Location: Children's Nutrition Research Center2012 Annual Report
1a. Objectives (from AD-416):
Childhood obesity is a major public health problem in the U.S. and successful approaches to prevent obesity are needed. The prevalence of overweight in preschool children has more than doubled in the past two decades. Currently, a third of children in the United States are at risk of overweight, while 17% are overweight. A greater concern is that most existing obesity prevention intervention approaches thus far have been found to be largely ineffective. Diverse novel behavioral, genetic, and biological methods and models are needed to better understand the causes and find effective ways to combat this problem. Children's Nutrition Research Center scientists will address these issues through targeting the following research objectives: 1) determine the extent to which relationships between appetite-related genetic factors and dietary intake are mediated by subjective feelings of hunger, satiety, and other psychosocial variables in children; 2) determine the extent to which relationships between activity-related genetic factors and physical activity are mediated by subjective feelings of enjoyment and related psychosocial variables in children; 3) investigate the effectiveness of community-based intervention strategies to prevent childhood obesity and its associated health risks in 8- to 12-y-old Hispanic children with BMI >/= 85th percentile; 4) develop and evaluate family-centered intervention strategies for the pediatric primary care setting to prevent childhood obesity; 5) develop and evaluate the effectiveness of a culturally appropriate, web-based, dietary and physical activity intervention for preventing obesity in high school students; 6) develop and evaluate the effectiveness of novel, multi-media, diet and/or physical activity interventions for preventing obesity in youth; 7) develop and evaluate a model of childhood obesogenic environments based on parent-child dynamics affecting child eating behaviors and body weight status; 8) determine environmental factors and eating pattern typologies associated with obesity and related diseases in children, adolescents, and young adults using extant datasets; 9) identify promising theoretical approaches, mediators, and intervention components of nutrition and physical activity behavior change in children using extant datasets; 10) identify risk factors, moderators, and mediators for obesity and obesity-related behaviors, including dietary, physical activity and lifestyle factors using extant datasets; 11) evaluate relationships between parent and child beliefs about physical activity, and their relationship with child physical activity, sedentary behavior, and weight status using extant datasets; 12) determine obesity-related metabolic and body composition responses to exercise programs with and without a dietary intervention in lean and obese adolescents; and 13) develop and test pilot interventions to increase and sustain physical activity at a level consistent with the Dietary Guidelines for Americans (DG) in urban African- and Mexican-American children and families.
1b. Approach (from AD-416):
A multidimensional approach will be undertaken to address the obesity research conducted at the Children's Nutrition Research Center. In summary, investigators will address childhood obesity through research in genetics, biology, behavioral modeling, and by the implementation of a wide range of interventions. Researchers will investigate the effects of a controlled exercise program alone as compared to exercise with a diet intervention and determine the impact on numerous biological measures of the research participants. Genes related to satiety or physical activity signaling pathways will be examined by researchers as they learn the association of eating and physical activity experiences in children. Additional research will permit new models of how known genes may be influencing diet and physical activity practices. Researchers will develop, test, and validate innovative youth behavioral models and validate a measure of youth physical activity problem solving ability. Additional models will be developed to understand the functional relationships of behavioral factors that influence the weight status of children, as a result of examining parent and child characteristics (individually and combined) to ascertain their contributions to the probability of pediatric obesity. Model refinement will occur by employing dyadic and mixture modeling approaches to account for latent heterogeneity in how these factors are functionally inter-related within the given population. Assessment of the validity of current theories of obesity-related behavior change will be conducted through mediating variable analyses of existing datasets. Several interventions will be conducted in order to establish functional programs that will reduce obesity and/or further weight gain. A family-based randomized controlled trial will be conducted to test the effectiveness of diet behavior modification, structured aerobic exercise, or diet behavior modification plus structured aerobic exercise for obesity prevention and improvement in fitness, health risks, and psychological state in at-risk children. Research studies will also evaluate the effectiveness of a culturally appropriate, web-based, dietary and physical activity intervention for preventing obesity in high school students when compared with a control group. Weight, dietary and physical activity behaviors, and psychosocial mediating variables will be measured and compared to determine the effectiveness of specific web-based interventions. Furthermore, as a result of these interventions, models will be developed and formative work performed to evaluate the developed model for obesity prevention.
