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Kim CN, Messito MJ, Duh-Leong C, Katzow M, Teli R, Gross RS. The effects of parent-child dysfunctional interactions on early childhood weight: A serial mediation model through emotional feeding and child appetite traits. Appetite 2024; 200:107564. [PMID: 38897417 DOI: 10.1016/j.appet.2024.107564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/22/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
Parent-child dysfunctional interactions (PCDI) are known to contribute to children's weight status. However, the underlying mechanisms in how dysfunctional interactions between parent and child influence child weight are not clear. This study investigates the impact of PCDI on toddlers' weight, focusing on the potential serial mediation by maternal emotional feeding and child appetite traits. We conducted a secondary analysis of longitudinal data from a larger intervention trial to prevent childhood obesity in low-income Hispanic families. A total of 241 mother-child dyads were included in these analyses. Measurements were taken at various stages: PCDI at child age 19 months, maternal emotional feeding at 28 months, and both child appetite traits and weight-for-age z-score (WFAz) at 36 months. Serial mediation analyses revealed a significant indirect effect of early PCDI on later child WFAz through maternal emotional feeding and two child food approach traits (food responsiveness, emotional overeating) out of the eight child appetite traits assessed. PCDI at 19 months was associated with increased use of emotional feeding in mothers at 28 months, which was associated with heightened food responsiveness and emotional overeating in children at 36 months, which in turn was linked to greater child WFAz at 36 months. The findings of this study expand the understanding of the mechanisms underlying PCDI and child weight, emphasizing the interplay between maternal feeding practices and child appetite in the context of adverse parent-child interactions during early childhood.
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Affiliation(s)
| | | | | | | | - Radhika Teli
- New York University Grossman School of Medicine, USA
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2
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Liu C, Neiderhiser JM, Ram N, Leve LD, Shaw DS, Natsuaki MN, Reiss D, Ganiban JM. Modeling BMI z score lability during childhood as a function of child temperament and genetic risk for obesity. Obesity (Silver Spring) 2023; 31:2593-2602. [PMID: 37724056 PMCID: PMC10846492 DOI: 10.1002/oby.23867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE This study aimed to examine whether child genetic risk for obesity and temperament (i.e., negative affectivity, effortful control) accounted for stability versus lability in children's weight status (BMI z score) over time. METHODS A total of 561 adopted children (42% female; 56% Caucasian, 13% African American, 11% Latino, and 20% other) and their birth and adoptive parents were followed from birth to age 9 years. The multilevel location-scale model was used to examine whether child genetic risk for obesity and temperament were related to differences in level and lability in child BMI z scores over time. RESULTS For the full sample, higher levels of child negative affectivity were associated with greater BMI z score lability, whereas higher levels of effortful control and children's mean-level BMI z scores were related to less lability across childhood. Additional analyses examined associations within groups of children with healthy versus overweight/obesity weight statuses. Within the healthy weight status group only, better effortful control was associated with more stable BMI z scores, whereas genetic risk for higher BMI was associated with more labile BMI z scores. CONCLUSIONS These findings provide insights into factors that can be harnessed to redirect unhealthy trajectories as well as factors that may challenge redirection or maintain a healthy trajectory.
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Affiliation(s)
- Chang Liu
- Washington State University, Department of Psychology, Pullman, WA, USA
| | - Jenae M. Neiderhiser
- The Pennsylvania State University, Department of Psychology, University Park, PA, USA
| | - Nilam Ram
- Stanford University, Departments of Psychology and Communication, Stanford, CA, USA
| | - Leslie D. Leve
- University of Oregon, Prevention Science Institute, Eugene, OR, USA
| | - Daniel S. Shaw
- University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
| | - Misaki N. Natsuaki
- University of California, Riverside, Department of Psychology, Riverside, CA, USA
| | - David Reiss
- Yale University, Child Study Center, New Haven, CT, USA
| | - Jody M. Ganiban
- George Washington University, Department of Psychological & Brain Sciences, Washington, DC, USA
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Wu JCL, Wang PL, Chiang TL. Early temperament and physical health in school-age children: Applying a short temperament measure in a population-based cohort. PLoS One 2023; 18:e0285710. [PMID: 37216365 DOI: 10.1371/journal.pone.0285710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/29/2023] [Indexed: 05/24/2023] Open
Abstract
Temperament has drawn considerable attention in the understanding of behavioural problems and psychopathology across developmental stages. However, less of a focus has been placed on the role of temperament in physical aspects of health. We aimed to examine the relations between early temperament traits and physical health in school-age children. This study used longitudinal data of 18,994 children (52.4% boys) born in 2005 from the Taiwan Birth Cohort Study, in which follow-up surveys were conducted via face-to-face interviews with the child's caregiver. Temperament at 5.5 years of age was assessed using a nine-item measure, and two higher-order temperament traits, surgency and regulation, were derived through confirmatory factor analysis. Physical health outcomes at age 8 included caregiver-rated general health status and medically attended injuries. Multiple logistic regression analysis was applied, with the child's birth outcome, early health status or injury history, health behaviours and family socioeconomic status as control variables. The results indicated that higher levels of surgency and regulation, as early temperament traits, significantly predicted lower odds of caregiver-rated poor health in later years. Higher level of regulation was also associated with lower odds of injury risk. Our findings suggest that assessing early temperament traits could be useful for the promotion and management of physical health in young school-age children.
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Affiliation(s)
- Jennifer Chun-Li Wu
- Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan
| | - Pei-Ling Wang
- Department of Early Childhood Education, University of Taipei, Taipei, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
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Rahmaty Z, Johantgen ME, Storr CL, Wang Y, Black MM. Preschoolers BMI: Associations with Patterns of Caregivers' Feeding Practices Using Structural Equation Models. Child Obes 2023; 19:169-178. [PMID: 35649202 PMCID: PMC10122251 DOI: 10.1089/chi.2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Childhood obesity is a major health concern. Caregivers' feeding practices are modifiable targets of obesity prevention. The study tested two hypotheses: (1) autonomy-promoting feeding practices are associated with lower BMI; and (2) diet mediates the association. We also explored examined whether feeding practices and BMI z-score (BMIz) associations are moderated by child sex, caregiver race, education, family poverty level, and food insecurity. Methods: Cross-sectional study of 437 preschoolers (44.4% girls, 38.2% Black/Other, mean age 48.1 months) and caregivers (90.2% female) from 50 child care centers. Feeding Practices were measured by Comprehensive Feeding Practices Questionnaire, child-size perception by preschooler silhouettes, temperament by the Behavior Rating Inventory of Executive Function, child diet by Young Children Food and Drink Questionnaire, and BMIz by measured weight and height. Latent profile analysis delineated feeding practice patterns. Structure equation modeling assessed the patterns in relationship to BMIz. Mediation and multiple-group analyses were used to assess mechanisms of feeding practice patterns and BMIz association. Results: From the three feeding practice patterns, Controlling, Balancing, and Regulating, Regulating was associated with lower child BMIz (b = -0.09) compared to Controlling. Higher difficult temperament (b = 0.09), higher caregiver BMIz (b = 0.26), and caregiver desire for thinner (b = 0.23) were associated with BMIz (p < 0.05). Evaluations of moderators and mediators were not significant. Conclusions: Comprehensive feeding practices support family factors related to child BMIz. Longitudinal research is needed to examine temporal associations between feeding practices and BMIz, with attention to autonomy-supporting practices, promotion of young children's self-regulation, and caregivers' perceptions of child temperament and size. Trial Registration: NCT03111264.
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Affiliation(s)
- Zahra Rahmaty
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
- Institute of Higher Education and Research in Healthcare (IUFRS), Department of Biology and Medicine, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Mary E. Johantgen
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L. Storr
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- RTI International, Research Triangle Park, NC, USA
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Bravo P, Cárcamo R, Santos S, Ringoot A, van IJzendoorn MH, Hillegers MHJ, Jansen PW. Maternal sensitivity in early childhood and body mass index in adolescence: A population-based study on the role of self-regulation as a mediator. Appetite 2023; 182:106418. [PMID: 36521650 DOI: 10.1016/j.appet.2022.106418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/07/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
Maternal sensitivity has been implicated in various aspects of child health and development, including overweight. However, long-term effects, the role of paternal sensitivity and the explanatory pathways are unclear. This study examined whether maternal sensitivity in early childhood is prospectively associated with adolescent body mass index and whether children's self-regulation mediates this relation. Data from 540 children and their mothers were available from a large cohort study in the Netherlands. Maternal sensitivity was assessed at child ages 1, 3, and at 4 years paternal sensitivity was also included. Children's self-regulation skills were observed at age 3, eating behaviour was assessed at 10 years, and child BMI was measured at 13 years. Longitudinal structural equation modelling was applied. The cross-sectional association between maternal sensitivity and child self-regulation was significant, while lower levels of self-regulation and higher levels of food responsiveness and restrained eating predicted a higher child BMI at 13 years. Furthermore, a direct association of paternal sensitivity at 4 years with BMI at 13 years was found, but only in girls. Maternal sensitivity was not directly associated with child BMI after adjusting for covariates. Our findings showed the importance of self-regulation in the early years for subsequent weight development. Nevertheless, as self-regulation could not explain the relationship between parenting and child weight, research should focus on the contribution of other contextual factors, such as feeding styles and the social environment, to this relationship.
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Affiliation(s)
- Patricia Bravo
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Rodrigo Cárcamo
- Facultad de Psicología, Universidad de Magallanes, Punta Arenas, Chile; Facultad de Psicología, Universidad San Sebastián, Sede Valdivia, Chile
| | - Susana Santos
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, Porto, Portugal
| | - Ank Ringoot
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands; Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands
| | - Marinus H van IJzendoorn
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Manon H J Hillegers
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands.
