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Nutrition Environment and Children’s Eating Behavior and Health
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Nutrition Environment and Children’s Eating Behavior and Health

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

Deadline for manuscript submissions: closed (20 February 2023) | Viewed by 51145

Special Issue Editors

Dr. Kirsi Laitinen

E-Mail Website
Guest Editor
Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku, 20520 Turku, Finland
Interests: nutrition; diet; probiotics; fish oil; RCTs; allergy; obesity; gestation; children; eating behavior
Special Issues, Collections and Topics in MDPI journals
Dr. Hanna Lagström

E-Mail Website
Guest Editor
Centre for Population Health Research, Turku University Hospital, University of Turku, 20520 Turku, Finland
Interests: nutrition; families; children; eating habits; childhood obesity; living environment

Special Issue Information

Dear Colleagues,

A range of factors shape and influence the dietary behavior and quality of a child. These factors may be collectively called the nutrition environment. The parents are a crucial part of a child’s dietary behavior as they are responsible for many aspects of the child’s nutrition environment, including acquiring and preparing food at home as well as modulating behavior during family meals. Parents’ own attitudes and behavior likely modify that of the child. Similarly, the nutritional environment outside the home, such as daycare, schools, or individual living environment (including socioeconomic disadvantage), may shape a child’s eating behavior and, subsequently, their health. Increased understanding of these factors is important, as the establishment of healthy lifestyle habits in childhood promotes life-long health and lowers the risk of chronic lifestyle-related diseases. One of the most alarming concerns globally is the high prevalence of obesity in children, a condition which may be influenced by many aspects of the nutrition environment.

For this Special Issue, we are seeking high-quality papers examining the factors of the nutrition environment and its contribution to the eating behavior, diet quality, and health of children.

Dr. Kirsi Laitinen
Dr. Hanna Lagström
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • parental nutrition awareness
  • parenting capacity
  • families
  • children
  • living environment
  • eating behavior
  • feeding practices
  • food choice
  • diet intake
  • diet quality
  • health
  • obesity

Published Papers (21 papers)

