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Objective The objective of this study was to explore barriers and facilitators to healthy eating among low-income Latino adolescents using an intervention development framework. Methods Semi-structured interviews (n = 30) were conducted with Latino youth ages 13–17 who had overweight or obesity at a safety-net clinic in San Francisco, CA. Adolescent beliefs and attitudes regarding healthy eating and individual, family, and community level barriers and facilitators were elicited. Interviews were analyzed using an inductive approach and the Capability-Opportunity-Motivation (COM-B) model. Results Participants had capability gaps; while they demonstrated basic nutrition knowledge, they also held significant misconceptions about healthy eating, equating “organic” with healthy and failing to recognize sugar in a number of beverages and foods. Families were a source of support through role modeling and purchasing fresh produce, yet in many cases also undermined adolescents’ healthy eating goals through purchases of high calorie low nutrient food, an opportunity facilitator and challenge. By contrast, peers were mostly a negative influence due to frequent consumption of high calorie low nutrient food. The school environment posed opportunity challenges as participants found school lunch unpalatable and had ready access to unhealthy options nearby. Participants were motivated to improve their eating habits but often not resilient in the face of obstacles. Conclusions Interventions to promote healthy eating among low-income Latino adolescents should address common nutritional misconceptions, target families as well as teens, consider peer influences, and advocate for policy approaches that improve the school food environment.

Objective To understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on parental perceptions of health behaviors and food insecurity among children with overweight and obesity living in San Francisco and to assess the relationship between food insecurity and dietary intake during the pandemic. Methods Parents of children ages 4 to 12 in San Francisco with body mass index ≥85th percentile measured at a clinic visit at a Federally Qualified Health Center or academic practice from January 1st to March 15th, 2020 were eligible to participate. Parents completed a survey reporting on child health behaviors and household food insecurity prior to and since the start of the pandemic. Survey items were abstracted from validated surveys with adaptations. Regression models evaluated associations between food insecurity and dietary intake variables. Results Most participants (n = 145) were publicly insured (90%), Latino (77%), and spoke Spanish at home (70%). Parents perceived that child mean daily nonacademic screen time was higher during the pandemic compared to before (3.8 hours vs 1.6 hours). Mean daily physical activity was reported to be lower compared to prior to the pandemic (1 hour vs 1.8 hours). On average, reported bedtime shifted 1.6 hours later. Food insecurity increased significantly but was not associated with intake of fruits, vegetables, sugar-sweetened beverages, or foods with added sugar during the pandemic. Conclusions Parents of children with overweight or obesity in San Francisco perceive increased child screen time, decreased physical activity and later bedtimes during the COVID-19 pandemic. Findings suggest a need for policies that support healthy lifestyle behaviors among low-income children during the pandemic.

Objective:To assess trends in consumption of soda, sweetened fruit drinks/sports drinks and any sugar-sweetened beverage (SSB) from 2013 to 2016 among all children in California aged 2–5 and 6–11 years and by racial-ethnic group.Design:Serial cross-sectional study using the California Health Interview Survey (CHIS).Setting:CHIS is a telephone survey of households in California designed to assess population-level estimates of key health behaviours. Previous research using CHIS documented a decrease in SSB consumption among children in California from 2003 to 2009 coinciding with state-level policy efforts targeting child SSB consumption.Participants:Parents of children in California aged 2–11 years (n 4901 in 2013–2014; n 3606 in 2015–2016) were surveyed about the child’s consumption of soda and sweetened fruit drinks/sports drinks on the day prior.Results:Among 2–5-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB remained stable. Sweetened fruit drink/sports drink consumption was higher than soda consumption in this age group. Latino 2–5- year-olds were more likely to consume any SSB in both 2013–2014 and 2015–2016 compared with Whites. Among 6–11-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB also remained stable over time. Latino and African-American 6–11-year-olds were more likely to consume an SSB in 2013–2014 compared with White children.Conclusions:SSB consumption among children in California was unchanged from 2013 to 2016 and racial-ethnic disparities were evident. Increased policy efforts are needed to further reduce SSB consumption, particularly among children of Latino and African-American backgrounds.

