Enhancing the quality of Family Child Care Home (FCCH) meals is an opportunity to impact children's diet and health. The purpose of this study is to assess Happy Healthy Homes (HHH) randomized controlled trial impact on health-related foods and nutrients served to and consumed by young children and achievement of Child and Adult Care Food Program (CACFP) requirements and best practices. Forty-five CACFP participating FCCHs in a moderately sized midwestern city were recruited in 2017-2018 and randomized to nutrition intervention (NUT = 24) or control (CON = 21). Participants received two in-home, individual 90-minute education sessions, one 3-hour small group class, and a 15-minute check-in phone call over 3 months. Outcomes include 3- and 12-month served and consumed fiber, sugar, grains, vegetables, and fruit and achievement of CACFP Best Practices. Primary analyses at 12 months used a mixed model under an intent-to-treat paradigm to account for repeated measures on participants with 3-month outcomes. Sensitivity analyses were completed on those with complete 12-month measures. There were no statistically significant group-by-time effects for foods served, consumed, or CACFP Best Practices score in the primary analysis. However, in sensitivity analysis, the CACFP Best Practice score (out of 18) increased in NUT +0.5 from 8.9 ± 1.5 at baseline at 12 months and decreased -0.9 in CON from 9.9 ± 1.7 at baseline, group by time = 0.05. The HHH intervention did improve the CACFP Best Practices score for lunches served. The study's effect may have been limited due to sample size and attrition. Clinicaltrials.gov, NCT03560050. Retrospectively registered on 23 May 2018. First participant enrolled October 2017.

Family style meal service is a nationally endorsed best practice. However, implementation in family child care homes (FCCHs) is low because child care providers are worried that it could increase plate waste. To examine this perceived barrier, the study aims to investigate the association between family style meal service and plate waste in FCCHs in Nebraska. In this cross-sectional study, the participants included FCCH providers ( = 46) in Nebraska and 3-5-year-old children attending these FCCH settings ( = 146). Providers were given a family style meal service score using 11 items from the Mealtime Observation in Child Care tool. Children's plate waste data over the observed lunchtime were collected using the Dietary Observation in Child Care method. We conducted multivariate, multilevel regression analyses in SAS (v9.4) to assess the relationship between family style meal service score and children's plate waste, while controlling for child-level characteristics and accounting for FCCH setting-level effects (ICCs 11.3%-31.2%). Increase in family style meal service score was associated with a decrease in vegetable waste ( = -4.7, = 0.03), fruit waste ( = -3.6, = 0.03), and protein waste ( = -4.2, = 0.02). Dairy and grain waste were not associated with family style meal service score. A higher family style meal service score was associated with a 3%-5% reduction in plate waste for three food groups. These findings warrant further research examining the effect of interventions promoting family style meal service in child care on improving children's dietary intake and reducing plate waste.

Child overweight and obesity is a critical global health issue with substantial individual and societal impacts necessitating early intervention to establish healthy habits. Health promoting early childhood education (ECE) settings are important as most young children attend ECEs in high- and middle-income countries. Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) is an evidence-based approach to support improvements to ECE environment for improving child health. While adapting proven child obesity prevention interventions from other countries offers efficiency, the process is frequently underreported and insufficiently documented. Guided by the ADAPT framework, this article describes the adaptation of NAPSACC in the United States (US), Australia (AU), and the United Kingdom (UK) from 2012 to 2023. Contextual differences in ECE systems in the US, AU, and UK and reflections on the process of adaptation were explored. NAPSACC was successfully adapted, maintaining core theoretical components while allowing for implementation flexibility to meet varying contexts. The iterative adaptation process revealed that a flexible dynamic approach was essential for maintaining the relevance and effectiveness of the NAPSACC intervention in different contexts. Our experience highlights the importance of ongoing iteration, international collaboration, research, and responsiveness to evolving circumstances in adaptation processes. Strong and flexible leadership, such as that demonstrated by NAPSACC's founder, Dr. Dianne S. Ward, facilitates successful adaptation and continuous improvement of public health programs. Trial registration: This paper includes multiple registered trials - NCT02889198, ACTRN12619001158156, ISRCTN16287377, and ISRCTN33134697.

