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Dietary Patterns and Health Outcomes in Children and Adolescents

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Children's Health".

Deadline for manuscript submissions: closed (30 August 2022) | Viewed by 47205

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Special Issue Editors

Dr. Mary F.F. Chong

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Guest Editor

Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Singapore 117549, Singapore
Interests: maternal and child nutrition; nutrition and non-communicable diseases; weight loss interventions; lifestyle and eating behaviors in adults and children
Special Issues, Collections and Topics in MDPI journals

Dr. Airu Chia

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Guest Editor

Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, Singapore 117549, Singapore
Interests: maternal and child nutrition; nutrition and non-communicable diseases; weight loss interventions, lifestyle, and eating behaviors in adults and children

Special Issue Information

Dear Colleagues,

The dietary pattern approach is a recent focus in nutrition research as it seeks to understand the totality of the diet and considers the synergistic effects of multiple food and nutrient components. While considerable research related to dietary patterns in adults and various health outcomes have emerged, research devoted to dietary patterns in children and adolescents in relation to health and the development of diseases over time is still lacking. This gap needs to be addressed as childhood and adolescence together represent one of the most rapid, dynamic and formative phases of human development and a critical period that forms the foundation for establishing healthy lifestyle habits that can track to adulthood.

In this Special Issue of the International Journal of Environmental Research and Public Health, we invite submissions that examine dietary patterns in children and adolescents in relation to various health outcomes, with a particular interest in adiposity, glucose intolerance, bone health, and mental health or cognition. We welcome papers that address lifestyle variables and psychosocial factors that influence dietary patterns as well as those which seek to better understand dietary patterns from various ethnic backgrounds. Systematic reviews in this area would be of particular interest.

Dr. Mary F.F. Chong
Dr. Airu Chia
Guest Editors

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Keywords

dietary patterns
children
adolescents
adiposity
glucose intolerance
bone health
mental health
cognition
lifestyle
ethnicity

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Published Papers (10 papers)

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Research

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9 pages, 887 KiB

Open AccessArticle

Modelling Analysis on Dietary Patterns and Oral Health Status among Adolescents

by Huay Woon You

Int. J. Environ. Res. Public Health 2022, 19(22), 15255; https://doi.org/10.3390/ijerph192215255 - 18 Nov 2022

Cited by 4 | Viewed by 2267

Abstract

Adolescence is a crucial stage between childhood and adulthood during which an individual learns new behaviours and practices including dietary patterns. This study aimed to examine the diet and oral health status among adolescents, and employed a structured questionnaire with three sections, namely, demographic, Adolescents’ Food Habits Checklist (AFHC) and the Kayser–Jones Brief Oral Health Status Examination (BOHSE). The AFHC was formulated consisting of 23 items to collect information about dietary patterns with respect to food purchase, preparation and consumption habits. Meanwhile, the BOHSE contained nine items to evaluate the oral conditions of adolescents. The relationship between dietary pattern and oral health in adolescents was investigated. A total of 160 adolescents were randomly selected in this study. The data analysis was presented in the form of tables. This study adhered to the STROBE checklist’s Guidelines for Systematic Reporting of Examination. According to the findings, food consumption dietary patterns among adolescents had the highest mean score (4.475). This demonstrates that adolescents practiced healthy food consumption. A significant positive correlation was found between food purchase, food preparation, food consumption and dietary patterns. Moreover, females had a slightly higher mean score than males, showing that females have a healthier diet status than males. This study can serve as points of reflection and recommendations on dietary patterns and oral health status. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

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12 pages, 2145 KiB

Open AccessArticle

Dietary Diversity and Dietary Patterns in School-Aged Children in Western Kenya: A Latent Class Analysis

by Tiange Liu, Sherryl Broverman, Eve S. Puffer, Daniel A. Zaltz, Andrew L. Thorne-Lyman and Sara E. Benjamin-Neelon

Int. J. Environ. Res. Public Health 2022, 19(15), 9130; https://doi.org/10.3390/ijerph19159130 - 26 Jul 2022

