Variability in energy expenditure is much greater in males than females.

In mammals, trait variation is often reported to be greater among males than females. However, to date, mainly only morphological traits have been studied. Energy expenditure represents the metabolic costs of multiple physical, physiological, and behavioral traits. Energy expenditure could exhibit particularly high greater male variation through a cumulative effect if those traits mostly exhibit greater male variation, or a lack of greater male variation if many of them do not. Sex differences in energy expenditure variation have been little explored. We analyzed a large database on energy expenditure in adult humans (1494 males and 3108 females) to investigate whether humans have evolved sex differences in the degree of interindividual variation in energy expenditure. We found that, even when statistically comparing males and females of the same age, height, and body composition, there is much more variation in total, activity, and basal energy expenditure among males. However, with aging, variation in total energy expenditure decreases, and because this happens more rapidly in males, the magnitude of greater male variation, though still large, is attenuated in older age groups. Considerably greater male variation in both total and activity energy expenditure could be explained by greater male variation in levels of daily activity. The considerably greater male variation in basal energy expenditure is remarkable and may be explained, at least in part, by greater male variation in the size of energy-demanding organs. If energy expenditure is a trait that is of indirect interest to females when choosing a sexual partner, this would suggest that energy expenditure is under sexual selection. However, we present a novel energetics model demonstrating that it is also possible that females have been under stabilizing selection pressure for an intermediate basal energy expenditure to maximize energy available for reproduction.

Beliefs of women of childbearing age on healthy sleep habits: a reasoned action approach elicitation study.

There is little information on the determinants of healthy sleep habits (HSH) among women of childbearing age (WOCBA). The objective was to identify WOCBA's beliefs on HSH based on the Reasoned Action Approach. Thirty WOCBA (18-41 years) were randomly assigned to answer questions regarding one of three HSH: avoiding screen use in bed; avoiding caffeine, alcohol and cigarettes before bedtime; and having a regular bedtime and wake up time even on weekends. A content analysis was performed independently by two experts to identify the most important beliefs using a 75% cumulative frequency of mention. Participants reported that adopting the HSH would improve sleep, avoid side effects, help them relax before bedtime and make them feel like they were missing out on things. Adopting the HSH was associated with feeling relaxed and satisfied, but also qualified as unpleasant and abnormal. WOCBA mentioned their parents, partner, siblings and children would approve/disapprove if they adopted the HSH and were the most/least likely to adopt them. Barriers were having activities in the evening and social situations. Facilitating factors were putting their electronic devices away from bed, having alternatives and a regular schedule. These results can guide the development of interventions promoting HSH among WOCBA.

Food Sources of Shortfall Nutrients Among US Adolescents: National Health and Nutrition Examination Survey (NHANES) 2011-2014.

To identify food sources of shortfall nutrients consumed by adolescents (n = 3156), data from the National Health and Nutrition Examination Survey (NHANES) (2011-2014) were used. Some of the food groups commonly consumed by adolescents made a significant contribution to shortfall nutrient intakes in the diet. Many food sources that provided significant amounts of shortfall nutrients were from foods that also provided nutrients to limit. Awareness of nutrient intakes and food sources is essential to establish dietary guidance in a practical context. Efforts to continue monitoring the food sources of nutrients consumed by adolescents will be important to improve the current knowledge on this topic of research.

Top food sources of percentage of energy, nutrients to limit and total gram amount consumed among US adolescents: National Health and Nutrition Examination Survey 2011-2014.

OBJECTIVE: To identify most commonly consumed foods by adolescents contributing to percentage of total energy, added sugars, SFA, Na and total gram intake per day. DESIGN: Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. SETTING: NHANES is a cross-sectional study nationally representative of the US population.ParticipantsOne 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. RESULTS: 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 %). CONCLUSIONS: 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.

Individual Correlates of Sleep Among Childbearing Age Women in Canada.

