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Niu L, Hanson S, Preciado-Becerra J, Eskandarani A, Lei X, Le M, Niu Z, Xie B. Psychosocial Adjustment as a Mediator in the Relationship between Childhood Exposure to Maternal Depression and Subsequent BMI and Overweight Risk. CHILDREN (BASEL, SWITZERLAND) 2024; 11:441. [PMID: 38671658 PMCID: PMC11049188 DOI: 10.3390/children11040441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES This study investigated the correlation between early exposure to maternal depression (from 1 month to Grade 3) and the body mass index (BMI) and potential for overweight in adolescents at age 15. It further examined if the pathway of this correlation was influenced by psychosocial adjustment during mid-childhood (Grade 3 to Grade 6), specifically through internalizing and externalizing behaviors. METHODS Our study utilized data from 844 participants in the NICHD Study of Early Child Care and Youth Development (SECCYD) to assess the effects of maternal depression, observed from when the children were one month old to Grade 3, on BMI and the likelihood of overweight or obesity in adolescents aged 15. We also explored whether the average scores of internalizing and externalizing behaviors between Grades 3 and 6 mediated the impact of early maternal depressive symptoms on subsequent health outcomes. The analysis was adjusted for demographic and socioeconomic factors. RESULTS Findings revealed that internalizing and externalizing behavioral issues significantly mediated the relationship between prolonged maternal depression exposure and subsequent BMI, as well as the risk of overweight or obesity, in adolescents at age 15. Notably, this mediating effect was predominantly evident in girls. CONCLUSIONS Our research demonstrated that the correlation between prolonged exposure to maternal depressive symptoms in childhood and increased BMI and overweight risk in adolescence was significantly mediated through psychosocial adjustment behaviors. We advocate for further exploration of additional mediating factors in future studies.
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Affiliation(s)
- Lijie Niu
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
| | - Skylar Hanson
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
| | - Juanita Preciado-Becerra
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
| | - Abdulaziz Eskandarani
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
| | - Xiaomeng Lei
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
- Department of Radiology and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mi Le
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
| | - Zhongzheng Niu
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA; (L.N.); (S.H.); (J.P.-B.); (A.E.); (X.L.); (M.L.); (Z.N.)
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Rojo M, Lacruz T, Solano S, Vivar M, Del Río A, Martínez J, Foguet S, Marín M, Moreno-Encinas A, Veiga ÓL, Cabanas V, Rey C, Graell M, Sepúlveda AR. ENTREN-F family-system based intervention for managing childhood obesity: Study protocol for a randomized controlled trial at primary care. Obes Res Clin Pract 2022; 16:319-329. [PMID: 35871907 DOI: 10.1016/j.orcp.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/14/2022] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Pediatric obesity is a primary public health concern, and designing effective programs for managing it is of the utmost importance. The objective of this study was to describe the protocol study of a three-arm, parallel, randomized controlled trial aimed at assessing the efficacy of a family-system-based intervention ("ENTREN-F" program) for managing childhood obesity, compared to the "ENTREN" program (no "F" - without specific family-system-based workshop) and a control group (behavioral monitoring). METHODS/DESIGN The ENTREN-F program was a multicomponent family-system-based intervention carried out by a multidisciplinary team in the primary health care setting. The program targeted children between 8 and 12 years with overweight and obesity (P ≥ 85th). Parents were actively involved in the process. The contents were designed using the Cognitive Behavioral Therapy (CBT) principles. The program comprised individual behavioral monitoring, a healthy habits workshop for children and their parents, a CBT workshop for children, and a family-system-based workshop for parents, enhancing parental management skills plus family functioning. The trial's primary outcomes included changes in child body mass index (BMI) z-scores, child's psychological well-being, and family functioning over six months. Secondary outcomes included changes in eating behavior, physical activity, self-esteem, parental distress, parental feeding practices, and parental modeling. DISCUSSION To our knowledge, this is one of the few randomized controlled trials to assess the efficacy of a multicomponent program that considers health from a comprehensive perspective, trying to improve children's psychological well-being and family functioning besides weight loss. This study, therefore, addresses a gap in the literature. If found to be efficacious, it suggests a new potential health service for translation into National Primary Health Care services in Spain, one of the ten countries with the highest prevalence of obesity in Europe.
