Objective Present the immediate post-intervention results of Kids and Adults Now - Defeat Obesity!, a randomized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler (2–5 years old) dyads in North Carolina (2007–2011). The outcomes include change from baseline in the child’s diet, physical activity and weight, and in the mother’s parenting behaviors, diet, physical activity, and weight. Method The intervention targeted parenting through maternal emotion regulation, home environment, feeding practices, and modeling of healthy behaviors. 400 Mother-child dyads were randomized. Results Mothers in the intervention arm, compared to the control arm, reduced instrumental feeding (−0.24 vs. 0.01, p<0.001) and TV snacks (−.069 vs. −0.24, p=0.001). There were also improvements in emotional feeding (p=0.03), mother’s sugary beverage (p=0.03) and fruit/vegetable (p=0.04) intake, and dinners eaten in front of TV (p=0.01); these differences were not significant after adjustment for multiple comparisons. Conclusion KAN-DO, designed to maximize the capacity of mothers as agents of change, improved several channels of maternal influence. There were no group differences in the primary outcomes, but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers’ diets. Long-term follow-up will address whether these short-term trends ultimately improve weight status.
BackgroundThe effects of the home environment on child health behaviors related to obesity are unclear.PurposeTo examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator.MethodsOverweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors (“junk” and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental timepoint, maternal education/work status, child body mass index and accelerometer wear-time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data was collected in North Carolina from 2007–2011.ResultsParental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced “junk” food intake scores while parental policies supporting family meals increased “junk” food intake scores.ConclusionsTo promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child’s food intake.
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