A low intensity, community based lifestyle programme to prevent weight gain in women with young children : cluster randomised controlled trial

Objective To develop and evaluate the effectiveness of a community behavioural intervention to prevent weight gain and improve health related behaviours in women with young children.
Design Cluster randomised controlled trial.
Setting A community setting in urban Australia. 
Participants 250 adult women with a mean age of 40. 39 years (SD 4.77, range 25-51) and a mean body mass index of 27.82 kg/m2 (SD 5.42, range 18-47) were recruited as clusters through 12 primary (elementary) schools. Intervention Schools were randomly assigned to the intervention or the control. Mothers whose schools fell in the intervention group (n=127) attended four interactive group sessions that involved simple health messages, behaviour change strategies, and group discussion, and received monthly support using mobile telephone text messages for 12 months. The control group (n=123)
attended one non-interactive information session based on population dietary and physical activity guidelines. 
Main outcome measures The main outcome measures were weight change and difference in weight change between the intervention group and the control group at 12 months. Secondary outcomes were changes in serum concentrations of fasting lipids and glucose, and changes in dietary behaviours, physical activity, and self management behaviours.
Results All analyses were adjusted for baseline values and the possible clustering effect. Women in the control group gained weight over the 12 month study period (0.83 kg, 95% confidence interval (CI) 0.12 to 1.54), whereas those in the intervention group lost weight (−0.20 kg, −0.90 to 0.49). The difference in weight change between the intervention group and the control group at 12 months was −1.13 kg (−2.03 to −0.24 kg; P<0.05) on the basis of observed values and −1.11 kg (−2.17 to −0.04) after multiple imputation to account for possible bias created by missing values. Secondary analyses after multiple imputation showed a difference in the intervention group compared with the control group for total cholesterol concentration (−0.35 mmol/l, −0.70 to −0.001), self management behaviours (diet score 0.18, 0.13 to 0.33; physical activity score 0.24, 0.05 to 0.43), and confidence to control weight (0.40, 0.11 to 0.69). Regular self weighing was associated with weight loss in the intervention group only (−1.98 kg, −3.75 to −0.23).
Conclusions Weight gain in women with young children could be prevented using a low intensity self management intervention delivered in a community setting. Self management of health behaviours improved with the intervention. The response rate of 12%, although comparable with that in other community studies, might limit the ability to generalise to other populations.    
Trial registration Australian New Zealand Clinical Trials Registry number ACTRN12608000110381.

Parental correlates of young children's dietary intakes : a review

Evidence suggests that parental modeling, use of feeding strategies, nutrition knowledge, self-efficacy for providing healthy foods and food availability are all likely to be important correlates in determining the dietary habits of young children. This paper reviews the literature regarding parental correlates of the dietary intakes of young children and provides insights regarding areas which may be important in early life but have as yet not been well researched.

Phonology and lexicon in a cross-linguistic perspective : the importance of phonetics – a commentary on Stoel-Gammon's 'relationships between lexical and phonological development in young children'

In her interesting article, Stoel-Gammon (this issue) reviews studies concerning the interactions between lexical and phonological development. While the focus of the review is on vocabulary production from children acquiring American English, she also suggests that cross-linguistic research be undertaken to examine how universal and language-specific properties affect the interaction between lexical and phonological acquisition. In this regard, Stoel-Gammon referred to the study of Bleses et al. (2008) who found differences in receptive vocabulary development across languages, based on norming studies for the Communicative Development Inventories (Fenson, Marchman, Thal, Dale, Reznick & Bates, 2007). Bleses et al. showed that Danish children were slower in the early comprehension of words (and phrases). It was hypothesized that the phonetic structure of Danish may account for the difference in receptive vocabulary skills in this population (Bleses & Basbøll, 2004).

Exposing young children to music through the production and presentation of music-appreciation television programs

This paper reports on a research study of the effectiveness of a series of music-appreciation activities for young children in Hong Kong. These activities were designed using world music and were presented as part of a local early childhood television program for community interest. One-undred-and-sixty-eight local preschool children (mean age 4.25) and their classroom teachers, from 16 childcare centres or kindergartens, participated in this study. Qualitative data was collected using individual structured interviews with both children and teachers. The data showed that these music-appreciation activities enriched children's musical experiences and teachers' musical repertoires in early childhood settings. Teachers also showed positive preferences to learn the activities using multimedia tools. Implications for the curriculum planning and teacher training of early childhood music education are discussed.

A study of the effectiveness of music appreciation TV programs for young children in Hong Kong

This paper provides a preliminary report of a small-scale research examining the effectiveness of a series of Music Appreciation segments of “Pre-school: Learn to Fly”—a locally designed and produced early childhood TV program in Hong Kong. Four aspects of young children’s musical development were studied: 1) musical exposure; 2) attention span; 3) response to music; and 4) musical memory. The findings enrich local understanding of early childhood music education and media, and provide more information for the production of the next series from late 2004.

Consumption of foods by young children with diagnosed campylobacter infection : a pilot case-control study

Objective: To determine whether parentally reported habitual intake of specific foods differed between children with diagnosed Campylobacter jejuni infection and children of a comparison group without diagnosed infection.

