Young Overweight Research Articles

Breakfast Protein Source Does Not Influence Postprandial Appetite Response and Food Intake in Normal Weight and Overweight Young Women.

Breakfasts higher in protein lead to a greater reduction in hunger compared to breakfasts higher in carbohydrate. However, few studies have examined the impact of higher protein breakfasts with differing protein sources. Our objective was to determine if protein source (animal protein (AP) versus plant protein (PP)) influences postprandial metabolic response in participants consuming a high protein breakfast (~30% energy from protein). Normal weight (NW; n = 12) and overweight women (OW; n = 8) aging 18–36 were recruited to participate. Participants completed two visits in a randomized, cross-over design with one week between visits. Subjects had 15 minutes to consume each breakfast. Blood glucose and appetite were assessed at baseline, 15, 30, 45, 60, and 120 minutes postprandial. Participants kept a 24-hour dietary record for the duration of each test day. No difference was found between NW and OW participants or breakfasts for postprandial appetite responses. AP had a significantly lower glucose response at 30 minutes compared with PP (−11.6%; 127 ± 4 versus 112 ± 4 mg/dL; P < 0.05) and a slower return to baseline. There was no difference in daily energy intake between breakfasts. These data suggest that protein source may influence postprandial glucose response without significantly impacting appetite response in breakfast consumers.

Assessment of Pulmonary Function and Functional Capacity in Overweight Young Adults: Correlation with Visceral Fat

Assessment of Pulmonary Function and Functional Capacity in Overweight Young Adults: Correlation with Visceral Fat

Common variants in LEPR, IL6, AMD1, and NAMPT do not associate with risk of juvenile and childhood obesity in Danes: a case-control study.

BackgroundChildhood obesity is a highly heritable disorder, for which the underlying genetic architecture is largely unknown. Four common variants involved in inflammatory-adipokine triggering (IL6 rs2069845, LEPR rs1137100, NAMPT rs3801266, and AMD1 rs2796749) have recently been associated with obesity and related traits in Indian children. The current study aimed to examine the effect of these variants on risk of childhood/juvenile onset obesity and on obesity-related quantitative traits in two Danish cohorts.MethodsGenotype information was obtained for 1461 young Caucasian men from the Genetics of Overweight Young Adults (GOYA) study (overweight/obese: 739 and normal weight: 722) and the Danish Childhood Obesity Biobank (TDCOB; overweight/obese: 1022 and normal weight: 650).Overweight/obesity was defined as having a body mass index (BMI) ≥25 kg/m2; among children and youths, this cut-off was defined using age and sex-specific cut-offs corresponding to an adult body mass index ≥25 kg/m2. Risk of obesity was assessed using a logistic regression model whereas obesity-related quantitative measures were analyzed using a general linear model (based on z-scores) stratifying on the case status and adjusting for age and gender. Meta-analyses were performed using the fixed effects model.ResultsNo statistically significant association with childhood/juvenile obesity was found for any of the four gene variants among the individual or combined analyses (rs2069845 OR: 0.94 CI: 0.85–1.04; rs1137100 OR: 1.01 CI: 0.90–1.14; rs3801266: 0.96 CI: 0.84–1.10; rs2796749 OR: 1.02 CI: 0.90–1.15; p > 0.05). However, among normal weight children and juvenile men, the LEPR rs1137100 A-allele significantly associated with lower BMI (β = −0.12, p = 0.0026).ConclusionsThe IL6, LEPR, NAMPT, and AMD1 gene variants previously found to associate among Indian children did not associate with risk of obesity or obesity-related quantitative measures among Caucasian children and juvenile men from Denmark.

Nutritional Considerations for the Overweight Young Athlete.

Nutritional considerations for the overweight young athlete have not been thoroughly discussed in the scientific literature. With the high prevalence of childhood obesity, more children participating in sports are overweight or obese. This is particularly true for select sports, such as American football, where large size provides an added advantage. While sport participation should be encouraged because of the many benefits of physical activity, appropriate nutritional practices are vital for growth, and optimizing performance and health. The overweight young athlete may face certain challenges because of variable energy costs and nutrient requirements for growth and routine training, compared with nonoverweight athletes. Special attention should be given to adopting healthy lifestyle choices to prevent adverse health effects due to increased adiposity. In this review, we aim to discuss special nutritional considerations and highlight gaps in the literature concerning nutrition for overweight young athletes compared with their nonoverweight peers.

