Helen Croker

University College London | UCL · Department of Epidemiology and Public Health

Children’s avid eating behaviour is characterised by frequent snacking and food responsiveness. Parents need evidence-based advice on specific feeding practices, such as distraction techniques and portioning, that can be used to reduce children’s intake of high energy-dense snacks. This experimental laboratory study tested the effectiveness of thes...

Background The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical a...

As the global population ages, and rates of modifiable risk factors for cancer change, cancer incidence and mortality continue to increase. While we understand many modifiable risk factors related to diet, nutrition, bodyweight, and physical activity in adulthood that influence cancer risk, how exposure during childhood, adolescence, and young adul...

Based on the World Cancer Research Fund Global Cancer Update Programme, we performed systematic reviews and meta‐analyses to investigate the association of post‐diagnosis adiposity, physical activity, sedentary behaviour, and dietary factors with colorectal cancer prognosis. We searched PubMed and Embase until 28th February, 2022. An independent ex...

Background An avid eating behavior profile is characterized by a greater interest in food and a tendency to overeat in response to negative emotions. Parents use specific strategies to manage feeding interactions with children with avid eating behavior. While momentary and contextual factors, such as parental mood, have been found to influence pare...

Background The number of women entering pregnancy with overweight or obesity is increasing. This can increase the risk for excessive gestational weight gain (GWG) which is associated with health complications for mother and baby. There are limited evidence-based interventions within antenatal care settings to encourage healthy eating and physical a...

BACKGROUND An avid eating behavior profile is characterized by a greater interest in food and a tendency to overeat in response to negative emotions. Parents use specific strategies to manage feeding interactions with children with avid eating behavior. While momentary and contextual factors, such as parental mood, have been found to influence pare...

Background Parental feeding practices (PFPs) are a key component of a child's food environment. Parent–child feeding relationships are hypothesised to be bidirectional; however, to date, few large prospective studies have examined this, instead focussing on unidirectional relationships. As such, the direction of relationships between PFPs and child...

Background Many individuals living with and beyond cancer (LWBC) have ongoing quality of life (QoL) issues, including fatigue. The World Cancer Research Fund (WCRF) provides health behaviour recommendations for people LWBC, and there is some evidence linking adherence to these with improved QoL. Methods Adults LWBC (specifically breast, colorectal...

Abstract Background Parental feeding practices (PFPs) have been implicated in the development of children’s eating behaviours. However, evidence suggests that feeding practices may also develop in response to their child’s weight or emerging appetitive traits. We used the twin design to test the hypothesis that parents develop their feeding practic...

Parental feeding practices are a key modifiable component of children's food environments. Evidence suggests that certain feeding practices may differentially influence children's eating behaviour or weight, depending on the child's temperament (e.g. emotionality). Building on this work, we tested the hypothesis that feeding practices during toddle...

Objective The aim of this study was to determine whether specific psychological factors influence intervention effects for children with severe obesity in a clinical setting. Design Secondary analyses of data about attention deficit/hyperactivity disorder (ADHD) characteristics, body satisfaction, social and emotional functioning, and the primary...

Self-completed 24 h dietary recalls (24-HRs) are increasingly used for research and national dietary surveillance. It is unclear how difficulties with self-completion affect response rates and sample characteristics. This study identified factors associated with being unable to self-complete an online 24-HR but willing to do so with an interviewer....

BACKGROUND AND OBJECTIVES Young people are exposed to an abundance of advertising for unhealthy products (eg, unhealthy foods, tobacco, alcohol). Because of their developing cognition, children may not be able to understand the intent of advertising. However, advertising restrictions often assume that adolescents have critical reasoning capacity an...

Little is known about how diet might influence breast cancer prognosis. The current systematic reviews and meta‐analyses summarise the evidence on postdiagnosis dietary factors and breast cancer outcomes from randomised controlled trials and longitudinal observational studies. PubMed and Embase were searched through 31st October 2021. Random‐effect...

It is important to clarify the associations between modifiable lifestyle factors such as physical activity and breast cancer prognosis to enable the development of evidence‐based survivorship recommendations. We performed a systematic review and meta‐analyses to summarise the evidence on the relationship between postbreast cancer diagnosis physical...

Based on the Global Cancer Update Programme, formally known as the World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project, we performed systematic reviews and meta‐analyses to investigate the association of postdiagnosis body fatness, physical activity and dietary factors with breast cancer prognosis. We searche...

Previous evidence on postdiagnosis body fatness and mortality after breast cancer was graded as limited‐suggestive. To evaluate the evidence on body mass index (BMI), waist circumference, waist‐hip‐ratio and weight change in relation to breast cancer prognosis, an updated systematic review was conducted. PubMed and Embase were searched for relevant...

Abstract Background This study aimed to capture public beliefs about living with obesity, examine how these beliefs have changed over time and to explore whether certain characteristics were associated with them in a nationally representative sample of adults from the Republic of Ireland (RoI) and Northern Ireland (NI). Methods A cross-sectional su...

