Preventing Childhood Obesity: Targeting the Diet of the Mother and Child Dyad

University Of Cincinnati, Cincinnati OH

Investigators

Abstract

[unreadable] DESCRIPTION (provided by investigator): Childhood obesity is a growing national public health concern. Poor dietary behaviors begin early, as evidenced by a recent national survey that found the diets of infants and toddlers to be high in calories, fat, and sugar and low in vegetables. Vegetables are a critical component of energy balance because they are nutrient dense and low in calories. The first year of life provides a unique opportunity to introduce a variety of vegetables because infants are more open to trying new foods than older children. Furthermore during this time the child's diet is greatly influenced by the mother, directly by choosing what her infant is offered to eat and indirectly by exposure to flavors of food through her breast milk if she chooses to breastfeed. Thus, improving infants' diets is dependent on improving mothers' diets. Additionally, because many women enter pregnancy overweight and gain excess weight during pregnancy, making improvements in the maternal diet will assist in postpartum weight control. To date there have been no studies showing that modifying the maternal diet can affect the child's diet in a real-life setting. The long-term goal of this research is to promote the early adoption of healthy eating patterns, thereby aiding in lifetime weight management. The objective of this proposal is to evaluate the effectiveness of a dietary intervention on increasing vegetable intake in postpartum, overweight mothers and their children. The aim is to evaluate the effectiveness of a dietary intervention by comparing the dietary intake and body weight-for-height between mother/child dyads in the intervention (N=70) and usual care (N= 70) groups. Each of these groups will have an equal proportion of breastfeeding and formula-feeding mothers. The 12-month intervention will emphasize the replacement of high-energy, low-nutrient-dense foods with vegetables (focusing on deep yellow and dark green). It will consist of four face-to-face dietary counseling sessions targeting the mother's diet, starting solid foods and transitioning to toddler foods. Monthly phone calls (8 total) using behavioral techniques will complement the counseling sessions. Outcomes (mother's self-efficacy, mother/child dietary parameters, and weight-for- height/length indices) will be assessed at baseline (six weeks after delivery) and when the child is 6, 12, and 18 months of age (6 months post intervention). Accordingly, the study has two hypotheses. The first hypothesis is that mother/child dyads who participate in the dietary intervention will be more likely to improve their diets through a greater increase in intake of vegetables and a greater decrease in caloric intake leading to normalization of body weight-for-height compared to mother/child dyads who receive usual care. The second hypothesis is that the child's vegetable intake will be associated with the mother's vegetable intake modified by degree of exposure to breastfeeding. Breastfeeding exposure will be measured as part of the dietary intake collected at each data measurement point. The rationale for this study is to lead to the design of a full-scale clinical trial to improve the diets of women and children. Until such trials are conducted, efforts to prevent childhood obesity will continue to face the challenge of reversing poor eating habits learned very early in life. [unreadable] [unreadable] PUBLIC HEALTH RELEVANCE: Recent available data show that not only do children struggle with overweight, but toddlers and infants are now experiencing similar problems as evidenced by the doubling of the rate of overweight in the last thirty years. This dietary intervention targeting postpartum, overweight mothers and their infants is aimed at preventing childhood obesity by giving mothers the skills and confidence to feed themselves and their children a diet that contains nutrient-dense, low energy foods. [unreadable] [unreadable] [unreadable]