Toddler Overweight Prevention Study Among Low-Income Families

Background:

Overweight is a serious public health problem which can begin in early childhood. Factors
which contribute to overweight include: overfeeding, excessive intakes of fat and sugar;
frequent sedentary activities (i.e. television watching).

Overweight, defined as a BMI > 95th percentile, in early childhood has reached epidemic
proportions with 14% of 2-5 year olds overweight and 26.2% "at risk of overweight," defined
as a BMI > 85th percentile (Ogden et al., 2006).

Dietary and physical activity patterns established early in life track over time, making the
first few years of life an ideal time to help families establish healthy eating and physical
activity behaviors and avoid overweight. This project works to identify techniques that
could prevent overweight.

Purpose of Study:

The investigators are collaborating with the Anne Arundel County, MD WIC Program and the
University of Maryland's Pediatric Ambulatory Center to implement strategies that will
prevent overweight among toddlers. The project focuses on the dietary, physical activity,
and growth patterns of WIC toddlers. The investigators are conducting a 3-cell randomized
trial consisting of: 1) a maternal intervention focusing on healthy diet and physical
activity patterns for mothers; 2) a toddler parenting intervention focusing on parenting,
limit setting, and development strategies; and 3) an intervention on child safety. The
interventions are implemented over 3 months, with 8 sessions.

The investigators hypothesize that altering maternal behavior will have a positive impact on
the growth and development of the toddler by preventing behaviors that lead to overweight
among children. The parenting intervention will improve parenting skills by offering
information on proper approaches to feeding, discipline and educational play. The
investigators will compare the growth patterns of toddlers whose mothers were randomized to
the maternal and parenting interventions with those in the safety intervention. This study
design allows us to examine the mechanisms linking the interventions to improvements in
diet, physical activity, and growth.

In addition, the investigators will conduct the safety promotion intervention for the
attention control group, considering the high risk of unintentional injuries among the
toddlers from low-income families. The investigators also hypothesize that the safety
promotion intervention will reduce the safety problems of the toddlers' homes. The
underlying mechanisms will be examined, if there is a significant intervention effect.

Inclusion Criteria:

- At least 18 yrs old

- Has child between 12-30 months

- Child able to walk

- Birth weight of child at least 5lbs. 8oz.

Exclusion Criteria:

- Mom cannot be pregnant

- No known congenital problems or disabilities