Children's Dietary Behaviors Research Articles

The effectiveness of lifestyle triple P in the Netherlands: a randomized controlled trial.

IntroductionLifestyle Triple P is a general parenting intervention which focuses on preventing further excessive weight gain in overweight and obese children. The objective of the current study was to assess the effectiveness of the Lifestyle Triple P intervention in the Netherlands.MethodWe used a parallel randomized controlled design to test the effectiveness of the intervention. In total, 86 child-parent triads (children 4–8 years old, overweight or obese) were recruited and randomly assigned (allocation ratio 1:1) to the Lifestyle Triple P intervention or the control condition. Parents in the intervention condition received a 14-week intervention consisting of ten 90-minute group sessions and four individual telephone sessions. Primary outcome measure was the children’s body composition (BMI z-scores, waist circumference and skinfolds). The research assistant who performed the measurements was blinded for group assignment. Secondary outcome measures were the children’s dietary behavior and physical activity level, parenting practices, parental feeding style, parenting style, and parental self-efficacy. Outcome measures were assessed at baseline and 4 months (short-term) and 12 months (long-term) after baseline. Multilevel multiple regression analyses were conducted to determine the effect of the intervention on primary and secondary outcome measures.ResultsNo intervention effects were found on children’s body composition. Analyses of secondary outcomes showed positive short-term intervention effects on children’s soft-drink consumption and parental responsibility regarding physical activity, encouragement to eat, psychological control, and efficacy and satisfaction with parenting. Longer-term intervention effects were found on parent’s report of children’s time spent on sedentary behavior and playing outside, parental monitoring food intake, and responsibility regarding nutrition.ConclusionAlthough the Lifestyle Triple P intervention showed positive effects on some parent reported child behaviors and parenting measures, no effects were visible on children’s body composition or objectively measured physical activity. Several adjustments of the intervention content are recommended, for example including a booster session.Trial RegistrationNederlands Trial Register NTR 2555

성조숙증 및 소아비만 아동에서 영양상담 모니터링에 따른 식습관 개선 효과

The purpose of this study was to investigate improvement of food habits and eating behavior in children with obesity and precocious puberty by nutritional education monitoring. The results are as follows. Average height and weight of subjects exceeded Korean height and weight standards for children as outlined by The Korea Pediatric Society. Using nutrition education monitoring, meals became more regular, overeating significantly decreased, and eating speed decreased. Further, frequencies of eating-out and night-eating significantly decreased. The most preferred menu item when eating-out was Korean food, and the most preferred menu item for night-eating was fruits, fast food, & processed food. Meat & fish and vegetable intakes all significantly increased. Fruit and milk intakes also significantly increased while bread, snack, and ice cream intakes decreased. Further, fast food & instant food intakes decreased. However, water intake was not significantly affected. The favorite food of children was meat & fish, followed by fast food & processed food. This study may provide information on dietary behavior of children with obesity and precocious puberty and suggests that nutrition education or counseling can improve food habits and eating behavior.

If we offer it, will children buy it? Sales of healthy foods mirrored their availability in a community sport, commercial setting in Alberta, Canada.

Community sports settings are often sources of unhealthy foods for children. Many managers in these settings are reluctant to increase availability of healthy food options because they perceive that healthy foods are not profitable. This study assessed the independent contribution of increased availability of healthy foods to their sales in a community sport, commercial context. Change in revenues per patron was also examined. The availability of healthy items was increased from 9.1% at baseline (35 days) to 25.0% during the intervention period (40 days), returning to 9.1% postintervention (6 days). Purchases of all patrons who bought foods/beverages (n=17,262 items sold) from two concessions at an outdoor community pool were assessed from baseline to postintervention. Chi-square analyses assessed differences in the proportion of healthy and unhealthy items sold, as well as in the proportion of total revenues per patron across periods. A trained observer also recorded qualitative observations pertaining to a subset of patrons' (n=221) dietary behaviors and activities. Healthy items represented 7.7%, 22.7%, and 9.8% of sales during the preintervention, intervention, and postintervention periods, respectively (p<0.01). Sales of healthy beverages exceeded sales of all other product types. The proportion of total revenues per patron did not differ by period. Food availability was an important environmental determinant of food purchasing behaviors in this community commercial context, given that sales of healthy foods closely mirrored their availability. Increased availability of healthy foods in community and commercial settings is important because concurrent changes within multiple environments will be required to improve children's dietary behaviors.

