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Park SH, Cormier E, Grove K, Kelley SJ, Faith MS. Health-related behaviors and weight-related outcomes within sibling pairs: A systematic review. J Pediatr Nurs 2023; 73:e154-e163. [PMID: 37582674 DOI: 10.1016/j.pedn.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Siblings reciprocally contribute to mutual social and physical development. The aim of this review was to examine the health-related behaviors and weight-related outcomes within child-sibling pairs and to determine how these factors vary by sibling composition. METHODS Following the PRISMA guidelines, a systematic review of studies published since 2000 obtained from MEDLINE, CINAHL, PubMed, Cochrane Reviews, Web of Science, PsycINFO, Health and Wellness, and Science Direct was performed. The eligibility criteria for inclusion were: 1) peer-reviewed and published in English; 2) included children ages 2 to 20 and their siblings; and 3) explored health-related behaviors (i.e., diet) and/or weight-related outcomes (i.e., body weight) within child-sibling dyads. RESULTS A total of 13 studies were included in the review. The study findings are summarized according to three major themes: 1) sibling concordance in health-related behaviors and weight-related outcomes, 2) differences in health-related behaviors within weight-concordant/weight-discordant sibling dyads, and 3) influence of sibling composition on health-related behaviors and weight-related outcomes. CONCLUSIONS Family-based interventions for childhood obesity may benefit from including siblings as key family members in promoting children's health-related behaviors and preventing excessive weight gain. Future studies should explore variable sibling dynamics (e.g., adoptive siblings) in more culturally/racially diverse families to further explore the role of a sibling in a child's health. IMPLICATIONS TO PRACTICE The findings of this study may help healthcare providers in developing effective family-based obesity interventions for families with more than one child in their household.
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Affiliation(s)
- So Hyun Park
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Republic of Korea.
| | - Eileen Cormier
- College of Nursing, Florida State University, 98 Varsity Way, Tallahassee, FL 32306, United States of America.
| | - Kelly Grove
- GIS and Earth Sciences, Paul A. M. Dirac Library, 110 N. Woodward Ave., Tallahassee, FL 32306, United States of America.
| | - Susan J Kelley
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Urban Life Building, Atlanta, GA 30302-3995, United States of America.
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo - The State University of New York, 420 Baldy Hall, Buffalo, NY 14260-1000, United States of America.
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Deer LK, Doom JR, Harrall KK, Glueck DH, Glynn LM, Sandman CA, Davis EP. Infant effortful control predicts BMI trajectories from infancy to adolescence. Pediatr Obes 2023; 18:e13059. [PMID: 37287418 PMCID: PMC10525013 DOI: 10.1111/ijpo.13059] [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: 10/07/2022] [Revised: 04/07/2023] [Accepted: 05/08/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Effortful control, or the regulation of thoughts and behaviour, is a potential target for preventing childhood obesity. OBJECTIVES To assess effortful control in infancy through late childhood as a predictor of repeated measures of body mass index (BMI) from infancy through adolescence, and to examine whether sex moderates the associations. METHODS Maternal report of offspring effortful control and measurements of child BMI were obtained at 7 and 8 time points respectively from 191 gestational parent/child dyads from infancy through adolescence. General linear mixed models were used. RESULTS Effortful control at 6 months predicted BMI trajectories from infancy through adolescence, F(5,338) = 2.75, p = 0.03. Further, when effortful control at other timepoints were included in the model, they added no additional explanatory value. Sex moderated the association between 6-month effortful control and BMI, F(4, 338) = 2.59, p = 0.03, with poorer infant effortful control predicting higher BMI in early childhood for girls, and more rapid increases in BMI in early adolescence for boys. CONCLUSIONS Effortful control in infancy was associated with BMI over time. Specifically, poor effortful control during infancy was associated with higher BMI in childhood and adolescence. These findings support the argument that infancy may be a sensitive window for the development of later obesity.
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Affiliation(s)
| | | | - Kylie K. Harrall
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Anschutz Medical Campus
| | - Deborah H. Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado, Anschutz Medical Campus
- Department of Pediatrics, University of Colorado, Anschutz Medical Campus
| | | | - Curt A. Sandman
- Department of Psychiatry & Human Behavior, University of California, Irvine
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver
- Department of Psychiatry & Human Behavior, University of California, Irvine
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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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Hayes S, Lonergan A, Trompeter N, Bussey K, Hay P, Mitchison D. Longitudinal relationship between experience of sexual harassment and 2-year body image and weight outcomes in adolescence: mediation through self-objectification and psychological distress. Eat Weight Disord 2022; 27:3095-3108. [PMID: 35834106 PMCID: PMC9803756 DOI: 10.1007/s40519-022-01432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The current study investigated the experience of sexual harassment as a risk factor for weight gain and weight/shape concerns in a community sample of adolescents, with potential mediating factors self-objectification and psychological distress. METHOD 1034 Australian adolescents (aged 11 to 19 years) from the EveryBODY longitudinal study of disordered eating pathology participated. Data were collected through online surveys annually for 3 years. Participants completed self-report measures of demographics, sexual harassment, psychological distress, self-objectification, weight/shape concerns and BMI percentile. RESULTS A parallel mediation model adjusting for baseline scores found no direct effect between baseline experiences of sexual harassment and change in BMI percentile or weight/shape concern after 2 years. Experiences of sexual harassment significantly increased self-objectification scores after 1 year in female adolescents. Subsequently, higher self-objectification significantly increased the risk of greater weight/shape concern after 1 year in female adolescents. However, no significant mediating relationship was found in the relationship between sexual harassment and weight/shape concern or BMI percentile for either gender. Psychological distress was found to be a clear risk factor for weight/shape concern in both genders after 1 year. CONCLUSIONS Intervention programmes in schools should focus on developing policies to reduce sexual harassment, self-objectification and distress in adolescents. LEVEL OF EVIDENCE Level IV, longitudinal multiple time series without intervention.
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Affiliation(s)
- Samantha Hayes
- School of Psychology, Western Sydney University, 51 Captain Cook Drive, Kurnell, Sydney, NSW, 2231, Australia.
| | | | - Nora Trompeter
- School of Psychology, Macquarie University, Sydney, NSW, Australia
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Kay Bussey
- School of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Phillipa Hay
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- Camden and Campbelltown Hospitals, SWSLHD, Campbelltown, NSW, Australia
| | - Deborah Mitchison
- School of Psychology, Macquarie University, Sydney, NSW, Australia
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
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Miadich SA, Swanson J, Doane LD, Davis MC, Iida M, Lemery-Chalfant K. Effortful control and health among triads of mothers and twin children: An actor-partner interdependence modeling approach. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:102-113. [PMID: 34197156 PMCID: PMC9575840 DOI: 10.1037/fam0000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Associations between effortful control and physical and mental health were examined among triads of mothers and twin children by simultaneously modeling the effects of one's own effortful control on one's own health (actor effects) with the effects of the other two family members' effortful control on one's health (partner effects). Families (N = 761 individuals; 254 families) included mothers (Mage = 39.98, SD = 5.64) and their twin children (Mage = 8.58, SD = 0.57; 51% female; 54.7% non-Hispanic White, 28% Hispanic). Mothers completed online and in-person questionnaires, and mothers' and children's body composition indicators and dominant-handgrip strength were directly assessed during two home visits. Actor effects dominated in families with twin boys and mixed-sex twins, whereas partner effects were more apparent in families with twin girls. In addition, the effects of children's effortful control on mothers' health depended on the sex of the twins. Findings uncovered important family dynamics linking effortful control to health, including that associations may vary by sex match of children in the family. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Samantha A. Miadich
- Department of Psychology, University of Massachusetts Lowell, Lowell, MA
- Department of Psychology, Arizona State University, Tempe, AZ
| | - Jodi Swanson
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ
| | - Leah D. Doane
- Department of Psychology, Arizona State University, Tempe, AZ
| | - Mary C. Davis
- Department of Psychology, Arizona State University, Tempe, AZ
| | - Masumi Iida
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ
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Thorsteinsdottir S, Olafsdottir AS, Brynjolfsdottir B, Bjarnason R, Njardvik U. Odds of fussy eating are greater among children with obesity and anxiety. Obes Sci Pract 2022; 8:91-100. [PMID: 35127125 PMCID: PMC8804926 DOI: 10.1002/osp4.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/25/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Fussy eating has been associated with autism spectrum disorder (ASD), attention-deficit/hyperactive disorder (ADHD), anxiety, and depression. Despite these disorders being prevalent in obesity treatment, no studies have been published on the association of fussy eating in children with obesity and these disorders. Understanding fussy eating in children with obesity and comorbid disorders is important as acceptance of healthy foods tends to be low, especially in children with sensory sensitivities. OBJECTIVES Investigate the prevalence of fussy eating in a cross-sectional sample of children with obesity and ASD, ADHD, anxiety, and depression; and whether they were more likely to be fussy eaters, comparing those with and without these disorders. METHODS One hundred and four children referred to family-based obesity treatment in Iceland 2011-2016, mean age 12.0 (SD = 3.0), mean body mass index standard deviation score 3.5 (SD = 0.9). Binary logistic regression was used to estimate the relationship between fussy eating and disorders, adjusting for medication use. RESULTS A large minority (41.6%) were fussy eaters and 48.9% had at least one comorbid disorder. Over a third of children rejected bitter and sour tastes, and 1.9% and 7.9% rejected sweet and salty tastes, respectively. Compared with those without disorders, the odds of being a fussy eater were increased by a factor of 4.11 when having anxiety (95% confidence intervals) (1.02-16.58, p = 00.046), adjusting for medication use. The odds of being a fussy eater were not increased for other disorders; ASD, ADHD, or depression. CONCLUSIONS In children attending obesity treatment, fussy eating was common. Clinical care models in pediatric obesity treatment should address fussy eating, especially in children with anxiety.