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14 pages, 700 KiB  
Article
Post-Pandemic Feeding Patterns and Mediterranean Diet Adherence in Spanish Toddlers
by Ana Isabel Reyes-Domínguez, Javier Bernabeu-Sendra, Cristina Rodríguez-Sinovas, Alicia Santamaria-Orleans, Roser de Castellar-Sanso and Jorge Martinez-Perez
Nutrients 2023, 15(9), 2049; https://doi.org/10.3390/nu15092049 - 24 Apr 2023
Viewed by 1302
Abstract
During the last decade, feeding patterns, more specifically those of children, have worsened—affecting dietary habits and Mediterranean diet adherence. Here, we examine the post-pandemic feeding habits of Spanish toddlers. A total of 2465 parents of children aged between 12 and 36 months completed [...] Read more.
During the last decade, feeding patterns, more specifically those of children, have worsened—affecting dietary habits and Mediterranean diet adherence. Here, we examine the post-pandemic feeding habits of Spanish toddlers. A total of 2465 parents of children aged between 12 and 36 months completed an online 25-item multiple-choice survey asking about dietary habits and Mediterranean diet adherence. Only 34 children (1.38%) had an adequate intake of all of the food groups included in the questionnaire. Adherence worsened as toddlers grew (p < 0.0001). Further, lower compliance was found in children with a higher intake of fast food (p < 0.001), those with siblings (p = 0.0045), and children who were the second or third child (p = 0.0005). The food group with the most commonly reported adequate intake was fish (88% of children), followed by pulses (80%), water (79%), and meat (78%). Cow’s milk was the most commonly consumed dairy product among all age groups analyzed. Half of the children exhibited a low consumption of milk and dairy products. These results showed that a lack of adherence to a balanced diet is common among Spanish toddlers in the post-pandemic period and that greater parent education could improve the nutrition of toddlers. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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16 pages, 303 KiB  
Article
Elementary School-Aged Children’s and Parents’ Report of Health-Related Quality of Life and Relationships with Lifestyle Measures: A Cross-Sectional Study
by Soili Alanne, Ella Koivuniemi, Eliisa Löyttyniemi and Kirsi Laitinen
Nutrients 2023, 15(5), 1264; https://doi.org/10.3390/nu15051264 - 03 Mar 2023
Viewed by 1534
Abstract
Supporting a child’s health-promoting lifestyle is an investment in their future health and health-related quality of life (HRQoL). Particularly children with overweight and obesity may be at an increased risk of a poor HRQoL. Currently, a comprehensive evaluation of lifestyle factors and age [...] Read more.
Supporting a child’s health-promoting lifestyle is an investment in their future health and health-related quality of life (HRQoL). Particularly children with overweight and obesity may be at an increased risk of a poor HRQoL. Currently, a comprehensive evaluation of lifestyle factors and age in relation to HRQoL in healthy children and, further, separate child and parental proxy-reports of HRQoL are lacking. The aims of this cross-sectional study in Finland are to compare healthy elementary school-aged children’s and parents’ reports of the child‘s HRQoL, and to view them in relation to lifestyle markers. The HRQoL was measured with Pediatric Quality of Life InventoryTM 4.0, and the following lifestyle markers: leisure-time physical activity as MET, diet quality via a validated index (ES-CIDQ), sleeping time and screen time by questionnaires. Furthermore, age and BMI were recorded. Data were obtained from 270 primary school-aged children (6–13 years). Female gender, the child’s older age (8–13 years), high physical activity level and less screen time were strong predictors of a higher HRQoL in both the child’s and parental proxy-reports. Means to promote healthy lifestyles should be particularly targeted to young children, especially boys, and new ways to promote physical activity and other forms of free-time activities should be sought. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
16 pages, 1496 KiB  
Article
Self-Reported Parental Healthy Dietary Behavior Relates to Views on Child Feeding and Health and Diet Quality
by Irene Mäkelä, Ella Koivuniemi, Tero Vahlberg, Monique M. Raats and Kirsi Laitinen
Nutrients 2023, 15(4), 1024; https://doi.org/10.3390/nu15041024 - 18 Feb 2023
Cited by 1 | Viewed by 1363
Abstract
The aim of this cross-sectional study was to investigate whether parental views on child feeding and its impact on health differ between those parents whose self-perception was that they followed a healthy diet to those who do not. Furthermore, differences in the child’s [...] Read more.
The aim of this cross-sectional study was to investigate whether parental views on child feeding and its impact on health differ between those parents whose self-perception was that they followed a healthy diet to those who do not. Furthermore, differences in the child’s diet quality and weight were compared between the groups. Parents of 2−6-year-old children (n = 738), recruited from child health clinics throughout Finland, answered semi-structured questionnaires on their views on child feeding and health as well as their child’s diet quality. Participants were divided into two groups based on their self-perceived report of following a healthy diet: health-conscious (HC, n = 396) and non-health-conscious (non-HC, n = 342) parents. HC parents considered health, eating behavior, and nutrient-related factors more often when feeding their child than non-HC parents (<0.001 < p < 0.03). Moreover, they more commonly considered diet to have an important impact on their child’s long-term health than the non-HC parents (<0.001 < p < 0.05). Children of HC parents were more likely to have a good diet quality (p = 0.01) and lower BMI-SDS values (p = 0.015) than those of non-HC parents. Parental health consciousness was linked with better diet quality and healthier weight in their children. This information may be useful in the regular clinical monitoring of children’s health. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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16 pages, 283 KiB  
Article
Family Facilitators of, Barriers to and Strategies for Healthy Eating among Chinese Adolescents: Qualitative Interviews with Parent–Adolescent Dyads
by Kiki S. N. Liu, Julie Y. Chen, Kai-Sing Sun, Joyce P. Y. Tsang, Patrick Ip and Cindy L. K. Lam
Nutrients 2023, 15(3), 651; https://doi.org/10.3390/nu15030651 - 27 Jan 2023
Cited by 1 | Viewed by 2206
Abstract
Healthy eating is vital in preventing obesity and long-term non-communicable diseases. This study explores potential family facilitators of, barriers to and strategies for healthy eating among adolescents in Chinese families to guide the development of effective interventions in the future. Parent–adolescent dyads were [...] Read more.
