Offering children a wide variety and large quantities of snack food encourages them to eat more

Less focus on plate size and more on reducing quantity and variety of food key to getting children to snack less

July 19, 2019

Science Daily/Murdoch Childrens Research Institute

Offering children a wide variety and large quantities of snack food encourages them to eat more - and may contribute to weight problems, a new study has found. The research also found that how snacks are presented (in a large or small container) has little influence on how much children snack.

A new study has found that offering children a wide variety and large quantities of snack food encourages them to eat more -- and this practice may be contributing to Australia's weight problem.

The research*, led by the Murdoch Children's Research Institute and published in the latest International Journal of Obesity, also found that how snacks are presented (in a large or small container) has little influence on how much children snack.

Lead researcher Dr Jessica Kerr said their study found children weren't greatly affected by container size, with food consumption mainly driven by the quantity/variety of snacks on offer.

"There has been a popular push by nutritionists and public health officials towards replacing large dishware with smaller versions to nudge people towards healthier decisions," she said. "But we have found dishware size has very little effect on the amount of food consumed."

Dr Kerr said while the overconsumption of snack foods is an important contributor to obesity, most people do not recognise the impact it has on their calorie intake.

"Children and adults should only consume energy-dense snacks occasionally -- they do not need to be part of daily energy intake," she said. "But the reality is that Australians typically get around 30-40 per cent of their energy intake from snack foods."

Dr Kerr said three times as many children in Australia are now overweight or obese compared to 30 years ago.

"About 20 per cent (1 in 5) of children are overweight or obese," she said. "There are many complications of children being overweight such as type 2 diabetes, orthopaedic and respiratory disorders, liver problems and sleep apnoea."

Dr Kerr said until now studies into snacking behavior were limited by self-reported data or small sample sizes.

"Past dietary studies have mostly focused on main meals," Dr Kerr said. "It is important to determine on a larger scale how dishware size and the quantity, variety, and energy density of snacks affect both child and adult snacking behavior when apart from each other outside of the family environment," she said.

For the study, participants ate during a 15-minute snack break between 20 other health assessments at the Child Health CheckPoint, which looked at the health of 1800 children, aged 11-12 years, and their parents across a variety of factors from physical activity to sleep.

The children and parents were given a snack box containing non-perishable items such as crackers, cheese, a muesli bar, biscuits, a tub of peaches and chocolate.

The quantity/number and variety of snack food items and the container sizes that the food was presented in varied. Children and parents ate separately and at different times.

Researchers recorded how much food each child and parent left in the box uneaten, and calculated the total grams and kilojoules consumed.

"Children who were offered more snack items consumed considerably more energy and a slightly higher food mass. Manipulating box/container size had little effect on consumption," she said.

The impact on adults was little, however Dr Kerr said adults were more aware that they were being observed and this may have impacted their eating behaviour.

Dr Kerr said further research should be done with parents and community leaders to better understand the use and purpose of snack food items in the face of time pressures, marketing, and child preferences.

"Although there is sometimes a place for snack items to bridge the gap between main meals, our results reinforce calls to educate parents and schools about appropriate snack items and amounts of food to offer children," she said.

"Our research indicates that more attention and resources should be directed to toward offering children smaller amounts of food and, specifically, fewer and less variety of energy-dense foods and pre-packaged items. Interventions should not solely invest in reducing dishware size in the expectation that this will lead to reduced intake of snack foods."

https://www.sciencedaily.com/releases/2019/07/190719105511.htm

Supervised fun, exercise both provide psychosocial benefit to children with obesity

July 2, 2019

Science Daily/Medical College of Georgia at Augusta University

A program with clear rules, routines and activities, attentive adults and a chance to interact with peers appears to work as well at improving the quality of life, mood and self-worth of a child who is overweight or obese as a regular exercise program, researchers report.

While regular exercise is clearly beneficial to children -- and adults -- the psychosocial health of children may benefit as much from other kinds of adult-led after school programs, Medical College of Georgia researchers report in the journal Translational Behavioral Medicine.

"For me the take-home message is yes, exercise has many wonderful benefits but some of that is because you are in a program run by caring adults," says Dr. Catherine Davis, clinical health psychologist at MCG's Georgia Prevention Institute and the study's corresponding author.

They looked at 175 predominantly black children ages 8-11 who had overweight or obesity and were previously inactive. Children participated in either a fun-driven aerobic exercise program or a sedentary after-school program where they played board games and did artistic activities.

The investigators hypothesized that they would find that the exercise intervention would be more effective at improving quality of life, mood and self-worth than the sedentary program.

