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Nutrition and Healthy Lifestyle in Adolescents

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 April 2021) | Viewed by 51995

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Prof. Dr. Dawn K. Wilson

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Department of Psychology, College of Arts and Science, University of South Carolina, Columbia, SC, USA
Interests: Developing theory-based interventions for health promotion and obesity prevention in ethnic minority adolescents and their families. Her theoretical approach integrates family systems, motivation, and cognitive-behavioral approaches for understanding long-term health behavior change for improving diet and other lifestyle outcomes related to preventing obesity, diabetes, and cardiovascular disease in high-risk populations.

Special Issue Information

Stressors such as poverty and economic inequality interfere with adolescents’ capacity to develop healthy dietary habits. Many adolescents consume diets that are high in fat intake and processed sugars, and relatively low in fruits and vegetables, fiber, and essential macronutrients. Thus, this increases their risk for develop life threatening chronic diseases such as obesity, diabetes, metabolic syndrome, and cardiovascular disease in early adulthood. These conditions are even more prevalent among adolescents who live in neighborhoods of concentrated disadvantage and who lack the resources, family support, and environments to promote engagement in healthy lifestyles. This Special Issue takes a close look at the types of programs/interventions and psychosocial influences that may be most likely to promote health dietary intake in adolescents through behavioral lifestyle changes. Past research shows that multiple systems of influence shape adolescents’ capacity for engaging in healthful eating and long-term lifestyles, including motivational strategies, behavioral approaches, positive parenting practices, and socioecological approaches. Thus, in this Special Issue we highlight a series of papers that are both cross sectional and longitudinal, that build the evidence base to support important behavioral lifestyle approaches for creating long-term dietary improvements in adolescents and especially among those who may be at high risk for health inequities.

Prof. Dr. Dawn K. Wilson
Guest Editor

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Keywords

adolescence
nutrition
lifestyle
dietary intake
psychosocial factors
interventions
dietary behaviour
diet modification
social factors
environmental factors
parenting factors

Published Papers (11 papers)

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Research

18 pages, 309 KiB

Open AccessArticle

A Qualitative Study of Stress and Coping to Inform the LEADS Health Promotion Trial for African American Adolescents with Overweight and Obesity

by Mary Quattlebaum, Colby Kipp, Dawn K. Wilson, Allison Sweeney, Haylee Loncar, Asia Brown, Sydney Levine and Nicole Zarrett

Nutrients 2021, 13(7), 2247; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072247 - 29 Jun 2021

Cited by 6 | Viewed by 2652

Abstract

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70–0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

19 pages, 1645 KiB

Open AccessArticle

Healthy Food on Instagram Social Network: Vegan, Homemade and Clean Eating

by Ladislav Pilař, Lucie Kvasničková Stanislavská, Roman Kvasnička, Richard Hartman and Ivana Tichá

Nutrients 2021, 13(6), 1991; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061991 - 09 Jun 2021

Cited by 22 | Viewed by 13092

Abstract

Social media platforms have become part of many people’s lives. Users are spending more and more time on these platforms, creating an active and passive digital footprint through their interaction. This footprint has high research potential in many research areas because understanding people’s communication on social media is essential in understanding their values, attitudes, experiences and behaviors. Researchers found that the use of social networking sites impacts adolescents’ eating behavior. If we define adolescents as individuals between ages 10 and 24 (WHO’s definition), 76% of USA young people at age 18–⁠24 use Instagram, so the Instagram social network analysis is important for understanding young people’s expressions in the context of healthy food. This study aims to identify the main topic associated with healthy food on the Instagram social network via hashtag and community analysis based on 2,045,653 messages created by 427,936 individual users. The results show that users most associate Healthy food with healthy lifestyle, fitness, weight loss and diet. In terms of food, these are foods that are Vegan, Homemade, Clean and Plant-based. Given that young people change their behavior in relation to people’s behavior on social networks, it is possible to use this data to predict their future association with healthy food characteristics. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

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16 pages, 465 KiB

Open AccessArticle

Moderating Effects of Parental Feeding Practices and Emotional Eating on Dietary Intake among Overweight African American Adolescents

by Mary Quattlebaum, Dawn K. Wilson, Allison M. Sweeney and Nicole Zarrett

Nutrients 2021, 13(6), 1920; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061920 - 03 Jun 2021

Cited by 6 | Viewed by 2247

Abstract

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child’s weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction (B = −0.331, SE = 0.162, p = 0.043), and concern (B = −0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