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Affiliation(s)
| | - Anna S. Olafsdottir
- Faculty of Health Promotion, Sport and Leisure StudiesUniversity of IcelandReykjavikIceland
| | | | - Ragnar Bjarnason
- Department of PediatricsLandspitali University HospitalReykjavikIceland
- Faculty of MedicineUniversity of IcelandReykjavikIceland
| | - Urdur Njardvik
- Faculty of PsychologyUniversity of IcelandReykjavikIceland
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Psychophysiological Regulation and Classroom Climate Influence First and Second Graders' Well-Being: The Role of Body Mass Index. Eur J Investig Health Psychol Educ 2021; 11:1581-1598. [PMID: 34940390 PMCID: PMC8700215 DOI: 10.3390/ejihpe11040112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
This study examines the associations between physical and emotional well-being and classroom climate, cardiac vagal response, and body mass index (BMI) in a sample of 6- to-8-year-olds. Specifically, we expected a direct link between classroom climate, vagal withdrawal, BMI and children's physical and emotional comfort. Furthermore, we explored whether these individual and environmental characteristics influenced well-being in an interactive fashion. Participants were 142 (63 boys, 44%) first and second graders living in the North of Italy who were interviewed on their emotional and physical comfort. Heart rate and a measure of vagal influence on the heart (cardiac vagal tone) were recorded at rest and during an oral academic test. Height and weight were collected. Classroom climate was positively linked with physical well-being, whereas emotional well-being was negatively related with BMI. In addition, an inverted U-shaped effect of cardiac vagal withdrawal (i.e., cardiac vagal tone during stress minus resting vagal tone) on emotional well-being was found. Two regression models highlighted the role played by BMI when interacting with vagal withdrawal in predicting children's physical and emotional well-being. The interplay between BMI and cardiac vagal withdrawal played an important role in primary school children's well-being. From a clinical perspective, preventive training to improve autonomic regulation in concert with interventions promoting healthy eating attitudes might be critical for supporting primary school children's emotional and physical health.
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Button A, Faith MS, Paluch RA, Kong KL. Interplay between Prepregnancy Body Mass Index, Early Childhood Negative Temperament, and Slowness in Eating on Early Childhood Rapid Weight Gain. Child Obes 2021; 17:534-541. [PMID: 34197210 PMCID: PMC8818509 DOI: 10.1089/chi.2021.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Early childhood eating behaviors and temperament have been linked to excess weight gain in separate lines of research. However, the interplay among these variables along with maternal prepregnancy body mass index (BMI) in predicting rapid weight gain is poorly understood. Methods: This observational study tested superfactors of early childhood temperament using the Infant Behavior Questionnaire-Revised, and their relationships with eating behavior using the Baby Eating Behavior Questionnaire on rapid weight gain among 9-18 months children (n = 283). The bivariate relationships were evaluated using Pearson correlations. Two-way interactions assessed whether childhood temperament moderated the relationship between childhood eating behaviors and rapid weight gain, with prepregnancy BMI as a higher order moderator. Results: Food responsiveness positively correlated with Negativity [r = 0.256, adjusted (adj) p < 0.001] and inversely with Regulation (r = -0.203, adj p = 0.006). Slowness in eating positively correlated with Negativity (r = 0.196, p = 0.006) and inversely with Surgency (r = -0.188, adj p = 0.008) and Regulation (r = -0.181, p = 0.007). Slowness in eating was significantly correlated with rapid weight gain (r = -0.168, p = 0.005). Prepregnancy BMI was a moderator of slowness in eating and Negativity such that children of mothers with high prepregnancy BMI in conjunction with high Negativity and low in slowness in eating experienced the greatest rapid weight gain, whereas children of mothers with low prepregnancy BMI in conjunction with low Negativity and high in slowness in eating experienced the least rapid weight gain. Conclusions: Assessing early childhood temperament may bolster health care and parenting interventions to increase early eating regulation and to promote healthier weight trajectories.
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Affiliation(s)
- Alyssa Button
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, State University of New York at Buffalo, Buffalo, NY, USA
| | - Myles S. Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, State University of New York at Buffalo, Buffalo, NY, USA
| | - Rocco A. Paluch
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children's Mercy Research Institute, Children's Mercy Hospital, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA
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Vandyousefi S, Gross RS, Katzow MW, Scott MA, Messito MJ. Infant and Early Child Appetite Traits and Child Weight and Obesity Risk in Low-Income Hispanic Families. J Acad Nutr Diet 2021; 121:2210-2220. [PMID: 33994142 DOI: 10.1016/j.jand.2021.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/03/2021] [Accepted: 04/01/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Child appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight. OBJECTIVE To determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children. DESIGN A secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial. PARTICIPANTS/SETTING Three hundred twenty-two low-income, Hispanic mother-child pairs enrolled between 2012 and 2014 in a public hospital in New York City. MAIN OUTCOME MEASURES ATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years. STATISTICAL ANALYSES PERFORMED AT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years. RESULTS There was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = -0.18, 95% CI -0.33 to -0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = -0.29, 95% CI -0.47 to -0.12; P < 0.01; B = -0.36, 95% CI -0.55 to -0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = -0.74, 95% CI -1.18 to -0.2 [Slowness in Eating]; B = -1.19, 95% CI -1.87 to -0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002). CONCLUSIONS Infants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.
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Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E. Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2020; 9:e014520. [PMID: 32389066 PMCID: PMC7660848 DOI: 10.1161/jaha.119.014520] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.
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van Eeden AE, Hoek HW, van Hoeken D, Deen M, Oldehinkel AJ. Temperament in preadolescence is associated with weight and eating pathology in young adulthood. Int J Eat Disord 2020; 53:466-475. [PMID: 32073176 PMCID: PMC7318707 DOI: 10.1002/eat.23241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/14/2020] [Accepted: 01/26/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Few longitudinal studies have investigated the role of temperament traits on weight and eating problems thus far. We investigated whether temperament in preadolescence influences body weight and the development of eating pathology in adolescence and young adulthood. METHOD This study used data from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2,230) from preadolescence into adulthood. At age 11, the temperament dimensions negative affectivity and effortful control were measured with the Early Adolescent Temperament Questionnaire-Revised. Body mass index (BMI) was measured at all assessment waves. At age 19, the prevalence of eating disorders was investigated by two-stage screening including interviews by eating disorder experts. At age 22 and 26, the Eating Disorder Diagnostic Scale was used to assess the level of eating pathology. RESULTS Higher negative affectivity in preadolescence was associated with higher BMI and eating pathology in young adulthood. Lower effortful control in preadolescence was found to be a risk factor for the development of obesity in young adulthood. No association was found between effortful control in preadolescence and eating pathology in later life. DISCUSSION Both negative affectivity and effortful control play a role in the development of weight or eating problems during adolescence.
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Affiliation(s)
- Annelies E. van Eeden
- Parnassia Psychiatric InstituteThe HagueThe Netherlands,University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands
| | - Hans W. Hoek
- Parnassia Psychiatric InstituteThe HagueThe Netherlands,University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands,Columbia UniversityMailman School of Public Health, Department of Epidemiology, New YorkNew York
| | | | - Mathijs Deen
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
| | - Albertine J. Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands
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12
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Russell CG, Russell A. A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research. Obes Rev 2019; 20:725-749. [PMID: 30768750 DOI: 10.1111/obr.12838] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/16/2018] [Accepted: 01/07/2019] [Indexed: 12/12/2022]
Abstract
Childhood obesity has reached alarming proportions in many countries. There is consensus that both biological (especially genetic) and environmental (including psychosocial) factors contribute to weight gain and obesity in childhood. Research has identified extensive risk or predictive factors for childhood obesity from both of these domains. There is less consensus about the developmental processes or pathways showing how these risk factors lead to overweigh/obesity (OW/OB) in childhood. We outline a biopsychosocial process model of the development of OW/OB in childhood. The model and associated scholarship from developmental theory and research guide an analysis of research on OW/OB in childhood. The model incorporates biological factors such as genetic predispositions or susceptibility genes, temperament, and homeostatic and allostatic processes with the psychosocial and behavioral factors of parenting, parental feeding practices, child appetitive traits, food liking, food intakes, and energy expenditure. There is an emphasis on bidirectional and transactional processes linking child biology and behavior with psychosocial processes and environment. Insights from developmental theory and research include implications for conceptualization, measurement, research design, and possible multiple pathways to OW/OB. Understanding the developmental processes and pathways involved in childhood OW/OB should contribute to more targeted prevention and intervention strategies in childhood.
