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15 pages, 526 KiB

Open AccessArticle

Theoretically Based Factors Affecting Diet Quality of Preschool Children: A Cross-Sectional Study

by Qutaibah Oudat, Sarah Couch, Elaine Miller, Rebecca C. Lee and Tamilyn Bakas

Children 2025, 12(2), 114; https://doi.org/10.3390/children12020114 - 21 Jan 2025

Cited by 1 | Viewed by 1018

Abstract

Background/Objectives: Diet quality during early childhood significantly influences long-term health outcomes, including obesity and chronic disease risks. Parental feeding practices, dietary beliefs, and demographic factors have been shown to impact children’s diet quality. This study aimed to determine the extent to which the [...] Read more.

Background/Objectives: Diet quality during early childhood significantly influences long-term health outcomes, including obesity and chronic disease risks. Parental feeding practices, dietary beliefs, and demographic factors have been shown to impact children’s diet quality. This study aimed to determine the extent to which the demographic characteristics and the factors of primary caregivers (dietary beliefs, intention to provide a healthy diet, feeding practices) can explain the variance in the diet quality of preschoolers in the US Methods: This descriptive correlational cross-sectional study was guided by the Theory of Planned Behavior (TPB). A total of 146 primary caregivers of preschool children (aged 3–5) were recruited through convenience and snowball sampling. Data were collected using a self-reported questionnaire and a structured telephone interview. Diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) score. Hierarchical multiple regression analyses were conducted to determine the factors associated with preschoolers’ diet quality. Results: The mean DASH score was 40.5 (SD = 10.1), reflecting moderate to low diet quality. The results showed that 16% of the variance in diet quality was significantly explained by race (non-White) and three caregiver feeding practices (food as a reward, restriction food for health, and restriction for weight control). Of these, race (non-White) and restriction food for health were significant predictors and associated with lower diet quality in preschoolers. Conclusions: These findings align with previous studies and suggest that the conceptual framework of this study might be further refined and tested in future studies. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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12 pages, 280 KiB

Open AccessArticle

Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents

by Alejandra Gallego, Jorge Olivares-Arancibia, Rodrigo Yáñez-Sepúlveda, Héctor Gutiérrez-Espinoza and José Francisco López-Gil

Children 2024, 11(8), 1020; https://doi.org/10.3390/children11081020 - 21 Aug 2024

Cited by 4 | Viewed by 1629

Abstract

Background: This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2–14. Methods: Parents or guardians reported the weight and height of participants, used to calculate body mass [...] Read more.

Background: This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2–14. Methods: Parents or guardians reported the weight and height of participants, used to calculate body mass index (BMI) and BMI z-scores according to the International Obesity Task Force standards. Participants were categorized into “overweight/obesity” and “no overweight/obesity” and further into “obesity” and “no obesity”. The rate of poverty rate was determined using data from the National Statistics Institute of Spain, defining it as the percentage of people with income below 60% of the national median. SES was based on the head of household’s occupation and categorized into low, medium, and high levels. Results: Adjusted multilevel models showed participants with medium or high SES had lower odds of overweight/obesity compared to those with low SES (medium SES: odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.54–0.73; high SES: OR: 0.59, 95% CI: 0.49–0.70). Participants in the high-poverty group had higher odds of having overweight/obesity (OR: 1.40, 95% CI: 1.13–1.74) compared to the low-poverty group. Conclusions: The study highlights significant socioeconomic disparities in childhood overweight/obesity, emphasizing the potential impact of SES and poverty on health outcomes in Spanish children and adolescents. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

12 pages, 658 KiB

Open AccessArticle

Optimizing Dietary Habits in Adolescents with Polycystic Ovary Syndrome: Personalized Mediterranean Diet Intervention via Clinical Decision Support System—A Randomized Controlled Trial

by Alexandra Foscolou, Panos Papandreou, Aristea Gioxari and Maria Skouroliakou

Children 2024, 11(6), 635; https://doi.org/10.3390/children11060635 - 24 May 2024

Cited by 3 | Viewed by 2110

Abstract

The hypothesis of this randomized controlled trial was that a clinical decision support system (CDSS) would increase adherence to the Mediterranean diet (MD) among adolescent females with polycystic ovary syndrome (PCOS). The objective was to assess the impact of personalized MD plans delivered [...] Read more.

