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INTRODUCTION: Food Parenting Practices (FPPs) include the practices parents use in the act of feeding their children, which may further influence their health. OBJECTIVES: To assess associations between changes in FPPs (permissiveness, food availability, guided choices, water encouragement, rules and limits and the use of food as reward) over 1 year and dietary intake (water, energy-dense/nutrient-poor and nutrient-dense foods) at follow-up in 4- to 6-year-old preschool-aged children. METHODS: Longitudinal data from the control group of the ToyBox study, a cluster-randomized controlled intervention study, was used (NCT02116296). Multilevel ordinal logistic regression analyses including FPP as the independent variables and dietary intake as outcome. RESULTS: Nine hundred sixty-four parent-child dyads (50.5% boys and 95.0% mothers) were included. Limited changes on the use of FPPs were observed over time. Nevertheless, in boys, often having F&V at home was associated with higher F&V consumption (OR = 6.92 [1.58; 30.38]), and increasing home availability of F&V was directly associated with higher water consumption (OR = 7.62 [1.63; 35.62]). Also, not having sweets or salty snacks available at home was associated with lower consumption of desserts (OR = 4.34 [1.75; 10.75]). In girls, having F&V availability was associated with higher F&V consumption (OR = 6.72 [1.52; 29.70]) and lower salty snack consumption (OR = 3.26 [1.50; 7.10]) and never having soft drinks at home was associated with lower consumption of sweets (OR = 7.89 [6.32; 9.86]). Also, never being permissive about soft drink consumption was associated with lower soft drink consumption (OR = 4.09 [2.44; 6.85]). CONCLUSION: Using favorable FPPs and avoiding the negative ones is prospectively associated with healthier dietary intake, especially of F&V, and less intake of soft drinks, desserts, and salty snacks.
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Dieta , Responsabilidad Parental , Humanos , Masculino , Femenino , Preescolar , Estudios Longitudinales , Dieta/estadística & datos numéricos , Dieta/métodos , Niño , Conducta Alimentaria/psicología , Relaciones Padres-HijoRESUMEN
Snacking outside main meals may contribute to the high intakes of discretionary foods (i.e., unhealthful foods) among young adults. This study assessed the snacking behaviours of Australian young adults including the contribution of snacking to energy and nutrient intakes, the main foods consumed, and portion sizes. A secondary analysis of the MYMeals study of adults aged 18-30 years who consumed at least one snack food during the recording period (n = 889) was conducted. All food consumed over 3 consecutive days was recorded using a purpose-designed smartphone app. Snack foods contributed 13.2% of energy, 23.4% of total sugars, and 16.2% of saturated fat. Females consumed more energy (13.8% vs. 12.2%, p = 0.007) and total sugars (25.8% vs. 20.8%, p = 0.009), from snacking than males. Fruit (20.2%), chocolate (9.9%), cake-type desserts (8.4%), sweet biscuits (6.1%), and ice-cream-type desserts (5.6%) were the most frequently consumed snacks by young adults. The median portion sizes for the top five snack foods consumed were fruit-106 g (IQR: 73), chocolate-26 g (IQR: 36), cake-95 g (IQR: 88), sweet biscuits-26 g (IQR: 29), and ice cream-75 g (IQR: 42). The current findings may inform population-wide strategies to encourage healthful snacks such as fruit, inform portion control by individuals, and persuade the food industry to reduce the serving size of discretionary snack foods such as cake.