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11 pages, 222 KiB

Open AccessArticle

Effect of a High-Intensity Dietary Intervention on Changes in Dietary Intake and Eating Pathology during a Multicomponent Adolescent Obesity Intervention

by Hollie A. Raynor, Suzanne E. Mazzeo, Jessica Gokee LaRose, Elizabeth L. Adams, Laura M. Thornton, Laura J. Caccavale and Melanie K. Bean

Nutrients 2021, 13(6), 1850; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061850 - 28 May 2021

Cited by 9 | Viewed by 2808

Abstract

Concerns remain about dietary changes during pediatric obesity treatment and eating pathology, which have not been investigated. This secondary data analysis from a randomized clinical trial examined associations between adolescents’ changes in energy intake and diet quality during obesity treatment with post-treatment eating pathology. Adolescents (N = 82: 13.7 ± 1.2 y, 34.9 ± 7.0 kg/m², 63.4% female, 46.3% black) received TEENS+, a 4-month multicomponent intervention. TEENS+ provided individualized dietary goals (1200–1800 kcal/day; number of “Go” foods/day (low-energy, high-nutrient-dense foods)). At 0 and 4 months, 3-day food records assessed energy intake and diet quality (Healthy Eating Index 2015 (HEI-2015)). Two HEI-2015 subscores were created: components to increase (increase), and components to limit (decrease). The Eating Disorder Examination Questionnaire measured eating pathology (total score and subscales: restraint; and eating, weight, and shape concern). Corrected p-values are reported as q-values. Energy intake decreased (−292 ± 418 kcal/day; q < 0.001), while diet quality improved during treatment (total HEI-2015 (4.5 ± 15.1; q = 0.034) and increase (3.3 ± 9.4; q = 0.011)). Restraint increased (+0.6 ± 1.4; q < 0.001), whereas shape (−0.5 ± 1.3; q = 0.004) and weight (−0.5 ± 1.4; q = 0.015) concerns decreased. Greater decreases in energy intake were associated with greater restraint post-treatment (F = 17.69; q < 0.001). No other significant associations were observed. Changes in adolescents’ dietary intake during obesity treatment were unrelated to increased shape, weight, or eating concerns post-treatment. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

15 pages, 1374 KiB

Open AccessArticle

The Moderating Effects of the Families Improving Together (FIT) for Weight Loss Intervention and Parenting Factors on Family Mealtime in Overweight and Obese African American Adolescents

by Dawn K. Wilson, Allison M. Sweeney, Mary Quattlebaum, Haylee Loncar, Colby Kipp and Asia Brown

Nutrients 2021, 13(6), 1745; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13061745 - 21 May 2021

Cited by 7 | Viewed by 2164

Abstract

Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child’s weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent’s weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

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14 pages, 249 KiB

Open AccessArticle

Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity

by Bridget K. Biggs, Dawn K. Wilson, Mary Quattlebaum, Seema Kumar, Alicia Meek and Teresa B. Jensen

Nutrients 2021, 13(5), 1729; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13051729 - 20 May 2021

Cited by 2 | Viewed by 3210

Abstract

The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated a need for further understanding of these weight-loss motivators in the context of SDT. The current study findings highlight the importance of addressing motivational factors and family influences in research and practice related to promoting healthy dietary habits and weight management strategies among adolescents with obesity. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

15 pages, 1060 KiB

Open AccessArticle

Social Inequalities in Changes in Diet in Adolescents during Confinement Due to COVID-19 in Spain: The DESKcohort Project

by Alicia Aguilar-Martínez, Marina Bosque-Prous, Helena González-Casals, Ester Colillas-Malet, Susanna Puigcorbé, Laura Esquius and Albert Espelt

Nutrients 2021, 13(5), 1577; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13051577 - 08 May 2021

Cited by 18 | Viewed by 6670

Abstract

Adolescence is a critical period in the consolidation of healthy lifestyles that can last into adulthood. To analyze changes in food consumption and eating behaviors in high-school adolescents during the first confinement, a cross-sectional study was conducted at the end of confinement in Spain. Changes in the frequency or quantity of consumption of different types of food and food-related behaviors were analyzed. Socioeconomic and health-related variables were also considered. To determine whether dietary changes were related to socioeconomic position (SEP), Poisson regression models with robust variance were estimated. Overall, there were some changes towards a healthier diet such as an increase in fruit consumption (38.9%) and a decrease in the consumption of soft drinks (49.8%), sweets and pastries (39.3%), and convenience foods (49.2%). Some changes, however, were related to less healthy behaviors, such as a more irregular pattern of meal distribution (39.9%) or an increase in snacking between meals (56.4%). Changes towards less healthy eating were also related to students’ SEP. The risk of worsening the diet was found to be 21% higher in adolescents from a more disadvantaged SEP. Future public policies could be adapted to avoid increasing nutritional and health inequalities. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