Early childhood interventions that support the development of healthy lifestyle behaviors are key to ensuring equitable health outcomes later in life. The aim of this article is to assess the extent to which early care and education (ECE) sites adopt best practices to support healthy diet and physical activity (PA) behaviors and whether adoption differs between centers and family child care homes (FCCHs). The study is a cross-sectional analysis of best practices at Supplemental Nutrition Assistance Program-Education (SNAP-Ed)-eligible child care centers ( = 76) and FCCHs ( = 47) in California. Generalized linear models were used to estimate associations of facility type with eight best practice index measures in the following three areas: dietary intake (nutrition education, food and beverage quality, staff training in nutrition), PA (quantity of PA opportunities, quality of PA opportunities, environmental support for PA), and parent engagement and wellness policies (comprehensive, active parent engagement and support for wellness policy implementation, monitoring, and feedback). Overall, ECE sites scored an average of 64.8% of maximum points possible for best practices to improve dietary intake, 81.7% for best practices to improve PA, and 51.8% in comprehensive parent engagement and wellness policies. FCCHs adhered to fewer best practices for robust nutrition education, relative to centers (β = -0.41, 95% CI [-0.70, -0.12]). Differences were also observed in individual practices between settings. This study highlights opportunities for programs such as SNAP-Ed to support ECE providers in implementing nutrition and PA best practices to help children ages 0-5 develop healthy habits.

Head Start (HS) is the largest federally funded early childhood education program in the United States. It prepares children socially, emotionally, and academically and sets the foundation for school readiness and academic success. In 2024, the Head Start Program Performance Standards were updated to provide enhanced support and workforce stability, including improvements in health and wellness. This study assessed the availability, participation, satisfaction, and interest in Workplace Wellness Programs (WWPs) for HS educators. An electronic survey was sent to nearly 74,000 HS grantees and educators; 2,611 complete surveys were included in the analysis. Descriptive analyses examined the availability, participation, satisfaction, and interest in WWPs, and multivariate regression analyses identified factors associated with WWP participation. Approximately 71% of HS educators reported access to at least one WWP. The most common programs available were health education and promotion (51%), stress management (25%), and healthy lunch and snack options (20%). Participation rates for available programs ranged from 6% to 93%, and interest in unavailable programs ranged from 40% to 93%. Job dissatisfaction was associated with lower odds of participating in any WWP or in health education and wellness programs. Receipt of community food assistance was associated with lower odds of participating in nutrition and stress management programs. There is considerable variability in availability, participation, and interest in WWPs among HS educators. Research is needed to understand if expression of interest would translate into take-up of WWPs, identify strategies to reduce barriers, and increase participation.

Although racial, ethnic minorities, and immigrants are more likely to have poor diet-related health outcomes, few studies have compared children's dietary quality across diverse households, which is the formative step to designing targeted interventions. The current study evaluates and compares the dietary quality of young children from diverse racial, ethnic, and immigrant households in Nebraska. Cross-sectional survey data were collected from adults living in Nebraska with at least one 2-6-year-old child residing in their household via an online survey regarding their federal assistance program participation and dietary quality of child(ren) residing in their household, measured using the short Healthy Eating Index (sHEI). With nearly two-third participating in a federal assistance program, the sample includes respondents from diverse households ( = 1,277) including first-generation immigrant ( = 61), non-immigrant Hispanic ( = 538), non-immigrant non-Hispanic White ( = 509), non-immigrant non-Hispanic Black or African American ( = 120), and non-Hispanic American Indian or Native Hawaiian ( = 49). Based on analysis of covariance controlling for demographic variables, children from immigrant households had lower mean sHEI score 43.9 as compared to non-immigrant Hispanic 46.4, non-immigrant non-Hispanic White 47.1, non-immigrant non-Hispanic Black or African American 50.2, and non-Hispanic American Indian or Native Hawaiian 48.9. Racial/ethnic/immigrant household group differences were also observed for some sHEI component scores. Children from immigrant and non-immigrant Hispanic households had significantly lower sHEI scores on some subcomponents compared with other groups. Findings emphasize the need for additional research and culturally responsive multilevel nutrition interventions.

Prebiotic fiber has been examined as a way to foster gut bacteria less associated with obesity. Tests of prebiotic fiber in reducing obesity have occurred mainly in animals, adults, and Caucasians when the highest obesity rates are in African American and Latinx youth. Response to prebiotic fiber is determined by the pre-existing intestinal microbiota. The type of microbiota varies based on diet and physical activity (PA), so it is important to examine acceptability and response to prebiotic fiber in those most at risk for obesity. This cluster randomized controlled feasibility trial included an online program designed to improve diet and PA along with administration of prebiotic fiber for 12 weeks in 123 4th and 5th grade students where 98% were eligible for free or reduced fee lunch. Of these 56% were male; 71% Latinx; 15% African American; and 14% Other. A decrease in body fat (BF) was associated with higher pre-test BF. Lower BMI was associated with a decrease in fecal and an increase in . Prebiotic fiber was evaluated in additional studies. Determining those most responsive to prebiotic fiber can also permit individual recommendations for greater inclusion in usual diet choices.

