Progress 10/01/08 to 09/30/13
Outputs
Target Audience: Undergraduate students in Rutgers University Nutrition classes. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? Undergraduate students received training in diet analysis, survey design, and measuring physical activity using motion recorders. How have the results been disseminated to communities of interest? Our statistics on the prevalence of overweight and obesity in our New Brunswick cohort of children were shared with civic leaders of New Brunnwick Tomorrow, the New Jersey Partnership for Healthy Kids-New Brunswick, and directors of the local WIC agency and HeadStart center. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
This project has allowed for the exploration of how child physical activity, among other factors, relates to excess child weight gain, namely overweight and obesity. A cohort of black and latino infants were followed from roughly birth through age 5. Percent of overweight was tracked year by year, and it was found that by 12 months, ~40%of the infants were at or above the 85th percentile, an alarming percent that was sustained through age 5. Immersion in physical actvity literature also prompted a related study of the barriers to physical activity , that is, what discourages children from being active in the summer. We did not resolve our question, as over the 5 target ages (1-, 2-, 3-, 4-, and 5-years-old), heavier children displayed higher levels of physical activity. We re-affirmed the higher risk of overweight in Hispanic children, particularly boys, as well as in low income pre-schoolers. We also gained experence in survey techniques to measure barriers to outdoor physical activity.
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2013
Citation:
R Ventura, A.K. & Worobey, J. (2013). Early influences on the development of food preferences. Current Biology, 23, R409-R418. http://dx.doi.org/10.1016/j.cub.2013.04.010
- Type:
Journal Articles
Status:
Published
Year Published:
2013
Citation:
Worobey, J., Borrelli, A., Espinosa, C., & Worobey, H.S. (2013). Feeding practices of mothers from varied income and racial/ethnic groups. Early Child Development and Care, 183(11), 1661-1668. http://www.tandfonline.com/doi/full/10.1080/03004430.2012.752735
R Ventura, A.K. & Worobey, J. (2013). Early influences on the development of food preferences. Current Biology, 23, R409-R418. http://dx.doi.org/10.1016/j.cub.2013.04.010
- Type:
Journal Articles
Status:
Published
Year Published:
2013
Citation:
Worobey, J., Lelah, L., & Gaugler, R. (2013). Environmental barriers to childrens outdoor summer play. Journal of Behavioral Health. doi:10.5455/jbh.20131125111329
- Type:
Other
Status:
Published
Year Published:
2013
Citation:
Worobey, J. (2013). Preventing infant obesity Its never too soon to start (Editorial). Journal of Food & Nutritional Disorders, 2. http://dx.doi.org/10.4172/2324-9323.1000e109
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Progress 01/01/12 to 12/31/12
Outputs
OUTPUTS: Activities: Surveys and assessments of child nutrition and development were conducted. Research results shared with undergraduate students in child nutrition classes. Events: Research results shared with research colleagues at professional conference (International Conference on Infant Studies, Minneapolis,MN, June) PARTICIPANTS: PI: Oversaw data entry, cleaning and analysis. Students: Acquired research skills (see Outcomes). TARGET AUDIENCES: Low income, minority mothers and their children were the research participants. Study is not an intervention, but participants did acquire some knowledge of effective parenting in the feeding context through questions the staff answered. PROJECT MODIFICATIONS: Not relevant to this project.
Impacts
Change in knowledge: Students learned about the role of maternal behavior as it influences risk for childhood obesity. Change in actions: Students learned research skills in using accelerometers to measure physical activity and to conduct nutrient analysis using industrial software.
Publications
- Worobey, J., Pena, J., Ramos, I., & Espinosa, C. (2012). Infant difficulty and early weight gain: Does fussing promote feeding Maternal and Child Nutrition, in press.
