Weiwen Chai

Development and validation of a social cognitive theory-based survey for elementary nutrition education program

BackgroundThe Social Cognitive Theory (SCT) is a widely used model for developing elementary nutrition education programs; however, few instruments are available to assess the impact of such programs on the main constructs of the SCT. The purposes of this study were: 1) to develop and validate a SCT-based survey instrument that focuses on knowledge, behavior, and self-efficacy for fifth grade students; 2) to assess the relationships between knowledge, behavior, and self-efficacy; and 3) to assess knowledge, behavior, and self-efficacy for healthy eating among the fifth grade students.MethodsA 40-item instrument was developed and validated using content validity and tested among 98 fifth grade students for internal consistency reliability. Relationships between knowledge, behavior, and self-efficacy were assessed using Pearson Correlation Coefficients. Differences in behavior and knowledge scores between children with high and low self-efficacy were examined using t-test.ResultsCronbach’s alphas for self-efficacy (0.70) and behavior (0.71) subscales of the survey were acceptable, although lower for knowledge (0.56). Summary scores for self-efficacy and behaviors were positively correlated (r = 0.40, P = 0.0001); however, summary knowledge scores were not associated with self-efficacy (r = 0.02, P = 0.88) or behavior scores (r = 0.14, P = 0.23). Participants with high self-efficacy also had significantly higher scores on consuming fruits (P = 0.0009) and dairy products (P = 0.009), eating breakfast (P = 0.008), helping plan family meals (P = 0.0006) and total behaviors for healthy-eating (P = 0.001) compared to those with low self-efficacy. In addition, approximately two thirds of the fifth grade students reported that they did not eat any fruits or vegetables or ate them only once on a typical day.ConclusionsThe developed instrument is a reliable and useful tool to assess SCT-based elementary nutrition education programs, particularly for self-efficacy and behavior. Our results also indicated that strategic interventions are necessary to improve dietary behaviors regarding fruit and vegetable consumptions among elementary school students.

Serum Coenzyme Q10, α-Tocopherol, γ-Tocopherol, and C-Reactive Protein Levels and Body Mass Index in Adolescent and Premenopausal Females

Objective: Lipid-soluble antioxidants are associated with a lower incidence for many chronic diseases of aging, possibly by preventing damage from chronic inflammation. In the current study, we compared serum levels of coenzyme Q10 (CoQ10), α-tocopherol, γ-tocopherol, and C-reactive protein (CRP) between adolescent girls and premenopausal women to assess changes from childhood to midlife. Methods: Baseline serum CoQ10, α-tocopherol, γ-tocopherol, and CRP levels were measured in 207 girls (13–19 years) and 183 premenopausal women (34–47 years) using standard methods and the 2 age groups were compared by t test. The influence of age, body mass index (BMI), and race/ethnicity and interaction effects on serum values were assessed using analysis of covariance. Pearson correlation coefficients were used to assess associations between pairs of lipid micronutrients. Results: Overall, adolescent girls had significantly lower mean serum CoQ10, α-tocopherol, γ-tocopherol, and CRP levels relative to premenopausal women (CoQ10: 376 vs 544 ng/mL, p < 0.0001; α-tocopherol: 6.9 vs 13.5 μg/mL, p < 0.0001; γ-tocopherol: 1.3 vs 1.7 μg/mL, p < 0.0001; CRP: 1.29 vs 2.13 mg/L, p < 0.0001). The differences in CoQ10 and tocopherols remained significant after adjustment for BMI and race/ethnicity. CoQ10 was significantly and positively correlated to α- and γ-tocopherol, and BMI was positively associated with CRP and γ-tocopherol in both groups. Conclusions: Lower serum CoQ10, α-tocopherol, γ-tocopherol, and CRP levels in adolescent girls compared to women suggests that adolescents may have a reduced need for antioxidants possibly due to their lower BMI and inflammatory status as indicated by CRP.

A Qualitative Phenomenological Exploration of Teachers' Experience With Nutrition Education

Background: Nutrition education delivered by classroom teachers has become a popular intervention designed to combat childhood obesity. However, few qualitative studies have explored nutrition education with teachers Purpose: The purpose of this study was to explore how elementary teachers describe their experience with nutrition education. Methods: A qualitative phenomenological approach was used. Semistructured interviews, observations, and document analysis were conducted with 10 teachers who delivered nutrition education in their classrooms. Inductive coding was used to determine invariant constituents, reduce constituents to categories, and cluster categories into themes. Reliability and validity were accomplished through intercoder agreement, audio recording, triangulation, bracketing, and member checking. Results: Results identified 5 core themes related to roles teachers play in nutrition education, the importance placed upon nutrition, motivation for supplementary activities, barriers, and a triadic relationship between students, teachers, and curriculum. Discussion: Findings reveal interactions within the nutrition education experience in which teachers balance barriers with their value of nutrition education and motivation to help students make healthy choices. Translation to Health Education Practice: Health educators should work with classroom teachers at the program design, implementation, and evaluation stages of curriculum development to better address needs and facilitate the delivery of high-quality nutrition education for students.

