Parent meal self-efficacy and practices in households with healthy home food environments in the face of economic hardship

Some families who experience economic hardship demonstrate remarkable strength and resourcefulness to sustain a healthy home food environment. This ability to navigate economic barriers could be associated with parent meal practices that promote children's healthful dietary intake. Therefore, this study aimed to examine 1) whether parent meal self-efficacy and practices were associated with economic assistance status and home fruit and vegetable (FV) availability and 2) how parent meal self-efficacy and practices differed by home FV availability and economic assistance status. Analyses utilized baseline data from 274 parent/child dyads from two childhood obesity prevention trials: HOME Plus (urban) and NU-HOME (rural). Parents in households with high FV availability (regardless of economic assistance) had significantly higher self-efficacy in preparing healthy foods, family dinner routines, frequency of child's plate being half filled with FV, frequency of family dinner and breakfast, and lower frequency of purchasing dinner from fast food restaurants. Economic assistance was not associated with parent meal self-efficacy and practices. Four family groups were created and defined by economic assistance (yes/no) and home FV availability (high/low). About 31% of families that received economic assistance and had high home FV availability were food insecure. Families (n = 39) receiving economic assistance and having high home FV availability had greater frequency of family dinners compared to those in households with economic assistance and low home FV availability (n = 47) (p = 0.001); no other parent meal self-efficacy or practices differed between groups. Our findings suggest some families can maintain healthy home food environments despite economic hardship and frequent family dinners may be an important strength for these families. More research is needed to investigate asset-based models to understand the family strengths that enable them to thrive during difficult times.

Characteristics associated with persistent versus transient food insecurity among US veterans screened in the Veteran Health Administration

BACKGROUND

Awareness of negative health impacts associated with food insecurity among US veterans is growing. Yet, little research has examined characteristics associated with persistent versus transient food insecurity.

OBJECTIVE

To investigate characteristics associated with persistent versus transient food insecurity among US veterans.

DESIGN

The study used a retrospective, observational design to examine data from Veteran Health Administration (VHA) electronic medical records.

PARTICIPANTS/SETTING

The sample consisted of veterans (N=64,789) who screened positive for food insecurity in VHA primary care during fiscal years 2018-2020 and were rescreened within 3-15 months.

MAIN OUTCOME MEASURES

Food insecurity was operationalized using the VHA food insecurity screening question. Transient food insecurity was a positive screen followed by a consecutive negative screen within 3-15 months. Persistent food insecurity was a positive screen followed by a consecutive positive screen within 3-15 months.

STATICAL ANALYSES

A multivariable logistic regression model was used to assess characteristics (e.g., demographics, disability rating, homelessness, physical and mental health conditions) associated with persistent versus transient food insecurity.

RESULTS

Veterans with increased odds of persistent versus transient food insecurity included men (AOR=1.08, 95%CI[1.01, 1.15]) and those from Hispanic (AOR=1.27, 95%CI[1.18, 1.37]) or Native American (AOR=1.30, 95%CI[1.11, 1.53]) racial/ethnic groups. Psychosis (AOR=1.16, 95%CI[1.06, 1.26]), substance use disorder excluding tobacco/alcohol (AOR=1.11, 95%CI[1.03, 1.20]), and homelessness (AOR=1.32, 95%CI[1.26, 1.39]) were associated with increased odds of persistent versus transient food insecurity. Veterans who were married (AOR=0.87, 95%CI[0.83, 0.92]) or had service-connected disability rating of 70-99% (AOR=0.85, 95%CI[0.79, 0.90]) or 100% (AOR=0.77, 95%CI[0.71, 0.83]) had lower odds of persistent versus transient food insecurity.

CONCLUSIONS

Veterans at risk for persistent versus transient food insecurity may struggle with underlying issues like psychosis, substance use, and homelessness alongside racial/ethnic inequities and gender differences. More research is needed to understand characteristics and mechanisms that increase risk for persistent versus transient food insecurity among veterans.

