Food choices of young African-American and Latino adolescents: where do parents fit in?

To gain insight into parents' perceptions of the food preferences of their young adolescents, and their negotiating and decision-making strategies around food purchasing and meals, four focus groups were held with 32 African-American parents and three focus groups with 14 Spanish-dominant, first-generation immigrant Latina mothers. Most participants were of low socioeconomic status and were single parents. Many African-American parents emphasized children's growing appetites and preferences for fast food. Many reported making weekday dinner decisions jointly with the child or allowing the child to eat a lunch-like alternative, and allowing serve-yourself meals on weekends. A few prepared traditional ethnic foods. Latina parents reported that their children liked ethnic foods and fast/junk foods. They emphasized buying foods their children wanted, making no eating restrictions, and preparing traditional ethnic dinners without alternatives. African-American and Latina parents displayed concern over whether to place restrictions on young adolescents' eating. Further research is needed on the ways in which socioeconomic inequalities compound barriers to healthful eating, with particular attention to low income and immigrant populations.     

Nutrition-related health promotion through an after-school project: the responses of children and their families

UK health policy is concerned with emphasising nutritional status as a factor in the relationship of social inequalities to health outcomes. This paper examines pupil and parent responses to an after-school 'Food Club' designed to promote food preparation skills and healthier food choices amongst 12-13 year olds in low-income areas in North East England. The rationale for the intervention was a series of distinct but connected premises: food preparation skills are essential to inexpensive healthier eating; practical cooking skills are given limited emphasis in the secondary school curriculum; children have some choice over what they eat and may serve as a conduit of influence within the family. The qualitative investigation used group discussions and individual interviews with participating pupils and their parents. Most participating pupils enjoyed the practical emphasis upon food preparation, believed their skills developed, and were aware of the underlying message about healthier eating, but only made limited changes to their diet. Interviews with parents showed most to be positive about their child's involvement in such a club, though they varied in their attitude to its underlying message. There was some evidence of children being more involved in cooking at home and making some specific requests about food, but little to suggest they were influencing family food consumption. The findings suggest that an extra-curricular Food Club is an appropriate and feasible approach to developing food preparation skills with pupils in this age group. These findings raise questions about children's opportunities to exercise food preparation skills and make food choices within families, and the extent to which barriers to dietary change may be lowered through educational initiatives directed at pupils.     

Understanding Barriers to Implementing Quality Lunch and Nutrition Education

Food services and nutrition education are priorities for the Coordinated School Health Program in Massachusetts, which is a CDC funded partnership between the Massachusetts Departments of Education and Public Health. Despite funding and resources provided by governmental and non-governmental agencies, schools are facing barriers in effectively creating a healthy nutritional environment. A qualitative survey was conducted to understand barriers to implementing quality lunch and nutrition education programs perceived by superintendents, principals, food service directors, nurses, and health educators in Massachusetts. The results suggest that while funding can initially enable schools to provide quality lunch, but without changes in students' preference for unhealthy food and parental and community involvement in fostering students' healthy eating behavior, the lunch programs cannot achieve a sustainable success. Lack of opportunity for communication among food service staff, health educators, and teachers appears to hinder the coordination necessary to promote school lunch as well as school-wide nutrition education. Respondents acknowledged that the state's academic assessment system is the priority issue in their schools, but expressed that the interests and initiatives of superintendents and principals in the lunch and nutrition education programs can be enhanced. Overall, the results suggest that successful implementation of quality lunch and nutrition education programs require not only the collaborative efforts of school administration and staff but also the support of parents, community, and the mass media.     

Children eat their school lunch too quickly: an exploratory study of the effect on food intake

