Laura S. Sims

Environmental influences on children's eating

Executive Summary Dramatic changes in lifestyles and the environment have brought about significant alterations in childrens eating patterns and food choices. Understanding these changes is pivotal if we are to help todays children establish healthy eating patterns, which contribute to the prevention and delay of chronic disease later in life. This paper describes the most salient environmental factors affecting childrens eating patterns and identifies those that appear most amenable to influence through public policy initiatives. A myriad of sociocultural and demographic factors that characterize the U.S. population today have combined to affect what children eat, where children eat, and with whom they eat. What was once mainly in the purview of family decision making is now increasingly in the realm of caregivers and peers, and many eating encounters occur away from home. Equally important is the plethora of societal and cultural factors that influence childrens food intake in the home, schools, institutions, child care settings, health care programs, and the marketplace. American children are given more and more responsibility for making their own food decisions and are constantly exposed to advertising messages about food. Federally sponsored food assistance programs, such as Food Stamps, Child Nutrition Programs, Head Start, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), make positive contributions to the kinds and amounts of food made available to many children. This paper makes a number of policy recommendations that have the potential to positively influence childrens eating patterns and nutritional status. These include: 1. Provide tools to families so that they can provide healthful food choices and facilitate the teaching of sound eating practices to children, by means of (a) promoting partnerships and coordination among government programs, the private sector, and schools to support the family structure, which is pivotal for teaching decision making and self-management of health and nutrition; (b) developing family-school partnerships for teenagers to combat negative peer influences and help parents and adolescents adopt positive health and eating behaviors; (c) reform the welfare system to reward work, bolster parents academic and job skills, and ensure a decent standard of living that will enable families to provide adequate food and foster healthful eating patterns. 2. Reduce fragmentation and lack of coordination among food assistance, public health, social service, and education programs that serve the same target populations. 3. Form partnerships with the media to help children improve their eating habits by promoting food choices consistent with recommendations made in Dietary Guidelines for Americans. An ample supply of healthful foods must be made available to children from which they can choose, and the information base on which these food choices are made must be relevant and sound. By working together in partnerships between public and private sector enterprises, we can make the eating environment more healthful, thus enabling Americas children to enjoy better health and well-being.

Use of the Transtheoretical Model of Change to Successfully Predict Fruit and Vegetable Consumption

Abstract This study examined the applicability of the transtheoretical model of change to assess readiness to increase fruit and vegetable intake in a nationally representative sample of U.S. adults. Using data from the 1991 5 A Day baseline survey of 2811 respondents, this study developed an algorithm based in part on responses to fruit and vegetable questions for classifying people into alternative stages of change. Associations were examined between stages of change, fruit and vegetable intake, and demographic and psychosocial factors. Results indicated that individuals can be classified by stage of change vis a vis fruit and vegetable intake. Persons in the higher stages of maintenance reported intakes that met national dietary recommendations of five or more servings of fruit and vegetables daily and those in action reported intakes that approached this level. Regression analyses showed that stages of change were a significant predictor of fruit and vegetable consumption, explaining 17% of the variation in fruit and vegetable intake. Stages of change and knowing the number of fruit and vegetable servings one should eat for good health provided the most parsimonious model, explaining 25% of the variance in total fruit and vegetable intake, compared with 29% for the full model.These findings suggest that stages are a successful predictor of fruit and vegetable consumption and implies a utility for the transtheoretical theory in the design and evaluation of stage-based nutrition messages for chronic disease prevention.

Employing cognitive response analysis to examine message acceptance in nutrition education

Abstract Cognitive responses (CRs) are mental reactions to incoming information. They consist of all the thoughts elicited by initial exposure to a message, and are thought to form the basis of message acceptance and impact. The authors objective was to investigate this proposed relationship to see if it held true within the context of nutrition education. Thirty female household food managers were asked to say aloud everything that came to mind as they browsed through a kit of print materials encouraging moderation of dietary fat. They then took the kit home. Four weeks later, they were interviewed to determine the number of recommended changes they had undertaken to reduce fat in their diets. Results showed that the number of changes undertaken was significantly related to an index reflecting the types of CRs elicited by the materials. These results suggest that cognitive response research may serve as a valuable approach to the formative evaluation and development of nutrition education materials.

Federal Trade Commission Study on Food Health Claims in Advertising: Implications for Nutrition Education and Policy

Abstract Increasingly, foods are being marketed on the basis of health-promoting properties their sellers claim they possess. The Federal Trade Commission (FTC) has published a study, “Generic Copy Test of Food Health Claims in Advertising,” in which they studied various types of disclosures and warnings in food ads on consumers’ interpretation of the information and their ability to use it in answering questions related to the test ads.The study is reviewed and implications for nutrition education and for public policy are presented.

Translating Nutrition Facts into Action: Helping Consumers Use the New Food Label

By the summer of 1994, consistent nutrition information will appear on food labels all over the United States. The educational challenge is to assist consumers to use the new food label to make more informed, healthier food choices. This article identifies the key issues in helping consumers understand and use the new food label, which effective food label education programs must successfully address.

Our Perspective: Nutrition Education Enhances Food Assistance Programs

What is the role of nutrition education in food assistance programs? Nutritionists must give this question serious thought as domestic nutrition policy evolves and as policy decisions are made about the degree of support for nutrition education. Issues of great importance to policy makers and the general public include the growing costs of health care and welfare reform.The major premise of this paper is that nutrition education and food assistance programs are mutually reinforcing intervention strategies and that nutrition education magnifies the effect of food assistance programs for needy families. We are not aware of any comprehensive, scholarly treatment that demonstrates the benefits of nutrition research and education for welfare reform, although assumptions about the benefits of incorporating nutrition education in welfare reform pilot projects appear to be common. Nutrition education is a major feature in the Wisconsin Work, Not Welfare county pilot projects. Local administrators feel that people who are being trained for employment also need help with life skills so that they are healthy and fit for work.The link between childrens nutritional status with their cognitive and behavioral development, and even their success in school, has been well documented. Further, there is evidence that the rather small financial outlays going to school feeding programs are offset by substantial gains in protecting the value of the educational investment. Placing nutrition research and education within a health promotion framework is nothing new.A document produced by USDA in the late 1970s provided a cost-benefit analysis of nutrition research and e d ~ c a t i o n . ~ More recently, additional information has been forthcoming about the potential savings in health care costs conferred by investments in nutrition. In 1992, diet-related diseases consumed a major portion of the nations health costs, as shown below:

Panel versus novice focus groups: Reactions to content and design features of print materials*

136 billion spent for coronary heart disease in direct health expenditures alone; more than

Public Policy in Nutrition: A Framework for Action

1 1 billion spent for stroke health care; more than

NUTRIENT UPDATE THE POLITICS OF FAT

72 billion spent for cancer treatment, including lost productivity;

Lecture Size and Its Relationship to Student Performance and Student and Faculty Attitudes and Behavior in a College-Level Nutrition Course

20 billion spent annually on diabetes treatment; another