We aimed to quantify associations of cardiovascular (CV) large and small artery measures with body composition and body mass (1) separately and (2) in combination in 11- to 12-year-old children and their parents. In the population-based cross-sectional Child Health CheckPoint study (1495 children, mean 12 ± 0.4 years, 49.3% girls; 1496 parents, mean 44.3 ± 5.0 years, 86.7% mothers), we measured weight, height, body composition [truncal fat, non-truncal fat, fat-free mass (FFM)], and CV functional (blood pressure, pulse wave velocity, arterial elasticity) and structural (carotid intima-media thickness, retinal arteriolar/venular caliber) outcomes. Using compositional data analyses, we examined associations of body composition (expressed as log ratios) and body mass (multiplicative total) with CV measures in separate and combined models. Mean BMI z-score was 0.3 in children [standard deviation (SD) 1.0, 4.5% obese], and mean BMI was 27.9 in parents (SD 6.1, 28.8% obese). In both children and adults, more adverse CV measurements were associated with higher %truncal fat, %non-truncal fat, and body mass and lower %FFM. Compared with normal-weight children, children with obesity had poorer CV measures (e.g., 1 SD faster pulse wave velocity, 0.5 SD lower arterial elasticity), with higher body mass and lower %FFM mainly accounting for these relationships. All relationships were similar, albeit larger, for parents. Poorer CV health in both generations was associated with higher body mass, lower %FFM, and, to a lesser extent, higher %truncal and non-truncal fat. Trials could test whether weight reduction interventions with vs. without FFM preservation differentially improve CV functional and structural precursors.

Direct observation (DO) tools developed for preschoolers have been used to describe toddler physical activity (PA). No DO system created to assess PA levels and the childcare environment of toddlers exists. The purpose of this study was to develop the Observational System for Recording Physical Activity in Children-Toddlers (OSRAC-T) and assess the inter- and intra-rater reliability. This tool is an extension of the Observational System for Recording Physical Activity in Children-Preschool and uses the same focal child, time sampling system (5-second observation and 25-second recording). Tool content was established through identifying similar research, consulting with experts, and conducting informal observations. A sample of toddlers (12-36 months) was observed and video recorded during childcare. In-person observations were compared to video observations from one coder (intrarater reliability). Video observations (39% of intervals) were coded by two raters to determine interrater reliability. The final instrument included nine categories that described PA level and type, social and environmental contexts, and transition support relevant to toddlers. Observers completed 124 observation sessions ( = 31; 25.5 ± 6.0 months) resulting in 7,757 30-second observation intervals. Interval-by-interval agreement was moderate to high (58.90%-95.30%) for all categories, and interrater reliability was low to moderate ( = 0.28-0.69). The OSRAC-T is a reliable observation system to assess several PA-related behaviors of toddlers. It may be used to better inform early childcare center design, future intervention studies, or to assess correlates or relationships between PA behavior and health outcomes in toddlers.

Early childhood education (ECE) educators play an instrumental role in children's health and development but unfortunately have poor health themselves. This project examined the physical and psychological health of New York licensed ECE educators. A sequential, explanatory mixed methods design (quan→QUAL) consisted of a 110-item survey and semi-structured interviews to examine physical (diet, physical activity [PA], sleep, and body mass index [BMI]) and psychological health (stress and burnout). Quantitatively, multiple linear regressions tested associations between physical and psychological health, controlling for age and income, using R (v4.3.2, 2023); α < 0.05. Qualitatively, content analysis with pattern recognition for pragmatic synthesis was performed. Survey respondents ( = 1423) and interview participants ( = 36) worked in a variety of ECE settings; 74% had overweight/obesity and 24% deemed themselves "unhealthy." Many had poor health behaviors-low diet quality (74%), limited regular PA (28%), poor sleep quality (34%), and moderate/high stress levels (74%). Most desired changes to health behaviors but were challenged due to work environments and job demands. Work-based factors impacted both their physical and mental health and influenced their personal life. Burnout and stress were high, and feelings of underappreciation were prevalent. Higher burnout (emotional exhaustion) was significantly associated with higher BMI (β = 0.18, < 0.01) and stress (β = 1.09, < 0.01) and lower PA (β = 2.62, < 0.01) and sleep (β = 0.94, < 0.01). ECE educators are experiencing high stress/burnout, have poor health behaviors, and have high prevalence of obesity. Workplace health promotion efforts are needed to improve educators' health and potentially that of the children in their care.

