A number of cross-sectional and prospective studies have now been published demonstrating inverse relationships between diet quality and the common mental disorders in adults. However, there are no ...existing prospective studies of this association in adolescents, the onset period of most disorders, limiting inferences regarding possible causal relationships.
In this study, 3040 Australian adolescents, aged 11-18 years at baseline, were measured in 2005-6 and 2007-8. Information on diet and mental health was collected by self-report and anthropometric data by trained researchers.
There were cross-sectional, dose response relationships identified between measures of both healthy (positive) and unhealthy (inverse) diets and scores on the emotional subscale of the Pediatric Quality of Life Inventory (PedsQL), where higher scores mean better mental health, before and after adjustments for age, gender, socio-economic status, dieting behaviours, body mass index and physical activity. Higher healthy diet scores at baseline also predicted higher PedsQL scores at follow-up, while higher unhealthy diet scores at baseline predicted lower PedsQL scores at follow-up. Improvements in diet quality were mirrored by improvements in mental health over the follow-up period, while deteriorating diet quality was associated with poorer psychological functioning. Finally, results did not support the reverse causality hypothesis.
This study highlights the importance of diet in adolescence and its potential role in modifying mental health over the life course. Given that the majority of common mental health problems first manifest in adolescence, intervention studies are now required to test the effectiveness of preventing the common mental disorders through dietary modification.
Background
Early childhood caries (ECC) describes dental caries affecting children aged 0–71 months. Current research suggests ECC has important aetiological bases during the first year of life. Gaps ...in knowledge about disease progression prevent the effective and early identification of ‘at risk’ children.
Aim
To conduct a systematic review of research studies focusing on (a) acquisition and colonization of oral bacteria and ECC and (b) risk and/or protective factors in infants aged 0–12 months.
Design
Ovid Medline and Embase databases (1996–2011) were searched for RCT, longitudinal, cross‐sectional and qualitative studies. Two investigators undertook a quality assessment for risk of bias.
Results
Inclusion criteria were met for (a) by four papers and for (b) by 13 papers; five papers were rated medium or high quality. Bacterial acquisition/colonization and modifying factor interrelationships were identified, but their role in the caries process was not clarified. Key risk indicators were infant feeding practices (nine papers), maternal circumstances and oral health (6) and infant‐related oral health behaviours (4).
Conclusion
This review confirmed that factors occurring during the first year of life affect ECC experience. Despite heterogeneity, findings indicated maternal factors influence bacterial acquisition, whereas colonization was mediated by oral health behaviours and practices and feeding habits.
Objectives
This study sought to advance understanding of the influence of psychosocial factors on oral health by examining how parental self‐efficacy (with regard to acting on their child's oral ...health needs) and oral health knowledge relate to parental and child oral health behaviors and self‐rated oral health.
Methods
Parents of children in grades 0/1 and 5/6 (n = 804) and children in grades 5/6 (n = 377, mean age 11.5 ± 1.0, 53.9% female) were recruited from a stratified random sample of 11 primary (elementary) schools. Participants completed surveys capturing psychosocial factors, oral health‐related knowledge, and parental attitudes about oral health. Parents also rated their own oral health status and the oral health of their child. Correlations and logistic regression analysis (adjusted for socioeconomic status, child age, and gender) examined associations between psychosocial factors and the outcomes of interest (parent and child behaviors and self‐rated oral health status).
Results
Higher parental self‐efficacy was associated with more frequent toothbrushing (by parent and child), and more frequent visits to a dental professional. These associations were particularly strong with regard to dental visits for children, with parents with the highest tertile for self‐efficacy 4.3 times more likely to report that their child attended a dentist for a checkup at least once a year (95%CI 2.52–7.43); and 3 times more likely to report their child brushing their teeth at least twice a day (Adjusted Odds Ratio 3.04, 95%CI 1.64–5.64) compared with those parents in the lowest tertile for self‐efficacy. No associations with oral health knowledge were found when examined by tertile of increasing knowledge.
Conclusions
Oral health self‐efficacy and knowledge are potentially modifiable risk factors of oral health outcomes, and these findings suggest that intervening on these factors could help foster positive dental health habits in families.
