To aid the design of nutrition interventions in low- and middle-income countries undergoing a nutrition transition, this study examined behavioural and environmental risk factors associated with childhood overweight and obesity in urban Indonesia.

Body height and weight of children were measured to determine BMI-for-age Z-scores and childhood overweight and obesity status. A self-administered parental survey measured socio-economic background, children’s diet, physical activity, screen time and parental practices. Logistic and quantile regression models were used to assess the association between risk factors and the BMI-for-age Z-score distribution.

Public primary schools in Central Jakarta, sampled at random.

Children (n 1674) aged 6–13 years from 18 public primary schools.

Among the children, 31·0 % were overweight or obese. The prevalence of obesity was higher in boys (21·0 %) than in girls (12·0 %). Male sex and height (aOR = 1·67; 95 % CI 1·30, 2·14 and aOR = 1·16; 95 % CI 1·14, 1·18, respectively) increased the odds of being overweight or obese, while the odds reduced with every year of age (aOR = 0·43; 95 % CI 0·37, 0·50). Maternal education was positively associated with children’s BMI at the median of the Z-score distribution (P = 0·026). Dietary and physical activity risk scores were not associated with children’s BMI at any quantile. The obesogenic home food environment score was significantly and positively associated with the BMI-for-age Z-score at the 75th and 90th percentiles (P = 0·022 and 0·023, respectively).

This study illustrated the demographic, behavioural and environmental risk factors for overweight and obesity among primary schoolchildren in a middle-income country. To foster healthy behaviours in primary schoolchildren, parents need to ensure a positive home food environment. Future sex-responsive interventions should involve both parents and children, promote healthy diets and physical activity and improve food environments in homes and schools.

To describe the feasibility, acceptability and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention.

Pilot randomised controlled trial.

Participants received six visits with a community health worker trained in motivational interviewing (three home visits, three phone calls); an in-home cooking or reading activity; personalised feedback on a recorded family meal or reading activity; text messages and tailored printed materials.

Parents and their 2–5-year-old child were randomised into intervention (responsive food parenting practices/nutrition) or control (reading readiness) groups.

Parents (n 63) were mostly mothers (90 %), Hispanic/Latinx (87 %), born outside the USA (62 %), with household incomes <$25 k (54 %). Despite delivery during COVID-19, 63 % of dyads were retained at 6 months. The intervention was delivered with high fidelity. All parents in the intervention group (n 24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component Healthy Eating Index-2015 scores (point estimate (PE) = 2·14, 95 % CI (0·17, 1·48); PE = 1·71, 95 % CI (0·16, 1·47), respectively) and negative treatment effects for sodium (PE = -2·09, 95 % CI (−1·35, −0·04)). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE = 1·08, 95 % CI (0·61, 2·00)), reducing distractions during mealtimes (PE = -0·79, 95 % CI (−1·52, −0·19)), using food as a reward (PE = -0·54, 95 % CI (−1·35, −0·04)) and providing a supportive meal environment (PE = 0·73, 95 % CI (0·18, 1·51)).

Given the continued disparities in diet quality among low-income and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.

To explore women’s perceptions of changes in specific food habits at home, specifically the food budget and shopping, and food preparation, during the COVID-19 period.

Non-probabilistic, exploratory study. Participants completed an online self-administered questionnaire. Perceptions of food habit changes were measured on a five-point Likert scale (strongly disagree to strongly agree). Data analysis was conducted in STATA v16.0.

Chile.

Adult women between 25 and 65 years old (n 2047).

Of the participants, 72 % were responsible for cooking, 69 % for buying food and 85 % for child care. Difficulties in organising and doing food budget works were observed in groups with a lower educational level, lower income and single mothers with children. Younger participants, dependent workers, women from biparental families with children and those in mandatory quarantine perceived more changes in their food shopping and budget management tasks. Participants more educated, with higher income and non-mandatory quarantine perceived to cook and eat healthier. Older participants perceived minor changes in their food preparation tasks at home; in contrast, more educated women and women from biparental families with children perceived more changes. If women were in charge of the kids or grocery shopping, more food environment changes were noticed.

