Food environment and whole-diet in children : Studies on parental role modelling and food availability
Year: 2018
Type: dissertation
Abstract: Since food behaviors are learned during childhood and may also track into adulthood, promoting healthy food habits among children and families is of special importance. Health promotion has traditionally been focused on individuals, but during the recent decades, the attention has shifted more and more towards environments. The food environment – a concept that encompasses physical, social, cultural, economic and political environmental factors associated with food behavior – is especially important for children, who cannot be considered to be fully responsible for their food choices. Arguably, home, preschool and school are the most prominent food environments for children. It has been shown that parental food consumption and home food availability – the two most commonly used measures for food environment - are consistently associated with dietary behavior among children. However, most of the studies investigating parent-child dietary resemblance have focused on the consumption of single food groups, such as consumption of fruit and vegetables. Similarly, home food availability has mostly been measured unidimensionally: as the availability of a single food group or as healthy/unhealthy food availability. Additionally, the outcomes used in the studies have mostly been food groups or theory-based dietary indices. However, the use of data-driven dietary patterns may give a more realistic picture of the actual diets of the participants. Thus, this study aimed at investigating social and physical environmental factors associated with whole-diet among children. This thesis used data from two cross-sectional studies. Papers I and II were based on data from the DAGIS study, which was conducted in 66 Finnish preschools and investigated health behaviors and associated factors. The participants were 864 children from the groups of 3–6-year-olds. Food consumption among the children and both parents was measured using a food frequency questionnaire (FFQ) filled in by the parents. The parents also reported home food availability and sociodemographic factors of the family. Paper III used data from the ISCOLE study, which examined obesity-related lifestyle and environmental factors among 9–11-year-olds in 12 study sites worldwide. Altogether 6560 children (54% girls) were included in the current analyses. The children reported their own food consumption, whereas the parents of the participating children reported home food availability. Detailed school audits were performed in all participating schools (n=256) to measure school food availability. In paper I, parent-child dietary resemblance and associated sociodemographic factors were studied. A novel statistical method was used in order to compare food consumption of the parent and that of the child on a whole-diet level. Based on the consumption frequency, the food items were ranked separately in the child’s and the parents’ FFQs. A dietary resemblance measure was calculated for each parent-child pair: a similar ranking in both the child’s and the parent’s FFQ yielded a resemblance measure of +1, whereas no resemblance in ranking resulted in the resemblance measure of 0. Father-child resemblance was on average 0.50 (95% CI, confidence interval 0.48–0.52), whereas mother-child resemblance was 0.57 (95% CI 0.55–0.58). However, having mother as a respondent (providing food consumption information on behalf of the child) was inversely associated with father-child resemblance, and a tendency for similar reporter-bias was also seen in the mother-child resemblance. Additionally, the number of weekly family meals was positively associated with mother-child dietary resemblance. Parental educational level was not associated with parent-child dietary resemblance. In papers II and III, the availability of unhealthy foods in the home was positively associated with dietary patterns generally regarded as unhealthy. Although having healthy foods in the home was inversely associated with unhealthy dietary patterns, the abundance of unhealthy foods seemed to at least partly overrule this inverse relation. Respectively, the availability of healthy foods in the home was positively and that of unhealthy foods inversely associated with dietary patterns generally regarded as healthy. The results were similar both among preschoolers and school-aged children. School food availability was not associated with dietary patterns. In conclusion, parent-child dietary resemblance was moderate regardless of the socio-economic background of the family. In addition, an important observation was made: the diet of the child resembled more the diet of the parent providing food consumption data on behalf of the child. Since the possible reporter-bias can affect the interpretation of the results, it would be advisable for researchers to report who filled in food consumption information for the child and take this into account in further analyses. Furthermore, in order to capture the social food environment more comprehensively, fathers – not only mothers - should be involved as parents in family-based studies. Additionally, since the availability of unhealthy foods in the home was associated with unhealthy eating regardless of the availability of healthy foods, the results suggest that it is particularly important to limit the availability of unhealthy foods in the home. The results of this study can be used in planning and carrying out health promotion programs aiming at improving the diets of the families.
Source: Työväentutkimus Vuosikirja
Author: Henna Vepsäläinen
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2806927128