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Research Project: Preventing the Development of Childhood Obesity

Location: Children's Nutrition Research Center

2020 Annual Report

Objectives
Today, an estimated 16% of US children and adolescents are overweight and 17% are obese, and the prevalence continues to rise. Most child obesity prevention interventions have not been effective and additional research is necessary to address broader eating patterns, rural/urban differences and how parents influence their children’s behaviors. Researchers will conduct studies on: 1) characterize the food & activity environments in which teens in rural areas live, work, and play and their perceptions regarding obesity, challenges to eating healthfully and being physically active (PA), and ways in which technology might be useful in helping them engage in healthy behaviors; 2) in low-income Hispanic families with children, examine the following parent feeding and child eating behaviors based on data from an existing data set: the direction of effects between parent feeding styles and child eating behaviors; how parent feeding styles and child eating behaviors at baseline predict individual growth curve trajectories for child BMI across 3 time points; and how child eating behaviors interact with parent feeding styles in predicting child BMI over time; 3) assess the psychometrics of sub-scales of food and PA parenting and whether there is differential item functioning among a sample of ethnically and racially diverse fathers; 4) describe fathers' use of parenting practices that support healthful nutrition and PA for their children and how this varies by demographic factors, household responsibilities, and co-parenting alliance; 5) develop and assess the feasibility of child obesity prevention videos for mothers to better engage them during a father targeted obesity prevention program; 6) assess 3 aspects of infant temperament: a) surgency, negative affectivity, and affiliation/orienting by direct observation; b) infant eating behaviors as measured by several sucking parameters, for example maximal suck pressure, burst rate and reductions in pressure during bottle feeding, and c) infant adiposity by dual-energy x-ray absorptiometry, and characterize the associations between these traits; 7) the NHANES will be used to identify diet-related risk factors for obesity, and other health outcomes in children, adolescents, and adults specifically: identify eating patterns in children, adolescents and adults by gender and ethnicity; examine the association between eating patterns and obesity and related health risk factors; examine the impact of individual foods, nutrients, and food-specific patterns on obesity and health outcomes in children, adolescents, and adults; and identify the impact of eating patterns on dietary intake, nutrient adequacy, and diet quality; 8) examine the rural-urban differences in and associations between food security status, food availability, participation in federal nutrition assistance programs, dietary intake, and obesity among children across different age groups; and 9) determine the relationship between children's physical activity, diet, sedentary behavior, and sleep, on summer weight gain in children and the impact of parenting on these behaviors.

Approach
A multidimensional approach will be undertaken to address the obesity research conducted at the Children's Nutrition Research Center. A mixed methods research using a sequential explanatory design will be used to address the goals of understanding why rural adolescents have a higher prevalence of obesity than their urban counterparts. A secondary data analysis will be performed on data collected from a previous study to gain an insight on the direction of effects between parent feeding styles and child eating behaviors. A cross-sectional study of a racially/ethnically, income and educational diverse sample of fathers will be conducted to be able to better design food or physical activity parenting practice survey instruments for use amongst fathers. A cohort of infants from late preterm or full term births (>=36 weeks gestation) will be recruited and various observational studies will be conducted to monitor the infants’ temperament and correlation amongst the observations. Researchers will also perform secondary analysis using the 2011-2014 NHANES to compare weight and health risk outcome measures and nutrient intake with eating patterns in children, adolescents, and adults; using the 4 years of data will ensure an adequate sample size for the analyses. NHANES data from child as well as adult datasets on food security status will be used for the analyses to assess child as well as household food security status. And to better understand summer weight gain in children, researchers will review demographics, sleep, screen media use, meal patterns, physical activity, childcare arrangements and medication usage during summer via a structured parent interview.

Progress Report
To review the progress made during the year, please refer to the following projects: 3092-51000-063-01S (Project #1), 3092-51000-063-02S (Project #2), and 3092-51000-063-03S (Project #3).