ABSTRACT: BACKGROUND: Speed of eating, an important aspect of eating behaviour, has recently been related to loss of control of food intake and obesity. Very little time is allocated for lunch at school and thus children may consume food more quickly and food intake may therefore be affected. Study 1 measured the time spent eating lunch in a large group of students eating together for school meals. Study 2 measured the speed of eating and the amount of food eaten in individual school children during normal school lunches and then examined the effect of experimentally increasing or decreasing the speed of eating on total food intake. METHODS: The time spent eating lunch was measured with a stop watch in 100 children in secondary school. A more detailed study of eating behaviour was then undertaken in 30 secondary school children (18 girls). The amount of food eaten at lunch was recorded by a hidden scale when the children ate amongst their peers and by a scale connected to a computer when they ate individually. When eating individually, feedback on how quickly to eat was visible on the computer screen. The speed of eating could therefore be increased or decreased experimentally using this visual feedback and the total amount of food eaten measured. RESULTS: In general, the children spent very little time eating their lunch. The 100 children in Study 1 spent on average (SD) just 7 (0.8) minutes eating lunch. The girls in Study 2 consumed their lunch in 5.6 (1.2) minutes and the boys ate theirs in only 6.8 (1.3) minutes. Eating with peers markedly distorted the amount of food eaten for lunch; only two girls and one boy maintained their food intake at the level observed when the children ate individually without external influences (258 (38) g in girls and 289 (73) g in boys). Nine girls ate on average 33% less food and seven girls ate 23 % more food whilst the remaining boys ate 26% more food. The average speed of eating during school lunches amongst groups increased to 183 (53) % in the girls and to 166 (47) % in the boys compared to the speed of eating in the unrestricted condition. These apparent changes in food intake during school lunches could be replicated by experimentally increasing the speed of eating when the children were eating individually. CONCLUSIONS: If insufficient time is allocated for consuming school lunches, compensatory increased speed of eating puts children at risk of losing control over food intake and in many cases over-eating. Public health initiatives to increase the time available for school meals might prove a relatively easy way to reduced excess food intake at school and enable children to eat more healthily.     

What helps children eat well? A qualitative exploration of resilience among disadvantaged families

It is well known that persons of low socioeconomic position consume generally a less healthy diet. Key determinants of unhealthy eating among disadvantaged individuals include aspects of the family and external environment. Much less is known about family and environmental determinants of healthy eating among social disadvantaged children. The aim of this study was to gain insight into the family and environmental factors underlying resilience to poor nutrition among children and their mothers living in disadvantaged neighbourhoods. Semi-structured interviews were conducted with 38 mother-child pairs (N = 76) from disadvantaged neighbourhoods. Children were selected if they were a healthy weight, consumed adequate intakes of fruit and vegetables and were physically active. Two main themes emerged from the interviews: active strategies from parents to promote healthy eating and external barriers and supports to healthy eating. Mothers believed that exercising control over access to unhealthy food, providing education and encouragement for consumption of healthy food and enabling healthy food options aided their child to eat well. Children did not perceive food advertisements to be major influences on their eating preferences or behaviour. The results of the current study offer insight into potential avenues for nutrition promotion among disadvantaged children.     

Children's eating behavior: the importance of nutrition standards for foods in schools

BACKGROUND: To enhance the impact of school nutrition programs on children's health, more information is needed on the associations between healthy and unhealthy food offerings during school lunch periods and children's eating behavior. The purpose of this study is to evaluate the contributions of food offerings and participation in school lunch programs on children's overall (both in‐ and out‐of‐school) eating behavior. METHODS: A cross‐sectional observational study was conducted in which 2039 students in 12 elementary and 10 middle schools reported their eating behavior and the frequencies with which they purchased meals and à la carte items in the school cafeteria. Food service managers from each school provided information on the availability of foods and beverages during school lunch periods. Multilevel regression analyses were conducted to identify school‐ and student‐level predictors of children's eating behavior. RESULTS: The availability of nutritious foods during school lunch periods was associated with healthier eating behavior among students. However, this effect was observed only among children who infrequently purchased à la carte food items, and not among those who were frequent purchasers. CONCLUSION: Increased availability of fruits, vegetables, whole grains, and low‐fat dairy products as components of school meals may be an effective strategy to promote healthy eating behaviors among children. Improving the nutrition standards for foods offered in competition with federally reimbursable school meals may enhance the positive effects of school meal programs on student eating behavior.     

Parent's views of the importance of making changes in settings where children spend time to prevent obesity

AIM: To examine the kinds of changes parents would like to see in those settings where children spend time (kindergartens and schools, child care centres and after-school care facilities, and the local neighbourhood) in policies and practices that impact on children's risk of obesity, and to establish whether parents might be willing to advocate for changes in these settings. MATERIALS AND METHODS: 175 parents from five randomly selected primary schools and five randomly selected kindergartens located in suburbs of metropolitan Melbourne completed a questionnaire in which they rated the importance of a number of potential changes to promote healthy eating and increase physical activity in their children. RESULTS: Parents of children in kindergarten most commonly rated changes to the eating environment as important. In contrast, parents of primary school children believed changes related to both eating and physical activity in school were important. Ninety-five per cent of parents of kindergarten children and 89% of parents of primary school children believed it was possible for parents to bring about change to provide more opportunities for their child to eat more healthily and be more physically active. One in four parents reported that they had thought about or had tried to bring about changes in their community. CONCLUSIONS: The findings suggest that mobilising parents to take an active role in advocating for change in those settings that have the potential to shape their children's physical activity and eating behaviours may be feasible.     

