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Association between barriers and facilitators to meeting the Dietary Guidelines for Americans and body weight status of caregiver-child dyads: the Healthy Eating and Lifestyle for Total Health Study.
Am J Clin Nutr. 2016 Jul; 104(1):143-54.AJ

Abstract

BACKGROUND

Few Americans meet the Dietary Guidelines for Americans (DGA), yet a large percentage are overweight.

OBJECTIVE

The goal of this research was to examine the association between barriers and facilitators to meeting the DGA and weight in a multisite study.

DESIGN

This was a cross-sectional study in which 836 caregiver-child dyads among 3 race/ethnic groups completed the questionnaire across 6 sites participating in the HEALTH (Healthy Eating and Lifestyle for Total Health) Study. Barriers and facilitators to meeting the DGA were assessed by using a validated questionnaire developed specifically for the HEALTH Study. Heights and weights were measured. A series of bivariate regression analyses were conducted to examine the association between caregiver body mass index (BMI) or child BMI z score and the barriers and facilitators to meeting the DGA, adjusting for appropriate covariates in the models. Path analysis was used to examine the relation of caregiver and child barriers and facilitators to their relative BMIs.

RESULTS

In children, the BMI z score was associated positively (P < 0.001) with total barriers and negatively (P < 0.001) with total facilitators. In caregivers, BMI was associated positively only with total barriers (P < 0.0001). For each of the 8 MyPyramid components, barriers consistently were associated positively (P < 0.0001) and facilitators were associated negatively (P < 0.001) with BMI z score in children (with the exception of the fruit and physical activity components). For caregivers, most of the barriers to meeting recommendations for meats and beans; solid fats, alcohol, and added sugars; and physical activity components were associated positively (P < 0.01) with BMI. Path analyses show that caregiver facilitators were significantly related to children's facilitators to meeting DGA recommendations (standardized β: 0.12; P < 0.001).

CONCLUSION

To our knowledge, our findings are among the first to show associations between weight and barriers and/or facilitators to meeting the DGA in a national, large sample of caregiver-child dyads. This trial was registered at clinicaltrials.gov as NCT02725970.

Authors+Show Affiliations

USDA Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; tnicklas@bcm.edu.USDA Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX;Department of Nutrition and Food Sciences, California State University Chico, Chico, CA;USDA Agricultural Research Service Grand Forks Human Nutrition Research Center, Grand Forks, ND;Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA;USDA Agricultural Research Service Western Human Nutrition Research Center, Obesity and Metabolism Research Unit, UC Davis, Davis, CA;USDA Agricultural Research Service Delta Obesity Prevention Research Unit, Dallas, TX;USDA Agricultural Research Service Beltsville Human Nutrition Research Center, Beltsville, MD.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

27194306

Citation

Nicklas, Theresa, et al. "Association Between Barriers and Facilitators to Meeting the Dietary Guidelines for Americans and Body Weight Status of Caregiver-child Dyads: the Healthy Eating and Lifestyle for Total Health Study." The American Journal of Clinical Nutrition, vol. 104, no. 1, 2016, pp. 143-54.
Nicklas T, Liu Y, Giovanni M, et al. Association between barriers and facilitators to meeting the Dietary Guidelines for Americans and body weight status of caregiver-child dyads: the Healthy Eating and Lifestyle for Total Health Study. Am J Clin Nutr. 2016;104(1):143-54.
Nicklas, T., Liu, Y., Giovanni, M., Jahns, L., Tucker, K., Laugero, K., Bogle, M., & Chester, D. (2016). Association between barriers and facilitators to meeting the Dietary Guidelines for Americans and body weight status of caregiver-child dyads: the Healthy Eating and Lifestyle for Total Health Study. The American Journal of Clinical Nutrition, 104(1), 143-54. https://doi.org/10.3945/ajcn.115.123372
Nicklas T, et al. Association Between Barriers and Facilitators to Meeting the Dietary Guidelines for Americans and Body Weight Status of Caregiver-child Dyads: the Healthy Eating and Lifestyle for Total Health Study. Am J Clin Nutr. 2016;104(1):143-54. PubMed PMID: 27194306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between barriers and facilitators to meeting the Dietary Guidelines for Americans and body weight status of caregiver-child dyads: the Healthy Eating and Lifestyle for Total Health Study. AU - Nicklas,Theresa, AU - Liu,Yan, AU - Giovanni,Maria, AU - Jahns,Lisa, AU - Tucker,Katherine, AU - Laugero,Kevin, AU - Bogle,Margaret, AU - Chester,Deirdra, Y1 - 2016/05/18/ PY - 2015/09/24/received PY - 2016/04/13/accepted PY - 2016/5/20/entrez PY - 2016/5/20/pubmed PY - 2017/5/5/medline KW - BMI KW - Dietary Guidelines for Americans KW - HEALTH KW - barriers KW - facilitators SP - 143 EP - 54 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 104 IS - 1 N2 - BACKGROUND: Few Americans meet the Dietary Guidelines for Americans (DGA), yet a large percentage are overweight. OBJECTIVE: The goal of this research was to examine the association between barriers and facilitators to meeting the DGA and weight in a multisite study. DESIGN: This was a cross-sectional study in which 836 caregiver-child dyads among 3 race/ethnic groups completed the questionnaire across 6 sites participating in the HEALTH (Healthy Eating and Lifestyle for Total Health) Study. Barriers and facilitators to meeting the DGA were assessed by using a validated questionnaire developed specifically for the HEALTH Study. Heights and weights were measured. A series of bivariate regression analyses were conducted to examine the association between caregiver body mass index (BMI) or child BMI z score and the barriers and facilitators to meeting the DGA, adjusting for appropriate covariates in the models. Path analysis was used to examine the relation of caregiver and child barriers and facilitators to their relative BMIs. RESULTS: In children, the BMI z score was associated positively (P < 0.001) with total barriers and negatively (P < 0.001) with total facilitators. In caregivers, BMI was associated positively only with total barriers (P < 0.0001). For each of the 8 MyPyramid components, barriers consistently were associated positively (P < 0.0001) and facilitators were associated negatively (P < 0.001) with BMI z score in children (with the exception of the fruit and physical activity components). For caregivers, most of the barriers to meeting recommendations for meats and beans; solid fats, alcohol, and added sugars; and physical activity components were associated positively (P < 0.01) with BMI. Path analyses show that caregiver facilitators were significantly related to children's facilitators to meeting DGA recommendations (standardized β: 0.12; P < 0.001). CONCLUSION: To our knowledge, our findings are among the first to show associations between weight and barriers and/or facilitators to meeting the DGA in a national, large sample of caregiver-child dyads. This trial was registered at clinicaltrials.gov as NCT02725970. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/27194306/Association_between_barriers_and_facilitators_to_meeting_the_Dietary_Guidelines_for_Americans_and_body_weight_status_of_caregiver_child_dyads:_the_Healthy_Eating_and_Lifestyle_for_Total_Health_Study_ DB - PRIME DP - Unbound Medicine ER -