Location: Children's Nutrition Research Center
2023 Annual Report
Objectives
Objective 1: Characterize the food and 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, and ways in which technology might be useful in helping them engage in healthy behaviors.
Objective 2: In low-income Hispanic families with children ages 4 to 5 at baseline, examine the following parent feeding and child eating behaviors based on data from an existing data set:
Objective 2A: the direction of effects between parent feeding styles and child eating behaviors;
Objective 2B: how parent feeding styles and child eating behaviors at baseline predict individual growth curve trajectories for child body mass index (BMI) across three time points 18 months apart (ages 4 to 5 at baseline; ages 5 1/2 to 6 1/2 at Time 2; ages 7 to 8 at Time 3);
Objective 2C: how child eating behaviors interact with parent feeding styles in predicting child BMI overtime.
Objective 3: Assess the psychometrics of sub-scales of food and physical activity parenting and whether there is differential item functioning among a sample of ethnically and racially diverse fathers.
Objective 4: Describe fathers' use of parenting practices that support healthful nutrition and physical activity for their children and how this varies by demographic factors (race/ethnicity, education, income), household responsibilities, and co-parenting alliance.
Objective 5: Develop and assess the feasibility of child obesity prevention videos for mothers to better engage them during a father targeted obesity prevention program.
Objective 6: Assess three aspects of infant temperament: 1) surgency, negative affectivity, and affiliation/orienting by direct observation; 2) infant eating behaviors as measured by several sucking parameters, for example maximal suck pressure, burst rate and reductions in pressure during bottle feeding, and 3) infant adiposity by dual-energy x-ray absorptiometry, and characterize the associations between these traits.
Approach
Obesity is the most prevalent nutrition-related pediatric problem in the US and most child obesity prevention interventions have not been effective. Although there has been disagreement regarding the reasons for this lack of documented success, likely reasons include not understanding or adequately addressing: a) the role of place of residence on obesity risk; b) how parents influence child behaviors; c) how to accurately assess intervention effects; d) cultural influences; and/or e) the role of child characteristics, such as temperament, on obesity risk. Using an approach informed by the Socio-Ecological Model, four independent research projects will address these knowledge gaps. We will conduct mixed methods research to understand factors that influence obesity risk of rural adolescents and the ways in which technology may be used to help them make healthy choices. Additionally, we will take an intensive look at the family by assessing how feeding styles and practices influence child eating behaviors, and assess how to independently engage both fathers and mothers in obesity prevention interventions and accurately assess father's food and physical activity parenting behaviors. Researchers will also examine the role of child temperament on infant feeding behavior and adiposity.
Progress Report
For Objective 1, recruitment was closed January 2023 (40 families), data collection closed in March, and data analyses were initiated. Preliminary findings were shared during a Children's Nutrition Research Center research seminar in March and an invitation to present to the ARS National Program Leaders (Office of National Programs) was extended where more complete results were presented. In general, adult research participants were 30-49 years old (75%), female (83%), and married (83%). Most self-identified as White (90%), while a few self-identified as Black (8%) or Other (3%). When asked ethnicity, 43% self-identified as Hispanic. Most had a college educated adult living in the home (75%), owned a vehicle (100%), had an annual household education of $61,000 or greater (70%), and spoke English at home (98%). Nearly all reported food shopping one or more times per week (90%) at a grocery store (95%) 20 or fewer miles away from home (88%). Eating the dinner meal together as a family three or more times a week was common (85%). Not having enough to eat (5%) and hunger over the past 12 months (10%) was uncommon. The sample also contained more younger (58%) than older (43%) teens. Teen racial and ethnic distribution was similar to that of parents. Preliminary findings indicated that teens perceived family, particularly the mother, to be the strongest positive influence on diet, while the father and siblings were the strongest family influences on physical activity. Friends influenced both behaviors in positive and negative ways. Modeling and co-participation in activities were the most often reported ways in which physical activity (PA) was supported. The lack of healthy food options in the community was a common challenge to eating healthy. School was a positive influence on physical activity. Being physically active appeared to be a normative behavior in teens who live in rural communities – i.e., being physically active was part of daily living.
