Early child care and risk of obesity

描述（由申请人提供）：预防儿童肥胖的需要延伸到我们最小的孩子。出生后第一年的肥胖和体重过度增加与高血压、反复喘息、较高的住院率以及儿童期其他不良的身体和心理健康状况独立相关。因此，需要有效的方法来预防儿童早期肥胖。由于近三分之二的美国6岁以下儿童经常在家庭外接受照顾，有组织的儿童保育是预防肥胖的重要环境。最近的研究表明，参加儿童保育的儿童比由父母或其他照顾者在家照顾的儿童更容易肥胖，而年幼的儿童可能面临最大的风险。我们自己的研究发现，在出生后的前6个月里花时间照顾孩子的婴儿在一是的时比在家里照顾的孩子重，在3岁时仍然重。这些先前的研究确定了儿童保育和肥胖之间的关系，但未能确定具体的因果关系。拟议的纵向研究将检查可能受儿童保育环境影响的导致肥胖发展的因素，包括饮食行为，身体活动和不活动，压力以及睡眠时间和质量。为了实现这些目标，我们提出了一个多元化的南方队列的800名黑人，白色，和拉丁美洲/a婴儿在各种儿童保育安排，定期从出生到12个月大。在婴儿期进行频繁的家庭评估将有助于准确地确定儿童何时开始开始过度增重，并将确定与肥胖相关的能量摄入、能量消耗、压力和睡眠相关的风险因素。为了减轻参与者的负担并提高保留率，我们将使用交互式语音应答（IVR）技术，通过创新的电话管理评估与父母和儿童保育提供者补充亲自访问。这项研究的结果将提供有关儿童保育出勤率和肥胖之间关系的新信息，并可能有助于确定这些变量之间的关联尚不清楚的情况下的因果关系。调查结果将为州和联邦管理儿童保育环境的政策提供信息，也将指导干预工作，以帮助预防儿童保育中幼儿的肥胖。

DESCRIPTION (provided by applicant): The need to prevent childhood obesity extends down to our youngest children. Obesity and excessive weight gain in the first year of life are independently associated with higher blood pressure, recurrent wheezing, higher hospital admission rates, and other adverse physical and psychosocial health conditions in childhood. Thus, effective approaches to obesity prevention in early childhood are needed. Because nearly two-thirds of U.S. children under 6 years of age are routinely cared for outside of the home, organized child care is an important setting for obesity prevention. Recent studies suggest that children who attend child care are more likely to be obese than children cared for at home by a parent or other caregiver, and younger children might be most at risk. Our own research found that infants who spent time in child care during the first 6 months of life were heavier at one yea and still heavier at 3 years of age than children cared for at home. These previous studies identified a relationship between child care and obesity, but failed to pinpoint specific causal pathways. The proposed longitudinal study will examine factors contributing to the development of obesity that may be influenced by the child care setting, including dietary behaviors, physical activity and inactivity, stress, and sleep duration and quality. To accomplish these aims, we propose a diverse southern cohort of 800 black, white, and Latino/a infants in various child care arrangements, followed regularly from birth to 12 months of age. Frequent in-home assessments throughout infancy will help pinpoint exactly when children begin to gain weight excessively and will identify risk factors related to energy intake, energy expenditure, stress, and sleep associated with obesity. To mitigate participant burden and enhance retention, we will use Interactive Voice Response (IVR) technology to supplement in-person visits through innovative telephone-administered assessments with parents and child care providers. Results of this study will provide new information on the relationship between child care attendance and obesity and may help determine causality in instances where the associations between these variables have been unclear. Findings will inform state and federal policy governing child care settings and will also guide intervention efforts to help prevent obesity in young children in chil care.