Low-Income, Overweight and Obese Mothers as Agents of Change to Improve Food Choices, Fat Habits, and Physical Activity in their 1-to-3-Year-Old Children

Division of Nutritional Sciences, The University of Texas at Austin, Austin, TX 78712, USA.
Journal of the American College of Nutrition (Impact Factor: 1.45). 06/2007; 26(3):196-208. DOI: 10.1080/07315724.2007.10719602
Source: PubMed

ABSTRACT To examine the effects of a weight loss program for mothers on the diet and activity of mothers and their 1-3 year old children.
Overweight and obese mothers participated in an 8-week weight loss intervention encompassing diet, physical activity, and behavioral modification. Anthropometrics, demographic, dietary, and physical activity questionnaires were administered at weeks 0 and 8; anthropometrics were re-evaluated at week 24.
Mothers (N=91) of a 1-3 year old child; body mass index (BMI) >or= 25 kg/m2; non-breastfeeding; age 18-45 years; income < 200% of federal poverty index; Hispanic, African American, or white; and English-speaking were recruited from Special Supplemental Program for Women Infants and Children (WIC) and public health clinics. INTERVENTION MEASURES OF OUTCOME: Weight loss in mothers and improvements in diet (reduction in calories, fat, snacks/desserts, sweetened beverages, and increases in fruit, vegetables) and activity in mothers and children.
Weight loss in mothers was modest (-2.7 kg, p < 0.001) and sustained at week 24 (-2.8 kg, p < 0.001), and children gained in height and weight as expected for normal growth (p < 0.001). Initial energy intakes of children exceeded Estimated Energy Requirements (123%) and were reduced to acceptable levels post-intervention (102%, p < 0.001); additional beneficial changes in children's diets were decreased total (47.7 to 39.9 g/day) and saturated fat (19.2 to 16.6 g/day), high-fat snacks/desserts (1.6 to 0.9 servings/day), added fats (81.8 to 40.9% using), sweetened beverages (0.8 to 0.4 servings/day), and fast food consumption (11.6 to 6.6% of meals), and increased home-prepared meals (63.2 to 71.6% of meals) (p < 0.01 for all). Physical activity scores improved by 7% in children (p < 0.05). Comparable changes in food choices and activity also were seen in mothers.
Offering weight loss classes was a successful method of enticing low-income women to participate in an educational intervention that benefited their children. Overweight and obese mothers who modified their food choices and fat habits made comparable changes for their child.

