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de Vries Mecheva M, Rieger M, Sparrow R, Prafiantini E, Agustina R. Behavioural and environmental risk factors associated with primary schoolchildren's overweight and obesity in urban Indonesia. Public Health Nutr 2023; 26:1562-1575. [PMID: 37138496 PMCID: PMC10410387 DOI: 10.1017/s1368980023000897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 04/03/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. DESIGN Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children's diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. SETTING Public primary schools in Central Jakarta, sampled at random. PARTICIPANTS Children (n 1674) aged 6-13 years from 18 public primary schools. RESULTS Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P = 0·026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0·022 and 0·023, respectively). CONCLUSIONS This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.
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Affiliation(s)
- Margarita de Vries Mecheva
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
| | - Matthias Rieger
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
| | - Robert Sparrow
- The International Institute of Social Studies of Erasmus University Rotterdam, 2518 AXThe Hague, the Netherlands
- Development Economics Group, Wageningen University, Wageningen, the Netherlands
| | - Erfi Prafiantini
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia – Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Serasinghe N, Vepsäläinen H, Lehto R, Abdollahi AM, Erkkola M, Roos E, Ray C. Associations between socioeconomic status, home food availability, parental role-modeling, and children's fruit and vegetable consumption: a mediation analysis. BMC Public Health 2023; 23:1037. [PMID: 37259139 DOI: 10.1186/s12889-023-15879-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. METHODS Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. RESULTS The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51-4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10-1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35-1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 - -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06-1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40-1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. CONCLUSIONS Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.
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Affiliation(s)
- Nithya Serasinghe
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland.
| | - Henna Vepsäläinen
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Reetta Lehto
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Anna M Abdollahi
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Maijaliisa Erkkola
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
| | - Eva Roos
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Public Health, University of Helsinki, P.O. Box 63, Helsinki, FI-00014, Finland
| | - Carola Ray
- Folkhälsan Research Center, Topeliuksenkatu 20, Helsinki, 00250, Finland
- Department of Food and Nutrition, University of Helsinki, P.O. Box 66, Helsinki, FI-00014, Finland
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Tovar A, Fox K, Gans KM, Markham Risica P, Papandonatos GD, Ramirez A, Gorin AA, von Ash T, Jennings E, Bouchard K, McCurdy K. Results from the Strong Families Start at Home/Familias Fuertes Comienzan en Casa: feasibility randomised control trial to improve the diet quality of low-income, predominantly Hispanic/Latinx children. Public Health Nutr 2023; 26:1-15. [PMID: 36691686 PMCID: PMC10131154 DOI: 10.1017/s1368980023000174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/21/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention. DESIGN Pilot randomised controlled trial. SETTING Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials. PARTICIPANTS Parents and their 2-5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups. RESULTS Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group (n 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (-1·35, -0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (-1·52, -0·19)), using food as a reward (PE = -0·54, 95 % CI (-1·35, -0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)). CONCLUSION Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.
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Affiliation(s)
- Alison Tovar
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | - Katelyn Fox
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Kim M Gans
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Patricia Markham Risica
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | | | - Andrea Ramirez
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Amy A Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Tayla von Ash
- Department of Behavioral and Social Sciences, Brown School of Public Health, Box G-121S Rm 813, Providence, RI02912, USA
| | - Ernestine Jennings
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Kelly Bouchard
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, USA
| | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI, USA
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Fulkerson JA, Horning M, Barr-Anderson DJ, Sidebottom A, Linde JA, Lindberg R, Friend S, Beaudette J, Flattum C, Freese RL. Weight outcomes of NU-HOME: a randomized controlled trial to prevent obesity among rural children. Int J Behav Nutr Phys Act 2022; 19:29. [PMID: 35305674 PMCID: PMC8934465 DOI: 10.1186/s12966-022-01260-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
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 .
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Affiliation(s)
- Jayne A Fulkerson
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455, USA.
| | - Melissa Horning
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455, USA
| | | | | | - Jennifer A Linde
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Sarah Friend
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN, 55455, USA
| | | | - Colleen Flattum
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rebecca L Freese
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
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Trofholz A, Hersch D, Norderud K, Berge JM, Loth K. Changes to the home food environment and parent feeding practices during the COVID-19 pandemic: A qualitative exploration. Appetite 2022; 169:105806. [PMID: 34798223 PMCID: PMC8594079 DOI: 10.1016/j.appet.2021.105806] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 12/29/2022]
Abstract
The COVID-19 pandemic brought about many changes that potentially altered the home food environment, which has been associated with child eating patterns and dietary intake. There is also some evidence that changes due to the COVID-19 pandemic are associated with health behaviors in children, such as an increased intake of high-calorie snack food. The current study aimed to more deeply understand how the COVID-19 pandemic affected the home food environment of meal and snack time routines and parent feeding practices within families of young children. Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2-5 year old children. Qualitative interviews were conducted by phone and video conference with mothers (n = 25) during August/September 2020 and were coded using a hybrid deductive/inductive analysis approach. This allowed coders to identify themes using the interview questions as an organizational template (deductive) while also allowing unique themes to emerge from the qualitative data (inductive). Three overarching themes emerged with multiple sub-themes: 1) Mothers were more directive in the types of food and amounts of food eaten by children; 2) Mothers had less rules around mealtimes; 3) Mothers had increased meal responsibilities. When faced with a change in a structured schedule and increased stress-such as occurred with the COVID-19 pandemic, parents may benefit from advice on how to manage parent feeding practices, including tips on appropriate limit setting, establishing a schedule and routines, and improving accessibility of healthful snacks. Lessons learned during the COVID-19 pandemic may have relevance to other time periods when families face disruptions to routine and during other times of transition.
