Perceptions of cigarettes and e-cigarettes: does health literacy matter?

OBJECTIVE: This study assessed the relationship between health literacy, perceptions of traditional and electronic cigarettes, and smoking status among college students. PARTICIPANTS: Participants (N = 150; Mage= 20.41 years, SD 3.48), included nonsmokers (78%) and smokers (21%) of traditional (12%) and e-cigarettes (17%). METHOD: Participants completed a novel questionnaire to assess perceptions of traditional and e-cigarettes, and the Health Literacy Skills Instrument to evaluate health literacy. RESULTS: Traditional cigarettes were perceived as having a greater negative impact on physical health than e-cigarettes, whereas e-cigarettes were perceived as having a greater positive impact on social-emotional health than traditional cigarettes. Most participants (57%) had below basic health literacy skills. CONCLUSIONS: This study did not find a relationship between health literacy skills and smoking status or smoking perceptions. Further research is needed to investigate correlates of smoking status and perceptions to inform prevention and cessation efforts.

An examination of food parenting practices: structure, control and autonomy promotion.

OBJECTIVE: In recent years, researchers have been working towards creating a standard conceptual framework of food parenting. To understand how parents' reports correspond with the proposed model, the current study examined parents' reports of their feeding behaviours in the context of a newly established framework of food parenting. DESIGN: Cross-sectional, with a two-week follow-up for a subset of the sample. Participants completed a quantitative and qualitative survey to assess food parenting. The survey included items from common food parenting instruments to measure the constructs posited in the framework. Exploratory factor analyses were conducted to ascertain which items related most closely to one another and factors were mapped on to existing constructs. SETTING: Online. PARTICIPANTS: Parents of children aged 2·5-7 years (n 496). Of these, 122 completed a two-week follow-up. RESULTS: Analyses revealed eleven aspects of Structure (monitoring; distraction; family presence; meal/snack schedule; unstructured practices; healthy/unhealthy food availability; food preparation; healthy/unhealthy modelling; rules), ten aspects of Coercive Control (pressure to eat; using food to control emotions; food incentives to eat; food incentives to behave; non-food incentives to eat; restriction for health/weight; covert restriction; clean plate; harsh coercion) and seven aspects of Autonomy Promotion (praise; encouragement; nutrition education; child involvement; negotiation; responsive feeding; repeated offering). Content validity, assessed via parents' open-ended explanations of their responses, was high, and test-retest reliability was moderate to high. Structure and Autonomy Promoting food parenting were highly positively correlated. CONCLUSIONS: In general, parents' responses provided support for the model, but suggested some amendments and refinements.

Friday Night Is Pizza Night: A Comparison of Children's Dietary Intake and Maternal Perceptions and Feeding Goals on Weekdays and Weekends.

Childhood obesity is a serious issue in the U.S. While obesity is the result of a multitude of factors, a great deal of research has focused on children's dietary intake. While children's eating patterns vary throughout the week, not much else is known about weekday-weekend differences. Therefore, the current study examined differences in the frequency and portion size of school-age children's consumption of common foods and beverages, as well as mothers' perceptions of those items and their child feeding goals, on weekdays and weekends. A total of 192 mothers of children aged 7 to 11 were recruited through Amazon's Mechanical Turk. Results showed a consistent pattern of more frequent consumption and larger portions of unhealthy foods and beverages on weekends. This aligned with mothers' perceptions of those foods and beverages as weekend items, as well as their feeding goals of health and price being less important on weekends. It is quite possible that weekends are viewed as having less structure and facilitate schedules that allow children to consume more meals away from home. These findings shed light on additional risk factors in children's eating patterns and highlight the serious implications that day of the week can have on childhood obesity.

Using food as a reward: An examination of parental reward practices.

Eating patterns and taste preferences are often established early in life. Many studies have examined how parental feeding practices may affect children's outcomes, including food intake and preference. The current study focused on a common food parenting practice, using food as a reward, and used Latent Profile Analysis (LPA) to examine whether mothers (n = 376) and fathers (n = 117) of children ages 2.8 to 7.5 (M = 4.7; SD = 1.1) grouped into profiles (i.e., subgroups) based on how they use of food as a reward. The 4-class model was the best-fitting LPA model, with resulting classes based on both the frequency and type of reward used. Classes were: infrequent reward (33%), tangible reward (21%), food reward (27%), and frequent reward (19%). The current study also explored whether children's eating styles (emotional overeating, rood fussiness, food responsiveness, and satiety responsiveness) and parenting style (Authoritative, Authoritarian, and Permissive) varied by reward profile. Analyses of Variance (ANOVA) revealed that the four profiles differed significantly for all outcome variables except satiety responsiveness. It appears that the use of tangible and food-based rewards have important implications in food parenting. More research is needed to better understand how the different rewarding practices affect additional child outcomes.

A randomized trial comparing two approaches to weight loss.

