Piloting a food photo sorting activity in Samoa to assess maternal beliefs and their role in child diet

Veeraya K Tanawattanacharoen,Courtney C Choy,Trevor J Anesi,Nicola L Hawley,Take Naseri,Christina Soti‐Ulberg,Muagututia S Reupena

doi:10.1111/mcn.12974

Veeraya K Tanawattanacharoen, Courtney C Choy + Show 5 more

Open Access

https://doi.org/10.1111/mcn.12974

Copy DOI

Abstract

Eating habits begin forming early in life when parental beliefs and behaviours often play a major role in shaping dietary intake. We aimed to assess maternal beliefs about the cost, social status, and nutritional value of foods in Samoa—a setting with an alarming burden of childhood obesity—and to determine how those beliefs may be related to child dietary intake. Samoan mothers (n = 44) sorted photographs of 26 foods commonly consumed in children in Samoa by cost, social status, and nutritional value (healthfulness). Responses were then assessed for their association with child dietary intake (reported using a food frequency questionnaire) using Pearson correlations. Mothers indicated that traditional Samoan foods were healthier, of higher social status, and lower cost compared with non‐traditional/imported food items. Compared with nutritional experts and a market survey of food prices, mothers demonstrated strong nutritional (r = .87, 95% CI [0.68, 0.95], p < .001) and consumer (r = .84, 95% CI [0.68, 0.93], p < .001) knowledge. The perceived cost of food was more strongly associated (r = −.37, 95% CI [−0.66, 0.02], p = .06) with child dietary intake than either healthfulness or social status, with decreasing consumption reported with increasing food cost. Our findings contradicted the notion that the high social status of imported foods may be contributing to increased intake and rising prevalence of childhood obesity in this developing country setting. Despite their nutritional knowledge, Samoan mothers may need additional support in applying their knowledge/beliefs to provide a healthy child diet, including support for access to reasonably priced healthy foods.

Highlights

Samoa, a small island nation in the South Pacific, faces an alarming and rising burden of obesity, metabolic syndrome, and associated noncommunicable diseases (NCDs; Hawley & McGarvey, 2015; Ng et al, 2014; World Health Organization, 2002)
The increasing prevalence has been well-documented among adults, the burden of overweight/obesity has been less studied among Samoan children
This study addresses that gap by documenting beliefs about commonly consumed foods and nutritional knowledge among Samoan mothers

Summary

Introduction

A small island nation in the South Pacific, faces an alarming and rising burden of obesity, metabolic syndrome, and associated noncommunicable diseases (NCDs; Hawley & McGarvey, 2015; Ng et al, 2014; World Health Organization, 2002). The increasing prevalence has been well-documented among adults, the burden of overweight/obesity has been less studied among Samoan children. Recent data from the Ola Tuputupua'e (Growing Up) study, following the growth and development of a cohort of ~500 Samoan children, estimated that 16–30% of 2- to 4-year-olds were overweight/obese (Choy et al, 2017), indicating that interventions to reduce obesity risk must begin early in life. Following a ‘modern’ diet has been associated with obesity and metabolic syndrome in Samoan adults and obesity in children (Choy, 2018; DiBello et al, 2009; Wang et al, 2017)

Objectives

Methods

Findings

Discussion

Conclusion