The prevalence of overweight among preschool children in the U.S. is over 10 percent. Overweight in childhood is linked to overweight in adulthood, as well as earlier morbidity and mortality. This strongly suggests the need for primary prevention and intervention in children. Furthermore, in contrast to the disappointing weight loss outcome data for adults, weight loss studies with children report far more effective results. The inclusion of a parent in the intervention appears to contribute to the success. Thus, it seems vital that a successful overweight prevention and intervention program must include both children and parents. Finally, studies indicate that early prevention and intervention efforts may be particularly important for minority populations. For example, the prevalence of overweight among minority women approaches a staggering 50 percent compared to 33 percent for White women. Children often acquire a genetic predisposition toward overweight and model their eating patterns after their parents. Therefore, it follows that minority children from families where one or both parents are overweight are at greatest risk for becoming overweight themselves. The proposed research was designed to address the needs of the Black and Hispanic communities, focusing on intervention with preschool aged children. Twenty-four Head Start sites will be randomly assigned to intervention or no-intervention conditions. Of these 24 sites, 12 will serve a predominantly Black population, and 12 will serve a predominantly Hispanic population. The investigators anticipate enrolling an average of 35 Black or Hispanic children and parents per site. Parents and children will participate in health screenings at baseline, following the intervention, and 12 and 24 months later. The intervention consists of a 16-week nutrition and activity based weight control program that includes parental participation. The no-intervention control group will receive the standard curriculum provided by the Head Start preschool program. It is expected that children in the intervention group will show a greater mean reduction in the primary outcome measure, percent ideal body weight for height (%IBWH), as well as dietary fat intake; and an increase in dietary fiber and fruit and vegetable intake. It is expected that the parent intervention group will show a greater mean reduction in body mass index; decreased dietary fat; and increased dietary fiber, fruit and vegetable intake, physical activity, nutrition knowledge, nutrition attitudes, and support for healthy eating. These changes will be seen following the intervention and at 12 and 24 months later.