Cited by 13 | Viewed by 4044

Abstract

Inadequate diet among children has both immediate and long-term negative health impacts, but little is known about dietary diversity and dietary patterns of school-aged children in rural Kenya. We assessed dietary diversity and identified dietary patterns in school-aged children in Western Kenya using a latent class approach. We collected dietary intake using a 24 h dietary recall among students in elementary schools in two rural villages (hereafter village A and B) in Western Kenya in 2013. The mean (SD) age was 11.6 (2.2) years in village A (n = 759) and 12.6 (2.2) years in village B (n = 1143). We evaluated dietary diversity using the 10-food-group-based women’s dietary diversity score (WDDS) and found a mean (SD) WDDS of 4.1 (1.4) in village A and 2.6 (0.9) in village B. We identified three distinct dietary patterns in each village using latent class analysis. In both villages, the most diverse pattern (28.5% in A and 57.8% in B) had high consumption of grains, white roots and tubers, and plantains; dairy; meat, poultry, and fish; and other vegetables. Despite variation for some children, dietary diversity was relatively low for children overall, supporting the need for additional resources to improve the overall diet of children in western Kenya. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

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10 pages, 778 KiB

Open AccessArticle

HOMA Index, Vitamin D Levels, Body Composition and Cardiorespiratory Fitness in Juvenile Obesity: Data from the CHILT III Programme, Cologne

by Annika Fraemke, Nina Ferrari, David Friesen, Fabiola Haas, Marlen Klaudius, Esther Mahabir, Lisa Schmidt and Christine Joisten

Int. J. Environ. Res. Public Health 2022, 19(4), 2442; https://doi.org/10.3390/ijerph19042442 - 20 Feb 2022

Cited by 5 | Viewed by 3283

Abstract

Juvenile obesity is associated with insulin resistance, among other comorbidities. In the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes, Vitamin D deficiency is very common. Therefore, the relationship between insulin resistance, body composition, vitamin D level, and cardiorespiratory fitness in obese children and youth were analyzed based on the Children’s Health InterventionaL Trial III project, Germany. Data on vitamin D levels and homeostatic model assessment (HOMA) indices were available from 147 participants (52.4% female; 90.5% obese; 12.3 ± 2.3 years, BMI: 30.5 ± 5.2 kg/m², BMI standard deviation score (BMI-SDS): 2.52 ± 0.46). Vitamin D levels correlated negatively with the HOMA index, BMI, BMI-SDS, abdominal circumference, and body fat percentage but positively with relative cardiorespiratory fitness (p < 0.05 in each case). In the backward stepwise linear regression analysis, body fat (in kg; β = 0.403) and vitamin D levels (β = −0.154) explained 21.0% of the variance in the HOMA index. In summary, increased body fat and lower vitamin D levels are associated with increased HOMA indices in overweight and obese children and adolescents. In order to prevent potential negative consequences, including the development of manifest Type 2 diabetes, a healthy lifestyle with a vitamin-D-enriched diet and more time spent outdoors should be promoted. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

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14 pages, 831 KiB

Open AccessArticle

Associations of Childcare Arrangements with Adiposity Measures in a Multi-Ethnic Asian Cohort: The GUSTO Study

by Beverly Wen-Xin Wong, Jia Ying Toh, Ray Sugianto, Airu Chia, Mya Thway Tint, Wen Lun Yuan, Natarajan Padmapriya, Carla Lança, Seang-Mei Saw, Yung Seng Lee, Lynette Pei-Chi Shek, Kok Hian Tan, Fabian Yap, Keith M. Godfrey, Yap-Seng Chong, Falk Müller-Riemenschneider, Johan G. Eriksson, Shiao-Yng Chan and Mary Foong-Fong Chong

Int. J. Environ. Res. Public Health 2021, 18(22), 12178; https://doi.org/10.3390/ijerph182212178 - 19 Nov 2021