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Affiliation(s)
- Catherine G Russell
- Faculty of Health, School of Exercise and Nutrition Sciences, Centre for Advanced Sensory Science, Deakin University, Burwood, Australia
| | - Alan Russell
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia
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13
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Faith MS, Hittner JB, Hurston SR, Yin J, Greenspan LC, Quesenberry CP, Gunderson EP. Association of Infant Temperament With Subsequent Obesity in Young Children of Mothers With Gestational Diabetes Mellitus. JAMA Pediatr 2019; 173:424-433. [PMID: 30855657 PMCID: PMC6503510 DOI: 10.1001/jamapediatrics.2018.5199] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Infant temperament is associated with excess weight gain or childhood obesity risk in samples of healthy individuals, although the evidence has been inconsistent. To our knowledge, no prior research has examined this topic among children exposed to gestational diabetes mellitus (GDM) in utero. OBJECTIVE To prospectively evaluate infant temperament in association with overweight and obesity status at ages 2 to 5 years among children born to mothers who experienced GDM. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study took place at Kaiser Permanente Northern California medical centers. We studied singleton infants delivered at 35 weeks' gestational age or later to mothers who had been diagnosed with GDM. Data were collected from 2009 to 2016, and data analysis occurred from June 2017 to October 2018. EXPOSURES The primary exposures in the child's first year were soothability, distress to limitations, and activity aspects of temperament, as assessed by a validated questionnaire. Modifiable covariates in the child's first year included breastfeeding intensity and duration monthly ratio scores, along with the timing of the introduction of sugary beverages and complementary foods. MAIN OUTCOMES AND MEASURES The primary outcome was child overweight and obesity status, assessed at ages 2 to 5 years. Multinomial logistic regression models estimated adjusted odds ratios and 95% CIs for infants whose temperaments were measured at 6 to 9 weeks of age and categorized as elevated (≥75th percentile) or not elevated in the 3 domains. We controlled for nonmodifiable and modifiable covariates across models. RESULTS A total of 382 mother-infant pairs participted, including 130 infants (34.0%) who were non-Hispanic white, 126 infants (33.0%) who were Hispanic, 96 infants (25.1%) who were Asian, 26 infants (6.8%) who were non-Hispanic black, and 4 infants (1.1%) who were of other races/ethnicities. In descriptive analyses, elevated infant soothability and activity temperaments were associated with the early introduction of 100% fruit juice and/or sugar-sweetened beverages (at ages <6 months) and shorter breastfeeding duration (from 0 to <3 months), while elevated distress to limitations was associated with early introduction of complementary foods (at ages <4 months). Elevated soothability consistently was associated with a higher odds of later childhood obesity, with adjusted odds ratios across models ranging from 2.22 (95% CI, 1.04-4.73) to 2.54 (95% CI, 1.28-5.03). Greater breastfeeding intensity and duration (12-month combined) score was associated with lower odds of obesity, independent of infant temperament and other covariates. CONCLUSIONS AND RELEVANCE Among this high-risk population of infants, elevated soothability was associated with early childhood obesity risk, perhaps in part because caregivers use sugary drinks to assuage infants. Soothability temperament may be a novel screening target for early obesity prevention interventions involving responsive feeding and emotion regulation.
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Affiliation(s)
- Myles S. Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo–State University of New York, Buffalo
| | - James B. Hittner
- Department of Psychology, College of Charleston, Charleston, South Carolina
| | - Shanta R. Hurston
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | - Jie Yin
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | | | - Charles P. Quesenberry
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | - Erica P. Gunderson
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
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Volger S, Estorninos EM, Capeding MR, Lebumfacil J, Radler DR, Scott Parrott J, Rothpletz-Puglia P. Health-related quality of life, temperament, and eating behavior among formula-fed infants in the Philippines: a pilot study. Health Qual Life Outcomes 2018; 16:121. [PMID: 29884187 PMCID: PMC5994097 DOI: 10.1186/s12955-018-0944-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 05/23/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The rising prevalence of childhood obesity in Asia has led to interest in potential risk factors such as infant health-related quality of life (HRQoL), temperament and eating behaviors. This pilot study evaluated the utility of administering parent-reported outcome measures (PROMs) to explore these factors in Filipino infants and examined the relationships between these factors and infant sex, formula intake and weight, over time. METHODS Forty healthy, 4-week-old, formula-fed infants (n = 20 males) were enrolled in this 6-week, prospective, uncontrolled study during which infants were exclusively fed a standard term infant formula enriched with alpha-lactalbumin. On Day-1 and 42, anthropometrics were measured and mothers completed a 97-item measure of HRQoL [Infant Toddler Quality of Life Questionnaire (ITQOL)] covering 6 infant-focused and 3 parent-focused concepts and a 24-item measure of infant temperament [Infant Characteristics Questionnaire (ICQ)]. At Day-42, mothers also completed an 18-item measure of infant appetite [Baby Eating Behaviour Questionnaire (BEBQ)]. A 3-day formula intake diary was completed before Day-42. Nonparametric statistics were used to evaluate correlations among outcomes and compare outcomes by visit and sex. RESULTS Thirty-nine infants completed the study; similar results were observed in males and females. Completion of PROMs was 100% with no missing responses, but Cronbach's α was low for many concept scales scores. ITQOL scores [range 0 (worst)-100 (best)] were generally high (median ≥ 80) except for Day-1 and Day-42 Temperament and Mood and Day-1 General Health Perceptions scores. ITQOL but not ICQ temperament scores improved significantly between Day-1 and Day-42 (P < 0.01). Mean ± standard deviation BEBQ scores (range 1-5) were high for Enjoyment of Food (4.59 ± 0.60) and Food Responsiveness (3.53 ± 0.81), and low for Satiety Responsiveness (2.50 ± 0.73) and Slowness in Eating (1.71 ± 0.60). Better HRQoL scores were significantly (P < 0.05) associated with high General Appetite scores (3 ITQOL concepts, r = 0.32 to 0.54), greater Enjoyment of Food (4 ITQOL concepts, r = 0.35 to 0.42) and low levels of Slowness in Eating (7 ITQOL concepts, r = - 0.32 to - 0.47). CONCLUSION Findings demonstrated the utility of the ITQOL, ICQ and BEBQ for measuring HRQoL, temperament and eating behavior, and the need for further adaptations for use in Filipino infants. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02431377; Registered May 1, 2015.
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Affiliation(s)
- Sheri Volger
- Rutgers University School of Health Professions, Department of Clinical and Preventive Nutrition Sciences, 65 Bergen Street, Newark, NJ 07107 USA
- Nestlé Nutrition Research, King of Prussia, PA USA
| | - Elvira M. Estorninos
- Asian Hospital & Medical Center, Medical Office Building, 2205 Civic Drive, Filinvest Corporate City Alabang, 1708 Muntinlupa City, Philippines
| | - Maria R. Capeding
- Asian Hospital & Medical Center, Medical Office Building, 2205 Civic Drive, Filinvest Corporate City Alabang, 1708 Muntinlupa City, Philippines
| | - Jowena Lebumfacil
- Wyeth Philippines Inc, 8 Rockwell, Hidalgo Drive, Rockwell Center, Makati City, Philippines
| | - Diane Rigassio Radler
- Rutgers University School of Health Professions, Department of Clinical and Preventive Nutrition Sciences, 65 Bergen Street, Newark, NJ 07107 USA
| | - J. Scott Parrott
- Rutgers University School of Health Professions, Department of Clinical and Preventive Nutrition Sciences, 65 Bergen Street, Newark, NJ 07107 USA
| | - Pamela Rothpletz-Puglia
- Rutgers University School of Health Professions, Department of Clinical and Preventive Nutrition Sciences, 65 Bergen Street, Newark, NJ 07107 USA
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Sharp JR, Maguire JL, Carsley S, Abdullah K, Chen Y, Perrin EM, Parkin PC, Birken CS, Maguire JL, Lau E, Laupacis A, Parkin PC, Salter M, Szatmari P, Weir S, Abdullah K, Aglipay M, Ali Y, Anderson LN, Bayoumi I, Birken CS, Borkhoff CM, Carsley S, Chen S, Chen Y, Dai DW, Darmawikarta D, Dennis CL, Eny K, Erdle S, Furlong K, Kavikondala K, Koroshegyi C, Kowal C, Lee GJ, Maguire JL, Mason D, Omand J, Parkin PC, Persaud N, Plumptre L, van den Heuvel M, Vanderhout S, Wong P, Zabih W, Abdurrahman M, Anderson B, Anderson K, Arbess G, Baker J, Barozzino T, Bergeron S, Bhagat D, Blanchette N, Bloch G, Bonifacio J, Bowry A, Brown A, Bugera J, Calpin C, Campbell D, Cheema S, Cheng E, Chisamore B, Constantin E, Culbert E, Danayan K, Das P, Derocher MB, Do A, Dorey M, Doukas K, Egger A, Farber A, Freedman A, Freeman S, Fung K, Gazeley S, Goldenberg D, Guiang C, Ha D, Hafiz S, Handford C, Hanson L, Harrington L, Hatch H, Hughes T, Jacobson S, Jagiello L, Jansz G, Kadar P, Kiran T, Kitney L, Knowles H, Kwok B, Lakhoo S, Lam-Antoniades M, Lau E, Leung FH, Li A, Li P, Loo J, Louis J, Mahmoud S, Male R, Mascoll V, Moodie R, Morinis J, Nader M, Naymark S, Neelands P, Owen J, Parry J, Peer M, Pena K, Perlmutar M, Persaud N, Pinto A, Pitt T, Porepa M, Qi V, Ramji N, Ramji N, Rana J, Rosenthal A, Rouleau K, Saunderson J, Saxena R, Schiralli V, Sgro M, Shepherd S, Smiltnieks B, Srikanthan C, Taylor C, Turner S, Uddin F, Vaughan J, Weisdorf T, Wijayasinghe S, Wong P, Wormsbecker A, Ying E, Young E, Zajdman M, Bustos M, Camacho C, Dalwadi D, Jegathesan T, Malhi T, Thadani S, Thompson J, Thompson L, Allen C, Boodhoo B, Hall J, Juni P, Lebovic G, Pope K, Shim J, Thorpe K, Azad A. Temperament Is Associated With Outdoor Free Play in Young Children: A TARGet Kids! Study. Acad Pediatr 2018; 18:445-451. [PMID: 28842293 DOI: 10.1016/j.acap.2017.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/04/2017] [Accepted: 08/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Outdoor free play is important for preschoolers' physical activity, health, and development. Certain temperamental characteristics are associated with obesity, nutrition, and sedentary behaviors in preschoolers, but the relationship between temperament and outdoor play has not been examined. This study examined whether there is an association between temperament and outdoor play in young children. METHODS Healthy children aged 1 to 5 years recruited to The Applied Research Group for Kids (TARGet Kids!), a community-based primary care research network, from July 2008 to September 2013 were included. Parent-reported child temperament was assessed using the Childhood Behavior Questionnaire. Outdoor free play and other potential confounding variables were assessed through validated questionnaires. Multivariable linear regression was used to determine the association between temperament and outdoor play, adjusted for potential confounders. RESULTS There were 3393 children with data on outdoor play. The association between negative affectivity and outdoor play was moderated by sex; in boys, for every 1-point increase in negative affectivity score, mean outdoor play decreased by 4.7 minutes per day. There was no significant association in girls. Surgency was associated with outdoor play; for every 1-point increase in surgency/extraversion, outdoor play increased by 4.6 minutes per day. CONCLUSIONS Young children's temperamental characteristics were associated with their participation in outdoor free play. Consideration of temperament could enhance interventions and strategies to increase outdoor play in young children. Longitudinal studies are needed to elucidate the relationship between children's early temperament and physical activity.