Dutch Preadolescents’ Food Consumption at School: Influence of Autonomy,Competence and Parenting Practices

Eating habits appear to become less healthy once children move into adolescence. Adolescence is characterized by increasing independence and autonomy. Still, parents continue influencing adolescents’ eating habits. This cross-sectional study used a Self-Determination Theory perspective to examine how parents can support preadolescents’ food-related autonomy and competence and how these factors are associated with healthy eating motivation and food consumption at school. In addition, the effect of relative healthy food availability at home on preadolescents’ food consumption at school was explored. In total, 142 Dutch preadolescents (mean age 12.18) and 81 parents completed questionnaires. The results showed that preadolescents perceived themselves as having higher food-related autonomy and lower competence to eat healthily as compared to their parents’ perceptions. A path analysis was conducted to test the hypothesized model. Although parental support was positively associated with food-related autonomy, higher food-related autonomy was related to less healthy food intake at school. On the other hand, competence to eat healthily indirectly affected preadolescents’ healthy intake ratio through their healthy eating motivation. Finally, the relative availability of healthy options at home was positively associated with preadolescents’ healthy intake ratio outside the home. Findings from the study advance the understanding of individual and environmental factors that influence eating habits during the key life period of early adolescence. The results may inform interventions aiming to guide preadolescents to make healthy food choices on their own.     

Changing memory of food enjoyment to increase food liking, choice and intake

Novel ways to increase liking and intake of food are needed to encourage acceptance of healthier food. How enjoyable we remember food to have been is likely to be a significant predictor of food choice. Two studies examined whether remembered enjoyment of eating a food can be increased and whether this makes individuals more likely to eat that food in the future. In Study One, a simple manipulation of instructing participants to rehearse what they found enjoyable about a food immediately after eating it was used to increase remembered enjoyment (relative to controls). In a separate study; Study Two, the effect of increasing remembered enjoyment on food choice was tested by examining whether the manipulation to increase remembered enjoyment resulted in participants choosing to eat more of a food as part of a later buffet lunch. The experimental manipulation increased remembered enjoyment for the food (Study One). A change in remembered enjoyment was shown to have a significant effect on the amount of a food participants chose to eat the following day for lunch (Study Two). The present studies suggest that remembered enjoyment can be increased via a simple act of rehearsal, resulting in a later increase in the amount of food chosen and eaten. Interventions based on altering remembered enjoyment of healthy food choices warrant further investigation.     

Adolescents from low‐income families in Hong Kong and unhealthy eating behaviours: Implications for health and social care practitioners

The development of dietary preferences of adolescents involves a complex interplay of individual behaviours and environmental factors. Interpersonal factors—such as peer influences and unpleasant school experiences—and institutional factors—such as school rules and policies—are closely associated with unhealthy eating of adolescents. Family support and guidance are also crucial in influencing adolescents’ eating habits. However, the low social status, low educational levels, and low household incomes of disadvantaged parents can markedly prevent their children from establishing healthy eating habits. Therefore, adolescents from low‐income families are more likely to engage in unhealthy dietary behaviours and hence to be more susceptible to diet‐related health problems. However, few studies have addressed the difficulties associated with inculcating healthy eating habits among adolescents from low‐income families. Therefore, to investigate the barriers to adopting healthy eating habits, this study adopted a qualitative research approach and conducted five focus‐group semistructured interviews with 30 junior‐ and senior‐form students of a secondary school in Hong Kong, all of whom were from low‐income families. The results revealed skipping meals because of poverty, following irregular meal patterns on school holidays, receiving poor guidance from family and peers, perceiving healthy eating as expensive and unappealing, and geographical inaccessibility to healthy food all prevented these students from healthy eating. These mutually reinforcing factors were interlocking with the economic strain that was experienced by the participants and their families. In particular, the stereotype of “healthful food is expensive” was strong. Therefore, we suggest students from low‐income families should be enabled to understand that healthy eating is not necessarily expensive. The participants’ stereotypes about healthy food was handed down by their parents. Such stereotypes, together with the low health literacy, influence the food preparation habits of the parents. Therefore, parents should be made to aware that healthful food can also be affordable.     

