Title: efficacy of a food parenting intervention for mothers with low income to reduce preschooler's solid fat and added sugar intakes: a randomized controlled trial

Jennifer O Fisher; Elena L Serrano; Gary D Foster; Chantelle N Hart; Adam Davey; Yasmeen P Bruton; Linda Kilby; Lisa Harnack; Karen J Ruth; Alexandria Kachurak; Hannah G Lawman; Anna Martin; Heather M Polonsky

doi:10.1186/s12966-018-0764-3

Title: efficacy of a food parenting intervention for mothers with low income to reduce preschooler's solid fat and added sugar intakes: a randomized controlled trial

Int J Behav Nutr Phys Act. 2019 Jan 17;16(1):6. doi: 10.1186/s12966-018-0764-3.

Authors

Jennifer O Fisher¹, Elena L Serrano², Gary D Foster^{3

4}, Chantelle N Hart⁵, Adam Davey⁶, Yasmeen P Bruton⁷, Linda Kilby⁸, Lisa Harnack⁹, Karen J Ruth¹⁰, Alexandria Kachurak⁵, Hannah G Lawman¹¹, Anna Martin⁵, Heather M Polonsky¹²

Affiliations

¹ Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA. jofisher@temple.edu.
² Department of Human Nutrition, Foods, and Exercise, Virginia Tech, 327 Wallace Hall, Blacksburg, VA, 24061, USA.
³ Weight Watchers International, 675 6th Ave, New York, NY, USA.
⁴ Weight and Eating Disorders Program, University of Pennyslvania, Pennyslvania, USA.
⁵ Center for Obesity Research and Education, College of Public Health, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA.
⁶ Department of Behavioral Health and Nutritio, University of Deleware, 385 McDowell Hall, Neward, Newark, DE, 19716, USA.
⁷ Department of Obstetrics & Gynecology, Division of Urogynecology, Duke University at Patterson Place, 5324 McFarland Drive, Suite 310, Durham, NC, 27707, USA.
⁸ LDN. NORTH Inc, Philadelphia WIC program, 1300 W Lehigh Avenue, Philadelphia, PA, 19132, USA.
⁹ Division of Epidemiology and Community of Public Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Room 300 West Bank Office Building, Minneapolis, MN, 55454, USA.
¹⁰ Biostatistics Facility, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
¹¹ Division of Chronic Disease Prevention, Philadelphia Department of Public Health, 1101 Market Street, 9th Floor, Philadelphia, PA, 19107, USA.
¹² Providence Health and Services, Center for Outcomes Research & Education, 5251 NE Gilsan Street, Bldg A, Portland, OR, 97213, USA.

Abstract

Background: Few interventions have shown efficacy to influence key energy balance behaviors during the preschool years.

Objective: A randomized controlled trial (RCT) was used to evaluate the efficacy of Food, Fun, and Families (FFF), a 12 week authoritative food parenting intervention for mothers with low-income levels, to reduce preschool-aged children's intake of calories from solid fat and added sugar (SoFAS).

Methods: Mothers were randomly assigned to receive FFF (n = 59) or to a delayed treatment control (n = 60). The primary outcome was children's daily energy intake from SoFAS at the end of the 12 week intervention, controlling for baseline levels, assessed by 24-h dietary recalls. Secondary outcomes included children's daily energy intake, children's BMI z-scores, and meal observations of maternal food parenting practices targeted in FFF (e.g. providing guided choices).

Results: Participating mothers were predominantly African American (91%), with 39% educated beyond high school and 66% unemployed. Baseline demographics and child SoFAS intakes did not differ by group. Lost to follow-up was 13% and did not differ between groups. At post-intervention, FFF children consumed ~ 94 kcal or 23% less daily energy from SoFAS than children in the control group, adjusting for baseline levels (307.8 (95%CI = 274.1, 341.5) kcal vs. 401.9 (95%CI = 369.8, 433.9) kcal, FFF vs. control; p < 0.001). FFF mothers also displayed a greater number of authoritative parenting practices when observed post-intervention with their child at a buffet-style meal (Wilcoxon z = - 2.54, p = 0.012). Neither child total daily energy intake nor BMI z-scores differed between groups post-intervention.

Conclusions: Findings demonstrate the initial efficacy of an authoritative food parenting intervention for families with low-income to reduce SoFAS intake in early childhood. Additional research is needed to evaluate longer-term effects on diet and growth.

Trial registration: Retrospectively registered at ClinicalTrials.gov : #NCT03646201.

Keywords: Added sugars; Authoritative; Dietary intervention; Food parenting; Low-income; Preschooler; Prevention; Randomized controlled trial; Solid fats.

Publication types

Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Child Behavior
Child, Preschool
Diet*
Dietary Fats / administration & dosage*
Dietary Sugars / administration & dosage*
Energy Intake
Feeding Behavior*
Female
Food
Health Promotion / methods*
Humans
Male
Mothers
Parenting*
Poverty*
Retrospective Studies
Treatment Outcome
Young Adult

Substances

Dietary Fats
Dietary Sugars

Associated data

ClinicalTrials.gov/NCT03646201