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Affiliation(s)
- Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Derek Hersch
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Kristin Norderud
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Jara MF, Leyton B, Cuevas C, Gálvez Espinoza P. Women's perceptions about changes in food-related behaviours at home during COVID-19 pandemic in Chile. Public Health Nutr 2021;:1-10. [PMID: 34120673 DOI: 10.1017/S1368980021002639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore women's perceptions of changes in specific food habits at home, specifically the food budget and shopping, and food preparation, during the COVID-19 period. DESIGN Non-probabilistic, exploratory study. Participants completed an online self-administered questionnaire. Perceptions of food habit changes were measured on a five-point Likert scale (strongly disagree to strongly agree). Data analysis was conducted in STATA v16.0. SETTING Chile. PARTICIPANTS Adult women between 25 and 65 years old (n 2047). RESULTS Of the participants, 72 % were responsible for cooking, 69 % for buying food and 85 % for child care. Difficulties in organising and doing food budget works were observed in groups with a lower educational level, lower income and single mothers with children. Younger participants, dependent workers, women from biparental families with children and those in mandatory quarantine perceived more changes in their food shopping and budget management tasks. Participants more educated, with higher income and non-mandatory quarantine perceived to cook and eat healthier. Older participants perceived minor changes in their food preparation tasks at home; in contrast, more educated women and women from biparental families with children perceived more changes. If women were in charge of the kids or grocery shopping, more food environment changes were noticed. CONCLUSIONS Women perceived changes in their food environments. Some of these changes are perceived worse in the more vulnerable population. COVID-19 presents a challenge for the food system and gender perspectives. This information should be considered in the design of food-related interventions.
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Rex SM, Kopetsky A, Bodt B, Robson SM. Relationships Among the Physical and Social Home Food Environments, Dietary Intake, and Diet Quality in Mothers and Children. J Acad Nutr Diet 2021:S2212-2672(21)00179-9. [PMID: 33888436 DOI: 10.1016/j.jand.2021.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Both the physical and social home food environment (HFE) are believed to influence dietary intake and diet quality, but few studies have examined both aspects together. OBJECTIVE The purpose of this study was to examine the relationships among the physical and social HFE, dietary intake, and diet quality in mothers and children. DESIGN This was a cross-sectional substudy of a larger study. PARTICIPANTS/SETTING The study included 24 mothers (aged ≥30 years) with a biological child aged 6 to 12 years living in the Newark, DE, area between June and November 2018. MAIN OUTCOME MEASURES The outcome measures of interest included the physical HFE (ie, home food availability); aspects of the social HFE (ie, parenting styles, family meal frequency, and policies); maternal and child intake of fruits, vegetables, sugar-sweetened beverages, and snacks; and diet quality using the 2015 Healthy Eating Index total score. STATISTICAL ANALYSIS Pearson correlations were used to examine the relationship between physical HFE and dietary intake as well as social HFE and dietary intake in both mothers and children. The relationships were further examined through exploratory regression analyses. RESULTS In mothers, fruit availability in the physical HFE was correlated with fruit intake (r = 0.50; P = 0.02). Fruit and vegetable availability in the physical HFE were correlated with 2015 Healthy Eating Index total score in both the mother and child. Family meals participation was correlated with dietary intake (vegetable intake in children, r = 0.44; P = 0.04; and snack intake in mothers, r = -0.74; P < .001). Exploratory regression analysis showed vegetables in the HFE was associated with vegetable intake and 2015 Healthy Eating Index total score in mothers, and fruits and vegetables in the HFE were associated with child 2015 Healthy Eating Index total score. Family meals participation was negatively associated with maternal snack intake and child sugar-sweetened beverages intake. Authoritative parenting was negatively associated with child snack intake and permissive parenting was negatively associated with mother's fruit intake. CONCLUSIONS Both the physical and social HFE are associated with maternal and child dietary intake, but only the physical HFE was associated with dietary quality. Although preliminary, these data indicate the importance of future studies that include measures to assess both the physical and social HFE to better elucidate the influences of the HFE on dietary intake.
