Abstract
Individuals from racial minority backgrounds, especially those in low income situations, are at increased risk for obesity. Family meals positively impact child nutritional health; however, there is limited evidence examining the impact on caregivers, particularly racial minority and income-restricted individuals. The objective of this intervention study was to determine the effect of Simple Suppers, a 10 week family meals program, on caregiver diet and nutrition outcomes. Intervention versus waitlist control participants were compared from baseline (T0) to post-intervention (T1). In addition, intervention participants were assessed at a 10 week follow-up time point (T2). This study was a two-group quasi-experimental intervention trial. Lessons (10 total) were delivered on a weekly basis for 90 min. Data were collected from intervention and waitlist control participants at T0 and T1, and intervention participants at T2. After baseline (T0) data collection, families enrolled in the immediate upcoming session of Simple Suppers (intervention group) or waited for 10 weeks (waitlist control group) to begin the program. Participants were caregivers of children ages 4–10 years. This study was conducted in a faith-based community center for underserved families in Columbus, Ohio. Primary outcomes were: diet quality assessed by Healthy Eating Index (HEI) total and component scores, and total energy intake (kcal/day); body mass index (BMI) (kg/m2), waist circumference (cm), systolic and diastolic blood pressure (BP) (mmHG); and self-efficacy for having healthy meals and menu planning (both scalar). The impact of the intervention (T0:T1) was assessed using generalized mixed-effects linear regression models. Maintenance of change in study outcomes among intervention participants (T1:T2) was examined with paired t-tests. 109 caregivers enrolled in this study. The retention rate at T1 was 90% (i.e., 98 participants). 56 of 68 intervention participants completed T2, resulting in a retention rate of 82%. Almost all (99%) were female, 61% were Black, and 50% were between 31 and 40 years old. In total, 40% had low income and 37% had low or very low food security. At T1, intervention vs. waitlist controls had a lower daily energy intake (p = 0.04), but an HEI-2010 component score for fatty acids (adequacy) that was lower indicating a lower dietary intake of fatty acids (p = 0.02), and a component score for empty calories (moderation) that was significantly lower indicating a higher intake of empty calorie foods (p = 0.03). At T1, intervention vs. waitlist controls also had a lower BMI (p < 0.001) and systolic BP (p = 0.04), and higher self-efficacy (p = 0.03). There were no group differences in other outcomes. At T2, intervention participants maintained the changes in daily energy intake, BMI, systolic BP, and self-efficacy that improved during the intervention period. There was no change (improvement) in the component score for fatty acids; however, the component score for empty calories significantly improved (p = 0.02). Engagement in the Simple Suppers program led to improvements in caregivers’ daily caloric intake, weight status, systolic blood pressure, and self-efficacy for family meals. Future research should further explore the dietary and nutritional health benefits of family meals among caregivers at the highest risk for obesity.
Highlights
Adult obesity is a persisting and pressing nutrition-related public health problem in theU.S, affecting over 30% of the population [1]
The main objective of this study was to determine the effect of Simple Suppers, a 10 week family meals program tailored to racially diverse and underserved families with school-aged children on caregiver diet and nutrition outcomes [19]
Service area census tracts at the time of this study demonstrated that the center’s surrounding neighborhoods had a median household income of $32,307–$58,490, 10.7–24.9% were under the federal poverty line (FPL), 41.8% were Black, and 58.7% of households were classified as families
Summary
Adult obesity is a persisting and pressing nutrition-related public health problem in theU.S, affecting over 30% of the population [1]. The health consequences of obesity are devastating and well documented Those with obesity are at increased risk for multiple diseases including type 2 diabetes, certain types of cancers, heart disease and heart failure, and hypertension and stroke [4]. Rates of obesity in childhood and adulthood are tightly linked in that adults with obesity are more likely to have been diagnosed with overweight or obesity as children [6]. This is fueled in part by modifiable behavioral factors such as diet [4], which are established early in life [7]. Interventions aimed at preventing the accumulation of excessive weight (fat mass) in childhood, and engage both children and caregivers, via improved dietary patterns have the greatest potential in terms of a having a marked impact on the obesity epidemic
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