Special Issue "Child Obesity and Nutrition Promotion Intervention"

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (30 September 2020).

Special Issue Editor

Dr. Ana Isabel Rito
E-Mail Website
Guest Editor
Center for Studies and Research in Social Dynamics and Health & National Institute of Health Doutor Ricardo Jorge, I.P., 1649-016 Lisbon, Portugal
Interests: childhood obesity—epidemiology and surveillance; childhood obesity—determinants and interactions among multiple etiological factors and with co morbidities; research concerning intervention sustainability and maintenance of intervention effects; community-based interventions—family and school settings; school-based initiatives on promotion of healthy and sustainable child nutrition and diet; children’s food and dietary surveys

Special Issue Information

Dear Colleagues,

Childhood obesity continues to be a global problem, with several regions showing increasing rates and others, despite an apparent halt or downward trend, still having one in every three children overweight. Children are exposed to nutritional, social, and obesogenic environmental risks at different settings, and this affects their lifelong health. There is an increasing consensus that high-quality multifaceted smart and cost-effective interventions enable children to grow with a healthy set of habits that have lifelong benefits to their wellbeing. Literature has shown that the dietary approach plays a key role in improving children’s health, not only on a nutritional level but also on diet quality and patterns. An association of the nutritional strategy with other lifestyle components promotes a more comprehensive approach and should be envisioned in intervention studies. This Special Issue entitled “Child Obesity and Nutrition Promotion Intervention” welcomes the submission of either original research manuscripts or reviews of the scientific literature, concerning classical or innovative approaches to tackle this public health issue. We welcome nutrition interventions in interaction with other lifestyle health promoters, with outcome indicators of effectiveness and sustainability from the traditional to ground-breaking ways exploiting both qualitative and quantitative approaches on tackling child obesity.

Dr. Ana Isabel Rito
Guest Editor

Manuscript Submission Information

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Keywords

  • Childhood obesity
  • Childhood overweight
  • Health intervention
  • Diet
  • Nutrition
  • Lifestyle
  • Behaviour
  • Children
  • Community-based interventions

Published Papers (18 papers)

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Research

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Article
How Minority Parents Could Help Children Develop Healthy Eating Behaviors: Parent and Child Perspectives
Nutrients 2020, 12(12), 3879; https://doi.org/10.3390/nu12123879 - 18 Dec 2020
Viewed by 1217
Abstract
Minority children and children living in under-resourced households are at the greatest risk for obesity and diet-related disparities. Identifying effective strategies to reduce these risks is an important step in child obesity prevention. Parents influence the home environment and play a critical role [...] Read more.
Minority children and children living in under-resourced households are at the greatest risk for obesity and diet-related disparities. Identifying effective strategies to reduce these risks is an important step in child obesity prevention. Parents influence the home environment and play a critical role in child obesity prevention. Eighteen parent–child dyads living in under-resourced Houston area communities participated in a mixed methods study (online surveys, telephone interviews). The purpose of the research reported here was to conduct a secondary analysis of the qualitative data to explore Black/African American and Hispanic parent and child perspectives of the ways in which parents could help their children make healthy food choices. Descriptive statistics were calculated for parent and child demographic characteristics; hybrid thematic analysis was used to code and analyze the interview transcripts. Frequencies were calculated for children’s interview responses to rating scales and the grade they gave their eating habits. Mothers’ responses were grouped into two broad categories: facilitators (modeling, availability, and teaching) as ways parents could help their child eat healthy, and barriers (lack of time, cost of healthy foods, and lack of knowledge) to helping their child eat healthy. Alternatively, child responses focused on ways in which parents could provide support: environmental support (home availability, home cooking, and introducing new foods) and personal support (providing child choice, teaching, and encouragement). Most children reported that eating healthy was easy, and most rated their personal eating habits as an A or B. These findings suggest that understanding the perspectives of Black/African American and Hispanic parent–child dyads can provide insight into the development of culturally and economically relevant healthy eating strategies and interventions for families living in under-resourced communities. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
Effects of the Preschool-Based Family-Involving DAGIS Intervention on Family Environment: A Cluster Randomised Trial
Nutrients 2020, 12(11), 3387; https://doi.org/10.3390/nu12113387 - 04 Nov 2020
Viewed by 772
Abstract
Interventions promoting young children’s healthy energy balance-related behaviours (EBRBs) should also examine changes in the family environment as this is an important determinant that may affect the effectiveness of the intervention. This study examines family environmental effects of the Increased Health and Wellbeing [...] Read more.
