Children's Healthy Eating Research Articles

Using Incentives to Encourage Healthy Eating in Children

There is growing interest in the situations in which incentives have a significant effect on positive behaviors, particularly in children. Using a randomized field experiment, we find that incentives increase the fraction of children eating a serving of fruits or vegetables during lunch by 80 percent and reduce the amount of waste by 33 percent. At schools with a larger fraction of low-income children, the increase in the fraction of children who eat a serving of fruits or vegetables is even larger, indicating that incentives successfully target the children who are likely to benefit the most from the increased consumption.

Nutrition knowledge and behaviours of low-income Latino parents of preschoolers: associations with nutrition-related parenting practices

Parents are in an ideal position to promote long-term healthy dietary behaviours for their children. This study aimed to determine parent and child characteristics and to test their associations in a cross-sectional sample of urban low-income, low-education Latino immigrants with preschool-age children. Also determined were family demographic characteristics, child feeding practices, parent nutrition knowledge, parent fruit and vegetable consumption, and child Body Mass Index (BMI). Our analysis shows several significant associations: (1) lower parent nutrition knowledge and less healthy child feeding practices (increased pressure, p = 0.017 and increased restrictions, p = 037); (2) higher parent vegetable consumption and healthier child feeding practices (more responsibility for the types and amount of food eaten, p = 0.022, and less restrictions on child eating, p = 0.030); and (3) a significant difference by child gender, such that parents of girls with higher BMIs for their age group being more concerned about their daughter's weight (p = 0.004) and practising healthier feeding practices, that is, less pressure (p = 0.008). Our findings support promoting healthy eating within the context of the family, and contribute to a growing literature on preschool parent–child feeding practices. Understanding the practices of immigrant Latino parents can help researchers and practitioners develop culturally appropriate interventions to address childhood obesity.

Assessment of Parent Orientation towards Autonomy vs. Control in Promoting Children's Healthy Eating and Exercise.

Self-determination theory has been widely applied to understanding individuals' health-related behaviors such as eating healthy foods and exercising. Different reasons for engagement are associated with varying levels of personal agency or autonomy. Authority figures in the environment can be supportive of autonomy or, in contrast, controlling. Although researchers have assessed individuals' perceptions of the autonomy-support in their environments, studies have not directly examined the authority figures' orientations to autonomy with respect to health contexts. A new scale, Parent Orientations to Health, was created to investigate parent orientation to autonomy and control with respect to healthy eating and exercise in children. One hundred and forty-three parents of elementary school-aged children responded to the scale. Scale validation and reliability results indicate that the scale successfully assessed parent orientation towards autonomy for children in health contexts. Furthermore, parent autonomy orientation varied according to child weight status and the healthiness of the child's diet. Parent orientation towards autonomy can be evaluated through the use of the Parent Orientations to Health scale. In addition, parent autonomy orientation is associated with both the healthiness of the child's diet (as perceived by the parent) and the child's body mass index.

Socio‐cultural factors associated with child feeding practices among Hmong, Latino and white parents

ObjectiveTo examine parent perceptions of healthy feeding practices and to identify the association between socio‐cultural factors and child feeding practice among Hmong, Latino, and white parentsMethodsSix focus groups were held with parents separated by gender and ethnicity from Hmong, Latino, and white communities. Transcribed and translated data were analyzed using the Nvivo9 software program. Focus groups interviews were independently coded by two trained researchers based on the principles of grounded theory.ResultsFour themes were identified in the study: 1) attitude toward local foods; 2) acceptance of food from other culture; 3) food culture preservation; 4) barriers to healthy child feeding practices. White mothers were accepting of new and local food. Hmong parents highly valued traditional food. Latino and Hmong mothers were traditionally responsible for determining children's meals and teaching them how to cook while white fathers were more involved in child feeding practices. All parents valued feeding fruits and vegetables to their children but had different barriers to promoting them to their children, such as financial struggles noted by Latino fathers.ConclusionsIdentifying and promoting cultural assets for healthy child feeding among different cultural groups may be important for future studies. This research was funded by the USDA Agriculture and Food Research Initiative.

