Parental influences on children's dairy products consumption: a narrative review.

OBJECTIVE: To review research on the influence of parent-related factors on children's dairy products consumption. DESIGN: A search of electronic databases and a narrative synthesis of the literature were conducted. English-language articles were included if they reported data relating to parental influences on children's consumption of dairy products and if statistical significance was reported. SETTING: Studies were carried out in the USA (n 8) and in a range of countries across Europe (n 12) and Asia (n 5). PARTICIPANTS: The subjects of this research were children aged between 2 and 12 years of age, from a range of geographical locations. RESULTS: Twenty-five studies met the inclusion criteria. The studies examined children's dairy products consumption in relation to parental socio-economic status (education level and income) (n 12), home availability (n 2), home food environment (n 3), parental dairy products consumption (n 4), parent feeding practices (n 3), parents' beliefs and attitudes (n 3) and parental nutrition knowledge (n 3). Results on the association between socio-economic status and children's dairy products consumption varied; however, studies reporting a significant association generally observed a positive relationship. Fifteen studies reported children's total dairy products intake as an outcome measure, with the remaining studies reporting intake of milk or other dairy products as individual foods. CONCLUSIONS: This review identified literature exploring a range of parental factors in relation to children's dairy products intake. However, there were limited numbers of studies published within each category of modifiable factors. Further research on the parent-related determinants of dairy products consumption in children is required in order to identify potential intervention targets in this age group.

Theoretical and practical approaches for dietary behavior change in urban socioeconomically disadvantaged adolescents: a systematic review.

CONTEXT: There is limited evidence on strategies used to promote dietary behavior changes in socioeconomically disadvantaged urban adolescents and on their effectiveness. OBJECTIVE: A synthesis of nutrition interventions used in this group of adolescents is provided in this systematic review. DATA SOURCES: Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO, and ERIC) were searched until November 2020 to identify relevant studies. DATA EXTRACTION: Forty-six manuscripts (n = 38 intervention studies) met the inclusion criteria. Quality was assessed with the Effective Public Health Practice Project Quality Assessment Tool. A qualitative synthesis summarizing data on study characteristics was conducted. DATA ANALYSIS: Studies were classified by intervention type as those focusing on hedonic determinants of dietary intake (n = 1), environmental changes to promote a specific dietary intake (n = 3), cognitive determinants (n = 29), and multicomponent strategies (n = 13). The social cognitive theory was the most applied theoretical framework, either alone or combined with other frameworks. Most of the intervention studies targeted multiple dietary outcomes, and success was not always reported for each. CONCLUSIONS: Despite the heterogeneity of the studies and lack of combination of dietary outcomes into dietary scores or patterns to evaluate changes on the individuals' whole diets, long-term, theory-driven interventions targeting a single dietary factor seem promising in obtaining sustainable dietary behavior changes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020188219.

Acceptability of the Pregnancy, Exercise, and Nutrition Research Study With Smartphone App Support (PEARS) and the Use of Mobile Health in a Mixed Lifestyle Intervention by Pregnant Obese and Overweight Women: Secondary Analysis of a Randomized Controlled Trial.

BACKGROUND: Dietary interventions can improve pregnancy outcomes among women with increased BMI. Although the interest in mobile health interventions is growing, little is known about the acceptability of smartphone apps to support lifestyle interventions in such a cohort. OBJECTIVE: We aimed to assess the acceptability of the pregnancy, exercise, and nutrition research study with smartphone app support (PEARS) and the use of mobile health in a mixed lifestyle intervention delivered to overweight and obese pregnant women. METHODS: PEARS was a randomized controlled trial of a low glycemic index dietary intervention with exercise prescription and a smartphone app, which was delivered to pregnant women who were overweight or obese. Acceptability questionnaires were completed by the intervention group at 28 weeks of gestation (n=149) and at postintervention (n=123). Maternal characteristics were recorded (ie, age, ethnicity, BMI, socioeconomic status). Associations between maternal characteristics and acceptability of the intervention and app were analyzed using two-tailed t tests, Mann-Whitney U tests, chi-square test, and logistic regression. One-on-one semistructured interviews were conducted with a subcohort of the intervention participants (n=28) at 34 weeks of gestation, in which the participants shared their experiences of the PEARS intervention. RESULTS: The intervention was generally accepted, with respondents agreeing that the diet was easy to follow (98/148, 68.5%), enjoyable (106/148, 74.1%), and affordable (110/148, 76.9%). Qualitative and quantitative results were consistent with each another, both demonstrating that app acceptability was high. The participants agreed that the app was enjoyable (96/120, 80.0%) and easy to use (116/119, 97.5%). Compared to those with tertiary education, those with lower education levels were more likely to enjoy the dietary changes (P=.04). Enjoyment of the app was associated with disadvantaged neighborhood deprivation index (P=.01) and higher BMI (P=.03). CONCLUSIONS: The PEARS intervention and use of a supportive smartphone app were accepted by pregnant women, particularly by those from vulnerable subgroups of this population. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) 29316280; https://www.isrctn.com/ISRCTN29316280.

Sustaining executive functions during sleep deprivation: A comparison of caffeine, dextroamphetamine, and modafinil.

