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Objective: To investigate primiparous women's knowledge, attitudes, and practices regarding the physical home food environment (PHFE) and to assess if the first pregnancy provides a teachable opportunity to enhance the PHFE of first-time pregnant couples. Design: Longitudinal in-depth qualitative study involving questionnaires and individual interviews during and after pregnancy. Participants: Fifteen primigravida women. Main outcome measures: Knowledge, attitudes, and behaviors concerning PHFE; lifestyle and dietary habits; and interest in guidance regarding healthy PHFE during the first pregnancy and the transition to motherhood. Analysis: Thematic analysis for qualitative data and descriptive statistics. Results: Key findings include the significance of health, nutrition, and spousal support in the transition to motherhood. The first pregnancy was recognized as a critical period for establishing a healthy PHFE, while noting the physical and emotional challenges involved. A gap was found in guidance regarding PHFE for first-time pregnant women despite their interest in practical advice. Conclusions and Implications: The first pregnancy presents a significant opportunity to improve PHFE. 'Nestrition' (nutritional nesting), a new health-promotion strategy, incorporates nutrition education to enhance this process. These data support future research encompassing partners and diverse at-risk populations prior to the development of effective nutrition education for PHFE in the first pregnancy. [ABSTRACT FROM AUTHOR]

To explore the goals, barriers, and facilitators set by caregivers of preschool-aged children to improve food parenting practices and household food environments. Secondary qualitative analysis of collaborative goal sheets completed during in-home and telephone visits as part of a home-based pilot intervention. Thirty-three Hispanic/Latinx caregivers, predominantly of low income. Patterns in goal content and anticipated barriers and facilitators. Thematic analysis of goal sheets with a mixed inductive-deductive approach. Almost half of the goals were to support a healthy environment (40.7%) by increasing the availability of healthy foods through food shopping and meal planning. Other goals were to increase structure (33.7%) by establishing food-related routines and decreasing distractions. Goals related to autonomy support (25.4%) included involving their children (eg, cooking together). Caregivers' perceived barriers encompass individual (eg, stress, lack of time), interpersonal (eg, other family members' eating behaviors), and environmental-level (eg, food availability) factors. Caregivers only identified facilitators at the individual and interpersonal levels (eg, motivation). Understanding goals, barriers, and facilitators can be used to tailor key messages to improve food parenting practices and children's diets. Future interventions can target broader environmental barriers while increasing awareness of individual, interpersonal, and environmental-level facilitators. [ABSTRACT FROM AUTHOR]

BackgroundAccurate measurement of food-related parenting practices is necessary to inform related interventions and program evaluation. Valid tools reflect cultural attributes that affect household food environments and feeding practices. Simple, unidirectional language adaptation approaches are insufficient to capture these attributes in assessment tools. My Child at Mealtime (MCMT) is a 27-item, validated, visually enhanced self-assessment tool to measure food-related parenting practices of low-income English-speaking parents of preschoolers.ObjectivesThe aim of this study was to describe the cross-cultural adaptation of MCMT into its Spanish version Mi Niño a la Hora the Comer (Mi Niño) and to establish its face validity, factor structure, and internal consistency.MethodsMCMT was adapted into its Spanish version after an iterative process that triangulated cognitive interviews with verification of conceptual equivalence by content experts to establish face validity and semantic equivalence. The resulting tool underwent confirmatory factor analysis to determine whether internal consistency was equivalent across the 2 versions.ResultsFour rounds of cognitive interviews (n = 5, n = 6, n = 2, and n = 4, respectively) with Spanish-speaking women caregivers of children aged 3-5 y recruited from Head Start were conducted. Ten items were modified throughout the adaptation process. Modifications included improved clarity (6 items), comprehension (7 items), appropriateness (4 items), suitability (4 items), and usefulness (2 items) of text and/or accompanying visuals. Confirmatory factor analysis with a sample of Spanish-speaking caregivers (n = 243) resulted in 2 reliable factors representing "child-centered" (α = 0.82) and "parent-centered" (α = 0.87) food-related parenting practices.ConclusionsFace validity, semantic equivalence, and internal consistency of Mi Niño were established. This tool can be used in community settings to inform program content and measure changes in food-related parenting practices of Spanish-speaking parents and assist in setting food-related parenting goals. The next steps include exploring the correspondence of Mi Nino with mealtime behaviors observed through video recording.

As rates of metabolic syndrome rise, children consume too few vegetables and too much added sugar. Because children tend to eat what is available at home, the home environment plays a key role in shaping dietary habits. This secondary analysis evaluated the effects of a school-based gardening, cooking, and nutrition education intervention (TX Sprouts) compared to control on the availability of vegetables, fruit juice, and sugar-sweetened beverages (SSBs) at home. In the TX Sprouts cluster-randomized trial, 16 schools were randomized to TX Sprouts (n = 8 schools) or control (n = 8 schools) for one academic year. All schools served predominately Hispanic families with low incomes. TX Sprouts built school gardens and taught 18 lessons to all 3rd-5th grade students at intervention schools. TX Sprouts also offered monthly caregiver lessons before and/or after school. Caregivers completed questionnaires pre and post, providing demographics and information about home availability of vegetables, fruit juice, and SSBs. Summary statistics were used to describe the sociodemographic characteristics of participants. Linear regression assessed the change in scores (pre to post) for the food/ beverage availability question. The model was adjusted for the caregivers education, employment status, childs grade, and free or reduced-price lunch eligibility. The analytic sample included 895 participants. Compared to control, the intervention positively changed the home availability of targeted foods and beverages, largely by improving the availability of vegetables and vegetable juice. This study showed that a school gardening, nutrition, and cooking program delivered to elementary children may positively influence the home food environment.

Objective: To investigate primiparous women’s knowledge, attitudes, and practices regarding the physical home food environment (PHFE) and to assess if the first pregnancy provides a teachable opportunity to enhance the PHFE of first-time pregnant couples. Design: Longitudinal in-depth qualitative study involving questionnaires and individual interviews during and after pregnancy. Participants: Fifteen primigravida women. Main outcome measures: Knowledge, attitudes, and behaviors concerning PHFE; lifestyle and dietary habits; and interest in guidance regarding healthy PHFE during the first pregnancy and the transition to motherhood. Analysis: Thematic analysis for qualitative data and descriptive statistics. Results: Key findings include the significance of health, nutrition, and spousal support in the transition to motherhood. The first pregnancy was recognized as a critical period for establishing a healthy PHFE, while noting the physical and emotional challenges involved. A gap was found in guidance regarding PHFE for first-time pregnant women despite their interest in practical advice. Conclusions and Implications: The first pregnancy presents a significant opportunity to improve PHFE. ‘Nestrition’ (nutritional nesting), a new health-promotion strategy, incorporates nutrition education to enhance this process. These data support future research encompassing partners and diverse at-risk populations prior to the development of effective nutrition education for PHFE in the first pregnancy.

