Age, sex, ethnicity, body composition, and resting energy expenditure of obese African American and white children and adolescents

BACKGROUND: African Americans may have a lower resting energy expenditure (REE) than do whites, although the data are limited for obese children and adolescents and for boys. Differences in bone density and trunk lean body mass may account for some of these measured differences in REE. OBJECTIVE: We assessed the REE and body composition of obese African American and white children and adolescents. DESIGN: Obese, 5-17-y-old children and adolescents were evaluated (n = 203). Body composition was assessed by dual-energy X-ray absorptiometry. REE was measured by open-circuit calorimetry. African American and white children were compared. The relation between REE and the independent variables (age, sex, ethnic group, fat mass, and fat-free mass or lean tissue mass) was assessed. RESULTS: Of those evaluated, 66% were girls and 34% were African American. Age, sex, pubertal status, and body composition did not differ significantly by ethnic group. All the independent variables were significantly associated with REE. Using lean tissue mass to account for differences in bone density did not significantly alter the results. REE decreased with age and was lower in the girls than in the boys and in the African Americans than in the whites. When trunk fat-free mass was included in the model in place of whole-body fat-free mass, the ethnic difference in REE decreased. CONCLUSIONS: Adjustment for trunk lean tissue mass partially explains the lower REE of obese African American children and adolescents. The lower relative REE of older obese children suggests the importance of early intervention in the prevention of childhood obesity. The lower REE of girls and of African Americans may contribute to the difficulty in weight management in these groups.     

不同性别、年龄及营养状态儿童的人体成分分析

目的 探讨不同性别、年龄及营养状态儿童体成分的差异,为儿童健康评价提供线索。方法 选取2019年1—12月在深圳市妇幼保健院儿童健康科体检的儿童1 185例,年龄3~8岁。所有研究对象均进行身高、体重测量;应用多频生物电阻抗分析仪测量人体成分各指标;分析不同性别、年龄、营养状态与儿童体成分之间的关系。结果 男童的体重、BMI、去脂体重、身体水分及基础代谢率均高于女童,体脂率低于女童(t=2.94、5.05、5.21、4.67、2.88、5.27,P＜0.05);而身高和体脂含量在不同性别组间变化小,差异无统计学意义(P＞0.05)。男、女童的体脂含量、去脂体重均随年龄增长而增加,而BMI随年龄增加呈现先降低后(至6~岁)增加的趋势(P＜0.05),按BMI变化趋势,儿童脂肪重聚年龄约5岁。男、女童体脂含量、体脂百分比、去脂体重、均随BMI增加而逐渐递增(男:F=33.28、29.81、33.02,女:F=28.57、13.38、24.55,P＜0.05)。PBF与BMI评价儿童超重和肥胖有较高的一致性(χ²=143.28、99.02,P＜0.05),但PBF的超重及肥胖检出率更高(P＜0.05)。结论 不同性别、年龄及营养状态儿童的人体成分存在明显差异,体成分对于儿童超重和肥胖的发生有较好的预警作用,是对儿童健康评价的有益补充。     

Dietary factors and body mass index in a group of Iranian adolescents: Tehran lipid and glucose study--2

OBJECTIVE: To study the prevalence of overweight and obesity in an adolescent population in Tehran and to determine possible association with energy and nutrient intake and distribution of energy over the day. METHOD: A cross-sectional study on 177 boys and 244 girls between 10-19 years old was performed. Overweight and obesity were defined by using recommended body mass index (BMI) cut-off values for adolescents. Total energy intake, percent of energy derived from protein, carbohydrate and fat and percent of energy supplied by each meal and snack were assessed by means of two 24-hour dietary recalls. RESULTS: Prevalence of overweight and obesity was 10.7 and 5.1 in boys and 18.4 and 2.8 in girls, respectively. The composition of diet was not different between overweight/obese and normal weight subjects. BMI was related with breakfast energy percentage in girls (r = -0.18, p < 0.01), with total energy intake in boys (r = 0.23, p < 0.01), and with lunch energy percentage in both sexes. In boys (r = 0.16, p < 0.05) and in girls (r = 0.22, p < 0.01). CONCLUSION: High prevalence of overweight and obesity among adolescents was seen. In boys some relationship between total energy intake, distribution of energy over the day and BMI was seen. In girls BMI was only related with distribution of energy over the day.     

