Trial of a Sugar-Sweetened Beverage Intervention in Overweight Mothers and Their Children Ages 3-5
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss, Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 3 - Any |
| Updated: | 11/8/2014 |
| Start Date: | May 2014 |
| End Date: | December 2014 |
| Contact: | Brooke T Nezami, MA |
| Email: | kbtompkins@unc.edu |
| Phone: | 919-966-5852 |
Randomized Controlled Trial of a Sugar-Sweetened Beverage Intervention in Overweight Mothers and Their Children Ages 3-5
The purpose of this study is to test the effect of a novel six-month behavioral program to
reduce sugar-sweetened beverage consumption among preschoolers and their mothers. The
behavioral intervention tested will be delivered via a mobile-based website, text messages
and email in addition to one face-to-face group meeting. The intervention will be compared
to a waitlist control group. Participants will be 42 overweight/obese mothers and their
children ages 3-5 living in the Chapel Hill/Raleigh/Durham area. Sugar-sweetened beverage
consumption and weight in both children and mothers will be measured at three- and
six-months post-randomization. It is hypothesized that children randomized to the
intervention will have a greater reduction in sugar-sweetened beverage consumption at 6
months compared to children randomized to the control group.
reduce sugar-sweetened beverage consumption among preschoolers and their mothers. The
behavioral intervention tested will be delivered via a mobile-based website, text messages
and email in addition to one face-to-face group meeting. The intervention will be compared
to a waitlist control group. Participants will be 42 overweight/obese mothers and their
children ages 3-5 living in the Chapel Hill/Raleigh/Durham area. Sugar-sweetened beverage
consumption and weight in both children and mothers will be measured at three- and
six-months post-randomization. It is hypothesized that children randomized to the
intervention will have a greater reduction in sugar-sweetened beverage consumption at 6
months compared to children randomized to the control group.
Obesity in young children remains a significant public health issue. Interventions targeting
this age group are needed, but few have been successful. The most effective childhood
obesity prevention interventions for young children thus far have involved significant
parent engagement, suggesting that family-based interventions that take into account the
needs of both parents and children are needed. But, 2 out of 3 adults are either overweight
or obese, and the risk of obesity increases with at least one child under the age of 5 in
the home. So not only is obesity among adults high, but maternal obesity is one of the
strongest predictors of child obesity, meaning that intervening with overweight and obese
mothers could be an effective way of preventing the development of obesity in their young
children.
Many family-based or parent-targeted interventions conducted thus far have broadly targeted
dietary intake and physical activity, but only a handful have had success in changing child
behavior. Interestingly, when evaluating the dietary determinants of childhood obesity,
sugar-sweetened beverage (SSB) consumption is most consistently associated with obesity
across studies, more so than overall caloric intake, fruit and vegetable consumption, and
intake of added dietary fats. Consumption of SSBs makes up 5-18% of preschoolers'
recommended daily energy intake, with an average of 176 calories a day consumed from drinks
such as caloric carbonated beverages, fruit drinks, sport drinks, and 100% fruit juice. Few
interventions have targeted a reduction in SSBs and fruit juice in children, but results
from a study in children ages 4-12 found that replacing SSBs with noncaloric beverages can
lead to a lower increase in BMI z-scores over time. Reducing SSB consumption in adults is
equally as important as in children, because adults consume 21% of their calories from SSBs
alone, and consumption of SSBs is associated with a higher risk of obesity, non-alcoholic
fatty liver disease, diabetes, the metabolic syndrome, and cardiovascular disease. Several
adult intervention studies have shown that replacing caloric beverages, including SSBs, with
water or noncaloric beverages can lead to weight loss in the absence of other prescribed
changes.
While the research indicates that reducing SSB consumption in children and adults can lead
to changes in weight, what is not yet known is if a mother-targeted behavioral intervention
can successfully reduce intake of SSBs and fruit juice in preschool-aged children. Because
mothers face many barriers to weight control behavior change, including time demands and
lack of childcare, there is a need for interventions that are uniquely targeted to the needs
of mothers and children, such that they minimize mothers' need to travel, prevent them from
having to rearrange their schedules, and minimize the amount of time spent in participation
in order to be successful at weight loss and changing their own and their child's behaviors.
This intervention has been developed to focus on changing a small set of behaviors,
primarily SSB consumption, in mothers and their children ages 3-5. Guided by Social
Cognitive Theory, the intervention will target increases in self-efficacy, outcome
expectations, limit setting, and self-monitoring, and decreases in perceived barriers to
behavior change. In addition, mothers will be asked to make other small changes in her own
behavior to promote modest weight losses. The evidence from traditional behavioral weight
loss intervention research has been adapted to focus on making small diet and physical
activity changes more suitable for mothers of young children and to be delivered primarily
via a mobile-based website and text messaging to reduce time demands and increase adherence.
