Dietary interventions for mental health

This 2018 study investigated whether food advertising literacy training influences children’s food choices, with a particular focus on its effect on the manner in which children weigh the importance of taste characteristics in their food decisions. Of the 39 participants (aged 8-13 years), twenty-three children had four sessions of food advertising literacy training. During these sessions, 4 food commercial videos were shown to the audience in the lab during the first and last week, and in their houses during the second and third week. Some commercials included factual narratives that may build cognitive defenses, while others were presented with evaluative narratives. Children were encouraged to think aloud while watching these advertisements and even provided narratives. The young subjects were also asked to rate 60 food items in terms of health and taste. The aim was to test whether these taste and health attributes predict variance in the children’s food choices. The kids’ taste ratings given after completing the training was significantly lower than those documented before these commercial-viewing sessions. Thus, enhancing food advertising literacy may help reduce the effect of taste attributes in the food decision-making processes. Furthermore, viewing food adverts designed to build cognitive defenses led to an increase in critical thinking towards commercials. Food advertising literacy training may help attenuate the importance of taste in the participants’ food decisions. The 16 children in the control condition who watched 4 videos of food commercials without narratives showed no change in their food choices. Ha et al. believe that food advertising literacy training has a big role to play in the promotion of healthy eating and the prevention of childhood obesity in the future. [NPID: diet intervention, mental health, literacy training, food choice, food decisions, food advertising, advertising, cognitive defenses, decision making, childhood obesity]

Häberling et al. (2019) describes the dilemma that comes with depressive disorders in childhood and adolescence, including the poor treatment adherence and the concerns over the use of antidepressant drugs at such a young age (e.g., side effects). But depressive disorders represent the highest burden of disease in this age group. The aim of this trial was to investigate the safety and efficacy of omega-3 fatty acids in the early course of pediatric major depressive disorder (MDD). The sample consisted of 220 patients aged 8-17 years with major depressive disorder of at least moderate severity. The children and adolescents were randomized to either receive omega-3 fatty acids or placebo daily for 36 weeks. The primary outcomes measured were alterations in depression severity, and remission and recovery rates, while the participants’ omega-3 index and inflammatory parameters were measured as secondary outcomes. This trial was conducted to determine if omega-3 fatty acids play a role in the development of pediatric major depressive disorder. This study particularly focused on the clinically depressed with pre-existing omega-3 fatty acid deficiencies, elevated markers of oxidative stress, or signs of inflammation. [NPID: MDD, pediatric, omega-3, depression, trial]

In this 2019 study, a web-based nutritional intervention named the EATS (Eating Advice to Students) was tested for its feasibility and efficacy in a sample of young university students. One hundred and twenty-four students from the University of Newcastle, Australia were randomized to either the EATS or attention control condition. The aim of the EATS intervention was to enhance certain dietary behaviors involving breakfast, fruits, vegetables, and discretionary foods. Whatnall et al. measured the efficacy of the intervention by examining changes in diet quality and consumption of fruits, vegetables, discretionary foods, and breakfast. Recruitment was completed in 5 weeks, while retention rate was 73% at the 3-month mark. The intervention participants used EATS 1.5 ± 1.0 times and scored the intervention 4.04 ± 0.74 (out of 5) for satisfaction. As for the efficacy, there was a significant reduction in intake of discretionary foods by the intervention group, compared with the control, although no difference was found in terms of diet quality, fruit, vegetable or breakfast consumption. EATS appears to be highly feasible and has the potential to improve young college students’ dietary behaviors. [NPID: diet intervention, mental health, EATS, nutrition intervention, Australia, attention, attention control, diet quality, FV intake, fruits, vegetables, breakfast, college students, university students]

Schoeppe et al. (2017) point out that there has been a rise in the number of commercial apps designed to enhance children’s health-related behaviors, but few have analyzed the content and quality of these apps targeting the youth. This review did exactly this, in the context of improving diet, physical activity and sedentary behaviour in children and adolescents. Also, the researchers looked at the relationships between app quality ratings, the number of app features, and behaviour change techniques (BCTs) used. To be included in this review, the apps were required to be available on the iTunes and Google Play stores, be designed to improve diet, physical activity and/or sedentary behaviour, be available in English, and have a user rating of at least 4+ based on at least 20 ratings. The 25 apps selected scored 3.6 out of 5 on overall app quality (assessed using the Mobile App Rating Scale). The highest scores were for functionality (average 4.1), followed by aesthetics (mean = 3.8), engagement (mean = 3.6), and information quality (mean = 2.8). On average, 6 behaviour change techniques were employed by the apps, including ‘instructions’ (most frequently used), ‘general encouragement’, ‘contingent rewards’, and ‘feedback on performance’. There was a correlation found between the app quality ratings with the number of technical app features and BCTs included. To summarize, popular commercial apps aimed at positively affecting the diet, physical activity and sedentary behaviour of children and adolescents were of moderate quality. Furthermore, there were more app features and BCTs in the higher quality apps. Future apps should find out what increases users’ app engagement and should be made for specific population groups. [NPID: diet intervention, mental health, apps, social media, sedentary behavior, behavior change techniques, physical activity, aesthetics, engagement, information quality, behaviors, app engagement]

