NOURISH: Parents get tools for helping their children lead healthy lifestyles

Virginia Commonwealth University researchers are taking a unique approach in the fight against pediatric obesity by reaching out to parents and giving them the tools to encourage their children to lead healthy and active lives.

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Suzanne Mazzeo, Ph.D., associate professor of psychology at VCU, together with colleagues Marilyn Stern, Ph.D., professor of psychology and pediatrics in the Department of Psychology;  Ronald Evans, Ph.D., associate professor in the VCU School of Education; Resa Jones, Ph.D., with the Department of Family Medicine in the VCU School of Medicine; and Diane Wilson, Ed.D., associate professor with Department of Internal Medicine in the VCU School of Medicine, have been investigating the effectiveness of a program called NOURISH that arms parents of overweight children with the skills to lead their family to good health.

NOURISH, which stands for Nourishing Our Understanding of Role Modeling to Improve Support and Health, targets parents of overweight children aged 6 to 11 and engages them in a series of six group sessions designed to spark discussion on a variety of topics.

“This program emphasizes the crucial role parents play as models of eating and exercise behavior,” said Mazzeo.

In sessions, parents have the opportunity to learn about nutrition, exercise, mindful eating (versus emotional eating), body image, how to help their children develop a healthy relationship with food, the importance of family meals, how to avoid power struggles over foods and junk foods and how to help children cope with weight-based teasing.

The research team recently completed a pilot study, supported by the National Institutes of Health, which evaluated the effectiveness of weight reduction of children who had parents enrolled in NOURISH versus a control group.

According to Mazzeo, preliminary data suggest a small, but significant difference in the Body Mass Index, or BMI percentile, of the children whose parents were enrolled in NOURISH. The children of parents who participated in NOURISH had lower BMIs at the conclusion of the study. Further, although the current study included a small sample of 90 families, the team noted that the children who had parents enrolled in NOURISH had a trend toward better quality of life and better body/self-image compared to the control group.

Parenting strategies
Mazzeo said the program is designed to be realistic and arm parents and caregivers with simple, economical ideas that they can really use in their own homes on a daily basis. For example, parents learn about the importance of family meals and have the opportunity to brainstorm ways to sit down together for meals daily and to plan meals for the entire week.

“By planning ahead families can avoid falling into the trap of eating fast food too often. Also, making time to plan makes meals at home less expensive, less stressful and healthier,” said Mazzeo.

She believes that the structure offered by having meals together as a family offers stability in the home. Plus there could be an added bonus of family mealtime – other research indicates that having a meal together as a family not only promotes healthy eating, but it also reduces dangerous behaviors such as sexual risk taking, drug use and eating disorders.

A second strategy reviewed in NOURISH, Mazzeo explained, comes from what is referred to by registered dietician and author Ellyn Satter as the feeding relationship. Satter suggests that the way parents should feed their children is to offer healthy foods, have set meal and snack times and in between those times, do not allow what she calls ‘pan-handling,’ so if a child is hungry, they have to wait until the next time there is food. Also, no short-order cooking – so children have to eat what’s presented.

“Communicating the ideas of no pan-handling or short-order cooking and the importance of structure of meals and snacks to these parents is very helpful to these families,” Mazzeo said.

Parents also learn about not restricting foods, such as junk foods, because children who are deprived of these foods tend to overeat them when they have the opportunity, Mazzeo said. Additionally, culture can influence body size and the types of foods people eat – but people don’t need to give up all these things to be healthier, they can just think of healthier ways to adapt some of their favorite foods

“Junk food is like TV - it’s in the environment. You can try to keep it out of your house, but your child is going to be faced with it at some point – so help them deal with it in moderation so it’s not this forbidden fruit that they can’t get enough of,” Mazzeo said.

“We want children to have a healthy relationship with food; we don’t want them to think that all these things are bad for them. As parents, we have to promote a balance,” she said.

Moving forward, Mazzeo plans to conduct a larger scale study that will include more families and further examine the effects of role modeling on obesity on a larger scale.