Children's Snack Research Articles

Knowledge, attitude and behavior among parents of school-aged children towards snack in Shenzhen

Objective To investigate knowledge, attitude and purchase behavior for snack nutrition among parents of school-aged children in Shenzhen, so as to provide support and scientific basis for developing targeted intervention program for child healthy dietary behavior. Methods Through cluster random sampling method, a total of 4 517 parents of students graded in 2 from 116 primary schools in Shenzhen were invited to participate into a self-administered questionnaire survey. Results Parental cognition towards snack nutrition varied substantially. The majority of parents were worried about the health and safety issues of snack and were aware of the risk of eating disorder of consistent snakc consumption in children. Only 21.18% of parents reported frequent snack-purchasing behaviors. Children's snacks, mainly included milk, dairy products, vegetable, fruit, bread and cake, are mostly purchased by parents, and the snack choices were related to nutrition, hygiene and taste. In addition, most parents paid attention to the production date whereas less than one-third of them read the nutrition facts labels. Parents with different knowledge level towards snack nutrition differed in eating attitude and behavior. Conclusion Parents should be further educated about nutrition and food safety knowledge to improve nutritional literacy, as well as attitude towards healthy diet and snack-purchasing ehavior to better guide their children to develop good eating habits.

Hubungan tingkat pengetahuan tentang gizi, peer group dan uang saku dengan pemilihan jajanan pada siswa SLTP

Poor nutritional behaviour among students is the increasing of snacking proportion and the consumption unnutritious and unsafe food. The aims of the study was to know the determinants of school children's snack behavior using behavioural ecological model. This was a cross-sectional study design based on ecological models behaviour. The study was conducted at a state junior high school in Sleman Regency, D.I Yogyakarta. The sample was 80 students of 381 students. The data were analyzed by the chi-square test. The result showed that only 52.5% students had selected behaviour in snacking, 50% students had a good level of knowledge about nutrition and food security, 68.8% had a large amount of pocket money, 83.8% had breakfast habit, 70% were highly influenced by peers. There were significant relations between knowledge about nutrition and food security and breakfast habits. There were no significant relations between the amount of pocket money, peers with students' behaviour to the selection of snacks in the State Junior High School in Sleman, Special Region Yogyakarta. It is recommended for schools to strengthen their school health institutions through increasing the role of student cadres and counseling about nutrition and food safety in the provision of healthy canteens. Include content about nutrition and the consequences of consuming unsafe food, placing posters on healthy and unhealthy food in the school canteen. Schools are also advised to provide socialization to parents and students about the importance of having breakfast and bringing lunch from home.

DETERMINAN PERSEPSI DAN PERILAKU IBU DALAM MEMBACA LABEL MAKANAN RINGAN ANAK TK-SD BUMI SERPONG DAMAI

children can be truly guaranteed. If the reading of children’s snack labels is ignored by mothers, then it can have an impact in the form of children’s growth and development not being optimal. In Indonesia, based on the survey results of National Consumer Protection Survey (BPKN) in 2007, only 6.7% of Indonesia’s population paid attention to the completeness of food labels. This study was conducted to determine perceptions, behaviors, and factors, which influence the perceptions and behaviors of mothers in reading the snack labels of kindergarten-elementary school children of School X in the area of Bumi Serpong Damai (BSD). This study used a cross-sectional method by conducting structured interviews through questionnaires. Mothers, who were included in the category of good perception, were mothers with a mode score 4, and those who were in the category of good behavior when the mode score was 5. After obtaining the data, the data was processed and analyzed by the T-Test. From 95 respondents, 62 respondents (65.3%) had poor perceptions in reading children's snack labels. A total of 73 respondents (76.8%) had poor reading behavior of children's snack labels. The factors studied consisted of internal and external factors. After statistical tests were accomplishedly and properly taken, the results showed significant differences for internal factors, namely the age and ethnicity of the respondents regarding the respondents' behaviors and reading abilities (p <0.05). While there were no significant differences in external factors. From the results of this study, it can be concluded that the perceptions and behavior of mothers, who have kindergarten-elementary school children in School X in BSD area are still not good.

