Passive, wearable sensors can be used to obtain objective information in infant feeding, but their use has not been tested. Our objective was to compare assessment of infant feeding (frequency, duration and cues) by self-report and that of the Automatic Ingestion Monitor-2 (AIM-2).

A cross-sectional pilot study was conducted in Ghana. Mothers wore the AIM-2 on eyeglasses for 1 d during waking hours to assess infant feeding using images automatically captured by the device every 15 s. Feasibility was assessed using compliance with wearing the device. Infant feeding practices collected by the AIM-2 images were annotated by a trained evaluator and compared with maternal self-report via interviewer-administered questionnaire.

Rural and urban communities in Ghana.

Participants were thirty eight (eighteen rural and twenty urban) breast-feeding mothers of infants (child age ≤7 months).

Twenty-five mothers reported exclusive breast-feeding, which was common among those < 30 years of age (n 15, 60 %) and those residing in urban communities (n 14, 70 %). Compliance with wearing the AIM-2 was high (83 % of wake-time), suggesting low user burden. Maternal report differed from the AIM-2 data, such that mothers reported higher mean breast-feeding frequency (eleven v. eight times, P = 0·041) and duration (18·5 v. 10 min, P = 0·007) during waking hours.

The AIM-2 was a feasible tool for the assessment of infant feeding among mothers in Ghana as a passive, objective method and identified overestimation of self-reported breast-feeding frequency and duration. Future studies using the AIM-2 are warranted to determine validity on a larger scale.

Survival rates for paediatric cancers have increased dramatically since the 1970s, but childhood cancer survivors (CCS) are at increased risk for several chronic diseases throughout life. Nutrition interventions promoting healthy family meals may support wellness for survivors, but little research has explored CCS family food preparation habits. The goal of the present study was to describe and compare food preparation practices of CCS and non-CCS families.

Observational.

Typical evening meal preparation events were observed and recorded in participant homes. Recordings and notes were analysed using the Healthy Cooking Index (HCI), a measure of nutrition-optimizing food preparation practices relevant to survivor wellness. Demographics, BMI and nutrient composition of prepared meals were also collected.

Forty parents with a CCS or non-CCS child aged 5–17 years were recruited.

There were no major differences between the CCS and non-CCS families with regard to summative HCI score or specific food preparation behaviours. Meals prepared by CCS and non-CCS families had similar nutrient compositions.

The study revealed areas for practical nutrition intervention in CCS and non-CCS families. Future studies should consider adopting and tailoring nutrition intervention methods that have been successful in non-CCS communities.

To identify most commonly consumed foods by adolescents contributing to percentage of total energy, added sugars, SFA, Na and total gram intake per day.

Data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014.

NHANES is a cross-sectional study nationally representative of the US population.

One 24 h dietary recall was used to assess dietary intake of 3156 adolescents aged 10–19 years. What We Eat in America food category classification system was used for all foods consumed. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were sample-weighted and ranked based on percentage contribution to intake of total amount.

Three-highest ranked food subgroup sources of total energy consumed were: sugar-sweetened beverages (SSB; 7·8 %); sweet bakery products (6·9 %); mixed dishes – pizza (6·6 %). Highest ranked food sources of total gram amount consumed were: plain water (33·1 %); SSB (15·8 %); milk (7·2 %). Three highest ranked food sources of total Na were: mixed dishes – pizza (8·7 %); mixed dishes – Mexican (6·7 %); cured meats/poultry (6·6 %). Three highest ranked food sources of SFA were: mixed dishes – pizza (9·1 %); sweet bakery products (8·3 %); mixed dishes – Mexican (7·9 %). Three highest ranked food sources of added sugars were: SSB (42·1 %); sweet bakery products (12·1 %); coffee and tea (7·6 %).

Identifying current food sources of percentage energy, nutrients to limit and total gram amount consumed among US adolescents is critical for designing strategies to help them meet nutrient recommendations within energy needs.

The eButton takes frontal images at 4s intervals throughout the day. A three-dimensional manually administered wire mesh procedure has been developed to quantify portion sizes from the two-dimensional images. The present paper reports a test of the inter-rater reliability and validity of use of the wire mesh procedure.

Seventeen foods of diverse shapes and sizes served on plates, bowls and cups were selected to rigorously test the portion assessment procedure. A dietitian not involved in inter-rater reliability assessment used standard cups to independently measure the quantities of foods to generate the ‘true’ value for a total of seventy-five ‘served’ and seventy-five smaller ‘left’ images with diverse portion sizes.