Recent literature proposed an association between physical activity (PA) and carotenoid status due to their overlapping role in mediating oxidative stress. However, this relationship has yet to be explored in young children. This study examined the relationship between objectively measured PA (ActiGraph triaxial accelerometry) and skin carotenoid levels (pressure-mediated reflection spectroscopy) in a sample of 3- to 5-years-old. Fourteen children (44 ± 7 months old, 71% male) from a single child care center were included in this cross-sectional analysis. Linear regression modeling indicated more time spent in PA was associated with higher skin carotenoid scores (β = 3.448, = 0.032). These findings from our pilot study indicate a potential cross-sectional link between physical activity and carotenoid status in young children.

The importance of establishing national surveillance systems to monitor physical activity promotion is well recognized. This article outlines the methodological process undertaken to develop an evaluation rubric for assessing state licensing regulations alignment with the National Physical Activity Plan Education Sector Early Childhood Education (ECE) strategy. This tool offers a cost-effective mechanism for ongoing surveillance of ECE physical activity policies, with the potential to inform modifications that promote uniform standards and establish consistent, high-quality opportunities for the nation's youngest children.

The COVID-19 pandemic has exacerbated the obesity epidemic, with both adults and children demonstrating rapid weight gain during the pandemic. However, the impact of having a COVID-19 diagnosis on this trend is not known. Using longitudinal data from January 2019 to June 2023 collected by the US National Institute for Health's National COVID Cohort Collaborative (N3C), children (age 2-18 years) with positive COVID-19 test results { = 11,474, 53% male, mean [standard deviation (SD)] age 5.57 [±3.29] years, 54% White, mean [SD] 5.2 [±2.9] BMI observations per participant} were matched with COVID-19-negative children with identical demographic characteristics and similar observation window. We compared BMI percentile trajectories between the COVID-19-positive and COVID-19-negative cohorts, with further evaluation performed on COVID-19-positive patients stratified by hospitalization status. COVID-19-positive patients had a greater increase in than COVID-19-negative patients (average increase of 2.34 (±7.73) compared to 1.46 (±6.09), < 0.0005). COVID-19-positive patients gained more weight after their diagnosis of COVID-19 than before. Nonhospitalized children gained more weight than hospitalized children [average increase in of 2.38 (±7.65) compared to 1.87 (±8.54)]. Mixed-effect regression analyses demonstrated that these associations remained even after adjusting for time, demographics, and baseline . Having a COVID-19 diagnosis was associated with more rapid weight gain, especially after diagnosis and early in the pandemic. Future research should explore the reasons for this association and the implications for future health emergencies.

There is need to identify evidence-based early childhood obesity prevention programs that are feasible and demonstrate cost-effectiveness for a broader health impact. This scale-out study leveraged community-engaged principles to compare the feasibility and cost-effectiveness of three delivery modes of a childhood obesity prevention family meals program (Simple Suppers) that demonstrated positive impacts on child and caregiver diet/nutritional health-related outcomes in a previous experimental trial tested among elementary-aged children. This three-arm (in-person, online, hybrid) pre-(T0) and post-(T1)-test study included families recruited from Head Start. Forty-five families (45 caregivers; 55 children) completed the study. The program was adapted to families with younger children (3-5 years). During the 8-week program, participants received weekly group education and meals through in-person, online, or hybrid format. Feasibility outcomes were attendance, acceptability (post-test survey; focus groups), fidelity, and cost (food; staff). Participant outcomes were related to diet/nutritional health. Kruskal-Wallis test was used to compare T0 to T1 differences in participant outcomes across delivery modes. Qualitative data were analyzed using thematic analysis. Cost-effectiveness was calculated as the net-cost of the program by changes in outcomes. Overall attendance was 51.2%, and higher for in-person (72.0%) and hybrid (59.7%). Program satisfaction rate was highest for hybrid (93.0%), as well as program fidelity (96.7%). Focus group results revealed areas of program improvement, behavior change, and program approval. Cost was lowest for hybrid ($17.09/family). Children in the hybrid group had a reduced waist circumference ( = 0.02) versus in-person and online groups. The hybrid mode of Simple Suppers demonstrated the greatest scaling potential for a broader public health impact.

