Investigating nutritional and lifestyle factors associated with dietary habits of children and young adults (university students) using a mixed methods approach

Abstract

Obesity has become increasingly prevalent over recent years, and is now recognised as a global public health issue. Preventing obesity during early childhood is important as obese children are also more likely than non-obese peers to be overweight or obese in both adolescence and adulthood. Evidence has shown that the weight of a child at five-years-old is a good predictor
of future weight and health status, having long-term effects on both mortality and morbidity. In addition strong evidences that 79% of children who are obese in their early teens are likely to remain obese as adults. The aetiology of obesity is complex and multi-faceted, and many factors are known to contribute to its development- such as diet, activity level, individual biology/genetics, societal influences and individual psychology. Dietary factors that create a positive energy balance have been shown to aid in the development of excess adiposity,
partially from the consumption of energy-dense diets, which are thought to be low in fruit, vegetables, and dairy products. Therefore, the promotion of healthy dietary habits is required in children and adults to establish healthy dietary intakes and reduce the likelihood of developing obesity in future years. The aim of this thesis was to investigate the dietary habits of children and young adults required to maintain a healthy weight. The systematic review evaluated the use of social network in weight loss interventions among university students
and showed significant BMI reduction using social network sites (n=6). Findings from this were used to design focus group discussions which explored the eating behaviours and experiences of (n=42) university students living away from home and identified 3 key themes which influenced dietary choices and eating behaviours: nutritional awareness and knowledge, personal factors and physical factors and suggested the use of social networks as a method of
providing nutritional advise to young adults. Both the systematic review and focus groups were used to design a randomised control trail to test the use of Facebook at delivering nutritional education and increase fruit and vegetable consumption. Results showed that consumption of FV increased in both intervention groups, however Facebook was insufficient to enhance the effect on FV consumption. Following on from this finding observational data (HAPO) was
used to assess dietary intake of young children to investigate dietary habits at this early age and associations with the development of obesity. Dietary patterns were used and identified 3 main patterns: processed, junk and healthy, showing that children who consumed ‘junk dietary pattern’ which contained more sweets, chocolate, confectionary and less fruit and vegetables had higher BMI than those consuming healthy and processed dietary patterns. This finding led to more in depth nutritional analysis to investigate these diets in relation to carbohydrates intake and associations with BMI and in addition to identify the major sources of sugars and their contribution to energy intake in the diets of children . In conclusion, the research presented in this thesis provides evidence to literature that: that the diets of children and young adults are generally not meeting the healthy eating guidelines with respect to fruit and vegetables intake, in addition providing free fruit and vegetables increased consumption, While Facebook was
not effective and had no impact of changing dietary intake. Dietary assessment using principle component analysis identified 3 dietary patterns: processed, junk and healthy. In addition children who consumed ‘junk dietary pattern’ had higher BMI than those consuming healthy and processed dietary patterns. Sugar-sweetened beverages were identified as the major source of FS’s, however this study did not provide evidence that dietary carbohydrates including free sugars increased the risk of childhood obesity.

Date of Award	Mar 2019
Original language	English
Sponsors	Umm Al Qura University
Supervisor	Alison Gallagher (Supervisor) & Alyson Hill (Supervisor)