Research

Preventing the Development of Childhood Obesity

Master
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Eating Patterns and Obesity Prevention in Children

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Obesity is the most prevalent nutrition-related pediatric problem in the United States. 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 are proposed to address these knowledge gaps. Objective 1 proposes to 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. Objectives 2-5 propose to take an intensive look at the family. Specifically, Objective 2 will assess how feeding styles and practices influence child eating behaviors, and Objectives 3-5 will assess how to independently engage both fathers and mothers in obesity prevention interventions and accurately assess father’s food and physical activity parenting behaviors. Our final objective, Objective 6, proposes to examine the role of child temperament on infant feeding behavior and adiposity. These projects address important knowledge gaps, thereby establishing a firm foundation for future child obesity prevention interventions and evaluations. 
 

Research Faculty: Debbe Thompson / Sheryl Hughes / Teresia O’Connor / Lekki Wood 

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Epidemiology of Childhood Diet and Obesity

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Today, an estimated 16% of US children and adolescents are overweight and 17% are obese, and the prevalence continues to rise. Obesity is the result of energy imbalance, and dietary behaviors associated with overweight need to be examined. The long-term objective of this project is to better understand eating patterns, impact of food security status, rural/urban differences, and seasonal differences in weight-related behaviors that influence obesity and other health risk factors in children, adolescents, and adults. Few attempts have been made to identify broader eating patterns and their association with weight status and other chronic disease risk factors. This project aims to identify eating patterns--in terms of food sources, food group consumption, and nutrient intake--that may be associated with obesity and other health risk factors in children, adolescents, and adults using extant datasets. Also, food insecurity is related to poor dietary behaviors that can lead to net positive energy balance and obesity. Thus, we aim to assess the impact of food security status on dietary intake and quality, food availability, participation in federal food assistance programs, and weight status based on rural/urban residence. Finally, we will examine other behavioral predictors of children’s weight gain (i.e., sleep, physical activity, sedentary behavior) using the school-summer paradigm. Together these objectives will facilitate a better understanding of how to behaviorally target interventions to prevent obesity during childhood.
 

Research Faculty: Theresa Nicklas / Jennette Moreno / Jayna Dave

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Acute Effects of Sedentary Behaviors on Cardiometabolic Risk in Latino Youth

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Latino adolescents are disproportionately impacted by obesity compared to the general population (25.8% vs 18.5%) and are at an increased risk for obesity-related metabolic diseases like type 2 diabetes and cardiovascular diseases. These disparities are due in part to unhealthy lifestyle behaviors like sedentary behaviors. Youth with obesity spend an estimated 65-75% of their day in sedentary pursuits. In adults, sedentary behaviors are associated with adverse metabolic profiles. However, evidence on the association between objective sedentary behaviors and cardiometabolic disease risk factors in youth remains inconclusive. This is due in part to the lack of controlled studies with rigorous measures of sedentary behaviors or metabolic outcomes. To address these gaps, the primary objective of this study is to 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.

Research Faculty: Erica Soltero 

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Developing and Testing an Evidence-based Digital Cooking Intervention for Low-Income Parents

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Low-income children are at high risk of having obesity and poor diet quality, which can impact their long-term health. Parents, as key gatekeepers of the home food environment, are an important target for intervention. Cooking education may facilitate compliance with the Dietary Guidelines for Americans by teaching parents strategies to improve the nutritional content of foods they already prepare at home. One major limitation in the existing literature is the lack of clear scientific guidance to inform cooking course curricula. We recently addressed this gap in knowledge by creating an evidence-based conceptual framework to guide healthy cooking programs, the Healthy Cooking Index (HCI). The HCI includes three overarching domains defined by 19 evidence-based practices with the potential to influence the nutritional content of prepared meals. The HCI has been used to teach in-person cooking classes, but these require substantial expertise and resources. Digital interventions may offer a more accessible and scalable approach. Although low-income populations spend more time cooking than other groups and engage with digital technologies at high rates, limited research has been conducted on the use of digital cooking education interventions in this group. We propose to address this gap by using the HCI 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 (n=25) in a single arm, prospective feasibility trial. Intervention development will be informed by qualitative formative research. Primary feasibility and acceptability outcomes will assess recruitment, retention, change in cooking practices, change in diet quality, and user feedback (including program satisfaction, perceived effectiveness, barriers/facilitators to participation, and recommendations for improvement). This project represents an important step in developing practical, scalable approaches to improve and sustain adherence to the dietary guidelines among low-income families. 

Research Faculty: Margaret Raber-Ramsey 

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