Differences in Food Environment Perceptions and Spatial Attributes of Food Shopping Between Residents of Low and High Food Access Areas

ObjectiveTo explore potential differences in food shopping behaviors and healthy food availability perceptions between residents living in areas with low and high food access.DesignA cross-sectional telephone survey to assess food shopping behaviors and perceptions. Data from an 8-county food environment field census used to define the Centers for Disease Control and Prevention (CDC) healthier food retail tract and US Department of Agriculture Economic Research Service food desert measure.ParticipantsA total of 968 residents in 8 South Carolina counties.Main Outcome MeasuresResidents' food shopping behaviors and healthy food availability perceptions.AnalysisLinear and logistic regression.ResultsCompared with residents in high food access areas, residents in low food access areas traveled farther to their primary food store (US Department of Agriculture Economic Research Service: 8.8 vs 7.1 miles, P = .03; CDC: 9.2 vs 6.1 miles, P < .001), accumulated more total shopping miles per week (CDC: 28.0 vs 15.4 miles; P < .001), and showed differences in perceived healthy food availability (P < .001) and shopping access (P < .001).Conclusions and ImplicationsThese findings lend support to ongoing community and policy interventions aimed at reducing food access disparities.     

Food Consumption Patterns of Nigerian Adolescents and Effect on Body Weight

ObjectiveAssociation between nutritional status of adolescents and food consumption pattern.DesignData on number of meals and snacks consumed daily were collected using structured questionnaires. Nutritional status was assessed as weight-for-age body mass index score less than fifth percentile of the National Center for Health Statistics/World Health Organization International Growth Reference.SettingCross-sectional studies of adolescents using multistage random sampling procedure.Participants401 adolescents from 32 secondary schools in Osun State, Nigeria.AnalysisFrequency counts, percentages, and cross-tabulation analysis were used to analyze data, analysis of variance was used to test the differences, as well as chi-square analysis. Level of significance was taken at .05 and .01 levels.Results66.1% of adolescents ate 3 meals daily; this percentage was higher among rural (75.4%) than urban (61.4%) children (P < .001). About 33.0% consumed snacks daily but to a varying degree, which was higher among urban than rural adolescents (P = .002). Prevalence of underweight was 20.1%, more common in rural (22.1%) than urban adolescents (18.7%). Underweight prevalence was highest among those who ate 3 meals and no snacks daily (28.6%) and least among those who ate 3 meals and snacks twice daily (15.9%).ConclusionSnacks are important in food consumption among adolescents; when snacks are consumed in addition to 3 meals, they will improve the nutritional status of adolescents.     

Family Eating Behavior and Child Eating Patterns Differences Between Children With and Without Siblings

ObjectiveTo examine the differences in family eating behaviors and child eating patterns in children with siblings (nonsingletons) and without siblings (singletons).MethodsCross-sectional analysis of mother–child dyads of 5–7-year-old children, (nonsingletons with a 2-to-4-year-old sibling) was conducted. Anthropometrics were measured. Mothers completed questionnaires and a child dietary log. Healthy Eating Index 2010 (HEI) score was calculated. Linear regression models adjusting for child age, child sex, maternal body mass index, and hours-away-from-home were conducted, with a revised P < .021.ResultsSixty-eight mother–child dyads (27 singletons, 41 nonsingletons) participated. Singletons exhibited less healthy family eating behaviors (β = ?4.98, SE = 1.88, P = .003), and lower total HEI scores than did nonsingletons (average: β = ?8.91, SE =2.40, P = .001). On average, singletons had lower scores in 3 HEI components compared with nonsingletons (P < .021 for all).ConclusionIn this sample, singleton children exhibited less healthy eating behaviors. Additional investigation into parent-level differences is warranted.     

Eating habits and eating behaviors by family dinner frequency in the lower-grade elementary school students

BACKGROUND/OBJECTIVES

Recently, there has been an increased interest in the importance of family meals on children''s health and nutrition. This study aims to examine if the eating habits and eating behaviors of children are different according to the frequency of family dinners.

SUBJECTS/METHODS

The subjects were third-grade students from 70 elementary schools in 17 cities nationwide. A two-stage stratified cluster sampling was employed. The survey questionnaire was composed of items that examined the general characteristics, family meals, eating habits, eating behaviors, and environmental influence on children''s eating. The subjects responded to a self-reported questionnaire. Excluding the incomplete responses, the data (n = 3,435) were analyzed using χ²-test or t-test.

