Barbara Fiese

ABSTRACTBackgroundAlthough intake of Hass avocado has been cross-sectionally linked to lower abdominal obesity, knowledge of the effects of avocado consumption on abdominal adiposity and glycemic outcomes remains limited.ObjectiveThe effects of avocado consumption on abdominal adiposity, insulin resistance, oral-glucose-tolerance test (OGTT), and estimated β-cell function were evaluated.MethodsA total of 105 adults aged 25–45 y (61% female) with BMI ≥25 kg/m2 were randomly assigned to an intervention (N = 53) that received a daily meal with 1 fresh Hass avocado or a control (N = 52) that received an isocaloric meal with similar ingredients without avocado for 12 wk. DXA was used to assess the primary outcomes of abdominal adiposity [visceral adipose tissue (VAT), subcutaneous abdominal adipose tissue (SAAT), and the ratio of VAT to SAAT (VS Ratio)]. Fasted glucose and insulin were used to assess the primary outcomes of insulin resistance (HOMA-IR), and insulin sensitivity (Matsuda i...

The purpose of this qualitative study was to better understand the lived experience of head and neck cancer (HNC) survivors between 6 months to 9 years post-radiation. Quality of life, coping strategies, concerns for the future, and preferences for supportive care were explored. Semi-structured interviews were conducted in 31 HNC survivors from a Midwestern hospital. Interviews were recorded, transcribed verbatim and analyzed using qualitative thematic analysis. Survivors described restrictions on daily living, social eating, and financial concerns. Despite these restrictions, survivors reported an overall high mentality and enjoyment of life. Coping considerations included adapting to a new normal and increased involvement in cancer support and faith groups. Preferences for supportive care included receiving more information about and being more involved in the treatment care plan, referrals to therapy and support groups, and more comprehensive follow-up in survivorship. While long-term HNC survivors adapt to daily living restrictions, a high proportion continue to have unmet needs. This data can guide the development of HNC survivorship interventions to inform optimal clinical guidelines based on patients’ perceived needs. This qualitative study uncovered distinct perceived needs of HNC survivors which can inform future service development. Incorporating referrals to supportive care services including speech language pathologist, physical therapists, and dietitians into the standard of care before, during, and after treatment would assist survivors in adapting to life after treatment and managing long-term health consequences of their disease.

BACKGROUND Head and neck cancer (HNC) survivors may face an array of nutrition impact symptoms (NIS), including dysphagia, xerostomia, taste alterations, and difficulty chewing, which occur as a result of tumor location and treatment with radiation. Few qualitative studies have assessed the chronic impact of NIS on everyday life. OBJECTIVE The aim of this study was to obtain a comprehensive understanding of the lived experience of chronic NIS burden on HNC survivors. DESIGN AND PARTICIPANTS Semi-structured, face-to-face interviews were conducted with 31 HNC survivors to address the research aims and objectives. An interview guide was utilized to consider themes that had been generated through the review of literature and through the researchers' clinical experience within the field. There were probes within the interview for participants to raise unanticipated issues and flexibility to follow such leads. Interviews were conducted between March 2018 and May 2019. ANALYSIS A single researcher conducted the interviews to maintain consistency in data collection. Interviews lasted approximately 1 hour and were audio-recorded. All interview transcripts were professionally transcribed verbatim and checked for accuracy to ensure a complete account of participants' responses. Two researchers applied qualitative thematic content analysis to identify major themes. RESULTS The following 4 major thematic categories emerged from the interview data: symptom presence, dietary preferences, eating adjustments, and addressing symptoms. The most common symptoms were dysphagia, xerostomia, taste alterations, and bothered chewing. As a result of dietary preferences, survivors avoided citrus fruits, dry foods, raw vegetables, sweets, and meats. Survivors preferred soft and moist foods, spices or seasonings, and sauces or gravies. Eating adjustments were described as increased time to consume meals, cutting food into smaller pieces, consuming less food, and consuming more fluid. As a result of food preference changes and eating adjustments, survivors reported dietary pattern changes from pre to post treatment. All survivors experienced 1 or more chronic NIS, yet nearly 40% were unaware before treatment that NIS had the potential to persist chronically. CONCLUSIONS The results of this study provide unique qualitative insight into the lived experience of chronic NIS burden on HNC survivors. By recognizing the daily challenges, health care team members can better support HNC survivors in the transition from active treatment to follow-up care.

