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Children's Health: Studies of the Effect of Lifestyle and Dietary Habits

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

Deadline for manuscript submissions: closed (25 August 2021) | Viewed by 36309

Special Issue Editors


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Guest Editor
School of Medicine and Public Health, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia
Interests: intervention; RCTs; online interventions; system approaches; prevention; children; families; digital health; fruit and vegetable consumption; eHealth; mHealth

E-Mail Website
Guest Editor
School of Medicine and Public Health, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia
Interests: intervention; RCTs; online interventions; implementation; dissemination; prevention; children; adolescents; digital health; physical activity; eHealth; mHealth

Special Issue Information

Dear Colleagues,

The dietary patterns and eating habits that we establish, as children, have important health implications for dietary habits and health status in adulthood. As such, these years represent an important time period to introduce and regularly consume a wide variety of foods, including adequate representation from each of the core food groups, whilst limiting the consumption of non-core or discretionary foods. This groundwork is fundamental if we are to establish and maintain behaviors that encourage and support healthy eating habits. This Special Issue of Nutrients focuses on childhood (including infancy, the pre-school and school years) and investigates a range of behaviors and patterns associated with food and eating during this time. The issue welcomes opinion pieces, descriptive studies, intervention studies and systematic reviews and will have a particular focus on ways to improve dietary patterns and eating behaviors during this key time.

Dr. Rebecca Wyse
Dr. Rachel Sutherland
Guest Editors

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Keywords

  • children
  • childhood
  • nutrition
  • behavior
  • preschool
  • toddler
  • school-age
  • infancy
  • diet
  • dietary patterns
  • eating habits
  • associations
  • intervention
  • systematic review
  • RCT

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Published Papers (9 papers)