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Comidas , Bocadillos , Masculino , Femenino , Humanos , Adulto Joven , Estudios Transversales , Australia , Conducta Alimentaria , Azúcares , Ingestión de Energía , DietaRESUMEN
There is a growing interest in the effects of ultra-processed/energy-dense nutrient-poor foods on health outcomes, and few interventions to reduce their consumption have been tested. We tested a simple intervention to help people reduce the indulgences they consume (energy-dense nutrient-poor (EDNP) foods). Herein, we report the qualitative findings to understand how participants reduced their consumption by exploring intervention fidelity and the factors affecting consumption. We conducted a qualitative descriptive study of 23 adults who had taken part in a feasibility randomised controlled trial that asked participants to say no to seven indulgences/week and record what they said no to. Data were collected using face-to-face semi-structured interviews and analysed thematically. A total of 23 adults with an average BMI of 30.8 kg/m2 took part. Participants liked the term indulgence, as they could apply it to their normal dietary intake and make small changes. They found self-monitoring what they said no to helpful and reported that emotional eating and habits affected consumption. They had difficulty overcoming these. As most people are consuming too many foods that are EDNP, this simple intervention of "Say No" seven times/week has the potential to be developed as a public health campaign.
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Bebidas , Alimentos , Adulto , Humanos , Estudios de Factibilidad , Ingestión de Alimentos , NutrientesRESUMEN
Daily routines may influence children and adolescents' eating patterns, however the influence of days of the week on dietary intake has rarely been explored. This study aimed to examine discretionary choices intake in the context of diet quality on weekdays versus weekends. A secondary analysis was conducted using the Australian National Nutrition and Physical Activity Survey 2011-2012. Differences in discretionary choices intake and diet quality on weekdays versus weekends, were examined using ANCOVA analyses. Associations between child and parent-proxy characteristics and weekday/weekend discretionary choices intake were examined using multivariable regression models. Primary analyses included 2584 Australian 2-17-year-olds. There were small differences in discretionary choices intake and diet quality between weekdays and weekends in all age subgroups. Compared to weekdays, intakes on weekends were characterized by a higher intake of discretionary choices, and lower total Dietary Guidelines Index for Children and Adolescents (DGI-CA) scores across the age subgroups (all p < 0.01). Parent-proxy discretionary choices intake and child age were predictors of weekday and weekend discretionary choices intake. Parent-proxy obesity weight status compared with healthy weight status was a predictor of weekend intake, while parent-proxy education level was a predictor of weekday discretionary choices intake. Future intervention strategies should target discretionary choices intake on both weekdays and weekends.
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Conducta del Adolescente , Conducta Infantil , Dieta , Preferencias Alimentarias , Conductas Relacionadas con la Salud , Adolescente , Factores de Edad , Análisis de Varianza , Australia , Niño , Preescolar , Conducta de Elección , Dieta/normas , Encuestas sobre Dietas , Ingestión de Alimentos , Escolaridad , Ejercicio Físico , Conducta Alimentaria , Femenino , Humanos , Masculino , Política Nutricional , Obesidad , PadresRESUMEN
OBJECTIVE: School food intake of Australian children is not comprehensively described in literature, with limited temporal, nationally representative data. Greater understanding of intake at school can inform school-based nutrition promotion. This study aimed to describe the dietary intake of primary-aged children during school hours and its contribution to daily intake. DESIGN: This secondary analysis used nationally representative, cross-sectional data from the 2011 to 2012 National Nutrition and Physical Activity Survey. Dietary intake was assessed using validated 24-h dietary recalls on school days. Descriptive statistics were undertaken to determine energy, nutrients, food groups and food products consumed during school hours, as well as their contributions to total daily intake. Associations between school food intake and socio-demographic characteristics were explored. SETTING: Australia. PARTICIPANTS: Seven hundred and ninety-five children aged 5-12 years. RESULTS: Children consumed 37 % of their daily energy and 31-43 % of select nutrient intake during school hours, with discretionary choices contributing 44 % of school energy intake. Most children consumed less than one serve of vegetables, meat and alternatives or milk and alternatives during school hours. Commonly consumed products were discretionary choices (34 %, including biscuits, processed meat), bread (17 %) and fruit (12 %). There were limited associations with socio-economic position variables, apart from child age. CONCLUSIONS: Children's diets were not aligned with national recommendations, with school food characterised by high intake of discretionary choices. These findings are consistent with previous Australian evidence and support transformation of the Australian school food system to better align school food consumption with recommendations.