Weight outcomes of NU-HOME: a randomized controlled trial to prevent obesity among rural children

BACKGROUND

Rural children are at greater obesity risk than their urban peers. The NU-HOME study is an innovative collaborative effort to prevent childhood obesity in rural communities. Weight outcomes of the NU-HOME study, a family-meal focused randomized controlled trial (RCT) are described. We hypothesized that compared to control group children, intervention group children would have significantly lower weight-related post-intervention (PI) outcomes.

METHODS

Participants were 114 dyads (7-10 year-old rural children and a parent). In 2017-2018 and 2018-2019, research staff measured height, weight and body fat at baseline (BL) and PI. Families were randomized to intervention (n = 58) or control (n = 56) groups without blinding. Designed with Social Cognitive Theory and community engagement, the NU-HOME program included seven monthly sessions delivered in community settings and four goal-setting calls. The program engaged entire families to improve healthy eating, physical activity, family meals and the home food environment. Multiple linear and logistic regression models tested PI outcomes of child BMIz-score, percent body fat, percent over 50th percentile BMI, and overweight/obesity status by treatment group, adjusted for BL values and demographics (n = 102).

RESULTS

No statistically significant intervention effects were seen for child BMIz or overweight/obesity status. However, a promising reduction in boys' percent body fat (- 2.1, 95% CI [- 4.84, 0.63]) was associated with the intervention.

CONCLUSIONS

Although our findings were in the hypothesized direction, making significant impacts on weight-related outcomes remains challenging in community trials. Comprehensive family-focused programming may require intensive multi-pronged interventions to mitigate complex factors associated with excess weight gain.

CLINICAL TRIAL REGISTRATION

This study is registered with NIH ClinicalTrials.gov: NCT02973815 .

Family-focused obesity prevention program implementation in urban versus rural communities: a case study

Purpose

Despite public health efforts to reduce childhood obesity, there remains an unequal distribution of obesity among rural and urban children, with higher rates in rural areas. However, few studies have compared differences in program delivery. This paper aims to describe differences between an urban and rural program delivery of a family-focused, community-based intervention program to prevent and reduce obesity among children.

Methods

This paper uses a case study format to provide a descriptive analysis of similar obesity prevention programs, designed by the same research team, implemented in Minnesota in different settings (i.e., an urban and rural setting) with significant community engagement in the adaptation process. The rural NU-HOME program is compared to HOME-Plus, an urban family-based obesity prevention program for school-aged children.

Results

Community engagement in the adaptation process of an urban program to a rural program confirmed some anticipated program content and delivery similarities while identifying key differences that were necessary for adaptation related to engagement with the community, recruitment and data collection, and intervention delivery.

Discussion

When adapting research-tested programs from urban to rural areas, it is important to identify the modifiable behavioral, social, and environmental factors associated with obesity to ensure the content of effective childhood obesity prevention programs is relevant. Customizing a program to meet the needs of the community may increase reach, engagement, and sustainability. In addition, long-term dissemination of a tailored program may significantly reduce childhood obesity in rural communities and be implemented in other rural settings nationally.

Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial

BACKGROUND

Research has demonstrated a significant positive association between frequent family meals and children's dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial.

OBJECTIVE

To describe family home food environment and nutrition-related parent and child personal and behavioral outcomes of the Healthy Home Offerings via the Mealtime Environment Plus program, the first rigorously tested family meals intervention targeting childhood obesity prevention.

DESIGN

Randomized controlled trial. Baseline, postintervention (12 months, 93% retention), and follow-up (21 months, 89% retention) data (surveys and dietary recalls) were collected.

PARTICIPANTS/SETTING

Children aged 8 to 12 years (N=160) and their parents were randomized to intervention (n=81) or control (n=79) groups.

INTERVENTION

The intervention included five parent goal-setting calls and 10 monthly sessions delivered to families in community settings that focused on experiential nutrition activities and education, meal planning, cooking skill development, and reducing screen time.

MAIN OUTCOME MEASURES

Family home food environment outcomes and nutrition-related child and parent personal and behavioral outcomes.

