The U.S. toxic food environment has impacted the increased rates of childhood obesity and disordered eating patterns (Battle & Brownell, 1996), and prevention efforts are beginning to take an ecological approach to addressing these weight-based problems. Researchers have begun to discuss the importance of starting prevention efforts during infancy and early childhood (Flynn et al., 2006; Olstad & McCargar, 2008). Caregivers and parents have the most impact on child eating and activity levels during early development, but there is scarce research on ways to engage parents in programming. The present study used a qualitative design to investigate parents' experiences receiving, making meaning of, and applying sociocultural messages about children's health and nutrition. Individual interviews were conducted with parents from 16 very low-income Early Head Start families. Interview transcripts, field notes, documentary evidence, and follow-up participant checks were used during grounded theory analysis of the data (Corbin & Strauss, 2008). A theoretical model of parental movement toward action was developed that included (a) the culture and context influencing parents, (b) parents' sources of social and cultural messages, (c) parental attitude and engagement, (d) parental motivation for action, (e) intervening conditions impacting motivation and application, and (f) parent action taken on the individual and social levels. The categories and subcategories of the model are illustrated by narrative data. Implications for research, parent engagement, and prevention programming for weight-related problems in young children are discussed.

abstract: Childhood obesity is associated with many well established health risks as well as high annual public health costs. Because of this, the childhood obesity literature has highlighted the need to detect at-risk groups in order to implement targeted preventions. Emotional eating has been identified as an unhealthy behavior and a risk factor for overweight status among children though very little is known about what predisposes children to emotionally eat. Stress has often been found to elicit emotional eating but most studies looking at this relationship have relied on self-reports in adult and clinical samples. Thus, the current study seeks to investigate the relationship between stress reactivity (measured using heart rate variability) and emotional eating in a sample of 247 children between the ages of 4-6. Furthermore, levels of control may moderate the relationship between stress reactivity (HRV) and emotional eating. Linear regression analysis was used to explore these relationships. It was expected that higher levels of reactivity to stress would predict an increased likelihood of emotional eating. This association was expected to be attenuated among children with higher levels of inhibitory control and attentional focusing as well as lower levels of impulsivity. However, the hypothesized findings were not supported by the data. Despite these null findings, and in light of several limitations, it is still hypothesized that emotional eating involves physiological and impulsivity/effortful control processes. Implications of future research are discussed. / Dissertation/Thesis / Masters Thesis Psychology 2016

