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Int J Behav Nutr Phys Act. 2019 Feb 4;16(1):16. doi: 10.1186/s12966-019-0777-6.

Changes in diet quality and home food environment in preschool children following weight management.

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Department of Behavioral Health and Nutrition, University of Delaware, 26 N College Avenue, Newark, DE, 19716, USA.
Biostatistics Core, College of Health Sciences, University of Delaware, 540 S. College Avenue, Newark, DE, 19713, USA.
Psychology Department, Suffolk University, 73 Tremont Street, Boston, MA, 02108, USA.
Department of Psychology, University of Cincinnati, 47 W Corry Blvd Edwards 1 Bldg Suite 4130, P.O. Box 210376, Cincinnati, OH, 45219, USA.
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 3015, Cincinnati, OH, 45229, USA.
Department of Pediatrics, Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, 13123 E 16th Ave B395 Aurora, Aurora, CO, 80045, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 5041, Cincinnati, OH, 45229, USA.



Family-based obesity treatment interventions can successfully reduce energy intake in preschoolers. An implicit goal of obesity treatment interventions is to improve diet quality, but diet quality has been less examined as a treatment outcome in studies of preschoolers. The purpose of this study was to conduct a secondary analysis comparing the change in diet quality and home food environment in preschoolers assigned to a behavioral family-based obesity intervention (LAUNCH), motivational interviewing (MI) condition, or standard care (STC) condition.


Three 24-h dietary recalls were completed at baseline and 6-months and were analyzed using NDS-R software; diet quality was assessed using the Healthy Eating Index-2010 (HEI-2010). Availability of foods and beverages in the home was assessed through direct observation using the Home Health Environment tool that classifies foods and beverages as 'red' or 'green' based upon fat and sugar content. Repeated measures linear mixed effects models were used to examine changes in diet quality and home food environment between conditions (LAUNCH, MI, STC).


At 6-months, preschoolers in the LAUNCH condition had a higher HEI-2010 total score (62.8 ± 13.7) compared to preschoolers in the MI (54.7 ± 13.4, P = 0.022) and STC (55.8 ± 11.6, P = 0.046) conditions. Regarding the home food environment, families in LAUNCH had significantly less 'red' foods in their home at 6-months (12.5 ± 3.4 'red' foods) compared to families in MI (14.0 ± 3.7 'red' foods, P = 0.030), and STC (14.3 ± 3.4 'red' foods, P = 0.006). There were no statistically significant differences across home food environments for number of 'green' foods.


Family-based obesity treatment interventions for preschoolers can improve overall diet quality and alter the home food environment through reductions in 'red' foods.

TRIAL REGISTRATION:, NCT01546727 . Registered March 7, 2012.


Family-based obesity treatment; Healthy eating index; Home food environment; Preschool nutrition

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