Determinants of Healthy Eating in Children and Youth
Taylor, Jennifer P., Evers, Susan, McKenna, Mary, Canadian Journal of Public Health
This review outlines the state of knowledge and research gaps in the area of determinants of healthy eating among children and youth. The article is structured around individual and collective determinants that affect healthy eating in children and youth. We defined healthy eating as "eating practices and behaviours that are consistent with improving, maintaining and/or enhancing health." Relevant databases were searched for papers published between January 1992 and March 2003 that focussed on children or youth and reported at least one factor relevant to healthy eating. Among collective factors, familial factors and the nature of foods available in the physical environment, including at home, schools and in fast-food establishments, stand out as significant influences on healthy eating in children and youth. The media, particularly television, also have an enormous potential influence and can overshadow familial influences. Individual factors identified include knowledge, attitudes and food preferences; only the latter have been identified as a strong determinant of healthy eating in both children and adolescents. The results of the review identified a significant body of literature in the area of determinants of healthy eating in children and youth; however, very little of this research has taken place in Canada. Only a few determinants, such as economic factors and food security, the content of media nutritional messages, and the issue of flavours, neophobia and food preferences, have undergone some examination by Canadian researchers. Research priorities for Canada in the area of determinants of healthy eating and surveillance of eating behaviours are identified.
MeSH terms: Eating; child; adolescent; factors
There is mounting evidence that Canadian children may be making unhealthy food choices, leading to both dietary excesses and inadequacies. Most information comes from nutritional surveillance in the United States (US), which suggests that few children meet dietary recommendations. They have low intakes of fruits, vegetables and milk products; high intakes of less healthy choices, such as soft drinks and high-fat, high-sugar snack foods; and consumption of too much fat and saturated fat, and too little folate and calcium.1-7 Overall dietary quality declines with age, and the rate of breakfast skipping increases. Although there are no comparable national data available on children's eating behaviours in Canada, limited information from a national study,8 and some provincial data,9,10 suggest that similar concerns exist about Canadian children, including low fruit and vegetable consumption and high consumption of candy, chocolate bars and soft drinks.
Unhealthy eating habits during childhood may interfere with optimal growth and development while setting the stage for poor eating habits during adolescence and adulthood.11,12 Moreover, poor diet and inactivity during childhood have been implicated in the worrisome increase in childhood overweight,13 which is considered to be at epidemic proportions in Canada and in other developed nations.14-16 Increases in other nutrition-related risk factors for chronic disease in children such as hypertension, hypercholesterolemia and Type 2 diabetes have also been observed.17,18
A range of health promotion strategies are required in order to support healthy eating during childhood and adolescence and promote optimal growth and development while reducing risk for obesity as well as chronic disease rates in the adult population.11'19 However, in order to design effective interventions, an understanding of the complexity of factors that influence the eating behaviours of children and adolescents is needed.
This review outlines the state of knowledge and research gaps in the area of determinants of healthy eating among children and youth. The paper is structured around individual and collective determinants, as described in the Framework for Population Health,20 that affect healthy eating in children and youth. …