Adolescents' views about a proposed rewards intervention to promote healthy food choice in secondary school canteens

Using rewards may be an effective method to positively influence adolescent eating behaviour, but evidence regarding this approach is limited. The aim of this study was to explore young adolescent views about a proposed reward intervention associated with food choice in school canteens. Focus groups were held in 10 schools located in lower socioeconomic areas within Northern Ireland and involved 90 pupils aged 11-12 years (54 girls, 36 boys). Our findings indicated a high degree of acceptability for a reward scheme but there was major diversity in the type of rewards valued by pupils, largely defined by geographical area and socio-cultural differences. Pupils from rural areas tended to emphasize group-based and longer-term rewards, whereas pupils from urban-city schools tended to suggest individualistic and immediate rewards. The major factors influencing food choice were food price, value for money, taste and visual appearance. Pupils felt that factors outside of their control, such as being assigned to the second lunch sitting placed considerable constraints on their food choice. This research not only indicated a high degree of acceptability for a rewards-based intervention but also highlighted a number of socio-cultural and environmental factors that should be considered by researchers when developing such an intervention.

Knowledge Exchange, Spatial Analysis & Healthy Urban Environments (KESUE): Project Report

The Knowledge Exchange, Spatial Analysis and Healthy Urban Environments (KESUE) project has extended work previously undertaken by a QUB team of inter-disciplinary researchers engaged with the Physical Activity in the Regeneration of Connswater (PARC) project (Tully et al, 2013). The PARC project focussed on parts of East Belfast to assess the health impact of the Connswater Community Greenway. The KESUE project has aimed to extend some of the tools used initially in East Belfast so that they have data coverage of all of Belfast and Derry-Londonderry. The purpose of this has been to enable the development of evidence and policy tools that link features of the built environment with physical activity in these two cities. The project has used this data to help shape policy decisions in areas such as physical activity, park management, public transport and planning.

Working with a range of local partners who part-funded the project (City Councils in Belfast and Derry-Londonderry, Public Health Agency, Belfast Healthy Cities and Department of Regional Development), this project has mapped all the footpaths in the two cities (covering 37% of the NI population) and employed this to develop evidence used in strategies related to healthy urban planning. Using Geographic Information Systems (GIS), the footpath network has been used as a basis for a wide range of policy-relevant analyses including pedestrian accessibility to public facilities, site options for new infrastructure and assessing how vulnerable groups can access services such as pharmacies. Key outputs have been Accessibility Atlases and maps showing how walkability of the built environment varies across the two cities.

In addition to generating this useful data, the project included intense engagement with potential users of the research, which has led to its continued uptake in a number of policies and strategies, creating a virtuous circle of research, implementation and feedback. The project has proved so valuable to Belfast City Council that they have now taken on one of the researchers to continue the work in-house.

Young children's food brand knowledge. Early development and associations with television viewing and parent's diet

Brand knowledge is a prerequisite of children's requests and choices for branded foods. We explored the development of young children's brand knowledge of foods highly advertised on television - both healthy and less healthy. Participants were 172 children aged 3-5 years in diverse socio-economic settings, from two jurisdictions on the island of Ireland with different regulatory environments. Results indicated that food brand knowledge (i) did not differ across jurisdictions; (ii) increased significantly between 3 and 4 years; and (iii) children had significantly greater knowledge of unhealthy food brands, compared with similarly advertised healthy brands. In addition, (iv) children's healthy food brand knowledge was not related to their television viewing, their mother's education, or parent or child eating. However, (v) unhealthy brand knowledge was significantly related to all these factors, although only parent eating and children's age were independent predictors. Findings indicate that effects of food marketing for unhealthy foods take place through routes other than television advertising alone, and are present before pre-schoolers develop the concept of healthy eating. Implications are that marketing restrictions of unhealthy foods should extend beyond television advertising; and that family-focused obesity prevention programmes should begin before children are 3 years of age.

Let's talk about health: shoppers' discourse regarding health while food shopping

Objective: The present study aimed to examine the role of health in consumers’ food purchasing decisions through investigating the nature of people’s discourse regarding health while conducting their food shopping.

Design: The study employed the think-aloud technique as part of an accompanied shop. All mentions of health and terms relating to health were identified from the data set. Inductive thematic analysis was conducted to examine how health was talked about in relation to people’s food choice decisions.

Setting: Supermarkets in Dublin, Republic of Ireland and Belfast, Northern Ireland.

Subjects Participants: (n 50) were aged over 18 years and represented the main household shopper.

Results: Responsibility for others and the perceived need to illicit strict control to avoid ‘unhealthy’ food selections played a dominant role in how health was talked about during the accompanied shop. Consequently healthy shopping was viewed as difficult and effort was required to make the healthy choice, with shoppers relating to product-based inferences to support their decisions.