The feeding demands questionnaire: assessment of parental demand cognitions concerning parent-child feeding relations

BACKGROUND: There are few validated instruments measuring parental beliefs about parent-child feeding relations and child compliance during meals. OBJECTIVE: To test the validity of the Feeding Demands Questionnaire, a parent-report instrument designed to measure parents' beliefs about how their child should eat. METHODS: Participants were 85 mothers of 3- to 7-year-old same-sex twin pairs or sibling pairs, and their children. Mothers completed the eight-item Feeding Demands Questionnaire and the Child Feeding Questionnaire, plus measures of depression and fear of fat. STATISTICAL ANALYSES: Psychometric evaluations of the Feeding Demands Questionnaire included principal components analysis, Cronbach's alpha for internal consistency, tests for convergent and discriminant validities, and Flesh-Kincaid for readability. RESULTS: The Feeding Demands Questionnaire had three underlying factors: anger/frustration, food amount demandingness, and food type demandingness, for which subscales were computed. The Feeding Demands Questionnaire showed acceptable internal consistency (alpha ranging from .70 to .86) and was written at the 4.8th grade level. Mothers reporting greater anger/frustration during feeding were more likely to pressure their children to eat, while those reporting greater demands about the type of foods their children eat were more likely to monitor child fat intake. Mothers reporting greater demands about the amount of food their children eat were more likely to restrict eating, pressure children to eat, and monitor their fat intake. CONCLUSIONS: The Feeding Demands Questionnaire appears valid for assessing maternal beliefs that children should comply with rules for eating and frustration during feeding. Different demand beliefs can underlie different feeding practices.     

Energy expenditure and substrate oxidation predict changes in body fat in children

BACKGROUND: The hypothesis that alterations in energy metabolism predict body fat gain is controversial. OBJECTIVE: The aim of this study was to determine which components of energy metabolism were most important in predicting fat gain in children aged 10.8 +/- 0.6 y. DESIGN: A 2-y longitudinal study to examine whether components of energy metabolism are predictors of body fat gain was conducted in 114 preadolescent African American and white children aged 9-11 y by measuring total daily energy expenditure on the basis of doubly labeled water (DLW), resting metabolic rate, the thermic effect of food, energy expended in physical activity, and substrate oxidation after a meal. The primary endpoint was the 2-y change in percentage body fat (%BF). RESULTS: Individual variables of energy metabolism predicted up to 7% of the variance in changes in %BF over the 2-y interval in the whole group. Predictors of change in body fatness tended to be sex and race specific. Protein oxidation during a test meal explained a significant portion of the variance in change in %BF in the overall group and in nearly all of the subgroups. Multivariate prediction models accounted for 10-41% of the variance in change in %BF. Tanner stage at 2-y follow-up was highly predictive of change in body fatness and improved the overall prediction, accounting for 24-62% of the variance in change in %BF in those groups in which Tanner entered the model. CONCLUSION: This study provides evidence that total daily energy expenditure, resting metabolic rate, substrate oxidation, and total energy intake are predictors of gain in body fatness during late childhood in boys and girls.     