Social-environmental influences on children's diets: results from focus groups with African-, Euro- and Mexican-American children and their parents

Children's fruit, juice and vegetable (FJV) and fat intakes do not meet recommended guidelines. Since personal factors account for only a small percentage of the variability in children's FJV consumption, social and environmental influences were explored via focus group discussions with Grade 4-6 African-, Euro- and Mexican-American students and parents. Questions included the effects of social influences, availability and accessibility on children's FJV and low-fat food choices. Few ethnic differences were noted. A variety of low-fat items and fresh FJV (not cut-up) were available at home; older children were expected to prepare their own. Eating out occurred at least twice a week; FJV were not usual restaurant choices. Students reported some modeling by parents (more mothers) and friends (usually at lunch). Negative peer responses for eating vegetables were reported. Parents were concerned with children eating too much junk food and not enough FJV, recognized the outside influences their children received about food, and reported several methods to encourage children to eat FJV. Recommendations for future interventions are proposed.     

Nordic adolescents' school lunch patterns and their suggestions for making healthy choices at school easier

This article examines Nordic adolescents' school lunch patterns and their perceptions of how making healthy choices at school could be easier. Analysis is based on a quantitative data-set collected between 2006 and 2007 as part of a Nordic research project. The sample of 1539 respondents consisted of 14-17 year old adolescents from Finland, Sweden, Denmark, and Norway. The number of adolescents regularly eating either a packed lunch or a hot school lunch differed between countries and statistically significant differences were found between girls' and boys' school lunch patterns in the Swedish and Finnish data. Results suggest that adolescents have an understanding of what is healthy, but that school resources do not always support their ability to make healthy choices. Adolescents' own suggestions for improvement imply that more attention should be paid to building a healthy school food environment. An important future challenge is trying to involve school health care personnel and aligning classroom activities more coherently with adolescents' eating patterns during the school day.     

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 family meal panacea: exploring how different aspects of family meal occurrence,meal habits and meal enjoyment relate to young children’s diets

The general consensus in the research to date is that family meals are linked to healthier eating habits in children, compared to not eating with the family. Yet, few studies explore what it is about commensality which leads to better food choices among children. Using a representative Scottish sample of five‐year‐old children, this research explores the extent to which family meal occurrence, meal patterns regarding where, when and with whom children eat and perceived meal enjoyment predict the quality of children’s diets after controlling for indicators of maternal capital that influence both meal rituals and taste preferences. Eating the same food as parents is the aspect of family meals most strongly linked to better diets in children, highlighting the detrimental effect in the rise of ‘children’s food’. Although theoretical and empirical work pointed to the important health advantage in children eating together with parents, the results suggested that eating together was a far less important aspect of family meals. In evaluating the importance of the family meal, this article redirects attention away from issues of form and function towards issues of food choice. Policy implications and the importance for public health to recognise the way eating habits are defined by and reproduce social and cultural capital are discussed.     

Facilitators and Barriers to Implementing Healthy School Canteen Intervention among Malaysian Adolescents: A Qualitative Study

This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools’ stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students’ food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsidising healthy meals might encourage healthy eating. Among barriers to implementing healthy school initiatives were the student’s perception of healthy food and their eating habits, which also affect the food vendors’ profit if they want to implement a healthy canteen. The school-based intervention has the potential to promotes healthier eating among school adolescents. Continuous training and monitoring of canteen operators and convenience shops are needed, including building partnerships and educating the students on healthy eating to cultivate healthy eating habits.     

Australian Middle Eastern parents’ perceptions and practices of children's weight‐related behaviours: Talking with Parents’ Study