Objective: The objective of this study was to evaluate the home food environment of the elderly in Beijing and analyze its association with the body mass index (BMI) of the elderly, as well as to provide recommendations for improving the home food environment for the elderly. Methods: This study was conducted in Beijing, China, in 2019. The participants were 1764 elderly individuals aged 65 to 80, recruited from 12 communities through a multistage stratified random sampling method. The study involved the use of questionnaire surveys to gather data on participants' demographics, the availability of various foods in their households, and their living conditions. Socioeconomic status (SES) was evaluated based on their educational level, occupation, and income level. Height and weight measurements were taken to calculate BMI. We conducted both univariate analysis and multiple linear regression analysis to evaluate the relationship between the home food environment and BMI. Results: A total of 1800 questionnaires were distributed, of which 1775 were retrieved, resulting in a questionnaire recovery rate of 98.6%. Among these, 1764 questionnaires were deemed valid, corresponding to a questionnaire validity rate of 99.4%. The participants had a mean age of 69.7 ± 4.3 years old, over 40% of whom were overweight or obese. In terms of low-energy/high-nutrient-density foods, the most readily available items were fresh vegetables (95.6%), followed by coarse grains (94.1%), fresh fruits (90.4%), and dairy products (83.6%). Among high-energy/low-nutrient-density foods, preserved foods were the most available (51.9%), followed by salted snacks (40.6%), sugary beverages (28.2%), and fried foods (9.4%). Approximately 7.3% of participants lived alone. Elderly individuals with higher SES had a lower BMI compared to those with medium to low SES (25.9 vs. 26.5, 25.9 vs. 26.4, p < 0.05). Those living alone had a higher BMI than those who did not (27.2 vs. 26.2, p = 0.001). After controlling for potential confounding variables, older adults with high SES exhibited a BMI reduction of 0.356 kg/m2 (p = 0.001), whereas those living alone exhibited an increase in BMI of 1.155 kg/m2 (p < 0.001). The presence of preserved foods at home was linked to a BMI increase of 0.442 kg/m2 (p = 0.008). Conclusion: This study underscores the significant impact of family SES, living conditions, and the availability of preserved foods on the BMI of elderly individuals. [ABSTRACT FROM AUTHOR]

Abstract Objectives: To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. Design: Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children’s diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. Setting: Public primary schools in Central Jakarta, sampled at random. Participants: Children (n 1674) aged 6–13 years from 18 public primary schools. Results: Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children’s BMI at the median of the Z-score distribution (P = 0·026). Dietary and physical activity risk scores were not associated with children’s BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0·022 and 0·023, respectively). Conclusions: This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.

The home food environment (HFE), the availability and accessibility of foods and food products within the home, has a strong influence on healthy eating behaviors. Studies assessing the HFE commonly utilize a home food inventory (HFI) for data collection. However, this approach tends to be burdensome for participants. This study validated a low-burden digital photo method for assessing the home food environment and confirmed that this method is preferred by participants. Study participants completed an HFI, submitted photos of household foods, then identified preference for the HFI or photo reporting method. Researchers completed an HFI based on each participant’s photo submissions. Researcher-to-participant and researcher-to-researcher comparisons were made through ANOVA and randomized block analyses to determine concurrent validity and inter-rater reliability. Method preference was assessed using the Z-test. The participant group (N = 53) was predominantly female (68%), young adult (90.5%), and Hispanic or Latino (71.7%). Concurrent validity was initially moderate (ĸ = 0.54); adjustments yielded substantial agreement (ĸ = 0.61). The inter-rater reliability (p = 0.98) demonstrated significant consistency among reviewers. The photo-documentation method was found to be valid and preferred (p = 0.01) for reporting on the HFE. The photo method can be used advantageously to collect quality data.

As rates of metabolic syndrome rise, children consume too few vegetables and too much added sugar. Because children tend to eat what is available at home, the home environment plays a key role in shaping dietary habits. This secondary analysis evaluated the effects of a school-based gardening, cooking, and nutrition education intervention (TX Sprouts) compared to control on the availability of vegetables, fruit juice, and sugar-sweetened beverages (SSBs) at home. In the TX Sprouts cluster-randomized trial, 16 schools were randomized to TX Sprouts (n = 8 schools) or control (n = 8 schools) for one academic year. All schools served predominately Hispanic families with low incomes. TX Sprouts built school gardens and taught 18 lessons to all 3rd-5th grade students at intervention schools. TX Sprouts also offered monthly caregiver lessons before and/or after school. Caregivers completed questionnaires pre and post, providing demographics and information about home availability of vegetables, fruit juice, and SSBs. Summary statistics were used to describe the sociodemographic characteristics of participants. Linear regression assessed the change in scores (pre to post) for the food/ beverage availability question. The model was adjusted for the caregiver’s education, employment status, child’s grade, and free or reduced-price lunch eligibility. The analytic sample included 895 participants. Compared to control, the intervention positively changed the home availability of targeted foods and beverages, largely by improving the availability of vegetables and vegetable juice. This study showed that a school gardening, nutrition, and cooking program delivered to elementary children may positively influence the home food environment.

Prior research suggests that food security status may have an effect on the home food environment. Further, the literature suggests that food access factors may function to influence said relationship. The purpose of this research is to fill a gap in the literature on this relationship, as well as to identify potential food access effect modifiers. This research employs linear mixed effects modeling with a random intercept variable (zip codes). Eleven food access variables are included in regression analyses and are tested as potential effect modifiers in the association between food security status and the home food environment. Food security status is significantly associated with the home food environment (95% CI = 0.1–1.38) in the unadjusted model. In the adjusted model, food pantry usage is found to be a significant effect modifier on the association between food security status and the home food environment. This research concludes that food security status has a significant but disparate effect on the home food environment depending on participant food pantry usage. Practical implications from this research would be for relevant stakeholders to potentially improve rural food pantry access in order to increase the home food environment among rural and food insecure populations. [ABSTRACT FROM AUTHOR]

The home food environment (HFE) can have important direct and indirect impacts on dietary practices. Nutrient transitions in the HFE of Pacific Island countries (PICs) are key contributors of the high rates of adult and childhood overweight and obesity in the region. Pacifica mothers are important sociocultural agents who play critical roles in their HFE through setting eating-appropriateness standards and mitigating the impacts of food availability and accessibility on the HFE. This study used an interpretative phenomenological approach to explore how urban indigenous Fijian mothers perceive healthy eating and how these perceptions impacted the food decisions they made for their families. Mothers in this study held complex, multifaceted perceptions on healthy eating and these perceptions had both positive and negative impacts on the family food choices they made, the strategies they adopted for healthy eating and their perceived motivators for healthy eating. The findings of this study underscore the need for a deeper understanding and analysis of uptake of public health messaging related to healthy and unhealthy eating and the importance of targeted promotion of healthful nutrition in this community. Promoting consumption of traditional and locally grown foods can enhance nutrition and food security and combat nutrition transition in the region. [ABSTRACT FROM AUTHOR]

The aim of this study is to put forward an approach designed to calculate and sum up discrepancies between the actual food acquisition or intake and any standard or norm. Based on secondary analysis of cross-sectional data from the Mexican National Survey of Household Income and Expenditure, our proposed method to produce classes of entropy-based Diet Adherence Indices generates a Food Basket Adherence Index (FBAI) for Mexico City (2129 households). Findings suggest that it is possible to measure and decompose diet adherence using a cross entropy measure. Using food expenditure data and a normative food basket for Mexico City results, we show households' deviations from the suggested norm for different food groups. The average FBAI was 0.44, far above the minimum score of 0 which would indicate full adherence to the normative food basket. Our measure has a distribution wide enough to detect meaningful changes and distinguish between groups with known differences, providing important new insights on the linkages between home food environments and income distribution, and food insecurity and household distribution. [ABSTRACT FROM AUTHOR]

Abstract Background Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children’s diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children’s diet. This study aimed to determine the associations between family SES and children’s fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. Methods Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children’s FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level (“low”, “middle”, and “high”) and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. Results The positive association between high parental educational level and children’s FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51–4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10–1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35–1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 – -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children’s FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06–1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40–1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. Conclusions Parental educational level showed more associations with children’s FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children’s FV consumption. Future interventions to improve children’s dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion.

