Laura McGowan

Environmental and individual determinants of core and non-core food and drink intake in preschool-aged children in the United Kingdom

Background/Objectives:Strategies to achieve healthier diets for children are likely to benefit from an understanding of the determinants. We examined environmental and individual predictors of childrens intake of ‘core’ foods (fruit and vegetables) and ‘non-core’ foods (snacks and sweetened beverages). Predictors included parental intake, home availability, parental feeding styles (Encouragement and Monitoring) and childrens food preferences. Based on research with older children, we expected intake of both food types to be associated with maternal intake, core foods to be more associated with childrens preferences and non-core food intake more with the home environment.Subjects/Methods:Primary caregivers (n=434) of children (2–5 years) from preschools and Childrens Centres in London, UK, completed a self-report survey in 2008.Results:Multiple regression analyses indicated childrens fruit intake was associated with maternal fruit intake (B=0.29; P=0.000), childrens liking for fruit (B=0.81; P=0.000) and a Monitoring style of parental feeding (B=0.13; P=0.021). Childrens vegetable intake was similarly associated with maternal intake (B=0.39; P=0.000), childrens liking for vegetables (B=0.77; P=0.000), Encouragement (B=0.19; P=0.021) and Monitoring (B=0.11; P=0.029). Non-core snack intake was associated with maternal intake (B=0.25; P=0.029), Monitoring (B=−0.16; P=0.010), home availability (B=0.10; P=0.022) and television viewing (TV) (B=0.28; P=0.012). Non-core drink intake was associated with maternal intake (B=0.32; P=0.000) and TV (B=0.20; P=0.019).Conclusions:Results indicate commonalities and differences in the predictors of core and non-core food intake, with only maternal intake being important across all types. Effective interventions to improve young childrens diets may need to call on different strategies for different foods.

Putting habit into practice, and practice into habit: a process evaluation and exploration of the acceptability of a habit-based dietary behaviour change intervention

BackgroundForming `habit’ - defined as a learned process that generates automatic responses to contextual cues - has been suggested as a mechanism for behaviour maintenance, but few studies have applied habit theory to behaviour change. This study used process evaluation data, taken from a randomised controlled trial of a healthy child-feeding intervention for parents previously shown to be effective, to explore the applicability to dietary behaviour change of predictions and recommendations drawn from habit theory. The intervention supported parents in pursuing child-feeding habit goals in three domains (giving fruit and vegetables, water, healthy snacks), over four fortnightly home visits. We explored whether (a) the habit-formation model was acceptable to participants, (b) better-specified habit-formation goals yielded greater habit gains, and (c) habit gains were sustained (d) even when subsequent, new habit goals were pursued.MethodsQualitative and quantitative data were taken from 57 parents randomised to the intervention arm, and so analyses presented here used a pre-post intervention design. Thematic analysis of post-intervention qualitative interviews evaluated acceptability, and self-reported habit goals were content-analysed. ANOVAs explored changes in habit strength, recorded at home visits and one- and two-month follow-ups, across time and goals.ResultsParticipants understood and engaged positively with the habit-formation approach. Although many seemingly poorly-specified habit goals were set, goal characteristics had minimal impact on habit strength, which were achieved within two weeks for all behaviours (p’s < .001), and were maintained or had increased further by the final follow-up.ConclusionsThe habit-formation model appears to be an acceptable and fruitful basis for dietary behaviour change.

Domestic cooking and food skills: A review

ABSTRACT Domestic cooking skills (CS) and food skills (FS) encompass multiple components, yet there is a lack of consensus on their constituent parts, inter-relatedness, or measurement, leading to limited empirical support for their role in influencing dietary quality. This review assessed the measurement of CS and FS in adults (>16 years); critically examining study designs, psychometric properties of measures, theoretical basis, and associations of CS/FS with diet. Electronic databases (PsychInfo), published reports, and systematic reviews on cooking and home food preparation interventions provided 834 articles of which 26 met the inclusion criteria. Multiple CS/FS measures were identified across three study designs—qualitative, cross-sectional, and dietary interventions—conducted from 1998 to 2013. Most measures were not theory-based, limited psychometric data were available, with little consistency of items or scales used for CS/FS measurements. Some positive associations between CS/FS and fruit and vegetables intake were reported, though lasting dietary changes were uncommon. The role of psycho-social (e.g., gender, attitudes) and external factors (e.g., food availability) on CS/FS is discussed. A conceptual framework of CS/FS components is presented for future measurement facilitation, which highlights the role for CS/FS on food-related behavior and dietary quality. This will aid future dietary intervention design.