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Affiliation(s)
- Marta Rojo
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain.
| | - Tatiana Lacruz
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Santos Solano
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Mario Vivar
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Andrea Del Río
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Jone Martínez
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Sara Foguet
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Marta Marín
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Alba Moreno-Encinas
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain
| | - Óscar Luis Veiga
- Department of Physical Education, Sport & Human Motricity, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - Verónica Cabanas
- Department of Physical Education, Sport & Human Motricity, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - Consuelo Rey
- Valdelasfuentes Primary Health Care Center (Alcobendas), Public Health System from Madrid, Spain
| | - Montserrat Graell
- Child and Adolescent Psychiatry and Psychology Department, University Hospital Niño Jesús, Centro de Investigación Biomédica en Red de SaludMental (CIBERSAM), Madrid, Spain
| | - Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology (Department of Biological and Clinical Psychology), Autonomous University of Madrid, Spain.
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Ek A, Vásquez‐Barquero MY, Sandvik P, Eli K, Somaraki M, Nowicka P. The role of parental depression during early childhood obesity treatment-Secondary findings from a randomized controlled trial. Pediatr Obes 2021; 16:e12754. [PMID: 33291185 PMCID: PMC8243967 DOI: 10.1111/ijpo.12754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/29/2020] [Accepted: 11/09/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Parental depression is a risk factor for childhood obesity. OBJECTIVES To examine the influence of parental depression on child weight status, eating behaviours, and parental feeding practices during childhood obesity treatment. METHODS Hundred and twenty eight children with obesity aged 4 to 6 years and their parents were randomized to a parent support program or to standard treatment. At baseline and after 12 months, children's heights and weights were measured. Parents reported levels of depression (Beck's Depression Inventory-II), feeding practices (Child Feeding Questionnaire), and children's eating behaviors (Child Eating Behavior Questionnaire). Independent and dependent paired sample t-tests and linear regressions were used to analyze data. RESULTS After obesity treatment, mothers reported lower levels of depression, whereas fathers did not. No associations were found between parental level of depression and child weight status, or between baseline level of parental depression and feeding practices. Associations were found between baseline parental depression and children's food responsiveness (β = .03; P = .01; 95% CI [0.01, 0.05]), emotional overeating (β = .02; P = .02; 95% CI [0.004, 0.04]), and desire to drink (β = .02; P = .03; 95% CI [0.002, 0.04]) (adjusted for background variables). CONCLUSIONS Parental depression did not influence child weight status or parental feeding practices but was associated with obesity-related child eating behaviors.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and TechnologyKarolinska InstitutetStockholmSweden
| | | | - Pernilla Sandvik
- Department of Food Studies, Nutrition and DieteticsUppsala UniversityUppsalaSweden
| | - Karin Eli
- Division of Health Sciences, Warwick Medical SchoolUniversity of WarwickCoventryUK,Unit for Biocultural Variation and Obesity, Institute of Social and Cultural AnthropologyUniversity of OxfordOxfordUK
| | - Maria Somaraki
- Department of Food Studies, Nutrition and DieteticsUppsala UniversityUppsalaSweden
| | - Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and TechnologyKarolinska InstitutetStockholmSweden,Department of Food Studies, Nutrition and DieteticsUppsala UniversityUppsalaSweden
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Skelton JA, Van Fossen C, Harry O, Pratt KJ. Family Dynamics and Pediatric Weight Management: Putting the Family into Family-Based Treatment. Curr Obes Rep 2020; 9:424-441. [PMID: 33108634 DOI: 10.1007/s13679-020-00407-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW The treatment of pediatric obesity entails working with entire families. However, aside from parenting and family health behaviors, family dynamics and relationships are not often incorporated in clinical treatment of obesity. RECENT FINDINGS Evidence across several studies suggest a relationship between family dynamics and child weight, with impaired family dynamics associated with higher weight status in children. Evidence is mixed if child age and family function are associated. Unfortunately, there is little evidence that addressing family dynamics (i.e., relationships and overall family system) will improve weight in children with obesity. Notably, few studies target family dynamics specifically. There are several validated measures of family dynamics available for researchers to explore the family system as it relates to child health and behaviors. A deeper understanding of family dynamics and relationships may provide new avenues to address issues of weight in children; accounting for the family, and their underlying functioning, may benefit the clinician and child engaged in weight management.
