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BMC Public Health
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Study protocol

Healthy eating and obesity prevention for preschoolers: a randomised controlled trial

Authors: Helen Skouteris, Marita McCabe, Boyd Swinburn, Briony Hill

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Developing effective prevention and intervention programs for the formative preschool years is seen as an essential step in combating the obesity epidemic across the lifespan. The overall goal of the current project is to measure the effectiveness of a healthy eating and childhood obesity prevention intervention, the MEND (Mind Exercise Nutrition Do It!) program that is delivered to parents of children aged 2-4 years.

Methods/Design

This randomised controlled trial will be conducted with 200 parents and their 2-4 year old children who attend the MEND 2-4 program in metropolitan and regional Victoria. Parent-child dyads will attend ten 90-minute group workshops. These workshops focus on general nutrition, as well as physical activity and behaviours. They are typically held at community or maternal and child health centres and run by a MEND 2-4 trained program leader. Child eating habits, physical activity levels and parental behaviours and cognitions pertaining to nutrition and physical activity will be assessed at baseline, the end of the intervention, and at 6 and 12 months post the intervention. Informed consent will be obtained from all parents, who will then be randomly allocated to the intervention or wait-list control group.

Discussion

Our study is the first RCT of a healthy eating and childhood obesity prevention intervention targeted specifically to Australian parents and their preschool children aged 2-4 years. It responds to the call by experts in the area of childhood obesity and child health that prevention of overweight in the formative preschool years should focus on parents, given that parental beliefs, attitudes, perceptions and behaviours appear to impact significantly on the development of early overweight. This is 'solution-oriented' rather than 'problem-oriented' research, with its focus being on prevention rather than intervention. If this is a positive trial, the MEND2-4 program can be implemented as a national program.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12610000200088
Appendix
Available only for authorised users
Literature
1.
Booth ML, Dobbins T, Okely AD, Denney-Wilson E, Hardy LL: Trends in the prevalence of overweight and obesity among young Australians, 1997, and 2004. Obesity (Silver Spring). 1985, 15: 1089-1095. 10.1038/oby.2007.586.CrossRef
2.
Vaska V, Volkmer R: Increasing prevalence of obesity in South Australian 4-year-olds: 1995-2002. J Paediatr Child Health. 2004, 40: 353-355. 10.1111/j.1034-4810.2004.00401.x.CrossRefPubMed
3.
Wake M, Nicholson JM, Hardy P, Smith K: Preschooler obesity and parenting styles of mothers and fathers: Australian national population study. Pediatrics. 2007, 120: e1520-1527. 10.1542/peds.2006-3707.CrossRefPubMed
4.
Access Economics: The growing cost of obesity in 2008: Three years on. Canberra: Report for Diabetes Australia. 2008
5.
World Health Organization: Obesity and Overweight. Global strategy on diet, physical activity and health. 2003, Geneva, World Health Organization
6.
de la Eva RC, Baur LA, Donaghue KC, Waters KA: Metabolic correlates with obstructive sleep apnea in obese subjects. J Pediatr. 2002, 140: 654-659. 10.1067/mpd.2002.123765.CrossRefPubMed
7.
Garnett SP, Cowell CT, Baur LA, Shrewsbury VA, Chan A, Crawford D, Salmon J, Campbell K, Boulton TJ: Increasing central adiposity: the Nepean longitudinal study of young people aged 7-8 to 12-13 y. Int J Obes (Lond). 2005, 29: 1353-1360. 10.1038/sj.ijo.0803038.CrossRef
8.
Lobstein T, Baur L, Uauy R: Obesity in children and young people: a crisis in public health. Obes Rev. 2004, 5 (Suppl 1): 4-104. 10.1111/j.1467-789X.2004.00133.x.CrossRefPubMed
9.
McCabe MP, Ricciardelli LA: Body image and strategies to lose weight and increase muscle among boys and girls. Health Psychol. 2003, 22: 39-46. 10.1037/0278-6133.22.1.39.CrossRefPubMed
10.
Ricciardelli LA, McCabe MP: Children's body image concerns and eating disturbance: A review of the literature. Clinical Psychology Review. 2001, 21: 325-344. 10.1016/S0272-7358(99)00051-3.CrossRefPubMed
