Teri Burgess-Champoux

Are Family Meal Patterns Associated with Overall Diet Quality during the Transition from Early to Middle Adolescence

OBJECTIVE To examine longitudinal associations of participation in regular family meals (>or= 5 meals/week) with eating habits and dietary intake during adolescence. DESIGN Population-based, longitudinal study (Project EAT: Eating Among Teens). Surveys were completed in Minnesota classrooms at Time 1 (1998-1999) and by mail at Time 2 (2003-2004). SETTING Baseline surveys were completed in Minneapolis/St. Paul, Minnesota, schools and by mail at follow-up. PARTICIPANTS 677 adolescents (303 males and 374 females) who were in middle school at Time 1 (mean age = 12.8 +/- 0.74 years) and high school at Time 2 (mean age = 17.2 +/- 0.59 years). MAIN OUTCOME MEASURES Dietary intake, frequency of meals, and fast-food intake patterns. ANALYSIS Generalized linear modeling stratified by gender and adjusted for race/ethnicity, socioeconomic status, and the Time 1 outcome. RESULTS Regular family meals were positively associated with Time 2 frequency of breakfast, lunch, and dinner meals for males and breakfast and dinner meals for females. Among males, regular family meals were negatively associated with Time 2 fast-food intake. Regular family meals were also positively associated with Time 2 mean daily intakes of vegetables, calcium-rich food, fiber, calcium, magnesium, potassium, iron, zinc, folate, and vitamins A and B(6) among both genders. CONCLUSIONS AND IMPLICATIONS Regular family meals during early adolescence may contribute to the formation of healthful eating habits 5 years later. Parents should be made aware of the importance of shared mealtime experiences.

Associations Between School Meals Offered Through the National School Lunch Program and the School Breakfast Program and Fruit and Vegetable Intake Among Ethnically Diverse, Low-Income Children

BACKGROUND Despite evidence in support of the health benefits associated with fruit and vegetable (FV) intake, national data indicate that FV consumption among school-aged children is below recommended levels, particularly among low-income children. School meals offered through the School Breakfast Program and National School Lunch Program can provide an important contribution to child FV intake. This study examines the proportion of fruits and vegetables consumed from school meals programs among ethnically diverse, low socioeconomic status children. METHODS Participants (n = 103) included fourth to sixth grade boys and girls from 4 urban elementary schools in St. Paul, Minnesota serving primarily low-income populations. Research staff interviewed children during school hours and recorded dietary intake via 24-hour recall. Analysis included descriptive statistics using cross tabulations and means. RESULTS Average reported mean (SD) daily FV intake was 3.6 (2.5) servings, with 80% of children consuming fewer than 5 daily servings of FV. On average, children consumed over half of their daily FV intake within school. Children with low FV intake (<5 FV servings daily) consumed a higher proportion of their daily intake at school than children with higher FV intake (≥5 FV servings daily) (39% vs 59%; p = .002). CONCLUSIONS Child FV intake is below recommended levels. School meals provide an important contribution to the daily FV intake among ethnically diverse, low socioeconomic status children, particularly among those with the lowest FV intake. School meals programs promoting FV intake within the school environment may provide an opportunity to encourage increased FV consumption.

Fruits and vegetables at home: child and parent perceptions.

OBJECTIVE Examine child and parent perceptions of home food environment factors and associations with child fruit and vegetable (FV) intake. DESIGN Research staff administered surveys to children during after-school sessions, and parents completed surveys by mail or over the phone. SETTING Four urban elementary schools in St. Paul, Minnesota, serving primarily low-income populations. PARTICIPANTS Seventy-three children (55 girls, 18 boys) and 1 parent/guardian per child participated in a theater-based intervention aimed at obesity prevention. MAIN OUTCOME MEASURES Perceptions of home food environment factors (home FV availability, home FV accessibility; parental encouragement to eat FV; family meal frequency). ANALYSIS Descriptive statistics and paired t tests. RESULTS On average, child and parent perceptions of the home food environment were similar. When comparing child-parent dyad perceptions of home food environment, a moderate to high level of agreement (56%-86%) was found. Child report of home FV availability, home FV accessibility, parental encouragement to eat FV, and family meal frequency explained 26.7% of the variance in child FV intake, whereas parent report of these factors explained 4.9% of the variance. CONCLUSIONS AND IMPLICATIONS It is important to understand both child and parent perceptions of the home food environment when developing interventions aimed at increasing child FV intake.