A obesidade infantil vem aumentando progressivamente e está associada a várias complicações na infância e na idade adulta. Apresenta etiologia multifatorial, sendo o resultado de complexas interações entre fatores genéticos, dietéticos e ambientais. O presente estudo investiga um dos fatores ambientais, a influência familiar, e utiliza um novo instrumento para especificar como o comportamento dos pais influencia o excesso de peso de seus filhos durante a infância. O Questionário de Alimentação da Criança (QAC) avalia as crenças, atitudes e práticas dos pais em relação à alimentação de seus filhos e a relação destes componentes com a tendência ao desenvolvimento obesidade infantil. A versão original deste instrumento apresenta 31 questões e avalia 07 fatores: Percepção de responsabilidade, Percepção do peso dos pais, Percepção do peso da criança, Preocupação com o peso da criança, Restrição, Pressão para comer e Monitoramento. Portanto, o objetivo deste estudo foi investigar as atitudes, crenças e práticas das mães em relação à alimentação e propensão à obesidade em crianças que são atendidas pelo Sistema Único de Saúde (SUS) da cidade de Ribeirão Preto - SP. Os participantes foram 300 pais e filhos, sendo 150 mães e 150 crianças, aleatoriamente selecionadas, com idade entre 2 a 11 anos e de ambos os sexos. O QAC foi aplicado às mães e a avaliação antropométrica foi realizada através da aferição de peso corporal e estatura das mães e filhos, de acordo com as instruções recomendadas pelo Ministério da Saúde. Realizou-se a descrição dos dados por meio de frequências e percentuais e o teste de correlação de Kendall entre as variáveis em estudo. Os níveis de significância estatísticaestabelecido foi p<0,05. A avaliação do estado nutricional foi realizada através do IMC, segundo os critérios de classificação recomendados pela OrganizaçãoMundial da Saúde (OMS).Os resultados mostraram que parte das crianças e das mães apresentou excesso de peso. Em relação ao QAC, no fator Percepção de responsabilidade as mães consideram-se, na maior parte do tempo, responsáveis pela alimentação dos filhos. Para o fator Percepção do peso dos pais e percepção do peso da criança, estas relatam peso normal desde a infância até atualmente. Para o fator Preocupação com o peso da criança as mães consideram-se preocupadas. Para o fator Restrição, as mães concordam com a prática de restringir que sua criança coma determinados alimentos. No fator Pressão para comer, as mães concordam em relação à pressão para que sua criança coma determinada quantidade ou tipo de alimento. No fator Monitoramento, as mães relatam que sempre devem monitorar o que sua criança come. Além disso, verificou-se correlação positiva entre as variáveis IMC dos filhos e dos pais; IMC dos filhos e os fatores Percepção de responsabilidade, Percepção do peso da criança, Preocupação com o peso da criança, Restrição e Monitoramento; e negativa entre IMC dos filhos e Pressão para comer. Desta forma, é possível sugerir que as crenças, atitudes e práticas dos pais durante a alimentação dos filhos estão associadas com o excesso de peso na infância. / Childhood obesity has been increasing steadily and is associated with various complications in childhood and adulthood. Presents several causes and is the result of complex interactions between genetic, dietary and environmental. This study investigates one of the environmental factors, family influence, and uses a new tool to specify how parents\' behavior influences the overweight of their children during infancy. The Child Feeding Questionnaire (CFQ) assesses parents beliefs, attitudes and practices about childs feeding and relationship of these components with the trend of childhood obesity. The original version of this questionnaire has 31 questions and it evaluates 7 factors: Perceived Responsibility, Perceived Parent Weight, Perceived Child Weight, Concern about Child Weight, Restriction, Pressure to Eat and Monitoring. Therefore, the aim of this study was to investigate the attitudes, beliefs and practices of the parents about childs feeding and obesity proneness on children who are served by the Unified Health System in the city of Ribeirão Preto-SP. The participants were 300 parents and children (150 mothers and 150 children). The children were randomly chosen, with the age ranging from 2 to 11 years and of both sexes. The CFQ was applied on mothers and the anthropometric measurements were recorded by measurement of mothers and childrens body weight and height, according to the instructions recommended by the Ministry of Health. For the data analysis, a descriptive statistics (percentages and frequencies), the Kendall correlation test, when applicable, was used. The levels of statistical significance were set at p<0.05. The assessment of nutritional status used the Body Mass Index (BMI) according to the classification criteria recommended by the World Health Organization (WHO). The results showed that most children and mothers were overweight. In relation to the QAC, for the Perceived Responsibility Factor, mothers considered themselves, the responsible ones for feeding their child most of the time. As for Perceived Parent Weight Factor, they reported to have had normal weight from childhood up to the present moment. The Perceived Child Weight Factor, parents also affirmed that their children always had normal weight from their childhood up to the present moment. On Concern about Child Weight Factor, the mothers are considered to be worried. About the Restriction Factor, mothers agree with the practice to restrict the ingestion of some type of food to their children. For the Pressure to Eat Factor, mothers agree about the pressure to regulate the quantity of determined type of food consumed by their children. On Monitoring Factor, mothers reported that, they always should monitor what their child eats. Moreover, there was a positive correlation between children and parents BMI variables, as well as childrens BMI and the factors Perceived Responsibility; Perceived Child Weight; Concern about Child Weight, Restriction and Monitoring, and negative correlation between childrens BMI and Pressure to Eat. It can be concluded that the parental attitudes, beliefs and practices about childs feeding are positively associated with overweight in childhood.

This project analyzed First Lady Michelle Obama’s Let’s Move! campaign for how it constructs obesity and health. Let’s Move! is a national internet-based campaign to end childhood obesity. The literature on Let’s Move! is limited and focuses on the privatization and corporatization of children’s physical education in public schools. Taking an intersectional approach to critical fat studies, I use critical discourse analysis to investigate how the language used in the Let’s Move! campaign (re)enforces and (re)signifies cultural notions of fat as a social problem – specifically that fat bodies are diseased, unproductive, and a financial burden. I maintain that the Let’s Move! campaign is a symptomatic text that reveals a moral panic over the so-called childhood obesity epidemic by insisting that childhood obesity is a threat to national economy and security. I contend that Let’s Move! constructs good citizens as informed consumers, and the biopedagogies recommended by Let’s Move! promote White middle-class norms as the proper way to live while ignoring structural inequalities. Furthermore, I posit the campaign employs neoliberal discourses to frame mothers as responsible for their obese children’s weight and encourages women to conform to the cultural notion of the “good mother.” Overall, I argue the Let’s Move! campaign produces classed, raced, gendered, and able-bodied ideals of citizenship that function to further marginalize poor and minority groups.

