Lifestyle plays a significant role in the development of CVD risk factors. Some of these risk factors (obesity, cholesterol, hypertension) track from childhood into adulthood, which argues for early intervention. Although it is known that there are familial relationships among these risk factors, it is uncertain how much can be attributed to environment and how much to interprsonal interaction patterns within families. The goal of this longitudinal study is to test a model hypothesizing that the CVD risk status of black children is influenced by predisposing factors (e.g., the CVD risk status of an older sibling), and environmental factors (e.g., day care vs. home care) on the child's food intake and activity levels, primarily through interpersonal interaction between the child and significant others. Within this model a number of hypotheses will be tested. A pilot phase involving 60 black children, age 2-4 years, stratified on the CVD risk status of an older sibling, will be used to evaluate and adapt existing instruments to measure food intake and activity levels, physiologic values, family CV disease history, 24-hour diet history, and environmental and psychosocial questionnaires, in the children's homes, day care centers, and schools. In years 2-5, a cohort of 300 black children, ages 42-48 months will be recruited through an older sibling in a D.C. elemetary school, and observed 4 times. Measurement includes video-taping eating events, recording activity levels, obtaining physiological measurements (height, weight, cholesterol, HDL, systolic and diastolic blood pressure, skinfold, fitness of the child, sibling and parent(s); performing 24-hour diet recalls, and questionnaires to record family CV disease history and environmental and psychosocial factors. The results should help determine where it is possible to intervent to reduce the risk of children developing CVD when they are older. The research team include a psychologist, pediatrician, nutritionist-anthropologist, medical sociologist, health educator, and biostatistician.