Women perceived changes in their food environments. Some of these changes are perceived worse in the more vulnerable population. COVID-19 presents a challenge for the food system and gender perspectives. This information should be considered in the design of food-related interventions.

To categorize the home food environment and dietary intake of young children (5–7 years old) from racially/ethnically diverse households using objectively collected data.

Cross-sectional study.

In-home observations in Minneapolis/Saint Paul, Minnesota, USA.

Families with 5–7-year-old children who identified as Black, White, Hmong, Latino, Native American or Somali.

There were many significant differences by race/ethnicity for child dietary intake and for the home food environment, with specific patterns emerging by race/ethnicity. For example, Somali children had high Healthy Eating Index-2010 (HEI-2010) scores, but low daily intakes of fruits and vegetables. Black children had low HEI-2010 scores and a pattern of low intake of healthful foods and high intake of unhealthful foods. White and Latino families had high levels of both healthful and unhealthful home food availability and children with high HEI-2010 scores.

Results indicate that the home food environment of young children varies across racial/ethnic group. Study findings also provide new information regarding the home food environment of young children in previously understudied racial/ethnic groups and indicate that interventions working to improve the home food environment and dietary intake of children may want to consider race/ethnicity.

To study the associations between home food availability and dietary patterns among pre-school children.

Cross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.

The DAGIS study, Finland.

The participants were 864 Finnish 3–6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.

We identified three dietary patterns explaining 16·7 % of the variance. The patterns were named ‘sweets-and-treats’ (high loadings of e.g. sweet biscuits, chocolate, ice cream), ‘health-conscious’ (high loadings of e.g. nuts, natural yoghurt, berries) and ‘vegetables-and-processed meats’ (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=−0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=−0·03, P<0·01).

Considering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home.

The mechanism by which the home food environment (HFE) influences childhood obesity is unclear. The present study aimed to investigate the relationship between HFE and childhood obesity as mediated by diet in primary-school children.

Cross-sectional data collected from parents and primary-school children participating in the Obesity Prevention and Lifestyle Evaluation Project. Only children aged 9–11 years participated in the study. Matched parent/child data (n 3323) were analysed. Exploratory factor analysis underlined components of twenty-one HFE items; these were linked to child diet (meeting guidelines for fruit, vegetable and non-core food intakes) and measured child BMI, in structural equation modelling, adjusting for confounders.

Twenty geographically bounded metropolitan and regional South Australian communities.

School children and their parents from primary schools in selected communities.

In the initial exploratory factor analysis, nineteen items remaining extracted eight factors with eigenvalues >1·0 (72·4 % of total variance). A five-factor structure incorporating ten items described HFE. After adjusting for age, gender, socio-economic status and physical activity all associations in the model were significant (P<0·05), explaining 9·3 % and 4·5 % of the variance in child diet and BMI, respectively. A more positive HFE was directly and indirectly associated with a lower BMI in children through child diet.

The robust statistical methodology used in the present study provides support for a model of direct and indirect dynamics between the HFE and childhood obesity. The model can be tested in future longitudinal and intervention studies to identify the most effective components of the HFE to target in childhood obesity prevention efforts.

The purpose of the present study was to explore food preparation behaviours, attitudes, meal planning and shopping among Mexican-American mothers.

Data were collected through four focus groups with mothers of Mexican origin/ancestry who considered themselves to be the primary food preparer. Topics included food preparation behaviours and influencers (culture, family, attitudes, barriers, meal planning and shopping). Data were analysed using a qualitative grounded theory approach. All focus groups were audio recorded, transcribed verbatim and coded for themes.

Data were collected in southern California, USA in 2013.

Of the sample of twenty-one Mexican-American mothers, thirteen were born outside the USA and the mean household size was five members.

