The goal of this demonstration and education study is to evaluate the efficacy of an inexpensive educational intervention to promote the substitution of low-fat for whole milk as a strategy for implementing the National Cholesterol Education Program (NCEP) dietary recommendation to reduce average daily intake of saturated fat. the intervention is directed at Hispanic preschool children and comprises a brief personal contact, low-literacy level print materials, and reinforcers. Hispanic families, which are increasing rapidly in the population, tend to have high prevalence of several cardiovascular disease risk factors, low levels of knowledge about cardiovascular disease prevention, and consume more saturated fat and less low-fat milk than non-Hispanic whites. Further, Hispanic preschool children have high prevalence rates of obesity, and tend to use whole milk exclusively. The proposed intervention strategy is a direct result of the NIH-sponsored Columbia University Study of Children's Activity and Nutrition, which indicated that virtually all the Hispanic preschool children in the sample consumed whole milk exclusively, that whole milk was the main source of dietary saturated fat, and that substitution of low-fat (1% fat) milk would reduce mean dietary saturated fat intake from over 30% above levels currently recommended by the NCEP to within recommended levels (< 10% of calories). The study design is a randomized controlled intervention trial with blinding, with the individual as the unit of sampling, assignment and analysis. A total of 600 low-income Hispanic families with preschool children will be sampled from a large urban network of pediatrics practices and randomized to intervention or control. The study endpoints are serum total and LDL cholesterol level and dietary saturated fat intake at 6 months post-intervention. Sample size determinations were based on alpha = 0.01, beta = 0.80, and delta (for total and LDL cholesterol) = 8.0 mg/dl and 7.1 mg/dl respectively. Measures of mothers' knowledge and beliefs and children's growth will also be collected. The intervention was designed in a practical way, so if efficacious and safe it can be disseminated, implemented and sustained in existing community programs in our target community and in others.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
1R01HL049508-01
Application #
3368625
Study Section
Special Emphasis Panel (ZHL1-CCT-G (01))
Project Start
1993-01-01
Project End
1996-12-31
Budget Start
1993-01-01
Budget End
1993-12-31
Support Year
1
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Columbia University Teachers College
Department
Type
Schools of Education
DUNS #
071050983
City
New York
State
NY
Country
United States
Zip Code
10027
Castro, Cecilia; Tracy, Russell P; Deckelbaum, Richard J et al. (2009) Adiposity is associated with endothelial activation in healthy 2-3 year-old children. J Pediatr Endocrinol Metab 22:905-14
Shea, Steven; Aymong, Eve; Zybert, Patricia et al. (2003) Obesity, fasting plasma insulin, and C-reactive protein levels in healthy children. Obes Res 11:95-103
Shea, Steven; Aymong, Eve; Zybert, Patricia et al. (2003) Fasting plasma insulin modulates lipid levels and particle sizes in 2- to 3-year-old children. Obes Res 11:709-21
Colchico, K; Zybert, P; Basch, C E (2000) Effects of after-school physical activity on fitness, fatness, and cognitive self-perceptions: a pilot study among urban, minority adolescent girls. Am J Public Health 90:977-8
Wechsler, H; Basch, C E; Zybert, P et al. (1998) Promoting the selection of low-fat milk in elementary school cafeterias in an inner-city Latino community: evaluation of an intervention. Am J Public Health 88:427-33
Shea, S; Rabinowitz, D; Stein, A D et al. (1998) Components of variability in the systolic blood pressures of preschool children. Am J Epidemiol 147:240-9
Wechsler, H; Basch, C E; Zybert, P et al. (1995) The availability of low-fat milk in an inner-city Latino community: implications for nutrition education. Am J Public Health 85:1690-2
Basch, C E; Zybert, P; Shea, S (1994) 5-A-DAY: dietary behavior and the fruit and vegetable intake of Latino children. Am J Public Health 84:814-8
Basch, C E; Shea, S; Zybert, P (1994) The reproducibility of data from a Food Frequency Questionnaire among low-income Latina mothers and their children. Am J Public Health 84:861-4
Shea, S; Basch, C E; Gutin, B et al. (1994) The rate of increase in blood pressure in children 5 years of age is related to changes in aerobic fitness and body mass index. Pediatrics 94:465-70