2009 Annual Report
1)Nutrition Basics: labeling, MyPyramid,.
2)Breakfast and snacks,.
3)Fruit and vegetables,.
4)Dairy and Meat,.
6)Smart shopping. Resources that were provided to the participants included class outlines, lesson handouts, and goal-setting materials. This intervention was tested in Texas with 100 classes and did result in a reduction in maternal BMI at the end of the program. This study successfully shows how educational multi-media can be used with different ethnic populations for the goal of leading a healthy lifestyle for the prevention of obesity. These materials are available for free download from the Children's Nutrition Research Center website. (Project 2: The development and testing of interventions to promote healthy dietary behavior) 3. Free Fruit/Vegetable Program Reviewed for Student Intake of New Foods: Poor dietary choices like low fruit and vegetable intakes are associated with overweight, and because this is known the USDA implemented a Free Fruit and Vegetable Program in 2006-2007. One Houston-area high school was selected to participate and received funding to provide baskets of fresh fruit and vegetables daily for each classroom. The Children's Nutrition Research Center scientists conducted a study to assess if this program improved student fruit and vegetable intake. An anonymous, post-intervention only fruit and vegetable intake surveys were distributed to students in the intervention school and a comparison (control) school. Intervention school students were more likely to report eating fruit and 100% fruit juice at least two times per day and total fruit, juice, and vegetables five or more times per day in the last seven days than comparison (control) school students. More intervention school students as compared to comparison (control) school students reported eating fruit at least one time per day. There were no differences in vegetable intake. From this study we can show that free fruit and vegetable distribution programs provide the opportunity for students to taste a variety of fruit and vegetables, and that these programs may improve consumption of certain foods in this adolescent age group. (Project 2: The development and testing of interventions to promote healthy dietary behavior) 4. Free Fruit/Vegetable Program Reviewed for Student Exposure to New Foods: The USDA sponsors a Free Fruit and Vegetable Program in schools whereby students receive free fruit and vegetable (FV) snacks daily. Children's Nutrition Research Center researchers conducted a study to assess whether the program improved student exposure to and preferences for FV in a Houston high school in 2006-2007. Anonymous, post-intervention surveys addressing only FV exposure and preference were completed by 2,000 intervention school students and by 1,600 students in a comparison (control) school. Differences in FV exposure and preferences were assessed, as well as differences in preferences between those students who tasted the item for the first time at school compared to those who had tasted the item before. The comparison school average scores for prior FV exposure and vegetable preferences were significantly higher than the intervention school scores. Intervention school students who had tasted the item previously reported significantly higher preferences than students who had tasted it for the first time at school. This study indicates that access to the Free Fruit and Vegetable Program did not appear to improve high school student reported FV exposure and preferences. (Project 2: The development and testing of interventions to promote healthy dietary behavior) 5. Relationships Between Active Commuting to School and Adiposity: Walking or bicycling to school, i.e., active commuting, has the potential for improving physical activity and preventing obesity in youth. Children's Nutrition Research Center scientists examined whether active commuting was inversely associated with adiposity and positively associated with moderate-to vigorous physical activity, and whether physical activity mediated the relationships between active commuting and adiposity. Our study used data on a nationally representative sample of adolescents, and we found that active commuting was inversely associated with BMI, and positively associated with physical activity. Greater before- and after-school physical activity explained part of the relationship between active commuting and waist circumference. We were able to conclude from that study that active commuting to school is a viable population-level intervention to promote physical activity and reduce childhood obesity, and that longitudinal and experimental studies are necessary to confirm these relationships. (Project 7: Prevention and treatment of obesity in children) 6. Parental Influences on preschool children's fruit and vegetable consumption: Diets that are high in fruit and vegetables have been shown to lower the risk of several chronic diseases and may help prevent overweight; however, most children do not eat the recommended amounts of fruit and vegetables. There is a need to better understand which strategies parents use to promote fruit and vegetable consumption in children and how they are associated with children's actual fruit and vegetable intake. Using data collected from 755 Head Start preschool children and their parents, Children's Nutrition Research Center researchers were able to successfully group parents into three groups based on similar use of fruit and vegetable parenting practices (strategies intended to get their 3- to 5-year-old child to eat fruit and vegetables). Children whose parents were Non-Directive in promoting fruit and vegetables (used enhanced availability/accessibility and teachable moments practices, but less firm discipline practices than the other two groups) consumed more fruit and vegetables than children from the other two groups. Identifying how parents use fruit and vegetable parenting practices in combination helps provide a better understanding of parental influences on children's fruit and vegetable intake and which parenting practices should be promoted in Healthy Lifestyle programs.