Brian Wrotniak is a professor and the director of the Center for Health Behavior Research at D’Youville College in Buffalo, New York. Brian is examining associations between dairy intake and obesity prevention and treatment in youth. In addition, Brian currently is researching nutrition in the nation of Botswana.
What inspired you to start working on childhood obesity?
When I graduated with a physical therapy degree in 1995, I had an interest in promoting physical activity and an active lifestyle in my patients. Individuals who seemed at most need for increasing physical activity were children with obesity. With two other physical therapists and a dietician, we developed an 8-week, family-based physical activity and nutrition education program that we ran at our College and at an orthopedic clinic.
As rates of childhood obesity continued to grow, so did my interest in addressing this epidemic, particularly from a community based perspective. I obtained a degree in epidemiology, followed by postdoctoral training, to gain training that could provide opportunities to conduct research and public health strategies to combat childhood obesity on a wider scale. Childhood obesity is, at times, perceived solely as an individual choice resulting from children's poor self-control around food and physical activity. There is a much greater need for a joint societal responsibility approach to tackle this epidemic, with bold community and policy based changes that help encourage and make healthy behavior choices much easier.
How are you helping to reverse childhood obesity?
My work involves conducting behavioral and epidemiological research to help generate new evidence for better understanding how to prevent and treat childhood obesity. A particular interest is understanding how children make decisions about health behaviors (physical activity and sedentary behavior) associated with obesity. By better understanding the determinants of health behavior choices in children, more effective strategies can be developed to help children choose healthy options.
Our family-based behavioral obesity treatment program, Fit Families, is designed to test how potential behavioral determinants such as parental role modeling, positive reinforcement and perceptions of food and physical activity are associated with weight change in young children. In other research, our team has developed behavioral interventions that can be delivered by primary care providers for preventing obesity in their pediatric patients. Results from this work support implementing behavior therapy in the primary care setting as an effective strategy for obesity prevention in children. As a physical therapist, I am on task forces working toward educating the health care community about the role physical therapists can play in the obesity epidemic through their expertise in human movement.
Internationally I am involved in research on the nutrition and epidemiological transition occurring in Botswana, a country in Southern Africa. Childhood obesity rates in some parts of this country are nearly as high as they are in the U.S., and illustrate that the nutrition transition occurring in Botswana is due in part to changes in the socioeconomics and accompanying unhealthy diet and activity patterns. Interventions in many developing countries are urgently needed in order to prevent obesity from reaching the levels in developed countries.
What’s your biggest accomplishment so far in helping reduce childhood obesity?
I lead a study using existing data from a large national project to examine the role of gestational weight gain on offspring obesity. Results of this study published in the American Journal of Clinical Nutrition showed that the likelihood of offspring overweight at age seven was 48 percent greater for children of mothers who gained more than the Institute of Medicine’s gestational weight gain recommendations than for children of mothers who met the weight gain guidelines. These results, along with other similar published research, suggest an important role of the intrauterine environment in fetal programming of future health risk in the offspring and provide an exciting area of study. In response to the growing evidence on the potential influence of gestational weight gain on childhood obesity, the national guidelines for how much weight a woman should gain during pregnancy were revised by the Institute of Medicine; a gestational weight gain recommendation with a maximum limit was also established for the first time.
Who is your role model in your work?
There have been several important influences on my work. During my doctoral studies, the opportunity to learn how to develop and administer family-based behavioral obesity treatment from Dr. Leonard Epstein has provided a foundation for my interest in pediatric behavioral health. As important, my postdoctoral training with Dr. Nicolas Settler at The Children’s Hospital of Philadelphia provided an opportunity to develop my research skills and enhance my passion for public health approaches to childhood obesity. Finally, my wife and three young children provide me with motivation, encouragement and support in pursuing my work and in realizing that our children's health is at stake.
What healthy snacks did you enjoy growing up?
Growing up, health behavior patterns and influences were very different than they are today. Obesity was not in the forefront, and there was not as much attention on issues of unhealthy eating and inactivity. Portion sizes were smaller, families ate out less, sugar sweetened beverage intake was lower, and sedentary behaviors and snacking less frequent. Fortunately, my parents valued good nutrition and physical activity. We ate balanced meals together each night as a family. One of my favorite snacks was air-popped popcorn. My father was also an avid tennis player and taught me how to play when I was 6 years old. It is a sport I particularly enjoy today.
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