Journal of The American Dietetic Association最新文献

This study sought to identify maternal styles of talking about child feeding from a semistructured interview and to evaluate associated maternal and child characteristics. Mothers of preschool-aged children (n=133) of diverse race/ethnicity and socioeconomic status (SES) (45 lower SES black, 29 lower SES white, 32 lower SES Hispanic, 15 middle to upper SES white, and 12 middle to upper SES Asian) participated in a semistructured interview about feeding. Interviews were audiotaped and transcribed. Themes were identified, and individual interviews were coded within these themes: authority (high/low), confidence (confident/conflicted/unopinionated), and investment (deep/mild/removed). Demographic characteristics were collected and a subset of children had measured weights and heights. Cluster analysis was used to identify narrative styles. Participant characteristics were compared across clusters using Fisher's exact test and analysis of variance. Six narrative styles were identified: Easy-Going, Practical No-Nonsense, Disengaged, Effortful No-Nonsense, Indulgent Worry, and Conflicted Control. Cluster membership differed significantly based on maternal demographic group (P<0.001) and child weight status (P<0.05). More than half (60%) of children of mothers in the Conflicted Control cluster were obese. Maternal styles of talking about feeding are associated with maternal and child characteristics.

Snacking may play a role in weight control. The associations of timing and frequency of snacking with observed weight change and nutrient intake were assessed in an ancillary study to a 12-month randomized controlled trial in Seattle, WA. Overweight-to-obese postmenopausal women (n=123) enrolled in the two dietary weight-loss arms from 2007 to 2008 with complete data at 12 months were included in these analyses. Generalized linear models were used to test the associations between snacking and weight loss (percent) and nutrient intake at the 12-month time point. Participants were, on average, 58 years old and mainly non-Hispanic white (84%). Ninety-seven percent reported one or more snacks per day. Weight loss (percent) was significantly lower among mid-morning (10:30 am to 11:29 am) snackers (7.0%, 95% confidence interval: 4.3 to 9.7) compared to non–mid-morning snackers (11.4%, 95% confidence interval: 10.2 to 12.6; P=0.005). A higher proportion of mid-morning snackers reported more than one snack per day (95.7%), compared to afternoon (82.8%) and evening (80.6%) snackers, although differences were not statistically significant (P>0.05). Women who reported two or more snacks per day vs one or no snacks per day had higher fiber intake (P=0.027). Afternoon snackers had higher fruit and vegetable intake compared to non–afternoon-snackers (P=0.035). These results suggest that snack meals can be a source for additional fruits, vegetables, and fiber-rich foods; however, snacking patterns might also reflect unhealthy eating habits and impede weight-loss progress. Future dietary weight-loss interventions should evaluate the effects of timing, frequency, and quality of snacks on weight loss.

Large disparities exist in obesity and other chronic diseases across racial/ethnic and socioeconomic status (SES) groups in the United States. This study examined how much of racial/ethnic differences in diet, exercise, and weight status could be explained by nutrition- and health-related psychosocial factors (NHRPF) and SES among US adults. Nationally representative data of 4,356 US adults from the 1994-1996 Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey were used. NHRPF were assessed using 24 questions and related index scores. Dietary intakes were assessed using two nonconsecutive 24-hour dietary recalls. The US Department of Agriculture 2005 Healthy Eating Index was applied to evaluate diet quality. Body mass index was calculated based on self-reported weight and height. SES was assessed using education and household income. Americans with higher SES had better NHRPF and Healthy Eating Index scores. There were some small racial/ethnic differences in NHRPF, including making food choices and awareness of nutrition-related health risks. Multivariable linear and logistic regression models revealed some racial/ethnic differences in diet, exercise, and body mass index, but few of these disparities was explained by NHRPF, whereas SES explained some. The odds ratio of body mass index ≥25 for non-Hispanic blacks compared with whites decreased by 38% after SES was adjusted for. For exercise, we found a smaller change (9.5%) in the racial/ethnic differences when controlling for SES. In conclusion, NHRPF may explain very few, but SES may contribute some of the racial/ethnic disparities in diet, exercise, and weight status in the United States.