Availability Of Unhealthy Foods Research Articles

The association of parenting practices with toddlers' dietary intake and BMI, and the moderating role of general parenting and child temperament.

The objective was to examine the association between parenting practices, toddler's dietary intake and BMI. In addition, potential moderation of these associations by general parenting and child temperament was examined. The current cross-sectional study assessed parenting practices using the Comprehensive Feeding Practices Questionnaire, general parenting using the Comprehensive General Parenting Questionnaire, child temperament using the Child Behavior Check List, and children's dietary intake through parental questionnaires. Children's weight and length were objectively measured to determine BMI z-scores. Associations were examined using multiple linear regression analyses. Moderation was examined using interaction terms. Home setting. 393 Dutch toddlers (age 1-3 years) and their parents recruited through fifty childcare centres and preschools in the Netherlands. Various practices were related to children's diet and BMI. For instance, the availability of healthy foods is the most important predictor of healthy dietary intake (e.g. β = -0·35 for sweets; β = 0·18 for fruit). The association of availability with a healthier diet was strongest when parents scored low on the positive parenting style dimensions, including nurturance, structure and/or behavioural control. In addition, it seemed that a high availability of healthy foods and low availability of unhealthy foods is especially beneficial for children showing withdrawal/depressive, anxious or overactive behaviour, while encouraging balance and variety is not beneficial for these children. All other practices were related to children's diet and/or BMI as well. The findings underline the importance of viewing the impact of parenting practices in the context of general parenting and child temperament.

Association of Home Food Availability with Prediabetes and Diabetes among Adults in the United States.

This study examined associations of home food availabilities with prediabetes and diabetes among 8929 adults (20–70 years) participating in 2007–2010 National Health and Nutrition Examination Surveys. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression. Relative to non-diabetic participants (individuals without diabetes or prediabetes), prediabetes participants were associated with lower availabilities of green vegetables (OR = 0.82; 95% CI = 0.73–0.91; p = 0.0006) and fat-free/low-fat milk (OR = 0.80, 95% CI = 0.65–0.89; p = 0.001) and higher sugary drink availability (OR = 1.24, 95% CI = 1.04–1.48; p = 0.02), adjusting for age, sex, and ethnicity (Model 1). The associations remained significant for vegetables (p = 0.005) and fat-free/low-fat milk (p = 0.02) adjusting for additional confounders (body mass index, education, Model 2). Adjusting for dietary components did not change the above results (in model 2) significantly. Participants with high healthy food availability scores had approximately 31% reduction (p = 0.003) in odds of prediabetes compared to those with low scores in Model 1. No associations were detected for diabetes except for fat-free/low-fat milk availability, for which an inverse association was observed in Model 1 (OR = 0.80, 95% CI = 0.65–0.99; p = 0.04). The results show prediabetes participants had lower availability of healthy foods and higher availability of unhealthy foods, suggesting the need to improve healthy food availability at home for this population.

Improving the food environment in kindergartens and schools: An overview of policies and policy opportunities in Europe

Childhood obesity and unhealthy nutrition are high on the European policy agenda because of their association with chronic diseases and due to the related social and economic burden. In 2014, the EU Action Plan on Childhood Obesity 2014–2020 was launched with an overarching goal to halt the rise of overweight and obesity in children by the year 2020. To facilitate the implementation of the Action Plan, the Directorate-General for Health and Food Safety of the European Commission provided support to bring together 25 Member States plus Norway for a Joint Action on Nutrition and Physical Activity (JANPA). The current paper is based on the results of JANPA and presents the explored policy options to improve children's nutrition by targeting the food environment in and around kindergartens and schools. We conclude that for effective actions countries need to combine various mutually reinforcing policies in parallel, including the provision of healthy foods, lowering the availability of unhealthy foods, restricting marketing, and promoting education. Success will depend on the coherence of messages and on the engagement of a wide range of stakeholders and sectors. Evaluation should be carefully designed, using indicators of progress towards the goal of improving diet and reducing obesity in children.

