Infant Care, Feeding, and Risk of Obesity

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Overweight and obesity are increasing rapidly in the U.S., particularlyamong low-income minority populations. While genetic factors no doubt play an important role, environmental and behavioralfactors must surely be drivingthe epidemic given its rapid increase in the past decade (Hill and Peters 1998). Recent research suggests that care and feeding styles during childhood may be related to subsequent risk of obesity (Johnson and Birch 1994; Birch et al 2000; Black et al 2001) yet little is known about the period when infants make the transitionthrough the weaning period to a family diet or how specific parenting styles or environments may influencethe development of obesity in very young children(Kumanyika 1993). The obesity literature has focused primarily on children during the adiposity rebound period or older, and few studies describe risk factors in the first two years of life, when patterns first develop and are under parental or caregiver control. This research will examine: 1) household factors that influence parenting and infant feeding patterns; 2) relationship of feeding styles to infant diet; and 3) relationshipof dietary intake to infant fatness. We will conduct the study among African American mothers and infants in North Carolina, a group at high risk for the development of obesity. In Phase I, we will conduct in-depth ethnographicresearch that defines culture-specific features of parentingand feeding and to identify household and contextual factors that may either prevent or promote infant obesity development in this population. This is a critical part of the research because it will allow us to define specific indicators related to our ecological model. We will also adapt an existing instrument, the Child Feeding Questionnaire (CFQ) (Birch et al 1998; in press), to be culturallyand age-appropriate for administrationamong mothers of African-Americans infants during the longitudinal study. In Phase II, we will conduct a longitudinal, observational study of 200 mother-infant African-American dyads, Followed from 3-18 months of age. The study is designed to identify the constellation of household, caregiver, andchild characteristics associated with the risk of obesity. Infants will be followed at 3, 6, 9, 12, and 18 months through assessments in their home environments. We will assess relationships among feeding styles, dietary intake, and infant Fatness, while taking into account the role of activity, maternal BMI, and other risk factors. PERFORMANCE S1TE(S) (organization, city, state) Carolina Population Center, The University of North Carolina at Chapel Hill KEY PERSONNEL.See instructions on Page II. Use continuation pages as needed to provide the required informationin Name Organization Margaret E. Bentley University of North Carolina at Chapel Hill Linda Adair University of North Carolina at Chapel Hill Lorraine Taylor University of North Carolina at Chapel Hill Anna Maria Siega-Riz University of North Carolina at Chapel Hill Eva Schaff-Blass University of North Carolina at Chapel Hill Barbara Goldman University of North Carolina at Chapel Hill Penny Gordon-Larsen University of North Carolina at Chapel Hill Chirayath Suchindran University of North Carolina at Chapel Hill Leann Birch Pennsylvania StateUniversity Jennifer Fisher Baylor University Maureen Black University of Maryland PHS 398 (Rev. 4/98) Page 2 Number pages consecutively at the bottom throughout the application. Do not use suffixes such as 3a. 3b. the format shown below. Role on Project PI Collaborating Investigator Collaborating Investigator Collaborating Investigator Collaborating Investigator Collaborating Investigator Collaborating Investigator Collaborating Investigator Consultant Consultant Consultant BB cc Principalinvestigator/Program Director (Last, first, middle): i BeWley, Margaret E. Type the name of the principal investigator/program director at the top of each printed page and each continuation page. (For type specifications, see instructions on page 6.) j RESEARCH GRANT ! TABLE OF CONTENTS Page Numbers Face Page .' 1 Description,