Lori Stark | University of Cincinnati College of Medicine (original) (raw)

Papers by Lori Stark

The Journal of pediatrics, 2018

To examine whether feeding patterns from birth to age 6 months modify the association between bir... more To examine whether feeding patterns from birth to age 6 months modify the association between birth weight and weight at 7-12 months of age. Longitudinal mixed models were used to examine feeding trajectories across categories of birth weight and weight at 7-12 months of age in 1799 mother-infant dyads enrolled in the Infant Feeding Practices Study II. The percentage of breast milk received and the average daily formula consumption were calculated from birth to 6 months of age. Birth weights were classified as high (≥4000 g) and normal (≥2500 g and <4000 g). Weights at 7-12 months of age were categorized as high (z score >1) or normal (z score ≤1). A secondary analysis was performed using categories defined by birth weight adjusted for gestational age percentiles (>90% and 10th-90th percentile). High birth weight (HBW) infants with high weights at 7-12 months of age demonstrated a rapid decline in the percentage of breast milk feedings compared with HBW infants with normal ...

Sleep

High birth weight (HBW; ≥ 4000g) is strongly associated with later overweight, yet little is know... more High birth weight (HBW; ≥ 4000g) is strongly associated with later overweight, yet little is known about how to disrupt this trajectory. The current study examined sleep practices during infancy and toddlerhood among children born HBW or normal birth weight (NBW; 2500-3999g). Latent growth curve models were used to examine sleep during infancy and toddlerhood among 270 mother-child dyads enrolled in the Health Outcomes and Measures of the Environment Study. Total sleep duration in 24-h, sleep maintenance, and restlessness/vocalizations were collected at 6-month intervals between ages 6 to 24 months. Height and weight were obtained at ages 24 or 36 months, and normal and overweight BMI was derived. Sleep was examined among children with a normal BMI during the preschool years who were either HBW (HBW-Normal, n=36) or NBW (NBW-Normal, n=184) compared with overweight preschoolers (Overweight, n=50). It was predicted that the Overweight group would have poorer sleep across infancy and toddlerhood compared to HBW-Normal and NBW-Normal. HBW-Normal had the longest and Overweight had the shortest mean 24-h sleep duration across all time points with NBW-Normal falling in-between the two groups. Compared to Overweight, HBW-Normal exhibited longer 24-h sleep duration at age 6 months with this group difference maintained over infancy and toddlerhood. No group difference was found for NBW-Normal. A longer sleep duration in the first several years of life is associated with development of normal BMI among HBW children. These findings suggest that longer sleep duration may protect HBW children from becoming overweight.

Journal of pediatric psychology, Jan 17, 2017

National health organizations and expert committees have issued recommendations for health behavi... more National health organizations and expert committees have issued recommendations for health behaviors related to obesity risk. Behavioral and family-based weight management interventions for preschoolers often target improving adherence to these recommendations, but it is unknown how the health behaviors of preschoolers with obesity enrolled in weight control treatments (WCTs) compare with these guidelines. In this study, the dietary intake, activity, and sleep behaviors of preschoolers with obesity enrolled in a family-based behavioral WCT are described and compared with national health behavior recommendations. Health behaviors of 151 preschoolers with obesity (M age = 4.60, SD = 0.93) enrolled in a clinical trial of a weight management program were measured at baseline through caregiver-report questionnaires, three 24-hr dietary recalls, and accelerometers. In total, 70% of the sample exceeded daily caloric recommendations, only 10 and 5% met recommendations for fruit and vegetabl...

Appetite

The reinforcing value of food is an important determinant of food intake. Research has yet to exa... more The reinforcing value of food is an important determinant of food intake. Research has yet to examine the relative reinforcing value (RRV) of snack foods in young children with overweight and obesity (OW/OB). The current study compared the RRV of high-energy dense foods (cookies) to low-energy dense foods (fruits) between preschoolers with OW/OB and healthy weight (HW). RRV of cookies and fruits in preschoolers with OW/OB (n = 30; Mage = 4.4 ± 0.84; 60% male) and HW (n = 30; Mage = 4.5 ± 0.85; 70% male) was assessed with a developmentally-tailored computer program which used a progressive fixed ratio reward schedule. The results showed that the RRV of cookies was significantly higher for preschoolers with OW/OB compared to HW while the RRV of fruits was significantly higher for preschoolers with HW compared to OW/OB. These results suggest that cookies are more reinforcing for preschoolers with OW/OB and less reinforcing for preschoolers with HW. Finding ways to reduce the reinforcing value of high-energy dense snack foods and identify alternatives that are as reinforcing for preschoolers is a challenge for weight control treatments.

