Longitudinal changes in home food availability and concurrent associations with food and nutrient intake among children at 24-48 months

OBJECTIVES

To describe changes in home food availability during early childhood, including modified, developmentally sensitive obesogenic scores, and to determine whether home food availability is associated with food and nutrient intakes of children concurrently, over time.

DESIGN

Data were drawn from the STRONG Kids 2 longitudinal, birth cohort to achieve the study objectives. Home food availability was assessed with the Home Food Inventory (HFI) and included fifteen food groups (e.g. fruit and vegetables) and three obesogenic scores (one original and two modified). Food and nutrient intakes were measured using the Block FFQ and included twenty-seven food groups and eighteen nutrients (e.g. vitamins A and C, protein). HFI and FFQ were completed by trained researchers or mothers, respectively, at 24, 36 and 48 months. Repeated-measures ANOVA and Spearman's correlations were used to achieve the study objectives.

SETTING

Central Illinois, USA.

PARTICIPANTS

Participants were 468 children at 24, 36 and 48 months of age.

RESULTS

Availability of less nutritious foods and obesogenic foods and beverages increased as children aged, and availability of both nutritious and less nutritious foods were associated with child food and nutrient intake. The three obesogenic scores demonstrated similar, positive associations with the intake of energy, saturated fat, added sugars and kilocalories from sweets.

CONCLUSION

These findings offer novel insight into changes in home food availability and associations with food and nutrient intake during early childhood. Additional attention is needed examining antecedents (e.g. built environments, purchasing behaviours) and consequences (e.g. child diet quality and weight) of home food availability.

Exploring the associations between neighbourhood food environment, household food insecurity and child weight-related outcomes in socio-economically and racially/ethnically diverse families

OBJECTIVE

To examine associations among neighbourhood food environments (NFE), household food insecurity (HFI) and child's weight-related outcomes in a racially/ethnically diverse sample of US-born and immigrant/refugee families.

DESIGN

This cross-sectional, observational study involving individual and geographic-level data used multilevel models to estimate associations between neighbourhood food environment and child outcomes. Interactions between HFI and NFE were employed to determine whether HFI moderated the association between NFE and child outcomes and whether the associations differed for US-born v. immigrant/refugee groups.

SETTING

The sample resided in 367 census tracts in the Minneapolis/St. Paul, MN metropolitan area, and the data were collected in 2016-2019.

PARTICIPANTS

The sample was from the Family Matters study of families (n 1296) with children from six racial/ethnic and immigrant/refugee groups (African American, Latino, Hmong, Native American, Somali/Ethiopian and White).

RESULTS

Living in a neighbourhood with low perceived access to affordable fresh fruits and vegetables was found to be associated with lower food security (P < 0·01), poorer child diet quality (P < 0·01) and reduced availability of a variety of fruits (P < 0·01), vegetables (P < 0·05) and whole grains in the home (P < 0·01). Moreover, residing in a food desert was found to be associated with a higher child BMI percentile if the child's household was food insecure (P < 0·05). No differences in associations were found for immigrant/refugee groups.

CONCLUSIONS

Poor NFE were associated with worse weight-related outcomes for children; the association with weight was more pronounced among children with HFI. Interventions aiming to improve child weight-related outcomes should consider both NFE and HFI.

Emerging adults' intersecting experiences of food insecurity, unsafe neighbourhoods and discrimination during the coronavirus disease 2019 (COVID-19) outbreak

OBJECTIVE

To examine how food insecurity is related to emerging adults' food behaviours and experiences of neighbourhood safety and discrimination and to identify resources needed to support their health during the COVID-19 outbreak.

DESIGN

Rapid response online survey. Participants completed the six-item US Household Food Security Survey Module, a brief measure of food insufficiency, and measures of food behaviours, neighbourhood safety and discrimination. Open-ended questions were used to assess changes in eating behaviours during COVID-19 and needed resources.