Healthy eating is vital in preventing obesity and long-term non-communicable diseases. This study explores potential family facilitators of, barriers to and strategies for healthy eating among adolescents in Chinese families to guide the development of effective interventions in the future. Parent–adolescent dyads were purposively sampled by age, gender, fruit and vegetable intake and household income. Key family factors were identified by thematic analysis. Fourteen themes under five domains were identified: family health with (1) illness experienced in the family; parental knowledge of (2) dietary recommendations, (3) the preparation of healthy food and (4) healthy food choice; parental attitudes towards (5) the importance of healthy eating and (6) the priority of family health; socioeconomic factors of (7) time concerns and (8) cost concerns; and food parenting practices in (9) nutritional education, (10) role modeling, (11) food provision, (12) child involvement, (13) parental supervision and (14) the cultivation of food preference. Useful strategies included incorporating healthy ingredients in adolescents’ favorite recipes and providing a variety of fruit and vegetables at home. There is a need to empower parents with practical nutrition knowledge, to be more authoritative in food parenting practices, to discuss healthy eating with children and to acquire practical skills related to time- and cost-saving healthy cooking. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
15 pages, 1594 KiB  
Article
Dietary Factors May Delay Tolerance Acquisition in Food Protein-Induced Allergic Proctocolitis
by Gavriela Feketea, John Lakoumentas, George N. Konstantinou, Nikolaos Douladiris, Nikolaos G. Papadopoulos, Maria Petrodimopoulou, Ioannis Tasios, Mina Valianatou, Vasiliki Vourga and Emilia Vassilopoulou
Nutrients 2023, 15(2), 425; https://doi.org/10.3390/nu15020425 - 13 Jan 2023
Cited by 3 | Viewed by 2591
Abstract
Background: Dietary and environmental factors may influence tolerance acquisition in food protein-induced allergic proctocolitis (FPIAP). This retrospective observational study explored the role of maternal diet during pregnancy and breastfeeding in tolerance acquisition in infantile FPIAP. Methods: Breastfed infants with FPIAP from six diverse [...] Read more.
Background: Dietary and environmental factors may influence tolerance acquisition in food protein-induced allergic proctocolitis (FPIAP). This retrospective observational study explored the role of maternal diet during pregnancy and breastfeeding in tolerance acquisition in infantile FPIAP. Methods: Breastfed infants with FPIAP from six diverse regions in Greece were divided into two groups, based on development of tolerance to the trigger food: Group A (n = 43), before, and Group B (n = 53), after, the 6th month of age. Maternal diet during pregnancy and breastfeeding was elicited using the Mediterranean Diet Score Questionnaire and the Mediterranean Oriented Culture Specific Semi-Quantitative Food Frequency Questionnaire. Results: Mean age at diagnosis of FPIAP (1.5 months) and weaning (5.5 months) were the same in both groups. The main trigger was cow’s milk. Group A received infant milk formula earlier than Group B. Group B had a higher incidence of asthma/wheeze, siblings with milk allergy, maternal smoking and rural residence. On multivariate analysis, earlier resolution of FPIAP was associated with higher maternal education and with salt intake and consumption of goat/sheep cheese during pregnancy and olive oil during breastfeeding. Consumption of multivitamins during pregnancy and meat, winter fruits, green vegetables, butter, salt, “ready-to-eat” meals and pastries during breastfeeding were correlated with longer duration of symptoms. Conclusions: Mothers of children with FPIAP to cow’s milk protein can be advised to eat more yogurt, cheese and olive oil during subsequent pregnancies, and avoid multivitamins, grilled food, “ready-to-eat” meals, pastries, meat and alcohol during breastfeeding, to reduce the duration of FPIAP presenting in future infants. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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20 pages, 1880 KiB  
Article
“Good Food Causes Good Effects and Bad Food Causes Bad Effects”: Awareness, Meanings and Perceptions of Malnutrition among Pakistani Adolescents Living in Slums through Photodiaries and Interviews
by Sara Estecha-Querol, Syeda Kisa Zehra Zaidi, Lena Al-Khudairy, Paramjit Gill and Romaina Iqbal
Nutrients 2023, 15(1), 33; https://doi.org/10.3390/nu15010033 - 21 Dec 2022
Viewed by 5118
Abstract
Around 30% of the urban population of Southern Asia lives in a slum setting where basic necessities such as sanitation, education, employment, infrastructure are lacking, and people are more exposed to health problems. Children living in slums are at high risk of malnutrition. [...] Read more.
Around 30% of the urban population of Southern Asia lives in a slum setting where basic necessities such as sanitation, education, employment, infrastructure are lacking, and people are more exposed to health problems. Children living in slums are at high risk of malnutrition. However, there is limited knowledge on adolescents living in slums. We explored awareness and meanings of malnutrition (under and over-nutrition) as well as examining malnutrition risk factors among adolescents living in a slum. A qualitative approach was undertaken using photodiaries and semi-structured interviews with 14 adolescents (13–16 years old) living in a slum in Karachi (Pakistan). An inductive strategy was used moving from open-ended data to patterns using reflexive thematic analysis. We identified widespread malnutrition awareness amongst these adolescents. Food consistently underpinned participants’ narratives and photodiaries, which was reflected in how they made sense of malnutrition: undernutrition was understood as lack of food, while overnutrition as excess of food. This study identified malnutrition drivers: sanitation, exercise, families, peers, wellbeing, gender, nutritional knowledge, media, and most importantly, food. People’s responsibility to eat healthily was highlighted by the participants, implying that people are to be blamed for their poor lifestyle choices. Following this responsibility discourse, most participants contemplated merely individually focused health interventions in order to overcome the problem of malnutrition in their area. It is necessary to study slum food environments better to implement effective nutrition programs and interventions to reduce malnutrition in slum settings. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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15 pages, 506 KiB  
Article
The Relationships between Parenting Practices and Child Health-Related Behaviors in Children with Intellectual Disability: The Moderating Role of Child Body Weight Status
by Yan Sun, Rashmi Supriya, Yang Gao, Siyue Yu, Aiwei Wang, Xiaoting Ou, Dan Tao and Julien S. Baker
