Mothers' and fathers' depressive symptoms across four years postpartum: An examination of between- and bidirectional within-person relations.

BACKGROUND: Both mothers and fathers are at risk for experiencing postpartum depressive symptoms shortly after the birth of a child. Previous studies suggest mothers' and fathers' depressive symptoms to be interrelated. This study examined bidirectional relations between mothers' and fathers' depressive symptoms across four years postpartum. METHODS: Longitudinal data for this study were collected across five waves from 485 mothers and 359 fathers of infants when infants were on average 6 months-old until children were 54 months-old (1-year lags). Mothers and fathers reported on their depressive symptoms using the Center for the Epidemiological Studies Short Depression Scale (CES-D 10). A random intercept cross-lagged panel model (RICLPM) was specified to examine the bidirectional relations between mothers' and fathers' depressive symptoms over time. RESULTS: At the between-person level, mothers' and fathers' depressive symptoms were positively associated. At the within-person level, unique carry-over effects were found for mothers and fathers in that when reporting higher depressive symptoms than their trait levels, they were more likely to report higher depressive symptoms one year later. Moreover, intermittent cross-lagged effects were observed from mothers' depressive symptoms to fathers' depressive symptoms during toddlerhood. LIMITATIONS: The sample was not racially or structurally diverse thereby limiting the generalizations of the findings. CONCLUSIONS: After the birth of a child, mothers and fathers are at risk for experiencing chronic depressive symptoms which can have implications for individual, couple and child health. Mothers' depressive symptoms are related to fathers' depressive symptoms over time.

Adolescent Independent Eating Occasions, Dietary Intake, and Parenting Practices During the COVID-19 Pandemic: A Qualitative Study of Parents and Adolescents From Households With Low Income.

OBJECTIVE: Examine how experiencing the coronavirus disease 2019 (COVID-19) pandemic influenced adolescent independent eating occasions (iEOs) and iEO-related parenting practices from the perspective of parents and adolescents METHODS: Cross-sectional remote interviews were conducted for this basic qualitative research study. Participants were a purposive sample of multiracial/ethnic adolescents aged 11-14 years and their parents from households with low income (n = 12 dyads) representing 9 US states. The main outcome measures were iEOs and iEO-related parenting practices. Data were analyzed using directed content analysis. RESULTS: About half of the parents indicated that their adolescents had more iEOs during the COVID-19 pandemic and that there were changes in the types of foods consumed during iEOs. In contrast, most adolescents indicated their iEOs had not changed remarkably in frequency or foods consumed since the onset of the pandemic. Most parents reported no change in how they taught their adolescents about healthy food, the rules for foods/beverages permitted during iEOs, or how they monitored what their adolescents ate during iEOs; adolescent reports were in general agreement. Most parents indicated that family members were home together more often during the pandemic, which increased cooking frequency. CONCLUSIONS AND IMPLICATIONS: The effect of the COVID-19 pandemic on adolescents' iEOs varied, and the parenting practices used to influence iEOs remained stable during the pandemic. Families experienced having more time together and cooking at home more often.

Barriers to Healthy Family Dinners and Preventing Child Obesity: Focus Group Discussions with Parents of 5-to-8-Year-Old Children.

BACKGROUND: Although numerous physical and mental health benefits for children have been linked to family dinners, many families still do not have regular family meals together. This study sought to identify the barriers that keep families from having dinners together. METHODS: We interviewed 42 parents of 5-to-8-year-old children in small focus groups to identify barriers and challenges that keep families from having healthy and consistent dinners together. RESULTS: Parents reported the main barriers were time (e.g., time strain and overscheduling, mismatched schedules, long work hours, etc.), lack of meal planning or failure to follow plans, lack of skills (e.g., cooking skills or nutritional awareness), external factors (e.g., daycare, schools, or extended family, and competing with advertising), and food-related challenges (e.g., picky eating, food allergies). Parents also suggested potential solutions to overcome these barriers. CONCLUSIONS: Overall, parents had a desire to have family dinners with their children, but they felt that there are many barriers keeping them from establishing or maintaining consistent family mealtimes. Future research, as well as child obesity prevention and intervention efforts, should consider these barriers and suggested solutions in efforts to promote healthy and consistent family meals as a means of lowering the prevalence of childhood obesity.