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Ingestión de Alimentos , Ingestión de Energía , Anciano , Australia , Niño , Preescolar , Estudios Transversales , Dieta , Ejercicio Físico , Humanos , Encuestas Nutricionales , VerdurasRESUMEN
In January 2014, taxes on sugar-sweetened beverages and nonessential energy-dense food were implemented in Mexico to discourage the consumption of these products. Published evaluations have shown reductions in purchases of taxed food and beverages associated with the implementation of this fiscal policy. Although there are some studies on the impact on health based on simulation studies, no evaluations with empirical data on changes in oral health have been published. We used administrative records and data from an epidemiological surveillance system to estimate changes in (1) outpatient visits related to dental caries; (2) having experienced dental caries: Decayed, Missing and Filled Teeth (DMFT) >0 for permanent dentition or dmft >0 for primary dentition (dmft); (3) number of teeth with caries experience (DMFT and dmft), (4) cases with DMFT >0 or dmft >0, and (5) the series of mean DMFT or dmft, associated with the taxes. We estimated probit and negative binomial models for outcomes at individual level, and interrupted time series analysis for population-level outcomes. The implementation of the taxes was associated with negative changes in the trends of outpatient visits, as well as for cases with DMFT >0, dmft >0 and mean DMFT. Taxes were also associated with a lower probability of having experienced dental caries and with a lower number of teeth with caries experience in the samples studied. Our results suggest positive impacts of the implementation of taxes on unhealthy food and beverages in the oral health of Mexicans, which are the first health benefits observed, and add to the health benefits predicted by modeling studies.
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Caries Dental , Salud Bucal , Bebidas/efectos adversos , Índice CPO , Caries Dental/epidemiología , Caries Dental/etiología , Caries Dental/prevención & control , Humanos , México/epidemiología , ImpuestosRESUMEN
The single-serve packaging of discretionary foods is becoming increasingly popular, but evidence is limited on whether smaller package sizes can reduce food intake. The aim of this scoping review is to assess the effect of reducing the package size of energy-dense, nutrient-poor (EDNP) snacks and drinks on consumption, intentions, and perception, and to examine the effects of potential moderators or mediators. The search was conducted in six selected databases and grey literature sources, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for the scoping review process (PRISMA-ScR) guidelines. After screening 5562 articles, 30 articles comprising 47 intervention studies were included. Twelve of 15 studies found a significant effect in lowering the actual or intended consumption when a single smaller package was offered compared with a single larger package. When the total serving size was held constant between varying package conditions, such as a multipack, single package, or unpackaged, the results on the actual and intended consumption were inconsistent and varied according to the presence of moderators. Overall, these findings suggest that an overall reduction in the size of a single package is a more promising strategy than providing multipacks to reduce consumption. Changes to the current food environment to promote single smaller packages of EDNP snacks and drinks are necessary to support the better selection of appropriate portion sizes and reduce consumption.
