Meat reduction meets family reality: Negotiating sustainable diets in households with adolescents.

Limited research exists on how the transition towards more sustainable eating takes place at the meso-level of family decision-making, or how children and adolescents engage in and possibly influence the process towards more sustainable diets in families. In this paper, we study how public recommendations that encourage reducing the consumption of meat for the benefit of both health and climate are interpreted, negotiated, and acted upon in Danish families with adolescents (aged 15-20) residing at home. We use novel methodological stimuli, including vignettes and a visual sorting task, embedded in qualitative, in-depth interviews to elicit data on parents' and adolescents' everyday meat consumption/reduction behaviours. Findings reveal that a desire to uphold harmony and family cohesion serves as simultaneous drivers and barriers to reducing meat consumption. Further, we identify barriers to change in the gendered work hidden in the tasks of planning the integration of more sustainable, green dishes into the meal repertoires. Implications are drawn for social marketers, marketers, and public policymakers, encouraging these to use insights into family food decision-making processes as a lever to facilitate the needed green transition of diets in family households.

Bringing down barriers to children's healthy eating: a critical review of opportunities, within a complex food system.

This narrative review revises the scientific evidence of recent years on healthy eating in children and adolescents, making sense of promising avenues of action, from a food system perspective. A conceptual framework is provided to better understand how eating habits of children and adolescents are shaped to identify key multisectoral approaches that should be implemented to promote healthier diets. The following influencing factors are discussed: individual factors (physiological and psychological factors, food preferences and food literacy competencies), factors within the personal and socio-cultural food environments, external food environments, and the supply chain. In each section, the main barriers to healthy eating are briefly discussed focussing on how to overcome them. Finally, a discussion with recommendations of actions is provided, anchored in scientific knowledge, and transferable to the general public, industry, and policymakers. We highlight that multidisciplinary approaches are not enough, a systems approach, with a truly holistic view, is needed. Apart from introducing systemic changes, a variety of interventions can be implemented at different levels to foster healthier diets in children through fostering healthier and more sustainable food environments, facilitating pleasurable sensory experiences, increasing their food literacy, and enhancing their agency by empowering them to make better food related decisions. Acknowledging children as unique individuals is required, through interpersonal interactions, as well as their role in their environments. Actions should aim to enable children and adolescents as active participants within sustainable food systems, to support healthier dietary behaviours that can be sustained throughout life, impacting health at a societal level.

Spicing up food interactions: Development of a healthy food education activity targeting fathers and their young children.

BACKGROUND: Childhood obesity rates have been rapidly increasing worldwide. Several actions to reduce this trend have addressed maternal feeding practices. However, research reports an unwillingness to taste healthful foods expressed by children and fathers, which represents a major obstacle to a healthy diet in the family household. The present study aims to propose and qualitatively evaluate an intervention to increase fathers' involvement with their families' healthy eating through exposure to new/disliked healthy foods. METHODS: Fifteen Danish families took part in a 4-week online intervention involving picture book reading, a sensory experience session and the cooking of four recipes with four targeted vegetables (celeriac, Brussels sprouts, spinach and kale) and two spices (turmeric and ginger). Interviews were conducted with the families and the content was analysed through a blended or abductive approach. RESULTS: Participating in the activities motivated children and fathers to try new vegetables and spices, and increased fathers' sense of self-efficacy toward cooking, tasting new foods and healthy feeding. For the family, the intervention acted as a trigger to consume a higher variety of vegetables and spices and prompted feelings of "food joy". The outcomes observed are of importance considering the relatively low cost and the remote approach of the intervention. CONCLUSIONS: The results highlight the fact that fathers play an important role in the home food environment. We conclude that fathers should be included to a higher extent in food and nutrition strategies aimed at promoting healthy weight development in their children.

Senior citizens' vitamin D supplements intake: evidence from Denmark.

