International Journal of Behavioral Nutrition and Physical Activity最新文献

{"title":"Physical activity calorie equivalent (PACE) food labelling on discretionary foods in secondary school canteens in England: an efficacy cluster randomised controlled trial.","authors":"Natalia Iris, Fehmidah Munir, Amanda J Daley","doi":"10.1186/s12966-025-01710-1","DOIUrl":"10.1186/s12966-025-01710-1","url":null,"abstract":"<p><strong>Background: </strong>Schools do not typically implement food labelling in their canteens, therefore young people may not be given nutrition information on which to make their food choices. One way of expressing the energy/calorie content of foods is to provide this information in the form of physical activity calorie equivalent (PACE) food labelling, which may help to contextualise the energy content of food/drinks to young people in a simple and understandable way. The study aimed to assess the usefulness of implementing PACE labelling in school canteens and to conduct a process evaluation of using this type of food labelling with young people.</p><p><strong>Methods: </strong>A parallel two-armed cluster RCT to evaluate a PACE labelling intervention in secondary schools (typically, adolescents aged 11 and above) in England was conducted. Schools were randomised on a 2:1 basis to display PACE labelling by cakes/sweet biscuits in canteens or to continue with usual practice (comparator) for up to six weeks. There was a baseline period of no PACE labelling for a minimum of four weeks in all schools. Anonymised purchase data were provided by schools and analysed both descriptively and using analysis of covariance.</p><p><strong>Results: </strong>Eighteen schools in England were randomised and 11 participated (6 intervention and 5 comparators). Analyses are based on ~ 99,000 purchase transactions of cakes and biscuits from participating schools. There was a reduction in cake/biscuit purchases in intervention schools versus comparators of ~ 11 items per week per 100 students at follow-up (adjusted mean difference = -0.112, 95% CI [-0.179 to -0.045], p = 0.005). Intervention schools did not report major difficulties with the implementation of PACE labelling.</p><p><strong>Conclusions: </strong>PACE labelling appeared to reduce cakes/biscuit purchases by a small amount and may be a useful approach to reducing the purchase of discretionary foods in young people in the school environment. The implementation of PACE labelling appeared feasible for some schools, but other schools had reservations about the adverse effects this type of labelling may have on the well-being of students.</p><p><strong>Trial registration: </strong>Registered on ClinicalTrials.gov on 18th November 2022. NCT05623618, https://clinicaltrials.gov/study/NCT05623618 .</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"24"},"PeriodicalIF":5.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing stepped wedge trials to evaluate physical activity interventions in schools: methodological considerations.","authors":"Ruth Salway, Danielle House, Simona Kent-Saisch, Robert Walker, Lydia Emm-Collison, Alice Porter, David R Lubans, Michael Beets, Frank de Vocht, Russell Jago","doi":"10.1186/s12966-025-01720-z","DOIUrl":"10.1186/s12966-025-01720-z","url":null,"abstract":"<p><strong>Background: </strong>In a stepped wedge design, schools are randomised to a sequence of measurements, with each sequence transitioning to intervention status at a different time. There are several advantages to such designs, including increased statistical power, logistical benefits and the ability to explore change over time. However, stepped wedge designs have not previously been used to evaluate school-based physical activity interventions in children. This paper aimed to explore the feasibility of this design, by identifying school constraints, balancing these with statistical considerations and exploring the power of this chosen design under different scenarios.</p><p><strong>Methods: </strong>We conducted three interlinked studies, with the results from one informing the next. Study 1 was a qualitative study to identify school constraints that inform the choice of stepped wedge configuration. Study 2 used simulation to choose a configuration that balanced these school constraints and statistical properties. Study 3 explored the statistical power for the chosen design for different school and pupil sample sizes, using an open cohort design (a mixture of new and repeated pupils).</p><p><strong>Results: </strong>School staff considered the proposed data collection feasible, and supported a maximum of 3-4 measurements per year and an implementation period of one school term. Study 2 therefore considered incomplete stepped wedge designs with five steps. Statistically, the best designs had a mix of control and intervention measurements in terms 2-4 and a spread of measurements across the whole study duration. Power depended on a combination of the overall recruitment rate and the retention rate. For 20 schools with an eligible class size of 30 pupils, we would be able to detect a 6 min difference in average weekday moderate-to-vigorous physical activity with 80% power, provided there were > 50% of pupils measured per school at each time. A similarly powered cluster randomised controlled trial would require 42 schools.