Using Group Model Building to Describe the System Driving Unhealthy Eating and Identify Intervention Points: A Participatory, Stakeholder Engagement Approach in the Caribbean.

Many Small Island Developing States of the Caribbean experience a triple burden of malnutrition with high rates of obesity, undernutrition in children, and iron deficiency anemia in women of reproductive age, driven by an inadequate, unhealthy diet. This study aimed to map the complex dynamic systems driving unhealthy eating and to identify potential points for intervention in three dissimilar countries. Stakeholders from across the food system in Jamaica (n = 16), St. Kitts and Nevis (n = 19), and St. Vincent and the Grenadines (n = 6) engaged with researchers in two group model building (GMB) workshops in 2018. Participants described and mapped the system driving unhealthy eating, identified points of intervention, and created a prioritized list of intervention strategies. Stakeholders were also interviewed before and after the workshops to provide their perspectives on the utility of this approach. Stakeholders described similar underlying systems driving unhealthy eating across the three countries, with a series of dominant feedback loops identified at multiple levels. Participants emphasized the importance of the relative availability and price of unhealthy foods, shifting cultural norms on eating, and aggressive advertising from the food industry as dominant drivers. They saw opportunities for governments to better regulate advertising, disincentivize unhealthy food options, and bolster the local agricultural sector to promote food sovereignty. They also identified the need for better coordinated policy making across multiple sectors at national and regional levels to deliver more integrated approaches to improving nutrition. GMB proved to be an effective tool for engaging a highly diverse group of stakeholders in better collective understanding of a complex problem and potential interventions.

Investigating the impact of the HSE Healthier Vending Policy on unit sales of snack items

AbstractVending machines provide quick and easy access to snacks and, in general, provide few healthy options to consumers. Given this high availability of unhealthy foods in vending machines, consumers are likely to purchase and consume a less healthy option. The aim of this study was to investigate the impact of a Healthier Vending policy in all Health Service Executive (HSE) premises across the Republic of Ireland on unit sales of vending machine snacks. Under the policy, the contents of vending machines were altered so that healthier, Better Choice (BC), snacks would constitute a majority of the vending machine stock (minimum 60%) in comparison to the less healthy, Other Choice (OC), snacks. Snacks were defined as BC if they contained: ≤ 150kcals/packet, ≤ 20g/100 g total fat, ≤ 5g/100 g saturated fat, ≤ 15g/100 g sugar, and ≤ 1.5g/100 g salt/sodium. Products stocked as OC should be ≤ 250kcals/packet. BC snacks were placed in prime slots and at eye-level in order to prompt the consumer towards buying a BC snack, with OC snacks being placed to incentivise the choice of BC snacks. Consumers were also incentivised to purchase BC snacks through written cues that appear on the vending machines. Sales data was provided by vending companies for 2015 (baseline) and 2016 (year 1). Unit sales of all snack types increased between the two time points, with the exception of dried fruit and nuts. The proportion of OC products purchased relative to total unit sales decreased following the intervention, as did the proportion of gum and mints and dried fruit and nuts sales. While the proportion of BC crisps purchased relative to total unit sales increased post-intervention, an increase in the proportion of OC bars purchased relative to total unit sales was also seen. Sales of both BC and OC dried fruit/nuts relative to total unit sales decreased. Our results indicate that policies aiming to improve the nutrition environment in health care settings, through increasing the availability of healthy products in vending machines and promoting their purchase, could be an effective method of reducing the amount of unhealthy products purchased overall. These policies can alter consumers’ purchasing patterns and prompt consumers towards purchasing a healthier/unhealthier version of the same product, as seen with crisps and bars in this study.

Unhealthy Lifestyle Associated with Higher Intake of Sugar-Sweetened Beverages among Malaysian School-Aged Adolescents.