The images appeared on the computer to which the digital wire meshes were applied.

Two dietitians and three engineers independently estimated portion size of the larger (‘served’) and smaller (‘left’) images for the same foods.

The engineers had higher reliability and validity than the dietitians. The dietitians had lower reliabilities and validities for the smaller more irregular images, but the engineers did not, suggesting training could overcome this limitation. The lower reliabilities and validities for foods served in bowls, compared with plates, suggest difficulties with the curved nature of the bowls.

The wire mesh procedure is an important step forward in quantifying portion size, which has been subject to substantial self-report error. Improved training procedures are needed to overcome the identified problems.

Habit has been defined as the automatic performance of a usual behaviour. The present paper reports the relationships of variables from a Model of Goal Directed Behavior to four scales in regard to parents’ habits when feeding their children: habit of (i) actively involving child in selection of vegetables; (ii) maintaining a positive vegetable environment; (iii) positive communications about vegetables; and (iv) controlling vegetable practices. We tested the hypothesis that the primary predictor of each habit variable would be the measure of the corresponding parenting practice.

Internet survey data from a mostly female sample. Primary analyses employed regression modelling with backward deletion, controlling for demographics and parenting practices behaviour.

Houston, Texas, USA.

Parents of 307 pre-school (3–5-year-old) children.

Three of the four models accounted for about 50 % of the variance in the parenting practices habit scales. Each habit scale was primarily predicted by the corresponding parenting practices scale (suggesting validity). The habit of active child involvement in vegetable selection was also most strongly predicted by two barriers and rudimentary self-efficacy; the habit of maintaining a positive vegetable environment by one barrier; the habit of maintaining positive communications about vegetables by an emotional scale; and the habit of controlling vegetable practices by a perceived behavioural control scale.

The predictiveness of the psychosocial variables beyond parenting practices behaviour was modest. Discontinuing the habit of ineffective controlling parenting practices may require increasing the parent’s perceived control of parenting practices, perhaps through simulated parent–child interactions.

To model effective vegetable parenting practices using the Model of Goal Directed Vegetable Parenting Practices construct scales.

An Internet survey was conducted with parents of pre-school children to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items. Block regression modelling was conducted using the composite score of effective vegetable parenting practices scales as the outcome variable and the Model of Goal Directed Vegetable Parenting Practices constructs as predictors in separate and sequential blocks: demographics, intention, desire (intrinsic motivation), perceived barriers, autonomy, relatedness, self-efficacy, habit, anticipated emotions, perceived behavioural control, attitudes and lastly norms. Backward deletion was employed at the end for any variable not significant at P<0·05.

Houston, TX, USA.

Three hundred and seven parents (mostly mothers) of pre-school children.

Significant predictors in the final model in order of relationship strength included habit of active child involvement in vegetable selection, habit of positive vegetable communications, respondent not liking vegetables, habit of keeping a positive vegetable environment and perceived behavioural control of having a positive influence on child’s vegetable consumption. The final model’s adjusted R2 was 0·486.

This was the first study to test scales from a behavioural model to predict effective vegetable parenting practices. Further research needs to assess these Model of Goal Directed Vegetable Parenting Practices scales for their (i) predictiveness of child consumption of vegetables in longitudinal samples and (ii) utility in guiding design of vegetable parenting practices interventions.

Increasing a parent’s ability to influence a child’s vegetable intake may require reducing the parent’s use of ineffective vegetable parenting practices. The present study was designed to understand the psychosocial influences on ineffective vegetable parenting practices.

A cross-sectional web-based survey was conducted to model use of ineffective vegetable parenting practices using validated scales from a Model of Goal Directed Vegetable Parenting Practices.

The dependent variable was a composite ineffective vegetable parenting practices index. The independent variables included validated subscales of intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioural control and anticipated emotions. Models were analysed using block regression with backward deletion.

Parents of 307 pre-school children (3–5 years old).

Variables significantly positively related to ineffective vegetable parenting practices in order of relationship strength included habit of controlling vegetable practices (standardized β=0·349, P<0·0001) and desire (standardized β=0·117, P=0·025). Variables significantly negatively related to ineffective vegetable parenting practices in order of relationship strength included perceived behavioural control of negative parenting practices (standardized β=–0·215, P<0000), the habit of active child involvement in vegetable selection (standardized β=–0·142, P=0·008), anticipated negative parent emotional response to child vegetable refusal (standardized β=–0·133, P=0·009), autonomy (standardized β=–0·118, P=0.014), attitude about negative effects of vegetables (standardized β=–0·118, P=0·015) and descriptive norms (standardized β=–0·103, P=0·032). The model accounted for 40·5 % of the variance in use of ineffective vegetable parenting practices.