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Parrott A, Zvara BJ, Keim SA, Andridge R, Anderson SE. Play & Grow: prospective observational cohort of toddlers to inform obesity prevention, Columbus, Ohio, USA. BMJ Open 2022; 12:e055490. [PMID: 34996797 PMCID: PMC8744096 DOI: 10.1136/bmjopen-2021-055490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Obesity prevention is increasingly focused on early childhood, but toddlers have not been well-studied, and children born preterm are frequently excluded. The Play & Grow Cohort was established to investigate child growth in relation to parent-child interactions in mealtime and non-mealtime settings. PARTICIPANTS Between December 2017 and May 2019, 300 toddlers and primary caregivers were recruited from records of a large paediatric care provider in Columbus, Ohio, USA. This report describes recruitment of the cohort and outlines the data collection protocols for two toddler and two preschool-age visits. The first study visit coincided with enrolment and occurred when children (57% boys) were a mean (SD) calendar age of 18.2 (0.7) months. FINDINGS TO DATE Children in the cohort are diverse relative to gestational age at birth (16%, 28-31 completed weeks' gestation; 21%, 32-36 weeks' gestation; 63%, ≥37 weeks' gestation) and race/ethnicity (8%, Hispanic; 35%, non-Hispanic black; 46%, non-Hispanic white). Caregivers enrolled in the cohort are primarily the child's biological mother (93%) and are diverse in age (range 18-54 years), education (23%, high school or less; 20% graduate degree) and annual household income (27%, <US$20 000 24%, ≥US$90 000). Parent-child interactions were video-recorded during play in the laboratory at 18 months (n=299) and during play, reading and mealtime in the home (n=284) at 24 months. The preschool phase of the study was impacted by COVID-19. Parent-child interactions were video-recorded during play and mealtime at home at 36 months (n=141) and during a standardised buffet meal in the laboratory at 42 months (n=50). Caregivers unable to participate in face-to-face visits due to COVID-19 completed questionnaires. FUTURE PLANS Assessment during middle childhood is being planned. Future visits will include anthropometric measurements and parent-child interactions at mealtime. School-based outcomes are additionally being considered.
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Affiliation(s)
- Andria Parrott
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Bharathi J Zvara
- Gillings School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah A Keim
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Rebecca Andridge
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Sarah E Anderson
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA
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Schlensog-Schuster F, Klein AM, Biringen Z, von Klitzing K, Bergmann S. Maternal sensitivity and intrusiveness in early childhood as predictors of children's weight at school age. Pediatr Obes 2022; 17:e12842. [PMID: 34553841 DOI: 10.1111/ijpo.12842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND While previous research indicates that low maternal sensitivity in mother-child interactions puts children at risk of overweight and obesity, maternal intrusiveness has rarely been investigated in association with children's weight. We investigated whether maternal sensitivity and intrusiveness in early childhood predict children's increased body mass index standard deviation scores (BMI-SDS) at school age. BMI-SDS are standardized for age and gender with respect to a reference standard. METHODS At baseline (t1), we assessed maternal sensitivity and (non-)intrusiveness of 116 mothers with their children (48.3% female) aged 5-47 months (M = 24.00, SD = 11.36) using the emotional availability scales. We obtained anthropometric data for mothers at t1 by measuring height and weight in the laboratory and for children at birth assessed by medical staff. Six years later (t2) we obtained anthropometric data for children in the laboratory or based on parental report. Linear regression analyses were run with child BMI-SDS at t2 as outcome and sensitivity and (non-)intrusiveness as predictors, adjusting for confounders and exploring child age and gender as moderators. RESULTS Maternal sensitivity only negatively predicted children's BMI-SDS in girls, while maternal intrusiveness predicted higher child BMI-SDS at school age regardless of child gender. The effect of maternal non-intrusiveness remained significant when controlling for confounders. CONCLUSION Maternal intrusiveness in early childhood seems to represent a risk factor for increased BMI-SDS in children, while lower maternal sensitivity tends to be a risk factor for increased BMI-SDS in girls. This may have implications for prevention or intervention programmes.
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Affiliation(s)
- Franziska Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
| | | | - Zeynep Biringen
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany
| | - Sarah Bergmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Leipzig, Germany.,International Psychoanalytic University, Berlin, Germany
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Leerkes EM, Buehler C, Calkins SD, Shriver LH, Wideman L. Protocol for iGrow (Infant Growth and Development Study): biopsychosocial predictors of childhood obesity risk at 2 years. BMC Public Health 2020; 20:1912. [PMID: 33317498 PMCID: PMC7734916 DOI: 10.1186/s12889-020-10003-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/26/2022] Open
Abstract
Background Childhood obesity remains a significant public health problem. To date, most research on the causes and correlates of obesity has focused on a small number of direct predictors of obesity rather than testing complex models that address the multifactorial nature of the origins of obesity in early development. We describe the rationale and methods of iGrow (Infant Growth and Development Study) which will test multiple pathways by which (a) prenatal maternal psychobiological risk predicts infant weight gain over the first 6 months of life, and (b) this early weight gain confers risk for obesity at age 2. Infant hormonal and psychobiological risk are proposed mediators from prenatal risk to early weight gain, though these are moderated by early maternal sensitivity and obesogenic feeding practices. In addition, higher maternal sensitivity and lower obesogenic feeding practices are proposed predictors of adaptive child self-regulation in the second year of life, and all three are proposed to buffer/reduce the association between high early infant weight gain and obesity risk at age 2. Methods iGrow is a prospective, longitudinal community-based study of 300 diverse mothers and infants to be followed across 5 data waves from pregnancy until children are age 2. Key measures include (a) maternal reports of demographics, stress, well-being, feeding practices and child characteristics and health; (b) direct observation of maternal and infant behavior during feeding, play, and distress-eliciting tasks during which infant heart rate is recorded to derive measures of vagal withdrawal; (c) anthropometric measures of mothers and infants; and (d) assays of maternal prenatal blood and infant saliva and urine. A host of demographic and other potential confounds will be considered as potential covariates in structural equation models that include tests of mediation and moderation. Efforts to mitigate the deleterious effects of COVID-19 on study success are detailed. Discussion This study has the potential to inform (1) basic science about early life processes casually related to childhood obesity and (2) development of targeted intervention and prevention approaches that consider mother, infant, and family risks and resources.
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Affiliation(s)
- Esther M Leerkes
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA.
| | - Cheryl Buehler
- UNC Greensboro, Department of Human Development and Family Studies, Greensboro, NC, 27402-6170, USA
| | - Susan D Calkins
- UNC Greensboro, Office of Research and Engagement, Greensboro, NC, 27402-6170, USA
| | - Lenka H Shriver
- UNC Greensboro, Department of Nutrition, Greensboro, NC, 27402-6170, USA
| | - Laurie Wideman
- UNC Greensboro, Department of Kinesiology, Greensboro, NC, 27402-6170, USA
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Parental Child-feeding in the Context of Child Temperament and Appetitive Traits: Evidence for a Biopsychosocial Process Model of Appetite Self-Regulation and Weight Status. Nutrients 2020; 12:nu12113353. [PMID: 33143216 PMCID: PMC7692583 DOI: 10.3390/nu12113353] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/17/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
Pediatric obesity is a serious public health challenge and there is a need for research that synthesizes the various linkages among the child and parental factors that contribute to pediatric overweight and obesity. The main objective of this study was to examine potential mechanisms and pathways that might explain how child temperament is indirectly related to child body composition through appetitive traits and parental child-feeding practices. Participants consisted of 221 children between 4–6 years of age (51% males, mean age = 4.80 years, standard deviation = 0.85) and their parents (90.5% biological mothers, (Mage) = 32.02 years, (SDage) = 6.43) with 71% of the parents being married. Study variables included child temperament (negative affectivity and effortful control), child appetitive traits (food avoidance and food approach), controlling parental child-feeding practices (restrictive feeding and pressure to eat), and child body composition. Body composition were indexed by parent perceptions, body mass index (BMI), and percent body fat. Results showed that children with low levels of effortful control are more prone to exhibit food avoidance, which in turn is likely to elicit parental pressure to eat that in turn is linked to high child weight status. In addition, children with high levels of negative affectivity are prone to exhibit a food approach, which in turn is likely to elicit restrictive feeding from parents that in turn is linked to high child objective weight status. Findings situate controlling parental child-feeding practices in the context of child temperament and appetitive traits using a biopsychosocial framework of appetite self-regulation and weight. Results highlight that child appetite self-regulation processes and parental child-feeding practices could be essential components to target in childhood obesity preventive interventions.
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Hepworth AD, Berlin LJ, Martoccio TL, Jones Harden B. Maternal attachment style, sensitivity, and infant obesity risk in low-income, Latino families. Attach Hum Dev 2020; 23:75-89. [PMID: 32126901 DOI: 10.1080/14616734.2020.1729214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Disparities in childhood obesity highlight the need for research to identify its early predictors in high-risk populations, such as low-income, Latino families. In the current study, the first of its kind in a low-income Latino sample (N = 55; M child age = 12.74 months, SD = 3.96), we investigated whether mothers' self-reported attachment style predicted their infants' weight-for-length (WFL; an early indicator of childhood obesity). We also explored whether observed maternal sensitivity, coded from a video-recorded semi-structured play assessment, mediated this association. We found a significant direct effect of maternal attachment style on infants' WFL z-scores (c' = -0.68, SE = 0.22, p = .004). Infants of mothers who classified themselves as secure had lower WFL z-scores than infants of insecure mothers (avoidant or anxious). Maternal sensitivity did not mediate this association, but was positively associated with infant WFL z-scores. We discuss implications of these findings for future research.
