Unhealthy Snack Intake Research Articles

Analyzing the Effectiveness of Family-Based Interventions in Promoting Healthy Behaviors among Children in China

Objectives: The children's health has become every society's priority to promote a healthy future generation. In China, different measures are being taken by the government and other associated organizations to promote important family-based interventions to improve healthy behaviors among Children. Methods: This study has also focused on evaluating the effectiveness of a family-based (REDUCE) intervention in promoting health behaviors among children in China. For this study, a randomized-controlled trial (RCT) was implemented for the parents and children (with age of 7 to 10 years). These children were obese or overweight. Face-to-face sessions and social media were used for conducting the associated intervention. The "child eating behaviors questionnaire (CEBQ)" was used for assessing the children's eating behaviours. In contrast, a parental report was used for determining the dietary consumption of fruits and unhealthy snacks among the children for three days. The significance level was < 0.05. About 124 parents participated in this study. Results: The results obtained show that at six-month of post-training, there was significant differences in the mean of food (p < 0.0011), intake of fruits and vegetables (p < 0.0011) and intake of unhealthy snacks (p < 0.011) within the context of control and intervention groups. Conclusion: The current study provides important implications, focusing on improving the literature review concerning family-based intervention in improving the health behaviors among children.

COMPARISON OF PRACTICES RELATED TO MID-MORNING SNACKS AMONG SCHOOL GIRLS OF DIFFERENT SOCIOECONOMIC STATUS

Background: Adolescence is the second most critical period of physical growth and development; therefore, it is very important to fulfill their dietary needs in this period. Objective: To compare practices related to mid-morning snacks and observation of students for taking healthy foods as mid-morning snacks. Methodology: This is the survey based or conclusive research that was conducted on teenage girls of Beacon house School System Lahore and Govt. Model Girls High School Lahore. The sample size was calculated from the online calculator Raosoft (Raosoft 2020). The study sample size was 60. They were divided into two groups with 30 in each group; one of high and the second of low socio-economic status. This research was conducted with the ethical permission of Department of Food and Nutrition; College of Home Economics and this data were collected with the consent of School’s authorities and students. Data collection tools were Anthropometrics, Interview schedule and Dietary record. Results: Mean age was 13.6±15.9. Results of taking mid-morning snacks in students was recorded 9.084±0.05. Awareness about nutritive mid-morning snacks was 2.639±0.05. Fruits preferences were 6.358±0.05. Food frequency of high carbohydrate food was 10.24±0.221. High fat food frequency was recorded as 13.9±0.229. Result of food frequency of beverages was 7.59±0.219. Frequency of mid-morning meals was 6.7±0.309. Conclusion: Results revealed that the snacking practices of both schools were unhealthy and intake of unhealthy snacks was more prevalent as compared to healthy snacks.

Self-identified strategies to manage intake of tempting foods: cross-sectional and prospective associations with BMI and snack intake.

Individuals often use self-directed strategies to manage intake of tempting foods, but what these strategies are and whether they are effective is not well understood. This study assessed the frequency of use and subjective effectiveness of self-directed strategies in relation to BMI and snack intake. A cross-sectional and prospective study with three time points (T1: baseline, T2: 3 months and T3: 3 years). At T1, demographics, frequency of use and subjective effectiveness of forty-one identified strategies were assessed. At T2 and T3, current weight was reported, and at T2 frequency of snack intake was also recorded. Online study in the UK. Data from 368 participants (Mage = 34·41 years; MBMI = 25·06 kg/m2) were used for analysis at T1, n = 170 (46·20 % of the total sample) at T2 and n = 51 (13·59 %) at T3. Two strategy factors were identified via principal axis factoring: (1) diet, exercise, reduction of temptations, and cognitive strategies, and (2) planning, preparation and eating style. For strategy 1, frequency of use, but not subjective effectiveness, was positively related to BMI at T1. Subjective effectiveness predicted an increase in BMI from T1 and T2 to T3. No relationship to snack intake was found. For strategy 2, frequency of use was negatively related to BMI at T1. Neither frequency of use nor subjective effectiveness were related to changes in BMI over time, but subjective effectiveness was negatively correlated with unhealthy snack intake. Self-directed strategies to reduce the intake of tempting foods are not consistently related to BMI or snack intake.

