Alabama Children's Body Mass Index, Nutritional Attitudes, and Food Consumption: An Exploratory Analysis

This study had three aims: assess the extent to which middle school children in southern Alabama were classified as overweight or obese; determine the magnitude of the relation between children's attitudes toward healthy eating and their actual dietary choices; and examine the role of race, sex, and ZIP codes on children's eating attitudes and behaviors.

Registered dietitians took height and weight measurements of middle school children in southern Alabama to establish body mass index (BMI). Children were given a Likert-type survey with multiple-choice items to assess the study's objectives. Descriptive statistics were generated, and structural equation modeling was used to examine potential moderating effects on the associations between a latent variable of healthy eating attitudes and a latent variable of healthy eating behaviors across race and ethnicity. A series of analyses of variance was used to determine any significant differences in the children's attitudes across schools. The χ² tests were used to examine potential race differences in BMI.

A total of 630 children participated in the study. Their average age was 12 years. More than half (53%) of the children were girls, and more than half (61%) were White. Approximately one-third (29%) identified as Black/African America. A large proportion of children across the sample (42.3%) were classified as overweight or obese. The multigroup structural equation modeling yielded a significant direct path between healthy attitudes and healthy eating behaviors. Healthy eating attitudes strongly predicted intentions toward healthy eating behaviors for children classified as normal weight and for those children classified as overweight or obese. Children's BMI classifications did not differ significantly across schools, race, or sex.

A large percentage of children in south Alabama were classified as overweight or obese, conditions that are preventable. Moreover, evidence suggests a lack of nutritious food in their diets. Children overall endorsed healthy eating attitudes, and those attitudes were strongly related to healthy food choices; however, their level of healthy food consumption was not related to their BMI classification. Although children in this study were from three schools and represented a variety of racial, sex, and socioeconomic systems, there were more similarities than differences in their healthy eating attitudes or behavior. These similarities highlight the need for research to examine other factors, such as southern culture, as a potential contributor to childhood obesity.