Abstract Objective: To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention. Design: Pilot randomised controlled trial. Setting: Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials. Participants: Parents and their 2–5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups. Results: Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes

Objectives: To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia. Design: Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children's diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution. Setting: Public primary schools in Central Jakarta, sampled at random. Participants: Children (n 1674) aged 6–13 years from 18 public primary schools. Results: Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children's BMI at the median of the Z-score distribution (P = 0·026). Dietary and physical activity risk scores were not associated with children's BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0·022 and 0·023, respectively). Conclusions: This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools. [ABSTRACT FROM AUTHOR]

The home food environment (HFE), the availability and accessibility of foods and food products within the home, has a strong influence on healthy eating behaviors. Studies assessing the HFE commonly utilize a home food inventory (HFI) for data collection. However, this approach tends to be burdensome for participants. This study validated a low-burden digital photo method for assessing the home food environment and confirmed that this method is preferred by participants. Study participants completed an HFI, submitted photos of household foods, then identified preference for the HFI or photo reporting method. Researchers completed an HFI based on each participant's photo submissions. Researcher-to-participant and researcher-to-researcher comparisons were made through ANOVA and randomized block analyses to determine concurrent validity and inter-rater reliability. Method preference was assessed using the Z-test. The participant group (N = 53) was predominantly female (68%), young adult (90.5%), and Hispanic or Latino (71.7%). Concurrent validity was initially moderate (ĸ = 0.54); adjustments yielded substantial agreement (ĸ = 0.61). The inter-rater reliability (p = 0.98) demonstrated significant consistency among reviewers. The photo-documentation method was found to be valid and preferred (p = 0.01) for reporting on the HFE. The photo method can be used advantageously to collect quality data. [ABSTRACT FROM AUTHOR]

Background: Recent literature has suggested that associations and interactions between family socioeconomic status (SES) and home food environment influence children's diet, but little is known about the mediation roles of parental role-modeling and food availability in the socioeconomic inequalities of children's diet. This study aimed to determine the associations between family SES and children's fruit and vegetable (FV) consumption and to assess the mediation roles of parental role-modeling and food availability in the above associations. Methods: Cross-sectional data of 574 Finnish children (aged 3 to 6) were analyzed. Parents completed an FFQ assessing their children's FV consumption frequency and a questionnaire assessing SES and home food environment. Two exposure variables: parental educational level ("low", "middle", and "high") and the relative family income tertiles of the family were used. The frequencies of parental role-modeling of FV and sugary food and drink (SFD) consumption, and the availability of FV and SFD at home were calculated. Single- and multiple-mediator models were created using IBM SPSS 27.0. Results: The positive association between high parental educational level and children's FV consumption (direct effect coefficient: 2.76, 95% CI: 0.51–4.86) was partially mediated by more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.89, 95% CI: 0.10–1.76), higher availability of FV (indirect effect coefficient: 1.00, 95% CI: 0.35–1.77), and lower availability of SFD (indirect effect coefficient: -0.30, 95% CI: -0.72 – -0.01). The relative family income was not directly associated with the outcome. However, the higher relative family income level indirectly predicted the Children's FV consumption (full mediation) through more frequent parental role-modeling of FV consumption (indirect effect coefficient: 0.91, 95% CI: 0.06–1.83) and higher availability of FV (indirect effect coefficient: 0.98, 95% CI: 0.40–1.67). Parental role-modeling on SFD consumption did not mediate any of the above associations. Conclusions: Parental educational level showed more associations with children's FV consumption than relative family income. Our findings suggest that reducing the availability of SFD is as important as increasing the availability of FV to enhance children's FV consumption. Future interventions to improve children's dietary behaviors should pay greater attention to the lower SES segments of society. Longitudinal studies and intervention studies supporting these findings are needed for making meaningful recommendations for health promotion. [ABSTRACT FROM AUTHOR]

Objective: To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention. Design: Pilot randomised controlled trial. Setting: Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials. Participants: Parents and their 2–5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups. Results: Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group (n 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (−1·35, −0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (−1·52, −0·19)), using food as a reward (PE = -0·54, 95 % CI (−1·35, −0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)). Conclusion: Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the home food environment of the elderly in Beijing and analyze its association with the body mass index (BMI) of the elderly, as well as to provide recommendations for improving the home food environment for the elderly. Methods: This study was conducted in Beijing, China, in 2019. The participants were 1764 elderly individuals aged 65 to 80, recruited from 12 communities through a multistage stratified random sampling method. The study involved the use of questionnaire surveys to gather data on participants’ demographics, the availability of various foods in their households, and their living conditions. Socioeconomic status (SES) was evaluated based on their educational level, occupation, and income level. Height and weight measurements were taken to calculate BMI. We conducted both univariate analysis and multiple linear regression analysis to evaluate the relationship between the home food environment and BMI. Results: A total of 1800 questionnaires were distributed, of which 1775 were retrieved, resulting in a questionnaire recovery rate of 98.6%. Among these, 1764 questionnaires were deemed valid, corresponding to a questionnaire validity rate of 99.4%. The participants had a mean age of 69.7 ± 4.3 years old, over 40% of whom were overweight or obese. In terms of low-energy/high-nutrient-density foods, the most readily available items were fresh vegetables (95.6%), followed by coarse grains (94.1%), fresh fruits (90.4%), and dairy products (83.6%). Among high-energy/low-nutrient-density foods, preserved foods were the most available (51.9%), followed by salted snacks (40.6%), sugary beverages (28.2%), and fried foods (9.4%). Approximately 7.3% of participants lived alone. Elderly individuals with higher SES had a lower BMI compared to those with medium to low SES (25.9 vs. 26.5, 25.9 vs. 26.4, p < 0.05). Those living alone had a higher BMI than those who did not (27.2 vs. 26.2, p = 0.001). After controlling for potential confounding variables, older adults with high SES exhibited a BMI reduction of 0.356 kg/m2 (p = 0.001), whereas those living alone exhibited an increase in BMI of 1.155 kg/m2 (p < 0.001). The presence of preserved foods at home was linked to a BMI increase of 0.442 kg/m2 (p = 0.008). Conclusion: This study underscores the significant impact of family SES, living conditions, and the availability of preserved foods on the BMI of elderly individuals.

Background: Accurate measurement of food-related parenting practices is necessary to inform related interventions and program evaluation. Valid tools reflect cultural attributes that affect household food environments and feeding practices. Simple, unidirectional language adaptation approaches are insufficient to capture these attributes in assessment tools. My Child at Mealtime (MCMT) is a 27-item, validated, visually enhanced self-assessment tool to measure food-related parenting practices of low-income English-speaking parents of preschoolers. Objectives: The aim of this study was to describe the cross-cultural adaptation of MCMT into its Spanish version Mi Niño a la Hora the Comer (Mi Niño) and to establish its face validity, factor structure, and internal consistency. Methods: MCMT was adapted into its Spanish version after an iterative process that triangulated cognitive interviews with verification of conceptual equivalence by content experts to establish face validity and semantic equivalence. The resulting tool underwent confirmatory factor analysis to determine whether internal consistency was equivalent across the 2 versions. Results: Four rounds of cognitive interviews (n = 5, n = 6, n = 2, and n = 4, respectively) with Spanish-speaking women caregivers of children aged 3-5 y recruited from Head Start were conducted. Ten items were modified throughout the adaptation process. Modifications included improved clarity (6 items), comprehension (7 items), appropriateness (4 items), suitability (4 items), and usefulness (2 items) of text and/or accompanying visuals. Confirmatory factor analysis with a sample of Spanish-speaking caregivers (n = 243) resulted in 2 reliable factors representing "child-centered" (α = 0.82) and "parent-centered" (α = 0.87) food-related parenting practices. Conclusions: Face validity, semantic equivalence, and internal consistency of Mi Niño were established. This tool can be used in community settings to inform program content and measure changes in food-related parenting practices of Spanish-speaking parents and assist in setting food-related parenting goals. The next steps include exploring the correspondence of Mi Nino with mealtime behaviors observed through video recording. [ABSTRACT FROM AUTHOR]