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Dolwick AP, Persky S. Parental reward-based eating drive predicts parents' feeding behaviors and Children's ultra-processed food intake. Appetite 2021; 164:105241. [PMID: 33839147 DOI: 10.1016/j.appet.2021.105241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 03/11/2021] [Accepted: 03/26/2021] [Indexed: 12/29/2022]
Abstract
Reward-based eating drive is associated with individual consumption, but there has been a paucity of research on the relationships between parental reward-based eating, child feeding behaviors, and child food consumption. Child feeding behaviors likely to be associated with parental reward-based eating drive include the provision of ultra-processed foods, as they are designed to be hyperpalatable and are associated with disordered food intake. The present study uses a virtual reality (VR) buffet restaurant environment to examine parents' food choice behaviors for their children and a food frequency assessment to measure the children's reported consumption over the course of a week. Results found that parental reward-based eating drive significantly predicted ultra-processed calories chosen by parents for their children in the VR Buffet, as well as the amount of ultra-processed food children ate according to the food frequency assessment. Both of these effects were significantly mediated by the healthfulness of the home food environment. This study is among the first to demonstrate associations between parental reward-based eating drive and child-focused food behavior and to elucidate a mediating effect of the home food environment on such relationships. These findings may be useful for the development of family-based interventions to improve child feeding and ultimately child health.
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Affiliation(s)
- Alexander P Dolwick
- Social and Behavioral Research Branch, National Human Genome Research Institute, 31 Center Drive, Bethesda, MD, 20892, USA
| | - Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, 31 Center Drive, Bethesda, MD, 20892, USA.
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Nansel TR, Lipsky LM, Faith M, Liu A, Siega-Riz AM. The accelerator, the brake, and the terrain: associations of reward-related eating, self-regulation, and the home food environment with diet quality during pregnancy and postpartum in the pregnancy eating attributes study (PEAS) cohort. Int J Behav Nutr Phys Act 2020; 17:149. [PMID: 33228724 PMCID: PMC7684737 DOI: 10.1186/s12966-020-01047-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 10/29/2020] [Indexed: 01/04/2023] Open
Abstract
Background Neurobehavioral factors, including reward-related eating and self-regulation, in conjunction with the food environment, may influence dietary behaviors. However, these constructs have not been examined in pregnancy and postpartum, a time of changing appetite and eating behaviors, and when dietary intake has implications for maternal and child health. This study examined associations of reward-related eating, self-regulation, and the home food environment with pregnancy and postpartum diet quality. Methods Participants in the Pregnancy Eating Attributes Study observational cohort were enrolled at ≤12 weeks gestation and followed through one-year postpartum. Pregnancy and postpartum Healthy Eating Index-2015 (HEI-total), and adequacy and moderation scores, respectively, were calculated by pooling 24-h diet recalls administered each trimester and during 2, 6, and 12 months postpartum. Participants completed four measures of reward-related eating – Modified Yale Food Addiction Scale (mYFAS), Power of Food Scale (PFS), Multiple Choice Procedure (MCP), and Reinforcing Value of Food Questionnaire (RVFQ); two measures of self-regulation – Barratt Impulsiveness Scale (BIS) and Delay of Gratification Inventory (DGI); and a Home Food Inventory (HFI), yielding obesogenic (OBES) and fruit/vegetables (FV) scores. Linear regression analyses estimated associations of reward-related eating, self-regulation, and home food environment with diet quality during pregnancy and postpartum, adjusting for sociodemographic characteristics. Results Pregnancy HEI-total was inversely associated with PFS (β = − 0.14 ± 0.05, p = 0.009), mYFAS(β = − 0.14 ± 0.06, p = 0.02), 2 of the 5 RVFQ indices, MCP (β = − 0.14 ± 0.05, p = 0.01), and DGI food subscale (β = 0.23 ± 0.05, p < 0.001), but associations of postpartum HEI-total with reward-related eating measures and self-regulation were small and not statistically significant. Pregnancy and postpartum HEI-total were associated inversely with HFI-OBES (β = − 0.17 ± 0.06, p = 0.004 and β = − 0.19 ± 0.07, p = 0.006, respectively), and positively with HFI-FV (β = 0.21 ± 0.05, p < 0.001 and β = 0.17 ± 0.06, p = 0.009, respectively). Conclusions Associations of poorer diet quality with greater reward-related eating during pregnancy but not postpartum suggests the need to better understand differences in the determinants of eating behaviors and approaches to circumvent or moderate reward-related eating to facilitate more optimal diet quality across this critical period. Trial registration Clinicaltrials.gov. URL – Registration ID – NCT02217462. Date of registration – August 13, 2014.
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Affiliation(s)
- Tonja R Nansel
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, 20892, USA.