This article introduces the 30th anniversary of the Journal of Family Psychology (JFP). In addition it marks the 125th anniversary of publications by the American Psychological Association. In recognition of this milestone the editorial team has invited the past editors of the journal to write brief reflections on the field and commenting on their vision for the future of the field. (PsycINFO Database Record

The present study investigated the prevalence of gender-stereotyped messages in family stories told to preschool age children. Based on previous research and theory it was expected that mothers would frame their stories with sadness and fathers would frame their stories with themes of anger. It was further expected that sons and daughters would be presented with stories that differed in emotional themes. One hundred and twenty families with preschool age children participated in the study. Mothers and fathers were asked to tell their child a story about when they were disappointed as a child. Two hundred and four stories were coded for themes of sadness, anger, mixed sadness and anger, and no emotional frame. Contrary to predictions, there were relatively few stories told with an anger frame. Mothers overall tended to tell disappointment stories with a frame of sadness. Fathers overall were more likely to use no emotional frame in their stories. Mothers were more likely to tell stor...

Responsive feeding and frequency of family mealtimes are related to healthier eating behaviors and weight outcomes in children and adolescents. Distractions at mealtimes are related to greater intake of unhealthy food and a less positive mealtime emotional climate. However, there is little understanding of the effects of routines and father availability on distractions at family meals, and there is limited research investigating the effects of distractions among all family members on maternal feeding practices in toddlerhood. This study aims to characterize distractions at family mealtimes and examine associations between father availability, distractions, and observed responsive feeding. Descriptive analyses, nonlinear mixed models, and path analyses were conducted using observational (home-based family mealtimes) and self-report data collected from a subsample of families (n = 109) of 18- to 24-month-old children in the larger STRONG Kids 2 Study (N = 468). Between fathers, mothers, and children, families spent almost half of the mealtime distracted. Fathers and mothers engaged in about equal amounts of distractions, and children engaged in more technology-related distractions than parents. Fathers' absence at the mealtime was associated with more child distractions and less maternal feeding responsiveness. Lower paternal total distractions, maternal non-technology-object-related distractions, and higher household income were significantly associated with more observed maternal feeding responsiveness. Future research should investigate how father availability and family mealtime distractions may be associated directly and indirectly with children's eating behaviors and weight outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objective:To address calls for a resilience-informed approach to understanding the etiology and prevention of childhood obesity, the current study aims to investigate the independent and interactive associations between household chaos, maternal emotional responsiveness, and eating behavior in early childhood.Method:A sample of (n = 108) families of 18-24 month-olds completed self-report surveys and consented to home visits as part of the larger STRONG Kids 2 Study (N = 468). Videotapes of family mealtimes were collected during home visits, and coded for observed maternal emotional responsiveness. Mothers completed questionnaires assessing maternal emotional responsiveness, household chaos, and child eating behaviors. Moderation analyses assessed independent and interactive effects of chaos and emotional responsiveness on child appetite self-regulation.Results:In moderation analyses controlling for demographic covariates, higher levels of chaos were associated with more emotional overeating and with more food responsiveness, but only among children of mothers observed engaging in low levels of emotional responsiveness at mealtimes. There was no association between chaos and eating behavior among children of mothers observed engaging in high levels of emotional responsiveness at mealtimes. There was also no independent or interactive association between chaos and child eating behaviors characterized by food avoidance.Conclusion:Preliminary evidence suggests that maternal emotional responsiveness at mealtimes may attenuate the deleterious effects of chaos on child overeating and food responsiveness. Future research should prioritize using longitudinal designs, developing of observational assessments of early childhood eating behaviors, and understanding these processes among families exposed to greater socioeconomic adversity.