Nutritional status, body composition and diet quality in children with cancer.

During cancer treatment, nutritional status disorders such as malnutrition or obesity affect the tolerance of cancer treatment, quality of life, but also the pharmacokinetics of drugs. It is hypothesized that changes in fat and lean body mass can modify chemotherapy volume distribution, metabolism and clearance. In children with cancer, lean body mass decreases or remains low during treatment and fat mass increases. Body composition is influenced by the cancer itself, aggressive multimodal-therapies, changes in metabolism, unbalanced diet and reduced physical activity. Due to the side effects of treatment, including changes in the sense of taste and smell, nausea, vomiting, diarrhea, and stress, eating according to recommendation for macronutrients and micronutrients is difficult. Research indicates that throughout cancer treatment, the consumption of fruits, vegetables, and dairy products tends to be insufficient, whereas there is an elevated intake of sugar and unhealthy snacks. Children exhibit a preference for high-carbohydrate, salty, and strongly flavored products. This review revealed the importance of body composition and its changes during cancer treatment in children, as well as eating habits and diet quality.

Effect of Ending the Nationwide Free School Fruit Scheme on the Intake of Fruits, Vegetables, and Unhealthy Snacks in Norwegian School Children Aged 10-12 Years.

The Norwegian authorities started a nationwide free school fruit program in 2007, implemented in all secondary schools (grades 8-10) and combined schools (grades 1-10) in Norway. The program ended in 2014. This study evaluates the effect of ending the nationwide free school fruit program on the consumption of fruit, vegetables, and unhealthy snacks among Norwegian sixth and seventh graders. The study sample consists of pupils at 18 schools that participated in all data collections in the Fruits and Vegetables Make the Marks project (FVMM), initiated in 2001, with new data collections in 2008 and 2018. Four of the schools were combined schools, therefore children in sixth and seventh grade at these schools received free fruit in 2008 (intervention schools), and fourteen schools did not (control schools). Between 2008 and 2018, pupils at the intervention schools ate a lower proportion of fruits and vegetables per school week, and the consumption of unhealthy snacks increased compared to the control schools. Completion of the free fruit program was not significantly different for boys and girls, or low and high parental education. The results indicate that the end of the free school fruit program resulted in less healthy eating habits among children.

Changes in modifiable risk factors for Alzheimer´s disease and dementia during the COVID‐19 pandemic in Swedish older adults: a population‐based digital survey

AbstractBackgroundOlder adults have a higher risk of Alzheimer´s disease (AD) and dementia. In terms of morbidity and mortality, they also represent the group most severely affected by the SARS‐CoV‐2 (COVID‐19) pandemic. Since February 2020, the Swedish government recommended different general measures limiting mobility and social contact, to contain the spread of infection. Pandemic‐related changes in lifestyle and access to healthcare could have a negative impact on modifiable factors for AD and dementia.MethodsA digital survey was distributed to the general population (multiple distribution channels, voluntary participation) during the last waves of the COVID‐19 pandemic in Sweden (May/2021 – December/2021). Participants were people aged 60+ years, free of dementia, and living in Sweden. The survey aimed to measure changes in lifestyle (e.g., diet, physical activity), care of vascular/metabolic risk factors (e.g., diabetes, hypertension), as well as psychosocial factors (e.g., depressive symptoms, sleep quality, social isolation) relevant for AD and dementia. The survey is part of the World‐Wide‐FINGERS‐SARS‐CoV‐2 initiative.Results6,918 participants completed the survey, mean age was 67.9 (5.11 SD), 58% were female, 71.6% were from urban areas. Preliminary results showed that, during the pandemic, 27% of participants decreased their physical activity, 26.3% increased intake of unhealthy snacks, 25.7% experienced increased sleep problems. Also, 58.7% had less contact with family, 40.4% experienced loneliness, 24.7% experienced worsening of memory, and 26.8% rated their health worse than before the pandemic. On the other hand, the reported increase in consumption of vegetables and fruits was 14.1% and 15.7%, respectively, and 65.2% of people had increased the use of digital services to keep in contact with family and friends. Also, 2.6% of participants decreased smoking, and 11.2% reduced their alcohol consumption. The occurrence of chronic vascular and metabolic diseases and related disruption in access to healthcare is presented in Table 1.ConclusionThe COVID‐19 pandemic has had an effect on modifiable factors for AD and dementia in Swedish older adults. These changes can affect future AD/dementia occurrence and should be addressed in forthcoming interventions for AD/dementia risk reduction and prevention. The survey can also be used for pre‐screening participants for prevention trials.