Objective/Background: Women of childbearing age (WOCBA) may be at high risk for short or poor sleep. Yet few studies have focused on this population. The study objective was to identify individual correlates of sleep duration and quality among WOCBA. Participants: The sample consisted of 9,749 WOCBA aged 18-44 years from the Canadian Community Health Survey 2011-2014. Methods: All variables were self-reported. Sleep duration was dichotomized as insufficient (< 7 hr/night) or adequate (≥ 7 hr/night). A composite score of sleep quality was dichotomized as having sleeping problems none/little or some/most/all the time. Age, ethnicity, level of education, household income, mood disorders, parity, geographical location, fruit and vegetable (FV) intake, physical activity, smoking and alcohol consumption were tested as correlates of sleep duration or quality using hierarchical logistic regression. Results: Ethnicity, parity, geographical location and smoking were correlates of sleep duration; this model discriminated 56.9% of WOCBA. Ethnic minorities, WOCBA with many children, living in urban areas and smoking were associated with lower odds of having adequate sleep duration. Ethnicity, level of education, mood disorders, geographical location, FV intake, and alcohol consumption were correlates of sleep quality; this model discriminated 59.0% of WOCBA. Ethnic minorities, lower level of education, mood disorders, living in urban areas, low FV intake, and alcohol consumption were associated with lower odds of having quality sleep. Conclusions: Some WOCBA may be more at risk for short or poor sleep based on their demographics and health behaviors. This can be used to identify which WOCBA are most in need of sleep interventions.

"Healthy Habits, Healthy Girls-Brazil": an obesity prevention program with added focus on eating disorders.

PURPOSE: To evaluate the immediate post-intervention and 6-month post-intervention effects of a Brazilian school-based randomized controlled trial for girls targeting shared risk factors for obesity and disordered eating. METHODS: Total of 253 girls, mean of 15.6 (0.05) years from 1st to 3rd grades of high school participated in this 6-month school-based cluster randomized controlled trial. "Healthy Habits, Healthy Girls-Brazil (H3G-Brazil)", originally developed in Australia, emphasized 10 key nutrition and physical activity (PA) messages delivered over 6 months. Disordered eating prevention procedures, i.e., prevention of weight-teasing, body satisfaction, and unhealthy weight control behavior, were added to the intervention. Body dissatisfaction, unhealthy weight control behaviors and social cognitive-related diet, and physical activity variables were assessed at baseline, immediate post-intervention, and 6-month post-intervention. Intervention effects were determined by one-way analysis of covariance or logistic regression, after checking for the clustering effects of school. The control group did not receive intervention prior to follow-up assessment. A conservative significance level was set at p < 0.01. RESULTS: Beneficial effects were detected for PA social support (F = 6.005, p = 0.01), and healthy eating strategies (F = 6.08, p = 0.01) immediate post-intervention; and healthy eating social support (F = 14.731, p = 0.00) and healthy eating strategies (F = 5.812, p = 0.01) at 6-month post-intervention. Intervention group was more likely to report unhealthy weight control behaviors (OR = 1.92, 95% CI 1.15-3.21, p = 0.01) at 6-month post-intervention. No other significant immediate or 6-month post effects were detected. CONCLUSION: H3G-Brazil demonstrated positive 6-month effects on some social cognitive variables but an adverse effect on unhealthy weight control behaviors. Thus, this study was not able to achieve synergy by combining obesity and disordered eating prevention procedures in an intervention among low-income girls in Brazil. TRIAL REGISTRATION: Level I: cluster randomized controlled trial.

Motivational theater to increase consumption of vegetable dishes by preschool children.

