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Research Project: Acute Effects of Sedentary Behaviors on Cardiometabolic Risk in Latino Youth

Location: Children's Nutrition Research Center

2022 Annual Report


Objectives
(1) Examine the acute effects of sedentary behaviors on energy metabolism and cardiometabolic health in Latino adolescents, after adjusting diet. (2. NEW) To assess the feasibility and acceptability of a digital cooking intervention among low-income parents of 6-11 year-old children.


Approach
Researchers will utilize whole-room calorimetry to examine the effects of an acute bout of sedentary behaviors on cardiometabolic outcomes (glucose, insulin, lipids, arterial stiffness) and energy metabolism (energy expenditure, substrate utilization) in Latino adolescents (12-16 years old) with obesity (BMI% '95th) as compared to non-Latino white adolecents (12-16 years old) with obesity (BMI% '95th). Findings from this study will increase our understanding of the contributions of sedentary behaviors to the development of cardiometabolic diseases in high-risk youth. This information will inform future behavioral interventions aimed at reducing sedentariness to reduce disease risk and address health disparities in Latino youth. Researchers will use the Healthy Cooking Index to create a tailored, digital cooking intervention with the goal of improving cooking practices among low-income parents and, in turn, increasing the diet quality of their children. The primary objective of this study is to develop and test a digital cooking intervention in low-income parents of 6-11 year-old children in a single arm, prospective feasibility trial. Intervention development will be informed by qualitative formative research.


Progress Report
Progress towards Objective 1 was made as we continued recruitment and data collection efforts. Regarding recruitment, we have contacted 162 potential participants from the Children's Nutrition Research Center Volunteer Database. Many potential participants have received multiple phone calls and follow-up emails. To date, 38 youth have been screened for participation and eight were found to be eligible. We have successfully completed data collection on four participants. Preliminary reviews have been conducted on calorimeter, dual-energy X-ray absorptiometry (DXA), and anthropometric data to assess protocol fidelity and check for abnormal values. To continue progress towards Objective 1, we will continue to contact potential participants through the volunteer database and will expand our recruitment network by working with the Baylor College of Medicine marketing department to launch a social media campaign to identify additional potential research participants. Adherence to COVID-19 safety protocols prior to subject data collection has become a barrier to data collection. While this requirement was put in place to ensure the safety of both participants and research staff, it has discouraged participation during the screening process. Furthermore, a few participants have completed the COVID-19 testing requirement, yet were not able to obtain results within 48 hours, resulting in a canceled appointment. This year, we will attempt to work with Texas Children's Hospital's pathology services to develop a suitable testing strategy to overcome this barrier to data collection. A new project was also established based upon a new researcher joining the center. This research focuses on promoting healthy cooking skills among high-risk communities, to encourage adherence to the USDA’s Dietary Guidelines for Americans. Specifically, we plan to develop and test a digital healthy cooking intervention for low-income parents of 6 – 11 year old children. Our primary objective is to assess the feasibility and acceptability of the intervention. It is important to include communities in the development of new health interventions to ensure that program materials are relevant and meaningful to users. Sub-objective 2A was to characterize current food preparation behaviors and the use of online cooking resources among low-income parents of 6 – 11 year old children; Sub-objective 2B was to examine the needs and preferences for digital cooking intervention content in this population. To accomplish these Sub-objectives and inform the development of our intervention, this year we conducted mixed methods research (surveys and in-depth interviews) with 20 low-income parents to find out what and how they would like to learn healthy cooking skills in a digital environment. We hired and trained staff to conduct interview research and created surveys and interview guides through an iterative process with our Children's Nutrition Research Center colleagues. Beginning in February, we successfully screened 33 potential participants and enrolled 20 eligible parents in ~3 months using community outreach and our volunteer database. All enrolled participants completed the survey and interviews. The digital surveys examined current food and cooking behaviors, use of online food media, and cooking intervention preferences. The follow-up interviews examined these topics in more depth, and asked participants about their perspectives on healthy eating, as well as facilitators and barriers to healthy cooking. Interviews lasted up to an hour, were conducted over video conferencing software (i.e., Zoom), and were recorded and professionally transcribed. All interviews and surveys are complete and the survey data has been analyzed. Interviews have been transcribed, quality checked, and we are in the process of analyzing the documents. Our participants were all women (which was expected as women are typically responsible for home food preparation), 45% had educational achievement of a high school degree or less, and there was substantial racial/ethnic diversity (35% were Non-Hispanic Black/African American, 40% Hispanic, 5% Non-Hispanic White, and 20% Other (not listed / biracial)). This is in line with the low-income population of the Houston Metropolitan Area wherein 70% of those living in poverty identify as Black/African American or Hispanic. We found substantial use of online recipes and digital cooking media in our sample. Based on our survey findings, 90% of participants reported seeing online recipes at least 2 days per week, with 40% reporting looking at online recipe content every day. Overwhelmingly (95%), respondents indicated using their phones to find online recipe/nutrition content, as opposed to other devices like a computer or tablet. This is in line with national research on technology adoption that suggests low-income Americans are more likely to rely on their smartphones for internet access. Participants reported finding online recipes primarily through search engines (70%) and social media (70%), which suggests that parents are getting information from multiple sources. With regard to program preferences, the most popular types of online recipe content are short videos (such as those on Instagram Reels or TikTok) (60%), step-by-step photo recipes (50%), and step-by-step text only recipes (50%). Along with the interview data currently being analyzed, this information will be used to inform the development of our digital cooking intervention. We plan to begin creating content for the intervention this fall.


Accomplishments