Obesogenic Features of Food-Related Content Aimed at Children on YouTube

Obesity, and particularly childhood obesity, is considered an epidemic by the WHO because of the health problems it causes and its impact on the lives and environment of those who suffer from it. In this article, the term “obesogenic features” refers to the set of supposedly aggravating risk factors that could intensify the proven effect on minors of exposure to food-related media content. The article explores the characteristics of food-related content in YouTube videos aimed at children, with the objective of identifying videos that pose a high risk due to the presence of obesogenic arguments, as well as videos with innovative media trends. It presents an exploratory study of 293 videos (22 hr 41 min) aimed at children and containing food and/or food brands, posted from May 2020 to April 2021 on 28 YouTube channels of food brands and child YouTubers with the largest numbers of subscribers. Child YouTubers often appear to explicitly promote calorie intake as a diet alternative and to disseminate content in which the presence of low-nutrition foods undermines childhood obesity prevention policies. The sensitivity of this target audience and the highly emotional nature of the formats in which messages with obesogenic features appear, such as “challenges,” point to an urgent need to adopt ethical standards and legal measures to regulate such content.

Play & Grow: prospective observational cohort of toddlers to inform obesity prevention, Columbus, Ohio, USA

PurposeObesity prevention is increasingly focused on early childhood, but toddlers have not been well-studied, and children born preterm are frequently excluded. The Play & Grow Cohort was established to investigate child growth in relation to parent-child interactions in mealtime and non-mealtime settings.ParticipantsBetween December 2017 and May 2019, 300 toddlers and primary caregivers were recruited from records of a large paediatric care provider in Columbus, Ohio, USA. This report describes recruitment of the cohort and outlines the data collection protocols for two toddler and two preschool-age visits. The first study visit coincided with enrolment and occurred when children (57% boys) were a mean (SD) calendar age of 18.2 (0.7) months.Findings to dateChildren in the cohort are diverse relative to gestational age at birth (16%, 28–31 completed weeks’ gestation; 21%, 32–36 weeks’ gestation; 63%, ≥37 weeks’ gestation) and race/ethnicity (8%, Hispanic; 35%, non-Hispanic black; 46%, non-Hispanic white). Caregivers enrolled in the cohort are primarily the child’s biological mother (93%) and are diverse in age (range 18–54 years), education (23%, high school or less; 20% graduate degree) and annual household income (27%, <US$20 000 24%, ≥US$90 000). Parent-child interactions were video-recorded during play in the laboratory at 18 months (n=299) and during play, reading and mealtime in the home (n=284) at 24 months. The preschool phase of the study was impacted by COVID-19. Parent-child interactions were video-recorded during play and mealtime at home at 36 months (n=141) and during a standardised buffet meal in the laboratory at 42 months (n=50). Caregivers unable to participate in face-to-face visits due to COVID-19 completed questionnaires.Future plansAssessment during middle childhood is being planned. Future visits will include anthropometric measurements and parent-child interactions at mealtime. School-based outcomes are additionally being considered.

Nutritionists as Policy Advocates: The Case of Obesity Prevention in Quebec, Canada

Objective A core function of the public health nutrition workforce is advocacy. Little is known of the nutritionists’ role in policymaking from a policy process theory perspective. This study analyzes the nutritionists’ role in advocating for a six-year governmental plan on obesity prevention in Quebec, Canada. Design We conducted qualitative research using Quebec´s obesity policy as a case study to understand the role of nutritionists in advocating for obesity prevention policies. A conceptual framework combining the Advocacy Coalition Framework with a political analysis model based on the Theory of the Strategic Actor was developed to analyze the beliefs, interests, and strategies of policy actors including nutritionists. Data sources comprised semi-structured open-ended interviews with key policy actors (n=25), including eight nutritionists (32%), and policy-related documents (n=267). Data analysis involved thematic coding and analysis using NVivo 11 Pro. Setting Quebec, Canada Participants Key policy actors including nutritionists Results Nutritionists formed the core of the dominant public health coalition. They advocated for an inter-sectoral governmental plan to prevent obesity through enabling environments. Their advocacy, developed through an iterative process, comprised creating a think tank and reinforcing partnerships with key policy actors, conducting research and developing evidence, communicating policy positions and advocacy materials, participating in deliberative forums and negotiating an agreement with other coalitions in the policy subsystem. Conclusion Nutritionists’ advocacy influenced agenda-setting and policy formulation. This research may contribute to empowering the public health nutrition workforce and strengthening its advocacy practices. It informs practitioners and researchers concerned with obesity policy and workforce development.

