Using a community-engaged approach to design and pilot-test an intervention aimed at reducing ultra-processed food consumption in preschool children to improve cardiovascular health

In the United States, cardiovascular diseases (CVDs) are the leading cause of mortality, responsible for one in four deaths. While CVD typically manifests during adulthood, its risk factors -including obesity, lipid abnormalities, and subclinical atherosclerosis- begin to develop in early childhood. A significant contributor to these cardiovascular risk factors is the consumption of ultra-processed foods (UPF, foods made using industrial processing methods with added ingredients such as sugar, salt, fat, and food additives). The consumption and availability of UPF in children is alarmingly high providing 66% of the total energy intake among 2- to 5-year-old children in the U.S., and 70% of foods purchased in the U.S. market for babies or toddlers contain at least one food additive. Although there is substantial evidence of the cardiometabolic effects of UPF consumption in adults, there is a need for evidence of the effect of UPF in young children. Additionally, there is a critical need to identify interventions that can reduce UPF consumption in young children. The focus of this study is on toddlers (2-3 years old), as this is a critical age when children’s food preferences and long-term eating habits begin to develop. Establishing eating behaviors at this early age is a promising approach to improving diet quality and reducing cardiometabolic risk. The goal of this proposed research is to use a community-engaged approach to generate evidence of feasible and acceptable interventions that reduce UPF consumption in toddlers (2-3 years old) to improve cardiovascular health. To achieve this, I will 1) evaluate the association between UPF consumption and changes in adiposity, cardiometabolic risk factors, and microbiome in toddlers, 2) identify barriers and facilitators to reducing UPF consumption among parents of toddlers, and 3) pilot-test and evaluate a family-based intervention aimed at reducing UPF consumption in toddlers. This research will help me to achieve my long-term goal of generating robust evidence and partnering with communities and policy officials to co-design sustainable, rigorous, and effective interventions to reduce health disparities and improve child health through nutrition. With the support of this K01, I will build on my expertise in nutrition epidemiology and health policy nutrition, to gain training and new skills in: 1) community-engaged research, 2) qualitative research methods, 3) Design, implementation, and evaluation of clinical trials and longitudinal studies, and 4) Microbiome assessment and advanced statistical methods for its analysis. I have the support of my institution and have assembled a group of highly supportive mentors and advisors, who will provide me with the resources, expertise, and mentorship to become an independent researcher and successfully compete for R01 funding. Project Number: 1K01HL181683-01 | Fiscal Year: 2025 | NIH Institute/Center: National Heart Lung and Blood Institute (NHLBI) | Principal Investigator: Andrea Pedroza Tobias | Institution: STANFORD UNIVERSITY, STANFORD, CA | Award Amount: $166,968 | Activity Code: K01 | Study Section: NHLBI Mentored Clinical and Basic Science Study Section[MCBS (MA)] View on NIH RePORTER: https://reporter.nih.gov/project-details/1K01HL18168301