O37 Fruit and Vegetable Preparation Changes During and After Cost-Offset Community Supported Agriculture and Nutrition Education

<h3>Background</h3> Most adults and children in the US do not consume recommended levels of fruit and vegetables (FV). Providing subsidized or cost-offset community supported agriculture (CO-CSA) alongside nutrition education is 1 approach to increase FV intake among rural, low-income families. <h3>Objective</h3> This analysis assessed change in the frequency and method of FV preparation during and after a CO-CSA plus nutrition education intervention. <h3>Study Design, Setting, Participants</h3> Participants were caregivers in low-income households (<185% FPL) living in rural areas of 4 U.S. states (n = 148). Half-price weekly summer CSA shares of farm produce and 9 seasonal nutrition education lessons were provided. Attendance was recorded at lessons and other data were collected via online surveys at baseline, 1 season later, and 1 year later. <h3>Measurable Outcome/Analysis</h3> Outcomes included monthly frequency of preparing 9 different, seasonal FV for children's snacks and 6 different vegetables for dinner with preparation methods for each. Repeated measures ANOVA and pairwise comparisons with Bonferroni correction tested change in FV preparation frequency over time at 95% confidence. Moderation analysis assessed whether changes in FV preparation frequency varied by lesson attendance. <h3>Results</h3> At baseline, caregivers prepared fruit for snacks and vegetables for dinner almost every day, and vegetables for snacks every other day. Preparation frequency for total snack fruit, celery, cucumber, peppers, other vegetables, total snack vegetables, lettuce, cabbage, greens, squash, and total dinner vegetables all increased during the intervention; and, increases in vegetables for both snacks (celery, cucumber, and total) and dinner (greens and total) were maintained one-year later. At baseline, the majority of participants (>70%) reported using healthy methods to prepare vegetables, and no changes were observed over time. Observed increases in FV preparation frequency were not moderated by lesson attendance. <h3>Conclusion</h3> CO-CSA plus education was associated with increases in FV preparation frequency, increases in vegetable preparation were maintained 1 year later, but improvements were not associated with attending nutrition education.

P59 Parenting and Snacks: A Mixed Methods Study to Guide Intervention Development

<h3>Background</h3> Recent work in family nutrition suggests a focus on snacking, since children's snacks are often lower in nutrients than foods served at mealtime and have increased in frequency and caloric contribution. Developing healthy snacking habits in early life may impact the trajectory of snacking behaviors later in life. <h3>Objective</h3> To explore the relationships between snacking patterns and snack-related parenting; and drivers of snacking decisions and desired support for parents. <h3>Study Design, Setting, Participants</h3> A mixed-methods approach was used among student parents whose child(ren) attended a preschool program at a Southern California university. <h3>Measurable Outcome/Analysis</h3> A modified version of the Snack Intake Frequency Questionnaire and the Parenting around Snacking Questionnaire (P-SNAQ) were used to explore correlations between snacking patterns and snack-related parenting. Three focus groups were conducted to identify drivers of snacking decisions and to guide design of healthy snacking intervention strategies. Focus group transcripts were coded using thematic analysis by 2 independent coders. <h3>Results</h3> Survey participants (n = 42) were predominantly female (n = 35) and identified as Hispanic/Latino (n = 19). Findings indicated positive correlations between frequency of offering healthy snacks and reasoning/support for healthy snacks (r = 0.43, <i>P</i> = 0.006) and snack planning/routines (r = 0.37, <i>P</i> = 0.02); a negative correlation between frequency of unhealthy snacks and availability of healthy snacks (r = -0.32, <i>P</i> = 0.04); and negative correlations between parent age and emotion-based snacking (r = -0.46, <i>P</i> = 0.003), snacks as rewards (r = -0.35, <i>P</i> = 0.03), and snacks to manage behavior (r = -0.45, <i>P</i> = 0.005). Focus group findings (n = 11) suggest parents balance priorities when making snacking decisions, including health, behavior control, convenience/accessibility, parent/child roles, and social influences. Parents suggested a snacking-focused class with information on snacking strategies and social support. <h3>Conclusion</h3> Findings suggest younger parents may benefit from snacking-focused intervention programs that support healthy snacking routines and alternative behavior management strategies for children.