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Affiliation(s)
- Allison D Hepworth
- Department of Social Work, University of Maryland School of Social Work , Baltimore, MD, USA
| | - Lisa J Berlin
- Department of Social Work, University of Maryland School of Social Work , Baltimore, MD, USA
| | - Tiffany L Martoccio
- Department of Human Development and Quantitative Methodology, University of Maryland , College Park, MD, USA
| | - Brenda Jones Harden
- Department of Social Work, University of Maryland School of Social Work , Baltimore, MD, USA.,Department of Human Development and Quantitative Methodology, University of Maryland , College Park, MD, USA
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11
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Bergmeier H, Paxton SJ, Milgrom J, Anderson SE, Baur L, Hill B, Lim S, Green R, Skouteris H. Early mother-child dyadic pathways to childhood obesity risk: A conceptual model. Appetite 2019; 144:104459. [PMID: 31533059 DOI: 10.1016/j.appet.2019.104459] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/06/2019] [Accepted: 09/14/2019] [Indexed: 01/24/2023]
Abstract
Understanding the emotional quality of the mother-child dyadic relationship and parent-child feeding interactions may further clarify early developmental pathways to eating behaviours and obesity risk. The quality of parent-child relationships fosters all aspects of child development but has not yet been extensively examined in relation to childhood weight gain. The aim of this paper is to propose a conceptual model, which outlines early mother-child dyadic pathways linking parent-child feeding interactions to child body mass index, where parent-child relationships have a central role. It maps out individual and dyadic mother-child factors (i.e., attachment, child temperament and maternal mental health) that influence the nature and quality of parent-child feeding interactions from infancy to toddlerhood. Our model bridges the gap between research fields by bringing together key maternal and child factors implicated in child development. Understanding early parent-child feeding interactional patterns and their influence on child self-regulation and eating behaviours may be relevant to multidisciplinary approaches toward preventing childhood obesity. High quality quantitative and observational data capturing meaningful parent, child and dyadic level interactions around food contexts, attachment security, maternal mental health, child temperament and self-regulation will help to inform new, aetiologically important, targets for preventative intervention.
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Affiliation(s)
- Heidi Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jeannette Milgrom
- School of Psychological Sciences, Melbourne University, Melbourne, Australia; Parent-Infant Research Institute, Department of Clinical and Health, Psychology, Heidelberg Repatriation Hospital, Heidelberg West, Australia
| | - Sarah E Anderson
- Division of Epidemiology, School of Public Health, The Ohio State University, Columbus, OH, USA
| | - Louise Baur
- Discipline of Paediatrics and Child Health and Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Rachael Green
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
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12
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Kinnally EL, Martinez SJ, Chun K, Capitanio JP, Ceniceros LC. Early Social Stress Promotes Inflammation and Disease Risk in Rhesus Monkeys. Sci Rep 2019; 9:7609. [PMID: 31110226 PMCID: PMC6527690 DOI: 10.1038/s41598-019-43750-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022] Open
Abstract
Early social stress has potent lifelong health effects. We examined the association of early stress in the attachment relationship (low maternal sensitivity, low MS), lower maternal social hierarchy rank, and greater frequency of group-level social conflict, with biomarkers of inflammatory stress response in plasma (IL-8, MCP-1 and CRP collected two hours after temporary separation from mothers and social groups) and risk for developing a common macaques disease outcome (infectious colitis) in 170 socially-housed rhesus monkeys. We controlled for gene-environment correlations by comparing cross-fostered subjects with infants reared by their biological mothers. Low MS predicted higher levels of pro-inflammatory cytokines and proteins at 3-4 months of age (F(3, 162) = 3.508, p = 0.002, partial eta2 = 0.061) and higher lifetime risk for developing colitis for up to twelve years of age (chi square = 5.919, p = 0.026). Lower maternal social rank (F (3, 162) = 3.789, p = 0.012, partial eta2 = 0.06) and higher rates of social conflict (F (3, 162) = 4.264, p = 0.006, partial eta2 = 0.074) each also predicted greater inflammation in infancy, but not lifetime colitis risk (both p > 0.05). The effects of low MS, lower social rank, and higher social conflict were significant in infants reared by biological mothers and cross-fostered infants, suggesting that our results did not arise from gene-environment correlations, but environmental stressors alone. We conclude that several types of early social stress confer risk for inflammation in infancy, but that stress in the mother-infant relationship may confer the longest-term risk for adverse health outcomes.
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Affiliation(s)
- Erin L Kinnally
- University of California Davis, Department of Psychology, Davis, USA.
- California National Primate Research Center, Davis, USA.
| | | | - Katie Chun
- University of California Davis, Department of Psychology, Davis, USA
- California National Primate Research Center, Davis, USA
| | - John P Capitanio
- University of California Davis, Department of Psychology, Davis, USA
- California National Primate Research Center, Davis, USA
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Food portion at ages 8–11 and obesogeny: The amount of food given to children varies with the mother's education and the child's appetite arousal. Soc Sci Med 2019; 228:111-116. [DOI: 10.1016/j.socscimed.2019.03.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/23/2019] [Accepted: 03/15/2019] [Indexed: 11/21/2022]
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Greydanus DE, Agana M, Kamboj MK, Shebrain S, Soares N, Eke R, Patel DR. Pediatric obesity: Current concepts. Dis Mon 2018; 64:98-156. [DOI: 10.1016/j.disamonth.2017.12.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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15
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Impact of the Social and Natural Environment on Preschool-Age Children Weight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030449. [PMID: 29510565 PMCID: PMC5876994 DOI: 10.3390/ijerph15030449] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 02/27/2018] [Accepted: 03/02/2018] [Indexed: 12/18/2022]
Abstract
Background: The complex impact of environmental and social factors on preschool children being overweight/obese is unclear. We examined the associations between the levels of green space exposure and the risk of being overweight/obese for 4–6 year-old children and assessed the impact of maternal education on these associations. Methods: This cross-sectional study included 1489 mother-child pairs living in Kaunas, Lithuania, in 2012–2013. We assessed children overweight/obesity by standardized questionnaires using international body mass index cut-off points, and the level of greenness exposures by satellite-derived normalized difference vegetation index (NDVI) of each child’s home and by the distance to a nearest city park. The maternal education was used as the SES indicator. We used logistic regression models to investigate the strength of the associations. Results: Children from families with poorer maternal education, pathological mother-child relations and smoking mothers, and living in areas with less greenness exposure (NDVI-100 m), had significantly higher odds ratios of being overweight/obese. Lower maternal education and distance to a city park modified the effect of greenness cover level exposure on the risk of children being overweight/obese. Conclusions: Higher greenness exposure in the residential settings has beneficial effects on children’s physical development. The green spaces exposures for psychosocial stress management is recommended as a measure to prevent overweight/obesity among children.
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Grazuleviciene R, Petraviciene I, Andrusaityte S, Balseviciene B. Psychosocial stress and obesity among children residing in Kaunas City. ENVIRONMENTAL RESEARCH 2017; 157:37-43. [PMID: 28511079 DOI: 10.1016/j.envres.2017.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION An unfavorable psychosocial environment has been associated with an increased prevalence of obesity among children. However, the available evidence on the association of low socioeconomic status and parent-child relationships with childhood obesity is scarce. The aim of our study was to conduct a simultaneous evaluation of the risks associated with pathological mother-child relationships, education level, and overweight/obesity among 4-6 year-old children. METHODS This cross-sectional study included 1489 mother-child pairs living in Kaunas city, Lithuania. The Parenting Stress Index was measured using the Parent-Child Dysfunctional Interaction subscale. Children's overweight/obesity was defined as the body mass index ≥18kg/m2. Logistic regression models as well as crude and adjusted odds ratios (OR) and their 95% confidence intervals (CI) were used to indicate the strength of the associations between childhood overweight/obesity, maternal education level, and psychosocial stress. RESULTS The percentage of children with overweight/obesity rose with an increasing Parenting Stress Index score. The percentage of children with overweight/obesity in the group of parents with better education and normal mother-child relations was 6.0%, while in the group of less educated parents and pathological mother-child relations, this percentage reached 13.9%. The stratified multivariable model showed that, with reference to the group of better educated parents and normal mother-child relations, lower education level and pathological mother-child relations were statistically significant risk factors for overweight/obesity in 4-6 year-old children, increasing the OR of overweight/obesity (aOR: 2.43; 95% CI: 1.31-4.51). Pathological mother-child relations and maternal smoking mediated the effect of low maternal education level on children's BMI z-scores. CONCLUSION Pathological mother-child relations, lower parental education levels, and smoking may be predictors of children's overweight/obesity. Measures oriented towards health behavior and psychosocial stress management should be encouraged among parents in order to decrease the risk of overweight/obesity in their children.
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Affiliation(s)
- Regina Grazuleviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania.
| | - Inga Petraviciene
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania
| | - Birute Balseviciene
- Department of Theoretical Psychology, Vytauto Didziojo Universitetas, K. Donelaicio str. 58, 44248 Kaunas, Lithuania
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Peacock-Chambers E, Radesky JS, Parker SE, Zuckerman B, Lumeng JC, Silverstein M. Infant Regulatory Problems and Obesity in Early Childhood. Acad Pediatr 2017; 17:523-528. [PMID: 28669453 DOI: 10.1016/j.acap.2016.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 09/24/2016] [Accepted: 11/06/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Difficult infant temperament is associated with higher weight status in infancy. However, the association of infant temperament, including regulatory capacities, has not been well studied as a possible predictor of future weight status in early childhood. We examined prospective associations of infant regulatory difficulties with obesity in early childhood in a large, diverse cohort. METHODS We used data from 5750 children in the Early Childhood Longitudinal Study-Birth Cohort, excluding preterm infants and infants small or large for gestational age. Infant regulatory ability was measured at age 9 months by the Infant Toddler Symptom Checklist (ITSC). We created a multivariable logistic regression model comparing risk of obesity at preschool age in infants with ITSC scores ≥6 to infants with scores <6. We further examined the association when stratified by a measure of maternal sensitivity. RESULTS The cohort of children was 48% non-Hispanic white, and 51% were boys. Twenty-one percent of children with ITSC scores ≥6 were obese at preschool age. Infants with ITSC scores ≥6 had 32% increased odds of being obese at preschool age (adjusted odds ratio 1.32 [95% confidence interval 1.03, 1.70]). The strongest association existed among children described as demanding attention constantly. There was no difference in the association when comparing mothers with high or low maternal sensitivity. CONCLUSIONS Infant regulatory difficulties are associated with a higher risk of obesity at preschool age. Helping parents manage and respond to difficult infant behaviors before preschool may serve as a focal point for future interventions.
