Improving WIC Services: Identifying Children at Risk for Obesity in the First 24 Months of Life

项目摘要/摘要 低收入家庭的儿童和少数族裔儿童受风险的影响不成比例 婴儿出生后24个月内肥胖的因素，例如纯母乳喂养率较低和母乳喂养率较高 粮食不安全的问题。向700多万低收入、不同种族的参与者提供特别补充资料 妇女、婴儿和儿童营养计划(WIC)在改善膳食方面处于重要地位 儿童早期的模式，这是建立终身饮食习惯的关键发展时期。一个联邦政府 WIC的要求是识别儿童的营养风险，并向所有低收入者提供营养教育 接受该计划服务的家庭。心理咨询的有效性直接关系到心理咨询的有效性 营养筛查措施。目前，全国各地的WIC计划使用营养问卷来 评估所有婴幼儿的营养风险，并使用结果来确定咨询服务的基础 在这些评估上。然而，这些问卷中很少有经过验证的，也没有一份被证明具有预测性 在24个月龄时识别肥胖和饮食质量的有效性。我们的长期目标是确定有效的饮食 预防肥胖和减少低收入婴幼儿差异的战略。总的目标是 这项拟议的研究是为了更好地了解婴儿期关键时期的饮食模式是如何 与出生后头24个月的肥胖风险有关。这项工作与我的K01奖有关，因为我的 对学龄儿童的研究使我找到了在生命早期改善营养的方法。儿童作为 早在24个月的时候，人们就已经养成了影响长期体重和健康的饮食习惯。我们 将使用有史以来第一次在WIC注册的全国儿童队列的数据，纵向跟踪调查从0岁到 24个月在美国农业部的WIC婴儿和幼儿喂养实践研究-2(WIC ITFPS-2)。WIC ITFPS-2 从最大的，最多样化的队列中收集关于饮食，摄食行为和人体测量的广泛数据 到目前为止，WIC参与者进行了研究。最后，这项研究将为R01提案提供初步证据 进行一项随机对照试验，以测试是否针对营养风险较高的婴儿进行更具体的WIC 营养教育服务与提供标准教育服务相比减少了肥胖差距 低收入人群。

PROJECT SUMMARY/ABSTRACT Children in low-income families and who are racial/ethnic minorities are disproportionately affected by risk factors for obesity in the first 24 months of life, such as lower rates of exclusive breastfeeding and higher rates of food insecurity. Reaching over 7 million low-income, racially diverse participants, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is in an important position to improve dietary patterns in early childhood, a critical developmental period for establishing lifelong eating habits. A federal requirement of WIC is to identify nutritional risk of children and provide nutrition education to all low-income families served by the program. The effectiveness of this counseling is directly related to the effectiveness of nutrition screening measures. Currently, WIC programs around the country use nutrition questionnaires to assess nutrition risk of all infants and young children and use results to determine counseling services based on these assessments. Few of these questionnaires are validated, however, and none have proven predictive validity to identify obesity and diet quality at 24 months of age. Our long-term goal is to identify effective dietary strategies to prevent obesity and reduce disparities in low-income infants and toddlers. The overall objective of this proposed study is to better understand how diet patterns during a critical time period during infancy are associated with risk for obesity in the first 24 months of life. This work is relevant to my K01 award because my research with school-aged children has led me to identify ways to improve nutrition earlier in life. Children as early as 24 months have already established dietary habits that can impact long-term weight and health. We will use data from the first-ever national cohort of WIC-enrolled children followed longitudinally from ages 0 to 24 months in the USDA’s WIC Infant and Toddler Feeding Practices Study-2 (WIC ITFPS-2). WIC ITFPS-2 collects extensive data on diet, feeding behaviors, and anthropometry from the largest, most diverse cohort of WIC participants studied to date. Finally, this study will provide the preliminary evidence for a R01 proposal to conduct a randomized controlled trial to test if targeting nutritionally at-risk infants for more specific WIC nutrition education services compared to providing standard education services reduces obesity disparities in a low-income population.