Nutrients 2022, 14(24), 5206; https://doi.org/10.3390/nu14245206 - 07 Dec 2022
Cited by 3 | Viewed by 1949
Abstract
This study aimed to examine the associations between parenting practices and child health-related behaviors, and the moderating role of child body weight status in children with intellectual disability (ID). A cross-sectional study was conducted among a sample of children with ID in Hong [...] Read more.
This study aimed to examine the associations between parenting practices and child health-related behaviors, and the moderating role of child body weight status in children with intellectual disability (ID). A cross-sectional study was conducted among a sample of children with ID in Hong Kong; 440 participants were included in this study. All the variables investigated were collected from questionnaires, except body weight status, which was objectively measured. Logistic regression analysis was used to examine the associations between parenting practices and children’s unhealthy behaviors. Interaction items were added to investigate the moderation effect of child body weight status, adjusting for significant background characteristics. Results showed that the parenting practices of “restricting access to unhealthy food and sedentary behaviors (RA)” (OR range: 0.63–0.64) and “using food or sedentary behaviors as rewards (UR)” (OR range: 1.28–1.60) were significantly associated with some eating behaviors, but not with sedentary behaviors. Body weight status significantly moderated these associations. Only RA showed favorable effects on some eating behaviors in children with overweight and obesity (OR range: 0.17–0.28), whereas the effects of UR differed by body weight status. Future research should focus on developing educational interventions which encourage parents to use practices that are tailored towards children’s individual characteristics. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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15 pages, 778 KiB  
Article
Barriers and Facilitators of Weight Management among School Children with Obesity: A Qualitative Investigation of Parents’ Perceptions
by Sara Zuarub, Lily Stojanovska and Habiba I. Ali
Nutrients 2022, 14(23), 5117; https://doi.org/10.3390/nu14235117 - 01 Dec 2022
Cited by 1 | Viewed by 3168
Abstract
Parents play a critical role in influencing the eating habits of their children. This study examined parents’ perceptions of factors that contributed to childhood obesity and sought their suggestions on various modalities for overcoming the barriers to healthy eating. Semi-structured in-depth interviews were [...] Read more.
Parents play a critical role in influencing the eating habits of their children. This study examined parents’ perceptions of factors that contributed to childhood obesity and sought their suggestions on various modalities for overcoming the barriers to healthy eating. Semi-structured in-depth interviews were undertaken with 26 parents of 9–13 years old school children with obesity from the United Arab Emirates. Three main topics covered in the interviews were: (1) Parents’ perceptions of their children’s weight and eating habits; (2) Attitudes towards healthy eating and weight management; and (3) Suggestions on how their children can adopt a healthy lifestyle. Interview transcripts were thematically analyzed using the NVIVO software to identify the emerging main themes and sub-themes. Parents identified individual/intrapersonal (child), interpersonal (peers, family, nannies), and institutional/school environment barriers and facilitators to a healthier lifestyle. The three major themes that emerged were: (1) Negative effects of obesity on children’s lives; (2) Barriers to weight management and healthy lifestyle; and (3) Facilitators to healthy eating. Nutritional education and a supportive home and school environment were suggested for the adoption of a healthy lifestyle by children. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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18 pages, 1181 KiB  
Article
The Impact of the COVID-19 Lockdown on Sugar-Sweetened Beverage Consumption in Children in Saudi Arabia: A Mixed-Methods Study
by Khlood Baghlaf, Dania Bormah, Anwar Hakami and Sara M. Bagher
Nutrients 2022, 14(23), 4972; https://doi.org/10.3390/nu14234972 - 23 Nov 2022
Cited by 2 | Viewed by 1601
Abstract
(1) Background: In 2020, there seems to have been a global shift in lifestyle and eating habits with the emergence of the coronavirus disease 2019 (COVID-19) and the ensuing lockdowns implemented by national governments. This study assessed the impact of the COVID-19 lockdown [...] Read more.
(1) Background: In 2020, there seems to have been a global shift in lifestyle and eating habits with the emergence of the coronavirus disease 2019 (COVID-19) and the ensuing lockdowns implemented by national governments. This study assessed the impact of the COVID-19 lockdown on SSBs consumption among healthy 6–11 years old children in Saudi Arabia; (2) Methods: This is a mixed-methods study, incorporating a quantitative component, which was a validated Arabic online questionnaire completed by parents, and a qualitative component, involving structured interviews with 10 selected parents using a criterion sampling method; (3) Results: There was a small decrease in consumption reported during lockdown across all SSBs types (soft drinks, n = 58 (13.9%); juices: n = 115 (27.6%); flavored milk: n = 93 (22.3%)). The results showed that with every increase in the dental pain scale there was a positive odd (AOR:0.64; p = 0.001) of decreased consumption of SSBs. Several themes related to increase and decrease SSBs consumption emerged; (4) Conclusions: There was a small decrease in SSBs consumption during lockdown reported by parents. Several themes emerged that can be used to strategize against problematic eating behavior, enabling such provisions as family dietary interventions, which target both parents and children. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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13 pages, 521 KiB  
Article
Parental Self-Efficacy and Child Diet Quality between Ages 2 and 5: The STEPS Study
by Saija Tarro, Mirkka Lahdenperä, Niina Junttila, Antti Lampimäki and Hanna Lagström
Nutrients 2022, 14(22), 4891; https://doi.org/10.3390/nu14224891 - 18 Nov 2022
Viewed by 2166
Abstract
Parental self-efficacy (PSE), a measure of the subjective competence in the parental role, has been linked with child well-being and health. Research on the influence of PSE on child eating habits is scarce, and the few studies have concentrated on certain food groups, [...] Read more.
