Samantha Ramsay

Creating Potential for Common Ground and Communication Between Early Childhood Program Staff and Parents About Young Children's Eating

OBJECTIVES To explore child care staff and parent perspectives and communications about childrens eating in child care. DESIGN Focus groups (FGs) conducted with child care staff and parents. SETTING Four Western states in the United States. PARTICIPANTS Thirty-nine child care staff in 7 FGs and 25 parents in 6 FGs. PHENOMENON OF INTEREST Thoughts and concerns about childrens eating and opportunities to improve communication between staff and parents. ANALYSIS Content analysis (FG coding inter-rater reliability: staff = 0.74; parents = 0.81) and identification of meta-themes. RESULTS Three meta-themes were identified: (1) recognition of positive influences of the child care setting in childrens development of healthy eating; (2) concerns about childrens eating in child care and at home; and (3) strategies to improve communications and transactions related to childrens eating. CONCLUSIONS AND IMPLICATIONS Staff reported that their roles included informing parents about food at mealtimes in child care (eg, menus, recipes) but also educating parents about child nutrition and feeding. Parents valued daily information about their childs eating to adjust home mealtimes and to feel connected to their child. Barriers to effective communication included limited time and concerns regarding parent reactions and defensiveness. Staff requested training about child nutrition and feeding and about sensitive communications with parents.

Engaging Parents to Promote Children’s Nutrition and Health: Providers’ Barriers and Strategies in Head Start and Child Care Centers

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health. Design: Qualitative. Setting: State-licensed center-based childcare programs. Participants: Full-time childcare providers (n = 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience. Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted. Results: Two overarching themes were barriers and strategies to communicate with parents about children’s nutrition. Barriers to communication included—(a) parents are too busy to talk with providers, (b) parents offer unhealthy foods, (c) parents prioritize talking about child food issues over nutrition, (d) providers are unsure of how to communicate about nutrition without offending parents, and (e) providers are concerned if parents are receptive to nutrition education materials. Strategies for communication included—(a) recognize the benefits of communicating with parents about nutrition to support child health, (b) build a partnership with parents through education, (c) leverage policy (federal and state) to communicate positively and avoid conflict, (d) implement center-level practices to reinforce policy, and (e) foster a respectful relationship between providers and parents. Conclusion: Policy and environmental changes were recommended for fostering a respectful relationship and building a bridge between providers and parents to improve communication about children’s nutrition and health.

Nutrient Intake and Consumption of Fruit and Vegetables in Young Children

Children’s fruit and vegetable consumption (FVC) is below recommendations. Objectives of the study were to (a) describe the type and frequency of FVC, (b) analyze the average nutrient intake from young children’s fruit consumption and vegetable consumption separately, and (c) determine the contribution of demographic factors on FVC. Children aged 2 to 5 years (n = 821) were identified using the 2009-2010 National Health and Nutrition Examination Survey. Average servings and nutrient intake from FVC were estimated. Multiple comparisons among age, gender, body mass index (BMI), ethnicity, and poverty index ratio (PIR) were analyzed using an ANCOVA. Akaike’s information criterion determined relative contribution of each factor to FVC. Children consumed 3 times as many fruit servings as vegetable servings regardless of age, gender, BMI, ethnicity, and PIR. Potato products and fruit juice were consumed most frequently and in the greatest amounts. In general, children obtained more nutrients from fruits than ve...

Type and Frequency of Food Images in Parenting Magazines: IdentifyingAreas for Improvement

Abstract Parents and children are influenced by food advertisements, which can impact children’s healthy weight. The purpose of the study was to identify the type and frequency of food images in parenting magazines. Content analysis of twelve issues from each of three parenting magazines (36) for 2010 was conducted by two researchers. The inter-rater reliability was 0.70 or above for the categories: food items, restaurants, infant feeding, feeding equipment, and supplements. From the 2445 food related images, breads and grains appeared most frequently (476), followed by the fats, oils, and sweets category (334). Few breastfeeding images (9) appeared compared to bottle (29) or formula (50) feeding images. Supplement images occurred more frequently than drink, condiment, restaurant, and infant feeding images. Knowledge of the type and frequency of food related images in magazines can be used by health professionals to provide education and information to parents that will address obesigenic behaviors and environments.