OBJECTIVE: To assess trends in consumption of soda, sweetened fruit drinks/sports drinks and any sugar-sweetened beverage (SSB) from 2013 to 2016 among all children in California aged 2–5 and 6–11 years and by racial-ethnic group. DESIGN: Serial cross-sectional study using the California Health Interview Survey (CHIS). SETTING: CHIS is a telephone survey of households in California designed to assess population-level estimates of key health behaviours. Previous research using CHIS documented a decrease in SSB consumption among children in California from 2003 to 2009 coinciding with state-level policy efforts targeting child SSB consumption. PARTICIPANTS: Parents of children in California aged 2–11 years (n 4901 in 2013–2014; n 3606 in 2015–2016) were surveyed about the child’s consumption of soda and sweetened fruit drinks/sports drinks on the day prior. RESULTS: Among 2–5-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB remained stable. Sweetened fruit drink/sports drink consumption was higher than soda consumption in this age group. Latino 2–5- year-olds were more likely to consume any SSB in both 2013–2014 and 2015–2016 compared with Whites. Among 6–11-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB also remained stable over time. Latino and African-American 6–11-year-olds were more likely to consume an SSB in 2013–2014 compared with White children. CONCLUSIONS: SSB consumption among children in California was unchanged from 2013 to 2016 and racial-ethnic disparities were evident. Increased policy efforts are needed to further reduce SSB consumption, particularly among children of Latino and African-American backgrounds.

Introduction: Latino adolescents experience high rates of obesity and physical activity can protect against obesity and obesity comorbidities. Health interventions to promote physical activity are more likely to be successful if they take into account the experiences and perspectives of their target population. Our study objective was to explore barriers and facilitators to physical activity among Latino adolescents with the goal of informing future interventions for this population. Method: Semistructured interviews were conducted with ( n = 30) low-income, Latino adolescents. The interviews were analyzed using inductive methods and the Capability–Opportunity–Motivation model of behavior. Results: Adolescents described capability gaps including lacking skills for preferred activities. School physical education and parks provided opportunities for adolescents to be physically active. Adolescents also described opportunity challenges, including age limits, not being able to afford preferred classes, and safety concerns. Families provided role modeling but rarely engaged in activities with adolescents. Adolescents were motivated to engage in physical activity but often lacked the necessary resources. Conclusions: Interventions to increase physical activity among urban Latino adolescents should offer tailored programming, incorporate families, enhance physical education, and improve the safety and appeal of recreational facilities.

Latino children are more likely to be obese than non-Hispanic white children, and feeding patterns that begin in infancy may contribute to this disparity. The objective of this study was to elucidate beliefs and practices related to the introduction of solids and solid food feeding in the first year of life among low-income Latino parents residing in Northern California. We conducted 26 semi-structured interviews that explored the timing of introduction of solids, selection of foods to serve to infants, feeding strategies, sources of information on solid food feeding and concerns about infant weight. We found that most parents relied on traditional practices in selecting first foods for infants and had a strong preference for homemade food, which was often chicken soup with vegetables. Parents generally described responsive feeding practices; however a minority used pressuring practices to encourage infants to eat more. Very few parents practiced repeated gentle introduction of unfamiliar food to increase acceptance. High calorie low nutrient foods were typically introduced at around 12 months of age and parents struggled to limit such foods once children were old enough to ask for them. Parents were concerned about the possibility of infants becoming overweight and considered health care providers to be an important source of information on infant weight status. The results of this study can be used to inform the development of interventions to prevent obesity in Latino children with similar demographics to our study population.

The objective of this study was to evaluate an educational module for Latino parents about the health effects of sweet beverages. Latino parents were randomized to receive the beverage module or a control module. Child beverage consumption was assessed at baseline, 2 weeks, 2 months, and 3 months via a beverage recall survey. At 2-week follow-up, children of intervention participants had a mean reduction in 7-day total sugar-sweetened beverage and 100% fruit juice consumption of 16 ounces while controls had a mean increase of 4 ounces ( P = .01). At 2-month and 3-month follow-up, there was a reduction in mean total sugar-sweetened beverage and 100% fruit juice consumption among both intervention and control children. An educational module on beverages for Latino parents reduced child consumption of sweet beverages at 2-week follow-up. However, study participation appears to have also reduced controls’ beverage consumption suggesting that frequent intensive surveys of beverage intake may be an intervention unto itself.