</p><p><strong>Conclusion: </strong>Stepped wedge trials are a viable design for evaluating school-based physical activity interventions. Incomplete designs, where not all schools are measured at each point, offer the flexibility to work around practical constraints.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"22"},"PeriodicalIF":5.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BMI or not to BMI? debating the value of body mass index as a measure of health in adults.","authors":"Carmen Byker Shanks, Meg Bruening, Amy L Yaroch","doi":"10.1186/s12966-025-01719-6","DOIUrl":"10.1186/s12966-025-01719-6","url":null,"abstract":"<p><p>Body mass index (BMI) is used across public health to calculate height to weight ratio and translate into weight status. Whether BMI is appropriate as an individual- or population-level health measure for adults is debated. BMI is a cost-effective and feasible metric to establish health risk. Yet, BMI's historical underpinnings, weight categories, usefulness as clinical diagnostic measure, and application across population subgroups has called the measurement tool into question. At the annual ISBNPA meeting in June 2023, the co-authors engaged in a debate session on the topic. This paper presents the complexity of arguments for or against BMI as a measurement tool and proposes its evolution to support whole-person health.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"23"},"PeriodicalIF":5.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is meeting 24-hour movement guidelines associated with a lower risk of frailty among adults?","authors":"Yuhang Liu, Siyao Gao, Zhigang Dou, Zhen Chen, Jialing Tang","doi":"10.1186/s12966-025-01722-x","DOIUrl":"10.1186/s12966-025-01722-x","url":null,"abstract":"<p><strong>Background: </strong>The relationship between 24-hour (24-h) movement guidelines and frailty remains unclear. We aimed to investigate the associations between meeting 24-h movement guidelines and frailty and to conduct secondary analyses by age, gender, and ethnicity.</p><p><strong>Methods: </strong>In this study, we extracted data from the National Health and Nutrition Examination Survey (2007-2018) database. A total of 5,726 participants (50.25 ± 0.31 years) were included in this analysis, representing 38,240,356 noninstitutionalized U.S.</p><p><strong>Individuals: </strong>Three 24-h movement behaviors, namely, physical activity, sedentary behavior (SB), and sleep, were self-reported using the standardized questionnaires. The 49-item frailty index was used to measure frailty. Multivariable logistic regression models and trend tests were used to examine the associations between meeting 24-h movement guidelines and frailty. Sensitivity analyses were also conducted to ensure the robustness of our results.</p><p><strong>Results: </strong>The total age-adjusted prevalence of frailty was 30.5%. In the fully adjusted model, compared with not meeting any of the 24-h movement guidelines, the adjusted odds ratios (AORs) of frailty were 0.786 (95% CI: 0.545, 1.133), 1.161 (95% CI: 0.787, 1.711), and 0.915 (95% CI: 0.616, 1.358) for participants meeting only moderate to vigorous physical activity (MVPA), only SB, and only sleep guidelines, respectively, but no statistically significant differences were observed (all P values > 0.05). Participants who met the SB + sleep guidelines (AOR = 0.613, 95% CI: 0.423, 0.887), MVPA + sleep guidelines (AOR = 0.389, 95% CI: 0.255, 0.593), and MVPA + SB guidelines (AOR = 0.555, 95% CI: 0.383, 0.806) presented a significantly lower risk of frailty by 39%, 61%, and 45%, respectively. Meeting all 3 guidelines (AOR = 0.377, 95% CI: 0.264, 0.539) and meeting 2 guidelines (AOR = 0.527, 95% CI: 0.377, 0.736) were associated with a lower risk of frailty (P value < 0.001), showing a linear trend (P for trend < 0.001). The strength of these associations varied somewhat by age, gender, and ethnicity.</p><p><strong>Conclusions: </strong>Significant associations between the 24-h movement guidelines and frailty were observed among U.S. adults. Future studies are warranted to examine the causality and trajectory of these associations.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"21"},"PeriodicalIF":5.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communicating physical activity messages with adolescents: what works? A scoping review with stakeholder consultation.","authors":"Caera L Grady, Elaine Murtagh, Kwok Ng, Enrique García Bengoechea, Catherine B Woods","doi":"10.1186/s12966-025-01717-8","DOIUrl":"10.1186/s12966-025-01717-8","url":null,"abstract":"<p><strong>Background: </strong>Global levels of adolescents' physical inactivity are cause for concern, despite the well-documented health benefits of physical activity (PA). Addressing the messaging of PA is one approach to improve PA knowledge. While increased knowledge does not necessarily lead to behavior change, physically active students have better knowledge of the health benefits of PA. Recently, researchers have highlighted the need for an effective communication strategy for PA messages. This review aimed to summarize the state of the available evidence about the operationalization of communicating PA messages, the evaluation, and effectiveness of PA messages.