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Progress 01/01/11 to 12/31/11
Outputs
OUTPUTS: Spoke about overnourishment as a form of child neglect to an audience of 40 at the New Jersey Conference on Child Abuse and Neglect in October 2011. Shared research results on maternal feeding style and children's weight among Latino dyads at the Biennial Meeting of the Society for Research in Child Development in March 2011. Provided an overview of obesity corrrelates from infancy through early childhood at the Health Services Advisory Committee of Middlesex/ Monmouth County Head Start in January 2011. PARTICIPANTS: Principal Investigator- oversaw all aspects of data collection, entry, quality control, and analysis. Graduate Student- assisted PI in data management; assigned work to undergraduate assistants. Three undergraduate students assisted with home visits, data collection, coding and entry. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Students in my community nutrition class learned the fundamentals of grant writing in areas pertaining to child obesity prevention, healthier food choice and access, and increased physical activity. Students on my research staff learned anthropometric measurement techniques, practiced interview skills, and facets of data management such as collection, coding, entry and cleaning.
Publications
- Lewis, M. & Worobey, J. (2011). Mothers and toddlers lunch together: The relation between observed and reported behavior. Appetite, 56, 732-736.
- Ramos, I., Espinosa, C., Collado, J., & Worobey, J. (2011). Overweight Hispanic infants in an urban area: Saturated fat as a contributing factor. The FASEB Journal, 25(Supplement), 603.4.
- Espinosa, C., Ramos, I., Barrios, P., Pena, J., & Worobey, J. (2011). The impact of beverage type intake on energy intake and weight in 12-month-old Hispanic infants. The FASEB Journal, 25(Supplement), 604.2.
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Progress 01/01/10 to 12/31/10
Outputs
OUTPUTS: Lessons learned though our research with our low-income, minority mothers and their at-risk for overweight infants/toddlers were shared with health professionals at the 2010 Chronic Disease Summit in Somerset, NJ, as well as via input to ShapingNJ-the State Partnership for Nutrition, Physical Activity and Obesity. At the national level, some of our data was discussed at the 10th Head Start National Research Conference in Washington, DC. From a pure dissemination perspective, different aspects of our findings were presented to a variety of audiences: to Registered Dietitians (at the New Jersey Dietetics Association meeting), to infant researchers (at the International Conference on Infent Studies, held in Baltimore), and to New Brunswick High School students (via the Rutgers Office for Diversity and Academic Success in the Sciences). PARTICIPANTS: Individuals - Graduate Students - all aspect of data management: Carolina Espinosa, Isabel Ramos, Jennifer Collado; Undergraduate Work/Study Students - data coding and cleanup: Jessica Alarcon, Danah Atieh, Elisa Mendez, Felise Ortiz, Kaitlin Raferty TARGET AUDIENCES: Health and Dietetics professionals at conferences; Child Development researchers at conferences; High School students on track for science-related majors PROJECT MODIFICATIONS: Not relevant to this project.
Impacts
The primary outcome of this year's activities (apart from our research findings) has been the change in knowledge of our student research staff. Three graduate students have become well-versed in our research techniques, and have made contributions to a series of conference papers. Five undergraduate students have also demonstrated an increase in knowledge of the data collection and clean up aspects of data management.
Publications
- No publications reported this period
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Progress 01/01/09 to 12/31/09
Outputs
OUTPUTS: Ongoing results of this project were shared with psychologists at the 14th European Conference on Developmental Psychology, Vilnius, Lithuania, in August; with nutrition professionals at the annual meeting of New Jersey Dietetics Association, New Brunswick, NJ, in May; with child development researchers at the biennial meetings of the Society for Research in Child Development, Denver, CO, in March; with medical professionals via Pediatric Grand Rounds at the Robert Wood Johnson Medical School, New Brunswick, NJ, in March; and with community stakeholders at the Mt. Zion AME Church, New Brunswick, NJ, in January. PARTICIPANTS: John Worobey, PI. Conceptualized study's hypotheses and methods; developed codebook for data reduction; outlined data analyses; conceptualized, wrote and submitted manuscripts; presented findings at conferences. Estrella Torres, Project Manager. Oversaw student research assistants, including their assignment of home visits and data collection and input. TARGET AUDIENCES: Low-income minority mothers and their infants/children are the participants of this descriptive investigation. Neither education nor any intervention was delivered; however, participants were paid for their enrollment in the project. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
An unforeseen outcome of the project was the discovery that counts of infant motor activity as measured by the motion-recorders were confounded with maternal movements. This phenomenon was demonstrated via a yoked experiment where a human infant and doll's movements were co-recorded. The finding that as much as 40% of a 3-month-old's movements might actually reflect its mother's carrying and other manipulations has been of interest to other researchers. The findings were disseminated via a conference talk and a publication, and the PI has been contacted by a psychologist to replicate this effect, and by a pediatrician to serve as a consultant on a a project involving physical activity by premature infants.
