RESUMO
PURPOSE OF REVIEW: Sleep health is a commonly overlooked component of pediatric cardiometabolic risk. Disparities in sleep duration and meeting of pediatric sleep guidelines have been well documented among at-risk populations in the United States, including Latinos. However, sleep research often fails to describe or account for contextual and cultural factors impacting the ability for Latino families to meet guidelines. The current review focuses on recent findings related to measurement of sleep duration, understanding of contextual factors that impact sleep hygiene, and interventions designed to increase sleep duration and quality among U.S. Latino families with infants, young children, and adolescents. RECENT FINDINGS: Ten studies focusing on sleep health in U.S. Latino children, using different study designs were identified. Overall, cross-sectional studies confirmed inadequate sleep among Latino children, intervention studies demonstrated promise of culturally-sensitive health behavior education for improving sleep in early childhood, and qualitative studies highlighted neighborhood and cultural factors that impact sleep quality. IMPLICATIONS FOR CLINICAL PRACTICE AND RESEARCH: Rather than new prevalence studies on adherence to sleep recommendations among Latino families, research focusing on adapting clinical guidelines to accommodate the realities of many Latino families (e.g., co-sleeping and bedsharing) will advance our knowledge. A shift towards objective measurement of the 24-h period as well as evaluating specific contextual barriers that make It challenging to meet sleep guidelines for Latino children is needed.
Assuntos
Comportamentos Relacionados com a Saúde , Sono , Humanos , Pré-Escolar , Criança , Estados Unidos/epidemiologia , Adolescente , Estudos Transversais , Educação em Saúde , Hispânico ou LatinoRESUMO
Evidence for the association between breastfeeding (BF) duration and later body mass index (BMI) is inconsistent. We explored how BF duration and BF type (exclusive or partial) related to BMI from childhood to young adulthood in a Chilean cohort. Infants were recruited at 6 months between 1994 and 1996 in Santiago, Chile (n = 821). Mothers reported date of first bottle and last BF; anthropometry was measured at 1, 5, 10, 16, and 23 years. We tested whether: (1) type of BF at 6 months (none, partial, exclusive) and (2) duration of exclusive BF (<1 month, 1 to <3 months, 3 to <6 months, and ≥6 months) related to BMI. At 6 months, 35% received both breastmilk and formula ("partial BF") and 38% were exclusively breastfed. We found some evidence of an association between longer BF and lower BMI z-scores at young ages but observed null effects for later BMI. Specifically, BF for 3 to <6 months compared to <1 month related to lower BMI z-scores at 1 and 5 years (both p < 0.05). Our results are in partial accordance with others who have not found a protective effect of longer BF for lower BMI.
Assuntos
Aleitamento Materno , Leite Humano , Lactente , Feminino , Humanos , Criança , Adulto Jovem , Adulto , Índice de Massa Corporal , Mães , Suplementos NutricionaisRESUMO
PURPOSE: Understanding parental experiences with managing their toddler's screen use is important to inform the design of interventions addressing early childhood screen use, yet current evidence is limited. To enhance our understanding of the context of toddler screen use, this study characterizes the screen-related discord and dismay parents experience in families with toddlers. DESIGN AND METHODS: In-depth interviews were conducted to explore everyday experiences with screen use among low-income Mexican American caregivers of toddlers (21 mothers, 10 fathers, 1 grandmother). Transcripts were content analyzed to identify prominent themes. RESULTS: Three themes were identified. Experiences of screen-related discord and dismay arose (1) between parent and child, (2) between parents, and (3) surfaced as parental internal dissonance about toddler screen use. Parent-child discord resulted from parental limit setting and child reactions to parental screen use, which often included tantrums. Parent-partner discord included patterns of agreeing to disagree and direct disagreement between partners. Parents also reported their own feelings of ambivalence and dismay as they struggled to reconcile their preferences against their toddler's actual screen use, while living in a screen-saturated world. CONCLUSIONS: Findings offer insight into types of screen-related discord and dismay low-income Mexican American parents experience as they attempt to manage their toddler's screen use. PRACTICE IMPLICATIONS: Although discord in families is normal, the screen-specific discord reported by participants warrants consideration in efforts promoting healthy screen use in families. Providers can tailor their counseling to consider the range of screen-related discord families of toddlers may experience.