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, 20892, USA
| | - Myles Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, 420 Baldy Hall, University at Buffalo - SUNY, Buffalo, NY, 14250-1000, USA.,Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Aiyi Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Dr., MSC 7004, Bethesda, MD, 20892, USA
| | - Anna Maria Siega-Riz
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, 27599, USA.,Departments of Nutrition and Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, 109 Arnold House, 715 Pleasant St, Amherst, MA, 01003-9303, USA
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Hammersley ML, Wyse RJ, Jones RA, Wolfenden L, Yoong S, Stacey F, Eckermann S, Okely AD, Innes-Hughes C, Li V, Green A, May C, Xu J, Rissel C. Translation of two healthy eating and active living support programs for parents of 2-6 year old children: a parallel partially randomised preference trial protocol (the 'time for healthy habits' trial). BMC Public Health 2020; 20:636. [PMID: 32381052 PMCID: PMC7204000 DOI: 10.1186/s12889-020-08526-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background Parents are key decision makers and role models in establishing and maintaining healthy behaviours in their children. Interventions involving parents have been shown to be more effective than those that do not, but there are barriers to participation. Efficacy trials have previously been conducted on two such parent-focussed healthy eating and active living interventions with the potential to overcome these barriers - Healthy Habits (telephone-based) and Time2bHealthy (online) with promising results. Further research is now required to determine the effectiveness of these interventions in a real-world context. The Time for Healthy Habits study is a 3-arm partially randomised preference trial which aims to evaluate the effectiveness and cost-effectiveness of two theory-based programs to promote healthy eating and appropriate levels of movement behaviours (physical activity, sedentary behaviour and sleep) for parents of 2- to 6-year-old children (Healthy Habits Plus telephone-based program and Time2bHealthy online program), when compared to a comparison group receiving written materials. Methods Participants will be recruited across five Local Health Districts in New South Wales, Australia. The partially randomised preference design initially allows for participants to decide if they wish to be randomised or opt to select their preferred intervention and has been recommended for use to test effectiveness in a real-world setting. Both interventions incorporate multiple behaviour change techniques and support parents to improve their children’s healthy eating, and movement behaviours (physical activity, sedentary behaviour and sleep) and run for 12 weeks, followed by a 3-month and 9-month post-baseline follow-up. Participants will also be asked to complete a process evaluation questionnaire at the completion of the intervention (3-months post-baseline). Outcomes include fruit and vegetable intake (primary outcome), non-core food intake, weight status, physical activity, sedentary behaviour, and sleep habits. Discussion To our knowledge, this is the first translational research trial evaluating the effectiveness and cost-effectiveness of a healthy eating and active living intervention in the 2- to 6-years age group. The results will build the evidence base in regard to translation of effective childhood obesity prevention interventions and inform the implementation and delivery of community based childhood obesity prevention programs. Trial registration UTN: U1111–1228-9748, ACTRN: 12619000396123p.
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Affiliation(s)
- Megan L Hammersley
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia. .,Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, NSW, 2522, Australia.
| | - Rebecca J Wyse
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Priority Research Centre for Heath Behaviour, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Rachel A Jones
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Priority Research Centre for Heath Behaviour, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Serene Yoong
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter New England Population Health, Locked Bag 10, Wallsend, NSW, 2287, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Priority Research Centre for Heath Behaviour, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Fiona Stacey
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.,Priority Research Centre for Heath Behaviour, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - Simon Eckermann
- Australian Health Services Research Institute, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Christine Innes-Hughes
- NSW Office of Preventive Health, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, Australia
| | - Vincy Li
- NSW Office of Preventive Health, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, Australia
| | - Amanda Green
- NSW Office of Preventive Health, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, Australia
| | - Christine May
- Formerly Murrumbidgee Local Health District, Cootamundra Health Service, McKay St, Cootamundra, NSW, Australia
| | - Joe Xu
- NSW Office of Preventive Health, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, Australia
| | - Chris Rissel
- NSW Office of Preventive Health, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, Australia.,Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia
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11
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Liu Y, Gittelsohn J, Thorne-Lyman AL, Song S, Orta-Aleman D, Ma Y, Wen D. Caregiver perceptions of the neighborhood food environment and their relationship with the home food environment and childhood obesity in Northeast China. Appetite 2020; 144:104447. [PMID: 31560936 DOI: 10.1016/j.appet.2019.104447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/20/2019] [Accepted: 09/09/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the relationships between caregiver perceptions of their neighborhood food environment and home food environment and between caregiver perceptions of neighborhood food environment and childhood obesity. DESIGN Cross-sectional. SETTING A total of twenty-six primary schools in northeast China. PARTICIPANTS Anthropometric measurements and questionnaire surveys were carried out on 3670 children (aged 9-12 years) and their caregivers. RESULTS Children of caregivers who perceived high local healthy food availability were more likely to always have fruits, vegetables, 100% juice, and low-fat milk or skim milk in their homes. Children of caregivers who perceived fast-food shopping to be easy were more likely to eat out for fast food. Children of caregivers who perceived high general access to food shopping were less likely to always have fruits, vegetables, and sugar-free breakfast in their home, and were more likely to eat out for fast food. CONCLUSIONS Future public health programs and interventions should take into consideration the role caregivers play in connecting neighborhood food environments with the home food environment.
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Affiliation(s)
- Yang Liu
- Institute of Health Science, China Medical University, Shenyang, Liaoning, China
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew L Thorne-Lyman
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shenzhi Song
- School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Dania Orta-Aleman
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yanan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Deliang Wen
- Institute of Health Science, China Medical University, Shenyang, Liaoning, China.