Publications
- Worobey, J. & Islas-Lopez, M. (2009). Temperament measures of African-American infants: Change and convergence with age. Early Child Development and Care, 179(1), 107-112.
- Worobey, J., Islas-Lopez, M. & Hoffman, D.J. (2009). Maternal behavior and infant weight gain in the first year. Journal of Nutrition Education and Behavior, 41(3), 169-175.
- Worobey, J., Vetrini, N.R., & Rozo, E.M. (2009). Mechanical measurement of infant activity: A cautionary note. Infant Behavior & Development, 32, 167-172.
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Progress 01/01/08 to 12/31/08
Outputs
OUTPUTS: Outputs: Activities. The 2008 calendar year represented a transitional period for the present investigation, as the aims have shifted from a focus on maternal feeding and dietary factors in predicting infant excess weight gain, to an expanded look at the role of motor activity as a proxy for energy expenditure. As has been true since the project's inception, maternal demographic data, infant growth measures, and maternal attitudes toward feeding are measured in low-income, minority families, with mothers observed in feeding their offspring as they continue to grow. In addition, infant motor movements are being measured to begin exploring the relative contributions of energy intake against normal physical activity in these infants who are too young to exercise. Outputs: Events/Dissemination. Findings from the project were disseminated to an audience of graduate students in Nutritional Sciences and Educational Psychology, as well as to audiences of academic professionals at the International Conference on Infant Studies in Vancouver, and the National Head Start Research Conference in Washington, DC. PARTICIPANTS: Collaborating individuals: Maria Islas-Lopez, initial project manager. Daniel J. Hoffman, statistical consultant. Monica Medina, former project manager. Estella Dorwani-Torres, current project manager. Carolina Espinosa, graduate student. Elisa Rozo, undergraduate student. Elisa Neira, undergraduate student. Partner organization: WIC of Central New Jersey TARGET AUDIENCES: Target audience: Stakeholders. Women of color, of childbearing age Target audience: Professionals. Dietitians, nurses, social workers, child development researchers PROJECT MODIFICATIONS: All elements of project retained, but have added the systematic measurement of motor activity in infants and children.
Impacts
Some 40% of the infants in the study were found to be at or above the 85th percentile for age and sex. The results of the project to date suggest that maternal insensitivity to satiety signals, that is, an inability to read her infant as being full, along with more frequent feeds were associated with higher infant weights. These findings have not been shared with the participants in this exploratory study, but have been shared with caseworkers and other professionals who work with new mothers. In a future study, contingent on funding, these findings may be used as part of a proactive educational intervention.
Publications
- Worobey, J., Islas-Lopez, M., & Hoffman, D.J. (2008). Predictors of infant feeding frequency by Mexican immigrant mothers. Topics in Clinical Nutrition, 23(4), 33-339.
- Worobey, J., & Islas-Lopez, M. (2009). Temperament measures of African- American infants: Change and convergence with age. Early Child Development and Care, 179(1), 107-112.