Shifting From Tokenism to Meaningful Adolescent Participation in Research for Obesity Prevention: A Systematic Scoping Review

Background: Traditionally, adolescent participation in research has been tokenistic. Adolescents are rarely afforded the opportunity to influence decision-making in research designed to prevent obesity. Engaging adolescents in meaningful decision-making may enhance research translation. This review aimed to analyze the current modes and nature of adolescent participation in obesity prevention research decision-making.Methods: A systematic scoping review was conducted using Arksey and O'Malley's six-stage framework. Six major databases were searched for peer-reviewed primary research studies with adolescent participation related to obesity, physical activity, and diet. Modes of adolescent participation were categorized based on the Lansdown-UNICEF conceptual framework for measuring outcomes of adolescent participation. The framework outlines three modes of meaningful participation: (i) consultative, which involves taking opinions and needs into consideration; (ii) collaborative, where adolescents are partners in the decision-making process; and (iii) adolescent-led participation where adolescents have the capacity to influence the process and outcomes. The degree of involvement in research cycles was classified based on the National Health and Medical Research Council consumer engagement framework. Five stages of the research cycle were determined: identify, design and develop, conduct, analyze and disseminate.Results: In total, 126 papers describing 71 unique studies were identified. Of these, 69% (49/71) took place in the USA, and 85% (52/61) were conducted in minority or underserved communities, while males were more likely to be under-represented. In 49% (35/71) of studies, participation was consultative and 9% (6/71) of studies involved an adolescent-led approach. Furthermore, 87% (62/71) of studies incorporated adolescent participation in one or more of the research cycle's formative phases, which involve eliciting views, opinions and idea generation. Only 11% of studies engaged adolescents in all five stages of the research cycle where adolescents could have more influence over the research process.Conclusion: Meaningful adolescent participation in the obesity prevention research cycle is limited. Empowering and mobilizing equal partnership with adolescents should be at the forefront of all adolescent-related obesity prevention research.

The causal model of health literacy and health behavior for obesity prevention among primary school students in Bangkok, Thailand

Background: The aim of the study was to develop a research instrument to study the levels of health literacy for obesity prevention (HLFOP), as well as health behavior for obesity prevention (HBFOP). In addition, we investigated the causal model between health literacy and health behavior for obesity prevention among primary school students in Bangkok, Thailand. Methods: A cross-sectional study among 600 participants who were primary school students (aged 9-13 years) was conducted. The participants were selected from schools in all parts of Bangkok using multi-stage random sampling technique. The research instrument to assess HLFOP and HBFOP, constructed by the researchers, were utilized for data collection. Data were analyzed using descriptive statistics, exploratory and confirmatory factor analyses, and structural equation model through linear structural relationship. Results: We found that HBFOP was directly influenced by heath literacy in the category of Critical Literacy with an effect size of 0.65 (p < 0.01), and was indirectly influenced in the category of Basic Literacy and Interactive Literacy through Critical Literacy with effect sizes of 0.46 and 0.58 (p<0.01), respectively. The model was consistent with the empirical data, with Chi-Square=13.68, df=7, p=0.05721, RMSEA (root mean square error of approximation)= 0.040, SRMR (standardized root mean square residual)= 0.017 NFI (normal fit index)=0.99, GFI (goodness of fit index)=0.99, and AGFI (adjusted goodness of fit index)=0.97. Conclusions: HLFOP was influential on HBFOP in primary school students in the Bangkok Metropolis. The categories that were particularly influential were: 1) Basic Literacy: accessing health information skills; 2) Interactive Literacy: communication skills; and 3) Critical Literacy: media literacy and self-management skills.