How, when and why do young women use nutrition information on food labels? A qualitative analysis

Background: Nutrition information (NI) on food packaging offers a public health tool that could be used to promote informed consumer choice and aid consumption of a healthy diet. Research indicates that the use of NI can lead to reduced energy intake and lower BMI, but little evidence is available regarding how, when or why people use NI when making everyday food choices. Methods: This qualitative study explored motivations and contexts surrounding the use of NI among 25 UK-based female NI users aged 23–35 years, using semi-structured individual interviews. Verbatim transcripts were analysed using thematic analysis. Results: Six themes were identified: (1) understanding and (2) functions of NI, (3) health versus appearance motives, NI use in (4) affective and (5) symbolic food episodes, and (6) competing point-of-purchase influences. Notable observations included a difficulty in understanding and converting NI into personally meaningful terms, and eschewal of NI in settings where food plays an affective or symbolic role (e.g. food consumption after a stressful day, buying food for a dinner party). Conclusions: We suggest evidence-based directions for future research and offer policy and practice recommendations, including the adoption of clear and consistent NI formats.

Do habits always override intentions? Pitting unhealthy snacking habits against snack-avoidance intentions

BackgroundHabit is defined as a process whereby an impulse towards behaviour is automatically initiated upon encountering a setting in which the behaviour has been performed in the past. A central tenet of habit theory is that habit overrides intentional tendencies in directing behaviour, such that as habit strength increases, intention becomes less predictive of behaviour. Yet, evidence of this effect has been methodologically limited by modelling the impact of positively-correlated habits and intentions. This study sought to test the effect of habits for unhealthy snacking on the relationship between intentions to avoid unhealthy snacks and snack intake.MethodsMethods were chosen to match those used in studies that have shown habit-intention interactions. 239 adults completed valid and reliable measures of habitual snacking and intention to avoid snacking at baseline, and a self-report measure of snack intake two weeks later. Data were analysed using multiple regression.ResultsWhile both habit and intention independently predicted snack intake, no interaction between habit and intention was found.ConclusionsNo support was found for the expected moderating impact of habit on the intention-behaviour relationship, indicating that individuals with intentions can act on those intentions despite having habits. Previous evidence of a habit-intention interaction effect may be unreliable. A growing literature indicates that habitual tendencies can be inhibited, albeit with difficulty. Habits and intentions may vary in the influence they exert over discrete behaviour instances. While the aggregation of behaviours across instances and individuals used in our study reflects the dominant methodology in habit research, it precludes examination of effects of in-situ habits and intentions. More sophisticated data collection and analysis methods may be needed to better understand potential habit-intention interactions.

Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study

ABSTRACT Background Evidence suggests that short sleep duration may be a newly identified modifiable risk factor for obesity, yet there is a paucity of studies to investigate this. Objective We assessed the feasibility of a personalized sleep extension protocol in adults aged 18–64 y who are habitually short sleepers (5 to <7 h), with sleep primarily measured by wrist actigraphy. In addition, we collected pilot data to assess the effects of extended sleep on dietary intake and quality measured by 7-d food diaries, resting and total energy expenditure, physical activity, and markers of cardiometabolic health. Design Forty-two normal-weight healthy participants who were habitually short sleepers completed this free-living, 4-wk, parallel-design randomized controlled trial. The sleep extension group (n = 21) received a behavioral consultation session targeting sleep hygiene. The control group (n = 21) maintained habitual short sleep. Results Rates of participation, attrition, and compliance were 100%, 6.5%, and 85.7%, respectively. The sleep extension group significantly increased time in bed [0:55 hours:minutes (h:mm); 95% CI: 0:37, 1:12 h:mm], sleep period (0:47 h:mm; 95% CI: 0:29, 1:05 h:mm), and sleep duration (0:21 h:mm; 95% CI: 0:06, 0:36 h:mm) compared with the control group. Sleep extension led to reduced intake of free sugars (–9.6 g; 95% CI: –16.0, –3.1 g) compared with control (0.7 g; 95% CI: –5.7, 7.2 g) (P = 0.042). A sensitivity analysis in plausible reporters showed that the sleep extension group reduced intakes of fat (percentage), carbohydrates (grams), and free sugars (grams) in comparison to the control group. There were no significant differences between groups in markers of energy balance or cardiometabolic health. Conclusions We showed the feasibility of extending sleep in adult short sleepers. Sleep extension led to reduced free sugar intakes and may be a viable strategy to facilitate limiting excessive consumption of free sugars in an obesity-promoting environment. This trial was registered at www.clinicaltrials.gov as NCT02787577.