Clusters of lifestyle behaviours and their associations with socio-demographic characteristics in Dutch toddlers

PurposeThis study aimed to identify clusters of lifestyle behaviours in toddlers and assess associations with socio-demographic characteristics.MethodsWe used data from the Dutch National Food Consumption Survey 2012–2016 and included 646 children aged 1–3 years. Based on 24-h dietary recalls and a questionnaire, a two-step cluster analysis was conducted to identify clusters in the intake of fruit, vegetables, sugar-sweetened beverages and unhealthy snacks, physical activity and screen time. Logistic regression models assessed associations between socio-demographic characteristics and cluster allocation.ResultsThree clusters emerged from the data. The ‘relatively healthy cluster’ demonstrated a high intake of fruit and vegetables, low sugar-sweetened beverage and unhealthy snack intake and low screen time. The ‘active snacking cluster’ was characterised by high unhealthy snack intake and high physical activity, and the ‘sedentary sweet beverage cluster’ by high intake of sugar-sweetened beverages and high screen time. Children aged 1 year were most likely to be allocated to the ‘relatively healthy cluster’. Compared to children of parents with a high education level, children of parents with a low or middle education level were less likely to be in the ‘relatively healthy cluster’, but more likely to be in the ‘sedentary sweet beverage cluster’.ConclusionClusters of lifestyle behaviours can be distinguished already in children aged 1–3 years. To promote healthy lifestyle behaviour, efforts may focus on maintaining healthy behaviour in 1-year-olds and more on switching towards healthy behaviour in 2- and 3-year-olds.

Dietary Counseling Aimed at Reducing Sugar Intake Yields the Greatest Improvement in Management of Weight and Metabolic Dysfunction in Children with Obesity.

Pediatric obesity is a significant public health problem, the negative outcomes of which will challenge individual well-being and societal resources for decades to come. The objective of this study was to determine the effects of dietary counseling on weight management and metabolic abnormalities in children with obesity. One hundred and sixty-five patients aged 2–18 years old were studied over a two and a half year period. Data collected included demographic information, anthropometric assessment, laboratory measurements, and self-reported eating behaviors. Dietary counseling was provided at each visit. The data was analyzed from the first and last visits and the subjects were retrospectively divided into responders and non-responders based on a decrease in their BMI. After receiving dietary guidance, BMI decreased in 44% of the children, and these participants were classified as responders (BMI-R; n = 72). However, BMI did not improve in 56% of the participants, and these were classified as non-responders (BMI-NR; n = 93). At the initial visit, anthropometric measurements and dietary habits were similar between the groups. At the time of the last visit, mean change in BMI was −1.47 (SD 1.31) for BMI-R and +2.40 (SD 9.79) for BMI-NR. Analysis of food intake revealed that BMI-R significantly improved their dietary habits (p = 0.002) by reducing the intake of sugar-sweetened beverages (p = 0.019), processed foods (p = 0.002), sweets (p < 0.001), and unhealthy snacks (p = 0.009), as compared with BMI-NR. There was no change in the intake of second helpings, portion sizes, skipping meals, frequency of meals eaten at school, condiment use, intake of fruits and vegetables and consumption of whole grains between the groups. BMI-R also achieved an improvement in fasted glucose (p = 0.021), triglycerides (p < 0.001), and total cholesterol (p = 0.023), as compared to BMI-NR. In conclusion, children with obesity who were able to decrease their BMI implemented a significant reduction in consumption of foods with high sugar content. Focusing on reducing sugar intake may yield the biggest impact in terms of weight management and the improvement of metabolic abnormalities.

