Quirke-McFarlane Sophia, Carstairs Sharon A, Cecil Joanne E
Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK.
Nutr Health. 2025 Jun;31(2):701-714. doi: 10.1177/02601060241245255. Epub 2024 Apr 16.
Childhood obesity is one of the most serious public health epidemics of the 21st century. Observational studies report that increases in portion size (PS) have occurred in parallel with levels of obesity. Increased PSs of high-energy-dense foods can promote overeating, and without compensatory behaviours, can contribute to childhood obesity. Caregivers make decisions about PSs for children in the home and nursery environment, thus are gatekeepers to child food intake. Understanding caregiver PS decisions can aid in the best practice of PS provision to young children. The aim of this study was to explore parent and nursery staff influences on child PS selection and their suggestions for useful tools/strategies in PS decisions. A qualitative design was employed using focus group discussions (FGDs) with parents and nursery staff of children aged 3-5 years. FGDs were employed given their ability to generate rich data, as well as permit the exploration of collective perceptions, attitudes, behaviours and experiences. Data were analysed using an inductive, semantic approach to reflexive thematic analysis. Four FGDs were conducted: two with parents (= 13), two with nursery staff (= 17). Four overarching themes were derived: (i) awareness of PS guidelines; (ii) control over PS; (iii) social influences on children's eating behaviours; (iv) child-specific, social and external factors influencing parent and nursery staff PS decisions. Additionally, participants discussed tools/strategies they believe would be useful in PS decisions. Data from the themes suggest that caregiver control, social, child-specific and external factors are more influential than PS guidelines in both parent and nursery staff PS decisions for young children aged 3-5 years. These findings can inform future childhood obesity prevention initiatives focussed on improving parent and nursery staff provision/use of age-appropriate PSs.
儿童肥胖是21世纪最严重的公共卫生问题之一。观察性研究报告称，食物分量的增加与肥胖水平同步上升。高能量密度食物分量的增加会促进暴饮暴食，若没有补偿性行为，会导致儿童肥胖。照顾者在家庭和托儿所环境中决定儿童的食物分量，因此是儿童食物摄入量的把关人。了解照顾者关于食物分量的决定有助于为幼儿提供食物分量的最佳做法。本研究的目的是探讨家长和托儿所工作人员对儿童食物分量选择的影响，以及他们对食物分量决定中有用工具/策略的建议。采用定性设计，对3至5岁儿童的家长和托儿所工作人员进行焦点小组讨论（FGD）。采用FGD是因为其能够产生丰富的数据，并允许探索集体认知、态度、行为和经历。使用归纳性语义方法对数据进行反思性主题分析。共进行了四次FGD：两次与家长（=13人），两次与托儿所工作人员（=17人）。得出了四个总体主题：（i）对食物分量指南的认识；（ii）对食物分量的控制；（iii）社会对儿童饮食行为的影响；（iv）影响家长和托儿所工作人员食物分量决定的儿童特定、社会和外部因素。此外，参与者讨论了他们认为在食物分量决定中有用的工具/策略。主题数据表明，在3至5岁幼儿的家长和托儿所工作人员的食物分量决定中，照顾者的控制、社会、儿童特定和外部因素比食物分量指南更具影响力。这些发现可为未来旨在改善家长和托儿所工作人员提供/使用适合年龄的食物分量的儿童肥胖预防举措提供参考。
