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Background: Many young people form unhealthy behavioural habits, such as low intake of fruit and vegetables, high intake of energy-dense snack foods, and excessive sedentary screen-based behaviours. However, there is a shortage of parent-and home-focused interventions to change multiple health behaviours in children.Methods: Kids FIRST was a 12-week, home- and school-based pilot randomised controlled trial to reduce screen-time and unhealthy snacking with assessments at pre- (baseline) and post-intervention. Four UK schools were randomised to control or one of three interventions targeting reductions in (1) screen-time and unhealthy snacking (ST + Sn), (2) screen-time (ST only), (3) unhealthy snacking (Sn only), and parents with children aged 9-11 years were recruited via schools. Intervention group parents received four online 'sessions' and four packages of resources tailored to each group. Children received four 30-min lessons during school time. Children and parents reported their own screen-time behaviours, children reported their own snacking behaviours. Descriptive analyses were undertaken using principles of intention to treat.Results: Initial feasibility was shown in that this study successfully recruited schools and families into all four study arms and retained them over a period of 13 weeks (retention rate ≥ 74%). Seventy-five children and 64 parents provided full baseline questionnaire data. Reductions in children's school day and weekend day TV/DVD viewing and computer game use were found in the ST + Sn and ST groups, while self-reported smartphone use increased in these groups. Similar results were found for parents' TV/DVD, computer and smartphone use in these groups. Little to no changes were found in reports of the dietary variables assessed in any intervention group for children or parents.Conclusions: These preliminary findings show some promise for the Kids FIRST intervention. Based on these findings, a future full trial should recruit a more diverse sample of families and optimise the intervention and intervention resources to more fully engage parents with the dietary-based components of the intervention programme, where fewer changes were seen. Although most parents reporting receiving the intervention resources, further development work is required to achieve higher levels of engagement. This might include greater parent and child engagement work early in the development of the project.Trial Registration: Retrospectively registered in June 21st 2019 with ClinicalTrials.gov (number NCT03993652). [ABSTRACT FROM AUTHOR]

Objective: To characterize associations of snacking frequency with weight status among US children aged 1 to 5 years.Methods: Participants were children (n = 4,669) aged 1 to 5 years in the 2005 to 2014 National Health and Nutrition Examination Survey (NHANES). Snacking was assessed by two 24-hour dietary recalls using definitions that considered "snack" occasions as well as other foods/beverages consumed between meals. Overweight/obesity (OW/OB) was defined using percentile cutoffs: ≥ 97.7th weight-for-length (< 2 years) cutoff and the ≥ 85th BMI-for-age (≥ 2 years) cutoff. Linear/logistic regressions evaluated snacking based on daily occasions and relative to current recommendations (two to three snacks per day).Results: During 2005 to 2014, US children aged 1 to 5 years consumed, on average, two to three snacks daily. Children with normal weight in both age groups tended to snack less frequently than children with OW/OB when considering all foods/beverages eaten between meals (P < 0.01-0.12). Across most snacking definitions, children < 2 years who snacked more frequently than recommended had greater odds of having OW/OB (P < 0.01-0.12) and consumed greater daily snack energy than those who snacked within recommendations (all P < 0.01). Recommendations did not clearly delineate weight status among children aged 2 to 5 years.Conclusions: Snacking frequency and weight are positively associated among US children 1 to 5 years old, with most consistent associations seen among children < 2 years old and when considering all foods/beverages consumed between meals. [ABSTRACT FROM AUTHOR]

Snack foods, though regarded as unhealthy, are widely eaten by children, particularly those with eating and feeding difficulties. This article outlines the ways in which paediatricians have traditionally made use of snack foods as incentives and then reviews the key nutritional and practical characteristics of commonly eaten snack foods, to allow practitioners to evaluate their role in the child's diet. Generally savoury snacks are preferable to sweet, while dry foods are preferable to drinks or semiliquid desserts. Many ostensibly healthy snacks are also rich in sugar or fat. Eaten in addition to other meals, snack foods may lead to obesity or else displace family foods, but the instant appeal of snack foods can be exploited to introduce young children to otherwise aversive sensations and tastes and can prove a useful path towards a more diverse future diet. If a reasonable variety of snack foods are taken, this will still form a fairly balanced, if non-ideal, diet. [ABSTRACT FROM AUTHOR]