Determinants of dietary behavior among youth: an umbrella review.

BackgroundThe literature on determinants of dietary behavior among youth is extensive and unwieldy. We conducted an umbrella review or review-of-reviews to present a comprehensive overview of the current knowledge.MethodsTherefore, we included systematic reviews identified in four databases (i.e. PubMed, PsycINFO, The Cochrane Library and Web of Science) that summarized determinants of observable child and adolescent dietary behaviors. Data extraction included a judgment of the importance of determinants, strength of evidence and evaluation of the methodological quality of the eligible reviews.ResultsIn total, 17 reviews were considered eligible. Whereas social-cognitive determinants were addressed most intensively towards the end of the 20th century, environmental determinants (particularly social and physical environmental) have been studied most extensively during the past decade, thereby representing a paradigm shift.With regard to environmental determinants, mixed findings were reported. Sedentary behavior and intention were found to be significant determinants of a wide range of dietary behaviors in most reviews with limited suggestive evidence due to the cross-sectional study designs. Other potential determinants such as automaticity, self-regulation and subjective norm have been studied in relatively few studies, but results are promising.ConclusionThe multitude of studies conducted on potential determinants of dietary behavior provides quite convincing evidence of the importance of several determinants (i.e. quite some variables were significantly related to dietary behavior). However, because of the often used weak research designs in the studies covered in the available reviews, the evidence for true determinants is suggestive at best.

Design of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) study.

Childhood obesity is highly prevalent, is associated with both short- and long-term adverse outcomes, disproportionately affects racial/ethnic minority and economically deprived children, and represents a major threat to public health. Among the most promising approaches for its prevention and management are multilevel, multisector strategies. The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study was a comprehensive, systematic intervention to prevent and reduce childhood obesity among low-income children ages 2-12 years in two selected cities in Massachusetts. Building on the Obesity Chronic Care Model, MA-CORD expanded a state public health department community-level obesity prevention initiative that incorporated evidence-based interventions in primary healthcare, the Women, Infants, and Children program, early care and education, schools/afterschool programs, as well as community-wide programs to improve food, beverage, physical activity (PA), and messaging environments. The study used a combination of pre- and post-time series and quasi-experimental designs to examine the extent to which the intervention resulted in changes in BMI, individual-level lifestyle behaviors, satisfaction with healthcare services, and quality of life among children, as well as changes in health policies, programs, and environments in the two intervention cities, compared to a comparison city. The intervention period was 2 years. MA-CORD will determine the extent to which a multisetting, multilevel intervention that integrates activities in primary care with broader public health interventions in schools, early care and education, and the community at large can improve children's dietary and PA behaviors and ultimately reduce obesity in low-income children.

Development of a Report Card on Healthy Food Environments and Nutrition for Children in Canada

ObjectiveThe purpose of the Report Card on Healthy Food Environments and Nutrition for Children is to assess how current environments and policies in Canada support or create barriers to improving children's dietary behaviours and body weights. MethodIn 2014 we reviewed the literature to identify indicators of the quality of children's food environments and related policies. Scoring systems used to monitor and report on progress on a variety of public health activities were consulted during development of a grading scheme. The Report Card was revised following reviews by an Expert Advisory Committee. ResultsThe Report Card assigns a grade to policies and actions (42 indicators and benchmarks) within 4 micro-environments (physical, communication, economic, social) and within the political macro-environment. Grade-level scores of A through F are assigned that reflect achievement of, supports for, and monitoring of indicator-specific benchmarks. A Canadian Report Card will be released annually starting in 2015. ConclusionThe Report Card is a novel tool to monitor the state of children's food environments and supportive policies, inform stakeholders of the state of these environments and policies, engage society in a national discussion, and outline a policy-relevant research agenda for further study.

Analysis of dietary behavior of children of classes III - V primary school

Introduction: Eating habits of a family constitute an important factor that reflects the nutritional condition of children. Children while choosing food do not pay attention on its nutritional value. Seldom do they know which products they should pick up to provide necessary nutrients to their bodies. However, unbalanced diet and, in consequence, a long deficiency or excess of some of the nutrients can cause unwanted health effects. Eating habits acquired in childhood remain throughout life, therefore, their early identification and possible adjustments are so essential.Aim of the study: To determine the dietary behaviours of children attending primary school (grade III - V) in Toszek.Material and methods: The study was conducted in December 2012. The study group consisted of 100 (100%) primary school pupils in Toszek, including 50 (50%) girls and 50 (50%) boys. The average age of all respondents was 9.92 years (±3.2). The research tool was the author’s own survey.Results: The majority of students (94%) consume incorrect number of meals per day (2 or 3-4). More than a half (77%) of the respondents take lunch to school. Most children consume meat more often (82%) than fish (16%). More than a half of the students like sweets (86%) and confirm the desire to eat fast food (77%).Conclusions: The results of the study showed that children attending the primary school in Toszek make mistakes in their eating habits. They do not eat enough meals per day (2 or 3), consuming too little milk and its products. What is more, they snack between meals and buy sweets and sugary juices in the school store.