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Affiliation(s)
- Joseph A Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Catherine Van Fossen
- Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
| | - Onengiya Harry
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Keeley J Pratt
- Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
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Sepúlveda AR, Lacruz T, Solano S, Blanco M, Moreno A, Rojo M, Beltrán L, Graell M. Identifying Loss of Control Eating within Childhood Obesity: The Importance of Family Environment and Child Psychological Distress. CHILDREN-BASEL 2020; 7:children7110225. [PMID: 33187289 PMCID: PMC7696176 DOI: 10.3390/children7110225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 01/18/2023]
Abstract
This study aims to examine the differences in family environment, psychological distress, and disordered eating symptomatology between children classified by weight status with or without loss of control (LOC) eating and to test a model of the role of emotional regulation of LOC eating based on a dysfunctional family environment. A cross-sectional study was conducted among 239 families. The assessment measured family expressed emotion, family adaptability and cohesion, child levels of depression and anxiety, body esteem, and disordered eating attitudes. The assessment was carried out in primary care centers and primary schools. Child body mass index (BMI) was associated with higher expressed emotion, psychological distress, and disordered eating symptomatology. Children with obesity and LOC presented higher BMI, poorer body esteem, and more disordered eating attitudes than children without LOC. Children with overweight/obesity, both with or without LOC, exhibited higher psychological distress and emotional overinvolvement than normal-weight children. A partial mediation of depression or anxiety and disordered eating attitudes between expressed emotion and LOC was found. Findings support that children with overweight/obesity show more family and psychological distress. Body esteem issues and disordered eating attitudes could alert the presence of LOC in children with obesity. The function of LOC might be to cope with psychological distress that may appear in a dysfunctional family environment.
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Affiliation(s)
- Ana Rosa Sepúlveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
- Correspondence: ; Tel.: +34-914-975-214
| | - Tatiana Lacruz
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Santos Solano
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Miriam Blanco
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Alba Moreno
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Marta Rojo
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Lucía Beltrán
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, 28049 Madrid, Spain; (T.L.); (S.S.); (M.B.); (A.M.); (M.R.); (L.B.)
| | - Montserrat Graell
- Department of Child and Adolescent Psychiatry and Psychology, University Hospital Niño Jesús, 28009 Madrid, Spain;
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Pierce M, Hope HF, Kolade A, Gellatly J, Osam CS, Perchard R, Kosidou K, Dalman C, Morgan V, Di Prinzio P, Abel KM. Effects of parental mental illness on children's physical health: systematic review and meta-analysis. Br J Psychiatry 2020; 217:354-363. [PMID: 31610824 DOI: 10.1192/bjp.2019.216] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Children of parents with mental disorder face multiple challenges. AIMS To summarise evidence about parental mental disorder and child physical health. METHOD We searched seven databases for cohort or case-control studies quantifying associations between parental mental disorders (substance use, psychotic, mood, anxiety, obsessive-compulsive, post-traumatic stress and eating) and offspring physical health. Studies were excluded if: they reported perinatal outcomes only (<28 days) or outcomes after age 18; they measured outcome prior to exposure; or the sample was drawn from diseased children. A meta-analysis was conducted. The protocol was registered on the PROSPERO database (CRD42017072620). RESULTS Searches revealed 15 945 non-duplicated studies. Forty-one studies met our inclusion criteria: ten investigated accidents/injuries; eight asthma; three other atopic diseases; ten overweight/obesity; ten studied other illnesses (eight from low-and middle-income countries (LMICs)). Half of the studies investigated maternal perinatal mental health, 17% investigated paternal mental disorder and 87% examined maternal depression. Meta-analysis revealed significantly higher rates of injuries (OR = 1.15, 95% CI 1.04-1.26), asthma (OR = 1.26, 95% CI 1.12-1.41) and outcomes recorded in LMICs (malnutrition: OR = 2.55, 95% CI 1.74-3.73; diarrhoea: OR = 2.16, 95% CI 1.65-2.84). Evidence was inconclusive for obesity and other atopic disorders. CONCLUSIONS Children of parents with mental disorder have health disadvantages; however, the evidence base is limited to risks for offspring following postnatal depression in mothers and there is little focus on fathers in the literature. Understanding the physical health risks of these vulnerable children is vital to improving lives. Future work should focus on discovering mechanisms linking physical and mental health across generations. DECLARATION OF INTEREST None.