Helping parents provide vegetable snacks: Investigating price and taste as barriers

Snacks contribute nearly one-quarter of children's daily energy intake in the USA. Snack time therefore represents an opportunity for parents to provide foods with key nutrients. Instead, the most common snack foods are major contributors to children's consumption of added sugars and sodium. Parents face major barriers to providing healthier snacks, including perceptions of high cost and lack of child acceptance. We obtained both economic and qualitative data to inform and optimize interventions for parents to promote vegetable snacks for children. We conducted a survey with parents (n = 368) to estimate how much of a discount would influence vegetable snack purchases by estimating willingness-to-pay using the contingent valuation method, using baby-cut carrots as a sample product. We conducted three focus groups (n = 19) and 1 group interview (n = 2) with children to help understand how to increase the appeal of vegetable snacks. Most (70%) parents accepted the reference price for the vegetable snack. Among those who did not, contingent valuation analysis revealed that a mean discount of approximately 30% would shift consumers to purchasing the snack. Focus group results revealed that the appeal of vegetable snacks to children was influenced by how they were prepared and presented, and the child's familiarity with the vegetables and ability to choose among them. This study lays the groundwork for effective interventions to promote the provision of vegetable snacks by parents.

Dietary practices among children with early childhood caries and the associated factors: A qualitative study.

Parents play a vital role in their children's dietary habits. A comprehensive understanding of the perspectives of parents of children with early childhood caries (ECC) is required for prevention program planning. To describe the parental perspective of the dietary habits of children with ECC. In this descriptive qualitative study, the participants were parents of children with ECC receiving routine dental care. Data were collected through focus groups using an interview guide. Data were analyzed manually using the content analysis method. Five focus groups involving 27 participants were conducted. Two main categories emerged: cariogenic food literacy and factors that affect food choices. Most of the participants knew that sugary foods are responsible for tooth decay. Parents felt that children's snacking habits were influenced by multiple factors, such as family environment, peers, commercials on television or the Internet, and affordability of food. Parents are not able to translate their knowledge into action to modify their children's diet as they may lack self-efficacy and feel pressured by their children, the media and the environment in which they live. Motivational interviewing of parents and governmental and school policies to reduce sugary food consumption may be required.

An Intervention Package Including Egg and Milk-Based Snack Improved Growth and Development of U-2 Children in Bangladesh: A Community-Based Randomized Controlled Trial

Abstract Objectives We aimed to compare the effect of a comprehensive intervention package focusing on the animal-source protein (egg and milk)-based snack in conjunction with feeding counseling, water sanitation and hygiene, and supplementation with multiple micronutrient powder on linear growth and development of 6‒12-month old children in rural Bangladesh. Primary and secondary outcomes were differences in length-for-age Z score and cognitive development. Methods A community-based cluster randomized controlled longitudinal trial included 412 mother-infant pairs from 13 unions (small-administrative-unit) of Harirampur sub-district, allocating to receive treatment (n = 206) or regular health messages (n = 206) as control. The treatment group received monthly food vouchers (30 eggs, 12 L milk, 500 g semolina, 500 mL oil, 500 g sugar) to prepare nutritious children's snacks, micronutrient powder, child feeding and handwashing counseling for 12 months. The Control group received routine health messages from the government. Anthropometry, feeding and morbidity data were collected at baseline, monthly and endpoint. Children's development was assessed only once at an endpoint using Extended Ages and Stages Questionnaire (EASQ), Bayley III and Wolke's behavior rating scales. We used generalized linear regression modelling to conduct intention to treat analysis. Results Children's mean weight and length were similar between groups at baseline. At endpoint, compared to the control, treatment children had higher mean length (83.52 and 80.89 cm; difference: 2.62, P &amp;lt; 0.001); higher LAZ score (β: 0.38, CI: 0.24, 0.51); 61% lower rate of stunting (IRR: 0.39, CI: 0.22, 0.67); higher cognitive (β: 4.01, CI: 2.08, 5.94), language (β: 2.94, CI: 0.94, 4.94) and motor (β: 4.53, CI: 1.87, 7.20) scores, all being statistically significant. The intervention also improved developmental EASQ outcomes of the treatment children (gross and fine motor, problem-solving, and socio-emotional scores). Conclusions A comprehensive intervention package focusing on egg and milk-based snacks improved child growth and development in poor households in Bangladesh. Reducing the intervention cost and scale-up to larger communities in resource-poor settings merit further research. Funding Sources Children Investment Fund Foundation funded the trial.

