BROCODILE THE CROCODILE: OBESITY PREVENTION IN DAY CARE

在美国，肥胖的流行不仅包括成年人，还延伸到学龄前儿童。虽然基因在肥胖的发展中起作用，但只有环境和行为的改变才能解释最近的增加。因此，为了扭转目前肥胖及其伴随的合并症患病率上升的趋势，需要以人群为基础的干预措施，重点是改变行为。由于生活方式行为起源于儿童时期，而肥胖的患病率在5岁之前就开始增加，因此改变肥胖自然过程的干预措施需要从学龄前开始。我们提出了一种新颖的，创新的，令人兴奋的，基于日托的方法来预防儿童肥胖的发展。鳄鱼布罗科迪尔认识到日托在幼儿生活中扮演着越来越重要的角色，它的设计是有趣的，吸引幼儿、他们的父母和他们的日托提供者。这个由三部分组成的项目包括：1)发展适合的音乐运动，基于一个发展良好的音乐运动项目，Kindermusik(R)，利用儿童的大肌肉运动能力，对重复的反应和对音乐的享受；2)健康饮食，一个以发育为基础的心脏健康饮食计划，关注行为和环境；3)育儿，一个基于技能的项目。我们建议在20个日托中心中进行一项为期18个月的随机临床试验，其中10个干预中心将接受Brocodile the Crocodile计划，10个中心将作为对照，并评估作为主要结果的儿童在干预与对照日托中心之间BMI（肥胖）变化的差异。此外，还将评估其他变量（如儿童饮食、体育活动、看电视、父母行为等）与BMI变化的关系，以及识别肥胖风险最高的儿童的筛查策略。在该研究项目结束时，将开发、实施并评估一项以日托为基础的创新肥胖预防计划，以预防儿童肥胖。这些发现将有助于填补知识空白，并指导未来预防幼儿肥胖的建议。

The obesity epidemic in the US includes not only adults but extends to the preschool-age group. Although genetics plays a role in the development of obesity, only environmental and behavioral changes can account for the recent increases. Thus, to reverse the current trend of increasing prevalence of obesity and its attendant comorbidities, population-based interventions, focusing on behavioral changes are required. Because lifestyle behaviors have their origins in childhood and the increased prevalence of obesity is present by age 5, interventions to alter the natural course of obesity need to begin during the preschool years. We propose a novel, innovative, exciting, day care-based approach to prevent the development of childhood obesity. Brocodile the Crocodile, recognizes the increasing role that day care plays in the lives of young children and is designed to be fun and appealing to young children, their parents, and their day care providers. This three- component program consists of: l) developmentally-appropriate Music Movement, based on a well-developed music-movement program, Kindermusik(R), capitalizes on children's gross motor abilities, response to repetition, and enjoyment of music; 2) Healthy Eating, a developmentally-based heart-healthy eating program, focusing on behavior and environment; and 3) Parenting, a skills-based program. We propose to conduct a 18-month, randomized clinical trial among 20 day care centers, where 10 Intervention centers will receive the Brocodile the Crocodile program and 10 centers will be the Controls, and to evaluate, as the primary outcome, the difference in the change in BMI (adiposity) between the children attending the Intervention vs. Control day care centers. In addition, the relationship of other variables (e.g., child diet, physical activity, TV viewing, parent behavior, etc.), to change in BMI will be evaluated, as will screening strategies to identify children at greatest risk of developing obesity. At the conclusion of this research project, an innovative day care-based obesity prevention program will have been developed, implemented, and evaluated for effectiveness in preventing childhood obesity. The findings will help fill the knowledge gap and guide future recommendations for the prevention of obesity in young children.