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Research

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14 pages, 290 KiB  
Article
A Cross-Sectional Study of the Nutritional Quality of New South Wales High School Student Food and Drink Purchases Made via an Online Canteen Ordering System
by Tara Clinton-McHarg, Tessa Delaney, Hannah Lamont, Christophe Lecathelinais, Sze Lin Yoong, Luke Wolfenden, Rachel Sutherland and Rebecca Wyse
Nutrients 2021, 13(12), 4327; https://doi.org/10.3390/nu13124327 - 30 Nov 2021
Cited by 2 | Viewed by 3300
Abstract
Unhealthy dietary patterns in adolescence are associated with an increased risk of future chronic disease. This study aimed to assess online canteen lunch purchases made by high school students to identify: (1) the nutrient composition of purchases (energy, saturated fat, sugar, sodium, percent [...] Read more.
Unhealthy dietary patterns in adolescence are associated with an increased risk of future chronic disease. This study aimed to assess online canteen lunch purchases made by high school students to identify: (1) the nutrient composition of purchases (energy, saturated fat, sugar, sodium, percent energy from saturated fat and total sugar); (2) the proportion of items classified as healthier (‘Everyday’) and less healthy (‘Occasional’ or ‘Should not be sold’) according to the New South Wales Healthy Canteen Strategy; (3) the frequency of purchases by product type (e.g., salty snacks), their classification and nutrient composition; and (4) associations between student characteristics and the nutrient composition and classification of purchases. The average order contained 2075 kJ of energy, 6.4 g of saturated fat, 18.4 g of sugar and 795 mg of sodium. Less healthy (‘Occasional’ and ‘Should not be sold’) items combined accounted for 56% of purchases. The most frequently purchased products were burgers and crumbed/coated foods. Students in higher grades purchased a significantly higher mean percent of ‘Everyday’ items, compared to students in grades 7 or 8. The majority of high school student purchases were less healthy (‘Occasional’ or ‘Should not be sold’) items, warranting further investigation of factors influencing online canteen purchasing behaviour in this setting. Full article
18 pages, 1080 KiB  
Article
Translation of Two Healthy Eating and Active Living Support Programs for Parents of 2–6-Year-Old Children: Outcomes of the ‘Time for Healthy Habits’ Parallel Partially Randomised Preference Trial
by Megan L. Hammersley, Rebecca J. Wyse, Rachel A. Jones, Fiona Stacey, Anthony D. Okely, Luke Wolfenden, Marijka J. Batterham, Serene Yoong, Simon Eckermann, Amanda Green, Joe Xu, Christine Innes-Hughes, Jacklyn Jackson, Vincy Li and Chris Rissel
Nutrients 2021, 13(10), 3348; https://doi.org/10.3390/nu13103348 - 24 Sep 2021
Cited by 6 | Viewed by 3649
Abstract
This translation study assessed the effectiveness of two remotely delivered healthy eating and active living interventions for parents of 2- to 6-year-old children in improving child fruit and vegetable intake, non-core food intake, body mass index (BMI), physical activity, screen time, and sleep. [...] Read more.
This translation study assessed the effectiveness of two remotely delivered healthy eating and active living interventions for parents of 2- to 6-year-old children in improving child fruit and vegetable intake, non-core food intake, body mass index (BMI), physical activity, screen time, and sleep. Parents (n = 458) were recruited to a partially randomised preference trial comprising three intervention groups. Healthy Habits Plus comprised six telephone calls, Time2bHealthy comprised six online modules, and the active control comprised ten information sheets and a summary booklet. Data were collected from parents via a telephone questionnaire at baseline and nine months post-baseline. Data were analysed for randomised participants alone (n = 240), preference participants alone (n = 218), and all participants combined (n = 458). There was no significant improvement in fruit and vegetable intake (primary outcome) when comparing the telephone and online interventions to the control. In both the randomised only and all participants combined analyses, there was a significant improvement in non-core food intake for the telephone intervention compared to the control (p < 0.001). Differences between interventions for other outcomes were small. In conclusion, the telephone and online interventions did not improve child fruit and vegetable intake relative to written materials, but the telephone intervention did improve non-core food intake. Full article
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20 pages, 368 KiB  
Article
Dietary Outcomes of the ‘Healthy Youngsters, Healthy Dads’ Randomised Controlled Trial
by Lee M. Ashton, Philip J. Morgan, Jacqueline A. Grounds, Myles D. Young, Anna T. Rayward, Alyce T. Barnes, Emma R. Pollock, Stevie-Lee Kennedy, Kristen L. Saunders and Clare E. Collins
Nutrients 2021, 13(10), 3306; https://doi.org/10.3390/nu13103306 - 22 Sep 2021
Cited by 9 | Viewed by 2298
Abstract
(1) Background: The effect of fathers on dietary intake in preschool-aged children is under-explored. The aims were to: (i) evaluate the efficacy of a family-based lifestyle intervention, Healthy Youngsters, Healthy Dads, on change in dietary intake in fathers and their preschool-aged children [...] Read more.