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Affiliation(s)
| | - Jenny S Radesky
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Mich
| | - Samantha E Parker
- Department of Epidemiology, Boston University School of Public Health, Boston, Mass
| | - Barry Zuckerman
- Division of General Pediatrics, Boston Medical Center, Boston, Mass
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich; Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Mich
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Dalle Molle R, Fatemi H, Dagher A, Levitan RD, Silveira PP, Dubé L. Gene and environment interaction: Is the differential susceptibility hypothesis relevant for obesity? Neurosci Biobehav Rev 2016; 73:326-339. [PMID: 28024828 DOI: 10.1016/j.neubiorev.2016.12.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 12/09/2016] [Accepted: 12/20/2016] [Indexed: 02/04/2023]
Abstract
The differential susceptibility model states that a given genetic variant is associated with an increased risk of pathology in negative environments but greater than average resilience in enriched ones. While this theory was first implemented in psychiatric-genetic research, it may also help us to unravel the complex ways that genes and environments interact to influence feeding behavior and obesity. We reviewed evidence on gene vs. environment interactions that influence obesity development, aiming to support the applicability of the differential susceptibility model for this condition, and propose that various environmental "layers" relevant for human development should be considered when bearing the differential susceptibility model in mind. Mother-child relationship, socioeconomic status and individual's response are important modifiers of BMI and food intake when interacting with gene variants, "for better and for worse". While only a few studies to date have investigated obesity outcomes using this approach, we propose that the differential susceptibility hypothesis is in fact highly applicable to the study of genetic and environmental influences on feeding behavior and obesity risk.
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Affiliation(s)
- Roberta Dalle Molle
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Bronfman Building, 1001 Sherbrooke St. W., Montreal, QC H3A 1G5, Canada; McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC H3A 2B4, Canada.
| | - Hajar Fatemi
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Bronfman Building, 1001 Sherbrooke St. W., Montreal, QC H3A 1G5, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, QC H3A 2B4, Canada
| | - Robert D Levitan
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON M6J 1H4, Canada
| | - Patricia P Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Douglas Institute, Perry Pavilion, 6875 Boulevard LaSalle, Montreal, QC H4H 1R3, Canada
| | - Laurette Dubé
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Bronfman Building, 1001 Sherbrooke St. W., Montreal, QC H3A 1G5, Canada
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Bergmeier H, Aksan N, McPhie S, Fuller-Tyszkiewicz M, Baur L, Milgrom J, Campbell K, Demir D, Skouteris H. Mutually Responsive Orientation: A novel observational assessment of mother-child mealtime interactions. Appetite 2016; 105:400-9. [PMID: 27317618 DOI: 10.1016/j.appet.2016.06.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 02/08/2023]
Abstract
Mother-child mealtime interactions during preschool years is an important but overlooked factor when evaluating the influence of parent-child relationships on child eating and weight. This paper describes the validation of the Mutually Responsive Orientation (MRO) coding system adapted for assessing parent-child interactions during food preparation and consumption situations. Home-based mealtimes of 94 mothers and their children (3.03 ± 0.75 years) were filmed at two time points, 12-months apart. Filmed dimensions of mutual mother-child responsiveness, shared positive affect, maternal control relating to food and child compliance were assessed. Objective BMI and maternal reports of parenting, feeding, child eating, diet and child temperament were also collected. Correlations, repeated measures ANOVAs and regressions were performed to examine the validity of MRO variables and their stability across both time points. Validation analysis showed the MRO coding system performed as expected: dyads with higher MRO scores expressed lower control/power assertion, lower child non-compliance, and greater committed compliance. The measure demonstrated sensitivity to specific contexts: maternal responsiveness, mother and child positive affect were higher during food consumption compared to food preparation. Coded dimensions were stable across time points, with the exception of decreases in maternal responsiveness in food consumption and child non-compliance in food preparation. MRO and maternal dimensions were correlated with maternally reported parenting and feeding measures. Maternal responsiveness (inversely) and child responsiveness (positively) were concurrently associated with child fussy eating, and child refusal was prospectively and inversely associated with child fussy eating. Findings suggest the adapted MRO coding system is a useful measure for examining observed parent-child mealtime interactions potentially implicated in preschoolers' eating and weight development.
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Affiliation(s)
| | - Nazan Aksan
- Department of Neurology, University of Iowa, Iowa City, IA, USA
| | - Skye McPhie
- School of Psychology, Deakin University, Geelong, Australia
| | | | - Louise Baur
- Discipline of Paediatrics and Child Health and Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Jeannette Milgrom
- School of Psychological Sciences, Melbourne University, Melbourne, Australia; Parent-Infant Research Institute, Department of Clinical and Health, Psychology, Heidelberg Repatriation Hospital, Heidelberg West, Australia
| | - Karen Campbell
- Centre for Physical Activity and Nutrition Research, Deakin University, Geelong, Australia
| | - Defne Demir
- School of Psychology, Deakin University, Geelong, Australia
| | - Helen Skouteris
- School of Psychology, Deakin University, Geelong, Australia.
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Sleddens EFC, Ten Hoor GA, Kok G, Kremers SPJ. Associations between parental impulsivity and child body mass index. SPRINGERPLUS 2016; 5:1422. [PMID: 27625976 PMCID: PMC5001965 DOI: 10.1186/s40064-016-3048-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 08/11/2016] [Indexed: 01/09/2023]
Abstract
Objective The aim of this study was to examine the association between parental impulsivity and (12–15 year old) child body mass index (BMI). Methods In total, 300 parents completed a survey regarding their own impulsivity level (Barratt impulsiveness scale) and that of their child (impulsivity scale of the temperament in middle childhood questionnaire), and supplied details of their own and their child’s height and weight. Partial correlations were computed to assess relationships between both parental and child impulsiveness scores and child BMI z-scores, independent of parental BMI. Mediation analyses were performed to assess the potential mediating role of child impulsivity on the relationship between parental impulsivity and child BMI z-score. Results For daughters, parental impulsivity was significantly correlated with BMI z-score. Parent-reported child impulsivity was not related to child BMI z-score, and no evidence was found for a mediating effect of parent-reported child impulsivity on the relationship between parental impulsivity and child BMI z-score. Conclusion There is a stronger association between parental impulsivity and child BMI z-score than between child impulsivity and child BMI z-score. The relationship between parental impulsivity and-child BMI z-score could possibly be explained by parenting styles and practices. The potentially mediating role of parenting should be taken into account in future studies investigating the role of personality in children becoming overweight or obese. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-3048-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ester F C Sleddens
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gill A Ten Hoor
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands ; Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Gerjo Kok
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Taylor RW, Heath ALM, Galland BC, Cameron SL, Lawrence JA, Gray AR, Tannock GW, Lawley B, Healey D, Sayers RM, Hanna M, Meredith-Jones K, Hatch B, Taylor BJ. Three-year follow-up of a randomised controlled trial to reduce excessive weight gain in the first two years of life: protocol for the POI follow-up study. BMC Public Health 2016; 16:771. [PMID: 27514714 PMCID: PMC4982410 DOI: 10.1186/s12889-016-3383-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/27/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The Prevention of Overweight in Infancy (POI) study was a four-arm randomised controlled trial (RCT) in 802 families which assessed whether additional education and support on sleep (Sleep group); food, physical activity and breastfeeding (FAB group); or both (Combination group), reduced excessive weight gain from birth to 2 years of age, compared to usual care (Control group). The study had high uptake at recruitment (58 %) and retention at 2 years (86 %). Although the FAB intervention produced no significant effect on BMI or weight status at 2 years, the odds of obesity were halved in those who received the sleep intervention, despite no apparent effect on sleep duration. We speculate that enhanced self-regulatory behaviours may exist in the Sleep group. Self-regulation was not measured in our initial intervention, but extensive measures have been included in this follow-up study. Thus, the overall aim of the POI follow-up is to determine the extent to which augmented parental support and education on infant sleep, feeding, diet, and physical activity in the first 2 years of life reduces BMI at 3.5 and 5 years of age, and to determine the role of self-regulation in any such relationship. METHODS/DESIGN We will contact all 802 families and seek renewed consent to participate in the follow-up study. The families have received no POI intervention since the RCT finished at 2 years of age. Follow-up data collection will occur when the children are aged 3.5 and 5 years (i.e. up to 3 years post-intervention). Outcomes of interest include child anthropometry, body composition (DXA scan), diet (validated food frequency questionnaire), physical activity (accelerometry), sleep (questionnaire and accelerometry), and self-regulation (questionnaires and neuropsychological assessment). DISCUSSION Our follow-up study has been designed primarily to enable us to determine whether the intriguing benefit of the sleep intervention suggested at 2 years of age remains as children approach school age. However, cohort analyses will also investigate how BMI, self-regulation, and sleep consolidation develop during the early years. This information will be valuable to researchers and policy makers progressing the field of early childhood obesity prevention. TRIAL REGISTRATION ClinicalTrials.gov number NCT00892983 .
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Affiliation(s)
- Rachael W. Taylor
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054 New Zealand
| | | | - Barbara C. Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Sonya L. Cameron
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Julie A. Lawrence
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Andrew R. Gray
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Gerald W. Tannock
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Blair Lawley
- Department of Microbiology and Immunology, University of Otago, Dunedin, New Zealand
| | - Dione Healey
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Rachel M. Sayers
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Maha Hanna
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Kim Meredith-Jones
- Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054 New Zealand
| | - Burt Hatch
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Barry J. Taylor
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
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Bergmann S, Schlesier-Michel A, Wendt V, Grube M, Keitel-Korndörfer A, Gausche R, von Klitzing K, Klein AM. Maternal Weight Predicts Children's Psychosocial Development via Parenting Stress and Emotional Availability. Front Psychol 2016; 7:1156. [PMID: 27559321 PMCID: PMC4978733 DOI: 10.3389/fpsyg.2016.01156] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/20/2016] [Indexed: 12/16/2022] Open
Abstract
Introduction: Maternal obesity has been shown to be a risk factor for obesity in children and may also affect children's psychosocial outcomes. It is not yet clear whether there are also psycho-emotional mechanisms explaining the effects of maternal weight on young children's weight and psychosocial development. We aimed to evaluate whether maternal body mass index (BMI), mother–child emotional availability (EA), and maternal parenting stress are associated with children's weight and psychosocial development (i.e., internalizing/externalizing symptoms and social competence) and whether these predictors interact with each other. Methods: This longitudinal study included three assessment points (~11 months apart). The baseline sample consisted of N = 194 mothers and their children aged 5–47 months (M = 28.18, SD = 8.44, 99 girls). At t1, we measured maternal weight and height to calculate maternal BMI. We videotaped mother–child interactions, coding them with the EA Scales (fourth edition). We assessed maternal parenting stress with the Parenting Stress Index (PSI) short form. At t1 to t3, we measured height and weight of children and calculated BMI–SDS scores. Children's externalizing and internalizing problems (t1–t3) and social competence (t3, N = 118) were assessed using questionnaires: Child Behavior Checklist (CBCL 1.5–5), Strengths and Difficulties Questionnaire (SDQ: prosocial behavior), and a checklist for behavioral problems at preschool age (VBV 3–6: social-emotional competence). Results: By applying structural equation modeling (SEM) and a latent regression analysis, we found maternal BMI to predict higher BMI–SDS and a poorer psychosocial development (higher externalizing symptoms, lower social competence) in children. Higher parenting stress predicted higher levels of externalizing and internalizing symptoms and lower social competence. Better maternal EA was associated with higher social competence. We found parenting stress to serve as a mediator in the association between maternal weight and children's psychosocial outcomes. Moreover, children of mothers with an elevated BMI were at greater risk of lower social competence only when their mothers showed low levels of maternal EA (moderation). Conclusion: Interventional studies are needed that investigate the causal pathways between parenting stress, mother–child interaction quality and child outcomes. These aspects might be targets to improve the psychosocial development of the offspring of overweight or obese mothers.