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12
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Poulsen MN, Bailey-Davis L, Pollak J, Hirsch AG, Schwartz BS. Household Food Insecurity and Home Food Availability in Relation to Youth Diet, Body Mass Index, and Adiposity. J Acad Nutr Diet 2019; 119:1666-1675. [PMID: 30858071 DOI: 10.1016/j.jand.2019.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/28/2018] [Accepted: 01/02/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Food security status is related to food types available in the home, which may shape youth dietary patterns, with implications for obesity. OBJECTIVE Investigate whether household food insecurity and home food availability (HFA) are associated with youth fruit and vegetable (F/V) consumption and anthropometric outcomes. DESIGN Cross-sectional study. Youth and parents completed questionnaires during in-home visits (2013-2014). Research staff obtained anthropometric measures. PARTICIPANTS/SETTING Medical record data for 10- to 15-year-old Pennsylvania youths were used to identify 434 parent-youth dyads, with 408 evaluated after excluding missing data. MAIN OUTCOME MEASURES Parent-reported household food security was assessed with the six-item US Department of Agriculture Food Security Scale (dichotomized as high vs low). Healthy and obesogenic HFA scales assessed parent report of how frequently particular foods were present in the home. Youth self-reported daily average F/V consumption. Anthropometric outcomes included age- and sex-standardized z scores for body mass index (BMIz), waist circumference (WCz), and percent body fat (PBFz). STATISTICAL ANALYSES Associations were evaluated with multivariable linear regression adjusted for youth age, sex, and race or ethnicity, and parent age and income. RESULTS Compared with food secure counterparts, youth from food insecure households had higher mean (beta [standard error]) BMIz (.30 [.15]), WCz (.27 [.12]), and PBFz (.43 [.16]). Food insecure households had lower mean healthy HFA scores (-1.23 [.54]); there was no evidence obesogenic HFA differed between food secure and insecure households. Youth from lower healthy HFA or higher obesogenic HFA households reported fewer mean daily F/V servings (healthy HFA: .08 [.02]; obesogenic HFA: -.06 [.02]). Food security status was not associated with F/V consumption, nor was there evidence HFA modified associations between food insecurity and anthropometric outcomes. CONCLUSIONS Despite an observed association between healthy HFA and youth F/V consumption, this study did not provide evidence that HFA explained associations between food insecurity and youth anthropometric outcomes.
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13
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Robson SM, Ziegler ML, McCullough MB, Stough CO, Zion C, Simon SL, Ittenbach RF, Stark LJ. Changes in diet quality and home food environment in preschool children following weight management. Int J Behav Nutr Phys Act 2019; 16:16. [PMID: 30717746 PMCID: PMC6360745 DOI: 10.1186/s12966-019-0777-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/30/2019] [Indexed: 01/21/2023] Open
Abstract
Background Family-based obesity treatment interventions can successfully reduce energy intake in preschoolers. An implicit goal of obesity treatment interventions is to improve diet quality, but diet quality has been less examined as a treatment outcome in studies of preschoolers. The purpose of this study was to conduct a secondary analysis comparing the change in diet quality and home food environment in preschoolers assigned to a behavioral family-based obesity intervention (LAUNCH), motivational interviewing (MI) condition, or standard care (STC) condition. Methods Three 24-h dietary recalls were completed at baseline and 6-months and were analyzed using NDS-R software; diet quality was assessed using the Healthy Eating Index-2010 (HEI-2010). Availability of foods and beverages in the home was assessed through direct observation using the Home Health Environment tool that classifies foods and beverages as ‘red’ or ‘green’ based upon fat and sugar content. Repeated measures linear mixed effects models were used to examine changes in diet quality and home food environment between conditions (LAUNCH, MI, STC). Results At 6-months, preschoolers in the LAUNCH condition had a higher HEI-2010 total score (62.8 ± 13.7) compared to preschoolers in the MI (54.7 ± 13.4, P = 0.022) and STC (55.8 ± 11.6, P = 0.046) conditions. Regarding the home food environment, families in LAUNCH had significantly less ‘red’ foods in their home at 6-months (12.5 ± 3.4 ‘red’ foods) compared to families in MI (14.0 ± 3.7 ‘red’ foods, P = 0.030), and STC (14.3 ± 3.4 ‘red’ foods, P = 0.006). There were no statistically significant differences across home food environments for number of ‘green’ foods. Conclusion Family-based obesity treatment interventions for preschoolers can improve overall diet quality and alter the home food environment through reductions in ‘red’ foods. Trial registration Clinicaltrials.gov, NCT01546727. Registered March 7, 2012.