BACKGROUND: Several public interventions have been designed in recent years to urge the intake of vitamin D supplements among the senior population to avoid the direct and indirect consequences associated with vitamin D deficiency. However, the effectiveness of these public campaigns remains quite limited. In an online survey, the current study investigates attitudes towards vitamin D supplements intake and associated behaviours in a representative sample of Danish senior citizens (N = 554) - that is, individuals aged 55 years and above. RESULTS: Approximately half of the sample reported taking vitamin D supplements in the preceding year. Furthermore, being male and having a positive perception of individuals' own health status increased the probability of being a non-user. Increasing confidence in the information provided by health authorities (such as medical doctors and pharmacies) is particularly critical for enhancing the likelihood of non-users to purchase vitamin D supplements. However, also encouraging the uptake of vitamin D supplements in specialized supermarkets with stands and promotions seems an appealing and practical solution to increase seniors' uptake of vitamin D supplements. CONCLUSIONS: The present study outlines the characteristics of senior Danish non-users of vitamin D supplements. Additionally, the research provides information on the strategies that could be applied by public organizations to foster vitamin D supplements intake among this target segment of the population. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Efficacy of a smartphone application-based intervention for encouraging children's healthy eating in Denmark.

The growing rates of childhood obesity constitute a public health challenge worldwide. Therefore it is important to identify effective and widely applicable interventions to prevent it. This study aims to explore children's experience of using a newly developed smartphone application (app) designed to promote healthy eating and evaluate its efficacy on encouraging healthy eating. First, two focus groups were conducted to explore children's experience of using the app. Then, a quasi-experimental design was used to evaluate the app's efficacy. The children were asked to use the app for three months. Afterwards, the effect of the intervention was evaluated. 118 children aged 9 to 13 years (M=10.9, Sd=1.1) participated in the study. The children's experience of using the app was relatively positive, and they found the app easy to use. A significant increase in fruit (η2=.10) and vegetable preferences (η2=.37) and fruit intake (η2=.06) was found in the experimental group. No effects were found for vegetable intake, selfefficacy for healthy eating, or peer norms for healthy and unhealthy eating (p>0.05). The smartphone app-based intervention could potentially serve as an attractive and low-cost intervention to reach a wide population of children for the promotion of healthy eating and prevention of childhood obesity.

Parental feeding practices and parental involvement in child feeding in Denmark: Gender differences and predictors.

Studies about fathers and feeding are scarce and little is known about predictors of parental involvement in child feeding and of paternal feeding practices. Therefore, this study aimed to examine possible differences between Danish mothers and fathers with regard to their feeding practices and involvement in feeding related tasks, and to assess possible parent-related predictors of parental practices and involvement. A total of 261 mothers and 321 fathers of pre-schoolers completed an online survey with items from validated questionnaires. Gender differences were observed; fathers reported using higher levels of coercive control practices, while mothers reported using higher levels of structure practices and autonomy support practices. Both mothers and fathers reported to be highly involved in feeding their child. Regressions showed that a higher concern for child weight and a higher motivation for child preference when buying food were linked to a higher use of coercive control practices while a higher motivation for health control when buying food, cooking confidence, feeding/general self-efficacy and perceived responsibility for feeding were linked to a higher use of structure and autonomy support practices. The results of this study provide valuable insight into maternal and paternal practices in Denmark and their determinants.

Preadolescents' healthy eating behavior: peeping through the social norms approach.

BACKGROUND: The rising childhood obesity rate is a major public health challenge. The objective of this study is to examine key underlying mechanisms for peer-related social influence on preadolescents' healthy eating behavior by including factors closely linked with the quality of preadolescents' relationship with peers. METHODS: A cross-sectional study was conducted in a convenience sample of 278 Lithuanian preadolescents, recruited from a public school. A questionnaire containing sociodemographic questions, questions about food intake, peer-related social norms of healthy eating, social self-efficacy, vegetable preference, need for peer approval and feeling of belonging were applied. Data was analyzed using structural equation modeling. RESULTS: The results of the SEM showed that social self-efficacy predicts feeling of belonging to the peer group and need for peer approval. Feeling of belonging and need for peer approval predict actual intake of vegetables via injunctive norms of healthy eating. However, neither feeling of belonging nor need for peer approval predicted descriptive norms of healthy eating. Contrary to our expectations, descriptive norms were found to be unrelated with actual intake of vegetables, though vegetable preference predicted actual intake of vegetables. Vegetable preference was not predicted by injunctive or descriptive peers' social norms of healthy eating. CONCLUSIONS: The findings of this study offer insight for informing parents, teachers and for social norms marketing interventions by stressing the importance of social relations when the aim is to encourage healthy eating among preadolescents.