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Progress 01/01/07 to 12/31/07
Outputs
OUTPUTS: This investigation is being conducted to identify the precursors of excess weight gain in the first years of life. Given national findings on risk factors for child overweight, we are deliberately enrolling low-income minority mothers who are formula-feeding their infants. In 2007, maternal demographic data, infant growth measures, and maternal attitudes toward feeding were analyzed for 96 mother-infant dyads that were visited when the infants were approximately 3-, 6- and 12-months-old. At 3- and 6-months, each mother was observed feeding her infant using the NCAST Feeding Scale and instructed to keep a 24-hour diary of all things fed to her baby, and her was infant weighed and measured. At 12-months the families were again visited to obtain infant growth measures. Data collection is continuing with this cohort, and future reports will describe 2- and 3-year-old child outcomes. Regression analyses were run to examine predictors from the initial set of variables to weight
gain from birth to 3-months, 3-month measures to weight gain from 3-6 months, and 6-month measures to weight gain from 6-12 months. None of the demographic, weight, or attitudinal variables were associated with weight gain to 3-months. The number of feeds per day at 3-months was the only predictor to weight gain from 3-6 months (Beta = .107), with number of feeds (Beta = .152) and maternal insensitivity to infant feeding cues (Beta = -.121) additionally predictive from 6-12 months.
PARTICIPANTS: Monica Medina, B.A., served as Project Manager. Isabel Martin, B.S., was a graduate research assistant. Carolina Espinosa and Elisa Rozo served as undergraduate research assistants. We are collaborating with the local WIC Program for subject recruitment.
TARGET AUDIENCES: The target audience for this investigation is women of color, and their infants. Preminary results are being shared with professionals who work with such individuals. When final results are available, prescriptions regarding optimal feeding styles will be developed and disseminated for similar target populations.
PROJECT MODIFICATIONS: No changes implemented in 2007.
Impacts
These maternal behaviors are not inconsequential, as 40% of these infants were at or above the 85th percentile of weight for length at 1-year. As maternal insensitivity and more frequent feeds were the most salient predictors of greater weight gain, caseworkers who serve low-income populations should pay special attention to guiding formula-feeding mothers who may be at risk for over feeding their infants. These results have been shared with professionals who work with new families, in both the fields of child development and dietetics.
Publications
- Worobey, J., Martin, I., & Medina, M.M. (2007). Feeding frequency versus caloric intake in low-income minority infants. Journal of the American Dietetic Association, 107(8)(Supplement), A-26.
- Worobey, J., Medina, M.M., & Martin, I. (2007). Maternal feeding style as a contributing factor to infant weight gain. Journal of the American Dietetic Association, 107(8)(Supplement), A-112.
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Progress 01/01/06 to 12/31/06
Outputs
The child obesity epidemic continues to command the nation's attention, as new reports still indicate that rates of overweight in low-income Hispanic and black infants are significantly higher than for whites. This investigation is exploring the interactions of diet (energy intake), activity (energy expenditure), and maternal factors as they predict to infant Body Mass Index (BMI). Over 200 black and Latina mothers have been recruited from a WIC Program, with data now complete for 100 of these mothers and their infants that includes observations of feeding in their homes at 3-, 6-, and 12-months postpartum. At each home visit trained observers scored maternal feeding style, caregivers completed 24-hour diet records, and infant motor activity was measured with actometers attached to their ankles for 24-hours. Using BMI-for-age percentile charts, 40% of the infants are >/= the 85th percentile at 12-months, with 21% of them at the 95th or above. Neither age at which
solid foods were introduced, kilocalories ingested over 24 hours, or infant difficulty predict infant weight at 1-year. However, 6-month maternal sensitivity to infant cues and infant activity while asleep were both inversely related to infant BMI at 12-months, while more dietary fat at 6-months predicted higher BMI at 12-months. Mexican mothers appeared to be most desiring of fatter babies, followed by other Latina and Black mothers. In addition, a higher number of feeds per day at 3-months was associated with a higher infant weight-for-length percentile at 6-months. These results so far suggest that nutrition educators must be culturally sensitive to maternal feeding and body-size attitudes, and that efforts with new mothers should attempt to improve their ability to read their infants' signals and monitor levels of fat in supplementary foods.
Impacts
The results so far have implications for nutrition educators that work in the maternal-child field. Efforts should be made to improve nutrition educators' sensitivity to culture, and guide mothers to be better able to read their infants signals and monitor levels of fat in supplementary foods.
Publications
- Worobey, J. (2006). Does desiring a fat baby result in a fat baby? Journal of Developmental & Behavioral Pediatrics, 27(5), 444.