Weight loss programs evidence considerable variability in treatment outcomes, and weight regain is common, signaling the need for the refinement of effective treatments. This study compared the recently developed Transforming Your Life program to the Diabetes Prevention Program, considered the "Gold Standard" in behavioral weight loss treatment. A total of 98 participants (Transforming Your Life = 51; Diabetes Prevention Program = 47) were randomized to the two weight loss interventions. The Transforming Your Life program and Diabetes Prevention Program produced comparable weight loss and maintenance outcomes. Individuals may benefit from engagement in the Transforming Your Life program, if they are searching for a somewhat novel approach to losing weight other than that offered by the Diabetes Prevention Program.

Influence of maternal feeding goals and practices on children's eating behaviors.

Parents are highly influential in shaping their children's dietary habits. This study examined whether negative feeding practices mediated the relationship between feeding goals (health and convenience) and children's eating behaviors. One hundred ninety-two mothers (mean age = 34.2; mean BMI = 27.0) of 7-11 year old children participated via Amazon's Mechanical Turk. Results showed that negative feeding practices fully mediated the relationship between convenience feeding goals and children's eating behaviors (goals to healthy/unhealthy eating behaviors: ß = -0.08/.09, n.s.; goals to feeding practices: ß = 0.27, p < 0.01; feeding practices to healthy/unhealthy eating behaviors: ß = -0.57/.48, p < 0.05). On the other hand, negative feeding practices did not fully mediate the relationship between health feeding goals and children's eating behaviors (goals to healthy/unhealthy eating behaviors: ß = 0.66/-0.29, p < 0.01; goals to feeding practices: ß = -0.28, p < 0.001; feeding practices to healthy/unhealthy eating behaviors: ß = -0.26/.44, p < 0.05). In other words, children whose mothers emphasized health goals consumed more healthy food and less unhealthy food, above and beyond the use of negative feeding practices. Because parents are on the front lines of shaping children's eating habits, understanding the best point of intervention for parents (e.g., shaping parents' goals, changing parents' feeding practices) might be especially fruitful, considering that childhood obesity has become a global public health crisis and energy intake is one of the key factors contributing to this problem.

Meals and snacks: Children's characterizations of food and eating cues.

This study examined preschoolers' and their parents' categorizations of eating episodes based on cues used for defining these occasions (i.e., time, portion size, preparation, content, and emotion) as a meal or snack. Thirty-four children aged 4 to 6 saw pictorial representations of each cue, along with a short verbal description, and were asked to place the picture in one of three boxes: "meal", "snack", or "either meal or snack". One parent per child (85% mothers, Mean age = 35.1 years) separately categorized the same items in an online survey. Results illustrated which cues play a role in how parents and children categorize eating occasions as meals or snacks. Parents used 24 of the 32 cue-related items to distinguish between eating occasions as a meal or a snack, while children used only four. Parents and preschoolers were consistent in using cartoon character packaging to indicate a snack, and also used several of the same content cues. The current study highlights the various cues used to categorize an eating occasion, and the unhealthy character of snacks, as participants associated some unhealthy foods and very few healthy foods with snacks. Future research should focus on the role of parents, the home environment, and advertising media in shaping children's characterizations of eating occasions towards development of healthy eating habits and away from problematic eating behaviors that may persist later in life.

It's always snack time: an investigation of event scripts in young children.

This study examined whether young children include eating in their cognitive scripts for various events, and whether food-related scripts are associated with body mass index (BMI) percentile. Data were collected in a structured interview format. Participants, recruited from area preschools and day cares, provided a four-activity sequence for each of three events, and responses were recorded verbatim. Forty-four children (45% female) participated, with an average BMI percentile of 73.3% (SD = 25.9). Data were binarily coded to indicate whether each response was food-related. Frequencies were obtained, and responses were correlated with BMI percentile. Over 22% of the activities in the children's scripts involved food. The number of food-related activities reported was positively correlated with children's BMI percentile (r = 0.53, p = 0.03). Results provide preliminary evidence that food features prominently in young children's event scripts and that children with higher BMI percentiles may possess scripts that feature more food-related themes. Future researchers should investigate the causal nature of this relationship.

Implicit bias about weight and weight loss treatment outcomes.

OBJECTIVES: The goal of the current study was to examine the impact of a weight loss intervention on implicit bias toward weight, as well as the relationship among implicit bias, weight loss behaviors, and weight loss outcomes. Additionally, of interest was the relationship among these variables when implicit weight bias was measured with a novel assessment that portrays individuals who are thin and obese engaged in both stereotypical and nonstereotypical health-related behaviors. METHODS: Implicit weight bias (stereotype consistent and stereotype inconsistent), binge eating, self-monitoring, and body weight were assessed among weight loss participants at baseline and post-treatment (N=44) participating in two weight loss programs. RESULTS: Stereotype consistent bias significantly decreased from baseline to post-treatment. Greater baseline stereotype consistent bias was associated with lower binge eating and greater self-monitoring. Greater post-treatment stereotype consistent bias was associated with greater percent weight loss. Stereotype inconsistent bias did not change from baseline to post-treatment and was generally unrelated to outcomes. CONCLUSION: Weight loss treatment may reduce implicit bias toward overweight individuals among weight loss participants. Higher post-treatment stereotype consistent bias was associated with a higher percent weight loss, possibly suggesting that losing weight may serve to maintain implicit weight bias. Alternatively, great implicit weight bias may identify individuals motivated to make changes necessary for weight loss.