(1) Background: The effect of fathers on dietary intake in preschool-aged children is under-explored. The aims were to: (i) evaluate the efficacy of a family-based lifestyle intervention, Healthy Youngsters, Healthy Dads, on change in dietary intake in fathers and their preschool-aged children post-intervention (10 weeks) and at 9 months follow-up compared to a waitlist control group and (ii) investigate associations in father–child dietary intakes. (2) Methods: Linear mixed models estimated group-by-time effects for all dietary outcomes, measured by food frequency questionnaires. Cohen’s d determined effect sizes, while correlation tests determined associations in father–child dietary intakes. (3) Results: For children, medium group-by-time effects sizes were identified at 10 weeks for sodium intake (d = 0.38) and percentage energy from core foods (d = 0.43), energy-dense, nutrient-poor (EDNP) foods (d = 0.43) and prepacked snacks (d = 0.45). These findings were sustained at 9 months follow-up. For fathers, medium to large, group-by-time effect sizes were identified at 10 weeks for energy intake (d = 0.55), sodium intake (d = 0.64) and percentage energy from core foods (d = 0.49), EDNP foods (d = 0.49), and confectionary (d = 0.36). For all of these dietary variables, except sodium, effects were sustained at 9 months. Moderate to strong associations existed in father–child dietary intakes for some of the dietary variables. (4) Conclusions: Although further research is required, this study provides preliminary support for targeting fathers as agents of change to improve dietary intakes in their preschool-aged children. Full article
27 pages, 2572 KiB  
Article
How Do French Parents Determine Portion Sizes for Their Pre-Schooler? A Qualitative Exploration of the Parent–Child Division of Responsibility and Influencing Factors
by Kaat Philippe, Sylvie Issanchou, Anaïs Roger, Valérie Feyen and Sandrine Monnery-Patris
Nutrients 2021, 13(8), 2769; https://doi.org/10.3390/nu13082769 - 12 Aug 2021
Cited by 7 | Viewed by 3092
Abstract
Large portion sizes can make children overeat, alter their self-regulation abilities and induce weight gain. However, little is known about how parents determine portion sizes for their children. Using semi-structured interviews with 5 fathers and 32 mothers of pre-schoolers, this study examined French [...] Read more.
Large portion sizes can make children overeat, alter their self-regulation abilities and induce weight gain. However, little is known about how parents determine portion sizes for their children. Using semi-structured interviews with 5 fathers and 32 mothers of pre-schoolers, this study examined French parents’ food portioning practices. The division of responsibility between parent and child in deciding portion sizes was explored, as well as the influencing factors and possible sources of information. Parents described a wide range of practices. For most, determining portion sizes is an intuitive action that depends on habits and mainly arises from experiences with feeding their child and his/her appetitive traits. Few parents grant autonomy to their child for portioning and serving food, especially for the first serving. Many influencing factors were identified, including child-related (e.g., appetite, food preferences), parent-related (e.g., avoiding food waste), and external factors (e.g., influence of siblings, French food culture). Most parents do not search for information/recommendations to guide their practices. Stimulating optimal self-regulation of eating in children is important and parents can play a crucial role in this. This study identified barriers and facilitators to guide parents in providing appropriate portion sizes and help include children in this decision process. Full article
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13 pages, 994 KiB  
Article
A Cluster Randomized Controlled Trial Evaluating the Impact of Tailored Feedback on the Purchase of Healthier Foods from Primary School Online Canteens
by Fiona Stacey, Tessa Delaney, Kylie Ball, Rachel Zoetemeyer, Christophe Lecathelinais, Luke Wolfenden, Kirsty Seward and Rebecca Wyse
Nutrients 2021, 13(7), 2405; https://doi.org/10.3390/nu13072405 - 14 Jul 2021
Cited by 1 | Viewed by 3054
Abstract
Few online food ordering systems provide tailored dietary feedback to consumers, despite suggested benefits. The study aim was to determine the effect of providing tailored feedback on the healthiness of students’ lunch orders from a school canteen online ordering system. A cluster randomized [...] Read more.
Few online food ordering systems provide tailored dietary feedback to consumers, despite suggested benefits. The study aim was to determine the effect of providing tailored feedback on the healthiness of students’ lunch orders from a school canteen online ordering system. A cluster randomized controlled trial with ten government primary schools in New South Wales, Australia was conducted. Consenting schools that used an online canteen provider (‘Flexischools’) were randomized to either: a graph and prompt showing the proportion of ‘everyday’ foods selected or a standard online ordering system. Students with an online lunch order during baseline data collection were included (n = 2200 students; n = 7604 orders). Primary outcomes were the proportion of foods classified as ‘everyday’ or ‘caution’. Secondary outcomes included: mean energy, saturated fat, sugar, and sodium content. There was no difference over time between groups on the proportion of ‘everyday’ (OR 0.99; p = 0.88) or ‘caution’ items purchased (OR 1.17; p = 0.45). There was a significant difference between groups for average energy content (mean difference 51 kJ; p−0.02), with both groups decreasing. There was no difference in the saturated fat, sugar, or sodium content. Tailored feedback did not impact the proportion of ‘everyday’ or ‘caution’ foods or the nutritional quality of online canteen orders. Future research should explore whether additional strategies and specific feedback formats can promote healthy purchasing decisions. Full article
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14 pages, 304 KiB  
Article
Adapting a Parental Support App to Promote Healthy Diet and Physical Activity Behaviors (MINISTOP) for a Multi-Ethnic Setting: A Qualitative Study on the Needs and Preferences of Parents and Nurses within Swedish Child Health Care
by Christina Alexandrou, Ulrika Müssener, Kristin Thomas, Hanna Henriksson and Marie Löf
Nutrients 2021, 13(7), 2190; https://doi.org/10.3390/nu13072190 - 25 Jun 2021