3. Progress Report:
Significant research progress was accomplished during the year. To review the progress, please refer to project 6250-51000-053-10S (Project 1), 6250-51000-053-20S (Project 2), 6250-51000-053-30S (Project 3), 6250-51000-053-40S (Project 4),6250-51000-053-50S (Project 5), 6250-51000-053-60S (Project 6), and 6250-51000-053-70S (Project 7).
1. Videogame impact on children's diet and physical activity. Most interventions for changing children's diet and physical activity for obesity prevention have not been working, and those that have worked have had small effects that have rarely continued beyond the end of the program. Innovative methods are needed that appeal to children. Video games offer a technology that most children find enjoyable and can be used to deliver behavior change procedures and messages. A research study was conducted by Children's Nutrition Research Center researchers in Houston, Texas, with 10- to 12- year-old children to evaluate the impact of two videogames ("Escape from Diab" and "Nanoswarm: Invasion from Inner Space") on children’s diet and physical activity practices. Our results indicated that children who played these games increased their consumption of fruit and vegetables by two-thirds serving per day, but did not increase their moderate to vigorous physical activity. This pilot study offers promise of helping children at risk of obesity to meaningfully change their lifestyle behaviors, and a more fully powered trial is needed to test the efficacy of these videogames.
2. Effect of active videogames on child physical activity. Most children are not getting adequate amounts of physical activity, which could protect against obesity. Active video games offer some promise of enabling children to increase their physical activity, especially those who live in unsafe neighborhoods and are not allowed to play outside. Children's Nutrition Research Center researchers in Houston, Texas, conducted a study with 9-to 12-year-old children above the 50th percentile Body Mass Index (BMI) to test the effect of receiving two active videogames versus two inactive videogames using a particular gaming system. There was no detectable increase in moderate to rigorous physical activity among children receiving the active videogames versus those receiving the inactive videogames. We concluded there was no public health value to having active video games on this particular gaming system (using a motion activated controller), however other systems (those that capture whole body movement without a motion controller) may provide different results.
3. Vegetable parenting game. Parents of preschoolers commonly complain that they can't get their child to eat vegetables. Researchers at the Children's Nutrition Research Center in Houston, Texas, have been conducting behavioral research on what parents can do to get their child to eat vegetables. Videogames for smart phones simulating parent-child interaction offer an easy, convenient way to train parents in effective vegetable parenting practices. We completed several formative studies, including a test of an episode from a videogame. Parents enjoyed it and gave many valuable suggestions for improvement. This study showed that videogames for smart phones can be an educational tool for parents to learn effective vegetable parenting practices.
4. Ask the audience. Online obesity prevention programs should be designed to meet the needs of the intended participants to increase the likelihood of intervention success. Researchers at the Children's Nutrition Research Center at Houston, Texas conducted formative research with 12-17 year old adolescents to enlist their help in the design of an online program focused on healthy eating and physical activity. The participants provided information on the design of the website, characters, and the different components of the website, like goal setting and recipes. This research will enable other researchers to more fully understand the benefits of asking for input from intervention targets as online intervention programs are designed. These results may influence how nutritional intervention research is designed and developed.
5. Let the games begin! Fruit and vegetable intake has been associated with a decreased risk of chronic disease, yet children eat fewer fruit and vegetables than what is recommended. Because fruit and vegetable intake during childhood is associated with fruit and vegetable intake in adulthood, it is important to help children learn to eat more fruit and vegetables. Children's Nutrition Research Center researchers in Houston, Texas, have found that video games may offer a solution to this concern. Fourth and 5th graders who created a plan of how to meet their fruit and vegetable goals while playing a 10-epsidode video game entitled Squire's Quest! II increased their fruit and vegetable intake and maintained this pattern three months later. This research has identified a potentially important way to not only increase fruit and vegetable consumption among youth, but maintain those increases over time.
