Paternal self-efficacy for promoting children's obesity protective diets and associations with children's dietary intakes.

OBJECTIVE: Fathers' parenting behaviours contribute to the development of children's dietary behaviours and subsequent weight outcomes, yet the majority of research focusses on maternal influences. Understanding fathers' perceptions of their effectiveness to influence children's dietary behaviours will allow the development of whole-of-family interventions promoting obesity protective behaviours. This unique study is the first to investigate 1) tracking of paternal self-efficacy for promoting obesity protective dietary intakes in young children; 2) demographic characteristics of fathers and their self-efficacy category; and 3) associations between paternal self-efficacy and young children's dietary intakes. METHODS: Paternal self-efficacy for promoting children's obesity protective dietary intakes was assessed longitudinally from fathers (n = 195) in the Extended Infant Feeding Activity and Nutrition Trial Program at child age 4 and 36 months. Multinomial logistic regression examined self-efficacy tracking categories (persistently high; persistently low; increasing; decreasing) by paternal age, education and BMI. Linear regression examined associations between paternal self-efficacy tracking categories and child dietary intakes at 36 months. RESULTS: Paternal self-efficacy for promoting children's obesity protective dietary intakes reduced over time. Fathers with trade/certificate or university qualifications had lower odds of having persistently low/decreasing self-efficacy (97 and 87% lower respectively) compared to high-school educated fathers. Positive associations (ß (95% CI)) were observed between paternal self-efficacy category and children's dietary intakes at 36 months: increasing self-efficacy and fruit (ß89.8 (6.8; 172.7)), and vegetables (ß39.2 (12.2; 66.2)); persistently high self-efficacy and water (ß69.1 (2.9; 135.1)); decreasing self-efficacy and non-core drinks ((ß30.1 (10.1; 50.1)). Persistently high self-efficacy was negatively associated with non-core drinks (ß-20.2 (- 34.8; - 5.5)), with negative associations observed between decreasing self-efficacy and children's intakes of fruit (ß - 49.9 (- 87.5; - 12.3)), vegetables (ß-19.9 (- 31.7; - 8.2)) and water (ß-92.4 (- 172.6; - 12.3)). CONCLUSIONS: Higher and/or sustained paternal self-efficacy is associated with fathers' education and is important in promoting children's obesity protective dietary intakes. Associations between paternal self-efficacy and children's dietary intakes are present at a young age. This investigation was unique in its focus on paternal self-efficacy for promoting children's obesity protective dietary intakes and associations with children's dietary intakes. Future family interventions should consider how to maintain and/or improve paternal self-efficacy to promote obesity protective intakes from early childhood.

Differences Between Mothers and Fathers of Young Children in Their Use of the Internet to Support Healthy Family Lifestyle Behaviors: Cross-Sectional Study.

BACKGROUND: In early life, both mothers and fathers are important influences on their children's diet, active play, and obesity risk. Parents are increasingly relying on the internet and social media as a source of information on all aspects of parenting. However, little is known about the use of Web-based sources of information relevant to family lifestyle behaviors and, in particular, differences between mothers' and fathers' use and sociodemographic predictors. OBJECTIVE: The objective of this study was to examine if mothers and fathers differ in their use of the internet for information on their own health and their child's health, feeding, and playing and to examine sociodemographic predictors of the use of the internet for information on these topics. METHODS: We conducted a secondary analysis on data collected from mothers (n=297) and fathers (n=207) participating in the extended Infant Feeding, Activity and Nutrition Trial (InFANT Extend) when their children were 36 months of age. The main outcome variables were the use of the internet for information gathering for parents' own health and child health, feeding, and playing. Binary logistic regression was used to examine the sociodemographic predictors of outcomes. RESULTS: Compared with fathers (n=296), a higher proportion of mothers (n=198) used the internet for information on their own health (230, 78.5% vs 93, 46.5%), child health (226, 77.1% vs 84, 42.4%), child feeding (136, 46.3% vs 35, 17.5%), and child play (123, 42.1% vs 28, 14.0%) and intended to use Facebook to connect with other parents (200, 74.9% vs 43, 30.5%). Despite the high use of the internet to support family health behaviors, only 15.9% (47/296) of mothers reported consulting health practitioners for advice and help for their own or their child's weight, diet, or physical activity. Sociodemographic predictors of internet use differed between mothers and fathers and explained only a small proportion of the variance in internet use to support healthy family lifestyle behaviors. CONCLUSIONS: Our findings support the use of the internet and Facebook as an important potential avenue for reaching mothers with information relevant to their own health, child health, child diet, and active play. However, further research is required to understand the best avenues for engaging fathers with information on healthy family lifestyle behaviors to support this important role in their child's life. TRIAL REGISTRATION: ISRCTN Registry ISRCTN81847050; http://www.isrctn.com/ISRCTN81847050.

