I wanted to first express my gratitude the EASO Early Career Network for the opportunity to share my research. My name is Cara Ruggiero, and I am a Research Associate in the MRC Epidemiology Unit at the University of Cambridge in the UK. I am a behavioural nutrition researcher and registered dietitian.
The overarching goal of my research is to apply a family systems lens to efforts that aim to address obesity and food insecurity, with a particular focus on eating behaviour and family development. I use mixed methods to address questions about the prevention and treatment of obesity across development and design effective interventions that are policy relevant.
Addressing obesity and food insecurity within families is an urgent priority in the UK, especially in the growing cost of living crisis among households with lower incomes. This co-occurrence may be related to aspects of the home environment. In reception aged children, 20.3% in the most deprived areas of England have obesity compared to 7.8% in the least deprived areas. Intervening early in the first 1,000 days of life, especially among lower income households is critical to the prevention of obesity.
My research experience to date includes population and individual level approaches and I aspire to bridge the gap between these two fields. I gained some early research experience as a project coordinator at the Johns Hopkins School of Public Health, managing multilevel, multicomponent community-based obesity prevention interventions to improve the food environment in minoritized communities. After working at the population level, I was motivated to focus on families, and I pursued an MS and PhD in Nutritional Sciences and a minor in Human Development and Family Studies from The Pennsylvania State University.
There, my master’s thesis research examined intervention spillover effects of the INSIGHT responsive parenting intervention and found that mothers who received the intervention with their firstborn used less nonresponsive, controlling feeding practices such as pressuring their secondborn infant to finish, despite no new intervention content. My doctoral thesis built upon this work and examined the influence of sibling-related family systems processes (Learned Experience and Resource Dilution) on parent feeding practices in the INSIGHT and SIBSIGHT cohorts. The study on Learned Experience revealed that firstborn negative affect predicted mothers’ less consistent mealtime routines and more pressure. Firstborn appetite predicted mothers’ less frequent use of food to soothe when secondborns were toddlers. Interviews with mothers revealed three ways that maternal experiences with firstborns informed feeding practices of secondborns: 1) Use of feeding practices with secondborn that worked for the firstborn; 2) Confidence came from firstborn feeding experiences making secondborn feeding less anxiety-provoking; and 3) Additional experiences with firstborn and other factors that contributed to secondborn feeding practices. Findings from the study on Resource Dilution showed secondborn temperament and appetite were associated with how mothers fed their firstborn. Qualitative data explained maternal feeding practices in three primary ways: 1) Mothers explained shifting predictable meal and snack routines after birth of the secondborn, but did not perceive sibling characteristics as the source; 2) Family chaos following the secondborn’s birth led to “survival mode” in feeding; and 3) Social support was protective against feeding resource dilution.
After completing my PhD, I wanted to gain more experience in obesity treatment and food insecurity in order to integrate those topics into my work with families. I completed the Harvard-Wide Paediatric Health Services Research Fellowship, where I led research related to intensive health behaviour lifestyle treatment for obesity in collaboration with the Centres for Disease Control and Prevention and the American Academy of Paediatrics as well as a statewide survey on food equity and access at The Greater Boston Food Bank.
In my current role, I recently received The Public Engagement Starter fund at the University of Cambridge to conduct PPIE work with families and healthcare professionals. My project will build relationships with the Cambridgeshire and Peterborough NHS Foundation Trust Healthy Child Programme to engage with caregivers and healthcare professionals to identify the beliefs and behaviours of families with lower incomes regarding feeding practices and food insecurity. I’m currently working on fellowship applications to expand upon these findings.
In the future, I aim to be leading an interdisciplinary, independent line of research and training junior researchers. My research will aim to elevate lived experience and co-develop ‘whole family’ interventions to address obesity and food insecurity. My diverse training in nutrition, public health, and human development has given me a unique perspective and pushed me to answer these questions, translate results to impact policy change, and improve the health of families in the US, the UK and throughout the world.
If you would like to connect or collaborate, please find me here.
https://www.mrc-epid.cam.ac.uk/people/cara-ruggiero/
Twitter: @CaraRuggiero
Bluesky: @cararuggiero.bsky.social
Linkedin: www.linkedin.com/in/cara-ruggiero-phd-rd-ldn-3b03b831