SETTING

C-EAT (COVID-19 Eating and Activity over Time) study invitations were sent by email and text message to a longitudinal cohort.

PARTICIPANTS

A total of 218 emerging adults (mean age = 24·6 (sd 2·0) years, 70·2 % female) completed a survey in April-May 2020 during a stay-at-home order in Minnesota.

RESULTS

The past year prevalence of food insecurity was 28·4 %. Among food-insecure respondents, 41·0 % reported both eating less and experiencing hunger due to lack of money in the past month. Food-insecure respondents were less likely than those who were food secure to have fruits/vegetables at home and more likely to have frequent fast-food restaurant meals, feel unsafe in their neighbourhood and experience discrimination during the stay-at-home order. Food-insecure adults reported changes including eating more food prepared at home, eating more take-out restaurant meals and purchasing more energy-dense snacks as a result of events related to COVID-19. Resources most needed to support their health included eligibility for more food assistance and relief funds.

CONCLUSIONS

Food-insecure emerging adults experience many barriers to maintaining healthful eating patterns during COVID-19.

Food shopping, home food availability, and food insecurity among customers in small food stores: an exploratory study

Customers who frequently shop in small food stores (e.g., convenience stores) may face numerous challenges to procuring healthful food for their household, and these may vary by food security status. The purpose of this study is to examine associations between food security and food shopping-related behaviors among frequent shoppers at small stores. Our sample included participants from customer intercept interviews at small food stores in an urban area. A follow-up in-home visit with a subset of customers who reported frequently shopping in these stores (≥1/week; n = 78) included a survey and researcher-administered home food inventory. Food security status was identified via the U.S. Household Food Security Survey Six-Item Short Form. Outcomes included shopping frequency and money spent by store type (e.g., small vs. large), home-to-store distance, and observed home availability of fruits, vegetables, and obesogenic foods. We estimated associations between food security status and each outcome, adjusting for demographic and poverty-related confounders. Participants were 56% female and 65% people of color; 45% received Supplemental Nutrition Assistance Program benefits and 54% experienced food insecurity in the past year. Unadjusted models indicated several significant associations: compared to those who were food secure, food-insecure participants shopped for food/beverages at small stores more times per month, spent more on food/beverages at dollar stores, and had less home availability of fruit and obesogenic foods. Associations remained significant (p = .04) between food insecurity and shopping frequency in adjusted models. Interventions requiring or incentivizing small food stores to stock healthful products could be important for improving access to nutritious food for food-insecure persons.

Description of the home food environment in Black, White, Hmong, Latino, Native American and Somali homes with 5-7-year-old children

OBJECTIVE

To categorize the home food environment and dietary intake of young children (5-7 years old) from racially/ethnically diverse households using objectively collected data.

DESIGN

Cross-sectional study.

SETTING

In-home observations in Minneapolis/Saint Paul, Minnesota, USA.

SUBJECTS

Families with 5-7-year-old children who identified as Black, White, Hmong, Latino, Native American or Somali.

RESULTS

There were many significant differences by race/ethnicity for child dietary intake and for the home food environment, with specific patterns emerging by race/ethnicity. For example, Somali children had high Healthy Eating Index-2010 (HEI-2010) scores, but low daily intakes of fruits and vegetables. Black children had low HEI-2010 scores and a pattern of low intake of healthful foods and high intake of unhealthful foods. White and Latino families had high levels of both healthful and unhealthful home food availability and children with high HEI-2010 scores.

CONCLUSIONS

Results indicate that the home food environment of young children varies across racial/ethnic group. Study findings also provide new information regarding the home food environment of young children in previously understudied racial/ethnic groups and indicate that interventions working to improve the home food environment and dietary intake of children may want to consider race/ethnicity.