Healthy whole-grain choices for children and parents: a multi-component school-based pilot intervention

OBJECTIVE The aim of the present study was to pilot-test a school-based intervention designed to increase consumption of whole grains by 4th and 5th grade children. DESIGN This multi-component school-based pilot intervention utilised a quasi-experimental study design (intervention and comparison schools) that consisted of a five-lesson classroom curriculum based on Social Cognitive Theory, school cafeteria menu modifications to increase the availability of whole-grain foods and family-oriented activities. Meal observations of children estimated intake of whole grains at lunch. Children and parents completed questionnaires to assess changes in knowledge, availability, self-efficacy, usual food choice and role modelling. SETTING/SAMPLE Parent/child pairs from two schools in the Minneapolis metropolitan area; 67 in the intervention and 83 in the comparison school. RESULTS Whole-grain consumption at the lunch meal increased by 1 serving (P < 0.0001) and refined-grain consumption decreased by 1 serving for children in the intervention school compared with the comparison school post-intervention (P < 0.001). Whole-grain foods were more available in the lunches served to children in the intervention school compared with the comparison school post-intervention (P < 0.0001). The ability to identify whole-grain foods by children in both schools increased, with a trend towards a greater increase in the intervention school (P = 0.06). Parenting scores for scales for role modelling (P < 0.001) and enabling behaviours (P < 0.05) were significantly greater for parents in the intervention school compared with the comparison school post-intervention. CONCLUSIONS The multi-component school-based programme implemented in the current study successfully increased the intake of whole-grain foods by children.

Whole-Grain Intake Correlates among Adolescents and Young Adults: Findings from Project EAT

BACKGROUND National survey data indicate few adolescents or young adults consume whole grains in the amount recommended to prevent chronic disease and maintain a healthful weight. Interventions are needed to address this gap; however, little is known about what modifiable factors influence whole-grain intake among youth. OBJECTIVE This study aimed to identify socioenvironmental, personal, and behavioral correlates of whole-grain intake among adolescents and young adults. DESIGN Data for this cross-sectional analysis were drawn from Project EAT (Eating Among Teens)-II, the second wave of a population-based study in Minnesota. Mailed surveys and food frequency questionnaires were completed by male (44.8%) and female (55.2%) participants in 2003-2004, including 792 adolescents (mean age=17.2 years) and 1,686 young adults (mean age=20.5 years). Linear regression models adjusted for demographic characteristics were used to identify factors associated with energy-adjusted daily intake of whole grains. RESULTS Mean daily intake of whole grains was lower than recommended among adolescents (males: 0.59+/-0.04 servings, females: 0.61+/-0.04 servings) and young adults (males: 0.68+/-0.03 servings, females: 0.58+/-0.03 servings). Home availability of whole-grain bread, self-efficacy to consume > or =3 daily servings of whole grains, and preference for the taste of whole-grain bread were positively associated with whole-grain intake during adolescence and young adulthood across sex. Conversely, fast-food intake was associated with lower intake of whole grains among adolescents and young adults of both sexes. The factors examined in this study explained 28% to 34% of variance in whole-grain intake across sex and the two age groups. CONCLUSIONS The findings suggest nutrition interventions should address the availability of whole-grain foods in homes and restaurants. In addition, young people should be provided with opportunities to taste a variety of whole-grain foods to enhance taste preferences and self-efficacy to consume whole-grain products.