STATISTICAL ANALYSES PERFORMED

Analyses used generalized linear mixed models. Primary comparisons were contrasts between intervention and control groups at postintervention and follow-up, with adjustments for child age and parent education.

RESULTS

Compared with control parents, intervention parents showed greater improvement over time in scores of self-efficacy for identifying appropriate portion sizes, with significant differences in adjusted means at both post-intervention (P=0.002) and follow-up (P=0.01). Intervention children were less likely to consume at least one sugar-sweetened beverage daily at post-intervention than control children (P=0.04).

CONCLUSIONS

The Healthy Home Offerings via the Mealtime Environment Plus program involved the entire family and targeted personal, behavioral, and environment factors important for healthful changes in the home food environment and children's dietary intake. The intervention improved two nutrition-related behaviors and this may inform the design of future family meal interventions.

An Exploration of How Family Dinners Are Served and How Service Style Is Associated With Dietary and Weight Outcomes in Children

OBJECTIVE

To explore how families serve meals and how different service styles are associated with responsive feeding and child dietary and weight outcomes.

METHODS

Baseline data from a subset (n = 75) of randomized controlled trial participants (Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, aged 8-12 years) were analyzed using a series of linear regression models. Adjusted means (95% confidence intervals) and beta coefficients (SEs) are presented.

RESULTS

Families were most likely to report plated meal service (36% of families), followed by family-style (29%). Family-style was significantly associated with a lower mean level of food restriction (P = .01). No significant associations were observed between style of meal service and child outcomes (all P > .05).

CONCLUSIONS AND IMPLICATIONS

Although plated meal service may seem like a desirable strategy for ensuring that children eat a healthier diet, the current results did not provide support for this association. Evidence was found to support the use of family-style meal service to promote the use of responsive feeding.

Promoting healthful family meals to prevent obesity: HOME Plus, a randomized controlled trial

Background

Family meal frequency has been shown to be strongly associated with better dietary intake; however, associations with weight status have been mixed. Family meals-focused randomized controlled trials with weight outcomes have not been previously conducted. Therefore, this study purpose was to describe weight-related outcomes of the HOME Plus study, the first family meals-focused randomized controlled trial to prevent excess weight gain among youth.

Methods

Families (n = 160 8-12-year-old children and their parents/guardians) were randomized to intervention (n = 81) or control (n = 79) groups. Data were collected at baseline (2011–2012), post-intervention (12-months post-baseline) and follow-up (21-months post-baseline). The intervention included ten monthly group sessions (nutrition education; hands-on meal and snack planning, preparation, and skill development; screen time reductions) and five motivational, goal-setting phone calls. The main outcome was child body mass index (BMI) z-score.

Results

General linear models, adjusted for baseline values and demographics, showed no significant treatment group differences in BMI z-scores at post-intervention or follow-up; however, a promising reduction in excess weight gain was observed. Post-hoc stratification by pubertal onset indicated prepubescent children in the intervention group had significantly lower BMI z-scores than their control group counterparts.

Conclusions

The study used a strong theoretical framework, rigorous design, quality measurement and a program with high fidelity to test a family meals-focused obesity prevention intervention. It showed a modest decrease in excess weight gain. The significant intervention effect among prepubescent children suggests the intervention may be more efficacious among relatively young children, although more research with appropriately powered samples are needed to replicate this finding.

Trial registration

This study is registered at www.clinicaltrials.gov NCT01538615. Registered 01/17/2012.