- Worobey, J. & Worobey, H.S. (2006). The physical environment as a contributing factor to overweight in preschool-age children Journal of Developmental & Behavioral Pediatrics, 27(5), 444.
- Jaffe , K., & Worobey, J. (2006). Mothers' attitudes towards fat, weight, and dieting in themselves and their children. Body Image, 3, 113-120.
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Progress 01/01/05 to 12/31/05
Outputs
Recent data indicate that rates of overweight in low-income Hispanic and black infants are significantly higher than for whites. This investigation seeks to explore whether diet (energy intake) or activity (energy expenditure) is more strongly related to infant Body Mass Index (BMI), and if other maternal factors may contribute to differences in BMI. To date, over 100 black and Latina mothers have been recruited from a WIC Program, and 77 of these mothers and their infants were observed in their homes at 3-, 6-, and 12-months postpartum. At each home visit trained observers scored maternal feeding style, caregivers completed 24-hour diet records, and infant motor activity was measured with actometers attached to their ankles for 24-hours. Using BMI-for-age percentile charts, 40% of the infants were >/= the 85th percentile at 12-months, with 21% of them at the 95th or above. Neither age at which solid foods were introduced, kilocalories ingested over 24 hours, or
infant difficulty predicted infant weight at 1-year. However, 6-month maternal sensitivity to infant cues (r = -.22, p < .05) and infant activity while asleep (r = -.23, p < .05) were both inversely related to infant BMI at 12-months, while more dietary fat at 6-months predicted higher BMI at 12-months (r = .24, p < .05). These results so far suggest that nutrition education efforts with new mothers should attempt to improve their ability to read their infants signals and monitor levels of fat in supplementary foods.
Impacts
The results so far have implications for nutrition educators that work in the maternal-child field. Efforts should be made to improve mothers ability to read their infants signals and monitor levels of fat in supplementary foods.
Publications
- Worobey, J. & Lopez, M.I. (2005). Perceptions and preferences for infant body size by low-income mothers. Journal of Reproductive and Infant Psychology, 23(4), 303-308.
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Progress 01/01/04 to 12/31/04
Outputs
National estimates indicate that up to 20% of preschoolers may be considered overweight (BMI for age for sex at or above the 95th percentile), with a number of recent studies suggesting even higher levels in urban, low-income areas. Given its prevalence, it is important to identify factors in infancy that may account for this phenomenon. In epidemiological studies, formula feeding has been linked to risk for childhood overweight, although the mechanism is not well understood. Low educated mothers may mix cereal with formula or simply overfeed their infants. Alternately, work in our laboratory has suggested that formula-fed infants may be less active, relative to breastfed. In adults, weight is gained when energy intake exceeds energy expenditure. With preschoolers, however, we have shown that heavier children may actually expend more energy, relative to their normal weight peers. The aim of this ongoing investigation is to determine the relationship between formula
feeding and weight in infancy, and to examine how temperamental activity might mediate early weight gain. Methods: To date, 75 low-income Black and Hispanic mothers and their infants were seen at 3-4 weeks when recruited at WIC and at 3- and 6-months in their homes. At both home visits, mothers were interviewed with respect to temperamental activity level, infant motor activity was measured over 24 hours with a Micro-Mini-Motionlogger (Ambulatory Monitoring, Inc.), and mothers kept a 24-hour diary of their infants' feeding, sleeping, crying and awake periods. Results: Nearly all the measures have shown stability over time. In addition, the mothers' Estimated number of Feeds at 3-months predicted their Actual number of Feeds when visited, their Estimated and Actual Feeds at 6-months, infants' Weight at 6-months, and Weight Gain from 3-6-months (all correlations at or better than p < .05). Higher Awake Activity at 3-months was positively correlated with a greater number of Estimated and
Actual Feeds, as well as with higher Weight and BMI (again, all ps < .01 or .05). At 6-months, higher Awake Activity was again positively correlated with Weight and with Weight Gain from 3-6 months. These findings for Weight are important, as nearly half of the infants were at the 85th percentile of weight (for age and sex)at 6- months, indicating a risk for overweight at this young age. Conclusion: Awake Activity as measured by the motionlogger appeared to be stable from 3-to 6-months, was associated with more Feeds, and was also predictive of Weight Gain, indicating that heavier infants exhibited more activity. Sleep Activity was also stable over time, though it did not show relationships with the weight or feeding variables, which also remained stable. These results indicate that global measures of activity may mask true stability, if, for example, the context of activity is not taken into consideration. Since lessened energy expenditure (activity) is typically associated with
weight gain or overweight, we are attempting to identify at what age the positive correlations between weight and activity shown here will begin to reverse themselves.