Activities and social contact as antecedents to sleep onset time in U.S. adolescents.

This study evaluated adolescents' evening patterns in activities, social contact, and location to better understand antecedents to adolescents' sleep onset time (SOT). The SOT is important for sleep duration and related health outcomes. Using a nationally representative sample of 15- to 18-year-old adolescents from the American Time Use Survey (N = 10,341; 47% female; 57% white), structural equation modeling demonstrated that late SOTs mediated links between evening activities, social contact, locations, and shorter sleep durations. Passive leisure, time in public locations, and time with friends late in the evenings were associated with later SOTs, whereas homework and active leisure did not. Parents and practitioners can use this information to carefully evaluate evening activities, social contact, and location to support healthy SOTs for adolescents across time.

Parenting Practices Are Associated With Adolescent Food Choices During Independent Eating Occasions.

BACKGROUND: Frequency of independent eating occasions (iEOs) has been linked to intake of unhealthy foods and overweight or obesity among adolescents. Parenting practices involving modeling healthy food intake and making healthy foods available have been associated with healthy food intake among adolescents; however, little is known about these associations during iEOs. OBJECTIVE: To determine whether parenting practices involving structure (monitoring, availability, modeling, and expectations), lack of structure (indulgence), and autonomy support reported by adolescents or parents were associated with adolescent iEO intake of junk foods, sugar-sweetened beverages (SSBs), sugary foods, and fruit and vegetables. DESIGN: Cross-sectional study measuring parenting practices and adolescent iEO food choices via an online survey and adapted food frequency questionnaire. PARTICIPANTS/SETTING: Parent/adolescent dyads (n = 622) completed surveys (November-December 2021) using a national Qualtrics panel database. Adolescents were 11 to 14 years of age and had iEOs at least weekly. MAIN OUTCOME MEASURES: Primary measures included parent- and adolescent-reported frequency of food parenting practices and adolescent-reported iEO intake of junk foods, sugary foods, SSBs, and fruits and vegetables. STATISTICAL ANALYSES PERFORMED: Multivariable linear regression models were used to examine associations between parenting practices and iEO intake of foods/beverages, adjusting for adolescent's age, sex, race and ethnicity, iEO frequency, parent's education and marital status, and household food security status. Bonferroni multiple comparison corrections were conducted. RESULTS: More than half of parents were female (66%) and 35 to 64 years of age (58%). Adolescents/parents identified as White/Caucasian (44%/42%), Black/African American (28%/27%), Asian (21%/23%), and Hispanic ethnicity (42%/42%). Positive associations were observed among adolescent-reported and parent-reported autonomy support, monitoring, indulgence and expectations parenting practices, and adolescent-reported daily iEO intake frequencies of junk foods, sugary foods, and fruits and vegetables (P < 0.001). CONCLUSIONS: Structural and autonomy support parenting practices were positively associated with both healthy and unhealthy iEO food intake by adolescents. Interventions to improve adolescent iEO intake could promote positive practices associated with healthy food consumption.

Stress and Health Outcomes in Midwestern Latinx Youth: The Moderating Role of Ethnic Pride.

BACKGROUND: Stress has been linked to numerous health outcomes, including internalizing and externalizing behaviors, self-esteem, and physical health. Culture has also been linked to stress and health. This study examined the links between stress and health, and the potential moderating role of Latinx ethnic pride (LEP). METHODS: The sample consisted of 119 Latinx youth from the Midwestern U.S. Mothers and youth completed surveys. Variables included the Multicultural Events Scale for Adolescents (MESA), parent and home stressors/risks (PHSR), LEP, depressive symptoms, aggression, frustration, and self-esteem. Research assistants measured child heights and weights and calculated BMI percentiles. RESULTS: LEP was negatively related to MESA, depressive symptoms, aggression, and frustration, and positively related to self-esteem. MESA and PHSR were associated with depressive symptoms, aggression, frustration, and self-esteem, but not with BMI percentile. In adjusted regression analyses, LEP moderated the effects MESA had on frustration and self-esteem, marginally moderated the link between MESA and depressive symptoms, and was not related to aggression or BMI percentile. LEP did not moderate the relationship between PHSR with any health outcomes. CONCLUSIONS: Stressors were generally related to child mental health. LEP may play an important role in protecting against some of the effects of stressful events on mental health outcomes.