Parental self-efficacy (PSE), a measure of the subjective competence in the parental role, has been linked with child well-being and health. Research on the influence of PSE on child eating habits is scarce, and the few studies have concentrated on certain food groups, such as vegetables or fruits, and have mostly included only maternal PSE. Thus, the aim of this study was to explore the associations between PSE (separately for mothers and fathers and as a total family-level score) and child diet quality in a cross-sectional and longitudinal study setting. PSE was measured at child ages of 1.5 and 5 years, and diet quality was measured at ages 2 and 5. Participants are from the Steps to Healthy Development (STEPS) Study (n = 270−883). We found that maternal PSE and family level PSE score were associated with child diet quality. Paternal PSE was not, but the dimension Routines was associated with child diet quality. PSE was similarly associated with child diet quality at both age points. Our results suggest that PSE is an important construct in the development of healthy dietary habits in children, and supporting parenting programs aimed at higher PSE could promote healthy diet quality in children. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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18 pages, 612 KiB  
Article
Is Responsive Feeding Difficult? A Case Study in Teso South Sub-County, Kenya
by Eleonore C. Kretz, Annet Itaru, Maria Gracia Glas, Lydiah Maruti Waswa and Irmgard Jordan
Nutrients 2022, 14(21), 4677; https://doi.org/10.3390/nu14214677 - 04 Nov 2022
Viewed by 1684
Abstract
Responsive infant and young child feeding as a reciprocal relationship between the child and his or her caregiver is recommended by the WHO but has received less attention than dietary diversity or meal frequency up to now. The current study assessed common (non)responsive [...] Read more.
Responsive infant and young child feeding as a reciprocal relationship between the child and his or her caregiver is recommended by the WHO but has received less attention than dietary diversity or meal frequency up to now. The current study assessed common (non)responsive child feeding practices and factors that facilitate or hinder caregivers to improve feeding practices in rural Teso South Sub-County, Western Kenya. The qualitative study used focus group discussion (n = 93) and Trials of Improved Practices (TIPs) (n = 48) to identify challenges and opportunities in household food distribution and feeding practices. Overall, the implementation of responsive feeding practices was feasible for the caregivers. Parents reported mainly positive experiences in terms of the child’s feeding behavior and effects on child health. Traditional beliefs, practices, and cultural norms hindered some households to change intrahousehold food distribution. Households who manage to implement responsive feeding even in food insecure regions should be consulted to (a) improve existing nutrition education messages that acknowledge these cultural norms, (b) to include more responsive feeding information in nutrition education material, and (c) to address gender norms to create awareness of the importance of responsive feeding practices and the need for adequate time allocation for infant and young child feeding. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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13 pages, 342 KiB  
Article
Symptoms of Avoidant/Restrictive Food Intake Disorder among 2–10-Year-Old Children: The Significance of Maternal Feeding Style and Maternal Eating Disorders
by Anna Brytek-Matera, Beata Ziółkowska and Jarosław Ocalewski
Nutrients 2022, 14(21), 4527; https://doi.org/10.3390/nu14214527 - 27 Oct 2022
Cited by 3 | Viewed by 2104
Abstract
The aim of the present study was to investigate whether the feeding style and core behavioral features of eating disorders of mothers are related to the symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID) among their children. This study involved 207 mothers of children [...] Read more.
The aim of the present study was to investigate whether the feeding style and core behavioral features of eating disorders of mothers are related to the symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID) among their children. This study involved 207 mothers of children aged 2 to 10 years (Mage = 5.82 ± 2.59 years), of which 19.32% were children with neurodevelopmental disorders and 22.71% were children with chronic diseases (e.g., allergy, asthma, diabetes). The mothers were asked to complete the ARFID Parents Questionnaire–Parents Report (ARFID-Q-PR), the Parental Feeding Style Questionnaire (PFSQ) and the Eating Disorder Examination Questionnaire (EDE-Q). Our findings revealed that both the maternal feeding style and core behavioral features of eating disorders were associated with ARFID symptoms among their 2–10-year-old children. While biological factors increase the risk of feeding/nutrition difficulties, the maternal attitude towards feeding and eating behavior may play a relevant role in children’s eating behavior. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
16 pages, 1177 KiB  
Article
Effectiveness of a Multi-Strategy Behavioral Intervention to Increase Vegetable Sales in Primary School Canteens: A Randomized Controlled Trial
by Astrid A. M. Poelman, Shadia Djakovic, Jessica E. Heffernan, Maeva Cochet-Broch, Rebecca K. Golley, David N. Cox and Janne Beelen
Nutrients 2022, 14(19), 4218; https://doi.org/10.3390/nu14194218 - 10 Oct 2022
Cited by 1 | Viewed by 2534
Abstract
Children’s vegetable intake remains inadequate and school canteens may provide opportunities to address this public health concern. This study aimed to determine the effectiveness of an 8-week multi-strategy behavioral intervention that included vegetable provisioning and online menu architecture on vegetable sales in primary [...] Read more.
Children’s vegetable intake remains inadequate and school canteens may provide opportunities to address this public health concern. This study aimed to determine the effectiveness of an 8-week multi-strategy behavioral intervention that included vegetable provisioning and online menu architecture on vegetable sales in primary school canteens. A randomized controlled trial was undertaken in 16 Australian primary schools (n = 4302 students). The control arm kept their regular canteen menu. The primary outcome was vegetable sales measured by assessing vegetable content (in grams) from all menu items and using canteen sales (ordered online and over-the-counter) to calculate vegetable sales (in grams/week) at baseline (3 weeks) and during intervention implementation (8 weeks). Secondary outcomes were vegetable sales in subcategories, intervention acceptability among canteen managers and vegetable waste (four schools). Linear mixed model analysis showed that from baseline to follow-up, the intervention group had significantly higher weekly vegetable sales overall compared with the control group (2707 g/week, 95% CI 1276 to 4137 g/week; p < 0.001), with increased vegetable sales in the subcategories of burgers, hot foods and snacks, but not in sandwiches and pasta/rice dishes. The intervention did not lead to more vegetable waste, nor to a decrease in canteen revenue. The canteen managers found the intervention easy to implement and felt children responded favorably to three of the seven strategies. In conclusion, a multi-strategy behavioral canteen intervention increased vegetable sales amongst primary school students. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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18 pages, 3052 KiB  