BACKGROUND: By 3 years of age, many children have developed a dislike for certain foods, particularly vegetables. Seventy-five percent of young children consume less than the recommended levels for vegetables. The objective of this randomized feasibility intervention was to demonstrate the impact of an innovative approach to increase consumption of vegetable dishes by minority preschool children attending Head Start. The specific aims included the collection of data to assess feasibility and efficacy of the intervention. METHODS: Both qualitative and quantitative assessments were conducted. Qualitative data was used for development of the intervention and for program feedback at post assessments. Two hundred fifty-three preschool children (49% boys; 66% Hispanics and 34% African-Americans; mean age 4.4 years) were randomized either to the intervention (n = 128) or the control group (n = 125). The teacher/parent intervention group showed the children videotaped (DVD) puppet shows. Based on the theoretical framework "transportation into a narrative world", three professionally developed characters, unique storylines and an engaging, repetitious song were incorporated in four 20-min DVD puppet shows. Prior to lunch each show was shown for five consecutive days in school and a minimum of once in the home. Digital photography was used in school to assess consumption of vegetable dishes at the lunch meal (quantitative assessment). At home parents were asked to complete the booklet questions corresponding to each DVD; questions could be answered correctly only if parents watched the DVD with their child. A multilevel mixed-effect model was used to analyze the data, adjusting for age, gender, and ethnicity. RESULTS: Children in the intervention group significantly (p < 0.0001) increased consumption of vegetable dishes from baseline to follow-up compared to no change in the control group. At follow-up, the intervention group continued to have significantly (p = 0.022) higher intake of vegetable dishes compared to the control group. Sixty percent of the mothers completed the booklet's questions with 76 to 98% correct responses. CONCLUSION: Using theory-based motivational theater with multiple exposures may be an effective behavioral intervention to increase consumption of vegetable dishes by preschool children that can be easily disseminated to a large sample. TRIAL REGISTRATION: ClinicalTrials.gov; Identifier: NCT02216968.

Predicting habits of vegetable parenting practices to facilitate the design of change programmes.

OBJECTIVE: 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. DESIGN: Internet survey data from a mostly female sample. Primary analyses employed regression modelling with backward deletion, controlling for demographics and parenting practices behaviour. SETTING: Houston, Texas, USA. SUBJECTS: Parents of 307 pre-school (3-5-year-old) children. RESULTS: 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. CONCLUSIONS: 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.

Differing statistical approaches affect the relation between egg consumption, adiposity, and cardiovascular risk factors in adults.

BACKGROUND: Associations between food patterns and adiposity are poorly understood. OBJECTIVE: Two statistical approaches were used to examine the potential association between egg consumption and adiposity. METHODS: Participants (n = 18,987) aged ≥19 y were from the 2001-2008 NHANES who provided 24-h diet recall data, body mass index (BMI) and waist circumference (WC)-determined adiposity measures, and blood pressure, circulating insulin, glucose, and lipid concentrations were considered cardiovascular risk factors (CVRFs). Covariate-adjusted least-squares means ± SEs were generated. RESULTS: The first statistical approach categorized participants into egg consumers or nonconsumers. Consumers had higher mean BMI (in kg/m(2); 28.7 ± 0.19; P = 0.006) and WC (98.2 ± 0.43 cm; P = 0.002) than did nonconsumers (28.2 ± 0.10 and 96.9 ± 0.23 cm, respectively). Second, cluster analysis identified 8 distinct egg consumption patterns (explaining 39.5% of the variance in percentage of energy within the food categories). Only 2 egg patterns [egg/meat, poultry, fish (MPF)/grains/vegetables and egg/MPF/grains], consumed by ≤2% of the population, drove the association (compared with the no-egg pattern) between egg consumption and BMI and WC. Another analysis controlled for the standard covariates and the other food groups consumed with eggs in those 2 egg patterns. Only the egg/MPF/other-grains pattern remained associated with BMI and WC (both P ≤ 0.0063). The pattern analyses identified associations between an egg pattern (egg/MPF/other grains/potatoes/other beverages) and diastolic blood pressure (DBP) and serum LDL cholesterol (both P ≤ 0.0063). A final analysis was conducted by adding percentage of energy from fast foods and medication use for diabetes to the covariates. The association between the egg/MPF/grains pattern and BMI and the egg/MPF/potatoes/other beverages and DBP and LDL cholesterol disappeared. CONCLUSIONS: Care needs to be taken with data interpretation of diet and health risk factors and the choice of statistical analyses and covariates used in the analyses because these studies are typically used to generate hypotheses. Additional studies are needed to better understand these relations.