Assuntos
Americanos Mexicanos , Pais , Feminino , Humanos , Pré-Escolar , Pais/psicologia , Mães/psicologia , Pobreza , Pesquisa Qualitativa , Poder FamiliarRESUMO
The aim of this study was to examine video-recorded observations of evening family mealtime at home among Mexican American children to help elucidate style of meal service, fathers' and mothers' feeding practices and child's eating behavior. Consistent with guidelines for coding behaviors, we analyzed observational data of evening mealtimes of 71 Mexican American children aged eight to 10 years. Regarding style of meal service, in almost all cases (96%), parents plated the child's food, with more available on the table or counter in 40% of the observations. Mothers almost always served the child (94%). Regarding parental feeding practices, parents used positive involvement in meals (80%), pressure to eat (42%) and restriction of food (9%). Using food as a reward to control behavior was never used by either parent. The majority (75%) of children requested or negotiated to eat less food, or only eat certain items. In Mexican American families, both mothers and fathers play a role in family mealtimes and both use positive involvement in child's meals, and to a lesser extent pressure to eat, with their children aged eight to 10 years. To help reduce the obesity epidemic, intervention strategies are needed, which integrate the family, a plating style of meal and parental feeding practices that promote healthy eating in the home. To reduce obesity among Mexican American children, interventions that focus on parental positive involvement in child's meal and maintenance of home cooked meals could have a positive impact on the entire family.
Assuntos
Americanos Mexicanos , Mães , Criança , Comportamento Infantil , Pai , Comportamento Alimentar , Feminino , Humanos , Masculino , Refeições , Poder FamiliarRESUMO
This study examined parenting styles, parenting practices and family practices that may be associated with weeknight sleep duration among 8- to 10-year-old Mexican American (MA) children. This cross-sectional study of MA children used baseline data from a 2-year cohort study of mother-child pairs (n = 308) with additional data on fathers (n = 166). Children's weeknight sleep duration was accelerometer estimated and averaged for 2 weeknights. Parents reported on their parenting styles and practices regarding food and family food-related practices. Multivariable linear regression analysis was used to examine sleep duration with parenting styles and practices, and family practices, and adjusting for child gender and body mass index. Model 1 included mothers' parenting styles and practices; Model 2 included both mothers' and fathers' parenting styles and practices. Children's average sleep duration was 9.5 (SD = 0.8) hr. Mothers who used pressure to encourage their children to eat and those who used food to control behavior had children with longer sleep duration (ß = 0.21, p < 0.01; ß = 0.15, p = 0.03, respectively). Mothers who reported their children ate dinner with the TV on and those who valued eating dinner as a family had children with shorter sleep duration (ß = -0.16, p = 0.01; ß = -0.18, p = 0.01, respectively). Fathers who restricted the amount of food their children ate had children with shorter sleep duration (ß = -0.27, p = 0.01). Mothers' and fathers' feeding practices, the child's eating dinner with the TV on, and valuing family dinners, played a role in children's weeknight sleep duration among Mexican American families. Parental feeding practices and family mealtime contexts may have an effect on children's weeknight sleep duration.
Assuntos
Pai/psicologia , Mães/psicologia , Poder Familiar/psicologia , Sono/fisiologia , Criança , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Americanos MexicanosRESUMO
Mothers' feeding practices are associated with their children's weight status, but little is known about the associations between fathers' feeding practices and children's weight status. Moreover, there is a dearth of research on Latino fathers' feeding practices and children's weight status, even though Latino children suffer some of the highest obesity rates in the U.S. We examined the associations between fathers' feeding practices and child weight status, conditional on mothers' feeding practices, within 174 Mexican American families with children aged 8-10 years. Parents completed the Parental Feeding Practices Questionnaire, which consists of four subscales: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. To assess child weight status, body mass index (BMI) was calculated and converted to age- and gender-specific percentile scores (BMI z-score). We fit four sets of regression models, one set for each of the four parental feeding practices subscales, with child BMI z-score as the outcome variable. Fathers' pressure to eat (b = -0.20, p = 0.04; 95% CI: -0.39, -0.01) and use of food to control behavior (b = -0.36, p = 0.02; 95% CI: -0.65, -0.07) were associated with lower child BMI z-score, and restriction of amount of food (b = 0.56, p < 0.001; 95% CI: 0.27, 0.84) was associated with higher child BMI z-score, after accounting for mothers' feeding practices. Fathers' positive involvement in child eating was not associated with child BMI z-score. These findings provide empirical evidence that fathers' feeding practices are independently associated with children's weight status, even when mothers' feeding practices are taken into account, and suggest that fathers' feeding practices also matter in regard to children's weight status.