Physiological predictors of long-term survival in juvenile Steller sea lions (Eumetopias jubatus)

This study builds on a continued effort to document potential long-term research impacts on the individual, as well as to identify potential markers of survival for use in a field framework. The Transient Juvenile Steller sea lion (TJ) project was developed as a novel framework to gain access to wild individuals. We used three analyses to evaluate and predict long-term survival in temporarily captive sea lions (n = 45) through Cormack-Jolly-Seber open population modelling techniques. The first analysis investigated survival in relation to the observed responses to handling stress through changes in six principal blood parameters over the duration of captivity. The second analysis evaluated survival compared with body condition and mass at entry and exit from captivity. Finally, the third analysis sought to evaluate the efficacy of single-point sampling to project similar survival trends for use in field sampling operations. Results from a priori models ranked through Akaike information criterion model selection methods indicated that mass gains (4.2 ± 12%) over captivity and increases in leucocytes (WBC, 1.01 ± 3.54 × 10(3)/mm(3)) resulted in a higher average survival rate (>3 years). Minor support was identified for the single-point measures of exit mass and entry WBC. A higher exit mass predicted a higher survival rate, whereas a higher WBC predicted a lower survival rate. While changes in mass and WBC appear to be the best predictors of survival when measured as a change over time, single-point sampling may still be an effective way to improve estimates of population health.

Summing the strokes: energy economy in northern elephant seals during large-scale foraging migrations

BACKGROUND

The energy requirements of free-ranging marine mammals are challenging to measure due to cryptic and far-ranging feeding habits, but are important to quantify given the potential impacts of high-level predators on ecosystems. Given their large body size and carnivorous lifestyle, we would predict that northern elephant seals (Mirounga angustirostris) have elevated field metabolic rates (FMRs) that require high prey intake rates, especially during pregnancy. Disturbance associated with climate change or human activity is predicted to further elevate energy requirements due to an increase in locomotor costs required to accommodate a reduction in prey or time available to forage. In this study, we determined the FMRs, total energy requirements, and energy budgets of adult, female northern elephant seals. We also examined the impact of increased locomotor costs on foraging success in this species.

RESULTS

Body size, time spent at sea and reproductive status strongly influenced FMR. During the short foraging migration, FMR averaged 90.1 (SE = 1.7) kJ kg(-1)d(-1) - only 36 % greater than predicted basal metabolic rate. During the long migration, when seals were pregnant, FMRs averaged 69.4 (±3.0) kJ kg(-1)d(-1) - values approaching those predicted to be necessary to support basal metabolism in mammals of this size. Low FMRs in pregnant seals were driven by hypometabolism coupled with a positive feedback loop between improving body condition and reduced flipper stroking frequency. In contrast, three additional seals carrying large, non-streamlined instrumentation saw a four-fold increase in energy partitioned toward locomotion, resulting in elevated FMRs and only half the mass gain of normally-swimming study animals.

CONCLUSIONS

These results highlight the importance of keeping locomotion costs low for successful foraging in this species. In preparation for lactation and two fasting periods with high demands on energy reserves, migrating elephant seals utilize an economical foraging strategy whereby energy savings from reduced locomotion costs are shuttled towards somatic growth and fetal gestation. Remarkably, the energy requirements of this species, particularly during pregnancy, are 70-80 % lower than expected for mammalian carnivores, approaching or even falling below values predicted to be necessary to support basal metabolism in mammals of this size.

HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity

Background

Involvement in meal preparation and eating meals with one’s family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at improving and increasing family meals are needed. This paper presents the design of key intervention components and process evaluation of a community-based program (Healthy Home Offerings via the Mealtime Environment (HOME) Plus) to prevent obesity.

Methods

The HOME Plus intervention was part of a two-arm (intervention versus attention-only control) randomized-controlled trial. Ten monthly, two-hour sessions and five motivational/goal-setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based settings in the Minneapolis/St. Paul, MN metropolitan area. The present study included 81 families (8-12 year old children and their parents) in the intervention condition. Process surveys were administered at the end of each intervention session and at a home visit after the intervention period. Chi-squares and t-tests were used for process survey analysis.

Results

The HOME Plus program was successfully implemented and families were highly satisfied. Parents and children reported that the most enjoyable component was cooking with their families, learning how to eat more healthfully, and trying new recipes/foods and cooking tips. Average session attendance across the ten months was high for families (68%) and more than half completed their home activities.

Conclusions

Findings support the value of a community-based, family-focused intervention program to promote family meals, limit screen time, and prevent obesity.