For Objective 2, in the previous years of this project we examined the interrelationships between feeding styles, child eating behaviors, and child weight. Specifically, the goal of Objective 2C was to examine how child eating behaviors interact with parent feeding styles in predicting child body mass index over time. Results showed that children who were highly motivated to eat were found to interact with parental feeding styles in predicting child weight three years later. Unexpectedly, parents whose feeding styles were considered authoritative (described as balanced regarding parental control and autonomy support) predicted higher child weight but only for children who were low on motivation to eat. This is in contrast to the literature on general parenting styles, which has repeatedly found that a balance between parental control and autonomy support (authoritative parenting style) predicts better child outcomes across multiple domains including socio-emotional development, cognitive development, and health outcomes. More research is needed to better understand feeding style approaches to feeding children and child outcomes.
In Objective 3, researchers have finalized the analysis of the shortened food and PA parenting surveys to assess the reliability and statistical soundness of the survey tools. As indicated in our research plan, this study leveraged existing data on Hispanic fathers on their use of food and PA parenting practices funded by the National Heart, Lung and Blood Institute (NHLBI) (R34HL131726), by adding a data collection on an ethnically and racially diverse sample of fathers. We have completed data collection, with 228 Hispanic fathers recruited for the NHLBI funded study and 378 non-Hispanic fathers recruited for our USDA study. The USDA study included 55.0% white, 27.5% black, 10.1% Asian, 7.4% other (American Indian, Hawaiian/Pacific Islander, mixed and self-identified as other) fathers. The primary objective of this study is to provide an assessment of the psychometric properties of a reduced version of the Physical Activity Parenting Practices and the Food Parenting Practices (FPP) item banks administered to a diverse sample of fathers of 5-11 years old children from the U.S. In addition, this study determined whether the factor structure of the Parenting Practices surveys was comparable between the English and Spanish versions, and by self-reported ethnicity (Hispanic, non-Hispanic). To ensure we had a large enough sample who completed the survey in Spanish for the analysis, data from the baseline assessment of the Feasibility Study of the culturally adapted Healthy Dads Healthy Kids was also utilized resulting in 81 surveys completed in Spanish and a statistical oversampling technique was applied to this data to increase the sample to 243 observations to aid in statistical testing. Overall, the results of the analysis of the shortened food parenting practices survey replicated the findings from a study of Canadian parents on the longer survey, with the exception of small modifications made to the Control portion of the FPP survey (three questions were dropped from the survey). Survey responses among those reported to be Hispanic and non-Hispanic had similar findings and across both survey languages, the FPP analyses was found to adequately support the conceptual framework of the survey. Similarly, the analysis of the shortened PA parenting practices survey found reasonable agreement to the structure of the longer survey based on Canadian parents’ responses, but the solutions were slightly more complex for the shortened survey than the originally survey structure. The proposed survey structure was almost identical for surveys completed in English and Spanish and surveys completed by Hispanic and non-Hispanic respondents. This study supports the use of a shortened version of both the food and physical activity parenting practice surveys when administering the survey in English and Spanish to Hispanic and non-Hispanic fathers in the U.S.
With the completion of Objective 3, we can now begin the analysis to address Objective 4, to assess fathers' use of parenting practices that support healthful nutrition and PA for their children and how this varies by demographic factors (race/ethnicity, education, income), household responsibilities, and co-parenting alliance. Using the data from the 606 fathers from the online study from Objective 3, we will evaluate different patterns of food and physical activity parenting practices and how those patterns vary by demographic variables, household responsibilities and co-parenting alliance within the sample.
Objective 5. Findings were presented at national and international meetings as part of the larger Healthy Dads Healthy Kids feasibility study. Videos that were developed for mothers/partners in the father-focused healthy weight program are being implemented in the NHLBI funded Efficacy Trial of Healthy Dads Healthy Kids for Hispanic families (R61/R33 HL155015).
