Esther Jansen

From the Garden of Eden to the land of plenty. Restriction of fruit and sweets intake leads to increased fruit and sweets consumption in children.

Overweight is increasing rapidly in children, compelling researchers to seek for determinants of adverse food intake. In a previous experiment it was found that manipulating the restriction of attractive snacks increased the desirability and intake of these snacks. In the present study, we tested whether this paradoxical restricting effect is also seen in relatively less attractive but healthy food, i.e. fruit. Will fruit become more desirable through restriction, and will children eat more forbidden fruit than non-forbidden fruit? Two groups of young children were forbidden to eat fruits and sweets, respectively, whereas a control group was invited to eat everything. Desire for sweets remained high in the sweets-prohibition condition, whereas it decreased in the fruit-prohibition and no-prohibition conditions. No group differences were found regarding the desire for fruit. With respect to intake, children in both the fruit- and the sweets-prohibition condition consumed more of the formerly forbidden food during a taste session as compared to the no-prohibition condition. In addition, total food intake was higher in the two prohibition conditions than in the no-prohibition condition. These data indicate that the adverse effects of restriction apply to both attractive unhealthy and relatively less attractive but healthy food.

How to promote fruit consumption in children. Visual appeal versus restriction

The prevalence of overweight is increasing dramatically in children. A protective factor against the development of overweight is a sufficient intake of fruit and vegetables. However, the consumption of fruit and vegetables in children is far from ideal these days. Therefore, it is important to examine how the intake of fruit and vegetables can be promoted. In this study, the effects of two fruit promoting techniques were evaluated in 4-7-year-old children: presenting fruit in a more visually appealing manner versus restricting the intake of fruit. Two presentations of fruit (regular and visually appealing) were offered to the participants. In a first taste session participants were either allowed to eat from both fruit presentations (no-prohibition group) or prohibited from eating one of the two presentations (regular fruit prohibited group/visually appealing fruit prohibited group). In a second taste session all participants were allowed to eat from both fruit presentations. The results indicated that visual appeal had a strong effect on consumption of the fruit. With respect to restriction, no effects were found. Parents, schools, supermarkets and food producers should take advantage of these results, and offer children fruit and vegetables that are presented in a visually appealing manner.

Tackling childhood overweight: treating parents exclusively is effective

Objective:In general, treatment of childhood obesity focuses on treating the obese children. The results of child-directed treatments are disappointing in the long run. In the current study, it is tested whether a treatment aimed solely at obese childrens parents results in positive effects on the childrens weight status. In addition, potential predictors of treatment success are identified.Methods:The parents of 98 overweight or obese children (aged 7–13 years) were randomly assigned to either the cognitive-behavioural group treatment (eight sessions) or the waiting-list control group.Results:With respect to child body mass index (BMI) percentile, the parents’ treatment was successful in reducing overweight from pretreatment to posttreatment: BMI percentile decreased significantly by 2.4% in the treatment group, whereas there was no change in the waiting-list control group. There was no significant relapse at follow-up (3 months). Child BMI percentile did not decrease in the waiting-list control group. In addition, significant main effects of time were found for both groups with respect to eating psychopathology (decrease), self-esteem (increase) and negative thoughts (decrease). Finally, parental BMI decreased significantly only in the treatment group. Four predictors were identified with respect to treatment success, namely, lower socioeconomic status, younger age of the child, higher parental attendance and lower BMI percentile of the child before treatment.Conclusions:The parents’ treatment had significant effects on child and parent BMI. Long-term endurance of these positive effects needs to be studied. Striking are the positive effects of time in the waiting-list control group for some psychological outcome measures. Obviously, waiting for treatment already affects psychological processes (but not behaviour) in the children.

Assessing eating disordered behaviour in overweight children and adolescents: bridging the gap between a self-report questionnaire and a gold standard interview

The current study compared two measurements assessing eating disorder psychopathology in overweight children and adolescents: an interview and a self-report questionnaire. An adjusted version of the Child Eating Disorder Examination Questionnaire (ChEDE-Q) was compared with the Child Eating Disorder Examination interview (ChEDE), which is considered the gold standard. Thirty-eight overweight children and adolescents (aged 8-14) participated in the study. Regarding objective bulimic episodes, the current study found that using smaller chunks of information decreased the discrepancy between interview and questionnaire. The chances are that the gap between ChEDE-Q and ChEDE can be reduced if more attention is paid to children’s abilities concerning the understanding of complex concepts. (Netherlands Journal of Psychology, 63, 102-106)

Tackling childhood overweight. Treating parents exclusively is effective

In general, treatment of childhood obesity focuses on treating the obese children. The results of child-directed treatments are disappointing in the long run. In the current study, it is tested whether a treatment aimed solely at obese children’s parents results in positive effects on the children’s weight status. In addition, potential predictors of treatment success are identified. The parents of 98 overweight or obese children (aged 7–13 years) were randomly assigned to either the cognitive-behavioural group treatment (eight sessions) or the waiting-list control group. With respect to child body mass index (BMI) percentile, the parents’ treatment was successful in reducing overweight from pre-treatment to post-treatment: BMI percentile decreased significantly by 2.4% in the treatment group, whereas there was no change in the waiting-list control group. There was no significant relapse at follow-up (3 months). Child BMI percentile did not decrease in the waiting-list control group. In addition, significant main effects of time were found for both groups with respect to eating psychopathology (decrease), self-esteem (increase) and negative thoughts (decrease). Finally, parental BMI decreased significantly only in the treatment group. Four predictors were identified with respect to treatment success, namely, lower socioeconomic status, younger age of the child, higher parental attendance and lower BMI percentile of the child before treatment. The parents’ treatment had significant effects on child and parent BMI. Long-term endurance of these positive effects needs to be studied. Striking are the positive effects of time in the waiting-list control group for some psychological outcome measures. Obviously, waiting for treatment already affects psychological processes (but not behaviour) in the children.