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Affiliation(s)
- Julia R Sharp
- Department of Post-Graduate Medical Education, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Jonathon L Maguire
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Department of Paediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Canada; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada; Department of Paediatrics, St Michael's Hospital, Toronto, Canada
| | - Sarah Carsley
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Kawsari Abdullah
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Yang Chen
- The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada
| | - Eliana M Perrin
- Department of Pediatrics, Division of Primary Care, Duke University, Durham, NC
| | - Patricia C Parkin
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Department of Paediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Canada
| | - Catherine S Birken
- Paediatric Outcomes Research Team, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Department of Paediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Canada; Child Health Evaluative Studies, SickKids Research Institute, Toronto, Canada; The Applied Health Research Centre of the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.
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Pattinson CL, Smith SS, Staton SL, Trost SG, Thorpe KJ. Investigating the association between sleep parameters and the weight status of children: night sleep duration matters. Sleep Health 2018; 4:147-153. [DOI: 10.1016/j.sleh.2017.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
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Galloway AT, Watson P, Pitama S, Farrow CV. Socioeconomic Position and Picky Eating Behavior Predict Disparate Weight Trajectories in Infancy. Front Endocrinol (Lausanne) 2018; 9:528. [PMID: 30279678 PMCID: PMC6154220 DOI: 10.3389/fendo.2018.00528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/21/2018] [Indexed: 01/27/2023] Open
Abstract
Infant weight gain has long-term implications for the establishment of overall health. We examined whether socioeconomic position (SEP), the use of pressure as a feeding practice, and picky eating relate to changes infant in weight-for-length (WFL). A modified developmental design was used to examine whether current levels of child picky eating, parental use of pressure, and SEP were associated with changes in WFL during infancy. Health providers distributed survey packets during routine well-child visits made in the homes of families with young children in New Zealand (n = 193). Primary caregivers of young children provided their child's current level of picky eating, their use of pressure, and their SEP. They also reported their child's professionally-measured WFL from birth, 8, 15, and 21 months of age. A multi-level modeling analysis yielded an interaction between SEP and picky eating in predicting infant weight change over time. Children who had a low SEP and were not picky eaters were on the highest WFL trajectory and children who had a low SEP and were picky eaters were lowest on the WFL trajectory. A main effect revealed that higher levels of parental pressure predicted lower WFL in infants at each age, but did not interact with SEP or picky eating. Findings from this study indicate that the combination of eating behavior and SEP are associated with differential infant growth patterns. These results suggest that eating behavior and SEP should be included in the development of interventions designed to achieve healthy weight during childhood.
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Affiliation(s)
- Amy T Galloway
- Department of Psychology, Appalachian State University, Boone, NC, United States
- Ara Institute of Canterbury, Christchurch, New Zealand
| | - Paul Watson
- Ara Institute of Canterbury, Christchurch, New Zealand
- Royal New Zealand Plunket Trust, Wellington, New Zealand
| | - Suzanne Pitama
- Māori/Indigenous Health Institute, Otago University, Christchurch, New Zealand
| | - Claire V Farrow
- Department of Psychology, School of Life & Health Sciences, Aston University, Birmingham, United Kingdom
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18
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Kidwell KM, Kozikowski C, Roth T, Lundahl A, Nelson TD. Concurrent and Longitudinal Associations Among Temperament, Parental Feeding Styles, and Selective Eating in a Preschool Sample. J Pediatr Psychol 2017; 43:572-583. [DOI: 10.1093/jpepsy/jsx148] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 11/26/2017] [Indexed: 01/20/2023] Open
Affiliation(s)
| | | | - Taylor Roth
- Department of Psychology, University of Nebraska-Lincoln
| | - Alyssa Lundahl
- Department of Psychology, University of Nebraska-Lincoln
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19
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van den Heuvel M, Chen Y, Abdullah K, Maguire JL, Parkin PC, Birken CS. The concurrent and longitudinal associations of temperament and nutritional risk factors in early childhood. Pediatr Obes 2017; 12:431-438. [PMID: 27273610 DOI: 10.1111/ijpo.12161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 04/22/2016] [Accepted: 05/09/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early childhood temperament is increasingly recognized as an important attribute that may impact screen time use, outdoor play and childhood obesity. The relationship between temperament and nutrition in preschool children is less clear. OBJECTIVE The objective of the study is to investigate if temperament dimensions (negative affectivity, effortful control and surgency) in early childhood are associated with nutritional risk factors. METHODS Six hundred seventy-eight children were followed (mean age at baseline visit 3.1 years; mean time to follow-up 16.5 months). Parents reported on child temperament and nutritional risk factors during regularly scheduled well-child clinic visits. RESULTS A mixed effect model demonstrated a significant association between higher negative affectivity (1.03; 95% CI 0.69 to 1.37) and higher effortful control (-0.88; 95% CI -1.27 to -0.49) on concurrent nutritional risk, independent of covariates. Multivariate linear regression analysis identified that higher effortful control, and not negative affectivity, was significantly associated with a decrease in nutritional risk (-0.67; 95% CI -1.10 to -0.24) over time, independent of covariates. There was no relationship identified between surgency and nutritional risk. CONCLUSION Three-year-old children with higher effortful control had reduced nutritional risk at 5 years of age. Future nutritional risk prevention strategies may benefit from interventions to increase effortful control in early childhood.
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Affiliation(s)
- M van den Heuvel
- Paediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, Department of Paediatric, The Hospital for Sick Children, Toronto, Ontario.,Department of Paediatric, St. Michael's Hospital, Toronto, Ontario.,Department of Paediatric, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Y Chen
- Paediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, Department of Paediatric, The Hospital for Sick Children, Toronto, Ontario.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario
| | - K Abdullah
- Paediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, Department of Paediatric, The Hospital for Sick Children, Toronto, Ontario.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario
| | - J L Maguire
- Paediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, Department of Paediatric, The Hospital for Sick Children, Toronto, Ontario.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.,The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario.,Department of Paediatric, St. Michael's Hospital, Toronto, Ontario.,Department of Paediatric, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - P C Parkin
- Paediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, Department of Paediatric, The Hospital for Sick Children, Toronto, Ontario.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.,Department of Paediatric, Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - C S Birken
- Paediatric Outcomes Research Team (PORT), Division of Paediatric Medicine, Department of Paediatric, The Hospital for Sick Children, Toronto, Ontario.,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario.,The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario.,Department of Paediatric, Faculty of Medicine, University of Toronto, Toronto, Ontario
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Kozieł S, Chakraborty R, Bose K. Relationship between temperament and fatness in 11-year-old children and 17-year-old adolescents from Wrocław, Poland. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2017; 68:479-486. [PMID: 29175059 DOI: 10.1016/j.jchb.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 10/12/2017] [Indexed: 11/29/2022]
Abstract
Childhood obesity is increasing globally, and Poland is no exception. Studies indicate that relationship between obesity and psychological well-being is a complex issue and this needs further research. The objective of the present cross sectional study was to analyze the relationship between some temperament components and fatness among children in two developmental periods, approximately before and after adolescence. Participants included 122 children aged 11 years (57 boys and 65 girls), and 153 adolescents aged 17 years (64 boys and 89 girls) from 6 primary and 4 secondary schools in Wrocław, Poland. Height, weight, triceps-, subscapular and abdominal skinfold thicknesses were measured. Temperament was assessed by a questionnaire of Buss and Plomin (1984) in two versions: EAS-C for children completed by parents and EAS-D for youth and adults. Physical activity (PAL) was also assessed by a questionnaire. Mean, median and standard deviation (SD) were calculated and Student's t tests were performed to test for significance of differences between groups. Chi squared (χ2) statistic was used to test the significance of differences in frequencies. Analyses of covariance (ANCOVA) were performed to show the effect of the social - psychological factors on fatness. Controlling for socioeconomic status and physical activity level, activity, as a component of temperament had a significant effect on body fatness. The only component of temperament, which significantly influenced level of fatness in girls, was emotionality. These relationships differed according to sex and the two age groups concerned.
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Affiliation(s)
- S Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Rudolf Weigiel 12, 53-114 Wroclaw, Poland.
| | - R Chakraborty
- Department of Anthropology, Dinabandhu Mahavidyalaya, Bongaon, West Bengal, India
| | - K Bose
- Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India
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Hankey M, Kidwell KM, Nelson JM, Espy KA, Nelson TD. Weight Status as a Mediator of the Association Between Preschool Extraversion and Adolescent Restrained Eating. J Pediatr Psychol 2017; 42:882-891. [PMID: 28369620 PMCID: PMC5896629 DOI: 10.1093/jpepsy/jsx049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/13/2017] [Accepted: 01/17/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives To determine the longitudinal association between preschool extraversion and weight/dieting outcomes in adolescence. Methods Children (N = 180) were recruited as part of a longitudinal study, with child temperament assessed in preschool (age 5.25 years), weight assessed in 2nd grade and early adolescence, and eating outcomes assessed in early adolescence (mean age = 12.02 years). Results Preschoolers high in extraversion were significantly more likely to have higher body mass index z-scores (zBMI) and more restrained eating behaviors in adolescence. zBMI was found to mediate the relationship between extraversion and restrained eating, such that children with high levels of extraversion were more likely to have higher zBMI in adolescence and, owing to this higher weight status, to engage in more restrained eating. Conclusions Temperament is an important predictor of later maladaptive weight/dieting outcomes in adolescence, making it a potentially important early factor to consider in weight management interventions.
