Spillover effects of a family-based childhood weight management intervention on parental nutrient biomarkers and cardiometabolic risk factors

Authors: MATTHAN, NIRUPA - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; BARGER, KATHRYN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; WYLIE-ROSETT, JUDITH - Albert Einstein College Of Medicine; XUE, XIAONAN - Albert Einstein College Of Medicine; GROISMAN-PERELSTEIN, ADRIANA - Albert Einstein College Of Medicine; DIAMANTIS, PAMELA - Albert Einstein College Of Medicine; GINSBERG, MINDY - Albert Einstein College Of Medicine; MOSSAVAR-RAHMANI, YASMIN - Albert Einstein College Of Medicine; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Current Developments in Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/17/2021
Publication Date: 12/23/2021
Citation: Matthan, N., Barger, K., Wylie-Rosett, J., Xue, X., Groisman-Perelstein, A.E., Diamantis, P.M., Ginsberg, M., Mossavar-Rahmani, Y., Lichtenstein, A.H. 2021. Spillover effects of a family-based childhood weight management intervention on parental nutrient biomarkers and cardiometabolic risk factors. Current Developments in Nutrition. 6(2):nzab152. https://doi.org/10.1093/cdn/nzab152.
DOI: https://doi.org/10.1093/cdn/nzab152

Interpretive Summary: Lifestyle interventions based on dietary modification, physical activity and behavioral therapy are the current recommendations to treat childhood obesity and associated cardiometabolic health complications. Involving parents in these interventions has been shown to improve dietary habits, weight loss success and health outcomes in their children. However, it is not known if benefits of these interventions spill-over to the parents of participating children. To address this question, we measured biomarkers of diet quality and cardiovascular disease (CVD) risk factors using blood samples collected from parents of children who participated in a 1-year lifestyle intervention trial. We found that the parents decreased their consumption of foods containing unhealthy trans fatty acids and increased their consumption of healthy carotenoid-rich fruits/vegetables, polyunsaturated omega-3 fatty rich vegetable oils and fish. There was no change in body weight of the parents but key CVD risk factors such as CRP (inflammation marker), triglyceride and insulin levels favorably improved at the end of 1 year. These findings have public health implications since obesity tends to run in families, so improving dietary and health outcomes in both children and their parents could potentially result in a major cost-benefit of family-based interventions.

Technical Abstract: Background Parental involvement has been shown to favorably affect childhood weight-management interventions, but whether these interventions influence parental diet and cardiometabolic health outcomes is unclear. Objectives The aim was to evaluate whether a 1-y family-based childhood weight-management intervention altered parental nutrient biomarker concentrations and cardiometabolic risk factors (CMRFs). Methods Secondary analysis from a randomized-controlled, parallel-arm clinical trial (NCT00851201). Families were recruited from a largely Hispanic population and assigned to either standard care (SC; American Academy of Pediatrics overweight/obesity recommendations) or SC + enhanced program (SC+EP; targeted diet/physical activity strategies, skill building, and monthly support sessions). Nutrient biomarkers (plasma carotenoids and fat-soluble vitamins, RBC fatty acid profiles) and CMRFs (BMI, blood pressure, glucose, insulin, lipid profile, inflammatory and endothelial dysfunction markers, adipokines) were measured in archived samples collected from parents of participating children at baseline and end of the 1-y intervention. Results Parents in both groups (SC = 106 and SC+EP = 99) had significant reductions in trans fatty acid (-14%) and increases in MUFA (2%), PUFA n-6 (omega-6) (2%), PUFA n-3 (7%), and beta-carotene (20%) concentrations, indicative of lower partially hydrogenated fat and higher vegetable oil, fish, and fruit/vegetable intake, respectively. Significant reductions in high-sensitivity C-reactive protein (hsCRP; -21%) TNF-alpha (-19%), IL-6 (-19%), and triglycerides (-6%) were also observed in both groups. An additional significant improvement in serum insulin concentrations (-6%) was observed in the SC+EP parents. However, no major reductions in BMI or blood pressure and significant unfavorable trajectories in LDL-cholesterol and endothelial dysfunction markers [P-selectin, soluble intercellular adhesion molecule (sICAM), thrombomodulin] were observed. Higher carotenoid, MUFA, and PUFA (n-6 and n-3) and lower SFA and trans fatty acid concentrations were associated with improvements in circulating glucose and lipid measures, inflammatory markers, and adipokines. Conclusions The benefits of a family-based childhood weight-management intervention can spill over to parents, resulting in apparent healthier dietary shifts that are associated with modest improvements in some CMRFs.