Obesity Prevention and Control in Overweight and Obese
Obesity Prevention and Control in Overweight and Obese Mothers of Preschool Children Sha. Coria Winston, MPH Expected 2017; Cindy Schwarz, MPH, MS, RD; Karen Steger-May, MA; Rachel Tabak, Ph. D, RD; Debra Haire-Joshu, Ph. D Center for Obesity Prevention and Policy Research, George Warren Brown School of Social Work and Department of Internal Medicine, Washington University, St. Louis, MO Background & Methods Results Background • Weight change in adulthood due to lifestyle barriers associated with decreased physical activity and additional caloric intake can impact lifelong risk for obesity. • Obese women have a 28 x greater risk of developing diabetes than normal weight women. • The HEALTH (Healthy Eating and Active Living Taught at Home) study evaluates the translation of the Diabetes Prevention Program (DPP) into the Parents As Teachers (PAT) child development program with overweight and obese mothers and their preschool child. Purpose • To evaluate the impact of HEALTH on overweight and obese women. Methods & Measures • Mothers recruited to HEALTH were located in the St. Louis region. • Intervention group received PAT + HEALTH; Usual care group received standard PAT program. Outcome Measures: Weight, Dietary and Physical Activity Behaviors (n=179) Demographics (N=179) Mother Age BMI MN = 32 (SD 6) MN BMI = 34. 4 (SD 5. 2) Measure Weight, lbs. (SD) Race White African American Other 55% 32% 13% Results • At 24 months, there was a significant difference between groups in achieving a 5% weight loss (usual care vs. intervention = 10% vs. 18%) • When compared to usual care, the intervention group reported a significant reduction in sugar through beverage intake at 12 and 24 months (-1. 9 vs. 3. 0 tsp sugar, p <. 04) • The intervention group significantly reduced their sedentary activity when compared to usual care (-1. 5 hrs. vs +. 6 hrs, p <. 01). A significantly larger percentage of this group moved from moderate to high physical activity by 24 months (usual care 42% to 33% vs. intervention 39% to 54%, p<. 05) Usual Care Intervention p-value BL-12 M p-value BL-24 M Baseline (BL) 12 Month (12 M) 24 Month (24 M) 205. 1(33. 6) 204. 1(35. 0) 210. 1(35. 4) 201. 7(37. 2) p=0. 0006 214. 4(36. 3) 201. 3(37. 1) p=. 002 p-value 12 M-24 M Added Sugars from Sugar-Sweetened Beverages, tsp (SD) Time spent sitting on a weekday, hrs. (SD) Physical Activity Category - Low Physical Activity Category - Moderate Physical Activity Category - High p=0. 35 Usual Care 8. 5(11. 2) 8. 1(12. 7) 6. 6(8. 3) Intervention 8. 1(11) 3. 9(3. 5) 5. 1(14. 6) p-value BL-12 M p-value BL-24 M p-value 12 M-24 M Usual Care Intervention p-value BL-12 M p-value BL-24 M p-value 12 M-24 M p=0. 04 5. 3(2. 9) 6. 3(3. 3) 22 (31%) 20(33%) 22 (31%) 30 (50%) 28 (39%) 10 (17%) 5. 9(3. 4) 4. 8(2. 9) p=0. 0001 15 (22%) 12 (22%) 25 (36%) 21 (39%) 29 (42%) 21 (39%) p=0. 20 p=0. 03 p=0. 52 5. 2(3. 0) 5. 1(3. 0) p=0. 09 p=0. 35 17 (28%) 6 (11%) 24 (39%) 20 (33%) 30 (54%) p=0. 0004 p=0. 03 Conclusions • Height, weight and blood pressure of the mother was collected by trained staff. • Participants completed NHANES Dietary Screener Questionnaire, and the International Physical Activity Questionnaire to assess diet and physical activity. Funded by: National Institutes of Health • The HEALTH intervention was effective in achieving weight loss as well as reduction in diabetes risk at 12 and 24 months. • Insight to behavior change was obtained, suggesting that participants are selective in adaptation, and with consistent reinforcement behaviors are sustained or added overtime. • Future studies to determine whether ongoing intervention support impacts women with collateral effect on child and family are needed.
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