- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02098902
Trial of a Sugar-Sweetened Beverage Intervention in Overweight Mothers and Their Children Ages 3-5
Randomized Controlled Trial of a Sugar-Sweetened Beverage Intervention in Overweight Mothers and Their Children Ages 3-5
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Obesity in young children remains a significant public health issue. Interventions targeting this age group are needed, but few have been successful. The most effective childhood obesity prevention interventions for young children thus far have involved significant parent engagement, suggesting that family-based interventions that take into account the needs of both parents and children are needed. But, 2 out of 3 adults are either overweight or obese, and the risk of obesity increases with at least one child under the age of 5 in the home. So not only is obesity among adults high, but maternal obesity is one of the strongest predictors of child obesity, meaning that intervening with overweight and obese mothers could be an effective way of preventing the development of obesity in their young children.
Many family-based or parent-targeted interventions conducted thus far have broadly targeted dietary intake and physical activity, but only a handful have had success in changing child behavior. Interestingly, when evaluating the dietary determinants of childhood obesity, sugar-sweetened beverage (SSB) consumption is most consistently associated with obesity across studies, more so than overall caloric intake, fruit and vegetable consumption, and intake of added dietary fats. Consumption of SSBs makes up 5-18% of preschoolers' recommended daily energy intake, with an average of 176 calories a day consumed from drinks such as caloric carbonated beverages, fruit drinks, sport drinks, and 100% fruit juice. Few interventions have targeted a reduction in SSBs and fruit juice in children, but results from a study in children ages 4-12 found that replacing SSBs with noncaloric beverages can lead to a lower increase in BMI z-scores over time. Reducing SSB consumption in adults is equally as important as in children, because adults consume 21% of their calories from SSBs alone, and consumption of SSBs is associated with a higher risk of obesity, non-alcoholic fatty liver disease, diabetes, the metabolic syndrome, and cardiovascular disease. Several adult intervention studies have shown that replacing caloric beverages, including SSBs, with water or noncaloric beverages can lead to weight loss in the absence of other prescribed changes.
While the research indicates that reducing SSB consumption in children and adults can lead to changes in weight, what is not yet known is if a mother-targeted behavioral intervention can successfully reduce intake of SSBs and fruit juice in preschool-aged children. Because mothers face many barriers to weight control behavior change, including time demands and lack of childcare, there is a need for interventions that are uniquely targeted to the needs of mothers and children, such that they minimize mothers' need to travel, prevent them from having to rearrange their schedules, and minimize the amount of time spent in participation in order to be successful at weight loss and changing their own and their child's behaviors.
This intervention has been developed to focus on changing a small set of behaviors, primarily SSB consumption, in mothers and their children ages 3-5. Guided by Social Cognitive Theory, the intervention will target increases in self-efficacy, outcome expectations, limit setting, and self-monitoring, and decreases in perceived barriers to behavior change. In addition, mothers will be asked to make other small changes in her own behavior to promote modest weight losses. The evidence from traditional behavioral weight loss intervention research has been adapted to focus on making small diet and physical activity changes more suitable for mothers of young children and to be delivered primarily via a mobile-based website and text messaging to reduce time demands and increase adherence. Mother-child dyads (N=42) will be randomized to either the Smart Moms intervention group (n=21) or to a waitlist control group (n=21) that will receive a modified version of the intervention after the 6-month assessment.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
North Carolina
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Chapel Hill, North Carolina, United States, 27599
- University of North Carolina at Chapel Hill
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- The parent is female
- The mother has a BMI between 25 and 50
- The mother has a smartphone with data and text messaging plan
- The child is between the ages of 3-5
- The child consumes at least 12 ounces of sugar-sweetened beverages/100% fruit juice per day
Exclusion Criteria:
- The mother cannot speak or read English
- They cannot participate in assessment visits at the UNC Weight Research Program
- The mother is currently participating in another weight loss program
- The mother is pregnant or planning to become pregnant in next 6 months
- They are planning on moving out of the study area in the next 6 months
- The mother has a diagnosis of schizophrenia or bipolar disorder, or hospitalization for a psychiatric diagnosis in the past year
- The mother has excessive intake of alcoholic beverages defined as >14 servings per week or they report a diagnosis of substance or alcohol abuse (on screening survey)
- The mother is unable to safely participate in alternatives to sedentary behavior including standing and walking
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Smart Moms Intervention
This arm will receive the Smart Moms intervention immediately following randomization.
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Reduction in child sugar-sweetened beverage consumption and maternal caloric beverage consumption, in addition to self-selected 100-calorie dietary and physical activity changes made by the mother to promote modest weight loss.
Content will be delivered via one in-person group meeting, weekly online lessons, and weekly text messages.
Mothers will self-monitor their weight and their own and their child's beverage consumption via text message every 2-3 days.
|
No Intervention: Waitlist control group
This arm will receive a modified version of the Smart Moms intervention after the 6-month assessment.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in child sugar-sweetened beverage consumption from baseline to 6 months
Time Frame: Baseline, 6 months
|
The primary outcome is the child's average ounces per day of sugar-sweetened beverage consumption change from baseline to 6 months.
Sugar-sweetened beverage consumption includes all beverages sweetened with sugar in addition to 100% fruit juice.
It will be measured using a 24-hour dietary recall during the in-person assessment visit.
A staff member trained to conduct dietary recalls will conduct a mother-reported dietary recall for the child.
Dietary data will be entered into the Nutrition Data System for Research (NDSR), which will produce a report that includes intake of sugar-sweetened beverages in ounces per day.
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Baseline, 6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in maternal caloric beverage consumption from baseline to 3 months
Time Frame: Baseline, 3 months
|
A secondary outcome is the mother's average ounces per day of caloric beverage consumption change from baseline to 3 months.
Caloric beverage consumption includes sugar-sweetened beverages, fruit juices, and alcoholic drinks.
It will be measured using a 24-hour dietary recall during the in-person assessment visit.
A staff member trained to conduct dietary recalls will conduct a dietary recall with the mother.
Dietary data will be entered into NDSR, which will produce a report that includes intake of caloric beverages in ounces per day.
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Baseline, 3 months
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Change in maternal weight from baseline to 6 months
Time Frame: Baseline, 6 months
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Mothers will be weighed wearing shorts and without shoes using a calibrated digital Tanita scale.
Trained study staff will conduct these measurements following a standardized protocol.
Two measures will be completed and the average of the two will be used.
Percent weight loss from baseline to 6 months will be calculated and used as the secondary outcome measure.
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Baseline, 6 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in child BMI z-score from baseline to 6 months
Time Frame: Baseline, 6 months
|
Change in child BMI z-score from baseline to 6 months will also be evaluated in this study.
Children will be weighed wearing shorts and without shoes using a calibrated digital Tanita scale.
Children's height will be measured at each time point using a wall-mounted stadiometer.
Trained study staff will conduct these measurements following a standardized protocol.
BMI z-score will be calculated using a program developed by the Centers for Disease Control (CDC).
|
Baseline, 6 months
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Collaborators and Investigators
Investigators
- Principal Investigator: Brooke T Nezami, MA, University of North Carolina, Chapel Hill
- Study Director: Deborah F Tate, PhD, University of North Carolina, Chapel Hill
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 14-0547
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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