Nutrition Education for Childhood Obesity

Overseen By Regina H Lozinski, M.S.

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Penn State University

Disqualifiers: Severe food allergies, Developmental disability, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

770 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how teaching about nutrition can help preschool children understand and accept healthy foods. It compares a basic nutrition program with an enhanced version that includes a healthy eating curriculum and education for parents. The focus is on children from families receiving nutrition assistance in Pennsylvania. This trial suits preschool kids in participating centers who don't have severe food allergies and whose parents actively participate in meal preparation. As an unphased trial, it allows families to contribute to research that could improve children's nutrition education and health.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this nutrition education program is safe for preschool children?

Research has shown that teaching kids about nutrition in schools is generally safe and well-received. Efforts to prevent obesity by improving school food options can help children eat better and grow healthily. These programs often introduce children to new fruits and vegetables, which they usually enjoy.

Studies on improving the food environment in classrooms indicate that offering healthier meals supports children's growth without negative effects. Providing free meals to all students, as part of a school-wide approach, effectively creates a positive food environment.

Educating parents is also important. Research suggests that when parents learn about nutrition, they can positively influence their children's eating habits, leading to healthier outcomes without reported negative side effects.

Overall, these educational programs are considered safe. They aim to increase knowledge and change behaviors in a supportive and non-invasive way. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these approaches to tackling childhood obesity because they emphasize education and environment rather than medication or surgery. Unlike traditional options like lifestyle counseling or pharmacotherapy, these methods focus on teaching kids about healthy eating through interactive lessons like the "Eating the Alphabet" curriculum. Additionally, the intervention enhances the classroom environment and involves parents, making it a comprehensive strategy that addresses food acceptance and parenting. This holistic approach has the potential to create lasting healthy habits in children by engaging both their immediate environment and support networks.

What evidence suggests that this trial's treatments could be effective for childhood obesity?

Research has shown that teaching kids about nutrition in schools can help manage their weight. In this trial, the Healthy Bodies Project Plus (HBP+) arm will implement a comprehensive approach, including the Healthy Eating curriculum, classroom materials, and teacher training to enhance the classroom food and mealtime environment. It will also involve parent/caregiver education on responsive food parenting. These programs can lower body mass index (BMI) and improve eating habits, especially when combined with physical activities. Changing the food options available in schools also seems promising, as evidence suggests it can improve children's diets and help reduce obesity. Educating parents about nutrition proves effective too, with studies showing that parents who learn about healthy eating often see positive changes in their children's eating habits and weight. Overall, combining education and environmental changes seems to promote healthier lifestyles in young children. ^{3 4 6 7 8}

Who Is on the Research Team?

Lori A Francis, Ph.D.

Principal Investigator

Penn State University; Professor

Are You a Good Fit for This Trial?

This trial is for preschool children aged 3 to 5 who are enrolled in participating childcare centers, primarily serving families eligible for the Supplemental Nutrition Assistance Program (SNAP) in Pennsylvania.

Inclusion Criteria

My child is in preschool at a participating center.

Exclusion Criteria

Presence of a developmental or sensory disability that affects food intake and/or learning

My child has severe food allergies that restrict their diet.

Lack of English fluency in children and caregivers

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Children receive food literacy lessons and, in intervention classrooms, additional healthy eating curriculum. Parents receive web-based lessons on responsive food parenting.

6 months

Weekly lessons

Follow-up

Participants are monitored for changes in food literacy, food acceptance, and other outcomes post-intervention.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• ECE Food Acceptance Training
• Healthy Eating Curriculum
• Improving the Classroom Food and Mealtime Environment
• Parent Education

Trial Overview The study tests a nutrition education program aimed at improving food literacy and acceptance among preschoolers. It compares outcomes of those with just this program to those also receiving a healthy eating curriculum and parent education.

How Is the Trial Designed?

Group I: Healthy Bodies Project Plus (HBP+) Experimental Treatment 4 Interventions

Intervention classrooms will receive the Eating the Alphabet curriculum described above for comparison classrooms, in addition to (1) the Healthy Eating curriculum, (2) classroom materials and teacher training designed to improve the classroom food and mealtime environment in ways that increase food acceptance, and (3) parent/caregiver education on responsive food parenting.

Group II: Healthy Bodies Project Comparison (HBP) Active Control 1 Intervention

All classrooms will receive the Eating the Alphabet curriculum, which includes 27 lessons that introduce children to a new fruit or vegetable from A-Z each week. Parents in comparison and intervention classrooms will receive access to web-based parent resources related to the Eating the Alphabet curriculum (e.g., food of the week fact sheets with recipes and suggestions for use, and coloring pages).

Who Is Running the Clinical Trial?

Penn State University

Lead Sponsor

Trials

380

Recruited

131,000+

Published Research Related to This Trial

After participating in a workplace wellness program, 84% of early childhood education (ECE) providers reported increased awareness of healthy eating and physical activity, with 81% stating they consumed more fruits and vegetables and 80% becoming more physically active at work.

The study found that the length of time ECE providers had been teaching positively influenced their agreement that the wellness program improved their health behavior awareness, suggesting that experience in the field may enhance the effectiveness of such programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of a Workplace Wellness Program on Provider Health in Early Childhood Education Settings. Powers, JN., Farewell, CV., Maiurro, E., et al.[2020]

A two-year community-based participatory research project in 10 early childhood education centers led to significant improvements in healthy eating and physical activity policies, with 16 nutrition goals and 11 physical activity goals achieved across the centers.