Relationship Between Serum IL-12 and p40 Subunit Concentrations and Lipid Parameters in Overweight and Obese Women.

Obesity is a chronic low-grade inflammatory state associated with the development of insulin resistance, type 2 diabetes mellitus, and atherosclerosis. Interleukin-12 (IL-12) is a proinflammatory cytokine composed of a 40-kD (p40) subunit and a 35-kD (p35) subunit. p40 might have an independent role in initiating the immune response. Recent findings indicate that IL-12 could be involved in the development of obesity-associated co-morbidities, especially atherosclerosis. It is unclear if there are alternations in circulating concentrations of total IL-12 and its subunit p40 in young subjects with increased adiposity without overt metabolic disturbances. The aim of the present study was to estimate serum total IL-12 together with its p40 subunit in young overweight and obese women and to investigate the associations of these parameters with insulin sensitivity and serum lipids. We studied 77 healthy women (37 lean and 40 obese or overweight). Anthropometric measurements, blood biochemical analyses, determination of serum IL-12, IL-12p40 concentrations, and euglycemic-hyperinsulinemic clamp were performed. We demonstrated an increase in serum p40 in obese subjects (P=0.029). We found positive correlations between p40 and fat mass (r=0.24, P=0.04) and significant negative associations with high-density lipoprotein cholesterol (HDL-C) (r=-0.27, P=0.002). Detectable concentrations of serum IL-12 were observed in 55% of subjects. Individuals with detectable serum concentrations of IL-12 had significantly higher levels of serum triglycerides (P=0.049). A significant association between IL-12 and serum total cholesterol (r=0.32, P=0.042) was observed in this subgroup. No association between p40 or IL-12 and insulin sensitivity was found. Our data indicate that the IL-12/IL-12p40 system may be associated with lipid abnormalities in obese subjects.

Heart Rate Variability Threshold Determined from Heart Rate Kinetics and Perceived Exertion in Overweight Young

The anaerobic threshold (AT) can be determined through different methods, including the heart rate variability threshold (HRVT), which delimits the withdrawal of parasympathetic nerve activity and is associated to the lactate threshold. Other methods such as the inflection point of the heart rate curve (PIHR) and the fixed value of 13 points of perceived exertion (PE13) are easily obtained, but still poorly investigated, especially in overweight young, which can exhibit exacerbated physiological responses to exercise, affecting the kinetics of HR and PE. PURPOSE:To compare and verify the association between the HRVT,PIHR and PE13 in eutrophic and overweight young. METHODS: Eutrophic (EuT;N=9; 20.4±1.8years; 22.4±2.4kg/m2) and overweight sedentary young men (OW;N=11; 21.7±1.8years; 30.1±2.8kg/m2) underwent a maximal incremental test (15W/min) on a cycle ergometer, with RR intervals continuously recorded (heart rate monitor) to analyze (Kubios program) the SD1 index (standard deviation of instantaneous RR intervals) and to identify the HRVT by 2 criteria: (1) 1st. load with SD1 <3ms (HRVT1); (2) 1st. load with a difference <1ms in SD1 between 2 consecutive stages (HRVT2); HR: PIHR, identifying the maximum distance for exponential and linear adjustment; and PE: At 13 points on the 6-20-point scale (PE13). Shapiro-Wilk, One-Way ANOVA or Kruskal-Wallis test with a post-hoc of Bonferroni or Dunn’s, as well as Pearson or Spearman correlation were used for load (W), %Maximum Load (%ML), HR (bpm), %Maximum HR (%MHR) and PE (p<0.05). RESULTS: There were no differences among the methods for the EuT, and the correlation between HRVT1-2 for the load, %ML, HR, %MHR and PE was: r=0.82, 0.88, 0.75, 0.89 and 0.99, respectively, and for HR between PIHR and HRVT1-2 it was r=0.73 and 0.87, respectively. Differences were found in the loads and HR in OW, overestimated by PE13 (128.2±31W; 153±22bpm) compared with HRVT1 (76.4±43.2W; 132±8bpm) and PIHR (75±48.4W; 107±54bpm). The PE at PIHR was lower than the PE13. There was a correlation in the load and %ML between HRVT1-2 (r=0.76; 0.77);in the %LM between PIHR and HRVT1-2 (r=0.65; 0.63);and in PE between HRVT1-2 and PIHR (r=0.89; 0.62). CONCLUSIONS: The methods of determining the AT can be used interchangeably, especially the PIHR, which is easy to apply, in both groups, except for the PE13 in the OW, which seems to overestimate the AT.Supported by FAPEMAT (151411/2014),CNPq

