Myles S. Faith's research while affiliated with University at Buffalo, The State University of New York and other places

Background Youth in rural areas are disproportionally affected by obesity. Given the unique barriers rural populations face, tailoring and increasing access to obesity interventions is necessary. Objective This paper evaluates the effectiveness of iAmHealthy, a family‐based paediatric obesity intervention delivered to rural children, compared to a Newsletter Control. Methods Participating schools (n = 18) were randomly assigned to iAmHealthy or Newsletter Control. iAmHealthy consists of individual health coaching and group sessions delivered via televideo to a participant's home. The child and parent's body mass index (BMI), child physical activity and child dietary intake were assessed at baseline, post‐treatment (8 months) and follow‐up (20 months). Multilevel modeling estimated the effect of treatment at both time points. Results Parent and child dyads were recruited (n = 148) and randomised to iAmHealthy (n = 64) or the Control group (n = 84). The Control group had significant increases in child BMIz from baseline to follow‐up. iAmHealthy youth had no significant changes in BMIz from baseline to post or follow‐up. Child dietary intake, physical activity and parent BMI results are also discussed. Conclusions This trial extends previous paediatric obesity work by simultaneously increasing convenience and dose of treatment. Results suggest iAmHealthy resulted in a change in BMIz trajectories and long‐term health behaviour for youth.

Background Gestational weight gain (GWG) is an expected component of a healthy pregnancy. Gaining weight within the recommended range helps support the mother's health by providing energy reserves and nutrients to meet the increased metabolic demands during pregnancy. Too much or too little GWG has been associated with adverse health outcomes for the mother and child. Objective The objective of the study was to examine how changes in anthropometric indicators during pregnancy, including fat gain, vary, compare changes among body mass index (BMI) (kg/m²) groups, and examine how the changes were associated with adequacy of GWG defined using the 2009 Institute of Medicine guidelines. Methods Data came from a cohort of 360 pregnant women with measured anthropometric indicators (weight, midupper arm circumference, and skin folds of the triceps, thigh, and upper iliac) at <12-, 16 to 22-, and 28 to 32-wks of gestation. Fat gain was calculated using a formula. Analysis of variance was used to test for differences in anthropometric changes by BMI and adequacy of GWG in the third trimester. Multiple logistic regression was used to examine associations between changes in anthropometric indicators and GWG recommendations. Results Women with normal weight had greater increases in all anthropometric indicators, which differed from women with obesity, who had negative changes and gained less weight. Women who gained inadequately (21%) had negative changes that were all less, compared with women who gained adequately (46%) (except in upper iliac) or excessively (34%). Women with BMI of >25 who gained adequately also had negative changes. Logistic regression results indicated that changes in midupper arm circumference, triceps, and thigh skin folds, and fat gain were all inversely associated with inadequate GWG, whereas all indicators were positively associated with excessive GWG. Conclusions Anthropometric changes during pregnancy differ by BMI and are associated with adequacy of GWG. Women who gained adequately had minimal fat gain, lending support for current GWG guidelines.

Appetitive traits, including food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating, are associated with childhood body mass index. Change in appetitive traits from infancy to childhood and the direction of causality between appetitive traits and body mass index are unclear. The present study examined the developmental trajectory of appetitive traits and their bidirectional relations with body mass index, from infancy to early childhood. Mothers in the Pregnancy Eating Attributes Study and follow‐up ( n = 162) reported child appetitive traits using the Baby and Child Eating Behaviour Questionnaires at ages 6 months and 3.5 years, respectively. Standardized body mass index (zBMI) was calculated from child anthropometrics. Cross‐lagged panel models estimated bidirectional relations between appetitive traits and zBMI. Food responsiveness, satiety responsiveness and slowness in eating increased from infancy to early childhood. In cross‐lagged panel models, lower infant satiety responsiveness ( B ± SE = −0.45 ± 0.19, p = .02) predicted greater child zBMI. Infant zBMI did not predict child appetitive traits ( p‐ values >.36). From infancy to early childhood, appetitive traits may amplify. Appetitive traits, particularly satiety responsiveness, appear to influence body mass index during this period, suggesting early intervention targeting these traits may reduce childhood obesity.

Researchers have been reimagining strategies to accelerate the pacing of translational science progress so that basic T0 discoveries can be converted more efficiently to T1 to T4 interventions. This is certainly true in the context of childhood obesity prevention given its complex etiology and heterogeneity. Here it is submitted that behavioral genetics methods, which have transformed the understanding of childhood obesity risk, have unrealized potential to accelerate translational science into childhood obesity protection (i.e., maintaining healthy weight status despite the presence of reliable risk factors). To illustrate this opportunity, this Perspective proposes the Augmented T0 Discordant Sibling Design (DSD+ ), which leverages the traditional discordant siblings design by recruiting obesity-discordant siblings specifically from families in which parents have obesity and thereby confer heightened risk. This one modification of a tried-and-true behavior genetics design arguably opens a fascinating door of inquiry, illustrating the broader point. Moreover, as most disorders are familial, the DSD+ may stimulate ideas beyond obesity protection.

