Maria Koleilat

Influences of the neighbourhood food environment on adiposity of low-income preschool-aged children in Los Angeles County: a longitudinal study

Background Few studies have examined the association between the food environment and adiposity in early childhood, a critical time for obesity prevention. The objective of this study was to examine the longitudinal association between neighbourhood food environment and adiposity among low-income preschool-aged children in a major metropolitan region in the USA. Methods The study sample was 32u2005172 low-income preschool-aged children in Los Angeles County who had repeated weight and height measurements collected between ages 2 and 5u2005years through a federal nutrition assistance programme. We conducted multilevel longitudinal analyses to examine how spatial densities of healthy and unhealthy retail food outlets in the childrens neighbourhoods were related to adiposity, as measured by weight-for-height z-score (WHZ), while controlling for neighbourhood-level income and education, family income, maternal education, and childs gender and race/ethnicity. Results Density of healthy food outlets was associated with mean WHZ at age 3 in a non-linear fashion, with mean WHZ being lowest for those exposed to approximately 0.7 healthy food outlets per square mile and higher for lesser and greater densities. Density of unhealthy food outlets was not associated with child WHZ. Conclusions We found a non-linear relationship between WHZ and density of healthy food outlets. Research aiming to understand the sociobehavioural mechanisms by which the retail food environment influences early childhood obesity development is complex and must consider contextual settings.

Breastfeeding Is Associated With Reduced Obesity in Hispanic 2- to 5-Year-Olds Served by WIC

Objective: To examine the relationship between breastfeeding (BF) and odds of childhood obesity in a large, primarily Hispanic Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) population. Setting: A large urban WIC program in California. Participants: Infants enrolled in WIC born between 2004 and 2007 and observed to age 5 years (N = 39,801; 88.6% Hispanic). Intervention: Level of BF: fully BF, fully formula feeding, or combination feeding. Main Outcome Measure: Obesity at age 2–5 years, measured by body mass index (BMI) ≥ 95th percentile. Analysis: Logistic regression analyses to evaluate the association between initiation, duration, and exclusivity of BF and odds of obesity at age 2–5 years, controlling for ethnicity, preferred language, family size, poverty level, and maternal BMI. Results: Infants exclusively formula fed at birth were significantly more likely than fully breastfed infants to be obese at age 2–5 years (χ2 [2, N = 39,801] = 123.31; P < .001). For every additional month of any BF, obesity risk at age 2–5 years decreased by 1%. Every additional month of full BF conferred a 3% decrease in obesity risk. Ethnicity, preferred language, family size, poverty level, and maternal BMI were also significantly related to obesity risk. Conclusions and Implications: Breastfeeding may have a role in the attenuation of obesity in early childhood among Hispanic children. The BF promotion and support offered at WIC may have a significant role in reducing rates of early childhood obesity.

Effects of Parental Nativity and Length of Stay in the US on Fruit and Vegetable Intake Among WIC-Enrolled Preschool-Aged Children

Exposure to US culture is negatively associated with fruits and vegetables (F&V) intake. Our goal was to investigate how parent’s nativity and length of stay in the US influences preschoolers’ F&V intake. We analyzed survey data from 2,352 children, aged 36–60xa0months, who participate in the Supplemental Nutrition Program for Women, Infants and Children (WIC) in Los Angeles County. Using multiple linear regression, we examined children’s F&V intake by parent’s nativity and years in the US, adjusting for possible confounders. Children of foreign born parents who had lived in the US for <10xa0years consumed fewer servings of vegetables than children of US born parents and of foreign born parents who had lived in the US for ≥10xa0years. Children of newer immigrant families may be at greater risk for consuming poor-quality diets. Research to identify determinants of poor diet quality among children of immigrant families may increase the effectiveness of WIC in addressing this population’s nutritional needs.

Depressive symptoms mediate the association between fear of crime and higher body mass index

Purpose. To investigate pathways in the association between fear of crime and obesity. Design. A cross-sectional survey was administered among residents aged 18 years and older across all Census tracts. Setting. Genesee County, Michigan. Subjects. A total of 3192 residents. Measures. Body mass index (BMI) was calculated by using the respondents reported height and weight. Composite fear-of-crime and depressive symptoms scores were calculated by using several survey items. Analysis. Path analysis examined the effects of fear of crime on BMI. Results. Fear of crime was associated with higher BMI. Depressive symptoms mediated the relationship between fear of crime and BMI (p < .001). Moderate exercise mediated the association between depressive symptoms and BMI (p < .001). Conclusion. Fear of crime was associated with depressive symptoms, which in turn were associated with reduced exercise and subsequently higher BMI.