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Affiliation(s)
- Matthias Pierce
- Research Fellow, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Holly F Hope
- Research Associate, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Adekeye Kolade
- Research Assistant, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Judith Gellatly
- Research Fellow, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Cemre Su Osam
- PhD Student, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Reena Perchard
- Clinical Research Fellow, Division of Developmental Biology & Medicine, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Kyriaki Kosidou
- Senior Consultant, Department of Public Health Sciences, Division Public Health Epidemiology, Karolinska Institutet, Stockholm; and Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Christina Dalman
- Professor of Psychiatric Epidemiology and Research Group Leader, Department of Public Health Sciences, Division Public Health Epidemiology, Karolinska Institutet, Stockholm; and Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Vera Morgan
- Winthrop Professor and Head, Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, University of Western Australia, Australia
| | - Patricia Di Prinzio
- Research Fellow, Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, University of Western Australia, Australia
| | - Kathryn M Abel
- Professor of Psychological Medicine and Director, Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, UK
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Marco PL, Valério ID, Zanatti CLDM, Gonçalves H. Systematic review: Symptoms of parental depression and anxiety and offspring overweight. Rev Saude Publica 2020; 54:49. [PMID: 32491095 PMCID: PMC7234214 DOI: 10.11606/s1518-8787.2020054001731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/22/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To evaluate the existing literature on the association between parents' depression and anxiety and their influence on their children's weight during childhood, identifying possible mechanisms involved in this association. METHODS A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND ("common mental disorder" OR "mental health" OR "mental disorder" OR "depressive disorder" OR depress* OR anxiety OR "anxiety disorder") AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR "body mass index" OR BMI). A total of 1,187 articles were found after peer selection. RESULTS In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.
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Affiliation(s)
- Paula Lobo Marco
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Inaê Dutra Valério
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Christian Loret de Mola Zanatti
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
- Universidade Federal do Rio Grande. Faculdade de Medicina. Programa de Pós-graduação em Saúde Pública. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Helen Gonçalves
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
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Blanco M, Veiga OL, Sepúlveda AR, Izquierdo-Gomez R, Román FJ, López S, Rojo M. [Family environment, physical activity and sedentarism in preadolescents with childhood obesity: ANOBAS case-control study]. Aten Primaria 2020; 52:250-257. [PMID: 30898477 PMCID: PMC7118555 DOI: 10.1016/j.aprim.2018.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/25/2018] [Accepted: 05/17/2018] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The aim of this study is to compare the levels of physical activity and sedentary behaviours in children with obesity and normal weight through accelerometer measures, and analyze the family environment related to physical activity. DESIGN Case-control study. LOCATION A health center and colleges of the Community of Madrid. PARTICIPANTS A total of 50 obese children between 8 and 12 years of age (P > 97) and their mothers were matched by age, sex and socioeconomic status of their parents (1: 1) with 50 children with normopeso (GN; P < 85). MAIN MEASUREMENTS Physical activity levels were measured by accelerometer (ActiGraph GT3X), levels of physical activity of the primary caregiver were measured through physical activity questionnaire (IPAQ) and the environment in relation to the physical activity was measured by the Home Environment Scale (HES-S). RESULTS The group GO showed less vigorous physical activity than their peers in the GN group. Vigorous physical activity in the GO group was associated with modeling and parental policies regarding physical activity. A multiple regression analysis revealed that 21% of the variance of weight status of children was explained by sex, vigorous physical activity and maternal body mass index. CONCLUSIONS The levels of vigorous physical activity and the family environment differ between children with obesity and normal weight. Therefore, it is important to continue working on the awareness of illness and the promotion of healthy habits from Primary Care and the school and institutional context.