Cardiac Autonomic Modulation at Rest and Aerobic Fitness in Overweight Young

Cardiac Autonomic Modulation at Rest and Aerobic Fitness in Overweight Young

Light Physical Activity Is Positively Associated With Aerobic Capacity In Young Overweight Sedentary Women

Light Physical Activity Is Positively Associated With Aerobic Capacity In Young Overweight Sedentary Women

Restrained and external-emotional eating patterns in young overweight children-results of the Ulm Birth Cohort Study.

Childhood obesity is one of the greatest public health challenges in Western countries. Abnormal eating behavior is thought to be a developmental trajectory to obesity. The Eating Pattern Inventory for Children (EPI-C) has not been used for children as young as eight years, and possible associations with body weight have not yet been established. Five hundred and twenty-one children of the Ulm Birth Cohort Study (UBCS; age eight) filled out the EPI-C and BMI was assessed. Adequacy of the scales was tested with confirmatory factor analysis and a MANOVA and cluster analysis established associations between eating patterns and BMI. The factor structure of the EPI-C was confirmed (GFI = .968) and abnormal eating behavior was associated with overweight (χ2(8) = 79.29, p<.001). The EPI-C is a valid assessment tool in this young age group. Overweight children consciously restrain their eating.

Limb specific comparison of flow‐mediated dilation in overweight, pre‐menopausal women (1158.1)

The dilatory responses of the brachial artery as compared to the popliteal artery have been found to be equal in healthy young women and reduced in normal aging in healthy, post‐menopausal women (Parker et al. 2006). However, limb‐specific differences have not been investigated among young overweight, premenopausal women who are at a greater propensity for advanced cardiovascular aging. The hypothesis is that overweight women will exhibit limb specific differences in artery dilation with reduced dilation in the popliteal artery as compared to the brachial artery. Artery dilatory responses were assessed using flow‐mediated dilation (FMD) in 18 women (9 controls, 9 overweight) aged 24.7+1.29, non‐smokers, and sedentary. Significant difference were found between groups including % body fat, BMI, weight, waist to hip ratio, fasting blood glucose and oxLDL. A between group comparison of percent dilation revealed that the popliteal artery in overweight participants were significantly lower than control (p&lt;0.05). We conclude that young, metabolically compromised women exhibit a limb specific difference in dilation of the upper and lower extremities as compared to healthy controls, showing possible complications of oxidative stress within the vasculature.Grant Funding Source: HSI STEM – Engaging Students in STEM Careers Award Number: P031C110114

Abstract MP20: Vitamin D Supplementation Increases Global DNA Methylation in Overweight and Obese African Americans with Vitamin D Deficiency

Introduction: Vitamin D deficiency is associated with cardiovascular disease, diabetes and cancer. Individuals with obesity or darker skin are at risk for vitamin D deficiency. Our genome-wide methylation study has shown that African Americans with vitamin D deficiency have reduced levels of methylation compared with controls. Global decrease in DNA methylation, a common feature of cancer, is associated with genomic and chromosomal instability. Therefore, we aimed to test our hypothesis that vitamin D supplementation will increase global DNA methylation level in overweight and obese African Americans with vitamin D deficiency. Methods: We recently conducted a 16 weeks randomized, placebo controlled clinical trial of vitamin D3 supplementation (NCT01583621). A total of 65 young overweight and obese African Americans (13-45 years, 83% females) with vitamin D deficiency (25-hydroxyvitamin D3 [25(OH)D] &lt; 20 ng/ml) were randomly assigned to receive a supervised monthly oral vitamin D3 dose of placebo (n=16), 18,000 IU (~600 IU/day, the current RDA; n=15), 60,000 IU (~2,000 IU/day; n=17), or 120,000 IU (~4,000 IU/day, the deemed tolerable upper intake level; n=17). Global DNA methylation level (percentage of 5-methylcytosine, %5-mC) was quantified using leukocyte DNA with the MethylFlash Methylated DNA Quantification kit (Epigentek) in a total of 58 participants. Results: At baseline, serum 25(OH)D levels were positively correlated with %5-mC (r=0.26, p=0.04) in the entire cohort. A significant increase was observed in the changes of serum 25(OH)D from baseline to 16 weeks (0.9 ± 2.0, placebo; 8.6 ± 2.1, 600 IU/day; 20.1 ± 2.0, 2,000 IU/day; and 21.2 ± 2.0 ng/ml, 4,000 IU/day; p&lt;0.01). In addition, a significant dose-responsive increase was observed in the changes of %5-mC from baseline to 16 weeks (0.00 ± 0.18, placebo; 0.02 ± 0.20, 600 IU/day; 0.29 ± 0.17, 2,000 IU/day; and 0.66 ± 0.18%, 4,000 IU/day group; p&lt;0.01). This response remained significant even after adjusting for age, sex and BMI. Moreover, the changes in %5-mC were significantly correlated with the changes in serum 25(OH)D (r=0.60, p=0.02) in the 4,000 IU group. Conclusions: Vitamin D supplementation increases global DNA methylation level in a dose-responsive manner. Increased global DNA methylation, subsequently increased genomic and chromosomal stability may be one of the underlying mechanisms by which vitamin D exerts its beneficial effects on cardiovascular disease, diabetes and cancer. Large scale vitamin D supplementation clinical trial is warranted to verify our findings.

