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Effectiveness of Nutrition Intervention in a Selected Group of Overweight and Obese African-American Preschoolers

  • Yulyu Yeh
  • Kathryn Brogan Hartlieb
  • Cynthia Danford
  • K.-L. Catherine Jen
Article

Abstract

High prevalence of childhood obesity persists as a public health concern in the USA. However, limited study has been conducted on the effectiveness of nutrition education focused on African-American (AA) preschoolers (PSLRs) in the preschool settings. The aim of this pilot study was to explore the effectiveness of nutrition education on AA PSLR’s health. A convenience sample of 164 PSLRs (95% AA, 44% female) from six Head Start (HS) centers in a Midwestern metropolitan area was randomly assigned to 3 groups: intervention group A, standard curriculum plus nutrition education for PSLRs; intervention group B, standard curriculum plus nutrition education for PSLRs and their caregivers (CGs); and control group, standard curriculum. Baseline and post-intervention differences within each group and differences among the three groups in body mass index (BMI) percentiles, blood lipid profile, and food preference/knowledge were analyzed. No significant changes in BMI percentiles among the three groups were observed. When only overweight and obese PSLRs were considered, there was a significant reduction in BMI percentile in group B (PSLR + CG) and control group. More PSLRs in all three groups had blood lipid levels in the acceptable with few in the high-risk levels. There were no changes in nutrition knowledge and healthy eating behavior post-intervention. This pilot study supports including both PSLRs and CGs in future preschool-based interventions and the need for more intense intervention to optimize healthy outcomes, especially for those AA PSLRs who are overweight or obese.

Keywords

Nutrition education Obesity Preschoolers African American 

Notes

Compliance with Ethical Standards

The research protocol was approved by Institution Review Board of the institution and the HS program.

Funding

This study was funded by a grant from the Office of the Vice President for Research, Wayne State University. The intervention material will be available upon request.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from children’s caregivers participating in the study.