Maternal depression, stress and feeding styles: towards a framework for theory and research in child obesity.

Against the background of rising rates of obesity in children and adults in the USA, and modest effect sizes for obesity interventions, the aim of the present narrative review paper is to extend the UNICEF care model to focus on childhood obesity and its associated risks with an emphasis on the emotional climate of the parent-child relationship within the family. Specifically, we extended the UNICEF model by applying the systems approach to childhood obesity and by combining previously unintegrated sets of literature across multiple disciplines including developmental psychology, clinical psychology and nutrition. Specifically, we modified the extended care model by explicitly integrating new linkages (i.e. parental feeding styles, stress, depression and mother's own eating behaviour) that have been found to be associated with the development of children's eating behaviours and risk of childhood obesity. These new linkages are based on studies that were not incorporated into the original UNICEF model, but suggest important implications for childhood obesity. In all, this narrative review offers important advancements to the scientific understanding of familial influences on children's eating behaviours and childhood obesity.

Tree Nut consumption is associated with better adiposity measures and cardiovascular and metabolic syndrome health risk factors in U.S. Adults: NHANES 2005-2010.

INTRODUCTION: Previous research has shown inconsistencies in the association of tree nut consumption with risk factors for cardiovascular disease (CVD) and metabolic syndrome (MetS). OBJECTIVE: To determine the association of tree nut consumption with risk factors for CVD and for MetS in adults. METHODS: NHANES 2005-2010 data were used to examine the associations of tree nut consumption with health risks in adults 19+ years (n = 14,386; 51% males). Tree nuts were: almonds, Brazil nuts, cashews, filberts [hazelnuts], macadamias, pecans, pine nuts, pistachios, and walnuts. Group definitions were non-consumers < » ounce/day and consumers of ≥ » ounce/day tree nuts using data from 24-h dietary recalls. Means and ANOVA (covariate adjusted) were determined using appropriate sample weights. Using logistic regression, odds ratios of being overweight (OW)/obese (OB) (body mass index [BMI] >25/<30 and ≥30, respectively) and having CVRF or MetS, were determined. RESULTS: Tree nut consumption was associated with lower BMI (p = 0.004), waist circumference (WC) (p = 0.008), systolic blood pressure (BP) (p = 0.001), Homeostatic Model Assessment-Insulin Resistance (p = 0.043), and higher high density lipoprotein-cholesterol (p = 0.022), compared with no consumption, and a lower likelihood of OB (-25%), OW/OB (-23%), and elevated WC (-21%). CONCLUSIONS: Tree nut consumption was associated with better weight status and some CVRF and MetS components.

Consumption of apples is associated with a better diet quality and reduced risk of obesity in children: National Health and Nutrition Examination Survey (NHANES) 2003-2010.

BACKGROUND: Most children do not meet the recommendation for fruit consumption. Apples are the second most commonly consumed fruit in the US; however, no studies have examined the association of total apple products, apples, apple sauce, and 100 % apple juice consumption on diet quality and weight/adiposity in children. METHODS: The purpose of this study was to examine the association between various apple consumption forms with diet quality and weight/adiposity in a nationally representative sample of children. Participants were children 2-18 years of age (N = 13,339) from the National Health and Nutrition Examination Survey 2003-2010. Intake was determined using a single interview administered 24-h diet recall. Apple product consumption was determined using the cycle-appropriate USDA Food and Nutrient Database for Dietary Studies food codes. Total diet quality and component scores were determined using the Healthy Eating Index-2010 (HEI). Anthropometrics were determined using standard methods. Covariate adjusted linear and logistic regressions were used to compare apple product consumers with non-consumers; sample weights were used. Probability was set at <0.01. RESULTS: Approximately 26 % of the population (n = 3,482) consumed some form of apple products. Consumers of apple products, whole apples, apple sauce, and 100 % apple juice had higher HEI scores than non-consumers: 50.4 ± 0.4 v 41.9 ± 0.3, 52.5 ± 0.5 v 42.7 ± 0.3, 52.1 ± 0.8 v 47.2 ± 0.4, and 51.4 ± 0.6 v 46.5 ± 0.4, respectively. Apple products and whole apple consumers had lower BMI z-scores than non-consumers: 0.4 ± 0.04 v 0.5 ± 0.03 and 0.3 ± 0.1 v 0.5 ± 0.02, respectively. Apple products and whole apple consumers were 25 % (0.59-0.95 99(th) CI) and 30 % (0.52-0.95 99(th) CI), respectively, were less likely to be obese than non-consumers. CONCLUSIONS: Consumption of any form of apples contributed to the fruit recommendation of children and improved diet quality. Apples should be included in the diets of children as a component of an overall healthy diet.

