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A THESIS Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of Requirements For the Degree of Master of Science, Major: Nutrition and Health Sciences, Under the Supervision of Professor Kaye Stanek-Krogstrand
Lincoln, Nebraska: March, 2010
Copyright 2010 Hillary Warren


Hillary Anne Warren, M.S.
University of Nebraska, 2010
Advisor: Kaye Stanek-Krogstrand
Childhood obesity has reached epidemic levels in developed countries. In the past 30 years, overweight in children has doubled and it is now estimated that one in five children in the US is overweight (1). Identifying connections between caregiver-child interactions and key behaviors associated with resilience to overweight is viewed as an approach which can lead to interventions which may result in a reduction in overweight and obese children. While children learn eating behaviors from adults and peers (9), there are relatively few studies examining the role of the family in shaping and supporting behaviors leading to weight gain, loss, or maintenance (10). The purpose of this study was to determine if certain feeding and physical activity caregiver/child behaviors can be directly related to the incidence of overweight or obesity in low income children 4-10 years of age. Participants were 30 primary caregivers of children participating in the Nutrition Education Program (NEP) or Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Interviews were conducted with caregivers using a card-sort method containing cards with behavior suggestions about feeding children. Information from interviews was recorded and reviewed for validity by multiple researchers. Of all caregivers in the study 28% were considered “overweight”, 32% were “obese”, and 16% were “morbidly obese”. The mean BMI of children was 19.7 and 45% had BMIs putting them “at risk for overweight” or “overweight”. The most commonly followed behaviors included eat together as a family; eat more fruits, vegetables, and whole grain foods, and decrease intake of sweetened beverages. Caregivers who reported “always” following ten or more behaviors had a lower average BMI (26.8) then the average BMI of those who followed nine or fewer behaviors (30.9). Although caregiver’s indicated they typically followed most behaviors when asked “yes” or “no” candid statements indicated otherwise. There appears to be confusion and misunderstanding concerning key behaviors and it is necessary to educate caregiver’s on their meaning so they can be followed and implemented successfully.

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