Carol Byrd-Bredbenner

Background: Parents are children’s primary role models, are food and physical activity gatekeepers, and create the home structure/lifestyle environment. Thus, parents strongly influence children’s weight-related behaviors and have the opportunity to cultivate a “culture of health” within the home. Methods: The aim of the HomeStyles-2 (also called HomeStyles-Child) RCT was to determine whether this online, novel, age-appropriate, family intervention enabled and motivated the 131 systematically randomly assigned by computer parents of children in middle childhood (ages 6 to 11) in the experimental condition to shape home environments and healthy weight-related lifestyle practices to be more supportive of optimal health and reduced obesity risk in middle childhood youth more than the 134 counterparts assigned to the attention control condition. Results: This RCT demonstrated the feasibility of online delivery of a health promotion intervention to parents of children in middle childhood, which may inform the development of interventions targeting other age groups and health outcomes. Results indicate the HomeStyles-Child intervention improved healthy-weight-related behavior cognitions, which are predictors of behavior change, of the experimental group. Additionally, improvements in experimental parent and child health-related behaviors were observed. These improvements occurred during a time when families faced unprecedented and extraordinary economic and social stresses associated with the COVID-19 pandemic. Conclusions: HomeStyles-Child is one of the few interventions for families with middle childhood youth. It has the potential to help ameliorate obesity in middle childhood youth and, by extension, other family members.

Virtual Reality (VR) simulations provide immersive, realistic educational experiences that are increasingly used to enhance teaching and learning in nursing and medicine; however, use in dietetics lags. To fill this gap, four Nutrition Counselor VR simulations were developed collaboratively with the goal of building confidence in dietetic students’ nutrition counseling skills. After formative testing, pilot testing, and refinements, simulations were field tested with 34 dietetic students (91% women; age 25.67 ± 3.79 SD years; 68% White) from four supervised practice programs using a standard protocol administered by trained researchers (N = 5). Students completed a pre-survey, one VR simulation (≥2 times w/varying outcomes), and a post-survey. Online pre- and post-surveys examined changes in nutrition counseling skills, knowledge and self-efficacy, and comfort in using nutrition counseling skills. Paired t-tests revealed significant (p < 0.05) mean differences in nutrition counseling skill self-efficacy (medium effect size, d = 0.46) and comfort in using nutrition counseling skills (large effect size, d = 0.96) between the pre- and post-survey. At post-survey, >75% agreed the simulations helped build their nutrition assessment skills (79%) and counseling skills (88%) and prepared them to work with real patients (97%). Findings suggest the Nutrition Counselor VR simulations provided a realistic and safe learning environment that may be a valuable learning tool for dietetic students.

Consumers often cite cognitive improvements as reasons for making dietary changes or using dietary supplements, a motivation that if leveraged could greatly enhance public health. However, rarely is it considered whether standardized cognitive tests that are used in nutrition research are aligned to outcomes of interest to the consumer. This knowledge gap presents a challenge to the scientific substantiation of nutrition-based cognitive health benefits. Here we combined focus group transcript review using reflexive thematic analysis and a multidisciplinary expert panel exercise to evaluate the applicability of cognitive performance tools/tasks for substantiating the specific cognitive benefits articulated by consumers with the objectives to (1) understand how consumers comprehend the potential benefits of nutrition for brain health, and (2) determine the alignment between consumers desired brain benefits and validated tests and tools. We derived a ‘Consumer Taxonomy of Cognitive and Affective Health in Nutrition Research’ which describes the cognitive and affective structure from the consumers perspective. Experts agreed that validated tests exist for some consumer benefits including focused attention, sustained attention, episodic memory, energy levels, and anxiety. Prospective memory, flow, and presence represented novel benefits that require the development and validation of new tests and tools. Closing the gap between science and consumers and fostering co-creative approaches to nutrition research are critical to the development of products and dietary recommendations that support realizable cognitive benefits that benefit public health.

Consumers often cite cognitive improvements as reasons for making dietary changes or using dietary supplements, a motivation that if leveraged could greatly enhance public health. However, rarely is it considered whether standardized cognitive tests that are used in nutrition research are aligned to outcomes of interest to the consumer. This knowledge gap presents a challenge to the scientific substantiation of nutrition-based cognitive health benefits. Here we combined qualitative consumer research and expert group methodology to (1) understand how consumers comprehend the potential benefits of nutrition for brain health, and (2) determine the alignment between consumers' articulated brain benefits and validated tests and tools. We derived a ‘Consumer Taxonomy of Cognitive and Affective Health in Nutrition Research’ which describes the cognitive and affective structure from the consumers' perspective. Experts agreed that validated tests exist for some consumer benefits including focused attention, sustained attention, episodic memory, energy levels, and anxiety. Prospective memory, flow, and presence represented novel benefits that require the development and validation of new tests and tools. Closing the gap between science and consumers, and fostering co-creative approaches to nutrition research, are critical to the development of products and dietary recommendations that support realizable cognitive benefits that benefit public health.