Barriers and facilitators to following the Dietary Guidelines for Americans reported by rural, Northern Plains American-Indian children.

OBJECTIVE: The Dietary Guidelines for Americans (DGA) promote healthy dietary choices for all Americans aged 2 years and older; however, the majority of Americans do not meet recommendations. The goal of the present study was to identify both barriers and facilitators to adherence to DGA recommendations for consumption of five recommended food groups: grains (specifically whole grains), vegetables, fruits, meat/beans and milk (specifically reduced-fat/non-fat), among American-Indian children. DESIGN: Nominal group technique sessions were conducted to identify and prioritize children's perceived barriers and facilitators to following the DGA, as presented in the 'MyPyramid' consumer education icon. After response generation to a single question about each food group (e.g. 'What sorts of things make it harder (or easier) for kids to follow the MyPyramid recommendation for vegetables?'), children individually ranked their top five most salient responses. Ranked responses are presented verbatim. SETTING: A rural Northern Plains American-Indian reservation, USA. SUBJECTS: Sixty-one self-selected fifth-grade children. RESULTS: Core barriers for all food groups studied included personal preference (i.e. 'don't like') and environmental (i.e. 'cost too much'; 'store is too far to get them'; 'grandma don't have'). Core facilitators included suggestions, i.e. 'make a garden and plant vegetables'; 'tell your friends to eat healthy'. CONCLUSIONS: Barriers and facilitators are dissimilar for individual food groups, suggesting that dietary interventions should target reduction of barriers and promotion of facilitators specific to individual food groups recommended by the DGA.

Parent emotional distress and feeding styles in low-income families. The role of parent depression and parenting stress.

PURPOSE: Depression and other stressors have been associated with general parenting and child outcomes in low-income families. Given that parents shape child eating behaviors through their feeding interactions with their child, it is important to investigate factors that may influence parental feeding of young children. The aim of this study was to examine how depressive symptoms and parenting stress might influence the nature of parent feeding styles in low-income families. METHODS: Questionnaires were completed by 290 African-American and Hispanic parents residing in a large urban city in the southwestern United States. Twenty-six percent of the parents reported depressive symptoms above the clinical cutoff. Multivariate logistic regression was used to examine how depressive symptoms and parenting stress might influence the nature of parent feeding styles. RESULTS: After adjusting for potential confounding variables (e.g., ethnicity, education, age), parents with an uninvolved feeding style reported less positive affect and more parenting stress than parents showing the other three feeding styles - authoritative, authoritarian, and indulgent. CONCLUSIONS: Because feeding styles tend to be associated with child obesity in low income samples, the results of this study provide important information regarding the parent-child eating dynamic that may promote less optimal child eating behaviors and the development of childhood obesity. This information could be useful for prevention studies aimed at changing parent behaviors that negatively impact the socialization of child eating behaviors.

The nutrient density approach to healthy eating: challenges and opportunities.

