller proportion were able to maintain the modification they achieved. The most frequently selected body weight modification method was dieting (83%), followed by exercise (69%). Only 40 adolescents (14%) reported consulting a physician regarding their body weight modification attempts. The most frequently reported source of support for weight modification was the family (51%), while the lowest frequency of support was reported concerning schools' contribution (29%). Upon assessing factors associated with the ability to modify weight or maintain the modification, a higher frequency of adolescents who indicated they employed dieting behavior were able to maintain the modification compared to other weight modification practices (p < 0.05). Conclusion The findings highlight the importance of collaboration between families, schools, and healthcare services to improve adolescent body image and ensure the adoption of healthy body weight modification practices among adolescents.
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Affiliation(s)
- Ibrahim M. Gosadi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Dave JM, Chen TA, Castro AN, White M, Onugha EA, Zimmerman S, Thompson D. Regional Variability in the Prevalence of Food Insecurity and Diet Quality among United States Children. Nutrients 2024; 16:224. [PMID: 38257117 PMCID: PMC10819603 DOI: 10.3390/nu16020224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/29/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Understanding the association between food security status (FSS) and diet quality in children is crucial. This study investigated regional variability in FSS, participation in the federal nutrition assistance program (FNAP), and diet quality among US children. National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2016 were analyzed. The association between FSS, FNAP participation, and diet quality (Healthy Eating Index-HEI-2015) was assessed using multiple linear/logistic regression models. The sample included 6403 children (mean age: 7.5 years; 51% male; 33% Hispanic). Within the sample, 13% reported child food insecurity, and 30% reported household food insecurity. Additionally, 90% participated in the FNAP, and 88% were enrolled in school lunch programs. Children in urban areas were significantly more likely to report household food insecurity than those in rural areas (29.15% vs. 19.10%). The overall HEI-2015 score was 48.2. The associations between child/household FSS and FNAP participation as well as between child/household FSS and diet quality did not differ by urban/rural residence status, irrespective of the children's age groups. There is a need for improvement in children's diet quality, regardless of age or urban/rural residence. The findings suggest that improving children's diets requires broader action as well as the prioritizing of children in urban areas experiencing food insecurity in future dietary interventions.
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Affiliation(s)
- Jayna M. Dave
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
| | - Tzuan A. Chen
- Department of Psychological, Health, and Learning Sciences, University of Houston, 3657 Cullen Boulevard, Houston, TX 77204, USA;
- HEALTH Research Institute, University of Houston, 4349 Martin Luther King Boulevard, Houston, TX 77204, USA
| | - Alexandra N. Castro
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
| | - Mamie White
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
| | - Elizabeth A. Onugha
- Renal Services, Texas Children’s Hospital, 1102 Bates Avenue, Houston, TX 77030, USA;
- Department of Pediatrics—Nephrology, Baylor College of Medicine, 1102 Bates Avenue, Houston, TX 77030, USA
| | - Sloane Zimmerman
- Department of Pediatrics—Gastroenterology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA;
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030, USA; (A.N.C.); (M.W.); (D.T.)
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