Abstract Background Rural children are at greater obesity risk than their urban peers. The NU-HOME study is an innovative collaborative effort to prevent childhood obesity in rural communities. Weight outcomes of the NU-HOME study, a family-meal focused randomized controlled trial (RCT) are described. We hypothesized that compared to control group children, intervention group children would have significantly lower weight-related post-intervention (PI) outcomes. Methods Participants were 114 dyads (7–10 year-old rural children and a parent). In 2017–2018 and 2018–2019, research staff measured height, weight and body fat at baseline (BL) and PI. Families were randomized to intervention (n = 58) or control (n = 56) groups without blinding. Designed with Social Cognitive Theory and community engagement, the NU-HOME program included seven monthly sessions delivered in community settings and four goal-setting calls. The program engaged entire families to improve healthy eating, physical activity, family meals and the home food environment. Multiple linear and logistic regression models tested PI outcomes of child BMIz-score, percent body fat, percent over 50th percentile BMI, and overweight/obesity status by treatment group, adjusted for BL values and demographics (n = 102). Results No statistically significant intervention effects were seen for child BMIz or overweight/obesity status. However, a promising reduction in boys’ percent body fat (− 2.1, 95% CI [− 4.84, 0.63]) was associated with the intervention. Conclusions Although our findings were in the hypothesized direction, making significant impacts on weight-related outcomes remains challenging in community trials. Comprehensive family-focused programming may require intensive multi-pronged interventions to mitigate complex factors associated with excess weight gain. Clinical trial registration This study is registered with NIH ClinicalTrials.gov: NCT02973815 .

The home food environment (HFE) can have important direct and indirect impacts on dietary practices. Nutrient transitions in the HFE of Pacific Island countries (PICs) are key contributors of the high rates of adult and childhood overweight and obesity in the region. Pacifica mothers are important sociocultural agents who play critical roles in their HFE through setting eating-appropriateness standards and mitigating the impacts of food availability and accessibility on the HFE. This study used an interpretative phenomenological approach to explore how urban indigenous Fijian mothers perceive healthy eating and how these perceptions impacted the food decisions they made for their families. Mothers in this study held complex, multifaceted perceptions on healthy eating and these perceptions had both positive and negative impacts on the family food choices they made, the strategies they adopted for healthy eating and their perceived motivators for healthy eating. The findings of this study underscore the need for a deeper understanding and analysis of uptake of public health messaging related to healthy and unhealthy eating and the importance of targeted promotion of healthful nutrition in this community. Promoting consumption of traditional and locally grown foods can enhance nutrition and food security and combat nutrition transition in the region.

Prior research suggests that food security status may have an effect on the home food environment. Further, the literature suggests that food access factors may function to influence said relationship. The purpose of this research is to fill a gap in the literature on this relationship, as well as to identify potential food access effect modifiers. This research employs linear mixed effects modeling with a random intercept variable (zip codes). Eleven food access variables are included in regression analyses and are tested as potential effect modifiers in the association between food security status and the home food environment. Food security status is significantly associated with the home food environment (95% CI = 0.1–1.38) in the unadjusted model. In the adjusted model, food pantry usage is found to be a significant effect modifier on the association between food security status and the home food environment. This research concludes that food security status has a significant but disparate effect on the home food environment depending on participant food pantry usage. Practical implications from this research would be for relevant stakeholders to potentially improve rural food pantry access in order to increase the home food environment among rural and food insecure populations.

Background A strong body of evidence links young children's intake of sugar-sweetened beverages (SSBs) with myriad negative outcomes. Objectives Our research provides insight into whether and to what extent potential intervention strategies can reduce young children's consumption of SSBs. Methods We built an agent-based model (ABM) of SSB consumption representing participants in the Project Viva longitudinal study between ages 2 and 7 y. In addition to extensive data from Project Viva, our model used nationally representative data as well as recent, high-quality literature. We tested the explanatory power of the model through comparison to consumption patterns observed in the Project Viva cohort. Then, we applied the model to simulate the potential impact of interventions that would reduce SSB availability in 1 or more settings or affect how families receive and respond to pediatrician advice. Results Our model produced age-stratified trends in beverage consumption that closely match those observed in Project Viva cohort data. Among the potential interventions we simulated, reducing availability in the home—where young children spend the greatest amount of time—resulted in the largest consumption decrease. Removing access to all SSBs in the home resulted in them consuming 1.23 (95% CI: 1.21, 1.24) fewer servings of SSBs per week on average between the ages of 2 and 7 y, a reduction of ∼60%. By comparison, removing all SSB availability outside of the home (i.e. in schools and childcare) had a smaller impact (0.77; CI: 0.75, 0.78), a reduction of ∼40%. Conclusions These results suggest that interventions reducing SSB availability in the home would have the strongest effects on SSB consumption. [ABSTRACT FROM AUTHOR]

Despite the fact that Indonesia has established nutrition and health measures to prevent childhood malnutrition, more than 70% of children aged 2 to 5 consume less iron than the Indonesian dietary recommendations. Iron deficiency harms children's cognitive and motor development, and increases morbidity. Sixty-five to 72% of children's daily calories are consumed at home, hence the environment is crucial. The purpose of this study is to observe if the iron and vitamin C consumption of children aged 2 to 6 in Pejagalan, North Jakarta, is related to their eating environment. A total of 191 samples was examined. To assess children's intake, 2x24h food recalls were performed. A modified version of the NHANES CBQ was used to assess the home food environment. SPSS Version 20 was used to perform Spearman correlation and multiple linear regression. The iron and vitamin consumption of the subjects was lower than the estimated average requirement (EAR) for Indonesia. It was shown that children who had more access to fruits and vegetables ingested more iron and vitamin C. Iron consumption was enhanced by fruits, vegetables, sweets, and sugar sweetened beverages. Fruit accessibility (p<0.05) and availability (p<0.05) were related to vitamin C consumption. A variety of home food environment characteristics such as the availability and accessibility of food, are related to a child's consumption, particularly of micronutrients. [ABSTRACT FROM AUTHOR]

Background: Home food availability has been identified as an important influence on dietary intake. Less is known about the relationship between the physical home food environment (HFE) and factors of cardiometabolic health in children., Objective: The purpose of this study was to explore the relationship between the physical HFE and diet quality and factors of cardiometabolic health (eg, weight and blood biomarkers)., Design: This was a cross-sectional secondary analysis with 1 or more children per household., Participants/setting: This study included 44 children aged 6 to 12 years from 29 households in the Newark, DE area between August 2020 and August 2021., Main Outcome Measures: The Home Food Inventory provides an obesogenic score (ie, score indicative of the presence of energy-dense foods) for the overall HFE and HFE subcategories scores; body mass index z-scores were calculated using measured height and weight; diet quality was measured using the Healthy Eating Index 2020 (HEI-2020) total scores; and cardiometabolic biomarkers were obtained from serum blood samples., Statistical Analyses Performed: Unadjusted and adjusted linear mixed model regressions were used to test the association between the physical HFE and each of the outcome variables: body mass index z scores, HEI-2020 total scores, and cardiometabolic biomarkers. HFE subcategories (eg, fruits and vegetables) were also examined with each outcome using linear mixed model regression., Results: Mean ± SD age of the children was 9.5 ± 1.9 years, 61.4% were female, 59.1% identified as White, and 90.9% were non-Hispanic. Obesogenic score was significantly associated with body mass index z scores (β = .03, P = .029), but not HEI-2020 total scores or cardiometabolic biomarkers. As HFE fruits and vegetables subcategory increased, HEI-2020 total scores significantly increased (β = .73, P = .005) and total cholesterol (β = -1.54, P = .014) and low-density lipoprotein cholesterol levels (β = -1.31, P = .010) significantly decreased. Increased availability of sweet and salty snack food and availability of sugar-sweetened beverages was associated with increased fasting blood glucose (β = 0.65, P = .033) and insulin levels (β = 5.60, P = .035) respectively., Conclusions: There is evidence of a relationship between the subcategories of the physical HFE and cardiometabolic factors. Future interventions are needed to understand whether altering the overall HFE or specific subcategories within the HFE can improve cardiometabolic health., (Copyright © 2024 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