High consumption of sugar-sweetened beverages (SSBs) among adolescents has turned into a global concern due to its negative impact on health. This cross-sectional study determined the amount of SSB consumption among adolescents and its associated factors. A total of 421 adolescents aged 13.3 ± 1.3 years (41.8% males, 58.2% females) completed a self-administered questionnaire on sociodemographic characteristics, physical activity, screen-viewing behavior, sleep quality, frequency of eating at fast food restaurants, home food availability, peer social pressure, parenting practice, and SSB consumption. Weight and height were measured. Results showed that the mean daily consumption of SSBs among adolescents was 1038.15 ± 725.55 mL. The most commonly consumed SSB was malted drink, while the least commonly consumed SSB was instant coffee. The multiple linear regression results revealed that younger age (β = −0.204, p < 0.001), higher physical activity (β = 0.125, p = 0.022), higher screen time (β = 0.147, p = 0.007), poorer sleep quality (β = 0.228, p < 0.001), and unhealthy home food availability (β = 0.118, p = 0.032) were associated with a higher SSB intake. Therefore, promoting a healthy lifestyle may help to reduce the excessive consumption of SSBs among adolescents.

Socioeconomic Inequalities in the Retail Food Environment around Schools in a Southern European Context

Across Europe, excess body weight rates are particularly high among children and adolescents living in Southern European contexts. In Spain, current food policies appeal to voluntary self-regulation of the food industry and parents’ responsibility. However, there is no research (within Spain) assessing the food environment surrounding schools. We examined the association between neighborhood-level socioeconomic status (NSES) and the spatial access to an unhealthy food environment around schools using both counts and distance measures, across the city of Madrid. We conducted a cross-sectional study citywide (n = 2443 census tracts). In 2017, we identified all schools (n = 1321) and all food retailers offering unhealthy food and beverages surrounding them (n = 6530) using publicly available data. We examined both the counts of retailers (within 400 m) and the distance (in meters) from the schools to the closest retailer. We used multilevel regressions to model the association of neighborhood-level socioeconomic status (NSES) with both measures, adjusting both models for population density. Almost all schools (95%) were surrounded by unhealthy retailers within 400 m (median = 17 retailers; interquartile range = 8–34). After adjusting for population density, NSES remained inversely associated with unhealthy food availability. Schools located in low-NSES areas (two lowest quintiles) showed, on average, 29% (IRR (Incidence Rate Ratio) = 1.29; 95% CI (Confidence Interval) = 1.12, 1.50) and 62% (IRR = 1.62; 95% CI = 1.35, 1.95) more counts of unhealthy retailers compared with schools in middle-NSES areas (ref.). Schools in high-NSES areas were farther from unhealthy food sources than those schools located in middle-NSES areas (β = 0.35; 95% CI = 0.14, 0.47). Regulating the school food environment (within and beyond school boundaries) may be a promising direction to prevent and reduce childhood obesity.

Is the type and location of grocery stores a predictor of healthy and unhealthy food availability? A cross-sectional study.

To investigate whether geographical location or type of store is associated with differences in healthy and unhealthy food availability in grocery stores. A cross-sectional study using the Victorian Healthy Food Basket to measure food availability (44 'healthy' and 10 'unhealthy' items) in a convenience sample of 112 stores in urban and regional Victoria, Australia. Logistic regression analyses assessed whether location (regional, urban), distance from capital city central business district (km) and type of store (chain supermarket, independent supermarket and general store) predicted the number of missing healthy and unhealthy food items. There were 54 chain supermarkets, 43 independent supermarkets and 15 general stores, with 56% of stores located in urban areas and 44% located regionally. The strongest significant predictor of missing items was being a general store, which had greater odds (odds ratio (OR) = 136, 95% confidence interval (CI) = 13-1399) of having missing 'healthy' items and missing 'unhealthy' items (OR = 63, 95% CI = 7-575), compared with chain supermarkets. Independent supermarkets had increased odds of having missing 'healthy' items (OR = 7, 95% CI = 2-22) compared with chain supermarkets. Regional store location was a significant predictor of missing 'healthy' and 'unhealthy' items, compared with urban location (OR = 6, 95% CI = 2-25) and (OR = 7, 95% CI = 2-29), respectively. Store type was a stronger predictor of stores having missing 'healthy' and 'unhealthy' food items than the store distance from a large urban centre. General stores and independent supermarkets may be important settings for interventions to improve availability of healthy food.

