Given the prevalence and consequences of childhood obesity, efforts are being made to identify risk factors and design evidence-based interventions to reduce its impact. Food and beverage consumption habits are established early in life, making preschool-age children an important group to focus on. This cross-sectional study explored beverage intake and its association with body weight status among low-income preschool-age children enrolled in the Special Supplementation Nutrition Program for Women, Infants, and Children (WIC). Authorized representatives for children between the ages of 3 and 4.9 years were interviewed at WIC clinics in Broward County, Florida. Anthropometric data were collected from the WIC data system. The intake of sugar-sweetened beverages (SSB), particularly fruit drinks, was significantly higher in overweight/obese children when compared with their under/normal weight counterparts. Independent of body weight status, the preschool-age children were consuming on average over twice as much as the recommended intake of 100% fruit juice per day for that age group. Close to 80% of the overweight/obese children consumed low-fat or fat-free milk most often than any other type of milk. The intake of SSB was positively correlated with both the intakes of 100% fruit juice and milk, and negatively correlated with the intake of water. When body weight status, race/ethnicity, and intake of other beverages were held constant, SSB intake was positively associated with milk intake and negatively associated with water intake. Results from this study support the need to encourage water intake and discourage SSB intake in an effort to reduce the risk for overweight and obesity in WIC-participating preschool-age children. Emphasizing the need to follow the recommendation to limit 100% fruit juice intake to 4 to 6 oz. per day is important when counseling families with young children. Efforts to increase awareness of the health consequences associated with consuming high-fat milk should continue.

BackgroundObesity disproportionately affects children from low-income families and those from racial and ethnic minorities. The relationship between snacking and weight status remains unclear, although snacking is known to be an important eating episode for energy and nutrient intake particularly in young children. The purpose of this pilot study was to examine the snack intake of minority preschool children enrolled in the Head Start Program in four centers in Detroit, Michigan, and investigate differences by child weight status.MethodsThis secondary data analysis used snack time food observation and anthropometric data from a convenience sample of 55 African American children (44 % girls, mean age = 3.8 years). Snack intake data was obtained over a mean of 5 days through direct observation of children by dietetic interns, and later converted into food group servings according to the United States Department of Agriculture (USDA) meal patterns and averaged for each child. Height and weight measurements were systematically collected and BMI-for-age percentiles were used to classify children into weight categories. One sample, paired samples and independent samples t-tests were performed to test for differences within and between means.ResultsBased on BMI-for-age percentiles, 72.7 % of the sample was under/healthy weight and 27.3 % was overweight/obese. Average (mean ± SD) intake of milk (0.76 ± 0.34) and overall fruits/vegetables (0.77 ± 0.34) was significantly lower than one USDA serving, while average intake of grains and breads (2.04 ± 0.89), meat/meat alternates (2.20 ± 1.89) and other foods (1.43 ± 1.08) was significantly higher than one USDA serving (p ≤ 0.05). Children ate more when offered canned versus fresh fruits (0.93 ± 0.57 vs. 0.65 ± 0.37, p = 0.007). Except for a significantly higher milk intake in the overweight/obese group compared to the under/healthy weight group (0.86 ± 0.48 vs. 0.72 ± 0.27, p = 0.021], no relationship was found between snack food intake and weight category. Only in the overweight/obese group was the intake of milk and fresh fruits not significantly different than one USDA serving.ConclusionsFindings suggest that regardless of weight status low-income minority preschool children are consuming larger serving sizes when offered less healthy versus healthier snack foods. Continued efforts should be made to provide healthful snack foods at preschool settings to prevent obesity and promote healthier food habits.

Snacking is an important eating episode for energy and development of food preferences in children. The purpose of this study was to describe the quality and quantity of snack intake in minority preschool children enrolled in the Head Start Program in four centers in Detroit, Michigan, and investigate differences by child weight status. This secondary data analysis used anthropometric and snack time food observation data from a convenience sample of 58 children (43% girls, 46±7.85 months old). BMI‐for‐age percentiles were used to separate children into weight categories according to CDC guidelines. Snack intake data (servings/snack) was converted into USDA food group portions and averaged for each child. Based on BMI‐for‐age percentiles, 70.7% of the sample was under/healthy weight and 29.3% was overweight/obese. Average snack time intakes of milk (0.74±0.33) and combined fruits/vegetables (0.77±0.33) were significantly lower than one USDA snack serving, while average intakes of energy dense foods such as grains (1.99±0.89), meat/meat alternates (2.20±1.91) and other foods (1.43±1.06) were significantly higher than one serving (p蠄0.05). Children ate more when offered canned fruits versus fresh fruits (0.93±0.57 vs. 0.65±0.37, p=0.007). Except for a significantly higher milk intake in the under/healthy weight group compared to the overweight/obese group (0.81±0.34 vs. 0.58±0.24, p=0.005], no relationship was found between snack food intake and weight category. A preference for energy dense foods was observed. Continued efforts should be made to provide nutrient dense foods at the preschool settings to promote healthier food habits. AC support: NIH/NIGMS R25 GM061347