Energy expenditure in preadolescent African American and white boys and girls: the Baton Rouge Children's Study

BACKGROUND: Low energy expenditure has been identified as a potential risk factor for body fat gain. OBJECTIVE: The objective was to determine the relations between race, sex, body fat, and energy expenditure. DESIGN: As part of the Baton Rouge Children's Study, energy expenditure was examined in 131 preadolescent African American and white girls and boys, further stratified as obese or lean. Total daily energy expenditure (TDEE) was measured by the doubly labeled water method. Resting metabolic rate (RMR) and the thermic effect of food were measured by indirect calorimetry. Fat-free mass and fat mass were measured by dual-energy X-ray absorptiometry. To account for differences in body size, energy expenditure variables were adjusted with the use of fat-free mass or fat-free mass and fat mass as covariates. RESULTS: The African American children had lower TDEE and RMR than did the white children. A lower level of energy expended in physical activity by the African American girls and a lower RMR in the African American boys accounted for the racial differences in TDEE. The white boys had a higher RMR than did the white girls. The girls had a lower TDEE and expended less energy in activity than did the boys. Energy expended in activity was lower in the obese children. CONCLUSIONS: The African American children expended less energy than did the white children. The obese children spent less time engaged in activity or engaged in lower-intensity activity. Obese children may maintain their obese state by spending less time in physical activity, but they do not have a reduced RMR or thermic effect of food.     

Longitudinal calcium intake is negatively related to children's body fat indexes

OBJECTIVE: To determine if dietary calcium was negatively related to children's body fat (BF), if BF indexes and calcium intakes changed over time, and to identify variables related to BF and calcium intake. DESIGN: Percent BF and kg BF were assessed by dual energy x-ray absorptiometry (DEXA) in 8-year-old children. In a prospective design, height, weight, dietary intakes, and related variables were monitored longitudinally from ages 2 months to 8 years during in-home interviews. SUBJECTS: Fifty-two white children, (n=25 boys, 27 girls) participated in a longitudinal study with their mothers. At 8 years of age, mean BMI was 17.3+/-2.1 (standard deviation) for boys and 17.1+/-2.5 for girls. ANALYSES: Regression analysis of all variables, followed by further regression analysis on selected models. RESULTS: At 8 years, percent BF was 22.7+/-6.7 for boys and 26.2+/-7.9 for girls, as assessed by DEXA. Dietary calcium (mg) and polyunsaturated fat intake (g) were negatively related to percent BF (P=.02 to.04) in 3 statistical models, which predicted 28% to 34% of the variability in BF among children. Variables positively associated with percent BF were total dietary fat (g) or saturated fat (g), female gender, sedentary activity (hours/day), father's BMI, and mothers' percent BF. Calcium intakes were significantly correlated over time. Dietary variety was positively related to calcium intake, and intakes of carbonated beverages and other sweetened beverages were negatively related. APPLICATIONS/CONCLUSIONS: Children should be strongly encouraged to regularly include calcium-rich foods and beverages in their diets.     

The relationship of childhood adiposity to parent body mass index and eating behavior

OBJECTIVE: To better understand risk factors for the development of obesity in early childhood, we examined the association between children's adiposity and their parents' eating behavior and body mass index (BMI). RESEARCH METHODS AND PROCEDURES: Parents of 85 white children 36 months of age (49 boys and 36 girls) completed the Three-Factor Eating Questionnaire measuring three dimensions of parent eating behavior: disinhibited eating, cognitive restraint of eating, and susceptibility to hunger. Parent BMI (kg/m2) was calculated using self-reported height and weight. The children's percentage body fat was assessed by dual energy X-ray absorptiometry analysis. RESULTS: Twenty-six percent of parents were obese (BMI > or = 30 kg/m2). Both maternal and paternal BMI were associated with higher scores for disinhibition (r = 0.69 and r = 0.68, p < 0.001), and maternal BMI was also associated with higher scores for hunger (r = 0.51, p < 0.001). There were no significant relationships between children's percentage body fat and parent eating scores, and the correlation between children's percentage body fat and parent BMI was significant only between mothers and daughters (r = 0.35, p = 0.04). Obese parents were no more likely to have a child who was fatter (upper quintile of percentage body fat for gender). DISCUSSION: Among 36 month-old white children, parent eating behavior was related to parent BMI, but not to children's adiposity. There was only a weak relationship between parent BMI and child adiposity. Despite the aggregation of adiposity within families due to shared genes and environments, children may not express differences in susceptibility to obesity by 3 years of age.     

