Associations Between Parental Concern for Adolescent Weight and the Home Food Environment and Dietary Intake

ObjectiveExamine associations between parental concern about adolescent weight and adolescent perceptions of their dietary intake, home food availability, family mealtime environment, and parents' feeding practices.DesignCross-sectional study.SettingAdolescents, aged 12-15 years from 37 secondary schools in Victoria, Australia, and their parents completed surveys in 2004-2005.Participants1,448 adolescent–parent pairs.Main Outcome MeasuresParental concern about adolescent weight; adolescent perceptions of their food intake and home food environment.AnalysisChi-square tests, exploratory factor analysis, independent t tests (P < .01).ResultsAlthough 12% of parents perceived their adolescent as overweight, 27% were concerned about their adolescent's weight (under- or overweight). Adolescents of concerned parents reported lower intakes of energy-dense snacks and less home availability of these food items, and they perceived that their parents less often listened to and considered their food preferences when shopping and cooking, than did adolescents of unconcerned parents. Concerned parents were no more likely to provide fruits and vegetables in the home or a positive family mealtime environment than unconcerned parents, at least as reported by their adolescents.Conclusions and ImplicationsParental concern about adolescent weight was associated with lower intakes of energy-dense snacks among adolescents, less home availability of these food items, and less supportive parental feeding practices. Parents should be encouraged to listen to and consider their adolescents' food preferences, and provide supportive family mealtime environments and healthful food in the home.     

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.     

Family Influence: Key to Fruit and Vegetable Consumption among Fourth- and Fifth-grade Students

ObjectiveTo assess social and familial environmental influences on fruit and vegetable (FV) consumption of fourth- and fifth-graders living in a culturally diverse, urban setting.DesignIn 2006, students from 9 fourth- and fifth-grade classrooms from a public school in the Washington-Baltimore Metropolitan Region were recruited as part of the Food Stamp Nutrition Education's initiative to increase FV consumption among school-aged children in low-income schools. This intervention was conducted in partnership with the school.ParticipantsNinety-three fourth- and fifth-grade students and their parents.Main Outcome MeasureThe average daily FV consumption of elementary school students was the dependent variable. Home engagement (eg, student participation in menu planning and food selection at home), parental modeling, school environment, peer influences, and individual characteristics were the independent variables.AnalysisMultiple regression analysis.ResultsFamily and home environment factors explained more than 50% of the variance in students' FV consumption.Conclusions and ImplicationsInterventions designed to influence school-aged children's FV consumption should target family members and consider incorporating strategies to reach families and promote meal planning activities with the children in their homes.     

Fruit and Vegetable Snack Consumption Among Children With a Body Mass Index at or Above the 75th Percentile

ObjectiveTo describe fruit and vegetable (FV) consumption as snacks and the association with diet quality and compare the snacking environment and child and parent characteristics between children who consumed FV as snacks and those who did not.MethodsThis secondary analysis study used baseline data from a healthy weight management study with 8- to 12-year-old children with a body mass index ≥75th percentile. Data collection included 24-hour dietary recalls, measured height/weight, and child and parent surveys.ResultsChildren (n = 119) consumed 0.1 cup equivalent per 1,000 kcal of FV as snacks, the equivalent of 16.9% of their daily FV consumption. More FV consumption as snacks occurred at home when a parent was present and was associated with higher parent support for FV consumption as snacks (P = 0.03).Conclusions and ImplicationsRenewed attention to strategies to promote FV consumption as snacks, especially at away-from-home locations, is merited.     

Race/Ethnicity and Income in Relation to the Home Food Environment in US Youth Aged 6 to 19 Years

BackgroundThe 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.ObjectiveTo 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).DesignA cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES).ParticipantsA 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 performedPrevalence 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.ResultsNon-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.ConclusionsRace/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.     