The influence of peers' and siblings' on children's and adolescents' healthy eating behavior. A systematic literature review.

OBJECTIVE: Peers and siblings are considered an important influence on children's and adolescents' food choice. However, there is a lack of studies examining how peer and sibling impact is related to children's and adolescents' eating behavior. The purpose of this study was to analyze peers' and siblings' impact on children's and adolescents' healthy eating behavior identified from a literature review, summarize the results, and discuss potential social factors that may predict these associations. METHOD: A systematic literature review. RESULTS: Findings of the systematic literature review show that peers, and to a lesser extent siblings' influence on children's and adolescents' healthy eating behavior more often is negative than positive, although in some studies, no significant effect was found. However, empirical research of which social factors related to relationships with siblings and peers may explain and predict peers' and siblings' influence on children's and adolescents' healthy eating behavior is limited. CONCLUSIONS: Peers' influence on children's and adolescents' healthy eating behavior is often found to be negative by the increase in consumption of energy-dense and low-nutrition value foods. However, in some cases, this influence can also be a positive one, and there is a need to find effective ways of how it could be used in encouraging healthy eating behavior of children and adolescents. Studies exploring siblings' impact on children's and adolescents' eating behavior are scarce. In addition, factors related to social interaction that may explain peers' and siblings' influence on children's and adolescents' healthy eating behavior are ambiguous. Therefore, more research in this area is needed.

Texting your way to healthier eating? Effects of participating in a feedback intervention using text messaging on adolescents' fruit and vegetable intake.

This study investigates the effects of a feedback intervention employing text messaging during 11 weeks on adolescents' behavior, self-efficacy and outcome expectations regarding fruit and vegetable intake. A pre- and post-survey was completed by 1488 adolescents school-wise randomly allocated to a control group and two experimental groups. Both experimental groups set weekly goals on fruit and vegetable intake, reported their consumption daily and subsequently received feedback on their performance via mobile text messaging (Short Message Service [SMS]). The second experimental group also received, in addition, a 45-min nutrition education session from a dietitian during school. The direct effects of the interventions were not significant. However, for adolescents participating in the SMS routines, there were significant effects of the level of engagement in the intervention, reflected in the number of sent text messages, on intervention outcomes. Participants sending more than half of the possible text messages significantly increased their fruit and vegetable intake. Participants sending between 10% and 50% of the possible text messages experienced a significant drop in self-efficacy and those sending less than 10% experienced a significant drop in outcome expectations. The findings suggest that participants' active engagement in an intervention is crucial to its success. Implications for health-promoting interventions are discussed.

Following family or friends. Social norms in adolescent healthy eating.

It is commonly believed that during adolescence children become increasingly influenced by peers at the expense of parents. To test the strength of this tendency with regards to healthy eating (fruit and vegetable intake), a survey was completed by 757 adolescent-parent dyads. Our theoretical framework builds on social cognitive theory and the focus theory of normative conduct, and data are analysed by means of confirmatory factor analysis and structural equation modelling. The study reveals that when it comes to adolescents' fruit and vegetable intake, parents remain the main influencer, with what they do (descriptive norms) being more important than what they say (injunctive norms). The study contributes to a more comprehensive understanding of what influences adolescent healthy eating, including the social influence of parents and friends, while also taking adolescent self-efficacy and outcome expectations into account. No previous studies have included all these factors in the same analysis. The study has a number of important implications: (1) healthy eating interventions should aim at strengthening self-efficacy and positive outcome expectations among adolescents, (2) the family context should be included when implementing healthy eating interventions and (3) parents' awareness of their influence on their children's healthy eating should be reinforced.