Human mind is like a monkey that cannot help but keep jumping from one thing to another. Many times, our hearts rule our brains and we take decisions based on our interests and pleasures rather than focusing on goals and needs. Food occupies a major role in our lives and we face debilitating health consequences owing to the wrong types of foods that we choose to eat. Given a choice between French fries and salads most would pick French fries. Choices spoil us unless they are all good ones that promote health! Obesity in adults and kids is a worldwide epidemic and exists as one of the most important problems worldwide. Obesity in childhood heightens the risk of health problems in adulthood, even more in kids who have obese parents. We have more than 45 million children who are obese worldwide and there is a dire need to stop this obesity epidemic immediately. There have been multiple steps taken and strategies implemented to reduce weight gain but all of them have been from an individual perspective. Children are children and such approaches might result in weight loss but this is only temporary and for a short-term as they once again go back to their earlier eating routines and practices after some time. This is mainly due to the fact that our environment has now become one that promotes consumption of high-energy foods and sedentary behavior. We would define such an environment as an ‘obesogenic’ environment-in simple terms, its an environment that encourages people to eat unhealthy food and not do enough exercise, promotes sedentary behavior and contributes to everything that increases obesity risk.
Individuals interact with the environment in different levels-homes, schools, neighborhoods and friends-and the fact is that, we don’t have much control over things that happen in the environment. Childhood obesity is the sum total of genetics, environment and behavioral response. Genetics is not in our hands and certain environmental factors too cannot be controlled but we can focus on changing the ones that can be influenced and also finetune behavioral response-for instance, the child’s eating behavior and family environment does affect obesity and this can be handled internally. Recently, there have been serious steps taken to alter ‘obesogenic’ behaviors and obesity development such as by modifying environmental factors. Environmental factors operate at micro (home, school, neighborhood) and macro (government, health system, food industry) levels. While macro environmental factors are not flexible to change, we can do bring about changes to the family food environment (FFE) that also seems to be the greatest contributor of obesity when compared to school and neighborhood. FFE also affect the eating behaviors of the kid greatly. When parents control eating habits of children it has been associated with increased body weight in kids and has also increased their inclination towards obesogenic eating behaviors. Even watching television and availability of fruits/veggies at home increase obesogenic eating behaviors in kids leading to overweight issues.
Family Food Environment
FFE is not something new and there are numerous FFE variables such as frequency of family meals, parental feeding strategies, viewing TV/electronic gadgets while having meals, parent’s food and nutrient beliefs, parent’s cooking and shopping skills and parent’s nutrition knowledge that have been analyzed individually for their impact on obesogenic eating behavior but we don’t have results on the collective impact of these variables. We also don’t have data on the impact caused by psycho-social factors such as income, parent’s marital status, depression status or parent’s BMI on FFE variables. An Australian study aimed at using factor analysis to derive composition of FFE variables and their effect in obesity and obesogenic eating behaviors. Also, the impact of psycho-social factors on FFE variables is dealt with.
Australian parents of children aged 2-5 years were included in the study based on an advertisement posted on the social media platform Facebook. All the participants were recommended to calculate height and weight measures of themselves and their kids using household measures such as bathroom scales or tapes. Children’s eating behavior was measured using sub-scales of the Children’s Eating Behavior Questionnaire (CEBQ that focused on enjoyment of food, food responsiveness, satiety responsiveness, food fussiness and slowness in eating). The 8 Feeding Practice and Structure Questionnaire (FPSQ-28) included Reward for Behavior (4 items), Reward for Eating (4 items), Persuasive feeding (6 items), Covert Restriction (4 items), Overt Restriction (4 items), Structured Meal Setting (3 items), Structured Meal Timing (3 items) and Family Meal (single item). Family meal frequency was measured based on three items including breakfast, lunch and dinner, general nutrition knowledge score was created based on a general knowledge questionnaire and four nutrition belief items (Eating healthy is expensive, It takes too long to prepare a healthy meal, Healthy food doesn’t taste good and Nutrition is important to your family’) were also measured apart from measurements on parental stress, anxiety, cooking and shopping skills.
A total of 977 participants were fetched of which 7.6% of them were underweight. The aim of the study was to reflect upon the impact of FFE variables on obesity and hence underweight children were excluded from the study leaving just 757 participants who were parents of children aged between 2 and 5 years. Results showed that:
Imposing SEM Concept on Obesogenic Behavior
Another study aimed at introducing an integrated model based on three basic concepts (parental socioeconomic status, parental feeding behavior and child’s food intake) within the Structured Equation Modeling (SEM) framework. In order to figure out the major factors involved in determining childhood obesity relationship among child technology use, child’s average amount of sleep, child’s school grade, child’s physical activity, parent’s physical activity and the child’s weight was noted. Parental socioeconomic status was measured based on six indicators that included the mom’s education, dad’s education, mother’s income, father’s income, mother’s work experience and father’s work experience. The last was ‘How long have the parents been married?’ Parental feeding behavior that included restricting, monitoring, rewarding, pressurizing, controlling and modeling was measured on a 5-point scale with higher scores indicating a more frequent use of a specific feeding behavior. Child’s food intake was measured based on seven indicators including consumption of fruits, vegetables, whole grain products, sweets, chips, soft drinks and fast food where parents indicated on a six-point scale (never, seldom, sometimes, most of the time, always and several times a day) how often their kids ate certain foods.
Control variables were measured: Parental physical activity was measured by categorizing parents into four categories based on their answers: none, 1 or 2 times a week, 3 or 4 times a week and more than 4 times a week. The kid’s average number of sleeping hours was categorized into ‘less than 7 h per day’, ‘7 to 8 h per day’, ‘8 to 9 h per day’ and ‘more than 9 h per day’. The child’s screen time was categorized into ‘less than an hour every day’, ‘1 to 2 h per day’, ‘3 to 4 h per day’ and ‘more than 4 h per day’. Child’s physical activity was sorted into ‘1 to 2 times per week’, ‘3 or 4 times per week’ and ‘more than 4 times per week’.
BMI of 402 observers was in the normal range and 147 observers was overweight or obese. The study presents two structured models: one based on the normal BMI range (normal model) and one based on obesity BMI range (obesity model). Results showed that:
Family food environment factors associated with obesity outcomes in early childhood: https://bmcobes.biomedcentral.com/articles/10.1186/s40608-019-0241-9
Family environment & childhood obesity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5334735/
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