Mondelēz Hope Kitchen Program, China: a Program Impact Pathways (PIP) analysis.

Mondelēz Hope Kitchen is a community program initiated jointly in 2009 by Mondelēz International and the China Youth Development Foundation (CYDF). In response to the urgent needs of students, parents, and teachers at primary and middle schools in poverty-stricken rural areas of China, the program addresses the complex and intertwined issues of undernutrition and obesity. By funding both kitchen equipment and teacher training in health and nutrition, the Mondelēz Hope Kitchen Program improves the capacity of schools to supply healthy meals, helping students to access safe and nutritious foods and, ultimately, to improve their nutritional status and health. In 2011, the Mondelēz International Foundation awarded CYDF a grant to formally assess the impact of the original program design. The Mondelēz International Foundation encouraged CYDF and six other healthy lifestyles-focused community partners around the world to participate in this program evaluation workshop. The goals of this study were to describe the logic model of the Mondelēz Hope Kitchen Program, summarize a recent evaluation of the Mondelēz Hope Kitchen Program, and conduct a Program Impact Pathways (PIP) analysis to identify Critical Quality Control Points (CCPs) and a suite of impact indicators. The findings were presented at the Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, under the auspices of the Mondelēz International Foundation. The authors developed the program's PIP diagram based on deliberations involving the program managers and Director and consulting the "Hope Kitchen Management Rules "and "Hope Kitchen Inspection and Acceptance Report". The PIP analyses identified three CCPs: buy-in from schools, kitchen infrastructure, and changes in teachers' knowledge of nutrition after training. In addition, changes in children's knowledge of nutrition will be added to the core suite of impact evaluation indicators that also includes children's dietary behaviors. Participation in this program evaluation workshop provided the Mondelēz Hope Kitchen team with the tools to improve the program using a sound monitoring system.

Contextual and Cultural Influences on Parental Feeding Practices and Involvement in Child Care Centers among Hispanic Parents.

Parental feeding practices shape children's dietary preferences and behaviors, which can influence a child's weight status. Limited research exists on the precursors and contextual influences of feeding, particularly among Hispanic parents. Therefore, this study explored two areas potentially important for obesity prevention in young children: (1) precursors and contextual influences on parental feeding and (2) parental perceptions and knowledge of the child care food environment. Four focus groups (n=36) were held with Hispanic parents, predominantly mothers, of preschool children at two child care centers. Parents were asked about influences on what and how they feed their children, awareness of the child care center feeding environment, and current involvement in the child care center. Themes were coded using NVivo10 software (QSR International, Melbourne, Australia). Participants' childhood experiences influenced how they feed their children. Parents stated that both husbands and grandparents often indulged their children with unhealthy foods and thought this interfered with their efforts to maintain a healthy home environment. Participants reported that what their children ate while in child care sometimes influenced the home feeding environment. Cultural and environmental factors influence parental feeding and involvement in the child care setting. Consistent with socioecological system theory, exploring interactions between the environment and culture using a family focus framework, such as the Family Ecological Model, could provide a better understanding of these influences among Hispanic parents. Future obesity prevention interventions with Hispanic families should be culturally relevant and target the different environments where children spend their time.

Multi-Component Nutrition Intervention Featuring a Learner-Centered, Garden-Enhanced Curriculum Improves Nutrition Knowledge

The Shaping Healthy Choices Program (SHCP) was developed to explore the effectiveness of a multi-component nutrition intervention to improve children's dietary behaviors. The objective of this study was to examine whether students participating in this program improved scores in nutrition knowledge and critical thinking skills.

