Contribution of home availability, parental child-feeding practices and health beliefs on children’s sweets and salty snacks consumption in Europe: Feel4Diabetes-Study

Adoption of healthy dietary and snacking habits could support optimum physical and mental development in children as they define health in adulthood. This study assessed parameters associated with children’s snacking such as food home availability, parenting practices, and parents’ health beliefs. In this cross-sectional study 12, 039 children, 49.4% boys 5-12 years old, participating in the European Feel4Diabetes-Study were included. Children’s weekly consumption of sweets and salty snacks, home availability of snacks, food parenting practices, and health beliefs were assessed via questionnaires. Logistic regression was applied to explore associations of a) home availability of snacks, b) food parenting practices (permissiveness and rewarding with snacks) and c) parent’s opinions on deterministic health beliefs with children’s consumption of sweets and salty snacks. Results showed that home availability (sweets: ORadj 4.76, 95%CI: 4.32, 5.23; salty snacks: ORadj: 6.56, 95%CI: 5.64, 7.61), allowing to consume (sweets: ORadj: 3.29, 95%CI: 2.95, 3.67; salty snacks: ORadj: 3.41, 95%CI: 2.98, 3.90) and rewarding with sweets/salty snacks (sweets: ORadj: 2.69, 95%CI: 2.23, 3.24; salty snacks: ORadj: 4.34, 95%CI: 3.57, 5.28) ‘sometimes/or less frequently’ compared to ‘always/or often’ were associated with lower weekly consumption of sweets and snacks. Parents’ disagreement compared to agreement with deterministic health beliefs and inattentive eating were associated with lower consumption of salty snacks and sweets in children. Overall, the findings of this study indicate that attempts to promote healthy snacking habits in children should aim to improve parental dietary habits, food parenting practices, health beliefs, and reducing home availability of unhealthy foods and snacks.

Caregiver Feeding Practices as Predictors for Child Dietary Intake in Low-Income, Appalachian Communities

The Appalachian region of the U.S. is disproportionately impacted by poverty, obesity, and nutrition-related chronic diseases. Evidence suggests that caregiver feeding practices may promote healthful eating behaviors among children; however, this has not been examined in low-income, rural, Appalachian populations. This study examines caregiver feeding practices as predictors for child diet in low-income Appalachian families, using a cross-sectional analysis of 178 caregivers of young children (ages 2–10 years old), that were recruited from low-income, rural communities in East Tennessee, from November 2017 to June 2018. Caregivers self-reported measures of demographics, feeding practices, and child dietary intake. Multiple linear regression analyses were run, and found that higher use of caregiver modeling positively predicted child vegetable consumption (Beta = 1.02; p = 0.04). Higher caregiver intake of fruits and vegetables positively predicted child fruit consumption (Beta = 0.29; p = 0.02) and vegetable consumption (Beta = 1.56; p < 0.001), respectively. Higher home availability of healthier foods positively predicted child fruit consumption (Beta = 0.06; p = 0.002) and vegetable consumption (Beta = 0.09; p = 0.05). Higher home availability of less healthy foods positively predicted child consumption of high-sugar/high-fat snack foods (Beta = 0.59; p = 0.003). The findings of this study indicate that caregiver modeling, healthy caregiver dietary intake, and healthful home food availability are associated with healthier child dietary intake among young children in low-income, rural, Appalachian areas. Promoting these practices among caregivers may be an important strategy to enhancing dietary intake of children in this hard-to-reach, underserved population.

Informal caregivers and persons with dementia’s everyday life coping

This qualitative study explores informal caregivers’ experiences of supporting persons with dementia’s everyday life coping. In the future, there will be fewer health personnel, increased dementia prevalence and limited nursing home availability. Accordingly, close relatives may be compelled to assume greater care responsibilities. Knowledge concerning persons with dementia’s everyday coping from the perspective of informal caregivers remains insufficient, despite these people’s importance for those with dementia. This investigation analyses informal caregivers’ perceived challenges and pleasures in providing care, how home health care affects everyday life coping and the factors that are most important to informal caregivers in supporting care receivers.

