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Research Project: Preventing the Development of Childhood Obesity

Location: Children's Nutrition Research Center

Title: Changes in toddler diet quality in a family wellness program: A pilot randomized control trial

item LEDOUX, TRACEY - University Of Houston
item CEPNI, ALIYE - University Of Houston
item TAYLOR, ASHLEY - University Of Houston
item CRUMBLEY, CHRISTINE - University Of Houston
item Thompson, Deborah - Debbe
item OLVERA, NORMA - University Of Houston
item O'CONNOR, DANIEL - University Of Houston
item MORAN, NANCY - Children'S Nutrition Research Center (CNRC)

Submitted to: Annals of Behavioral Medicine
Publication Type: Abstract Only
Publication Acceptance Date: 11/14/2019
Publication Date: 5/1/2020
Citation: Ledoux, T., Cepni, A., Taylor, A., Crumbley, C., Thompson, D.J., Olvera, N., O'Connor, D.P., Moran, N.E. 2020. Changes in toddler diet quality in a family wellness program: A pilot randomized control trial. Annals of Behavioral Medicine. 54(Suppl 1):S303.

Interpretive Summary:

Technical Abstract: Poor diet quality increases the risk of obesity, diabetes, heart disease, and some types of cancers. Diet habits begin to develop in early childhood and track through the lifespan. Thus, there is a need to design wellness programs to help toddler age children (i.e., 12-36 months) develop lifelong healthy eating habits from the start. The purpose of this study was to determine the preliminary effect of a family wellness program on fruit and vegetable (FV), snack, and sugar sweetened beverage (SSB) intake among toddlers. Families with toddlers (12-36 months) were recruited from the community and randomly assigned to an experimental wellness program called the Families Understanding Nutrition and Physically Active Lifestyles (FUNPALs), Playgroup or a usual care program called the Healthy Toddler Parent Group (HTPG). The FUNPALs Playgroup, largely based on Social Cognitive Theory and Family Systems Theory, aimed to improve toddler diet by helping parents to create a healthy home environment for the toddlers. FUNPALs Playgroup behavior change strategies included facilitator modeling and experiential learning delivered within a playgroup setting, which included the children. The HTPG aimed to improve toddler diet by teaching parents dietary recommendations for toddlers through facilitator instruction and group discussion within a parent group setting. Childcare was provided for HTPG participants. Both groups met 10 weekly sessions and completed pre (T1) and post program (T2) measurements. Snacks and SSB intake were assessed with the Kids Bite Food Frequency Questionnaire (FFQ), which has been validated for preschool age children (Aquilar et al., 2014). FV intake was assessed with the Kids Bite FFQ and with skin carotenoid intensity measured by non-invasive reflection spectroscopy, which is a biomarker of intake of carotenoid rich FV. Repeated measures ANOVA's were conducted to test group differences on FV, SSB, and snack intake and determine effect sizes of effects. The sample (n=50) comprised toddlers (Mage=27 months, 58% males) and parents (Mage=31.7 years, 84% female), who identified as either predominantly Non-Hispanic white (44%), Hispanic/Latino (38%), and/or African American (32%). There was a time by group interaction effect on SSB intake [Wilk’s Lambda=.802, F(1,36)=8.87, p=.005] indicating a greater decrease in SSB consumption from T1 to T2 among FUNPALs Playgroup toddlers when compared to HTPG toddlers. There was a main effect of time on skin carotenoid concentration levels [Wilk's Lambda=.864, F(1,33)=5.206, p=.029]. Both groups showed increased skin carotenoid concentrations from T1 to T2. Per Cohen (1988), the group by time interaction effect on SSB consumption (partial eta squared=.20) and the main effect of time on skin carotenoid intensity (partial eta squared=.14) represent large effects. No interaction or main effects on parent-report (FFQ) snack or FV consumption were found. This study provides preliminary evidence that a family wellness playgroup program may have a large positive effect on toddler diet quality. The next step in this research is to test the FUNPALs Playgroup in a fully powered RCT.