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Affiliation(s)
- Miriam Blanco
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España.
| | - Oscar L Veiga
- Departamento de Educación Física, Deporte y Motricidad Humana, Universidad Autónoma de Madrid, Madrid, España
| | - Ana R Sepúlveda
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España
| | - Rocío Izquierdo-Gomez
- Facultad de Educación, Universidad de Alcalá de Henares, Alcalá de Henares, Madrid, España
| | - Francisco J Román
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España
| | - Sara López
- Departamento de Enfermería Pediátrica, Centro de Salud Daroca, Madrid, España
| | - Marta Rojo
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, España
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Sepúlveda AR, Solano S, Blanco M, Lacruz T, Veiga O. Feasibility, acceptability, and effectiveness of a multidisciplinary intervention in childhood obesity from primary care: Nutrition, physical activity, emotional regulation, and family. EUROPEAN EATING DISORDERS REVIEW 2019; 28:184-198. [PMID: 31802570 DOI: 10.1002/erv.2702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 09/03/2019] [Accepted: 09/15/2019] [Indexed: 11/09/2022]
Abstract
Childhood obesity is a growing problem with a complex aetiology, for which multidisciplinary interventions are required. Our programme describes a novel structured psychosocial family-based intervention targeting the emotional regulation in childhood obesity, using a train trip metaphor aimed at improving healthy lifestyles for the family. The aims were (a) to describe the feasibility and acceptability of this psychosocial family-based intervention among children with overweight or obesity in primary care and (b) to examine the effectiveness of the "ENTREN-F" programme (with family intervention) compared with the "ENTREN" programme (without family intervention) among Spanish children regarding anthropometric variables, physical activity, emotional well-being, and family functioning. Children were randomly allocated to either ENTREN-F programme (n = 30) or psychological intervention for children (ENTREN, n = 40), and assessments were carried out over time (T0 baseline vs. T1 post/6-month vs. T2 6-month follow-up). Both parent groups expressed high levels of satisfaction with the interventions. ENTREN-F resulted in higher adherence to treatment and was more effective in improving z-body mass index, reducing children's anxiety, and increasing family adaptability than the ENTREN programme. There were no significant changes in parents' emotional well-being and expressed emotion. Both groups improved in the children's emotional well-being and light physical activity. In summary, this multidisciplinary psychosocial family-based intervention was succesful.
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Affiliation(s)
- Ana R Sepúlveda
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Santos Solano
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Miriam Blanco
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Tatiana Lacruz
- Department of Biological and Health Psychology, Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Oscar Veiga
- Department of Physical Education, Sport & Human Motricity, Autonomous University of Madrid, Madrid, Spain
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Sepulveda AR, Blanco M, Nova E, Marcos A, Martínez SG, Carrobles JA, Graell M. Identifying the relationship between biological, psychosocial and family markers associated with childhood obesity: Case-control "ANOBAS" study. Psychoneuroendocrinology 2019; 110:104428. [PMID: 31590062 DOI: 10.1016/j.psyneuen.2019.104428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022]
Abstract
The recent increase in childhood obesity prevalence rates illustrates the extreme relevance of biological, psychosocial and familial factors implicated in body weight status, which at the moment remain unclear. The study aims to compare biological, psychosocial and familial markers between preadolescents with obesity and their non-overweight peers, and explore the relationship with psychiatric diagnosis on these markers. Both groups were composed of 40% of males with a mean age of 10 years, and no differences in socio-demographic variables were found between groups. No sex differences were found on bio/psycho/family markers. While 48% (n = 24) of the preadolescents with obesity presented a DSM-IV diagnosis (OGD), only 2% (n = 1) of the non-overweight peers (NG) met diagnostic criteria. Significant differences were found for all bio/psycho/family markers among obese preadolescents with the exceptions of cortisol, peptide YY and maternal state-anxiety and depression. The preadolescents with obesity without a diagnosis (OGND) presented greater levels of leptin than NG (p = 0.01). For psychosocial markers, statistically significant differences were found between groups in the majority of the variables (p < 0.01), with the exception of trait anxiety where a tendency towards significance was revealed (p = 0.06). For family markers, we found statistically significant differences in emotional over-involvement (p = 0.01), with NG mothers presenting lower scores than OGD and OGND. Include psychosocial and family factors in obesity intervention programs is necessary. Also, health professionals working with children with obesity must take care to assess the presence of a psychiatric diagnosis amongst this population.