The present study is the first report of psychometrically tested scales to predict use of ineffective vegetable parenting practices. Innovative intervention procedures will need to be designed and tested to reduce ineffective vegetable parenting practices.

To test the effect of image size and presence of size cues on the accuracy of portion size estimation by children.

Children were randomly assigned to seeing images with or without food size cues (utensils and checked tablecloth) and were presented with sixteen food models (foods commonly eaten by children) in varying portion sizes, one at a time. They estimated each food model’s portion size by selecting a digital food image. The same food images were presented in two ways: (i) as small, graduated portion size images all on one screen or (ii) by scrolling across large, graduated portion size images, one per sequential screen.

Laboratory-based with computer and food models.

Volunteer multi-ethnic sample of 120 children, equally distributed by gender and ages (8 to 13 years) in 2008–2009.

Average percentage of correctly classified foods was 60·3 %. There were no differences in accuracy by any design factor or demographic characteristic. Multiple small pictures on the screen at once took half the time to estimate portion size compared with scrolling through large pictures. Larger pictures had more overestimation of size.

Multiple images of successively larger portion sizes of a food on one computer screen facilitated quicker portion size responses with no decrease in accuracy. This is the method of choice for portion size estimation on a computer.

To examine the relationship of 6-n-propylthiouracil (PROP) sensitivity to BMI while statistically controlling for demographic characteristics in two age groups of children: 9–10 years and 17–18 years (n 1551).

Cross-sectional design with a multi-ethnic (White, African-American, Hispanic, Other) sample of 813 children aged 9–10 years and 738 children aged 17–18 years. Children were recruited from local elementary and high schools with at least 30 % minority ethnic enrolment. Children’s height, weight and waist circumference were measured along with their PROP taster status. PROP was measured using two paper discs, one impregnated with NaCl (1·0 mol/l) and the other with PROP solution (0·50 mmol/l).

A significant PROP sensitivity by socio-economic status (SES) interaction term (P = 0·010) was detected wherein supertasters had the largest BMI percentile and Z-score, but only among the group with highest SES.

The results suggest that other factors overwhelmed the influence of PROP sensitivity on adiposity in lower-SES groups. The percentage of variance accounted for by the interaction term was about 1 %. Thus, PROP supertasters had the largest BMI percentile and Z-score, but only among the highest-SES group.

Parents may influence children’s fruit and vegetable (F&V) consumption in many ways, but research has focused primarily on counterproductive parenting practices, such as restriction and pressure to eat. The present study aimed to assess the association of diverse parenting practices to promote F&V and its consumption among pre-school children.

An exploratory analysis was performed on cross-sectional data from 755 Head Start pre-school children and their parents collected in 2004–5. Data included parent practices to facilitate child F&V consumption (grouped into five categories); parent-reported dietary intake of their child over 3 d; and a number of potential correlates. K-means cluster analysis assigned parents to groups with similar use of the food parenting practice categories. Stepwise linear regression analyses investigated the association of parent clusters with children’s consumption of F&V, after controlling for potential confounding factors.

A three-cluster solution provided the best fit (R2 = 0·62), with substantial differences in the use of parenting practices. The clusters were labelled Indiscriminate Food Parenting, Non-directive Food Parenting and Low-involved Food Parenting. Non-directive parents extensively used enhanced availability and teachable moments’ practices, but less firm discipline practices than the other clusters, and were significantly associated with child F&V intake (standardized β = 0·09, P < 0·1; final model R2 = 0·17) after controlling for confounders, including parental feeding styles.

Parents use a variety of parenting practices, beyond pressuring to eat and restrictive practices, to promote F&V intake in their young child. Evaluating the use of combinations of practices may provide a better understanding of parental influences on children’s F&V intake.

This exploratory study assessed how 8–13-year-old children categorised and labelled fruit and vegetables (FaV), and how these were influenced by child characteristics, to specify second-level categories in a hierarchical food search system for a computerised 24 h dietary recall (hdr).