The hypothesis of this randomized controlled trial was that a clinical decision support system (CDSS) would increase adherence to the Mediterranean diet (MD) among adolescent females with polycystic ovary syndrome (PCOS). The objective was to assess the impact of personalized MD plans delivered via a CDSS on nutritional status and psychological well-being. Forty adolescent females (15–17 years) with PCOS were randomly assigned to the MD group (n = 20) or the Control group (n = 20). The MD group received personalized MD plans every 15 days via a CDSS, while the Control group received general nutritional advice. Assessments were conducted at baseline and after 3 months. Results showed significantly increased MD adherence in the MD group compared to the Control group (p < 0.001). The MD group exhibited lower intakes of energy, total fat, saturated fat, and cholesterol, and higher intakes of monounsaturated fat and fiber (p < 0.05). Serum calcium and vitamin D status (p < 0.05), as well as anxiety (p < 0.05) were improved. In conclusion, tailored dietary interventions based on MD principles, delivered via a CDSS, effectively manage PCOS in adolescent females. These findings highlight the potential benefits of using technology to promote dietary adherence and improve health outcomes in this population. ClinicalTrials.gov registry: NCT06380010. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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17 pages, 533 KiB

Open AccessArticle

Schools as Hubs of Health: A Comprehensive Supplemental Nutrition Assistance Program—Education Model for Promoting Wellness in Low-Income Communities

by Shannon A. Klisch and Katherine E. Soule

Children 2024, 11(5), 525; https://doi.org/10.3390/children11050525 - 27 Apr 2024

Cited by 1 | Viewed by 2071

Abstract

Research indicates that health interventions are most effective when they address multiple social determinants of health to support positive behavior. Schools as Hubs of Health, a comprehensive model of nutrition and physical activity education, was developed to support wellness within school communities [...] Read more.

Research indicates that health interventions are most effective when they address multiple social determinants of health to support positive behavior. Schools as Hubs of Health, a comprehensive model of nutrition and physical activity education, was developed to support wellness within school communities defined as low-income by the national Supplemental Nutrition Assistance Program Education (SNAP-Ed). Components of the model include the following: classroom education; garden education; youth engagement; staff training; parent and community engagement; and policies, systems, and environments. Findings over the last decade indicate positive outcomes in nutrition and physical activity behaviors, youth leadership and engagement, and systems and environmental changes that support health and wellness. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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13 pages, 278 KiB

Open AccessEditor’s ChoiceArticle

Mechanisms of Stigmatization in Family-Based Prevention and Treatment of Childhood Overweight and Obesity

by Didde Hoeeg, Katherine L. Frohlich, Ulla Christensen and Dan Grabowski

Children 2023, 10(10), 1590; https://doi.org/10.3390/children10101590 - 23 Sep 2023

Cited by 6 | Viewed by 2268

Abstract

It is well established that overweight and obesity are often accompanied by stigmatization. However, the influence of stigmatization on interventions for overweight and obesity remains unknown. Stigma may be particularly harmful to children. This study aimed to examine how stigmatization affects efforts to [...] Read more.

It is well established that overweight and obesity are often accompanied by stigmatization. However, the influence of stigmatization on interventions for overweight and obesity remains unknown. Stigma may be particularly harmful to children. This study aimed to examine how stigmatization affects efforts to reduce childhood overweight and obesity through family interventions. This research was conducted in a socially disadvantaged area in Denmark. Twenty-seven families and forty professionals participated in in-depth interviews or workshops. The data were analyzed using CMO configurations from a realist evaluation and the theory of stigmatization developed by Link and Phelan. Thus, an abductive approach was employed in the analysis, with its foundation rooted in the empirical data. The study found that the mechanisms of stigmatization could 1. restrain professionals and parents from approaching the problem—thereby challenging family recruitment; 2. prevent parents from working with their children to avoid eating unhealthy food for fear of labeling the child as overweight or obese; and 3. cause children with obesity to experience a separation from other slimmer family members, leading at times to status loss, discrimination, and self-stigmatization. The study showed how the mechanisms of stigmatization may obstruct prevention and treatment of childhood obesity through family interventions. It is suggested that the concept of stigma should be incorporated into the program theories of interventions meant to reduce childhood overweight and obesity. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

16 pages, 777 KiB

Open AccessEditor’s ChoiceArticle

Attendance-Based Adherence and Outcomes of Obesity Management Program in Arab Adolescents

by Nasser M. Al-Daghri, Osama E. Amer, Malak N. K. Khattak, Syed D. Hussain, Ghadah Alkhaldi, Hanan A. Alfawaz, Mohamed A. Elsaid and Shaun Sabico

Children 2023, 10(9), 1449; https://doi.org/10.3390/children10091449 - 25 Aug 2023

Cited by 5 | Viewed by 1731

Abstract

Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to [...] Read more.

Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to the lifestyle educational program and target outcomes, obesity, and hypertension. A total of 363 (nonadherent, N = 179; adherent, N = 184) Saudi school adolescents aged 12–18 were recruited from 60 schools in Riyadh City, Saudi Arabia. Anthropometrics, lipid profile, and blood glucose were measured at baseline and post-intervention. The level of adherence was based on the number of attended educational sessions, and participants were grouped accordingly into two groups: adherent group (attended ≥ 3 sessions) and nonadherent group (attended 1–2 sessions) out of a total of five sessions. Results demonstrated that significantly more participants in the adherent group achieved the primary program goal of reducing obesity indices [body weight, body mass index (BMI), and BMI z-score] than the nonadherent group. Additionally, among adherent obese participants, BMI z-score significantly decreased after the 12-month intervention (post-intervention: 1.5 ± 0.7 vs. baseline: 1.7 ± 0.6, p < 0.05), while the trend in BMI z-score modestly increased in the nonadherent obese participants post-intervention (post-intervention: 1.8 ± 0.7 vs. baseline: 1.7 ± 0.6, p > 0.05). Moreover, there was a substantial reduction in hypertension prevalence only in the adherent group (p = 0.003) and among adherent obese participants in particular (p = 0.03). Furthermore, adherence to session attendance was higher in girls than boys, which led to better outcomes among girls than boys. For the secondary outcomes, lipid profile indices increased in both groups, while no changes were observed in the glycemic profile. In conclusion, greater adherence to educational sessions achieved modest but favorable weight changes and improved blood pressure among obese adolescents. Future intervention studies should take into consideration the need to improve attendance to enhance adherence to the program among adolescents at risk. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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Review

Jump to: Research

18 pages, 703 KiB

Open AccessReview

Understanding Caregivers’ Influence on Preschoolers’ Eating Behaviors: An Integrative Review Guided by the Theory of Planned Behavior

by Qutaibah Oudat, Elaine L. Miller, Sarah C. Couch, Rebecca C. Lee and Tamilyn Bakas

Children 2025, 12(2), 163; https://doi.org/10.3390/children12020163 - 29 Jan 2025

Cited by 1 | Viewed by 1120

Abstract

Background/Objectives: Primary caregivers of children play a significant role in developing their dietary behaviors. Guided by the Theory of Planned Behavior (TPB), this integrative review aimed to synthesize studies examining how personal and household characteristics, caregivers’ dietary beliefs, intentions, and feeding practices influence [...] Read more.

Background/Objectives: Primary caregivers of children play a significant role in developing their dietary behaviors. Guided by the Theory of Planned Behavior (TPB), this integrative review aimed to synthesize studies examining how personal and household characteristics, caregivers’ dietary beliefs, intentions, and feeding practices influence the eating behaviors of preschool-aged children (2–5 years). Methods: PubMed, CINAHL, and PsycINFO databases were searched for peer-reviewed articles published between January 2014 and September 2024. The expanded PRISMA 2020 checklist was used to guide the literature search and report the results. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) was also used to evaluate the quality of the selected articles. Results: A total of 10 studies were included in the final analysis. The studies revealed that preschoolers’ eating behaviors were significantly influenced by personal characteristics (e.g., caregivers’ BMI, and weight perceptions) and household factors (e.g., food availability). Additionally, caregivers’ feeding practices, such as restriction, modeling, and permissiveness, played a pivotal role in shaping children’s eating habits. Although caregivers expressed intentions to provide a healthy diet, they often faced barriers, including conflicting work schedules, financial constraints, and logistical challenges, which impeded their ability to consistently promote healthy eating behaviors. Conclusions: Caregivers’ beliefs, intentions, and feeding practices are pivotal in shaping preschoolers’ eating behaviors. However, the limited available literature and the underexplored mechanisms linking these factors make it challenging to draw solid conclusions. Future research should address these gaps and consider integrating caregiver-focused factors into tailored interventions to promote healthier eating habits in preschool-aged children. This can aid healthcare professionals in designing culturally and contextually sensitive strategies for improving childhood nutrition. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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15 pages, 650 KiB

Open AccessEditor’s ChoiceReview

Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children

by Archontoula Drouka, Dora Brikou, Céline Causeret, Nur Al Ali Al Malla, Stéphane Sibalo, Concha Ávila, Gabriela Alcat, Anastasia E. Kapetanakou, Patricia Gurviez, Nawel Fellah-Dehiri, Marine Masson, Meropi D. Kontogianni and Mary Yannakoulia

Children 2023, 10(10), 1676; https://doi.org/10.3390/children10101676 - 11 Oct 2023

Cited by 11 | Viewed by 3225

Abstract

The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6–10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases [...] Read more.

The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6–10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers’ training. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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