Purpose To explore the cross-sectional relationships between health-related quality of life (HRQoL) and physical activity (PA) behaviours and screen-based media (SBM) use among a sample of Australian ...adolescents. Methods Data came from baseline measures collected for the It's Your Move! community-based obesity prevention intervention. Questionnaire data on sociodemographics, PA, SBM and HRQoL were collected from 3,040 students (56% boys) aged 11–18 years in grade levels 7–11 in 12 secondary schools. Anthropometric data were measured. Results The highest level of PA at recess, lunchtime and after school was associated with higher HRQoL scores (boys, by 5.3, 8.1, 6.3 points; girls, by 4.2, 6.1, 8.2 points) compared with not being active during these periods. Exceeding 2 h of SBM use each day was associated with significantly lower HRQoL scores (boys, by 3.2 points; girls, by 4.0 points). Adolescents who were physically active and low SBM users on school days had higher HRQoL scores (boys, by 6.6 points; girls, by 7.8 points) compared with those who were not physically active every school day and high SBM users on school days. Conclusions Several of the relationships between low PA and high SBM use and HRQoL were comparable to those previously observed between chronic disease conditions and HRQoL, indicating that these behaviours deserve substantial attention.
BACKGROUND: There is growing evidence that community-based interventions can reduce childhood obesity in older children. OBJECTIVE: We aimed to determine the effectiveness of the Romp & Chomp ...intervention in reducing obesity and promoting healthy eating and active play in children aged 0-5 y. DESIGN: Romp & Chomp was a community-wide, multisetting, multistrategy intervention conducted in Australia from 2004 to 2008. The intervention occurred in a large regional city (Geelong) with a target group of 12,000 children and focused on community capacity building and environmental (political, sociocultural, and physical) changes to increase healthy eating and active play in early-childhood care and educational settings. The evaluation was repeat cross-sectional with a quasiexperimental design and comparison sample. Main outcome measures were body mass index (BMI), standardized BMI (zBMI; according to the Centers for Disease Control and Prevention 2000 reference charts), and prevalence of overweight/obesity and obesity-related behaviors in children aged 2 and 3.5 y. RESULTS: After the intervention there was a significantly lower mean weight, BMI, and zBMI in the 3.5-y-old subsample and a significantly lower prevalence of overweight/obesity in both the 2- and 3.5-y-old subsamples (by 2.5 and 3.4 percentage points, respectively) than in the comparison sample (a difference of 0.7 percentage points; P < 0.05) compared with baseline values. Intervention child-behavioral data showed a significantly lower intake of packaged snacks (by 0.23 serving), fruit juice (0.52 serving), and cordial (0.43 serving) than that in the comparison sample (all P < 0.05). CONCLUSION: A community-wide multisetting, multistrategy intervention in early-childhood settings can reduce childhood obesity and improve young children's diets. This trial was registered with the Australian Clinical Trials Registry at anzctr.org.au as ACTRN12607000374460.
Objective
To examine the cost‐effectiveness of Be Active Eat Well (BAEW), a large, multifaceted, community‐based capacity‐building demonstration program that promoted healthy eating and physical ...activity for Australian children aged 4‐12 years between 2003 and 2006.
Design and Methods
A quasi‐experimental, longitudinal design was used with anthropometric data collected at baseline (1001 children—intervention; 1183—comparator) and follow‐up. A societal perspective was employed, with intervention resource use measured retrospectively based on process evaluation reports, school newsletters, reports, and key stakeholder interviews, and valued in 2006 Australian dollars (AUD). Outcomes were measured as Body Mass Index (BMI) units saved and Disability Adjusted Life Years (DALYs) averted over the predicted cohort lifetime, and reported as incremental cost‐effectiveness ratios (with 95% uncertainty intervals).
Results
The intervention cost AUD0.34M ($0.31M; $0.38M) annually, and resulted in savings of 547 (−104; 1209) BMI units and 10.2 (−0.19; 21.6) DALYs. This translated to modest cost offsets of AUD27 311 (−$1803; $58 242) and a net cost per DALY saved of AUD29 798 (dominated; $0.26M).