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    • "Only one WIC study specifically targeted mothers as agents of change [57]. Klohe-Lehman and colleagues found that a weight loss program for overweight and obese mothers of one to three year olds was not only effective in promoting maternal weight loss and improving maternal diet and physical activity, but also had an effect in reducing the energy intake of their children and improving child diet quality and physical activity levels. "
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    ABSTRACT: Children from disadvantaged families including those from low socioeconomic backgrounds and Indigenous families have higher rates of obesity, making early intervention a priority. The aim of this study was to systematically review the literature to examine the effectiveness of interventions to prevent obesity or improve obesity related behaviours in children 0-5 years from socioeconomically disadvantaged or Indigenous families. Searches of major electronic databases identified articles published from 1993–2013 targeting feeding practices, anthropometric, diet, activity or sedentary behaviour outcomes. This was supplemented with snowballing from existing reviews and primary studies. Data extraction was undertaken by one author and cross checked by another. Quality assessments included both internal and external validity. Thirty-two studies were identified, with only two (both low quality) in Indigenous groups. Fourteen studies had a primary aim to prevent obesity. Mean differences between intervention and control groups ranged from -0.29 kg/m2 to -0.54 kg/m2 for body mass index (BMI) and -2.9 to -25.6% for the prevalence of overweight/obesity. Interventions initiated in infancy (under two years) had a positive impact on obesity related behaviours (e.g. diet quality) but few measured the longer-term impact on healthy weight gain. Findings amongst pre-schoolers (3–5 years) were mixed, with the more successful interventions requiring high levels of parental engagement, use of behaviour change techniques, a focus on skill building and links to community resources. Less than 10% of studies were high quality. Future studies should focus on improving study quality, including follow-up of longer-term anthropometric outcomes, assessments of cost effectiveness, acceptability in target populations and potential for implementation in routine service delivery. There is an urgent need for further research on effective obesity prevention interventions for Indigenous children. The findings from the growing body of intervention research focusing on obesity prevention amongst young children from socioeconomically disadvantaged families suggest intervention effects are modest but promising. Further high quality studies with longer term follow up are required. Trial registration PROSPERO Registration no: CRD42013006536.
    BMC Public Health 08/2014; 14(1):779. DOI:10.1186/1471-2458-14-779 · 2.26 Impact Factor
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    • "Assisting parents to create supportive home environments can be an effective strategy to increase the fruit and vegetable consumption of their children [15]. However, studies involving traditional means of delivering interventions to parents, such as education sessions, often report high drop-out rates [16] and low attendance due to barriers associated with transport, work schedules and lack of interest [17]. Parent participation in healthy eating interventions is also reportedly constrained by specific barriers associated with preschool-aged children, including unpredictable sleep times and frequent sickness [18]. "
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    ABSTRACT: Inadequate fruit and vegetable consumption in childhood increases the risk of developing chronic disease. Despite this, a substantial proportion of children in developed nations, including Australia, do not consume sufficient quantities of fruits and vegetables. Parents are influential in the development of dietary habits of young children but often lack the necessary knowledge and skills to promote healthy eating in their children. The aim of this study is to assess the efficacy of a telephone-based intervention for parents to increase the fruit and vegetable consumption of their 3- to 5-year-old children. The study, conducted in the Hunter region of New South Wales, Australia, employs a cluster randomised controlled trial design. Two hundred parents from 15 randomly selected preschools will be randomised to receive the intervention, which consists of print resources and four weekly 30-minute telephone support calls delivered by trained telephone interviewers. The calls will assist parents to increase the availability and accessibility of fruit and vegetables in the home, create supportive family eating routines and role-model fruit and vegetable consumption. A further two hundred parents will be randomly allocated to the control group and will receive printed nutrition information only. The primary outcome of the trial will be the change in the child's consumption of fruit and vegetables as measured by the fruit and vegetable subscale of the Children's Dietary Questionnaire. Pre-intervention and post-intervention parent surveys will be administered over the telephone. Baseline surveys will occur one to two weeks prior to intervention delivery, with follow-up data collection calls occurring two, six, 12 and 18 months following baseline data collection. If effective, this telephone-based intervention may represent a promising public health strategy to increase fruit and vegetable consumption in childhood and reduce the risk of subsequent chronic disease.
    BMC Public Health 04/2010; 10(1):216. DOI:10.1186/1471-2458-10-216 · 2.26 Impact Factor
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    • "Mothers, at younger ages, have significant influences on their children's eating and life-style patterns. Several studies reported that childhood obesity is associated with maternal characteristics, especially with the mother's eating habits, nutrition knowledge, perceptions of their children's body sizes, and mother's depression (Birch et al., 2000; Birch & Fisher, 1998; Contento et al., 2003; Danielzik et al., 1999; Hood et al., 2000; Klohe et al., 2007). Mothers who used more eating prompts had children with improper eating habits (Abramovitz, 2003). "
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    ABSTRACT: The purpose of this study was to assess the relationship between the mother's interest in weight control and its association with the preschooler's obesity and weight related concerns. This was a cross-sectional study based on 470 parents' self-reports. To score interests in weight control, mothers rated each of 6 items on a five-point Likert scale ranging from disagree (1) to agree (5). The perceptions of mothers' weights and their children's weights, mothers' Body Mass Index (BMI), preschoolers' Weight-Length Index (WLI) (%), and weight-related concerns were determined. The mothers' BMI was significantly correlated with interest scores of weight control in mothers (r=0.632, p<0.001) while their children's obesity was weakly correlated with the mothers' interest scores (r=0.133, p=0.025). Mothers with a high interest of weight control reported higher percentages of family history of obesity than mothers with lower interests (63.2% vs. 36.8%, p<0.001). Two-thirds of the mothers (65.4%) were accurate in their perceptions about their weights. Similarly, 63.7% of mothers knew exactly their children's weight-statuses. Compared with mothers with low interest in weight controls, mothers with high interest in weight control had lower correct-perceptions about their weights (p<0.05) but higher correct-perceptions about their children's weights. More than two-thirds of mothers (85%) reported not worrying about their children's obesity in the future. Only 14.3% of the mothers were satisfied with their current weight statuses. Three-fourths of mothers preferred exercise as an effective weight-control method for their children, 20% preferred diet therapy and 5.5% preferred behavior modification. More girls were overweight / obese, than boys (overweight: 16.1% (girl) vs. 12.8% (boy), obese: 5.4% (girl) vs. 4.5% (boy)). About 40% of overweight girls' mothers had low interests in their weight controls with low correct-perceptions in their children's weights, which suggests possible elevated risk of obesity, especially in girls, in the future.
    Nutrition research and practice 12/2007; 1(4):321-7. DOI:10.4162/nrp.2007.1.4.321 · 1.44 Impact Factor
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