The eating behavior (EB) and habits developed during adolescence tend to persist into adulthood, with parents and caregivers playing a significant role in shaping their children's food choices. The home environment is a crucial setting for developing eating behavior during adolescence. This study aimed to explore the influence of the home food environment (HFE) and its correlates on EB, family meals (FMs), and academic achievement among adolescents in schools in the United Arab Emirates (UAE). A cross-sectional study was conducted with 304 school-aged adolescents from the UAE. The questionnaire included sociodemographic data, dietary habits, information related to the HFE (food availability and accessibility), physical activity, sleep patterns, and academic achievement. Several questionnaire items were combined to create an HFE score. These questions included the frequency of weekly family meals, meal preparation practices, and accessibility to healthy and unhealthy food products and snacks at home. The HFE score was dichotomized into favorable and unfavorable HFE scores. Similarly, EB and FM scores were generated by combining responses to various related questions. The participants' weights and heights were measured. The findings reported that more than half (55%) of the adolescents were either overweight or obese. The majority of the participants had favorable HFE (57.2%), EB (69.1%), and FM scores (58.2%). The significant correlates to the HFE were as follows: male participants whose parents attended college (OR: 0.31; 95% CI: 0.15-0.62; p < 0.001), high academic achievers (OR: 1.98; 95% CI: 1.02-3.82; p = 0.043), and those who were physically active (OR: 1.80; 95% CI: 1.14-2.85; p = 0.012), were more likely to have favorable HFE. Moreover, the HFE score showed a highly significant positive correlation with the EB score (r = 0.573, p < 0.001) and the FM score (r = 0.384, p < 0.001). These results underscore the critical role of a healthy HFE in shaping healthy positive eating behaviors and food choices among adolescents. They provide a foundation for developing effective, evidence-based policies that can impact the health and academic success of adolescents in the UAE.

Background: Higher obesity prevalence and poorer diet quality disproportionately impacting groups based on income and race/ethnicity may be partially attributed to the home food environment. This study examined home- and individual-level diet quality with weight status among racially/ethnically diverse households. Methods: This cross-sectional study included African American (AA) and Hispanic/Latinx (H/L) households with preschool-age children ( n  = 97). Home-level diet quality was based on comprehensive home food inventories and individual-level diet quality was based on 24-hour dietary recalls; scores were estimated with the Healthy Eating Index. Child and adult appropriate weight categories based on BMI were estimated with measured heights and weights. Multiple linear regression models (independent variable: weight status, outcome: diet quality scores) with an interaction term for weight status and race/ethnicity and adjusting for potential confounding factors were used to estimate adjusted mean diet quality scores. Postestimation pairwise comparisons of these scores were used to look for within and between group differences by weight status and race/ethnicity. Results: Home-level diet quality scores were significantly higher among H/L households compared to AA counterparts regardless of weight status. AA parents with BMI <30 and AA children with BMI <85th percentile had poorer individual-level diet quality scores compared to AA parents and children of lower weight status and all H/L parents and children. Conclusions: These findings offer evidence that race/ethnicity modifies the relationship between diet quality and weight among AA and H/L households. Future research needs to examine the distinctive ways race/ethnicity shapes the relationship between weight and diet quality in these households.

The aim of this study is to put forward an approach designed to calculate and sum up discrepancies between the actual food acquisition or intake and any standard or norm. Based on secondary analysis of cross-sectional data from the Mexican National Survey of Household Income and Expenditure, our proposed method to produce classes of entropy-based Diet Adherence Indices generates a Food Basket Adherence Index (FBAI) for Mexico City (2129 households). Findings suggest that it is possible to measure and decompose diet adherence using a cross entropy measure. Using food expenditure data and a normative food basket for Mexico City results, we show households’ deviations from the suggested norm for different food groups. The average FBAI was 0.44, far above the minimum score of 0 which would indicate full adherence to the normative food basket. Our measure has a distribution wide enough to detect meaningful changes and distinguish between groups with known differences, providing important new insights on the linkages between home food environments and income distribution, and food insecurity and household distribution.

Parents have a role in shaping the eating behaviors of young children and the intergenerational transmission of eating attitudes. However, little is known regarding how parental intuitive eating practices are related to characteristics of home food and meal environments. To investigate the relationship between parental intuitive eating and the home food and meal environment. Cross-sectional analysis of survey data collected online and by mail in 2015–2016 as part of the Project EAT cohort study. Participants from 750 unique households (470 mothers, 280 fathers) were surveyed in young adulthood (Mean [M] age = 31.4 years, Standard Deviation [SD] = 1.5). Baseline enrollment of participants in the population-based Project EAT study was conducted in Minneapolis-St. Paul, Minnesota, schools. Intuitive eating was assessed via self-report. Modified Poisson regression models were conducted, adjusting for age, race/ethnicity, and socioeconomic status. Among mothers, higher intuitive eating scores were associated with greater likelihood of usually having fruits and vegetables in the home (prevalence ratio [PR] = 1.03) and with lower likelihood of usually having salty snacks and soda pop in the home (PR = 0.91). Higher intuitive eating scores were also associated with greater likelihood of usually serving fruits and vegetables at dinner among mothers (PR = 1.07). Among both mothers (PR = 1.08) and fathers (PR = 1.07), higher intuitive eating scores were associated with greater likelihood of usually having enough time and energy to prepare meals. Intuitive eating practices in parents are associated with specific home food environment characteristics. Extending the understanding of these relationships in longitudinal data has the potential to inform the directionality of influences and may help to identify targets for intervention. [ABSTRACT FROM AUTHOR]

Background: Rural children are at greater obesity risk than their urban peers. The NU-HOME study is an innovative collaborative effort to prevent childhood obesity in rural communities. Weight outcomes of the NU-HOME study, a family-meal focused randomized controlled trial (RCT) are described. We hypothesized that compared to control group children, intervention group children would have significantly lower weight-related post-intervention (PI) outcomes. Methods: Participants were 114 dyads (7–10 year-old rural children and a parent). In 2017–2018 and 2018–2019, research staff measured height, weight and body fat at baseline (BL) and PI. Families were randomized to intervention (n = 58) or control (n = 56) groups without blinding. Designed with Social Cognitive Theory and community engagement, the NU-HOME program included seven monthly sessions delivered in community settings and four goal-setting calls. The program engaged entire families to improve healthy eating, physical activity, family meals and the home food environment. Multiple linear and logistic regression models tested PI outcomes of child BMIz-score, percent body fat, percent over 50th percentile BMI, and overweight/obesity status by treatment group, adjusted for BL values and demographics (n = 102). Results: No statistically significant intervention effects were seen for child BMIz or overweight/obesity status. However, a promising reduction in boys' percent body fat (− 2.1, 95% CI [− 4.84, 0.63]) was associated with the intervention. Conclusions: Although our findings were in the hypothesized direction, making significant impacts on weight-related outcomes remains challenging in community trials. Comprehensive family-focused programming may require intensive multi-pronged interventions to mitigate complex factors associated with excess weight gain. Clinical trial registration: This study is registered with NIH ClinicalTrials.gov: NCT02973815. [ABSTRACT FROM AUTHOR]