11.
Dohnt HK, Tiggemann M: Development of perceived body size and dieting awareness in young girls. Percept Mot Skills. 2004, 99: 790-792. 10.2466/PMS.99.7.790-792.PubMed
12.
McCabe MP, Ricciardelli LA, Stanford J, Holt K, Keegan S, Miller L: Where is all the pressure coming from? Messages from mothers and teachers about preschool children's appearance, diet and exercise. Eur Eat Disord Rev. 2007, 15: 221-230. 10.1002/erv.717.CrossRefPubMed
13.
14.
Rankinen T, Zuberi A, Chagnon YC, Weisnagel SJ, Argyropoulos G, Walts B, Perusse L, Bouchard C: The human obesity gene map: the 2005 update. Obesity (Silver Spring). 2006, 14: 529-644. 10.1038/oby.2006.71.CrossRef
15.
McGarvey E, Keller A, Forrester M, Williams E, Seward D, Suttle DE: Feasibility and benefits of a parent-focused preschool child obesity intervention. Am J Public Health. 2004, 94: 1490-1495. 10.2105/AJPH.94.9.1490.CrossRefPubMedPubMedCentral
16.
Rhee KE: Childhood overweight and the relationship between parent behaviors, parenting style, and family functioning. Annals of the American Academy of Political and Social Science. 2008, 615: 12-37. 10.1177/0002716207308400.CrossRef
17.
18.
Faith MS, Kerns J: Infant and child feeding practices and childhood overweight: the role of restriction. Matern Child Nutr. 2005, 1: 164-168. 10.1111/j.1740-8709.2005.00024.x.CrossRefPubMed
19.
Faith MS, Scanlon KS, Birch LL, Francis LA, Sherry B: Parent-child feeding strategies and their relationships to child eating and weight status. Obes Res. 2004, 12: 1711-1722. 10.1038/oby.2004.212.CrossRefPubMed
20.
Farrow CV, Blissett J: Controlling feeding practices: cause or consequence of early child weight?. Pediatrics. 2008, 121: e164-169.PubMed
21.
Robinson TN, Kiernan M, Matheson DM, Haydel KF: Is parental control over children's eating associated with childhood obesity? Results from a population-based sample of third graders. Obes Res. 2001, 9: 306-312. 10.1038/oby.2000.38.PubMed
22.
Spruijt-Metz D, Lindquist CH, Birch LL, Fisher JO, Goran MI: Relation between mothers' child-feeding practices and children's adiposity. Am J Clin Nutr. 2002, 75: 581-586.PubMed
23.
Pugliese J, Tinsley B: Parental socialization of child and adolescent physical activity: a meta-analysis. J Fam Psychol. 2007, 21: 331-343. 10.1037/0893-3200.21.3.331.CrossRefPubMed
24.
Brown R, Ogden J: Children's eating attitudes and behaviour: a study of the modelling and control theories of parental influence. Health Educ Res. 2004, 19: 261-271. 10.1093/her/cyg040.CrossRefPubMed
25.
Contento IR, Basch C, Shea S, Gutin B, Zybert P, Michela JL, Rips J: Relationship of mothers' food choice criteria to food intake of preschool children: identification of family subgroups. Health Educ Q. 1993, 20: 243-259.CrossRefPubMed
26.
Gibson EL, Wardle J, Watts CJ: Fruit and vegetable consumption, nutritional knowledge and beliefs in mothers and children. Appetite. 1998, 31: 205-228. 10.1006/appe.1998.0180.CrossRefPubMed
27.
Moens E, Braet C, Soetens B: Observation of family functioning at mealtime: a comparison between families of children with and without overweight. J Pediatr Psychol. 2007, 32: 52-63. 10.1093/jpepsy/jsl011.CrossRefPubMed
28.
Rhee KE, Lumeng JC, Appugliese DP, Kaciroti N, Bradley RH: Parenting styles and overweight status in first grade. Pediatrics. 2006, 117: 2047-2054. 10.1542/peds.2005-2259.CrossRefPubMed
29.
Shelton D, Le Gros K, Norton L, Stanton-Cook S, Morgan J, Masterman P: Randomised controlled trial: A parent-based group education programme for overweight children. J Paediatr Child Health. 2007, 43: 799-805. 10.1111/j.1440-1754.2007.01150.x.CrossRefPubMed
30.
Haire-Joshu D, Elliott MB, Caito NM, Hessler K, Nanney MS, Hale N, Boehmer TK, Kreuter M, Brownson RC: High 5 for Kids: the impact of a home visiting program on fruit and vegetable intake of parents and their preschool children. Prev Med. 2008, 47: 77-82. 10.1016/j.ypmed.2008.03.016.CrossRefPubMedPubMedCentral
31.
Harvey-Berino J, Rourke J: Obesity prevention in preschool native-american children: a pilot study using home visiting. Obes Res. 2003, 11: 606-611. 10.1038/oby.2003.87.CrossRefPubMed
32.
Horodynski MA, Stommel M: Nutrition education aimed at toddlers: an intervention study. Pediatr Nurs. 2005, 31: 367-372.