Cited by 15 | Viewed by 4380
Abstract
Early efforts for prevention of childhood overweight and obesity are needed. In order to adapt an app promoting healthy diet and physical activity behaviors in children (MINISTOP 1.0) for multi-ethnic communities, we explored: (1) needs and concerns among Somali-, Arabic-, and Swedish-speaking parents [...] Read more.
Early efforts for prevention of childhood overweight and obesity are needed. In order to adapt an app promoting healthy diet and physical activity behaviors in children (MINISTOP 1.0) for multi-ethnic communities, we explored: (1) needs and concerns among Somali-, Arabic-, and Swedish-speaking parents in terms of supporting healthy diet and activity behaviors in their children; (2) nurses’ perceptions of parental needs and concerns in relation to diet and physical activity behaviors; and (3) how the features and content of the MINISTOP 1.0 app could be refined to better support health behaviors in children, among both parents and nurses. Focus groups with Somali-, Arabic-, and Swedish-speaking parents (n = 15), and individual interviews with nurses (n = 15) were conducted. Parents expressed several challenges in supporting children’s health behaviors, the need for a tailored app, and alternative ways of accessing the content (audio/video). Nurses emphasized the need of supporting parents early, and the value of a shared platform in different languages, to facilitate communication. This study contributes valuable insights about parental needs and relevant adaptations to a parental support app, such as addition of audio/video files for increased accessibility. This adapted app version—MINISTOP 2.0, can be useful for childhood obesity prevention in multi-ethnic communities. Full article
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15 pages, 1094 KiB  
Article
Associations of Feeding Practices in Early Life and Dietary Intake at School Age with Obesity in 10- to 12-Year-Old Arab Children
by Khitam Muhsen, Wasef Na’amnih, Rebecca Goldsmith, Maayan Maya, Nuha Zeidan, Eias Kassem and Asher Ornoy
Nutrients 2021, 13(6), 2106; https://doi.org/10.3390/nu13062106 - 19 Jun 2021
Cited by 2 | Viewed by 2935
Abstract
Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age [...] Read more.
Understanding the role in pediatric obesity of early life feeding practices and dietary intake at school age is essential for early prevention. The study aimed to examine associations of early life feeding practices, environmental and health-related exposures, and dietary intake at school age as determinants of obesity in children aged 10–12 years. In an earlier study of 233 healthy infants in two Arab towns in northern Israel, neonatal history, feeding practices, and health information were obtained up to age 18 months. This follow-up study assessed dietary intake and anthropometric measurements at age 10–12 years using the 24 h recall method. Overall, 174 children participated in this study. Almost all (98%) the children were breastfed. The prevalence of obesity at school age was 42%. A multivariable model adjusted for energy intake and socioeconomic status showed positive associations of total fat intake and of weight-for-height z score, but not feeding practices in infancy, with obesity. Higher gestational age at birth was associated with lower odds of obesity at age 10–12 years. In conclusion, in a population with near universal breastfeeding, gestational age at birth, weight indicators but not feeding practices in infancy, and total fat intake at school age were associated with increased likelihood of obesity. Full article
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9 pages, 686 KiB  
Article
Determinants of the Consumption of Regular Soda, Sport, and Energy Beverages in Spanish Adolescents
by Helmut Schröder, Vanessa Cruz Muñoz, Marta Urquizu Rovira, Victoria Valls Ibañez, Josep-Maria Manresa Domínguez, Gerard Ruiz Blanco, Monserrat Urquizu Rovira and Pere Toran Monserrat
Nutrients 2021, 13(6), 1858; https://doi.org/10.3390/nu13061858 - 29 May 2021
Cited by 3 | Viewed by 3643
Abstract
Increasing sugar-sweetened beverages (SSB) consumption and associated health impacts warrant health-policy action. We assessed associations of socioeconomic and lifestyle variables with adolescents’ consumption of regular soda (RSD), sport (SD), and energy (ED) drinks. Cross-sectional study of 3930 Spanish adolescents (2089 girls, 1841 boys) [...] Read more.
Increasing sugar-sweetened beverages (SSB) consumption and associated health impacts warrant health-policy action. We assessed associations of socioeconomic and lifestyle variables with adolescents’ consumption of regular soda (RSD), sport (SD), and energy (ED) drinks. Cross-sectional study of 3930 Spanish adolescents (2089 girls, 1841 boys) aged 13–18 years). We compared frequency of consuming each SSB type (European Food Safety Authority questionnaire) with sociodemographic and lifestyle variables (standardized questions). RSD, SD, and ED were consumed at least weekly by 72.7%, 32.3%, and 12.3% of participants, respectively, and more frequently (p < 0.001) by boys, compared to girls. Multivariate ordinal logistic regression showed inverse association between RSD, SD, and ED consumption and parental occupation-based socioeconomic status (p < 0.01). Daily smoking was associated (p < 0.001) with higher ED (OR 3.64, 95% CI 2.39–5.55) and RSD (OR 2.15, 95% CI 1.56–2.97) consumptions. SD intake was associated inversely with smoking (OR 0.60, 95% CI 0.40–0.89, p = 0.012) and directly with physical activity (OR 2.93, 95% CI 2.18–3.95, p < 0.001). School performance was lower among ED (OR 2.14, 95% CI, 1.37–3.35, p = 0.001) and RSD (OR 1.81, 95% CI 1.24–2.64, p = 0.002) consumers, compared to SD. Maleness and low socioeconomic status predicted SSB consumption. Smoking and low school performance were associated with higher ED and RSD intakes. Full article
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Review

