This study aims to examine children’s fruit, vegetable, and added sugar consumption relative to the Dietary Guidelines for Americans and the American Heart Association’s recommendations, as well as to compare children’s reported consumption with parental perception of the child’s overall diet quality. Data were drawn from 2 independent, cross sectional panels (2009–10 and 2014–15) of the New Jersey Child Health Study. The analytical sample included 2229 households located in five New Jersey cities. Daily consumption of fruit (cups), vegetables (cups), and added sugars (teaspoons) for all children (3–18 years old) were based on parent reports. Multivariate linear regression analyses estimated children’s adjusted fruit, vegetable, and added sugar consumption across parents’ perception categories (Disagree; Somewhat Agree; and Strongly Agree that their child eats healthy). Although only a small proportion of children meet recommendations, the majority of parents strongly agreed that their child ate healthy. Nonetheless, significant differences, in the expected direction, were observed in vegetable and fruit consumption (but not sugar) across parental perceptional categories for most age/sex groups. Dietary interventions tailored to parents should include specific quantity and serving-size information for fruit and vegetable recommendations, based on their child’s age/sex, and highlight sources of added sugar and their sugar content.
Objective: To evaluate five popular fast-food chains' menus in relation to dietary guidance.
Design: Menus posted on chains' websites were coded using the Food and Nutrient Database for Dietary Studies and MyPyramid Equivalents Database to enable Healthy Eating Index-2005 (HEI-2005) scores to be assigned. Dollar or value and kids' menus and sets of items promoted as healthy or nutritious were also assessed.
Setting: Five popular fast-food chains in the USA.
Subjects: Not applicable.
Results: Full menus scored lower than 50 out of 100 possible points on the HEI-2005. Scores for Total Fruit, Whole Grains and Sodium were particularly dismal. Compared with full menus, scores on dollar or value menus were 3 points higher on average, whereas kids' menus scored 10 points higher on average. Three chains marketed subsets of items as healthy or nutritious; these scored 17 points higher on average compared with the full menus. No menu or subset of menu items received a score higher than 72 out of 100 points.
Conclusions: The poor quality of fast-food menus is a concern in light of increasing away-from-home eating, aggressive marketing to children and minorities, and the tendency for fast-food restaurants to be located in low-income and minority areas. The addition of fruits, vegetables and legumes; replacement of refined with whole grains; and reformulation of offerings high in sodium, solid fats and added sugars are potential strategies to improve fast-food offerings. The HEI may be a useful metric for ongoing monitoring of fast-food menus.
Many factors influence children’s health behaviors and health outcomes. The Social Ecological Model (SEM) groups these factors into interactive layers, creating a framework for understanding their influence and for designing interventions to achieve positive change. The layers of influence in the SEM include individual, interpersonal, organizational, community, and policy factors (see figure). The New Jersey Child Health Study (NJCHS) was designed to examine how specific layers of the SEM, particularly food and physical activity environments in schools and communities, affect obesity outcomes in children
the US comparing parental perception of their child’s diet with quantitatively assessed diet quality. We examined the association between parent perception of their child’s overall diet and the child’s diet quality, as measured by frequency of consumption of key food categories.
Methods: Secondary analysis was conducted using data from two independent cross- sectional panels of surveys with parents of a 3-18 year old child. Data collection took place in 2009-2010 and 2014, the random sample was drawn from low-income cities. Well-established survey questions assessed parental perception of their child’s diet and frequency of consumption of fruits, vegetables, sugar-sweetened beverages (SSB), fast food and unhealthy snacks. Diet quality scores were calculated for each child, with higher scores reflective of healthier diets (max score= 40). Ordered logistic regressions examined associations between parental perception and consumption of food categories. Multinomial logistic regressions examined associations between levels of concordance in parent perception and diet scores by demographic sub-groups.
Results: Almost half of children were non-Hispanic black (46%) and 40% were Hispanic. Overall 52% of parents strongly agreed, 33% somewhat agreed, 10% somewhat disagreed, and 4% strongly disagreed that their child eats a healthy diet. The mean diet quality score for the sample was 20.58 ± 6.7. Children from our sample with the unhealthiest diet had a mean frequency of fruit intake = 0.8 times/day and SSBs = 2.2 times/day. Children with the healthiest diet had a mean consumption of fruit=1.7/day and
SSBs= 0.4/day. Parental perception of their child’s diet was significantly higher when their child consumed more fruit (p<0.001) and vegetables (p<0.001) and lower when their child consumed more fast food (p<0.001), SSBs (p=0.01) and unhealthy snacks (p=0.02). Over half of parents overestimated the healthfulness of their child’s diet (61%). Parent, child and household demographics did not moderate this association.
Conclusions: Although parental perceptions that their child eats healthy are associated when their child eats more healthy foods and less unhealthy foods, parents’ perceptions still do not align with their child’s diet.