Conclusions: This qualitative exploration has provided evidence of a number of factors influencing the consideration of health during consumers’ food shopping. These results highlight opportunities for stakeholders such as public health bodies and the food industry to explore further ways to help enable consumers make healthy food choices.

Correlates of food choice in unemployed young people: The role of demographic factors, self-efficacy, food involvement, food poverty and physical activity

Associations between socio-demographic and psychological factors and food choice patterns were explored in unemployed young people who constitute a vulnerable group at risk of poor dietary health. Volunteers (N = 168), male (n = 97) and female (n = 71), aged 15–25 years were recruited through United Kingdom (UK) community-based organisations serving young people not in education training or employment (NEET). Survey questionnaire enquired on food poverty, physical activity and measured responses to the Food Involvement Scale (FIS), Food Self-Efficacy Scale (FSS) and a 19-item Food Frequency Questionnaire (FFQ). A path analysis was undertaken to explore associations between age, gender, food poverty, age at leaving school, food self-efficacy (FS-E), food involvement (FI) (kitchen; uninvolved; enjoyment), physical activity and the four food choice patterns (junk food; healthy; fast food; high fat). FS-E was strong in the model and increased with age. FS-E was positively associated with more
frequent choice of healthy food and less frequent junk or high fat food (having controlled for age, gender and age at leaving school). FI (kitchen and enjoyment) increased with age. Higher FI (kitchen) was associated with less frequent junk food and fast food choice. Being uninvolved with food was associated with
more frequent fast food choice. Those who left school after the age of 16 years reported more frequent physical activity. Of the indirect effects, younger individuals had lower FI (kitchen) which led to frequent junk and fast food choice. Females who were older had higher FI (enjoyment) which led to less frequent fast food choice. Those who had left school before the age of 16 had low food involvement (uninvolved) which led to frequent junk food choice. Multiple indices implied that data were a good fit to the model which indicated a need to enhance food self-efficacy and encourage food involvement in order to improve dietary health among these disadvantaged young people.

The influence of socio-demographic, psychological and knowledge-related variables alongside perceived cooking and food skills abilities in the prediction of diet quality in adults: a nationally representative cross-sectional study

Background: Interventions to increase cooking skills (CS) and food skills (FS) as a route to improving overall diet are popular within public health. This study tested a comprehensive model of diet quality by assessing the influence of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. The correspondence of two measures of diet quality further validated the Eating Choices Index (ECI) for use in quantitative research.
Methods: A cross-sectional survey was conducted in a quota-controlled nationally representative sample of 1049 adults aged 20–60 years drawn from the Island of Ireland. Surveys were administered in participants’ homes via computer-assisted personal interviewing (CAPI) assessing a range of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. Regression models were used to model factors influencing diet quality. Correspondence between 2 measures of diet quality was assessed using chi-square and Pearson correlations.
Results: ECI score was significantly negatively correlated with DINE Fat intake (r = -0.24, p < 0.001), and ECI score was significantly positively correlated with DINE Fibre intake (r = 0.38, p < 0.001), demonstrating a high agreement. Findings indicated that males, younger respondents and those with no/few educational qualifications scored significantly lower on both CS and FS abilities. The relative influence of socio-demographic, knowledge, psychological variables and CS and FS abilities on dietary outcomes varied, with regression models explaining 10–20 % of diet quality variance. CS ability exerted the strongest relationship with saturated fat intake (β = -0.296, p < 0.001) and was a significant predictor of fibre intake (β = -0.113, p < 0.05), although not for healthy food choices (ECI) (β = 0.04, p > 0.05).
Conclusion: Greater CS and FS abilities may not lead directly to healthier dietary choices given the myriad of other factors implicated; however, CS appear to have differential influences on aspects of the diet, most notably in relation to lowering saturated fat intake. Findings suggest that CS and FS should not be singular targets of interventions designed to improve diet; but targeting specific sub-groups of the population e.g. males, younger adults, those with limited education might be more fruitful. A greater understanding of the interaction of factors influencing cooking and food practices within the home is needed.

Modelling Future Coronary Heart Disease Mortality to 2030 in the British Isles

OBJECTIVE: Despite rapid declines over the last two decades, coronary heart disease (CHD) mortality rates in the British Isles are still amongst the highest in Europe. This study uses a modelling approach to compare the potential impact of future risk factor scenarios relating to smoking and physical activity levels, dietary salt and saturated fat intakes on future CHD mortality in three countries: Northern Ireland (NI), Republic of Ireland (RoI) and Scotland.