Impacts
Data from this investigation should shed light on the problem of childhood obesity. Our preliminary results indicate that mothers who perceive their infants as being more difficult, are also likelier to be feeding their babies more often. The number of feeds at 3- and 6-months is associated with weight gain from 3-6 months. Since activity levels were also associated with weight, the preliminary results implicate energy intake as well as energy expenditure as factors contributing to excess weight gain in this sample.
Publications
- Worobey J., Pisuk, J., & Decker, K. (2004). Diet and behavior in at-risk chldren: Evaluation of an early intervention program. Public Health Nursing, 21(2), 122-127.
- Worobey, J., Adler, A.L., & Worobey, H.S. (2004). Diet, activity and risk for overweight in a sample of Head Start children. Journal of Children's Health, 2(2), 1-12.
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Progress 01/01/03 to 12/31/03
Outputs
To date, 87 mothers and their infants have been recruited and remain in our active sample. Recruiting efforts are ongoing to ensure a stable sample of at least 100 dyads. Analyses of the data are preliminary at this point, as the number of completed home visits range from none to three, depending on the infants' age. Age at weaning or time of introducing solid foods has not yet been analyzed, as data for only 60 of the 3-month visits, and 30 of the 6-month home visits has been entered into our database. However, the findings for the portion of the sample analyzed so far are very intriguing. For example, ratings on an infant body shape scale on which mothers indicate their perception of their babies current size on a pictorial continuum from 1 to 9 (1 being extremely lean, 9 being extremely heavy), followed by the size they would like their baby to be, were very revealing. Although the black and Hispanic babies were equivalent in weight at the time of recruitment
(approximately 9 lbs-4oz at about 2-3 weeks of age), the mothers ratings of their babies current size were 3.4 and 2.7, respectively. Yet both groups wished their babies to look bigger, with black mothers desiring the babies to be at 4.8, and Hispanic mothers indicating 5.3. By the time of their 3-month home visit, however, 50% of the babies across racial/ethnic lines are already at the 85th or higher percentile of weight-for age, with 54% of them at or greater than the 85th percentile at 6-months. The data derived from the feeding diaries, temperament ratings, and actometer measures is more telling, however. For the preliminary analysis, infant difficulty was assessed at time of recruitment with the Pictorial Assessment of Temperament, with difficulty at 3- and 6-months measured with the Infant Characteristics Questionnaire. The number of feeds is based on maternal reports made with a 24-hour diary, while physical activity was measured with a MicroMini Motionlogger Actigraph attached
to the infants right ankle. Maternal perceptions of infant difficulty appeared to be stable over time, and were related to the number of formula feeds provided by the mother at 3- and 6-months. The number of feeds was also consistent from 3-6 months, and was positively associated with weight gain over the 3 to 6 month interval. Activity at 3-months was not related from birth to 3-months, but did seem to predict weight gain from 3-to 6-months. Somewhat surprisingly, however, the correlation indicated a direct relationship between activity and weight gain, when an inverse association was expected.
Impacts
Data from this investigation should shed light on the problem of childhood obesity. Our preliminary results indicate that mothers who perceive their infants as being more difficult, are likelier to be feeding their babies more often. The number of feeds at 3- and 6-months is associated with weight gain from 3-6 months. Since activity levels are not associated with weight, the preliminary results implicate energy intake, based on maternal perceptions of infant difficulty, as the major factor contributing to excess weight gain in this sample.
Publications
- No publications reported this period
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