Two sets of food cards, sixty-seven for fruit (F) and sixty-four for vegetables (V), with pictures and names of FaV from ten professionally defined food categories were sorted, separately, by each child into piles of similar foods. Demographic data, BMI and 6-n-propylthiouracil (PROP) taster status were obtained.

Participants attended the Children’s Nutrition Research Center in the summer of 2006.

In all, 152 8–13-year-old children, predominantly English-speaking, of whom sixteen were predominantly Spanish-speaking.

Children created an average of 8·5 (5·3) piles with 7·9 (11·4) cards per pile for the F, and an average of 10·1 (4·8) piles with 6·2 (7·9) cards per pile for the V. No substantial differences in Robinson clustering were detected across subcategories for each of the demographic characteristics, BMI or PROP sensitivity. Children provided clusters names that were mostly ‘Taxonomic – Professional’ labels, such as salads, berries, peppers, for both F (51·8 %) and V (52·1 %).

These categories should be tested to assess their ability to facilitate search of FaV items in a computerised 24 hdr for children in this age group.

To determine the reliability and validity of scales measuring low-fat milk consumption self-efficacy and norms during school lunch among a cohort of 5th graders.

Two hundred and seventy-five students completed lunch food records and a psychosocial questionnaire measuring self-efficacy and norms for school lunch low-fat milk consumption during the fall and spring semesters of the 1998–1999 academic year. Test–retest reliability was assessed in participants who also completed the questionnaire in the spring semester (n = 262). Principal component analyses identified and confirmatory factor analyses confirmed latent variables. Bivariate correlations measured construct validity.

Houston-area middle school.

Fifth graders (n = 275) from one middle school in southeast Texas.

Two scales measuring psychosocial influences of low-fat milk consumption were identified and proved reliable in this population: milk self-efficacy and milk norms. Milk self-efficacy and norms were positively correlated with milk consumption and negatively correlated with consumption of sweetened beverages.

These questionnaires can be used in similar interventions to measure the impact of self-efficacy and norms for drinking low-fat milk during school lunch.

Psychosocial and demographic correlates of fruit, juice and vegetable (FJV) consumption were investigated to guide how to increase FJV intake.

Hierarchical multiple regression analysis of FJV consumption on demographics and psychosocial variables.

Houston, Texas, USA.

Boys aged 11–14 years (n = 473).

FJV preference and availability were both significant predictors of FJV consumption, controlling for demographics and clustering of Boy Scout troops. Vegetable self-efficacy was associated with vegetable consumption. The interaction of preference by home availability was a significant predictor of FJV. The interaction of self-efficacy by home availability showed a trend towards significantly predicting vegetable consumption. No significant interactions were found between body mass index and the psychosocial variables.

Findings suggest that future interventions emphasising an increase in preference, availability and efficacy may increase consumption of FJV in similar populations.

To examine the association between fruit and vegetable (F&V) availability and consumption, the possible influences on this association, research gaps, and implications for developing strategies to increase F&V consumption.

Systematic review of studies that have examined associations between F&V availability and consumption.

Qualitative studies conducted among children and adults indicated that greater availability was associated with greater consumption. This finding was supported by cross-sectional studies among children. Availability was associated with dietary psychosocial variables such as preferences, and it appears that availability may moderate the relationship between these psychosocial variables and consumption. Intervention studies attempting to increase availability have resulted in increased consumption, and availability has predicted change in consumption over an 18-month period.

Availability appears to be a key proximal determinant of consumption, especially of F&V, and thereby provides a target for change. However, the mechanisms that relate these variables are unclear and there is a need to clarify the direction of causality. We suggest that the possible causal mechanisms may include: (1) availability simply facilitates increased consumption; (2) the visual cues of available food may stimulate consumption; and (3) available food exposure may increase preference, which leads to increased consumption. Each of these possibilities requires close examination, as do policy-level interventions.

F&V availability is associated with increased consumption. Research that elucidates the mechanisms between availability and intake, and tests policy-level interventions, is needed to advance increased availability as a public health procedure.

To validate four scales – outcome expectancies for purchasing fruit and for purchasing vegetables, and comparative outcome expectancies for purchasing fresh fruit and for purchasing fresh vegetables versus other forms of fruit and vegetables (F&V).

Survey instruments were administered twice, separated by 6 weeks.

Recruited in front of supermarkets and grocery stores; interviews conducted by telephone.

One hundred and sixty-one food shoppers with children (18 years or younger).