RESULTS

The group that had more frequent family dinners (≥ 5 days/week, 63.4%), compared to those that had less (≤ 4 days/week, 36.6%), showed better eating habits, such as eating meals regularly, performing desirable behaviors during meals, having breakfast frequently, having breakfast with family members (P < 0.001), and not eating only what he or she likes (P < 0.05). Those who had more frequent family dinners also consumed healthy foods with more frequency, including protein foods, dairy products, grains, vegetables, seaweeds (P < 0.001), and fruits (P < 0.01). However, unhealthy eating behaviors (e.g., eating fatty foods, salty foods, sweets, etc.) were not significantly different by the frequency of family dinners.

CONCLUSIONS

Having dinner frequently with family members was associated with more desirable eating habits and with healthy eating behaviors in young children. Thus nutrition education might be planned to promote family dinners, by emphasizing the benefits of having family meals on children''s health and nutrition and making more opportunities for family meals.     

Do physicians discuss needed diet and nutrition health topics with adolescents?

PurposePreventive services guidelines recommend screening all adolescents for diet habits, physical activity and growth, counseling underweight teens about body image and dieting patterns, and counseling overweight or obese teens about dietary habits and exercise. In this study, we assess whether adolescents at risk for overweight or for eating disorders have discussed recommended diet and nutrition topics with their physicians.MethodsWe surveyed 14–18-year-old adolescents who had been seen for well care in primary care pediatric and family medicine practices. Adolescents self-reported their weight, height, body image, dieting habits, and issues they had discussed with their clinicians. Body mass index (BMI) was used to define those “at risk for an eating disorder” (< 5% BMI), “at risk of becoming overweight” (85%–95% BMI), and “overweight” (> 95% BMI).ResultsA total of 8384 adolescents completed surveys (72% completion rate). Nearly one-third of adolescents were “at risk” or overweight. Females were less likely to be overweight than males (9.4% vs. 15.7%; p < .001). Although 26.4% were attempting to lose weight, only 12.2% of all teens were actually overweight. Exercise and restricting intake were the preferred methods of weight loss. Physicians routinely discussed adolescents’ weight during visits, and were more likely to discuss it with those “at risk” (p < .001). Body image was more often discussed with girls than with boys (52% vs. 44.6%, p < .001) and with those at risk (51.6% vs. 45.5%; p < .001). Discussion of healthy eating and weight loss occurred more often with adolescents “at risk” for becoming overweight (p < .001).ConclusionsMany adolescents are at risk for being overweight or are currently overweight, confirming the importance of clinicians discussing diet and nutrition health topics with all teens. Many adolescents also misclassify their body image, and hence perceive their body image to be different from their actual BMI; clinicians should discuss body image with all adolescents, not just those at risk for eating disorders. Better interventions are needed to promote healthy nutrition and physical activity to all adolescents.     

Evaluation of a College-Level Nutrition Course With a Teaching Kitchen Lab

ObjectiveTo evaluate the impact of a college nutrition course with a teaching kitchen lab on students’ attitudes, self-efficacy, and behaviors about healthful eating and cooking.MethodsPreintervention and postintervention design, and anonymous online survey of sociodemographic information and students’ attitudes and self-efficacy about consuming fruits, vegetables, and whole grains and about cooking, self-reported intake, and cooking behaviors.ResultsTwo-hundred and fourteen participants enrolled in the study during 5 semesters. Of these, 171 (80%) had complete pretest and posttest data. Attitudes and self-efficacy scores about consuming fruits, vegetables, whole grains, and cooking were significantly higher in the posttest (vs pretest; all P < 0.0001). Self-reported intake of fruits (P < 0.0001) and vegetables (P = 0.0006) also increased. Cooking frequency increased (P < 0.0001), skipping meals frequency decreased (P < 0.0001), whereas no significant changes were observed for eating out, take-out, or premade meals frequency.Conclusions and ImplicationsA college nutrition course with a teaching kitchen lab could improve healthful eating and promote cooking in young adults.     

A Cross-Cultural Comparison of Eating Behaviors and Home Food Environmental Factors in Adolescents From São Paulo (Brazil) and Saint Paul–Minneapolis (US)

