February Blogspot - John

The issue of childhood obesity continues to be a prevalent concern facing the future of our nation’s health. According to the CDC, childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.

The consumption of sugar sweetened beverages (SSBs) as a role of excess weight gain continues to be a contributing factor and topic of research. Youth aged 2 to 19 years consume approximately 155 kcal per day from SSBs which is greater than two times the amount of calories from added sugar recommended by the American Heart Association (Riebl et. al). The time period of adolescence is a crucial period of development where we start to become more independent and begin to make more decisions for ourselves related to our food choices and health. Although children are beginning to become more autonomous at this age, they are still primarily dependent upon their parents financially and there is still a high level of parental influence when it comes to food and beverage choices. However, there is still much that is left to be understood about how adolescent health behaviors are influenced.

In the present study conducted by Rieb et. al (2016), a cross-sectional convenience sample of adolescents (n=100, 14 ± 0.2 yo) and parents (n=66, 46 ± 0.7 yo) were recruited as part of a larger, ongoing dietary assessment trial. The adolescents that participated in the study completed four separate 24-hour dietary recalls along with a TPB questionnaire at two separate visits. Consenting parents were required to complete a beverage intake questionnaire (BEVQ-15), the TPB tool, and Parent Response to Beverage Choice Questionnaire (Par-B-Q). Both groups completed additional anthropometric measuring at the initial visit. The researchers selected to test the Theory of Planned Behavior (TPB) to evaluate and predict adolescents’ and parents’ SSB consumption. They also sought to identify the most influential factors determining beverage choices and determine whether or not adolescent beverage choices are dependent upon parental reaction to their beverage choices.

The results from this study indicated that the TPB is shown to be an effective way to understand and predict adolescent and parent SSB consumption. Subjective norm was shown to most likely influence the adolescent’s decision to limit SSB intake; whereas parents that exhibited a high level of perception of control were most likely to limit SSB intake. Adolescents’ predicted SSB intake was highest when intentions to limit SSB intake were low and parents’ encouragement of SSB were high. The researchers suggest that this may indicate that adolescents are influenced by their parents when making decisions to drink SSBs. Additionally, more than 95% of the parents were mentioned to have discussed beverage choices with their child. Other factors such as peer influence and influence from other older or adult role models were also identified to potentially contribute to the adolescent’s decision as well.

In an interesting parallel research study conducted by Roberto et. al (2016), the influence of placing health warning labels on SSBs and how it relates to parent’s purchasing decision process is examined. Similar to using large text tobacco warnings that are associated with increased risk perceptions of the health harms of using tobacco products, these warning labels placed on SSBs are yet another strategy related to the goal of decreasing consumption. In this study, parents (n=2381) of children ages 6-11 participated in an online survey that randomly assigned them to one of six different conditions: (1) no warning label (control), (2) calorie label, or (3-6) 1 of 4 text versions of a warning or safety label related to the detrimental effects of drinking excess SSBs in contribution to obesity, diabetes, and tooth decay. Based upon the results from this study, the parents that were included in the health warning labels category chose significantly fewer SSBs than other groups. The participants in the study also strongly believed that health warning labels would help to change their beliefs about a beverage’s healthfulness and would encourage them to purchase fewer SSBs for their children.

Our daily beverage choices can have a significant impact upon our overall health and weight balance. SSBs provide little nutritional value or added satiety factor and it is important that we continue to educate both children and their parents about making appropriate beverage selections. Empowering others to make a more well-educated decision about their beverage choices and choosing to drink lower calorie beverages or more nutritious beverages such as 100% fruit juice or low-fat milk in place of SSBs is certainly a start. These research articles highlight the need for future intervention of dietetics professionals to address the SSB intake of our nation as a whole and create a positive change.

AND CE Article:
Riebl, S K., Macdougal, C., Hill, C., Estabrooks, P. A., Dunsmore, J. C., Savla, J. Davy, B. M. (2016). Beverage Choices of Adolescents and Their Parents Using the Theory of Planned Behavior: A Mixed Methods Analysis. Journal of the Academy of Nutrition and Dietetics, 116(2). http://www.andjrnl.org/article/S2212-2672%2815%2901624-X/abstract

Supplemental Article:
Roberto, C. A., Wong, D., Musicus, A., & Hammond, D. (2016). The Influence of Sugar-Sweetened Beverage Health Warning Labels on Parents Choices. Pediatrics, 137(2), 1-10. http://pediatrics.aappublications.org/content/early/2016/01/13/peds.2015-3185