Identification of behavior change techniques applied in interventions to improve cooking skills and food skills among adults

ABSTRACT Background: Cooking and food skills interventions have grown in popularity; however, there is a lack of transparency as to how these interventions were designed, highlighting a need to identify and understand the mechanisms of behavior change so that effective components may be introduced in future work. This study critiques cooking and food skills interventions in relation to their design, behavior change techniques (BCTs), theoretical underpinnings, and outcomes. Methods: A 40-item CALO-RE taxonomy was used to examine the components of 59 cooking and food skills interventions identified by two systematic reviews. Studies were coded by three independent coders. Results: The three most frequently occurring BCTs identified were #1 Provide information on consequences of behavior in general; #21 Provide instruction on how to perform the behavior; and #26 Prompt Practice. Fifty-six interventions reported positive short-term outcomes. Only 14 interventions reported long-term outcomes containing BCTs relating to information provision. Conclusion: This study reviewed cooking and food skills interventions highlighting the most commonly used BCTs, and those associated with long-term positive outcomes for cooking skills and diet. This study indicates the potential for using the BCT CALO-RE taxonomy to inform the design, planning, delivery and evaluation of future interventions.

The impact of video technology on learning: A cooking skills experiment

This study examines the role of video technology in the development of cooking skills. The study explored the views of 141 female participants on whether video technology can promote confidence in learning new cooking skills to assist in meal preparation. Prior to each focus group participants took part in a cooking experiment to assess the most effective method of learning for low-skilled cooks across four experimental conditions (recipe card only; recipe card plus video demonstration; recipe card plus video demonstration conducted in segmented stages; and recipe card plus video demonstration whereby participants freely accessed video demonstrations as and when needed). Focus group findings revealed that video technology was perceived to assist learning in the cooking process in the following ways: (1) improved comprehension of the cooking process; (2) real-time reassurance in the cooking process; (3) assisting the acquisition of new cooking skills; and (4) enhancing the enjoyment of the cooking process. These findings display the potential for video technology to promote motivation and confidence as well as enhancing cooking skills among low-skilled individuals wishing to cook from scratch using fresh ingredients.

The feasibility of lengthening sleep in habitually short sleepers and its effect on dietary intake, energy balance, and metabolic risk factors: A randomised controlled trial

H.K. Al Khatib, W.L. Hall, A. Creedon, E. Ooi, T. Masri, S.V. Harding, L. McGowan, J. Darzi* and G.K. Pot* Diabetes & Nutritional Sciences Division, Faculty of Life Sciences & Medicine, King’s College London, London SE1 9NH, U.K., Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast BT12 6BA, U.K. and Department of Health and Life, Virje Universiteit Amsterdam, Faculty of Earth and Life Sciences, Amsterdam, The Netherlands

Trial by Jury: Still a Lamp in the Dark?

Under the current law, where evidence of jury impropriety has become known following a trial, the Court of Appeal cannot investigate jury deliberations to determine if the verdict is unsafe. This article considers whether the justifications for this rule, and the safeguards present in a jury trial, are sufficient to justify the prohibition. It concludes that they are not. The rule is indefensible, and investigations should be permitted in certain circumstances.