The aim of the Bright Start study was to develop and test the effectiveness of a school environment intervention, supplemented with family involvement, to reduce excessive weight gain by increasing physical activity and healthy eating practices among kindergarten and first grade American Indian children. Bright Start was a group-randomized, school-based trial involving 454 children attending 14 schools on the Pine Ridge Reservation in South Dakota. Children were followed from the beginning of their kindergarten year through the end of first grade. Main outcome variables were mean BMI, mean percent body fat, and prevalence of overweight/obese children. The goals of the intervention were to: increase physical activity at school to at least 60 min/day; modify school meals and snacks; and involve families in making behavioral and environmental changes at home. At baseline, 32% of boys and 25% of girls were overweight/obese. While the intervention was not associated with statistically significant change in mean levels of BMI, BMI-Z, skinfolds or percentage body fat, the intervention was associated with a statistically significant net decrease of 10% in the prevalence of overweight. Intervention children experienced a 13.4% incidence of overweight, while the control children experienced a corresponding incidence of 24.8%; a difference of −11.4% (p=0.033). The intervention significantly reduced parent reported mean child intakes of sugar-sweetened beverages, whole milk and chocolate milk. Changes in duration of school physical activity were not significant. Because obesity is the most daunting health challenge facing American Indian children today, more intervention research is needed to identify effective approaches.

Purpose The literature suggests positive associations between family dinner frequency and dietary practices and psychosocial well-being, and inverse associations between family dinner frequency and overweight status among general adolescent populations. The present study aims to examine these associations among a population of adolescents at-risk of academic failure. Methods A racially-diverse sample of adolescents (n=145, 52% male, 61% nonwhite) from six alternative high schools (AHS) completed surveys and had their heights and weights measured by trained research staff. Mixed model logistic regression analyses assessed associations between family dinner frequency and overweight status, healthy and unhealthy weight management, and food insecurity, while mixed linear models assessed associations with breakfast consumption, fruit and vegetable consumption, high fat food intake, fast food intake, substance use, and depressive symptoms. Analyses adjusted for race/ethnicity, age, gender, socioeconomic status, and the random effect of school. Results Family dinner frequency was positively associated with breakfast consumption and fruit intake (p<.01 and p<.05, respectively), and inversely associated with depressive symptoms (p<.05). Adolescents who reported never eating family dinner were significantly more likely to be overweight (Odds ratio (OR) = 2.8, Confidence Interval (CI) = 1.1–6.9) and food insecure (OR=6.0, CI=2.2–16.4) than adolescents who reported 5–7 family meals per week. Conclusions In this at-risk sample of youth, some, but not all of the benefits of family meals found in other studies were apparent. Intervention programs to increase the availability and affordability of healthful foods and promote family meals for families of AHS students may be beneficial.

Objective: To examine longitudinal associations of parental report of household food availability and parent intakes of fruits, vegetables and dairy foods with adolescent intakes of the same foods. This study expands upon the limited research of longitudinal studies examining the role of parents and household food availability in adolescent dietary intakes. Design: Longitudinal study. Project EAT-II followed an ethnically and socioeconomically diverse sample of adolescents from 1999 (time 1) to 2004 (time 2). In addition to the Project EAT survey, adolescents completed the Youth Adolescent Food-Frequency Questionnaire in both time periods, and parents of adolescents completed a telephone survey at time 1. General linear modelling was used to examine the relationship between parent intake and home availability and adolescent intake, adjusting for time 1 adolescent intakes. Associations were examined separately for the high school and young adult cohorts and separately for males and females in combined cohorts. Subjects/setting: The sample included 509 pairs of parents/guardians and adolescents. Results: Vegetables served at dinner significantly predicted adolescent intakes of vegetables for males (P ¼ 0.037), females (P ¼ 0.009), high school (P ¼ 0.033) and young adults (P ¼ 0.05) at 5-year follow-up. Among young adults, serving milk at dinner predicted dairy intake (P ¼ 0.002). Time 1 parental intakes significantly predicted intakes of young adults for fruit (P ¼ 0.044), vegetables (P ¼ 0.041) and dairy foods (P ¼ 0.008). Parental intake predicted intake of dairy for females (P ¼ 0.02). Conclusions: The findings suggest the importance of providing parents of adolescents with knowledge and skills to enhance the home food environment and improve their own eating behaviours.

Policy and environmental changes were recommended for fostering a respectful relationship and building a bridge between providers and parents to improve communication about children's nutrition and health.

Background The population of the United States is becoming increasingly ethnically and racially diverse, much of it due to immigration patterns. However little is known about dietary intake and weight-related concerns and behaviors of youth from some ethnic-minority groups, especially Hispanic, Hmong, and Somali adolescents. Objective To describe dietary intake and weight-related concerns and behaviors among Hispanic, Hmong, and Somali adolescents and compare them to white adolescents. Design Cross-sectional analysis of data from EAT 2010 (Eating and Activity in Teens), a population-based study in the Minneapolis/St. Paul metropolitan area. Participants/Setting Current analysis includes 1,672 adolescents (Hispanic: n=562(33.6%); Hmong: n=477(28.5%); Somali: n=113(6.8%); White: n=520 (31.1%); mean age=15.0). Adolescents completed classroom surveys and had their height/weight measured during the 2009–2010 academic year. Statistical Analysis Multivariable regression models, adjusted for socioeconomic status, age, and school as a random effect were used to examine racial/ethnic differences for each outcome variable for boys and girls. Results There are numerous differences in the behaviors of Hispanic, Hmong, and Somali adolescents as compared to whites. Hispanic and Somali youth consumed fruit and fast food more frequently. Hmong adolescents consumed sugar-sweetened beverages less frequently, while Somali boys consumed energy and sports drinks more frequently than whites. Compared to white boys, overweight/obesity was higher among Hispanic and Hmong. A higher percentage of Hmong and Somali adolescents engaged in unhealthy weight control behaviors. Body satisfaction was lower for all Hmong adolescents compared to whites. Conclusions There were varying areas of concern in dietary intake, weight, and weight-related concerns and behaviors among adolescents in all ethnic groups. Future nutrition and physical activity interventions that include adolescents from these ethnic and cultural groups may benefit from, for example, modifying intervention strategies to the specific priority behaviors within the target population.