For Objective 6, we have completed the coding of infant temperament for the electronic recordings of up to 125 infants (125 infants at 4 months of age, and 80 infants at 12 months of age). Two aspects of infant temperament (positive affect and interest/persistence) have been coded for all infants, using the coding scheme proposed, which codes the presence/absence of behaviors in 10-15 second time spans (called "epochs"). Our analyses showed that positive affect, when assessed at 4 months of age, predicted adiposity at 12 months of age, but only when assessed in a non-social context (when the infants’ mothers were not present) vs. a social context (i.e., in the presence of their mothers). These findings provided some of the first evidence that aspects of temperament, in this case, positive affect, associates with adiposity in very early childhood. Subsequently, we were interested in whether nutrition could serve as a pathway between early temperament and adiposity. Therefore, we conducted four investigations examining pathways between nutrition and the risk of chronic disease, using metabolomics data. These investigations consistently demonstrated that the associations of diet-related metabolites with health outcomes are orders of magnitude stronger than those between reported dietary intake and health outcomes in the same cohorts and identified putative molecules (metabolites) contributing to the pathways between nutrition and health. We will apply this diet-metabolite-health paradigm to children in early childhood and use metabolites as an intermediate variable to investigate links between dietary intake, temperament, and adiposity.
Accomplishments
1. Maternal feeding, child eating and weight. It is understood that the way parents feed their children affects the child’s long-term health; however, little is known about how differences in child eating influence how parents feed their children. Children's Nutrition Research Center researchers in Houston, Texas, discovered that children’s motivation to eat and parental feeding styles played a role in children’s weight three years later. Multi-year data were collected from Hispanic Head Start mother/child groups; child ages 4-5 years (first time point) and 7-9 years (follow-up; second time point). Unexpectedly, children of parents with authoritative feeding styles (described as balanced regarding parental control and autonomy support), who were low on motivation to eat, had a higher risk for obesity. This is in contrast to existing literature showing that a balance between parental control and autonomy support (authoritative parenting style) predicts better child health outcomes. More research is needed to better understand feeding style approaches to feeding children and child outcomes.
2. Development of a passive tool for measuring children's TV viewing. Children's screen media use (TV viewing, mobile device use and videogame playing) has been associated with a higher a risk of overweight and obesity, but the mechanisms for how screen use leads to excess weight gain are not well understood. One reason for this is the inadequate methods used to measure children's screen media use. Researchers at the Children's Nutrition Research Center in Houston, Texas, partnered with electrical engineers at Rice University to develop a new, passive approach for measuring children's TV viewing in their home that is robust and provides time-stamped data throughout the day of when a target child is watching a TV in their home. This novel method for measuring TV viewing can be combined with newer approaches for tracking children's mobile device use to more accurately measure children's exposure to screen media throughout a day and across multiple days. Customers and stakeholders who will benefit from or have an interest in this research include families with children, researchers who investigate screen media use in children, practitioners involved in helping families monitor or regulate screen media use in children, and policy makers who develop and advocate for family-based policies promoting and supporting guidelines for screen media use in children.
3. Infant temperament predicts adiposity development in the first year of life. Pediatric obesity remains high, even in the very young with recent estimates almost 23% of 2-5 year olds are overweight or obese, and in approximately 8% of this population this tendency is seen before two years of age. Very little is known about what child factors correlate with weight status in infancy (0-12 months of age). Researchers at the Children's Nutrition Research Center in Houston, Texas, conducted observations of children's temperament and assessed their body composition at 4- and 12- months of age. In these children, positive affect at 4 months, i.e., how much a child smiles, laughs, and makes happy verbalizations at this early stage, was not concurrently associated with adiposity, but did predict a child's body composition at 12- months of age. This represents the first time that observations of infant temperament by someone other than the child's primary caregiver have predicted later adiposity. These findings may help identify children at risk of developing excess adiposity in the first year of life and give researchers a new pathway to examine for contributions to early-onset obesity.