Assuntos
Índice de Massa Corporal , Comportamento Infantil , Relações Pai-Filho , Pai , Comportamento Alimentar , Poder Familiar , Obesidade Infantil , Adulto , Peso Corporal , Criança , Família , Feminino , Humanos , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Obesidade Infantil/etiologia , Obesidade Infantil/prevenção & controle , Inquéritos e Questionários , Estados UnidosRESUMO
Study Objective: Short sleep duration is a risk factor for childhood obesity. Mechanisms are unclear, but may involve selection of high carbohydrate foods. This study examined the association between estimated sleep duration and macronutrient intake as percentages of total energy among Mexican American (MA) 9-11 year olds. Methods: This cross-sectional study measured diet using two 24-hour recalls and estimated sleep duration using hip-worn accelerometry in MA children (n = 247) who were part of a cohort study. Child and maternal anthropometry were obtained; mothers reported on demographic information. Using linear regression, we examined the relationship of sleep duration with energy intake, sugar intake, and the percentage of energy intake from carbohydrates, fat, and protein. Results: Children were 47% male; mean age was 10 (SD = 0.9) years. Mean sleep duration was 9.6 (SD = 0.8) hours; 53% were overweight/obese, with a mean energy intake of 1759 (SD = 514) calories. Longer sleep duration was independently associated with a lower percentage of energy intake from carbohydrates (ß = -0.22, p < .01) and a higher percentage of energy from fat (ß = 0.19, p < .01), driven by the percentage of energy from polyunsaturated fatty acids (PUFA; ß = 0.17, p < .05). No association was found with the intake of energy or total sugars, or the percent of calories from protein. Conclusions: MA children who slept longer consumed diets with a lower percentage of calories from carbohydrates and a higher percentage from fat, especially from PUFA. Short sleep duration may be a risk factor for food cravings that are high in carbohydrate content and may displace heart-healthy dietary fat, and thereby increase obesity risk among children.
Assuntos
Dieta , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Americanos Mexicanos , Privação do Sono/fisiopatologia , Sono/fisiologia , Acelerometria , Índice de Massa Corporal , Criança , Estudos de Coortes , Estudos Transversais , Carboidratos da Dieta/farmacologia , Gorduras na Dieta/farmacologia , Proteínas Alimentares/administração & dosagem , Ácidos Graxos Insaturados/administração & dosagem , Feminino , Humanos , Masculino , Mães , Obesidade/complicações , Sobrepeso/complicações , Fatores de Risco , Sono/efeitos dos fármacos , Fatores de TempoRESUMO
Objective To determine whether parents who prefer a heavier child would underestimate their child's weight more than those who prefer a leaner child. Methods Participants were Mexican-American families (312 mothers, 173 fathers, and 312 children ages 8-10) who were interviewed and had height and weight measurements. Parents reported their preferred child body size and their perceptions of their child's weight. Parents' underestimation of their child's weight was calculated as the standardized difference between parent's perception of their child's weight and the child's body mass index (BMI) z-score. Demographic factors and parental BMI were also assessed. Results Although 50 % of children were overweight or obese, only 11 % of mothers and 10 % of fathers perceived their children as being somewhat or very overweight. Multiple regressions controlling for covariates (parental BMI and child age) showed that parents who preferred a heavier child body size underestimated their children's weight more, compared to those who preferred a leaner child (ß for mothers = .13, p < .03; ß for fathers = .17, p < .03). Conclusions for Practice Parents who preferred a heavier child body size underestimated their child's weight to a greater degree than parents who preferred a leaner child. Attempts by pediatricians to correct parents' misperceptions about child weight may damage rapport and ultimately fail if the misperception is actually a reflection of parents' preferences, which may not be readily amenable to change. Future research should address optimal methods of communication about child overweight which take into account parent preferences.