6. Nutrient intake and diet quality in child breakfast patterns. Breakfast consumers have better nutrient intake and diet quality than breakfast skippers; however, a description of specific breakfast meals is lacking. Researchers at the Children's Nutrition Research Center in Houston, Texas, conducted a study to identify breakfast patterns and to determine the nutrient contribution and diet quality associated with these breakfast patterns. Twelve breakfast patterns (including No Breakfast) were identified, and they varied in contribution to daily intake of nutrients and diet quality. Patterns varied in their association with over-consumed nutrients; Eggs/Grain/Meat, Poultry, Fish /Fruit Juice and Meat, Poultry, Fish/Grain/Fruit Juice patterns were noteworthy as the only patterns showing higher intakes of saturated fatty acids, solid fats, cholesterol, and sodium and lower intakes of added sugars than No Breakfast; and most patterns showed higher intakes of at least some nutrients of public health concern (i.e. dietary fiber, vitamin D, calcium, potassium); however, Grain and Meat, Poultry, Fish /Grain/Fruit Juice did not. Grain/Low Fat Milk/Sweets/Fruit Juice, Presweetened Ready-to-eat Cereal/Low Fat Milk, Ready-to-eat Cereal / Low Fat Milk, Cooked Cereal/Milk/Fruit Juice, and Whole Fruit had higher HEI-2005 scores than No Breakfast, whereas, Meat, Poultry, Fish/Grain/Fruit Juice was lower. Breakfast is an important meal, but care should be taken to select nutrient dense foods, such low fat milk, fortified cereals and other healthy grains, fruit/fruit juice, and lean meat at this meal.
7. Snacking patterns, diet quality and risk of overweight in children. Snacking is very common among Americans, but the impact of the variety of snacking patterns on nutrient intake and weight status is unclear. Researchers at the Children's Nutrition Research Center in Houston, Texas, conducted a study to examine the associations of snacking patterns on nutrient intake and weight in children 2-18 years of age. Most of the snacking patterns resulted in higher total intake of saturated fatty acids, solid fats, added sugars, and sodium (nutrients to limit). Overall, children with several snacking patterns had better diet quality and were less likely to be overweight or obese and were less likely to have abdominal obesity when compared with non-snackers. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet.
8. Resemblance of mother-child dyads at the dinner meal. Parents' eating habits are associated with food and nutrient intake of their children; yet, the associations have not been very strong. Researchers at the Children's Nutrition Research Center in Houston, Texas, conducted a study to examine resemblance in intakes of foods, within the context of a meal, among mother-child dyads (a group/pair) from families of limited incomes. Mothers and children who were served larger amounts of total food/beverages consumed more. There was a positive association between the amount of total energy consumed in the mother-child dyads. Manipulating portion sizes may be an important strategy that can be used by parents to promote intake of fruits and vegetables and to decrease intake of energy-dense foods.
9. Increasing physical activity levels in minority children. Children are engaging in considerably less physical activity now than they were 20 years ago, and this decrease coincides with increased prevalence of obesity in youth. This is particularly important for minority children who are at greater risk for obesity related health problems. Currently, the dietary guidelines recommend that children engage in 60 minutes of physical activity daily; however, there are multiple barriers that reduce the likelihood of children being active, such as the home environment, busy daily schedules, and preferences for sedentary behaviors. Children's Nutrition Research Center researchers in Houston, Texas, have developed an intervention program designed to increase physical activity in children in order to meet the dietary guidelines and have demonstrated that the program improved physical activity levels in minority children. This accomplishment has important implications for future policy development and may help address the obesity epidemic in minority children.
Latif, H., Watson, K., Nguyen, N., Thompson, D.J., Baranowski, J., Jago, R., Cullen, K.W., Baranowski, T. 2011. Effects of goal setting on dietary and physical activity changes in the Boy Scout badge projects. Health Education and Behavior. 38(5):521-529.