Relationship between Family Racial/Ethnic Backgrounds, Parenting Practices and Styles, and Adolescent Eating Behaviors.

Obesity is more prevalent among racial minority children in the United States, as compared to White children. Parenting practices can impact the development of children's eating behaviors and habits. In this study, we investigated the relationships among racial/ethnic backgrounds, parenting practices and styles, and eating behaviors in adolescents. Fifty-one parent-adolescent dyads were interviewed to characterize parenting practices and styles, as well as the consumption of dairy, fruits and vegetables, and unhealthy snacks. Height and weight were measured to calculate parent BMI and adolescent BMI-for-age percentiles. Three parenting practice categories-modeling, authoritative, and authoritarian-were found to be related to race/ethnicity. A higher score in authoritarian parenting practices was related to higher BMI percentiles among African American adolescents, whereas a higher score in monitoring practices was related to lower BMI percentiles among non-Hispanic White adolescents. Modeling, reasoning, and monitoring led to higher consumption of fruits and vegetables among adolescents; however, the consumption of unhealthy snacks was higher with rule-setting and lower with reasoning and authoritative practices. Finally, an analysis of the relationships between environmental factors and snack intake showed that adolescents consumed significantly more unhealthy snacks when performing other activities while eating. In conclusion, the findings from this study suggest that families' racial heritages are related to their parenting practices, BMI percentiles, and their adolescents' food consumption and eating behaviors. The results of this study can be used to develop and improve adolescent nutrition education and interventions with consideration of their racial/ethnic backgrounds.

Parenting Practices and Adolescents' Eating Behaviors in African American Families.

Parents play an important role in developing the eating behaviors of their children by adopting specific parenting practices. As the prevalence of obesity is high amongst African American adolescents, investigations into associations of specific parenting practices and adolescents' eating behaviors are essential. In this exploratory study, 14 African American parent-adolescent dyads were interviewed to characterize the influence of eight different parenting practices on the consumption of three main food categories (dairy, fruits and vegetables, and unhealthy snacks). The results revealed that authoritarian parenting practices were correlated with a higher BMI percentile in adolescents, whereas modeling and monitoring are correlated with a higher parent BMI. In addition, reasoning, monitoring, modeling, and authoritative parenting practices were associated with less unhealthy snack consumption among adolescents. Reasoning and monitoring were the only parenting practices associated with higher fruit and vegetable consumption. Finally, a significant correlation was found between eating fruits and vegetables and unhealthy snacks and the location of eating. In conclusion, different parenting practices and environmental factors may impact BMI and food consumption of African American dyads. The results of this study can be used to guide improvement in, and/or development of, nutritional education interventions considering the cultural differences of racial minorities.

The Family Health Scale: Reliability and Validity of a Short- and Long-Form.

Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.

Cultural Contributors to Ego-Resiliency and Associations with Depressive Problems in Midwestern Latino Youth.

Ego-resiliency is an enduring psychological construct reflecting how individuals-adapt to environmental stressors, conflict, and change which is linked to positive adjustment. Ego-resiliency has not been examined in Latino youth, despite their high risk for mental health problems; nor have cultural precursors to ego-resiliency been examined. Given these gaps, we examined whether familism values (supportive, obligation, and referent) were associated with ego-resiliency and, in turn, depressive problems in Latino adolescents across two time points (N = 123, mean age = 11.53). Results indicated that supportive familism was associated positively with ego-resiliency and negatively with depressive problems. Ego-resiliency negatively predicted depressive problems across time, controlling for prior levels, suggesting that ego-resiliency may have long-term effects on depressive problems in Latino youth.