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Affiliation(s)
- Ana R Sepulveda
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain.
| | - Miriam Blanco
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Esther Nova
- Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain
| | - Ascension Marcos
- Institute of Food Science, Technology and Nutrition (ICTAN)-CSIC, Madrid, Spain
| | | | - José A Carrobles
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Montserrat Graell
- Eating Disorders Unit, Child and Adolescence Psychiatry Department, Niño Jesus University Hospital, CIBERSAM, Madrid, Spain
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Albano G, Rowlands K, Baciadonna L, Coco GL, Cardi V. Interpersonal difficulties in obesity: A systematic review and meta-analysis to inform a rejection sensitivity-based model. Neurosci Biobehav Rev 2019; 107:846-861. [PMID: 31585134 DOI: 10.1016/j.neubiorev.2019.09.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/05/2019] [Accepted: 09/29/2019] [Indexed: 01/27/2023]
Abstract
Obesity is associated with difficulties due to stigma and loneliness. These impact negatively on individuals' quality of life and behaviour change efforts. Increased sensitivity to others' negative feedback might play a role in the maintenance of these difficulties and could be addressed in psychological interventions. We conducted a systematic review of interpersonal difficulties in individuals with obesity, across the lifespan. We investigated early interpersonal adversity (i.e. frequency of teasing/bullying), perceived interpersonal stress and quality of social life, based on a rejection sensitivity model. The databases PubMed, Web of Knowledge and AGRIS, Embase, Medline and PsychINFO were searched for published peer-reviewed journal articles (1980-June 2018). Thirty-two studies met inclusion criteria. Results from the meta-analyses (n = 16 studies) indicated that overweight/obese individuals reported more frequent experiences of teasing/bullying, greater interpersonal stress and poorer quality of social life than healthy weight individuals. Findings in the systematic review aligned to this evidence. Psychological interventions targeting increased sensitivity to negative interpersonal feedback could improve interpersonal functioning and, in turn, eating behaviours in individuals with obesity.
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Affiliation(s)
- Gaia Albano
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
| | - Katie Rowlands
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Luigi Baciadonna
- Queen Mary University of London, Biological and Experimental Psychology, School of Biological and Chemical Sciences, London, UK.
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
| | - Valentina Cardi
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Interventions for obesity among schoolchildren: A systematic review and meta-analyses. PLoS One 2019; 14:e0209746. [PMID: 30625165 PMCID: PMC6326548 DOI: 10.1371/journal.pone.0209746] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 12/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background Childhood overweight and obesity has emerged as a major public health threat worldwide with challenges in its management. This review assessed the effectiveness of interventions for childhood overweight and obesity. Methods A systematic literature search was conducted using CINAHL, EMBASE, Ovid MEDLINE, PsycINFO and SPORTDiscus databases to retrieve articles published from 1st January 2000 to 31st December 2017. Randomised controlled trials (RCTs) and quasi-experimental studies comparing different strategies in managing overweight and obesity among schoolchildren (6 to 12 years of age) were included. The main outcomes of interest were reductions in weight related variables included anthropometry and body composition measurements. All variables were analysed using random effects meta-analyses. Results Fourteen studies were reviewed, 13 were RCTs and one was a quasi-experimental study. The risk of bias for randomisation was low risk for all of RCTs except for one, which was unclear. The risk of bias for randomisation was high for the quasi-experimental study. Most interventions incorporated lifestyle changes and behavioural strategies such as coping and problem solving skills with family involvement. The meta-analyses did not show significant effects of the intervention in reducing weight related outcomes when compared with controls. Conclusion Meta-analyses of the selected studies did not show significant effects of the interventions on weight related outcomes among overweight and obese schoolchildren when compared with controls. The role of interdisciplinary team approaches with family involvement using behaviour and lifestyle strategies to curb obesity among schoolchildren is important.