Participants reported that food was often prepared using traditional staples and food preparation behaviours were learned from maternal family members. Participants also suggested that health was influenced by foods eaten and how they were prepared. Salient factors influencing food preparation behaviours included culture and tradition, maternal family members’ food preparation behaviours, food preparation self-efficacy and attitudes towards healthy eating. Time and busy schedules were cited as barriers.

Future interventions should consider utilizing family-based approaches and teaching culturally relevant food preparation skills, especially to youth, while reinforcing more healthful dietary practices.

To explore perceived factors that impede or facilitate healthful eating within the home environment among overweight/obese adolescents.

In the present qualitative photovoice study, participants were instructed to take photographs of things that made it easier or harder to make healthful food choices at home. Digital photographs were reviewed and semi-structured interviews were conducted to promote discussion of the photographs. Data were analysed using constant comparative analysis.

Vancouver, Canada, in 2012–2013.

Twenty-two overweight/obese adolescents who completed a family-based lifestyle modification intervention.

The mean age of participants was 14 (sd 1·9) years, 77 % were female and their mean BMI Z-score was 2·4 (sd 0·6). Adolescents talked about six aspects of the home environment that influenced their eating habits (in order of frequency): home cooking, availability and accessibility of foods/beverages, parenting practices, family modelling, celebrations and screen use/studying. In general, homes with availability of less healthful foods, where family members also liked to eat less healthful foods and where healthier foods were less abundant or inaccessible were described as barriers to healthful eating. Special occasions and time spent studying or in front of the screen were also conducive to less healthful food choices. Home cooked meals supported adolescents in making healthier food choices, while specific parenting strategies such as encouragement and restriction were helpful for some adolescents.

Adolescents struggled to make healthful choices in their home environment, but highlighted parenting strategies that were supportive. Targeting the home food environment is important to enable healthier food choices among overweight/obese adolescents.

The aim of the present study was to gain insight into (i) processed snack-food availability, (ii) processed snack-food salience and (iii) the size of dinnerware among households with overweight gatekeepers. Moreover, associations between gatekeepers’ characteristics and in-home observations were determined.

A cross-sectional observation of home food environments was conducted as part of a baseline measurement of a larger study.

Home food environments of overweight and obese gatekeepers in the Netherlands.

Household gatekeepers (n 278). Mean household size of the gatekeepers was 3·0 (sd 1·3) persons. Mean age of the gatekeepers was 45·7 (sd 9·2) years, 34·9 % were overweight and 65·1 % were obese. Of the gatekeepers, 20·9 % had a low level of education and 42·7 % had a high level of education.

In 70 % of the households, eight or more packages of processed snack foods were present. In 54 % of the households, processed snack foods were stored close to non-processed food items and in 78 % of households close to non-food items. In 33 % of the households, processed snack foods were visible in the kitchen and in 15 % of the households processed snack foods were visible in the living room. Of the dinnerware items, 14 % (plates), 57 % (glasses), 78 % (dessert bowls), 67 % (soup bowls) and 58 % (mugs) were larger than the reference norms of the Netherlands Nutrition Centre Foundation. Older gatekeepers used significantly smaller dinnerware than younger gatekeepers.

Environmental factors endorsing overconsumption are commonly present in the home environments of overweight people and could lead to unplanned eating or passive overconsumption.

To examine: (i) the association between home availability of fruit and vegetables and children's fruit and vegetable intake; (ii) the association between parental perception of the local food shopping environment and the home availability of fruit and vegetables; and (iii) whether the home availability of fruit and vegetables mediates the association between parental perception of the local food environment and children's fruit and vegetable consumption.

Cross-sectional study.

A total of ninety-one primary schools in the Netherlands.

In total 1501 primary caregivers completed a questionnaire to measure children's fruit and vegetable consumption, home availability of fruit and vegetables, parental perceptions of the local food shopping environment (price, quality and availability), the child's socio-economic status, the child's ethnicity and maternal height and weight.