Trial registration

NCT01538615

A review of associations between family or shared meal frequency and dietary and weight status outcomes across the lifespan

OBJECTIVE

To summarize the research literature on associations between family meal frequency and dietary outcomes as well as weight status across the lifespan.

METHODS

Reviewed literature of family or shared meals with dietary and weight outcomes in youth, adults, and older adults.

RESULTS

Across the lifespan, eating with others, particularly family, is associated with healthier dietary outcomes. Among children and adolescents, these findings appear to be consistent for both boys and girls, whereas mixed findings are seen by gender for adult men and women. The findings of associations between family or shared meals and weight outcomes across the lifespan are less consistent and more complicated than those of dietary outcomes.

CONCLUSIONS AND IMPLICATIONS

Now is the time for the field to improve understanding of the mechanisms involved in the positive associations seen with family meal frequency, and to move forward with implementing interventions aimed at increasing the frequency of, and improving the quality of, food served at family meals, and evaluating their impact. Given the more limited findings of associations between family or shared meals and weight outcomes, capitalizing on the positive benefits of family and shared meals while addressing the types of foods served, portion sizes, and other potential mechanisms may have a significant impact on obesity prevention and reduction. Future research recommendations are provided.

Sink or swim: strategies for cost-efficient diving by marine mammals

Locomotor activity by diving marine mammals is accomplished while breath-holding and often exceeds predicted aerobic capacities. Video sequences of freely diving seals and whales wearing submersible cameras reveal a behavioral strategy that improves energetic efficiency in these animals. Prolonged gliding (greater than 78% descent duration) occurred during dives exceeding 80 meters in depth. Gliding was attributed to buoyancy changes with lung compression at depth. By modifying locomotor patterns to take advantage of these physical changes, Weddell seals realized a 9.2 to 59.6% reduction in diving energetic costs. This energy-conserving strategy allows marine mammals to increase aerobic dive duration and achieve remarkable depths despite limited oxygen availability when submerged.

Lunar cycles in diel prey migrations exert a stronger effect on the diving of juveniles than adult Galápagos fur seals

In our study of the development of diving in Galápagos fur seals, we analysed changes in diving activity and body mass trends over the lunar cycle. Based on previously observed lunar cycles in colony attendance patterns, we hypothesized a greater impact of prey migrations of deep scattering layer organisms on younger fur seals. Using electronic dive recorders, we determined that seals dived less and deeper on moonlit nights than at new moon, and incurred body mass losses. These changes in foraging over the lunar cycle correlate with the suppression of the vertical migration of prey by lunar light. All effects were more pronounced in juveniles than adult females, with greater relative mass loss during full moon, which must (i) negatively affect long-term juvenile growth rates, (ii) lengthen periods of maternal dependence, and (iii) contribute to the lowest reproductive rate reported for seals. This underlines the importance of studying ontogeny in order to understand life histories, and for determining the susceptibility of animal populations to fluctuations in food availability.

Development of diving capacity in emperor penguins

To compare the diving capacities of juvenile and adult emperor penguins Aptenodytes forsteri, and to determine the physiological variables underlying the diving ability of juveniles, we monitored diving activity in juvenile penguins fitted with satellite-linked time/depth recorders and examined developmental changes in body mass (Mb), hemoglobin concentration, myoglobin (Mb) content and muscle citrate synthase and lactate dehydrogenase activities. Diving depth, diving duration and time-at-depth histograms were obtained from two fledged juveniles during the first 2.5 months after their depature from the Cape Washingon colony in the Ross Sea, Antarctica. During this period, values of all three diving variables increased progressively. After 8–10 weeks at sea, 24–41 % of transmitted maximum diving depths were between 80 and 200 m. Although most dives lasted less than 2 min during the 2 month period, 8–25 % of transmitted dives in the last 2 weeks lasted 2–4 min. These values are lower than those previously recorded in adults during foraging trips. Of the physiological variables examined during chick and juvenile development, only Mb and Mb content did not approach adult values. In both near-fledge chicks and juveniles, Mb was 50–60 % of adult values and Mb content was 24–31 % of adult values. This suggests that the increase in diving capacity of juveniles at sea will be most dependent on changes in these factors.