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Affiliation(s)
- Maren Hankey
- Department of Psychology, University of Nebraska-Lincoln
| | | | - Jennifer Mize Nelson
- Department of Psychology, University of Nebraska-Lincoln
- Office of Research, University of Nebraska-Lincoln
| | - Kimberly Andrews Espy
- Department of Psychology, University of Nebraska-Lincoln
- Department of Psychology, University of Arizona
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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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Monnereau C, Jansen PW, Tiemeier H, Jaddoe VWV, Felix JF. Influence of genetic variants associated with body mass index on eating behavior in childhood. Obesity (Silver Spring) 2017; 25:765-772. [PMID: 28245097 PMCID: PMC5496668 DOI: 10.1002/oby.21778] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/23/2016] [Accepted: 12/26/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Childhood eating behaviors are associated with body mass index (BMI). Recent genome-wide association studies have identified many single-nucleotide polymorphisms (SNPs) associated with adult and childhood BMI. This study hypothesized that these SNPs also influence eating behavior. METHODS In a population-based prospective cohort study among 3,031 children (mean age [standard deviation]: 4.0 [0.1] years), two weighted genetic risk scores, based on 15 childhood and 97 adult BMI SNPs, and ten individual appetite- and/or satiety-related SNPs were tested for association with food fussiness, food responsiveness, enjoyment of food, satiety responsiveness, and slowness in eating. RESULTS The 15 SNP-based childhood BMI genetic risk score was not associated with the eating behavior subscales. The 97 SNP-based adult BMI genetic risk score was nominally associated with satiety responsiveness (β: -0.007 standard deviation, 95% confidence interval [CI] -0.013, 0.000). Of the 10 individual SNPs, rs11030104 in BDNF and rs10733682 in LMX1B were nominally associated with satiety responsiveness (β: -0.057 standard deviation, 95% CI -0.112, -0.002). CONCLUSIONS These findings do not strongly support the hypothesis that BMI-associated SNPs also influence eating behavior at this age. A potential role for BMI SNPs in satiety responsiveness during childhood was observed; however, no associations with the other eating behavior subscales were found.
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Affiliation(s)
- Claire Monnereau
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Pauline W Jansen
- Institute of Psychology, Erasmus University, Rotterdam, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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24
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Sutin AR, Kerr JA, Terracciano A. Temperament and body weight from ages 4 to 15 years. Int J Obes (Lond) 2017; 41:1056-1061. [PMID: 28280272 PMCID: PMC5496782 DOI: 10.1038/ijo.2017.62] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/11/2017] [Accepted: 02/10/2017] [Indexed: 12/20/2022]
Abstract
Background/Objectives In adulthood, conscientiousness and neuroticism are correlates of body weight and weight gain. The present research examines whether the childhood antecedents of these traits, persistence and negative reactivity, respectively, are associated with weight gain across childhood. We likewise examine sociability as a predictor of childhood weight gain and whether these three traits are associated with weight concerns and weight management strategies in adolescence. Subjects/Methods Participants (N=4,153) were drawn from the Longitudinal Study of Australian Children, an ongoing, population-based study of child and family health and well-being. At the baseline assessment, caregivers reported on their child's temperament. At every assessment from ages 4-5 to 14-15, study children were weighed and measured by trained staff; there were up to six biennial assessments of body mass index (BMI) and waist circumference. At age 14-15, study children (n=2,975) also self-reported on their weight concerns and weight management strategies. Results Study children rated lower in persistence or higher in negative reactivity in early childhood gained more weight between the ages of 4 and 15. Sociability was associated with weight gain among girls but not among boys. Lower persistence and higher negative reactivity at age 4-5 were also associated with greater weight concerns, restrained eating, and use of unhealthy weight management strategies at ages 14-15. Conclusions Childhood traits related to conscientiousness and neuroticism are associated with objective weight gain across childhood and with concerns and strategies to manage weight in adolescence. These results are consistent with a lifespan perspective that indicates that trait psychological functioning contributes to health-related markers from childhood through old age.
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Affiliation(s)
- A R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahasse, FL, USA
| | - J A Kerr
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - A Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Tallahasse, FL, USA
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25
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Kong KL, Anzman-Frasca S, Feda DM, Eiden RD, Sharma NN, Stier CL, Epstein LH. Infant Temperament Is Associated with Relative Food Reinforcement. Child Obes 2016; 12:411-417. [PMID: 27447680 DOI: 10.1089/chi.2016.0001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Food reinforcement refers to how hard someone is motivated to work to gain access to food. Infant temperament is defined as behavioral styles, or constitutionally based individual differences in reactive and regulatory aspects of behavior. Identifying correlates of food reinforcement, such as infant temperament, may help identify infants at risk for future negative health consequences (e.g., overweight or obesity) of high food reinforcement. METHODS This study tested aspects of parent-reported negative reactivity and regulation and their associations with relative food reinforcement in a cross-sectional sample of 105 9- to 18-month-old infants. Hierarchical linear regression models were then used to predict infant food reinforcement for the temperament dimensions that were significantly related to it. RESULTS Two temperament dimensions, cuddliness (regulatory aspect) (B = -0.050, ΔR2 = 0.074, p = 0.005) and rate of recovery from distress and arousal (reactive aspect) (B = -0.040, ΔR2 = 0.045, p = 0.031), were inversely associated with relative food reinforcement. CONCLUSION Clarifying the nature of relationships between these two behavioral predictors, infant temperament and relative food reinforcement, and early obesity can elucidate the role of individual differences in early obesity risk and can further inform targets for early behavioral obesity preventive interventions.
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Affiliation(s)
- Kai Ling Kong
- 1 Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo , Buffalo, NY
| | - Stephanie Anzman-Frasca
- 1 Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo , Buffalo, NY
| | - Denise M Feda
- 1 Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo , Buffalo, NY
| | - Rina D Eiden
- 2 Research Institute on Addictions, State University of New York at Buffalo , Buffalo, NY
| | - Neha N Sharma
- 1 Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo , Buffalo, NY
| | - Corrin L Stier
- 1 Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo , Buffalo, NY
| | - Leonard H Epstein
- 1 Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo , Buffalo, NY
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26
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Hayes JF, Altman M, Kolko RP, Balantekin KN, Holland JC, Stein RI, Saelens BE, Welch RR, Perri MG, Schechtman KB, Epstein LH, Wilfley DE. Decreasing food fussiness in children with obesity leads to greater weight loss in family-based treatment. Obesity (Silver Spring) 2016; 24:2158-63. [PMID: 27601189 PMCID: PMC5039088 DOI: 10.1002/oby.21622] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Food fussiness (FF), or the frequent rejection of both familiar and unfamiliar foods, is common among children and, given its link to poor diet quality, may contribute to the onset and/or maintenance of childhood obesity. This study examined child FF in association with anthropometric variables and diet in children with overweight/obesity participating in family-based behavioral weight loss treatment (FBT). Change in FF was assessed in relation to FBT outcome, including whether change in diet quality mediated the relation between change in FF and change in child weight. METHODS Child (N = 170; age = 9.41 ± 1.23) height and weight were measured, and parents completed FF questionnaires and three 24-h recalls of child diet at baseline and post-treatment. Healthy Eating Index-2005 scores were calculated. RESULTS At baseline, child FF was related to lower vegetable intake. Average child FF decreased from start to end of FBT. Greater decreases in FF were associated with greater reductions in child body mass index and improved overall diet quality. Overall, diet quality change through FBT mediated the relation between child FF change and child body mass index change. CONCLUSIONS Children with high FF can benefit from FBT, and addressing FF may be important in childhood obesity treatment to maximize weight outcomes.
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Affiliation(s)
- Jacqueline F Hayes
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA.
| | - Myra Altman
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Rachel P Kolko
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Jodi Cahill Holland
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Richard I Stein
- Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Brian E Saelens
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - R Robinson Welch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Michael G Perri
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Kenneth B Schechtman
- Department of Biostatistics, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Leonard H Epstein
- Department of Pediatrics, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri, USA
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27
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Associations between maternal sense of coherence and controlling feeding practices: The importance of resilience and support in families of preschoolers. Appetite 2016; 105:134-43. [DOI: 10.1016/j.appet.2016.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/07/2016] [Accepted: 05/13/2016] [Indexed: 11/17/2022]
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28
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Personality and Body-Mass-Index in School-Age Children: An Exploration of Mediating and Moderating Variables. PLoS One 2016; 11:e0158353. [PMID: 27486752 PMCID: PMC4972344 DOI: 10.1371/journal.pone.0158353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/14/2016] [Indexed: 02/07/2023] Open
Abstract
This study explored longitudinal associations between personality and body-mass-index (BMI) in school-age children, including the potential mediating role of screen time and physical activity, and the potential moderating roles of child demographics and neighbourhood socioeconomic position. Participants were the parents (and teachers) of 3857 ten-year-old children, who completed questionnaires at baseline with a two-year follow-up. After controlling for child demographics (e.g., sex, pubertal status), we found that personality was unimportant for concurrent BMI, but was important for subsequent BMI and change in BMI over two years. Low levels of introversion and persistence at baseline, and decreases in persistence over time, were associated with a higher BMI at follow-up and a greater increase in BMI over time. Moderator analyses showed that introversion was more strongly related to subsequent BMI for children listed as aboriginal or Torres Strait Islander. The relationship between personality and change in BMI was mediated by screen time, but not by physical activity. To conclude, findings demonstrate that personality is important for change in body mass in Australian children (particularly indigenous children), and that screen-based sedentary behaviour features an important role in this association.
