Healthy Eating Education for Mothers and Its Impact on Obesity in Children: A Randomised Controlled Trial

Health Advancement and Promotion
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Table of contents:
Background and rationale 3
Aims and objectives 4
Action plan 5
Anticipated outcomes and significance 10
Strategies to evaluate outcomes 10
Timeline 12
Budget and its justification 12
References 13
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Title: Healthy eating education with motivational interview for mothers and its impact
on obesity in children of age 2-5 years in rural India – A randomised controlled trial.
Background and rationale:
Diet plays a significant role in the health and well-being of children and adults. Diet impact
growth, development and metabolic process of children between 2-5 years. Hence, it
becomes mandatory to study dietary habits of children between age 2-5 years, since, dietary
habits developed in this age and remain same or change over time. Dietary habits can be
effectively studied through knowledge, behaviour and perceptions of their parent’s about diet
(Yee, Lwin, and Ho, 2009). Innate preference for the taste is a vital factor in developing
dietary habit because repeated consumption of same food can stimulate its acceptance. Other
factors such as family food environment, feeding practices, restriction for certain foods,
pressure to eat and adaptation to certain foods also influence eating habits of children
(Kersting, Alexy, and Schürmann, 2016). Rewards from parents also plays important role in
developing good food habits among children. Family members, specifically parents, are an
important reference for children’s food habit (Noughani, Bagheri, and Ramim, 2014). Even
though children can decide upon which food to accept or reject; parents can decide upon
which food to offer to children. It indicates, parents’ can have both positive and negative
influence on the food habit of their children. Parents behaviour, attitude, behaviour and food
satisfaction of parents also influence eating behaviour of children. In the recent years, dietary
habits of children are extensively studied through investigation of dietary habits of parents,
their knowledge, their perceptions and beliefs about the diet (de Ruiter, Olmedo-Requena,
and Jiménez-Moleón, 2017).
Obesity is more prevalent in children between 2-5 years age due to consumption of junk food
such as sweetened beverages, fast foods, refined grains, processed meats, desserts, pizza, fries
potatoes and sweets. It is evident that there is a positive correlation between high body mass
and consumption of high nutrient, high energy, high glycaemic load food and low fibre (Fox
et al., 2009; Datar and Nicosia, 2012). BMI is the main parameter for the assessment of
obesity. WHO stated that people with BMI values such as 30, 35 and 40 represent moderately
obese, severely obese and very severely obese respectively. In children also, BMI is
calculated with same method; however, it is being compared to the other children of similar
age group. Junk food constitutes approximately 15-40 % higher energy intake in children. It
has been estimated that children consuming junk food have 190 calories more energy intake
as compared to the children not consuming junk food (Payab et al., 2015).
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Studies reported that obesity is more prevalent in children consuming processed
carbohydrates and saturated fat in comparison to the sugar-free and low-fat diet. Abdominal
obesity is prevalent in approximately 15% of the children. Increase in childhood obesity
resulted in the increased prevalence of non-communicable diseases among these children
(Costa, Del-Ponte, Assunção, and Santos, 2018). Experts attributed this epidemic to fast food
and junk food consumption in India. Dental cavity is another complication which can occur
due to consumption of food containing more amount of sugar. Parents can play significant
role in the prevention of childhood obesity (Polfuss, Simpson, Neff Greenley, Zhang, and
Sawin, 2017). However, there is scarcity of literature to improve engagement of parents
specifically mothers in the prevention of childhood obesity. Few of the interventions were
focused on engaging parents in improving healthy food consumption and reducing childhood
obesity. However, these were associated with barriers such as cultural issues, family stressors
and lack of sustained impact and high dropout rate during intervention (Skelton and Beech,
2011). Hence, this study was undertaken to understand the knowledge and perception of
mothers about healthy eating and to provide them education about healthy eating in rural
India.
Research question:
1. What is level of knowledge and awareness of mothers of 2-5 years age children about
healthy food to their children?
2. What is the effect of improvement in the knowledge and awareness of mothers of 2-5
years age children on obesity rate ?
Goals:
Short-term goals decided for this study include improvement in knowledge and awareness
among parents of children 2-5 years old. Long-term goals decided for this study include
improvement in consumption of healthy food and the reduction in obesity.
Aims and objectives:
Aim of this healthy eating health promotion was to promote the consumption of healthy
eating, making better food choices and reducing unhealthy eating behaviour among children
of 2-5 years age.
Objectives:
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