Dietary intakes and food habits of adolescents in northern Greece

The purpose of this study was to assess the dietary intakes and food habits of 582 adolescents in Northern Greece. Anthropometric data have been collected for all the participating adolescents. The prevalence of obesity as determined by both body mass index (BMI) and triceps skinfold thickness (TST) was higher for boys than for girls. Furthermore, boys had higher energy and macronutrient intakes compared to girls. Of total energy intake, 41% for boys and 43% for girls was derived from fat. Energy intake was found adequate whereas fat intake was much higher than recommended. A percentage of adolescents also had lower than recommended iron, vitamin A, folate and zinc intakes, showing an unbalanced diet.     

Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness

The Child Feeding Questionnaire (CFQ) is a self-report measure to assess parental beliefs, attitudes, and practices regarding child feeding, with a focus on obesity proneness in children. Confirmatory factor analysis tested a 7-factor model, which included four factors measuring parental beliefs related to child's obesity proneness, and three factors measuring parental control practices and attitudes regarding child feeding. Using a sample of 394 mothers and fathers, three models were tested, and the third model confirmed an acceptable fit, including correlated factors. Internal consistencies for the seven factors were above 0.70. With minor changes, this same 7-factor model was also confirmed in a second sample of 148 mothers and fathers, and a third sample of 126 Hispanic mothers and fathers. As predicted, four of the seven factors were related to an independent measure of children's weight status, providing initial support for the validity of the instrument. The CFQ can be used to assess aspects of child-feeding perceptions, attitudes, and practices and their relationships to children's developing food acceptance patterns, the controls of food intake, and obesity. The CFQ is designed for use with parents of children ranging in age from about 2 to 11 years of age.     

The Cross-Sectional Association of Energy Intake and Dietary Energy Density with Body Composition of Children in Southwest China

Objective: We examined whether dietary energy intake (EI) and dietary energy density (ED) were cross-sectionally associated with body composition of children living in Southwest China. Design and Methods: Multivariate regression analyses were performed on three day, 24 h dietary recall data and information on potential confounders from 1207 participants aged 8–14 years. EI was calculated from all foods and drinks and ED was classified into five categories. Body mass index (BMI) z-scores, percentage of body fat (%BF), fat mass index (FMI), fat-free mass index (FFMI) and ratio of waist to hip circumference (WHR) were used to describe body composition. Results: Boys with higher total EI had higher BMI z-scores, %BF, and FMI than boys with lower total EI both before and after measurements were adjusted for confounders (age, fiber intake, physical activity, the timing of adding complementary foods, paternal education level and maternal BMI) (p ≤ 0.04). However, EI was not associated with body composition in girls. Dietary ED, in any category, was not associated with body composition in either gender. Conclusions: Dietary ED was not associated with body composition of children in Southwest China, while dietary EI in boys, not girls, was positively associated with body composition. Reducing dietary energy intake may help to prevent obesity and related diseases in later life among boys living in Southwest China.     

Total energy expenditure, body fatness, and physical activity in children aged 6-9 y