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Perceived Family Functioning in Relation to Energy Intake in Adolescent Girls with Loss of Control Eating. Nutrients 2018; 10:nu10121869. [PMID: 30513811 PMCID: PMC6315637 DOI: 10.3390/nu10121869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 11/19/2022] Open
Abstract
Family functioning is hypothesized to influence the development, maintenance, and treatment of obesity and eating disorders. However, there are limited data examining family functioning in relation to energy intake in the laboratory among youth at high-risk for eating disorders and excess weight gain. Therefore, we examined the relationship between perceived family functioning and energy intake during a laboratory test meal designed to model a binge episode. We performed hierarchical multiple regression analyses among 108 adolescent girls in an excess weight gain prevention trial. Participants were at high-risk for eating disorders and excess weight gain due to reports of loss of control eating (LOC) and high body mass index (BMI). Participants completed the Family Adaptability and Cohesion Scale III to assess family adaptability and cohesion. Following an overnight fast, girls consumed lunch from a laboratory test meal. Poorer family adaptability, but not cohesion, was associated with lower percentage of total energy intake from protein and greater percentage of total energy intake from carbohydrates. Neither adaptability nor cohesion were significantly associated with total intake. We conclude that among girls with LOC eating and high BMI, poor reported family adaptability is associated with greater consumption of obesity-promoting macronutrients during binge episodes. Directionality and temporality of this association between unhealthy consumption and family rigidity requires further study.
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The impact of positive contextual factors on the association between adverse family experiences and obesity in a National Survey of Children. Prev Med 2018; 116:81-86. [PMID: 30218722 DOI: 10.1016/j.ypmed.2018.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/20/2018] [Accepted: 09/11/2018] [Indexed: 01/08/2023]
Abstract
Adverse family experiences (AFEs) are associated with childhood obesity. We evaluated whether certain positive contextual factors reduce the risk of obesity and overweight among children exposed to AFEs in a nationally representative sample. Using data derived from the National Survey of Children's Health 2011-12 (N = 43,864), we calculated the distribution of positive contextual factors (very good/excellent maternal mental health, neighborhood and school safety, and child resilience) and AFEs across weight status. The AFEs composite score was modeled as a categorical measure (0 or ≥1 AFEs). Positive contextual factors, AFEs and their interactions were evaluated in weighted, adjusted, multinomial logistic regression models predicting the odds of overweight and obesity. Children exposed to lack of very good/excellent maternal mental health and at least one AFE were at risk for overweight (OR = 1.43; 95% CI: 1.16, 1.76) and obesity (OR = 1.53; 95% CI: 1.22, 1.93). Unsafe school or neighborhood environment and exposure to 1 or more AFEs was. associated with overweight (OR = 1.32; 95% CI: 1.08, 1.61) and obesity (OR = 1.66; 95% CI: 1.34, 2.05). Lack of child resilience and exposure to 1 or more AFEs was associated with an increased risk of obesity (OR = 1.45; 95% CI: 1.17, 1.90) and overweight (OR = 1.29; 95% CI: 1.06, 1.57). These odds of obesity and overweight all decreased when positive contextual factors were present. Among children exposed to AFEs, overweight and obesity risk is reduced with positive contextual factors. Optimizing the early childhood environment can impact obesity risk.
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