METHODS: CHD mortality models previously developed and validated in each country were extended to predict potential reductions in CHD mortality from 2010 (baseline year) to 2030. Risk factor trends data from recent surveys at baseline were used to model alternative future risk factor scenarios: Absolute decreases in (i) smoking prevalence and (ii) physical inactivity rates of up to 15% by 2030; relative decreases in (iii) dietary salt intake of up to 30% by 2030 and (iv) dietary saturated fat of up to 6% by 2030. Probabilistic sensitivity analyses were then conducted.

RESULTS: Projected populations in 2030 were 1.3, 3.4 and 3.9 million in NI, RoI and Scotland respectively (adults aged 25-84). In 2030: assuming recent declining mortality trends continue: 15% absolute reductions in smoking could decrease CHD deaths by 5.8-7.2%. 15% absolute reductions in physical inactivity levels could decrease CHD deaths by 3.1-3.6%. Relative reductions in salt intake of 30% could decrease CHD deaths by 5.2-5.6% and a 6% reduction in saturated fat intake might decrease CHD deaths by some 7.8-9.0%. These projections remained stable under a wide range of sensitivity analyses.

CONCLUSIONS: Feasible reductions in four cardiovascular risk factors (already achieved elsewhere) could substantially reduce future coronary deaths. More aggressive polices are therefore needed in the British Isles to control tobacco, promote healthy food and increase physical activity.

'Big, strong and healthy'. Young children's identification of food and drink that contribute to healthy growth

Growing awareness of the importance of healthy diet in early childhood makes it important to chart the development of children's understanding of food and drink. This study aimed to document young children's evaluation of food and drink as healthy, and to explore relationships with socioeconomic status, family eating habits, and children's television viewing. Data were gathered from children aged 3-5. years (. n=. 172) in diverse socioeconomic settings in Ireland, and from their parents. Results demonstrated that children had very high levels of ability to identify healthy foods as important for growth and health, but considerably less ability to reject unhealthy items, although knowledge of these increased significantly between ages 3 and 5. Awareness of which foods were healthy, and which foods were not, was not related to family socioeconomic status, parent or child home eating habits, or children's television viewing. Results highlighted the importance of examining young children's response patterns, as many of the youngest showed a consistent 'yes bias'; however, after excluding these responses, the significant findings remained. Findings suggest it is important to teach children about less healthy foods in the preschool years. © 2013 Elsevier Ltd.

Low-dose vitamin B-6 effectively lowers fasting plasma homocysteine in healthy elderly persons who are folate and riboflavin replete.

BACKGROUND: Current data suggest that physiologic doses of vitamin B-6 have no significant homocysteine-lowering effect. It is possible that an effect of vitamin B-6 was missed in previous trials because of a much greater effect of folic acid, vitamin B-12, or both. OBJECTIVE: The aim of this study was to investigate the effect of low-dose vitamin B-6 supplementation on fasting total homocysteine (tHcy) concentrations in healthy elderly persons who were made replete with folate and riboflavin. DESIGN: Twenty-two healthy elderly persons aged 63-80 y were supplemented with a low dose of vitamin B-6 (1.6 mg/d) for 12 wk in a randomized, double-blind, placebo-controlled trial after repletion with folic acid (400 microg/d for 6 wk) and riboflavin (1.6 mg/d for 18 wk); none of the subjects had a vitamin B-12 deficiency. RESULTS: Folic acid supplementation lowered fasting tHcy by 19.6% (P

Effect of chronic consumption of almonds on body weight in healthy humans

Small changes of diet may reduce CVD risk. One example is the inclusion of nuts. They are rich in fibre, unsaturated fatty acids and phytonutrients. However, their fat content and energy density raise concerns that chronic consumption will promote weight gain. Randomised intervention studies are required to evaluate whether this concern is well founded. This study's aim was to determine if the inclusion of a 1440 kJ serving of almonds in the daily diet results in positive energy balance, and body composition change. During a 23-week cross-over design study, participants were required to consume almonds for 10 weeks and were provided no advice on how to include them in their diet. For another 10 weeks (order counter-balanced), participants followed their customary diet and there was a 3-week washout between. The study group consisted of twenty women. Potential mechanisms of energy dissipation were measured. Ten weeks of daily almond consumption did not cause a change in body weight. This was predominantly due to compensation for the energy contained in the almonds through reduced food intake from other sources. Moreover, inefficiency in the absorption of energy from almonds was documented (P <0·05). No changes in resting metabolic rate, thermic effect of food or total energy expenditure were noted. A daily 1440 kJ serving of almonds, sufficient to provide beneficial effects on cardiovascular risk factors, may be included in the diet with limited risk of weight gain. Whether this can be generalised to other high-fat energy dense foods warrants evaluation.