Developmental antecedents of adolescent optimism in rural midwestern U.S. Latinx youth.

AIMS: Decades of scientific research have found optimism to have wide-ranging effects on individuals' health and well-being. Researchers have largely examined optimism in adults, but have begun addressing the benefits of optimism in adolescents. Challenges and stressors in adolescence can threaten youths' subjective well-being; therefore, identifying factors that contribute to the growth of optimism could have important health implications. However, researchers have more often examined the effect of optimism on youth outcomes rather than factors that might positively or negatively contribute to the development of optimism. METHODS: We assessed how salient developmental tasks (resilience, ethnic pride, and school attachment), family stress, and depressive problems individually contribute to Latinx youths' optimism at two time points (N = 123, 58.8% female, M age = 11.54 years). RESULTS: We found support for associations between both resilience and school attachment and optimism, but findings were weaker across time and with stressors included in the model. Depressive problems also appeared to weaken optimism across time. CONCLUSION: Given the established links between optimism and health, it will be important for researchers to continue to identify factors that contribute to the development of youth optimism, and assess whether they could be used in interventions to foster optimism.

Associations between Effortful Control, Cortisol Awakening Response, and Depressive Problems in Latino Preadolescents.

The present study examined associations between effortful control, a trait marker of self-regulation, adaptive HPA system functioning (as reflected by the CAR), and concurrent and longitudinal depressive problems, in a sample of preadolescent Latino youth (N = 119, mean age = 11.53 years, 59% female). We hypothesized that trait readiness for self-regulation (e.g., effortful control) could be related to physiological state readiness for self-regulation (e.g., CAR), and that both may counter depressive problems. We found that youth's CAR was positively associated with effortful control, and negatively with youth depressive problems. Effortful control and youth depressive problems were also negatively associated. Longitudinal relations of CAR and effortful control on depressive problems at T2 were not significant in the structural equation model after controlling for T1 depressive problems, although these variables were significant in the bivariate correlations. Results suggest that both trait-regulation and physiological regulation may counter depressive problems in Latino youth.

Parental restrictive feeding with Latinx adolescents: Examining the role of adolescent effortful control.

The objective of this study was to test if youth effortful control, a general process of self-regulation that is rooted in temperament, uniquely predicts maternal restrictive feeding with Latinx adolescents above and beyond demographic/contextual factors, prior use of restrictive feeding, and common markers of obesity-proneness. The study sample consisted of Latinx fifth and sixth graders and their mothers residing in the Midwestern U.S. (N =  97 dyads). Effortful control, maternal restrictive feeding, demographic/contextual factors, and markers of obesity proneness were measured across two waves of data collection approximately one year apart. Results demonstrated an inverse relation between effortful control and maternal restrictive feeding after controlling for Time 1 demographic/contextual factors, maternal BMI, maternal restrictive feeding, youth BMI z-score, and perceived youth weight. Future directions include testing for the presence of an ironic feedback process such that Latinx mothers' attempts to overcome deficits in their children's self-regulation skills through restrictive feeding may be inadvertently maintaining the problem.

Making time for family meals: Parental influences, home eating environments, barriers and protective factors.

Frequent family mealtimes have been associated with numerous positive dietary, health, and behavioral outcomes for children and families. This review article summarizes some of the beneficial outcomes associated with having frequent family dinners. Current trends in family dinner frequency are discussed in the context of barriers that influence how often families eat dinner together, including time issues, work issues, and distractions in the home environment. Next, several parental influences and home environment factors that promote healthy and consistent family dinners are outlined. Finally, limitations are discussed and a few practical suggestions are mentioned to help encourage families, employers, and policy-makers to make family mealtimes a regular practice for as many families as possible.

Salivary uric acid and C-reactive protein associations with hypertension in Midwestern Latino preadolescents and their parents.