Article
Changes in Eating Behaviors Following Taste Education Intervention: Focusing on Children with and without Neurodevelopmental Disorders and Their Families: A Randomized Controlled Trial
by Sigrun Thorsteinsdottir, Urdur Njardvik, Ragnar Bjarnason and Anna S. Olafsdottir
Nutrients 2022, 14(19), 4000; https://doi.org/10.3390/nu14194000 - 27 Sep 2022
Cited by 6 | Viewed by 2914
Abstract
Fussy-eating children often display problematic behaviors around mealtimes, such as irritation, opposition, or may even throw tantrums. This may lead to reduced food variety and poor nutritional profiles, which may increase parents’ worries about their children’s diet, particularly when the children also have [...] Read more.
Fussy-eating children often display problematic behaviors around mealtimes, such as irritation, opposition, or may even throw tantrums. This may lead to reduced food variety and poor nutritional profiles, which may increase parents’ worries about their children’s diet, particularly when the children also have neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD). To investigate the effect of Taste Education on problematic mealtime behaviors, 81 children aged 8–12 years, with ND (n = 33) and without (n = 48), and their parents, participated in a 7-week Taste Education intervention. Children were matched on age, sex, and ND, and allocated at random into Immediate-intervention and Delayed-intervention groups. Parents completed the Meals in Our Household Questionnaire (MiOH). To examine changes in MiOH-scores, repeated-measures analysis-of-variance with time-points were used, with condition as factors (Immediate intervention and Delayed intervention). Baseline measures were adjusted for, and a robust linear mixed-model was fitted. Results showed superior outcomes for Intervention compared to waiting on all measures of MiOH, with stable effects through six-month follow-up. Differences were non-significant between children with and without ND. The Taste Education program suggests a promising, simple, and non-intrusive way to reduce children’s problematic mealtime behaviors in the long term. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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14 pages, 3331 KiB  
Article
Impact of an Integrative Nutrition Package through Home Visit on Maternal and Children Outcome: Finding from Locus Stunting in Yogyakarta, Indonesia
by Tri Siswati, Slamet Iskandar, Nova Pramestuti, Jarohman Raharjo, Agus Kharmayana Rubaya and Bayu Satria Wiratama
Nutrients 2022, 14(16), 3448; https://doi.org/10.3390/nu14163448 - 22 Aug 2022
Cited by 2 | Viewed by 2976
Abstract
Background: Stunting has been a public health problem in several developing countries including Indonesia. One of the strategies to reduce stunting was family assistance. This study was aimed to estimate the effect of family assistance by using an integrative nutrition package through home [...] Read more.
Background: Stunting has been a public health problem in several developing countries including Indonesia. One of the strategies to reduce stunting was family assistance. This study was aimed to estimate the effect of family assistance by using an integrative nutrition package through home visits on the growth and development of stunted children. Method: This was an experimental study using pre-test post-test with control group design, conducted in Yogyakarta, Indonesia, on March to May 2022. The intervention group was provided an integrative nutrition package (INP) including maternal education, behavioral change through home visit, as well as monitoring children’s outcome, while the control group was asked to read and follow child care procedure in the maternal and child health (MCH) book as a standard procedure. Both groups were visited by trained health volunteers and had a complementary feeding (CF) package weekly for four weeks. The outcomes of this study were the maternal outcome (knowledge and behavior on children’s growth monitoring (CGM), children’s development monitoring (CDM), and infant/young children feeding (IYCF) as well as children’s outcomes, including body weight (BW), body height (BH), and child score development (CSD). This study used generalized estimating equation (GEE) to estimate the differences in differences (DID) of the impact of intervention compared with control group and compared among three different times (baseline, fourth, and eighth week). Results: There were 60 stunted children under five years in this study, i.e., 30 in intervention group and 30 in control group. From the GEE analysis, it was found that the regression adjusted DID showed statistically significant increase of all outcomes including children’s development score (CDS). The adjusted DID effect (95% CI) on 8th week for children’s weight, height, and development score were 0.31 (0.25–0.37), 0.41 (0.13–0.68), and −0.40 (−0.59–(−0.21)), respectively, among the intervention group. Conclusions: INP through home visit successfully increased maternal and children’s outcomes compared witsh standard procedure. The effect of intervention was found to be consistently significant in the fourth and eighth weeks after intervention. We recommend the local government to apply INP through home visit especially in high-prevalence stunting areas. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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9 pages, 296 KiB  
Article
Mapping of Outdoor Food and Beverage Advertising around Spanish Schools
by Ruben Martin-Payo, María del Rosario González-Moradas, Juan Iturrate-Bobes, Alejandro Fernández-Sutil, Rafael Cofiño and María del Mar Fernandez-Alvarez
Nutrients 2022, 14(15), 3167; https://doi.org/10.3390/nu14153167 - 31 Jul 2022
Cited by 1 | Viewed by 2162
Abstract
Overweight and obesity rates have increased worldwide in the last decades. The marketing strategies of food considered to be unhealthy significantly exacerbate the childhood obesity dilemma. Studies typically analyze the content of advertisement in television, movies, or social media, but there is a [...] Read more.