OBJECTIVES: Stimulant medications appear effective at restoring simple alertness and psychomotor vigilance in sleep deprived individuals, but it is not clear whether these medications are effective at restoring higher order complex cognitive capacities such as planning, sequencing, and decision making. DESIGN: After 44 hours awake, participants received a double-blind dose of one of 3 stimulant medications or placebo. After 45-50 hours awake, participants were tested on computerized versions of the 5-Ring Tower of Hanoi (TOH), the Tower of London (TOL), and the Wisconsin Card Sorting Test (WCST). SETTING: In-residence sleep-laboratory facility at the Walter Reed Army Institute of Research. PARTICIPANTS: Fifty-four healthy adults (29 men, 25 women), ranging in age from 18 to 36 years. INTERVENTIONS: Participants were randomly assigned to 1 of 3 stimulant medication groups, including caffeine, 600 mg (n=12), modafinil, 400 mg (n=12), dextroamphetamine, 20 mg (n=16), or placebo (n=14). MEASUREMENTS AND RESULTS: At the doses tested, modafinil and dextroamphetamine groups completed the TOL task in significantly fewer moves than the placebo group, and the modafinil group demonstrated greater deliberation before making moves. In contrast, subjects receiving caffeine completed the TOH in fewer moves than all 3 of the other groups, although speed of completion was not influenced by the stimulants. Finally, the modafinil group outperformed all other groups on indices of perseverative responding and perseverative errors from the WCST. CONCLUSIONS: Although comparisons across tasks cannot be made due to the different times of administration, within-task comparisons suggest that, at the doses tested here, each stimulant may produce differential advantages depending on the cognitive demands of the task.

Sleep deprivation reduces perceived emotional intelligence and constructive thinking skills.

BACKGROUND AND PURPOSE: Insufficient sleep can adversely affect a variety of cognitive abilities, ranging from simple alertness to higher-order executive functions. Although the effects of sleep loss on mood and cognition are well documented, there have been no controlled studies examining its effects on perceived emotional intelligence (EQ) and constructive thinking, abilities that require the integration of affect and cognition and are central to adaptive functioning. PATIENTS AND METHODS: Twenty-six healthy volunteers completed the Bar-On Emotional Quotient Inventory (EQi) and the Constructive Thinking Inventory (CTI) at rested baseline and again after 55.5 and 58 h of continuous wakefulness, respectively. RESULTS: Relative to baseline, sleep deprivation was associated with lower scores on Total EQ (decreased global emotional intelligence), Intrapersonal functioning (reduced self-regard, assertiveness, sense of independence, and self-actualization), Interpersonal functioning (reduced empathy toward others and quality of interpersonal relationships), Stress Management skills (reduced impulse control and difficulty with delay of gratification), and Behavioral Coping (reduced positive thinking and action orientation). Esoteric Thinking (greater reliance on formal superstitions and magical thinking processes) was increased. CONCLUSIONS: These findings are consistent with the neurobehavioral model suggesting that sleep loss produces temporary changes in cerebral metabolism, cognition, emotion, and behavior consistent with mild prefrontal lobe dysfunction.

The effects of sleep deprivation on symptoms of psychopathology in healthy adults.

BACKGROUND: Sleep loss leads to temporary changes in mood and cognition, and is associated with reduced cerebral metabolism within the prefrontal cortex, similar to findings observed in some psychiatric disorders. However, the extent to which sleep deprivation may be associated with the emergence of clinical symptoms of psychopathology in healthy normal individuals is not clear. METHODS: The Personality Assessment Inventory (PAI) was administered to 25 healthy adults at rested baseline and again after 56h of continuous wakefulness. RESULTS: Comparisons showed a significant global increase in PAI psychopathology scores from baseline to sleep-deprived sessions, particularly for somatic complaints, anxiety, depression, and paranoia. Mean elevations for the clinical scales remained within normal limits, however. In contrast, sleep loss was not associated with significant changes in anxiety-related disorders, manic symptoms, borderline, schizophrenic, or antisocial features. CONCLUSIONS: Two nights without sleep may lead to a sub-clinical increase in self-reported affective symptoms of psychopathology while having little effect on symptoms of thought disorder, psychotic processes, or behavioral dysregulation. These data suggest that sleep loss may be differentially disruptive to regions of the brain involved in affective regulation and may, therefore, serve as a model for understanding the brain dysfunction associated with affective psychopathology.

Effects of acute caffeine withdrawal on Short Category Test performance in sleep-deprived individuals.

Caffeine is a popular stimulant often used to counter the effects of sleep loss and fatigue. Withdrawal from caffeine may produce mild declines in simple cognitive capacities such as attention and concentration, but it is unclear whether more complex cognitive functions, such as abstract reasoning or concept formation, may be similarly affected. To assess the effect of acute caffeine withdrawal on executive functioning during sleep deprivation, 26 healthy volunteers were administered in double-blind form either repeated doses of caffeine or placebo over two nights of continuous wakefulness. The 108-item Short Category Test was administered after 56 hr. of total sleep deprivation (9 hr. post-caffeine administration). The caffeine group scored significantly more poorly, making approximately 57% more errors on the test than the placebo group. These findings suggest that acute caffeine withdrawal during prolonged sleep deprivation has an adverse effect on abstract reasoning and concept formation.

Clinical improvements of suicidal outpatients: Examining suicide status form responses as predictors and moderators.

This investigation used hierarchical linear modeling (HLM) to examine whether index responses on the Suicide Status Form (SSF) moderated the predicted session-to-session change over course of care in overall symptoms and suicidal ideation. Ninety-two suicidal patients at a university counseling center were studied. Overall, suicidal patients improved symptomatically and decreased their suicidal ideation over the course of care. SSF index ratings of overall risk of suicide significantly moderated the predicted session-to-session change in suicidal ideation over the course of care; patient ratings of frequency of suicidal thoughts were also moderated by index SSF ratings of hopelessness and self-hate. These findings partially replicated earlier data of differential treatment response outcomes and provide valuable assessment and treatment information that is relevant to future research and successful clinical care of suicidal outpatients.