Recommendations for a Culturally Relevant Internet-Based Tool to Promote Physical Activity Among Overweight Young African American Women, Alabama, 2010–2011

IntroductionInnovative approaches are needed to promote physical activity among young adult overweight and obese African American women. We sought to describe key elements that African American women desire in a culturally relevant Internet-based tool to promote physical activity among overweight and obese young adult African American women.MethodsA mixed-method approach combining nominal group technique and traditional focus groups was used to elicit recommendations for the development of an Internet-based physical activity promotion tool. Participants, ages 19 to 30 years, were enrolled in a major university. Nominal group technique sessions were conducted to identify themes viewed as key features for inclusion in a culturally relevant Internet-based tool. Confirmatory focus groups were conducted to verify and elicit more in-depth information on the themes.ResultsTwenty-nine women participated in nominal group (n = 13) and traditional focus group sessions (n = 16). Features that emerged to be included in a culturally relevant Internet-based physical activity promotion tool were personalized website pages, diverse body images on websites and in videos, motivational stories about physical activity and women similar to themselves in size and body shape, tips on hair care maintenance during physical activity, and online social support through social media (eg, Facebook, Twitter).ConclusionIncorporating existing social media tools and motivational stories from young adult African American women in Internet-based tools may increase the feasibility, acceptability, and success of Internet-based physical activity programs in this high-risk, understudied population.

Epicardial adipose tissue thickness in young Indian overweight and obese individuals

Epicardial adipose tissue (EAT) has been found to be an important reliable marker for future coronary events. Deposition of the EAT in young individuals is not well known. We studied EAT in 25 young overweight or obese individuals. In spite of the high visceral fat and total body fat, EAT thickness was not found to be high in the participants of our study.

A-FABP and its Association with Atherogenic Risk Profile and Insulin Resistance in Young Overweight and Obese Women

We evaluated the association of A-FABP with proatherogenic risk profile and insulin resistance (IR) in young, nondiabetic, overweight/obese women. Serum A-FABP, high-sensitivity CRP, adiponectin, glucose, insulin, lipids and apolipoproteins were measured in 104 women (aged 20-45 years; BMI ≥25 kg/m(2)) and age-matched healthy controls (n = 76; BMI <25 kg/m(2)). All patients underwent blood pressure and anthropometric measurements. A-FABP concentration was related to IR, and anthropometric and atherogenic indices. A-FABP was an independent predictor of triglyceride:high-density lipoprotein cholesterol, explaining 42% of its variation in overweight/obese women. At a cutoff level of 16 ng/ml, A-FABP discriminated between controls and overweight/obese (area under curve = 0.96) with high sensitivity and specificity. A-FABP predicted atherogenic risk, with an odds ratio of 11.2 (95% CI: 3.7-34.2), 7.1 (1.9-27.2) and 6.7 (2.6-17.2) for having elevated triglyceride:high-density lipoprotein cholesterol, apoB and CRP, respectively, and IR with an odds ratio 5.6 (1.8-17.2). A-FABP seems to be a valuable predictor of atherogenic risk profile; if elevated it contributes to cardiovascular disease beyond its effect on IR.