Associations between the physical activity levels of fathers and their children at 20 months, 3.5 and five years of age.

BACKGROUND: Early childhood (under five years of age) is a critical developmental period when children's physical activity behaviours are shaped and when physical activity patterns begin to emerge. Physical activity levels track from early childhood through to adolescence with low levels of physical activity associated with poorer health. The aims of this study were to examine cross-sectional and longitudinal associations between the physical activity levels of fathers and their children at the ages of 20 months, 3.5 and 5 years, and to investigate whether these associations differed based on paternal body mass index (BMI) and education. METHODS: The Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program was a cluster randomized-controlled trial delivered to pre-existing first-time parent groups. Physical activity levels of fathers and their first-born children were assessed using the Active Australia Survey and ActiGraph accelerometers respectively. Cross-sectional associations between father and child physical activity behaviours were assessed at each time point. Longitudinal associations between father and child physical activity were also investigated from child age 20 months to both 3.5 and 5 years. Additional stratified analyses were conducted based on paternal BMI and paternal education as a proxy for socioeconomic position (SEP). Data from the control and interventions groups were pooled and all analyses adjusted for intervention status, clustering by first-time parent group and accelerometer wear time. RESULTS: Physical activity levels of fathers and their children at child age 20 months were not associated cross-sectionally or longitudinally at child age 3.5 and 5 years. Positive associations were observed between light physical activity of healthy weight fathers and children at age 3.5 years. Inverse associations were observed for moderate/vigorous physical activity between fathers and children at age 5 years, including between overweight/obese fathers and their children at this age in stratified analyses. CONCLUSIONS: There were no clear associations between the physical activity of fathers and children. Future research should include the use of more robust measures of physical activity among fathers to allow in-depth assessment of their physical activity behaviours. Investigation of well-defined correlates of physical activity in young children is warranted to confirm these findings and further progress research in this field.

Fathers' perspectives on the diets and physical activity behaviours of their young children.

BACKGROUND: Children's learning about food and physical activity is considerable during their formative years, with parental influence pivotal. Research has focused predominantly on maternal influences with little known about the relationships between fathers' and young children's dietary and physical activity behaviours. A greater understanding of paternal beliefs regarding young children's dietary and physical activity behaviours is important to inform the design and delivery of child-focussed health promotion interventions. This study aimed to describe fathers' perceived roles in their children's eating and physical activity behaviours. It also sought to document fathers' views regarding how they could be best supported to promote healthy eating and physical activity behaviours in their young children. METHODS: In depth, semi-structured interviews were conducted with twenty fathers living in socio-economically diverse areas of metropolitan Melbourne, Australia who had at least one child aged five years or less. All interviews were audio recorded, transcribed verbatim and thematically analysed. RESULTS: Thematic analysis of the transcripts revealed eight broad themes about fathers' beliefs, perceptions and attitudes towards the dietary and physical activity behaviours of their young children: (i) shared responsibility and consultation; (ii) family meal environment; (iii) parental role modelling; (iv) parental concerns around food; (v) food rewards; (vi) health education; (vii) limiting screen time; and (viii) parental knowledge. Analysis of themes according to paternal education/employment revealed no substantial differences in the views of fathers. CONCLUSIONS: This exploratory study presents the views of a socio-economically diverse group of fathers regarding the dietary and physical activity behaviours of their young children and the insights into the underlying perceptions informing these views. The findings suggest that fathers believe healthy eating behaviours and being physically active are important for their young children. Fathers believe these behaviours can be promoted and supported in different ways including through the provision of appropriate meal and physical activity environments and parental role modelling of desired dietary and physical activity behaviours.

Dietary associations of fathers and their children between the ages of 20 months and 5 years.

OBJECTIVE: To examine associations between dietary intakes of fathers and their children at child age 20 months, 3·5 years and 5 years, and to determine if fathers' intake predicts change in children's intake between 20 months and 3·5 and 5 years of age. DESIGN: The diets of fathers and their first-born children participating in the longitudinal Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program were assessed using FFQ and three 24 h recalls, respectively. SETTING: Sixty-two pre-existing first-time parent groups were selected from fourteen local government areas within a 60 km radius of Deakin University Burwood, Victoria, Australia. SUBJECTS: Fathers and their first-born children at 20 months (n 317), 3·5 years (n 214) and 5 years of age (n 208). RESULTS: Positive associations were found between fathers' and children's intakes of fruit and sweet snacks at 20 months (P=0·001) and 5 years of age (P=0·012). Fathers' intake at child age 20 months was associated with change in children's intake for fruit, sweet snacks and sugar-sweetened beverages between child age 20 months and 3·5 years, and for sweet snacks and sugar-sweetened beverages between child age 20 months and 5 years (all P<0·05). After adjustment for maternal intake, fathers' intake of sweet snacks remained a predictor of change in children's sweet snack intake between 20 months and 3·5 years of age (P=0·03). CONCLUSIONS: Associations between the dietary intakes of fathers and their children commence at a young age and continue through early childhood. Fathers should be included in future interventions aimed at improving children's diets.