Research on the relative influence of package features on children's perception of food products is still necessary to aid policy design and development. The aim of the present work was to evaluate the relative influence of two front-of-pack (FOP) nutrition labelling schemes, the traffic light system and Chilean warning system, and label design on children's choice of two popular snack foods in Uruguay, wafer cookies and orange juice. A total of 442 children in grades 4 to 6 from 12 primary schools in Montevideo (Uruguay) participated in the study. They were asked to complete a choice-conjoint task with wafer cookies and orange juice labels, varying in label design and the inclusion of FOP nutrition information. Half of the children completed the task with labels featuring the traffic-light system (n = 217) and the other half with labels featuring the Chilean warning system (n = 225). Children's choices of wafer cookies and juice labels was significantly influenced by both label design and FOP nutritional labels. The relative impact of FOP nutritional labelling on children's choices was higher for the warning system compared to the traffic-light system. Results from the present work stress the need to regulate the design of packages and the inclusion of nutrient claims, and provide preliminary evidence of the potential of warnings to discourage children's choice of unhealthful products. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to evaluate the association of 4-year-old children's dietary patterns with adiposity at 7 years, according to child's sex, using a conceptual model.Design: Prospective cohort study. Diet was assessed using an FFQ. Age- and sex-specific BMI standard deviation scores (Z-scores) were defined according to the WHO. Fat mass percentage (FM%), fat mass index (FMI) and waist-to-height ratio (WHtR) were also considered, converted into Z-scores using sex-specific means and standard deviations of the current sample. Dietary patterns were identified by latent class analysis and their association with adiposity was estimated by linear regression models.Setting: Population-based birth cohort Generation XXI (Porto, Portugal, 2005-2006).Subjects: Children (n 3473) evaluated at both 4 and 7 years of age.Results: Three dietary patterns were identified: high in energy-dense foods (EDF); low in foods typically consumed at main meals and intermediate in snacks (Snacking); and higher in vegetables and fish and lower in EDF (Healthier, reference). The EDF dietary pattern at 4 years of age was positively associated with later BMI only in girls (β=0·075, 95 % CI 0·009, 0·140, P-interaction=0·046). The EDF dietary pattern was also associated with other adiposity indicators only in girls (FMI: β=0·071, 95 % CI 0·000, 0·142; WHtR: β=0·094, 95 % CI 0·023, 0·164). Snacking was not significantly associated with any marker of adiposity in either girls or boys.Conclusions: Although dietary patterns and adiposity persisted across the two ages in both sexes, EDF at 4 years of age increased adiposity at 7 years of age only in girls. [ABSTRACT FROM AUTHOR]

BACKGROUND: Snack foods; crisps and biscuits, and beverages; fruit juices and soft drinks, are some of the most commonly consumed products by children of school age worldwide. OBJECTIVE: The aim of this study is to investigate if snack foods and beverages are suitable for consumption by children of school age through recording and comparing the nutritional information presented on the nutrition panel such as energy, protein, total carbohydrates and total fat for these products. METHODS: The nutritional information from 56 products sold in different supermarket out lets across Muscat, the capital city of Oman, was collected and statistically analysed using the mean and the percentage of Recommended Daily Intake. RESULTS: Based on the percentage of Recommended Daily Intake of energy and nutrients, crisps offer higher amounts of energy and total fat for children when compared to biscuits. Meanwhile, biscuits offer lower amount of energy than crisps but offer a higher amount of total carbohydrates for children. Regarding fruit juices and soft drinks, the former offer higher amount of energy than the later but both, however, offer comparable amounts of total carbohydrates. CONCLUSION: Upon comparing the nutritional information of the products studied and considering their nutritional benefits and health risks, it seems that biscuits are suitable choice for children. [ABSTRACT FROM AUTHOR]

Objective To describe national trends in discretionary calories from sugar sweetened beverage (SSB) and snacks by age-specific body weight categories and by age- and weight-specific race/ethnicity groups. Examining these subpopulations is important as population averages may mask important differences. Design and Methods 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2003-2010 among children aged 2 to 19 ( N = 14,092) were used. Logistic and linear regression methods were used to adjust for multiple covariates and survey design. Results The number of calories from SSBs declined significantly for nearly all age-specific body weight groups. Among overweight or obese children, significant declines in the number of calories from SSBs were observed among Hispanic children aged 2 to 5 (117 vs. 174 kcal) and white adolescents aged 12 to 19 (299 vs. 365 kcal). Significant declines in the number of calories from salty snacks were observed among white children aged 2 to 5 (192 to 134 kcal) and 6 to 11 (273 vs. 200 kcal). Conclusions The decrease in SSB consumption and increase in snack consumption observed in prior research are not uniform when children are examined within subgroups accounting for age, weight, and race/ethnicity. [ABSTRACT FROM AUTHOR]

Background: Screen-time and unhealthy dietary behaviours are highly pervasive in young children and evidence suggests that these behaviours often co-occur and are associated. Identifying clusters of unhealthy behaviours, and their influences early in childhood, can assist in the development of targeted preventive interventions. The purpose of this study was to examine the sociodemographic, behavioural, and home physical environmental correlates of co-occurring screen-time and unhealthy eating behaviours and to assess the clustering of screen-time and unhealthy dietary behaviours in young children.Methods: Parents of 126 children, from the UK, aged 5-6 years (49% boys) completed a questionnaire which assessed their child's screen-time (ST), fruit and vegetable (FV), and energy-dense (ED) snack consumption. Categories of health behaviours were created based on frequencies of children meeting recommendations for FV and ST and median splits of frequencies for ED snacks. Parents reported on their own behaviours (ST, FV, and ED snack consumption), how often they ate meals and watched TV with their child, and on the availability and accessibility of foods within the home. An observed over expected ratio (O/E) was used to assess behavioural clustering. Multivariable multinomial logistic regression was used to examine correlates of behaviour patterns.Results: Approximately 25% of children had two or three health risk behaviours. Correlates consistently associated with clusters included parental income, eating meals at the TV, parental ST and ED snack food consumption, and home availability of ED snack foods. Observed over expected ratios were close to 1 and ranged from 0.78 to 1.43. The three-risk behaviour combination of insufficient FV consumption, high ED snack consumption, and excessive ST occurred more frequently than expected (1.23 (95% CI 0.89, 1.58)).Conclusions: ST and unhealthy dietary behaviours cluster in children as young as 5 years of age and parents' own behaviours appear to be important influencing factors. Further research into the development of behavioural clustering in young children to identify and further understand the mechanisms underlying the synergy among health behaviours is needed. Feasibility interventions promoting reductions in both screen-time and unhealthy dietary behaviours reciprocally, while simultaneously focusing on changing parental behaviours, are warranted. [ABSTRACT FROM AUTHOR]