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29
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Hildebrand M, Øglund GP, Wells JC, Ekelund U. Prenatal, birth and early life predictors of sedentary behavior in young people: a systematic review. Int J Behav Nutr Phys Act 2016; 13:63. [PMID: 27268003 PMCID: PMC4897914 DOI: 10.1186/s12966-016-0389-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 06/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our aim was to systematically summarize the evidence on whether prenatal, birth and early life factors up to 6 years of age predict sedentary behavior in young people (≤18 years). METHODS PRISMA guidelines were followed, and searches were conducted in PubMed, SPORTDiscus, EMBASE and Web of Science up to December 1, 2015. We included observational (non-intervention) and longitudinal studies, that reported data on the association between one or more of the potential predictors and objectively or subjectively measured sedentary behavior. Study quality was assessed using a formal checklist and data extraction was performed using standardized forms independently by two researchers. RESULTS More than 18,000 articles were screened, and 16 studies, examining 10 different predictors, were included. Study quality was variable (0.36-0.95). Two studies suggest that heritability and BMI in children aged 2-6 years were significant predictors of sedentary behavior later in life, while four and seven studies suggest no evidence for an association between gestational age, birth weight and sedentary behavior respectively. There was insufficient evidence whether other prenatal, birth and early life factors act as predictors of later sedentary behavior in young people. CONCLUSION The results suggest that heritability and early childhood BMI may predict sedentary behavior in young people. However, small number of studies included and methodological limitations, including subjective and poorly validated sedentary behavior assessment, limits the conclusions. TRIAL REGISTRATION The systematic review is registered in the International Prospective Register of Systematic Reviews, PROSPERO, 17.10.2014 ( CRD42014014156 ).
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Affiliation(s)
- Maria Hildebrand
- The Department of Sports Medicine, Norwegian School of Sport Sciences, P.O Box 4014, Ullevål Stadion, 0806, Oslo, Norway.
| | - Guro P Øglund
- The Department of Sports Medicine, Norwegian School of Sport Sciences, P.O Box 4014, Ullevål Stadion, 0806, Oslo, Norway
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
| | - Ulf Ekelund
- The Department of Sports Medicine, Norwegian School of Sport Sciences, P.O Box 4014, Ullevål Stadion, 0806, Oslo, Norway.,Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
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30
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Leung CY, Miller AL, Kaciroti NA, Chen YP, Rosenblum K, Lumeng JC. Low-income pre-schoolers with higher temperamental surgency enjoy and respond more to food, mediating the path to higher body mass index. Pediatr Obes 2016; 11:181-6. [PMID: 26083122 PMCID: PMC4683115 DOI: 10.1111/ijpo.12042] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Temperament is associated with obesity risk. However, the mechanisms linking temperament and eating behaviour to childhood adiposity are unclear. OBJECTIVES To examine whether three temperament dimensions (surgency, effortful control and negative lability) are uniquely associated with an increased BMI z score (BMIz) concurrently and an excessive rate of change in BMIz longitudinally through four eating behaviours (food responsiveness, enjoyment of food, emotional overeating and satiety responsiveness) among low-income pre-schoolers, independent of home environment quality. METHODS 379 pre-schoolers were recruited from Head Start in the Midwest region of the United States. Primary caregivers reported child temperament, eating behaviours and the level of chaos at home. Child BMIz was derived from weight and height measurements at ages 4, 5 and 6 years on average. RESULTS Path analyses revealed that higher levels of surgency predicted more food responsiveness and enjoyment of food, which was in turn associated with higher concurrent BMIz, independent of effortful control, negative lability and home chaos. CONCLUSION Low-income surgent pre-schoolers were more likely to have elevated BMIz as they were more inclined to eat in response to external cues and have a high appetitive drive. Obesity prevention programmes might target low-income children with surgent temperaments, and the identified eating behaviours.
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Affiliation(s)
- Christy Y.Y. Leung
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Alison L. Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Niko A. Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Yu Pu Chen
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Katherine Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Julie C. Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI,Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
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Abstract
OBJECTIVE Childhood eating problems, in particular restrictive eating, are common. Knowledge and understanding of risk mechanisms is still scarce. We aimed to investigate prospective early risk factors for restrictive eating across child, maternal, obstetric, and sociodemographic domains in a population-based sample of Danish 5 to 7 year olds. METHOD Data on restrictive eating patterns (picky eating, slow/poor eating, and emotional undereating) collected on 1327 children from the Copenhagen Child Cohort 2000 were linked with registered and routinely collected health nurse data (during the first year of life). Prospective risk factors were investigated in univariable and multivariable regression models. RESULTS Feeding problems in infancy were prospectively associated with childhood picky eating (odds ratio [OR] = 2.02, 95% confidence interval [CI], 1.20-3.40) and emotional undereating (OR = 1.49, 95% CI, 1.05-2.11). A high thriving index in infancy was inversely associated with both picky and slow/poor eating. Having 2 non-Danish-born parents predicted slow/poor eating (OR = 5.29, 95% CI, 1.16-24.09) in multivariable analyses, as did maternal diagnosis of a psychiatric disorder before child age 5 years in univariable analyses (OR = 6.08, 95% CI, 1.70-21.72). CONCLUSIONS Feeding problems and poor growth in the first year of life show high continuity into childhood restrictive eating. Maternal psychopathology is an important and modifiable risk factor. These findings confirm that early signs of poor eating and growth are persistent and might be useful in predicting eating problems in mid-childhood.
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32
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Faith MS, Hittner JB. Shadows of temperament in child eating patterns: implications for family and parenting research. Am J Clin Nutr 2016; 103:961-2. [PMID: 26984483 DOI: 10.3945/ajcn.116.132258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Myles S Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo-SUNY, Buffalo, NY; and
| | - James B Hittner
- Department of Psychology, College of Charleston, Charleston, SC
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33
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Hittner JB, Johnson C, Tripicchio G, Faith MS. Infant emotional distress, maternal restriction at a home meal, and child BMI gain through age 6years in the Colorado Adoption Project. Eat Behav 2016; 21:135-41. [PMID: 26872074 DOI: 10.1016/j.eatbeh.2016.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/30/2015] [Accepted: 01/19/2016] [Indexed: 11/26/2022]
Abstract
Infant temperament and parental feeding practices may be risk factors for childhood obesity, however most studies have relied upon parent-report assessments. We tested whether infant emotional distress and maternal restrictive feeding at 12-months of age, assessed observationally at a home feeding interaction, predicted child BMI through age 6years. We conducted a prospective observational study of 86 children (34 girls and 52 boys, from 55 adoptive and 31 non-adoptive families) enrolled in the Colorado Adoption Project. Mother-infant feeding interactions were video-recorded during a home snack or meal at year 1, and child anthropometrics (length or height, and weight) were assessed at years 1 through 6. The main outcome measures were child weight-for-length at year 1 and body mass index (BMI: kg/m(2)) at years 2-6. Results of generalized linear models indicated that greater infant emotional distress at 12-months predicted greater increases in child weight status through age 6years, B=0.62 and odds ratio (OR)=1.87. In separate analyses, restrictive feeding interacted with child sex in predicting weight status trajectories (p=.012). Male infants whose mothers displayed any compared to no restriction at year 1 showed a downward BMI trajectory from 2 to 6years; for female infants, exposure to any compared to no restriction prompts predicted increasing BMI from 4 to 6years. In sum, early obesity prevention strategies should pay greater attention to infant temperament, especially distress and negative affect, and how parents respond to such cues. Additionally, 'responsive feeding' strategies that provide an alternative to restriction warrant greater research during infancy.
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Affiliation(s)
- James B Hittner
- Department of Psychology, College of Charleston, United States
| | - Cassandra Johnson
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, United States
| | - Gina Tripicchio
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, United States
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology (CSEP), Graduate School of Education, University of Buffalo - SUNY, United States.
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34
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Gowey MA, Reiter-Purtill J, Becnel J, Peugh J, Mitchell JE, Zeller MH. Weight-related correlates of psychological dysregulation in adolescent and young adult (AYA) females with severe obesity. Appetite 2016; 99:211-218. [PMID: 26775646 DOI: 10.1016/j.appet.2016.01.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 01/03/2016] [Accepted: 01/12/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Severe obesity is the fastest growing pediatric subgroup of excess weight levels. Psychological dysregulation (i.e., impairments in regulating cognitive, emotional, and/or behavioral processes) has been associated with obesity and poorer weight loss outcomes. The present study explored associations of dysregulation with weight-related variables among adolescent and young adult (AYA) females with severe obesity. METHODS Fifty-four AYA females with severe obesity (MBMI = 48.71 kg/m(2); Mage = 18.29, R = 15-21 years; 59.3% White) completed self-report measures of psychological dysregulation and weight-related constructs including meal patterns, problematic eating behaviors, and body and weight dissatisfaction, as non-surgical comparison participants in a multi-site study of adolescent bariatric surgery outcomes. Pearson and bivariate correlations were conducted and stratified by age group to analyze associations between dysregulation subscales (affective, behavioral, cognitive) and weight-related variables. RESULTS Breakfast was the most frequently skipped meal (consumed 3-4 times/week). Eating out was common (4-5 times/week) and mostly occurred at fast-food restaurants. Evening hyperphagia (61.11%) and eating in the absence of hunger (37.04%) were commonly endorsed, while unplanned eating (29.63%), a sense of loss of control over eating (22.22%), eating beyond satiety (22.22%), night eating (12.96%), and binge eating (11.11%) were less common. Almost half of the sample endorsed extreme weight dissatisfaction. Dysregulation was associated with most weight-related attitudes and behaviors of interest in young adults but select patterns emerged for adolescents. CONCLUSIONS Higher levels of psychological dysregulation are associated with greater BMI, problematic eating patterns and behaviors, and body dissatisfaction in AYA females with severe obesity. These findings have implications for developing novel intervention strategies for severe obesity in AYAs that may have a multidimensional impact on functioning (e.g., psychosocial health, weight loss behaviors).
