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

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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.