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Author: Tamara Tabbakh Publisher: ISBN: Category : Languages : en Pages : 268
Book Description
The home environment is a critical setting for the development of weight status in adolescence. At present a limited number of valid and reliable tools are available to evaluate the weight-related comprehensive home environment of this population. Aim 1a was to develop and validate the Multidimensional Home Environment Scale (MHES), which measures multiple components of the home. This scale includes psychological, social, and environmental domains from the perspective of adolescents and their mothers. After establishing content validity via an expert panel in nutrition, a validation sample of 218 mother-adolescent dyads completed a demographics survey and original version of the MHES. A focus group with the target population of adolescents (n=7) was conducted and feedback regarding item difficulty, content, bias, and relevance was incorporated. Principal components analysis yielded a 12-factor structure for adolescents and 14-factor structure for mothers. Internal consistency reliability was achieved for the majority of subscales, with [alpha]=0.5-0.9 for adolescents and [alpha]=0.7-0.9 for mothers. In addition, the MHES showed test-retest reliability for both adolescents (r=0.90) and mothers (r=0.91). Aim 1 b was to develop and validate a Nutrition Knowledge scale using the same sample as Aim 1a. Nutrition knowledge was assessed in this sample of 114 dyads. A 20-item scale was modified from previous version developed by the author. This instrument was composed of multiple-choice questions classified into four categories of knowledge: macronutrient, micronutrient, healthy eating and physical activity recommendations and fast-food nutrition. Content validity of the scale was established using feedback from an expert panel in nutrition (n=10) and a focus group of the sample population tested (n=7). The scale demonstrated high internal consistency reliability (adolescents: [alpha]=0.70, mothers: [alpha]=0.78) and test-retest reliability (adolescents: r=0.47, p=0.01, mothers: r=0.77, p=0.00). Aim 2 was to examine the impact of the comprehensive home environment on diet quality and weight status of adolescents using the MHES. A sample of 206 mothers and adolescents were recruited from local middle schools in the Austin area and completed a demographics survey, final version of the MHES, Food Frequency Questionnaire, and a Nutrition Knowledge scale online. Weight and height of adolescents were measured by the author using a standard protocols. Body Mass Index (BMI)-for-age percentiles were determined using the Center for Disease Control growth charts. Diet quality was estimated using the Healthy Eating Index-2010. Two models were created and reported in this dissertation. The first univariate model included each of the home environment factors as independent variables, and diet quality and BMI as dependent variables. The second model was developed using significant variables only from the initial model. Availability of healthy foods (p=0.00), healthy eating attitude (p=0.01), and accessibility to unhealthy foods (p=0.04) in the home were the strongest predictors of diet quality. Self-efficacy (p=0.02) and availability of healthy foods (p=0.02) emerged as significant predictors of BMI. Aim 3 of this dissertation research was to determine the effect of nutrition knowledge on the home environment and diet quality using the Healthy Eating Index-2010. This aim was accomplished using the same sample as Aim 2. It was hypothesized that the comprehensive home, with its psychological, social, and environmental features, would mediate the relationship between maternal nutrition knowledge and diet quality. A non-linear relationship between nutrition knowledge of the mother and diet quality of the adolescent was observed. Inclusion of the mediator in the model yielded significant estimates of the indirect effect ([beta]=0.61, 95% CI: 0.3-1.0), with a 65.2% reduction in the model. This suggests that the home environment functioned as a partial mediator of the influence of nutrition knowledge on diet quality. Then, mediation analysis with the combination of psychological, social, and environmental factors was conducted in three separate regressions. Psychological ([beta]=0.46), social ([beta]=0.23), and environmental ([beta]=0.65) variables were all significant mediators of nutrition knowledge on diet quality. Collectively, these results suggest that the MHES is an appropriate tool for measurement of the nutritional home environment of adolescents. The home environment appeared to significantly modulate diet quality and BMI of adolescents, particularly with respect to availability of healthy foods, healthy eating attitudes, and self-efficacy.