They found instead that, while the exercise program had the additional benefits of reducing body fat, improving fitness, and even improved brain health, there was no mood advantage from the exercise program. Fatness and fitness did not change as much in the sedentary group.

In fact, in the case of the boys, those in the sedentary group reported depressive symptoms actually decreased more over time than their peers in the exercise group.

About 10 percent of children in both groups had symptoms indicating depression at the start of the study. Depressive symptoms in children include things like a sad mood, interpersonal problems and inability to feel pleasure.

Among participating girls, depressive symptoms yielded similar improvements whether in the exercise or sedentary group, says Celestine F. Williams, senior research associate at the Georgia Prevention Institute and first author on the study.

Those sex differences might be attributable to males in the sedentary group not being under the pressure they may feel to participate and succeed in physical activities, and finding instead an opportunity to pursue more artistic and social endeavors, which children of this age tend to prefer, the investigators write.

Countless studies, including some led by Davis, have shown that regular physical activity in children who are overweight or obese and inactive can yield a variety of benefits, including reducing fatness, improving fitness and insulin sensitivity -- which reduces the risk of diabetes and other maladies -- as well as perhaps less obvious benefits, like improved cognition and improved brain health, and reduced anger and depression.

This time Davis and her colleagues wanted to more directly compare the impact of an exercise program versus a similar sedentary program on the psychosocial wellbeing of these children. While there are often control groups in this type of study, most compare the exercise program to either no program, or a less interactive and fun program. Davis and Williams agree that likely was a big part of the differences they found this time.

All the children were evaluated for depressive symptoms, anger expression, self-worth and quality of life right before starting and after finishing either arm of the study. Depressive symptoms and quality of life were measured again about a year later.

In the exercise program, the instructor led fun aerobic activity for 40 minutes daily based on the interests and abilities of the children. Rather than time on a treadmill, for example, there were more entertaining strategies to get and keep the heart rate up like a version of the age-old game tag. Children wore heart rate monitors and were rewarded for an average heart rate above 150 beats per minute during the exercise -- the average resting heart rate for an 8-year-old is 70 to 110 beats per minute -- and they got more points for a higher average.

In the other group, children participated in instructor-led activities like board games, puzzles, arts and music, and were rewarded for participation and good behavior. There were arts and crafts, challenging games like the strategy board game Connect 4, guitar music and singing popular songs, and the children were rewarded with points for being nice and cleaning up behind themselves. The children were free to talk with each other as long as it was not disruptive, which was probably a highlight for the boys, Williams says.

Relationships the children built with each other over the course of both programs likely were beneficial in elevating their mood and quality of life, Williams says. The sedentary program may have given children more time to talk with each other and develop friendships with little competitive pressure.

Other investigators have shown that children in the 8-11 age range may actually prefer just talking or socializing with their friends as a fun activity, rather than some form of exercise, while younger children may think it's more fun to run around, Williams says.

The fact that both programs provided psychosocial benefit to the children led the investigators to conclude that some benefits of exercise found in previous studies, including Davis', resulted from the regular opportunity to be with attentive adults who provide behavioral structure. It also resulted from the children enjoying interacting with each other, sharing snacks and other activities, while spending less time watching television.

Rates of obesity among children and the adolescents in this country have more than tripled since the 1970s, according to the Centers for Disease Control and Prevention, and currently about 1 in 5 school-age children and young people has obesity. Young blacks are disproportionately affected in this country.

There is plenty of evidence that obesity and overweight can impact overall quality of life and that children with these conditions can have increased problems with anxiety, bullying, fatigue, anger and general behavior problems, and that generally higher BMI, or body mass index, a ratio of weight to height, is associated with a lower self-worth in children.

"Exercise is very well demonstrated to improve mood. However, I think you have to consider exercise in the context that it occurs, so the social context counts too," says Davis.

https://www.sciencedaily.com/releases/2019/07/190702112657.htm

Twofold overweight risk for five-year-olds given milk cereal drinks in infancy

December 19, 2018

Science Daily/University of Gothenburg

In five-year-old children, the risk for overweight is almost twice as high if they at 12 months had consumed milk cereal drinks every day, a study in the journal Acta Paediatrica shows.

"Milk cereal drinks are not bad as such; how it's used is the problem. That is, when it's seen not as a meal but as an extra, to supplement other food," says Bernt Alm, Associate Professor of Pediatrics at Sahlgrenska Academy, University of Gothenburg, Sweden.

The researchers behind the study have previously linked consumption of milk cereal drinks at age six months to high body mass index (BMI) at ages one year and one and a half years. The study now presented is of the same group of children, several years later.