Relationships between gonadotropins, sex hormones, and vascular structure and function in adolescents of varying weight statuses have not been fully investigated. In the present study, we examined associations among these in female and male adolescents with normal weight or obesity. We performed a cross-sectional analysis of adolescents ( = 58; 12-<18 years) grouped according to BMI percentile (BMI%) into normal weight (5th-<85th BMI%; = 25) and obesity (≥95th BMI%; = 33) categories. Fasting blood samples were collected to measure follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, and estradiol. Vascular function was measured via ultrasonography for measures of carotid artery diameter compliance (cDC), incremental elastic modulus (cIEM), and brachial artery flow mediated dilation (FMD). Females with obesity had a significantly ( = 0.009) greater mean FMD compared with those with normal weight. FSH, LH, testosterone, and estradiol did not differ between normal weight and obesity groups in either sex. After adjusting for age and multiple comparisons, higher testosterone was associated with decreased cDC ( = 0.189; = 0.018) and increased cIEM ( = 0.346; = 0.002) across all females. In all males, higher estradiol was associated with decreased cDC ( = 0.404; = 0.006) and increased cIEM ( = 0.411; = 0.003). We found that testosterone and estradiol were associated with vascular measures in female and male adolescents, respectively. Future studies are needed to confirm these relationships in larger cohorts and among those with BMIs in the overweight (85th-<95th BMI%) and severe obesity (BMI ≥120% of the 95th percentile and/or ≥35 kg/m) categories.

During summer, children may meet fewer 24 hours Movement Guidelines (24 hr-MGs) [moderate-vigorous physical activity (PA): ≥60 minutes/day, screen time: ≤2 hours/day, sleep: 9-11 hours/day) compared with the school year. Structured environments within community settings (, summer programs) support guideline adherence. Information about the relationship between structured home environments and 24 hr-MGs is needed. This mixed-methods study examined which features of the family, home, and community environment supported children in meeting 24 hr-MGs during the school year and summer. Children's PA and sleep data were estimated from wrist-worn accelerometry, and screen time was assessed via parent-reported nightly surveys (14 days) at two time points [school year: (March-April) and summer (July-August) of 2021]. Parents completed a survey at each time point with 13 measures of the family (, screen time rules), home (, bed sharing), and community (, summer program enrollment) environment. Multilevel mixed effect logistic regression estimated the odds of meeting 24 hr-MGs at each time point. Parents ( = 20) completed a qualitative interview and thematic analysis revealed parents perceived facilitators and barriers to guideline adherence. Summer program enrollment and bedtime rules were associated with greater odds of meeting the PA [odds ratios (ORs): 4.9, 95% confidence intervals (CIs): (1.4, 17.1)] and ≥two 24 hr-MGs [OR: 2.2, 95 CI: (1.2, 4.0)] during summer, respectively. Parents perceived family rules/routines supported guideline adherence and lack of access to summer programs was a barrier. Structured environments at home and in the community can support children in meeting 24 hr-MGs guidelines. Interventions that expand access to summer programming and encourage implementation of structured home routines may support meeting multiple 24 hr-MGs during summer.

Maternal depression has been linked with increased risk of childhood obesity. Furthermore, maternal negative affectivity in early childhood has been associated with food fussiness. We explored the relationship between longitudinal maternal well-being mid-pregnancy, at 2 years and 5 years postpartum and children's appetitive traits at 5 years of age. This is a secondary analysis of the ROLO (randomized control trial of low glycemic diet in pregnancy) longitudinal birth cohort study including pregnancy ( = 279), 2 years ( = 168), and 5 years ( = 295) postpartum. Maternal well-being was measured using the World Health Organization-Five Well-Being Index. Children's appetitive traits were measured at 5 years of age using the Children's Eating Behavior Questionnaire. Bivariate correlation and then linear regression, adjusted for potential confounders, were used to determine relationships between maternal well-being at each timepoint and offspring's appetitive traits at 5 years old. Mean maternal well-being was higher at 5 years postpartum (63.3%) than mid-pregnancy (58.2%) or at 2 years postpartum (61.0%) ( = 0.001). No relationships were observed between maternal well-being mid-pregnancy and child's appetitive traits at 5 years. In adjusted regression, at 2 years postpartum, maternal well-being was negatively associated with "Emotional Overeating" ( = -0.029, = 0.024), "Satiety Responsiveness" ( = -0.040, = 0.014), "Slowness Eating" ( = -0.072, = <0.001), and "Emotional Undereating" ( = -0.054, = 0.010) and positively associated with "Enjoyment of Food" ( = 0.050, = 0.007). Maternal well-being at 5 years postpartum was negatively associated with "Satiety Responsiveness" ( = -0.025, = 0.033) and "Slowness Eating" ( = -0.031, = 0.024). Maternal well-being in early childhood may influence children's appetitive traits; however, further research is required to fully explore this relationship.

