Sharon L. Hoerr

Associations among parental feeding styles and children's food intake in families with limited incomes

BackgroundAlthough general parenting styles and restrictive parental feeding practices have been associated with childrens weight status, few studies have examined the association between feeding styles and proximal outcomes such as childrens food intake, especially in multi-ethnic families with limited incomes. The purpose of this study was to evaluate the association of parental feeding styles and young childrens evening food intake in a multiethnic sample of families in Head Start.MethodsParticipants were 715 Head Start children and their parents from Texas and Alabama representing three ethnic groups: African-American (43%), Hispanic (29%), and White (28%). The Caregivers Feeding Styles Questionnaire (Hughes) was used to characterize authoritative, authoritarian (referent), indulgent or uninvolved feeding styles. Food intake in several food groups was calculated from 3 days of dietary recalls for the child for evening food intakes from 3 PM until bedtime.ResultsCompared to children of authoritarian parents, intakes of fruits, juice and vegetables were lowest among children of indulgent or uninvolved parents (1.77 ± 0.09 vs 1.45 ± 0.09 and 1.42 ± 0.11 cups) as were intakes of dairy foods (0.84 ± 0.05 vs 0.67 ± 0.05 and 0.63+0.06 cups), respectively.ConclusionFindings suggest that permissive parent feeding styles like indulgent or uninvolved relate negatively to childrens intake of nutrient-rich foods fruit, 100% fruit juice, vegetables and dairy foods from 3 PM until bedtime.

Among Young Adults, College Students and Graduates Practiced more Healthful Habits and made more Healthful Food Choices than did Nonstudents

OBJECTIVES Health-related characteristics and habits and food choices of young adults were compared for three groups: college students, college graduates, and nonstudents. DESIGN Subjects completed a mailed survey that included questions about demographics, attitudes, and behaviors and a food frequency questionnaire. Main outcome measures were health-related characteristics and habits and food choices. SUBJECTS Female (n = 758) and male (n = 580) 18- to 24-year-olds in nine states who were selected randomly by zip code in each state. The response rate averaged 43% for all states. STATISTICAL ANALYSES PERFORMED Analysis of variance of chi 2 tests were applied to health-related personal characteristic variables and the Kruskal-Wallis analysis of variance was applied to food consumption variables for women and men separately. RESULTS According to self-reported heights and weights, female nonstudents were more often overweight than female students or graduates. Nonstudents of both genders reported smoking more often than students or graduates. College students and graduates ate more grain foods high in dietary fiber, more fruits and dark-green vegetables, and more lower-fat milk and meats than nonstudents. CONCLUSIONS/APPLICATIONS Nonstudents were at greater health risk for some chronic illnesses, because of poorer health habits and food choices, than were college students and graduates. The behavior of nonstudents implies weaker response to messages promoting weight control, smoking cessation, and observance of the Dietary Guidelines for Americans than behavior exhibited by students or college graduates. Health promotion efforts could be enhanced by identifying demographic, educational, situational, and formative influences on positive health and dietary behaviors of young adults.

Risk for disordered eating relates to both gender and ethnicity for college students.

Objective: To estimate the frequency of disordered eating behaviors among college students and associations by gender, ethnicity, participation in social organizations and college athletics and to determine whether responses to eight health behavior and attitude questions and body weight predicted a high score on the Eating Attitudes Test (EAT)-26, a screening instrument used to identify risks of developing an eating disorder. Methods: Subjects were a convenience sample of 1,899 college students (cleaned to 1620) who attended four classes, were members of 14 sororities or lived in five residence halls. Students reported height and weight and responded to the EAT-26 and eight items regarding health behaviors and attitudes. Results: Among women and men, 4.5% and 1.4%, respectively, reported previous treatment for an eating disorder, and 10.9% of women and 4.0% of men were at risk for eating disorders (scores ≥ 20 on EAT). Among African-Americans, 8.3% of women were at risk. One group of women who lived separately in a social sorority had the highest risk of 15%. The frequency of “weight concerns interfering with academic performance” and “eliminating high fat foods” was moderately correlated to risk for disordered eating for both genders. Body mass only weakly related to risk for disordered eating and the association varied by subgroup. Conclusion: Students at risk for disordered eating report weight concerns interfering with their academic performance and include both men and African-Americans, as well as Caucasian American women. Sorority women living in separate residences might be at increased risk.