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Affiliation(s)
- Sarah Bergmann
- IFB AdiposityDiseases, Leipzig University Medical CenterLeipzig, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany
| | - Andrea Schlesier-Michel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany; Department of Developmental Psychology, Friedrich-Schiller-University of JenaJena, Germany
| | - Verena Wendt
- IFB AdiposityDiseases, Leipzig University Medical CenterLeipzig, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany
| | - Matthias Grube
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Leipzig, Germany
| | - Anja Keitel-Korndörfer
- IFB AdiposityDiseases, Leipzig University Medical CenterLeipzig, Germany; Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of LeipzigLeipzig, Germany
| | - Ruth Gausche
- CrescNet gGmbH, University of Leipzig Leipzig, Germany
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Leipzig, Germany
| | - Annette M Klein
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig Leipzig, Germany
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Abstract
This paper describes the epidemiologic evidence linking parent-child relationships, self-regulation, and weight status with a focus on early childhood. The emotional quality of parent-child interactions may influence children's risk for obesity through multiple pathways. Prospective studies linking observer ratings of young children's self-regulation, particularly inhibitory control, to future weight status are discussed. Although findings are preliminary, promoting positive relationships between parents/caregivers and young children holds promise as a component of efforts to prevent childhood obesity. Multi-disciplinary collaborations between researchers with training in developmental science and child health should be encouraged.
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Affiliation(s)
- Sarah E. Anderson
- Division of Epidemiology, College of Public Health, The Ohio State University, 336 Cunz Hall, 1841 Neil Ave, Columbus, Ohio, 43210, Ph. # 614 688 3600; Fax # 614 688-3533,
| | - Sarah A. Keim
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205, Ph. #614 722 2000,
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Woo Baidal JA, Locks LM, Cheng ER, Blake-Lamb TL, Perkins ME, Taveras EM. Risk Factors for Childhood Obesity in the First 1,000 Days: A Systematic Review. Am J Prev Med 2016; 50:761-779. [PMID: 26916261 DOI: 10.1016/j.amepre.2015.11.012] [Citation(s) in RCA: 566] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 12/27/2022]
Abstract
CONTEXT Mounting evidence suggests that the origins of childhood obesity and related disparities can be found as early as the "first 1,000 days"-the period from conception to age 2 years. The main goal of this study is to systematically review existing evidence for modifiable childhood obesity risk factors present from conception to age 2 years. EVIDENCE ACQUISITION PubMed, Embase, and Web of Science were searched for studies published between January 1, 1980, and December 12, 2014, of childhood obesity risk factors present during the first 1,000 days. Prospective, original human subject, English-language research with exposure occurrence during the first 1,000 days and with the outcome of childhood overweight or obesity (BMI ≥85th percentile for age and sex) collected between age 6 months and 18 years were analyzed between December 13, 2014, and March 15, 2015. EVIDENCE SYNTHESIS Of 5,952 identified citations, 282 studies met inclusion criteria. Several risk factors during the first 1,000 days were consistently associated with later childhood obesity. These included higher maternal pre-pregnancy BMI, prenatal tobacco exposure, maternal excess gestational weight gain, high infant birth weight, and accelerated infant weight gain. Fewer studies also supported gestational diabetes, child care attendance, low strength of maternal-infant relationship, low SES, curtailed infant sleep, inappropriate bottle use, introduction of solid food intake before age 4 months, and infant antibiotic exposure as risk factors for childhood obesity. CONCLUSIONS Modifiable risk factors in the first 1,000 days can inform future research and policy priorities and intervention efforts to prevent childhood obesity.
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Affiliation(s)
- Jennifer A Woo Baidal
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Medical Center, New York City, New York
| | - Lindsey M Locks
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Erika R Cheng
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Tiffany L Blake-Lamb
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, Massachusetts; Kraft Center for Community Health Leadership, Partners Healthcare, Boston, Massachusetts
| | - Meghan E Perkins
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
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Emotional availability, understanding emotions, and recognition of facial emotions in obese mothers with young children. J Psychosom Res 2016; 80:44-52. [PMID: 26721547 DOI: 10.1016/j.jpsychores.2015.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 11/12/2015] [Accepted: 11/17/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Recent research has identified mother-child relationships of low quality as possible risk factors for childhood obesity. However, it remains open how mothers' own obesity influences the quality of mother-child interaction, and particularly emotional availability (EA). Also unclear is the influence of maternal emotional competencies, i.e. understanding emotions and recognizing facial emotions. This study aimed to (1) investigate differences between obese and normal-weight mothers regarding mother-child EA, maternal understanding emotions and recognition of facial emotions, and (2) explore how maternal emotional competencies and maternal weight interact with each other in predicting EA. A better understanding of these associations could inform strategies of obesity prevention especially in children at risk. METHODS We assessed EA, understanding emotions and recognition of facial emotions in 73 obese versus 73 normal-weight mothers, and their children aged 6 to 47 months (Mchild age=24.49, 80 females). RESULTS Obese mothers showed lower EA and understanding emotions. Mothers' normal weight and their ability to understand emotions were positively associated with EA. The ability to recognize facial emotions was positively associated with EA in obese but not in normal-weight mothers. Maternal weight status indirectly influenced EA through its effect on understanding emotions. CONCLUSION Maternal emotional competencies may play an important role for establishing high EA in interaction with the child. Children of obese mothers experience lower EA, which may contribute to overweight development. We suggest including elements that aim to improve maternal emotional competencies and mother-child EA in prevention or intervention programmes targeting childhood obesity.
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Skogheim TS, Vollrath ME. Associations of Child Temperament with Child Overweight and Breakfast Habits: A Population Study in Five-Year-Olds. Nutrients 2015; 7:10116-28. [PMID: 26633494 PMCID: PMC4690074 DOI: 10.3390/nu7125522] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/04/2015] [Accepted: 11/26/2015] [Indexed: 11/20/2022] Open
Abstract
This study examines the associations of child temperament with overweight/obesity and breakfast habits. Participants were 17,409 five-year-olds whose mothers partake in the Norwegian Mother and Child Cohort Study (MoBa), and completed a questionnaire at the child’s 5th birthday. Temperament was assessed as externalizing, internalizing and sociable temperament. Breakfast habits differentiated between “every day”, “4 to 6 times a week”, and “0 to 3 times a week”. The child’s weight status was determined by Body Mass Index-percentiles and categorized as normal weight versus overweight/obese. Children with externalizing temperament had higher odds of being overweight and higher odds of not eating breakfast daily. Children high in internalizing temperament had higher odds of not eating breakfast daily, but not of being overweight. Children with average scores of sociability were more prone to being overweight but had normal breakfast habits. All results were adjusted for key confounders. That five-year-olds high in externalizing temperament had a higher risk to be overweight adds important information to the literature. The association of externalizing temperament with child breakfast habits so early in life is intriguing, as parents mostly control eating patterns in children that young. Mechanisms mediating this association should be explored.
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Affiliation(s)
| | - Margarete Erika Vollrath
- Norwegian Institute of Public Health, Oslo 0403, Norway.
- Institute of Psychology, University of Oslo, Oslo 0373, Norway.
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Pilot Study of a Computer-Based Parental Questionnaire and Visual Profile of Obesity Risk in Healthy Preschoolers. J Pediatr Nurs 2015; 30:e45-52. [PMID: 25813269 DOI: 10.1016/j.pedn.2015.02.008] [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: 08/27/2014] [Revised: 02/13/2015] [Accepted: 02/13/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE This group field-tested a computer-based, parental questionnaire entitled the Childhood Obesity Risk Questionnaire 2-5 (CORQ 2-5) designed to assess obesity risk in healthy preschoolers. COR 2-5 generates a profile of seven obesity risk factors. RESULTS Field studies provided good internal reliability data and evidence of discriminant validity for the CORQ 2-5. Pediatric nurse clinicians found the CORQ 2-5 profile to be clinically relevant. CONCLUSION The CORQ 2-5 is a promising measure of obesity risk in preschoolers who attend community-based health centers for their wellchild visits and who are not yet obese. CORQ 2-5 is intended to guide provider-parental obesity risk discussions.
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Negative temperament as a moderator of intervention effects in infancy: testing a differential susceptibility model. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 15:643-53. [PMID: 23832637 DOI: 10.1007/s11121-013-0408-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A consideration of potential moderators can highlight intervention effects that are attenuated when investigating aggregate results. Differential susceptibility is one type of interaction, where susceptible individuals have poorer outcomes in negative environments and better outcomes in positive environments, compared to less susceptible individuals, who have moderate outcomes regardless of environment. In the current study, we provide rationale for investigating this type of interaction in the context of a behavioral childhood obesity preventive intervention and test whether infant negativity moderated intervention effects on infant self-regulation and weight gain and on two aspects of mothers' parenting competence: parenting self-efficacy and parenting satisfaction. Results showed that infants' negative temperament at 3 weeks moderated intervention effects on some, but not all, outcomes. The intervention led to greater parenting satisfaction in mothers with highly negative infants but did not affect parenting satisfaction in mothers with less negative infants, consistent with a model of differential susceptibility. There was also a trend toward less weight gain in highly negative intervention group infants. In contrast, there was a main effect of the intervention on infant self-regulation at 1 year, such that the intervention group had higher observed self-regulation, across levels of infant negativity. Results support the importance of incorporating tests of moderation into evaluations of obesity interventions and also illustrate that individuals may be differentially susceptible to environmental effects on some outcomes but not others.