The home availability of fruit and vegetables was positively associated with children's fruit and vegetable intake (P < 0·01 and P < 0·001, respectively). Negative parental perceptions of the local food shopping environment were associated with less fruit available at home (P < 0·05, P < 0·01 and P < 0·05 for price, quality and availability of fruit, respectively). No significant associations were found between parental perception of the local food shopping environment and children's fruit and vegetable consumption. We found no evidence that home availability of fruit and vegetables mediates the association between parental perception of the local food environment and children's fruit and vegetable intake.

Interventions focusing on improving the home availability of fruit and vegetables may help to increase children's fruit and vegetable consumption. However, more data are required on factors influencing the home availability of fruit and vegetables.

To use an innovative mixed-method approach to analyse and describe 8–10-year-olds’ home and school food environments.

A mixed-method approach to collect qualitative and quantitative data was used, in which pupils took photographs over four days to record their food intake and food environment. The photographs were discussed in focus groups. A combination of lunchtime observations and questionnaires completed by parents were used to build up a picture of the children's home and school food environments.

A primary school in a suburb of Newcastle upon Tyne, UK.

Twenty-seven children aged 8–10 years consented to take part in the study. Twenty-four returned cameras, and eighteen parents completed questionnaires.

Photographs illustrated a range of locations throughout the home where children consumed food. Children's photographs revealed they ate less often with family and more often in front of the television than reported in parental questionnaires. Emergent themes during focus group discussions revealed a strong preference for packed lunches and dissatisfaction with school dinners. In this small sample, children's eating habits and preferences showed few associations with either gender or the deprivation level of the area in which they lived.

The children's home food environments showed a great deal of variation, with parents being key moderators of food availability and consumption. While the school's food provisions met national nutritional standards, the social aspects of having a packed lunch appeared to be a positive aspect of eating at school.

To identify the correlates of the home food environment (parents’ intake, availability and food-related parenting practices) at the age of 10 years with dietary patterns during childhood and in adolescence.

Primary-school children of fifty-nine Flemish elementary schools completed a questionnaire at school in 2002. Four years later they completed a questionnaire by e-mail or mail at home. Their parents completed a questionnaire on food-related parenting practices at baseline.

Longitudinal study.

The analyses included 609 matched questionnaires.

Multi-level regression analyses were used to identify baseline parenting practices (pressure, reward, negotiation, catering on demand, permissiveness, verbal praise, avoiding negative modelling, availability of healthy/unhealthy food items and mothers’ fruit and vegetable (F&V) and excess scores) associated with children’s dietary patterns (F&V and excess scores).

Mother’s F&V score was a significant positive independent predictor for children’s F&V score at baseline and follow-up, whereas availability of unhealthy foods was significantly negatively associated with both scores. Negotiation was positively associated with children’s follow-up score of F&V, while permissiveness was positively associated with children’s follow-up excess score. Availability of unhealthy foods and mother’s excess score were positively related to children’s excess score at baseline and follow-up.

Parental intake and restricting the availability of unhealthy foods not only appeared to have a consistent impact on children’s and adolescents’ diets, but also negotiating and less permissive food-related parenting practices may improve adolescents’ diets.

The objective of the present work was to cross-sectionally examine and compare dietary behaviours and home food environments by young adults’ living situation.

Using data from Project EAT (Eating Among Teens)-II, a large diverse youth cohort originally sampled in Minnesota, linear regression was used to examine self-reported meal frequency, dietary intake and home food availability outcomes by living situation (i.e. living with parents, renting an apartment/house or living on a college campus).

Young adults (n 1687), mean age 20·5 years.

Results suggested that young adults living with their parents or in rented apartments/houses had less frequent meals, poorer dietary intake and less healthy home food availability compared with those living on campus. These findings were evident even after controlling for sociodemographic factors (e.g. race/ethnicity, socio-economic status), particularly among females.

Although few emerging adults consume diets that are consistent with national recommendations, those living with parents and in rented apartments/houses may represent particularly at-risk groups. These differences in dietary factors across living situations appear to exist beyond the sociodemographic differences in these populations. Effective nutrition and healthy eating promotion strategies are needed for young adults.