Relationship of Food Label Use and Household Availability of Beverages in a Sample of Mothers of Preschool Children Participating in the Supplemental Nutrition Assistance Program

The purpose of this study was to assess the association between maternal participation in the Supplemental Nutrition Assistance Program (SNAP) and the use of food labels to purchase various types of beverages, and whether home availability of beverages differed by SNAP participation. Low-income mothers (n=250) of preschool children were surveyed. Food label use to purchase beverages and home availability of beverages were analyzed using adjusted multivariate logistic regression and iteratively reweighted with least squares regression. SNAP participants were approximately 50% less likely to use the food label to purchase beverages for the home than non-participants. SNAP homes also had significantly higher availability of fruit juice (192 oz vs. 128 oz), juice drinks (192 oz vs. 128 oz), regular soda (156 oz vs. 135 oz), and low-calorie beverages (469 oz vs. 243 oz) than non-SNAP homes (p < 0.05). Further research is needed to understand the attitudes and group-specific characteristics associated with food label use and beverage availability among low-income families.

Barriers to Preparing and Cooking Vegetables Are Associated with Decreased Home Availability of Vegetables in Low-Income Households

Knowing which barriers to buying and preparing/cooking vegetables at home are linked with the home availability of vegetables and how food-security status impacts this relationship will facilitate the tailoring of future public health interventions. Baseline data were used from an elementary-school-based intervention. Data on household food-security status, availability of vegetables at home, and barriers to buying and preparing/cooking vegetables were collected from 1942 parents. Differences between food-secure and food-insecure households were examined for barriers to buying and preparing/cooking vegetables. Mixed-effects linear regression was used to estimate the associations between barriers to buying and preparing/cooking vegetables and food-security status on the home availability of vegetables. Food insecurity was reported in 27% of households. Food-insecure households were significantly more likely to report barriers to buying and preparing/cooking vegetables. The barriers to purchasing/cooking vegetables score was associated with a decrease in the home availability of vegetables score (β = −0.77; 95% CI: −0.88, −0.65; p < 0.001). Compared to food-secure households, food-insecure households were 15% less likely to have home vegetable availability (β = −1.18; 95% CI: −1.45, −0.92; p < 0.001). Although home availability of vegetables does not guarantee consumption, this study identified specific barriers that were associated with availability that can be targeted in future interventions seeking to improve vegetable consumption in the homes of low-income families.

Housing, urban growth and inequalities: The limits to deregulation and upzoning in reducing economic and spatial inequality

Urban economics and branches of mainstream economics – what we call the ‘housing as opportunity’ school of thought – have been arguing that shortages of affordable housing in dense agglomerations represent a fundamental barrier to economic development. Housing shortages are considered to limit migration into thriving cities, curtailing their expansion potential, generating rising social and spatial inequalities and inhibiting national growth. According to this dominant view, relaxing zoning and other planning regulations in the most prosperous cities is crucial to unleash the economic potential of cities and nations and to facilitate within-country migration. In this article, we contend that the bulk of the claims of the housing as opportunity approach are fundamentally flawed and lead to simplistic and misguided policy recommendations. We posit that there is no clear and uncontroversial evidence that housing regulation is a principal source of differences in home availability or prices across cities. Blanket changes in zoning are unlikely to increase domestic migration or to improve affordability for lower-income households in prosperous areas. They would, however, increase gentrification within metropolitan areas and would not appreciably decrease income inequality. In contrast to the housing models, we argue that the basic motors of all these features of the economy are the current geography of employment, wages and skills.