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31 pages, 668 KiB  
Review
School-Based Nutrition Interventions in Children Aged 6 to 18 Years: An Umbrella Review of Systematic Reviews
by Kate M. O’Brien, Courtney Barnes, Serene Yoong, Elizabeth Campbell, Rebecca Wyse, Tessa Delaney, Alison Brown, Fiona Stacey, Lynda Davies, Sasha Lorien and Rebecca K. Hodder
Nutrients 2021, 13(11), 4113; https://doi.org/10.3390/nu13114113 - 17 Nov 2021
Cited by 37 | Viewed by 8306
Abstract
Schools are identified as a key setting to influence children’s and adolescents’ healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic [...] Read more.
Schools are identified as a key setting to influence children’s and adolescents’ healthy eating. This umbrella review synthesised evidence from systematic reviews of school-based nutrition interventions designed to improve dietary intake outcomes in children aged 6 to 18 years. We undertook a systematic search of six electronic databases and grey literature to identify relevant reviews of randomized controlled trials. The review findings were categorised for synthesis by intervention type according to the World Health Organisation Health Promoting Schools (HPS) framework domains: nutrition education; food environment; all three HPS framework domains; or other (not aligned to HPS framework domain). Thirteen systematic reviews were included. Overall, the findings suggest that school-based nutrition interventions, including nutrition education, food environment, those based on all three domains of the HPS framework, and eHealth interventions, can have a positive effect on some dietary outcomes, including fruit, fruit and vegetables combined, and fat intake. These results should be interpreted with caution, however, as the quality of the reviews was poor. Though these results support continued public health investment in school-based nutrition interventions to improve child dietary intake, the limitations of this umbrella review also highlight the need for a comprehensive and high quality systematic review of primary studies. Full article
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