Fill "half your child's plate with fruits and vegetables": Correlations with food-related practices and the home food environment

This study examined the prevalence of parental report of children's adherence to USDA's MyPlate guidelines of 'half of plate filled with fruits and vegetables (FV)' and associations with child and parent/guardian report of food-related practices and the home food environment. Data for this study represent the baseline assessment (n = 160 parent-child dyads) of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, a randomized controlled trial to prevent excess weight gain among 8-12 year-old children. Multiple logistic regression models examined associations between a newly created 'half plate FV' variable 'During the past seven days how many times was half of your child's plate filled with fruits and vegetables at dinner?" and personal and home food environmental factors, including food availability, child fruit/vegetable intake, and healthy eating index (HEI), adjusted for race and receipt of public assistance. Parents reported their children had half their plates filled with FV at dinner on average 2.7 times in the past week. With each reported child intake of FV, the odds of having half their plates filled with FV were almost one and a half times greater; there were significantly higher odds of children having half their plates filled with FV with greater children's HEI, parent and child cooking skills and self-efficacy to cook healthy meals, family meal frequency, and availability of more types of fruits and vegetables in the home. The findings demonstrate that the MyPlate campaign's message of "half the plate filled with FV" can be used in nutrition interventions focusing on improving the home food environment and increasing children's FV intake; the survey item used in the present study may be effective in capturing adherence to the MyPlate message.

Interrelationship between food security status, home availability of variety of fruits and vegetables and their dietary intake among low-income pregnant women

OBJECTIVE

To (i) determine differences in the availability of variety of fruits and vegetables (F&V) at home by food security status; and (ii) examine the inter-associations between food security status, availability of variety of F&V at home and frequency of F&V intake, among low-income pregnant women. Design/Setting Participants were interviewed to collect food security status, home availability of variety of F&V and frequency of F&V intake. Bivariate analyses, multivariate regression and exploratory mediation analyses were conducted using IBM SPSS Statistics version 23.0 and the PROCESS macro.

SUBJECTS

Low-income pregnant women (n 198) were interviewed if they were ≥18 years of age, in the second trimester of pregnancy, and spoke English or Spanish.

RESULTS

Low/very low food security was found among 43 % of participants. Compared with fully food-secure participants, very low food-secure participants reported a lower variety of fruits (P=0·028) and vegetables (P=0·058) available at home. Mediation analyses indicated that through home availability of variety of fresh F&V, food security status was associated with the daily intake of F&V (indirect effect (95 % CI): fresh fruits, -0·039 (-0·074, -0·013); fresh vegetables, -0·048 (-0·083, -0·023)). As food security worsened, the available variety of fresh F&V decreased, which was associated with lower intake.

CONCLUSIONS

The study highlights the interlink between food security, home food environment and diet quality, and the importance of nutrition education intervention to promote a healthy home food environment and improved pregnancy outcomes among low-income women.

Home food environment factors associated with the presence of fruit and vegetables at dinner: A direct observational study

BACKGROUND

Little research exists about the factors influencing the foods available at family meals. This study examines the home food environment factors contributing to the presence of fruit and vegetables at family meals.

METHODS

Home food inventory (HFI) and survey data were collected from low-income, minority families (n = 120) with children 6-12 years old. Observations from video-recorded family dinner meals, totaling 800 videos, were used to measure the frequency at which fruit and vegetables were served. Multiple regression was used to investigate how the fruit and vegetables in the HFI and other home food environment factors were related to the number of days fruit and vegetables were served at dinner during the observation period.

RESULTS

Availability and accessibility of fruit and vegetables in the home were each found to be significantly associated with the presence of fruits and vegetables at family dinners. Of the fruit and vegetable categories (i.e., fresh, canned, or frozen), having fresh fruit and vegetables available in the home was found to be most strongly associated with serving fruit and vegetables at dinner, respectively. Higher parent intake of vegetables was associated with the presence of vegetables at dinners, and parent meal planning was associated with the presence of fruit at dinners.