Interventions promoting young children’s healthy energy balance-related behaviours (EBRBs) should also examine changes in the family environment as this is an important determinant that may affect the effectiveness of the intervention. This study examines family environmental effects of the Increased Health and Wellbeing in Preschools (DAGIS) intervention study, and whether these effects differed when considering three parental educational level (PEL) groups. The DAGIS intervention was conducted in preschools and involving parents in Southern Finland from September 2017 to May 2018. It was designed as a randomised trial, clustered at preschool-level. Parents of 3–6-year-olds answered questionnaires recording PEL, parental role modelling for EBRBs, and the family environment measured as EBRBs availability and accessibility. Linear Mixed Models with Repeated Measures were used in order to detect intervention effects. Models included group by time interactions. When examining intervention effects separated by PEL groups, models with three-level interactions (group × time-points × PEL) were evaluated. There was an interaction effect for the availability of sugary everyday foods and drinks (p = 0.002). The analyses showed that the control group increased availability (p = 0.003), whereas in the intervention group no changes were detected (p = 0.150). In the analysis separated by PEL groups, changes were found only for the accessibility of sugary treats at home; the high PEL control group increased the accessibility of sugary treats (p = 0.022) (interaction effect: p = 0.027). Hence, results suggest that the DAGIS multicomponent intervention had a limited impact on determinants for children’s healthy EBRBs, and no impact was found in the low PEL group. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
Article
Is the Perceived Fruit Accessibility Related to Fruit Intakes and Prevalence of Overweight in Disadvantaged Youth: A Cross-Sectional Study
Nutrients 2020, 12(11), 3324; https://doi.org/10.3390/nu12113324 - 29 Oct 2020
Viewed by 774
Abstract
Background: Few investigations have studied the relationship between home and school food environments, fruit intakes, and prevalence of overweight in children and adolescents from disadvantaged backgrounds. This study aimed to determine whether food environments for fruit intake at household and school levels affect [...] Read more.
Background: Few investigations have studied the relationship between home and school food environments, fruit intakes, and prevalence of overweight in children and adolescents from disadvantaged backgrounds. This study aimed to determine whether food environments for fruit intake at household and school levels affect fruit intakes and risk of overweight among children and adolescents with low household income. Methods: Students (n = 3148) in Seoul, Korea completed questionnaires pertaining to select aspects of their food environments, frequency of fruit intakes, and weight status. Chi-square tests and logistic regressions evaluated associations between the aforementioned variables. Results: Participants consumed fruit an average of 0.77 times per day, though its frequency increased when fruit accessibility was perceived positively. The percentage of overweight participants was 23.5% for boys and 22.8% for girls. Generally, fruit intake frequency was linked to a lower prevalence of overweight. Regular provision of fruit in school lunches was associated with a reduced risk of overweight among elementary school girls (odds ratio (OR): 0.52, 95% confidence interval (CI): 0.30–0.92), and having someone at home to prepare fruit was associated with a reduced risk of overweight in elementary school boys (OR: 0.64, 95% CI: 0.43–0.94) and girls (OR: 0.63, 95% CI: 0.43–0.93). Conclusions: The frequency of fruit intake was low among disadvantaged youth. Increasing access to fruit in their food environments appears to enhance consumption and lower the risk of overweight, especially for elementary school girls. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
Article
Development of RisObIn.Com, a Screening Tool for Risk of Childhood Obesity in the Community
Nutrients 2020, 12(11), 3288; https://doi.org/10.3390/nu12113288 - 27 Oct 2020
Viewed by 1177
Abstract
The prevalence of childhood overweight has increased considerably in the past three decades and there is evidence that childhood obesity can persist into adulthood. A simple tool to identify relevant risk factors may alert families and prevent overweight and obesity. This study aims [...] Read more.
