Document Type



Doctor of Philosophy (PhD)


Dietetics and Nutrition

First Advisor's Name

Fatma G. Huffman

First Advisor's Committee Title

Committee chair

Second Advisor's Name

Adriana Campa

Second Advisor's Committee Title

Committee member

Third Advisor's Name

Catherine Coccia

Third Advisor's Committee Title

Committee member

Fourth Advisor's Name

Boubakari Ibrahimou

Fourth Advisor's Committee Title

Committee member


obesity, overweight, eating frequency, snacks, beverages, preschool, children, WIC, risk factors, childcare

Date of Defense



The objective of this study was to understand the influence of eating episodes and snack quality on body weight of children ages 3-4.9 years participating in the Broward County Special Supplementation Nutrition Program for Women, Infants, and Children (WIC).Additional objectives were to evaluate obesity risk factors and to examine the effect of childcare arrangements on body weight. Data was collected from 7 Broward County Health Department WIC clinics over 4 months via a researcher-administered questionnaire. Additional data was extracted from the WIC data system. BMI-for-age percentiles were used to categorize children by weight according to Centers for Disease Control (CDC) guidelines, which were further categorized into under/normal weight and overweight/obese. There were 197 participants included (45.7% boys), 3.6% of the children were underweight, 64.4% normal weight, 16.8% overweight, and 15.2% were obese. Most children consumed 3 meals (97.5%) and 2 to 3 snacks per day (33.0% and 37.1% respectively), with a significantly higher intake of snacks on the weekends when compared to weekdays (p=0.001). Children consumed more nutritious snacks more often (66%) than the nutrient-poor snacks (33.5%). We observed a marginally significant trend in which the WIC preschool children that more frequently consumed nutrient-poor snacks had a higher prevalence of overweight/obesity (p=0.090). In multivariate analyses, the children who consumed more than 4-oz of sugar sweetened beverages (SSB) per day, exercised for less than 1 hour per day, and had a higher birth weight had increased odds of being overweight/obese. Race and ethnicity were not predictive of body weight status, but Blacks or African Americans were at a higher risk for many of the risk factors. Children spent on average 20 hours per week under some type of nonparental care arrangement. There was no significant relationship between childcare and weight status. Our findings indicate that WIC children are at a greater risk for overweight and obesity, however there is potential for successful prevention interventions addressing prevalent risk factors. Longitudinal studies including a large sample of racial and ethnic diverse preschool children from low socioeconomic families could help elucidate the results from our study.

This study was approved by FIU IRB (Protocol Approval #15-0369) the State of Florida Department of Health IRB (Protocol Title: Meal Frequency and the Role of Snacking on Weight of Minority Preschool Children).



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