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Affiliation(s)
- Marissa A Gowey
- Nutrition Obesity Research Center, University of Alabama at Birmingham, United States.
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
| | - Jennifer Becnel
- School of Human Environmental Sciences, Program in Human Development and Family Sciences, University of Arkansas, United States
| | - James Peugh
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, United States
| | - Meg H Zeller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, United States
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35
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de Barse LM, Tiemeier H, Leermakers ETM, Voortman T, Jaddoe VWV, Edelson LR, Franco OH, Jansen PW. Longitudinal association between preschool fussy eating and body composition at 6 years of age: The Generation R Study. Int J Behav Nutr Phys Act 2015; 12:153. [PMID: 26666996 PMCID: PMC4678491 DOI: 10.1186/s12966-015-0313-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/02/2015] [Indexed: 01/13/2023] Open
Abstract
Background Children’s fussy eating behavior has been related to both underweight and overweight in cross-sectional studies, but the direction of these associations and the relation with more detailed measures of body composition remains unclear. We aimed to examine whether fussy eating at age 4 years is longitudinally related to body mass index (BMI), fat mass index (FMI) and fat-free mass index (FFMI) at 6 years of age. Methods This study was embedded in Generation R, a population-based, prospective cohort. Data were available for 4191 children. The Children’s Eating Behaviour Questionnaire (CEBQ), administered at age 4 years, was used to derive a fussy eating profile. This profile is characterized by high scores on food avoidant scales and low scores on food approach scales. At age 6 years, height and weight were measured at our research center. Body fat and fat-free mass were measured using Dual-energy-X-ray absorptiometry. We used age- and sex-specific standard deviation scores (SDS) for all outcomes. Results After adjustment for confounders, the fussy eating profile was related to lower BMI-SDS (B = −0.37, 95 % CI: −0.47;−0.26), lower FMI-SDS (B = −0.22, 95 % CI: −0.33;−0.12) and lower FFMI-SDS (B = −0.41, 95 % CI: −0.54;−0.29). When adjusting for baseline BMI at 4 years, the fussy eating profile predicted a 0.11 lower BMI-SDS at age 6 (95 % CI: −0.19;−0.04). This change in BMI was mainly due to a decrease in FFMI (B = −0.19, 95 % CI: −0.29;−0.09). Fussy eaters also had a higher risk of becoming underweight than non-fussy eaters (OR = 2.28, 95 % CI: 1.34;3.87). Conclusions Our findings suggest that young fussy eaters are at risk of having a lower fat free mass and of becoming underweight over a 2-year period. This implies that fussy eaters may benefit from careful monitoring to prevent an adverse growth development. Electronic supplementary material The online version of this article (doi:10.1186/s12966-015-0313-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lisanne M de Barse
- The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands. .,Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands. .,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, PO Box 2060, 3000, CB, Rotterdam, The Netherlands. .,Department of Psychiatry, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Elisabeth T M Leermakers
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands. .,Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands. .,Department of Pediatrics, Erasmus MC-University Medical Center, PO Box 2060, 3000, CB, Rotterdam, The Netherlands.
| | - Lisa R Edelson
- Taste and Behavioral Sciences, Nestlé Research Center, Lausanne, Switzerland.
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC-University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, PO Box 2060, 3000, CB, Rotterdam, The Netherlands. .,Institute of Psychology, Erasmus University Rotterdam, PO Box 1738, 3000, DR, Rotterdam, The Netherlands.
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36
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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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Ek A, Chamberlain KL, Ejderhamn J, Fisher PA, Marcus C, Chamberlain P, Nowicka P. The More and Less Study: a randomized controlled trial testing different approaches to treat obesity in preschoolers. BMC Public Health 2015; 15:735. [PMID: 26231850 PMCID: PMC4522072 DOI: 10.1186/s12889-015-1912-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 06/08/2015] [Indexed: 01/13/2023] Open
Abstract
Background While obesity has been shown to be difficult to treat in school aged children and in adolescence, promising results have been detected for children who started treatment in early childhood. Yet knowledge on the effectiveness of structured early childhood obesity treatment programs is limited, preventing the widespread implementation of such programs. The main objective of this study is to evaluate the effectiveness of early treatment of childhood obesity with respect to treatment focus (parenting practices or lifestyle), length and intensity. The study will also examine the influence of gender, age, parental weight status, parenting practices, child behavior as well as parents’ socioeconomic status and child and parental psychosocial health on children’s weight status. Methods/design This is a parallel open label randomized controlled trial assessing two different behavioral treatment approaches offered in three conditions to families with children aged 4–6 years in Stockholm County, Sweden. Children (n = 180) identified as obese will be referred from primary child health care, school health care, and from outpatient pediatric clinics, and randomized to: 1) a standard treatment with focus on lifestyle, provided within the current healthcare system (n = 90); 2) a 10-session, 1.5 h/week group treatment with focus on parenting (n = 45); or 3) the same group treatment as 2) with additional follow-up sessions (n = 45). The primary study outcome is change in children’s body mass index standard deviation score (BMI SDS) one year post-baseline. Secondary outcomes include changes in children’s waist circumference, metabolic health, lifestyle patterns (Food Frequency Questionnaire), obesity-related child behaviors (Child Eating Behavior Questionnaire and Lifestyle Behavior Checklist, Problem Scale), parents’ general and feeding parenting practices (Communicating with Children and Child Feeding Questionnaire) and lifestyle-specific self-efficacy (Lifestyle Behavior Checklist, Confidence Scale), family functioning (Family Assessment Device), child and parental psychosocial health (Child Behavior Checklist and Beck’s Depression Inventory II). Discussion This study will facilitate a close examination of key components of treatment for obesity during early childhood and mechanisms of change. Results from this study will lead to better healthcare options for obesity treatment during early childhood and ultimately to the prevention of obesity later in life. Trial registration ClinicalTrials.gov NCT01792531 Registered February 14, 2013.
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Affiliation(s)
- Anna Ek
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
| | | | - Jan Ejderhamn
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
| | - Philip A Fisher
- Oregon Social Learning Center, Eugene, OR, USA. philf@uoregon.\edu.,University of Oregon, Eugene, OR, USA. philf@uoregon.\edu
| | - Claude Marcus
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
| | | | - Paulina Nowicka
- Division of Pediatrics, B62, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86, Stockholm, Sweden.
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38
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Davis AM, Sampilo M, Gallagher KS, Dean K, Saroja MB, Yu Q, He J, Sporn N. Treating rural paediatric obesity through telemedicine vs. telephone: Outcomes from a cluster randomized controlled trial. J Telemed Telecare 2015; 22:86-95. [PMID: 26026186 DOI: 10.1177/1357633x15586642] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/16/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of the current study was to examine the feasibility of telemedicine vs. telephone for the delivery of a multidisciplinary weekly family-based behavioural group intervention to treat paediatric obesity delivered to families living in rural areas using a randomized controlled trial methodology. METHODS 103 rural children and their families were recruited. Feasibility measures included participant satisfaction, session attendance and retention. Treatment outcome measures included child Body Mass Index z-score (BMIz), parent BMI, 24-hour dietary recalls, accelerometer data, the child behavior checklist and the behavioral pediatrics feeding assessment scale. RESULTS Participants were highly satisfied with the intervention both via telemedicine and via telephone. Completion rates were much higher than for other paediatric obesity intervention programmes, and both methodologies were highly feasible. There were no differences in telemedicine and telephone groups on primary outcomes. CONCLUSION Both telemedicine and telephone intervention appear to be feasible and acceptable methods of delivering paediatric obesity treatment to rural children.
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Affiliation(s)
- Ann M Davis
- University of Kansas Medical Center, Department of Pediatrics, USA Center for Children's Healthy Lifestyles & Nutrition, USA
| | - Marilyn Sampilo
- Center for Children's Healthy Lifestyles & Nutrition, USA University of Kansas, Department of Clinical Child Psychology, USA
| | | | - Kelsey Dean
- University of Kansas Medical Center, Department of Pediatrics, USA
| | | | - Qing Yu
- University of Kansas Medical Center, Department of Biostatistics, USA
| | - Jianghua He
- University of Kansas Medical Center, Department of Biostatistics, USA
| | - Nora Sporn
- University of Kansas, Department of Psychology, USA
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Nagata JM, Hagan MJ, Heyman MB, Wojcicki JM. No Association between Obesity and Behavior in Low-income, Preschool Latino Children. J Health Care Poor Underserved 2015; 26:410-20. [PMID: 25913339 PMCID: PMC4469650 DOI: 10.1353/hpu.2015.0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The relationship between behavioral problems and obesity in early childhood in Latinos is largely unknown. METHODS Cross-sectional anthropometric and behavioral data of children at three years of age were gathered from a cohort of 174 children of Latina mothers at two San Francisco hospitals. Child behaviors were assessed using the preschool Child Behavior Checklist (CBCL/1½-5). Logistic regression was used to analyze the association between behavior and obesity. RESULTS At three years, 27.7% were obese. There were no associations between affective (OR = 1.89; 95% confidence interval [CI] 0.42-8.59), anxiety (OR = 1.86; 95% CI 0.53-6.47), pervasive developmental (OR = 0.42; 95% CI 0.13-1.36), attention deficit hyperactivity (OR = 0.58; 95% CI 0.12-2.76), or oppositional defiant (OR = 6.49; 95% CI 0.65-64.49) problems and obesity. CONCLUSIONS Though psychological problems and obesity are associated among older children and adolescents, there was no association in Latino three-year olds in a low-income sample.