FORMULASI SOFT CHEWY COOKIES BEBAS GLUTEN DAN KASEIN BERBASIS KOMBINASI MOCAF DAN TEPUNG MILLET PUTIH UNTUK ANAK AUTISM SPECTRUM DISORDER &lt;br&gt;&lt;i&gt;Free Gluten and Free Casein Soft Chewy Cookies Formulation with Combination of MOCAF and White Millet Flour Based for Children with Autism Spectrum Disorder&lt;/br&gt;&lt;/i&gt;

Children with Autism Spectrum Disorder (ASD) have to eat a gluten-free casein-free diet due to their special condition. Casein is protein that contained in milk and milk-based product which are source of calcium. Their special condition make children with ASD have a low bone-mass than other children. Modifi ed Cassava Flour (MOCAF) and white millet fl our are free gluten food sources which have rich calcium that is needed to increase nutrient quality in soft chewy cookies. This study was aimed to determine the eff ect of MOCAF fl our and white millet fl our combination on acceptability and nutritional value of free gluten and free casein soft chewy cookies. This study was true experimental study with complete randomized design. This study used un-trained panelist including ASD children(7–11 years old (25 panelists) and their parents (25 panelists). There were 4 formulas in this study consisted of 1 control formula (F0) based on 100% wheat fl our, and 4 treatment formulas which were combination of MOCAF fl our and white millet fl our with a percentage ratio of combination F1 (0%:100%) ; F2 (50%:50%) ; and F3 (75%:25%). Kruskal Wallis statistical test results showed there were signifi cant diff erences of aroma, color, texture, and taste between each formula. Result of acceptability and nutritional value showed F3 as the best formula. Each 60 g soft chewy cookies F3 contains 176,4 mg of calcium which fulfi ll 18% of calcium adequacy for 7–11 year old children. Gluten-free casein-free soft chewy cookies with combination of MOCAF and white millet fl our are suitable as an alternative snack for ASD children.

Penambahan Puree Bit ( Beta vulgari L.) Terhadap Kandungan Gizi Makro dan Kadar Serat Sosis Ikan Kembugn (Rastrelliger kanagurt L.)

The addition of beet puree can be used as a mixture to improve the quality of mackerel fish sausage (Rastrelliger kanagurt L.). Sausage with the addition of beet puree can be a healthy snack for school-age children with adequate macro nutrition and fiber content in mackerel sausage. In this study used a completely randomized design (CRD) including the formulation factor of mackerel and puree beet which consisted of 4 types of treatment repeated 3 times. The results of the analysis were statistically tested using ANOVA 5% and further tested using the Duncan test. The results showed that the use of puree beetroot had a water 71.20-76.66%, ash 1.72-1.81%, fat 9.36-9.61%, protein 9.27-15.80. % and fiber 1.28-1.91%. The contribution of serving 50 grams of sausage in all treatments can contribute to protein intake as much as 8.42-18.85% and fiber intake contributes 2.32-4.20% of the nutritional adequacy rate for school age children 7-12 years. Sausage with the addition of beet puree can be a healthy snack for school-age children with adequate macro nutrition and fiber content.