Hispanic Preschoolers Intake of Sugary Drinks: Interactions Between Mothers and Fathers Feeding Practices (OR03-04-19)

Objectives To 1) assess the relationship of home availability of sugary drinks (SD), mothers’ feeding practices, and fathers’ practices related to promoting their children's intake of SD (fathers’ SD practices) with children's intake of SD and 2) evaluate whether fathers’ SD practices moderated the relationship between mothers’ feeding practices and children's intake of SD. Methods Hispanic mothers (n = 202) of 2-to-5-year-old children reported home availability of sugary drinks, their feeding practices (i.e., monitoring, restriction, food for emotion regulation), their children's fathers’ SD practices (i.e., frequency of bringing SD to the home, using SD for emotion regulation) and children's intake of SD. Availability of SD was dichotomized as low (never/rarely/sometimes) and high (frequently/always) availability. Fathers’ feeding practices were dichotomized as low (never/once per month/once per week) and high frequency (2-3 days per week/4-6 days per week/everyday). Linear regression models tested the multivariable association between child's intake of SD and variables of interest, and interaction terms were tested for moderation effects. Results Home availability of SD, fathers drinking SD in front of the child, and fathers using SD for emotion regulation were associated with children's SD intake (P < 0.05). Fathers’ use of SD for emotion regulation moderated the association of mothers’ restriction and child's SD intake (P < 0.04). Fathers’ use of SD for emotion regulation moderated the association of mothers monitoring and child's SD intake (P < 0.02). When fathers used SD for emotion regulation at high frequencies, mothers’ restriction and monitoring practices reduced child's SD intake (P = 0.07 and 0.01, respectively). However, when fathers used SD for emotion regulation at low frequencies, there was no longer a relationship between mothers’ restriction and monitoring practices and child's SD intake (P = 0.30 and 0.95, respectively). Conclusions Mothers’ restriction and monitoring practices appear to weaken the influence of fathers use of SD in response to children's emotions and intake of SD. The moderating effect of mothers or fathers feeding behaviors on each other's behaviors warrants future investigation. Funding Sources U54GM104938.

A Newsletter/Text Message Intervention Promoting Beverage-Related Parenting Practices: Pilot Test Results

Positive beverage parenting practices may reduce sugar-sweetened beverage consumption by children and prevent potential health problems. An online newsletter/text message intervention was conducted with parents of children 6 to 12 years to improve beverage parenting practices. Newsletters and text messages were sent weekly over a 4-week period providing gain-framed messages encouraging parenting practices including role modeling and controlling home beverage availability. Pre–post surveys included measures of home availability of beverages and parent beverage intake as an indication of parenting practices. Parents were primarily White, well-educated, and female. About one third lived in rural areas. Results from 100 parents with pre–post data from baseline to 4 weeks showed decreased reported home availability of regular soda pop (p = .008), decreased parent intake of sweetened beverages (p = .004), and decreased parent-reported child intake of regular soft drinks (p = .001), and sweetened juice drink beverages (p < .0001). Most parents (82%) reported reading all three newsletters and indicated that the information provided was relevant (93%). A brief newsletter/text message intervention may be a positive and convenient approach to promote positive beverage parenting practices.

Interrelationship between food security status, home availability of variety of fruits and vegetables and their dietary intake among low-income pregnant women

ObjectiveTo (i) determine differences in the availability of variety of fruits and vegetables (F&V) at home by food security status; and (ii) examine the inter-associations between food security status, availability of variety of F&V at home and frequency of F&V intake, among low-income pregnant women.Design/SettingParticipants were interviewed to collect food security status, home availability of variety of F&V and frequency of F&V intake. Bivariate analyses, multivariate regression and exploratory mediation analyses were conducted using IBM SPSS Statistics version 23.0 and the PROCESS macro.SubjectsLow-income pregnant women (n 198) were interviewed if they were ≥18 years of age, in the second trimester of pregnancy, and spoke English or Spanish.ResultsLow/very low food security was found among 43 % of participants. Compared with fully food-secure participants, very low food-secure participants reported a lower variety of fruits (P=0·028) and vegetables (P=0·058) available at home. Mediation analyses indicated that through home availability of variety of fresh F&V, food security status was associated with the daily intake of F&V (indirect effect (95 % CI): fresh fruits, −0·039 (−0·074, −0·013); fresh vegetables, −0·048 (−0·083, −0·023)). As food security worsened, the available variety of fresh F&V decreased, which was associated with lower intake.ConclusionsThe study highlights the interlink between food security, home food environment and diet quality, and the importance of nutrition education intervention to promote a healthy home food environment and improved pregnancy outcomes among low-income women.