BACKGROUND: The recent worldwide increase in the prevalence of childhood obesity may be due in part to a decrease in children's physical activity levels. OBJECTIVE: The current study of children in the years just before puberty aimed to 1) measure total energy expenditure (TEE) by use of the doubly labeled water (DLW) method, 2) determine the proportion of TEE related to physical activity, 3) investigate the relations between measures of physical activity and body fatness, and 4) investigate possible sex differences in these relations. DESIGN: The DLW technique was used to measure TEE over 10 d in 106 healthy children (52 boys) aged 7.8 +/- 0.9 y (x +/- SD). Fat-free mass, and hence fat mass, was derived from the (18)O dilution space. Resting energy expenditure (REE) was calculated with use of the Schofield equations. Physical activity level was calculated as TEE/REE. RESULTS: Mean TEE in both boys (7871 +/- 1135 kJ/d) and girls (7512 +/- 1195 kJ/d) was significantly different (P < 0.0001) from FAO/WHO/UNU recommendations (13% and 9% lower, respectively). There was no significant difference in physical activity level between boys (1.69 +/- 0.22) and girls (1.71 +/- 0.23). In boys but not girls, physical activity level was inversely correlated with BMI (r = -0.37, P < 0.01), fat mass (r = -0.46, P < 0.005), and percentage of body fat (r = -0.50, P < 0.0001). CONCLUSIONS: In boys but not girls, percentage of body fat is inversely associated with physical activity level. Physical activity is one factor contributing to body fatness in boys, but additional factors may influence the size of the fat stores in girls.     

Evaluation of body fat in fatter and leaner 10-y-old African American and white children: the Baton Rouge Children's Study

BACKGROUND: Only a few published studies in children used several methods to compare body fat in large groups of fatter and leaner multiethnic children. We hypothesized that the preferred methods of determining body fat may differ in children with larger compared with smaller amounts of body fat, in boys compared with girls, and in African Americans compared with whites. OBJECTIVE: Our objective was to evaluate several methods of predicting body fat in 10-12-y-old white and African American boys and girls. DESIGN: The body fat of 129 African American and white boys and girls aged 10-12 y, distributed equally by sex and race, was measured with use of dual-energy X-ray absorptiometry (DXA), underwater weighing (densitometry), isotope dilution (H(2)18O), bioelectrical impedance, skinfold thicknesses, corporal diameters, and circumferences. RESULTS: With use of DXA as the criterion variable, body fat was bimodally distributed in the boys and skewed to higher values in the girls. Biceps skinfold thickness had the highest predictive value of any single skinfold thickness compared with DXA fat. All formulas for estimating body fat from skinfold thicknesses, body density, or impedance performed better in the children in the upper one-half of the fat distribution (the fatter children) than in those in the lower one-half (the leaner children). Body mass index was highly correlated with body fat (R2 = 0.77); there was a good correlation for the fatter children (R2 = 0.66) and no correlation for the leaner children (R2 = 0.09). The hydration of the fat-free mass was significantly higher in the fatter children than in the leaner ones (79.2% compared with 76.7%). CONCLUSIONS: These data are consistent with the hypothesis that all methods of estimating body fat work better in children with larger amounts of body fat. The best formulas use skinfold thicknesses, bioelectrical impedance, and a 4-compartment model.     

儿童行为问题与铅、营养素摄入量关系的研究

目的：探讨儿童行为问题与食物铅、营养素摄入量之间的关系.方法：在南京市选取404名学生,用CB-CL行为量表分析儿童行为问题,用三日膳食调查法了解儿童每日铅及各种营养素的摄入量.结果：男生行为异常率为12.7%、女生行为异常率为8.9%,男生行为异常率明显高于女生;行为异常组儿童铅摄入量明显高于行为正常组.行为异常组儿童脂肪的摄入量明显高于正常组,维生素C摄入量明显低于正常组.锌对行为异常的发生有保护作用.结论：铅摄入量过高可以导致儿童行为异常,锌则为保护因素.     