Background: Siblings reciprocally contribute to mutual social and physical development. The aim of this review was to examine the health-related behaviors and weight-related outcomes within child-sibling pairs and to determine how these factors vary by sibling composition. Methods: Following the PRISMA guidelines, a systematic review of studies published since 2000 obtained from MEDLINE, CINAHL, PubMed, Cochrane Reviews, Web of Science, PsycINFO, Health and Wellness, and Science Direct was performed. The eligibility criteria for inclusion were: 1) peer-reviewed and published in English; 2) included children ages 2 to 20 and their siblings; and 3) explored health-related behaviors (i.e., diet) and/or weight-related outcomes (i.e., body weight) within child-sibling dyads. Results: A total of 13 studies were included in the review. The study findings are summarized according to three major themes: 1) sibling concordance in health-related behaviors and weight-related outcomes, 2) differences in health-related behaviors within weight-concordant/weight-discordant sibling dyads, and 3) influence of sibling composition on health-related behaviors and weight-related outcomes. Conclusions: Family-based interventions for childhood obesity may benefit from including siblings as key family members in promoting children's health-related behaviors and preventing excessive weight gain. Future studies should explore variable sibling dynamics (e.g., adoptive siblings) in more culturally/racially diverse families to further explore the role of a sibling in a child's health. Implications to practice: The findings of this study may help healthcare providers in developing effective family-based obesity interventions for families with more than one child in their household.

Purpose: . Child appetitive traits, eating styles that reflect responsiveness to external influences and internal hunger and satiety signals, are associated with eating behaviors and susceptibility to excess weight gain. However, relatively little is known about early life influences on child appetitive traits. This study investigated relations of early life maternal feeding behaviors and food exposures with appetitive traits at age 3.5 years. Methods: . Participants of the Pregnancy Eating Attributes Study (PEAS) and follow-up study were enrolled in early pregnancy and followed prospectively. This analysis included data collected from baseline through child aged 3.5-years (n=160). Child appetitive traits at age 3.5 years were measured using the Child Eating Behavior Questionnaire. Age at introduction to fruit, vegetables, discretionary sweets, and discretionary savory foods was assessed, along with intake frequency at infant ages 6, 9, and 12 months, and 2 years. Maternal feeding to soothe was assessed at child aged 3, 6, and 12 months. Maternal permissive feeding was assessed at child aged 2 years. Multiple linear regressions estimated relations of maternal feeding behaviors and infant food exposures with child appetitive traits at age 3.5 years, controlling for sociodemographics and breastfeeding duration. Results: . Maternal feeding to soothe at 6 (r = 0.39, p<.001) and 12 months (r = 0.39, p<0.001) was positively associated with permissive feeding at 2 years. Maternal feeding to soothe at 12 months and permissive feeding at 2 years were associated with greater child emotional overeating, emotional undereating, and desire to drink. Older age at introduction to fruit (β=0.20±0.08, p=0.01) and younger age at introduction to discretionary sweet foods (β =-0.07±0.04, p=.06) were associated with greater emotional overeating. Older age at introduction to vegetables (β =0.22±0.11, p=0.04) and less frequent feeding of fruit (β =-0.20±0.08, p=0.01) were associated with greater food fussiness. Conclusions: . Associations of emotional eating with parent feeding behaviors and early life food exposures suggest the potential for interventions targeting early life feeding to have long-term impact on child appetitive traits and diet quality.

Background Infant appetitive traits including eating rate, satiety responsiveness, food responsiveness, and enjoyment of food predict weight gain in infancy and early childhood. Although studies show a strong genetic influence on infant appetitive traits, the association of parent and infant appetite is understudied. Furthermore, little research examines the influence of maternal pregnancy dietary intake, weight indicators, and feeding mode on infant appetite. The present study investigated relations of maternal reward-related eating, pregnancy ultra-processed food intake and weight indicators, and feeding mode with infant appetitive traits. Methods Mothers in the Pregnancy Eating Attributes Study (458 mothers enrolled, 367 retained through delivery) completed self-report measures of reward-related eating, and principal component analysis yielded two components: (1) food preoccupation and responsiveness and (2) reinforcing value of food. Mothers completed 24-h dietary recalls across pregnancy, and the standardized NOVA (not an acronym) system categorized recalled foods based on processing level. Maternal anthropometrics were measured across pregnancy. At infant age 6 months, mothers reported on feeding mode and infant appetitive traits. Linear regressions were conducted predicting infant appetitive traits from household income-poverty ratio (step 1); maternal reward-related eating components (step 2); pregnancy ultra-processed food intake (% of energy intake), early pregnancy body mass index, and gestational weight gain (step 3); and exclusive breastfeeding duration (step 4). Results A 1-SD greater maternal food preoccupation and responsiveness was associated with 0.20-SD greater infant satiety responsiveness ( p = .005). A 1-SD greater % energy intake from ultra-processed foods during pregnancy was associated with 0.16-SD lower infant satiety responsiveness ( p = .031). A 1-SD longer exclusive breastfeeding duration was associated with 0.18-SD less infant food responsiveness ( p = .014). Other associations of maternal reward-related eating, pregnancy ultra-processed food intake and weight indicators, and feeding mode with infant appetitive traits were non-significant. Conclusions Proximal early-life environmental factors including maternal pregnancy dietary intake and feeding mode may facilitate or protect against obesogenic infant appetitive traits, whereas infant appetite may not parallel maternal reward-related eating. Further investigation into the etiology of appetitive traits early in development, particularly during solid food introduction, may elucidate additional modifiable risk factors for child obesity. Trial registration Clinicaltrials.gov. Registration ID – NCT02217462 . Date of registration – August 13, 2014.