This thesis deals with methods used for childhood obese patient education. It is further devoted to the creation of new educational resource to help fight the childhood obesity. This educational material has been prepared on a similar basis as the educational material for diabetic patients called Conversation maps TM. The theoretical part is dedicated to three main topics. First of all it analyzes risk factors influencing progression of the child obesity, prevention and treatment of this disease. Secondly, the theme of education is further elaborated. Finally, the third main topic is focused specifically on education in childhood obesitology and educational materials dealing with this issue. Quality of childhood obesity prevention and its specific impact on children aged 11-15 years is assessed in practical part. This part was realized using quantitative research, where I used an anonymous non-standardized questionnaire (which contained 14 questions) to gather the necessary data. The aim of the questionnaire was to find two facts. First, I was wondering where the children got accurate information about a healthy lifestyle. This finding has influenced the formation of educational material. Second, I was wondering what the real dietary habits of children aged 11-15 years are. The survey shows that...

The purpose of this study was two-fold: (a) to identify, in a large representative sample of Canadian children, the age-related trajectories of overweight and obesity from toddlerhood into childhood and (b) to investigate the associations between these trajectories and children’s temperaments, their parents’ parenting practices and their interactions. Potentially important familial characteristics (i.e., the parents’ or surrogates’ age, income level, and educational attainment) were considered in the models. The sample for this study was drawn from the Canadian National Longitudinal Survey of Children and Youth (NLSCY). Group-based mixture modeling analyses were conducted to identify the number and types of distinct trajectories in the development of obesity (i.e., to explicate the developmental processes in the variability of childhood obesity) in a representative sample of children who were between 24 to 35 months of age, at baseline, and followed biennially over a 6-year span. Discriminant analysis was conducted to assess the theoretical notion of goodness-of-fit between parenting practices and children’s temperament, and their association with membership in the BMI trajectory groups. The results of the group-based modeling established three different BMI trajectories for the boys, namely: stable-normal BMI, transient-high BMI, and j-curve obesity. The analyses revealed four different trajectories of BMI change for the girls: stable-normal BMI, early-declining BMI, late-declining BMI, and accelerating rise to obesity. The multivariate analysis revealed that the combined predictors of the obesity trajectories of the girls (group membership) included having a fussy temperament, ineffective parenting, and parents’ educational attainment. Predictors of the boys’ obesity trajectory (group membership) included household income, parental education, and effective parenting practices. Understanding the different ways in which a child may develop obesity will allow nurses and other health professionals to take different approaches in the assessment, intervention and evaluation of obesity and obesity-related health problems. The results of this study further our understanding of factors associated with the development of obesity at a young age and hence may inform the development of early preventive programs. / Applied Science, Faculty of / Nursing, School of / Graduate

This research study focuses on examining the views of patients, their families, and staff member providers of the Centre for Healthy Active Living a clinical obesity management program for children and youth at the Children’s Hospital of Eastern Ontario, in Ottawa, Canada. Qualitative methodology was used and content analysis was conducted with data obtained from family questionnaires and a provider focus group. Analysis of obtained data was conducted to determine alignment of views between patient, family, and provider views, and the formal goals of the program. Emerging themes from the data indicated that patients and families place higher value on the formal goals of “improve quality of life; improve eating behaviours; improving fitness, increasing activity levels; and empower/strengthen families.” (Children’s Hospital of Eastern Ontario, 2012). Specific recommendations with regards to each component of these goals were provided. Instrumental, procedural, systemic, and conceptual recommendations of program components were also provided.

