Family Meals as a Strategy for the Primary Prevention of Cardiovascular Disease in Children

摘要 心血管疾病（CVD）是美国（US）的主要死亡原因。数据来自著名的 博加卢萨心脏研究表明，CVD的发病机制可以在幼儿中开始， 与肥胖症直接相关的症状。与肥胖相关的是饮食质量差， 质量已被确定为CVD的主要原因。这项工作的长期目标是确定战略 家庭可以很容易地实施儿童CVD的一级预防。家庭喂养 环境，父母作为孩子们可获得的食物的守门人，已被确定为 对饮食行为的重要影响。在家庭喂养环境中， 研究表明，更频繁的家庭聚餐与饮食质量的提高有关， 水果和蔬菜，降低超重和肥胖的风险，以及积极的心理社会结果。家庭 膳食可以作为促进预防肥胖和促进幼儿CVD健康的媒介物， 但先前研究的严谨性还没有充分测试家庭用餐频率作为干预目标。的 这项随机对照试验的目的是检验家庭用餐频率作为 在解决心血管疾病的一级预防干预目标。90名儿童（6-12岁）及其 父母将被随机分配到两种干预措施之一：（1）增加家庭用餐频率，或（2）增加 水果和蔬菜的摄入量。这两个干预组都将接受以预防为重点的家庭干预， 多成分生活方式改变计划，行为干预研究的黄金标准。 关注的CVD风险因素包括饮食质量（目标1）、zBMI（目标2）和心血管健康， 血压、空腹血胰岛素、血脂、血管功能（目的3）。考虑到家庭的性质， 这项研究的一个探索性目的是审查随着时间的推移父母更换的适度性。的 综合评价心血管病危险因素，以阐明与家庭膳食的关系 频率，建议在家庭喂养环境中进行CVD的一级预防， 孩子

ABSTRACT Cardiovascular disease (CVD) is a leading cause of death in the United States (US). Data from the famous Bogalusa Heart Study have demonstrated the pathogenesis of CVD can start in young children, with early manifestation directly associated with obesity. Inter-related with obesity, is poor diet quality, and poor diet quality has been identified as a leading cause of CVD. The long-term goal of this work is to identify strategies that can be easily implemented by families for the primary prevention of CVD in children. The home feeding environment, where parents serve as the gatekeepers of the foods available to children has been identified as a key influence on eating behavior. Within the home feeding environment observational work has demonstrated more frequent family meals is associated with increased dietary quality, greater consumption of fruits and vegetables, decreased risk for overweight and obesity, and positive psychosocial outcomes. Family meals may serve as a vehicle to promote the prevention of obesity and promote CVD health in young children, but the rigor of prior research has not sufficiently tested family meal frequency as an intervention target. The objective of the proposed randomized controlled trial is to examine the efficacy of family meal frequency as an intervention target in addressing the primary prevention of CVD. Ninety children (6-12 years-old) and their parent will be randomized to one of two interventions: (1) increasing family meal frequency, or (2) increasing fruit and vegetable intake. Both intervention arms will receive a prevention-focused family-based multicomponent lifestyle modification program, the gold standard in behavioral-based intervention research. CVD risk factors of interest include diet quality (Aim 1), zBMI (Aim 2) and cardiovascular health as assessed by blood pressure, fasting blood insulin, blood lipids, vascular function (Aim 3). Given, the family-based nature of the study the moderation of parent change over time will be examined as an exploratory aim. The comprehensive evaluation of CVD risk factors will be used to elucidate the relationship with family meal frequency, a proposed vehicle within the home feeding environment for the primary prevention of CVD in children.