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Comportamiento del Consumidor , Embalaje de Alimentos , Preferencias Alimentarias , Tamaño de la Porción , Tamaño de la Porción de Referencia , Consumo de Bebidas Alcohólicas , Bebidas , Ingestión de Energía , Humanos , Intención , Valor Nutritivo , Obesidad/prevención & control , Percepción , Ensayos Clínicos Controlados Aleatorios como Asunto , BocadillosRESUMEN
BACKGROUND: To help address rising rates of obesity in children, evidence is needed concerning impacts of common forms of marketing for unhealthy child-oriented food products and the efficacy of educational interventions in counteracting any detrimental impacts of such marketing. This study aims to explore parents' responses to advertising for unhealthy children's food products that employ different types of persuasive appeals and test whether a counter-advertising intervention exposing industry motives and marketing strategies can bolster parents' resistance to influence by unhealthy product advertising. METHODS: N = 1613 Australian parents were randomly assigned to view online either a: (A) non-food ad (control); (B) conventional confectionery ad (highlighting sensory benefits of the product); (C) pseudo-healthy confectionery ad (promoting sensory benefits and health attributes of the product); (D) conventional confectionery ad + counter-ad (employing inoculation-style messaging and narrative communication elements); (E) pseudo-healthy confectionery ad + counter-ad. Parents then viewed various snacks, including those promoted in the food ads and counter-ad. Parents nominated their preferred product, then rated the products. RESULTS: Exposure to the conventional confectionery ad increased parents' preference for the advertised product, enhanced perceptions of the product's healthiness and reduced sugar content and boosted brand attitude. Exposure to the pseudo-healthy confectionery ad increased parents' preference for the advertised product, and enhanced perceptions of healthiness, fibre content and lower sugar content. The counter-ad diminished, but did not eliminate, product ad effects on parents' purchasing preference, product perceptions and brand attitudes. The counter-ad also prompted parents to perceive processed foods as less healthy, higher in sugar and lower in fibre and may have increased support for advertising regulation. CONCLUSIONS: Exposure to unhealthy product advertising promoted favourable perceptions of products and increased preferences for advertised products among parents. Counter-advertising interventions may bolster parents' resistance to persuasion by unhealthy product advertising and empower parents to more accurately evaluate advertised food products.
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Publicidad/métodos , Alimentos/efectos adversos , Padres/psicología , Obesidad Infantil/prevención & control , Comunicación Persuasiva , Adulto , Australia/epidemiología , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad Infantil/epidemiologíaRESUMEN
OBJECTIVE: To assess the consumption of sugar-sweetened beverages (SSB) and other energy-dense nutrient-poor (EDNP) foods in two Southern low-income communities targeted by the Balance Calories Initiative, a campaign by the top-three American beverage companies intended to reduce the consumption of sugary beverages by 20 % over 10 years. DESIGN: We conducted self-administered intercept surveys in front of food retail outlets between August and November 2016. We recruited adults with children <18 years living at home and adolescents aged 10-17 years with parental consent. SETTING: Retail food outlets in Mississippi and Alabama, USA. PARTICIPANTS: Adults (n 11 311) and adolescents (n 3460). RESULTS: The percentage of high SSB consumers (≥4 servings/d) was 40·9 % among adult males, 32·3 % among adult females, 43·0 % among adolescent males and 34·4 % among adolescent females (male - female difference, P < 0·0001). In aggregate, respondents also reported consuming a mean of 3 servings of salty snacks, cookies and/or candy in the past 24 h, with adolescent males reporting 4 servings. CONCLUSIONS: SSB should be a primary target of future interventions to improve dietary intake, but EDNP foods likely contribute as many daily kilojoules as SSB among this population. Future campaigns should aim to limit the consumption of all EDNP foods.
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Comportamiento del Consumidor , Dieta/estadística & datos numéricos , Conducta Alimentaria , Pobreza/estadística & datos numéricos , Bebidas Azucaradas/estadística & datos numéricos , Adolescente , Adulto , Alabama , Niño , Dieta/psicología , Ingestión de Energía , Femenino , Industria de Alimentos/legislación & jurisprudencia , Promoción de la Salud , Humanos , Masculino , Mercadotecnía/métodos , Mississippi , Nutrientes/análisis , Política Nutricional , Pobreza/psicologíaRESUMEN
In 2014, an 8% tax on energy-dense nutrient-poor foods was implemented in Mexico with the aim of reducing its consumption. This paper estimated changes in household purchases of taxed food. We used the latest five waves of the nationally representative Mexican Income and Expenditure Survey (2008, 2010, 2012, 2014 and 2016). The analytic sample comprises 154,777 households. We estimated changes in purchases based on a before and after comparison. Results show a reduction in purchases of taxed food of -5.4â¯g/week per capita, equivalent to a relative reduction of -5.3% in the 2014 and 2016 waves compared to the 2008, 2010 and 2012 rounds. The largest relative reductions were in urban areas (-6.9%), among households with children (-7.0%), households where the head had an intermediate educational level (-9.9%) and the southern region (-14.8%). We did not find a significant reduction in rural areas. While there is a large heterogeneity, the fiscal instrument has been effective in reducing taxed food purchases and has generated substantial revenue that could be used to finance policies for the prevention and treatment of obesity.
