The Children in Action Pilot Study

Interventions that can successfully alter the trajectory toward obesity among high-risk children are critical if we are to effectively address this public health crisis. The goal of this pilot study was to implement and evaluate an innovative physical activity program with Hispanic-American (HA) preschool children attending Head Start. The Children in Action (CIA) program was a five month physical activity intervention. This intervention was a pilot study with 3- to 5-year-olds enrolled in four HA Head Start centers. After baseline assessment, centers were matched by enrollment and randomly assigned to either the intervention or the control condition. A total of 295 preschool children were randomly selected across the four centers. The primary endpoints of this study were favorable changes in physical activity levels and gross motor skills. Using mixed effect time-series regression models, changes in weight was a secondary endpoint. We did not observe a statistical difference between intervention and control groups in physical activity levels during the awake time, gross motor skills, or weight status. Process evaluation data showed that there was adherence to protocols and the intervention was delivered 92% of the time, four times per week, during the five month intervention. We demonstrated that it is feasible to conduct the SPARK-Early Childhood (EC) curriculum among preschool children attending Head Start centers but that an increased dose and/or longer intervention duration will be required to impact gross motor skills, physical activity levels and weight status during this critical early childhood development stage

Consumption of 100% Fruit Juice is Associated with Better Nutrient Intake and Diet Quality but not with Weight Status in Children: NHANES 2007-2010

Objective: This study examined the impact of various levels of 100% fruit juice (FJ) consumption on intake of nutrients, diet quality, and weight in children using the more recent national data.Methods: This was a cross-sectional study examining the data from children 2-18 years of age (n=6,090). Intake of nutrients and diet quality were assessed using the 24-hr dietary recall and Healthy Eating Index-2010, respectively. Various consumption levels of 100% FJ were determined. Covariate adjusted linear regression means, and standard errors were determined (p<0.01).Results: Average per capita consumption of 100% FJ consumed was 3.6 fl oz (50 kilocalories; 2.9% energy intake); 30% of children 2-6 years exceeded the recommendation for 100% FJ. Among 100% FJ consumers, the mean amount of 100% FJ consumed was 10.6 fl oz (147 kilocalories; 8.4% energy intake). Intakes of vitamin C, magnesium, and potassium and overall diet quality were higher with more 100% FJ consumed; no difference was found in total fiber intake. No trends were seen in weight with increased amounts of 100% FJ consumed.Conclusions: Consumption of 100% FJ should be recommended as a component of a healthy diet

Associations among sleep, body mass index, waist circumference and risk of type 2 Diabetes among US childbearing age women : national health and nutrition examination survey

Background. Women of childbearing age (18 to 44 years) present an important group for understanding sleep, but few studies have focused on this population. No study has investigated the associations among sleep, overweight/obesity and risk of type 2 diabetes among childbearing age women in the National Health and Nutrition Examination Survey (NHANES). Methods. Data were from NHANES, 2005-2008. The study population consisted of 18 to 44 year old women. Pregnant women and those diagnosed with sleep disorders were excluded. Sleep duration and quality were self-reported. Body mass index (BMI), waist circumference (WC) measurements and a 2-hour 75 g oral glucose tolerance test (OGTT) were performed by trained NHANES staff. An unadjusted linear regression analysis; a second adjusted for demographics only (partially adjusted model); and a third adjusted for demographics and variables associated with overweight/obesity and diabetes (fully adjusted model) were computed to assess associations among sleep duration/quality and BMI, WC and 2-hour OGTT. Results. Total sample consisted of 2388 childbearing age women. Only sleep duration was significantly associated with BMI and WC in the unadjusted and partially adjusted models, but was no longer significant in the fully adjusted model. Neither sleep duration nor quality were significantly associated with 2-hour OGTT in any of the models. Conclusions. Targeting sleep duration and sleep quality alone would not likely contribute to significantly lower BMI, WC or risk of type 2 diabetes in US childbearing age women. Additional studies, especially longitudinal ones using objective measures of sleep are needed to confirm the present findings

Relationship between Snacking Patterns, Diet Quality and Risk of Overweight and Abdominal Obesity in Children

Snacking is very common among Americans; the impact of variety of snacking patterns on nutrient intake and weight status is unclear. This study examined the associations of snacking patterns on nutrient intake and weight in U.S. children 2-18 years (n=14,220) participating in the 2001-2008 National Health and Nutrition Examination Survey. Cluster analysis generated 12 distinct snacking patterns, explaining 57% of variance in total calories consumed. Only 8% of the children did not consume snacks on the day of the 24-hour recall. Cakes, cookies and pastries was the most common snacking pattern (16%) followed by miscellaneous snacks (e.g. whole milk, orange juice and meat/fish/poultry; 13%), and crackers and salty snacks (10%). Most snacking patterns resulted in higher total energy intake than the no snack pattern. After controlling for energy intake, most snacking patterns resulted in higher intakes of fiber; vitamins A, C, B12, and K; riboflavin; folate; potassium; calcium; zinc; and magnesium than the no snack pattern. However, most of the snacking patterns resulted in higher total intake of saturated fatty acids, solid fats, added sugars, and sodium (nutrients to limit). Several of the snacking patterns (i.e. cakes/cookies/pastries, crackers/salty snacks, sweets, and other grains) were associated with a reduced risk of overweight and abdominal obesity. Overall, several snacking patterns compared with non-snackers had better diet quality and were less likely to be overweight or obese and less likely to have abdominal obesity. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet

Intergenerational effects of health issues among women of childbearing age : a review of the recent literature

Purpose of review. This review summarizes the latest scientific evidence, primarily from systematic reviews/meta-analyses and large cohort studies, on the impact of health issues among women of childbearing age and their effect on their offspring during pregnancy and from birth to adulthood. Recent findings. Women of childbearing age with overweight/obesity, diabetes and hypertension prior to pregnancy are at increased risk for adverse outcomes during pregnancy, such as excessive gestational weight gain, gestational diabetes mellitus and hypertensive disorders of pregnancy. These adverse outcomes could complicate delivery and put their offspring at risk of developing overweight/obesity, diabetes and hypertension (i.e., intergenerational transmission of health issues). Summary. Interventions should target women of childbearing age, especially those who wish to conceive, in order to possibly stop the transmission of women’s health issues to the offspring and favor a healthy pregnancy from the start. This could be one of the best strategies to promote both maternal and child health

Beverage Consumption in the Diets of Children is Not Consistently Associated with Weight: National Health and Nutrition Examination Survey 2007-2014

Objectives: The objective of this study was to examine whether there was significant risk associated with types of beverages consumed on the weight status in children.Design: Nationally representative cross-sectional sample.Setting: Demographic information was obtained from the NHANES interviews. Dietary intake data were obtained from Day 1, in-person 24-hour dietary recall interviews administered using an automated multiple-pass method. Height and weight were obtained according to NHANES Anthropometry Procedures Manual.Subjects: Children 2-18 years of age.Results: The likelihood of being overweight or obese was not significant for any of the beverages studied between consumers and non-consumers. For the total sample, for every 29.6 mL of water consumed the risk of being obese was 1%. For ages 6-11 years water consumption increased the risk of being obese and in ages 2-5 years, consumption of sugar sweetened beverages (SSB) increased the risk of being obese. The risk of being obese was significant p <0.05 for Hispanic males for every 29.6 mL of water consumed and for 100% fruit juice and SSB for other males; increased risk was ?3%. The risk of being obese increased for White females for every 29.6 mL of flavored milk consumed and water consumption for both Black females and Hispanic females; the significant p<0.05 increased risk of obesity was ?7%.Conclusions: Beverage consumption was not consistently associated with weight status in the diets of a nationally representative sample of children. In some cases the increased risk was very small

Nutrient Contribution of the Dinner Meal Consumed by Low-Income Minority Preschool Children

Objective: To examine the energy and nutrient intake of dinner of low income preschool minority groups, African-Americans and Mexican-Americans, attending Head Start (HS). Design: Cross-sectional study of intake at dinner using digital photography. Pictorial records were converted to energy and nutrient intakes using NDS-R Nutritional software. Means±SE for total grams of food and beverages, energy, and macro- and micro-nutrients were determined and compared with recommendations. Setting: Home assessment dinner of children enrolled in HS in Houston, TX. Subjects: Low-income children (n=214), 3 to 5 years (mean age 4.4 ± 0.7 years; 48% boys; 53% Mexican-American). Results: Energy from food and beverages and food was 350.29±10.36 kcals and 302.35±10.46 kcals, respectively. Mean protein, carbohydrate, and total fat intakes were 14.22±0.52 g (16.32% of total energy), 44.33±1.25 g (52.24%), and 13.18±0.56 g (32.29%), respectively, which provided 95.4±0.52%, 44.5±1.25%, and 10.4±0.11% of the requirements for protein, carbohydrate, and dietary fiber, respectively; these were consistent with recommendations. Intakes of vitamin D, calcium, and potassium were 0.66±0.08 mcg, 102.61±5.03 mg, and 404.42±13.63 mg, respectively; which constituted only 6.6±0.08%, 12.7±5.03%, and 10.7±13.63% of these nutrients of public health concern. Conclusions: Children participating in HS had low intakes of nutrients of public health concern at the dinner meal. The dinner meal is an integral part of the daily intake of preschool children and this study suggests that micronutrient intakes could be improved. It is important to educate mothers and children as to what constitutes a nutrient-dense meal and to confront barriers to consumption of these meals