Compensation and transfer effects of eating behavior change in daily life: Evidence from a randomized controlled trial

Pursuing specific eating goals may lead to the adoption of other healthy behaviors (transfer) or compensation with unhealthy behaviors. Previous research has mostly investigated such processes using non-experimental studies focusing on interindividual differences. To investigate transfer or compensation of eating behavior in daily life, we analyzed data from a 2 (eating goal: more fruit and vegetables [FV] vs. fewer unhealthy snacks) x 2 (intervention vs. control group) factorial randomized trial. Adopting a within-person perspective, we studied potential transfer and compensation 1) between different eating behaviors and physical activity (PA), and 2) in response to an eating behavior change intervention. Participants (N = 203) received either goals to increase FV intake or decrease unhealthy snack intake and completed a daily e-diary. Eating more unhealthy snacks predicted 0.16 less FV portions (β = −0.07; p < 0.001) and 18% less unhealthy snack intake the next day (p < 0.001). Eating more FV predicted 0.42 less FV portions the next day (β = −0.07; p < 0.001). Participants with the FV eating goal intervention decreased unhealthy snacks (p = 0.012) and PA (p = 0.019) by 8% compared to controls, respectively. Similar but non-significant patterns were observed for participants with the decreasing unhealthy snack goal intervention (p > 0.05). Results indicated both compensation and transfer processes in daily life. Relationships mostly occur within the same behavior and rather support compensatory effects. In turn, a behavior change intervention to promote FV intake potentially enhances non-assigned eating behaviors, indicating transfer, but may lower PA.

Environmental enteropathy and malnutrition in pre-school stunted children

Background Stunting is a common health problem that affects approximately one-third of children in developing countries. Environmental enteropathy is defined as an inflammatory condition of the gut, which is commonly presented in low-income countries that leads to intestinal malabsorption. Aim To study some risk factors of Environmental enteropathy in stunted children owing to malnutrition in the pre-school age (2–5 years). Patients and methods Our study was a cross-sectional study that was conducted on one group of 80 children aged from 2 to 5 years, who were diagnosed to have stunting owing to malnutrition. Their height-for-age was below −2 SD according to the WHO growth curves, matched regarding sex and age. They were from the National Nutrition Institute and attended the stunting clinic every Monday and Thursday from July 2017 to October 2019. Results There was a statistically significant difference between stool analysis and neopterin level (P=0.0035). A higher level of neopterin was among those with Entamoeba histolytica infection. Moreover, there was a statistically significant difference between the frequency of sweets and snack intake and neopterin level (P=0.001). Higher levels were among daily sweet intake. There was a positive correlation between neopterin level and age of starting weaning (P=0.006), whereas a negative correlation with duration of absolute breastfeeding (P=0.049). Conclusion Neopterin level was high among children with intestinal infection of E. histolytica followed by oxyrious and giardia. Dietary habits of daily intake of unhealthy sweety snacks showed a high level of neopterin. Exclusive 6 months of breastfeeding had a negative correlation with neopterin level.

Effect of Family-Based REDUCE Intervention Program on Children Eating Behavior and Dietary Intake: Randomized Controlled Field Trial.

