Title: efficacy of a food parenting intervention for mothers with low income to reduce preschooler's solid fat and added sugar intakes: a randomized controlled trial

BackgroundFew interventions have shown efficacy to influence key energy balance behaviors during the preschool years.ObjectiveA randomized controlled trial (RCT) was used to evaluate the efficacy of Food, Fun, and Families (FFF), a 12week authoritative food parenting intervention for mothers with low-income levels, to reduce preschool-aged children's intake of calories from solid fat and added sugar (SoFAS).MethodsMothers were randomly assigned to receive FFF (n=59) or to a delayed treatment control (n=60). The primary outcome was children's daily energy intake from SoFAS at the end of the 12week intervention, controlling for baseline levels, assessed by 24-h dietary recalls. Secondary outcomes included children's daily energy intake, children's BMI z-scores, and meal observations of maternal food parenting practices targeted in FFF (e.g. providing guided choices).ResultsParticipating mothers were predominantly African American (91%), with 39% educated beyond high school and 66% unemployed. Baseline demographics and child SoFAS intakes did not differ by group. Lost to follow-up was 13% and did not differ between groups. At post-intervention, FFF children consumed similar to 94kcal or 23% less daily energy from SoFAS than children in the control group, adjusting for baseline levels (307.8 (95%CI=274.1, 341.5) kcal vs. 401.9 (95%CI=369.8, 433.9) kcal, FFF vs. control; p<0.001). FFF mothers also displayed a greater number of authoritative parenting practices when observed post-intervention with their child at a buffet-style meal (Wilcoxon z=-2.54, p=0.012). Neither child total daily energy intake nor BMI z-scores differed between groups post-intervention.ConclusionsFindings demonstrate the initial efficacy of an authoritative food parenting intervention for families with low-income to reduce SoFAS intake in early childhood. Additional research is needed to evaluate longer-term effects on diet and growth.Trial registrationRetrospectively registered at ClinicalTrials.gov: #NCT03646201.