ObjectiveDescribe cross-cultural differences in nutrition-related factors among adolescents from São Paulo, Brazil and St Paul–Minneapolis, US.DesignTwo large-population-based studies with cross-cultural comparisons.SettingTwelve São Paulo and 10 St Paul–Minneapolis high schools in 2009–2010.ParticipantsA total of 1,148 adolescents from São Paulo and 1,632 adolescents from St Paul–Minneapolis.Main Outcome Measure(s)Meal consumption, family meals, fast-food consumption, and home food availability.AnalysisBinomial regressions, weighted for age distributions and adjusted for gender, were used to compare identical measures from each sample.ResultsGenerally, São Paulo adolescents reported healthier nutritional outcomes than St Paul–Minneapolis adolescents. São Paulo adolescents were 7 times less likely to report high fast-food consumption than St Paul–Minneapolis adolescents (P < .001). Whereas most measures of the home environment indicated healthier home environments in São Paulo, more São Paulo adolescents reported that sugar-sweetened beverages were usually available at home than did St Paul–Minneapolis adolescents (P < .001).Conclusions and ImplicationsSão Paulo youth tended to have healthier eating behaviors and home food environment factors than St Paul–Minneapolis youth. Brazilian eating patterns tend to be healthier and support a connection with food and culture. Interventions are needed to encourage youth and their families to maintain these patterns.     

School Type,Eating Habits,and Screen Time are Associated With Ultra-Processed Food Consumption Among Brazilian Adolescents

BackgroundThe increasing consumption of ultra-processed foods (UPFs) may be a result of the environmental influences to which adolescents are exposed and/or habits acquired since childhood through family interactions.ObjectiveOur aim was to investigate whether type of school administration (public or private), eating habits, and screen time are associated with the percentage caloric contribution of UPFs to total kilocalories consumed by Brazilian adolescents.DesignA cross-sectional secondary analysis of the Study of Cardiovascular Risk in Adolescents (ERICA) performed between March 2013 and December 2014.Participants/settingOverall, 71,553 adolescents from 1,247 public and private schools in 124 Brazilian cities (with a population of more than 100,000) were included.Main outcome measuresWe measured the percentage caloric contribution of UPFs to the total kilocalories consumed, obtained using one 24-hour food recall.Statistical analyses performedGeneralized linear models were used, guided by the hierarchical model. Sample complexity was considered using the Stata svy command, with a significance level of 5%.ResultsOverall, UPFs contributed an average of 28% (95% CI, 27.80%-28.15%) of total energy intake. Based on the final multivariate analysis, a significantly higher UPF diet was observed among adolescents from private schools (P < .001), those who do not consume meals offered by schools (P < .001), those who do not eat breakfast regularly (P < .05), those who eat in front of screens almost every day or every day (P < .001), and those who spend more time in front of screens (P < .001).ConclusionsThe findings of this study indicate that UPF consumption is associated with school type, eating habits, and screen time among Brazilian adolescents.     

Examining Predictors of Watching Television During Family Meals in a Diverse Sample

ObjectiveTo identify predictors associated with television (TV) watching during family meals.MethodsParents of racially and ethnically diverse 5- to 7-year-old children (n = 150) completed 8 days of ecological momentary assessment surveys. After each meal they shared with their child, parents answered meal-related questions (eg, who was present). Adjusted generalized estimating equations were used to estimate probabilities of watching TV during family meals for individual predictors.ResultsNumber of adults present, location, outside influences (eg, planned meal, stress), and time to prepare the meal were independently predictive of TV watching during the meal (P < .001).Conclusion and ImplicationsResults of the current study suggest that families may need assistance in addressing predictors (eg, stress) associated with watching TV during family meals, given prior research has shown watching TV during family meals is associated with negative dietary outcomes. Future research might investigate other factors that may also influence watching TV at family meals.     

Changes in the Frequency of Family Meals From 1999 to 2010 in the Homes of Adolescents: Trends by Sociodemographic Characteristics

ObjectiveTo examine secular trends from 1999 to 2010 in family meal frequency in a population-based sample of adolescents across sociodemographic characteristics.MethodsA repeated cross-sectional design was used. Participants were from middle schools and high schools in the Minneapolis/St. Paul area and included 3,072 adolescents (mean age = 14.6 ± 1.8 years) in 1999 and 2,793 adolescents (mean age = 14.4 ± 2.0 years) in 2010 from diverse ethnic/racial and socioeconomic backgrounds. Trends in family meal frequency were examined using inverse probability weighting to control for changes in sociodemographic characteristics over time.ResultsFamily meal frequency remained fairly constant from 1999 to 2010 in the overall sample, but decreases were found in population subgroups including girls, middle school students (grade: 6–8), Asians, and youth from low socioeconomic backgrounds. Among youth from the lowest socioeconomic backgrounds, the mean number of family meals in the past week decreased from 4.0 in 1999 to 3.6 in 2010 (p = .003). Furthermore, the percentage of youth from low socioeconomic backgrounds eating five or more meals in the past week decreased from 46.9% in 1999 to 38.8% in 2010 (p < .001). In contrast, family meal frequency tended to increase over time among youth from higher socioeconomic backgrounds.ConclusionsThe widening gap in family meal frequency between youth from low and high socioeconomic backgrounds is concerning, particularly given the greater risk for poor health outcomes among low-income youth. Given findings from other studies suggesting multiple benefits of family meals, interventions to increase family meal frequency are needed that target adolescents and their families from the most vulnerable segments of the population.     

