Family Food Talk and Obesity Risk in Toddlers, Preschoolers, and Preteens

 描述(申请人提供)：儿童肥胖是一个严重的公共卫生问题，17%的美国儿童超重或肥胖。肥胖症一旦确定，就会追溯到童年后期和成年。父母在塑造孩子的饮食行为、饮食摄入量以及最终的肥胖风险方面至关重要。研究表明，家庭用餐时间对于预防儿童肥胖和养成健康的饮食习惯很重要，但研究结果并不一致。这种不一致的联系的一个原因可能是，很大一部分围绕食物的亲子互动发生在用餐时间之外，而且在历史上是无法衡量的。近年来，在用餐时间以外进食，特别是放学后吃零食的情况有所增加，这被认为是导致儿童体重过度增加的原因之一，也是儿童围绕食物和饮食进行社交的潜在重要背景。然而，人们对以下问题知之甚少：1)餐外围绕食物的自然主义亲子互动(即“食物养育”)；2)儿童因素(例如，坚持要求零食)如何起作用；或3)餐外食物互动如何在发育过程中发生变化。在用餐时间之外了解食物谈话，为未来预防儿童肥胖的干预开发提供了希望。这项拟议的工作还将填补一个关键的方法学空白，因为现有的研究依赖于父母自我报告的喂养、观察到的有组织的实验室互动，或家庭用餐时间。此前没有研究观察到亲子两餐之间的食物交流与儿童肥胖风险的关系。利用一项正在进行的横断面研究，我们建议分析在课余时间围绕食物和饮食的自然亲子互动与详细的、 对儿童饮食行为、饮食摄入量、父母喂养方式、家庭用餐时间互动和儿童肥胖的多方法评估。我们将使用语篇分析和行为编码的方法来评估自然发生的父母和孩子谈论食物和饮食的过程和内容，基于使用语言环境分析(LENA)系统的录音。我们的团队率先使用这一系统来研究育儿问题，是评估食物养育和儿童饮食行为的唯一专家。我们的目标是，在孩子12-24个月(n=40)、3-5岁(n=40)和10-13岁(n=60)的家庭中：目的1.评估自然亲子互动的频率、话语特征和情绪基调，包括食物或餐外饮食(“食物谈话”)，以及这些是否因年龄而不同。目的2.评估食物谈话是否与父母报告的儿童进食行为和儿童膳食摄入量有关。目的3.评估食物交谈是否与父母报告的喂养方式和观察到的家庭用餐时间互动有关。目的4.评估食物谈话是否与儿童肥胖指标(BMIz、皮褶和体重状况)以及六个月期间BMIz的变化率有关。

 DESCRIPTION (provided by applicant): Childhood obesity is a significant public health problem with 17% of US children being overweight or obese. Once established, obesity tracks into later childhood and adulthood. Parents are vital in shaping child eating behavior, dietary intake, and ultimately obesity risk. Research implicates family mealtimes as important for child obesity prevention and development of healthy eating habits, but findings are not consistent. One reason for the inconsistent associations may be that a substantial proportion of parent-child interactions around food occur outside the mealtime context and have historically been unmeasured. Eating outside of mealtimes, particularly snacking after school hours has increased in recent years and is proposed as contributing to excessive child weight gain and a potentially important context for child socialization around food and eating. Yet, little is known about: 1) naturalistic parent-child interactions around food (i.e., "food parenting") outside of mealtimes; 2) how child factors (e.g., persistence in requesting snacks) may contribute; or 3) how food interactions outside of mealtimes vary across development. Understanding food talk outside of mealtimes holds promise for future intervention development to prevent childhood obesity. The proposed work would also fill a critical methodological gap, as extant studies rely on parents' self-reported feeding, observed structured laboratory interactions, or family mealtimes. No prior study has observed parent-child food talk between meals in relation to child obesity risk. Leveraging an ongoing cross-sectional study, we propose to analyze naturalistic parent-child interactions around food and eating during after school hours in relation to detailed, multi-method assessments of child eating behavior, dietary intake, and parent feeding style, family mealtime interactions, and child adiposity. We will use discourse-analysis and behavioral-coding approaches to assess the process and content of naturally occurring parent and child talk about food and eating based on audio recordings using the Language Environment Analysis (LENA) system. Our team has pioneered use of this system to study parenting and is uniquely expert in assessing food parenting and child eating behavior. Our aims are, in families with children ages 12-24 months (n=40), 3-5 years (n=40), and 10-13 years (n=60): Aim 1. To assess frequency, discourse features, and emotional tone of naturalistic parent-child interactions involving food or eating outside of mealtime ("food talk"), and whether these differ by age. Aim 2. To assess whether food talk is associated with parent-reported child eating behaviors and child dietary intake. Aim 3. To assess whether food talk is associated with parent-reported feeding styles and observed family mealtime interactions. Aim 4. To assess whether food talk is associated with child adiposity indicators (BMIz, skinfolds, and weight status) and with rate of change in BMIz across a six-month period.