The term 'nutrient density' for foods/beverages has been used loosely to promote the Dietary Guidelines for Americans. The 2010 Dietary Guidelines for Americans defined 'all vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, seafood, lean meats and poultry, eggs, beans and peas (legumes), and nuts and seeds that are prepared without added solid fats, added sugars, and sodium' as nutrient dense. The 2010 Dietary Guidelines for Americans further states that nutrient-dense foods and beverages provide vitamins, minerals and other substances that may have positive health effects with relatively few (kilo)calories or kilojoules. Finally, the definition states nutrients and other beneficial substances have not been 'diluted' by the addition of energy from added solid fats, added sugars or by the solid fats naturally present in the food. However, the Dietary Guidelines Advisory Committee and other scientists have failed to clearly define 'nutrient density' or to provide criteria or indices that specify cut-offs for foods that are nutrient dense. Today, 'nutrient density' is a ubiquitous term used in the scientific literature, policy documents, marketing strategies and consumer messaging. However, the term remains ambiguous without a definitive or universal definition. Classifying or ranking foods according to their nutritional content is known as nutrient profiling. The goal of the present commentary is to address the research gaps that still exist before there can be a consensus on how best to define nutrient density, highlight the situation in the USA and relate this to wider, international efforts in nutrient profiling.

Snacking patterns, diet quality, and cardiovascular risk factors in adults.

BACKGROUND: The relationship of snacking patterns on nutrient intake and cardiovascular risk factors (CVRF) in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of CVRF in adults participating in the 2001-2008 National Health and Nutrition Examination Survey. METHODS: 24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weight were obtained and the health indices that were evaluated included diastolic and systolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein cholesterol, triacylglycerides, blood glucose, and insulin. RESULTS: The sample was participants (n = 18,988) 19+ years (50% males; 11% African-Americans; 72% white, 12% Hispanic-Americans, and 5% other). Cluster analyses generated 12 distinct snacking patterns, explaining 61% of the variance in snacking. Comparisons of snacking patterns were made to the no snack pattern. It was found that miscellaneous snacks constituted the most common snacking pattern (17%) followed by cakes/cookies/pastries (12%) and sweets (9%). Most snacking patterns were associated with higher energy intakes. Snacking patterns cakes/cookies/pastries, vegetables/legumes, crackers/salty snacks, other grains and whole fruit were associated with lower intakes of saturated fatty acids. Added sugars intakes were higher in the cakes/cookies/pastries, sweets, milk desserts, and soft drinks patterns. Five snack patterns (cakes/cookies/pastries, sweets, vegetable/legumes, milk desserts, soft drinks) were associated with lower sodium intakes. Several snack patterns were associated with higher intakes of potassium, calcium, fiber, vitamin A, and magnesium. Five snacking patterns (miscellaneous snacks; vegetables/legumes; crackers/salty snacks; other grains; and whole fruit) were associated with better diet quality scores. Alcohol was associated with a lower body mass index and milk desserts were associated with a lower waist circumference. No snack patterns were associated with other CVRF studied. CONCLUSIONS: Overall, several snacking patterns were associated with better diet quality than those consuming no snacks. Yet, the majority of the snacking patterns were not associated with CVRF. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet along with more nutrient-dense foods to be included in snacks.

Parents' perceptions of preschool children's ability to regulate eating. Feeding style differences.

Parent feeding styles have been associated with children's eating behaviors and weight status across multiple studies. However, little is known about the mechanism through which parent feeding styles influence child weight status. Children's ability to self-regulate their eating may be the mechanism that links these two constructs. This study examined the relationship between parent feeding styles, child self-regulatory ability, and weight status to determine whether self-regulatory ability mediated the relationship between parent feeding styles and child weight status in a group of 296 parents and their preschool aged children. Indulgent feeding style was related to children having lessened satiety responsiveness and higher enjoyment of food (two components of self-regulation around eating) compared to other parent feeding styles. Children of parents with an indulgent feeding style were also higher in weight status compared to other feeding styles. Mediation analyses revealed that satiety responsiveness and enjoyment of food mediated the relationship between parent feeding style and child BMI z-score such that children of parents with indulgent feeding styles had lessened ability to self-regulate around eating and higher BMI z-scores. Findings from this study suggest that children's ability to self-regulate eating might be an important mechanism by which parent feeding style and child weight are related to each other.

What Hispanic parents do to encourage and discourage 3-5 year old children to be active: a qualitative study using nominal group technique.

