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

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.