Oregon Parents’ Perceptions of the Supportiveness of the School Environment for Their Children's Health Behaviors

ObjectiveTo describe Oregon parents’ perceptions of their children's school regarding health behaviors; examine how perceptions vary by parent, child, and community characteristics; and identify recommendations for improving school environments.MethodsOregon parents with an elementary school–aged child completed an electronic survey.ResultsOver 90% of parents (n = 814) described their child's school as supportive of healthy eating and physical activity. Parents who ate ≥5 fruits/vegetables per day more often perceived their children's school as unsupportive of healthy eating (P < 0.001) and physical activity (P < 0.05) relative to others. Parents of children eligible for free/reduced-price lunch more often perceived the school as unsupportive of physical activity (P < 0.05) relative to others. Parental recommendations included improving school meals and providing short physical activity breaks.Conclusions and ImplicationsParents’ suggested school improvements can inform school wellness committees’ and administrators’ quality-improvement efforts and, in turn, better support children's healthy behaviors.     

The Effect of Goal Setting on Fruit and Vegetable Consumption and Physical Activity Level in a Web-Based Intervention

ObjectiveTo explore the relationship between goal setting and fruit and vegetable (FV) consumption and physical activity (PA) in an intervention for college students.MethodsSecondary data analysis of intervention group participants from a 10-week online intervention with complete weekly data (n = 724). Outcomes (cups of FV per day and minutes of PA per week) and goals for both behaviors were reported online each week. Weekly differences between goals and behaviors were calculated, as well as the proportion meeting individual goals and meeting recommendations for behaviors.ResultsThere were significant (P < .05) effects of goal setting on both behaviors and of goal group (tertile of meeting weekly goals) on behavior, as well as meeting recommendations for both behaviors. There was an increase in FV consumption (P < .001) but no change in PA over time.Conclusions and ImplicationsGoal setting as part of a Web-based intervention for college students was effective, but results differed for FV and PA. Goal setting for maintaining behavior may need to differ from goal setting for changing behavior.     

Health Behaviors,Nutritional Status,and Anthropometric Parameters of Roma and Non-Roma Mothers and Their Infants in the Czech Republic

ObjectiveTo compare maternal health behaviors, maternal nutritional status, and infant size at birth of Romas and non-Romas in the Czech Republic.DesignMaternal interviews and food frequency questionnaire, maternal blood samples, physical measurements of mothers and infants.SettingHospital, maternal/child care center; 2-4 days postpartum.Participants76 Roma mothers and 151 mothers from the majority population.Main Outcome MeasuresInfant length/weight; maternal height/weight; weight gain during pregnancy; duration of pregnancy; maternal smoking habits; dietary intake; use of food supplements during pregnancy; and maternal blood levels of folate, β-carotene, retinol, and α-tocopherol.AnalysisComparison of ethnic groups by 2-sample Wilcoxon test, chi-square, Fischer's exact test, relative risk, and analysis of variance (ANOVA).ResultsPregnancy duration was about 1 week shorter in Roma women (P < .001), and their infants had lower birth weight (P < .001) and shorter length (P < .001). Prevalence of smoking was significantly higher among Roma mothers (P < .001). Roma women used food supplements less frequently than non-Roma women (P < .001) and had significantly lower mean blood concentrations of folate (P < .001), β-carotene (P < .001), retinol (P < .02), and α-tocopherol (P < .02).Conclusions and ImplicationsThe nutritional status of Roma mothers is worse than that of mothers from the majority Czech population. The dietary and smoking habits of pregnant Roma women should be of special concern to family doctors, obstetricians, nutrition educators, and social workers.     

Acquisition of Cooking Skills and Associations With Healthy Eating in Swiss Adults

ObjectiveTo evaluate the association of early involvement in cooking activities with cooking skills in adulthood, the importance of different sources for the acquisition, and the link between cooking skills and healthy eating.DesignCross-sectional survey.ParticipantsA random sample of 3,659 Swiss adults (47% men; average age = 58.8 years).Main Outcome MeasureSelf-reported cooking skills.AnalysisANOVA, Pearson correlations, t tests, and multiple regressions.ResultsMore frequent involvement in cooking activities during childhood predicted better cooking skills in adulthood in males (β = .13, P < .001) and females (β = .12, P < .001). Females were more involved than males in most age groups (P < .001). Women learned most about cooking from their mothers, cooking courses, and self-study using different media. Men identified their partners/spouses and mothers as the 2 most important sources. The study found associations between cooking skills and diet quality in men (r = .11; P < .001; r² = .01) and women (r = .12; P < .001; r² = .01).Conclusions and ImplicationsIn children and adolescents, frequent involvement in cooking at home may promote better cooking skills in later life. Additional prospective research into the impact of cooking classes and interventions on developing cooking skills in children and adolescents is warranted.     