Author: Tamara Tabbakh Publisher: ISBN: Category : Languages : en Pages : 268
Book Description
The home environment is a critical setting for the development of weight status in adolescence. At present a limited number of valid and reliable tools are available to evaluate the weight-related comprehensive home environment of this population. Aim 1a was to develop and validate the Multidimensional Home Environment Scale (MHES), which measures multiple components of the home. This scale includes psychological, social, and environmental domains from the perspective of adolescents and their mothers. After establishing content validity via an expert panel in nutrition, a validation sample of 218 mother-adolescent dyads completed a demographics survey and original version of the MHES. A focus group with the target population of adolescents (n=7) was conducted and feedback regarding item difficulty, content, bias, and relevance was incorporated. Principal components analysis yielded a 12-factor structure for adolescents and 14-factor structure for mothers. Internal consistency reliability was achieved for the majority of subscales, with [alpha]=0.5-0.9 for adolescents and [alpha]=0.7-0.9 for mothers. In addition, the MHES showed test-retest reliability for both adolescents (r=0.90) and mothers (r=0.91). Aim 1 b was to develop and validate a Nutrition Knowledge scale using the same sample as Aim 1a. Nutrition knowledge was assessed in this sample of 114 dyads. A 20-item scale was modified from previous version developed by the author. This instrument was composed of multiple-choice questions classified into four categories of knowledge: macronutrient, micronutrient, healthy eating and physical activity recommendations and fast-food nutrition. Content validity of the scale was established using feedback from an expert panel in nutrition (n=10) and a focus group of the sample population tested (n=7). The scale demonstrated high internal consistency reliability (adolescents: [alpha]=0.70, mothers: [alpha]=0.78) and test-retest reliability (adolescents: r=0.47, p=0.01, mothers: r=0.77, p=0.00). Aim 2 was to examine the impact of the comprehensive home environment on diet quality and weight status of adolescents using the MHES. A sample of 206 mothers and adolescents were recruited from local middle schools in the Austin area and completed a demographics survey, final version of the MHES, Food Frequency Questionnaire, and a Nutrition Knowledge scale online. Weight and height of adolescents were measured by the author using a standard protocols. Body Mass Index (BMI)-for-age percentiles were determined using the Center for Disease Control growth charts. Diet quality was estimated using the Healthy Eating Index-2010. Two models were created and reported in this dissertation. The first univariate model included each of the home environment factors as independent variables, and diet quality and BMI as dependent variables. The second model was developed using significant variables only from the initial model. Availability of healthy foods (p=0.00), healthy eating attitude (p=0.01), and accessibility to unhealthy foods (p=0.04) in the home were the strongest predictors of diet quality. Self-efficacy (p=0.02) and availability of healthy foods (p=0.02) emerged as significant predictors of BMI. Aim 3 of this dissertation research was to determine the effect of nutrition knowledge on the home environment and diet quality using the Healthy Eating Index-2010. This aim was accomplished using the same sample as Aim 2. It was hypothesized that the comprehensive home, with its psychological, social, and environmental features, would mediate the relationship between maternal nutrition knowledge and diet quality. A non-linear relationship between nutrition knowledge of the mother and diet quality of the adolescent was observed. Inclusion of the mediator in the model yielded significant estimates of the indirect effect ([beta]=0.61, 95% CI: 0.3-1.0), with a 65.2% reduction in the model. This suggests that the home environment functioned as a partial mediator of the influence of nutrition knowledge on diet quality. Then, mediation analysis with the combination of psychological, social, and environmental factors was conducted in three separate regressions. Psychological ([beta]=0.46), social ([beta]=0.23), and environmental ([beta]=0.65) variables were all significant mediators of nutrition knowledge on diet quality. Collectively, these results suggest that the MHES is an appropriate tool for measurement of the nutritional home environment of adolescents. The home environment appeared to significantly modulate diet quality and BMI of adolescents, particularly with respect to availability of healthy foods, healthy eating attitudes, and self-efficacy.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309149894 Category : Medical Languages : en Pages : 336
Book Description
To battle the obesity epidemic in America, health care professionals and policymakers need relevant, useful data on the effectiveness of obesity prevention policies and programs. Bridging the Evidence Gap in Obesity Prevention identifies a new approach to decision making and research on obesity prevention to use a systems perspective to gain a broader understanding of the context of obesity and the many factors that influence it.
Author: Donald A. P. Bundy Publisher: World Bank Publications ISBN: 1464804397 Category : Medical Languages : en Pages : 977
Book Description
More children born today will survive to adulthood than at any time in history. It is now time to emphasize health and development in middle childhood and adolescence--developmental phases that are critical to health in adulthood and the next generation. Child and Adolescent Health and Development explores the benefits that accrue from sustained and targeted interventions across the first two decades of life. The volume outlines the investment case for effective, costed, and scalable interventions for low-resource settings, emphasizing the cross-sectoral role of education. This evidence base can guide policy makers in prioritizing actions to promote survival, health, cognition, and physical growth throughout childhood and adolescence.
Author: Jessica S. Gubbels Publisher: MDPI ISBN: 3039365339 Category : Medical Languages : en Pages : 308
Book Description
Childhood is a crucial period for establishing lifelong healthy nutritional habits. The environment has an important influence on children’s dietary intake. This book focuses on the influence of environmental factors on the dietary intake of children and adolescents (0–18 years of age) within various settings including home, early care and education, school, college, holiday clubs, neighborhoods, and supermarkets. The reported studies examine a variety of factors within these settings, including the influence of cooking and parenting, teacher style, resources and barriers within various settings, marketing, and many other factors. The dietary intake behaviors examined include snacking, fruit and vegetable intake, beverage intake, and also nutrition in general. In addition, several papers focus on problems caused by inadequate nutrition, such as hunger and obesity. This work underlines the importance of the environment in influencing children’s and adolescents’ dietary intake. In addition, the papers identified some crucial barriers and facilitators for the implementation of environmental changes to enable a healthy diet for young children. Therefore, it provides some important directions for both future research and practice.