Early childhood education and care (ECEC) settings are key for improving health behaviors, including physical activity (PA) and nutrition. In 2017, the province of British Columbia (BC) implemented a provincial-level Active Play policy supported by a capacity-building intervention. Significant improvements in all PA policies and practices and the majority of nutrition policies were observed post-implementation. The purpose of this study was to understand if PA and nutrition policies and practices were maintained at 5+ years post-provincial policy implementation. This study employed a repeated cross-sectional design to distribute surveys querying about PA and nutrition policies and practices to ECEC centers across BC at three time points: time 1, prior to implementation of the Active Play standard (2016-2017) and capacity-building intervention, time 2, 1-2 years post-implementation (2018-2019), and time 3, 5+ years post-implementation (2022-2023). The majority of PA and all nutrition policies were maintained from time 2 ( = 378) to time 3 ( = 639). Prevalence of policies related to the provision of activities that address fundamental movement skills (odds ratio [OR] = 0.30) and total amount of active play (OR = 0.56) significantly decreased from time 2 to time 3. All reported PA practice prevalence levels decreased to time 1 levels. Center-level health behavior policies were largely maintained 5 years post-implementation, except some PA policies and practices returned to pre-implementation levels. Staff capacity and turnover as well as change in implementation support may explain these changes. Ongoing implementation support is needed to ensure maintenance of health promoting policies and practices in ECEC.

Steatotic liver disease (SLD) represents a multisystem disease and is a common complication of childhood obesity. We studied fat content at the abdominal level (liver, subcutaneous, and visceral) and the response to childhood obesity management. In this retrospective longitudinal study, 8-18-year-olds with a body mass index (BMI) z-score above 1.28 (corresponding to a BMI above the 90th percentile), as a proxy for obesity, were offered person-centered, family-oriented obesity management in a hospital setting and in a magnetic resonance (MR) scan. Liver fat content (LFC) was assessed by MR spectroscopy, whereas subcutaneous adipose tissue and visceral adipose tissue (VAT) were assessed by MR imaging. We conducted nonparametric tests to evaluate baseline-to-follow-up changes and comparisons between participants with and without an MR assessment. Additionally, a logistic regression model examined the association between changes in LFC and BMI z-score. The study group comprised 1002 children and adolescents (52% females) with an MR assessment at baseline. The median age was 13.0 years, the median BMI was 28.4, and the BMI z-score was 2.90. At baseline, 378 (38%) exhibited SLD defined by an LFC above 1.5%. Among the 322 with a follow-up MR scan, 76% of the patients with SLD reduced their LFC. BMI z-score and VAT (both < 0.001) were reduced during intervention. SLD is highly prevalent (38%) in children and adolescents with obesity. A chronic care obesity management model reduced the fat content in the liver, the visceral fat, and the degree of obesity.

Although positive coparenting, or how parents relate during childrearing, is known to support children's socioemotional development, the role of coparenting in supporting children's healthy eating and growth is poorly understood. This study examined associations between coparenting quality, the home food environment, and young children's body mass index (BMI). Cross-sectional data were obtained from 290 mothers and their 3-year-old children who participated in the Sprout study. Mothers who indicated they had a coparent in their household completed surveys to assess coparenting quality, food parenting practices, family mealtime routines and structure, and home food availability. Mothers also reported the foods served at two typical meals, and a healthy meal index (HMI) score was calculated to assess the nutritional quality of meals. Children's height and weight were measured and used to calculate BMI z-scores (BMIz). Mothers who reported more positive coparenting also reported providing children more guidance for healthy eating (β = 0.15, < 0.001), less use of food to control children's emotions (β = -0.15, < 0.01), less use of food as a reward (β = -0.27, < 0.01), more structured mealtimes (β = 0.22, < 0.001), and more household availability of fruits and vegetables (β = 0.11, < 0.01). Mothers who reported greater coparent agreement on childrearing also had children with lower BMIz (β = -0.11, = 0.03). Mothers who reported greater endorsement of their partner's childrearing competency had a higher mean HMI score (β = 1.82, < 0.01). Among dual-parent, highly resourced families with young children, stronger coparenting practices were associated with several food-related parenting practices that support healthy eating and weight among young children.