Assuntos
Tamanho Corporal , Peso Corporal , Americanos Mexicanos/psicologia , Mães/psicologia , Obesidade Infantil/etnologia , Percepção , Adulto , Índice de Massa Corporal , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Mães/estatística & dados numéricos , Inquéritos e Questionários , Estados UnidosRESUMO
BACKGROUND: Parental feeding practices are thought to influence children's weight status, through children's eating behavior and nutritional intake. However, because most studies have been cross-sectional, the direction of influence is unclear. Moreover, although obesity rates are high among Latino children, few studies of parental feeding practices have focused on this population. METHODS: This 2-year longitudinal study examined mutual influences over time between parental feeding practices and children's weight status, in Mexican American families with children 18 years old at baseline. Mothers (n = 322) and fathers (n = 182) reported on their feeding practices at baseline, 1-year follow-up, and 2-year follow-up. Weight status, defined by waist-height ratio (WHtR) and body mass index (BMI), was ascertained at all assessments. Cross-lagged panel models were used to examine the mutual influences of parental feeding practices and child weight status over time, controlling for covariates. RESULTS: Both mothers' and fathers' restriction of food predicted higher subsequent child weight status at Year 1, and for fathers this effect was also found at Year 2. Mothers' and fathers' pressure to eat predicted lower weight status among boys, but not girls, at Year 1. Child weight status also predicted some parental feeding practices: boys' heavier weight predicted mothers' less pressure to eat at Year 1, less use of food to control behavior at Year 2, and greater restriction at Year 2; and girls' heavier weight at Year 1 predicted fathers' less pressure to eat and less positive involvement in child eating at Year 2. CONCLUSIONS: This study provides longitudinal evidence that some parental feeding practices influence Mexican American children's weight status, and that children's weight status also influences some parental feeding practices. Feeding practices of both mothers and fathers were related to children's weight status, underscoring the importance of including fathers in research on parental feeding practices and child obesity.
Assuntos
Comportamento do Adolescente/psicologia , Peso Corporal/fisiologia , Comportamento Alimentar/psicologia , Relações Pais-Filho/etnologia , Poder Familiar/etnologia , Adolescente , Índice de Massa Corporal , Pai/psicologia , Comportamento Alimentar/etnologia , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Americanos Mexicanos/etnologia , Mães/psicologia , Poder Familiar/psicologia , Fatores de Risco , Fatores Sexuais , Fatores de TempoRESUMO
This study aimed to explore the attitudes and behaviors of Latino mothers around feeding their children. Using qualitative methods, we conducted four focus groups in Spanish with 41 Latino mothers of elementary school-age children in San Diego County, CA. Latino mothers' mean age was 41 years; 90% were foreign-born; and 74% had a high school education or less. We explored cultural viewpoints around feeding and cooking and feeding strategies used. Focus groups were analyzed based on a priori and emergent themes. The following themes around feeding emerged: feeding attitudes central to the maternal responsibility of having well-fed children and feeding behaviors that centered on cooking methods, supportive behaviors, and reinforcement strategies for "eating well." These findings increase our understanding of the Latino maternal role to feed children and can help to inform more culturally appropriate research to effectively address nutritional issues and obesity prevention in Latino children.
RESUMO
Informed by the reserve capacity model, we examined pathways between socioeconomic status (SES) and internalizing symptoms (IS) in 1119 Chilean 10-year-olds. Mediators included parental disciplinary style and reserve capacity resources (RCR), namely home environment, parent-child engagement, and self-esteem, and conduct problems. Using structural equation modeling, the model was stratified by gender. For boys, the SES-IS relationship was mediated by the home environment and parental disciplinary style. For girls, the SES-IS relationship was mediated by the home environment, parent-child engagement, self-esteem, and conduct problems. Findings suggest different RCR may protect against IS in a sample of Chilean children.
