Background Interventions to prevent and control childhood obesity have shown mixed results in terms of short- and long-term changes. Objectives “MOVE/me Muevo” was a two-year family- and recreation center-based randomized controlled trial to promote healthy eating and physical activity among 5-8 year old children. It was hypothesized that children in the intervention group would demonstrate lower post-intervention BMI values and improve obesity-related behaviors compared to control group children. Methods Thirty recreation centers in San Diego County, California were randomized to an intervention or control condition. Five hundred and forty-one families were enrolled and children’s body mass index (BMI), diet, physical activity and other health indicators were tracked from baseline to two years post-baseline. Analyses followed an intent-to-treat approach using mixed effects models. Results No significant intervention effects were observed for the primary outcomes of child or parent BMI and child waist circumference. Moderator analyses however showed girls (but not boys) in the intervention condition reduced their BMI. At the two-year follow-up, intervention condition parents reported that their children were consuming fewer high-fat foods and sugary beverages. Conclusions Favorable implementation fidelity and high retention rates support the feasibility of this intervention in a large metropolitan area; however, interventions of greater intensity may be needed to achieve effects on child’s BMI. Also, further research is needed to develop gender-specific intervention strategies so that both genders may benefit from such efforts.

Parents exert a strong influence on their children's diet. While authoritative parenting style is linked to healthier weight and dietary outcomes in children, and authoritarian and permissive parenting styles with unhealthy eating, little is known about the mechanisms that mediate these relationships. Feeding styles are often examined in relation to child diet, but they do not consider the social and physical environmental contexts in which dietary behaviors occur. Therefore, this study examined whether parenting styles (authoritative, authoritarian, and permissive) were associated with three specific food-related parenting practices - mealtime structural practices (e.g., eating meals as a family), parent modeling of healthy food, and household food rules and whether these parenting practices mediated the association between parenting styles and children's diet. Participants were 174 mother-child dyads. Mothers (68% married, 58% college graduates, M = 41 years [SD = 6.2]) reported on their parenting practices using validated scales and parenting style using the Parenting Styles and Dimensions Questionnaire. Children (52% female, M = 10 years [SD = 0.9]) completed two telephone-based 24-hour dietary recalls. Dietary outcomes included the Healthy Eating Index (HEI)-2010 score, and fruit and vegetables and added sugar intake. Using PROCESS, multiple mediation cross-sectional analyses with parallel mediators using 10,000 bootstraps were performed. Significant indirect effects were observed with mealtime structure and the relationships between authoritative parenting and HEI-2010 score (b = 0.045, p < .05, CI = [0.006, 0.126]), authoritarian parenting and HEI-2010 score (b = -0.055, p < .05, CI = [-0.167, -0.001]), and permissive parenting and HEI-2010 score (b = -0.093, p < .05, CI = [-0.265, -0.008]). Child diet quality is affected by mealtime structural practices. Further examination of the features by which mealtime structural practices serve as a mechanism for parents to support healthy eating among their children may improve children's diet quality.

Consumption of sugary beverages has been identified as a contributor to childhood obesity. Studies have established the importance of specific parenting practices to children's beverage consumption; however, no study has examined multiple operationalizations of parenting to better understand where to focus future interventions. The present study examined the relationship between children's sugary beverage consumption and a parenting model that included household food rules, parent modeling of food rules, parent-mediated behaviors, and parent support. Baseline data from Project MOVE/me Muevo were used. Participants included 541 children, aged 5 to 8 years old, and their parents. Parents completed a 45-minute self-administered survey in Spanish or English, providing information about their child's dietary intake, as well as their parenting practices. Children's sugary beverage consumption included nondiet soda, noncarbonated sugary drinks, and sport drinks. Household food rules and parent modeling of food rules were assessed with seven items each. Parent-mediated behaviors consisted of four behaviors. Parent support was assessed with five items. Parent support and parent-mediated behaviors, including total screen time and eating at fast-food restaurants at least weekly, were associated with greater consumption of sugary beverages in children. No other parenting variables were significant. Encouraging caregivers to promote healthy dietary behaviors and provide healthy choices, limiting children's television and computer use, and reducing fast-food consumption can contribute to reductions in sugary beverage consumption among children.

Objective Parents who overestimate their child’s physical activity (PA) level may not encourage their children to increase their PA. We assessed parental awareness of child PA, and investigated potential correlates of overestimation. Method Child PA (accelerometer) and parent-classified child PA [‘active’ ≥ 60mins/day vs. ‘inactive’ <60mins/day moderate and vigorous PA (MVPA)] were measured over 7 days [n=329, 44% male, 39% Latino; Mean (SD) 9.1 (0.7) yrs] in an obesity prevention study in San Diego (Project MOVE). Agreement between date-matched objective MVPA and parent-classified child PA was assessed; % days parental overestimation was the outcome variable. Associations between parental overestimation and potential correlates were investigated using three-level mixed effects linear regression. Results Children met PA guidelines on 43% of days. Parents overestimated their children’s PA on 75% of days when children were inactive. Most parents (80%) overestimated their child’s PA on ≥1 measurement day. Parental support for child PA (transport, encouragement and participation with child) (p<0.01) was positively associated with higher overestimation. Parents of girls showed more overestimation than parents of boys (p=0.01). Conclusion Most parents incorrectly classified their child as active when their child was inactive. Strategies addressing parental overestimation may be important in PA promotion.

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