The effect of the home environment on physical activity and dietary intake in preschool children.

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BACKGROUND: The effects of the home environment on child health behaviors related to obesity are unclear. PURPOSE: To examine the role of the home physical activity (PA) and food environment on corresponding outcomes in young children, and assess maternal education/work status as a moderator. METHODS: Overweight or obese mothers reported on the home PA and food environment (accessibility, role modeling and parental policies). Outcomes included child moderate-vigorous PA (MVPA) and sedentary time derived from accelerometer data and two dietary factors ('junk' and healthy food intake scores) based on factor analysis of mother-reported food intake. Linear regression models assessed the net effect (controlling for child demographics, study arm, supplemental time point, maternal education/work status, child body mass index and accelerometer wear time (for PA outcomes)) of the home environment on the outcomes and moderation by maternal education/work status. Data were collected in North Carolina from 2007 to 2011. RESULTS: Parental policies supporting PA increased MVPA time, and limiting access to unhealthy foods increased the healthy food intake score. Role modeling of healthy eating behaviors increased the healthy food intake score among children of mothers with no college education. Among children of mothers with no college education and not working, limiting access to unhealthy foods and role modeling reduced 'junk' food intake scores whereas parental policies supporting family meals increased 'junk' food intake scores. CONCLUSIONS: To promote MVPA, parental policies supporting child PA are warranted. Limited access to unhealthy foods and role modeling of healthy eating may improve the quality of the child's food intake.





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Østbye, T, R Malhotra, M Stroo, C Lovelady, R Brouwer, N Zucker and B Fuemmeler (2013). The effect of the home environment on physical activity and dietary intake in preschool children. Int J Obes (Lond), 37(10). pp. 1314–1321. 10.1038/ijo.2013.76 Retrieved from

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Rebecca Brouwer

Dir, Research Initiatives

My overarching goal is to facilitate effective research and collaborations for the Duke research community, through the delivery of targeted programs, tools, and individual consultations.


Nancy Lee Zucker

Professor in Psychiatry and Behavioral Sciences

Our laboratory studies individuals who have difficulty detecting, interpreting, and/or using signals from their body to guide adaptive behavior towards themselves and their environment.  We explore how disruptions in these capacities contribute to psychosomatic disorders such as functional abdominal pain or anorexia nervosa and how the adaptive development of these capacities helps individuals to know themselves, trust themselves, and flourish.

Our primary populations of study are individuals struggling with eating disorders and feeding disorders of childhood: conditions that are sine quo non for dysregulation of basic motivational drives or conditions in which disruption in these processes may be more likely: such as the presence of pediatric pain. Several conditions are of particular focus due to the presence of profound deficits in interoception or/and integration of internal arousal: anorexia nervosa, a disorder notable for extreme, determined, rigid, and repetitive behaviors promoting malnourishment and the inability to use signals of interoception and proprioception in the service of goal-directed actions, Avoidant Restrictive Food Intake Disorder (ARFID), children with "sensory superpowers" who may be hypersensitive to somatic signals and external sensory features; and pediatric functional abdominal pain, children who may become afraid of their bodies' messages due to generalization of fear of pain to innocuous sensations. Study of children allows us to ask different questions about disorder etiology, maintenance, and course as we can minimize the impact of malnutrition on brain function and perhaps better characterize prior learning history. What we most passionate about is using this conceptualization to design and test novel treatments that enable individuals across the lifespan to feel safe in their bodies and to achieve this in a way that is fun.

Our parallel line of research examines how individuals’ sense others when they have difficulties sensing themselves. Increasing evidence suggests that we understand others via embodied enactments of our own experiences. These findings have profound implications for individuals who have dysfunction in the experience of their bodies as it suggests limited capacities to truly understand others’ experiences. By studying these processes in parallel, we hope to better understand how this interaction between sensing ourselves and others unfolds.

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