PURPOSE: Hispanic preschoolers are less active than their non-Hispanic peers. As part of a feasibility study to assess environmental and parenting influences on preschooler physical activity (PA) (Niños Activos), the aim of this study was to identify what parents do to encourage or discourage PA among Hispanic 3-5 year old children to inform the development of a new PA parenting practice instrument and future interventions to increase PA among Hispanic youth. METHODS: Nominal Group Technique (NGT), a structured multi-step group procedure, was used to elicit and prioritize responses from 10 groups of Hispanic parents regarding what parents do to encourage (5 groups) or discourage (5 groups) preschool aged children to be active. Five groups consisted of parents with low education (less than high school) and 5 with high education (high school or greater) distributed between the two NGT questions. RESULTS: Ten NGT groups (n = 74, range 4-11/group) generated 20-46 and 42-69 responses/group for practices that encourage or discourage PA respectively. Eight to 18 responses/group were elected as the most likely to encourage or discourage PA. Parental engagement in child activities, modeling PA, and feeding the child well were identified as parenting practices that encourage child PA. Allowing TV and videogame use, psychological control, physical or emotional abuse, and lack of parental engagement emerged as parenting practices that discourage children from being active. There were few differences in the pattern of responses by education level. CONCLUSIONS: Parents identified ways they encourage and discourage 3-5 year-olds from PA, suggesting both are important targets for interventions. These will inform the development of a new PA parenting practice scale to be further evaluated. Further research should explore the role parents play in discouraging child PA, especially in using psychological control or submitting children to abuse, which were new findings in this study.

Food insecurity, CD4 counts, and incomplete viral suppression among HIV+ patients from Texas Children's Hospital: a pilot study.

Determine the relationship between food insecurity and CD4 counts and viral suppression among pediatric HIV-positive patients. Food insecurity was assessed by validated survey. CD4 counts and viral load were abstracted from patients' charts. We used linear regression for the dependent variable of the natural log of CD4 counts and logistic regression for viral suppression, with backward deletion of covariates with p > 0.1. Food insecurity (ß = -0.23, 95 % CI [-0.40, -0.01]) was associated with lower CD4 counts and higher odds of incomplete viral suppression (OR = 4.07, 95 % CI [1.02, 13.92]). Food insecurity may adversely impact pediatric HIV outcomes.

The relationship of breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome in young adults. The National Health and Nutrition Examination Survey (NHANES): 1999-2006.

OBJECTIVE: To examine the association between breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome (MetS). DESIGN: Cross-sectional. Three breakfast groups were identified, breakfast skippers (BS), ready-to-eat-cereal (RTEC) consumers and other breakfast (OB) consumers, using a 24 h dietary recall. Risk factors were compared between the breakfast groups using covariate-adjusted statistical procedures. SETTING: The 1999­2006 National Health and Nutrition Examination Survey, USA. SUBJECTS: Young adults (20­39 years of age). RESULTS: Among these young adults (n 5316), 23.8% were BS, 16.5% were RTEC consumers and 59.7% were OB consumers. Relative to the BS, the RTEC consumers were 31%, 39%, 37%, 28%, 23%, 40% and 42% less likely to be overweight/obese or have abdominal obesity, elevated blood pressure, elevated serum total cholesterol, elevated serum LDL-cholesterol, reduced serum HDL-cholesterol or elevated serum insulin, respectively. Relative to the OB consumers, the BS were 1.24, 1.26 and 1.44 times more likely to have elevated serum total cholesterol, elevated serum LDL-cholesterol or reduced serum HDL-cholesterol, respectively. Relative to the OB consumers, the RTEC consumers were 22%, 31% and 24% less likely to be overweight/ obese or have abdominal obesity or elevated blood pressure, respectively. No difference was seen in the prevalence of the MetS by breakfast skipping or type of breakfast consumed. CONCLUSIONS: Results suggest that consumption of breakfast, especially that included an RTEC, was associated with an improved cardiometabolic risk profile in U.S. young adults. Additional studies are needed to determine the nature of these relationships.