Accomplishments
1. Outreach to parents and practitioners on healthy eating behaviors in young children. Researchers know that how a child eats may be as important as what they eat from the point of view of preventing childhood obesity. Further, we know that the first five years of life are a critical period for helping children learn how to regulate their food intake to match their energy expenditure, and so reduce their obesity risk. To help parents (and other caregivers) understand how they can best foster healthy behavior tendencies in their children, and help clinicians relay this information to patients and clients, researchers in Houston, Texas, partnered with the American Heart Association to release their first ever scientific statement giving advice on how to foster heathy eating behaviors in children ages 0-5 years. This is important as this guidance will broadly reach parents across the country providing strategies for healthy eating behaviors with the goal of reducing childhood obesity.

2. Food sources of shortfall nutrients among U.S. adolescents. Adolescents have greater nutrient needs compared to other age groups, and many do not adhere to the Dietary Guidelines for Americans/MyPlate recommendations. Researchers in Houston, Texas, conducted a study using existing datasets to identify food sources of shortfall nutrients (i.e. nutrients that are under-consumed relative to national recommendations) consumed by adolescents. Some of the food subgroups commonly consumed by adolescents made a significant contribution to shortfall nutrient intakes in the diet (i.e., vitamins A, C, D, and E, folate, calcium, magnesium, fiber, potassium, and iron). Awareness of nutrient intakes and food sources is essential to establish dietary guidance in a practical context.

3. Feeding styles, eating behaviors, and child weight status. Parent feeding and child eating behaviors have been implicated in the development of childhood obesity. Researchers in Houston, Texas, examined how parental feeding during preschool impacted child weight status. We found that parents who were indulgent feeders (no eating boundaries) had children with a higher weight status over a three-year period. This was found over and above child eating characteristics such as food responsiveness (responding to food cues such as smell and color), emotional overeating (eating when bored or unhappy), and satiety responsiveness (stopping eating when full). These results are important as they provide insight for the development of prevention programs targeting parental feeding behaviors.

4. Benefits of introducing complementary foods in the diets of infants and toddlers. Understanding which foods are introduced in the diet and when provides valuable information on complementary feeding. Fortified baby rice cereal is the most common first solid food given to infants, often followed by other baby cereals. Researchers in Houston, Texas, examined food patterns among infants and toddlers consuming rice or non-rice baby cereals versus cereal non-consumers using existing datasets. Baby cereal consumer groups, compared to non-consumers, had higher intakes of carbohydrates, iron, calcium, magnesium, zinc, and vitamin E. Infants 0–3 month and 4–6 month among the baby cereal consumption groups consumed other solid foods, including baby foods and beverages, sweetened beverages, coffee and tea, 100% juice, vegetables (excluding potatoes), fruit, sugars, milk and yogurt, and mixed dishes. This study provided detailed information on the introduction of baby cereals which was associated with other complementary foods and better intakes of nutrients that require special attention during early life.

5. Feeding styles and child weight status over time. Typical parent-directed analyses only look at the influence of parents' behaviors on their child's weight status. These analyses do not take into account the part that children play in the parent/child feeding dynamic. Researchers in Houston, Texas, examined the impact of a child's weight status on parental feeding and vice versa. We examined how a child's weight status influenced parental feeding of their child by looking at the direction of influence. We found that the weight status of the child impacted how indulgent parents (those who set no eating boundaries) fed their child. This is important as it is takes into consideration a neglected aspect of the parent/child feeding relationship – aiding parents to better understand that child characteristics may play a role in how they feed their children.

6. Gender impacts self-regulated eating behavior. Eating self-regulation (eating when hungry and stop eating when full) has been linked to the development of obesity in children. Researchers in Houston, Texas, conducted a study with Hispanic families which showed that, for girls only, lower levels of eating self-regulation during preschool predicted weight gain over a three year period. Girls' inability to wait for a larger pile of chocolate candies and immediately consuming the smaller pile was also related to weight gain over time. No such relationships were found for boys. These research findings support a focus on self-regulatory skills in prevention programs targeting young preschool aged girls. More research is needed on young boys to determine possible characteristics that may play a part in early obesity prevention.

U.S. DEPARTMENT OF AGRICULTURE

Children's Nutrition Research Center: Houston, TX