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Affiliation(s)
- Shannon M Robson
- Department of Behavioral Health and Nutrition, University of Delaware, 26 N College Avenue, Newark, DE, 19716, USA.
| | - Melissa L Ziegler
- Biostatistics Core, College of Health Sciences, University of Delaware, 540 S. College Avenue, Newark, DE, 19713, USA
| | - Mary Beth McCullough
- Psychology Department, Suffolk University, 73 Tremont Street, Boston, MA, 02108, USA
| | - Cathleen Odar Stough
- Department of Psychology, University of Cincinnati, 47 W Corry Blvd Edwards 1 Bldg Suite 4130, P.O. Box 210376, Cincinnati, OH, 45219, USA
| | - Cynthia Zion
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 3015, Cincinnati, OH, 45229, USA
| | - Stacey L Simon
- Department of Pediatrics, Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Ave B395 Aurora, Aurora, CO, 80045, USA
| | - Richard F Ittenbach
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.,Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 5041, Cincinnati, OH, 45229, USA
| | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 3015, Cincinnati, OH, 45229, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA
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14
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Trofholz A, Tate A, Fulkerson JA, Hearst MO, Neumark-Sztainer D, Berge JM. Description of the home food environment in Black, White, Hmong, Latino, Native American and Somali homes with 5-7-year-old children. Public Health Nutr 2019; 22:882-93. [PMID: 30477596 DOI: 10.1017/S136898001800280X] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
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.
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15
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Watts AW, Barr SI, Hanning RM, Lovato CY, Mâsse LC. The home food environment and associations with dietary intake among adolescents presenting for a lifestyle modification intervention. BMC Nutr 2018; 4:3. [PMID: 32153867 PMCID: PMC7050879 DOI: 10.1186/s40795-018-0210-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/29/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The home food environment may be an important target for addressing adolescent obesity. The aim of this study was to investigate associations between aspects of the home food environment and the diets of adolescents who present for obesity treatment. METHODS Cross-sectional baseline data were collected from 167 overweight/obese adolescent-parent pairs participating in an e-health lifestyle modification intervention. Adolescent intake of specific foods (fruit and vegetables, total fat, sugar-sweetened beverages, desserts/treats, and snacking occasions) was assessed by three 24-h dietary recalls, while household factors were collected from adolescent and parent questionnaires. Structural Equation Modeling, controlling for relevant covariates, was used to examine the relationship between adolescent diet and the following household factors: parent modeling, parenting style, family meal practices, and home food/beverage availability. RESULTS Findings reveal that few characteristics of the home food environment were associated with adolescent dietary intake. Greater home availability of high-fat foods was moderately associated with adolescent snack intake (β = 0.27, p < .001). Associations with fruit/vegetables and fat intake were small and some were in unexpected directions. Parent modeling of healthful food choices and healthier family meal practices were associated with lower availability of high-fat foods and treats in the home, but were not directly associated with adolescent diets. CONCLUSIONS Parent modeling of healthy foods and positive mealtime routines might contribute to the healthfulness of foods offered in the homes of adolescents who are overweight/obese. Additional research is needed to better characterize the complex aspects of the household environment that influence adolescent diet.
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Affiliation(s)
- Allison W. Watts
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z9 Canada
- Present address: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55401 USA
| | - Susan I. Barr
- Department of Food, Nutrition & Health, University of British Columbia, 2357 Main Mall, Vancouver, British Columbia V6T 1Z4 Canada
| | - Rhona M. Hanning
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G5 Canada
| | - Chris Y. Lovato
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z9 Canada
| | - Louise C. Mâsse
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z9 Canada
- Child and Family Research Institute, University of British Columbia, 4480 Oak Street, room F512a, Vancouver, BC V6H 3V4 Canada
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16
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Rathi N, Riddell L, Worsley A. Indian adolescents' perceptions of the home food environment. BMC Public Health 2018; 18:169. [PMID: 29357849 DOI: 10.1186/s12889-018-5083-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/16/2018] [Indexed: 11/17/2022] Open
Abstract
Background The home food environment has the potential to influence the eating behaviour of adolescents. This investigation aimed to understand Indian adolescents’ perspectives of their home food environments. Methods Adolescents aged 14–16 years (n = 1026, 65.3% girls) attending private secondary schools in Kolkata completed a paper-based questionnaire during school time which included questions about family food rules, availability and accessibility of foods at home, and domestic cooking responsibility. Boys’ and girls’ opinions and experiences were compared through cross-tabulation analyses. Results Almost all the adolescents reported that fruits (91.6%) and vegetables (95.7%) were always available in their homes. Approximately two-fifths reported that sugar-sweetened beverages (36.2%) and salty snack foods (38.0%) were readily available. In 56.1% households, adolescents were expected to follow certain food rules during mealtimes (e.g. not talking with my mouth full). The majority of the respondents (80.4%) identified mothers as the primary meal providers, only a minority reported that fathers (5.1%) were responsible for preparation of family meals. Conclusion This understanding of the family-environmental determinants of adolescent dietary habits provides useful directions for nutrition promotion interventions. Health and educational professionals associated with adolescents could communicate about the development of healthy home food environments to provide positive health benefits for adolescents and their families.