Longitudinal and secular trends in adolescent whole-grain consumption, 1999–2004

BACKGROUND The replacement of refined grains in the diet with whole grains may help prevent chronic disease and excess weight gain, but intakes in adolescents are often lower than recommended. OBJECTIVES This study aimed to examine demographic disparities and 5-y longitudinal and secular trends (1999-2004) in whole-grain intake among 2 cohorts of Minnesota adolescents. DESIGN Whole-grain intake was examined among 996 adolescent males and 1222 adolescent females who were Project EAT (Eating Among Teens) participants in 1999 and 2004. Multinomial logistic regression models were used to examine demographic differences in whole-grain intake. Mixed linear regression models were used to estimate 1) longitudinal trends among 2 cohorts of adolescents during developmental transitions and 2) age-matched secular trends between the cohorts at middle adolescence. RESULTS In 1999, 11% of adolescent males and 13% of adolescent females reported that they consumed more than one daily serving of whole grains. Whole-grain intake was lowest among youth of the Native American and white races and among youth of high socioeconomic status. During the transition from middle to late adolescence, whole-grain intake increased by a mean of 0.14 daily servings among adolescent males and 0.09 daily servings among adolescent females. No significant changes in whole-grain intake were shown among either sex during the transition from early to middle adolescence. Yeast breads, popcorn, and ready-to-eat breakfast cereals were major sources of whole grains in 1999 and 2004. CONCLUSION Findings suggest the need to advance efforts that target improvements in the amount of whole-grain foods selected by adolescents.

The Development of Psychosocial Measures for Whole-Grain Intake among Children and Their Parents

The effectiveness of behavioral intervention programs can be assessed by measuring changes in behavior using reliable and valid instruments. To our knowledge, a reliable instrument designed to measure changes in psychosocial determinants of whole-grain intake by children due to an intervention does not exist in the literature. This article describes the development and testing of two questionnaires designed to measure psychosocial determinants of whole-grain intake among children and their parents. The questionnaires were pilot-tested with 39 parent/child pairs from one school and subsequently used in an intervention program with 150 parent/child pairs from two schools. Internal consistencies for the child and parent scales were modest (alpha=.41 to .63), with the exception of intention to choose whole-grain foods for children, which was low (alpha=.19). Test-retest reliability of the child and parent scales was acceptable (r=0.58 to 0.90). Principal components analysis confirmed three parenting subscales: enabling behaviors, whole grain health benefits, and role modeling. Identification of whole-grain foods remains a substantial barrier to the development of a questionnaire that accurately measures psychosocial determinants related to whole-grain intake. Future work should focus on instrument development and testing on a broader scale.

Higher Quality Intake From School Lunch Meals Compared With Bagged Lunches

Studies show that nutritional quality of lunches brought from home is poor when compared with school lunches. Most of these studies were conducted in the United Kingdom, while studies of this type are limited in the United States. Therefore, this study compared lunch food, nutrient, and energy intake by lunch type (school lunch vs bagged lunch) in 2 schools in a Midwest metropolitan area of the United States. Food intake data were collected from 129 children with meal observation procedures. Energy, food, and nutrient intakes were estimated using Nutrition Data System for Research software and compared with t tests by lunch type. Children eating school lunches had higher intakes of protein; vitamins A, D, and K; and calcium and lower intakes of energy, fat, carbohydrate, vitamin E, and sugar compared with children eating bagged lunches. The ratios of mean protein and calcium consumption to minimum required values tended to be greater for children eating school lunches compared with those eating bag lunche...

Associations between Whole-Grain Intake, Psychosocial Variables, and Home Availability among Elementary School Children

OBJECTIVE Develop, refine, and test psychosocial scales for associations with whole-grain intake. METHODS A cross-sectional survey was conducted in a Minneapolis/St. Paul suburban elementary school with children in fourth through sixth grades (n = 98) and their parents (n = 76). Variables of interest were child whole-grain intake, self-efficacy, outcome expectations, preferences, knowledge regarding whole-grain food, and whole-grain availability at home. Correlation analysis and one-way analysis of variance were used to analyze data. RESULTS Internal consistency and test-retest correlation coefficients for child psychosocial scales were modest or acceptable (α = .55-.70). Parents reported a mean of 15 ± 7 whole-grain products available at home. Child mean daily intake of total grain was about 8 servings, and intake of products containing whole grain was slightly over 2 servings. Reported home availability and refined-grain intake were significantly related to whole-grain intake, whereas psychosocial variables were not. CONCLUSIONS AND IMPLICATIONS Home availability may be a more important variable associated with whole-grain intake than psychosocial variables.