Parent Readiness to Change Differs for Overweight Child Dietary and Physical Activity Behaviors

Parent involvement is important to help overweight children lose weight. However, parent readiness to make changes around child eating and physical activity (PA) behaviors can differ across domains. Using a cross-sectional design, our aim was to examine which factors were associated with parents being in the Action/Maintenance stage of change in each domain. From November 2008 to August 2009, parents of overweight/obese children (n=202) attending a tertiary care obesity clinic in Providence, RI, answered questions assessing their stage of change, beliefs about child health and weight, and provider behaviors. Separate multivariate logistic regression models were created to determine which factors were associated with parent readiness to make changes for child dietary and PA behaviors. Almost 62% of parents were in the Action stage of change for child dietary behaviors, but only 41% were in the Action stage of change for PA behaviors. Parents who believed their own weight was a health problem were less likely to be ready to make changes to their child's dietary behaviors. Physician discussion of strategies was related to readiness to make changes for child dietary behaviors, but not PA behaviors. In the PA domain, parents of younger children were more likely to be ready to make changes. Training health care providers to address PA readiness and be aware of factors influencing dietary and PA readiness may result in more effective conversations with parents and improve behavior change efforts for pediatric weight loss.

Food parenting practices and child dietary behavior. Prospective relations and the moderating role of general parenting

Research on parenting practices has focused on individual behaviors while largely failing to consider the context of their use, i.e., general parenting. We examined the extent to which food parenting practices predict children's dietary behavior (classified as unhealthy: snacking, sugar-sweetened beverage; and healthy: water and fruit intake). Furthermore, we tested the moderating role of general parenting on this relationship. Within the KOALA Birth Cohort Study, in the Netherlands, questionnaire data were collected at 6 and 8 years (N = 1654). Correlations were computed to assess the association between food parenting practices and general parenting (i.e., nurturance, behavioral control, structure, coercive control, and overprotection). Linear regression models were fitted to assess whether food parenting practices predict dietary behavior. Instrumental and emotional feeding, and pressure to eat were found to have associations with undesirable child dietary behavior (increased unhealthy intake/decreased healthy intake), whereas associations were in the desirable direction for covert control, encouragement and restriction. Moderation analyses were performed by evaluating interactions with general parenting. The associations of encouragement and covert control with desirable child dietary behaviors were found to be stronger for children who were reared in a positive parenting context. Future research should assess the influence of contextual parenting factors moderating the relationships between food parenting and child dietary behavior as the basis for the development of more effective family-based interventions.

“It's Like Big Mama's House”: Examining Extended Family Influences on the Dietary Behaviors of African American Children

The family environment plays an important role in influencing children's dietary behaviors. Traditionally, African American extended family members play a key role in child socialization. We examine the role of extended families in how children are socialized to adopt dietary norms. We conducted in-depth, semi-structured interviews with 24 individuals across eight family units to elicit information regarding the influences of culture and families on children's dietary behaviors. Findings suggest that families teach children to value activities that combine quality time and enjoying food together; adults are inconsistent in how they teach children to adopt desired dietary behaviors. This work has implications for improving family-based interventions for African American children through promoting healthful behaviors that are also respectful of family dietary traditions, improving communication between adults and children, and leveraging family members as attitudinal and behavioral referents.

Intergenerational differences in acculturation experiences, food beliefs and perceived health risks among refugees from the Horn of Africa in Melbourne, Australia.

To investigate the differences in acculturation experiences between parent and adolescent refugees from the Horn of Africa in Melbourne, Australia and to explore food beliefs and perceived health risks from an intergenerational perspective. Qualitative cross-sectional study involving a combination of semi-structured one-on-one interviews and focus group discussions. North-West suburbs of Melbourne, Australia. Eritrean, Ethiopian, Somali and Sudanese refugees. Using a purposeful sampling technique, twelve semi-structured face-to-face interviews (nine adults and three adolescents) and four in-depth focus groups (two with adolescents each containing six participants and two with adults one containing six participants and the other ten participants) were carried out. Thus overall data were obtained on fifteen adolescents and twenty-five parents. Qualitative analysis identified differences between parents and adolescents in relation to lifestyle, diet and physical activity. Views regarding health consequences of their changed diets also differed. Parental feeding practices encompassed a variety of methods and were enforced in an attempt by parents to control their children's dietary behaviours and prevent their drift away from traditional eating habits. These findings call for more research to contextualise dietary acculturation among refugee youth and the impact of migration on parenting styles and feeding practices in communities from the Horn of Africa. Preventive health programmes with Horn of Africa refugees need to acknowledge the effect of acculturation on diet and physical activity levels and a socio-cultural framework needs to be developed with respect to the importance and influence of the family environment.

