***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Restricting children 's access to palatable foods may appeal to parents as a straightforward means of promoting moderate intakes of foods high in fat and sugar ; however , restricting access to palatable foods may have unintended effects on children 's eating . The efficacy of restricting children 's access to palatable foods as a means of promoting patterns of moderate intake of those foods is unknown . OBJECTIVE Two experiments were conducted to test the hypothesis that restricting access to a palatable food enhances children 's subsequent behavioral responses to , selection of , and intake of that restricted food . DESIGN Both experiments used a within-subjects design to examine the effects of restricting access to a palatable food on children 's subsequent behavior , food selection , and food intake . The first experiment examined the effects of restriction within and outside the restricted context and the second experiment focused on the effects within the restricted context . RESULTS In both experiments , restricting access to a palatable food increased children 's behavioral response to that food . Experiment 2 showed that restricting access increased children  's subsequent selection and intake of that food within the restricted context . CONCLUSIONS Restricting access focuses children 's attention on restricted foods , while increasing their desire to obtain and consume those foods . Restricting children 's access to palatable foods is not an effective means of promoting moderate intake of palatable foods and may encourage the intake of foods that should be limited in the diet OBJECTIVE The High 5 for Preschool Kids ( H5-KIDS ) program tested the effectiveness of a home based intervention to teach parents how to ensure a positive fruit-vegetable ( FV ) environment for their preschool child , and to examine whether changes in parent behavior were associated with improvements in child intake . METHODS A group r and omized nested cohort design was conducted ( 2001 to 2006 ) in rural , southeast Missouri with 1306 parents and their children participating in Parents As Teachers , a national parent education program . RESULTS When compared to control parents , H5-KIDS parents reported an increase in FV servings ( MN=0.20 , p=0.05 ) , knowledge and availability of FV within the home ( p=0.01 ) , and decreased their use of noncoercive feeding practice s ( p=0.02 ) . Among preschoolers , FV servings increased in normal weight ( MN=0.35 , p=0.02 ) but not overweight children ( MN=-0.10 , p=0.48 ) , relative to controls . The parent 's change in FV servings was a significant predictor of child 's change in FV in the H5-KIDS group ( p=0.001 ) . CONCLUSION H5-KIDS suggests the need for , and promise of , early home intervention for childhood obesity prevention . It demonstrates the importance of participatory approaches in developing externally valid interventions , with the potential for dissemination across national parent education programs as a means for improving the intake of parents and young children OBJECTIVE The relationships among primary sources of social support in adolescents ' environments ( family and friends ) and eating behaviors ( fat and fiber consumption ) were examined in a sample of rural adolescents . DESIGN Cross-sectional baseline health surveys were administered in classrooms as part of a larger r and omized trial evaluating a cancer education program . SETTING Data were collected in middle schools drawn from 22 rural counties in Virginia and New York . PARTICIPANTS 1942 sixth grade rs with a modal age of 12 years , roughly equal gender distribution , and racially diverse ( 53 % white , 37 % black ) . MAIN OUTCOME MEASURE Variables included a 10-item scale of social support from family and friends for healthy eating , a brief food frequency question naire estimating daily grams of fat and fiber intake , and demographics ( age , gender , race ) . ANALYSIS Hierarchical multiple regressions and analyses of variance ( ANOVAs ) . RESULTS Controlling for demographics , family and friend support were found to significantly predict fat ( P < .05 ) and fiber ( P < .01 ) intake . Black respondents reported higher support from friends than did white adolescents ( F = 47.49 , P < .01 ) . IMPLICATION S FOR RESEARCH AND PRACTICE Support for healthful eating was related to healthful dietary practice s and differed among racial subgroups . Identifying and fostering sources of positive support for healthful eating is critical to developing effective health promotion programs targeting high-risk adolescents The aims of the study were to investigate family members ' reasons for rejection of foods served in the family , the reasons for not serving specific foods , children 's reasons for liking/disliking foods and the use of parental mealtime practice s to encourage child eating . Also , the relationships between child/parental neophobia