The intervention resulted in a notable increase in physical activity policies (10.0 point increase) compared to nutrition policies (3.3 point increase), highlighting the effectiveness of the program in enhancing physical activity environments for children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

LiveWell in early childhood: results from a two-year pilot intervention to improve nutrition and physical activity policies, systems and environments among early childhood education programs in South Carolina. Slining, M., Wills, S., Fair, M., et al.[2021]

A pilot study involving 22 early childhood education centers in New South Wales, Australia, demonstrated that a web-based program combined with health promotion officer support significantly improved the implementation of healthy eating practices, with 4 out of 5 targeted practices showing increased adoption.

The intervention was highly acceptable to participants, with 100% of centers completing data collection and high engagement with the web-based program, suggesting that this approach could effectively support healthy eating policy implementation in early childhood settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of a Web-Based Implementation Intervention to Improve Child Dietary Intake in Early Childhood Education and Care: Pilot Randomized Controlled Trial. Barnes, C., Yoong, SL., Nathan, N., et al.[2022]

The modified EFNEP curriculum, which included videos and interactive discussions, led to a significant decrease in BMI for the intervention group, highlighting its effectiveness in obesity prevention among participants.

Both the intervention and control groups showed improvements in dietary habits and psychosocial factors, but only the intervention group experienced a notable reduction in BMI, suggesting that the enhanced curriculum may be particularly beneficial for managing weight.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Creating healthful home food environments: results of a study with participants in the expanded food and nutrition education program. Cullen, KW., Lara Smalling, A., Thompson, D., et al.[2021]

Early care and education (ECE) programs play a crucial role in shaping children's nutrition and dietary habits, which can influence their health into adulthood, including risks for diseases like obesity and cardiovascular issues.

The Go NAPSACC initiative provides ECE programs with tools for continuous quality improvement in nutrition education, emphasizing the need for support from nutrition experts and policymakers to enhance children's dietary practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multi-Level Opportunities to Improve Nutrition in Child Care Settings. Ward, DS., Vaughn, AE.[2020]

This systematic review will evaluate the effectiveness of healthy eating interventions in early childhood education and care (ECEC) settings, focusing on children up to 6 years old, to improve dietary intake and overall health outcomes.

The review will also assess secondary outcomes such as child growth, cognition, mental health, and cost-effectiveness of the interventions, providing valuable insights for public health policies aimed at improving children's diets.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Early childhood education and care-based healthy eating interventions for improving child diet: a systematic review protocol. Jackson, J., Wolfenden, L., Grady, A., et al.[2021]

The Expanded Food and Nutrition Education Program (EFNEP) was successfully integrated into five medical clinics, with physicians generating 686 referrals and 106 parents participating in the 8-week pediatric obesity prevention intervention.

Parents reported significant improvements in their children's behaviors related to sleep, screen time, physical activity, and nutrition, indicating that the intervention was both feasible and beneficial for families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of Colocating a Nutrition Education Program into a Medical Clinic Setting to Facilitate Pediatric Obesity Prevention. Shilts, MK., Diaz Rios, LK., Panarella, KH., et al.[2021]

Healthy eating interventions in early childhood education and care (ECEC) settings may slightly improve children's diet quality and increase fruit consumption, although the evidence is uncertain, based on a review of 52 studies involving over 7,000 children.

These interventions showed little to no effect on children's BMI and consumption of non-core foods and sugar-sweetened beverages, suggesting they may help manage weight and reduce obesity risk, but further research is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Yoong, SL., Lum, M., Wolfenden, L., et al.[2023]

Healthy eating interventions in early childhood education and care (ECEC) settings may slightly improve children's diet quality and likely increase fruit consumption, although the evidence is uncertain based on a review of 52 studies involving over 7,000 children.

These interventions showed little to no effect on children's BMI and consumption of less healthy foods, but they may help reduce the risk of overweight and obesity, indicating potential benefits for child health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Healthy eating interventions delivered in early childhood education and care settings for improving the diet of children aged six months to six years. Yoong, SL., Lum, M., Wolfenden, L., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11698265/

Effectiveness of School-Based Interventions for Preventing ... We found that school-based interventions that integrate nutritional education and physical activity programs effectively reduce body mass index (BMI) and ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9768697/

Effectiveness of a school-based nutrition education program ... School-based nutritional education program has been found to be a successful intervention in controlling unnecessary weight gain among overweight adolescents.

3. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0002916524008773

School-based nutrition education programs alone are not ... SNAP-Ed-endorsed nutrition education curricula alone are unlikely to be cost-effective for preventing childhood obesity.

4. cdc.gov cdc.gov/school-health-conditions/chronic/obesity.html

Managing Obesity in Schools Obesity affects nearly 1 in 5 young people aged 6–19 years in the United States. Schools reach a majority of children and adolescents and ...

5. rti.org rti.org/rti-press-publication/effective-healthy-eating-interventions-delivered-early-childhood-education-care-settings-cochrane-re

How effective are healthy eating interventions delivered in ... Findings of the systematic review indicate that ECEC-based healthy eating interventions may improve child diet quality slightly, potentially increasing fruit ...

6. odphp.health.gov odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/children

Children - Healthy People 2030 | odphp.health.gov Healthy People 2030 focuses on ways to directly and indirectly improve children's health, safety, and well-being.

7. fns.usda.gov fns.usda.gov/nutritioneducation

Nutrition Education A key resource for health professionals and policymakers to help Americans enjoy a healthy eating pattern, promote health, and prevent chronic disease.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2879179/

Schools and Obesity Prevention - PubMed Central - NIH While the schools alone cannot solve the childhood obesity epidemic, it also is unlikely that childhood obesity rates can be reversed without strong school- ...