Cytokine profiling of young overweight and obese female African American adults with prediabetes

Approximately 5–10% of subjects with prediabetes become diabetic every year. Inflammation is involved in the development of obesity-related type 2 diabetes (T2D). However, to date, the relationship between inflammation and prediabetes, defined by hemoglobin A1c (HbA1c) ⩾5.7 and <6.5%, remains largely unexplored, especially in African Americans. Therefore, in this study we examined a comprehensive panel of 13 cytokines involved in the inflammatory response in overweight/obese subjects with prediabetes. A total of 21 otherwise healthy, overweight/obese, young adult African American females with prediabetes, together with 20 matched overweight/obese controls, were selected for this study. Plasma cytokines were assessed by multiplex cytokine profiling. Plasma concentrations of interleukin (IL)-5, IL-6, IL-7, tumor necrosis factor-α (TNF-α), and granulocyte–monocyte colony-stimulating factor (GM-CSF) were significantly higher in the prediabetic group, as compared to the control group (all p<0.05). Plasma concentrations of all the other cytokines, interferon-γ (IFN-γ), IL-1β, IL-2, IL-4, IL-8, IL-10, IL-12p70 and IL-13, seemed to be elevated in the prediabetic group, but failed to reach statistical significances. Upon merging both groups, HbA1c was found to be positively correlated with IFN-γ, IL-1β, IL-2, IL-5, IL-7, IL-8, TNF-α and GM-CSF. This study demonstrates elevated levels of various pro-inflammatory cytokines in overweight/obese young subjects with prediabetes, which place them at higher risk of developing T2D and cardiovascular diseases. Our data also call for further investigations in animal models and population cohorts to establish the roles of a variety of pro-inflammatory cytokines in the early development of obesity-related T2D.

Effectiveness of strategies for recruiting overweight and obese Generation Y women to a clinical weight management trial.

Limited research in young overweight and obese women indicates that they are difficult to recruit to weight management trials, with attrition higher and weight loss success lower than middle to older age participants. This study aimed to evaluate the effectiveness of different recruitment strategies for a clinical weight loss trial in overweight and obese Generation Y women. Overweight and obese (BMI >=27.5 kg/m-2) women aged 18-25 years (n=70) were required for a 12 month clinical weight management trial including diet, exercise and behaviour modification. Contact with researchers and eventual recruitment are reported for the various strategies employed to engage participants. Data reported as % or mean±SE. Recruitment was challenging with only 50 of the total 70 participants recruited within the scheduled time frame (24 months). Just over one quarter (27%) of volunteers assessed were recruited. Flyers posted around local tertiary education campuses were the most successful method, yielding 36% of included participants. This was followed by advertisements on the local area health service intranet (26%) and in local and metropolitan newspapers (16%). Recruitment of overweight and obese Generation Y women for a clinical weight loss trial was difficult. Multiple strategies targeted at this age and gender group were required. Less rigorous selection criteria and reduced face-to-face intervention time may improve recruitment and retention rates into clinical trials for this age group.

Effect of weight loss and regain on adipose tissue distribution, composition of lean mass and resting energy expenditure in young overweight and obese adults

Although weight cycling is frequent in obese patients, the adverse consequences on body composition and an increased propensity to weight gain remain controversial. We investigated the effect of intentional weight loss and spontaneous regain on fat distribution, the composition of lean mass and resting energy expenditure (REE). Weight regainers (≥ 30% of loss, n=27) and weight-stable subjects (within <± 20% of weight change, n=20) were selected from 103 overweight and obese subjects (body mass index 28-43 kg m(-2), 24-45 years) who passed a 13-week low-calorie diet intervention. REE and body composition (by densitometry and whole-body magnetic resonance imaging) were examined at baseline, after weight loss and at 6 months of follow-up. Mean weight loss was -12.3 ± 3.3 kg in weight-stable subjects and -9.0 ± 4.3 kg in weight regainers (P<0.01). Weight regain was incomplete, accounting for 83 and 42% of weight loss in women and men. Regain in total fat and different adipose tissue depots was in proportion to weight regain except for a higher regain in adipose tissue of the extremities in women and a lower regain in extremity and visceral adipose tissue in men. In both genders, regain in skeletal muscle of the trunk lagged behind skeletal muscle regain at the extremities. In contrast to weight-stable subjects, weight regainers showed a reduced REE adjusted for changes in organ and tissue masses after weight loss (P<0.001). Weight regain did not adversely affect body fat distribution. Weight loss-associated adaptations in REE may impair weight loss and contribute to weight regain.

