Current estimates reveal that 25 percent of American children are obese and that the incidence of early childhood obesity is increasing. Many overweight children become obese adults who constantly struggle with weight issues and the metabolic disorders that accompany obesity. If a child enters adolescence in the obese state, the odds are 4 to 1 against achieving normal weight later in life. Thus, it is evident that prevention or early management of this disease is critical in combating a lifetime of obesity and its complications. However, when long-term success rates of the numerous treatment programs are examined it becomes apparent that the adult who maintains a long-term weight loss is an anomaly. The results for children are even more grim since there is little research, and less consensus, regarding the treatment of childhood obesity. Previously reported studies have focussed on selectively modifying behaviors which precede obesity onset (food intake and exercise protocols) or alternatively on documenting and ameliorating the metabolic consequences of obesity.

The aim of this proposal is to unify behavioral and metabolic procedures under a common experimental design to produce a comprehensive view of the antecedents and consequences of early childhood obesity. Previously developed protocols will be employed to characterize individual children, 5-10 years of age, with respect to: 1) their ability to regulate food intake; 2) the influence of diet composition on children's food intake regulation; 3) their body composition characteristics; 4) 24 hour energy expenditure as determined by whole room indirect calorimetry; and 5) selected psychological variables such as children's self-esteem, body image and their perception of the degree to which parents attempt to control their eating behavior. In addition, data will be collected which focusses on the family environment so that differences in children's outcome measures can be interpreted in the context of the family environment in which they have developed. Parents' dieting histories and weight statuses, their concerns about their children's weight statuses as well as their child-feeding practices will be measured. These data will be used to test a model of obesity development which, based upon preliminary data, suggests that children's energy intake regulation and weight outcome are the result of a bidirectional relationship between parents and children that is both genetic and environmental in nature. The long-term goal of this line of research is to identify points at which effective intervention and prevention strategies can be developed.

R29HD033511

1996-05-01

2002-03-31