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Comercio/estadística & datos numéricos , Comportamiento del Consumidor/economía , Ingestión de Energía , Composición Familiar , Alimentos/economía , Impuestos/economía , Adolescente , Adulto , Pan/estadística & datos numéricos , Dulces/estadística & datos numéricos , Niño , Preescolar , Comercio/tendencias , Femenino , Alimentos/estadística & datos numéricos , Humanos , Renta/estadística & datos numéricos , Lactante , Masculino , México , Nutrientes , Obesidad/prevención & control , Encuestas y Cuestionarios , Edulcorantes/administración & dosificación , Edulcorantes/economía , Impuestos/legislación & jurisprudenciaRESUMEN
This study aimed to examine the changes in typical portion sizes of commonly consumed discretionary foods among Australian adults from 1995 to 2011-2012. Data of adults (age ≥19 years) from the 1995 Australian National Nutrition Survey and 2011-2012 National Nutrition and Physical Activity Survey were used. Typical portion sizes (median portion) of fourteen discretionary foods that contributed the most to energy intake were determined. Ten out of fourteen food categories demonstrated a significant change in kJ per typical portion from 1995 to 2011-2012 (p ≤ 0.001). kJ per typical portion increased for pizza, cake, sausage, cereal bar, processed meat, ice cream and wine, with pizza and cake demonstrating the largest increases (+570 kJ and +950 kJ in 2011-2012, respectively; both +66% above 1995). In contrast, kJ per typical portion of pastry, snack food and potato fries decreased by 10-40% over time, and did not change for biscuit, chocolate, sugar-sweetened beverage and beer. Similar changes were observed for grams per typical portion consumed. Temporal trends in typical portion sizes were similar according to age group, gender and socioeconomic status. The findings suggest that population-wide strategies that enable consumers to choose smaller portions of discretionary foods are needed to reduce the excess consumption of these products.
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Dieta , Encuestas Nutricionales , Tamaño de la Porción/tendencias , Adulto , Anciano , Australia , Bebidas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación Nutricional , Estado Nutricional , Valor Nutritivo , Bocadillos , Factores Socioeconómicos , Adulto JovenRESUMEN
BACKGROUND: The ubiquitous supply of junk foods in our food environment has been partly blamed for the increased rates in overweight and obesity. However, consumption of these foods has generally been examined individually perhaps obscuring the true extent of their combined consumption and impact on health. An overall measure of children's junk food consumption may prove useful in the development of child obesity prevention strategies. We describe the development of a children's Junk Food Intake Measure (JFIM) to summarise temporal change in junk food consumption and examine the association between the JFIM and health-related behaviours. METHODS: Cross-sectional population surveillance survey of Australian children age 5-16 years collected in 2010 and 2015. Data were collected by questionnaire with parent's proxy reporting for children in years K, 2 and 4 and children in years 6, 8 and 10 by self-report. Information on diet, screen-time and physical activity was collected using validated questionnaires. The JFIM comprised consumption of fried potato products, potato crisps/salty snacks, sweet and savoury biscuits/cakes/doughnuts, confectionary and, ice cream/ice blocks. RESULTS: A total of 7565 (missing = 493, 6.1%) and 6944 (missing n = 611, 8.1%) children had complete data on consumption of junk foods, in 2010 and 2015, respectively. The 2015 survey data showed that among students from high socio-economic status neighbourhoods, there were fewer high junk food consumers than low junk food consumers. Children from Middle Eastern cultural backgrounds had higher junk food consumption. High junk food consumers were more likely to consume take-away ≥3/week, eat dinner in front of the television, receive sweet rewards, be allowed to consume snacks anytime, have soft drinks available at home and a TV in their bedroom. There was a lower proportion of high junk food consumers in 2015 compared to 2010. CONCLUSION: This is the first study to provide and examine a summary measure of overall junk food consumption among Australian children. The results indicate that junk food consumption among Australian children is lower in 2015, compared with 2010. Still, the public health workforce must continue their efforts as levels of junk food consumption remain of concern among Australian children.