Dietary Behavior Of University Going Female Adolescents In Pakistan: Issues, Challenges And Strategies For General Health And Academic Performance

Young generation is the major human capital of any country, especially female adolescents as they are future mothers and future mentor. Adolescence is a critical period of the human life cycle، during this time hormonal, physical and psychosocial development occurs rapidly, any insufficient and poor dietary intake during this period impact on physical and mental health. According to World Health Organization (WHO) 51% young females in Pakistan, suffer with malnutrition, whereas, National Nutrition Survey of Pakistan (2011) 35-39% of adolescent female affected with nutritional deficiencies. This study attempts to explore the factors related to dietary behavior of female adolescent students and its effect on their general health and academic performance. Qualitative approach through a focus group discussion with semi-structured questionnaire was applied. 10 participants were selected purposefully. Result shows that general health of female adolescents is very deprived. Anemia, headache, low concentration, inattention inactiveness, frequent illness, majority have joint problems in early age, harsh behavior, short-temper as main issues. The major challenges were selection and availability of unhealthy food in canteens, influence of peer in food choices, skipping breakfast, commonly used fast foods or junk foods, high consumption of soft, energy drinks. Participants suggested a need of collaborate effort to overcome the immense problem

Challenges and opportunities to tackle the rising prevalence of diet-related non-communicable diseases in Africa

Africa is experiencing a sharp rise in non-communicable diseases (NCD) related to rapid globalisation and urbanisation leading to shifts in dietary and lifestyle patterns characterised by increased energy intake and physical inactivity. However, unlike more resource-endowed regions, Africa has a double burden of disease: NCD co-exist with infectious diseases including lower respiratory tract infections, HIV/AIDS and diarrhoeal diseases. The African economy is also relatively weaker, making it difficult to cope with this burden. It is postulated that NCD will soon overtake infectious diseases as the number one cause of death in the African region. The recognition of NCD as diseases and obesity as a related risk factor is weak in Africa, compounded by stigma associated with wasting in HIV/AIDS and obesity being perceived as a sign of wealth, achievement and care. There is also a dearth of data on overweight and obesity in the region and little knowledge that infant feeding practices, such as breast-feeding, are linked to reduced risk of NCD in both children and mothers. While complex multi-sectoral approaches to address this NCD menace are needed, Africa may benefit from taking simple initial steps to address NCD risk factors including: (1) behaviour change communication to challenge perceptions on NCD; (2) promoting and protecting breast-feeding; (3) formulating policies and regulations limiting wide availability of unhealthy foods; (4) mainstream nutrition education in school curricula and (5) collection of accurate data based on indicators that can reflect the double burden of disease and malnutrition; and fostering multi-sectoral actions against NCD.

Perceived barriers and facilitators for healthy behaviours among parents of adolescents receiving mental health care in a public hospital in Cape Town, South Africa: A qualitative study

Objective: To explore the perceived barriers and facilitators for healthy behaviours among parents and caregivers of adolescents receiving mental health care in Cape Town, South Africa.Method: Thirty-five qualitative in-depth interviews were conducted with parents and caregivers of adolescents receiving mental health treatment by six facilitators matched for language. The data was analysed using thematic analysis.Results: The participants were predominantly female (n = 28, 80%) and parents (n = 29, 83%) of the adolescents. Personal barriers to good health included unhealthy eating, substance use and physical inactivity. Environmental barriers were inherited medical conditions, the easy availability of unhealthy foods and the absence of recreational facilities in communities. Perceived facilitators to good health were parental role modelling, planning and preparing healthy meals, exercise opportunities providing by walking long distances to work, and doing physically demanding jobs and household chores.Conclusion: Parents and caregivers are essential to adolescents’ healthy development as they may influence adolescent health behaviours. It is likely that the promotion of positive health behaviours may be achieved though family-based interventions.