The follow-up study comprised 1,870 children in Halland County, Sweden, whose particulars were taken from the Halland Health and Growth Study. Height and weight data have been recorded by the child health services, while the information on their food and beverage intake comes from the parents.

Among the five-year-olds, 11.6 percent were overweight and 2.3 percent had obesity. The risk for overweight or obesity proved to be almost double (factor 1.94) if the children had formerly, at age 12 months, been daily consumers of milk cereal drinks. This risk elevation was independent of other factors.

Examples of other conditions found to make overweight more likely were if the parents had low educational attainment, if they smoked, and if there was a history of obesity in the family. Heredity was the strongest single factor.

In Sweden, children commonly drink milk cereal drinks once to five times a day from age six months. In the study in question, 85 percent of the children had been daily consumers at 12 months of age.

The Swedish milk cereal drinks consists of milk and flour, and is nutritionally close to porridge, and usually enriched with vitamins and minerals. Similar products exist elsewhere in the world, but are not as common.

"Milk cereal drinks are nutritious and good, and has been used for hundreds of years in Sweden. Getting rid of it isn't a panacea. But if, for example, the child has other risk factors for overweight, such as heredity, perhaps not using milk cereal drinks should be considered," Alm says.

https://www.sciencedaily.com/releases/2018/12/181219115552.htm

Early to bed and early to rise: it's keeping kids leaner

September 30, 2011

Science Daily/American Academy of Sleep Medicine

Researchers recording the bedtimes and wake times of 2,200 Australian youths found that the night owls were 1.5 times more likely to become obese than the early birds, twice as likely to be physically inactive and 2.9 times more likely to sit in front of the TV and computer or play video games for more hours than guidelines recommend.

A study in the Oct. 1 issue of the journal Sleep recorded the bedtimes and wake times of 2,200 Australian participants, ages 9 to 16, and compared their weights and uses of free time over four days. Children who went to bed late and got up late were 1.5 times more likely to become obese than those who went to bed early and got up early. Furthermore, late-nighters were almost twice as likely to be physically inactive and 2.9 times more likely to sit in front of the TV and computer or play video games for more hours than guidelines recommend.

"The children who went to bed late and woke up late, and the children who went to bed early and woke up early got virtually the same amount of sleep in total," said co-author Carol Maher, PhD, a postdoctoral fellow with the University of South Australia. "Scientists have realized in recent years that children who get less sleep tend to do worse on a variety of health outcomes, including the risk of being overweight and obese. Our study suggests that the timing of sleep is even more important."

Maher said mornings are more conducive to physical activity for young people than nights, which offer prime-time TV programming and social networking opportunities. This relationship between time of day and available activities might explain why more sedentary and screen-based behaviors were observed with later bedtimes, she said. At a time when research is showing that teenagers have a natural tendency to stay up late and wake late, the results of this study could stand as a warning.

"It is widely accepted that the sleep patterns of adolescents are fundamentally different from children and adults, and that it is normal for adolescents to stay up very late and sleep in late in the morning," Maher said. "Our findings show that this sleeping pattern is associated with unfavorable activity patterns and health outcomes, and that the adolescents who don't follow this sleep pattern do better."

Other findings from the University of South Australia study:

• ·      Early-bed/early-risers went to bed 70 to 90 minutes earlier, woke up 60 to 80 minutes earlier and accumulated 27 minutes more moderate to vigorous physical activity each day than late-risers.

• ·      Late-bed/late-risers watched TV, played video games or were online 48 minutes longer each day than early-bed/early risers, primarily between 7 p.m. and midnight.

• ·      Only 12 percent of late-bed/late-risers had an average of two hours or less screen time per day, which is recommended for children and teens by the Australian Department of Health and Aging. In comparison, 28 percent of early-bed/early risers met the recommendation for screen time.

• ·      On a broad scale, late-bed/late-risers replaced about 30 minutes of moderate to vigorous physical activity with 30 minutes of sedentary behavior each day, relative to the early-bed/early-rise group.

• ·      Body-mass index (BMI) scores were higher in late-risers than early-risers, and late-risers were more likely to be overweight or obese.

• ·      Late-bed/late-risers tended to have few siblings, live in major cities, come from lower household incomes and have a part-time job.

http://www.sciencedaily.com/releases/2011/09/110930052216.htm

Sleep Problems Linked to Obesity, Lower Quality of Life in School-Aged Children

June 10, 2008

Science Daily/American Academy of Sleep Medicine

A research abstract that will be presented on June 10 at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), finds an increased prevalence of sleep problems among school-aged children who are obese and an association between increased weight and lower quality of life.