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Conducta Alimentaria , Preferencias Alimentarias , Obesidad Infantil/epidemiología , Bocadillos , Adolescente , Australia/epidemiología , Niño , Servicios de Salud del Niño , Preescolar , Estudios Transversales , Ejercicio Físico , Femenino , Humanos , Masculino , Obesidad Infantil/prevención & control , Encuestas y Cuestionarios , TelevisiónRESUMEN
For nutrition practitioners and researchers, assessing dietary intake of children and adults with a high level of accuracy continues to be a challenge. Developments in mobile technologies have created a role for images in the assessment of dietary intake. The objective of this review was to examine peer-reviewed published papers covering development, evaluation and/or validation of image-assisted or image-based dietary assessment methods from December 2013 to January 2016. Images taken with handheld devices or wearable cameras have been used to assist traditional dietary assessment methods for portion size estimations made by dietitians (image-assisted methods). Image-assisted approaches can supplement either dietary records or 24-h dietary recalls. In recent years, image-based approaches integrating application technology for mobile devices have been developed (image-based methods). Image-based approaches aim at capturing all eating occasions by images as the primary record of dietary intake, and therefore follow the methodology of food records. The present paper reviews several image-assisted and image-based methods, their benefits and challenges; followed by details on an image-based mobile food record. Mobile technology offers a wide range of feasible options for dietary assessment, which are easier to incorporate into daily routines. The presented studies illustrate that image-assisted methods can improve the accuracy of conventional dietary assessment methods by adding eating occasion detail via pictures captured by an individual (dynamic images). All of the studies reduced underreporting with the help of images compared with results with traditional assessment methods. Studies with larger sample sizes are needed to better delineate attributes with regards to age of user, degree of error and cost.
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Registros de Dieta , Dieta/efectos adversos , Internet , Aplicaciones Móviles , Tamaño de la Porción , Adulto , Investigación Biomédica/métodos , Investigación Biomédica/tendencias , Teléfono Celular , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Computadoras de Mano , Congresos como Asunto , Dietética/métodos , Dietética/tendencias , Humanos , Evaluación Nutricional , Ciencias de la Nutrición/métodos , Ciencias de la Nutrición/tendencias , Fotograbar/instrumentación , Fotograbar/tendencias , Sociedades Científicas , Grabación en Video/instrumentación , Grabación en Video/tendenciasRESUMEN
BACKGROUND: Early adulthood represents the transition to independent living which is a period when changes in diet and body weight are likely to occur. This presents an ideal time for health interventions to reduce the effect of health problems and risk factors for chronic disease in later life. As young adults are high users of mobile devices, interventions that use this technology may improve engagement. The Connecting Health and Technology study aimed to evaluate the effectiveness of tailored dietary feedback and weekly text messaging to improve dietary intake of fruit, vegetables and junk food over 6 months among a population-based sample of men and women (aged 18-30 years). METHODS: A three-arm, parallel, randomized control trial was conducted. After baseline assessments, participants were randomized to one of three groups: A) dietary feedback and weekly text messages, B) dietary feedback only or C) control group. Dietary intake was assessed using a mobile food record App (mFR) where participants captured images of foods and beverages consumed over 4-days at baseline and post-intervention. The primary outcomes were changes in serves of fruits, vegetables, energy-dense nutrient-poor (EDNP) foods and sugar-sweetened beverages (SSB). The intervention effects were assessed using linear mixed effect models for change in food group serves. RESULTS: Young adults (n = 247) were randomized to group A (n = 82), group B (n = 83), or group C (n = 82). Overall, no changes in food group serves for either intervention groups were observed. An unanticipated outcome was a mean weight reduction of 1.7 kg (P = .02) among the dietary feedback only. Men who received dietary feedback only, significantly reduced their serves of EDNP foods by a mean of 1.4 serves/day (P = .02). Women who received dietary feedback only significantly reduced their intake of SSB (P = .04) by an average of 0.2 serves/day compared with controls. CONCLUSIONS: Tailored dietary feedback only resulted in a decrease in EDNP foods in men and SSB in women, together with a reduction in body weight. Using a mobile food record for dietary assessment and tailored feedback has great potential for future health promotion interventions targeting diet and weight in young adults. TRIAL REGISTRATION: Australian Clinical Trials Registry Registration number: ACTRN12612000250831 .