Abstract Background Parents are key decision makers and role models in establishing and maintaining healthy behaviours in their children. Interventions involving parents have been shown to be more effective than those that do not, but there are barriers to participation. Efficacy trials have previously been conducted on two such parent-focussed healthy eating and active living interventions with the potential to overcome these barriers - Healthy Habits (telephone-based) and Time2bHealthy (online) with promising results. Further research is now required to determine the effectiveness of these interventions in a real-world context. The Time for Healthy Habits study is a 3-arm partially randomised preference trial which aims to evaluate the effectiveness and cost-effectiveness of two theory-based programs to promote healthy eating and appropriate levels of movement behaviours (physical activity, sedentary behaviour and sleep) for parents of 2- to 6-year-old children (Healthy Habits Plus telephone-based program and Time2bHealthy online program), when compared to a comparison group receiving written materials. Methods Participants will be recruited across five Local Health Districts in New South Wales, Australia. The partially randomised preference design initially allows for participants to decide if they wish to be randomised or opt to select their preferred intervention and has been recommended for use to test effectiveness in a real-world setting. Both interventions incorporate multiple behaviour change techniques and support parents to improve their children’s healthy eating, and movement behaviours (physical activity, sedentary behaviour and sleep) and run for 12 weeks, followed by a 3-month and 9-month post-baseline follow-up. Participants will also be asked to complete a process evaluation questionnaire at the completion of the intervention (3-months post-baseline). Outcomes include fruit and vegetable intake (primary outcome), non-core food intake, weight status, physical activity, sedentary behaviour, and sleep habits. Discussion To our knowledge, this is the first translational research trial evaluating the effectiveness and cost-effectiveness of a healthy eating and active living intervention in the 2- to 6-years age group. The results will build the evidence base in regard to translation of effective childhood obesity prevention interventions and inform the implementation and delivery of community based childhood obesity prevention programs. Trial registration UTN: U1111–1228-9748, ACTRN: 12619000396123p .

Background: The etiology of obesity is multifaceted, with multiple risk factors occurring during early childhood (e.g., fast food frequency, eating dinner as a family, TV in the bedroom). Many past studies have largely considered obesity risk factors in isolation, when in reality, the risk factors likely cluster together. A latent class analysis can be used to identify patterns in child eating behaviors, parent feeding behaviors, and household habits among preschool-aged children and their families to identify distinct, heterogenous classes and to determine if classes are associated with overweight and obesity. Methods: We used data from a community-based study of 624 three- to five-year-old children and a parent in New Hampshire, from March 2014 to October 2015. Parent-reported data were used to determine frequency of eating behaviors and household habits. Height and weight were objectively measured. Results: Four classes were identified; Class 1: "Healthy/Mildly accommodating," Class 2: "Healthy/Accommodating," Class 3: "Moderately healthy/Moderately accommodating," and Class 4: "Least healthy/Least accommodating." Compared with Class 1, children in Class 4 had increased odds of being overweight or obese [adjusted odds ratio (aOR): 1.64, 95% confidence interval (CI): 1.13-2.15], whereas Classes 2 and 3 were not associated with BMI (Class 2: aOR: 1.24, 95% CI: 0.62-1.86; Class 3: aOR: 1.31, 95% CI: 0.81-1.81). Conclusion: Study findings highlight that child-parent interactions around meals differentially relate to children's weight status given the context of children's eating habits. Most important, our study findings confirm the importance of adapting multiple healthy habits within the home social and physical environment to offset obesity risk in young children.

Objective: To explore women's perceptions of changes in specific food habits at home, specifically the food budget and shopping, and food preparation, during the COVID-19 period.Design: Non-probabilistic, exploratory study. Participants completed an online self-administered questionnaire. Perceptions of food habit changes were measured on a five-point Likert scale (strongly disagree to strongly agree). Data analysis was conducted in STATA v16.0.Setting: Chile.Participants: Adult women between 25 and 65 years old (n 2047).Results: Of the participants, 72 % were responsible for cooking, 69 % for buying food and 85 % for child care. Difficulties in organising and doing food budget works were observed in groups with a lower educational level, lower income and single mothers with children. Younger participants, dependent workers, women from biparental families with children and those in mandatory quarantine perceived more changes in their food shopping and budget management tasks. Participants more educated, with higher income and non-mandatory quarantine perceived to cook and eat healthier. Older participants perceived minor changes in their food preparation tasks at home; in contrast, more educated women and women from biparental families with children perceived more changes. If women were in charge of the kids or grocery shopping, more food environment changes were noticed.Conclusions: Women perceived changes in their food environments. Some of these changes are perceived worse in the more vulnerable population. COVID-19 presents a challenge for the food system and gender perspectives. This information should be considered in the design of food-related interventions. [ABSTRACT FROM AUTHOR]

Abstract Background Family-based obesity treatment interventions can successfully reduce energy intake in preschoolers. An implicit goal of obesity treatment interventions is to improve diet quality, but diet quality has been less examined as a treatment outcome in studies of preschoolers. The purpose of this study was to conduct a secondary analysis comparing the change in diet quality and home food environment in preschoolers assigned to a behavioral family-based obesity intervention (LAUNCH), motivational interviewing (MI) condition, or standard care (STC) condition. Methods Three 24-h dietary recalls were completed at baseline and 6-months and were analyzed using NDS-R software; diet quality was assessed using the Healthy Eating Index-2010 (HEI-2010). Availability of foods and beverages in the home was assessed through direct observation using the Home Health Environment tool that classifies foods and beverages as ‘red’ or ‘green’ based upon fat and sugar content. Repeated measures linear mixed effects models were used to examine changes in diet quality and home food environment between conditions (LAUNCH, MI, STC). Results At 6-months, preschoolers in the LAUNCH condition had a higher HEI-2010 total score (62.8 ± 13.7) compared to preschoolers in the MI (54.7 ± 13.4, P = 0.022) and STC (55.8 ± 11.6, P = 0.046) conditions. Regarding the home food environment, families in LAUNCH had significantly less ‘red’ foods in their home at 6-months (12.5 ± 3.4 ‘red’ foods) compared to families in MI (14.0 ± 3.7 ‘red’ foods, P = 0.030), and STC (14.3 ± 3.4 ‘red’ foods, P = 0.006). There were no statistically significant differences across home food environments for number of ‘green’ foods. Conclusion Family-based obesity treatment interventions for preschoolers can improve overall diet quality and alter the home food environment through reductions in ‘red’ foods. Trial registration Clinicaltrials.gov, NCT01546727. Registered March 7, 2012.