and ( 1 ) the reasons for not serving specific foods and ( 2 ) the use of mealtime practice s were studied . A group of r and omly selected families ( n = 370 ) with children aged 2 - 17 years from two Swedish towns ( stratified , 185 from each ) were invited and 57 participated . The results are based on an ad hoc food-frequency question naire , a mealtime- practice s question naire , the Food and Neophobia Scale ( Pliner & Hobden , 1992 ) , parental ratings of child food neophobia and on a child interview . The main reason for family members rejecting the foods and the main reason for children 's dislikes was " distaste " . The most frequent reason for children 's likings was " good taste " . The most frequent reasons for not serving the specific foods were " distaste " , the " food did not occur to me " , " seasonal/availability " and " habit " . The mothers ' total Food Neophobia score was significantly correlated with " did not occur to me " . Parental ratings of child food neophobia were significantly correlated with mealtime- practice factors " postpone meals " and " child decides portion " Background The contribution of the environment to the obesity epidemic is well recognized . Parents have control over their home environment and can , therefore , support healthy dietary and activity habits in their children by manipulating factors such as access to energy-dense foods , availability of physical activity equipment , and restricting screen time . This paper describes the development of the Healthy Home Survey and its reliability and validity . The Healthy Home Survey was design ed to assess characteristics of the home environment that are hypothesized to influence healthy weight behaviors in children including diet and physical activity . Methods We recruited 85 families with at least one child between 3–8 years . The Healthy Home Survey was administered to parents via telephone and repeated in a r and om sample of 45 families after 7 days . In-home observations were performed within 14 days of the first Healthy Home Survey interview . Percent agreement , Kappa statistics , Intra-class correlation coefficients and sensitivity analyses were used to evaluate reliability and validity evidence . Results Reliability and validity estimates for the Healthy Home Survey were varied , but generally high ( 0.22–1.00 and 0.07–0.96 respectively ) , with lower scores noted for perishable foods and policy items . Lower scores were likely related to actual change in the perishable foods present and the subjective nature or clarity of policy questions and response categories . Conclusion Initial testing demonstrated that the Healthy Home Survey is a feasible , reliable , and valid assessment of the home environment ; however , it has also highlighted areas that need improvement . The Healthy Home Survey will be useful in future research exploring the relationship between the home environment and child weight OBJECTIVE : This study examined the reduction in overweight and changes in eating-related behaviours in obese children treated with a  family-based approach  , in which the parents were the exclusive agents of change . Results were compared to the conventional approach in which children are responsible for their own weight loss . DESIGN : A one-year longitudinal prospect i ve design was used . Participants were r and omly allocated for the experimental ( parents as the agents of change ) or the conventional ( children as the agents of change ) intervention . METHODS : Sixty obese children ( 20 % over ideal weight for age , height and gender ) aged 6–11 y ( mean±s.d . 9.2±1.0 y ) were included in the study . Anthropometric measurements and biochemical tests were performed on the children and their parents before and after the programme , and both parents completed a sociodemographic and a family eating and activity habits question naire . Hour-long support/educational sessions were conducted by a clinical dietitian–14 sessions for the parents in the experimental intervention and 30 for the children in the conventional intervention . Individual sessions were held for members of both groups , when necessary . RESULTS : Significant differences were found between the two groups in the reduction of exposure to food stimuli and changes in eating habits ( eating while st and ing , watching TV , reading or doing homework , eating following stress and eating between meals ) . Mean weight reduction ( by percentile ) was significantly greater in the experimental intervention group ( parent-only treatment ) in comparison to the conventional intervention group ( child-only treatment ) . CONCLUSIONS : Treatment of childhood obesity with the parents as the exclusive agents of change , induces more behavioural changes as well as greater weight loss , than the conventional approach Objective : The present study aim ed at investigating the influence of food availability , rules and television viewing habits on eating