Obesity
Conditions
Brief summary
This study will assess the impact of a randomized intervention aimed at increasing consumption of whole grain foods among children from low-income households that participate in the Special Nutrition Assistance Program (SNAP, or food stamps). A total of 60 obese children (8 to 16 years) will be recruited from a clinical population (Healthy Eating Active Living Program) at University of California San Francisco (UCSF) Benioff Children's Hospital Oakland. Participants and their caregivers will all receive education about whole grain foods, and will be randomized to either an intervention or control group. The intervention group will receive a monthly reimbursement allotment of up to 10% of their usual SNAP benefit for specific whole grain foods purchased during the three month study period. The control group will not have the financial incentive for purchasing whole grain foods during the 12 week study period. The investigators will assess the feasibility of the intervention, the impact of the intervention on household grocery purchases, and the impact on the child's anthropometrics, dietary intake of whole grain foods (24-hour recall), and markers of metabolic risk.
Detailed description
RUN-IN PHASE (Weeks -4 to 0) * Participants will participate in a run-in phase where they will be asked to keep all grocery receipts for a 4 week period RANDOMIZATION (Week 0) * Child participants with caregivers who are able to successfully complete the run-in phase are then randomized at that point to be either in the intervention arm or the control arm. * Patients will be block randomized by age group (8-11 and 12-16). ACTIVE PHASE (Weeks 0-12) * Participants will be given education about whole grains and whole grain preparation. Intervention and control participant activities described elsewhere. RETURN VISIT (Week 24) * 12 weeks after the completion of the active phase of the study, patients will be asked to return for a final visit at the research center, during which they will also have blood tests and other study activities repeated for one final time.
Interventions
BEHAVIORALReimbursement for whole grain purchases
All participants will receive education about whole grain foods. Those in the experimental arm will have a monthly financial incentive for purchases of specific whole grain foods foods during the 12-week study period, whereas the control group will not have a financial incentive for whole grain purchases during the study period.
Sponsors
UCSF Benioff Children's Hospital Oakland
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
8 Years to 16 Years
Healthy volunteers
Yes
Inclusion criteria
* Obese (BMI greater than 95th percentile for age and gender) * Low-income family currently participating in SNAP (food stamps) * Participant and caregiver speaks either English or Spanish
Exclusion criteria
* medications to lower lipid levels (statins), which would affect insulin sensitivity (e.g. metformin, abilify) or which are known to affect serum cholesterol (e.g. carbamazepine). * Type II diabetes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in whole grains consumption (ounce equivalents) | Baseline and 3 months | Using the Nutrition Data System for Research (NDSR) for 24-hour food recall, intake of whole grains (and refined grains, and proportion of grains that are whole) will be assessed. The change in this dietary outcome at the end of 3 months will be evaluated for intervention participants compared to controls. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in serum triglycerides (mg/dl) | Baseline and 3 months | Fasting lipid panel at the end of three month period will be compared to baseline lipid panel: serum triglycerides will be an outcome of particular interest given the intervention. |
| Change in TG/HDL ratio | Baseline and 3 months | Fasting lipid panel at the end of three month period will be compared to baseline lipid panel: the ratio of serum triglycerides (TG) to high-density lipoprotein (HDL-C) will be an outcome of particular interest given the intervention. |
| Change in percent of monthly SNAP benefit spent on whole grain purchases (dollars) | Baseline and 3 months | Using collected grocery receipts, monthly expenditure (as a percentage of the household's monthly SNAP benefit) for whole grain foods in the third month of the intervention period will be compared to the percent of the SNAP benefit during the baseline month (run-in phase). The change in this expenditure amount will be evaluated for intervention participants compared to controls. |
| Change in waist to height ratio (WHtR) | Baseline and 3 months | Change in waist to height ratio at the end of the 3 month period will be examined for intervention group compared to control group. |
| Change in proportion of subjects with pre-diabetes | Baseline and 3 months | The proportion of subjects with prediabetes (using both criteria of Hemoglobin A1c greater than or equal to 5.7% and fasting glucose greater than or equal to 100 mg/dl) after the 3 month intervention period will be compared for intervention and control groups. |
| Change in body mass index (BMI, or kg/m2) | Baseline and 3 months | The change in BMI after the 3 month intervention period will be examined for intervention group compared to control group. |
Countries
United States
Outcome results
None listed