(Project 9: Helping HAND (Healthy Activity and Nutrition Directions): An obesity prevention program for pediatric primary care.) 7. Developing Effective Interventions to Help Youth Become More Physically Active: Youth are less physically active than recommended, with continued decreases throughout childhood and adolescence. Theory helps predict, explain, and understand behavior, and provides a blueprint for intervention research; however, there is not a good theoretical model of youth physical activity. Children's Nutrition Research Center scientists are conducting a research study to develop and validate such a model. This fiscal year, our research team successfully conducted statistical analyses to examine item functioning within the scales and correlations among the scales. Future research will validate the scales and the model. The impact of this research is that it will ultimately provide a tested theoretical model of youth physical activity behavior that can be used to guide future intervention research. (Project 8: Predicting and explaining youth physical activity behavior: Model testing and scale validation) 8. Vegetable Consumption Patterns of Children: Due to genetic variation, there is a subgroup of individuals who are most susceptible to cancer, and who potentially could benefit from isothiocyante intake, found in particular vegetables. Children's Nutrition Research Center nutritionists conducted an analysis of a previous research study for dietary intake, with particular emphasis on food sources of the chemopreventive substance, isothiocynates. Using an existing dataset of dietary assessment on nearly 700 individuals, we were able to show that low-income children do not consume sufficient amounts of vegetables containing isothiocynates, although African-American and Hispanic children tended to consume more than Caucasian children. These studies indicate a greater need to emphasize and promote brassica vegetable intake in children, especially those families that are considered low income. (Project 5: Dietary and genetic interactions of isothiocyanates) 9. Comparing the Prevalence of Metabolic Syndrome in the United States (US) and Korea: The Metabolic Syndrome is a major health concern that describes the various risk factors assocaiated with diabetes and cardiovascular disease. Children's Nutrition Research Center researchers conducted a study that compared the Metabolic Syndrome among young adults from the US versus Korea using nationally representative databases. Our results showed that young adults from the US had higher rates of the Metabolic Syndrome and three of its components: abdominal obesity, hyperglycemia, and hypertriglyeridemia. Korean young adults had higher rates of low high density lipoprotein-cholesterol or HDL. These findings are of national importance and provide a foundation for the need to customize national policy to prevent the Metabolic Syndrome in the US for obesity and related chronic disease prevention. (Project 7: Prevention and treatment of obesity in children) 10. Dietary Patterns Associated with Metabolic Syndrome, Socio-Demographic, and Lifestyle Factors in Young Adults: The Bogalusa Heart Study: A need exists to identify differences in dietary patterns (DPs) by socioeconomic, demographic, and lifestyle factors and to examine the relationship between DPs and risk for metabolic syndrome (MetS). Children's Nutrition Research Center researchers reviewed data collected from the Bogalusa (LA) Heart Study (1995-1996) on young adults from a semi-rural community. Dietary intake was assessed from a food frequency questionnaire; sociodemographic information, anthropometrics, and risk factors/score for MetS were evaluated; and factor analysis was used to identify the DPs. Our research team found that the African Americans and males consumed more servings from the (WDP) 'Western Dietary Pattern' (refined grains, high-fat dairy foods, red/processed meats, eggs, cheese dishes, French fries, snacks, sweets/desserts, and sweetened beverages) than their counterparts; white females consumed the fewest servings from the WDP; and that individuals with a higher income and education consumed more servings from the 'Prudent Dietary Pattern' (PDP) which consisted of whole grains, fruits, vegetables, 100% fruit juices, low-fat dairy products, and low-fat salad dressings. From this data, our research team was able to conclude that DPs are associated with sociodemographic and lifestyle factors and the presence of MetS, and that dietary changes may be beneficial in reducing the risk for MetS/and related disorders in this population. (Project 4: Investigation of dietary intakes of children) 11. Eating Ready-To-Eat Cereal is Positively Associated with Daily Nutrient Intake: Ready-to-eat cereal (RTEC) has been associated with improved nutrient intake and weight status, but intake has not been studied in Hispanic-American (HA) children. Children's Nutrition Research Center researchers assessed whether nutrient intake, the Mean Adequacy Ratio (MAR), and weight were associated with three breakfast consumption groups: breakfast skippers, (RTEC) breakfast consumers, and other breakfast (OB) consumers. Our team conducted a secondary analysis of nutrient intake and weight of over 1,000 Hispanic American children ages 6-12 years and adolescents (13-18 years) included in the 1999-2002 National Health and Nutrition Examination Survey and discovered that 9% of children and 28% of adolescents skipped breakfast; 34% and 22% of those age groups consumed RTEC breakfasts, respectively. Children who consumed an RTEC breakfast had higher intakes of thiamin, riboflavin, niacin, vitamin B-6, folate, calcium, iron, and zinc than children in the OB consumption group and