A successful program that increased the number of fruits and vegetables eaten and decreased sugar-sweetened beverage consumption by 50 percent among Latino children had two secret weapons, according to a University of Illinois researcher.
"First, we got mothers and other relatives involved because family togetherness is a very important value for Latinos. Many programs, delivered at school, target only the child, but we know that kids have very little ability to choose the foods they eat at home—they don't purchase or prepare them," said Angela Wiley, a U of I professor of applied family studies.
The second guiding principle was "mas y menos," meaning "a little more, a little less."
"Interventions often fail because their goals are too lofty. If someone tells me that ice cream is the root of my problem and I can't eat any more of it, I'll be disheartened and say I can't do this. If someone says, would you be willing to eat ice cream two days a week instead of five, or eat light ice cream instead, I would be more willing to try," she said.
Wiley said Hispanics in the Midwest have among the highest obesity rates (30%) in the U.S., and 24 percent of Latino children between the ages of 6 and 13 are overweight or obese.
In the six-week study, the researchers attempted to change dietary behaviors, including increasing the number of servings of fruit and vegetables that children and parents consumed and decreasing their consumption of sugar-sweetened beverages.
Participant families were recruited in the community. In each weekly session, parents and children were separated for age-tailored lessons, then reunited for taste testing and demonstrations. The rest of the two-hour session was spent in joint family physical activity and a family mealtime class.
"We believe it's important to know your audience, and we tried to address the real needs of these families. For example, we taste-tested tortillas made with vegetable oil versus others made with lard and urged parents to go for the healthier alternative. Also, if we could get them to substitute one corn or whole-wheat tortilla for a flour tortilla daily, we felt—mas y menos—that we'd made progress," she said.
When the 73 participating families began the intervention, 19 percent of the children did not eat fruit at all, and 62 percent ate less than one serving of vegetables daily. Nearly half (48%) drank at least one sugar-sweetened beverage each day.
"When the program ended, fruit and vegetable consumption had increased by about a serving. We were most happy to see a significant drop in the children's daily consumption of sugar-sweetened beverages by over 50 percent at our two-month follow-up evaluation," Wiley said.
Cost and preparation time were seen as barriers to serving more fruits and vegetables. Parents were encouraged to purchase frozen veggies and to decrease their reliance on fast-food restaurants.
"There are a number of competing pressures for this group in that they are mainly blue-collar, dual-earner, shift-working families. The convenience of fast food often trumps preparing a more nutritious home-cooked meal," she said.
Wiley would like to adapt and improve the content for future sessions, eventually conducting a community-wide trial that compares program participants to a control group that has not received the training.
A demonstration that showed the number of sugar cubes in a can of soda made a big impression on the participants so the researchers plan to use more striking visuals when they are teaching about reducing fat in the diet during future sessions.
"When you can actually see what a pound of fat looks like, or what an artery looks like when it's clogged with plaque, it makes a difference," she said.
The patterns children develop at home are tremendously important throughout their lives so it's important to get family members on board, Wiley said. "These kids are our country's future health-care consumers, and we want to give them the best possible start in life."
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"Six-week Latino family prevention pilot program effectively promotes healthy behaviors and reduces obesogenic behaviors" is available pre-publication online in the Journal of Nutrition Education and Behavior.