Overweight and obesity rates have increased worldwide in the last decades. The marketing strategies of food considered to be unhealthy significantly exacerbate the childhood obesity dilemma. Studies typically analyze the content of advertisement in television, movies, or social media, but there is a gap in the assessment of the real-life promotion of food and beverages around the schools. The primary aim of the study was to assess the products advertised around public and concerted schools in three cities in the north of Spain, and to categorize them as healthy (core) or unhealthy (discretionary). The secondary aim was to describe the types of food and beverages in advertisements, as well as to determine the density of core and discretionary product advertisements. A cross-sectional descriptive study was carried out between September and December 2021. The units of analysis were outdoor food and beverage advertisements that were located around public and concerted schools of three cities in the north of Spain. We found 104 schools that met the criteria. We identified 6469 products advertised, 35.1% core and 61.2% discretionary, observing significant differences (p < 0.001) among the cities. Fruit (core) and alcohol (discretionary) were the most heavily advertised products. In conclusion, children attending schools located in the assessed cities are currently exposed to a significant amount of discretionary product advertisement, a situation that should be regulated. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
17 pages, 311 KiB  
Article
De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies
by Taren Swindle, Julie M. Rutledge, Dong Zhang, Janna Martin, Susan L. Johnson, James P. Selig, Amy M. Yates, Daphne T. Gaulden and Geoffrey M. Curran
Nutrients 2022, 14(14), 2861; https://doi.org/10.3390/nu14142861 - 12 Jul 2022
Cited by 4 | Viewed by 2033
Abstract
This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or [...] Read more.
This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or de-implementation strategies (i.e., Basic Support; B), (b) implementation strategies only (i.e., Enhanced Support; E), and (c) implementation and de-implementation strategies (i.e., De-implementation + Enhanced Support; D + E) and (2) a within-site pre-post comparison among sites with D + E. At nutrition lessons, the D + E group had more Positive Comments (Hedege’s g = 0.60) and higher Role Model fidelity (Hedege’s g = 1.34) compared to the E group. At meals, assistant teachers in the D + E group had higher Positive Comments than in the B group (g = 0.72). For within-group comparisons, the D + E group decreased Negative Comments (t(19) = 2.842, p = 0.01), increased Positive Comments (t(20) = 2.314, p = 0.031), and improved use of the program mascot at nutrition lessons (t(21) = 3.899, p = 0.001). At meals, lead teachers’ Negative Comments decreased (t(22) = 2.73, p = 0.01). Qualitative data identified strengths and opportunities for iteration. Despite a COVID interruption, mid-point comparisons and qualitative feedback suggest promise of the de-implementation strategy package. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
11 pages, 1414 KiB  
Article
The Effect of a Product Placement Intervention on Pupil’s Food and Drink Purchases in Two Secondary Schools: An Exploratory Study
by Suzanne Spence, John N. S. Matthews, Lorraine McSweeney, Ashley J. Adamson and Jennifer Bradley
Nutrients 2022, 14(13), 2626; https://doi.org/10.3390/nu14132626 - 24 Jun 2022
Cited by 2 | Viewed by 1555
Abstract
Limited research exists on the effectiveness of product placement in secondary schools. We explored the impact of re-positioning sweet-baked goods, fruit, sugar-sweetened beverages (SSBs) and water on pupil’s lunchtime purchases in two secondary schools in North-East England. We employed a stepped-wedge design with [...] Read more.
Limited research exists on the effectiveness of product placement in secondary schools. We explored the impact of re-positioning sweet-baked goods, fruit, sugar-sweetened beverages (SSBs) and water on pupil’s lunchtime purchases in two secondary schools in North-East England. We employed a stepped-wedge design with two clusters and four time periods. The intervention(s) involved re-positioning selected food and drinks to increase and decrease accessibility of ‘healthier’ and ‘less healthy’ items, respectively. Unidentifiable smartcard data measured the change in number of pupil’s purchasing the above items. McNemar tests were undertaken on paired nominal data in Stata(v15). In School A, pupils purchasing fruit pots from control to intervention increased (n = 0 cf. n = 81; OR 0, 95% CI 0 to 0.04); post-intervention, this was not maintained. In School B, from control to intervention pupil’s purchasing sweet-baked goods decreased (n = 183 cf. n = 147; OR 1.2, 95% CI 1 to 1.6). This continued post-intervention (n = 161 cf. n = 122; OR 1.3, 95% CI 1.0 to 1.7) and was similar for SSBs (n = 180 cf. n = 79; OR 2.3, 95% CI 1.7 to 3.0). We found no evidence of other changes. There is some evidence that product placement may positively affect pupil’s food and drink purchases. However, there are additional aspects to consider, such as, product availability, engaging canteen staff and the individual school context. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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11 pages, 270 KiB  
Article
Parental Traits Associated with Adherence to the Mediterranean Diet in Children and Adolescents in Croatia: A Cross-Sectional Study
by Ivana Franić, Petra Boljat, Endica Radić Hozo, Ante Burger and Antonela Matana
Nutrients 2022, 14(13), 2598; https://doi.org/10.3390/nu14132598 - 23 Jun 2022
Cited by 1 | Viewed by 1628
Abstract
The Mediterranean diet (MD) is known to be one of the healthiest dietary patterns. Despite the significance of a healthful diet during the early stage of life, data for young individuals indicate that nutrition problems are common. This cross-sectional study aimed to determine [...] Read more.
The Mediterranean diet (MD) is known to be one of the healthiest dietary patterns. Despite the significance of a healthful diet during the early stage of life, data for young individuals indicate that nutrition problems are common. This cross-sectional study aimed to determine parental factors associated with MD adherence in children and adolescents living in the Mediterranean region in Croatia. In total, 2623 children aged 2 to 18 years and their parents participated in this study. Data were collected during the period from September 2021 to February 2022 by using an anonymous questionnaire. We used KIDMED and MEDAS questionnaires for assessing MD adherence in young individuals and their parents, respectively. To assess the association of children’s MD adherence categories with the parental predictors, we performed multivariate multinomial logistic regression. Results showed that the children of parents with a low MD adherence are much more likely to have poor MD adherence than good (OR = 47.54 (95% C.I 18.24, 123.87), p < 0.001) or average (OR = 5.64 (95% C.I 3.70, 8.6), p < 0.001) MD adherence. Further, children of fathers with higher BMI (OR = 1.035 (95% C.I 1.0, 1.071)) and those who do not live with both parents (OR = 1.703 (95% C.I 0.994, 2.916), p = 0.053) are more likely to have poor MD adherence than good MD adherence. These results indicate that interventions focusing on enhancing the quality of both parents’ diets could effectively improve their children’s eating habits. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)