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O'Connor TG, Wang H, Moynihan JA, Wyman PA, Carnahan J, Lofthus G, Quataert SA, Bowman M, Burke AS, Caserta MT. Observed parent-child relationship quality predicts antibody response to vaccination in children. Brain Behav Immun 2015; 48:265-73. [PMID: 25862953 PMCID: PMC4508214 DOI: 10.1016/j.bbi.2015.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 04/01/2015] [Accepted: 04/03/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Quality of the parent-child relationship is a robust predictor of behavioral and emotional health for children and adolescents; the application to physical health is less clear. METHODS We investigated the links between observed parent-child relationship quality in an interaction task and antibody response to meningococcal conjugate vaccine in a longitudinal study of 164 ambulatory 10-11 year-old children; additional analyses examine associations with cortisol reactivity, BMI, and somatic illness. RESULTS Observed Negative/Conflict behavior in the interaction task predicted a less robust antibody response to meningococcal serotype C vaccine in the child over a 6 month-period, after controlling for socio-economic and other covariates. Observer rated interaction conflict also predicted increased cortisol reactivity following the interaction task and higher BMI, but these factors did not account for the link between relationship quality and antibody response. CONCLUSIONS The results begin to document the degree to which a major source of child stress exposure, parent-child relationship conflict, is associated with altered immune system development in children, and may constitute an important public health consideration.
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Affiliation(s)
- Thomas G O'Connor
- Wynne Center for Family Research, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States; Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States.
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Jan A Moynihan
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Peter A Wyman
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Jennifer Carnahan
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Gerry Lofthus
- Department of Medicine, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Sally A Quataert
- Department of Microbiology and Immunology, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Melissa Bowman
- Department of Pediatrics, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Anne S Burke
- Department of Psychology, University of Rochester, 300 Crittenden Blvd, Rochester, NY 14642, United States
| | - Mary T Caserta
- Department of Pediatrics, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642, United States.
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Dixon WE, Dalton WT, Berry SM, Carroll VA. Improving the accuracy of weight status assessment in infancy research. Infant Behav Dev 2014; 37:428-34. [PMID: 24956502 DOI: 10.1016/j.infbeh.2014.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 04/24/2014] [Accepted: 06/02/2014] [Indexed: 10/25/2022]
Abstract
Both researchers and primary care providers vary in their methods for assessing weight status in infants. The purpose of the present investigation was to compare standing-height-derived to recumbent-length-derived weight-for-length standardized (WLZ) scores, using the WHO growth curves, in a convenience sample of infants who visited the lab at 18 and 21 months of age. Fifty-eight primarily White, middle class infants (25 girls) from a semi-rural region of southern Appalachia visited the lab at 18 months, with 45 infants returning 3 months later. We found that recumbent-length-derived WLZ scores were significantly higher at 18 months than corresponding standing-height-derived WLZ scores. We also found that recumbent-length-derived WLZ scores, but not those derived from standing height measures, decreased significantly from 18 to 21 months. Although these differential results are attributable to the WHO database data entry syntax, which automatically corrects standing height measurements by adding 0.7 cm, they suggest that researchers proceed cautiously when using standing-height derived measures when calculating infant BMI z-scores. Our results suggest that for practical purposes, standing height measurements may be preferred, so long as they are entered into the WHO database as recumbent length measurements. We also encourage basic science infancy researchers to include BMI assessments as part of their routine assessment protocols, to serve as potential outcome measures for other basic science variables of theoretical interest.
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Affiliation(s)
- Wallace E Dixon
- Department of Psychology, East Tennessee State University, United States.
| | - William T Dalton
- Department of Psychology, East Tennessee State University, United States
| | - Sarah M Berry
- Department of Psychology, East Tennessee State University, United States
| | - Vincent A Carroll
- Department of Psychology, East Tennessee State University, United States
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Wendland BE, Atkinson L, Steiner M, Fleming AS, Pencharz P, Moss E, Gaudreau H, Silveira PP, Arenovich T, Matthews SG, Meaney MJ, Levitan RD. Low maternal sensitivity at 6 months of age predicts higher BMI in 48 month old girls but not boys. Appetite 2014; 82:97-102. [DOI: 10.1016/j.appet.2014.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 07/04/2014] [Accepted: 07/10/2014] [Indexed: 11/16/2022]
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Brødsgaard A, Wagner L, Poulsen I. Childhood Overweight Dependence on Mother-Child Relationship. Health Psychol Res 2014; 2:1583. [PMID: 26973939 PMCID: PMC4768551 DOI: 10.4081/hpr.2014.1583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 04/19/2013] [Indexed: 12/03/2022] Open
Abstract
The causes of childhood overweight are numerous and inter-related. The mother-child relationship is of great significance for the child's health. Previous studies have found patterns of dysfunctional interaction in families with obese children. Therefore, development of childhood overweight could be due to the mother-child relationship. The aim of this study was to investigate how, and to what degree, the mother-child relationship, assessed by the mothers, was related to overweight among children aged seven to nine years. The study was a cross sectional case-controlled one. It included 111 overweight and 149 non-overweight seven to nine year old children and their mothers. Weight status was determined according to the International Obesity Task Force reference for children Body Mass Index, age and gender adjusted. An interviewer-administered questionnaire was used to categorize the mother-child relationship as: complementary, asymmetrical, symmetrical or symbiotic prototypes. There was no difference in mother-child relationships - characterized by the prototypes - between the overweight and non-overweight mother-child pairs. Therefore, we conclude that the mother-child relationship has no bearing on the child's weight status according to the prototypes. It is suggested that it is more the culture, or the universal phenomenon of expressing love through food, than the mother-child relationship, which influences the development of childhood overweight, or that the mothers are not capable of assess the true attachment style between themselves and their children.
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Affiliation(s)
- Anne Brødsgaard
- Department of Paediatrics, Hvidovre Hospital, Copenhagen University, Denmark
- Nursing Research Unit, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lis Wagner
- Nursing Research Unit, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ingrid Poulsen
- Department of Neuro-rehabilitation, TBI Unit, Glostrup Hospital, Copenhagen University, Denmark
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Leung CYY, Lumeng JC, Kaciroti NA, Chen YP, Rosenblum K, Miller AL. Surgency and negative affectivity, but not effortful control, are uniquely associated with obesogenic eating behaviors among low-income preschoolers. Appetite 2014; 78:139-46. [PMID: 24685763 DOI: 10.1016/j.appet.2014.03.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 03/21/2014] [Accepted: 03/24/2014] [Indexed: 01/09/2023]
Abstract
Despite increased attention to the role of temperament in children's obesogenic eating behaviors, there is a paucity of research examining whether different dimensions of temperament may be differentially associated with specific eating behaviors among preschool-age children. The purpose of the current study was to examine whether three temperament dimensions (surgency, negative affectivity, and effortful control) were uniquely associated with six obesogenic eating behaviors (caregiver-reported food responsiveness, enjoyment of food, emotional overeating, satiety responsiveness, and tantrums over food; and observed eating in the absence of hunger) among low-income preschool-age children, covarying home environment quality. Results showed that temperament dimensions were differentially associated with different eating behaviors. Specifically, preschoolers with higher surgency were more likely to overeat in response to external cues, have frequent desire to eat, derive pleasure from food, and eat in the absence of hunger. In contrast, preschoolers with higher negative affectivity were more likely to have tantrums over being denied food and less likely to eat in the absence of hunger. Effortful control was not uniquely associated with obesogenic eating behavior. Findings remained significant even when home chaos was accounted for, suggesting that child surgency and negative affectivity are important to consider, independent of home environment. Results are discussed with regard to theoretical implications for the study of childhood obesity and for applied prevention implications.
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Affiliation(s)
- Christy Y Y Leung
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Niko A Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Yu Pu Chen
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Katherine Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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Child temperament and maternal predictors of preschool children’s eating and body mass index. A prospective study. Appetite 2014; 74:125-32. [DOI: 10.1016/j.appet.2013.12.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 11/26/2013] [Accepted: 12/01/2013] [Indexed: 11/20/2022]
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Anderson SE, Lemeshow S, Whitaker RC. Maternal-infant relationship quality and risk of obesity at age 5.5 years in a national US cohort. BMC Pediatr 2014; 14:54. [PMID: 24564412 PMCID: PMC3938469 DOI: 10.1186/1471-2431-14-54] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 02/19/2014] [Indexed: 11/29/2022] Open
Abstract
Background Poor quality relationships between mothers and toddlers have been associated with higher risk for childhood obesity, but few prospective studies of obesity have assessed maternal-child relationship quality in infancy. In addition it is not known whether the increased risk is associated with the mother’s or the child’s contribution to the relationship quality. Methods We analyzed data (n = 5650) from the Early Childhood Longitudinal Study, Birth Cohort, a national study of U.S. children born in 2001 and followed until they entered kindergarten. At 9 months of age, the Nursing Child Assessment Teaching Scale (NCATS) was used to assess the quality of observed playtime interactions between mothers and infants, yielding separate scores for maternal and infant behaviors. Obesity (BMI ≥95th percentile) at age 5.5 years was based on measured weight and height. Results The prevalence (95% confidence interval) of obesity at 5.5 years of age was higher among children in the lowest quartile of maternal NCATS score (20.2% [95% CI: 17.2%, 23.2%]) than in the highest quartile (13.9% [11.3%, 16.5%]), but maternal NCATS score was not significantly associated with obesity after adjustment for race/ethnicity, maternal education and household income. The prevalence of obesity at 5.5 years of age was similar among children in the lowest quartile of infant NCATS score (17.4% [14.4%, 20.3%]) and in the highest quartile (17.6% 14.4%, 20.8%]), and was not changed with covariate adjustment. Conclusions Maternal-infant relationship quality, assessed by direct observation at 9 months of age in a national sample, was not associated with an increased risk of obesity at age 5.5 years after controlling for sociodemographic characteristics.