Body composition of African American and white children: a 2-year follow-up of the BAROC study

OBJECTIVE: To evaluate the 2-year changes in body composition of white and African American boys and girls. RESEARCH METHODS AND PROCEDURES: A total of 114 boys and girls ages 12 to 14 years with equal sex and ethnic distribution between African American and white races participated in measurements of body composition using DXA, underwater weighing (densitometry), skinfold thickness, corporal diameters, circumferences, isotope dilution (H(2)(18)O), and bioelectric impedance. RESULTS: Sixty-eight of the 114 children advanced from Tanner Stages 1 and 2 to Tanner Stages 3 to 5 over a 2-year period. More than 50% of the children were in the top 15th percentile according to normative data for body mass index but not for triceps skinfold. All measures except for percentage of fat, density, and four of the six skinfolds increased significantly during the 2 years, with no differences between races, genders, or fat group. The boys who advanced in Tanner Stage reduced their percentage of fat and a number of skinfolds and increased their lean body mass, but the girls did not. The percentage of water was significantly higher in the fatter children and declined significantly over 2 years. Most children remained in the same quartile of body fat, lean body mass, and bone mineral content over 2 years. DISCUSSION: The data are consistent with the hypothesis that over 2 years, growth is the major determinant of changing body composition, with body-fat group and sexual maturation being additional variables.     

Body mass index and lipid levels in children from Ankara, Turkey versus Bogalusa, Louisiana

BACKGROUND: Turkish Heart Study demonstrated that low high density lipoprotein cholesterol levels are prevalent among Turkish adults. METHODS: We compared body mass index and lipid levels of Turkish children (n = 1525, ages 10-17) with the bi-racial community of Bogalusa Heart Study. RESULTS: Turkish children have lower body mass index than American children (19.0 +/- 3 kg/m(2) for Turkish girls, 20.2 +/- 4 for White American girls, 20.9 +/- 5 for African American girls; and 18.9 +/- 3 kg/m(2) for Turkish boys, 20.2 +/- 4 for White American boys, 20.0 +/- 4 for African American boys, P < 0.01). Turkish children have higher triglyceride and lower high density lipoprotein cholesterol levels despite their lower body mass index. High density lipoprotein cholesterol levels (mmol/L) are 1.3 +/- 0.3 for Turkish girls and boys versus 1.4 +/- 0.5 for White American girls and boys, versus 1.6 +/- 0.5 and 1.7 +/- 0.5 for African American girls and boys, respectively (P < 0.01). Triglyceride levels (mmol/L) are 1.0 +/- 0.6 and 1.0 +/- 0.5 for Turkish girls and boys versus 0.9 +/- 0.5 and 0.8 +/- 0.5 for White American; and 0.7 +/- 0.3 for African American girls and boys, respectively (P < 0.01). CONCLUSIONS: Our observation of a lower HDL-C and a higher TG level in Turkish children (despite their lower BMI) is of interest and may indicate that unique characteristics in lipoprotein levels of Turkish adults start early in life.     

Maternal core beliefs and children's feeding problems

BACKGROUND: Although maternal mental health problems have been implicated in the exacerbation of childhood feeding difficulties, little research has assessed the contribution of broader maternal cognitions to these problems. The current study examined gender differences in the relationships between mothers' core beliefs and children's feeding problems. METHODS: One hundred and three mothers of girls and 93 mothers of boys (age range, 7-64 months) completed the Young Schema Questionnaire and the Child Feeding Assessment Questionnaire. RESULTS: While controlling for child age, a clear link between maternal core beliefs and perceived feeding difficulties emerged for mothers of girls. In particular, abandonment, failure to achieve, dependence and incompetence, enmeshment and defectiveness, and shame beliefs were associated with increased reports of feeding problems in girls. In contrast, emotional deprivation and subjugation beliefs were associated with maternal reports of food fussiness and food refusal in boys. CONCLUSIONS: There appears to be a clear role for maternal core beliefs in the reporting of feeding difficulties in children, and the specificity of these links differs depending on the gender of the child. Further research is required to establish the direction of causality and the specificity of these relationships.     

Energy density of the diet and change in body fatness from childhood to adolescence; is there a relation?

