UNIVERSITY OF MARYLAND

Overweight is a serious public health problem that begins as early as toddlerhood, and has negative health and developmental consequences throughout life. Although caregiver-child interaction patterns influence children's growth, most overweight prevention programs have focused exclusively on diet and physical activity, with little attention to feeding styles, the socio-emotional environment that the family establishes around meals. This application takes advantage of a unique opportunity afforded by a recently funded randomized controlled trial to prevent rapid weight gain among low- income toddlers in collaboration with the Special Supplemental Nutrition Program among Women, Infants, and Children (WIC). The overall aim is to examine feeding styles among low-income families of toddlers. The specific aims are: 1) to identify caregiver and child characteristics associated with feeding styles, 2) to assess whether feeding styles are related to toddler weight and weight gain, and 3) to examine whether feeding styles are altered by an intervention to prevent rapid weight gain. A multimodal process will be used to measure feeding and parenting styles, including maternal self-report and home visits with videotaped observations of mothers and their toddlers during meal and playtime. The proposed project involves 288 low-income mothers, fathers, and toddlers, recruited at 12-15 months and followed for 12 months. Following a baseline evaluation, families will be randomized to one of three 8-session intervention groups (maternal diet and activity, parenting/toddler, and safety), with follow-up evaluations 6 and 12 months following recruitment. The proposed project evaluates feeding styles at baseline and during the two follow-up evaluations. By focusing on whether feeding styles are related to toddler weight gain and whether feeding styles are modifiable, the proposed study will enhance our theoretical understanding of feeding styles and inform the content of public health interventions to prevent overweight among toddlers. PUBLIC HEALTH RELEVANCE: Overweight begins as early as toddlerhood, setting children on a negative pathway toward obesity. Most interventions include recommendations on diet and physical activity, with little attention to the socio-emotional mealtime environment, known as feeding styles. A finding that feeding styles are associated with toddler weight gain and are modifiable would have a major impact on the content of public health interventions to prevent overweight among toddlers.

Clarification of Codes