Variety of fruit and vegetables is related to preschoolers' overall diet quality

Children are encouraged to eat a specific amount of fruits and vegetables to optimize health. The purpose of this study was to assess whether consumption of a variety of fruits and vegetables, respectively, was associated with a greater diet quality among preschool-aged children. Analyses were performed using a cross-sectional, nationally representative sample of US children. Dietary intakes from 24-h dietary recalls of two-five year old children (n = 2595) in 2005–2010 NHANES were examined. Diet quality was evaluated using MyPlate equivalents and the Healthy Eating Index 2010 (HEI-2010). Variety categories were determined based on childrens fruit, fruit juice, and vegetable consumption on the recalled day. Differences in diet quality were examined using t-tests. Variety of fruits and vegetables was linked to higher overall diet quality. Children who consumed whole fruit had better diet quality scores for total fruit, whole fruit, whole grains, dairy, seafood, refined grains, sodium, and empty calories (P ≤ 0.018). Significantly higher HEI-2010 scores for total fruit, whole fruit, fatty acids, sodium, and empty calories, but a lower dairy HEI-2010 score, were identified in children who drank fruit juice (P ≤ 0.038). Vegetable consumption was significantly associated with higher total vegetables, greens/beans, and empty calories, but a lower sodium score (P ≤ 0.027). Children who consumed whole fruit, fruit juice and non-starchy vegetables (P ≤ 0.017), but not white potatoes, had significantly higher total HEI-2010 scores. Reinforcing fruit and 100% fruit juice consumption may indirectly support healthier diets among children. However, underlying associations between fruit and vegetable intakes and overall diet quality should be examined further.

How much is enough? Tablespoon per year of age approach meets nutrient needs for children

BACKGROUND Adults often ask health professionals for guidance on offering the appropriate serving sizes for young children and little research is available on whether serving size approaches meet childrens nutrient needs. OBJECTIVE Determine whether three serving size approaches for young children meet dietary standards for nutrient adequacy. DESIGN We examined nutrient contents of three serving size approaches for children ages 2-5 years of age: 1 tablespoon per year of age (T/y), MyPyramid, and Child and Adult Care Food Program. Nutrient content of the three approaches were compared to the Estimated Energy Requirements (EER), Estimated Average Requirement (EAR), or Adequate Intake (AI) for each year of age for males and females; Analysis of Variance identified differences in nutrient content among the three approaches. RESULTS Young childrens nutrient requirements were met for most nutrients by all approaches. However, the recommendation for vitamin E, potassium, and fat were not met by any approach, for any year, for either girls or boys. Energy content of the T/y serving size approach was below the EER for each year of age and for both sexes but still met minimal vitamin and mineral needs. CONCLUSION Health professionals can feel comfortable using any of the three approaches. However, the T/y approach is a more graduated serving size approach, may be more consistently age appropriate for young children, and may be implemented more easily by adults.

Child Care Mealtime and Active Play Partnerships (Child Care MAPP): Evaluation of a Training Resource Web Site for Enhancing Nutrition Education Communication

The communication component of the Child Care MAPP Web site was designed according to an established theoretical base, and was critically reviewed. The communication materials were targeted for use by trainers who educate child care providers, and may be incorporated into higher education curricula to guide nutrition educators who will be working in child nutrition and child feeding programs. Evaluation of the impact of the communication materials on a group of trainers demonstrated a significant increase in participant confidence to communicate about nutrition. In particular, the child- and adult-centered phrases developed as a novel and developmentally appropriate approach to nutrition education were evaluated by respondents as useful, and were found to increase confidence to communicate with children. Future research should further examine the use of child-centered and adult-centered nutrition phrases in nutrition education and higher education, to determine whether the way in which adults talk with children improves children’s knowledge about nutrition, and whether use of the phrases can positively affect children’s nutrition behaviors.