Relationships Among the Physical and Social Home Food Environments, Dietary Intake, and Diet Quality in Mothers and Children

BackgroundBoth the physical and social home food environment (HFE) are believed to influence dietary intake and diet quality, but few studies have examined both aspects together. ObjectiveThe purpose of this study was to examine the relationships among the physical and social HFE, dietary intake, and diet quality in mothers and children. DesignThis was a cross-sectional substudy of a larger study. Participants/settingThe study included 24 mothers (aged ≥30 years) with a biological child aged 6 to 12 years living in the Newark, DE, area between June and November 2018. Main outcome measuresThe outcome measures of interest included the physical HFE (ie, home food availability); aspects of the social HFE (ie, parenting styles, family meal frequency, and policies); maternal and child intake of fruits, vegetables, sugar-sweetened beverages, and snacks; and diet quality using the 2015 Healthy Eating Index total score. Statistical analysisPearson correlations were used to examine the relationship between physical HFE and dietary intake as well as social HFE and dietary intake in both mothers and children. The relationships were further examined through exploratory regression analyses. ResultsIn mothers, fruit availability in the physical HFE was correlated with fruit intake (r = 0.50; P = 0.02). Fruit and vegetable availability in the physical HFE were correlated with 2015 Healthy Eating Index total score in both the mother and child. Family meals participation was correlated with dietary intake (vegetable intake in children, r = 0.44; P = 0.04; and snack intake in mothers, r = –0.74; P < .001). Exploratory regression analysis showed vegetables in the HFE was associated with vegetable intake and 2015 Healthy Eating Index total score in mothers, and fruits and vegetables in the HFE were associated with child 2015 Healthy Eating Index total score. Family meals participation was negatively associated with maternal snack intake and child sugar-sweetened beverages intake. Authoritative parenting was negatively associated with child snack intake and permissive parenting was negatively associated with mother’s fruit intake. ConclusionsBoth the physical and social HFE are associated with maternal and child dietary intake, but only the physical HFE was associated with dietary quality. Although preliminary, these data indicate the importance of future studies that include measures to assess both the physical and social HFE to better elucidate the influences of the HFE on dietary intake.

Children's perceptions of a Centrally Procured School Food Program in southwestern Ontario, Canada.

This qualitative study investigates children's perceptions of the influences of a Centrally Procured School Food Program on their dietary behaviours and their recommendations on how to improve the program. The observations of 208 students aged 9 to 14 years (Grades 5-8) at 21 elementary schools were collected through focus groups in 2017/18. The larger intervention consisted of a 10-week program offering daily snacks (i.e. fruit, vegetables, whole grains, dairy, meat alternatives) for elementary school children in southwestern Ontario, Canada. The participants' overall impressions of the program were positive. They noted reduced hunger, increased energy and improved nutrition. Many children felt that the program changed their dietary patterns at home as well as at school, particularly in terms of eating more fruit and vegetables. The snack program also enabled children to try healthy foods. Most participants considered the program to be beneficial in promoting healthy eating. Participants recommended adding educational activities, expanding the variety of foods and increasing child involvement in selecting and preparing foods.

Pelatihan diversifikasi produk olahan ikan bagi istri nelayan di Gampong Cot Seurani Aceh Utara untuk meningkatkan gemar makan ikan pada anak-anak (Diversification training of fish processed product for fisherman wife in Cot Seurani Village Aceh Utara to improve fish eating pleasure in children)

The aim of this service activity was to socialize and train fishermen's wives in Cot Seurani Village, Muara Batu Sub-District, North Aceh District how to process fish. The target of the training was that fishermen's wives understand and are creative in producing fish products as healthy alternative snacks for children during their growth and development stages. This activity had several stages which were program planning, preparation, training to process fish into fish nuggets and dragon feet products. From the program planning stage, the survey showed that: 1) the fishermen's wives did not have sufficient skills to process fish; 2) during the catching season, fish is usually sold at a low price; and 3) the children of the fishermen did not like to eat fish and preferred chicken and other street foods. The result of this service activity was that the participants have already had the skills and practiced directly how to make fish nuggets and dragon feets. In conclusion, the fishermen's wives can now provide fish products for their children.