Single dimension scales were specified for fruit and for vegetable purchasing outcome expectancies, and for comparative (fresh vs. other) fruit and vegetable purchasing outcome expectancies. Item Response Theory parameter estimates revealed easily interpreted patterns in the sequence of items by difficulty of response. Fruit and vegetable purchasing and fresh fruit comparative purchasing outcome expectancy scales were significantly correlated with home F&V availability, after controlling for social desirability of response. Comparative fresh vegetable outcome expectancy scale was significantly bivariately correlated with home vegetable availability, but not after controlling for social desirability.

These scales are available to help better understand family F&V purchasing decisions.

To identify the most common frequency of food-purchasing patterns and relate this pattern to characteristics of individuals and families.

A customer-intercept survey was conducted in the greater Houston area, Texas, USA, in 2002. The frequency of food shopping at supermarkets, convenience stores and restaurants to buy food for eating at home was assessed.

A total of 823 adults (78.5% female; mean age 37.4 years) who went to any of several grocery or convenience stores, including European, Hispanic and African Americans, and Asian/Pacific Islanders.

Major food-shopping patterns were a weekly big trip with a few small trips (34.9%), biweekly big trips with a few small trips (21.9%), no big shopping trips (15.4%), a weekly big trip without small trips (13.9%), a monthly big trip (8.3%), and biweekly big trips without small trips (6.4%). While 61.1% of participants never went to convenience stores to buy fruit and vegetables (F&V) for eating at home, 67% went to restaurants for F&V. African American families shopped for food least frequently, while Asian American families shopped for food most frequently. Educational level was negatively associated with the use of convenience stores and positively associated with takeaway from restaurants.

There is substantial variability in the frequency of food shopping. Future research on food shopping should incorporate this variable.

Dietary assessment has been used for certification to receive food supplements or other nutrition services and to provide feedback for educational purposes. The proportion of individuals correctly certified as eligible is a function of the amount of error that exists in the dietary measures and the level of dietary intake used to establish eligibility. Whether individuals are correctly counselled to increase or decrease the consumption of selected foods or nutrients is a function of the same factors. It is not clear, however, what percentage of individuals would be correctly classified under what circumstances. The objective of this study is to demonstrate the extent to which measurement error and eligibility criteria affect the accuracy of classification.

Hypothetical distributions of dietary intake were generated with varying degrees of measurement error. Different eligibility criteria were applied and the expected classification rates were determined using numerical methods.

Simulation study.

Cut points of dietary intake at decreasing levels below the 50th percentile of true intake were associated with lower sensitivity and predictive value positive rates, but higher specificity and predictive value negative rates. The correct classification rates were lower when two cut points of dietary intake were used. Using a single cut point that was higher than the targeted true consumption resulted in higher sensitivity but lower predictive value positive, and lower specificity but higher predictive value negative.

Current methods of dietary assessment may not be reliable enough to attain acceptable levels of correct classification. Policy-makers and educators must consider how much misclassification error they are willing to accept and determine whether more intensive methods are necessary.

To pilot test theory-based questionnaires to measure socioenvironmental influences on children's fruit, juice and vegetable (FJV) consumption as reported by parents.

Cross-sectional.

Parents of fourth to sixth grade students completed socioenvironmental questionnaires. The students completed food records (FRs) for 2 days in the classroom.

Interviews were completed by 109 parents (17% African-American, 32% Hispanic-American and 51 Euro-American).

Student mean daily FJV intake was 2.1 servings. Principal components analyses revealed subscales measuring positive and negative parenting practices; self-efficacy for modelling and planning/encouraging FJV consumption, and making FJV available; encouraging, consequences and discouraging food socialization practices; negative home, cost and canned/frozen food barriers; meal planning; child shopping; mother food preparation; and child lunch and dinner FJV preparation practices. Internal consistencies were adequate to high. Negative parent practices and negative home FJV barriers were significantly negatively correlated with child FJV consumption variables. Planning/encouraging self-efficacy was positively associated with fruit consumption, and child dinner FJV preparation was significantly negatively correlated with child juice consumption.

These questionnaires may provide important insights about the relationship between parent-reported socioenvironmental influences and children's FJV consumption. Future work should test these questionnaires with larger groups of parents and youths, with more reliable estimates of usual FJV intake, e.g. 7-day food records, to obtain a detailed understanding of how parents influence what children eat. Tests of models of relationships among these variables are warranted, but should control for possible confounding variables, e.g. socioeconomic status, gender of the child, etc