Associations of the Home Food Environment with Eating Behaviors and Weight Status among Children and Adolescents

Primary objective: Understanding the aspects of the home food environment of children and adolescents such as the availability, accessibility, and visibility of home healthy and unhealthy foods and the frequency and quality of family meals is necessary for developing direct interventions for weight management. This review examined the literature on associations of home food environment including availability, accessibility, and visibility of home healthy and unhealthy foods and frequency and quality of family meals with children’s eating behaviors and weight status and methods to assess the availability and accessibility of foods in the home. Main outcomes and results: Research suggests:1) the availability and/or accessibility of home healthy or unhealthy foods were associated with children or adolescents’ dietary intakes; 2) the link between home food availability and accessibility with weight status is weak; 3) the evidence on associations of frequency or nutritional quality of family meals with weight status is inconsistent; 4) the in-home assessments for food availability, accessibility and visibility appear to be necessary; however the assessment tools may need to be further improved to capture the quantity of the healthy and unhealthy foods in the home; and 5) repeated in-home assessments are needed to help determine the stability of foods routinely purchased at home. Conclusions: The obesogenic home environment is complex. This review aims to provide valuable insights for designing direct interventions for weight management in children and adolescents by improving their home food environment.

Dietary Red and Processed Meat Intake and Markers of Adiposity and Inflammation: The Multiethnic Cohort Study

ABSTRACT Objective: The potential influence of dietary factors on inflammation is important for cancer prevention. Utilizing data from control participants (312 men, 911 women) in 2 nested case–control studies of cancer within the Multiethnic Cohort, we examined the associations of red and processed meat intake with serum levels of leptin, adiponectin, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 and the mediator effect of body mass index (BMI) on the above associations (if present). Methods: Multivariable linear models were applied to assess the association between red and processed meat intake at cohort entry and serum biomarker levels measured 9.1 years later after adjusting for covariates and to determine the mediator effect of BMI. Results: Overall red and processed meat intake was positively associated with serum leptin levels in men (β = 0.180, p = 0.0004) and women (β = 0.167, p < 0.0001). In women, higher red and processed meat consumption was significantly associated with higher CRP (β = 0.069, p = 0.03) and lower adiponectin levels (β = −0.082, p = 0.005). In mediation analyses with red and processed meat intake and BMI as predictors, the associations of red and processed meat with biomarkers decreased substantially (as indicated by percentage change in effect: leptin in men, 13.4%; leptin in women, 13.7%; adiponectin in women, −4.7%; CRP in women, 7.4%) and were no longer significant (p > 0.05), whereas BMI remained significantly associated with serum leptin (men: β = 3.209, p < 0.0001; women: β = 2.891, p < 0.0001), adiponectin (women: β = −1.085, p < 0.0001), and CRP (women: β = 1.581, p < 0.0001). Conclusion: The current data suggest that the amount of excess body weight or the degree of adiposity may mediate the relations between dietary red and processed meat intake and serum biomarkers associated with obesity and inflammation.

Parental Views of Promoting Fruit and Vegetable Intake Among Overweight Preschoolers and School-Aged Children

Given the importance of parental influence on children’s eating habits, we explored perceptions of parents of overweight (body mass index–for-age percentile ≥85%) preschoolers (3-5 years) and overweight school-aged children (6-12 years) regarding challenges in promoting fruit and vegetable intake and how they and other family members influence their overweight children’s dietary habits. Focus groups were conducted with 13 parents of overweight preschoolers and 14 parents of overweight school-aged children. Codes and themes were developed by inductive data analysis. Four common themes were identified: short shelf life of fresh fruits and vegetables prohibiting parents from purchasing, children’s taste changes in fruits and vegetables, parents having the primary influence on children’s dietary intake, and wanting fruits and vegetables “ready to go.” Parents of school-aged children were more concerned about their children’s weight, and extended family members negatively influenced children’s dietary intake compared with parents of preschoolers. Our findings provide valuable insight for nutrition/health educators when developing family-based interventions for weight management.