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Dieta , Conducta Alimentaria , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Aplicaciones Móviles , Telemedicina , Envío de Mensajes de Texto , Adulto , Australia , Retroalimentación , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
OBJECTIVE: To systematically review the literature and map published studies on 4-8-year-olds' intake of discretionary choices against an ecological framework (ANalysis Grid for Environments Linked to Obesity; ANGELO). DESIGN: Articles were identified through database searches (PubMed, PyscINFO®, Web of Science) in February and March 2014 and hand-searching reference lists. Studies were assessed for methodological quality and mapped against the ANGELO framework by environment size (macro and micro setting) and type (physical, economic, policy and socio-cultural influences). SETTING: Studies were conducted in the USA (n 18), Australia (n 6), the UK (n 3), the Netherlands (n 3), Belgium (n 1), Germany (n 1) and Turkey (n 1). SUBJECTS: Children aged 4-8 years, or parents/other caregivers. RESULTS: Thirty-three studies met the review criteria (observational n 23, interventions n 10). Home was the most frequently studied setting (67 % of exposures/strategies), with the majority of these studies targeting family policy-type influences (e.g. child feeding practices, television regulation). Few studies were undertaken in government (5·5 %) or community (11 %) settings, or examined economic-type influences (0 %). Of the intervention studies only four were categorised as effective. CONCLUSIONS: The present review is novel in its focus on mapping observational and intervention studies across a range of settings. It highlights the urgent need for high-quality research to inform interventions that directly tackle the factors influencing children's excess intake of discretionary choices. Interventions that assist in optimising a range of environmental influences will enhance the impact of future public health interventions to improve child diet quality.
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Fenómenos Fisiológicos Nutricionales Infantiles , Dieta , Conducta Alimentaria , Australia , Bélgica , Bebidas , Niño , Preescolar , Conducta de Elección , Alemania , Promoción de la Salud , Humanos , Países Bajos , Turquía , Reino Unido , Estados UnidosRESUMEN
The aim of this study was to determine the effect of television food advertising on participant food intake and risk of obesity. A total of 2419 children aged 11-13 years were selected from 118 elementary schools in South Korea. All participants completed a self-administered questionnaire with questions about height, weight, television viewing times, food preferences, and food intakes. To estimate actual exposure to food advertising, we asked participants to specify the times at which they usually watched television. We then collected data on the various types of food advertisement broadcast on five different television networks during those viewing times over the course of the previous 7 months. The amount of television watched and exposure to energy-dense/nutrient-poor (EDNP) food advertising were associated with an increased risk of being overweight or obese. Exposure to television advertising for EDNP food was also significantly associated with higher EDNP food preference and intake and lower fruit and vegetable intake. However, these relationships disappeared for all foods after adjusting for the overall amount of television watched. Although it was not possible to conclude that exposure to television advertising for EDNP food was associated with an increased risk of obesity, preference for EDNP foods, or overall food intake due to the strong comprehensive effects of television viewing time, there was a reason to believe the evidence of the effects of advertising in this study. Future longitudinal studies are needed to determine the exclusive effects of exposure to television advertising for EDNP food.