In 2015, Tesco Express convenience stores implemented a healthy checkouts initiative; products high in fat, salt or sugar were removed from in‐queue areas. We compare purchasing of less healthy foods before and after its introduction. Tesco provided store‐level sales data (n = 1151) for Express stores in England over two 8‐week periods, May–July 20...

Front-of-pack labels (FOPLs) provide simplified nutritional information that aims to inform consumer choice and encourage reformulation. We conducted an online randomised controlled experiment on a representative British sample to test the effectiveness of FOPLs across a range of outcomes. The primary outcomes have been published; here, we present...

Purpose Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI). Method A sample of 1...

Licensed and brand equity characters are used to target children in the marketing of products high in fat, salt, and sugar (HFSS), but the impact of characters on dietary outcomes is unclear. The primary aim of this review was to quantify the impact of both licensed and brand equity characters on children's dietary outcomes given that existing regu...

Background Simulated interventions using observational data have the potential to inform policy and public health interventions where randomised controlled trials are not feasible. National childhood obesity policy is one such area. Overweight and obesity are primarily caused by energy-rich and low-nutrient diets that contribute to a positive net e...

Celebrities, including influencers, are commonly used to market products that are high in fat, sugar, and salt (HFSS) to children but the impact on dietary outcomes has been unclear. The primary aim of this study was to systematically review the literature and quantify the impact of celebrities in HFSS marketing on children’s dietary outcomes. We s...

Importance School closures as part of broader social lockdown measures during the COVID-19 pandemic may be associated with the health and well-being of children and adolescents. Objective To review published reports on the association of school closures during broader social lockdown with mental health, health behaviors, and well-being in children...

Purpose: The present study aimed to quantify the level of sleep problems in 5835 breast, prostate, and colorectal cancer survivors, and explore a number of potential determinants of poor sleep quality in the present sample. BMI, diet, and physical activity were of particular interest as potential determinants. / Methods: Participants who completed...

Appetitive traits are associated with weight and could be managed using behavioural strategies. Personalised approaches to weight loss could use a person's appetitive trait profile to tailor weight management advice. This study aimed to explore participants’ experiences of a brief Appetitive Trait Tailored Intervention (ATTI) based on participants’...

Background Optimal energy balance behaviours in pregnancy reduce maternal and foetal risk of obesity. A brief intervention (defined as one that is purposefully limited in frequency and time of contact) delivered by during routine antenatal care may promote health behaviour change. We aimed to assess the effectiveness of brief interventions targetin...

Obesity is widespread, with serious health consequences; addressing it requires considerable effort at a public health level, incorporating prevention and management along with policies to support implementation. Behavioural weight-management programmes are widely used by public health bodies to address overweight and obesity. Shape-Up is an eviden...

Background The aim was to pilot an adapted manualised weight management programme for persons with mild–moderate intellectual disabilities affected by overweight or obesity (‘Shape Up-LD’). Method Adults with intellectual disabilities were enrolled in a 6-month trial (3-month active intervention and 3-month follow-up) and were individually randomi...

Background Maternal obesity and excessive gestational weight gain are associated with adverse maternal and foetal health outcomes. Interventions targeting dietary and physical activity behaviours during pregnancy have typically been directed at women only. A digital intervention targeting couples could encourage expectant parents to support each ot...

Background In the UK, rates of childhood obesity are high and inequalities in obesity have widened in recent years. Children with obesity face heightened risks of living with obesity as adults and suffering from associated morbidities. Addressing population prevalence and inequalities in childhood obesity is a key priority for public health policym...

Front of pack food labels (FOPLs) provide accessible nutritional information to guide consumer choice. Using an online experiment with a large representative British sample, we aimed to examine whether FOPLs improve participants’ ability to identify the healthiness of foods and drinks. The primary aim was to compare ability to rank between FOPL gro...

Background The well-documented links between education and health mean that school closures during the COVID-19 pandemic are likely to be associated with significant health harms to children and young people (CYP). A systematic review of the evidence is needed to inform policy decisions around school closures and re-openings during the pandemic. Me...

Background Maternal obesity and excessive gestational weight gain are associated with adverse maternal and foetal health outcomes. Interventions targeting dietary and physical activity behaviours during pregnancy have typically been directed at women only. A digital intervention targeting couples could encourage expectant parents to support each ot...

Background Evidence indicates that early life is critical for determining future obesity risk. A sharper policy focus on pregnancy and early childhood could help improve obesity prevention efforts. This study aimed to systematically identify and categorise policy levers used in England with potential to influence early life course (pregnancy, 0–5 y...

Background Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. A novel 3D body size scale (3D BSS) may facilitate engagement with this topic during pediatric appointments. Objectives To explore barriers and facilitators to using the 3D BSS through a mixed‐methods design. Methods For the qualitative phase,...