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Affiliation(s)
- Sarah E Anderson
- Division of Epidemiology, The Ohio State University College of Public Health, 336 Cunz Hall, 1841 Neil Avenue, Columbus, Ohio 43210, USA.
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Bergmeier H, Skouteris H, Horwood S, Hooley M, Richardson B. Associations between child temperament, maternal feeding practices and child body mass index during the preschool years: a systematic review of the literature. Obes Rev 2014; 15:9-18. [PMID: 23957249 DOI: 10.1111/obr.12066] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/24/2013] [Accepted: 06/26/2013] [Indexed: 01/09/2023]
Abstract
It is a research priority to identify modifiable risk factors to improve the effectiveness of childhood obesity prevention strategies. Research, however, has largely overlooked the role of child temperament and personality implicated in obesogenic risk factors such as maternal feeding and body mass index (BMI) of preschoolers. A systematic review of relevant literature was conducted to investigate the associations between child temperament, child personality, maternal feeding and BMI and/or weight gain in infants and preschoolers; 18 papers were included in the review. The findings revealed an association between the temperament traits of poor self-regulation, distress to limitations, low and high soothability, low negative affectivity and higher BMI in infants and preschool-aged children. Temperament traits difficult, distress to limitations, surgency/extraversion and emotionality were significantly associated with weight gain rates in infants. The results also suggested that child temperament was associated with maternal feeding behaviours that have been shown to influence childhood overweight and obesity, such as using restrictive feeding practices with children perceived as having poor self-regulation and feeding potentially obesogenic food and drinks to infants who are more externalizing. Interestingly, no studies to date have evaluated the association between child personality and BMI/weight gain in infants and preschoolers. There is a clear need for further research into the association of child temperament and obesogenic risk factors in preschool-aged children.
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Affiliation(s)
- H Bergmeier
- School of Psychology, Deakin University, Melbourne, Australia
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Boles RE, Reiter-Purtill J, Zeller MH. Persistently obese youth: interactions between parenting styles and feeding practices with child temperament. Clin Pediatr (Phila) 2013; 52:1098-106. [PMID: 23884967 PMCID: PMC3823689 DOI: 10.1177/0009922813497091] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the interaction of parent and child characteristics with feeding practices and mealtime functioning. DESIGN Longitudinal, predictive study comparing baseline characteristics with follow-up assessments. PARTICIPANTS The caregivers of 52 persistently obese youth and 32 nonoverweight comparison youth completed measurements of child temperament, parental feeding practices, parenting styles, and interactions during mealtimes. RESULTS Adolescents with persistent obesity were significantly more likely to be parented using problematic feeding practices when parents also reported difficult child temperaments. Additionally, adolescents with persistent obesity and difficult temperaments were significantly more likely to have lower levels of positive mealtime interactions. CONCLUSION Persistently obese youth are at increased risk for problematic parental feeding practices and mealtime functioning, particularly when youth are described as having difficult temperaments. These results indicate that further investigations are needed to better understand the mechanisms linking parent and child characteristics with health-related behaviors for adolescents with obesity.
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Affiliation(s)
- Richard E. Boles
- School of Medicine, University of Colorado Denver, Aurora, CO, USA
| | | | - Meg H. Zeller
- College of Medicine, University of Cincinnati, OH, USA
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Connell LE, Francis LA. Positive parenting mitigates the effects of poor self-regulation on body mass index trajectories from ages 4-15 years. Health Psychol 2013; 33:757-64. [PMID: 23977874 DOI: 10.1037/hea0000014] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study sought to determine whether parenting style moderates the effects of delay of gratification on body mass index (BMI) trajectories from ages 4-15 years. METHOD Longitudinal data were analyzed for 778 children drawn from the Study of Early Child Care and Youth Development. Parenting style (i.e., authoritative, authoritarian, permissive, and neglectful) was created from measures of mothers' sensitivity and expectations for self-control when children were age 4 years. Self-regulation was also measured at 4 years using a well-known delay of gratification protocol. BMI was calculated from measured height and weight at each time point. Mixed modeling was used to test the interaction of parenting styles and ability to delay gratification on BMI trajectories from 4-15 years. RESULTS There was a significant interaction effect of parenting and ability to delay on BMI growth from 4-15 years for boys. Boys who had authoritarian mothers and failed to delay gratification had a significantly steeper rate of growth in BMI from childhood through adolescence than children in any other parenting by delay group. CONCLUSION Authoritative and permissive parenting styles were protective against more rapid BMI gains for boys who could not delay gratification. Ability to delay gratification was protective against BMI gains for boys who had parents with authoritarian or neglectful parenting styles.
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Affiliation(s)
- Lauren E Connell
- Department of Biobehavioral Health, Pennsylvania State University
| | - Lori A Francis
- Department of Biobehavioral Health, Pennsylvania State University
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Anzman-Frasca S, Stifter CA, Paul IM, Birch LL. Infant temperament and maternal parenting self-efficacy predict child weight outcomes. Infant Behav Dev 2013; 36:494-7. [PMID: 23728195 DOI: 10.1016/j.infbeh.2013.04.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/28/2013] [Accepted: 04/30/2013] [Indexed: 02/05/2023]
Abstract
Relationships between infant negative reactivity and self-regulation, parenting self-efficacy, and child weight outcomes were examined. Greater observed negative reactivity predicted more child weight gain when mothers had lower parenting self-efficacy. Lower mother-reported self-regulation predicted a greater child weight status. Results highlight potential early risk/protective factors.
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Esposito M, Marotta R, Gallai B, Parisi L, Patriciello G, Lavano SM, Mazzotta G, Roccella M, Carotenuto M. Temperamental characteristics in childhood migraine without aura: a multicenter study. Neuropsychiatr Dis Treat 2013; 9:1187-92. [PMID: 23983467 PMCID: PMC3748055 DOI: 10.2147/ndt.s50458] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Children with migraine seem to be more anxious, sensitive, deliberate, cautious, fearful, vulnerable to frustration, tidy, and less physically enduring than comparisons. To the best our knowledge no studies about the temperamental and the characterial dimension aspects in childhood migraine was conducted. Therefore, the aim of the present study was to describe the temperamental and character aspects in a sample of children affected by migraine without aura (MoA) and their relationship with clinical aspects of MoA such as frequency, duration, and severity of attacks. MATERIALS AND METHODS In our study, 486 children affected by MoA (239 male, 247 female) aged 7-12 years, (mean 10.04 ± 2.53 years) and 518 typical developing children comparable for age (P = 0.227) and sex (P = 0.892) were enrolled to assess their temperamental characteristics. The mothers of all subjects filled out the Junior Temperament and Character Inventory: Parent Version. RESULTS Children affected by migraine show a higher prevalence of harm avoidance and persistence temperamental domains (P < 0.001) and significantly lower prevalence of the self-directedness character trait (P = 0.023) with respect to the comparisons, according to Cloninger's model. The Spearman rank correlation analysis shows a significant relationship between migraine characteristics and temperamental domains. CONCLUSION The present study first identified differences in temperamental characteristics in children affected by MoA with respect to the comparisons, suggesting the need for this evaluation in order for better psychological pediatric management of children with migraine, with possible consequences and impact on the future outcomes of these subjects.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
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Anzman-Frasca S, Liu S, Gates KM, Paul IM, Rovine MJ, Birch LL. Infants' Transitions out of a Fussing/Crying State Are Modifiable and Are Related to Weight Status. INFANCY 2012; 18:662-686. [PMID: 25302052 DOI: 10.1111/infa.12002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Currently, about 10% of infants have a weight for length greater than the 95th percentile for their age and sex, which puts them at risk for obesity as they grow. In a pilot obesity prevention study, primiparous mothers and their newborn infants were randomly assigned to a control group or a Soothe/Sleep intervention. Previously, it has been demonstrated that this intervention contributed to lower weight-for-length percentiles at 1 year; the aim of the present study was to examine infant behavior diary data collected during the intervention. Markov modeling was used to characterize infants' patterns of behavioral transitions at ages 3 and 16 weeks. Results showed that heavier mothers were more likely to follow their infants' fussing/crying episodes with a feeding. The intervention increased infants' likelihood of transitioning from a fussing/crying state to an awake/calm state. A shorter latency to feed in response to fussing/crying was associated with a higher subsequent weight status. This study provides preliminary evidence that infants' transitions out of fussing/crying are characterized by inter-individual differences, are modifiable, and are linked to weight outcomes, suggesting that they may be promising targets for early behavioral obesity interventions, and highlighting the methodology used in this study as an appropriate and innovative tool to assess the impact of such interventions.
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Affiliation(s)
| | - Siwei Liu
- Department of Human Ecology, University of California, Davis
| | - Kathleen M Gates
- Psychology Department, Virginia Polytechnic Institute and State University
| | - Ian M Paul
- The Pennsylvania State University College of Medicine
| | - Michael J Rovine
- The Department of Human Development & Family Studies, The Pennsylvania State University
| | - Leann L Birch
- The Center for Childhood Obesity Research, The Pennsylvania State University
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Abstract
OBJECTIVE Temperament, or individual differences in behavioral styles, could explain why many individuals are susceptible to childhood obesity in the current environment while others are not. The objective of this article is to review the growing body of literature linking weight outcomes with 2 aspects of temperament, negativity and self-regulation. METHOD Studies conducted through 2011 and assessing at least 1 weight outcome and 1 aspect of early negativity or self-regulation in normally developing infants and young children were included. RESULTS Most studies suggest that greater levels of negative reactivity in early life may increase the risk of obesity, and greater self-regulation may be protective. While temperaments of individuals tend to be relatively stable over time, there is evidence that links between early temperament and weight outcomes are malleable. CONCLUSIONS Relationships between temperament and weight outcomes are becoming well established. More research is needed to confirm the longitudinal nature of these relationships and to shed light on the mediators and moderators of these relationships and their implications for obesity interventions.