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12 pages, 991 KiB

Open AccessArticle

Breakfast: A Crucial Meal for Adolescents’ Cognitive Performance According to Their Nutritional Status. The Cogni-Action Project

by Humberto Peña-Jorquera, Valentina Campos-Núñez, Kabir P. Sadarangani, Gerson Ferrari, Carlos Jorquera-Aguilera and Carlos Cristi-Montero

Nutrients 2021, 13(4), 1320; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13041320 - 16 Apr 2021

Cited by 16 | Viewed by 7545

Abstract

This study aimed to determine whether pupils who have breakfast just before a cognitive demand, do not regularly skip breakfast, and consume a high-quality breakfast present higher cognitive performance than those who do not; furthermore, to establish differences according to their nutritional status. In this study, 1181 Chilean adolescents aged 10–14 years participated. A global cognitive score was computed through eight tasks, and the body mass index z-score (BMIz) was calculated using a growth reference for school-aged adolescents. The characteristics of breakfast were self-reported. Analyses of covariance were performed to determine differences in cognitive performance according to BMIz groups adjusted to sex, peak height velocity, physical fitness global score, and their schools. A positive association was found in adolescents’ cognitive performance when they had breakfast just before cognitive tasks, did not regularly skip breakfast, presented at least two breakfast quality components, and included dairy products. No significant differences were found between breakfast components, including cereal/bread and fruits/fruit juice. Finally, pupils who were overweight/obese who declared that they skipped breakfast regularly presented a lower cognitive performance than their normal-BMIz peers. These findings suggest that adolescents who have breakfast just prior to a cognitive demand and regularly have a high quality breakfast have better cognitive performance than those who do not. Educative nutritional strategies should be prioritized, especially in “breakfast skippers” adolescents living with overweight/obesity. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

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13 pages, 294 KiB

Open AccessArticle

Association of Dietary Patterns with Weight Status and Metabolic Risk Factors among Children and Adolescents

by Seulki Oh, So Yeong Lee, Do-Yeon Kim, Sarah Woo, YoonMyung Kim, Hye-Ja Lee, Han Byul Jang, Sang Ick Park, Kyung Hee Park and Hyunjung Lim

Nutrients 2021, 13(4), 1153; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13041153 - 31 Mar 2021

Cited by 6 | Viewed by 2879

Abstract

Unhealthy dietary patterns are associated with obesity in children and adolescents. However, few studies have investigated the relationships between dietary patterns and obesity-related metabolic disorders among Asians. We identified dietary patterns in children and adolescents and examined the associations between these patterns and obesity, insulin resistance, and metabolic syndrome in South Korea. This study is a cross-sectional design. We used baseline data from an intervention study of 435 Korean children and adolescents aged 6–17 years. Insulin resistance was assessed as HOMA-IR ≥ 2.6. Metabolic syndrome was diagnosed by cardiovascular disease risk factor clustering. Dietary intakes were estimated using 3-day food records. Factor analysis was used to obtain dietary patterns, and we examined the associations between dietary patterns and obesity-related markers adjusted for potential covariates. Three dietary patterns were identified as fast food and soda (FFS), white rice and kimchi (WRK), and oil and seasoned vegetable (OSV) patterns. Compared with participants in the lower intake of FFS pattern, those in the top intake were associated with a higher waist circumference (WC) (β = 1.55), insulin level (β = 1.25), and body mass index (BMI) (β = 0.53) and it was positively associated with HOMA-IR ≥ 2.6 (OR = 2.11; 95% CI: 1.227–3.638) (p < 0.05). WRK pattern was associated with lower weight and higher HDL cholesterol, and the OSV pattern was associated with a lower weight, WC, and insulin level (p < 0.05). The FFS pattern showed a positive relation with WC, serum insulin, and BMI, and the other two dietary patterns indicated a preventive effect of those parameters. The FFS pattern was associated with significantly elevated insulin resistance among children and adolescents. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