Objectives To understand the influence of eating frequency and snack quality on body weight of preschool children ages 3 up to 5 years participating in the Broward County Special Supplementation Nutrition Program for Women, Infants, and Children (WIC). Methods Cross-sectional data were collected from all 7 Broward County Health Department WIC clinics over 4 months via a researcher-administered questionnaire. Additional data were extracted from the WIC data system. Centers for Disease Control and Prevention's BMI-for-age percentiles were used to classify children into weight categories that were combined into under/normal weight and overweight/obese. Snacks were categorized into nutrient-based food groups and assigned a quality score. Results A total of 197 participants [90 boys (45.7%) and 107 girls (54.3%)] were included. From those, 3.6% were underweight, 64.4% normal weight, 16.8% overweight and 15.2% were obese. Most children consumed 3 meals (97.5%) and between 2 (33%) to 3 (37.1%) snacks on average per day. Mean number of snacks on the weekend was significantly higher than on weekdays (2.78 ± 1.20 vs. 2.67 ± 1.08, P = 0.001). We found a tendency for a lower prevalence of overweight/obesity as the number of eating events increased, although it was not significant. The most frequently consumed snacks were milk, 100% fruit juice, and fresh fruits, consumed daily by more than 75% of the children, irrespective of weight category. There was an overall higher consumption of more nutritious snacks when compared to nutrient-poor snacks (66% vs. 33.5%), with under/normal weight children consuming nutritious snacks more frequently than overweight/obese children (P = 0.09). Conclusions Most children included in this study engaged in frequent eating events with a higher intake of the more nutritious snacks, which were both associated with a lower prevalence of overweight/obesity. Our findings suggest that in this age range, participation in the WIC program may foster positive eating behaviors. Funding Sources A.C. was supported by a NIH/NIGMS R25 grant. Support to conduct the study was provided by the FIU Dietetics and Nutrition research foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Objectives To identify risk factors associated with the risk for overweight/obesity in preschool children ages 3 up to 5 years participating in the Broward County Special Supplementation Nutrition Program for Women, Infants, and Children (WIC). Methods Cross-sectional data were collected from all 7 Broward County Health Department WIC clinics over 4 months via a researcher-administered questionnaire. Additional data were extracted from the WIC data system. Children were classified into weight categories following the CDC's BMI-for-age percentiles, which were further combined into under/normal weight and overweight/obese. Results A total of 197 participants [90 boys (45.7%) and 107 girls (54.3%)] were included. From those, 68% were overweight/obese and 32% under/normal weight. Sugar sweetened beverage (SSB) intake was significantly greater in the overweight/obese group (7.45 ± 8.71 vs. 4.60 ± 6.64 oz/d, P = 0.024). Fruits were consumed daily by 67% of the children, and vegetables by 35%, with no significant association with weight category. Breakfast was skipped at least once/week by 16.5% of the children, independent of body weight. On average, children had 2.3 h/d of screen time and were physically active for 37.9 min/d. While screen time was not significantly different by weight category, children in the under/normal weight group were significantly more physically active when compared to their counterparts (41.9 ± 29.3 vs. 29.3 ± 27.0 min/d, P = 0.004). Only 15.2% of parents/guardians of overweight and 43.3% of obese children identified their child as being too big. Mean birth weight for overweight/obese children was significantly higher (7.41 ± 1.12 vs. 7.04 ± 1.17 lbs, P = 0.038). On a logistic regression model, SSB intake, physical activity, and birth weight were significant predictors of overweight/obesity. Conclusions Physical activity was negatively correlated with the risk of overweight/obesity, while the intake of SSB and birth weight were positively correlated. In addition, most participants failed to perceive their overweight/obese child as such. This study points out important factors to be considered in obesity prevention interventions in this population. Funding Sources AC was supported by a NIH/NIGMS R25 grant. The FIU Dietetics and Nutrition research foundation supported the study.