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Relation of emotional and behavioral problems with body mass index in preschool children: the Generation R study. J Dev Behav Pediatr 2012; 33:641-8. [PMID: 23027138 DOI: 10.1097/dbp.0b013e31826419b8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Although problem behavior in children and adolescents has frequently been associated with overweight, it is unclear whether this relationship is already present in early childhood. We hypothesized that problem behavior is positively related to body mass index (BMI) in children of preschool age and that eating behavior explains part of this relation. METHODS The study was embedded in the Generation R Study, a population-based cohort with data available on BMI and problem behavior for 3137 children aged 3 to 4 years. Problem behavior was measured with the child behavior checklist (CBCI), and eating behavior was assessed using the child eating behaviour questionnaire (CEBQ). Linear regression analyses were conducted to assess the association between the CBCI (expressed as z-scores). CEBQ, and BMI standard deviation scores (BMI-SDS), Bootstrapping was used to formally test mediation. RESULTS Children with higher levels of emotional problems had a lower BMI-SDS after adjustment for relevant covariates (e.g., β [95% confidence interval {Cl}] for mother report of emotional problems = -0.04 [-0.07, -0.001], father report = -0.04 [-0.08, -0.001]). Behavioral problems were not associated with BMI. Emotional and behavioral problems were not associated with underweight or overweight if studied categorically. The effect estimate for the relation of emotional problems with BMI-SDS attenuated to nonsignificance after adjustment for specific eating behaviors, i.e., they were accounted for by satiety responsiveness, fussiness, and emotional undereating. CONCLUSION In this population-based study, emotional problems in preschoolers were negatively related to BMI, and this relation was fully explained by food avoidant eating behaviors.
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Sleddens EFC, Hughes SO, O'Connor TM, Beltran A, Baranowski JC, Nicklas TA, Baranowski T. The Children's Behavior Questionnaire very short scale: psychometric properties and development of a one-item temperament scale. Psychol Rep 2012; 110:197-217. [PMID: 22489386 DOI: 10.2466/08.10.21.pr0.110.1.197-217] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Little research has been conducted on the psychometrics of the very short scale (36 items) of the Children's Behavior Questionnaire, and no one-item temperament scale has been tested for use in applied work. In this study, 237 United States caregivers completed a survey to define their child's behavioral patterns (i.e., Surgency, Negative Affectivity Effortful Control) using both scales. Psychometrics of the 36-item Children's Behavior Questionnaire were examined using classical test theory, principal factor analysis, and item response modeling. Classical test theory analysis demonstrated adequate internal consistency and factor analysis confirmed a three-factor structure. Potential improvements to the measure were identified using item response modeling. A one-item (three response categories) temperament scale was validated against the three temperament factors of the 36-item scale. The temperament response categories correlated with the temperament factors of the 36-item scale, as expected. The one-item temperament scale may be applicable for clinical use.
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Affiliation(s)
- Ester F C Sleddens
- Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
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Brotman LM, Dawson-McClure S, Huang KY, Theise R, Kamboukos D, Wang J, Petkova E, Ogedegbe G. Early childhood family intervention and long-term obesity prevention among high-risk minority youth. Pediatrics 2012; 129:e621-8. [PMID: 22311988 PMCID: PMC3289522 DOI: 10.1542/peds.2011-1568] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To test the hypothesis that family intervention to promote effective parenting in early childhood affects obesity in preadolescence. METHODS Participants were 186 minority youth at risk for behavior problems who enrolled in long-term follow-up studies after random assignment to family intervention or control condition at age 4. Follow-up Study 1 included 40 girls at familial risk for behavior problems; Follow-up Study 2 included 146 boys and girls at risk for behavior problems based on teacher ratings. Family intervention aimed to promote effective parenting and prevent behavior problems during early childhood; it did not focus on physical health. BMI and health behaviors were measured an average of 5 years after intervention in Study 1 and 3 years after intervention in Study 2. RESULTS Youth randomized to intervention had significantly lower BMI at follow-up relative to controls (Study 1 P = .05; Study 2 P = .006). Clinical impact is evidenced by lower rates of obesity (BMI ≥95th percentile) among intervention girls and boys relative to controls (Study 2: 24% vs 54%, P = .002). There were significant intervention-control group differences on physical and sedentary activity, blood pressure, and diet. CONCLUSIONS Two long-term follow-up studies of randomized trials show that relative to controls, youth at risk for behavior problems who received family intervention at age 4 had lower BMI and improved health behaviors as they approached adolescence. Efforts to promote effective parenting and prevent behavior problems early in life may contribute to the reduction of obesity and health disparities.
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Affiliation(s)
- Laurie Miller Brotman
- New York University Child Study Center, Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY 10016, USA.
| | - Spring Dawson-McClure
- New York University Child Study Center, Department of Child and Adolescent Psychiatry, and
| | - Keng-Yen Huang
- New York University Child Study Center, Department of Child and Adolescent Psychiatry, and
| | - Rachelle Theise
- New York University Child Study Center, Department of Child and Adolescent Psychiatry, and
| | - Dimitra Kamboukos
- New York University Child Study Center, Department of Child and Adolescent Psychiatry, and
| | - Jing Wang
- New York University Child Study Center, Department of Child and Adolescent Psychiatry, and
| | - Eva Petkova
- New York University Child Study Center, Department of Child and Adolescent Psychiatry, and
| | - Gbenga Ogedegbe
- Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, New York, New York
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Anderson SE, Gooze RA, Lemeshow S, Whitaker RC. Quality of early maternal-child relationship and risk of adolescent obesity. Pediatrics 2012; 129:132-40. [PMID: 22201144 PMCID: PMC3255468 DOI: 10.1542/peds.2011-0972] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The goal of this study was to determine whether obesity in adolescence is related to the quality of the early maternal-child relationship. METHODS We analyzed data from 977 of 1364 participants in the Study of Early Child Care and Youth Development. Child attachment security and maternal sensitivity were assessed by observing mother-child interaction at 15, 24, and 36 months of age. A maternal-child relationship quality score was constructed as the number of times across the 3 ages that the child was either insecurely attached or experienced low maternal sensitivity. Adolescent obesity was defined as a measured BMI ≥95th percentile at age 15 years. RESULTS Poor-quality maternal-child relationships (score: ≥3) were experienced by 24.7% of children compared with 22.0% who, at all 3 ages, were neither insecurely attached nor exposed to low maternal sensitivity (score: 0). The prevalence of adolescent obesity was 26.1%, 15.5%, 12.1%, and 13.0% for those with risk scores of ≥3, 2, 1, and 0, respectively. After adjustment for gender and birth weight, the odds (95% confidence interval) of adolescent obesity was 2.45 (1.49-4.04) times higher in those with the poorest quality early maternal-child relationships (score: ≥3) compared with those with the highest quality (score: 0). Low maternal sensitivity was more strongly associated with obesity than insecure attachment. CONCLUSIONS Poor quality of the early maternal-child relationship was associated with a higher prevalence of adolescent obesity. Interventions aimed at improving the quality of maternal-child interactions should consider assessing effects on children's weight and examining potential mechanisms involving stress response and emotion regulation.
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Affiliation(s)
| | - Rachel A. Gooze
- Department of Public Health, Center for Obesity Research and Education, and
| | - Stanley Lemeshow
- Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio; and
| | - Robert C. Whitaker
- Department of Public Health, Center for Obesity Research and Education, and,Department of Pediatrics, Temple University, Philadelphia, Pennsylvania
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Abstract
An understanding of how infant eating behaviour relates to later obesity is required if interventions in infancy are to be attempted. The aim of this paper is to review findings from the Gateshead Millennium Study to describe (i) what we have already established about the relationship between infant feeding transitions, infancy weight gain and eating behaviour and (ii) describe new analyses that examine how infant eating behaviour and temperament relate to infancy weight gain and childhood adiposity. The Gateshead Millennium Study recruited 1029 infants at birth and parents completed questionnaires five times in the first year. We have already described how starting solids and ceasing breast-feeding seems to be a response to rapid early weight gain, rather than a cause, and that parents identify and respond to the individual appetite characteristics of their child. A number of questions about eating behaviour at 12 months were used to construct an infancy eating avidity score that was positively associated with height at age 7-8 years, but not with an adiposity index constructed using bioelectrical impedance, waist and skinfolds. Infancy eating avidity score was associated with greater fussiness and lower satiety responsivity on the Child Eating Behaviour Questionnaire at age 6-8 years. Temperament measured at age 6 weeks and 8 months showed no consistent associations with either infancy weight gain or adiposity at 6-8 years. While infancy may seem a logical time to intervene with children at risk of future obesity, the collective findings from this substantial population-based study largely suggest otherwise.
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Garthus-Niegel S, Hagtvet KA, Vollrath ME. A prospective study of weight development and behavior problems in toddlers: the Norwegian Mother and Child Cohort Study. BMC Public Health 2010; 10:626. [PMID: 20961446 PMCID: PMC2972243 DOI: 10.1186/1471-2458-10-626] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 10/20/2010] [Indexed: 12/03/2022] Open
Abstract
Background Previous research has suggested that overweight children have a higher risk of behavior problems, but the causal direction of this relationship remains unclear. In a large prospective population study, we investigated whether child behavior problems and body mass index are associated in toddlers and whether overweight is a risk for behavior problems or vice versa. Methods The study was part of the Norwegian Mother and Child Cohort Study. The sample consisted of 10 860 toddlers, followed up to age 36 months. We used data from maternal questionnaires from gestation week 17 and at child ages 18 and 36 months, and data from the Medical Birth Registry of Norway. Child height and weight were assessed at child health stations and recorded by mothers. Behavior problems were assessed using shortened subscales from the Child Behavior Checklist. Statistical analyses were conducted using structural equation modeling. Results Behavior problems in toddlers were not associated with higher body mass index cross-sectionally at either age 18 or 36 months, and there was no indication that behavior problems caused increasing body mass index over time or vice versa. Conclusions The association between behavior problems and body mass index found in older children did not appear in toddlers up to age 36 months. Future studies should focus on the age span from 3 to 6 years, which includes the period of adiposity rebound.
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Affiliation(s)
- Susan Garthus-Niegel
- Department of Psychosomatics and Health Behavior, Norwegian Institute of Public Health, Postbox 4404, Nydalen, 0403 Oslo, Norway.
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