</p><p><strong>Methods: </strong>The Levac six steps and Joanna Briggs Institute methodological guidance for scoping reviews were followed. Five databases were searched up until April 8th 2024. Both title and abstract and full-text screening were piloted whereby 10% of the total articles were double-screened and the remainder were completed by CG. Data were extracted and a data-based convergent synthesis design was used following qualitative synthesis methods. Finally, a consultation with key stakeholders was held to confirm the findings concerning practical relevance.</p><p><strong>Results: </strong>A total of 19,412 articles were identified from searches, 94 full texts were included in the final analysis, corresponding to 80 individual studies. The evidence confirms that there are many factors to consider when communicating PA messages and evaluating their effectiveness. Inconsistencies exist regarding the timing and frequency of message delivery and the evaluation of effective communication. When communicating PA with adolescents, messages commonly focus on the benefits of PA and strategies to overcome barriers and are commonly delivered in the school setting by researchers or school stakeholders i.e. teachers, peers. Messages should be concise, positively framed, support adolescent autonomy, and utilize different messaging platforms and techniques to avoid staleness.</p><p><strong>Conclusions: </strong>There is a lack of a standardized approach to communicating PA messages with adolescents making evaluation and comparison challenging. Future research should focus on developing guidance to facilitate the effective communication of PA messages with adolescents.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"20"},"PeriodicalIF":5.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing co-purchased food products with soda, fresh fruits, and fresh vegetables using loyalty card purchasing data in Montréal, Canada, 2015-2017.","authors":"Hiroshi Mamiya, Kody Crowell, Catherine L Mah, Amélie Quesnel-Vallée, Aman Verma, David L Buckeridge","doi":"10.1186/s12966-024-01701-8","DOIUrl":"10.1186/s12966-024-01701-8","url":null,"abstract":"<p><strong>Background: </strong>Foods are not purchased in isolation but are normally co-purchased with other food products. The patterns of co-purchasing associations across a large number of food products have been rarely explored to date. Knowledge of such co-purchasing patterns will help evaluate nutrition interventions that might affect the purchasing of multiple food items while providing insights about food marketing activities that target multiple food items simultaneously.</p><p><strong>Objective: </strong>To quantify the association of food products purchased with each of three food categories of public health importance: soda, fresh fruits and fresh vegetables using Association Rule Mining (ARM) followed by longitudinal regression analysis.</p><p><strong>Methods: </strong>We obtained transaction data containing grocery purchasing baskets (lists of purchased products) collected from loyalty club members in a major supermarket chain between 2015 and 2017 in Montréal, Canada. There were 72 food groups in these data. ARM was applied to identify food categories co-purchased with soda, fresh fruits, and fresh vegetables. A subset of co-purchasing associations identified by ARM was further tested by confirmatory logistic regression models controlling for potential confounders of the associations and correlated purchasing patterns within shoppers.</p><p><strong>Results: </strong>We analyzed 1,692,716 baskets. Salty snacks showed the strongest co-purchasing association with soda (Relative Risk [RR] = 2.07, 95% Confidence Interval [CI]: 2.06, 2.09). Sweet snacks/candies (RR = 1.73, 95%CI: 1.72-1.74) and juices/drinks (RR:1.71, 95%CI:1.71-1.73) also showed strong co-purchasing associations with soda. Fresh vegetables and fruits showed considerably different patterns of co-purchasing associations from those of soda, with pre-made salad and stir fry showing a strong association (RR = 3.78, 95% CI:3.74-3.82 for fresh vegetables and RR = 2.79, 95%CI:2.76-2.81 for fresh fruits). The longitudinal regression analysis confirmed these associations after adjustment for the confounders, although the associations were weaker in magnitude.</p><p><strong>Conclusions: </strong>Quantifying the interdependence of food products within shopping baskets provides novel insights for developing nutrition surveillance and interventions targeting multiple food categories while motivating research to identify drivers of such co-purchasing. ARM is a useful analytical approach to identify such cross-food associations from retail transaction data when combined with confirmatory regression analysis to adjust for confounders of such associations.