According to the results, children who were obese had poorer scores for sleep onset delay, sleep-disordered breathing, sleep duration, and daytime sleepiness, compared to children who were overweight or healthy weight. Weight category was a significant predictor of parent-reported physical, psychosocial, and total quality of life scores, as well as child-reported physical functioning scores. Weight category and sleep problem category were significant predictors of child-reported psychosocial and total quality of life scores.

While an increasing number of adults are considered obese, the number of obese children is also on the rise. Obesity can increase children's risk for developing obstructive sleep apnea (OSA), a sleep-related breathing disorder that causes your body to stop breathing during sleep. OSA, which can disturb your sleep numerous times on any given night, can result in daytime sleepiness, as well as an increased risk of stroke, diabetes and heart disease. OSA is a serious sleep disorder that can be harmful, or even fatal, if left untreated.

It is recommended that school-aged children get between 10-11 hours of nightly sleep and children in pre-school between 11-13 hours.

http://www.sciencedaily.com/releases/2008/06/080610072004.htm

School obesity-prevention curriculum can reduce medical costs

August 1, 2011

Science Daily/Children's Hospital Boston

Teaching middle-school children about nutrition and exercise and encouraging them to watch less TV can save the health care system a substantial amount of money, suggests a new economic analysis.

"Because eating disorders can be so expensive to treat, preventing even one case in the five Planet Health schools translated into reducing medical costs by $34,000," says Austin. "But if we scale up our calculations to include, say, 100 middle schools in Massachusetts, the medical costs reduced by preventing bulimia increase to over half a million dollars. And if we scale up nationwide, to say 1,000 schools, the potential reduction in the medical cost burden is sizable."

Austin notes that obesity prevention programs that stigmatize obesity or create a sense of blame can actually contribute to eating disorders. "We need to be smart about choosing obesity prevention strategies that, at the same time, can prevent eating disorders," she says. "Our study shows that when we do both, we substantially increase the benefits, both in terms of health and reducing medical costs."

http://www.sciencedaily.com/releases/2011/08/110801161416.htm

Stressed parent? New research shows your children may be twice as likely to have obesity

November 4, 2015

Science Daily/Obesity Society

Prior research has shown that stress is associated with obesity in adults, and now for the first time, research suggests Latino parents who feel high levels of stress are twice as likely to have children with obesity as well. Researchers examined data from the Study of Latino Youth (SOL Youth) to determine the relationship between parental stress and child weight status in the Latino population.

"Obesity and chronic stress were both prevalent among this Latino population, with more than one-quarter (28%) of children ages 8-16 with obesity, and nearly one-third (29%) of their parents reporting high levels of stress," said Dr. Isasi. "This study is among the first of its kind to show that parental stress is a risk factor for childhood obesity among Latinos, and adds to the understanding of family influences on child weight status."

In this study, Dr. Isasi and colleagues examined data on weight and stress from children and their parents from the SOL Youth study, an ancillary study to HCHC/SOL, a large community-based cohort study of Latino individuals living in the Bronx (New York City), Chicago, Miami and San Diego. The researchers followed guidelines from the Centers for Disease Control and Prevention (CDC) to define child weight status, and assessed parental stress using the Chronic Stress Burden Scale, an eight-item measure of ongoing stressors in important life domains. Stress factors included having difficulties at work or difficulties in a relationship, among others. The researchers found that prevalence of obesity in the child increased with the number of parental stress factors, from 20% among parents who experienced no stress to 34% among parents with three or more stress factors. After adjusting the data for age, sex, place of birth and location, researchers found that parents who experienced three or more chronic stressors were twice as likely to have children with obesity than parents who experienced no stress.

"This research should encourage clinicians and healthcare practitioners to consider high stress levels as a warning sign for developing obesity not only in the adult patient, but also in the patient's entire family," said Margarita Teran-Garcia, MD, PhD, FTOS, At-Large Mexico Council member for The Obesity Society. "Although the study is cross-sectional, it suggests that special attention should be paid to adult patients who report experiencing high stress levels in this population, and providers are encouraged to consider behavioral counseling as one measure for obesity prevention and treatments."

Future research is needed to examine the causes and possible preventive strategies to address the parental stress and childhood obesity associations. Additionally, future research should explore these relationships in other populations.

To help providers integrate obesity treatment in their practices, The Obesity Society offers free tools as part of the Treat Obesity Seriously campaign, including a BMI pad, an office poster and a BMI-measurement wheel. Clinicians can sign up to receive these materials online.

http://www.sciencedaily.com/releases/2015/11/151104134036.htm