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

摘要 心血管疾病(CVD)是美国主要的死亡原因。来自著名的 博加卢萨心脏研究表明，心血管疾病的发病机制可从幼儿开始，早期 与肥胖直接相关的症状。与肥胖相互关联的是不良的饮食质量，以及不良的饮食 质量已被确定为CVD的主要原因。这项工作的长期目标是确定战略 家庭可以很容易地实施这一点，作为儿童心血管疾病的一级预防。家庭喂养 父母充当儿童可获得食物的看门人的环境被确定为 对饮食行为的关键影响。在家庭喂养环境中，观察工作有 研究表明，更频繁的家庭聚餐与饮食质量的提高、更多的 水果和蔬菜，降低超重和肥胖的风险，以及积极的心理社会结果。家庭 膳食可以作为一种工具来促进预防肥胖和促进幼儿的心血管健康， 但之前的严谨研究并没有充分测试家庭用餐频率作为干预目标。这个 建议的随机对照试验的目的是检查家庭用餐频率作为一种 解决心血管疾病一级预防的干预目标。90名儿童(6-12岁)及其 父母将随机接受两种干预措施之一：(1)增加家庭用餐频率，或(2)增加 水果和蔬菜的摄入。两个干预部门都将接受以家庭为基础的预防 多成分生活方式调整计划，基于行为的干预研究的黄金标准。 感兴趣的心血管疾病危险因素包括饮食质量(目标1)、zBMI(目标2)和心血管健康，由 血压、空腹血胰岛素、血脂、血管功能(目标3)。考虑到家庭的本质， 父母变化随时间变化的适度性研究将作为一个探索性目标进行检验。这个 将使用心血管疾病危险因素的综合评估来阐明与家庭用餐的关系 频率，建议在家庭喂养环境中用于心血管疾病一级预防的车辆 孩子们。

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.