The objective of this research was to evaluate the relationships between greater adiposity and bone development during adolescence. Bone was evaluated from age 11 to 17 years in the Iowa Bone Development Study using peripheral quantitative computed tomography (pQCT). Body composition (fat and lean mass) was estimated by dual energy x-ray absorptiometry (DXA). The first research aim evaluated the associations between greater overall adiposity and subsequent maturation and bone strength in 135 girls and 123 boys. Greater adiposity was defined according to age 8 Body Mass Index (BMI) to categorize participants as overweight (OW) or healthy-weight (HW). Maturation was defined as the age of peak height velocity (PHV). Bone strength was assessed at the radius and tibia (bone strength index, BSI, and strength-strain index, SSI). Differences in bone strength between OW and HW were evaluated with sex-specific multi-level regression models to account for individual growth and correlation between repeated measurements. Analyses were adjusted for centered age (measurement visit age - grand mean age of cohort), change in fat mass, and limb length in Model 1, with additional adjustment for lean mass in Model 2. Analyses were repeated using biological age (visit age - age PHV). BMI was positively associated with age of maturation in girls and boys (p< 0.05). HW versus OW girls had significantly lower BSI and SSI at the radius and tibia (p< 0.05) in Model 1. Results remained significant except for radial BSI in Model 2. HW versus OW boys had significantly lower BSI and SSI (all p< 0.05) at the tibia, but not radius, in Model 1. Significant differences were sustained in Model 2. Analyses were repeated using biological age, which yielded similar results for boys, but reduced parameter estimates were observed in girls, with only tibial SSI significant in Model 2 (p< 0.05). These findings support a stronger role for greater adiposity in the occurrence of earlier maturation and greater bone strength in girls than boys while greater lean mass appeared to play a greater role in boys. The second research aim evaluated associations between abdominal adiposity and bone in 132 girls and 122 boys. Visceral adipose tissue area (VAT, cm2) and subcutaneous adipose tissue area (SAT, cm2) were estimated from DXA scans. Sex-specific analyses evaluated the fat-bone relationship with growth models using biological age as the time variable adjusted for limb length and lean mass. There were no significant associations between bone parameters and VAT or SAT in girls. In boys, greater VAT was associated with lower trabecular bone density (tBMD) and BSI (all p< 0.05) at the tibia, but not radius. Greater VAT and SAT were associated with smaller cortical bone size and thickness (all p< 0.01) at the radius, but not tibia. Analyses limited to overweight participants showed VAT was negatively associated with periosteal circumference at the radius and tibia, cortical bone thickness at the tibia and SSI (all p< 0.05) at the radius in girls. In boys, the results were relatively unchanged for VAT, while SAT was only significantly associated with lower tBMD (p< 0.05) at the tibia. These results suggest the bone-fat relationship may vary depending on adiposity and bone site. The third research aim evaluated the longitudinal association between intramuscular fat and cortical bone at the tibia from age 11 to 17 years in 153 girls and 143 boys. Muscle density (MD) was used to estimate intramuscular fat (IMF). Lower MD indicates greater IMF. The relationships between muscle density and cortical bone parameters were modeled using multi-level regression models adjusted for biological age, limb length and muscle cross-sectional area measured by pQCT. In the adjusted multi-level regression models, MD was positively associated with cortical bone parameters, but only reached statistical significance for BMD, bone mineral content (BMC), bone cross-sectional area, cortical thickness and SSI in girls, while only SSI was significant in boys (all p< 0.05). These results suggest that greater fat content within muscle may be harmful to weight-bearing cortical bone during adolescence. In conclusion, findings from the first aim suggest there are sex- and site-specific differences in the relationship between adiposity and bone during adolescence. Findings from the second and third aims indicate these differences could be explained, in part, by the existence of specific fat depots (abdominal more so than intramuscular fat) that could be harmful to bone and that may be more apparent in boys due to a sex-specific fat distribution pattern that favors accumulation of abdominal rather than peripheral fat.

Obesity is an increasing problem in the United States with 17% of youth currently classified as obese and an even higher prevalence of obesity among disadvantaged populations. The food environment may be contributing to these high rates as there has been a well documented association among increased away from home food consumption and excess adiposity, as well as evidence to support that children\'s diets are composed of a large portion of restaurant foods. The main purpose of this study is to describe the quality of restaurant food offered to children in a rural health disparate region. Two trained research assistants conducted systematic audits of all food outlets offering a children\'s menu in the Dan River region using the Children\'s Menu Assessment (CMA) tool. A composite score for each outlet for was calculated from the 29 scored items on the CMA. The total sample consisted of 137 outlets with CMA scores ranging from -4 to 9 with a mean score of 1.6+2.7. Scores were lowest in the predominantly Black block groups (0.2+0.4) when compared to the predominately White block groups (1.4+1.6) and Mixed block groups (2.6+2.4) with significantly lower scores in the predominantly Black block group than the Mixed block groups (F=4.3; p<0.05). The results of this study reveal a lack of few healthy food options available for children in this region. These findings have the potential to contribute to public health efforts in developing public policy changes or environmental interventions for the children\'s food environment in the Dan River Region. / Master of Science

No description available.