Caregivers’ Role in the Effectiveness of Two Dutch School-Based Nutrition Education Programmes for Children Aged 7–12 Years Old

Childhood eating behaviours can track into adulthood. Therefore, programmes that support early healthy eating, including school-based nutrition education programmes, are important. Although school-based programmes may be beneficial in improving nutrition knowledge, impact on actual fruit and vegetable (FV) intake is generally limited as FV intake is also influenced by the home environment. The current study includes secondary analyses of data from an evaluation study on Dutch nutrition education and examined the role of caregivers’ health promotion behaviours (HPB) in influencing healthy eating behaviours in primary school children (n = 1460, aged 7–12 years) and whether caregivers’ HPB contribute to programme effectiveness. Children’s nutrition knowledge, FV intake and caregivers’ HPB (FV/sugar-sweetened beverages/sweets provision to take to school, cooking together and talking about healthy food at home) were measured by child-reported questionnaires at baseline, during, and 6 months post-programme. Results indicated that caregivers’ HPB was positively associated with children’s healthy eating behaviours and that programme effectiveness was highest in those in the lower HPB subcategory. In conclusion, children with less encouragement to eat healthily at home potentially benefit more from school-based nutrition education programmes than children receiving more encouragement. This highlights the important role of the home environment in supporting healthy eating behaviour in children.     

Parent Food and Eating Behavior Assessments Predict Targeted Healthy Eating Index Components

ObjectiveTo examine the ability of parent response to assessments of in-home availability of 20 fruits and vegetables (FV), self-efficacy/outcome expectancy to prepare FV that their child would eat, modeling of FV eating behavior, and eating competence to predict parents’ targeted Healthy Eating Index–2010 (HEI) scores at baseline.DesignCross-sectional survey.SettingSixty-one classrooms in 8 northern Colorado elementary schools over 4 years participating in Fuel for Fun (FFF), a school-based culinary and physical activity intervention.ParticipantsParents and guardians (n = 71) of fourth-grade youths from participating classrooms.Main Outcome Measure(s)Healthy Eating Index–2010 scores as derived from 24-hour recalls administered with the Automated Self-Administered 24-hour dietary assessment tool.AnalysisGeneralized linear regression models tested the predictive validity of survey assessments for targeted HEI components. Results were considered statistically significant at P ≤ .05.ResultsIn-home FV availability predicted total fruit (P = .01), whole fruit (P = .001), and total vegetable (P = .01) HEI, and parent modeling of FV eating behavior predicted total fruit (P = .01) and whole fruit (P = .02) HEI. However, these survey measures were not associated with other HEI components, including total HEI. Parent self-efficacy/outcome expectancy to prepare FV that their child would eat or like was not associated with total HEI or HEI components. Eating competence did not predict total HEI but was associated with seafood and plant proteins in the anticipated direction (P = .04).Conclusions and ImplicationsThe results demonstrated construct validation of some parent Fuel for Fun survey assessments with targeted HEI components. Additional assessment in larger and more diverse samples is warranted so that nutrition education and behavior researchers may use these valid and reliable, brief, low-cost, and easy-to-use survey instruments as a proxy for dietary intake.     

Skin Carotenoid Scores Assessed with Reflection Spectroscopy Are Associated with Self-Reported Fruit and Vegetable Intake Among Latino Early Adolescents

BackgroundLatino early adolescents have a high prevalence of overweight and obesity. Interventions to address healthy eating among Latino youth frequently focus on fruit and vegetable (FV) intake. Reflection spectroscopy assessed skin carotenoid (SC) levels has been proposed as an easy, noninvasive method to evaluate FV intake, but validation studies involving ethnically diverse youth are lacking.ObjectiveThis study aimed to assess the association between reflection spectroscopy-measured SC scores and self-reported FV intake among low-income, urban, Latino early adolescents, controlling for potential confounding factors.DesignThis study was a cross-sectional secondary analysis of baseline data from a community-based intervention program (Padres Preparados, Jóvenes Saludables) involving Latino fathers and adolescents to improve paternal parenting practices and youth energy balance-related behaviors.Participants/settingParticipants were 195 low-income, Latino early adolescents (aged 10 to 14 years). Data were collected in the Minneapolis/St Paul metropolitan area from 2017 to 2020 during fall or winter months.Main outcome measuresSC scores were measured using reflection spectroscopy, usual intakes of FV and carotenoid compounds were estimated based on the assessment using 24-hour dietary recalls.Statistical analysisMultivariable linear regression analyses were used to estimate associations of SC scores and each dietary component and potential confounding factors after assessing variables for inclusion in the analyses.ResultsThe mean SC score was 225 ± 95. The mean FV and total carotenoid intakes were 3.3 ± 0.5 servings/day and 8,360 ± 786 μg/day, respectively. Higher SC scores were observed among youth who had higher FV (β = .37 and P < 0.01) or total carotenoid intakes (β = .31 and P < 0.01). SC scores measured during fall were higher than scores measured during winter. Study participants with higher home FV availability and accessibility had higher SC scores.ConclusionsFindings supported using SC score as a potential easy-to-use indicator of FV intake among Latino youth with consideration of seasonal variation and home FV availability and accessibility.     

