Parents substantially influence children’s diet and physical activity behaviors, which consequently impact childhood obesity risk. Given this influence of parents, the objective of this umbrella review was to synthesize evidence on effects of parent involvement in diet and physical activity treatment and prevention interventions on obesity risk among children aged 3–12 years old. Ovid/MEDLINE, Elsevier/Embase, Wiley/Cochrane Library, Clarivate/Web of Science, EBSCO/CINAHL, EBSCO/PsycInfo, and Epistemonikos.org were searched from their inception through January 2020. Abstract screening, full-text review, quality assessment, and data extraction were conducted independently by at least two authors. Systematic reviews and meta-analyses of diet and physical activity interventions that described parent involvement, included a comparator/control, and measured child weight/weight status as a primary outcome among children aged 3–12 years old were included. Data were extracted at the level of the systematic review/meta-analysis, and findings were narratively synthesized. Of 4158 references identified, 14 systematic reviews and/or meta-analyses (eight treatment focused and six prevention focused) were included and ranged in quality from very low to very high. Our findings support the inclusion of a parent component in both treatment and prevention interventions to improve child weight/weight status outcomes. Of note, all prevention-focused reviews included a school-based component. Evidence to define optimal parent involvement type and duration and to define the best methods of involving parents across multiple environments (e.g., home, preschool, school) was inadequate and warrants further research. PROSPERO registration: CRD42018095360.

Background: Diet is pivotal in preventing and managing cardiometabolic diseases. Our study aimed to describe the prevalence of poor diet quality and perceiving a poor diet as healthy and to determine individual-level factors associated with these groups. Methods: This cross-sectional study analyzed seven 2-year cycles of National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018, which included non-pregnant adults between 20 and 85 years old, who completed a one-day 24-h dietary recall and dietary interview. Diet quality was measured using the American Heart Association (AHA) primary diet score, and perceived diet quality was based on NHANES questionnaire response. Results: Among 31,644 adults, the prevalence of poor diet quality was 47%. Male sex and smoking were associated with a higher risk of poor diet quality, while older age, higher levels of education, increased income, diabetes mellitus diagnosis, and increased vigorous activity levels were associated with a lower risk of poor diet quality. Among adults with poor diet quality (n = 14,952), 23% perceived their diet as healthy. In multivariable analysis, older age, higher education, and vigorous activity level were associated with a higher risk of perceiving a poor diet as healthy. Conclusions: Nearly half of US adults had poor diet quality based on AHA guidelines for cardiovascular health, yet nearly a quarter of them perceived their diet as healthy. This gap underscores the need for focused educational efforts and interventions in both healthcare and public health settings to dispel diet-related misperceptions and motivate the adoption of a healthier diet to address cardiometabolic health.

Aim: The purpose of this systematic review was to evaluate robust interventions across seven eating practice outcomes and to consider potential modifiers, including parental involvement, intervention setting, and quality of food practice evaluation. Methods: The search procedure reflected Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Web of Science, PsychInfo, PubMed, and Elton B. Stephens Company (EBSCO) (2004–2019) were searched for studies that aimed to change children’s (2 to 12 years old) diet (one or more eating practice components: fruit, vegetables, whole grains, lower saturated fat, lower sugar-sweetened beverages (SSBs), intake of dairy, diet quality). Of 2316 papers, 22 met inclusion criteria. Results: Fruits ( n = 12) and vegetables ( n = 15) were the most frequent outcomes. Half of fruit-targeted, two-thirds of vegetable-targeted, half of fruit/vegetable-targeted, eight of nine SSB-targeted, and one of two whole grain-targeted outcomes showed significant improvements. The actual food intake change was modest in most cases. Eighteen interventions included parents, although the four that did not also reported significant outcomes. Most studies were conducted in schools, early childcare, or after-school programs ( n = 13) with significant improvements in most settings. Only about half of the studies involving children < 10 years used proxy reporting/direct observation. Eight studies included no reliability, validity, or citation for the method of dietary measurement. Conclusion: Robust studies continue to focus on one or two foods, parental involvement may be beneficial depending on the intervention, and more research is needed to establish best practices across all settings.