BACKGROUND: The contribution of energy density (ED) of the total diet to increased risk of obesity from childhood into adolescence is unclear. OBJECTIVE: We assessed the relation between the ED of the diet in childhood, calculated in a number of ways, and change in adiposity from childhood to adolescence. DESIGN: In a prospective study, 48 children (30 boys, 18 girls) were initially studied at age 6-8 y (baseline) and followed up at age 13-17 y. Daily ED, energy intake, and food intake were assessed at baseline by 7-d weighed food records concurrent with estimates of total energy expenditure (TEE) by doubly labeled water. ED was calculated with the use of 5 published methods. Obesity risk was defined with the use of body fat from total body water by isotope dilution. Body fat was normalized for height and expressed as fat mass index (FMI). Change in adiposity was calculated as follow-up FMI minus baseline FMI. RESULTS: Misreporting of energy intake at the group level at baseline was low relative to the TEE. ED of the total diet at baseline by the 3 methods for calculating ED that excluded all or most beverages was prospectively associated with change in FMI. However, ED of the total diet by any of the methods was not associated with change in the percentage body fat, body mass index, or waist circumference z scores. CONCLUSION: The methods used to calculate ED and to assess obesity risk lead to different conclusions about the relation between the ED of the diet in childhood and gain in fat into adolescence.     

Obesity prevention in preschool native-american children: a pilot study using home visiting

OBJECTIVE: To determine whether maternal participation in an obesity prevention plus parenting support (OPPS) intervention would reduce the prevalence of obesity in high-risk Native-American children when compared with a parenting support (PS)-only intervention. RESEARCH METHODS AND PROCEDURES: Forty-three mother/child pairs were recruited to participate. Mothers were 26.5 +/- 5 years old with a mean BMI of 29.9 +/- 3 kg/m(2). Children (23 males) were 22 +/- 8 months old with mean weight-for-height z (WHZ) scores of 0.73 +/- 1.4. Mothers were randomly assigned to a 16-week OPPS intervention or PS alone. The intervention was delivered one-on-one in homes by an indigenous peer educator. Baseline and week 16 assessments included weight and height (WHZ score and weight-for-height percentile for children), dietary intake (3-day food records), physical activity (measured by accelerometers), parental feeding style (Child Feeding Questionnaire), and maternal outcome expectations, self-efficacy, and intention to change diet and exercise behaviors. RESULTS: Changes in WHZ scores showed a trend toward significance, with WHZ scores decreasing in the PS condition and increasing among the OPPS group (-0.27 +/- 1.1 vs. 0.31 +/- 1.1, p = 0.06). Children in the OPPS condition also significantly decreased energy intake (-316 +/- 835 kcal/d vs. 197 +/- 608 kcal/d, p < 0.05). Scores on the restriction subscale of the Child Feeding Questionnaire decreased significantly in the OPPS condition (-0.22+/- 0.42 vs. 0.08+/- 0.63, p < 0.05), indicating that mothers in the OPPS group were engaging in less restrictive child feeding practices over time. DISCUSSION: A home-visiting program focused on changing lifestyle behaviors and improving parenting skills showed promise for obesity prevention in high-risk Native-American children.     

Mothers misunderstand questions on a feeding questionnaire

Feeding questionnaires have not consistently identified mothers' beliefs or behaviors associated with preschool children becoming overweight. One reason may be that mothers do not understand the constructs in the questions in the way intended by the developers of the questionnaire. This study assessed items on the Preschooler Feeding Questionnaire (PFQ)--a maternal questionnaire about feeding practices and beliefs relating to the weight status of preschoolers. Seven audio-taped interviews were conducted with African American mothers of 24-59 month-old children in Chicago enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children. Questions in the PFQ were interpreted by respondents to mean something other than what was intended. In particular, the constructs difficulty in child feeding, pushing the child to eat more, and using food to calm the child were present among the mothers but not captured by items on the questionnaire. Thus, qualitative interviewing could help to match the intention in asking a question with its interpretation by respondents. A mismatch may contribute to our low level of understanding about the causes of early obesity.