The influence of experimental confederate peers on children's food intake: A systematic review and meta-analysis.

Confederates influence eating behaviour. Systematic reviews and meta-analyses have been conducted on this topic, however, the majority have examined adults, or a combination of adults and children, therefore, an up-to-date meta-analysis is needed to examine the impact of confederate peers on children's food intake. We systematically reviewed and meta-analysed the influence of confederate peers on children's food intake in research using present and remote-confederates. Six publications summarising findings from seven studies were included in this review. One publication was excluded from the meta-analysis because it was not possible to extract the required data. The meta-analysis showed that children were influenced by confederate peers; eating more when exposed to a high-intake compared to a no or low-intake confederate. Larger effects were observed when children were exposed to a remote-than a present-confederate, and for studies using healthy snacks compared to high fat high sugar (HFHS) snacks. No difference in effect size was observed when children were exposed to a high-vs. low-intake confederate compared to a high-vs. no-intake confederate. In the narrative synthesis, confederate intake influenced children's eating behaviour 24-h later, and possible moderators and a potential mechanism underlying the influence of confederates were identified. Caution is needed when interpreting the results, as the sub-groups were not compared statistically due to high heterogeneity, and a small number of studies were included in this review. Furthermore, all studies using the present-confederate design examined HFHS snack intake, therefore, it is unclear whether observed differences in effect sizes between present- and remote-confederates may be due to confederate or food type. Research is needed to further examine the influence of confederate peers on children's food intake and to examine mechanisms and moderators.

Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

BACKGROUND: Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. OBJECTIVE: This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. CONCLUSION: The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention.

Friends and social contexts as unshared environments: a discordant sibling analysis of obesity- and health-related behaviors in young adolescents.

OBJECTIVE: This study examines the contribution of best friends' weight and the peer social context (time spent alone versus with friends) as sources of unshared environment associated with variability in weight and health behaviors among weight-discordant siblings. METHODS: Pairs of same-sex biologic siblings (N=40 pairs; ages 13-17) were originally recruited as part of a study evaluating putative factors contributing to differences in adiposity among weight-discordant siblings. Siblings were asked to bring their best friends to the laboratory and siblings and friends' height and weight were objectively measured. Siblings also completed multi-pass dietary recalls to assess energy intake and sugar sweetened beverage (SSB) consumption. Siblings' physical activity was measured using accelerometry. Experience sampling methodology was used to assess sedentary behaviors/screen time and the number of occasions siblings spent alone and in the presence of friends. Multilevel models were used to estimate the relationships between predictors (best friends' zBMI, time spent alone or with friends) and outcomes (siblings' zBMI and obesity-related health behaviors). RESULTS: Best friends' zBMI was the best predictor of participants' zBMI, even when controlling for child's birth weight. Best friends' weight (zBMI) further predicted participants' SSB intake and time engaged in sedentary behaviors. Being active with friends was positively associated with participants' overall physical activity, whereas spending time alone was negatively associated with accelerometer counts regardless of siblings' adiposity. CONCLUSIONS: A friends' weight and the social context are unshared environmental factors associated with variability in adiposity among biologically-related weight-discordant siblings.

Nutritional interventions for individuals with bulimia nervosa.

Many physical and psychological effects of bulimia nervosa are caused by the patient's partial starvation and chaotic nutritional cycle. Attention should thus be initially directed to correcting nutritional deficiencies and abnormal eating patterns, and providing dietary counselling. Nevertheless, very little has been written about the nutritional management of this eating disorder. Nutritional counselling for bulimia patients is reviewed in this paper. Current knowledge about nutritional therapy and its efficacy, goals and objectives is presented, along with recommendations used in treatment programmes. Lastly, the key steps of nutritional management are summarised.