Mexican American Mothers' Eating and Child Feeding Behaviors

Objective: The purpose of this study of Mexican-American mothers of 2–6 year old children was to explore the relationships among maternal attitude, perceived behavioral controls, mother’s intent, mother’s regulation of her own Simple Carbohydrate Intake (SCI), and mother’s child feeding behaviors. The overall objective was to increase understanding of the complex process of intention to eat healthy. Methods: A prospective exploratory design using a convenience sample of a cohort of 82 Mexican-American mothers was used in this study. Structured questionnaires were selected to measure cognitive restraint, disinhibition, hunger, intent to regulate SCI, and mothers’ monitoring, restricting, and pressuring of children’s diets. Descriptive statistics and correlations were analyzed for each relationship. Results: The relationships between disinhibition, hunger, cognitive restraint, and the intent variable were significant. More than half of these mothers reported limiting soda and candy for themselves. According to the Food Frequency Questionnaire, mothers were regulating only one-third of simple carbohydrate items they intended to regulate. Significant relationships were found between mothers’ regulation of her specific SCI and her control of child feeding behaviors including pressuring, monitoring, and restricting. Conclusion: The findings support the idea that mother’s eating behaviors, attitudes, and intent may affect how they feed their pre-school children. Nurses need to develop and test interventions targeted at educating Mexican-American mothers about healthy food choices and healthy child feeding behaviors.

Feeding infants and young children. From guidelines to practice

Following a workshop on infant feeding held at the Rowett Institute of Nutrition and Health, University of Aberdeen on March 17, 2010 experts were invited to exchange ideas and to review evidence on both pre and post natal dietary environments in shaping children's eating habits. A central theme during the workshop was the idea of “sensitive periods” during infancy for learning about foods and a particular focus was developed around acceptance and intake of fruits and vegetables. Presentations covered the guidelines provided by various governments on how to feed infants during weaning; the importance of the in utero experience; the impact of varying the sensory experience at weaning; the effect of parenting styles and practices on children's eating habits; the use of visual experience in promoting intake of vegetables; and reports from mothers regarding their decisions about weaning and the introduction of vegetables. This collection of papers seeks to review guidance from governments on feeding infants and to consider current evidence on parental feeding practices with the aim of enhancing insight into best practice in establishing healthy eating in children.

Globalization, Localization, and Food Culture: Perceived Roles of Social and Cultural Capital in Healthy Child Feeding in Japan

Globalization, Localization, and Food Culture: Perceived Roles of Social and Cultural Capital in Healthy Child Feeding in Japan

Use of a Tool to Determine Perceived Barriers to Children's Healthy Eating and Physical Activity and Relationships to Health Behaviors

This pilot investigation assesses whether barriers to children's healthy eating and physical activity reported by parents on a newly developed brief pediatric obesity screening and counseling tool are related to healthy eating and physical activity behaviors. The sample included parents of 115 Medicaid-enrolled children in a general pediatric clinic. Of 10 barriers, 7 were statistically associated with parent-reported behaviors with odds ratios (ORs) ranging from 0.6 to 9.4. Relationships remained significant when child characteristics were controlled in the analysis. Although additional testing is needed, the tool provides clinicians with an approach to identify barriers and behaviors for targeted counseling.

The substance and sources of young children's healthy eating and physical activity knowledge: implications for obesity prevention efforts

The prevalence of overweight among young children is increasing at an alarming rate. Global efforts to address the issue can benefit from understanding how young children's experiences across multiple contexts shape their perspectives of healthy weight. This qualitative study examines the substance and sources of young American children's knowledge related to healthy eating, physical activity and media practices. Role play and semi-structured interviews were conducted in child-care settings with 81 children aged 3-5 who represented diverse socio-economic statuses and ethnic backgrounds. Children demonstrated better understanding of the benefits of healthy eating compared with physical activity. Snacks and beverages consumed outside mealtime were less likely to be healthy even among the 40% of children who demonstrated an understanding of healthy nutrition. The majority of children's leisure activity selections involved media and minimally active pursuits. Three quarters of the children were unable to articulate reasons for healthy choices or identify the sources of their health understandings. The media was listed as source of health information more frequently than adults. Obesity prevention efforts targeting young children need to use consistent messaging across all contexts in which children develop in order to increase their understanding that physical activity and eating choices support health. Efforts need to counter inaccurate information and address the rationale for health practices. Key gaps in young children's understanding include: the importance of drinking water, that snacks are part of nutritional intake and the benefits of engaging in physical activities.