breakfast skippers; RTEC breakfast consumers also had a higher MAR, and higher intakes of phosphorus, magnesium, and potassium than breakfast skippers, but not than OB consumers; RTEC breakfast consumers had lower intakes of total fat, polyunsaturated fatty acid, and cholesterol than other breakfast consumers. We were able to conclude that for Hispanic American children and adolescents, RTEC breakfast consumers had improved nutrient intake compared to breakfast skippers and OB consumers, and RTEC should be encouraged as a convenient, low fat nutrient dense breakfast option. (Project 4: Investigation of dietary intakes of children) 12. Ready-To-Eat Cereal Breakfasts Permits Improved Nutrient Intake in Black Adolescents: The goal of this study was to determine whether nutrient intake, dietary adequacy, and weight status were associated with type of breakfast consumption: skipping breakfast, consuming ready-to-eat cereal (RTEC) at breakfast, or consuming other types of foods at breakfast. Data from black adolescents 13-18 years of age participating in the 1999-2002 National Health and Nutrition Examination Survey were used in a secondary data analysis conducted by Children's Nutrition Research Center nutritionists. Our analysis showed that 37% of black adolescents skipped breakfast, 19% consumed RTEC at breakfast, and 44% consumed other breakfasts; RTEC breakfast and other breakfast consumers had higher mean energy intakes than breakfast skippers, and after adjusting for gender and energy intake, RTEC breakfast consumers had higher intakes of vitamins A, B-6, B-12; thiamin; riboflavin, niacin; folate; calcium, phosphorus, magnesium, iron, zinc, and potassium than breakfast skippers and other breakfast consumers. We conclude that, if confirmed in prospective studies, consuming a breakfast meal with RTEC may be a useful strategy to encourage in black adolescents as a way to improve nutrient intake and dietary adequacy without increasing weight. (Project 4: Investigation of dietary intakes of children) 13. Whole Grain Consumption by Children Improves Diet Quality/Nutrient Intake: Children's Nutrition Research Center researchers examined the association that whole grain consumption has on diet quality and nutrient intake in a recent, nationally representative sample of children/adolescents from the 1999-2004 National Health and Nutrition Examination Survey. Nutritionists conducted a secondary analysis of data collected on children/adolescents (2-5 years, 6-12 years, and 13-18 years). We found that the mean number of servings of whole grains consumed was 0.45, 0.59, and 0.63 for children/adolescents 2-5 y, 6-12 y, and 13-18 y, respectively. In children 2-5 years, Healthy Eating Index, and intake of energy, fiber, vitamins A, C, B1, B6, folate, magnesium, phosphorus, and iron increased with increasing consumption of whole grains; intake of protein, added sugars, total fat, saturated fatty acids, monounsaturated fatty acids, and cholesterol decreased. We were able to conclude that the overall consumption of whole grains in this population was low; however, diet quality and nutrient intake in children/adolescents was significantly improved with increasing consumption of whole grains. (Project 4: Investigation of dietary intakes of children) 14. Are African-American Children's Breakfast Consumption Patterns Associated With Weight Status: The objective of this study was to assess whether weight status, nutrient intake, and dietary adequacy were associated with breakfast consumption patterns. A representative sample of the US population was used in a Children's Nutrition Research Center secondary analysis of nutrient intake/diet quality and weight status by breakfast consumption patterns using the 1999-2002 National Health and Nutrition Examination Survey (NHANES). The study sample included African-American children 1-12 years of age. We found that 45% of children 1-5 years of age and 38% of those 6-12 years of age consumed ready-to-eat cereal (RTEC) at breakfast, while 7.4% and 16.9% in those age groups skipped breakfast, respectively. RTEC breakfast consumers had the highest mean intakes of vitamins A, B-6, and B-12; thiamin; riboflavin; niacin; folate; calcium; iron; and zinc, and the highest Mean Adequacy Ratio. We were able to conclude that consuming a RTEC breakfast was associated with improved weight and nutrient adequacy in African-American children; African-American children in all breakfast categories still had mean intakes of most nutrients below recommended levels. The implications are that consuming a breakfast meal should be encouraged in these children, and that RTEC at breakfast provides important nutrients and may help promote a healthy weight. (Project 4: Investigation of dietary intakes of children) 15. Whole Grain Consumption and Body Weight Measures in 6- to 18-Year Olds: Children's Nutrition Research Center researchers examined the relationship of whole grain consumption with anthropometric and adiposity measures in children and adolescents by conducting a secondary analysis from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. We found that the mean whole grain intake was 0.59 and 0.63 servings/day among 6- to 12-year olds and 13- to 18-year olds, respectively. In children 6-12 years old, whole grain intake was not associated with BMI or waist circumference. In adolescents 13-18 years olds BMI but not waist circumference was significantly lower in the highest whole grain consumption group. We were able to conclude that the overall consumption of whole grain was below current recommendations of 3 servings per day. (Project 4: Investigation of dietary intakes of children)
Thompson, D., Baranowski, T., Cullen, K., Watson, K., Liu, Y., Canada, A., Bhatt, R., Zakeri, I. 2008. Food, fun, and fitness internet program for girls: Pilot evaluation of an e-Health youth obesity prevention program examining predictors of obesity. Preventive Medicine. 47(5):494-497.
