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Restaurants are playing an increasingly important role in children’s dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants.
A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child’s gender, person ordering for the child and server interactions with the dining party. Interview data included: child’s age, restaurant visit frequency, timing of child’s decision making, and factors influencing decision making.
Ten independent, table-service restaurants in San Diego, CA, USA participated.
Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3–14 years).
Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children’s) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children’s menu.
Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants.
We assessed serum homocysteine (tHcy) and folate concentrations among US adolescents before and after fortification of cereal-grain products with folic acid, and associations with demographic, behavioural and physiological factors.
Observational study conducted among participants of a randomized trial.
The Child and Adolescent Trial for Cardiovascular Health (CATCH) study.
Adolescents (n 2445) in grades 8 (pre-fortification, mean age 14 years) and 12 (post-fortification, mean age 18 years).
Average serum concentrations of tHcy, folate and vitamin B6 increased by 17 %, 16 % and 14 %, respectively, while serum concentrations of vitamin B12 decreased by 11 % post-fortification. Folic acid fortification provided, on average, an additional intake of 118 μg folate/d. Male sex (P < 0·0001) and white race (P = 0·0008) were associated with significantly greater increases in tHcy concentration, while increases in BMI (P = 0·006) and serum folate concentration (P < 0·0001) were associated with significant decreases in tHcy concentration. Female sex (P < 0·0001), non-smoking (P < 0·0001), use of multivitamins (P < 0·0001) and higher dietary intake of folate (P = 0·001) were associated with significantly greater increases in serum folate concentrations. From grade 8 to grade 12, the upward age trend in serum tHcy concentration was uninterrupted in its course (P > 0·50); whereas serum folic acid concentration showed a downward trend that incurred a discrete jump upward (17 % higher; P < 0·0001) with fortification. These trends differed significantly for males v. females (P < 0·001 for interaction).
Fortification had a significant impact on improving folate status but not serum tHcy concentrations among US adolescents.
The purpose of this paper is to present longitudinal data on nutrient intakes of youth with emphases on differences by sex and race/ethnicity. Nutrients selected for examination are those implicated in chronic disease.
24-hour dietary recalls were collected from a cohort of third, fifth and eighth graders (n=1874).
Setting and subjects:
The sample is drawn from the Child and Adolescent Trial for Cardiovascular Health and includes students from California, Louisiana, Minnesota and Texas.
Across the total sample, nutrient intakes met recommended levels except that total fat, saturated fat and sodium consistently exceeded recommendations and calcium and iron intake of girls consistently fell short of recommended levels. Nutrient consumption between third and eighth grade differed by sex and race/ethnicity for a number of nutrients. In particular, females' intake of energy from total fat, calcium, iron, folic acid, vitamin A and vitamin D decreased over time relative to males' intakes, controlling for overall energy intake. Compared with the other ethnic/racial groups, African-American students increased their intake of energy from total fat and saturated fat over time.
Our results suggest that the diets of youth change over time, and negative trends are more common in females than in males and in African-American and Hispanics compared with Caucasian students. Nutrition education and intervention are needed throughout childhood and adolescence with an emphasis on choosing healthful foods. In addition, greater attention to differential opportunities and reinforcements for females and males, and Caucasian, Hispanic and African-American students is warranted.
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