Conclusions
BAEW was affordable and cost‐effective, and generated substantial spin‐offs in terms of activity beyond funding levels. Elements fundamental to its success and any potential cost efficiencies associated with scaling‐up now require identification.
With an increasing focus on obesity prevention there is a need for simple, valid tools to assess dietary indicators that may be the targets of intervention programs. The objective of this study was ...to determine the relative validity of previous day dietary intake using a newly developed parent-proxy questionnaire (EPAQ) for two to five year old children.
A convenience sample of participants (n = 90) recruited through preschools and the community in Geelong, Australia provided dietary data for their child via EPAQ and interviewer-administered 24-hour dietary recall (24 hr-recall). Comparison of mean food and beverage group servings between the EPAQ and 24 hr-recall was conducted and Spearman rank correlations were computed to examine the association between the two methods.
Mean servings of food/beverage groups were comparable between methods for all groups except water, and significant correlations were found between the servings of food and beverages using the EPAQ and 24-hr recall methods (ranging from 0.57 to 0.88).
The EPAQ is a simple and useful population-level tool for estimating the intake of obesity-related foods and beverages in children aged two to five years. When compared with 24-hour recall data, the EPAQ produced an acceptable level of relative validity and this short survey has application for population monitoring and the evaluation of population-based obesity prevention interventions for young children.
Obesity is a major public health issue; however, only limited evidence is available about effective ways to prevent obesity, particularly in early childhood. Romp & Chomp was a community-wide obesity ...prevention intervention conducted in Geelong Australia with a target group of 12,000 children aged 0-5 years. The intervention had an environmental and capacity building focus and we have recently demonstrated that the prevalence of overweight/obesity was lower in intervention children, post-intervention. Capacity building is defined as the development of knowledge, skills, commitment, structures, systems and leadership to enable effective health promotion and the aim of this study was to determine if the capacity of the Geelong community, represented by key stakeholder organisations, to support healthy eating and physical activity for young children was increased after Romp & Chomp.
A mixed methods evaluation with three data sources was utilised. 1) Document analysis comprised assessment of the documented formative and intervention activities against a capacity building framework (five domains: Partnerships, Leadership, Resource Allocation, Workforce Development, and Organisational Development); 2) Thematic analysis of key informant interviews (n = 16); and 3) the quantitative Community Capacity Index Survey.
Document analysis showed that the majority of the capacity building activities addressed the Partnerships, Resource Allocation and Organisational Development domains of capacity building, with a lack of activity in the Leadership and Workforce Development domains. The thematic analysis revealed the establishment of sustainable partnerships, use of specialist advice, and integration of activities into ongoing formal training for early childhood workers. Complex issues also emerged from the key informant interviews regarding the challenges of limited funding, high staff turnover, changing governance structures, lack of high level leadership and unclear communication strategies. The Community Capacity Index provided further evidence that the project implementation network achieved a moderate level of capacity.
Romp & Chomp increased the capacity of organisations, settings and services in the Geelong community to support healthy eating and physical activity for young children. Despite this success there are important learnings from this mixed methods evaluation that should inform current and future community-based public health and health promotion initiatives.
ANZCTRN12607000374460.
>In 2006, the Victorian Government adopted the School Canteens and other school Food Services (SCFS) Policy that bans the sale of sweet drinks and confectionary and recommends the proportions of menu ...items based on a traffic light system of food classification. This study aims to determine whether compliance with the policy improves the nutritional profile of the menus.
Items from food service menus were assessed for compliance with the SCFS policy and categorised as ‘everyday’ (‘green’), ‘select carefully’ (‘amber’) or ‘occasionally’ (‘red’) (n=106). Profile analysis assessed differences in the nutritional profile of the menus between sub‐groups.
Overall, 37% of menus contained items banned under the policy. The largest proportion of items on the assessed menus were from the ‘amber’ category (mean: 51.0%), followed by ‘red’ (29.3%) and ‘green’ (20.3%). No menus met the traffic light‐based recommendations and there was no relationship between policy compliance and the proportion of items in each of the three categories.
To increase the healthiness of the school food service we recommend a greater investment in resources and infrastructure to implement existing policies, and establishing stronger monitoring and support systems.
PDF