Perceived parental food controlling practices are related to obesogenic or leptogenic child life style behaviors

To better understand whether the parental food controlling practices pressure and restriction to eat are obesity preventing or obesity promoting, this study examined whether these parenting practices are related to other (food or non-food) areas that are generally regarded as obesogenic or leptogenic. Are these foods controlling practices more indicative of obesogenic or leptogenic child life style behaviors? In a sample of 7–12-year-old boys and girls (n = 943) the perceived parental food controlling practices were related to various measures for unhealthy life style. Using factor analysis we assessed whether there is a constellation of lifestyle behaviors that is potentially obesogenic or leptogenic. Remarkably, perceived parental restriction and pressure loaded on two different factors. Perceived parental restriction to eat had a negative loading on a factor that further comprised potential obesogenic child life style behaviors, such as snacking (positive loading), time spend with screen media (television or computer) (positive loadings) and frequency of fruit consumption (negative loading). Perceived parental pressure to eat had a positive loading on a factor that further comprised potential leptogenic life style behaviors such as frequency of eating a breakfast meal and sporting (positive loadings). It is concluded that low perceived parental restriction in regard to food may perhaps be a sign of more uninvolved ‘neglecting’ or indulgent parenting/obesogenic home environment, whereas high perceived parental pressure to eat may be sign of a more ‘concerned’ leptogenic parenting/home environment, though more research into style of parenting is needed.     

Perceived Produce Availability and Child Fruit and Vegetable Intake: The Healthy Communities Study

Children eat more fruits and vegetables when more are available at home, but less is known about how the neighborhood food environment relates to children’s diet and weight outcomes. The goal of this study was to determine whether parental perception of the food environment (neighborhood and home) is associated with children’s fruit and vegetable (F&V) intake and weight outcomes, and to assess differences by household food security status and household income. Cross-sectional data from the 2013–2015 U.S. Healthy Communities Study included 5138 children, aged 4 to 15 years old, from 130 U.S. communities. Neighborhood and home food environments were assessed with parent-reported, perceived F&V availability scores. Associations were tested with multi-level linear regression models. Parents’ perception of produce availability was associated with household F&V availability ratings (β = 0.09 points, p < 0.001). Household F&V availability was associated with child F&V intake (β = 0.32 cups/day or 25.6 g/day, p < 0.001). A higher child F&V intake was associated with a lower child BMI z-score (β = −0.05, p = 0.002). Weaker relationships were seen for children living in food insecure or low-income households. Optimizing neighborhood and home access to F&V may help children improve diet quality, but may not be as effective for children living in food insecure or low-income households.     

Taste preferences, liking and other factors related to fruit and vegetable intakes among schoolchildren: results from observational studies

The present paper explores the relative importance of liking and taste preferences as correlates of fruit and vegetable (FV) intakes among schoolchildren in Europe. The paper first provides an overview of potential determinants of food choice among children and subsequently summarizes the results of two recent observational studies on determinants of FV intakes among school-aged children. It is proposed that taste preferences and liking are important for children's food choices as part of a broader spectrum of nutrition behaviour determinants. Taste preferences and liking are important for motivation to eat certain foods, but social-cultural and physical environmental factors that determine availability and accessibility of foods, as well as nutrition knowledge and abilities should also be considered. Study 1 shows that children with a positive liking for FV have a greater likelihood to eat fruits (odds ratio (OR) = 1.97) or vegetables (OR = 1.60) every day, while ability and opportunity related factors such as knowledge, self-efficacy, parental influences and accessibility of FV were also associated with likelihood of daily intakes (ORs between 1.16 and 2.75). These results were consistent across different countries in Europe. Study 2 shows that taste preferences were the strongest mediator of gender differences in FV intakes among children; the fact that girls eat more could for a large extend be explained by there stronger taste preferences.     