The prevalence of childhood overweight has increased considerably in the past three decades and there is evidence that childhood obesity can persist into adulthood. A simple tool to identify relevant risk factors may alert families and prevent overweight and obesity. This study aims to develop a pre-school screening tool to assess the risk of childhood obesity. Child anthropometric measurements and several risk factors for childhood obesity factors were obtained. The effect of the variables on the outcome of obesity (defined as increased anthropometry-estimated adiposity) was assessed by binary logistic regression analyses. The identified variables were submitted for expert panel validation and combined for the tool development. A total of 304 children were included. Eight items were included in the tool. A higher score of the tool indicates a greater risk for obesity in childhood with the cutoff point set at 0. The tool sensitivity for obesity was 95%, specificity was 74.4%, the positive predictive value was 37.3%, and negative predictive value was 98.9%. The Risk of childhood Obesity In the Community (RisObIn.Com) tool is proposed to be a comprehensive tool to identify children at high risk for late childhood obesity at admission to primary school. Further studies are needed to assess the performance of the tool. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
Play with Your Food and Cook It! Tactile Play with Fish as a Way of Promoting Acceptance of Fish in 11- to 13-Year-Old Children in a School Setting—A Qualitative Study
Nutrients 2020, 12(10), 3180; https://doi.org/10.3390/nu12103180 - 17 Oct 2020
Cited by 3 | Viewed by 1152
Abstract
Despite a tradition of consuming fish in Denmark and despite the health benefits of eating fish, Danish children consume only one-third of the officially recommended amount of fish. The objective of this study was to explore an experiential and sensory-based exercise in a [...] Read more.
Despite a tradition of consuming fish in Denmark and despite the health benefits of eating fish, Danish children consume only one-third of the officially recommended amount of fish. The objective of this study was to explore an experiential and sensory-based exercise in a school setting with focus on tactile play and cooking as a way of promoting 11- to 13-year-old children’s acceptance of fish. The design was a qualitative exploratory multiple-case design using participant observation in a school setting. Six classes were recruited from the Eastern part of Denmark (n = 132). Based on an exercise with cooking fish and gyotaku (fish print), four meta-themes were identified by applying applied thematic analysis: rejection, acceptance, craftsmanship, and interaction. Rejection and acceptance appeared along a rejection–acceptance continuum related to how the fish was categorised (animal, non-animal, food) in different phases of the experiment. Rejection was promoted by mucus, smell, animalness, and texture, whereas helping each other, tactile play, and craftsmanship promoted acceptance. In conclusion, this study found that tactile play combined with cooking could be a way of promoting acceptance of fish. The findings also support a school setting as a potential gateway in promoting healthy food behaviour. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
Effects of the Preschool-Based Family-Involving DAGIS Intervention Program on Children’s Energy Balance-Related Behaviors and Self-Regulation Skills: A Clustered Randomized Controlled Trial
Nutrients 2020, 12(9), 2599; https://doi.org/10.3390/nu12092599 - 26 Aug 2020
Cited by 1 | Viewed by 1208
Abstract
The study examines the effects of a preschool-based family-involving multicomponent intervention on children’s energy balance-related behaviors (EBRBs) such as food consumption, screen time and physical activity (PA), and self-regulation (SR) skills, and whether the intervention effects differed among children with low or high [...] Read more.
The study examines the effects of a preschool-based family-involving multicomponent intervention on children’s energy balance-related behaviors (EBRBs) such as food consumption, screen time and physical activity (PA), and self-regulation (SR) skills, and whether the intervention effects differed among children with low or high parental educational level (PEL) backgrounds. The Increased Health and Wellbeing in Preschools (DAGIS) intervention was conducted as a clustered randomized controlled trial, clustered at preschool level, over five months in 2017–2018. Altogether, 802 children aged 3–6 years in age participated. Parents reported children’s consumption of sugary everyday foods and beverages, sugary treats, fruits, and vegetables by a food frequency questionnaire, and screen time by a 7-day diary. Physical activity was assessed by a hip-worn accelerometer. Cognitive and emotional SR was reported in a questionnaire by parents. General linear mixed models with and without repeated measures were used as statistical methods. At follow-up, no differences were detected in EBRBs or SR skills between the intervention and control group, nor did differences emerge in children’s EBRBs between the intervention and the control groups when stratified by PEL. The improvement in cognitive SR skills among low PEL intervention children differed from low PEL control children, the significance being borderline. The DAGIS multicomponent intervention did not significantly affect children’s EBRBs or SR. Further sub-analyses and a comprehensive process evaluation may shed light on the non-significant findings. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
A Snapshot of European Children’s Eating Habits: Results from the Fourth Round of the WHO European Childhood Obesity Surveillance Initiative (COSI)
Nutrients 2020, 12(8), 2481; https://doi.org/10.3390/nu12082481 - 17 Aug 2020
Cited by 6 | Viewed by 2719
Abstract
Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015–2017) of the WHO European Childhood Obesity [...] Read more.