A Review of the Nutritional Quality of School Canteen Foods in South Asia

In Schools, canteens play a crucial role in ensuring nutritional well-being of adolescents. Regular consumption of unhealthy food items purchased from the school canteens may add to the existing burden of malnutrition in children, especially adolescents. A narrative review was conducted to comprehensively summarize the nutritional quality of food products served in South Asian school canteens. Three electronic scientific databases were searched for articles and selected articles were analyzed. Literature review indicated the absence of school food policy/guidelines, unhygienic school canteens, high availability and accessibility of unhealthy foods in school canteens and lack of awareness regarding healthy school food environment among parents, teachers, students, and principals. Further, well-designed studies to assess the nutritional quality of foods served in school canteens using appropriate indices are required.

A qualitative exploration of social and environmental factors affecting diet and activity in knee replacement patients.

To examine perceived social and environmental barriers and facilitators for healthy eating and activity before and after knee replacement. Many patients undergoing knee replacement surgery are overweight or obese. While obesity treatment guidelines encourage diet and activity modifications, gaps exist in understanding social and environmental determinants of these behaviours for knee replacement patients. Identifying these determinants is critical for treatment, as they are likely amplified due to patients' mobility limitations, the nature of surgery and reliance on others during recovery. This qualitative study used semi-structured interviews. Twenty patients (M=64.7±9.8years, 45% female, 90% Caucasian, body mass index 30.8±5.5kg/m2 ) who were scheduled for or had recently undergone knee replacement were interviewed. Participants were asked to identify social and environmental factors that made it easier or harder to engage in healthy eating or physical activity. Deidentified transcripts were analysed via constant comparative analysis to identify barriers and facilitators to healthy eating and activity. This paper was written in accordance with COnsolidated criteria for REporting Qualitative research standards. Identified social and environmental healthy eating barriers included availability of unhealthy food and attending social gatherings; facilitators included availability of healthy food, keeping unhealthy options "out of sight," and social support. Weather was the primary activity barrier, while facilitators included access to physical activity opportunities and social support. Results provide salient factors for consideration by clinicians and behavioural programmes targeting diet, activity, and weight management, and patient variables to consider when tailoring interventions. Practitioners treating knee replacement patients would be aided by an understanding of patients' perceived social and environmental factors that impede or facilitate surgical progress. Particularly for those directly interacting with patients, like nurses, physiotherapists, or other professionals, support from health professionals appears to be a strong facilitator of adherence to diet and increased activity.

Perceptions of Obesity Prevention Policies: Socioeconomic Assessment in the Turkish Capital

PurposeThe purpose of this study was to inform public policy opportunities to reduce childhood obesity by identifying parents' perceptions of factors contributing to childhood obesity, attribution of responsibility, and the extent of their support for public prevention policies with attention to socio-economic status. Design and MethodsIn 2015, 2066 parent-child dyads across socio-economic strata from 43 randomly selected schools in Ankara completed surveys and measurements to examine perceptions, attribution, and prevention policies related to childhood obesity. ResultsParents across the socio-demographic spectrum recognized obesity as a serious problem. Unhealthy food availability was identified as the leading cause of while industry and media were credited with having the greatest responsibility for childhood obesity. There was strong public support for policy strategies targeting schools, marketing, and the built environment, though support tempered as socio-economic status and parental education decreased. ConclusionsThis survey provided insight into parents' knowledge and beliefs surrounding childhood obesity as well as their endorsement of related prevention strategies. Educational messages that address variations in SES to describe the causes of childhood obesity and connect those causes to actionable community prevention strategies may improve community support for enhanced policy actions within and beyond school settings.

