Kylie Ball

Family food environment and dietary behaviors likely to promote fatness in 5-6 year-old children

Background:The family food environment (FFE) is likely to exert important influences on young childrens eating. Examination of multiple aspects of the FFE may provide useful insights regarding which of these might most effectively be targeted to prevent childhood obesity.Objective:To assess the associations between the FFE and a range of obesity-promoting dietary behaviors in 5–6-year-old children.Design:Cross-sectional study.Subjects:Five hundred and sixty families sampled from three socio-economically distinct areas.Measurements:Predictors included parental perceptions of their childs diet, food availability, child feeding practices, parental modeling of eating and food preparation and television (TV) exposure. Dietary outcomes included energy intake, vegetable, sweet snack, savory snack and high-energy (non-dairy) fluid consumption.Results:Multiple linear regression analyses, adjusted for all other predictor variables and maternal education, showed that several aspects of the FFE were associated with dietary outcomes likely to promote fatness in 5–6-year-old children. For example, increased TV viewing time was associated with increased index of energy intake, increased sweet snack and high-energy drink consumption, and deceased vegetable intake. In addition, parents increased confidence in the adequacy of their childs diet was associated with increased consumption of sweet and savory snacks and decreased vegetable consumption.Conclusion:This study substantially extends previous research in the area, providing important insights with which to guide family-based obesity prevention strategies.

Socio-economic inequalities in women's fruit and vegetable intakes: a multilevel study of individual, social and environmental mediators.

OBJECTIVE This study employed a multilevel design to test the contribution of individual, social and environmental factors to mediating socio-economic status (SES) inequalities in fruit and vegetable consumption among women. DESIGN A cross-sectional survey was linked with objective environmental data. SETTING A community sample involving 45 neighbourhoods. SUBJECTS In total, 1347 women from 45 neighbourhoods provided survey data on their SES (highest education level), nutrition knowledge, health considerations related to food purchasing, and social support for healthy eating. These data were linked with objective environmental data on the density of supermarkets and fruit and vegetable outlets in local neighbourhoods. RESULTS Multilevel modelling showed that individual and social factors partly mediated, but did not completely explain, SES variations in fruit and vegetable consumption. Store density did not mediate the relationship of SES with fruit or vegetable consumption. CONCLUSIONS Nutrition promotion interventions should focus on enhancing nutrition knowledge and health considerations underlying food purchasing in order to promote healthy eating, particularly among those who are socio-economically disadvantaged. Further investigation is required to identify additional potential mediators of SES-diet relationships, particularly at the environmental level.

Deleterious Associations of Sitting Time and Television Viewing Time with Cardiometabolic Risk Biomarkers: Australian Diabetes, Obesity and Lifestyle (AusDiab) study 2004-2005

OBJECTIVE We examined the associations of sitting time and television (TV) viewing time with continuously measured biomarkers of cardio-metabolic risk in Australian adults. RESEARCH DESIGN AND METHODS Waist circumference, BMI, resting blood pressure, triglycerides, HDL cholesterol, fasting and 2-h postload plasma glucose, and fasting insulin were measured in 2,761 women and 2,103 men aged ≥30 years (mean age 54 years) without clinically diagnosed diabetes from the 2004–2005 Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Multivariate linear regression analyses examined associations of self-reported sitting time and TV viewing time (hours per day) with these biomarkers, adjusting for potential confounding variables. RESULTS For both women and men, sitting time was detrimentally associated with waist circumference, BMI, systolic blood pressure, fasting triglycerides, HDL cholesterol, 2-h postload plasma glucose, and fasting insulin (all P < 0.05), but not with fasting plasma glucose and diastolic blood pressure (men only). With the exception of HDL cholesterol and systolic blood pressure in women, the associations remained significant after further adjustment for waist circumference. TV viewing time was detrimentally associated with all metabolic measures in women and all except HDL cholesterol and blood pressure in men. Only fasting insulin and glucose (men only) remained deleteriously associated with TV viewing time after adjustment for waist circumference. CONCLUSIONS In women and men, sitting time and TV viewing time were deleteriously associated with cardio-metabolic risk biomarkers, with sitting time having more consistent associations in both sexes and being independent of central adiposity. Preventive initiatives aimed at reducing sitting time should focus on both nonleisure and leisure-time domains.