Consuming a healthy diet in childhood helps to protect against malnutrition and noncommunicable diseases (NCDs). This cross-sectional study described the diets of 132,489 children aged six to nine years from 23 countries participating in round four (2015–2017) of the WHO European Childhood Obesity Surveillance Initiative (COSI). Children’s parents or caregivers were asked to complete a questionnaire that contained indicators of energy-balance-related behaviors (including diet). For each country, we calculated the percentage of children who consumed breakfast, fruit, vegetables, sweet snacks or soft drinks “every day”, “most days (four to six days per week)”, “some days (one to three days per week)”, or “never or less than once a week”. We reported these results stratified by country, sex, and region. On a daily basis, most children (78.5%) consumed breakfast, fewer than half (42.5%) consumed fruit, fewer than a quarter (22.6%) consumed fresh vegetables, and around one in ten consumed sweet snacks or soft drinks (10.3% and 9.4%, respectively); however, there were large between-country differences. This paper highlights an urgent need to create healthier food and drink environments, reinforce health systems to promote healthy diets, and continue to support child nutrition and obesity surveillance. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
The Effect of Supportive Implementation of Healthier Canteen Guidelines on Changes in Dutch School Canteens and Student Purchase Behaviour
Nutrients 2020, 12(8), 2419; https://doi.org/10.3390/nu12082419 - 12 Aug 2020
Cited by 1 | Viewed by 1467
Abstract
We developed an implementation plan including several components to support implementation of the “Guidelines for Healthier Canteens” in Dutch secondary schools. This study evaluated the effect of this plan on changes in the school canteen and on food and drink purchases of students. [...] Read more.
We developed an implementation plan including several components to support implementation of the “Guidelines for Healthier Canteens” in Dutch secondary schools. This study evaluated the effect of this plan on changes in the school canteen and on food and drink purchases of students. In a 6 month quasi-experimental study, ten intervention schools (IS) received support implementing the guidelines, and ten control schools (CS) received only the guidelines. Changes in the health level of the cafeteria and vending machines were assessed and described. Effects on self-reported purchase behaviour of students were analysed using mixed logistic regression analyses. IS scored higher on healthier availability in the cafeteria (77.2%) and accessibility (59.0%) compared to CS (60.1%, resp. 50.0%) after the intervention. IS also showed more changes in healthier offers in the cafeteria (range −3 to 57%, mean change 31.4%) and accessibility (range 0 to 50%, mean change 15%) compared to CS (range −9 to 46%, mean change 9.7%; range −30 to 20% mean change 7% resp.). Multi-level logistic regression analyses on the intervention/control and health level of the canteen in relation to purchase behaviour showed no relevant relations. In conclusion, the offered support resulted in healthier canteens. However, there was no direct effect on students’ purchase behaviour during the intervention. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
Salt Reduction Strategies in Portuguese School Meals, from Pre-School to Secondary Education—The Eat Mediterranean Program
Nutrients 2020, 12(8), 2213; https://doi.org/10.3390/nu12082213 - 24 Jul 2020
Viewed by 1349
Abstract
High sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean [...] Read more.