Hornick, B.A., Krester, A.J., Nicklas, T.A. 2008. Menu modeling with MyPyramid food patterns: Incremental dietary changes lead to dramatic improvements in diet quality of menus. Journal Of The American Dietetic Association. 108(12):2077-2083.
Venditti, E.M., Elliot, D.L., Faith, M.S., Firrell, L.S., Giles, C.M., Goldberg, L., Marcus, M.D., Schneider, M., Solomon, S., Thompson, D.J., Yin, Z. 2009. Rationale, design and methods of the HEALTHY study behavior intervention component. International Journal of Obesity. 33(Supp 4):S44-S51.
Jago, R., Baranowski, T., Watson, K., Bachman, C., Baranowski, J., Thompson, D., Hernandez, A., Venditti, E., Blackshear, T., Moe, E. 2009. Development of new physical activity and sedentary behavior change self-efficacy questionnaires using item response modeling. International Journal of Behavioral Nutrition and Physical Activity. 6:article 20.
Schneider, M., Hall, W.J., Hernandez, A.E., Hindes, K., Montez, G., Pham, T., Rosen, L., Sleigh, A., Thompson, D.J., Volpe, S.L., Zeveloff, A., Steckler, A. 2009. Rationale, design and methods for process evaluation in the HEALTHY study. International Journal of Obesity. 33(Supp 4):S60-S67.
Drews, K.L., Harrell, J.S., Thompson, D.J., Mazzuto, S.L., Ford, E.G., Carter, M., Ford, D.A., Yin, Z., Jessup, A.N., Roullett, J. 2009. Recruitment and retention strategies and methods in the HEALTHY study. International Journal of Obesity. 33(Supp 4):S21-S28.
Jago, R., Thompson, D., O'Donnell, S., Cullen, K., Baranowski, T. 2009. Prevention: Changing children's diet and physical activity patterns via schools, families, and the environment. In: Heinberg, L.J., Thompson, J.K., editors. Obesity in Youth: Causes, Consequences, and Cures. 1st edition. Washington, D.C.: American Psychological Association. p. 183-201.
O'Neil, C.E., Nicklas, T.A. 2008. A review of the relationship between 100% fruit juice consumption and weight in children and adolescents. American Journal of Lifestyle Medicine. 2(4):315-354.
Hughes, S.O., Shewchuk, R.M., Baskin, M.L., Nicklas, T.A., Qu, H. 2008. Indulgent feeding style and children's weight status in preschool. Journal of Developmental and Behavioral Pediatrics. 29(5):403-410.
Fisher, J.O., Butte, N.F., Mendoza, P.M., Wilson, T.A., Hodges, E.A., Reidy, K.C., Deming, D. 2008. Overestimation of infant and toddler energy intake by 24-h recall compared with weighed food records. American Journal of Clinical Nutrition. 88(2):407-415.
Zakeri, I., Adolph, A.L., Puyau, M.R., Vohra, F.A., Butte, N.F. 2008. Application of cross-sectional time series modeling for the prediction of energy expenditure from heart rate and accelerometry. Journal of Applied Physiology. 104(6):1665-1673.
Franklin, P.D., Farzanfar, R., Thompson, D.J. 2008. E-Health Strategies to Support Adherence. In: Shumaker, S.A., Ockene, J.K., Riekert, K.A., editors. The Handbook of Health Behavior Change. 3rd edition. New York, NY: Springer Publishing Company, LLC. p. 169-190.
Jago, R., Baranowski, T., Baranowski, J.C., Cullen, K., Thompson, D.J. 2007. Distance to food stores & adolescent male fruit and vegetable consumption: mediation effects. International Journal of Behavioral Nutrition and Physical Activity [serial online]. 4:35. Available: http://www.ijbnpa.org/content/4/1/35.