19 pages, 2697 KiB

Open AccessArticle

Fast Eating Is Associated with Increased BMI among High-School Students

by Petter Fagerberg, Evangelia Charmandari, Christos Diou, Rachel Heimeier, Youla Karavidopoulou, Penio Kassari, Evangelia Koukoula, Irini Lekka, Nicos Maglaveras, Christos Maramis, Ioannis Pagkalos, Vasileios Papapanagiotou, Katerina Riviou, Ioannis Sarafis, Athanasia Tragomalou and Ioannis Ioakimidis

Nutrients 2021, 13(3), 880; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13030880 - 09 Mar 2021

Cited by 12 | Viewed by 4362

Abstract

Fast self-reported eating rate (SRER) has been associated with increased adiposity in children and adults. No studies have been conducted among high-school students, and SRER has not been validated vs. objective eating rate (OBER) in such populations. The objectives were to investigate (among high-school student populations) the association between OBER and BMI z-scores (BMIz), the validity of SRER vs. OBER, and potential differences in BMIz between SRER categories. Three studies were conducted. Study 1 included 116 Swedish students (mean ± SD age: 16.5 ± 0.8, 59% females) who were eating school lunch. Food intake and meal duration were objectively recorded, and OBER was calculated. Additionally, students provided SRER. Study 2 included students (n = 50, mean ± SD age: 16.7 ± 0.6, 58% females) from Study 1 who ate another objectively recorded school lunch. Study 3 included 1832 high-school students (mean ± SD age: 15.8 ± 0.9, 51% females) from Sweden (n = 748) and Greece (n = 1084) who provided SRER. In Study 1, students with BMIz ≥ 0 had faster OBER vs. students with BMIz < 0 (mean difference: +7.7 g/min or +27%, p = 0.012), while students with fast SRER had higher OBER vs. students with slow SRER (mean difference: +13.7 g/min or +56%, p = 0.001). However, there was “minimal” agreement between SRER and OBER categories (κ = 0.31, p < 0.001). In Study 2, OBER during lunch 1 had a “large” correlation with OBER during lunch 2 (r = 0.75, p < 0.001). In Study 3, fast SRER students had higher BMIz vs. slow SRER students (mean difference: 0.37, p < 0.001). Similar observations were found among both Swedish and Greek students. For the first time in high-school students, we confirm the association between fast eating and increased adiposity. Our validation analysis suggests that SRER could be used as a proxy for OBER in studies with large sample sizes on a group level. With smaller samples, OBER should be used instead. To assess eating rate on an individual level, OBER can be used while SRER should be avoided. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

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14 pages, 886 KiB

Open AccessArticle

Effects of a Rice-Based Diet in Korean Adolescents Who Habitually Skip Breakfast: A Randomized, Parallel Group Clinical Trial

by Hyun-Suk Kim, Su-Jin Jung, Eun-Gyung Mun, Myung-Sunny Kim, Soo-Muk Cho and Youn-Soo Cha

Nutrients 2021, 13(3), 853; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13030853 - 05 Mar 2021

Cited by 3 | Viewed by 2761

Abstract

During adolescence, healthy eating habits are important, and regular meal intake has an especially positive effect on future health. However, the rate of skipping breakfast has gradually increased. Therefore, this study was conducted to evaluate the positive effects of a rice-based breakfast in Korean adolescents who usually skip breakfast. In this open parallel-group, randomized controlled trial, 105 middle and high school students aged 12–18 years who habitually skipped breakfast were recruited. They were randomly divided into three groups: the rice meal group (RMG, n = 35), wheat meal group (WMG, n = 35), and general meal group (GMG, n = 35). The RMG and WMG received a rice-based breakfast and wheat-based breakfast, respectively, for 12 weeks. After a 12-week intervention, the body fat mass (p < 0.05) and body mass index (p < 0.05) in the RMG were significantly lower than those in the other two groups, and the stress score was also significantly lower in the RMG (p < 0.05). Moreover, after the intervention, in the RMG only, compared to baseline levels, the relative theta (RT) wave activity significantly decreased in eight electrode sites, and the relative alpha (RA) wave activity increased significantly. Eating a rice-based breakfast has positive effects on body fat accumulation and cognitive function in Korean adolescents. Furthermore, a rice-based breakfast plan that is preferred by adolescents should be developed to assist them in developing healthy eating habits. Full article

(This article belongs to the Special Issue Nutrition and Healthy Lifestyle in Adolescents)

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