Skipping breakfast is associated with lower diet quality in young US children

Background/objectivesBreakfast consumption has been shown to impact children’s growth and development, but the influence of breakfast skipping on total daily intakes is not known. The purpose of this study was to examine the differences in nutritional intakes and food consumption between children who consume breakfast versus those who do not.Subjects/methodsDietary recall data were assessed for 2-year-old to 5-year-old children (n = 3443) and 6-year-old to 12-year-old children (n = 5147) from NHANES 2005–2012. Dietary intakes and diet quality scores were compared across breakfast consumption and skipping with means and 95% confidence interval.ResultsChildren who skipped breakfast on the day of intake had significantly lower energy intakes for the total day (5911 vs 6723 kJ) but had greater energy intakes from non-breakfast meals and snacks. Children who skipped breakfast consumed nearly 40% of the day’s intake (2332 kJ of 5911 kJ) from snacks, with 586 kJ from snacks as added sugars. Breakfast skipping was also related to significantly lower intakes of fiber, folate, iron, and calcium intakes. Overall diet quality scores, as well as fruit, whole fruit, whole grains, dairy and empty calorie subscale scores were significantly better in children who ate breakfast.ConclusionsChildren who skipped breakfast presented poorer overall diet quality and lower total intakes commonly obtained at breakfast. To address missed opportunities, nutrition professionals should encourage children’s consumption of a nutritious breakfast to support overall diet quality.

A Comparison of College Students’ Reported Fruit and Vegetable Liking and Intake from Childhood to Adulthood

Objectives: Fruit and vegetable intake (FVI) is below recommendations and fruit and vegetable liking (FVL) is associated with intake. Greater understanding of college student FVL and FVI is needed; therefore, the study objectives were to compare reported FVL and frequency of FVI in adulthood to recollection of FVL and frequency of fruit and vegetable offering (FVO) in childhood and identify factors related to FVL and FVI in college students. Methods: A retrospective survey was administered via e-mail to randomly selected college students (18–25 years) from 2 Northwestern universities (n = 676). McNemars chi-square tests were used to evaluate differences in FVL and FVI scores. Spearmans rank identified an association between current FVL and FVI scores and their recollection of FVO as a child. Pearsons chi-square tests were used to examine differences in FVL and FVI scores within the demographic factors age, gender, year in school, urban/rural, body mass index (BMI), childhood overweight, breastfed, and forced to eat fruits or vegetables. Results: FVL was more frequent in adulthood, but college students reported FVO as a child more frequently than their current FVI. Females reported greater FVL and FVI. Upperclassmen and the 21–25 age group reported greater frequency of vegetable liking and intake compared to underclassmen and the 18–20 age group. Lower vegetable liking and fruit intake were reported for those identifying as overweight, and recollection of FVO in childhood was associated with increased FVL and FVI scores in adulthood. Individuals forced by caregivers to eat vegetables as a child reported a lower vegetable liking than those not forced. Conclusions: FVL increased from childhood to adulthood, demonstrating a progression; however, recollection of childhood offering was higher than FVI in young adulthood. Results indicate a need for behavioral strategies to increase FVI in college students and encourage offering fruit and vegetables but refrain from forcing children to eat vegetables.

Engaging Overweight Adolescents in a Health and Fitness Program Using Wearable Activity Trackers

INTRODUCTION Our objectives were to (a) examine feasibility and receptivity of overweight adolescents joining a community-based group fitness program and (b) test preliminary efficacy of a 12-week pilot intervention designed to promote health, fitness, and self-efficacy for the identified teens. METHODS The 12-week fitness program for overweight adolescents was developed and included planned physical activities, nutrition classes, and goal-setting sessions. A one-group pre-/posttest study design evaluated 20 participants from grades 10 through 12 who enrolled in the program pilot study. Participants were given a wearable activity tracker that captured data using an Internet-based platform. Outcome measures included body mass index, screen time, fitness, and cardiovascular measures. RESULTS A community fitness program for overweight adolescents was successfully implemented. High school students were receptive to the intervention and reported high program satisfaction. Positive effects included measurements of strength, systolic blood pressure, weight, and screen time behaviors. DISCUSSION This study provides evidence to support the feasibility, acceptance, and preliminary effects of the pilot program with overweight adolescents.