Yen Li Chu

Involvement in home meal preparation is associated with food preference and self-efficacy among Canadian children

OBJECTIVE To examine the association between frequency of assisting with home meal preparation and fruit and vegetable preference and self-efficacy for making healthier food choices among grade 5 children in Alberta, Canada. DESIGN A cross-sectional survey design was used. Children were asked how often they helped prepare food at home and rated their preference for twelve fruits and vegetables on a 3-point Likert-type scale. Self-efficacy was measured with six items on a 4-point Likert-type scale asking children their level of confidence in selecting and eating healthy foods at home and at school. SETTING Schools (n =151) located in Alberta, Canada. SUBJECTS Grade 5 students (n = 3398). RESULTS A large majority (83-93 %) of the study children reported helping in home meal preparation at least once monthly. Higher frequency of helping prepare and cook food at home was associated with higher fruit and vegetable preference and with higher self-efficacy for selecting and eating healthy foods. CONCLUSIONS Encouraging children to be more involved in home meal preparation could be an effective health promotion strategy. These findings suggest that the incorporation of activities teaching children how to prepare simple and healthy meals in health promotion programmes could potentially lead to improvement in dietary habits.

Involvement in Meal Preparation at Home Is Associated With Better Diet Quality Among Canadian Children

OBJECTIVE To examine the associations between home meal preparation involvement with diet quality and food group intake among children. METHODS Grade 5 children aged 10-11 years (n = 3,398) were surveyed. Food intake was measured using the Harvard Youth/Adolescent Food Frequency Questionnaire, and diet quality was measured using the Diet Quality Index-International. Random effects regression models with children nested within schools were used to test for associations. RESULTS Higher frequency of involvement in home meal preparation was associated with higher Diet Quality Index-International scores. Children who were involved in meal preparation daily ate 1 more serving/d of vegetables and fruit compared with children who never helped (P < .001). Similar significant differences, although small, were observed for intake of the other food groups. CONCLUSIONS AND IMPLICATIONS Children who were more involved in home meal preparation also consumed healthier diets. Encouraging parents to involve their children in meal preparation could be a viable health promotion strategy.

Are sleep duration and sleep quality associated with diet quality, physical activity, and body weight status? A population-based study of Canadian children

ObjectivesTo describe sleep duration and sleep characteristics, and to examine the associations between sleep duration and characteristics and body weight status, diet quality, and physical activity levels among grade 5 children in Nova Scotia.MethodsA provincially representative sample of 5,560 grade 5 children and their parents in Nova Scotia was surveyed. Parents were asked to report their child’s bedtime and wake-up time, and to indicate how often their child snored or felt sleepy during the day. Dietary intake and physical activity were self-reported by children using the Harvard Youth/Adolescent Food Frequency Questionnaire and the Physical Activity Questionnaire for Children respectively. Body weight status was determined using measured heights and weights. Linear and logistic random effects models with children nested within schools were used to test for associations.ResultsApproximately half of the surveyed parents reported that their children were not getting adequate sleep at night. Longer sleep duration was statistically significantly associated with decreased risk for overweight and obesity independent of other sleep characteristics (OR = 0.82, 95% CI: 0.73, 0.91). Longer sleep duration was also associated with better diet quality and higher levels of physical activity.ConclusionsThese findings indicate a need for health promotion strategies to encourage adequate sleep and to promote healthy sleep environments among children. Given the links among sleep, body weight status and lifestyle behaviours, these messages should be included in public health interventions aimed at preventing obesity and promoting health among children.RésuméObjectifsDécrire la durée et les caractéristiques du sommeil, et examiner les associations entre la durée et les caractéristiques du sommeil, d’une part, et le statut pondéral, la qualité du régime alimentaire et les niveaux d’activité physique, d’autre part, chez les élèves de 5e année en Nouvelle-Écosse.MéthodeNous avons sondé un échantillon provincial représentatif de 5 560 élèves de 5e année et leurs parents en Nouvelle-Écosse. Nous avons demandé aux parents d’inscrire l’heure du coucher et du lever de leur enfant et d’indiquer combien souvent leur enfant ronflait ou se sentait fatigué durant la journée. L’apport alimentaire et l’activité physique ont été autodéclarés par les enfants à l’aide des questionnaires Harvard Youth/Adolescent Food Frequency et Physical Activity Questionnaire for Children, respectivement. Nous avons déterminé le statut pondéral à l’aide de la taille et du poids mesurés. Des modèles linéaires et logistiques à effets aléatoires, avec les données des enfants emboîtées dans celles des écoles, ont servi à tester les associations.RésultatsEnviron la moitié des parents sondés ont déclaré que leurs enfants ne dormaient pas suffisamment la nuit. Un sommeil plus long présentait une corrélation statistiquement significative avec un risque réduit de surpoids et d’obésité, indépendamment des autres caractéristiques du sommeil (RC = 0,82, IC de 95 %: 0,73, 0,91). Un sommeil plus long était également associé à un régime alimentaire de meilleure qualité et à des niveaux d’activité physique supérieurs.ConclusionsIl faudrait des stratégies de promotion de la santé qui encouragent un sommeil suffisant et de sains environnements de sommeil chez les enfants. Étant donné les liens entre le sommeil, le statut pondéral et les comportements liés au mode de vie, de tels messages devraient être inclus dans les interventions de santé publique visant à prévenir l’obésité et à promouvoir la santé chez les enfants.