Maternal work and children's diet, activity, and obesity

Mothers' work hours are likely to affect their time allocation towards activities related to children's diet, activity and well-being. For example, mothers who work more may be more reliant on processed foods, foods prepared away from home and school meal programs for their children's meals. A greater number of work hours may also lead to more unsupervised time for children that may, in turn, allow for an increase in unhealthy behaviors among their children such as snacking and sedentary activities such as TV watching. Using data on a national cohort of children, we examine the relationship between mothers' average weekly work hours during their children's school years on children's dietary and activity behaviors, BMI and obesity in 5th and 8th grade. Our results are consistent with findings from the literature that maternal work hours are positively associated with children's BMI and obesity especially among children with higher socioeconomic status. Unlike previous papers, our detailed data on children's behaviors allow us to speak directly to affected behaviors that may contribute to the increased BMI. We show that children whose mothers work more consume more unhealthy foods (e.g. soda, fast food) and less healthy foods (e.g. fruits, vegetables, milk) and watch more television. Although they report being slightly more physically active, likely due to organized physical activities, the BMI and obesity results suggest that the deterioration in diet and increase in sedentary behaviors dominate.

The socioeconomic status and family context of eating attitudes and dietary behaviours of children in Polish primary schools

Aim of the studyThe aim of the study was to assess the correlation between the results of the Polish version of Maloney’s ChEAT-26, the socio-economical status of pre-pubertal pupils from Krakow schools and their family situation.Subject or material and methodsThe study group comprised 218 pupils that attended Grades from 4 to 6 and their mothers. The children’s ChEAT-26 results were related to family structure, emigration, parental education, the mother’s state of health and her subjective judgement of her state of health and her family circumstances, employment status and financial circumstances.ResultsDisordered eating attitudes of the children were elevated in families where one of the parents had emigrated. Parents with higher education levels tend to have a stronger influence on their child’s eating habits. The children of such parents are more aware of dietary standards, they tend to control their eating habits more but they also get less pleasure out of eating food. Having the mother achieve professional success, in her estimation, turned out to be positively correlated with an increased desire in her child to lose weight. A mother’s positive assessment of her family was correlated with her child’s greater compliance with the principles of healthy eating. Some of the observed correlations were different in the boys’ group and in the girls’ group.DiscussionAny discussion concerning the relationship of the obtained results with a change in the social circumstance, although likely, is only hypothetical.ConclusionsStudy has provided evidence of a connection between socioeconomic status, family variables and eating attitudes in young children in modern Poland.

Impacts of the Primary School Free Breakfast Initiative on socio-economic inequalities in breakfast consumption among 9–11-year-old schoolchildren in Wales

Universal interventions may widen or narrow inequalities if disproportionately effective among higher or lower socio-economic groups. The present paper examines impacts of the Primary School Free Breakfast Initiative in Wales on inequalities in children's dietary behaviours and cognitive functioning. Cluster-randomised controlled trial. Responses were linked to free school meal (FSM) entitlement via the Secure Anonymised Information Linkage databank. Impacts on inequalities were evaluated using weighted school-level regression models with interaction terms for intervention × whole-school percentage FSM entitlement and intervention × aggregated individual FSM entitlement. Individual-level regression models included interaction terms for intervention × individual FSM entitlement. Fifty-five intervention and fifty-six wait-list control primary schools. Approximately 4500 children completed measures of dietary behaviours and cognitive tests at baseline and 12-month follow-up. School-level models indicated that children in intervention schools ate a greater number of healthy items for breakfast than children in control schools (b = 0·25; 95 % CI 0·07, 0·44), with larger increases observed in more deprived schools (interaction term b = 1·76; 95 % CI 0·36, 3·16). An interaction between intervention and household-level deprivation was not significant. Despite no main effects on breakfast skipping, a significant interaction was observed, indicating declines in breakfast skipping in more deprived schools (interaction term b = -0·07; 95 % CI -0·15, -0·00) and households (OR = 0·67; 95 % CI 0·46, 0·98). No significant influence on inequality was observed for the remaining outcomes. Universal breakfast provision may reduce socio-economic inequalities in consumption of healthy breakfast items and breakfast skipping. There was no evidence of intervention-generated inequalities in any outcomes.

