Healthy Eating Practices

Abstract

Purpose-The purpose of this study was to explore the perceptions of healthy eating by youth with diabetes as well as facilitators of and barriers to healthy eating behavior.Methods-One hundred forty youth aged 7 to 16 years with diabetes participated in 18 focus groups. Sample race/ethnicity was 71% white, 18% African American, 6% Hispanic, and 5% other; 69% of the participants were female.Results-Healthy eating was defined primarily in terms of eating fruits and vegetables, low fat, low sugar, and eating to keep blood sugar in range. However, there were notable differences in perceptions of healthy eating versus perceptions of eating practices good for diabetes management. Specifically, "free" foods (foods high in fat but low in carbohydrate) were commonly reported as being good for diabetes management. Major barriers to healthy eating included widespread availability of unhealthy foods, preparation time, and social situations. Parental behaviors, including monitoring food choices and positive modeling, were the most commonly reported facilitators of healthy eating.Conclusion-Findings suggest that youth with diabetes have a general understanding of healthy eating and face similar barriers and facilitators to healthy eating as nondiabetic children do. However, the diabetes regimen may influence their understanding of healthy eating, sometimes negatively. Diabetes nutrition education sessions should emphasize the connection between healthy eating and both short-and long-term diabetes outcomes, and they should highlight strategies to reduce saturated fat consumption while avoiding excessive carbohydrate consumption. The diabetes educator can play an integral role in promoting healthy dietary practices by facilitating parental involvement, designing action plans for managing social situations, and increasing awareness of healthier alternatives to widely available unhealthy foods.Adolescence has been described as a time of physiological, emotional, and behavioral change. 1,2 In particular, eating behaviors transform as youth gain autonomy over their food choices.Poor eating habits initiated during adolescence can pose acute and chronic health, growth, and developmental consequences. Not only are adolescent eating habits associated with subsequent adult diet, but recent research suggests that chronic disease risk can be perpetuated during this time. 3,4 Cardiovascular disease risk factors have been seen in youth, 5 and the prevalence of type 2 diabetes has increased markedly in the adolescent population. 6Correspondence to Dr Tonja R. Nansel, The Prevention Research Branch at National Institute of Child Health and Human Development (NICHD), 6100 Executive Blvd., Room 7B13R, Bethesda, MD 20892-7510 (Nanselt@mail.nih.gov). Healthful dietary practices are of particular interest for youth with diabetes. Many children and adolescents with diabetes are unable to sustain recommended blood glucose values for optimal health. 7 The American Diabetes Association recommends that nutritional guidelines for children and ad...

Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies

“…Some children were able to list specific healthy effects [31,33,36,52]. Hill et al (1998) reported that dietary knowledge increased by age in New Zealand [32].…”

“…Some children said that the choice of fruit in school was limited to canned fruit salad which they did not like or, as for the diabetic children in the study by Gellar et al (2007) they could not eat it because it was "drenched in sugary syrup" [27,31,32]. …”

Relationships of neophobia and pickiness with dietary variety, dietary quality and diabetes management adherence in youth with type 1 diabetes

“…1 Although dietary intake is an integral part of diabetes management, 35 previous research suggests that families of youth with T1D may not prioritize healthful eating, given the multiple demands of diabetes management, as well as barriers to healthy eating such as the widespread availability of unhealthy foods, lack of food preparation time and desire for intakes consistent with friends given the already substantial differences placed upon the youth with diabetes compared with their peer group. 19,36 In addition, some families may focus on a food’s postprandial glycemic response, emphasizing both the amount of carbohydrate and ease of carbohydrate estimation, which may limit the foods children with T1D choose to eat. 36 …”

“…18 Given the intense burden of T1D management for youth and their parents, including monitoring blood glucose, estimating carbohydrate intake, administering insulin and responding to blood glucose fluctuations, families may find recommendations for healthful eating to be less salient. 19 At a time when all youth struggle with physical, personal and social changes, adherence to dietary recommendations can be especially difficult for youth with T1D. 15 Food neophobia and pickiness may further complicate adherence to overall diabetes management, potentially impacting glycemic control; however, no research has examined these associations.…”

Exploratory Research to Design a School Nurse-Delivered Intervention to Treat Adolescent Overweight and Obesity

“…One study 22 of 108 urban Costa Rican adolescents found that adolescent boys were peer pressured to eat unhealthy foods as a sign of masculinity, where as adolescent girls were peer pressured to eat healthy foods as a sign of femininity. In another study 21 conducted with 140 adolescents with type 1 diabetes investigating perceptions, barrier and motivation to healthy eating, peer relationships were cited as a barrier to healthy eating and peer interactions were found to increase social pressure to eat unhealthy foods. In contrast, French et al 20 investigated potential motivating factors for vending snack choices in 418 adolescents and found peer influence was the least cited motivator for snack choice.…”