References

  1. 1.
    Flegal K, Kruszon-Moran D, Carroll M, Fryar C, Ogden C. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284–91. doi: 10.1001/jama.2016.6458.CrossRefPubMedGoogle Scholar
  2. 2.
    Flegal K, Carroll M, Ogden C, Johnson C. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288:1723–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Ogden C, Carroll M, Kit B, Flegal K. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311:806–14.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Ogden C, Carroll M, Lawman H, Fryar C, Kruszon-Moran D, Kit B, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA. 2016;315(21):2292–9. doi: 10.1001/jama.2016.6361.CrossRefPubMedGoogle Scholar
  5. 5.
    Freedman D, Khan L, Serdula M, Dietz W, Srinivasan S, Berenson G. Racial differences in the tracking of childhood BMI to adulthood. Obes Res. 2005;13(5):928–35.CrossRefPubMedGoogle Scholar
  6. 6.
    Kranjac A, Wagmiller R. Association between age and obesity overtime. Pediatrics. 2016;137(5):e20152096. doi: 10.1542/peds.2015-2096.CrossRefPubMedGoogle Scholar
  7. 7.
    National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med. 2000;160(7):898–904. doi: 10.1001/archinte.160.7.898.CrossRefGoogle Scholar
  8. 8.
    Eeg-Olofsson K, Cederholm J, Nilsson P, Zethelius B, Nunez L, Gudbjörnsdóttir S, et al. Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients. Diabetologia. 2009;52(1):65–73. doi: 10.1007/s00125-008-1190-x.CrossRefPubMedGoogle Scholar
  9. 9.
    May A, Freedman D, Sherry B, Blanck H. CDC health disparities and inequalities report—United States, 2013. MMWR Morb Mortal Wkly Rep. 2013;62(3):120–8.Google Scholar
  10. 10.
    Lutfiyya M, Garcia R, Dankwa C, Young T, Lipsky M. Overweight and obese prevalence rates in African American and Hispanic children: an analysis of data from the 2003-2004 National Survey of Children’s Health. J Am Board Fam Med. 2008;21(3):191–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Sherry B, Mei Z, Scanlon K, Mokdad A, Grummer-Strawn L. Trends in state-specific prevalence of overweight and underweight in 2- through 4-year-old children from low-income families from 1989 through 2000. Archives Pediatr Adolesc Med. 2004;158(12):1116–24.CrossRefGoogle Scholar
  12. 12.
    MMWR Morbidity and Mortality Weekly Report. Obesity prevalence among low-income, preschool-aged children—United States, 1998–2008. 2009;58(28):769–73.Google Scholar
  13. 13.
    Mei Z, Scanlon K, G-S LM, Freedman D, Yip R, Trowbridge F. Increasing prevalence of overweight among US low-income preschool children. The Centers for Disease Control and Prevention Pediatric Nutrition Surveillance, 1983-1995. Pediatrics. 1998;101:1–6.CrossRefGoogle Scholar
  14. 14.
    Bollella M, Spark A, Boccia L, Nicklas T, Pittman B, Williams C. Nutrient intake of Head start children: home vs. school. J Am Coll Nutr. 1999;18(2):108–14.CrossRefPubMedGoogle Scholar
  15. 15.
    Williams C, Bollella M, Strobino B, Spark A, Nicklas T, Tolosi L, et al. “Healthy start”: outcome of an intervention to promote a heart healthy diet in preschool children. J Am Coll Nutr. 2002;21:62–71.CrossRefPubMedGoogle Scholar
  16. 16.
    Williams C, Strobino B, Bollella M, Brotanek J. Cardiovascular risk reduction in preschool children: the “Healthy Start” project. J Am Coll Nutr. 2004;23(2):117–23.CrossRefPubMedGoogle Scholar
  17. 17.
    Fitzgibbon M, Stolley M, Dyer A, Van Horn L, KauferChristoffel K. A community-based obesity prevention program for minority children: rationale and study design for hip-hop to heath jr. Prev Med. 2002;34:289–97.CrossRefPubMedGoogle Scholar
  18. 18.
    Perry C, Luepker R, Murray D, Kurth C, Mullis R, Crockett S, et al. Parent involvement with children’s health promotion: the Minnesota Home Team. Am J Public Health. 1988;78:1156–60.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Panz V, Raal F, Paiker J, Immelman R, Miles H. Performance of the CardioChek PA and Cholestech LDX point-of-care analysers compared to clinical diagnostic laboratory methods for the measurement of lipids. Cardiovasc J S Afr. 2005;16(2):112–7.PubMedGoogle Scholar
  20. 20.
    Fitzgibbon M, Stolley M, Schiffer L, Braunschweig C, Gomez S, Van Horn L, et al. Hip-Hop to Health Jr. Obesity Prevention Effectiveness Trial: postintervention results. Obesity. 2011;19(5):994–1003. doi: 10.1038/oby.2010.314.CrossRefPubMedGoogle Scholar
  21. 21.
    Jouret B, Ahluwalia N, Dupuy M, Cristini C, Nègre-Pages L, Grandjean H, et al. Prevention of overweight in preschool children: results of kindergarten-based interventions. Int J Obes. 2009;33(10):1075–83. doi: 10.1038/ijo.2009.166.CrossRefGoogle Scholar
  22. 22.
    Johns D, Hartmann-Boyce J, Jebb S, Aveyard P, on behalf of the Behavioural Weight Management Review Group. Weight change among people randomized to minimal intervention control groups in weight loss trials. Obesity. 2016;24:772–80. doi: 10.1002/oby.21255.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Waters L, St George A, Chey T, Bauman A. Weight change in control group participants in behavioural weight loss interventions: a systematic review and meta-regression study. BMC Med Res Methodol. 2012;12:120. doi: 10.1186/1471-2288-12-120.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    van Hoek E, Feskens E, Bouwman L, Janse A. Effective interventions in overweight or obese young children: systematic review and meta-analysis. Child Obes. 2014;10(6):448–60. doi: 10.1089/chi.2013.0149.CrossRefPubMedGoogle Scholar
  25. 25.
    Ward S, Bélanger M, Donovan D, Boudreau J, Vatanparast H, Muhajarine N, et al. “Monkey see, monkey do”: peers’ behaviors predict preschoolers’ physical activity and dietary intake in childcare centers. Prev Med. 2017;97:33–9. doi: 10.1016/j.ypmed.2017.01.00.CrossRefPubMedGoogle Scholar
  26. 26.
    Examining the Impact of Food Deserts on Public Health in Detroit. http://www.uconnruddcenter.org/resources/upload/docs/what/policy/DetroitFoodDesertReport.pdf. Accessed30 June 2017.
  27. 27.
    Dubowitz T, Ghosh-Dastidar M, Cohen D, Beckman R, Steiner E, Hunter G, et al. Diet and perceptions change with supermarket introduction in a food desert, but not because of supermarket use. Health Aff (Millwood). 2015;34(11):1858–68. doi: 10.1377/hlthaff.2015.0667.CrossRefGoogle Scholar
  28. 28.
    Houston-Price C, Burton E, Hickinson R, et al. Picture book exposure elicits positive visual preferences in toddlers. J Exp Child Psychol. 2009;104(1):89–104.CrossRefPubMedGoogle Scholar

Copyright information

© W. Montague Cobb-NMA Health Institute 2017

Authors and Affiliations

  • Yulyu Yeh
    • 1
    • 2
  • Kathryn Brogan Hartlieb
    • 1
    • 3
  • Cynthia Danford
    • 1
    • 4
  • K.-L. Catherine Jen
    • 1
  1. 1.Wayne State UniversityDetroitUSA
  2. 2.Texas A & M UniversityCollege StationUSA
  3. 3.Florida International UniversityMiamiUSA
  4. 4.University of PittsburgPittsburgUSA

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