Impact of an online healthful eating and physical activity program for college students.

Purpose. To identify impact of an online nutrition and physical activity program for college students. Design. Randomized, controlled trial using online questionnaires and on-site physical and fitness assessments with measurement intervals of 0 (baseline), 3 (postintervention), and 15 months (follow-up). Setting. Online intervention delivered to college students; a centralized Web site was used for recruitment, data collection, data management, and intervention delivery. Subjects. College students (18–24 years old, n = 1689), from eight universities (Michigan State University, South Dakota State University, Syracuse University, The Pennsylvania State University, Tuskegee University, University of Rhode Island, University of Maine, and University of Wisconsin). Intervention. A 10-lesson curriculum focusing on healthful eating and physical activity, stressing nondieting principles such as size acceptance and eating competence (software developer: Rainstorm, Inc, Orono, Maine). Measures. Measurements included anthropometrics, cardiorespiratory fitness, fruit/vegetable (FV) intake, eating competence, physical activity, and psychosocial stress. Analysis. Repeated measures analysis of variance for outcome variables. Results. Most subjects were white, undergraduate females (63%), with 25% either overweight or obese. Treatment group completion rate for the curriculum was 84%. Over 15 months, the treatment group had significantly higher FV intake (+.5 cups/d) and physical activity participation (+270 metabolic equivalent minutes per week) than controls. For both groups, anthropometric values and stress increased, and fitness levels decreased. Gender differences were present for most variables. First-year males and females gained more weight than participants in other school years. Conclusion. A 10-week online nutrition and physical activity intervention to encourage competence in making healthful food and eating decisions had a positive, lasting effect on FV intake and maintained baseline levels of physical activity in a population that otherwise experiences significant declines in these healthful behaviors.

Quantitative Use of the Food Guide Pyramid to Evaluate Dietary Intake of College Students

OBJECTIVES To evaluate the usefulness of the Food Guide Pyramid as a quantitative tool for assessing nutritional adequacy and quality. DESIGN One-day food records (n = 2,489) were assigned food group scores (1 through 5) by two systems. System 1 recorded the number of food groups on a given record that included the minimum number of servings suggested by the Food Guide Pyramid. System 2 recorded the number of food groups in the Food Guide Pyramid for which at least one serving was included. The food records were further evaluated by mean adequacy ratio (MAR) for iron, calcium, magnesium, vitamin A, and vitamin B-6 (MAR-5 score) and percentage of energy contributed by fat and sugar. Sensitivity and specificity of the food group scores to predict nutritional inadequacy were determined. SUBJECTS College students (n = 2,489) attending introductory nutrition, foods, and health-related courses at a mid-western university. STATISTICAL ANALYSES Students t test, chi2 test, Dunnetts multiple mean comparison test. RESULTS A food group score of 5 was given to 11% and 35% of the diet records by systems 1 and 2, respectively; MAR-5 scores of 75 or greater were given to 70% of the records. Only 4% of the diets contained both 30% or less and 10% or less of energy from fat and sugar, respectively. Both scoring systems can be used as a quantitative tool for screening nutritional inadequacy with high sensitivity (correctly classifying nutritionally inadequate diets) but with a moderate to low specificity (correctly classifying nutritionally adequate diets).

Recommendations for planning and reporting focus group research

Abstract The use of focus group interviews as a qualitative research method has grown in popularity. This paper was written to provide ideas on how to determine if publication of focus group-based research should be pursued. Included are viewpoints on methodological, design, analysis, and reporting issues. In addition, a list of suggested readings is provided.

