Spillover Effects of a Family-Based Childhood Obesity Intervention on Parental Nutrient Biomarkers and Cardiometabolic Risk Factors

Abstract

ObjectivesTo evaluate the impact of a family-based weight management intervention for children with overweight/obesity on parental nutrient biomarker concentrations and cardiometabolic risk factors (CMRF). MethodsSecondary analysis from a randomized-controlled, parallel-arm clinical trial. Families were recruited from a largely Hispanic population and assigned to either Standard Care (SC; American Academy of Pediatrics overweight/obesity recommendations) or Standard Care + Enhanced Program (SC + EP; eight skill-building cores, subsequent monthly support sessions, targeted diet/physical activity strategies). Nutrient biomarkers (plasma carotenoids and fat soluble vitamins; red blood cell [RBC] fatty acid profiles) and CMRF (BMI, blood pressure, plasma glucose, insulin, lipid profile, inflammatory markers and adipokine concentrations) were measured in archived samples collected from the parents at baseline and at the end of the 1-year intervention. ResultsParents of children in both groups (SC = 106; SC + EP = 99) had significantly lower total SFA (–3%) and trans fatty acid (–14%), and higher MUFA (2%), PUFAn-6 (2%), PUFAn-3 (7%) and beta-carotene (20%) concentrations, indicative of decreased partially-hydrogenated fat and increased vegetable oil, fish and fruit/vegetable intake, respectively. In both groups, there were significant reductions in inflammatory markers (hsCRP [–21%], TNFα [–19%] and IL-6 [–19%]), but not in BMI, blood pressure or lipid profile. Parents with children assigned to the SC + EP group had additional improvements in serum insulin (–6%) and leptin (–1.3%) concentrations. Using multiple linear regression models adjusted for sex, age, group, baseline BMI, and baseline CMRF values, improvements in circulating inflammatory and glucose metabolism markers, and adipokine concentrations were associated with higher carotenoid and PUFAn-3 (specifically 20:5n-3), and lower SFA and trans fatty acid concentrations, at the end of the 1-year intervention. ConclusionsThese results suggest that a family-based childhood obesity intervention can spill over to parents, resulting in apparent healthier dietary shifts that are associated with modest improvements in some CMRF. Funding SourcesNIH, NIDDK, USDA.