The Effect of Tempe Substitution and Addition of Carrot Puree on The Acceptability and Nutritional Value of Sausages for Snacks for School Children

Snacks for school children were generally only high in carbohydrates and fats, but low in protein, therefore it was necessary to study the juveniles of high-protein school children but the price was relatively cheap. This study aims to determine the effect of tempeh substitution and the addition of carrot puree to the acceptability and nutritional value of sausages for snacks for school children. Organoleptic test results were statistically analyzed using the Friedman non-parametric test and if there were significant differences then to find out the different pairs the Wilcoxon test was used with α = 0.05. Determination of the best formula was taken from the highest average value of the overall acceptance of carrot tempe sausage. Laboratory test data for nutrient content were analyzed with a single ANOVA and followed by Duncan test if the treatment affected certain parameters. Tempe substitution and the addition of carrot puree significantly influence on the taste and aroma of sausages, but did not significantly influence on the color and thickness of sausages. The best sausage product based on panelist acceptance was F1 formula. Tempeh substitution and addition of carrot puree significantly influence to the content of all nutritional parameters analyzed. The best sausage product based on nutrient content was F1 formula with protein content per 100 grams of sausage of 16.62 ± 0.45 grams and could meet the standard levels of protein in commercial sausages (minimum 13.00%) and was able to meet 33.24% of the protein requirements in the RDA children aged 10-12 years.

Parental stress, food parenting practices and child snack intake during the COVID-19 pandemic

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to the lives of families. This study aimed to investigate the impact of pandemic-associated stress on food parenting practices including interactions surrounding snacks, and child diet. MethodsParents (N = 318) of 2–12-year old children completed a cross-sectional online survey assessing current COVID-19-specific stress, pre-COVID-19 stress, financial stress (e.g. food insecurity), food parenting practices, and child snack intake frequency. Structural Equation Modeling was used to model simultaneous paths of relationships and test direct and indirect effects. ResultsStress, including financial hardship, was higher compared with before the crisis. The majority of children had regular mealtimes and irregular snack times. Higher COVID-19-specific stress was associated with more non-nutritive use of food and snacks (e.g. emotional and instrumental feeding), but also more structure and positive interactions (e.g. eating with or engaging with child around mealtimes). Higher COVID-19-specific stress was also associated with greater child intake frequency of sweet and savory snacks, with some evidence for mediation by snack parenting practices. ConclusionOur findings indicate that stress associated with the COVID-19 pandemic may be linked to child snack intake with potential impacts on child obesity risk, and suggest several modifiable points of intervention within the family context.

Profiling children's snack products in Ireland

Profiling children's snack products in Ireland

The Frequency and Context of Snacking among Children: An Objective Analysis Using Wearable Cameras.

Snacking is a common eating behaviour, but there is little objective data about children’s snacking. We aimed to determine the frequency and context of children’s snacking (n = 158; mean age = 12.6 years) by ethnicity, gender, socioeconomic deprivation and body mass index (BMI) children. Participants wore wearable cameras that passively captured images of their surroundings every seven seconds. Images (n = 739,162) were coded for snacking episodes, defined as eating occasions in between main meals. Contextual factors analysed included: snacking location, food source, timing, social contact and screen use. Rates of total, discretionary (not recommended for consumption) and healthful (recommended for consumption) snacking were calculated using negative binomial regression. On average, children consumed 8.2 (95%CI 7.4, 9.1) snacks per day, of which 5.2 (95%CI 4.6, 5.9) were discretionary foods/beverages. Children consumed more discretionary snacks than healthful snacks in each setting and at all times, including 15.0× more discretionary snacks in public spaces and 2.4× more discretionary snacks in schools. Most snacks (68.9%) were sourced from home. Girls consumed more total, discretionary and healthful snacks than boys, and Māori and Pacific consumed fewer healthful snacks than New Zealand (NZ) Europeans. Results show that children snack frequently, and that most snacking involves discretionary food items. Our findings suggest targeting home buying behaviour and environmental changes to support healthy snacking choices.