Cited by 5 | Viewed by 3442

Abstract

Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. However, little is known of its influence on childhood obesity in Singapore. We aim to examine the associations between childcare arrangements at the age of 5 years and childhood adiposity at age 6 years. Children from the GUSTO study were grouped into three childcare arrangements at age 5: full-time centre-based childcare (FC), partial centre-based with parental care (PCP), and partial centre-based with non-parents (grandparents and domestic helpers) as caregivers (PCN). Diet, physical activity and sedentary behaviour information were collected at age 5, while anthropometric measurements were collected at age 6. Associations were analysed using multivariable regression models. Among 540 children, those in PCN had higher BMI z-scores (β: 0.34; 95% CI: 0.01, 0.66), greater sum of skinfold thicknesses (mm) (β: 3.75; 95% CI: 0.53, 6.97) and were 3.55 times (95% CI: 1.78, 7.05) more likely to be overweight/obese than those in FC. Adiposity measures in PCP children did not differ from those in FC. PCN children were reported to have more screen time and greater fast-food intake. Children in PCN tended to have higher adiposity measures. Greater engagement of non-parental caregivers should be considered in interventions targeting child obesity. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

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15 pages, 21018 KiB

Open AccessArticle

Caregiver Perceptions of Environmental Facilitators and Barriers to Healthy Eating and Active Living during the Summer: Results from the Project SWEAT Sub-Study

by Laura C. Hopkins, Amy R. Sharn, Daniel Remley, Heather Schier, Regan Olak, Dorsena Drakeford, Cara Pannell and Carolyn Gunther

Int. J. Environ. Res. Public Health 2021, 18(21), 11396; https://doi.org/10.3390/ijerph182111396 - 29 Oct 2021

Cited by 3 | Viewed by 2806

Abstract

Objective: The aim of this study was to examine caregiver perceptions of summertime neighborhood-level environmental barriers and facilitators to healthy eating and active living in their elementary-age racial minority children. Methods: Caregivers with students in the prekindergarten–fifth grade were recruited from two schools located in low-income urban neighborhoods of Columbus, OH, with a predominantly Black population. Participants engaged in the research portion of the Healthy Eating Active Living: Mapping Attribute using Participatory Photographic Surveys (HEALth MAPPS^TM) protocol, which included (1) orientation; (2) photographing and geotagging facilitators and barriers to HEALth on daily routes; (3) in-depth interview (IDI) discussing images and routes taken; (4) focus groups (FG). IDIs and FGs were transcribed verbatim. Analyses were guided by grounded theory and interpretive phenomenology and were coded by researchers (n = 3), who used comparative analysis to develop a codebook and determine major themes. Results: A total of 10 caregivers enrolled and 9 completed the IDIs. Five caregivers participated in focus groups. A majority (77.8%, n = 7) of caregivers identified as Black, female (88.9%, n = 8), and low income (55.6%, n = 5). IDI and FG themes included (1) walkway infrastructure crucial for healthy eating and active living; (2) scarce accessibility to healthy, affordable foods; (3) multiple abandoned properties; (4) unsafe activity near common neighborhood routes. Conclusions: Caregivers perceived multiple neighborhood-level barriers to healthy eating and activity during the summer months when school is closed. Findings from this study provide initial insights into environmental determinants of unhealthy summer weight gain in a sample of predominantly racial minority school-age children from low-income households. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

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15 pages, 336 KiB

Open AccessArticle

The Relationship between Lifestyle Factors and Obesity Indices among Adolescents in Qatar

by Abdelhamid Kerkadi, Abdelmonem H. Sadig, Hiba Bawadi, Al Anoud Mohammed Al Thani, Walaa Al Chetachi, Hammad Akram, Hazzaa M. Al-Hazzaa and Abdulrahman O. Musaiger

Int. J. Environ. Res. Public Health 2019, 16(22), 4428; https://doi.org/10.3390/ijerph16224428 - 13 Nov 2019