The prevalence of obesity continues to rise. Preventing obesity, especially childhood obesity, is critically important. Parents, especially mothers, play a vital role in preventing childhood obesity. Numerous factors, such as maternal employment, may influence maternal weight-related practices and home environment characteristics that affect the risk of childhood obesity. Given the prevalence of both childhood obesity and maternal employment, this study was conducted to examine how weight-related maternal, child, and household behaviors as well as home environment characteristics differ by maternal employment hours and extends existing research by examining work impact on behaviors and home characteristics. U.S. mothers (n = 527) with at least one school-age child (6 to 11 years), who were between the ages of 25 and 54 years and the main food gatekeeper in the household completed an online survey. ANOVA comparisons of non-working, part-time employed, and full-time employed mothers revealed few differences in any of the variables studied. Cluster analysis of the 336 employed mothers based on six work impact scale scores found three unique clusters characterized as Enthusiastic Earners, Indifferent Earners, and Strained Earners. Few differences in sociodemographic and job characteristics occurred among clusters and the differences noted had small effect sizes. Clusters did not differ by maternal BMI or perceived child weight status. However, the clusters differed in numerous weight-related behaviors and home environment characteristics. Future research should aim to determine the direction of the associations of work impact with weight-related behaviors and home environments as well as identify potential strategies for overcoming the negative effects of employment on weight-related behaviors and environments and weight status as well as clarify other factors that may affect maternal work impact, such as time management, reasons for employment, and stress.

This study aimed to develop a questionnaire to assess male and female athletes’ perceived weight and shape pressure from coaches and establish its psychometric properties. Exploratory factor analysis (N = 412 in each female sample 1 and 2) provided evidence for 4 scales for female athletes and 3 scales for male athletes which were confirmed in confirmatory factor analysis (N = 260 in each male sample 1 and 2). For both females and males, KMO testing and Bartlett’s test of sphericity indicated that the sampling was adequate and survey items were appropriate for factor analysis. Additionally, all scales for both sexes had strong factor loadings (≥0.65), good Cronbach alpha coefficients (>0.70), and made contextual sense. The magnitude of difference results were indicative of a stable factor structure. Goodness-of-fit indicators were all in the expected direction. Good convergent validity was demonstrated. The questionnaire’s excellent psychometric properties and novelty make it a valuable tool for researchers and practitioners. This questionnaire has the potential to identify training needs in coaching staff, as well as to identify athletes who may benefit from support and guidance for effectively coping with pressure from coaches.

Women experience anxiety, depression, and stress at higher levels than men and have more parenting responsibilities, especially establishing health practices in the home. Given children’s vulnerability, this study aimed to increase understanding of how mothers’ mental health status relates to maternal weight-related cognitions, home food environments, and child health via a cross-sectional survey design. In a cluster analysis, using maternal anxiety, depression, and stress assessments, we placed the sample of 531 mothers of school-age children into four clusters: Cluster 1 had the best mental health status, Cluster 2 had high stress, Cluster 3 had anxiety and moderate stress, and Cluster 4 had anxiety, depression, and high stress. Our results indicate an overall downward trend in weight-related cognitions as mental health worsened. Similarly, as mental health declined, so did home food environment characteristics, such as the greater use of non-recommended child feeding practices, fewer family meals, and greater sugar-sweetened beverage supplies. As mothers’ mental health status became poorer, children’s general health and mental health quality of life declined, and sugar-sweetened beverage intake increased. Our findings suggest that maternal stress, anxiety, and depression are moderately to strongly linked with mothers’ cognitions, home food environments, and children’s health. Our results also suggest that mental health interventions for mothers should assess cognitions and home food environments and consider the extent to which these factors are affecting family health.

Body dissatisfaction is a common condition that poses health behavior risks, such as the use of maladaptive eating styles instead of adaptive eating styles. Few studies have simultaneously examined both adaptive and maladaptive eating styles and their association with body dissatisfaction in a comprehensive manner. To address this gap, this study examined how body dissatisfaction is related to an array of adaptive and maladaptive eating styles, weight-related behaviors, and health status as well as the associations of health status, BMI, and weight-related behaviors with body dissatisfaction in 261 young adult women. Maladaptive eating styles, such as emotional eating, tended to rise in tandem with body dissatisfaction, differing significantly among body-dissatisfaction levels with medium to large effect sizes. For adaptive eating styles, as body dissatisfaction increased, compensatory restraint increased, intuitive eating declined, and mindful eating did not differ. Weight-related dietary, physical activity, and sleep behaviors did not differ by body dissatisfaction level. BMI increased and health status decreased as body dissatisfaction increased. Binary logistic regression revealed those who were body-dissatisfied had significantly lower health status, higher BMIs, and did not differ on weight-related behaviors. Study findings suggest strategies to improve health-promotion interventions aiming to increase body satisfaction.

Families are a key provider of support that may encourage positive weight-related behaviors. Yet little is known about the relation of family support to children’s performance of weight-related behaviors. Mothers (N = 524) who completed an online survey were categorized as having low, moderate, or high family support for fruit/vegetable intake, breakfast intake, limiting sugar-sweetened beverage intake, physical activity, limiting sedentary screentime, and sleep. ANOVA revealed that children in families with high support for breakfast ate this meal significantly more often. Additionally, children in families with low support for limiting sugar-sweetened beverages had significantly greater intake. Surprisingly, families with moderate support for physical activity and sleep tended to have children with lower physical activity level, sleep duration, and sleep quality, and fewer days/week with set bedtimes than those with low and high support. Binomial logistic regression revealed that high family support for eating breakfast, limiting sugar-sweetened beverages, and getting sufficient sleep had greater odds of meeting recommendations for these behaviors. Findings suggest that greater family support for healthy weight-related behaviors tends to be associated with children’s performance of these behaviors. Future interventions should further examine the impact of different types of family support on weight-related behaviors to better understand this complex interplay.