Advances in nutrition (Bethesda, Md.), Jul 1, 2016

Family meals are associated with a range of positive outcomes among children and adolescents. The... more Family meals are associated with a range of positive outcomes among children and adolescents. There is inconsistency, however, in the way in which studies have defined and measured family meals. Therefore, a systematic review of the literature was conducted to determine how studies describe family meals with the use of structural characteristics. The current review focused on studies in the United States that included children ages 2-18 y. A total of 33 studies were identified that characterized family meals with the use of ≥1 of the following structural features: frequency or mean number of family meals per week, length of family meal, people present at meal, and where meals occurred. No study characterized family meals by using all 4 family meal features, whereas most studies (81%) characterized family meals by using frequency or mean number of meals per week. Findings not only provide an initial understanding of the structural features used to define family meals but also point t...

The Journal of pediatrics, Jan 22, 2016

To examine referral by primary care providers (PCPs) of preschool children with obesity (≥95th pe... more To examine referral by primary care providers (PCPs) of preschool children with obesity (≥95th percentile for body mass index [BMI]) to a weight management intervention when offered through a randomized clinical trial (RCT), and identify reasons for not referring children. In phase I, 3 experts in obesity, psychology, and nutrition completed an open card sort and classified PCPs' reasons for declining referral into groups based on similarity of reasons. Categories were then defined and labeled. In phase II, 2 independent sorters placed each decline into 1 of the categories defined in phase I. PCPs referred 78% of eligible children to the RCT. Compared with children declined for referral, referred children had a significantly higher weight (48.4 lb vs 46.1 lb; P < .001) and BMI percentile (97.6 vs 97.0; P < .001). Eleven categories for decline were identified in phase I. In phase II, excellent reliability was obtained between each independent sorter and the phase I categori...

Pediatrics, Feb 1, 1995

To investigate calorie intake, behavioral eating styles, and parent perception of eating behavior... more To investigate calorie intake, behavioral eating styles, and parent perception of eating behavior of preschool children with cystic fibrosis (CF) compared with healthy peers. A two group comparison study. A clinical sample of 32 preschool children with CF (aged 2 to 5 years) and a community sample of 29 healthy peers matched for age and socioeconomic status. The two groups did not differ on the total number of calories consumed per day or the percentage of calories derived form fat. The CF sample achieved a significantly higher percent of the recommended daily allowance (RDA) of energy (95% RDA) than the control group (84% RDA), P < .05, but did not achieve the CF dietary recommendations of 120% RDA. On measures of behavioral eating style, the CF sample had significantly longer meals (24.63 min) than the control group (18.57 min), P < .01, but did not differ on pace of eating or calories consumed per bite. On a measure of parent report of mealtime behavior, parents of the CF sample identified mealtime behaviors of "dawdles" and "refuses food" as more problematic (M = .93) than parents of control children (M = .22), P < .05. While preschool children with CF consume as much or more than healthy peers, they are not achieving the CF dietary recommendations. Furthermore, there appear to be behavioral differences in eating and parent perception of CF children's eating that may contribute to the failure to achieve dietary recommendations.

Pediatric Clinics of North America, 2016

Developing interventions targeting obesity reduction in preschoolers is an emergent area. Althoug... more Developing interventions targeting obesity reduction in preschoolers is an emergent area. Although intensive, multicomponent interventions seem a promising approach to preschool obesity reduction, this review identifies and discusses approaches to 3 critical gaps (poor reach to families from low-income and minority backgrounds, lack of sufficient evidence to determine the most effective and efficient treatment components and approaches to treating obesity in early childhood, and lack of consensus on how best to discern intervention effectiveness) that need to be addressed to advance the preschool obesity literature.