The aim of this 2013 Brazilian study was to present the health promotion strategies used at public and private schools in the Federal District of Brazil. Interviews were held with 122 private and 173 public schools to determine their health promotion efforts. Only one private school fulfilled the criteria for at least 20 of the 24 items investigated. On the other hand, there were 2 public schools that only fulfilled the criteria for 3 items. There was a positive correlation found between the number of meetings organized with the school community to address healthy eating with the presence of healthy environments in the school. Moreover, schools that monitored the nutritional status of its students were more likely to have healthy environments. Schools that held more meetings than average to help promote health had a smaller percentage of street vendors and local stores in the school’s vicinity. Most of the schools that partnered with health professionals included the topic of healthy eating in the curriculum. The different relationships highlighted by this study demonstrate the importance of these components of health promotion. The schools in the federal district of Brazil still require more support and training for them to be "health-promoting schools."[NPID: diet intervention, mental health, Brazil, health promotion, food environment]

In this 2019 study, Saxe-Custack et al. describe the characteristics, dietary patterns, food access, and food security reported at baseline by 261 caregiver-child dyads. The number of vegetables, whole grains, and dairy products eaten by the child participants was well below recommendation levels. Moreover, low, or very low food security was reported by 53% of children and 49% of caregivers. However, there were no marked differences in the child consumption of fruits and vegetables between households that reported high versus low food security. As many of these children living in Flint, Michigan are still experiencing an ongoing drinking water crisis, these results bring up serious concerns about the poor dietary patterns and the food insecurity issues that these kids encounter. Previously, there was a successful fruit and vegetable prescription program that offered a $15 spending allowance on fresh produce at numerous markets for each child in Flint. It is clear that further support is required in this region of the United States. [NPID: diet intervention, mental health, diet patterns, food access, food security, Michigan, fruit, vegetables, FV intake]

This 2018 study explores the 3 dimensions of eating pleasures that are learned during childhood. These include sensory dimension (pleasure from sensory sensations felt while eating), interpersonal dimension (pleasure from the social context of food consumption), and psychosocial dimension (pleasure based on what the food represents in your mind). The purpose of this review was to examine whether these three dimensions can be used to promote healthy eating among children. Marty et al. highlight the shortcomings of past strategies in influencing people’s food choices. It was once said that educating kids on which foods are “good” and “bad” would encourage healthier food choices, but this plan can actually be counterproductive. Sometimes this approach can lead to children avoiding healthy foods. According to this review, a different perspective is required to develop interventions that assist children to make healthy choices. [NPID: diet intervention, mental health, eating pleasure, sensory, interpersonal, social context, psychosocial, avoidance]

In this 2020 study, the BRA intervention was assessed on its impact on the kindergarten staff’s food-related practices and the frequency, variety and number of vegetables served in a department. This intervention was specifically targeted at public and private kindergartens in the counties of Vestfold and Buskerud, Norway. Among the 73 kindergartens that participated, the quantity of vegetables served increased by around 20g per day for each person in the intervention group at the first follow-up, compared with the control group. Moreover, the diversity in the vegetables served increased by 150% per month following the intervention. However, there was no clear indication of changes in frequency of vegetables served or in the staff's food-related practices. The researchers conclude that the BRA intervention successfully enhanced the number and variety of vegetables served within intervention kindergartens. [NPID: diet intervention, mental health, vegetables, vegetable intake]

Burrington et al. (2020) tell us that rural families are often at risk of developing diet-related diseases despite their close proximity to farms. This study introduced families to a Fruit and Vegetable Prescription Program (F&VRx), which consisted of family cooking and nutrition classes and shopping at a pilot online produce site. These families had been referred since they consisted of one or more children at risk for chronic diseases related to obesity. The objective of this project was to promote lifestyle dietary changes in rural families. Firstly, the family were given credit to spend at the online grocery store once a week for 5 months. Moreover, the families were invited to monthly nutrition/cooking lessons. After completing the program, the families reported higher consumption of fruits and vegetables by the children, as well as increased confidence, culinary skills, and food literacy. In fact, 60% of the families continued shopping online for fresh groceries on a weekly basis even 3 months after the program finished. It can be concluded that using a F&VRx, online groceries ordering, and family cooking classes can improve families’ behaviors with regards to shopping, preparing, and consuming fruits and vegetables. [NPID: diet intervention, mental health, rural families, diet-related diseases, farm, fruits, vegetables, FV intake, obesity, chronic disease, culinary skills, food literacy]