Time spent in home meal preparation affects energy and food group intakes among midlife women.

Time spent in meal preparation may be indicative of the healthfulness of meals and therefore with weight status. The purpose of this study was to examine the association between amount of time spent preparing meals and meal food group and nutrient content by meal occasion (breakfast, lunch, and dinner) among 1036 midlife women. Participants completed a 1-day food record and eating occasion questionnaires for each meal occasion. ANCOVA was used to identify possible associations. Approximately half of the participants reported spending <5 min preparing breakfast and lunch, and <20 min preparing dinner. Less time spent preparing breakfast was associated with lower energy and fat intakes (p<0.0001), while less time spent preparing lunch and dinner was associated with lower vegetable and sodium intakes (p<0.0001). There were no apparent differences in the association between time spent preparing meals and meal content by weight status. Nutrition education should encourage home meal preparation while stressing the selection of healthier options. The differing associations by meal occasion suggest that interventions should be tailored according to meal type.

Acceptance of Two US Department of Agriculture Commodity Whole-Grain Products: A School-Based Study in Texas and Minnesota

Whole-grain intake among children and adolescents is below national recommendations, prompting efforts to increase intake in schools. The purpose of this study was to compare the acceptance of whole-grain pancakes and tortillas to refined grain counterparts when served as part of the school meal. Data were collected at 10 schools in Minnesota and seven schools in Texas during the Spring and Fall semesters of 2009. Three pancake and two tortilla products of varying red or white whole-wheat flour content were each served an average of four times per school. Aggregate plate waste was collected and percent consumption used to assess acceptance. Students rated each product on overall liking, taste, color, and softness on 5-point (elementary schools) or 9-point hedonic scales (middle and high schools). Analysis of covariance was used to compare intake and rating scores of all products. For all children, intake of whole-grain products was substantial (percent consumption ranging from 67% to 75%). No differences were noted in consumption of whole-wheat pancakes compared to refined wheat pancakes, while consumption of whole-wheat tortillas was lower than refined products. In elementary schools, overall liking scores of pancakes made with red whole-wheat and both types of whole-wheat tortillas were lower than refined products. However, in middle and high schools, overall liking scores of 100% red whole-wheat pancakes and 66% white whole-wheat tortillas were similar to refined products. Substituting refined grain with whole-grain options represents a viable approach to increasing consumption of whole-grain products in schools.

School Foodservice Personnel's Struggle with Using Labels to Identify Whole-Grain Foods.

OBJECTIVE To describe how school foodservice personnel use current labeling methods to identify whole-grain products and the influence on purchasing for school meals. METHODS Focus groups explored labeling methods to identify whole-grain products and barriers to incorporating whole-grain foods in school meals. Qualitative analysis procedures and the constant comparative method were used to analyze data. RESULTS Participants were school foodservice personnel (n = 67) in 5 states across the United States. Limited ability and confidence were demonstrated in identifying whole-grain products from label information, statements, and claims. Participants indicated a need for a uniform labeling method such as whole-grain content to assist in ordering and purchasing. High cost and low acceptability were listed as barriers to incorporating whole-grain foods in school meals. CONCLUSIONS AND IMPLICATIONS Whole-grain product labeling should be improved to enhance understanding by foodservice personnel so that whole grains are included in school meals.

Fruit and vegetable preferences and intake among children in Alberta.