Neighbourhood deprivation and community nutrition environment: associations between the social and built environment and food availability

Eating habits are influenced by individual socioeconomic status (SES). As the association between neighbourhood characteristics and food availability is still unclear, we investigated the community nutrition environment in different neighbourhoods. Using official data of the city of Leipzig, we selected three neighbourhoods which differed in terms of their social (2 deprived vs. 1 affluent) and built (1 large housing estates vs. 2 historic buildings) environment. Data on food outlets were assessed via direct observation (ground truthing). Social and residential environment characteristics are associated with food availability. The proportion of fast food outlets is higher in deprived neighbourhoods compared to the affluent one (25%, 30.4% vs. 13.5%). Neighbourhoods with historic buildings offer a greater variety of food outlets. The greater availability of unhealthy food may contribute to the development of obesity. Preventive measures should consider the physical and social environment.

Perspectives on Underlying Factors for Unhealthy Diet and Sedentary Lifestyle of Adolescents at a Kenyan Coastal Setting.

Unhealthy diet and physical inactivity are among the key modifiable risk factors for non-communicable diseases, such as diabetes and cardiovascular disease. Although such diseases often only appear in adulthood, these behaviors are typically initiated or reinforced already during adolescence. However, knowledge on underlying factors for adolescents’ unhealthy dieting and physical inactivity in sub-Saharan Africa (SSA) is poor. We conducted in-depth interviews and focus group discussions to explore the perceptions of a diverse group of 78 young people of 10–19 years of age, which also included some adolescents living with HIV, as this is an emerging group in the HIV/AIDS epidemic in many parts of SSA. In addition, 10 stakeholders, such as teachers, clinicians, and staff from organizations at the Kenyan coast and seven young adult community representatives informed us on: (a) adolescents’ unhealthy food choices and their forms of sedentary behavior; (b) predisposing factors; and (c) protective factors against unhealthy food choices and sedentary behavior of adolescents living in Kilifi County. The findings reveal that adolescents occasionally access nutritious foods, such as fruits, vegetables, and animal protein. However, there is a growing tendency to consume unbalanced diets with high intake of carbohydrates, oily foods, and consumption of sugar dense processed foods and drinks. Sports and domestic chores were found to be major sources of physical activity. Sedentary lifestyles characterized by a long-time sitting and chatting, watching sports games and movies were described. Adolescents living with HIV did not indicate any divergent perceptions from those of other adolescents relating to diet and physical activity, but mentioned health-related conditions, such as medication, asthma, and low body weight, as a risk factors for sedentary lifestyle. Using a Socio-Ecological model, our findings suggest that risk factors are numerous and interrelated, especially at intrapersonal, interpersonal, and community level. The negative influences at an intrapersonal level were as follows: body image concerns, attitudes and misconceptions, substance use behavior, and taste for unhealthy foods. In the interpersonal domain, household poverty and parenting practices that condone unhealthy habits were identified risk factors. Availability of affordable unhealthy foods, high prices for nutritious food, farming practices, gambling, and influx of transportation alternatives in the community were interrelated but also had relationships with intrapersonal and interpersonal risk factors. Modernization and poor implementation of policies were discussed as enabling factors especially by stakeholders from a societal perspective. Seasonality and farming practices, school attendance, community-based services, and regulations mitigating adolescents’ engagement in gambling were identified as potential protective factors. Our findings provide a unique qualitative insight of the factors underlying adolescents’ dietary and sedentary lifestyle and highlight the need for ecological intervention approaches to address these forms of health risk behavior in a rural African setting.

Food insecurity, diet quality and body mass index of women participating in the Supplemental Nutrition Assistance Program: The role of intrapersonal, home environment, community and social factors