Mother-child dyads (N=42) will be randomized to either the Smart Moms intervention group
(n=21) or to a waitlist control group (n=21) that will receive a modified version of the
intervention after the 6-month assessment.
this age group are needed, but few have been successful. The most effective childhood
obesity prevention interventions for young children thus far have involved significant
parent engagement, suggesting that family-based interventions that take into account the
needs of both parents and children are needed. But, 2 out of 3 adults are either overweight
or obese, and the risk of obesity increases with at least one child under the age of 5 in
the home. So not only is obesity among adults high, but maternal obesity is one of the
strongest predictors of child obesity, meaning that intervening with overweight and obese
mothers could be an effective way of preventing the development of obesity in their young
children.
Many family-based or parent-targeted interventions conducted thus far have broadly targeted
dietary intake and physical activity, but only a handful have had success in changing child
behavior. Interestingly, when evaluating the dietary determinants of childhood obesity,
sugar-sweetened beverage (SSB) consumption is most consistently associated with obesity
across studies, more so than overall caloric intake, fruit and vegetable consumption, and
intake of added dietary fats. Consumption of SSBs makes up 5-18% of preschoolers'
recommended daily energy intake, with an average of 176 calories a day consumed from drinks
such as caloric carbonated beverages, fruit drinks, sport drinks, and 100% fruit juice. Few
interventions have targeted a reduction in SSBs and fruit juice in children, but results
from a study in children ages 4-12 found that replacing SSBs with noncaloric beverages can
lead to a lower increase in BMI z-scores over time. Reducing SSB consumption in adults is
equally as important as in children, because adults consume 21% of their calories from SSBs
alone, and consumption of SSBs is associated with a higher risk of obesity, non-alcoholic
fatty liver disease, diabetes, the metabolic syndrome, and cardiovascular disease. Several
adult intervention studies have shown that replacing caloric beverages, including SSBs, with
water or noncaloric beverages can lead to weight loss in the absence of other prescribed
changes.
While the research indicates that reducing SSB consumption in children and adults can lead
to changes in weight, what is not yet known is if a mother-targeted behavioral intervention
can successfully reduce intake of SSBs and fruit juice in preschool-aged children. Because
mothers face many barriers to weight control behavior change, including time demands and
lack of childcare, there is a need for interventions that are uniquely targeted to the needs
of mothers and children, such that they minimize mothers' need to travel, prevent them from
having to rearrange their schedules, and minimize the amount of time spent in participation
in order to be successful at weight loss and changing their own and their child's behaviors.
This intervention has been developed to focus on changing a small set of behaviors,
primarily SSB consumption, in mothers and their children ages 3-5. Guided by Social
Cognitive Theory, the intervention will target increases in self-efficacy, outcome
expectations, limit setting, and self-monitoring, and decreases in perceived barriers to
behavior change. In addition, mothers will be asked to make other small changes in her own
behavior to promote modest weight losses. The evidence from traditional behavioral weight
loss intervention research has been adapted to focus on making small diet and physical
activity changes more suitable for mothers of young children and to be delivered primarily
via a mobile-based website and text messaging to reduce time demands and increase adherence.
Mother-child dyads (N=42) will be randomized to either the Smart Moms intervention group
(n=21) or to a waitlist control group (n=21) that will receive a modified version of the
intervention after the 6-month assessment.
Inclusion Criteria:
- The parent is female
- The mother has a BMI between 25 and 5
- The mother has a smartphone with data and text messaging plan
- The mother consumes at least 18 ounces of caloric beverages per day
- The child is between the ages of 3-5
- The child consumes at least 12 ounces of sugar-sweetened beverages/100% fruit juice
per day
Exclusion Criteria:
- The mother cannot speak or read English
- They cannot participate in assessment visits at the UNC Weight Research Program
- The mother is currently participating in another weight loss program
- The mother is pregnant or planning to become pregnant in next 6 months
- They are planning on moving out of the study area in the next 6 months
- The mother has a diagnosis of schizophrenia or bipolar disorder, or hospitalization
for a psychiatric diagnosis in the past year
- The mother has excessive intake of alcoholic beverages defined as >14 servings per
week or they report a diagnosis of substance or alcohol abuse (on screening survey)
- The mother is unable to safely participate in alternatives to sedentary behavior
including standing and walking
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