To determine trends in the consumption of sugar-sweetened beverages (SSBs) and 100% fruit juice by California children ages 2 to 11 years from 2003 to 2009.This analysis used serial cross-sectional data from the California Health Interview Survey, a telephone survey of households in California. Parents were asked how many servings of SSBs and 100% fruit juice the child consumed the day before. A test of trend was used to evaluate changes in consumption over time. Multivariate logistic regression was used to determine the independent effects of race/ethnicity, parental education, and household income on beverage consumption.The percentage of children consuming an SSB on the prior day declined from 40% in 2003 to 16% in 2009 (P.001) among children ages 2 to 5 and from 54% in 2003 to 33% in 2009 (P.001) among children ages 6 to 11. The percentage of children consuming any SSB decreased for all racial/ethnic groups, although there were disparities with higher consumption among Latinos. Among children ages 2 to 5, consumption of 2 or more servings of 100% fruit juice per day decreased among white children and increased among Latinos. For children ages 6 to 11, consumption of 2 or more servings of 100% fruit juice per day remained stable for white children and increased among Latinos and African Americans.The decrease in SSB consumption by California children from 2003 to 2009 is a promising trend. The increase in 100% fruit juice consumption among minority children during this period may be an unintended consequence of efforts to reduce SSB consumption.

Childhood obesity is epidemic in the USA and there are significant racial/ethnic disparities in obesity rates, with Latino children disproportionately affected(1). The most recent National Health and Nutrition Examination Survey (NHANES) found that 39% of Mexican American children aged 6–11 years were overweight (BMI ≥ 85th percentile) and 22% were obese (BMI ≥ 95th percentile)(1). Childhood obesity significantly increases the risk of being obese in adulthood(2) and is also associated with numerous morbidities in childhood(3). Consequently, it is crucial to understand the aetiology of childhood obesity in Mexican American children to improve the efficacy of prevention measures. Of the dietary habits which may contribute to child obesity, beverage consumption is of particular interest. However, there are unanswered questions with respect to the effects of different beverages on obesity risk. Energy from sugar-sweetened beverages (SSB) now comprises nearly 10% of total energy intake for children in the USA, and the greatest increases in SSB consumption have been in minority youth(4). Several studies have found an association between SSB consumption and obesity in children(5–8). However, other studies have found no association(9–11), and recent review articles and meta-analyses differ in their conclusions on the strength of the evidence linking SSB consumption to obesity in children(12–15). With respect to beverages other than SSB, several observational and one experimental study found that the consumption of milk and other dairy products may be protective against obesity in children(16–20); although other studies have found that dairy consumption has a neutral effect on childhood obesity(21). Finally, while some studies have found that 100% fruit juice consumption is associated with obesity(18,22–24), other studies have not confirmed this finding(25,26). Of the previous studies that have analysed the association between beverage consumption and obesity in Latino children, all but one were limited to children aged 6 years or younger and most examined a limited number of beverage categories(5,6,8,27,28). We sought to broadly characterize the beverage consumption habits in a sample of Mexican American children aged 8–10 years and to determine whether beverage consumption was associated with obesity in this population.

Objective To evaluate the effects of diarrhea on appetite among Peruvian children age 12 to 71 months and to assess whether elevated plasma levels of peptide YY, tumor necrosis factor (TNF)-α, and interleukin (IL)-1β contribute to anorexia in this population. Study design A total of 46 Peruvian children with diarrhea and 46 healthy controls underwent an observed feeding trial that was repeated when cases were healthy. Blood samples were obtained from 30 cases and 30 controls at the first trial and from 30 cases at the second trial and assayed for peptide YY, TNF-α, and IL-1β. Results In the cases, mean consumption was less when sick than when healthy. The mean plasma level of peptide YY was higher for cases than controls and higher for cases when sick than when healthy. TNF-α levels were higher in cases than controls at visit 1 and also higher in cases when sick than when healthy. There were no differences in IL-1β levels between cases and controls or between cases when sick and healthy. Peptide YY levels in children with diarrhea correlated with the likelihood of them eating less when sick than when healthy. Conclusions Elevated serum peptide YY may be a mechanism for anorexia in children with diarrhea.