The purpose of this study was to assess whether maternal emotion responses mediate the association between maternal binge eating (BE) and child feeding practices, in order to elucidate potential risk and protective factors for feeding practices that influence maternal and child weight. In a sample of (n = 260) diverse, Midwestern mothers of preschool‐age children (M[SD] = 37 [6.94] months) from the STRONG Kids Panel Survey, 10.7% (n = 28) indicated engaging in any BE episodes over the course of the previous three months at Wave 1. The Coping with Children's Negative Emotions Scale, the Comprehensive Feeding Practices Questionnaire, the Eating Disorder Diagnostic Scale, and the Depression, Anxiety, and Stress Scale were used to assess mothers’ self‐reported responses to negative emotion, feeding practices, binge eating frequency, depressive, and anxiety symptoms respectively. Using bias‐corrected bootstrapping procedures and maximum likelihood estimation, we tested the hypothesis that Wave 1 maternal BE predicts child feeding practices 18–24 months later (Wave 2) indirectly through responses to children's negative emotions, while statistically controlling for parent BMI, child BMI percentile, and change from Wave 1 to Wave 2 feeding practices. First, maternal BE predicted use of more Emotion Regulation, Restriction for Health, and Food as Reward feeding practices indirectly through more Distress responses to children's negative emotions (Table 1). Maternal BE also predicted use of fewer Pressure to Eat feeding practices, but the pathway was not mediated by Distress responses. Second, maternal BE did not predict use of Balance/Variety, Modeling, or Involvement feeding practices directly, or indirectly, through Problem‐Focused responses (Table 2). Finally, maternal BE predicted use of fewer Balance/Variety and Modeling feeding practices indirectly, through less Emotion‐Focused responses to children's negative emotion (Table 3). Neither depressive nor anxiety symptoms moderated these results. These results suggest that maternal BE and emotion responsiveness are important for understanding the interpersonal context of feeding behaviors. Distress reactions may serve as a risk factor for use of unhealthful feeding practices among mothers with BE, and Problem‐Focused reactions may serve as a protective factor against use of unhealthful feeding practices among mothers with BE.Support or Funding InformationThis material is based upon work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2011‐67001‐30101. This research was funded, in part, by grants from the Illinois Council for Agriculture Research to Kristen Harrison (PI), the University of Illinois Health and Wellness Initiative to Barbara Fiese and Sharon Donovan, the United States Department of Agriculture (Hatch 793‐328) to Barbara Fiese (PI), and the Agriculture and Food Research Initiative of the United States Department of Agriculture National Institute of Food and Agriculture as part of the AFRI Childhood Obesity Prevention Challenge. The STRONG Kids Team includes Kristen Harrison, Kelly Bost, Brent McBride, Sharon Donovan, Diana Grigsby‐Toussaint, Juhee Kim, Janet Liechty, Angela Wiley, Margarita Teran‐Garcia, and Barbara Fiese. Direct effects of maternal binge eating, and indirect effects through maternal distress reactions to negative emotions, on child feeding practices using bias‐corrected bootstrapped (n=10,000) confidence intervals (CI) and maximum likelihood estimation procedures. Indirect effect Direct effect Total effect B SE 95%CI (LLCI, ULCI] B SE 95%CI (LLCI, ULCI] B SE 95%CI [LLCI, ULCI] Emotion Regulation .029 .022 [.003, .073] .005 .041 [−.072, .080] .034 .030 [−.027, .089] Food Reward .048 −.025 [.015, .132] .060 .085 [−.109, .216] .109 .089 [−.053, .291] Restriction for Health .070 .032 [.024, .157] .126 .078 [.010, .312] .196 .083 [.070, .395] Pressure to Eat .028 .041 [−.015, .126] −.166 .068 [−.338, −.066] −.138 .052 [−.262, −.051] Balance/Variety −.018 .017 [−.060, .004] .044 .043 [−.041, .130] .026 .040 [−.057, .100] Involvement −.010 .021 [−.046, .045] .000 .070 [−.152, .127] −.010 .067 [−.145, .118] Note. Statistically controlled for maternal body mass index (BMI) at Wave 1 (W1) and Wave 2 (W2), and change in feeding practice from Wave 1 to Wave 2 in all analyses. In analyses estimating effects on Pressure to eat, additional controls included parent age, child BMI percentile at W1 and W2, and parent race. LLCI= Lower level confidence interval, ULCI= Upper level confidence interval. Direct effects of maternal binge eating, and indirect effects through maternal problem‐focused reactions to negative emotions, on child feeding practices using bias‐corrected bootstrapped (n=10,000) confidence intervals (CI) and maximum likelihood estimation procedures. Indirect effect Direct effect Total effect B SE 95%CI [LLCI, ULCI] B SE 95%CI [LLCI, ULCI] B SE 95%CI [LLCI, ULCI]…

