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。生命第一年的肥胖和体重过度增加与儿童期高血压、复发性喘息、更高的住院率以及其他不利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幼儿肥胖。由于近三分之二的美国6岁以下儿童通常在家庭以外的地方接受照顾，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，参加托儿服务的孩子比在家由父母或其他照顾者照顾的孩子更容易肥胖，年龄较小的孩子可能面临的风险最大。我们自己的研究发现，在出生后的前6个月接受托儿服务的婴儿一岁时体重更重，三岁时体重仍比在家照顾的孩子重。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途径。这项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、体育活动和不活动、压力、睡眠时间和质量。为了实现这些目标，我们提出了一个多样化的南方队列，包括800名黑人、白人和拉丁裔婴儿，在不同的托儿安排下，从出生到12个月大定期随访。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过度增重，并将确定与能量摄入、能量消耗、压力和与肥胖相关的睡眠相关的风险因素。为了减轻参与者的负担和提高保留率，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进行面对面访问。这项研究的结果将为儿童看护和肥胖之间的关系提供新的信息，并可能有助于在这些变量之间的关联尚不清楚的情况下确定因果关系。研究结果将为管理儿童保育环境的州和联邦政策提供信息，并将指导干预工作，帮助预防儿童保育中的幼儿肥胖。

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.