Overweight is a serious public health problem that begins as early as toddlerhood, and has negative health and developmental consequences throughout life. Although caregiver-child interaction patterns influence children's growth and behavior, most overweight prevention programs have focused exclusively on diet and physical activity, with little attention to feeding styles, the socio-emotional environment that the family establishes around meals. This application takes advantage of a unique opportunity afforded by a recently funded randomized controlled trial to prevent rapid weight gain among low-income toddlers in collaboration with the Special Supplemental Nutrition Program among Women, Infants, and Children (WIC). The overall aim is to examine feeding styles among low-income families of toddlers.
The specific aims are: 1) to examine the feeding styles used by low-income mothers of toddlers and to identify caregiver and child characteristics associated with feeding styles, 2) to assess how feeding styles are related to toddler weight and rapid weight gain, and 3) to examine whether feeding styles are altered by an intervention to prevent rapid weight gain among toddlers. A multimodal process will be used to measure feeding and parenting styles, including maternal self-report and home visits with videotaped observations of mothers and their toddlers during meal and playtime. The proposed project involves 288 low-income mothers, fathers, and toddlers, recruited at 12-30 months and followed for 12 months. Following a baseline evaluation, families will be randomized to one of three 8-session intervention groups (maternal diet and activity, parenting/toddler, and safety), with follow-up evaluations 6 and 12 months following recruitment. In addition to changes in weight, height, and dietary intake supported by an existing project, the proposed project will evaluate feeding styles at baseline and during the two follow-up evaluations. By focusing on how caregiver toddler interaction patterns are related to toddler weight and weight gain, the proposed study will enhance our understanding of feeding styles and strategies to promote healthy growth and avoid overweight among toddlers. Overweight often begins as early as toddlerhood, setting children on a negative pathway toward obesity. Most interventions include recommendations on diet and physical activity, with little attention to the socio-emotional mealtime environment patterns, known as feeding styles. A focus on feeding styles addresses the interactive context in which feeding occurs and provides information on mechanisms leading to rapid weight gain that can be built into subsequent interventions to establish healthy dietary patterns early in life.

Public Health Relevance

Overweight begins as early as toddlerhood, setting children on a negative pathway toward obesity. Most interventions include recommendations on diet and physical activity, with little attention to the socio-emotional mealtime environment, known as feeding styles. A finding that feeding styles are associated with toddler weight gain and are modifiable would have a major impact on the content of public health interventions to prevent overweight among toddlers.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD056099-01A2
Application #
7582795
Study Section
Psychosocial Development, Risk and Prevention Study Section (PDRP)
Program Officer
Esposito, Layla E
Project Start
2009-09-30
Project End
2011-08-31
Budget Start
2009-09-30
Budget End
2010-08-31
Support Year
1
Fiscal Year
2009
Total Cost
$1,015,058
Indirect Cost
Name
University of Maryland Baltimore
Department
Pediatrics
Type
Schools of Medicine
DUNS #
188435911
City
Baltimore
State
MD
Country
United States
Zip Code
21201
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