behaviours  in adolescents . Design : Cross-sectional study . Setting : Four r and omly selected middle schools . Subjects : A sample of 534 seventh and eighth grade rs . Interventions : Vali date d question naires were used to measure the family environment and fat , soft drink and fruit consumption . Hierarchical regression analyses on fat , soft drink and fruit consumption , with demographic and psychosocial variables entered as the first and environmental factors as the second block were conducted in boys and girls . Results : Boys with more unhealthy products available at home consumed more fat ( P⩽0.001 , 95 % CI : 8.2–29.4 ) and more soft drinks ( P⩽0.01 , 95 % CI : 0.2–1.4 ) . Boys who reported better television viewing habits ate more fruit ( P⩽0.001 , 95 % CI : −1.7 to −0.5 ) . Girls who reported better television viewing habits consumed less fat ( P⩽0.01 , 95 % CI : 1.4–9.0 ) and more fruit ( P⩽0.05 , 95 % CI : −1.0 to −0.1 ) . Girls who reported higher availability of healthy products at home ( P⩽0.05 , 95 % CI : 0.3–3.1 ) and more food rules ( P⩽0.001 , 95 % CI : −1.8 to −0.5 ) , consumed more fruit . Environmental factors were poor predictors of soft drink consumption among girls . Conclusion : Availability of (un)healthy food products , family food rules and TV viewing habits were related to one or more eating behaviours in boys or girls . Although home environmental factors can play an important role in influencing adolescents  ’ eating behaviours , these factors were generally less predictive than demographic and psychosocial variables . Sponsorship : Ghent University and Policy Research Centre Sport , Physical Activity and Health funded by the Flemish Government This study examined the feasibility of implementing an innovative theater-based after-school program , ' Ready . Set . ACTION ! ' , to reach ethnically diverse and low-income children and their parents with obesity prevention messages . The study population included 96 children and 61 parents . Children were in fourth to sixth grade and 41 % were overweight at baseline .  Program impact was evaluated with a pre/post-r and omized controlled study design , but a major focus was placed on the process evaluation conducted in the intervention schools . Intervention children and parents reported high program satisfaction and that they had made changes or intended to make positive changes in their behaviors due to program participation . However , few meaningful differences between the intervention and control conditions were found at follow-up . Thus , the combined process and impact evaluation results suggest that the intervention was effective in leading to increased awareness of the need for behavioral change , but was not powerful enough on its own to lead to behavioral change . From this feasibility study , we concluded that Ready . Set . ACTION ! offers promise as a creative intervention strategy . The next research step may be to incorporate theater-based programs into more comprehensive school-based interventions , with both educational and environmental components , and evaluate program impact The main objective of this study was to test an explanatory model predicting preschool girls ' and boys ' body weight from certain child variables ( food intake , sedentary behaviors , and eating habits ) , as well as family variables ( interaction during mealtime and level of family financial re sources allocated to meeting children 's eating needs ) . A r and omized stratified sub sample of parents was selected from a larger study ( Quebec Longitudinal Study of Child Development , QLSCD-1998 - 2002 ) , with a breakdown of 581 girls and 611 boys of 4 years of age . Children 's skin fold ratio , weight , height , and Body Mass Index ( BMI ) were recorded . Question naires were administered to parents ( usually the mother ) . Using structural equation modeling ( SEM ) separately for girls and boys , the family environment model of healthy weight development was tested . Results yielded a good fit of the model for both genders . For boys , significant predictors of body weight in the model were family food insecurity and conflicts during mealtime . Healthy eating was predicted by food insecurity , mealtime conflicts , and sedentary behaviors . Mealtime conflicts predicted sedentary behaviors . For girls , none of the variables predicted body weight , however food insecurity predicted less healthy eating . These results outline the importance of prevention and intervention within families with young children SamenvattingGewichtsproblemen bij kinderen vormen een snelgroeiend probleem , in het bijzonder bij gezinnen met lage inkomens . Eetgedrag ontwikkelt zich vroeg bij kinderen en wordt gevormd door gezinsleden . De dreumesperiode is een kritische periode om een begin te maken met gezonde eet 
    Output:
    
Construct validity was most commonly presented ( 86 % ) , usually with analysis of associations with child diet or weight/ BMI .