CONCLUSIONS

Increasing the availability and accessibility of fresh fruit and vegetables in the home may be an effective approach to increasing the presence of fruits and vegetables at family dinners, especially among low-income, minority households. It is also essential to understand why families are not using all fruits and vegetables (e.g., canned and frozen) available in the home for family meals. Family meals are a place to promote the increased presence of both fruit and vegetables.

Home food environment in relation to children's diet quality and weight status

The objective of this cohort study was to explore relationships among the home food environment (HFE), child/parent characteristics, diet quality, and measured weight status among 699 child-parent pairs from King County, WA, and San Diego County, CA. HFE variables included parenting style/feeding practices, food rules, frequency of eating out, home food availability, and parents' perceptions of food costs. Child dietary intake was measured by 3-day recall and diet quality indicators included fruits and vegetables, sweet/savory snacks, high-calorie beverages, and Dietary Approaches to Stop Hypertension (DASH) score. Individual linear regression models were run in which child BMI z score and child diet quality indicators were dependent variables and HFE variables and child/parent characteristics were independent variables of interest. Fruit and vegetable consumption was associated with parental encouragement/modeling (β=.68, P<0.001) and unhealthful food availability (-0.27, P<0.05); DASH score with food availability (healthful: 1.3, P<0.01; unhealthful: -2.25, P<0.001), food rules (0.45, P<0.01), and permissive feeding style (-1.04, P<0.05); high-calorie beverages with permissive feeding style (0.14, P<0.01) and unhealthful food availability (0.21, P<0.001); and sweet/savory snacks with healthful food availability (0.26, P<0.05; unexpectedly positive). Children's BMI z score was positively associated with parent's use of food restriction (0.21, P<0.001), permissive feeding style (0.16, P<0.05), and concern for healthy food costs (0.10, P<0.01), but negatively with verbal encouragement/modeling (-0.17, P<0.05), and pressure to eat (-0.34, P<0.001). Various HFE factors associated with parenting around eating and food availability are related to child diet quality and weight status. These factors should be considered when designing interventions for improving child health.

Race/ethnicity and income in relation to the home food environment in US youth aged 6 to 19 years

BACKGROUND

The home food environment is complex and has the potential to influence dietary habit development in young people. Several factors may influence the home food environment, including income and race/ethnicity.

OBJECTIVE

To examine the relationship of income and race/ethnicity with three home food environment factors (ie, food availability frequency, family meal patterns [frequency of family and home cooked meals], and family food expenditures).

DESIGN

A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES).

PARTICIPANTS

A total of 5,096 youth aged 6 to 19 years from a nationally representative sample of US individuals participating in NHANES 2007-10.

STATISTICAL ANALYSES PERFORMED

Prevalence of food availability frequency was assessed for the entire sample, race/ethnicity, poverty income ratio (PIR), and race/ethnicity stratified by PIR. Mean values of family meal patterns and food expenditures were calculated based on race/ethnicity, PIR, and race/ethnicity stratified by PIR using analysis of variance and least squares means. Tests of main effects were used to assess differences in food availability prevalence and mean values of family meal patterns and food expenditures.

RESULTS

Non-Hispanic whites had the highest prevalence of salty snacks (51.1%±1.5%) and fat-free/low-fat milk (39.2%±1.7%) always available. High-income homes had the highest prevalence of fruits (75.4%±2.4%) and fat-free/low-fat milk (38.4%±2.1%) always available. Differences were found for prevalence of food availability when race/ethnicity was stratified by PIR. Non-Hispanic blacks had the lowest prevalence of fat-free/low-fat milk always available across PIR groups. Differences in mean levels of family meal patterns and food expenditures were found for race/ethnicity, PIR, and race/ethnicity stratified by PIR.

CONCLUSIONS

Race/ethnicity and PIR appear to influence food availability, family meal patterns, and family food expenditures in homes of youth. Knowledge of factors that influence the home food environment could assist in developing effective strategies to improve food environments for young people.