High sodium (salt) consumption is associated with an increased risk of developing non-communicable diseases. However, in most European countries, Portugal included, sodium intake is still high. This study aimed to assess the sodium content of school meals before and after the Eat Mediterranean (EM) intervention—a community-based program to identify and correct nutritional deviations through the implementation of new school menus and through schools’ food handlers training. EM (2015–2017) was developed in 25 schools (pre to secondary education) of two Portuguese Municipalities, reaching students aged 3–21 years old. Samples of the complete meals (soup + main course + bread) from all schools were collected, and nutritional quality and laboratory analysis were performed to determine their nutritional composition, including sodium content. Overall, there was a significant decrease (−23%) in the mean sodium content of the complete school meals, which was mainly achieved by the significant reduction of 34% of sodium content per serving portion of soup. In conclusion, EM had a positive effect on the improvement of the school meals’ sodium content, among the participant schools. Furthermore, school setting might be ideal for nutrition literacy interventions among children, for flavors shaping, and for educating towards less salty food acceptance. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
Do Parent–Child Dyads with Excessive Body Mass Differ from Dyads with Normal Body Mass in Perceptions of Obesogenic Environment?
Nutrients 2020, 12(7), 2149; https://doi.org/10.3390/nu12072149 - 19 Jul 2020
Cited by 1 | Viewed by 980
Abstract
Background: This study addressed differences between parent–child dyads with excessive body mass (overweight or obesity) and dyads with normal body mass in obesity determinants, derived from social-ecological models. It was hypothesized that parents and their 5–11 years-old children with excessive body mass would [...] Read more.
Background: This study addressed differences between parent–child dyads with excessive body mass (overweight or obesity) and dyads with normal body mass in obesity determinants, derived from social-ecological models. It was hypothesized that parents and their 5–11 years-old children with excessive body mass would (1) report lower availability of healthy food at home, (2) perceive fewer school/local community healthy eating promotion programs, (3) report lower persuasive value of food advertising. Methods: Data were collected twice (T1, baseline; T2, 10-month follow-up), including n = 129 parent–child dyads with excessive body mass and n = 377 parent–child dyads with normal body mass. Self-reported data were collected from parents and children; with body weight and height assessed objectively. General linear models (including analysis of variance with repeated measures) were performed to test the hypotheses. Results: Compared to dyads with normal body mass, dyads of parents and children with excessive body mass perceived lower availability of healthy food at home and fewer healthy eating promotion programs at school/local community (T1 and T2). These effects remained significant after controlling for sociodemographic variables. No significant differences in persuasive value of food advertising were found. Conclusions: Perceptions of availability of healthy food at home and healthy nutrition promotion may be relatively low in parent–child dyads with excessive weight which, in turn, may constitute a risk factor for maintenance of obesity. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
Article
Importance of Self-Efficacy in Eating Behavior and Physical Activity Change of Overweight and Non-Overweight Adolescent Girls Participating in Healthy Me: A Lifestyle Intervention with Mobile Technology
Nutrients 2020, 12(7), 2128; https://doi.org/10.3390/nu12072128 - 17 Jul 2020
Cited by 5 | Viewed by 1289
Abstract
Very little is known about how multicomponent interventions directed to entire populations work in selected groups of adolescents. The aim was to evaluate the effectiveness of the Healthy Me one-year program on changes in healthy eating and physical activity among overweight and non-overweight [...] Read more.
Very little is known about how multicomponent interventions directed to entire populations work in selected groups of adolescents. The aim was to evaluate the effectiveness of the Healthy Me one-year program on changes in healthy eating and physical activity among overweight and non-overweight female students. Randomization involved the allocation of full, partial or null intervention. The randomized field trial was implemented in 48 secondary schools (clusters) all over Poland among 1198 15-year-old girls. In this study, a sample of N = 1111 girls who participated in each evaluation study was analyzed. Using multimedia technologies, efforts were made to improve health behaviors and increase self-efficacy. The main outcome was a health behavior index (HBI), built on the basis of six nutritional indicators and one related to physical activity. HBI was analyzed before and immediately after intervention and at three months’ follow-up, and the HBI change was modeled. Statistical analysis included nonparametric tests and generalized linear models with two-way interactions. Comparing the first and third surveys, in the overweight girls, the HBI index improved by 0.348 (SD = 3.17), while in the non-overweight girls it had worsened. After adjusting for other factors, a significant interaction between body weight status and level of self-efficacy as predictors of HBI changes was confirmed. The program turned out to be more beneficial for overweight girls. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
Parent Stress as a Consideration in Childhood Obesity Prevention: Results from the Guelph Family Health Study, a Pilot Randomized Controlled Trial
Nutrients 2020, 12(6), 1835; https://doi.org/10.3390/nu12061835 - 19 Jun 2020
Cited by 3 | Viewed by 1572
Abstract
Parents’ stress is independently associated with increased child adiposity, but parents’ stress may also interfere with childhood obesity prevention programs. The disruptions to the family dynamic caused by participating in a behaviour change intervention may exacerbate parent stress and undermine overall intervention efficacy. [...] Read more.