PURPOSE The association between preference for and intake of fruits and vegetables was examined among Albertan children. METHODS Data used were collected as part of a provincial population-based survey among grade 5 children in Alberta. Intake of two fruits and five vegetables was assessed using the Harvard food frequency questionnaire, and preference for individual fruit and vegetable items was rated using a three-point Likert-type scale. Random effects models with children nested within schools were used to test for associations between fruit and vegetable preference and intake. RESULTS A total of 3398 children aged 10 to 11 years returned completed surveys. Children who reported a greater liking for fruits and vegetables also reported significantly (p<0.001) higher intake. On average, children who liked a food a lot ate 0.5 to 2.7 more weekly servings of the food than did children who did not like the food. CONCLUSIONS These findings suggest that focusing on interventions designed to increase taste preference may lead to increased fruit and vegetable intake among children. Introducing children to unfamiliar fruits and vegetables through taste testing may be an effective and practical health promotion approach for improving dietary habits.

A Qualitative Study to Explore How Parental Expectations and Rules Influence Beverage Choices in Early Adolescence

OBJECTIVE To understand parent beverage expectations for early adolescents (EAs) by eating occasion at home and in various settings. METHODS Descriptive study using focus group interviews and the constant comparative method for qualitative data analysis. RESULTS Six focus groups were completed, and 2 were conducted in Spanish. Participants (n = 49) were mostly female (86%) and non-Hispanic white (49%) and Hispanic (33%). Parent expectations for EA beverage intake were based on health beliefs, EA preferences, and cost, whereas those related to portion sizes and frequency varied by beverage type. Parents managed beverage expectations at home and away from home by making healthful beverages available and accessible, or by offering or allowing only specific beverages. CONCLUSIONS AND IMPLICATIONS Results from this qualitative study involving a small sample of parents showed that expectations were influenced by practical concerns and managed primarily through availability practices. These issues could be addressed to improve EA beverage consumption.

Leadership skills are associated with health behaviours among Canadian children

Life skills development is a core area for action in the Ottawa Charter for Health Promotion. The role of life skills in influencing health behaviours among children has received little attention in research. The purpose of this cross-sectional study was to investigate the relationship between self-leadership, as a model of life skills, and diet quality, physical activity, sleep duration and body weight. A provincially representative sample of 2328 grade 5 students (aged 10-11 years) was surveyed in Alberta, Canada. Self-leadership skills were assessed based on student responses indicating frequency of performing various leadership traits. Diet quality was based on responses to the Harvard Youth/Adolescent Food Frequency Questionnaire and physical activity on responses to the Physical Activity Questionnaire for Children. Sleep duration was assessed based on parent survey responses, and body mass index determined based on measured height and weight. Random effects regression models with children nested within schools were used to determine the associations. Higher self-leadership was associated with better diet quality (P < 0.01) and more physical activity (P < 0.01). Although not statistically significant, higher self-leadership was suggestive of healthier body weight status (OR = 0.91, 95% CI = 0.66, 1.27). No association of self-leadership with sleep duration was found. The incorporation of leadership skill development may enhance the effectiveness of school-based health promotion programs. This study reinforces the importance of leadership skill promotion in the promotion of healthy eating and active living, which may help curb the obesity epidemic in the short term, and prevention of chronic diseases and mounting healthcare costs in the long term.

Is it nutrients, food items, diet quality or eating behaviours that are responsible for the association of children's diet with sleep?

Both diet quality and sleep duration of children have declined in the past decades. Several studies have suggested that diet and sleep are associated; however, it is not established which aspects of the diet are responsible for this association. Is it nutrients, food items, diet quality or eating behaviours? We surveyed 2261 grade 5 children on their dietary intake and eating behaviours, and their parents on their sleep duration and sleep quality. We performed factor analysis to identify and quantify the essential factors among 57 nutrients, 132 food items and 19 eating behaviours. We considered these essential factors along with a diet quality score in multivariate regression analyses to assess their independent associations with sleep. Nutrients, food items and diet quality did not exhibit independent associations with sleep, whereas two groupings of eating behaviours did. ‘Unhealthy eating habits and environments’ was independently associated with sleep. For each standard deviation increase in their factor score, children had 6 min less sleep and were 12% less likely to have sleep of good quality. ‘Snacking between meals and after supper’ was independently associated with sleep quality. For each standard deviation increase in its factor score, children were 7% less likely to have good quality sleep. This study demonstrates that eating behaviours are responsible for the associations of diet with sleep among children. Health promotion programmes aiming to improve sleep should therefore focus on discouraging eating behaviours such as eating alone or in front of the TV, and snacking between meals and after supper.