Background: Feeding of nutrient-poor foods begins in infancy and may adversely influence long-term food preferences., Objective: To examine associations of socioeconomic characteristics, childbearing parent eating behaviors, and home food environment with infant feeding characteristics., Design: Secondary analysis of a prospective cohort study from first trimester of pregnancy through 12 months postpartum., Participants/setting: Participants with uncomplicated singleton pregnancies and no major chronic illness were enrolled from November 2014 through October 2016 from 2 university-based obstetrics clinics in Chapel Hill, NC. Of 458 enrolled, 321 were retained through 12 months postpartum., Main Outcome Measures: Participants completed infant food frequency questionnaires indicating age at introduction and frequency of consuming multiple food groups. Exposures included childbearing parent socioeconomic characteristics, hedonic hunger, addictive-like eating, Healthy Eating Index 2015 calculated from three 24-hour diet recalls, and home food environment fruit/vegetable and obesogenic scores., Statistical Analyses Performed: Multiple imputation using Heckman selection model; linear and logistic regressions examining associations with infant feeding characteristics., Results: Lower education and income were associated with later infant age at introduction to, and lower frequency of consuming fruits and vegetables at age 12 months. Socioeconomic characteristics were not associated with age at introduction to discretionary solid foods; however, lower education and income were associated with greater infant frequency of intake of discretionary foods and greater odds of introducing fruit juice and sweetened beverages by age 12 months. Childbearing parent Healthy Eating Index 2015, hedonic hunger, and addictive-like eating were not consistently associated with infant feeding characteristics. A more obesogenic food environment was associated with greater frequency of intake of discretionary foods, lower frequency of intake of fruit, and greater odds of fruit juice introduction by age 12 months., Conclusions: Infant feeding characteristics may be important intervention targets for addressing socioeconomic disparities in child diet quality. Efforts to reduce routine feeding of discretionary foods across socioeconomic groups are needed; modifying the home food environment may promote healthful infant feeding., (Published by Elsevier Inc.)

Healthful dietary changes after metabolic and bariatric surgery (MBS) may benefit not only patients, but the type and/or availability of foods/beverages in the family home food environment (HFE) overall, thereby reducing obesogenic environmental risks to child offspring in the home. Few studies have investigated the family HFE after MBS. To examine whether the HFE of mothers post-MBS differed from the HFE of mothers of normal weight, overweight, and with obesity using an open home food inventory. Cincinnati, Ohio and Newark, Delaware. Thirty-two mothers with a child (6–12 yr) participated (8 post-MBS, 8 normal weight, 8 overweight, 8 with obesity) in a pilot study. Research personnel recorded all foods and beverages in the home. Per person total energy and servings of fruits, vegetables, sugar-sweetened beverages, and energy-dense snack foods in the HFE were examined using 1-way analyses of variance and Cohen's d effect sizes. Mothers in the post-MBS group had significantly fewer servings of sugar-sweetened beverages available per person compared with mothers with obesity (P =.01). Effect sizes for group differences indicated total energy, sugar-sweetened beverages, and servings of fruits and vegetables were generally medium to large, most with lower mean values for the post-MBS group relative to comparator groups. These findings, while preliminary, highlight areas for future research and add to an emerging literature on obesogenic risks to offspring in the post-MBS home, a known subgroup at high risk for severe obesity. [ABSTRACT FROM AUTHOR]

Abstract Background The home food environment may be an important target for addressing adolescent obesity. The aim of this study was to investigate associations between aspects of the home food environment and the diets of adolescents who present for obesity treatment. Methods Cross-sectional baseline data were collected from 167 overweight/obese adolescent-parent pairs participating in an e-health lifestyle modification intervention. Adolescent intake of specific foods (fruit and vegetables, total fat, sugar-sweetened beverages, desserts/treats, and snacking occasions) was assessed by three 24-h dietary recalls, while household factors were collected from adolescent and parent questionnaires. Structural Equation Modeling, controlling for relevant covariates, was used to examine the relationship between adolescent diet and the following household factors: parent modeling, parenting style, family meal practices, and home food/beverage availability. Results Findings reveal that few characteristics of the home food environment were associated with adolescent dietary intake. Greater home availability of high-fat foods was moderately associated with adolescent snack intake (β = 0.27, p

Abstract Background The home food environment has the potential to influence the eating behaviour of adolescents. This investigation aimed to understand Indian adolescents’ perspectives of their home food environments. Methods Adolescents aged 14–16 years (n = 1026, 65.3% girls) attending private secondary schools in Kolkata completed a paper-based questionnaire during school time which included questions about family food rules, availability and accessibility of foods at home, and domestic cooking responsibility. Boys’ and girls’ opinions and experiences were compared through cross-tabulation analyses. Results Almost all the adolescents reported that fruits (91.6%) and vegetables (95.7%) were always available in their homes. Approximately two-fifths reported that sugar-sweetened beverages (36.2%) and salty snack foods (38.0%) were readily available. In 56.1% households, adolescents were expected to follow certain food rules during mealtimes (e.g. not talking with my mouth full). The majority of the respondents (80.4%) identified mothers as the primary meal providers, only a minority reported that fathers (5.1%) were responsible for preparation of family meals. Conclusion This understanding of the family-environmental determinants of adolescent dietary habits provides useful directions for nutrition promotion interventions. Health and educational professionals associated with adolescents could communicate about the development of healthy home food environments to provide positive health benefits for adolescents and their families.

Introduction: Obesity in children is a global epidemic issue. Home food environment is an important aspect that may influence children's body weight status. The aim of this study is to identify the association between socio-demographics and home food environment (HFE) factors with body weight status in primary school children in Bangi, Selangor. Methods: There were 398 children (43.5% males and 56.5% females) aged 7-11 years old (mean age of 9.04±1.41 years) and their parents (66.6% mothers and 33.4% fathers) from eight randomly selected primary schools participated in this study. Parents were asked to complete a self-administered questionnaire on socio-demographic background, feeding practices and food availability, while children were interviewed to obtain information on parental styles and physical activity level. Weight and height of children were assessed, and BMI-for-age z-score (BAZ) was calculated by using WHO Anthroplus Software. Results: Overweight and obesity prevalence was 17.8% and 13.1% respectively. A majority of the parents (61.3%) in this study practiced authoritative parenting style. The increased odds of childhood obesity has been found to be associated with an increasing age (OR=1.239, p<0.05). The risk for overweight or obese was greater for male students than for female students (OR=1.619, p<0.05). Parent's increasing restriction for weight control (OR=1.080, p<0.05) and decreasing pressure to eat (OR=0.913, p<0.05) increased childhood overweight and obesity risk. Conclusion: This study emphasizes the importance of involving parents in the obesity intervention programs for children. [ABSTRACT FROM AUTHOR]

The home food environment (HFE) is associated with dietary intake; yet measuring HFE quality often requires burdensome collection of detailed inventories. This project evaluated the capacity of the Home Inventory to Describe Eating and Activity, version 2 (Home-IDEA2) to capture HFE quality by measuring the presence or absence of household foods. Validity was tested using a modified application of the Healthy Eating Index-2010 (HEI). Comparative data were drawn from the National Food Acquisition and Purchase Survey (FoodAPS) Food-at-Home Public Use File. HEI scores were calculated for 4202 households in FoodAPS using Home-IDEA2 inventories and full reported inventories. Paired t-tests compared: (1) estimated vs. total edible grams (EEG; TEG); (2) limited vs. all reported foods; and (3) EEG + limited foods vs. TEG + all reported foods. Sensitivity and range of scores were compared. Mean HEI scores for Home-IDEA2 were higher (p < 0.003) than FoodAPS: (1) 51.6 ± 16.1 vs. 49.6 ± 18.1 (food amounts); (2) 53.5 ± 15.8 vs. 49.8 ± 15.4 (food items); (3) 55.5 ± 15.7 vs. 49.8 ± 15.4 (full instrument); differences were small. Scores demonstrated comparable sensitivity and range. The study found that the Home-IDEA2 can capture HFE quality adequately with low data collection burden.