Review

Jump to: Research, Other

18 pages, 965 KiB  
Review
Interventions for Picky Eaters among Typically Developed Children—A Scoping Review
by Mohd Shah Kamarudin, Mohd Razif Shahril, Hasnah Haron, Masne Kadar, Nik Shanita Safii and Nur Hana Hamzaid
Nutrients 2023, 15(1), 242; https://doi.org/10.3390/nu15010242 - 03 Jan 2023
Cited by 3 | Viewed by 4607
Abstract
Picky eating in children is often a major source of concern for many parents and caregivers. Picky eaters (PEs) consume limited foods, demonstrate food aversion, and have a limited food repertoire, which hinders their growth and health. These behaviours are common in children [...] Read more.
Picky eating in children is often a major source of concern for many parents and caregivers. Picky eaters (PEs) consume limited foods, demonstrate food aversion, and have a limited food repertoire, which hinders their growth and health. These behaviours are common in children with special health care needs despite the rise in typically developing children. This leads to less attention being given to intervention programmes for typically developing children. Therefore, this scoping review aims to investigate the key concept of an existing intervention programme for PE among typically developing children, primarily on the types and approaches selected. A thorough literature search was conducted on three primary databases (PubMed, Emerald In-sight, and Web of Science) using predefined keywords. The literature was then appraised using the Joanna Briggs Institute’s guidelines and protocols, and the PRISMScR checklist. Inclusion and exclusion criteria were also specified in the screening procedure. Results showed that the majority of the interventions in these studies were single-component interventions, with the sensory approach being the type that was most frequently utilised, followed by the nutrition approach and parenting approach. Single and multiple intervention components improved the assessed outcome, with a note that other components may or may not show a similar outcome, as they were not assessed in the single-component intervention. Given the evidence that picky eating is influenced by various factors, a multi-component intervention can provide a substantial impact on future programmes. In addition, defining picky eaters using standardised tools is also essential for a more inclusive subject selection. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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Other

Jump to: Research, Review

25 pages, 6117 KiB  
Systematic Review
The Relationships between Caregivers’ Concern about Child Weight and Their Non-Responsive Feeding Practices: A Systematic Review and Meta-Analysis
by Jian Wang, Xiaoxue Wei, Yan-Shing Chang, Ayako Hiyoshi, Kirsty Winkley and Yang Cao
Nutrients 2022, 14(14), 2885; https://doi.org/10.3390/nu14142885 - 14 Jul 2022
Cited by 3 | Viewed by 2182
Abstract
Background: It is unclear whether caregivers’ concern about child weight impacts their non-responsive feeding practices. This systematic review aimed to examine their relationships. Methods: A systematic search of PubMed, Embase, PsycINFO, Web of Science core collection, CINAHL and grey literature was conducted from [...] Read more.
Background: It is unclear whether caregivers’ concern about child weight impacts their non-responsive feeding practices. This systematic review aimed to examine their relationships. Methods: A systematic search of PubMed, Embase, PsycINFO, Web of Science core collection, CINAHL and grey literature was conducted from inception to March 2022, following PRISMA guidelines. Data synthesis was performed using a semi-quantitative approach and a meta-analysis. Results: A total of 35 studies with 22,933 respondents were included in the review for semi-quantitative analyses. Thirty-four studies examined 52 associations between concern about child weight and restriction with 40 statistically significant associations being observed. A total of 34 relationships between concern about child weight and pressure to eat were investigated, with 12 being statistically significant. The pooled regression coefficients (β) demonstrated that caregivers’ concern about child overweight was positively associated with restriction (β = 0.22; 95%CI: 0.12, 0.31), negatively associated with use of food as a reward (β = −0.06; 95%CI: −0.11, −0.01), and not statistically associated with pressure to eat (β = −0.05; 95%CI: −0.13, 0.04). The pooled odds ratios (ORs) indicated that caregivers who were concerned about child overweight were found to use restrictive feeding more often (OR = 2.34; 95%CI: 1.69, 3.23), while less frequently adopting pressure to eat (OR = 0.76; 95%CI: 0.59, 0.98) compared with those without concerns. The results also showed that caregivers who were concerned about child underweight were more likely to force their children to eat (OR = 1.83; 95%CI: 1.44, 2.33) than those without concerns. Conclusion: Caregivers’ concern about child weight may be an important risk factor for non-responsive feeding practices. Thus, interventions are needed to focus on managing and relieving caregivers’ excessive concern about child weight, especially overweight, which may optimize feeding practices and subsequently contribute to child health. Full article
(This article belongs to the Special Issue Nutrition Environment and Children’s Eating Behavior and Health)
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