The objective of this study was to evaluate the effect of a family-based intervention program (REDUCE) on children’s eating behaviors and dietary intake. A two-arm randomized controlled field trial was conducted among parents and children of 7 to 10 years old who were either overweight or obese. The intervention was conducted via face-to-face sessions and social media. The child eating behaviors were assessed using the child eating behaviors questionnaire (CEBQ), while their dietary consumption of vegetables and unhealthy snacks was assessed using a parental report of three days unweighted food. The generalized linear mixed modelling adjusted for covariates was used to estimate the intervention effects with alpha of 0.05. A total of 122 parents (91% response rate) completed this study. At the six-month post-training, there were statistically significant mean differences in the enjoyment of food (F(6481) = 4.653, p < 0.001), fruit and vegetable intake (F(6480) = 4.165, p < 0.001) and unhealthy snack intake (F(6480) = 5.062, p < 0.001) between the intervention and wait-list groups; however, it was not clinically meaningful. This study added to the body of knowledge of family-based intervention that utilized social media and assessed the effect in children’s eating behavior using the CEBQ and children’s dietary intake.

Effect of a free healthy school meal on fruit, vegetables and unhealthy snacks intake in Norwegian 10- to 12-year-old children

BackgroundNorwegian children have a lower intake of fruit, vegetables, and a higher intake of unhealthy snacks compared to dietary guidelines. Such dietary inadequacies may be detrimental for their current and future health. Schools are favorable settings to establish healthy eating practices. Still, no school meal arrangement is provided in Norway, and most children typically bring packed lunches from home. The aim of this study was to investigate whether serving a free healthy school meal for one year resulted in a higher intake of fruit and vegetables and a lower intake of unhealthy snacks in total among 10–12-year-olds in Norway.MethodsThe School Meal Project in Southern Norway was a non-randomized trial in two elementary schools in rural areas in the school year 2014/2015. The study sample consisted of 10- to 12-year-old children; an intervention group (N = 55) and a control group (N = 109) resulting in a total of 164 school children at baseline. A food frequency questionnaire was completed by the children at baseline, at five months follow-up and after one year to assess fruit, vegetable, and snacks intake. Multiple linear regression analyses were performed to assess intervention effects on overall intake of fruit and vegetables and unhealthy snacks.ResultsServing of a free healthy school meal for one year was associated with a higher weekly intake of vegetables on sandwiches in the intervention group compared to the control group, adjusted for baseline intake (B: 1.11 (95% CI: .38, 1.85)) at the end of the intervention. No other significant intervention effects were found for the remaining fruit and vegetables measures. Serving of a free healthy school meal was not associated with a lower weekly intake of unhealthy snacks (i.e. potato chips, candy, sugar sweetened beverages) in the intervention group compared to the control group.ConclusionsA free healthy school meal was associated with a higher weekly intake of vegetables on sandwiches but did not significantly change any other investigated dietary behaviors. However, given the inadequate intake of vegetables among children and that even moderate improvements have public health relevance, a free healthy school meal for all school children could be beneficial.Trial registrationISRCTN61703361.Date of registration: December 3rd, 2018.Retrospectively registered.

Exploring the directionality in the relationship between descriptive and injunctive parental and peer norms and snacking behavior in a three-year-cross-lagged study

BackgroundPeople’s eating behavior is assumed to be influenced by what other people do (perceived descriptive norms) and what others approve of (perceived injunctive norms). It has been suggested that adolescents are more susceptible to peer norms than parental norms, because they experience a strong need for group acceptance that leads to conforming to peer group norms. The current study examined changes in snacking behavior and four types of social norms (i.e., parental and peer descriptive and injunctive norms) that promoted fruit and vegetable intake among adolescents. This study was the first to examine whether snacking behavior also influenced norm perceptions by testing the directionality of these associations.MethodsThe study consisted of 819 participants (M [SD] age = 11.19 [1.36]; 46.1% boys), collected at three time points (T1 = 2016, T2 = 2017 and T3 = 2018) during the MyMovez project. Self-reported frequency of snack consumption, perceived parental and peer descriptive and injunctive norms were assessed. The primary analysis consisted of a series of cross-lagged autoregressive models specified in a structural equation modeling framework.ResultsModel comparisons testing the descriptive and injunctive norms in separate models and in an additional combined model revealed evidence for bi-directional associations between norms and snacking behavior. Descriptive peer and parent norms were not found to have an effect on subsequent snacking behaviors. Perceived injunctive parental norms were positively associated with healthy snack food intake and negatively associated with unhealthy snack intake (forward direction). Injunctive peer norms were negatively associated with healthy snack food intake. In addition, higher unhealthy snack food intake was negatively associated with the perception of descriptive and injunctive parental norms 1 year later (reversed direction). We did not find peer norms to be more closely associated with changes in snacking behaviors compared to parental norms.ConclusionsParents expecting their children to snack healthy had a positive influence on healthy snacking behavior whereas only acting as a healthy role model did not. Future research should address the possible interaction between descriptive and injunctive norms. Research should also take into account the bi-directional relations between eating behaviors and normative perceptions.