Http Dx Doi Org 10 1080 02739610701766891, Feb 14, 2008

Advances in Psychosomatic Medicine, Feb 1, 1988

Journal of Abnormal Child Psychology, Aug 1, 1988

Primates, 1982

Abstract Initial results of a small pilot project indicate thatCebus monkeys have the potential t... more Abstract Initial results of a small pilot project indicate thatCebus monkeys have the potential to serve as animal aides for quadriplegics. During the course of the pilot project the investigators developed a set of procedures for teaching aCebus monkey a variety of ...

Journal of Clinical Psychology in Medical Settings, 2006

Relations among weight, calcium, and milk have received considerable attention, but inconsistenci... more Relations among weight, calcium, and milk have received considerable attention, but inconsistencies remain regarding strength and direction of associations. Calcium, milk, other beverages, and weight status associations were examined among children &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;75th BMI percentile from three studies. Results indicated negative relations between z-BMI and non-whole milk and calcium in one sample, with lower z-BMI and percent body fat among older

Appetite, 2016

This pilot study investigated the impact of a parent-child dyad cooking intervention on reducing ... more This pilot study investigated the impact of a parent-child dyad cooking intervention on reducing eating dinner away from home. Eating away from home often results in consumption of energy-dense, nutrient poor foods that can contribute to excess energy consumption in children. A pre-post design to evaluate a 10-week cooking intervention on reducing eating dinner away from home, energy intake, and improving diet quality. The intervention was delivered at an instructional kitchen on a university campus and assessments were completed at a children&amp;#39;s academic medical center. Subjects included six parent-child dyads whom reported eating dinner away from home ≥3 times/week and in which the parent was overweight based on their body mass index (BMI) of ≥25 kg/m(2). Parents were a mean age of 34.7 (SD = 3.9) years, and children were a mean age of 8.7 (SD = 2.0) years. Two-thirds of parents self-identified themselves and their children as White. Results showed the proportion of dinners consumed by parent-child dyads away from home significantly decreased (F (1,161) = 16.1, p &amp;lt; 0.05) from 56% at baseline to 25% at post-treatment. Dyad cholesterol intake at dinner also significantly decreased over time; however, changes in energy intake, total fat, saturated fat, and sodium at dinner were not significant. A large effect size was found for changes in parent ratings of enjoyment of cooking between baseline and post-treatment. A cooking intervention that involves parent-child dyads and incorporates behavior management strategies and nutrition education may be an innovative obesity prevention intervention.

Children S Health Care, Jun 7, 2010

ABSTRACT

Journal of Pediatric Psychology

Appetite, 2015

This study sought to understand barriers and facilitators for preparing and eating dinner at home... more This study sought to understand barriers and facilitators for preparing and eating dinner at home in families who report eating dinner away from home ≥3 times per week. Cross-sectional, mixed methods (focus groups, questionnaires) study. Twenty-seven parents with a child 3-10 years-old who reported eating dinner away from home ≥3 times per week from a pediatric medical center in the Midwest participated. The key concepts analytic framework guided focus group analysis. Descriptive statistics were used to characterize parent demographics, anthropometrics, attitudes and confidence toward cooking, perceptions of dinner costs and portions, and parent and child dinners. Parents reported confidence in cooking a home prepared meal, but that eating away from home was reinforcing because it provided quality family time and diminished barriers such as picky eating and perceived costs. Home cooking was also hindered by early school lunch and after-school sports as children were not hungry or home at the typical dinner hour and parents did not want to cook after 8pm. Parents estimated preparing and eating a meal at home took significantly more time than driving and eating out (80.7 min vs. 30.3 min, p &amp;amp;amp;amp;amp;lt; 0.001). Parents significantly (F (3, 104) = 8.80, p &amp;amp;amp;amp;amp;lt; 0.001) overestimated the cost of home-prepared meals compared to take-out and frozen meals. Portion size was also overestimated for a protein serving. Findings are limited to predominantly married, female parents whom are highly educated and working. To reduce eating out, interventions should address family factors (e.g., time management, quality time) and child behavior (e.g., picky eating). Innovative interventions that include experiential cooking opportunities that incorporate time management, address picky eating and enthusiasm for cooking with education on decreasing costs may be particularly beneficial for middle-to high-income families.