33.
Wardle J, Cooke LJ, Gibson EL, Sapochnik M, Sheiham A, Lawson M: Increasing children's acceptance of vegetables; a randomized trial of parent-led exposure. Appetite. 2003, 40: 155-162. 10.1016/S0195-6663(02)00135-6.CrossRefPubMed
34.
Brown T, Kelly S, Summerbell C: Prevention of obesity: a review of interventions. Obes Rev. 2007, 8 (Suppl 1): 127-130. 10.1111/j.1467-789X.2007.00331.x.CrossRefPubMed
35.
Sacher P, Wolman J, Chadwick P, Swain C: Mini-MEND: MEND's early years healthy lifestyle programme for 2-4 year olds and their families. Nutrition Bulletin. 2008, 33: 364-367. 10.1111/j.1467-3010.2008.00735.x.CrossRef
36.
Moher D, Schulz KF, Altman DG: The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol. 2001, 1: 2-10.1186/1471-2288-1-2.CrossRefPubMedPubMedCentral
37.
Davison KK, Birch LL: Childhood overweight: a contextual model and recommendations for future research. Obes Rev. 2001, 2: 159-171. 10.1046/j.1467-789x.2001.00036.x.CrossRefPubMedPubMedCentral
38.
Wardle J, Herrera ML, Cooke L, Gibson EL: Modifying children's food preferences: the effects of exposure and reward on acceptance of an unfamiliar vegetable. Eur J Clin Nutr. 2003, 57: 341-348. 10.1038/sj.ejcn.1601541.CrossRefPubMed
39.
Sanders MR: Triple P - Positive Parenting Program: towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clin Child Fam Psychol Rev. 1999, 2: 71-90. 10.1023/A:1021843613840.CrossRefPubMed
40.
Wardle J, Guthrie CA, Sanderson S, Rapoport L: Development of the Children's Eating Behaviour Questionnaire. J Child Psychol Psychiatry. 2001, 42: 963-970. 10.1111/1469-7610.00792.CrossRefPubMed
41.
Bennett C-A, de Silva-Sanigorski A, Nichols M, Bell A, Swinburn B: Assessing the intake of obesity-related foods and beverages in young children: comparison of a simple population survey with 24 hr-recall. International Journal of Behavioral Nutrition and Physical Activity. 2009, 6: 71-10.1186/1479-5868-6-71.CrossRefPubMedPubMedCentral
42.
The Australian Guide to Healthy Eating. 1998, Canberra: Department of Health and Ageing
43.
Klohe DM, Clarke KK, George GC, Milani TJ, Hanss-Nuss H, Freeland-Graves J: Relative validity and reliability of a food frequency questionnaire for a triethnic population of 1-year-old to 3-year-old children from low-income families. J Am Diet Assoc. 2005, 105: 727-734. 10.1016/j.jada.2005.02.008.CrossRefPubMed
44.
Gibson R, (Ed): Principles of Nutritional Assessment. 2005, New York: Oxford University Press, 2
45.
Dwyer G, Higgs J, Hardy L, Baur L: What do parents and preschool staff tell us about young children's physical activity: a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. 2008, 5: 66-10.1186/1479-5868-5-66.CrossRefPubMedPubMedCentral
46.
Anderson DR, Lorch EP, Field DE, Collins PA, Nathan JG: Television viewing at home: age trends in visual attention and time with TV. Child Dev. 1986, 57: 1024-1033. 10.2307/1130376.CrossRefPubMed
47.
Huston AC, Wright JC, Marquis J, Green SB: How young children spend their time: television and other activities. Dev Psychol. 1999, 35: 912-925. 10.1037/0012-1649.35.4.912.CrossRefPubMed
48.
Huston AC, Wright JC, Rice ML, Kerkman D, St Peters M: Development of television viewing patterns in early childhood: A longitudinal investigation. Developmental Psychology. 1990, 26: 409-420. 10.1037/0012-1649.26.3.409.CrossRef
49.
Skouteris H, McHardy K: Television viewing habits and time use in Australian preschool children. Journal of Children & Media. 2009, 3: 80-89.CrossRef
50.
Ziegler P, Briefel R, Ponza M, Novak T, Hendricks K: Nutrient intakes and food patterns of toddlers' lunches and snacks: influence of location. J Am Diet Assoc. 2006, 106: S124-134. 10.1016/j.jada.2005.09.036.CrossRefPubMed
51.
Anderson DR, Field DE, Collins PA, Lorch EP, Nathan JG: Estimates of young children's time with television: a methodological comparison of parent reports with time-lapse video home observation. Child Dev. 1985, 56: 1345-1357. 10.2307/1130249.CrossRefPubMed
52.
Parmenter K, Wardle J: Development of a general nutrition knowledge questionnaire for adults. Eur J Clin Nutr. 1999, 53: 298-308. 10.1038/sj.ejcn.1600726.CrossRefPubMed
53.
de Onis M: WHO Child Growth Standards based on length/height, weight and age. Acta Paediatrica. 2006, 95: 76-85.
54.