Food Parenting Practices That Influence Early Adolescents’ Food Choices During Independent Eating Occasions

ObjectiveTo identify practices that parents use to influence early adolescents’ food choices during independent eating occasions (iEOs) from parent and child perspectives.DesignIn-depth interviews.ParticipantsLow-income parents (n = 49) and early adolescent children (aged 10–13 years; n = 44) from 10 US states and the District of Columbia.Phenomenon of InterestParent and child perspectives on parenting practices that influence food choices during iEOs.AnalysisAudio-recorded interviews transcribed verbatim, NVivo coding, and directed content analysis.ResultsParents reported setting rules and expectations and managing availability or accessibility as the most common practices used to influence iEOs. Other practices included teaching, pressuring to eat, monitoring, and modeling. Children reported that their parents had rules about what they could or could not eat during iEOs and that they used specific strategies (eg, call or text) to monitor their iEOs.Conclusions and ImplicationsAdditional studies are needed to confirm findings from this exploratory study. Future cross-sectional and longitudinal studies could determine whether and to what extent food parenting practices identified in the current study are associated with healthy dietary intake during iEOs, as well as potential racial and ethnic differences.     

Relationship Between Grocery Shopping Frequency and Home- and Individual-Level Diet Quality Among Low-Income Racial or Ethnic Minority Households With Preschool-Aged Children

BackgroundThe home food environment can shape the diets of young children. However, little is known about modifiable factors that influence home food availability and dietary intake.ObjectiveThe purpose of this study was to examine the relationship between grocery shopping frequency with home- and individual-level diet quality.DesignThis was a secondary, cross-sectional analyses of data from the Study on Children’s Home Food Availability Using TechNology. Data were collected in the homes of participants from November 2014 through March 2016.Participants/settingsA purposive sample of 97 low-income African American and Hispanic or Latinx parent–child dyads residing in Chicago, IL, enrolled in the study.Main outcome measuresThe main outcomes were home- and individual-level diet quality. Healthy Eating Index-2010 (HEI-2010) scores were calculated from home food inventory data collected in participants’ homes to assess home-level diet quality. To assess individual-level diet quality, HEI-2010 scores were based on multiple 24-hour diet recalls from parent–child dyads.Statistical analysesGrocery shopping frequency was examined in relation to diet quality at the home and individual levels. Grocery shopping frequency was defined as the number of times households shopped on a monthly basis (ie, once a month, twice a month, 3 times a month, or 4 times or more a month). Multivariable linear regression analysis, controlling for covariates, tested the relationships between grocery shopping frequency and HEI-2010 total and component scores at the home and individual levels.ResultsGrocery shopping frequency was positively associated with home-level HEI-2010 scores for total diet, whole grains, and empty calories (higher scores reflect better diet quality) and with individual-level HEI-2010 scores for total and whole fruit (parents only), vegetables (children only), and sodium (children only).ConclusionsGrocery shopping frequency was associated with multiple dimensions of diet quality at the home and individual levels. These results offer a potential strategy to intervene on home food availability and individual dietary intake.     

Changing the home nutrition environment: effects of a nutrition and media literacy pilot intervention

The specific aim for this pilot study was to evaluate the effectiveness of a nutrition and media literacy intervention targeting elementary students and their parents. The purpose of the intervention was to increase child fruit and vegetables (FV) consumption and change the home nutrition environment (measured with FV availability and accessibility and parental social support). During the intervention, students learned about nutrition, the role media plays in shaping values concerning nutrition, and developed a media campaign for their parents. A quasi-experimental research design was used to evaluate the effectiveness of the intervention. The media intervention was effective in changing the home environment.     