Physical Activity of Young Overweight and Obese Children

The purpose of this study was to compare objectively measured physical activity (PA) and parent-reported assessments of the children's PA in an overweight/obese child sample. A total of 67 child-parent dyads were recruited for study participation. Child anthropometric measures and parent-reported questionnaires were completed, and then PA was measured by accelerometers for 48 consecutive hours. These children demonstrated moderate-to-vigorous PA for 17.32 min per day on average. The children spent 86.7% of their time in sedentary activities. Parents' reports of hyperactivity were significantly related to the objectively measured PA; however, the parents significantly overestimated the average amount of time children spent in each activity level. These findings suggest that although parents may be able to generally characterize their child's PA, they may not be able to accurately report specific information and thus may struggle to identify clear activity goals for their child and/or be unable to assess intervention effects.

Young overweight and obese women with lower circulating osteocalcin concentrations exhibit higher insulin resistance and concentrations of C-reactive protein

The role of the skeleton in the regulation of energy metabolism in humans is not clear. This study investigates the hypothesis that biomarkers of bone turnover are associated with indices of glucose homeostasis and systemic inflammation in young adults. A cross-sectional study investigating the relationships between biomarkers of bone turnover (serum total and uncarboxylated osteocalcin, bone-specific alkaline phosphatase, C-telopeptide of type I collagen, urinary N-telopeptide of type I collagen) and glucose metabolism (fasting plasma glucose [FPG], insulin, insulin resistance [homeostatic model assessment of insulin resistance]), systemic inflammation (high-sensitivity C-reactive protein [hsCRP] and interleukin-6), adipokines (leptin and adiponectin), and body composition was conducted in 268 young, nondiabetic overweight and obese adults aged 20 to 40 years (116 men, 152 women; body mass index, 27.5-32.5 kg/m2). Data on diet, physical activity, serum 25-hydroxyvitamin D, and parathyroid hormone were also collected. In women, there was a stepwise increase in lean body mass (P < .05) and a decrease in serum hsCRP (P < .001) across tertiles of total osteocalcin. Multiple linear regression analysis showed significant inverse associations between total osteocalcin and FPG (β = −0.350; P = .016; 95% confidence interval [CI], −0.35 to −0.04), insulin (β = −0.455; P = .002; 95% CI, −1.9 to −0.46), and homeostatic model assessment of insulin resistance (β = −0.508; P = .001; 95% CI, −10.93 to −3.17) in women with total osteocalcin concentrations below the group median. Men in the lowest tertile of uncarboxylated osteocalcin had twice the concentration of hsCRP than did other men (P = .05). In this sample, women with less lean body mass had lower circulating total osteocalcin concentrations and exhibited higher FPG, insulin resistance, and hsCRP compared with their similarly sized counterparts, suggesting that associations between osteocalcin and systemic inflammation, glucose homeostasis, and insulin resistance may be influenced by differences in sex and body composition.

The Community-based Healthy-lifestyle Intervention for Rural Preschools (CHIRP) study: Design and methods

The CHIRP study is a two-arm, pilot randomized controlled trial assessing the effectiveness of a behavioral family weight management intervention in an important and at-risk population, overweight young children, 3 to 6years of age, and their parents from underserved rural counties. Participants will include 96 parent–child dyads living in rural counties in north central Florida. Families will be randomized to one of two conditions: (a) behavioral family based intervention or (b) a waitlist control. Child and parent participants will be assessed at baseline (month 0), post-treatment (month 4), and follow-up (month 10). Assessments and intervention sessions will be held at the Cooperative Extension office in each participating rural county. The primary outcome measure is change in child body mass index (BMI) z-score. Additional key outcome measures include child dietary intake, physical activity, and parent BMI.This study is unique because (1) it is one of the few randomized controlled trails examining a behavioral family intervention to address healthy habits and improved weight status in young overweight and obese children, (2) addresses health promotion in rural settings, and (3) examines intervention delivery in real world community settings through the Cooperative Extension Service offices. If successful, this research has potential implications for medically underserved rural communities and preventative health services for young children and their families.