Baughcum AE, Powers SW, Johnson SB, Chamberlin LA, Deeks CM, Jain A, Whitaker RC: Maternal feeding practices and beliefs and their relationships to overweight in early childhood. J Dev Behav Pediatr. 2001, 22: 391-408.CrossRefPubMed
55.
Birch LL, Fisher JO: Mothers' child-feeding practices influence daughters' eating and weight. Am J Clin Nutr. 2000, 71: 1054-1061.PubMedPubMedCentral
56.
Birch LL, Fisher JO, Grimm-Thomas K, Markey CN, Sawyer R, Johnson SL: Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite. 2001, 36: 201-210. 10.1006/appe.2001.0398.CrossRefPubMed
57.
National Nutrition Survey Users' Guide 1995. 1998, Canberra: Australian Bureau of Statistics, Department of Health and Family Services
58.
The Active Australia Survey: A Guide and manual for implementation, analysis and reporting. 2003, Canberra: Australian Institute of Health and Welfare (AIHW)
59.
Pliner P: Development of measures of food neophobia in children. Appetite. 1994, 23: 147-163. 10.1006/appe.1994.1043.CrossRefPubMed
60.
Mathews L, Kremer P, Sanigorski A, Simmons A, Nichols M, Moodie M, Swinburn BA: Nutrition and physical activity in children and adolescents. Barwon-South Western Region. Sentinel Site Series. Report 1: Methods and Tools. 2008, Department of Human Services (Victoria)
61.
Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z: The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: cluster-randomised controlled trial. BMC Public Health. 2008, 8: 103-10.1186/1471-2458-8-103.CrossRefPubMedPubMedCentral
62.
Clark A, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J: The relationship between depression and body dissatisfaction across pregnancy and the postpartum: a prospective study. J Health Psychol. 2009, 14: 27-35. 10.1177/1359105308097940.CrossRefPubMed
63.
64.
Schafer J: NORM: Multiple imputation of incomplete multivariate data under a normal model. Version 2.02 [Software for Windows 95/98]. 1999
65.
Smith J, Jarman M, Osborn M: Doing interpretive phenomenological analysis. Qualitative Health Psychology: Theories and Methods. Edited by: Murray M, Chamberlain K. 1999, London: Sage Publications, 218-240.CrossRef
66.
Clark A, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J: My baby body: A qualitative insight into women's body-related experiences and mood during pregnancy and the postpartum. Journal of Reproductive & Infant Psychology. 2009, 27: 330-345.CrossRef
67.
Powell MB, Skouteris H, Murfett R: Children's perceptions of the role of police: a qualitative study. International Journal of Police Science & Management. 2008, 10: 464-473.CrossRef
68.
Catford JC, Caterson ID: Snowballing obesity: Australians will get run over if they just sit there. Med J Aust. 2003, 179: 577-579.PubMed
69.
Zimmet PZ, James WP: The unstoppable Australian obesity and diabetes juggernaut. What should politicians do?. Med J Aust. 2006, 185: 187-188.PubMed
70.
Birch LL, Ventura AK: Preventing childhood obesity: what works?. Int J Obes (Lond). 2009, 33 (Suppl 1): S74-81. 10.1038/ijo.2009.22.CrossRef
71.
Dietz WH: Periods of risk in childhood for the development of adult obesity--what do we need to learn?. J Nutr. 1997, 127: 1884S-1886S.PubMed
72.
Birch LL, Fisher JO: Development of eating behaviors among children and adolescents. Pediatrics. 1998, 101: 539-549.PubMed
73.
Trost SG, Sirard JR, Dowda M, Pfeiffer KA, Pate RR: Physical activity in overweight and nonoverweight preschool children. Int J Obes Relat Metab Disord. 2003, 27: 834-839. 10.1038/sj.ijo.0802311.CrossRefPubMed
74.
Parsons TJ, Power C, Logan S, Summerbell CD: Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord. 1999, 23 (Suppl 8): S1-107.PubMed
75.
Campbell KJ, Hesketh KD: Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obes Rev. 2007, 8: 327-338. 10.1111/j.1467-789X.2006.00305.x.CrossRefPubMed
76.
Kitzmann KM, Beech BM: Family-based interventions for pediatric obesity: methodological and conceptual challenges from family psychology. J Fam Psychol. 2006, 20: 175-189. 10.1037/0893-3200.20.2.175.CrossRefPubMed
Metadata
Title
Healthy eating and obesity prevention for preschoolers: a randomised controlled trial
Authors
Helen Skouteris
Marita McCabe
Boyd Swinburn
Briony Hill
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-220

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