271 - Dosage Effects in A Mindful Eating Intervention among Economically Marginalized Preschoolers

Publication Number: 271.4577

Jiying Ling, Michigan State University College of Nursing, East Lansing, MI, United States; Yingcen Xie, Michigan State University College of Nursing, East Lansing, MI, United States; Hannah Lalonde, MSU College of Nursing, East Lansing, MI, United States; Tsui-Sui A.. Kao, Michigan State University College of Nursing, East Lansing, MI, United States

Background: To address the urban-rural and socioeconomic disparities in childhood obesity, a mindful eating intervention was developed for rural preschoolers from economically marginalized families.

Objective: Recognizing the limited understanding of dose-response effects in mindful eating interventions, this study investigated the relationships between intervention doses and their effects on reducing body mass index (BMI), BMI z-score, percent body fat, dietary intake, food insecurity, and child feeding attitudes and practices among preschoolers.

Design/Methods: A one-group pragmatic trial with pretest-posttest was conducted in 26 Head Start childcare classrooms in the Midwestern U.S. The 14-week “Eat My ABC” mindful eating intervention comprised 14 lessons taught by childcare teachers and 14 letters sent to parents to share the lessons learned in childcare. All outcomes were assessed at baseline and post-intervention. Data were analyzed using linear mixed-effect models with R studio.

Results: A total of 195 preschoolers (Mage=47.53 months) participated, with 7.7% being Hispanic and 9.7% being multiracial. Among their parents, 53.5% had a high school degree or less, 33.7% were single, and 42.2% were unemployed. Additionally, 35.3% of the families reported an annual income below $20,000. On average, preschoolers attended 11 lessons and completed 11 letters. The number of lessons attended and letters completed had significant L- or U-shaped relationships with preschoolers’ BMI, BMI z-score, and parents’ perceived child weight at post-intervention. The optimal doses were 10 lessons and 10 letters for reducing preschoolers’ BMI and BMI z-score, and 7 lessons and 7 letters for decreasing parents’ perceived child weight. Although not statistically significant, higher doses were negatively related to preschoolers’ percent body fat, sweet intake, parents’ perceived responsibility for child feeding and pressure to eat. Meanwhile, increased doses were positively associated with preschoolers’ skin carotenoid levels, vegetable intake, household food security, and parents’ concerns about child weight, as well as their restriction and monitoring of child eating.

Conclusion(s): The results suggest that a 7–10-week mindful eating intervention may be the optimal duration for preventing childhood obesity. These findings can help inform the selection of an appropriate intervention dose in future research. To further validate these optimal doses, future research could employ a factorial design or a Sequential Multiple Assignment Randomized Trial.

Predicted non-linear relationship between child lesson and preschoolers’ BMI z-score
Predicted BMI z-score = 1.22 + 0.01*Lesson² - 0.24*Lesson
Optimal Dose = 10.01 lessons


Predicted non-linear relationship between child letter and preschoolers’ BMI z-score
Predicted BMI z-score = 1.23 + 0.01*Letter² - 0.23*Letter
Optimal Dose = 10.32 letters

Predicted non-linear relationship between child lesson and parents' perceived child weight
Predicted Perceived Child Weight = 0.82 + 0.003*Lesson² - 0.05*Lesson
Optimal Dose = 7.20 lessons

Predicted non-linear relationship between child lesson and preschoolers’ BMI z-score
Predicted BMI z-score = 1.22 + 0.01*Lesson² - 0.24*Lesson
Optimal Dose = 10.01 lessons


Predicted non-linear relationship between child letter and preschoolers’ BMI z-score
Predicted BMI z-score = 1.23 + 0.01*Letter² - 0.23*Letter
Optimal Dose = 10.32 letters

Predicted non-linear relationship between child lesson and parents' perceived child weight
Predicted Perceived Child Weight = 0.82 + 0.003*Lesson² - 0.05*Lesson
Optimal Dose = 7.20 lessons