Design, setting and subjects: Information was collected from the parents or primary caregivers of South Australian children aged 1–5 years with diagnosed C. jejuni (cases, n=172) and an age- and gender-matched group of uninfected children (controls, n=173). Frequency of consumption of 106 food and drink items was determined for the preceding two months by food-frequency questionnaire. Four children in the control group had recorded diarrhoeal episodes during the assessment period and were excluded, so 169 responses were evaluated for this group. Information was gathered on possible confounders including socio-economic status. Response frequencies were classified into three levels of consumption (rarely, weekly or daily) and statistical comparison was made by frequency of consumption of foods versus the ‘rarely’ classification for cases and controls, respectively.

Results: Frequency of consumption of most foods, including starchy foods and fruits and vegetables, did not differ between cases and controls. However, reported consumption of eight food items (block and processed cheese (slices and spread), salami/fritz (a form of processed sausage), chicken nuggets, pasteurised milk, fish (canned or fresh) and hot French fries) was significantly higher by controls.

Conclusions: The hypothesis that reported consumption of starchy foods was lower by cases than by controls was not supported by the data. However, consumption of some processed and unprocessed foods was higher by controls. Some of these foods have established bactericidal actions in vitro that may indicate a possible mechanism for this apparent protection.

Iron nutrition and neurodevelopment in young children

Iron deficiency is the most common single-nutrient deficiency in the world, affecting over a billion individuals in both industrialised and economically developing countries (McLean et al. 2009). Three successive stages of iron deficiency are generally recognised: iron depletion; iron-deficient crythropoiesis and iron-deficiency anaemia.

Use of electronic games by young children and fundamental movement skills?

This study investigated associations between pre-school children's time spent playing electronic games and their fundamental movement skills. In 2009, 53 children had physical activity (Actigraph accelerometer counts per minute), parent proxy-report of child's time in interactive and non-interactive electronic games (min./week), and movement skill (Test of Gross Motor Development–2) assessed. Hierarchical linear regression, adjusting for age (range = 3–6 years), sex (Step 1), and physical activity (cpm; M = 687, SD = 175.42; Step 2), examined the relationship between time in (a) non-interactive and (b) interactive electronic games and locomotor and object control skill. More than half (59%, n = 31) of the children were female. Adjusted time in interactive game use was associated with object control but not locomotor skill. Adjusted time in non-interactive game use had no association with object control or locomotor skill. Greater time spent playing interactive electronic games is associated with higher object control skill proficiency in these young children. Longitudinal and experimental research is required to determine if playing these games improves object control skills or if children with greater object control skill proficiency prefer and play these games.

Maternal feeding practices predict weight gain and obesogenic eating behaviours in young children : a prospective study

Background Maternal feeding practices have been proposed to play an important role in early child weight gain and obesogenic eating behariours. However, to date longitudinal investigations in young children exploring these relationships have been lacking. The aim of the present study was to explore prospective relationships between maternal feeding practices, child weight gain and obesogenic eating behaviours in 2-year-old children. The competing hypothesis that child eating behaviours predict changes in maternal feeding practices was also examined.

Methods A sample of 323 mother (mean age = 35 years, + 0.37) and child dyads (mean age = 2.03 years, + 0.37 at recruitment) were participants. Mothers completed a questionnaire assessing parental feeding practices and child eating behaviours at baseline and again one year later. Child BMI (predominantly objectively measured) was obtained at both time points.

Results Increases in child BMI z-scores over the follow-up period were predicted by maternal instrumental feeding practices. Furthermore, restriction, emotional feeding, encouragement to eat, weight-based restriction and fat restriction were associated prospectively with the development of obesogenic eating behaviours in children including emotional eating, tendency to overeat and food approach behaviours (such as enjoyment of food and good appetite). Maternal monitoring, however, predicted decreases in food approach eating behaviours. Partial support was also observed for child eating behaviours predicting maternal feeding practices.

Conclusions Maternal feeding practices play an important role in the development of weight gain and obesogenic eating behaviours in young children and are potential targets for effective prevention interventions aiming to decrease child obesity.

Physical activity of young children

Occupational therapists concerned with the long-term health and welfare of children need be aware of the decline in physical activity of children in most Western societies. The current study examined the extent of physical activity in the lives of 50 Australian children with mean age of 7.74 years through questionnaires completed by the children’s parents and pedometer (step) data collected from the children during 4 days. The current data show that higher self-perception of physical competence, child’s levels of physical skill, and low parental perception of peer teasing were the best predictors of physical activity. Higher family socioeconomic status was found to be a significant predictor of more steps being taken on weekends, and partner’s (usually a father’s) level of exercise was an important predictor of the number of weekend steps. Children who were perceived to experience more peer teasing completed fewer steps the weekend. The findings from this study indicate that children’s physical activity levels depend on the availability of family resources, and that children in their early school years already experience negative effects from teasing that, combined with reduced self-confidence, may lay the foundation for their withdrawing from physical activity as they get older.