Impact of the corona lockdown on daily oral health care behaviour of young children

This study explores the possible effects of the current corona pandemic and the ensuing measures on parental oral care behaviour, particularly during the lockdown period. Moreover, this study examines to what extent these effects differ according to the educational level of the parents. In total, 120 parents of children aged 4-5 years completed a digital questionnaire about parental oral care behaviour. The results show that during the coronavirus lockdown, 26% of parents skipped toothbrushing more often in the morning, 44% let their child snack more often, and 22% let their child drink sweetened drinks more often. In addition, parents with a high educational level skipped tooth brushing in the morning more often than parents with a low educational level. In contrast, parents with a low educational level skipped toothbrushing more often in the evening than parents with a high educational level. The results of this small study suggest that the coronavirus lockdown affected parental oral care behaviour.

Associations between Child Snack and Beverage Consumption, Severe Dental Caries, and Malnutrition in Nepal.

The global nutrition transition and increased consumption of sugar-sweetened beverages and ultra-processed snacks have contributed to increasing rates of child obesity and dental caries in developing countries. In Nepal, where child malnutrition rates are high, the relationship between malnutrition and dental caries is poorly understood. This cross-sectional study aims to assess this relationship among a convenience sample of 273 children age six months to less than 12 years in three communities in Nepal, using parent/caregiver interviews, child dental exams, and anthropometric measurements. Fisher’s exact test and independent t-tests examined associations between dietary practices and severe caries and between severe caries and malnutrition, respectively. Children consumed sugar-sweetened beverages and processed snacks frequently: 80% consumed tea with sugar, 60% consumed sweet snacks, and 65% consumed processed savory snacks daily. Overall, 74% of children had untreated tooth decay, and 21% exhibited stunting malnutrition, 14% were underweight, and 6% presented wasting. Significant associations were found between daily consumption of sweets and processed snacks with severe caries and between severe caries and poorer nutritional status. These findings underscore the need to incorporate nutrition and oral health promotion and dental treatment into maternal–child health services and schools and to strengthen policies to reduce children’s access to junk food.

Parent perspectives on preschoolers' movement and dietary behaviours: a qualitative study in Soweto, South Africa.

Childhood obesity is of increasing concern in South Africa, and interventions to promote healthy behaviours related to obesity in children are needed. Young children in urban low-income settings are particularly at risk of excess adiposity. The current study aimed to describe how parents of preschool children in an urban South African township view children's movement and dietary behaviours, and associated barriers and facilitators. A contextualist qualitative design was utilised with in-depth interviews conducted in the home setting and analysed using reflexive thematic analysis. Field notes were used to contextualise findings. Four neighbourhoods in a predominantly low-income urban township. Sixteen parents (fourteen mothers, two fathers) of preschool-age children were recruited via preschools. Four themes were developed: children's autonomy and the limits of parental control; balancing trust and fears; the appeal of screens; and aspirations and pressures of parenthood. Barriers to healthy behaviours included children's food preferences, aspirations and pressures to consume unhealthy foods, other adults giving children snacks, lack of safe places to play, unhealthy food environments and underlying structural factors. Facilitators included set routines, the preschool environment, safe places to play and availability of healthy foods. Low-income families in Soweto face many structural challenges that cannot easily be addressed through public health interventions, but there may be opportunities for behavioural interventions targeting interpersonal and organisational aspects, such as bedtime routines and preschool snacks, to achieve positive changes. More research on preschoolers' movement and dietary behaviours, and related interventions, is needed in South Africa.