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Abstract
Latinos are the largest and fastest-growing ethnically diverse group in the United States. Latino children are also among the most overweight and obese ethnic groups of children in the United States. Research over the last decade has identified the home environment as a key influence on the diet and physical activity of children. To summarize cross-sectional and longitudinal research that has identified factors within the home environment of Latino families that are associated with childhood obesity and to provide recommendations for future research and intervention development with Latino families. A decade review from 2005 to 2015 was conducted. Studies identifying factors within the home environments of Latino families that were associated with childhood obesity were examined. Five main factors were identified across the literature as home environment factors that are associated with childhood obesity in Latino children. These factors included: parental influences (e.g., parent feeding practices, modeling), screen time, physical activity/sedentary behavior, socioeconomic status/food security and sleep duration. The current review identified several home environment factors that may contribute to the disparities in childhood obesity for Latino children. Results from this review such as, focusing on decreasing controlling parent feeding practices, and increasing parent modeling of healthy behaviors and child sleep duration, can be used in developing culturally-specific interventions for Latino children.
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Affiliation(s)
- Alejandra Ochoa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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18
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Loth KA, Friend S, Horning ML, Neumark-Sztainer D, Fulkerson JA. Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes. Appetite 2016; 107:188-95. [PMID: 27486926 DOI: 10.1016/j.appet.2016.07.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/12/2016] [Accepted: 07/27/2016] [Indexed: 12/17/2022]
Abstract
This study examines associations between an expanded conceptualization of food-related parenting practices, specifically, directive and non-directive control, and child weight (BMI z-score) and dietary outcomes [Healthy Eating Index (HEI) 2010, daily servings fruits/vegetables] within a sample of parent-child dyads (8-12 years old; n = 160). Baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME Plus) randomized controlled trial was used to test associations between directive and non-directive control and child dietary outcomes and weight using multiple regression analyses adjusted for parental education. Overall variance explained by directive and non-directive control constructs was also calculated. Markers of directive control included pressure-to-eat and food restriction, assessed using subscales from the Child Feeding Questionnaire; markers of non-directive control were assessed with a parental role modeling scale and a home food availability inventory in which an obesogenic home food environment score was assigned based on the types and number of unhealthful foods available within the child's home food environment. DIRECTIVE CONTROL Food restriction and pressure-to-eat were positively and negatively associated with BMI z-scores, respectively, but not with dietary outcomes. NON-DIRECTIVE CONTROL An obesogenic home food environment was inversely associated with both dietary outcomes; parental role modeling of healthful eating was positively associated with both dietary outcomes. Neither non-directive behavioral construct was significantly associated with BMI z-scores. TOTAL VARIANCE Greater total variance in BMI-z was explained by directive control; greater total variance in dietary outcomes was explained by non-directive control. Including a construct of food-related parenting practices with separate markers for directive and non-directive control should be considered for future research. These concepts address different forms of parental control and, in the present study, yielded unique associations with child dietary and weight outcomes.
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19
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Loth KA, MacLehose RF, Larson N, Berge JM, Neumark-Sztainer D. Food availability, modeling and restriction: How are these different aspects of the family eating environment related to adolescent dietary intake? Appetite 2016; 96:80-86. [PMID: 26327222 PMCID: PMC4684786 DOI: 10.1016/j.appet.2015.08.026] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To examine individual associations between aspects of the family eating environment (home food availability, parental modeling, and food restriction) and adolescent dietary intake and explore the combined relationship (i.e., environment profiles) between these aspects of the family eating environment and adolescent dietary intake. METHODS Adolescents [14.4 years old (SD = 2.0)] and their parents (N = 2383 parent-adolescent pairs] participated in 2 coordinated, population-based studies. Adolescent surveys were completed at school and parent surveys were conducted via mail or phone. RESULTS Healthy home food availability was positively associated with fruit/vegetable intake and negatively associated with soda and snack food intake in adolescents. Healthy parental modeling was negatively associated with adolescent soda consumption. Food restriction was positively associated with fruit/vegetable consumption and snack food intake. Examination of family eating environment profiles revealed that it was the home food availability component of the profiles that was associated with observed differences in fruits/vegetable consumption, whereas the parental modeling and food restriction components contributed to differences in soda and snack foods consumption. CONCLUSIONS Findings indicate that among the three aspects of the family eating environment explored, making healthy food available at home was most consistently associated with healthy dietary intake in adolescents.
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Affiliation(s)
- Katie A Loth
- Division of Epidemiology and Community Health, School of Public Health and Department of Psychiatry, University of Minnesota, USA; Department of Family Medicine and Community Health, University of Minnesota, USA.
| | - Richard F MacLehose
- Division of Epidemiology and Community Health, School of Public Health, USA.
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, USA.
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, USA.
