The pilot, unsupervised walking intervention increased the MPA of overweight and obese women during pregnancy.

OBJECTIVES: To identify dietary patterns in US infants at age 6 and 12 months, sociodemographic differences in these patterns, and their associations with infant growth from age 6 to 12 months. METHODS: We analyzed a subsample (760 boys and 795 girls) of the Infant Feeding Practices Study II (2005–2007). Mothers reported their infants’ intakes of 18 types of foods in the past 7 days, which were used to derive dietary patterns at ages 6 and 12 months by principal component analysis. RESULTS: Similar dietary patterns were identified at ages 6 and 12 months. At 12 months, infants of mothers who had low education or non-Hispanic African American mothers (vs non-Hispanic white) had a higher score on “High sugar/fat/protein” dietary pattern. Both “High sugar/fat/protein” and “High dairy/regular cereal” patterns at 6 months were associated with a smaller increase in length-for-age z score (adjusted β per 1 unit dietary pattern score, −1.36 [95% confidence interval (CI), −2.35 to −0.37] and −0.30 [−0.54 to −0.06], respectively), while with greater increase in BMI z score (1.00 [0.11 to 1.89] and 0.32 [0.10 to 0.53], respectively) from age 6 to 12 months. The “Formula” pattern was associated with greater increase in BMI z score (0.25 [0.09 to 0.40]). The “Infant guideline solids” pattern (vegetables, fruits, baby cereal, and meat) was not associated with change in length-for-age or BMI z score. CONCLUSIONS: Distinct dietary patterns exist among US infants, vary by maternal race/ethnicity and education, and have differential influences on infant growth. Use of “Infant guideline solids” with prolonged breastfeeding is a promising healthy diet for infants after age 6 months.

Our newly developed paradigm, which tested 2 different nonfood alternatives, demonstrated that lean infants find nonfood alternatives more reinforcing than do overweight/obese infants. This observation suggests that strengthening the alternative reinforcers may have a protective effect against childhood obesity.

Few studies have investigated the impact of lifestyle interventions during pregnancy on post-partum weight retention and infant growth. Thirty seven previously non-exercising, overweight or obese pregnant women were randomly assigned to a walking intervention or non-intervention control. For the follow-up study, weight of the mother and weight, length and body composition of the infant were collected at 1 month post-partum (n=37) and 6 months post-partum (n=33). Analysis of variance and linear regression were conducted to determine the differences and association in maternal post-partum weight retention and child outcomes. At 6 months post-partum, weight retention of obese women in the intervention group (Int-OB) was -0.10±8.11 kg; while, obese women in the control group (Con-OB) was 6.35±7.47 kg. A significantly higher percentage of Con-OB women retained more than 5 kg at 6 months post-partum (P=0.046). Even though statistically non-significant between the groups, the growth trend observed among offspring of obese women in the control group was consistently higher than the offspring of obese women in the intervention group from birth to 6-months. Third trimester gestational weight gain rate significantly predicted 6-m weight-for-length z-score after controlling for birth weight, treatment group and pre-pregnancy body mass index (r 2=0.31, β=1.75, P=0.03). The reduced post-partum weight retention observed among the obese women in the intervention group may be explained in part by the lifestyle modification during pregnancy.

Objective: To quantify the change in availability of hyper-palatable foods (HPF) in the US foods system over 30 years (1988 to 2018). Design: Three datasets considered representative of the US food system were used in analyses to represent years 1988, 2001, and 2018. A standardized definition from Fazzino et al (2019) that specifies combinations of nutrients was used to identify HPF. Differences in the prevalence of HPF were characterized by Cochran’s Q and McNemar’s tests. Generalized linear mixed models with a fixed effect for time and random intercept for food item estimated change in the likelihood that a food was classified as hyper-palatable over time. Results: The prevalence of HPF increased 20% from 1988 to 2018 (from 49% to 69%; p <.0001). The most prominent difference was in the availably of HPF high in fat and sodium, which evidenced a 17% higher prevalence in 2018 compared to 1988 (p <.0001). Compared to 1988, the same food items were >2 times more likely to be hyper-palatable in 2001, and the same food items were >4 times more likely to be classified as hyper-palatable in 2018 compared to 1988 (p values <.0001). Conclusions: The availability of HPF in the US food system increased substantially over 30 years. Existing food products in the food system may have been reformulated over time to enhance their palatability.

Objective The reinforcing value of food may be established early in life. Research shows that infant weight status is related to the relative reinforcing value of food versus non-food alternatives (food reinforcing ratio, FRR). The purpose of this pilot study was to assess the effects of a 6-week music enhancement program (Music Together®, n = 14) versus an active play date control group (n = 13) on the FRR in 9- to 16-month-old infants who were high in relative food reinforcement. Methods Participating parents and infants attended six weekly 45-min group classes. Parents in the music group and the play date group were encouraged to listen to the Music Together program CD or play with the play date group’s toy with their infants at home, respectively. Results Intent-to-treat analysis showed a decrease in FRR for infants in the music group (mean ± SD: −0.13 ± 0.13) in comparison to a slight increase in the control group (0.04 ± 0.11) (F[1, 24] = 11.86, P = 0.002). Conclusions These findings provide evidence that relative reinforcing value of food can be reduced by promoting alternative reinforcers at an early age.

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Background Effects of maternal leisure time physical activity (LTPA) on pediatric obesity are unknown. The objective of this study was to examine associations of maternal LTPA with offspring overall and central adiposity in mid-childhood. Methods We analyzed data from 802 mother-child dyads from Project Viva, a prospective pre-birth cohort study. Women reported average weekly LTPA before and during mid-pregnancy. At age 7-10 y, we measured fat, truncal fat, and lean mass with dual-energy X-ray absorptiometry. Using multivariable linear regression, we examined associations of maternal LTPA with offspring adiposity, adjusting for child age and sex, maternal race/ethnicity, education, age, pre-pregnancy BMI, marital status, and smoking status. Results Mean (SD) of LTPA before and during mid-pregnancy were 9.5 (8.1) and 7.1 (7.0) h/week. At mean age 7.8 (0.8) y, childhood fat, truncal fat and lean mass indices were 4.3 (1.8), 1.4 (0.8) and 12.9 (1.4) kg/m2. We did not find that higher maternal LTPA was associated with lower child adiposity outcomes. For example, compared with 0-3 h/week of LTPA during mid-pregnancy, children of mothers with 8+ h/week had fat mass index 0.07 kg/m2 (95% CI: −0.22, 0.36). In analyses of within-person LTPA change from before to mid-pregnancy, compared with 2+ h/week decrease in LTPA, increased LTPA (2 ± h/week) was associated with a 0.09 kg/m2 fat mass index (−0.25, 0.43). Conclusions Contrary to our hypothesis, higher LTPA before and during mid-pregnancy, and the change between them, were not associated with lower adiposity in mid-childhood.