Behavior Modification of Diet and Parent Feeding Practices in a Community‐ Vs Primary Care–Centered Intervention for Childhood Obesity

Abstract

Objective: To evaluate behavior modification of diet and parent feeding practices in childhood obesity interventions. Design: Secondary analysis of randomized, controlled trial comparing Mind, Exercise, Nutrition … Do It! (MEND2‐5 and MEND/Coordinated Approach to Child Health [CATCH6‐12]) vs Next Steps at baseline and 3 and 12 months. Setting: Austin and Houston, TX. Participants: A total of 549 Hispanic and black children randomized to programs by age groups (2–5, 6–8, and 9–12 years) Interventions: Twelve‐month MEND2‐5 and MEND/CATCH6‐12 vs Next Steps. Main Outcome Measure(s): Diet (MEND‐friendly/unfriendly food groups and Healthy Eating Index‐2010) and parent feeding practices (parental overt control, discipline, limit setting, monitoring, reinforcement, modeling, and covert control; and food neophobia). Analysis: Mixed‐effects linear regression. Results: Changes in diet quality, consumption of MEND‐unfriendly foods, and parent feeding practices did not differ between programs. In both interventions, MEND‐unfriendly vegetables, grains, dairy and protein, added fat and desserts/sugar‐sweetened beverages declined in 2–5‐ and 6–8‐year‐olds (P < .001). Healthy Eating Index‐2010 improved in 2–5‐ (treatment; P = .002) and 6–8‐year‐olds (P = .001). Parental overt control decreased and limit setting, discipline, monitoring, reinforcement, and covert control increased with both interventions in 2–5‐ and 6–8‐year‐olds (P < 0.01–0.001). Conclusions: Diet quality, consumption of MEND‐unfriendly foods, and parent feeding practices were altered constructively in 2 pediatric obesity interventions, especially in 2–5‐ and 6–8‐year‐olds.