Behavior Modification of Diet and Parent Feeding Practices in a Community- Vs Primary Care–Centered Intervention for Childhood Obesity

Abstract

ObjectiveTo evaluate behavior modification of diet and parent feeding practices in childhood obesity interventions. DesignSecondary analysis of randomized, controlled trial comparing Mind, Exercise, Nutrition … Do It! (MEND2-5 and MEND/Coordinated Approach to Child Health [CATCH6-12]) vs Next Steps at baseline and 3 and 12 months. SettingAustin and Houston, TX. ParticipantsA total of 549 Hispanic and black children randomized to programs by age groups (2–5, 6–8, and 9–12 years) InterventionsTwelve-month MEND2-5 and MEND/CATCH6-12 vs Next Steps. Main Outcome Measure(s)Diet (MEND-friendly/unfriendly food groups and Healthy Eating Index-2010) and parent feeding practices (parental overt control, discipline, limit setting, monitoring, reinforcement, modeling, and covert control; and food neophobia). AnalysisMixed-effects linear regression. ResultsChanges in diet quality, consumption of MEND-unfriendly foods, and parent feeding practices did not differ between programs. In both interventions, MEND-unfriendly vegetables, grains, dairy and protein, added fat and desserts/sugar-sweetened beverages declined in 2–5- and 6–8-year-olds (P < .001). Healthy Eating Index-2010 improved in 2–5- (treatment; P = .002) and 6–8-year-olds (P = .001). Parental overt control decreased and limit setting, discipline, monitoring, reinforcement, and covert control increased with both interventions in 2–5- and 6–8-year-olds (P < 0.01–0.001). ConclusionsDiet quality, consumption of MEND-unfriendly foods, and parent feeding practices were altered constructively in 2 pediatric obesity interventions, especially in 2–5- and 6–8-year-olds.