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"19"},"PeriodicalIF":5.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioecological correlates of parental lifestyle patterns during the antenatal period.","authors":"M Lecorguillé, M C Schipper, A M Aubert, A Douglass, M Tafflet, M Vrijheid, C Kelleher, C M Phillips, R Gaillard, Barbara Heude, Sandrine Lioret","doi":"10.1186/s12966-024-01697-1","DOIUrl":"10.1186/s12966-024-01697-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore socioecological correlates of parental lifestyle patterns during pregnancy, an overlooked topic except for individual socioeconomic factors.</p><p><strong>Methods: </strong>We used data from three European mother-offspring cohorts participating in the EndObesity Consortium [EDEN, France, n = 1,962; Generation R, the Netherlands, n = 8,765; and Lifeways, Ireland, n = 932]. In previous principal component analysis, we identified two separate parental lifestyle patterns in pregnancy, characterised by: 1) \"high parental smoking, poor-quality maternal diet, and low physical activity\"; and 2) \"low parental body mass index (BMI) and high gestational weight gain (GWG)\". Applying the socioecological model, we conducted multivariable linear regression analyses on lifestyle pattern scores (outcomes), first including parental socioeconomic and sociodemographic characteristics (block 1), then the urban environment (block 2), and finally psychosocial factors and health-care access (block 3).</p><p><strong>Results: </strong>Older parents, those born abroad, or with high SEP had lower scores for the first lifestyle pattern. Conversely, multiparous mothers, those with suboptimal health insurance coverage, or who did not attend parenting preparation sessions followed that pattern more closely. Multiparous mothers, parents with a low SEP, or living in highly deprived areas had lower scores on the second pattern, contrary to those exposed to high population density or living in a neighbourhood with high facility richness.</p><p><strong>Conclusions: </strong>Higher SEP, a foreign birthplace, wealthier neighbourhoods, and attendance at antenatal parenting preparation sessions were associated with healthier parental lifestyles during pregnancy. These potential facilitators should be considered for inclusion in tailored family-based health promotion interventions during the perinatal period.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"18"},"PeriodicalIF":5.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of emotional overeating: a longitudinal twin study from toddlerhood to early adolescence.","authors":"Vaishnavi K Madhavan, Zeynep Nas, Jacqueline Blissett, Clare Llewellyn, Moritz Herle","doi":"10.1186/s12966-025-01714-x","DOIUrl":"10.1186/s12966-025-01714-x","url":null,"abstract":"<p><strong>Background: </strong>Previous research has estimated the genetic and environmental contribution to individual differences in emotional overeating in toddlerhood and early childhood. However, little is known how this behaviour tracks into adolescence. Here, we aimed to replicated previous work and examine the aetiology of stability and change in emotional overeating across time.</p><p><strong>Methods: </strong>Data were from the UK Gemini Twin Study, which includes 2402 twin pairs born in 2007. Parents reported on children's emotional overeating at 16 months (n = 3784), 5 years (n = 2064), and 12 years (n = 964), using the Emotional Overeating Scale of the Child Eating Behaviour Questionnaire (CEBQ) at 5 and 12 years, and the CEBQ-T (toddler version) at 16 months. A Cholesky Decomposition twin model was used to quantify the additive genetic, shared, and nonshared environmental influences on emotional overeating at each time point, partitioned into aetiological effects unique to each age and those carried across time.</p><p><strong>Results: </strong>Additive genetic effects were minimal at 16 months and 5 years (9% and 7% respectively) but increased to 34% by 12 years. Shared environmental effects explained the majority of variance in emotional overeating at all three time points, but significantly less at 12 years (41%) than earlier (> 81%). The longitudinal phenotypic associations (r = 0.23-0.43) were explained by the shared environment.</p><p><strong>Conclusion: </strong>The shared environment plays a major role in the development of emotional overeating in early life. Most aetiological influences on emotional overeating were unique to each age, indicating the need for family-based interventions targeted to each developmental stage.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"17"},"PeriodicalIF":5.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parents' use of coercive and indulgent feeding practices for children with avid eating behaviour: an Ecological Momentary Assessment study.","authors":"Abigail Pickard, Katie L Edwards, Claire Farrow, Emma Haycraft, Moritz Herle, Clare Llewellyn, Helen Croker, Alice Kininmonth, Jacqueline Blissett","doi":"10.1186/s12966-025-01715-w","DOIUrl":"10.1186/s12966-025-01715-w","url":null,"abstract":"<p><strong>Background: </strong>Children with avid eating behaviour display high food responsiveness, high emotional overeating and low sensitivity to fullness; behaviours which may increase the risk of obesity and are challenging for parents to manage. This study explores the situational predictors of coercive or indulgent feeding practices among parents of children with avid eating behaviours using Ecological Momentary Assessment (EMA).