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20
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Virudachalam S, Chung PJ, Faerber JA, Pian TM, Thomas K, Feudtner C. Quantifying parental preferences for interventions designed to improve home food preparation and home food environments during early childhood. Appetite 2015; 98:115-24. [PMID: 26596704 DOI: 10.1016/j.appet.2015.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/13/2015] [Accepted: 11/08/2015] [Indexed: 12/13/2022]
Abstract
Though preparing healthy food at home is a critical health promotion habit, few interventions have aimed to improve parental cooking skills and behaviors. We sought to understand parents' preferences and priorities regarding interventions to improve home food preparation practices and home food environments during early childhood. We administered a discrete choice experiment using maximum difference scaling. Eighty English-speaking parents of healthy 1-4 year-old children rated the relative importance of potential attributes of interventions to improve home food preparation practices and home food environments. We performed latent class analysis to identify subgroups of parents with similar preferences and tested for differences between the subgroups. Participants were mostly white or black 21-45 year-old women whose prevalence of overweight/obesity mirrored the general population. Latent class analysis revealed three distinct groups of parental preferences for intervention content: a healthy cooking group, focused on nutrition and cooking healthier food; a child persuasion group, focused on convincing toddlers to eat home-cooked food; and a creative cooking group, focused on cooking without recipes, meal planning, and time-saving strategies. Younger, lower income, 1-parent households comprised the healthy cooking group, while older, higher income, 2-parent households comprised the creative cooking group (p < 0.05). The child persuasion group was more varied with regard to age, income, and household structure but cooked dinner regularly, unlike the other two groups (p < 0.05). Discrete choice experiments using maximum difference scaling can be employed to design and tailor interventions to change health behaviors. Segmenting a diverse target population by needs and preferences enables the tailoring and optimization of future interventions to improve parental home food preparation practices. Such interventions are important for creating healthier home food environments and preventing obesity starting from early childhood.
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Affiliation(s)
- Senbagam Virudachalam
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Paul J Chung
- Department of Pediatrics, University of California Los Angeles, Los Angeles, CA, USA; Department of Health Policy & Management, University of California Los Angeles, Los Angeles, CA, USA; RAND Corporation, Santa Monica, CA, USA; Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA.
| | | | - Timothy M Pian
- Warren Alpert Medical School, Brown University, Providence, RI, USA.
| | | | - Chris Feudtner
- Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Smith TM, Dunton GF, Pinard CA, Yaroch AL. Factors influencing food preparation behaviours: findings from focus groups with Mexican-American mothers in southern California. Public Health Nutr 2016; 19:841-50. [PMID: 26272414 DOI: 10.1017/S1368980015001949] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The purpose of the present study was to explore food preparation behaviours, attitudes, meal planning and shopping among Mexican-American mothers. DESIGN Data were collected through four focus groups with mothers of Mexican origin/ancestry who considered themselves to be the primary food preparer. Topics included food preparation behaviours and influencers (culture, family, attitudes, barriers, meal planning and shopping). Data were analysed using a qualitative grounded theory approach. All focus groups were audio recorded, transcribed verbatim and coded for themes. SETTING Data were collected in southern California, USA in 2013. SUBJECTS Of the sample of twenty-one Mexican-American mothers, thirteen were born outside the USA and the mean household size was five members. RESULTS Participants reported that food was often prepared using traditional staples and food preparation behaviours were learned from maternal family members. Participants also suggested that health was influenced by foods eaten and how they were prepared. Salient factors influencing food preparation behaviours included culture and tradition, maternal family members' food preparation behaviours, food preparation self-efficacy and attitudes towards healthy eating. Time and busy schedules were cited as barriers. CONCLUSIONS Future interventions should consider utilizing family-based approaches and teaching culturally relevant food preparation skills, especially to youth, while reinforcing more healthful dietary practices.
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Poelman MP, de Vet E, Velema E, Seidell JC, Steenhuis IH. The home food environment of overweight gatekeepers in the Netherlands. Public Health Nutr 2015; 18:1815-23. [PMID: 25358514 DOI: 10.1017/S1368980014002298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of the present study was to gain insight into (i) processed snack-food availability, (ii) processed snack-food salience and (iii) the size of dinnerware among households with overweight gatekeepers. Moreover, associations between gatekeepers' characteristics and in-home observations were determined. DESIGN A cross-sectional observation of home food environments was conducted as part of a baseline measurement of a larger study. SETTING Home food environments of overweight and obese gatekeepers in the Netherlands. SUBJECTS Household gatekeepers (n 278). Mean household size of the gatekeepers was 3.0 (SD 1.3) persons. Mean age of the gatekeepers was 45.7 (SD 9.2) years, 34.9% were overweight and 65.1% were obese. Of the gatekeepers, 20.9% had a low level of education and 42.7% had a high level of education. RESULTS In 70% of the households, eight or more packages of processed snack foods were present. In 54% of the households, processed snack foods were stored close to non-processed food items and in 78% of households close to non-food items. In 33% of the households, processed snack foods were visible in the kitchen and in 15% of the households processed snack foods were visible in the living room. Of the dinnerware items, 14% (plates), 57% (glasses), 78% (dessert bowls), 67% (soup bowls) and 58% (mugs) were larger than the reference norms of the Netherlands Nutrition Centre Foundation. Older gatekeepers used significantly smaller dinnerware than younger gatekeepers. CONCLUSIONS Environmental factors endorsing overconsumption are commonly present in the home environments of overweight people and could lead to unplanned eating or passive overconsumption.
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Masters MA, Stanek Krogstrand KL, Eskridge KM, Albrecht JA. Race/ethnicity and income in relation to the home food environment in US youth aged 6 to 19 years. J Acad Nutr Diet 2014; 114:1533-43. [PMID: 24935611 DOI: 10.1016/j.jand.2014.04.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
Abstract
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.
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