Relationships of adolescent's dietary habits with personality traits and food neophobia according to family meal frequency

BACKGROUND

A higher frequency of family meals is associated with good dietary habits in young people. This study focused on the relationships of family meal frequency with food neophobia and personality traits in adolescents.

SUBJECTS/METHOD

For this purpose, we administered a survey to 495 middle school students in Seoul metropolitan city, after which the data were analyzed using the SPSS (18.0) program. Pearson correlation was used to determine the relationships among dietary habits, personality traits, and food neophobia according to frequency of family meals.

RESULTS

Dietary habits, personality traits, and food neophobia all showed significant differences according to the frequency of family meals. Further, eating regular family meals was associated with good dietary habits (P < 0.001) and was linked with improved extraversion, agreeableness, conscientiousness, emotional stability, and openness/intellect (P < 0.001). On the other hand, it showed a negative relationship with food neophobia (P < 0.001). The relationship between dietary habits and food neophobia showed a negative correlation (P < 0.01). The relationship between dietary habits and personality traits showed a positive correlation (P < 0.01). Lastly, the relationship between personality traits and food neophobia showed a negative correlation (P < 0.01).

CONCLUSION

Based on the results of the study, the frequency of family meals affects dietary habits, personality traits, and food neophobia in adolescents.     

Family Meal Practices and Weight Talk Between Adult Weight Management and Weight Loss Surgery Patients and Their Children

ObjectiveTo identify predictors associated with specific family meal practices and weight talk among patients participating in weight management programs (WMPs) and weight loss surgery (WLS) and their children.DesignCross-sectional survey.SettingTwo US weight management centers.Participants259 patients (aged ≥ 18 years) in either WMP (n = 101) or WLS (n = 158) and residing with a child (aged 2–18 years)Main Outcome Measure(s)Dependent variables: family meal practices (Project EAT) and weight talk (investigator-created). Covariates: family communication (Family Communication Scale), family discouragement for making eating habit change (Social Support for Eating Habits Survey), child age, sex, and perceived weight status, and WMP or WLS participation.AnalysisBinomial and ordinal regression models determined the odds of engaging in specific family meal practices and weight talk, including covariates.ResultsPatients had increased odds of engaging in family dinners if they reported lower family discouragement (P = .003) and had younger children (P < .001), and increased odds of engaging in family breakfast if they had higher family communication (P = .002) and younger children (P = .020). Patients had increased odds of talking about their child's weight if their child was perceived to have an overweight/obese weight status (P < .001). Patients with older children had increased odds of talking about their weight with their child (P = .021).Conclusions and ImplicationsAdditional research assessing the family meal practices and weight talk in the families of adults pursuing weight loss could yield important evidence that could lead to improved patient outcomes, and safely promote healthy behaviors and prevention of obesity in children.     

Pilot Study of a Virtual Nutrition Intervention for Adolescents and Young Adults With Autism Spectrum Disorder

ObjectiveExamine the impact of a virtual nutrition education program, Bringing Adolescent Learners with Autism Nutrition and Culinary Education (BALANCE), on dietary intake and psychosocial determinants of healthy eating in adolescents and young adults (AYA) with autism spectrum disorder (ASD).MethodsA sample of AYA with ASD aged 12–21 years (n = 27; 6 groups of 2–7 adolescents) participated in BALANCE, a Social Cognitive Theory-based intervention, for eight 30–45-minute lessons. Outcomes were compared using a pre-post design and included dietary intake (assessed using a food frequency questionnaire) and psychosocial determinants of healthy eating (assessed by a validated survey). Wilcoxon signed-rank tests compared preintervention and postintervention medians with an alpha level of 0.05.ResultsMean added sugar intake (P = 0.026) decreased, and behavioral strategies (P = 0.010), self-efficacy (P < 0.001), and outcome expectations (P = 0.009) improved. There was no difference in fruit or vegetable intake or other psychosocial determinants.Conclusions and ImplicationsThe BALANCE intervention may improve psychosocial determinants and dietary behaviors in AYA with ASD. Future virtual programs may incorporate more assistance and support to be accessible for AYA with ASD of varying severity levels.