Author: Martha J. Nepper Publisher: ISBN: 9781339577814 Category : Languages : en Pages : 176
Book Description
The study found that the home food checklist showed acceptable validity and reliability and can be used independently by parents to assess the foods in the home. Additionally, the study found that overweight children and adolescents had lower scores of total unhealthy foods and total unhealthy refrigerator foods visible compared to healthy weight children. Overweight among children was inversely associated with refrigerator visibility of unhealthy foods in the home, and children who had family meals more frequently were less likely to be overweight. The study determined that while parents faced numerous challenges in promoting healthy eating in the home, they utilized several strategies in providing healthy foods. The home environment is complex and multifactorial and continues to warrant further research to understand fully the impact of the home environment on a child's weight.
Author: Sarah D. Jones Publisher: ISBN: Category : Obesity in adolescence Languages : en Pages : 493
Book Description
BACKGROUND: Disparities in the prevalence of childhood obesity exist among children from different race and socioeconomic groups. While these factors cannot cause obesity, these factors, along with many other factors may influence dietary intake and quality, both major contributors to obesity. PURPOSE: This research examined the relationships between intrapersonal, interpersonal, and environmental factors with dietary intake and quality as children transitioned into adolescence. METHODS: Data from a 7-year childhood obesity trial were used. Dietary intake (calories, added sugar, total fat, saturated fat, protein, sodium, calories per kilogram body weight) and diet quality (Healthy Eating Index-2010 total score) were measured through 3, 24-hour recalls. Intrapersonal factors (demographics, generational obesity, self-efficacy for diet), interpersonal factors (parental rules, family/peer support for healthy eating), and home and school environmental factors were self-reported. Neighborhood food environment was measured through the proportion of unhealthy food establishments within a 0.5-mile of home and school. Bivariate and multivariate linear regression was used to identify significant factors associated with all outcomes at 11-12 years and 14-15 years, as well as to examine the association between changes in the environment with changes in dietary outcomes over time. RESULTS: Results showed several intrapersonal (gender, generational obesity, self-efficacy for diet), interpersonal (discouragement for healthy eating from friends), and environmental (both food within and around the home) factors simultaneously influenced dietary intake at ages 11-12. At ages 14-15, dietary intake was influenced by intrapersonal (gender, generational obesity, self-efficacy for diet) and environmental (food in home) factors, while diet quality was influenced by the home food environment. Over time, changes in the food available within and around the home were significantly associated with both dietary intake and quality. CONCLUSIONS: This research demonstrated the importance of utilizing a multilevel approach when examining factors that influence diet of overweight and obese youth. When examined together, environmental factors, particularly the home food environment, appeared to be more important than personal or social influences; however, more research around the specific foods consumed both within and around the home needs to be completed. This study could influence the development of policies and interventions to improve diet and decrease obesity among low-SES, urban youth.
Author: Megan C. Lawless Publisher: ISBN: Category : Body mass index Languages : en Pages : 89
Book Description
"The prevalence of overweight and obesity are high in the U.S. and affect the population across all sociodemographic groups. Research shows that eating behaviors influence dietary intake as well as weight status, but both are complex processes that are influenced by a variety of biological, personal, behavioral, and environmental factors. Typically, adolescence is characterized by increased intakes of high-energy foods and beverages, higher obesity rates, as well as increasing prevalence of unhealthy weight management practices compared to younger age groups. Despite the obesogenic epidemic and high prevalence of unhealthy diets among adolescents, little is known about how eating behaviors, such as disinhibition and restraint, function in relation to weight and dietary outcomes in this age group. The purpose of the current research was to examine the associations between the two dysregulated eating behaviors, disinhibition and restraint, in relation to BMI and overall diet quality in a sample of adolescents. Subjects were 16-year olds participating in a longitudinal study that examines self-regulation as a predictor of cardiometabolic risks among adolescents. Disinhibition and restraint were measured using the subscales of the Three- Factor Eating Questionnaire (TFEQ). Dietary intake was assessed from 24 hour-dietary recalls that were used to calculate the Healthy Eating Index-2010 (HEI). Two separate hierarchical linear regression analyses were performed to test whether restraint moderated the associations between disinhibition and overall diet quality and BMI-for-age percentile. After adjusting for race and SES, the interaction effect between disinhibition and restraint fell short of statistical significance in the model that predicted BMI-for-age percentile (b=-.231 p=.176). There was a main effect of disinhibition on BMI-for-age percentiles (b=1.754, p=.012) such that individuals reporting higher scores for disinhibition had greater BMI-for-age percentiles. There was also a significant main effect of restraint on BMI-for-age percentile (b=.961, p=.038) so as the scores for restraint increased, so did BMI-for-age percentile. HEI-2010 scores were significantly associated with restraint scores (p=.009). Post-hoc probing revealed that at a high level of restraint, the association between disinhibition and HEI scores was non-significant (B=-.669, p=0.136). At low levels of restraint, there was a trend towards positive association between disinhibition and HEI-2010 score; however, this was statistically non-significant (B=1.073, p=0.069). In conclusion, the present study suggests that high levels of restraint independently predict both better diet quality and lower BMI-for-age percentiles, while disinhibition predicts only higher BMI-for-age percentiles among adolescents. Future studies should examine other factors, such as dieting status, to better understand these relationships in this target population."--Abstract from author supplied metadata.