The Role of WIC in Obesity Prevention

Purpose of ReviewThis paper seeks to answer the following two questions: (1) Is participation in the Supplemental Nutrition Program for Women, Infants and Children (WIC) associated with changes in obesity and overweight? and (2) What obesity prevention interventions in the WIC setting may be most effective for obesity prevention?Recent FindingsThe available evidence supports the conceptualization of the role of WIC in obesity prevention across the life course, with suggested impacts/influence on gestational weight gain during pregnancy, rapid infant weight gain during infancy, healthy lifestyle behavior during interconception, and prevalence of obesity during early childhood. Through the provision of nutrition education, breastfeeding support, and healthy foods and beverages, the WIC program has the potential to influence the mother’s nutritional knowledge and her and her child’s dietary intake and behaviors in a positive way.SummaryGiven the wide reach of the program and the high quality of height/weight measurements taken by the WIC program, WIC has the potential to capitalize upon the early critical periods of development to reduce the incidence of overweight and obesity in a substantial proportion of low-income women and children.

The Impact of Food Insecurity on the Home Emotional Environment Among Low-Income Mothers of Young Children

Objectives Household stressors, such as food insecurity, contribute to the home emotional environment and negatively affect child development. Little research on this topic has been conducted among very young children. This study aimed to examine the relationship between food insecurity and the home emotional environment, as well the extent to which the relationship may be mediated by maternal symptoms of depression. Frequency of praise, affection, and discipline of young children by mothers were examined as markers of the home emotional environment. Methods Data were collected in a cross-sectional study of mothers of children under the age of five (Nu2009=u20094231). Logistic regression was used to assess the relationship between level of food security and frequency of praise and discipline of children. Mediation analysis using the KHB method was conducted to test whether maternal mental health mediated the relationship between food insecurity and each outcome. Results Low and very low food security were significantly associated with higher odds of disciplining children with high frequency. Controlling for all covariates, frequency of praise was not significantly associated with level of household food insecurity. Differences in praise and discipline frequency were found by language of interview, maternal education, and employment. Conclusions for Practice Parent–child interactions, specifically related to discipline, are related to food insecurity. Further research should consider cultural patterns and mechanisms behind the relationship between food insecurity and the home environment. Household stressors begin affecting children at young ages, and early intervention is essential to prevent further negative sequelae as children grow older.

Response to Letter to the Editor by Joe Brew, Department of Epidemiology, University of Florida.

Dear EditorsnnWe are pleased that our paper has been deemed thought-provoking. Regarding the issues brought by Joe Brew, we would like to respond as follows: nn1. Brew suggests that we should have used body mass index (BMI) percentiles instead of weight-for-height z-scores (WHZ). We disagree and stand behind our original statement that WHZ is a more appropriate measure for longitudinally assessing adiposity among young children. In the paper cited by Brew1 as justification for his argument, …

Influences of the neighbourhood food environment on adiposity of low-income preschool-aged children in Los Angeles County

Background Few studies have examined the association between the food environment and adiposity in early childhood, a critical time for obesity prevention. The objective of this study was to examine the longitudinal association between neighbourhood food environment and adiposity among low-income preschool-aged children in a major metropolitan region in the USA. Methods The study sample was 32u2005172 low-income preschool-aged children in Los Angeles County who had repeated weight and height measurements collected between ages 2 and 5u2005years through a federal nutrition assistance programme. We conducted multilevel longitudinal analyses to examine how spatial densities of healthy and unhealthy retail food outlets in the childrens neighbourhoods were related to adiposity, as measured by weight-for-height z-score (WHZ), while controlling for neighbourhood-level income and education, family income, maternal education, and childs gender and race/ethnicity. Results Density of healthy food outlets was associated with mean WHZ at age 3 in a non-linear fashion, with mean WHZ being lowest for those exposed to approximately 0.7 healthy food outlets per square mile and higher for lesser and greater densities. Density of unhealthy food outlets was not associated with child WHZ. Conclusions We found a non-linear relationship between WHZ and density of healthy food outlets. Research aiming to understand the sociobehavioural mechanisms by which the retail food environment influences early childhood obesity development is complex and must consider contextual settings.