Influences of Parental Snacking-Related Attitudes, Behaviours and Nutritional Knowledge on Young Children's Healthy and Unhealthy Snacking: The ToyBox Study.

This study investigated parental influences on preschool children’s healthy and unhealthy snacking in relation to child obesity in a large cross-sectional multinational sample. Parents and 3–5 year-old child dyads (n = 5185) in a kindergarten-based study provided extensive sociodemographic, dietary practice and food intake data. Parental feeding practices that were derived from questionnaires were examined for associations with child healthy and unhealthy snacking in adjusted multilevel models, including child estimated energy expenditure, parental education, and nutritional knowledge. Parental healthy and unhealthy snacking was respectively associated with their children’s snacking (both p < 0.0001). Making healthy snacks available to their children was specifically associated with greater child healthy snack intake (p < 0.0001). Conversely, practices that were related to unhealthy snacking, i.e., being permissive about unhealthy snacking and acceding to child demands for unhealthy snacks, were associated with greater consumption of unhealthy snacks by children, but also less intake of healthy snacks (all p < 0.0001). Parents having more education and greater nutritional knowledge of snack food recommendations had children who ate more healthy snacks (all p < 0.0001) and fewer unhealthy snacks (p = 0.002, p < 0.0001, respectively). In the adjusted models, child obesity was not related to healthy or unhealthy snack intake in these young children. The findings support interventions that address parental practices and distinguish between healthy and unhealthy snacking to influence young children’s dietary patterns.

Can Parenting Practices Moderate the Relationship between Reward Sensitivity and Adolescents' Consumption of Snacks and Sugar-Sweetened Beverages?

Background: Reward sensitivity has been associated with adolescents’ intake of unhealthy snacks and sugar-sweetened beverages. However, so far, there are no studies published describing the impact of parenting practices on this relationship. The present study will, therefore, investigate whether food parenting practices can moderate the association between reward sensitivity and diet intakes. Method: A cross-sectional research study was conducted among 14- to 16-year old Flemish adolescents (n = 867, age 14.7 ± 0.8 y, 48.1% boys) and a subset of their parents (n = 131), collecting data on daily intakes, reward sensitivity, and food parenting practices. Linear regression was used to assess the moderation effect of parenting practices (both adolescent- and parent-reported) on the relationship between reward sensitivity, and diet using SPSS 25.0. Results: In the main analysis (adolescent-reported), no significant moderation effects were found for parenting practices on the relationship between reward sensitivity and diet. However, the sensitivity analysis (parent-reported) showed a moderation effect for health-reducing parenting practices on the association between reward sensitivity and unhealthy snack intake (β = 0.297, 95% CI = 0.062, 0.531, p = 0.01). Conclusion: Given the difference in the effect of parenting practices between the adolescent- and parent-reported data, our inconclusive findings warrant more research in larger adolescent-parent dyad samples.