Background Simulated interventions using observational data have the potential to inform policy and public health interventions where randomised controlled trials are not feasible. National childhood obesity policy is one such area. Overweight and obesity are primarily caused by energy-rich and low-nutrient diets that contribute to a positive net e...

In response to the coronavirus disease 2019 (COVID-19) pandemic, 107 countries had implemented national school closures by March 18, 2020. It is unknown whether school measures are effective in coronavirus outbreaks (eg, due to severe acute respiratory syndrome [SARS], Middle East respiratory syndrome, or COVID-19). We undertook a systematic review...

Background Evidence indicates that early life is a critical time for determining future risk of obesity. A sharper policy focus on pregnancy and early childhood would be useful to improve obesity prevention efforts. This study aimed to systematically identify and categorise the policy levers being used in England that have potential to influence ea...

Background Five linked studies were undertaken to inform identified evidence gaps in the childhood obesity pathway. Objectives (1) To scope the impact of the National Child Measurement Programme (NCMP) (study A). (2) To develop a brief evidence-based electronic assessment and management tool (study B). (3) To develop evidence-based algorithms for...

Background: Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventi...

Adapting a food frequency questionnaire to assess dietary intake of people living with and beyond cancer - Volume 79 Issue OCE1 - S. Esser, R. Conway, M. Michalopoulou, V. Ireland, P. Lally, R. Beeken, A. Fisher, H. Croker

Use of online dietary recalls to assess adherence to dietary guidelines in people living with and beyond cancer: feasibility and process requirements for ASCOT - Volume 79 Issue OCE1 - R. Conway, S. Esser, M. Michalopoulou, V. Ireland, P. Lally, R. Beeken, A. Fisher, H. Croker

Background Malnutrition is associated with increased morbidity and mortality, and is very common in frail older people. However, little is known about how weight loss in frail older people can be managed in primary care. Aims To explore the views and practices of primary care and community professionals on the management of malnutrition in frail o...

Background: dehydration is associated with significant adverse outcomes in older people despite being largely preventable and treatable. Little research has focused on the views of community-dwelling older people on hydration, healthy drinking and the perceived importance of drinking well in later life. Objectives: to understand community-dwelli...

Introduction Appetitive traits, including Food Responsiveness, Enjoyment of Food, Satiety Responsiveness, Emotional Over- and Under-Eating, Food Fussiness and Slowness in Eating, have been captured across childhood using the Children’s Eating Behavior Questionnaire (CEBQ). The Adult Eating Behavior Questionnaire (AEBQ) has explored these traits in...

Introduction: Malnutrition is associated with increased morbidity and mortality. However, we know little about the views of stakeholders on its current management in the community. Our aims were to a) explore the views and practices of older people at risk of malnutrition, their carers, primary care/community professionals on managing malnutrition,...

The problem Malnutrition is associated with increased morbidity and mortality and is estimated to affect 1.3 million people >65 in the UK. However, we know little about the views of older people, carers and health professionals on current management of weight/appetite loss in community-dwelling frail older adults. The aims of this study were to a)...

Background: While malnutrition is an important cause of morbidity and mortality in older people, it is commonly under-recognised. We know little on the views of community-dwelling older people and their carers regarding the management of malnutrition. The aim of the study was: (a) to explore views and dietary practices of older people at risk of m...

Background: The Ten Top Tips (10TT) is an intervention based on the habit formation theory that promotes a set of weight management behaviors alongside advice about repetition in a consistent context. Overall, 3 studies have demonstrated that the 10TT can support individuals to lose weight when delivered in a leaflet format. Delivery of 10TT via ne...

Data S1. Supporting Information

Evidence indicates that screen advertising for unhealthy food results in significant increases in dietary intake among children. This review was undertaken with the main aim of estimating the quantitative effect of screen advertising in experimental and nonexperimental conditions on children's dietary intake. Systematic searches were undertaken of...

Background Removing unhealthy products from checkouts will arguably reduce impulse purchasing, but evidence is lacking. In 2015, Tesco Express stores implemented so-called healthy checkouts; products high in sugar, fat, or salt (defined by national Nutrient Profiling Model criteria) were removed from in-queue areas. We aimed to compare the purchasi...

BACKGROUND The Ten Top Tips (10TT) is an intervention based on habit formation theory that promotes a set of weight management behaviours alongside advice about repetition in a consistent context. Three studies have demonstrated that the 10TT can support individuals to lose weight when delivered in leaflet format. Delivery of 10TT via new technolog...

Background: There is consistent evidence that suggests first year students are at risk of weight gain, but the reasons for this vulnerability are still unclear. This study aimed to explore whether the ability to regulate eating behaviours is a predictor of weight and dietary changes in first year undergraduate students. Methods: First year under...

Introduction There is consistent evidence that suggests first year students are at risk of weight gain, but the reasons for this vulnerability are still unclear. Given the dramatic changes in routine, environment and social life experienced by first year undergraduate students, some level of self-regulatory skills may be required to keep healthy ha...