BackgroundIt is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments. Less understood is the role that SES differences in physical and social aspects of the home food environment play in consumption patterns.MethodsUsing data on 4th grade children from the 2009–2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home food environment, and measures of the neighborhood environment accounted for these SES differences.ResultsSmall but significant differences in children’s SHEI by SES strata exist (-1.33 between highest and lowest SES categories, p<0.01). However, incorporating home food environment and neighborhood environment measures in this model eliminates these differences (-0.7, p=0.145). Home food environment explains a greater portion of the difference. Both social (mealtime structure) and physical aspects (food availability) of the home food environment are strongly associated with consumption of healthy and unhealthy foods.ConclusionsOur findings suggest that modifiable parent behaviors at home can improve children’s eating habits and that the neighborhood may impact diet in ways other than through access to healthy food.

Relying solely on obstetric codes for identifying maternal deaths appears to be insufficient and can lead to inaccurate maternal mortality ratios. A method enhanced with data matching and record review yields more accurate ratios. Results likely have national implications, because miscoding of obstetric deaths with the standard method may affect the accuracy of other states' maternal mortality ratios.

The findings that sports participation is associated with consumption of fruits and vegetables and lower consumption of soda suggest that efforts should be focused on supporting youth team sports to promote healthier food choices. Since sports are available to all ages, sports may be an important venue for promoting healthier dietary behaviors.

IntroductionAdolescents spend a substantial amount of time consuming media, including watching television, playing video games, and using electronic devices to access the internet. We examined the relationship between prolonged media use on screen devices and its potential association with obesity through several mechanisms.MethodsWe used data from 659,288 eighth and eleventh grade students who participated in the 2015–2016 School Physical Activity and Nutrition (SPAN) survey in Texas to examine the associations between hours of media use per day and 3 behaviors related to obesity: timing of last food intake, unhealthy eating behavior, and sleep hours. Also, mediation analyses were conducted to examine the pathways between hours of media use and body mass index (BMI).ResultsCompared with adolescents who used media 2 hours or less per day, those who used media 6 hours or more had higher odds of nighttime eating (odds ratio [OR], 3.16; 95% confidence interval [CI], 1.76–5.66) and inadequate sleep (OR, 1.57; 95% CI, 1.05–2.36) and a higher coefficient for Unhealthy Eating Index score (3.87; 95% CI, 1.3–6.37). Mediation analysis demonstrated that for males sleep hours and timing of last food intake mediated the pathway between hours of media use and BMI. For females, unhealthy eating behavior mediated this pathway.ConclusionAdolescents who used electronic media 6 or more hours at night had higher odds of unhealthy eating behavior and inadequate sleep hours than those with 2 hours’ use or less. Attention to behaviors associated with adolescents’ prolonged media use is needed to reduce risk of obesity.

This study examined the association between having been bullied at school during the past 6 months ("bullied status") and not meeting physical activity (PA) recommendations of 60 minutes of daily PA during the past week among 8th- and 11th-grade Texas adolescents. Multiple logistic regression analysis was conducted to examine this association, adjusted for weight status, grade, race/ethnicity, and stratified by gender; furthermore, a significant interaction was found between bullied status and weight status. Results are presented by interaction status. Results indicated that overweight girls who reported never being bullied, as well as those who reported being bullied more than twice, had higher odds of not meeting PA recommendations than normal weight girls who were never bullied (adjusted odds ratio [AOR] = 2.12, 95% confidence interval [CI: 1.12, 3.99]; AOR = 9.18, 95% CI [2.26, 37.27], respectively). Obese girls who were bullied once or twice had higher odds of not meeting PA recommendations than normal weight girls who were never bullied (AOR = 2.89, 95% CI [1.06, 7.89]). Overweight boys who reported never being bullied had lower odds of not meeting PA recommendations than normal weight boys who were never bullied (AOR = 0.62, 95% CI [0.39, 0.97]). Conversely, obese boys who were bullied once or twice reported higher odds of not meeting PA recommendations than normal weight boys who were never bullied (AOR = 3.61, 95% CI [1.22, 10.67]). Findings from this study indicate that the association between bullied status and meeting PA recommendations is complex and may differ by gender and the interaction between bullied status and weight status.