Original article The inﬂuence of family functioning on the consumption of unhealthy foods and beverages among 1- to 12-y-old children in Victoria, Australia Q5 Andre M.N. Renzaho Ph.D., M.P.H. a, b, * , Atemthi Dau a , Sheila Cyril M.P.H. a , Guadalupe X. Ayala Ph.D., M.P.H. c, d Q1 a Global Health and Society Unit, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia b Centre for International Health, Burnet Institute, Melbourne, Victoria, Australia c Graduate School of Public Health, San Diego State University, San Diego, California d Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, California article info Article history: Received 1 August 2013 Accepted 6 February 2014 Keywords: Unhealthy foods and beverages Family functioning Children Obesity Australia abstract Objective: Family functioning, which reﬂects how well family members communicate and interact with each other, is associated with childhood overweight and obesity, but its associationwith chil- dren’s eating behaviors remains unclear. The aim of this study was to examine the association between family functioning and unhealthy food and beverage consumption among children ages 1 to 12 y old. Methods: As part of the Victorian Child Health and Wellbeing study, a random sample of 4602 caregivers of children completed an interview during a single telephone interview in 2006. Caregivers reported on their child’s consumption of three types of unhealthy foods and beverages, and responses were recoded into weekly consumption of potato crisps and chips, monthly con- sumption of takeaway foods, and daily consumption of sweet beverages. Family functioning included general functioning (a ¼ 0.89) and parental psychological distress (a ¼ 0.78). Results: Consumption of potato crisps and chips occurred, on average, twice a week, while take- away foods were consumed an average of three times per month. Consistently and controlling for other covariates, male caregivers had children who consumed takeaway foods more frequently and who drank more daily cups of sweet beverages. Caregiver education and living in a single-parent household were consistently associated with poorer eating habits. In all models, general family functioning and parental psychological distress were associated with poorer eating habits. Conclusions: In addition to traditional methods for improving diet, family-based interventions need to target more general aspects of the family’s and caregiver’s functioning to improve dietary intake. Ó 2014 Elsevier Inc. All rights reserved. Introduction The consumption of unhealthy foods and beverages, espe- cially takeaway foods, is becoming more prevalent worldwide [1, 2]. The term unhealthy foods usually refers to energy-dense nutrient-poor foods and beverages that often are high in fat, sugar, and salt including sweet beverages; prepackaged snacks such as candy/lollies and chips; and takeaway or fast foods such as French fries, potato wedges, burgers, and pizza [3,4]. Increased consumption of unhealthy foods and beverages represents a public health concern affecting all levels of society [4,5]. Dele- terious health effects associated with increased consumption of unhealthy foods and beverages among children include obesity and its consequences [6–8] as well as asthma [9]. Many societal and family factors could explain the rise in consumption of unhealthy foods and beverages. Societal factors include increased reliance on takeaway foods [3], increased availability of high-calorie and nutrient-poor foods, particularly in poorer neighborhoods, and the availability of large portion sizes in restaurants [10–12]. Family functioning, as an element of the family environment, is an important factor in the regulation of children’s eating behaviors. It refers to activities essential to the survival of the family, including interactions between family members that involve emotional, physical, and psychological activities. It also involves other aspects of family life including acceptance of the individual, parental psychological well-being, problems in raising children, consumption of time by * Corresponding author. Tel.: þ61 3 929030802; fax: þ61 3 9466 9648. E-mail address: andre.renzaho@monash.edu (A. M. N. Renzaho). 0899-9007/$ - see front matter Ó 2014 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.nut.2014.02.006 Contents lists available at ScienceDirect Nutrition journal homepage: www.nutritionjrnl.com Please cite this article in press as: Renzaho AM, et al., The inﬂuence of family functioning on the consumption of unhealthy foods and beverages..., Nutrition (2014), http://dx.doi.org/10.1016/j.nut.2014.02.006 Nutrition xxx (2014) 1–6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 NUT9224_proof ■ 30 May 2014 ■ 1/6