Parents’ Perceptions of 5210 Nutrition Messaging and Child Weight Status

ObjectiveTo explore parent perceptions of child weight status and 5210 nutrition messaging recommendations, including daily consumption of 5 fruits and vegetables, limiting child screen time to ≤2 hours, incorporating 1 hour of daily physical activity, and no consumption of sugary, sweetened beverages.MethodsUsing the Convergence Model of Communication as a framework, qualitative focus groups (n = 5) were conducted at 4 Head Start sites across 1 Ohio County. Twenty-eight parents aged 20–60 years comprised the groups. A deductive analysis technique with respondent validation was used.ResultsParents have limited understanding of 5210 messages delivered by the program. Parent food preferences, family finances, and children's picky eating were identified as barriers to integrating healthy eating habits at home. Parents prefer practical strategies regarding how to integrate healthy eating habits into the home environment. Participants expressed concern about children's psychological health and happiness vs weight status.Conclusions and ImplicationsUnderstanding parental perceptions of 5210 messaging and program-reported weight status may assist Head Start programs in addressing childhood obesity through focused parent education and support.     

Differences between parents' and adolescents' perceptions of family food rules and availability

OBJECTIVE: To test the hypotheses that adolescents have different perceptions of family-environmental factors than do their parents, and that dietary intake of adolescents is more highly associated with the adolescent's own perceptions than those of their parents. DESIGN: Data from self-administered questionnaires were used. PARTICIPANTS: Five-hundred two students aged 12 to 14 years, and one of each student's parents. MAIN OUTCOME MEASURES: Two types of family-environmental factors (ie, family food rules and home availability and accessibility of food) for 3 self-reported dietary behaviors (ie, fruit, snack, and breakfast intake). ANALYSIS: Unpaired t tests, chi-square tests, percentage (gross) disagreement, standardized regression coefficients, and linear regression analyses. RESULTS: For most rules and most perceptions of availability and accessibility, considerable disagreement was found between parents and students. Self-reported intake of fruit and snacks was more highly associated with student measures, but breakfast intake was more highly associated with parent measures of rules and availability. IMPLICATIONS FOR RESEARCH AND PRACTICE: The findings might explain mixed results on the associations between family-environmental factors and children's dietary intake that were found in earlier studies. Researchers need to be aware that in studies into family-environmental determinants of dietary habits using self-reports, the results are possibly influenced by whether the data were reported by parents or by children.     

Determinants of Dietary Intake in a Sample of White and Mexican-American Children

Objective To assess the influence of several potential psychosocial determinants on children's eating behavior.Participants Three hundred fifty-one Mexican-American and non-Hispanic white children (mean age=4.4 years old at baseline) participated in the San Diego Study of Children's Activity and Nutrition for up to 2.5 years.Methods Child's eating behavior was described by 3 dependent variables: total energy, percentage energy from fat, and sodium intake per 1,000 kcal. Dietary information was collected 4 days a year using a 24-hour food intake record, which was a combination of direct observation and interviews with food preparers. The 35 predictor variables from child, parental, demographic, and environmental domains were collected by behavioral observation, interviewer-administered questionnaires, and physical measurements.Statistical analyses Bivariate and regression analyses via mixed linear models were performed.Results Variables from the children's domain (such as skinfold thickness and weight) had the strongest associations with energy intake; parental variables (such as fat avoidance behavior and prompts to increase children's food intake) were associated with child's percentage energy from fat and sodium intake. In regression analyses, parsimonious subsets of variables accounted for 46% of variance in energy intake (3 variables), 40% of the variance in percentage of energy from fat (4 variables), and 44% of variance in sodium intake per 1,000 kcal energy (1 variable) in between-subject variance components.Conclusions Fat and sodium intake of children may be improved by improving parents’ nutrition habits and by having parents encourage children to eat a healthful diet. Few modifiable correlates of children's energy intake were identified. J Am Diet Assoc. 1998;98:1282–1289.