Consistency of Nutrition Recommendations for Foods Marketed to Children in the United States, 2009–2010

IntroductionFood marketing has emerged as an environmental factor that shapes children’s dietary behaviors. “Advergames,” or free online games designed to promote branded products, are an example of evolving food marketing tactics aimed at children. Our primary objective was to classify foods marketed to children (aged 2–11 y) in advergames as those meeting or not meeting nutrition recommendations of the US Department of Agriculture (USDA), Food & Drug Administration (FDA), Center for Science in the Public Interest (CSPI), and the Institute of Medicine (IOM). We document the consistency of classification of those foods across agency guidelines and offer policy recommendations.MethodsWe used comScore Media Builder Metrix to identify 143 websites that marketed foods (n = 439) to children aged 2 to 11 years through advergames. Foods were classified on the basis of each of the 4 agency criteria. Food nutrient labels provided information on serving size, calories, micronutrients, and macronutrients.ResultsThe websites advertised 254 meals, 101 snacks, and 84 beverages. Proportions of meals and snacks meeting USDA and FDA recommendations were similarly low, with the exception of saturated fat in meals and sodium content in snacks. Inconsistency in recommendations was evidenced by only a small proportion of meals and fewer snacks meeting the recommendations of all the agencies per their guidelines. Beverage recommendations were also inconsistent across the 3 agencies that provide recommendations (USDA, IOM, and CSPI). Most (65%–95%) beverages advertised in advergames did not meet some of these recommendations.ConclusionOur findings indicate that a large number of foods with low nutritional value are being marketed to children via advergames. A standardized system of food marketing guidance is needed to better inform the public about healthfulness of foods advertised to children.

Association between dietary behavior and tic symptoms of children with Tourette syndrome

Objective To explore the association of dietary behavior of children with Tourette syndrome(TS) and tic symptoms. Methods 207 TS children and their 264 corresponding controls, who visited our hospital during the period of November 2008 to October 2010, were investigated with children’s dietary behavior questionnaire, under the guidance of professional staff, and the TS tic symptom severity was also evaluated according to The Yale Global Tic Severity Scale (YGTSS). Kruskal-Wallis H rank-sum test was applied for univariate analysis and multinominal logistic regression for further multivariate analysis, with values of odds ratio (OR) and population attributable risk (PAR) obtained to demonstrate the relation strength between dietary behavior and tic symptom severity. Results Results of univariate analysis showed that western fast meal, barbecues, cream food, cold food, and spicy food were related to TS tic symptom severity (P<0.05). Results of multivariate analysis demonstrated that western fast meal, fruits and vegetables, cream food and spicy food were risk factors for mild TS compared with control group, with OR and 95%CI of 3.282(1.922, 5.064), 2.239(1.298, 3.861), 2.341(1.355, 4.046), 2.118(1.327, 3.380) and their corresponding PAR of 0.306, 0.464, 0.169, 0.250 respectively. As to moderate and severe TS, the risk factors included western fast meal, fruits and vegetables, and spicy food, with their respective OR and 95%CI of 2.581(1.322, 5.038), 2.364(1.166, 4.795), 1.822(1.014, 2.272) and PAR of 0.234, 0.487, 0.197. Conclusion Dietary behavior, especially western fast meal, fruits and vegetables, cream food and spicy food, are considered to be associated with TS tic symptom severity. Therefore it’s obligatory to rectify undesirable dietary behaviors for TS children. Key words: Tourette syndrome; Dietary behavior; Univariate analysis; Multivariate analysis

Impacting Dietary Behaviors of Children from Low Income Communities

The purpose of this study was to evaluate an expanded version of the Food Fit program, a Social Cognitive Theory based (SCT) nutrition intervention, among children in a low-income community. Eighty-five children ages 8 to 13 (mean=9.15 years; SD=1.05) were enrolled in this study. Impact and outcome measures included BMI percentile and dietary behaviors, which were evaluated before and after the program, and after a three-month follow up period. In addition, constructs of social cognitive theory, including behavioral capabilities (BC), self efficacy (SE), and outcome expectancies (OE), were evaluated before and after each lesson. Results indicated statistically significant improvements for BC’s in 11 of the 14 lessons (p=0.001), but changes in SE’s and OE’s did not reach levels of significance. There was also a significant improvement in overall dietary behaviors (p=0.036), and an increase in BMI percentile for normal weight children only (p=0.001). Compared with the previous implementation of Food Fit with children from middle-income families, this group had a similar level of changes for knowledge and skills, but fewer self-reported changes in confidence and desire to use the knowledge and skills discussed during the program. Reasons for these differences necessitate further investigation.