The Eat Right Emirates Healthy Lifestyle Study
Condition: Childhood Obesity; Dietary Habits
MeSH terms: Obesity; Pediatric Obesity
Study type: Interventional

Summary: 
      The aim of the present study was to investigate the potential factors that determine
      preschool obesity in Al Ain, United Arab Emirates, and assess the effectiveness of a simple
      healthy lifestyle tool: Eat Right Emirates (ERE) adapted from the Ten Steps for Healthy
      Toddlers, produced in the UK by the Infant and Toddler Forum.
    

Detailed description: 
      Study Aims

      The aim of this study is to identify social, developmental and dietary risk factors, which
      predispose to obesity in preschool Emirati children and to assess the effectiveness of a
      simple healthy lifestyle tool: Eat Right Emirates (ERE) adapted from the Ten Steps for
      Healthy Toddlers, produced in the UK by the Infant and Toddler Forum using an RCT study
      design.

      Primary Research Questions

        1. Do dietary patterns influence obesity risk in Emirati children aged 3-4 years?

        2. Are dietary and other behaviours associated with obesity risk in Kuwaiti preschool
           children?

        3. Are developmental factors, associated with obesity risk in Emirati preschool children?

      Secondary Research Questions

      1. Does a healthy lifestyle intervention improve eating behaviour and physical activity in
      Emirati preschool children?

      Investigation Plan

      Determinants of obesity in children aged 3-4 years attending preschool centres in UAE will be
      investigated within a cross-sectional observation study. Dietary intake will be assessed
      using food records and questionnaires. These will be analysed to give information on dietary
      patterns and nutritional intake. Developmental factors, such as infant feeding and growth
      patterns and other lifestyle behaviours that may influence obesity risk, such as physical
      activity and food related behaviours, will also be evaluated using questionnaires. Obesity
      will be assessed using non-invasive methods to measure body size and fatness. Risk factors
      for CVD including blood pressure and pulse wave velocity will also be assessed using
      non-invasive methods.

      The same infants and mothers will be followed-up one year later to allow:

        1. Investigation into tracking of risk factors in preschool children.

        2. Study of the impact of risk factors on change in BMI during the preschool period.

      The cohort will then provide a resource to investigate the determinants of obesity in
      preschool children from UAE.

      Recruitment

      The study population of preschool children will be recruited from an existing sub-sample of
      parents who took part in a previous study in Al Ain district, Abu Dhabi. The study population
      will therefore be representative of the general Emirati population. Parents will be contacted
      prior to the study, with permission from the Ministry of Health.

      Data collection

      The potential determinants of obesity in preschool Emirati children (exposures) and effects
      on obesity and risk factors for CVD (outcomes) will be investigated as detailed below. Data
      will be collected at baseline and at follow up one year later. All measurements will be
      undertaken by trained team members and performed according to the UCL CNRC standard
      operational procedures.

      All testing procedures will take place on the school premises with parents present.

      Exposures

      Exposures investigated in this study include growth patterns, infant/child feeding practices,
      dietary patterns, appetite characteristics and dietary behaviours .

      Dietary Patterns and Intake

      Dietary patterns in mothers and children will be assessed using a food frequency
      questionnaire (FFQ). Mothers will also be asked to complete a 5-day food diary representative
      of their child's usual diet at study baseline and one-year follow up. Diaries will be
      analysed for all nutrients with UK dietary reference values using dietary analysis software
      based on food composition data from the 6th edition of McCance and Widdowson's composition of
      foods.

      Medical History and Sociodemographic Factors

      Information on child and parental sociodemographic characteristics and medical history will
      be collected using questionnaires. Parental anthropometry will be measured where possible to
      give a measure of genetic exposures.

      Lifestyle Practices

      Parental and child diet will be assessed using validated questionnaires.

      Outcome measures:

      Anthropometry Cardiovascular health
    

Intervention name(s): Ten Steps leaflet advice for healthy lifestyle
Intervention type(s): Behavioral
Intervention description(s): Ten steps leaflet advice for healthy lifestyle
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Prevention
Keywords: Overweight; Obesity; Preschool children; United Arab Emirates; Dietary patterns; BMI z-scores