Influences on children and adolescent's diet quality: An ecological systems perspective

The purpose of this study was to identify the individual and environmental factors associated with the nutritional quality of children and adolescents diets as measured by the Healthy Eating Index (HEI), calcium intake (mg), and fruit and vegetable (F&V) intake (number of servings/day). The sample for this study included a total of 2188 children aged 6 to 12, 568 adolescent males and 566 adolescent females aged 13 to 18. The source of the data was the Consumer Survey of Food Intake by Individuals 1994--96, 1998 and the Diet and Health Knowledge Survey 1994--96 conducted by the Agricultural Research Service of the United States Department of Agriculture. The analysis consisted of descriptive statistics and analytic analysis. The analytic analysis utilized general linear modeling and general linear mixed modeling. The intent of the model was to describe the relationship between the independent variables and the dependent variables for children, adolescent males and females. The analysis and results were examined within the context of the conceptual framework based on Bronfenbrenner's ecological model and Bandura's Social Cognitive Theory. The summary statistics showed that in general children and adolescents are not meeting their dietary intake recommendations. The final models for children and adolescent explained from 8.4% to 21.7% of the variance in HEI, calcium intake and F&V intake. The single common factor associated with higher HEI, calcium intake and F&V intake for children and adolescents was the corresponding parental HEI, calcium intake and F&V intake. The two environments which had the most profound impact on their dietary intake were the home and school environments. Developing strategies for interventions from an ecological perspective therefore need to take these two environments into consideration. At the same time interventions need to account for the social context of food, cultural implications, availability and accessibility of food and personal characteristics of individuals. And finally interventions which target single food items and capitalize on the association between parent and child dietary intake may meet with more success.