RESUMO
OBJECTIVE: Cross-sectional studies show that sleep is related to childhood obesity. We aimed to examine the longitudinal impact of sleep on the risk of obesity in Mexican American children. DESIGN AND METHODS: We evaluated 229 Mexican American 8-10-year-olds and their mothers at baseline and at 12- and 24-month follow-ups. Sleep duration and anthropometrics were collected. Age- and gender-specific body mass index (BMI) z-scores (BMIz) were calculated based on Centers for Disease Control and Prevention guidelines. Sleep duration was estimated using accelerometry. Children were also categorized as long or short sleepers, using the National Sleep Foundation's recommendation to define adequate sleep duration (10-11 h for 5-12-year-olds). Using linear regressions, we examined whether sleep duration predicted BMIz, waist-to-height ratio (WHtR), and weight gain at 24 months. RESULTS: Children were mostly short sleepers (82%). Children who slept less were more likely to have a higher BMIz, WHtR, and weight gain at the 24-month follow-up (ß = -0.07, P = 0.01; ß = -0.11, P <0.01; and ß = -0.14, P = 0.02, respectively), after controlling for baseline weight status, child gender, maternal BMI, and occupation. CONCLUSION: In Mexican American children, shorter sleep duration at baseline was associated with increased weight status over 24 months.
Assuntos
Americanos Mexicanos/estatística & dados numéricos , Obesidade Infantil/etiologia , Privação do Sono/complicações , Acelerometria , California/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de RiscoRESUMO
PURPOSE: Studies report an association between neighborhood risk and both obesity and cardiometabolic risk factors (CMR) among adolescents. Here we describe the effect of perceived neighborhood risk on adiposity and CMR among Chilean adolescents. METHODS: Participants were 523 low- to middle-income Chilean adolescents. We assessed neighborhood risk in early adolescence, adiposity in childhood and in early and later adolescence, and blood pressure and fasting glucose in later adolescence. Neighborhood risk profiles were estimated using latent profile analysis (LPA) and based on reported perceptions of crime and drug sales/use. Using linear and logistic regression, we examined the effect of neighborhood risk on adiposity and CMR. RESULTS: Mean age in early and later adolescence was 14 and 17 years, respectively. Participants were 52% male, with a mean BMI z-score of .67, and 8% met criteria for metabolic syndrome. LPA identified two neighborhood profiles: 61% low risk and 39% high risk. In later adolescence, being in the high risk profile predicted a higher BMI z-score, waist-to-height ratio, and fat mass index (p < .05). Adolescents in the high risk profile had three times greater odds of meeting criteria for metabolic syndrome (OR = 3.1, 95% CI: 1.5, 5.8) compared with those in the low risk profile. CONCLUSIONS: Our findings suggest that there are physiological responses to living in a neighborhood perceived as "risky," which may contribute to obesity and CMR even in adolescence. For Chilean neighborhoods with high crime and drugs, targeted public health interventions and policies for youth could be beneficial.
Assuntos
Crime/psicologia , Síndrome Metabólica/epidemiologia , Características de Residência/estatística & dados numéricos , Percepção Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Índice de Massa Corporal , Chile/epidemiologia , Comorbidade , Crime/estatística & dados numéricos , Feminino , Humanos , Masculino , Síndrome Metabólica/psicologia , Fatores de Risco , Fatores SocioeconômicosRESUMO
This study aimed to explore the attitudes and behaviors of Latino mothers around feeding their children. Using qualitative methods, we conducted four focus groups in Spanish with 41 Latino mothers of elementary school-age children in San Diego County, CA. Latino mothers' mean age was 41 years; 90% were foreign-born; and 74% had a high school education or less. We explored cultural viewpoints around feeding and cooking and feeding strategies used. Focus groups were analyzed based on a priori and emergent themes. The following themes around feeding emerged: feeding attitudes central to the maternal responsibility of having well-fed children and feeding behaviors that centered on cooking methods, supportive behaviors, and reinforcement strategies for "eating well." These findings increase our understanding of the Latino maternal role to feed children and can help to inform more culturally appropriate research to effectively address nutritional issues and obesity prevention in Latino children.