The home environment is associated with obesity‐related behaviours among children, and research in Australia has shown that some of these behaviours are more prevalent among children from particular cultural backgrounds including Middle Eastern. This study presents findings from face‐to‐face, semi‐structured interviews conducted in April 2013 with a convenience sample of Middle Eastern parents of primary school‐age children at an Islamic private school in Sydney, Australia. The interviews explored parental perceptions and practices regarding state government health messages addressing children's eating, physical activity and screen time. The purpose of the study was to investigate whether the content of these generic public health messages is relevant and acceptable to Middle Eastern parents of young children, and to identify any enablers and barriers to adopting these healthy practices at home. Thematic analysis identified predominant themes. In total, 21 interviews were conducted (reference children: 12 boys/9 girls, aged 5–12 years). The content of current health messages regarding children's weight‐related behaviours was familiar to respondents, and accepted as relevant for guiding their parenting practices. Parents perceived that they typically encouraged healthy behaviours, although they also reported making regular exemptions, in response to various circumstances. Overall, the perceptions and reported practices of the parents were consistent with other studies with Australian parents. There were no apparent culturally specific barriers or enablers to children's weight‐related behaviours. There is however scope for health promoters to provide more precise information on health recommendations, health risks and benefits, and to provide more specific ideas for ways in which parents can act on these health messages within the home and family environment, to encourage and support healthy behaviours in their children.     

Children's nutritional intake as part of the Eat Well Do Well scheme in Kingston‐upon‐Hull – a pilot study

In April 2004 Hull City Council introduced free healthy school meals for all primary and special schools in an attempt to reduce health inequalities. This pilot study aimed to compare nutritional intake between those children consuming a free healthy school meal and those consuming a packed lunch brought from home. The study compared two schools from different socio‐economic areas and considered the impact of lunch on total daily food and nutrient intakes in these children. Fieldwork was undertaken over five consecutive days in each school. Seven hundred and thirty‐five lunches were weighed and photographed before and after consumption to assess actual food intake vs. wastage. One hundred and forty‐seven children aged 8‐to‐11‐years participated from two primary schools. Five‐day food diaries were completed by a small number of participants (n = 20) receiving school meals (n = 10) and packed lunches (n = 10) from the two schools selected. While the lunches provided at the two schools met the majority of the nutritional guidelines for school meals, children ate only a small amount, often leaving the potatoes and vegetables behind; therefore, their intakes were below recommended levels. Children from both schools who opted for packed lunch consumed significantly more energy, fat, sugar and sodium but with this more micronutrients than children who had a free healthy school meal. Statistical differences (P < 0.01) were found between the two schools, with children from the less affluent school consuming less food from the school meal and therefore obtaining a lower nutrient intake from lunch than children from the more affluent school. Findings from a small number of food diaries suggest that the differences in intakes between those having a school meal and those having a packed lunch were compensated for by other food consumed during the day, such that daily nutrient intakes were not significantly different. This study suggests that many children may not be consuming sufficient amounts of the food provided in schools. Therefore, it cannot be assumed that the provision of school meals that conform to the School Food Trust guidelines will be of nutritional benefit to all children concerned. Bearing this in mind, more needs to be done to provide menus that are both healthy and enjoyable for children, so that they will want to consume the foods provided. Parents also need more advice regarding how they can provide their children with a healthy packed lunch, possibly via the introduction of a government‐led packed lunch policy, particularly in schools from areas of lower socio‐economic status. Although there was only a small sample of food diaries in this study, the findings suggest that socio‐economic demographics may exert more of an influence on the total daily nutrient intake of children than the type of lunch consumed.     

Prevalence of food insecurity and utilization of food assistance program: an exploratory survey of a Vermont middle school

BACKGROUND: Access to sufficient food—in terms of both quality and quantity—is especially critical for children. Undernourishment during childhood and adolescence can have health implications, both short and long term. The prevalence of food insecurity was assessed in a sample of Vermont school children, as well as the relationship between food insecurity, participation in school breakfast or lunch, exercise and body mass index (BMI), all with a goal to identify needs to improve effectiveness of current programs. METHODS: A cross‐sectional, 23‐item self‐administered survey of students attending a public middle school in Vermont. RESULTS: Twenty percent of the children were residing in a food insecure household. No statistically significant differences were observed in terms of age, sex or BMI percentile and food security status. Food insecure (with or without hunger) participants were less likely to eat breakfast at home compared to food secure participants (67.1% vs 81.4%, p = .007). However, such differences were not observed between eating school breakfast or lunch. Sixty‐two percent of food insecure (with or without hunger) participants engaged in daily exercise compared to 75.9% food secure participants (p = .014). CONCLUSION: Children in food insecure households were less likely to be physically active and to eat breakfast at home. However, the school breakfast program is negating any difference between the 2 groups in terms of eating breakfast at all. We consider this a success given the short‐ and long‐term implications of food insecurity in children. We believe these findings have important implications for schools, policy makers, and programs to reduce food insecurity.