Cited by 56 | Viewed by 7518

Abstract

Background: Physical inactivity, sedentary behaviour and an unhealthy diet are factors that may increase weight and general and/or abdominal obesity. Objective: To evaluate the relationship between general and abdominal obesity and lifestyle factors among adolescents in Qatar. Methods: The study data are based on the Arab Teens Lifestyle Study (ATLS). The target population consisted of 1184 adolescents aged between 14 and 18 years old (563 boys and 621 girls), randomly selected through multistage sampling. A validated questionnaire was used to collect data on lifestyle indicators. Anthropometric indicators, which included body weight, height and waist circumference (WC), were measured according to standardised procedures. International Obesity Task Force (IOTF) age- and sex-specific body mass index (BMI) reference values were used to define overweight and obesity. Abdominal obesity was defined by the ‘waist-to-height ratio’ (WHtR > 0.5) and by sex- and age-specific WC cutoff values. Results: Females were more inactive than males (63.7% vs. 36.3%; p < 0.001). The proportion of adolescents who reported screen time of over 2 h per day was 82.5%. Females engaged in more sedentary behaviour than males (53.4% vs. 46.4%, p = 0.009). Being male (OR: 1.3; CI: 1.0–1.7) and skipping breakfast (OR: 1.5; CI: 1.2–2) were significantly associated with overweight/obesity. In contrast, high intake of fast food, fries, sweets and cake were negative predictors of general and abdominal obesity. Conclusions: The findings revealed the prevalence of unhealthy lifestyle habits among adolescents in Qatar and indicated relationships between certain dietary habits and obesity. The findings of this study may help in advocating for the implementation of an intervention that includes lifestyle changes targeting adolescents. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

15 pages, 335 KiB

Open AccessArticle

The “Motor of the Day”: Parent and School-Age Children’s Cognitions, Barriers, and Supports for Breakfast

by Kaitlyn M. Eck, Colleen L. Delaney, Rashel L. Clark, Miriam P. Leary, Karla Pagan Shelnutt, Melissa D. Olfert and Carol Byrd-Bredbenner

Int. J. Environ. Res. Public Health 2019, 16(18), 3238; https://doi.org/10.3390/ijerph16183238 - 4 Sep 2019

Cited by 12 | Viewed by 5502

Abstract

Despite the many benefits of regular breakfast consumption few parents and children consume this meal every day and research examining the determinants of breakfast consumption is limited. Thus, the purpose of this study was to examine breakfast-related cognitions (i.e., beliefs, attitudes, facilitators, barriers) of parents and school-age children (ages 6–11 years) using the constructs of Social Cognitive Theory as a guide. Parents (n = 37) and children (n = 41) participated in focus group discussions held in community settings in 3 states (FL, NJ, WV). Data were qualitatively content analyzed to detect trends. Parents felt breakfast was important for numerous reasons. Parents expressed concern about the healthfulness of some traditional breakfast options, preferring breakfasts containing mostly fruits, vegetables, and protein and fewer carbohydrates. Parents identified lack of time as the greatest barrier to breakfast consumption. To overcome this barrier, they utilized grab-and-go foods, prepared breakfast ahead of time, and got up earlier. Utilizing the school breakfast program was another strategy mentioned, however some were concerned about the nutritional quality of this option. Children recognized the importance of breakfast and cited several benefits. The greatest barrier to breakfast identified by children was feeling rushed in the morning. To overcome barriers, children suggested having a morning routine, selecting or preparing breakfast foods ahead, and relying on parents to encourage breakfast consumption. The effectiveness of interventions aiming to improve breakfast intake may be improved by addressing parent and child breakfast-related cognitions and tailoring interventions to address their needs. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

9 pages, 298 KiB

Open AccessArticle

Early Eating Patterns and Overweight and Obesity in a Sample of Preschool Children in South-East Poland

by Joanna Baran, Aneta Weres, Ewelina Czenczek-Lewandowska, Edyta Łuszczki, Grzegorz Sobek, Grzegorz Pitucha, Justyna Leszczak and Artur Mazur

Int. J. Environ. Res. Public Health 2019, 16(17), 3064; https://doi.org/10.3390/ijerph16173064 - 23 Aug 2019

