L A Daniels

Does fat intake predict adiposity in healthy children and adolescents aged 2--15 y? A longitudinal analysis.

Objective: To investigate the relationship between food energy and macronutrient intake and body fatness assessed up to seven times between 2 and 15 y of age.Design: Prospective, observational study. Generalised linear estimating equations were used to evaluate the longitudinal relationship between body fatness and macronutrient intake. Regression analysis was used to assess whether body fatness at a particular age was predicted by intake at any of the previous ages.Setting: Community-based project in Adelaide, South Australia.Subjects: In all 143–243 subjects from a representative birth cohort of healthy children recruited in 1975 and followed over 15 y.Main outcome measures: The dependent variables were body mass index (BMI), triceps (TC) and subscapular (SS) skinfolds, expressed as standard deviation (s.d.) scores at each age. The predictor variables were energy-adjusted macronutrient intake and total energy intake, estimated from a 3–4 day diet diary, the previous corresponding measure of body fatness, sex and parental BMI, TC or SS.Results: Across 2–15 y energy-adjusted fat and carbohydrate intakes were respectively directly and inversely related to SS skinfold measures but not to either BMI or TC skinfold. The best predictor of fatness was previous adiposity, with the effect strengthening as the age interval shortened. Parental BMI, maternal SS and paternal TC contributed to the variance of the corresponding measure in children at some but not all ages.Conclusions: The current level of body fatness of the child and parental adiposity are more important predictors than dietary intake variables of risk of children becoming or remaining overweight as they grow.European Journal of Clinical Nutrition (2001) 55, 471–481

Facilitators and Barriers to the Achievement of Healthy Lifestyle Goals: Qualitative Findings From Australian Parents Enrolled in the PEACH Child Weight Management Program

Objectives: To describe the qualitative research methods used in the Parenting Eating and Activity for Child Health (PEACH) randomized controlled trial and to examine parent‐reported facilitators and barriers to the achievement of program goals. Design: Qualitative study using semistructured interviews. Setting: Parents enrolled in the Australian PEACH randomized controlled trial, a family‐focused child weight management program conducted blinded for review. Participants: A total of 95 parents of overweight children aged 5–10 years participated in face‐to‐face semistructured interviews. Phenomenon of Interest: Factors external to the PEACH intervention that facilitated or inhibited their success. Analysis: Interviews were recorded, transcribed, and analyzed using thematic analysis techniques. Results: Three facilitator themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors. Six barrier themes were identified: (1) internal locus of parental control, (2) external locus of parental control, and (3) child factors; (4) maintenance and managing special occasions; (5) time management challenges; and (6) inconsistencies or lack of support. Conclusions and Implications: The social and environmental barriers and time pressures identified by parents are a common feature of Western family life such that many parents are raising families in stressful situations. Insights provided by this qualitative research provide an important understanding of these experiences. Consideration of such issues in the design and implementation of future child weight management interventions may help to increase the acceptability and effectiveness of such programs.

Impact of a 6-month family-based weight management programme on child food and activity behaviours: short-term and long-term outcomes of the PEACH™ intervention: PEACH™ intervention behavioural outcomes

The PEACH™ randomized controlled trial measured changes to childrens food and activity behaviours following participation in a weight management programme. We have previously reported a 10% reduction in body mass index z‐score at intervention end (6‐month post‐baseline) that was maintained to 24 months with no further intervention for the full study sample.