Parents’ stress is independently associated with increased child adiposity, but parents’ stress may also interfere with childhood obesity prevention programs. The disruptions to the family dynamic caused by participating in a behaviour change intervention may exacerbate parent stress and undermine overall intervention efficacy. This study explored how family stress levels were impacted by participation in a home-based obesity prevention intervention. Data were collected from 77 families (56 fathers, 77 mothers) participating in the Guelph Family Health Study (GFHS), a pilot randomized control trial of a home-based obesity prevention intervention. Four measures of stress were investigated: general life stress, parenting distress, depressive symptoms, and household chaos. Multiple linear regression was used to compare the level of stress between the intervention and control groups at post-intervention and 1-year follow-up, adjusted for baseline stress. Analyses for mothers and fathers were stratified, except for household chaos which was measured at the family level. Results indicate no significant differences between intervention and control groups for any stress measure at any time point, indicating a neutral effect of the GFHS intervention on family stress. Future work should investigate the components of family-based intervention protocols that make participation minimally burdensome and consider embedding specific stress-reduction messaging to promote family health and wellbeing. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
Eating Vegetables First at Start of Meal and Food Intake among Preschool Children in Japan
Nutrients 2020, 12(6), 1762; https://doi.org/10.3390/nu12061762 - 12 Jun 2020
Cited by 1 | Viewed by 1409
Abstract
Eating behavior is an important aspect for dietary quality and long-term health. This study examined associations between eating vegetables first at a meal and food intakes among preschool children in Tokyo, Japan. We used cross-sectional data of 135 preschool children from seven nursery [...] Read more.
Eating behavior is an important aspect for dietary quality and long-term health. This study examined associations between eating vegetables first at a meal and food intakes among preschool children in Tokyo, Japan. We used cross-sectional data of 135 preschool children from seven nursery schools in Adachi City, Tokyo, Japan. Caregivers completed a survey on child’s eating behaviors and a diet questionnaire. Linear regression was used to examine frequency of eating vegetables first at a meal and food intakes; percent difference and the corresponding 95% confidence interval (95% CI) were presented. Overall, 25.2% of children reported eating vegetables first at a meal every time, 52.6% sometimes, and 22.2% not often or never. In the multivariate analysis, higher vegetable intake remained significant after adjusting for other covariates (compared with the group of eating vegetables first not often or never, the group reported sometimes: 27%, 95% CI: 0–63%; the group reported every time: 93%, 95% CI: 43–159%). No significant difference in intake by frequency categories of eating vegetables first was observed for other food groups, including fruits, meat, fish, cereals, and sweets. Children eating vegetables first at a meal more was associated with higher total intake of vegetables compared with children who did not eat vegetables first, among Japanese preschool children. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
Article
Dietary Habits in Children with Respiratory Allergies: A Single-Center Polish Pilot Study
Nutrients 2020, 12(5), 1521; https://doi.org/10.3390/nu12051521 - 23 May 2020
Cited by 1 | Viewed by 1335
Abstract
Background: The rising trend in allergic diseases has developed in parallel with the increasing prevalence of obesity, suggesting a possible association. The links between eating habits and allergies have not been sufficiently clarified. Aim: To evaluate the nutritional status, eating habits, and risk [...] Read more.