Latino families face increased risk for hypertension. Serum-based uric acid and C-reactive protein have been linked to hypertension. However, a paucity of salivary biomarker data exists in this area for Latino families. Using salivary biomarkers enables less invasive options for biomedical and biosocial research, which is especially important among vulnerable populations facing increased health disparities. This study examined the associations between salivary uric (sUA) acid, salivary C-reactive protein (sCRP), and hypertension among 151 participants (57 children, 57 mothers, 37 fathers) from 57 Midwestern Latino families. Participants self-administered the salivary samples, and blood pressure was measured by researchers. Results showed sUA was associated across family members, and child hypertension was related to parents' hypertension. sCRP was only related to sUA in fathers. Findings highlight the family-level health connections, along with the importance for further investigations using salivary biomarkers with Latinos, and the need for a robust sUA cut-off for hyperuricemia.

The impact of environmental, parental and child factors on health-related behaviors among low-income children.

Multi-level factors act in concert to influence child weight-related behaviors. This study examined the simultaneous impact of variables obtained at the level of the home environment (e.g., mealtime ritualization), parent (e.g., modeling) and child (e.g., satiety responsiveness) with the outcomes of practicing healthy and limiting unhealthy child behaviors (PHCB and LUCB, respectively) in a low-income U.S. SAMPLE: This was a cross sectional study of caregivers of preschool children (n = 432). Caregivers were interviewed using validated scales. Structural equation modeling was used to examine associations with the outcomes. Adjusting for study region, demographics and caregiver's body mass index, we found significant associations between PHCB and higher mealtime ritualizations (ß: 0.21, 95% confidence interval [CI]: 0.11; 0.32, more parental modeling (ß: 0.39, 95% CI: 0.27; 0.49) and less parental restrictive behavior (ß: -0.19, 95% CI: -0.29; -0.10). More parental covert control (ß: 0.44, 95% CI: 0.35; 0.54), more parental overt control (ß: 0.14, 95% CI: 0.03; 0.25) and less parental permissive behavior (ß: -0.25, 95% CI: -0.34; -0.09) were significantly associated with LUCB. Findings suggest the synergistic effects of mealtime ritualizations and covert control at the environmental-level and parental modeling, overt control, restrictive and permissive behavior at the parent-level on the outcomes. Most factors are modifiable and support multidisciplinary interventions that promote healthy child weight-related behaviors.

The Effects of Increased Protein Intake on Fullness: A Meta-Analysis and Its Limitations.

BACKGROUND: Higher protein intake has been implicated in weight management because of its appetitive properties. However, the effects of protein intake on appetitive sensations such as fullness have not been systematically assessed. Meta-analysis is a useful technique to evaluate evidence of an intervention's effect on testable outcomes, but it also has important limitations. OBJECTIVE: The primary aim of this study was to synthesize the available evidence on the effect of protein intake on fullness using a quantitative meta-analysis and a secondary directional analysis using the vote-counting procedure. A tertiary aim was to address limitations of meta-analyses as they pertain to findings from this meta-analysis. DESIGN: We searched multiple databases for interventional studies that evaluated the effect of increased protein intake on fullness ratings. Inclusion criteria for both analyses were as follows: healthy human participants, preload studies that utilized intact dietary protein, delivery of protein load orally, and studies reporting fullness as an outcome. For the meta-analysis, an additional criterion was that the studies also needed to report 2- to 4-hour area under the curve value for fullness. RESULTS: Five studies met all criteria for the meta-analysis. Twenty-eight studies met all criteria for the directional analysis. The meta-analysis indicated higher protein preloads have a greater effect on fullness than lower protein preloads (overall effect estimate: 2,435.74 mm.240 min, (95% CI 1,375.18 to 3,496.31 mm.240 min; P<0.0001). The directional analysis also revealed a positive effect on fullness with higher protein preloads (P<0.01). Many related scientifically rigorous studies were excluded from the analysis because analytical criteria required a narrowly focused research question. CONCLUSIONS: The present analyses show that higher protein preloads increase fullness ratings more than lower protein preloads under tightly defined conditions. Extrapolation of findings to common conditions outside the specified criteria of this analysis must be made cautiously, as must speculation about the influence of fullness sensations on ingestive behavior, body weight, and various health outcomes.

Parent routines, child routines, and family demographics associated with obesity in parents and preschool-aged children.