Use of a Tool to Determine Perceived Barriers to Children's Healthy Eating and Physical Activity and Relationships to Health Behaviors

Use of a Tool to Determine Perceived Barriers to Children's Healthy Eating and Physical Activity and Relationships to Health Behaviors

Promoting Healthy Eating in Children

A Department of Health (DoH) policy is to reduce inequalities in health. Choosing a better diet and how to do so is one of the topics in the Choosing Health White Paper published in November 2004.

P39 Healthy eating for children in early years settings: a systematic review of current guidance at local and national levels

BackgroundChildren's dietary habits are often well established by 5 years of age. However, statutory guidelines to promote healthy food currently only apply to schools, not pre-school nurseries. Furthermore, good practice...

Socio-economic gradients in health behaviours and overweight among children in distinct economic settings.

The socio-economic gradient in health does not seem to apply to overweight among Canadians adults. In the present study, we sought to determine the socio-economic gradient in overweight among Canadian children in distinct economic settings. We further examined socio-economic gradients in underlying behaviours, healthy eating and active living, as well as parental support for these behaviours. We surveyed 6430 grade five students and their parents in Alberta and Nova Scotia. Students completed dietary and activity questionnaires and had their height and weight measured. Parents completed questions on socio-economic background and their support for their child's health behaviours. We applied multi-level regression methods to characterize the socio-economic gradients. In both Alberta and Nova Scotia, we observed socio-economic gradients whereby children with parents who were more highly educated and had higher earnings were more physically active and less likely overweight. In contrast, we did not observe a socio-economic gradient with respect to healthy eating. Relative to socio-economically disadvantaged parents, those with better education and higher income were more likely to report encouraging their children's healthy eating and physical activity. Socio-economically disadvantaged parents, though, reported more engagement in physical activities with their children. Whereas the socio-economic gradient in overweight among Canadian adults is fading, we did not observe such a phenomenon among children. The mechanism preserving the socio-economic gradient among children may be related to more encouragement given to healthy eating and physical activity in the more socio-economically advanced families.

Developing an award program for children's settings to support healthy eating and physical activity and reduce the risk of overweight and obesity

BackgroundThis paper aimed to identify the best way to engage, motivate and support early childhood services (ECS) and primary schools (PS) to create policy and practise changes to promote healthy eating and physical activity. This information would be used to develop a suitable program to implement within these children's settings to reduce the risk of childhood overweight and obesity.MethodsThe Medical Research Council's (UK) framework for the design and evaluation of complex interventions was used to guide the development of the healthy eating and physical activity program suitable for ECS and PS. Within this framework a range of evaluation methods, including stakeholder planning, in-depth interviews with ECS and PS staff and acceptability and feasibility trials in one local government area, were used to ascertain the best way to engage and support positive changes in these children's settings.ResultsBoth ECS and PS identified that they had a role to play to improve children's healthy eating and physical activity. ECS identified their role in promoting healthy eating and physical activity as important for children's health, and instilling healthy habits for life. PS felt that these were health issues, rather than educational issues; however, schools saw the link between healthy eating and physical activity and student learning outcomes. These settings identified that a program that provides a simple guide that recognises good practise in these settings, such as an award scheme using a health promoting schools approach, as a feasible and acceptable way for them to support children's healthy eating and physical activity.ConclusionThrough the process of design and evaluation a program - Kids - 'Go for your life', was developed to promote and support children's healthy eating and physical activity and reduce the risk of childhood overweight and obesity. Kids - 'Go for your life' used an award program, based on a health promoting schools approach, which was demonstrated to be a suitable model to engage ECS and PS and was acceptable and feasible to create policy and practise changes to support healthy eating and physical activity for children.

A qualitative study exploring how mothers manage their teenage children's diets

Research indicates that an unhealthy diet is a risk factor for the development of a range of chronic conditions, including obesity, cancer, diabetes and coronary heart disease. Dietary habits formed in childhood persist into adulthood. Previous research on dietary habits has focused on families with young children. This qualitative study extends the literature by exploring how mothers manage their teenage children's diets. Semi-structured interviews were carried out with l5 British mothers who had at least one child aged 13–16 years. The data were analysed using interpretative phenomenological analysis. Five themes emerged: achieving gold standard, coping with obstacles, using strategies, resolving conflict and support. The participants were determined to achieve the gold standard (of nutrition) for their children and used a range of strategies to implement it. Mothers developed ways to cope with obstacles that undermined the gold standard. They were keen to resolve conflicts that were generated in the process. Some mothers received a degree of support in achieving the gold standard. The mothers felt that the strong presence of fast food and confectionary in the external environment was the biggest threat to the maintenance of their children's healthy eating. Participants were highly motivated to achieve the gold standard, as it was central to the notion of being a good mother. Being a good mother was a vital component of their self-identity.