Resemblance of Dinner Meal Consumption among Mother and Preschool-Aged Child Dyads from Families with Limited Incomes

Parents’ eating habits are associated with food and nutrient intake of their children; yet, the associations have not always been very strong. The objective of this study was to expand the current literature to include an examination of resemblance in intakes of foods, within the context of a meal, among mother and preschool-aged child dyads from families of limited incomes. Mother-child dyads (n=112; 41% Hispanic and 59% African-American) participated in the study. During the two home observations of each mother-child dyad, a digital photography method plus actual weighing of plate waste was used to assess the amount of food served and consumed by the mothers and children. There were significant correlations between the mother-child dyad intakes of food/beverages consumed at the dinner meal; ranging from 0.298 (total beverages, p<0.01) to 0.687 (100% fruit juice or milk, p<0.01). There was a significant linear association between the amount of total food/beverages served and the amount consumed for both the mothers (R2=0.72, p<0.0001) and the children (R2=0.55, p<0.0001). Mothers-children who were served larger amounts of total food/beverages consumed more. There was a positive association (p<0.05) between the amount of total energy consumed in the mother-child dyads. Portion sizes may be an important strategy that can be used by parents to promote intake of fruits and vegetables and to decrease intake of energy-dense foods. It is important that food and nutrition professionals provide the guidance needed that encourages intake of major food groups in mothers so they can model healthier food consumption behaviors for their children

Trends in Orange Juice Consumption and Nutrient Adequacy in Children 2003-2016

This study aimed to examine secular trends in 100% orange juice (OJ) consumption and trends in nutrient adequacy in children 2-18 years participating in the 2003-2016 National Health and Nutrition Examination Survey. The National Cancer Institute method was used to estimate the usual intake. Ten deciles of OJ consumption were determined based on intakes with non-consumers in the first decile. Nutrient adequacy was determined using the percentage below the Estimated Average Requirement (EAR) or the Adequate Intake (AI) percentage. Linear regression coefficients for changes in intake over time and across deciles of OJ were generated. Approximately 14% of the total sample consumed OJ with a mean intake of 40.0 g/d (77 KJ [0.9% of total energy intake]). Amounts of all 100% fruit juices consumed decreased by 44%, and whole fruit intake increased by approximately 32% from 2003-2016. Consumption of total energy, total carbohydrates, added sugars, and saturated fatty acids decreased. Intakes of folate, riboflavin, zinc, and vitamin C decreased from 2003-2016. The percentage of children below the EAR increased for vitamin C and zinc and decreased for vitamin A from 2003-2016. Percent of children above the AI increased for fiber. Across the deciles of OJ consumption, the percent of children with an inadequate vitamin D intake, calcium, iron, and phosphorus decreased. OJ and other 100% juices were major food sources of many nutrients consumed at levels below recommendations. One strategy to reduce inadequate intake of calcium, phosphorus, and potassium intake is to maintain or increase the consumption of OJ and other 100% juice

Behavioral interventions to promote adequate sleep among women : protocol for a systematic review and meta-analysis

Background: Short and poor sleep have been associated with adverse health outcomes in adults, such as overweight/obesity and type 2 diabetes, especially among women. Women therefore represent an important target for interventions aimed at improving sleep and such interventions have been advocated to enhance maternal, fetal, and infant health. This systematic review will assess the efficacy or effectiveness of behavioral interventions aimed at promoting adequate sleep among women. The primary outcomes will be changes in sleep duration and/or sleep quality from baseline to post-intervention and to the last available follow-up measured either through self-reports or objectively. Secondary outcomes will be assessing the behavior change techniques that are responsible for the changes in sleep duration and quality among women. Methods: Behavioral interventions that are non-pharmacological and target either sleep directly or sleep hygiene behaviors will be included. Randomized controlled trials, quasi-experimental, and one-group pre-post studies will be included, but treated separately in the analyses, given that a limited number of studies on the topic of sleep is expected. MEDLINE/PubMed, PsycINFO, CINAHL, EMBASE, and Proquest Dissertations and Theses will be investigated. There will be no restriction on the year of publication of the articles, but we will include only the ones written in English or French. Two authors will independently assess articles for eligibility and will extract data using a standardized data extraction form that will have been previously pilot-tested. The quality of the studies will be assessed using the Effective Public Health Practice Project tool for quantitative study designs. The intervention procedures will be classified according to the latest validated taxonomy of behavior change techniques. If there is a sufficient number of studies (k > 5), a meta-analysis of the results will be performed with a random-effect model. If the heterogeneity is high (I 2 ≥ 75%), it will be investigated through sensitivity analyses and meta-regression. Discussion: This review will provide valuable information to those interested in promoting adequate sleep among women and, hopefully, encourage additional research in this important field to promote maternal, fetal, and infant health. Systematic review registration: The study protocol was registered in PROSPERO in October 2016 (CRD42016049538)