The Transdisciplinary Obesity Prevention Research Sciences Program (TOPRS) is an applied research methods curriculum for undergraduates on the causes and consequences of childhood obesity that has been developed by a multidisciplinary team from the University of Illinois at Urbana‐Champaign, Purdue University, and California State University‐Fresno. To address the need of the contemporary workforce the course has been developed to integrate transdisciplinary approaches 1) to knowledge about the causes, consequences and correlates of obesity from an ecological framework from cell to society, 2) hands‐on research experience, and 3) a professional development series. The program development was an iterative process of integrating rigorous evaluation results with curriculum design. The class format is a “flipped” version with students viewing 10 minute lectures and class time spent in interactive discussions and activities focusing on research design and methodologies. The lectures are ...

Background: Emotional eating has been linked to child temperament and family environment factors, such as household chaos. However, few studies have examined how child and home characteristics independently and together influence children's overeating and undereating in response to negative emotions. Objective: The current study examined associations among child temperament, household chaos, and emotional eating in children 18-24 months of age, and interaction effects were also tested. Methods: The study included an analysis sample of 371 families participating in the larger STRONG Kids2 longitudinal birth cohort study (N = 468). The Early Childhood Behavior Questionnaire was used to assess child temperament at 18 months, and the Confusion, Hubbub, and Order Scale was used to assess disorganization in the household at 24 months. Child emotional eating at 24 months was assessed using parental reports of the Child Eating Behavior Questionnaire. Results: Negative affectivity and household chaos were independently associated with child emotional overeating. Negative affectivity, effortful control, and household chaos were significantly associated with emotional undereating. No significant interactions were found. Conclusions: Child temperament and household environment independently influence emotional eating in young children, highlighting the need to consider these factors in early prevention. Longitudinal studies are warranted to determine mechanisms that may be involved in these relations.

Understanding the knowledge, attitudes and practices pertaining to food insecurity among oncology Registered Dietitian Nutritionists (RDNs) is critical to ensuring that cancer survivors have adequate nutrition-a fundamental component of successful treatment and recovery. To qualitatively assess Oncology RDN's knowledge, attitudes and practices regarding the food access needs of their patients using a qualitative semantic approach to thematic analysis. The qualitative cross-sectional study was conducted from September 2018 to January 2019. Forty-one oncology RDNs working with cancer survivors in various clinical settings across the U.S participated. Participants completed a semi-structured, in-depth interview via telephone, lasting an average of 49 minutes. Two coders (primary and secondary) trained in qualitative thematic data analysis methods used a semantic approach to thematic analysis to analyze transcripts. A qualitative and mixed methods online coding program, Dedoose, was used to organize and analyze the data. Participants defined FI as a lack of access to nutritious foods and a lack of resources to purchase nutritious foods. RDNs stated they believe FI is a serious problem in the U.S., has a greater impact on cancer survivors than healthy individuals and they have specific concerns about FI among their own patients. Despite their concerns, most expressed that they do not use a validated tool to identify FI, nor were they aware that any exists. Only a small proportion of the RDNs stated that they regularly ask patients about their food access needs. While Oncology RDNs have heard of FI, they do not routinely assess patients' food security status with a validated tool, nor do they consistently ask patients directly about their food access needs. These findings suggest there is a need for developing education and training opportunities for oncology RDNs in order to enhance their ability to screen for and address FI with their patients.

We investigate whether media literacy and media use can moderate the association between U.S. media enjoyment and unhealthy eating among remotely acculturating “Americanized” adolescents and their mothers in Jamaica (n = 164 individuals/82 dyads; Madolescent.age = 12.83, SD = 0.48, 48% female; Mmother_age = 39.25, SD = 5.71). Socioeconomically diverse participants completed questionnaires reporting their degree of enjoyment of U.S. media (i.e., remote acculturation), media literacy (i.e., critical thinking about food media/advertising), and adherence to national dietary guidelines to reduce sugar/fat. Multilevel modeling showed that enjoying U.S. media and consuming high levels of U.S. TV plus Jamaican TV are associated with lower efforts to reduce sugar and fat. However, high media literacy, whether one’s own or a close family member’s, weakens or nullifies that association.