Author: Melissa A. Masters Publisher: ISBN: 9781267535627 Category : Cardiovascular fitness Languages : en Pages : 130
Book Description
Youth obesity is an ongoing problem in the United States. Obese children and adolescents are likely to be obese as adults and have an increased risk of developing chronic diseases, including coronary heart disease, earlier in life. The multifactorial nature of obesity continues to challenge researchers and health professionals to determine methods for preventing and reducing childhood obesity. Research has suggested that obesity is a normal response to an "obesigenic" environment. Emerging as one of the most influential environments in obesity and behavior development is the home food environment. However, little is understood about the role of the home food environment in obesity and disease development in youth. The purpose of this research was to examine factors that influence the home food environment as well as the relationship between the home food environment and dietary intake, obesity, and disease development in a nationally representative sample of U.S. youth aged 6-19 years from the National Health and Nutrition Examination Survey (NHANES). Race-ethnicity and poverty income ratio (PIR) were found to influence home food availability, family meal patterns, and family food expenditures, three aspects of the home food environment. Race-ethnicity, PIR, and home food availability appeared to influence dietary consumption in youth. However, home food availability did not appear to be related to overweight or obesity in youth. Overweight and obesity in children and adolescents was associated with adverse lipid concentrations. The home food environment is complex but may serve as a modifiable area for nutrition educators to influence dietary intake in youth. Racial and socioeconomic disparities in home food environments should be addressed in the development of effective public policy and nutrition education development. Although the home food environment was not found to be related to obesity in youth, research should continue assessing environmental factors of obesity development as obesity is related to disease development earlier in life.
Author: Jonae B. Perez Publisher: ISBN: Category : Languages : en Pages : 28
Book Description
Child and adolescent diets in the United States are high in fat and sodium and low in vegetables, fruits, whole grains, and dairy foods. Parental practices and foods provided in the home greatly influence children's food related behaviors. This impact may change as children progress through adolescence and other factors begin to play a role, such as peers, media, and convenience of food. This study aimed to investigate longitudinal relationships between parenting around food/eating, foods available in the home, and future child diet quality in younger versus older children. The National Impact on Kids (NIK) Study was a prospective cohort study with two time points, baseline and 2-year follow-up. Parental surveys were used to collect data on home food environment and 24-hour food recalls were used to collect child dietary intake. Child diet quality indicators include DASH score, fruit and vegetable intake, and high-energy beverage intake. In this secondary data analysis, participants were dichotomized in to two groups: younger (ages 6-8.99) versus older (ages 9-12.5) at study initiation. Hierarchical linear regression models were used to assess the association between initial parenting around food/eating and foods available in the home and future child diet quality indicators. Participants were 50.7% female and predominantly Non-Hispanic White (70.2%). A significant overall change in DASH scores (p=.053), total fruit and vegetable intake (p=.017), and high-energy beverage consumption (p
Author: Igor De Garine Publisher: Routledge ISBN: 1134316216 Category : Health & Fitness Languages : en Pages : 360
Book Description
This collection of essays examines obesity not as an objective medical or psychological problem, but as a subjective social and cultural phenomenon. The contributors take a cross-cultural perspective, examining both the negative casting of obesity in developed countries and the traditional view of obesity as a positive characteristic in subsistence societies which is threatened by the dominance of Western culture.
Author: Tamara Tabbakh
Author: Tamara Tabbakh
Author: Institute of Medicine
Author: Donald A. P. Bundy
Author: Jessica S. Gubbels
Author: Martha J. Nepper
Author: Sarah D. Jones
Author: Megan C. Lawless
Author: Melissa A. Masters
Author: Jonae B. Perez
Author: Igor De Garine