Background: The rising trend in allergic diseases has developed in parallel with the increasing prevalence of obesity, suggesting a possible association. The links between eating habits and allergies have not been sufficiently clarified. Aim: To evaluate the nutritional status, eating habits, and risk factors of obesity and pulmonary function in children with allergic rhinitis. Materials and methods: We evaluated 106 children with allergic rhinitis (mean age 12.1 ± 3.4 years; M/F 60/46) from the Department of Allergology. Clinical data were collected regarding allergies, physical activity, nutritional status (Bodystat), dietary habits (Food Frequency Questionnaire validated for the Polish population), skin prick test with aeroallergens (Allergopharma), and spirometry (Jaeger). Results: All children suffered from allergic rhinitis; among them, 43 (40.6%) presented symptoms of asthma. There were differences between children with only allergic rhinitis (AR group) and children with both rhinitis and asthma (AA group) in pulmonary function (forced expiratory volume in one second (FEV1) 100 ± 11 vs. 92.1 ± 15.0; p < 0.05). A total of 84 children (79%) presented a normal body mass index (BMI) (10–97 percentile), 8 (7.5%) were underweight, and 14 (13.5%) were overweight or obese. There were no differences in body composition between the AR and AA groups. Incorrect eating habits were demonstrated by most of the children, e.g., consumption of three or fewer meals in a day (38%), sweets every day (44%), snacking between meals every day (80%), and eating meals less than 1 h before bedtime (47%). Compared to the AR group, the AA group was more likely to eat more meals a day (p = 0.04), snack more often (p = 0.04), and eat before sleeping (p = 0.005). Multiple regression analysis showed a significant association between high BMI and snacking between meals and low physical activity (adjusted R2 = 0.97; p < 0.05). Conclusions: The risk factors for obesity in children with allergies include snacking and low physical activity. Most children with respiratory allergies, especially those with asthma, reported incorrect eating habits such as snacking and eating before bedtime. A correlation between pulmonary function and body composition or dietary habits was not found. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Article
A Serious Game Approach to Improve Food Behavior in Families—A Pilot Study
Nutrients 2020, 12(5), 1415; https://doi.org/10.3390/nu12051415 - 14 May 2020
Cited by 2 | Viewed by 1438
Abstract
The objective of this pilot study was to investigate the effect of a specially developed serious game to improve food behavior in families with children aged 5–13 years using mixed methods. Fourteen families were randomized into a game-group and a non-game-group and divided [...] Read more.
The objective of this pilot study was to investigate the effect of a specially developed serious game to improve food behavior in families with children aged 5–13 years using mixed methods. Fourteen families were randomized into a game-group and a non-game-group and divided into age groups (game-children (GC), game-parents (GP), non-game-children (nGC), and non-game-parents (nGP)). The families completed a baseline test, a three-week intervention period with or without a game element, and a follow-up test. Qualitative results showed a positive change in food behavior in all families. Quantitative results mainly showed an effect in food neophobia as a decrease was seen in all groups; however, it was only significant (p < 0.05) in three groups (GP, nGC, nGP). No changes were seen in willingness to taste, and only limited changes in liking and number of words used to describe the stimuli. In conclusion, qualitative results showed positive change in the children’s food behavior in most families, indicating a positive effect of performing tastings and tasks together as a family—regardless of the presence of a game element. However, this was not as clear in the quantitative data, indicating that current quantitative tools are less suited to measure complex concepts like willingness to taste. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Review

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Review
Food Consumption Patterns and Nutrient Intakes of Children and Adolescents in the Eastern Mediterranean Region: A Call for Policy Action
Nutrients 2020, 12(11), 3345; https://doi.org/10.3390/nu12113345 - 30 Oct 2020
Cited by 4 | Viewed by 1396
Abstract
The Eastern Mediterranean Region (EMR) has witnessed significant social and economic changes that may have influenced the diet of children and adolescents, and increased the risk for obesity and malnutrition in this age group. This review aims to characterize and assess food consumption [...] Read more.