Unhealthy snack intake modifies the association between screen-based sedentary time and metabolic syndrome in Brazilian adolescents

BackgroundExcessive screen time has been associated with metabolic syndrome (MetS) among adolescents; however, snack intake in front of screens may play a role in this association. Therefore, our objective was to investigate the association between screen-based sedentary time with MetS and whether this association is modified by unhealthy snack intake in front of screens.MethodsThis study was a nationwide, cross-sectional, school-based survey in Brazil including adolescents aged 12 to 17 years. The frequency of snack consumption in front of screen and screen-based sedentary time (TV view, computers and videogames use) were self-reported. Thereafter, screen time was categorized (≤2, 3–5 and ≥ 6 h/day); snack consumption in front of screens was dichotomized. Metabolic syndrome diagnosis was defined based on the International Diabetes Federation criteria. Associations between screen time and MetS were investigated using logistic regression in overall sample and after stratification by snack intake in front of screens.ResultsA total of 33,900 adolescents were included in the analysis. The final adjusted model, which included sociodemographic data, physical activity, and energy intake, showed that adolescents who spent ≥6 h/day in front of screens had an increased odds ratio for MetS (OR = 1.68, 95%CI: 1.03–2.74). However, after stratifying the sample according to reported snack intake, the association between higher screen-based sedentary time and MetS remained significant only for adolescents who reported consumption of snacks in front of screens.ConclusionLonger screen-based sedentary times were directly associated with MetS. However, this association seems to be modified by reported snack intake in front of screens.

OR21-5 Unhealthy Snack Intake Modifies the Association Between Screen-Based Sedentary Time and Metabolic Syndrome in Brazilian Adolescents: Findings from a Country-Wide Survey

Metabolic syndrome (MetS) in adolescence represents a higher risk for the development of subclinical atherosclerosis and type 2 diabetes mellitus during adulthood. Excessive screen time, has been associated with MetS; however, the findings are inconsistent due to the methodological differences among studies. Moreover, unhealthy food intake in front of screens could modify this association, an issue that is not completely clear. Therefore, our objective was to investigate the association between screen-based sedentary times and MetS and whether this association is modified by unhealthy snack intake in front of screens. This research is part of the Study on Cardiovascular Risks in Adolescents (ERICA), a nationwide, cross-sectional, school-based survey in Brazil. Adolescents aged 12 to 17 years were included. Measurements of waist circumference, blood pressure and fasting blood samples were collected for the measurement of blood glucose, HDL-cholesterol, and triglycerides. Metabolic syndrome was defined based on the International Diabetes Federation criteria. Screen time was self-reported (i.e. time in front of TV, computers, and videogames) and it was categorized as ≤ 2 hours, 3 to 5 hours, and ≥ 6 hours a day. Snack intake in front of screens was self-reported and the answers were dichotomized into no (if the subject reported no habit of eating in front of a screen) or yes (if they reported eating sometimes, almost every day or every day). For this analysis, we used data from 33,900 students. Associations between screen time and MetS were investigated using logistic regression to estimate the odds ratio. In further analyses, we stratified the sample based on snack intake in front of screens. The majority of the sample was composed of females (59.4%) and the mean age was 14.6 years (CI95%: 14.6-14.7). Half of the sample was classified as physically active, and the majority of them declared that they usually eat snacks in front of TV (85.1%) and computer/videogame (64%). The adjusted model, which included sociodemographic data, physical activity, and energy intake, showed that adolescents who spent ≥ 6 hours/day in front of screens had a higher odds ratio (OR) for MetS (OR = 1.71, 95%CI: 1.04-2.79) when compared with the reference group. However, the increase in the OR for MetS by screen time categories is observed only among those who reported habitual consumption of snacks while in front of the TV (3-5 hours/day: OR = 1.96, 95%CI: 1.37-2.80; ≥ 6 hours/day: OR = 2.63, 95%CI: 1.68-4.11) or computers/videogames (3-5 hours/day: OR = 1.77, 95%CI: 1.15-2.72; ≥ 6 hours/day: OR = 2.05, 95%CI: 1.24-3.38). We concluded that higher screen-based sedentary times were positively associated with MetS. However, this association is modified by snack intake. Interventions should address simultaneously the reduction of screen time and snack consumption in order to improve metabolic health among adolescents.

Social Media Influencer Marketing and Children's Food Intake: A Randomized Trial.

