Research Description
Overweight and obesity affect nearly half of all Latino children, who make up a growing percentage of all children in the United States. A growing body of evidence suggests that once obesity is established in early childhood, especially within the “first 1000 days”, it is very difficult to alter the path to obesity-related, poor health outcomes for the duration of life. This research effort will collect pilot data to build the evidence base for early interventions that are also culturally tested as appropriate for Latino parents and their infants and toddlers. These interventions include healthy nutrition habits, such as responsive feeding, breastfeeding, and no added sugar; as well as adequate infant and toddler physical activity and healthy sleep habits. Different types of parental coaching will be tested for effectiveness, including in-person support groups, text-based support, and the typical standard of care which is to measure BMI at age two years old—generally too late to prevent ongoing, unhealthy feeding and activity routines with infants and toddlers. The research will determine the impact of these different types of coaching on breastfeeding duration, formula quantity, dietary intake, and feeding practices across the first two years of life. The research will also explore the impact of social determinants of health (food security, home environment, social support, and parent self-efficacy); infant/toddler weight gain; and also prenatal factors such as maternal overweight/obesity.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?My research covers very upstream diabetes prevention, by taking a lifecourse approach to prevention of obesity. I aim to understand the socioenvironmental factors affecting both mothers and infants that may contribute to intergenerational transmission of health or disease, especially in low-resource populations. I study prenatal and early childhood nutrition, feeding and sleep behaviors in infants and toddlers, as well as food insecurity, and am experienced in qualitative research with Hispanic families. I aim to evaluate varying levels of parent coaching on healthy infant sleep and feeding in a community health setting. To stop cycles of intergenerational obesity and metabolic disease, we must "move the needle" meaningfully in the critical first thousand days of life, giving children healthy lifelong self-regulating habits.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?This project will help us learn how diabetes might be passed on through generations- starting in the earliest years of life, and what we can do now for families at risk. It will help us learn how even infants may be impacted by healthy feeding and sleep habits, that sets them up for lifelong health.
Why important for you, personally, to become involved in diabetes research? What role will this award play?I have eleven years of experience caring for pediatric patients at a Federally Qualified Health Center, the majority of whom are low-income and Hispanic. I have been dismayed at the high rates of very early life obesity and adolescent prediabetes and Type 2 diabetes I see in my patients. I keep encountering overfeeding in infants and toddlers, adolescents only eating once a day, and the majority of patients not getting the recommended hours of sleep per night. This award will allow me dedicated time to take a deeper dive into the social and systemic issues affecting my clinic population, and see where interventions may be most effective, and most accepted by our patients. We have been planning to expand the Centering Parenting program of group well child visits to my clinical site; this award will allow me time to research its effectiveness, which has not been done before in a rigorous way. Additionally, I will be able to pilot the use of accelerometers in a low-resource Hispanic infant population to determine acceptability.
In what direction do you see the future of diabetes research going?The future of diabetes research needs to include innovations at all levels- systems, communities, and individuals. On the clinical side, we need innovations to help people better understand their metabolism and the effects of sleep and movement on their glucose and energy levels throughout the day; in addition to having a better understanding of how different types of food change that energy balance. From a community angle, healthcare needs to partner with local governments and public health to research the effects of a healthier built environment: from affordable housing that shortens people’s commute to work or school, to transportation systems that minimize passive time sitting. Food systems research would include decreasing added sugar in products and developing alternatives to ultra-processed foods that still have a long shelf life and are affordable.