Is parenting style related to children's healthy eating and physical activity in Latino families?

Parenting styles influence a child's risk for obesity. The goals of this study are to evaluate the influence of (i) parenting style on children's health behaviors (physical activity and dietary intake), (ii) children's sociodemographic characteristics on parenting style and on children's health behaviors and (iii) parents' sociodemographic characteristics on their use of controlling styles to promote a healthy home environment. Survey and anthropometric data were collected from a community sample of Latino parents (n = 812) and their children in kindergarten through second grade. Parental use of positive reinforcement and monitoring was associated with children's healthy eating and exercise. Also, parents' use of appropriate disciplining styles was associated with healthier eating, while parental use of control styles was associated with unhealthy eating. The daughters of parents who used controlling styles ate more unhealthy foods than did the sons. Older, employed and more acculturated parents used less controlling styles than their counterparts. Parenting interventions targeting children's dietary intake and physical activity should encourage parents to use more positive reinforcement and monitor their children's health behaviors as these parenting styles are associated with healthier behaviors. Moreover, intervention researchers may want to encourage Latino parents to use less controlling styles with girls as this parenting style increased girls' risk for unhealthy eating.

Understanding Beliefs, Knowledge, and Practices of Mothers in the Dominican Republic Related to Feeding Infants and Young Children

Background: Obesity in children has reached epidemic proportions in the United States where an estimated 15% of children are obese. Perhaps even more troubling is the finding that childhood obesity is correlated strongly with obesity in adulthood and is increasingly observed in younger age groups and immigrant children. Parents have a major influence on the weight of children and are therefore an obvious initial focus for education and support on healthy feeding practices. Nurses are in a unique position to take the lead in helping parents develop healthy child feeding practices. Objectives: The purpose of this research was to understand the feeding practices, knowledge and nutritional beliefs of mothers with young children living in the Dominican Republic (DR). Methods: A focus group provided qualitative data for this exploratory, descriptive study. Results: The study resulted in a description of how mothers in the DR feed their children and on their beliefs about the health implications of child feeding practices. Discussion: Findings from this study help to increase understanding of feeding practices of children in the DR. This knowledge can be used by nurses to develop culturally appropriate interventions for immigrants from the DR aimed at preventing childhood obesity. Interventions that consider the effects of acculturation will be more effective when targeted to parents of young children than interventions focused on treatment of obesity in later years. Discussion:

Recommendations for the complementary feeding of the breastfed child

To present a review on the evidence that support the current recommendations for breastfed children feeding. An extensive bibliographic review of the topic was carried out. Articles selected in the MEDLINE and Lilacs databases, publications from national and international organizations, theses and dissertations were reviewed. Some key articles were also selected from the citations referred in other papers. New knowledge acquired about child feeding over the last 20 years have led to a significant change in the current feeding recommendations for breastfed children in relation to the prior recommendations. The current recommended nutritional needs are lower than the old recommendations, complementary food is introduced in a more precise age, around 6 months, and new methods are recommended for promoting the child's healthy eating. The new recommendations emphasize the health feeding practices which comprise both the adequate food quantity and quality, including care with food handling and preparation, feeding and storage practices, and the respect and adequacy to the cultural characteristics of each people. The adequate complementary feeding of the breastfed child is critical for the optimal child growth and development. Therefore, it is an essential factor for both the populations food security and the development of nations. The health professionals ought to effectively pass on to mothers/care takers the new recommendations for promoting the healthy complementary feeding of the breastfed child. It is up to the governments to provide the adequate conditions for supporting such a promotion.

Behavioral treatment of childhood obesity: Theoretical and practical implications.

The impressive 10-year success of behavioral treatment of childhood obesity stands in marked contrast to the disappointing long-term results obtained with obese adults. It may be easier to teach children healthy eating and activity habits. Parents also regulate access to food, thereby reducing the importance of self-control. Whether treatment of childhood obesity affects the later development of an eating disorder is a question that calls for future research.