To examine the impact of social media influencer marketing of foods (healthy and unhealthy) on children's food intake. In a between-subjects design, 176 children (9-11 years, mean 10.5 ± 0.7 years) were randomly assigned to view mock Instagram profiles of 2 popular YouTube video bloggers (influencers). Profiles featured images of the influencers with unhealthy snacks (participants: n = 58), healthy snacks (n = 59), or nonfood products (n = 59). Subsequently, participants' ad libitum intake of unhealthy snacks, healthy snacks, and overall intake (combined intake of healthy and unhealthy snacks) were measured. Children who viewed influencers with unhealthy snacks had significantly increased overall intake (448.3 kilocalories [kcals]; P = .001), and significantly increased intake of unhealthy snacks specifically (388.8 kcals; P = .001), compared with children who viewed influencers with nonfood products (357.1 and 292.2 kcals, respectively). Viewing influencers with healthy snacks did not significantly affect intake. Popular social media influencer promotion of food affects children's food intake. Influencer marketing of unhealthy foods increased children's immediate food intake, whereas the equivalent marketing of healthy foods had no effect. Increasing the promotion of healthy foods on social media may not be an effective strategy to encourage healthy dietary behaviors in children. More research is needed to understand the impact of digital food marketing and inform appropriate policy action.

Introducing functional and dysfunctional self-licensing: Associations with indices of (un)successful dietary regulation.

Giving in to food temptations is typically labeled as self-regulation failure. However, when indulgence stems from self-licensing processes, that is, relying on reasons to justify diet deviations, these instances might actually promote successful goal striving. This research aimed to theoretically define and test under what conditions self-licensing would be considered functional (e.g., when it ultimately serves the long-term goal of weight control) and dysfunctional (e.g., when it threatens successful goal striving). First, a pool of items reflecting functional and dysfunctional ways of self-licensing was tested and representative items were selected (Study 1; N=194). Next, their classification was corroborated by examining the associations with indices of (un)successful dietary regulation (Study 2; N=147). Finally, it was tested whether (dys)functional self-licensing predicted unhealthy snack intake, by means of participants keeping an unhealthy snack diary (Study 3; N=54). The theorized distinction was confirmed, and the obtained correlational patterns supported the proposed (dys)functionality of the two types of self-licensing. Importantly, results showed that dysfunctional self-licensing predicted higher snack intake, whereas functional self-licensing predicted lower snack intake. The present studies provide evidence for the existence of two types of self-licensing, and thereby contribute to theoretical development.

Effects of 1 y of free school fruit on intake of fruits, vegetables, and unhealthy snacks: 14 y later

There are not many studies evaluating the long-term effects of fruit and vegetable interventions. We examined the effects of 1 y of free fruit in elementary school on long-term consumption of fruit, vegetables, and unhealthy snacks, according to sex and educational attainment, 14 y after the intervention period. In 2001, the baseline survey of the longitudinal cohort, Fruits and Vegetables Make the Marks (FVMM), included 1950 children (mean age: 11.8 y) attending 38 randomly drawn elementary schools from 2 counties in Norway. In the following 10 mo, 9 schools served as intervention schools by participating in the Norwegian School Fruit Program for free, whereas 29 schools served as control schools. A follow-up survey conducted in 2016 included 982 participants (50%) from the original study sample (mean age: 26.5 y). The consumption of fruit and vegetables was measured by a 24-h recall (portions per day), and the consumption of unhealthy snacks was measured by food-frequency questions (portions per week). Linear mixed models were performed to test possible intervention effects on the consumption of fruit, vegetables, and unhealthy snacks 14 y after the intervention period. No overall intervention effects after 14 y due to the free-fruit scheme on the consumption of fruit, vegetables, and unhealthy snacks were observed, but significant interactions showed a sustained higher frequency of fruit consumption among females in the intervention group compared with the control group [mean difference (MD): 0.38 portions/d; P=0.023] and that this effect was only significant among less-educated females (MD: 0.73 portions/d; P=0.043). No significant long-term intervention effects were observed in the consumption of fruit among highly educated females and males nor in the consumption of vegetables or unhealthy snacks. Results from the present study indicate that receiving free fruit at school for 1 y may have positive long-term effects for females without higher education.