Many daily routines and behaviors are related to the prevalence of obesity. This study investigated the association between routines and behaviors that act as protective factors related to lower prevalence of obesity in parents (BMI ≥ 30 kg/m(2)) and overweight in preschool children (BMI ≥ 85th percentile). Socio-demographic characteristics were assessed in relation to protective routines (PRs), and prevalence of obesity/overweight data from 337 preschool children and their parents. The two PRs assessed with parents included adequate sleep (≥7 h/night) and family mealtime routine (scoring higher than the median score). The four PRs assessed in children included adequate sleep (≥10 h/night), family mealtime routine, limiting screen-viewing time (≤2 h/day of TV, video, DVD), and not having a bedroom TV. Overall, 27.9% of parents were obese and 22.8% of children were overweight, and 39.8% of the parents had both parent PRs, and only 11.6% of children had all four child PRs. Results demonstrated that several demographic factors were significantly related to the use of PRs for parents and children. The lack of PRs was related to increased risk for overweight in children, but not for obesity in parents. However, in the adjusted models the overall cumulative benefits of using PRs was not significant in children either. In the multivariate adjusted logistic regression models, the only significant individual PR for children was adequate sleep. In a path analysis model, parent sleep was related to child sleep, which was in turn related to decreased obesity. Overall, findings suggest that parent and child PRs, especially sleep routines, within a family can be associated and may play an important role in the health outcomes of both parents and children. Understanding the mechanisms that influence how and when parents and children use these PRs may be promising for developing targeted family-based obesity-prevention efforts.

Parent-child mealtime interactions in racially/ethnically diverse families with preschool-age children.

Family meals may improve diet and weight outcomes in children; however, results from nationally representative samples suggest that these relationships vary by race/ethnicity. Observing parent-child mealtime interactions may lend insight to why racial/ethnic differences exist. In this pilot study, a multi-ethnic sample of low-income families (n = 30) with a preschool-age child was videotaped during a dinner in their home. A global coding scheme was used to assess the following: 'Action' (behaviors that divert attention from eating), 'Behavior Control' (behaviors intended to modify another person's behavior), and 'Communication' (i.e., meal-oriented, interpersonal, and critical). All families spent a significant amount of time in 'action' oriented behaviors that diverted their attention from eating. We also observed racial/ethnic differences in communication (i.e. critical) and behavior patterns (i.e. behavior control). This study demonstrated that this approach for observing parent-child mealtime interactions in a naturalistic setting among a diverse study sample was feasible; however, future studies should address how these patterns relate to dietary intake and weight status.

Risk factors for overweight/obesity in preschool children: an ecological approach.

BACKGROUND: Identification of risk factors is critical to preventing the childhood obesity epidemic. Risk factors that contribute to obesity are multifactorial. However, limited research has focused on identifying obesity risk factors using an ecological approach. METHODS: Baseline self-report survey data from the STRONG Kids program were used. The sample consisted of 329 parent-child dyads recruited from childcare programs in east-central Illinois. Child height and weight were measured and converted to age- and sex-specific z-scores using standard growth charts. An ecological model provided the theoretical framework for the selection of 22 previously reported childhood obesity risk factors. Multiple logistic regression analyses were used to identify risk factors. RESULTS: Of 22 potential risk factors, three were found to be significantly associated with child overweight/obesity. These included child nighttime sleep duration (χ(2)=8.56; p=0.003), parent BMI (χ(2)=5.62; p=0.01), and parental restrictive feeding for weight control (χ(2)=4.77; p=0.02). Children who slept for 8 hours and less were 2.2 times more likely to be overweight/obese [95% confidence interval (CI): 1.3-3.7), whereas children with an overweight/obese parent were 1.9 times more likely to be overweight/obese (95% CI: 1.12-3.2). Finally, children whose parents used restrictive feeding practices were 1.75 times more likely to be overweight/obese (95% CI: 1.06-2.9). CONCLUSIONS: Using an ecological approach, we conclude that childhood obesity prevention efforts may benefit from targeting the key risk factors of child sleep duration, parent BMI, and parental restrictive feeding practices as focus areas for obesity prevention.