Parental Feeding Practices, Child Stress, and Childs Later Risk of Obesity

父母的喂养方式、儿童压力和儿童日后肥胖的风险

• 批准号: 9804414
• 负责人: Callie L Brown
• 金额: $ 15.12万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-10 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9804414
• 关键词: 6 year old; Address; Advisory Committees; Affect; Age; Anxiety; Behavior; Biometry; Blinking; Body Weight; Body mass index; Child; Clinical; Counseling; Data; Deposition; Development Plans; Diabetes Mellitus; Diet; Dietary intake; Eating; Eating Behavior; Energy Intake; Equation; Feasibility Studies; Feeding behaviors; Food; Food Preferences; Frequencies; Funding; Future; Goals; Hair; Heart Rate; Hour; Hydrocortisone; Hyperphagia; Informal Social Control; Intervention; K-Series Research Career Programs; Knowledge; Laboratories; Lead; Learning; Longitudinal Studies; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Modeling; Obesity; Overweight; Palate; Parents; Participant; Physiological; Pilot Projects; Positioning Attribute; Preventive Intervention; Primary Health Care; Questionnaires; Randomized Controlled Trials; Reporting; Research; Research Design; Research Personnel; Research Proposals; Risk Factors; Standardization; Stress; Structure; Time; Underweight; Weight; Weight Perception; Work; abdominal fat; career; career development; cohort; effective intervention; evidence base; experience; feeding; healthy weight; heart rate variability; improved; multidisciplinary; nutrition; obesity in children; obesity prevention; obesity risk; pediatrician; pressure; recruit; response; skills; therapy development; translational scientist

ABSTRACT The candidate for this K23 career development award is committed to a career as an independently funded clinical and translational researcher and leader in the field of pediatric obesity prevention. This K23 Career Development Award will allow the Candidate to complete her educational goals of gaining experience in structural equation modeling, longitudinal study design and analysis, diet assessment, observed standardized feedings, and measures of stress. In all these activities, she will be mentored by a highly accomplished, multidisciplinary team of mentors and advisors. Her mentors have complementary expertise in nutrition and longitudinal assessment (Dr. Mara Vitolins), biostatistics (Dr. Edward Ip), and childhood obesity (Dr. Joseph Skelton). The Candidate will also utilize an outstanding advisory committee with expertise in observational feeding studies (Dr. Julie Lumeng), weight perception (Dr. Eliana Perrin), physiologic measures of stress (Dr. Patricia Nixon), and anxiety (Dr. Gretchen Brenes). In her clinical work as a general pediatrician, the candidate noted that many parents express concerns about their young child’s picky eating, whether their child is eating enough, or whether their child is underweight. The candidate’s preliminary work has demonstrated that such concerns affect how parents feed their children, leading to behaviors such as pressuring to eat or overfeeding. These approaches could ultimately lead to increased child stress at mealtimes and decreased self-regulation of eating, which in turn can increase long-term risk of obesity and diabetes. However, the predictive relationships between child and parent factors, feeding practices, and obesity remain unclear. Additionally, the relationship between parent feeding practices and child stress has not been previously investigated. To address these gaps in knowledge, the following Specific Aims are proposed: 1) to assess the effects of parental concerns about their child’s weight and eating behaviors on pressure to eat, feeding frequency and amount, and dietary variety; 2) to assess the effects of parent feeding practices on child stress, child self- regulation of eating, and energy intake; and 3) assess the effect of parent concerns and parent feeding practices on child body weight (BMIz). The central hypotheses are that parental concerns about their child’s eating and weight are associated with children’s subsequent greater: 1) feeding frequency and amount; 2) pressure to eat; 3) stress at mealtimes; and 4) body weight status (body mass index z-score [BMIz]). To investigate these aims the Candidate will recruit a cohort of 300 parents of 3- to 6-year-old children to complete questionnaires and a subsample of 50 parent-child dyads to participate in standardized directly observed feedings (observing pressure to eat and stress) and dietary recalls to follow over 2 years. The preliminary data from this research proposal and the skills achieved throughout the career development plan will directly support future R01 applications to expand this work to conduct randomized controlled trials to determine effective interventions to improve feeding practices and reduce obesity.

抽象的 K23 职业发展奖的候选人致力于作为独立资助的职业 儿童肥胖预防领域的临床和转化研究员和领导者。 K23职业生涯 发展奖将使候选人能够完成获得以下领域经验的教育目标： 结构方程建模、纵向研究设计和分析、饮食评估、观察标准化 喂养和压力测量。在所有这些活动中，她将得到一位卓有成就的指导， 多学科的导师和顾问团队。她的导师在营养和营养方面拥有互补的专业知识 纵向评估（Mara Viitolins 博士）、生物统计学（Edward Ip 博士）和儿童肥胖（Joseph 博士） 斯克尔顿）。候选人还将利用一个在观察方面具有专业知识的优秀咨询委员会 喂养研究（Julie Lumeng 博士）、体重感知（Eliana Perrin 博士）、压力的生理测量（Dr. Eliana Perrin） 帕特里夏·尼克松）和焦虑（格雷琴·布雷内斯博士）。在她作为普通儿科医生的临床工作中，候选人 注意到许多家长对年幼的孩子挑食表示担忧，孩子是否吃东西 足够，或者他们的孩子是否体重不足。候选人的初步工作表明，这种 这些担忧会影响父母喂养孩子的方式，导致强迫进食或过度喂养等行为。 这些方法最终可能会导致儿童进餐时的压力增加并降低自我调节能力 饮食，这反过来又会增加肥胖和糖尿病的长期风险。然而，预测 儿童和父母因素、喂养方式和肥胖之间的关系仍不清楚。此外， 此前尚未研究过父母喂养方式与儿童压力之间的关系。到 为了解决这些知识差距，提出以下具体目标：1）评估 父母对孩子的体重和饮食行为的担忧，包括进食压力、喂食频率和 数量和饮食种类； 2）评估父母喂养方式对儿童压力、儿童自我认知的影响 饮食和能量摄入的调节； 3) 评估家长关心的问题和家长喂养的影响 儿童体重 (BMIz) 的实践。核心假设是父母对孩子的担忧 孩子的饮食和体重与孩子随后的更大程度有关：1）喂食频率和 数量; 2）吃饭的压力； 3）进餐时的压力； 4) 体重状况（体重指数 z 分数 [BMIz]）。为了调查这些目标，候选人将招募 300 名 3 至 6 岁儿童的家长组成的队列 完成问卷调查和50名亲子二人的子样本直接参与标准化 观察两年多的喂养情况（观察进食压力和压力）和饮食回忆。这 本研究提案的初步数据以及整个职业发展计划中获得的技能 将直接支持未来的 R01 应用，以扩展这项工作以进行随机对照试验 确定有效的干预措施以改善喂养方式并减少肥胖。