Healthy Eating for Rural Low-Income Toddlers: Caregivers' Perceptions

Caregivers exert a powerful influence on young childrens eating habits. This qualitative study used focus groups to assess nutritional needs and barriers in establishing healthy eating habits in toddlers. Three focus groups were conducted with rural, low-income caregivers, 2 with men and 1 with women, in 3 rural Michigan counties. Four major themes emerged: (a) barriers to providing healthy meals, (b) division of responsibility, (c) mealtime behavior, and (d) desired nutrition education. The major barriers identified were work schedules; cost of food; inadequate time to shop, plan, and prepare nutritious meals; or a combination thereof. Caregivers expressed concern for the nutritional well-being of their toddlers. The perceived needs and perceptions of low-income caregivers need to be considered when providing nutrition education. Findings from this study provided the basis for developing a nutrition education intervention for low-income parents of young children.

Internet-based Interventions Have Potential to Affect Short-term Mediators and Indicators of Dietary Behavior of Young Adults

OBJECTIVE Evaluate a theory-based, Internet-delivered nutrition education module. DESIGN Randomized, treatment-control design with pre-post intervention assessments. SETTING AND PARTICIPANTS Convenience sample of 160 young adults (aged 18-24) recruited by community educators in 4 states. Study completers (n = 96) included a mix of racial/ethnic groups and family demographics, but were predominately white females without children. INTERVENTION A Transtheoretical Model (TTM)-based, stage-tailored Internet program, F&V (Fruit & Vegetable) Express Bites, was delivered to treatment group participants; controls received nontailored messages in a comparable format. MAIN OUTCOME MEASURES AND ANALYSIS: TTM constructs at baseline, immediately postviewing, and at 30-day follow-up were compared via chi-square, McNemars test, and logistic regression. Qualitative use and acceptability indicators were collected postviewing (treatment only). RESULTS Of baseline respondents, 86.5% completed the study. At follow-up, self-efficacy, decisional balance, and selected processes improved for both groups, with only marginal advantages for the theory-based version. Fruit and vegetable consumption changes were similar for both groups. Qualitative measures of knowledge, confidence, and motivation improved (not measured for controls). Favorable ratings of treatment program acceptability and personal relevance were reported. CONCLUSIONS AND IMPLICATIONS The Internet is a favorable option for reaching young adults with nutrition messages. This study did not identify strong advantages of theory-based tailoring, especially for fruit consumption, which had weaker barriers than vegetable consumption among this target audience.

Self-efficacy, perceived benefits, and weight satisfaction discriminate among stages of change for fruit and vegetable intakes for young men and women

This study determined whether psychosocial, weight satisfaction, and dietary pattern variables discriminate between the Stages of Change for fruit and vegetable intakes among young men and women. A random sample of 18 to 24 year-olds, from 10 states returned 1438 surveys. Discriminant analyses for fruit intake conveyed that between precontemplation and contemplation/preparation, pro-scores and self-efficacy predicted the mens but not womens stages. Between contemplation/preparation and action/maintenance, self-efficacy and breakfast consumption best predicted stage for women, whereas men were discriminated only by self-efficacy. Discriminant analyses for vegetable intake were similar by gender. Precontemplation and contemplation/preparation were discriminated by pro-score and staging into contemplation/preparation versus action/maintenance was best predicted by self-efficacy and weight satisfaction. Young men and women are at different places in the Stages of Change process and few are meeting the vegetable guidelines. Dietary interventions can be most effective if specifically tailored to food group, stage, and gender.

What young adults say about factors affecting their food intake

Little research has been conducted examining the food choice behaviors of young adults. The few studies reported have been limited to college students and used survey questionnaire techniques. This study sought to describe a broader sample of young adults and to gather information about reasons for food choice behavior using a qualitative method. Fifty‐seven focus group interviews were conducted across seven states with 270 young adult participants. The interviews were focussed on discussions of food‐related behaviors. Across all states consistent responses were given regarding time constraints, financial barriers and health concerns impacting food choice. Varying responses between states seemed related to racial and ethnic differences among participants. These results suggest that the effectiveness of efforts to promote positive food behavior change among young adults may be improved by incorporating means to overcome common barriers.