Transition in food choices and their effect on overweight/obesity for adolescents and young adults

Siavash Baba Jafari (2010). Transition in food choices and their effect on overweight/obesity for adolescents and young adults PhD Thesis, School of Population Heallth, The University of Queensland.

       
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Author Siavash Baba Jafari
Thesis Title Transition in food choices and their effect on overweight/obesity for adolescents and young adults
School, Centre or Institute School of Population Heallth
Institution The University of Queensland
Publication date 2010
Thesis type PhD Thesis
Supervisor Geoffrey Marks
Abdullah Al Mamun
Jake M. Najman
Michael O’Callaghan
Total pages 234
Total colour pages 6
Total black and white pages 228
Subjects 11 Medical and Health Sciences
Abstract/Summary Abstract Background: Many factors are postulated to affect energy imbalance and risk of overweight and obesity. Most factors that influence the weight of adolescents, including food choices, occur within the family environment, with family factors and adolescent food choices interacting through complex mechanisms. It is assumed that food choices formed during adolescence partly track to shape food choice during adulthood and, if obesogenic, result in persistence of established cases, or development of new cases of overweight in young adults. Conceptual models have been proposed, however, the relative importance of family factors and strength of the relationships are not well established. Aim and objectives: To investigate the influence of family environment and food choices on the extent of overweight (BMI >= 25.0) amongst adolescents, to examine changes from adolescence to adulthood and the impact on young adults’ overweight. Specifically to: (1) investigate the association between family food choices and overweight at 14 years; (2) assess the prospective association between selected family food choices at 14 years and overweight at 21 years; (3) investigate the association between frequency of family food consumption at 14 years and frequency and amount of food consumption at 21 years; (4) examine the association between consumption of selected food groups and BMI at 21 years; and, (5) assess the association between change in consumption of individual food groups from 14 to 21 years and its impact on BMI at 21 years. Methods: Data were from the Mater-University of Queensland Study of Pregnancy, a prospective study of maternal and child health. Mothers’ responses to questionnaires at 14 years were used to assess family food choices, meal patterns, influences on food selection and frequency of consumption of food groups. Child food consumption at 21 years was assessed using a self-completed food frequency questionnaire. Weight and height were measured at 14 and 21 years. Cross tabulation and ANOVA were used to assess crude associations, and multivariable and multinomial modelling to adjust for potential influencing factors. Results: At 14 years 25.5% (boys 24.1% and girls 27.3%) were overweight, with 34.0% (males 33.6% and females 34.4%) at 21 years. Importance of eating together at 14 years was negatively associated (P < 0.05) with overweight at 14 and 21 years, frequency of family going out to eat and mother as decision maker for food purchases were positively associated with overweight, but the latter only at 14 years. Frequency of consumption of food groups at 14 years showed some unexpected results. Cooked vegetables and soft drinks were positively associated with overweight at 14 and 21 years. Cakes/biscuits was negatively associated with overweight at 14 years, and sweets/lollies negatively associated with overweight at 21 years. A positive association of red meat with overweight at 14 years, and of salad with overweight at 21 years were not significant after adjustment. Taste, healthiness and cost of food were reported by a majority of mothers as very important when choosing food, but no associations were identified with weight status. Mothers more concerned about whether food was fattening had higher risk of overweight children at both 14 and 21 years. Mothers who reported ease of food preparation as important had a lower risk of child overweight at 21 years; not significant after adjustment. Consumption by the family at 14 years of sweets/lollies, fresh fruits, fruit juice, fast food, red meat, cooked vegetables, salad and cakes/biscuits was significantly associated with both frequency and amount of food groups consumed at 21 years. Sweets/lollies and cakes/biscuits consumption at 21 years were negatively associated with BMI. Cooked vegetable consumption was positively associated, while fast food consumption was negatively associated and did not persist after adjustment. An increase from 14 to 21 years in consumption of sweets/lollies, fast foods and cakes/biscuits were associated with lower BMI at 21 years. Increased consumption of red meat was associated with higher BMI. Discussion: Our study partly supports the model of Story et al. (2002) concerning the effect of adolescent proximal social environment on food choices. We observed that concern about family meals, frequency of family going out to eat, importance of the family meal and concern about fattening food appeared to affect food choice and/or risk of overweight. But other factors such as frequency of family eating together, or having takeaway food were not associated. Thus in thispopulation some psychosocial and social environmental influences in the model are much more important than others. The study showed some unexpected relationships between dietary intake and overweight, illustrating the importance of considering overall diet rather than focusing only on individual foods when assessing diet and risk of overweight. The results demonstrate the persistence of food choices from adolescence to young adulthood and highlight the importance of early prevention and management of overweight. They have implications for managing overweight and wellbeing at both individual and social level and warrant further research.
Additional Notes Colour pages: 27, 32, 181-184 Landscape pages: 110, 113, 115,118,121, 122, 126, 127, 130, 139, 141, 143, 145, 200-232

 
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Created: Sat, 26 Feb 2011, 06:50:14 EST by Mr Siavash Baba Jafari on behalf of Library - Information Access Service