Challenges to Healthy Eating for KidsJune 17th is National Eat Your Vegetables Day. We know that getting kids to eat healthy foods such as vegetables can be a challenge for parents. But promoting healthy nutrition and a healthy lifestyle for children and adolescents is important to prevent childhood obesity and establish healthy habits that last into adulthood. To learn more about the challenges that parents face in getting their children to eat healthy foods, Ann & Robert H. Lurie Children’s Hospital teamed up with the Chicago Department of Public Health (CDPH) on the 2017–18 Healthy Chicago Survey, Jr. This is the first report in a two-part series on this topic.

We asked 1,002 Chicago parents and guardians (referred to here as parents) about various challenges to healthy eating for their children (see Figure 1). We also asked parents a number of other questions about their families and their own eating and activity habits. For more information about these issues, please go to our informational resources: luriechildrens.org/HealthyEatingPart1.

Childhood obesity in Chicago and the United StatesIn Chicago, children have higher obesity and overweight rates than the national rates.1 In Chicago, 37% of kindergarten students, 49% of sixth graders, and 45% of ninth graders are obese or overweight, compared with 24% of U.S. kindergarten students, 39% of U.S. sixth graders, and 32% of U.S. ninth graders.2,3 Furthermore, across the United States, childhood obesity rates have increased from 14% in 1999–2000 to 19% in 2015–16.4 Given these findings, it is understandable that childhood obesity was ranked as the second biggest problem facing Chicago youth by adults in the city.5

Nearly seven out of ten parents reported at least one challenge to healthy eating for their childrenAmong parents in our survey, 68% reported at least one challenge to healthy eating for their children. The top three challenges to healthy eating reported by parents were the time it takes for family meals (36%), the cost of healthy foods (33%), and the time it takes to prepare healthy foods (26%) (Figure 1).

Figure 1. Proportions of parents who reported each of the five challenges to healthy eating for youth

R E P O R T H I G H L I G H T S

Nearly seven out of ten parents reported at least one challenge to healthy eating for their children.

The cost of healthy foods was more frequently a challenge for younger parents than for older parents.

Latinx parents experienced challenges to healthy eating more frequently than non-Latinx parents.

Volume 1 Number 6 June 2019REPORT

36%Time for sit-down

family meals

33%Cost of

healthy foods

26%Time it takes

to preparehealthy foods

24%Convenience of

fast foods

18%Food

advertising

Some of the challenges, such as time for family meals, center on healthy eating in the home. It can be hard for families who are balancing school, activities, parents’ and other caregivers’ schedules, and other obligations to find the time to sit down to eat a meal together. However, children in families who eat more meals together are more likely to eat healthy and have healthy weight.6 Moreover, having a family meal together has been shown to be good for children’s mental health as well.7

Page 2 Voices of Child Health in Chicago Report

HOW THE SURVEY WAS CONDUCTED This report presents findings from the 2017-18 Healthy Chicago Survey, Jr., administered by the Chicago Department of Public Health in collaboration with Lurie Children’s. The survey was administered via phone interviews from December 2017 through June 2018. The sample consisted of 3,310 adults in Chicago, 1,002 of whom were the parent, step-parent or guardian (referred to as “parents” in this report) of at least one child under 18 years old living in the household. The survey cooperation rate was 18%. All analyses were conducted with statistical weighting so that they are representative of the adult population of the City of Chicago during the time period of data collection.

REFERENCES:1. http://www.clocc.net/about-childhood-obesity/prevalence/ 2. National Health and Nutrition Examination Survey (NHANES) data (2005-2010).3. Healthy Chicago: Transforming the Health of Our City. City of Chicago Department of

Public Health. February 2013.4. NCHS, National Health and Nutrition Examination Survey, 1999-2016. https://www.

stateofobesity.org/childhood-obesity-trends/5. Chicago adults identify the top 10 health problems for children and adolescents in

the city. Voices of Child Health in Chicago Report. 2019. www.luriechildrens.org/Top10HealthProblems

6. Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011;127(6):e1565-e1574. doi:10.1542/peds.2010-1440

7. Elgar FJ, Craig W, Trites SJ. Family Dinners, Communication, and Mental Health in Canadian Adolescents. J Adol Health. 2013;52(4):433-438. doi: 10.1016/j.jadohealth.2012.07.012

Cost of healthy food was a common challenge for younger parents Younger parents (18–29 years old) were more likely to say that the cost of healthy food was a challenge to healthy eating for their children (42%) than parents who were 30–44 years old (33%) or 45+ years old (24%). However, parent age was not associated with any of the other challenges to healthy eating for youth.

Parent race/ethnicity and challenges to healthy eatingWe also examined challenges to healthy eating among different groups of people in our diverse sample. Latinx parents experienced four of the five challenges more frequently than other groups (see Figure 2). For instance, 46% of Latinx parents reported that time for family meals was a challenge, 43% reported cost of healthy food, 31% reported time to prepare healthy food, and 27% reported food advertisements. Non-Latinx Black parents were more likely to report that the convenience of fast food was a challenge (31%). These findings mirror other research showing that Latinx youth and Non-Latinx Black youth have higher rates of obesity and overweight.4

Figure 2. Proportions of parents reporting that each issue was a challenge to healthy eating for their children, by parent race/ethnicity

Time for family meals

Cost of healthy food

Time to prepare healthy food

Convenience of fast food

Food advertisements

Latinx 46% 43% 31% 28% 27%

Non-Latinx Black

34% 40% 24% 31% 19%

Non-Latinx White

18% 10% 19% 8% —*

*The number of respondents in this category was too small to report.

0% 46%

Combinations of challenges to healthy eatingWhen we further examined the patterns in challenges to healthy eating that families experienced, we found that some of the challenges tended to co-occur. For instance, the time it takes to prepare healthy food and the time for family meals were challenges that tended to co-occur in the same families (Figure 3). Additionally, the convenience of fast food and food advertisements tended to co-occur in the same families.

Figure 3. Proportions of parents with overlapping concerns

Nikhil G. Prachand, MPH, Director of EpidemiologyKingsley N. Weaver, MPH, Senior EpidemiologistEmily M. Laflamme, MPH, Senior Epidemiologist

This report was developed and published as a partnership:

CONTACT INFORMATIONFor more information on

Voices of Child Health in Chicago, contact:

Mary Ann & J. Milburn Smith Child Health Research, Outreach and Advocacy Center

Stanley Manne Children’s Research InstituteAnn & Robert H. Lurie Children’s Hospital of Chicago

225 East Chicago Avenue, Box 157, Chicago, IL 60611-2991voicesofchildhealth@luriechildrens.org

luriechildrens.org/voices

This project is supported in part by an anonymous foundation, the Founders’ Board of Ann & Robert H. Lurie Children’s Hospital of Chicago,

and the Chicago Department of Public Health.

Matthew M. Davis, MD, MAPP, DirectorMarie E. Heffernan, PhD, Associate Director

Tracie Smith, MPH, Senior EpidemiologistAnne Bendelow, MPH, Data Analyst

Punreet Bhatti, MD, Research Associate

Convenience of fast food

14% 10% 8%

Food advertisements

Time for family meals

Time for food prep

26% of Chicago parents who report“time for food prep” as a challenge

36% of Chicago parents who report“time for family meals” as a challenge

18% of Chicago parents who report“food advertisements” as a challenge

24% of Chicago parents who report“convenience of fast food” as a challenge

18% 18% 8%