Associations between dietary intakes of first-time fathers and their 20-month-old children are moderated by fathers' BMI, education and age.

Children's learning about food is considerable during their formative years, with parental influence being pivotal. Research has focused predominantly on maternal influences, with little known about the relationships between fathers' and children's diets. Greater understanding of this relationship is necessary for the design of appropriate interventions. The aim of this study was to investigate the associations between the diets of fathers and their children and the moderating effects of fathers' BMI, education and age on these associations. The diets of fathers and their first-born children (n 317) in the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program were assessed using an FFQ and 3 × 24-h recalls, respectively. The InFANT Program is a cluster-randomised controlled trial in the setting of first-time parents groups in Victoria, Australia. Associations between father and child fruit, vegetable, non-core food and non-core drink intakes were assessed using linear regression. The extent to which these associations were mediated by maternal intake was tested. Moderation of associations by paternal BMI, education and age was assessed. Positive associations were found between fathers' and children's intake of fruit, sweet snacks and take-away foods. Paternal BMI, education and age moderated the relationships found for the intakes of fruit (BMI), vegetables (age), savoury snacks (BMI and education) and take-away foods (BMI and education). Our findings suggest that associations exist at a young age and are moderated by paternal BMI, education and age. This study highlights the importance of fathers in modelling healthy diets for their children.

The effect of an early childhood obesity intervention on father's obesity risk behaviors: the Melbourne InFANT Program.

BACKGROUND: To investigate the effect of an early childhood obesity prevention intervention, incorporating a parent modelling component, on fathers' obesity risk-related behaviours. METHODS: Cluster randomized-controlled trial in the setting of pre-existing first-time parents groups organised by Maternal and Child Health Nurses in Victoria, Australia. Participants were 460 first-time fathers mean age = 34.2 (s.d.4.90) years. Dietary pattern scores of fathers were derived using principal component analysis, total physical activity and total television viewing time were assessed at baseline (infant aged three to four months) and after 15 months. RESULTS: No significant beneficial intervention effect was observed on fathers' dietary pattern scores, total physical activity or total television viewing time. CONCLUSION: Despite a strong focus on parent modelling (targeting parents own diet, physical activity and television viewing behaviours), and beneficial impact on mothers' obesity risk behaviours, this intervention, with mothers as the point of contact, had no effect on fathers' obesity risk-related behaviours. Based on the established links between children's obesity risk-related behaviors and that of their fathers, a need exists for research testing the effectiveness of interventions with a stronger engagement of fathers.

Associations between nutritional status, weight loss, radiotherapy treatment toxicity and treatment outcomes in gastrointestinal cancer patients.

BACKGROUND & AIMS: Patients with gastrointestinal cancers are susceptible to nutritional deterioration which may be compounded by radiotherapy treatment toxicities. This study aimed to determine whether nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy were associated with treatment toxicity and outcomes in gastrointestinal cancer patients. METHODS: Seventy-three gastrointestinal cancer patients receiving curative radiotherapy underwent medical record audits assessing body weight, radiotherapy toxicity, unplanned treatment breaks or hospital admissions and completion of prescribed treatment/s. Nutritional status was assessed in a subset of patients (n = 11) using the Patient-Generated Subjective Global Assessment tool. RESULTS: Seventy-five percent of patients lost weight throughout radiotherapy. Weight loss was significantly greater in patients experiencing unplanned radiotherapy breaks (-3.1% vs -1.6%, p < 0.05) and in patients not completing prescribed chemotherapy (-3.3% vs -1.6%, p < 0.05). Toxicity severity was strongly correlated with Patient-Generated Subjective Global Assessment score (rho = 0.839, p < 0.001) and was increased in patients experiencing unplanned admissions compared to those without admission (42.1% vs 9.3% with grade 3 toxicity respectively, p < 0.001). CONCLUSIONS: Deterioration in nutritional status during radiotherapy (as measured by weight loss) may be associated with poorer short-term treatment outcomes in gastrointestinal cancer patients. Patient numbers were too small to definitively determine the effect of nutritional status at radiotherapy commencement or changes in nutritional status throughout radiotherapy (defined by PG-SGA) on treatment outcomes. Further research is required to investigate this in larger, longer-term studies.