Sedentary Behavior and Depression Among Adults: A Review

BackgroundPhysically inactive lifestyles and sedentary behaviors (SB) are key contributors to ill health. Although the association between SB (e.g., watching TV/using the computer) and physical health has been well documented, increasing research has focused on the possible link between SB and mental health (e.g., depression).PurposeThis review aims to investigate the effect of SB on the risk of depression in adults.MethodA systematic search for original research articles investigating associations between SB and depression in adults was performed using the several electronic data bases.ResultsA total of seven observational and four intervention studies were included in this review. All observational studies found positive associations between SB and risk of depression, while intervention studies showed contradictory results.ConclusionEvidence for the relationship between SB and risk of depression in adults is limited by methodological weaknesses. However, on balance, this review suggests that SB is associated with an increased risk of depression. Further studies are needed assessing different types of SB and depression; the interrelationship between physical activity, SB, and depression; causal links between SB and depression; and intervention strategies aimed at reducing SB and their effects on risk of depression.

Who does not gain weight? Prevalence and predictors of weight maintenance in young women

OBJECTIVE: To investigate the prevalence and predictors of weight maintenance over time in a large sample of young Australian women.DESIGN: This population study examined baseline and 4 y follow-up data from the cohort of young women participating in the Australian Longitudinal Study on Womens Health.SUBJECTS: A total of 8726 young women aged 18–23 y at baseline.MEASURES: Height, weight and body mass index (BMI); physical activity; time spent sitting; selected eating behaviours (eg dieting, disordered eating, takeaway food consumption); cigarette smoking, alcohol consumption; parity; and sociodemographic characteristics.RESULTS: Only 44% of the women reported their BMI at follow-up to be within 5% of their baseline BMI (maintainers); 41% had gained weight and 15% had lost weight. Weight maintainers were more likely to be in managerial or professional occupations; to have never married; to be currently studying; and not to be mothers. Controlling for sociodemographic factors, weight maintainers were more likely to be in a healthy weight range at baseline, and to report that they spent less time sitting, and consumed less takeaway food, than women who gained weight.CONCLUSIONS: Fewer than half the young women in this community sample maintained their weight over this 4 y period in their early twenties. Findings of widespread weight gain, particularly among those already overweight, suggest that early adulthood, which is a time of significant life changes for many women, may be an important time for implementing strategies to promote maintenance of healthy weight. Strategies which encourage decreased sitting time and less takeaway food consumption may be effective for encouraging weight maintenance at this life stage.

Why do women of low socioeconomic status have poorer dietary behaviours than women of higher socioeconomic status? A qualitative exploration.

In developed countries, persons of low socioeconomic status (SES) are generally less likely to consume diets consistent with dietary guidelines. Little is known about the mechanisms that underlie SES differences in eating behaviours. Since women are often responsible for dietary choices within households, this qualitative study investigated factors that may contribute to socioeconomic inequalities in dietary behaviour among women. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low- SES women, recruited from Melbourne, Australia, using an area-level indicator of SES. An ecological framework, in which individual, social and environmental level influences on diet were considered, was used to guide the development of interview questions and interpretation of the data. Thematic analysis was undertaken to identify the main themes emerging from the data. Several key influences varied by SES. These included food-related values such as health consciousness, and a lack of time due to family commitments (more salient among higher SES women), as well as perceived high cost of healthy eating and lack of time due to work commitments (more important for low SES women). Reported availability of and access to good quality healthy foods did not differ strikingly across SES groups. Public health strategies aimed at reducing SES inequalities in diet might focus on promoting healthy diets that are low cost, as well as promoting time-efficient food preparation strategies for all women.

Personal, social and environmental determinants of educational inequalities in walking: a multilevel study

Objective: To investigate the contribution of personal, social and environmental factors to mediating socioeconomic (educational) inequalities in women’s leisure-time walking and walking for transport. Methods: A community sample of 1282 women provided survey data on walking for leisure and transport; educational level; enjoyment of, and self-efficacy for, walking; physical activity barriers and intentions; social support for physical activity; sporting/recreational club membership; dog ownership; and perceived environmental aesthetics and safety. These data were linked with objective environmental data on the density of public open space and walking tracks in the women’s local neighbourhood, coastal proximity and street connectivity. Results: Multilevel modelling showed that different personal, social and environmental factors were associated with walking for leisure and walking for transport. Variables from all three domains explained (mediated) educational inequalities in leisure-time walking, including neighbourhood walking tracks; coastal proximity; friends’ social support; dog ownership; self-efficacy, enjoyment and intentions. On the other hand, few of the variables examined explained educational variations in walking for transport, exceptions being neighbourhood, coastal proximity, street connectivity and social support from family. Conclusions: Public health initiatives aimed at promoting, and reducing educational inequalities in, leisure-time walking should incorporate a focus on environmental strategies, such as advocating for neighbourhood walking tracks, as well as personal and social factors. Further investigation is required to better understand the pathways by which education might influence walking for transport.