Hunting behavior of a marine mammal beneath the antarctic fast Ice

The hunting behavior of a marine mammal was studied beneath the Antarctic fast ice with an animal-borne video system and data recorder. Weddell seals stalked large Antarctic cod and the smaller subice fish Pagothenia borchgrevinki, often with the under-ice surface for backlighting, which implies that vision is important for hunting. They approached to within centimeters of cod without startling the fish. Seals flushed P. borchgrevinki by blowing air into subice crevices or pursued them into the platelet ice. These observations highlight the broad range of insights that are possible with simultaneous recordings of video, audio, three-dimensional dive paths, and locomotor effort.

Prey ingestion revealed by oesophagus and stomach temperature recordings in cormorants

We examined the accuracy of both stomach and oesophagus temperature sensors-deployed on captive Brandt's cormorants-for determination of the mass of food ingested and the number of prey items swallowed. The oesophageal temperature sensor was a better detector of all feeding events, including that of small prey which were missed by the stomach sensor. Adapted to free-ranging animals (and coupled to data loggers for recording seawater temperature), oesophagus temperature recorders, in conjunction with both recordings of energy expenditure (e.g. doubly labelled water, heart rate) and determination of position (e.g. Argos transmitter, time/depth recorder), should provide further important insights into the foraging success of marine endotherms.

Age dependent changes of a biochemical rhythm--the glycolytic oscillator of the blowfly Phormia terraenovae

1. By monitoring changes of fluorescence of NADH the frequencies, amplitudes and maximum slopes of the glycolytic oscillator of Phormia were analyzed in 5, 9, 15 and 21-day-old male flies. 2. In order to evaluate the possible existence of circadian rhythms within the oscillatory system, all determinations were repeated eight times/day. 3. In addition, the activities of three key enzymes of glycolysis, PFK, GAPDH and PK, which are central to the glycolytic oscillator were measured with respect to age and day time. 4. With increasing age the amplitudes of oscillations increased together with the maximum slopes of the oscillatory waves. The frequency appeared to be independent of age. 5. Variations of enzyme activities over the day indicated an age dependent circadian rhythm which, due to the simultaneous activity changes of the three measured enzymes, was not reflected in the whole oscillatory system. 6. The results suggest that modifications in the allosteric regulation of enzymes are responsible for the age dependent changes of the glycolytic oscillator.

Ten year follow-up of paroxysmal choreoathetosis: a sporadic case becomes familial

A 30-year-old woman is reported who was originally described in 1967 as an isolated instance of paroxysmal choreoathetosis. In the subsequent 10 years, her movement disorder has decreased in severity. However, she now has a 7-year-old daughter with a similar but more persistent and more serious condition. This family emphasizes both variability of manifestations of paroxysmal choreoathetosis and the importance of genetic factors.

Correlation of aryl hydrocarbon hydroxylase activity of human lymphocyte cultures and plasma elimination rates for antipyrine and phenylbutazone

A high correlation was observed between the aryl hydrocarbon hydroxylase activities in short-term lymphocyte cultures of 23 individuals and their plasma half-lives of antipyrine and phenylbutazone. Individuals with low inducibility of aryl hydrocarbon hydroxylase activities had very long plasma half-lives of antipyrine and phenylbutazone, whereas subjects with high inducibility of aryl hydrocarbon hydroxylase activites had relatively short plasma half-lives. Individuals with intermediate aryl hydrocarbon hydroxylase activities displayed intermediate half-lives for both drugs. The observed correlation indicates determinants which are common to the elimination of antipyrine or phenylbutazone, and aryl hydrocarbon hydroxylase metabolism of hydrocarbons. The differences in rates of drug elimination are probably due to genetic differences and may have pharmacological and therapeutic significance.