</p><p><strong>Methods: </strong>The study involved 109 parents of 3-5-year-old children exhibiting avid eating behaviour. Over 10 days, participants completed EMA surveys via a mobile app to report on their mood, stress, feeding goals, and feeding practices during eating occasions. Multilevel modelling was used to assess how parental mood, goals, and the eating context (e.g., meal versus snack, public versus private setting) influenced feeding practices.</p><p><strong>Results: </strong>Parents were more likely to use specific coercive or indulgent feeding practices when experiencing higher stress, when aiming to avoid mealtime conflict, and during meals versus snacks. A negative meal atmosphere and a public setting also increased the likelihood of certain indulgent practices. Notably, parents were more likely to report giving their child food to calm them down or help manage their behaviour when the meal atmosphere was perceived as negative and if they aimed to reduce conflict at the meal. The findings highlight that the context of feeding occasions significantly drives the use of coercive or indulgent feeding practices.</p><p><strong>Conclusions: </strong>Parental stress, goals, and the eating context are key determinants of coercive or indulgent feeding practices with children exhibiting avid eating behaviours. Interventions to support parents should consider these dynamic factors, promoting healthier feeding strategies tailored to real-life contexts.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"16"},"PeriodicalIF":5.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of school salad bars on fruit and vegetable selection, intake, and waste in Mid-Atlantic elementary schools.","authors":"Melanie K Bean, Suzanne E Mazzeo, Lilian de Jonge, Laura Thornton, Hollie Raynor, Ashley Mendoza, Sarah Farthing, Bonnie Moore","doi":"10.1186/s12966-025-01713-y","DOIUrl":"10.1186/s12966-025-01713-y","url":null,"abstract":"<p><strong>Background: </strong>Few studies have empirically examined the impact of school salad bars on elementary students' fruit and vegetable (FV) consumption within the National School Lunch Program (NSLP). This natural experiment evaluated the impact of salad bars on FV selection, intake, and waste within elementary schools.</p><p><strong>Methods: </strong>Seven school pairs, matched on Title I status and percentage of students from ethnic or racial minority backgrounds, were randomly selected. All schools served pre-portioned FV at baseline. One school within each pair received a salad bar; the other continued to serve pre-portioned FV (Control). Digital imagery plate waste methods were applied at baseline and 4-6 weeks after schools installed salad bars (post). Images were rated in the laboratory (ICCs = .94-.99) to determine FV selection, intake, and waste (servings [1 NSLP serving = ½c]). Multilevel modeling evaluated group (Salad Bar vs Control) and time (baseline vs post) differences and group-by-time interactions. Differences in outcomes by Title I status were also examined.</p><p><strong>Results: </strong>Across schools, mean NSLP participation was 54%. N = 6,623 trays were included (n = 3,273 Salad Bar; n = 3,350 Control). Students in Salad Bar schools selected (+ .44c) and consumed (+ .36c) more FV at post, compared to baseline. Control students decreased FV selection (-.05c) with no change in intake from baseline to post. Group, time, and group-by-time interactions were significant (ps < .0001). When examined separately, results suggest that these effects are driven by fruit. Salad Bar students increased fruit selection (+ .45c), intake (+ .36c), and waste (+ .09c) from baseline to post; no significant changes were observed in Controls. There was no significant change in vegetable selection, intake or waste for either group. Findings did not differ based on Title I status.</p><p><strong>Conclusions: </strong>Salad bars were effective in increasing elementary school students' fruit selection and intake, yet did not increase vegetable selection or intake. Additional efforts are needed to increase vegetable intake and minimize fruit waste from salad bars. Consistent findings across schools, regardless of Title I status, suggest potential for salad bars to yield increased fruit intake across socioeconomic groups. Findings can inform policies designed to increase FV intake within the NSLP.</p><p><strong>Trial registration: </strong>This investigation reports results of a systematic evaluation of school salad bars and does not meet criteria for a clinical trial, yet was retrospectively registered (10/28/22) in clinicaltrials.gov (NCT05605483) as an observational study.</p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":"22 1","pages":"15"},"PeriodicalIF":5.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}