Mismatch between perceived and objective measures of physical activity environments

OBJECTIVES This study investigated the correspondence between measures of physical activity facilities obtained through self-report and objective audits; and identified the socio-demographic, cognitive and behavioral characteristics of those who perceive their physical activity environment to be less supportive than objective measures indicate. METHODS Self-report surveys were completed by 1540 women recruited from 45 neighborhoods in Melbourne, Australia. Women reported perceived access to physical activity facilities within 2 km from home, and also socio-demographic, cognitive and behavioral factors. Objective data on physical activity facilities within a 2 km pedestrian catchment area around womens homes were sourced. RESULTS There was relatively poor agreement between measures of access to physical activity facilities obtained via self-report and objective assessment. Mismatch between perceived and objectively-assessed environments was more common amongst younger and older women, and women of low income, with low self-efficacy for physical activity, who were less active, who reported using fewer facilities and who had lived in the neighborhood for less than 2 years. CONCLUSIONS Future studies of environmental determinants of physical activity should consider incorporating objective indices of access to facilities, or accounting for the systematic bias that may result from relying on self-report perceptions as an indicator of the actual physical activity environment.

Children's fruit and vegetable intake : Associations with the neighbourhood food environment

OBJECTIVE To examine associations between availability of different types of food outlets and childrens fruit and vegetable intake. METHOD Parents of 340 5-6 and 461 10-12 year-old Australian children reported how frequently their child ate 14 fruits and 13 vegetables in the last week in 2002/3. A geographic information system (GIS) was used to determine the availability of the following types of food outlets near home: greengrocers; supermarkets; convenience stores; fast food outlets; restaurants, cafés and takeaway outlets. Logistic regression analyses examined the likelihood of consuming fruit >or=2 times/day and vegetables >or=3 times/day, according to access to food outlets. RESULTS Overall, 62.5% of children ate fruit >or=2 times/day and 46.4% ate vegetables >or=3 times/day. The more fast food outlets (OR=0.82, 95%CI=0.67-0.99) and convenience stores (OR=0.84, 95%CI=0.73-0.98) close to home, the lower the likelihood of consuming fruit >or=2 times/day. There was also an inverse association between density of convenience stores and the likelihood of consuming vegetables >or=3 times/day (OR=0.84, 95%CI=0.74-0.95). The likelihood of consuming vegetables >or=3 times/day was greater the farther children lived from a supermarket (OR=1.27, 95%CI=1.07-1.51) or a fast food outlet (OR=1.19, 95%CI=1.06-1.35). CONCLUSION Availability of fast food outlets and convenience stores close to home may have a negative effect on childrens fruit and vegetable intake.

Deleterious associations of sitting time and television viewing time with cardio-metabolic risk biomarkers: AusDiab 2004-2005

OBJECTIVE We examined the associations of sitting time and television (TV) viewing time with continuously measured biomarkers of cardio-metabolic risk in Australian adults. RESEARCH DESIGN AND METHODS Waist circumference, BMI, resting blood pressure, triglycerides, HDL cholesterol, fasting and 2-h postload plasma glucose, and fasting insulin were measured in 2,761 women and 2,103 men aged ≥30 years (mean age 54 years) without clinically diagnosed diabetes from the 2004–2005 Australian Diabetes, Obesity and Lifestyle (AusDiab) study. Multivariate linear regression analyses examined associations of self-reported sitting time and TV viewing time (hours per day) with these biomarkers, adjusting for potential confounding variables. RESULTS For both women and men, sitting time was detrimentally associated with waist circumference, BMI, systolic blood pressure, fasting triglycerides, HDL cholesterol, 2-h postload plasma glucose, and fasting insulin (all P < 0.05), but not with fasting plasma glucose and diastolic blood pressure (men only). With the exception of HDL cholesterol and systolic blood pressure in women, the associations remained significant after further adjustment for waist circumference. TV viewing time was detrimentally associated with all metabolic measures in women and all except HDL cholesterol and blood pressure in men. Only fasting insulin and glucose (men only) remained deleteriously associated with TV viewing time after adjustment for waist circumference. CONCLUSIONS In women and men, sitting time and TV viewing time were deleteriously associated with cardio-metabolic risk biomarkers, with sitting time having more consistent associations in both sexes and being independent of central adiposity. Preventive initiatives aimed at reducing sitting time should focus on both nonleisure and leisure-time domains.