The Eastern Mediterranean Region (EMR) has witnessed significant social and economic changes that may have influenced the diet of children and adolescents, and increased the risk for obesity and malnutrition in this age group. This review aims to characterize and assess food consumption patterns and nutrient intakes amongst school-aged children (5–10 years) and adolescents (10–19 years) in countries of the EMR. Electronic databases (MedLine, PubMed, Scopus, and Google Scholar) were searched for relevant articles published between 2005 and 2020; international organizations and governmental websites were also searched. Available studies documented low intakes of fruits, vegetables and fiber, inadequate consumption of water, milk and dairy products, coupled with high intakes of fat, saturated fat, and sugar sweetened beverages, as well as a frequent consumption of energy-dense, nutrient poor foods such as sweet and savory snacks. Micronutrient inadequacies were also observed, particularly for calcium, iron, zinc and vitamins A, D, C, and folate. Acknowledging the impact that nutrition may have on building societies and transforming the lives of children, adolescents and their families, there is a crucial need for a food system approach in developing and implementing national and regional policies and interventions aimed at improving the diet of children and adolescents. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Review
Promoting Healthy Eating among Young People—A Review of the Evidence of the Impact of School-Based Interventions
Nutrients 2020, 12(9), 2894; https://doi.org/10.3390/nu12092894 - 22 Sep 2020
Cited by 2 | Viewed by 2181
Abstract
Intro: Globally, the prevalence of overweight and obesity is increasing among children and younger adults and is associated with unhealthy dietary habits and lack of physical activity. School food is increasingly brought forward as a policy to address the unhealthy eating patterns among [...] Read more.
Intro: Globally, the prevalence of overweight and obesity is increasing among children and younger adults and is associated with unhealthy dietary habits and lack of physical activity. School food is increasingly brought forward as a policy to address the unhealthy eating patterns among young people. Aim: This study investigated the evidence for the effectiveness of school-based food and nutrition interventions on health outcomes by reviewing scientific evidence-based intervention studies amongst children at the international level. Methods: This study was based on a systematic review using the PRISMA guidelines. Three electronic databases were systematically searched, reference lists were screened for studies evaluating school-based food and nutrition interventions that promoted children’s dietary behaviour and health aiming changes in the body composition among children. Articles dating from 2014 to 2019 were selected and reported effects on anthropometry, dietary behaviour, nutritional knowledge, and attitude. Results: The review showed that school-based interventions in general were able to affect attitudes, knowledge, behaviour and anthropometry, but that the design of the intervention affects the size of the effect. In general, food focused interventions taking an environmental approach seemed to be most effective. Conclusions: School-based interventions (including multicomponent interventions) can be an effective and promising means for promoting healthy eating, improving dietary behaviour, attitude and anthropometry among young children. Thus, schools as a system have the potential to make lasting improvements, ensuring healthy school environment around the globe for the betterment of children’s short- and long-term health. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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Review
Machine Learning Models to Predict Childhood and Adolescent Obesity: A Review
Nutrients 2020, 12(8), 2466; https://doi.org/10.3390/nu12082466 - 16 Aug 2020
Cited by 4 | Viewed by 2159
Abstract
The prevalence of childhood and adolescence overweight an obesity is raising at an alarming rate in many countries. This poses a serious threat to the current and near-future health systems, given the association of these conditions with different comorbidities (cardiovascular diseases, type II [...] Read more.
The prevalence of childhood and adolescence overweight an obesity is raising at an alarming rate in many countries. This poses a serious threat to the current and near-future health systems, given the association of these conditions with different comorbidities (cardiovascular diseases, type II diabetes, and metabolic syndrome) and even death. In order to design appropriate strategies for its prevention, as well as understand its origins, the development of predictive models for childhood/adolescent overweight/obesity and related outcomes is of extreme value. Obesity has a complex etiology, and in the case of childhood and adolescence obesity, this etiology includes also specific factors like (pre)-gestational ones; weaning; and the huge anthropometric, metabolic, and hormonal changes that during this period the body suffers. In this way, Machine Learning models are becoming extremely useful tools in this area, given their excellent predictive power; ability to model complex, nonlinear relationships between variables; and capacity to deal with high-dimensional data typical in this area. This is especially important given the recent appearance of large repositories of Electronic Health Records (EHR) that allow the development of models using datasets with many instances and predictor variables, from which Deep Learning variants can generate extremely accurate predictions. In the current work, the area of Machine Learning models to predict childhood and adolescent obesity and related outcomes is comprehensively and critically reviewed, including the latest ones using Deep Learning with EHR. These models are compared with the traditional statistical ones that used mainly logistic regression. The main features and applications appearing from these models are described, and the future opportunities are discussed. Full article
(This article belongs to the Special Issue Child Obesity and Nutrition Promotion Intervention)
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