Obesity is a public health problem that disproportionately affects low-income populations. Moreover, participation in Supplemental Nutrition Assistance Program (SNAP) has been associated with obesity among low-income women. The goal of this study was to determine the impact of intrapersonal, home environment, community and social factors on diet quality and body mass index (BMI) of low-income women participating in SNAP. This study also aimed to examine the role of these factors in mediating the relationship between food insecurity and diet quality, and BMI. A total of 152 women receiving SNAP benefits were recruited from low-income neighborhood centers and housing communities, and administered a demographics questionnaire, the United States adult food security scale, food frequency questionnaire, and multi-dimensional home environment scale (MHES). They also were measured for height and weight to calculate BMI. The Dietary Guidelines Adherence Index 2015 was used to measure diet quality. Regression analyses were conducted to determine the MHES subscales that were significant predictors of diet quality and BMI. The Preacher and Hayes mediation model was used to evaluate the mediation of the relationship between food insecurity and diet quality, and BMI by the MHES. Emotional eating resistance and favorable social eating behaviors were positively associated with diet quality; whereas emotional eating resistance, lower availability of unhealthy food at home, neighborhood safety and favorable social eating behaviors were inversely associated with BMI in women participating in SNAP. The MHES significantly mediated the relationship between food insecurity and BMI. These results emphasize the importance of intrapersonal, home environment, community and social factors in mediating the relationship between food insecurity and BMI in low-income women.

Association of Individual and Neighborhood Factors with Home Food Availability: Evidence from the National Health and Nutrition Examination Survey

BackgroundAccumulating evidence suggests the important role of the home food environment in an individual’s dietary intake. ObjectiveThis study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES). DesignA cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home. ParticipantsThe analysis included 8,975 participants aged 19 to 65 years. Statistical analyses performedAssociations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES’ complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis. ResultsFamily income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1.73) in the home compared with rural residents. Food desert status was not associated with home food availability. ConclusionsThe results show that SES at both individual (education, income) and neighborhood level was linked to home food availability, suggesting a need to improve the home food environment for socioeconomically disadvantaged individuals and neighborhoods.

Dietary patterns and their associations with home food availability among Finnish pre-school children: a cross-sectional study.

To study the associations between home food availability and dietary patterns among pre-school children. Cross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores. The DAGIS study, Finland. The participants were 864 Finnish 3-6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data. We identified three dietary patterns explaining 16·7 % of the variance. The patterns were named 'sweets-and-treats' (high loadings of e.g. sweet biscuits, chocolate, ice cream), 'health-conscious' (high loadings of e.g. nuts, natural yoghurt, berries) and 'vegetables-and-processed meats' (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=-0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=-0·03, P<0·01). Considering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home.

Food parenting and child snacking: a systematic review

BackgroundWhile the role of parenting in children’s eating behaviors has been studied extensively, less attention has been given to its potential association with children’s snacking habits. To address this gap, we conducted a systematic review to describe associations between food parenting and child snacking, or consuming energy dense foods/foods in between meals.MethodsSix electronic databases were searched using standardized language to identify quantitative studies describing associations of general and feeding-specific parenting styles as well as food parenting practices with snacking behaviors of children aged 2–18 years. Eligible peer-reviewed journal articles published between 1980 and 2017 were included. Data were extracted using a standard protocol by three coders; all items were double coded to ensure consistency.ResultsForty-seven studies met inclusion criteria. Few studies focused on general feeding (n = 3) or parenting styles (n = 10). Most studies focused on controlling food parenting practices (n = 39) that were not specific to snacking. Parental restriction of food was positively associated with child snack intake in 13/23 studies, while pressure to eat and monitoring yielded inconsistent results. Home availability of unhealthy foods was positively associated with snack intake in 10/11 studies. Findings related to positive parent behaviors (e.g. role modeling) were limited and yielded mixed results (n = 9). Snacking was often assessed using food frequency items and defined post-hoc based on nutritional characteristics (e.g. energy-dense, sugary foods, unhealthy, etc.). Timing was rarely included in the definition of a snack (i.e. chips eaten between meals vs. with lunch).ConclusionsRestrictive feeding and home access to unhealthy foods were most consistently associated with snacking among young children. Research is needed to identify positive parenting behaviors around child snacking that may be used as targets for health promotion. Detailed definitions of snacking that address food type, context, and purpose are needed to advance findings within the field. We provide suggested standardized terminology for future research.