This translation study assessed the effectiveness of two remotely delivered healthy eating and active living interventions for parents of 2- to 6-year-old children in improving child fruit and vegetable intake, non-core food intake, body mass index (BMI), physical activity, screen time, and sleep. Parents (n = 458) were recruited to a partially randomised preference trial comprising three intervention groups. Healthy Habits Plus comprised six telephone calls, Time2bHealthy comprised six online modules, and the active control comprised ten information sheets and a summary booklet. Data were collected from parents via a telephone questionnaire at baseline and nine months post-baseline. Data were analysed for randomised participants alone (n = 240), preference participants alone (n = 218), and all participants combined (n = 458). There was no significant improvement in fruit and vegetable intake (primary outcome) when comparing the telephone and online interventions to the control. In both the randomised only and all participants combined analyses, there was a significant improvement in non-core food intake for the telephone intervention compared to the control (p < 0.001). Differences between interventions for other outcomes were small. In conclusion, the telephone and online interventions did not improve child fruit and vegetable intake relative to written materials, but the telephone intervention did improve non-core food intake.

This study aimed to use path analysis to determine the association between perceived parental attitudes toward restricting junk food (JF)/sugar-sweetened beverage (SSB) intake and JF/SSB consumption among Chinese adolescents, and whether JF/SSB availability in the home environment and autonomous motivation of adolescents mediated the association. A cross-sectional survey was conducted using questionnaires adapted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study to collect data on 3819 participants with an average age of 14.7 years (SD = 1.7). Spearman correlations and path analysis were performed. It was found that perceived parental attitudes were not directly associated with adolescents’ JF/SSB consumption frequency, but indirectly related to them through JF/SSB availability in the home environment and autonomous motivation of adolescents. When parents held a less positive attitude toward JF/SSB consumption and kept less JFs/SSBs at home, youth displayed more autonomous motivation for restricting JF/SSB intake and consumed fewer JFs/SSBs.

As rates of metabolic syndrome rise, children consume too few vegetables and too much added sugar. Because children tend to eat what is available at home, the home environment plays a key role in shaping dietary habits. This secondary analysis evaluated the effects of a school-based gardening, cooking, and nutrition education intervention (TX Sprouts) compared to control on the availability of vegetables, fruit juice, and sugar-sweetened beverages (SSBs) at home. In the TX Sprouts cluster-randomized trial, 16 schools were randomized to TX Sprouts ( n = 8 schools) or control ( n = 8 schools) for one academic year. All schools served predominately Hispanic families with low incomes. TX Sprouts built school gardens and taught 18 lessons to all 3rd-5th grade students at intervention schools. TX Sprouts also offered monthly caregiver lessons before and/or after school. Caregivers completed questionnaires pre and post, providing demographics and information about home availability of vegetables, fruit juice, and SSBs. Summary statistics were used to describe the sociodemographic characteristics of participants. Linear regression assessed the change in scores (pre to post) for the food/ beverage availability question. The model was adjusted for the caregiver's education, employment status, child's grade, and free or reduced-price lunch eligibility. The analytic sample included 895 participants. Compared to control, the intervention positively changed the home availability of targeted foods and beverages, largely by improving the availability of vegetables and vegetable juice. This study showed that a school gardening, nutrition, and cooking program delivered to elementary children may positively influence the home food environment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hudson, Burgermaster, Isis, Jeans, Vandyousefi, Landry, Seguin-Fowler, Chandra and Davis.)

Food security status is related to food types available in the home, which may shape youth dietary patterns, with implications for obesity. Investigate whether household food insecurity and home food availability (HFA) are associated with youth fruit and vegetable (F/V) consumption and anthropometric outcomes. Cross-sectional study. Youth and parents completed questionnaires during in-home visits (2013-2014). Research staff obtained anthropometric measures. Medical record data for 10- to 15-year-old Pennsylvania youths were used to identify 434 parent-youth dyads, with 408 evaluated after excluding missing data. Parent-reported household food security was assessed with the six-item US Department of Agriculture Food Security Scale (dichotomized as high vs low). Healthy and obesogenic HFA scales assessed parent report of how frequently particular foods were present in the home. Youth self-reported daily average F/V consumption. Anthropometric outcomes included age- and sex-standardized z scores for body mass index (BMIz), waist circumference (WCz), and percent body fat (PBFz). Associations were evaluated with multivariable linear regression adjusted for youth age, sex, and race or ethnicity, and parent age and income. Compared with food secure counterparts, youth from food insecure households had higher mean (beta [standard error]) BMIz (.30 [.15]), WCz (.27 [.12]), and PBFz (.43 [.16]). Food insecure households had lower mean healthy HFA scores (−1.23 [.54]); there was no evidence obesogenic HFA differed between food secure and insecure households. Youth from lower healthy HFA or higher obesogenic HFA households reported fewer mean daily F/V servings (healthy HFA:.08 [.02]; obesogenic HFA: −.06 [.02]). Food security status was not associated with F/V consumption, nor was there evidence HFA modified associations between food insecurity and anthropometric outcomes. Despite an observed association between healthy HFA and youth F/V consumption, this study did not provide evidence that HFA explained associations between food insecurity and youth anthropometric outcomes. [ABSTRACT FROM AUTHOR]

Objective: To categorize the home food environment and dietary intake of young children (5-7 years old) from racially/ethnically diverse households using objectively collected data.Design: Cross-sectional study.Setting: In-home observations in Minneapolis/Saint Paul, Minnesota, USA.Subjects: Families with 5-7-year-old children who identified as Black, White, Hmong, Latino, Native American or Somali.Results: There were many significant differences by race/ethnicity for child dietary intake and for the home food environment, with specific patterns emerging by race/ethnicity. For example, Somali children had high Healthy Eating Index-2010 (HEI-2010) scores, but low daily intakes of fruits and vegetables. Black children had low HEI-2010 scores and a pattern of low intake of healthful foods and high intake of unhealthful foods. White and Latino families had high levels of both healthful and unhealthful home food availability and children with high HEI-2010 scores.Conclusions: Results indicate that the home food environment of young children varies across racial/ethnic group. Study findings also provide new information regarding the home food environment of young children in previously understudied racial/ethnic groups and indicate that interventions working to improve the home food environment and dietary intake of children may want to consider race/ethnicity. [ABSTRACT FROM AUTHOR]

Background: Home food environments (HFE) of children impact dietary intake, though relatively few studies have focused on young children from backgrounds with socioeconomic and racial-ethnic diversity. The objective of the present study was to examine the relationship between the HFE and child dietary intake of preschool-aged children from rural and low-income, culturally diverse families.Methods: Children (aged 2-5 years) and their primary caregivers (n = 164 parent-child dyads) participated in this study using a cross-sectional design. HFE, including home food availability, accessibility and purchasing, was measured by the Home-IDEA, a checklist instrument completed by parents. Parents also reported child dietary intake using the Block Kids Food Screener (BKFS).Results: Home food availability of both healthful and unhealthful foods, including fruits, vegetables, meats, and sugar-sweetened beverages significantly predicted reported child intake of these foods after controlling for demographic, location and weight status. Overall dietary intake recommendations were not met for vegetables, whole grains, protein, and dairy. The accessibility and purchasing frequency of foods was not associated with reported child dietary intake.Conclusions: The available HFE showed positive associations with dietary intake for a broad range of foods ranging from healthy and less healthy foods among preschool-aged children from a health disparate population. Recommendations to improve the quality of dietary intake for young children may be facilitated by modifying the HFE by focusing on increasing the availability of healthy foods and diminishing the presence of less healthful options. [ABSTRACT FROM AUTHOR]