Assuntos
Atitude Frente a Saúde/etnologia , Cultura , Dieta/etnologia , Comportamento Alimentar/etnologia , Hispânico ou Latino , Comportamento Materno , Adulto , Argentina/etnologia , California , Criança , Pré-Escolar , Culinária/métodos , Escolaridade , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino/psicologia , Humanos , Americanos Mexicanos/etnologia , Pessoa de Meia-Idade , Sobrepeso/etnologia , Sobrepeso/prevenção & controle , Obesidade Infantil/etnologia , Obesidade Infantil/etiologia , Obesidade Infantil/prevenção & controle , Inquéritos e QuestionáriosRESUMO
We know of no studies comparing parent-reported sleep with accelerometer-estimated sleep in their relation to paediatric adiposity. We examined: (i) the reliability of mother-reported sleep compared with accelerometer-estimated sleep; and (ii) the relationship between both sleep measures and child adiposity. The current cross-sectional study included 303 Mexican American mother-child pairs recruited from Kaiser Permanente Northern California. We measured sleep duration using maternal report and accelerometry and child anthropometrics. Concordance between sleep measures was evaluated using the Bland-Altman method. We conducted zero-ordered correlations between mother-reported sleep, accelerometer-estimated sleep and child BMI z-scores (BMIz). Using linear regression, we examined three models to assess child BMIz with mother-reported sleep (model 1), accelerometer-estimated sleep (model 2) and both sleep measures (model 3). Children had an average age of 8.86 years (SD = 0.82). Mothers reported that their child slept 9.81 ± 0.74 h [95% confidence interval (CI): 9.72, 9.89], compared to 9.58 ± 0.71 h (95% CI: 9.50, 9.66) based on accelerometry. Mother-reported sleep and accelerometer-estimated sleep were correlated (r = 0.33, P < 0.001). BMIz outcomes were associated negatively with mother-reported sleep duration (model 1: ß = -0.13; P = 0.02) and accelerometer-estimated sleep duration (model 2: ß = -0.17; P < 0.01). Accounting for both sleep measures, only accelerometer-measured sleep was related to BMIz (model 3: ß = -0.14, P = 0.02). Each sleep measure was related significantly to adiposity, independent of covariates. Accelerometry appeared to be a more reliable measure of children's sleep than maternal report, yet maternal report may be sufficient to examine the sleep-adiposity relationship when resources are limited.
Assuntos
Adiposidade/fisiologia , Peso Corporal , Americanos Mexicanos , Mães , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Sono/fisiologia , Acelerometria , Adiposidade/etnologia , Índice de Massa Corporal , California , Criança , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Obesidade/etnologia , Sobrepeso/etnologia , Reprodutibilidade dos Testes , Fatores de Risco , Fatores de TempoRESUMO
PURPOSE: To examine pathways between individual, social, and environmental factors associated with leisure-time physical activity (LTPA) among Mexican-American adults. DESIGN: Cross-sectional design using random-digit dialing to administer a structured telephone interview. SETTING: Mexican-American adults living in a U.S.-Mexican border community in San Diego, California (N = 672). MEASURES: Data were collected on LTPA, demographic characteristics, acculturation, and other psychosocial and environmental factors associated with LTPA. ANALYSIS: Structural equation modeling to test an a priori model of LTPA. RESULTS: Participants were mostly female (71%) with a mean age of 39 years (SD = 13). Only 32% of participants met PA guidelines in their leisure time, with men (39%) meeting the guidelines more than women (29%). Using structural equation modeling, neighborhood factors, both social and environmental, showed indirect relationships with meeting PA guidelines through community resource factors. Significant covariates included marital status and age. CONCLUSION: Individual, social, and environmental factors were associated with LTPA in this sample of Mexican-American adults. These findings can inform intervention studies that aim to increase LTPA in this population.