Cited by 11 | Viewed by 3342

Abstract

The aim of this study was to assess the impact of a child’s diet in the first year of life (breastfeeding duration, introduction of solid meals to the diet, the time of starting nutrition consistent with an adult diet) on the prevalence of overweight and obesity in preschool age. Three-hundred children aged 4–6 were included in the analysis. The children’s height and body weight were assessed and their body mass category was determined based on the BMI (Body Mass Index) percentile. Parents provided a photocopy of the child’s health book (with information concerning breastfeeding period, start of eating the same meals as the rest of the family, etc.). Obese children were breastfed for the shortest time, cow’s milk was introduced to their diets the earliest, they started eating the same food as the rest of the family the earliest, and they received vegetables, fruits, cereals, and meat products in their diet the latest. The results of this study suggest that extending the breastfeeding period beyond 6 months, starting to feed the child the same meals as the rest of the family after 12 months of age, and later introduction of cow’s milk to the diet would reduce the risk of the occurrence of excessive body weight in preschool children. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

14 pages, 646 KiB

Open AccessArticle

Impacts of Nutrition Subsidies on Diet Diversity and Nutritional Outcomes of Primary School Students in Rural Northwestern China—Do Policy Targets and Incentives Matter?

by Qihui Chen, Chunchen Pei, Yunli Bai and Qiran Zhao

Int. J. Environ. Res. Public Health 2019, 16(16), 2891; https://doi.org/10.3390/ijerph16162891 - 13 Aug 2019

Cited by 10 | Viewed by 4532

Abstract

Many developing countries have implemented nutrition intervention programs to reduce child malnutrition. However, the effectiveness of these programs differs greatly, and it remains unclear what is causing the differences in effectiveness across different programs. To shed some light on this issue, this article examines the role the specificity of policy targets, along with the incentives attached, plays in affecting the effectiveness of nutrition intervention programs. More specifically, we examined how different policy targets (and the associated incentives) affect primary students’ dietary structure and (thus) their nutritional and health status by analyzing a randomized intervention in rural Northwestern China that was designed with two treatment arms. The two treatments provided the same nutrition subsidy to project students but with different policy targets, one with a specific target of “anemia reduction” and the other with a general target of “malnutrition reduction”. Our analysis revealed that compared to the treatment arm with only a general policy target, the treatment arm with the specific “anemia reduction” target was more effective at improving students’ nutritional and health status, as measured by the incidences of being anemic and underweight, presumably through helping them develop a dietary structure with more flesh meat, bean products, vegetables, and fruits. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

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Review

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28 pages, 657 KiB

Open AccessReview

Determinants of Diet and Physical Activity in Malaysian Adolescents: A Systematic Review

by Shooka Mohammadi, Muhammad Yazid Jalaludin, Tin Tin Su, Maznah Dahlui, Mohd Nahar Azmi Mohamed and Hazreen Abdul Majid

Int. J. Environ. Res. Public Health 2019, 16(4), 603; https://doi.org/10.3390/ijerph16040603 - 19 Feb 2019

Cited by 36 | Viewed by 9049

Abstract

The increased prevalence of unhealthy eating habits and sedentary lifestyles among Malaysian adolescents has become a public health concern. The aim of this systematic review was to summarize evidence from observational studies related to diet and physical activity (PA) among Malaysian adolescents (13–18 years) and to recognize the associations between determinants of diet and PA and diet and PA behaviours. A systematic search for observational studies published from August 1990 through August 2017 was conducted via PubMed, Science Direct, Cochrane and Web of Science. A total of 18 studies met the inclusion criteria; these were independently extracted by two reviewers. Gender and ethnicity were the most commonly studied correlates of diet and PA; males were more physically active and they tended to have poorer diet quality and higher energy and macronutrient intakes in comparison to females; Malay adolescents had a lower diet quality and Chinese adolescents spent less time in PA compared to other ethnicities. However, the significance of these associations was often small or inconsistent. This review highlights the lack of longitudinal observational studies but summarizes the best available evidence for policymakers and public health practitioners to improve the diet and the level of PA in Malaysian adolescents. Full article

(This article belongs to the Special Issue Dietary Patterns and Health Outcomes in Children and Adolescents)

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