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40
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Christian LM, Galley JD, Hade EM, Schoppe-Sullivan S, Kamp Dush C, Bailey MT. Gut microbiome composition is associated with temperament during early childhood. Brain Behav Immun 2015; 45:118-27. [PMID: 25449582 PMCID: PMC4342262 DOI: 10.1016/j.bbi.2014.10.018] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/30/2014] [Accepted: 10/31/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Understanding the dynamics of the gut-brain axis has clinical implications for physical and mental health conditions, including obesity and anxiety. As such disorders have early life antecedents, it is of value to determine if associations between the gut microbiome and behavior are present in early life in humans. METHODS We used next generation pyrosequencing to examine associations between the community structure of the gut microbiome and maternal ratings of child temperament in 77 children at 18-27months of age. It was hypothesized that children would differ in their gut microbial structure, as indicated by measures of alpha and beta diversity, based on their temperamental characteristics. RESULTS Among both boys and girls, greater Surgency/Extraversion was associated greater phylogenetic diversity. In addition, among boys only, subscales loading on this composite scale were associated with differences in phylogenetic diversity, the Shannon Diversity index (SDI), beta diversity, and differences in abundances of Dialister, Rikenellaceae, Ruminococcaceae, and Parabacteroides. In girls only, higher Effortful Control was associated with a lower SDI score and differences in both beta diversity and Rikenellaceae were observed in relation to Fear. Some differences in dietary patterns were observed in relation to temperament, but these did not account for the observed differences in the microbiome. CONCLUSIONS Differences in gut microbiome composition, including alpha diversity, beta diversity, and abundances of specific bacterial species, were observed in association with temperament in toddlers. This study was cross-sectional and observational and, therefore, does not permit determination of the causal direction of effects. However, if bidirectional brain-gut relationships are present in humans in early life, this may represent an opportunity for intervention relevant to physical as well as mental health disorders.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry, The Ohio State University Wexner Medical Center, United States; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, United States; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, United States; Department of Psychology, The Ohio State University, United States.
| | - Jeffrey D Galley
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, United States; Division of Biosciences, The Ohio State University, United States
| | - Erinn M Hade
- Center for Biostatistics, College of Medicine, The Ohio State University, United States
| | | | - Claire Kamp Dush
- Department of Human Sciences, The Ohio State University, United States
| | - Michael T Bailey
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, United States; Division of Biosciences, The Ohio State University, United States
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41
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Nowicka P, Sorjonen K, Pietrobelli A, Flodmark CE, Faith MS. Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive. Appetite 2014; 81:232-41. [PMID: 24972134 DOI: 10.1016/j.appet.2014.06.027] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 12/12/2022]
Abstract
The Child Feeding Questionnaire (CFQ) assesses parental feeding attitudes, beliefs and practices concerned with child feeding and obesity proneness. The questionnaire has been developed in the U.S., and validation studies in other countries are limited. The aim of this study was to examine the psychometric properties of the CFQ in Sweden and the associations between parenting practices and children's weight status. Based on records from the Swedish population register, all mothers of 4-year-olds (n = 3007) from the third largest city in Sweden, Malmö, were contacted by mail. Those who returned the CFQ together with a background questionnaire (n = 876) received the CFQ again to enable test-retest evaluation; 564 mothers completed the CFQ twice. We used confirmatory factor analysis to test whether the original 7-factor model was supported. Good fit (CFI = 0.94, TLI = 0.95, RMSEA = 0.04, SRMR = 0.05) was obtained after minor modifications such as dropping 2 items on restriction and adding 3 error covariances. The internal reliability and the 2-week test-retest reliability were good. The scores on restriction were the lowest ever reported. When the influence of parenting practices on child BMI (dependent variable) was examined in a structural equation model (SEM), child BMI had a positive association with restriction and a negative association with pressure to eat. Restriction was positively influenced by concern about child weight. The second SEM treated parenting practices as dependent variables. Parental foreign origin and child BMI had direct effects on restriction, while pressure to eat was also influenced by parental education. While the results of the study support the usefulness of the CFQ in Sweden, carefully designed cross-cultural comparisons are needed to explain why the levels of restrictive feeding in Swedish families are the lowest reported.
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Affiliation(s)
- Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), B62, Karolinska Institute, 141 86 Stockholm, Sweden.
| | - Kimmo Sorjonen
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institute, 171 65 Solna, Sweden
| | - Angelo Pietrobelli
- Pediatric Unit, Verona University Medical School, Policlinic GB. Rossi, P.le LA. Scuro, 1, 37134 Verona, Italy; Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Carl-Erik Flodmark
- Childhood Obesity Unit, Childhood Centre Malmö, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Myles S Faith
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 2211 McGavran Greenberg Hall, CB 7461, Chapel Hill, NC 27599-7461, USA
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42
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Mallan KM, Daniels LA, Wilson JL, Jansen E, Nicholson JM. Association between maternal depressive symptoms in the early post-natal period and responsiveness in feeding at child age 2 years. MATERNAL AND CHILD NUTRITION 2014; 11:926-35. [PMID: 24784325 DOI: 10.1111/mcn.12116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Maternal depression is a known risk factor for poor outcomes for children. Pathways to these poor outcomes relate to reduced maternal responsiveness or sensitivity to the child. Impaired responsiveness potentially impacts the feeding relationship and thus may be a risk factor for inappropriate feeding practices. The aim of this study was to examine the longitudinal relationships between self-reported maternal post-natal depressive symptoms at child age 4 months and feeding practices at child age 2 years in a community sample. Participants were Australian first-time mothers allocated to the control group of the NOURISH randomized controlled trial when infants were 4 months old. Complete data from 211 mothers (of 346 allocated) followed up when their children were 2 years of age (51% girls) were available for analysis. The relationship between Edinburgh Postnatal Depression Scale (EPDS) score (child age 4 months) and child feeding practices (child age 2 years) was tested using hierarchical linear regression analysis adjusted for maternal and child characteristics. Higher EPDS score was associated with less responsive feeding practices at child age 2 years: greater pressure [β = 0.18, 95% confidence interval (CI): 0.04-0.32, P = 0.01], restriction (β = 0.14, 95% CI: 0.001-0.28, P = 0.05), instrumental (β = 0.14, 95% CI: 0.005-0.27, P = 0.04) and emotional (β = 0.15, 95% CI: 0.01-0.29, P = 0.03) feeding practices (ΔR(2) values: 0.02-0.03, P < 0.05). This study provides evidence for the proposed link between maternal post-natal depressive symptoms and lower responsiveness in child feeding. These findings suggest that the provision of support to mothers experiencing some levels of depressive symptomatology in the early post-natal period may improve responsiveness in the child feeding relationship.
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Affiliation(s)
- Kimberley M Mallan
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lynne A Daniels
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Nutrition and Dietetics, School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Jacinda L Wilson
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Elena Jansen
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jan M Nicholson
- Parenting Research Centre, Melbourne, Victoria, Australia.,School of Early Childhood, Faculty of Education, Queensland University of Technology, Brisbane, Queensland, Australia
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43
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Svensson V, Ek A, Forssén M, Ekbom K, Cao Y, Ebrahim M, Johansson E, Nero H, Hagströmer M, Ekstedt M, Nowicka P, Marcus C. Infant growth is associated with parental education but not with parental adiposity - Early Stockholm Obesity Prevention Project. Acta Paediatr 2014; 103:418-25. [PMID: 24387055 DOI: 10.1111/apa.12551] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 12/23/2013] [Accepted: 01/02/2014] [Indexed: 12/24/2022]
Abstract
AIM To explore the simultaneous impact of parental adiposity and education level on infant growth from birth to 12 months, adjusting for known early-life risk factors for subsequent childhood obesity. METHODS Baseline data for 197 one-year-old children and their parents, participating in a longitudinal obesity intervention, were used. Obesity risk groups, high/low, were defined based on parental body mass index (n = 144/53) and parental education (n = 57/139). Observational data on infant growth between 0 and 12 months were collected. The children's relative weight (body mass index standard deviation score) at 3, 6 and 12 months and rapid weight gain 0-6 months were analysed in regression models, with obesity risk as primary exposure variables, adjusting for gestational weight gain, birth weight, short exclusive breastfeeding and maternal smoking. RESULTS Relative weight at 3, 6 and 12 months was associated with low parental education but not with parental adiposity. No significant associations were observed with rapid weight gain. None of the early-life factors could explain the association with parental education. CONCLUSION Low parental education level is independently associated with infant growth, whereas parental obesity does not contribute to a higher weight or to rapid weight gain during the first year.
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Affiliation(s)
- V Svensson
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - A Ek
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - M Forssén
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - K Ekbom
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - Y Cao
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - M Ebrahim
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - E Johansson
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - H Nero
- Division of Physiotherapy; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - M Hagströmer
- Division of Physiotherapy; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - M Ekstedt
- Division of Patient Safety; School of Technology and Health; Royal Institute of Technology; Stockholm Sweden
| | - P Nowicka
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
| | - C Marcus
- Division of Pediatrics; Department of Clinical Science, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
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44
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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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45
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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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46
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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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47
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Gartstein MA, Potapova NV, Hsu AJ. Infant temperament: implications for later sleep and eating/feeding. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2013.853172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Carnell S, Benson L, Pryor K, Driggin E. Appetitive traits from infancy to adolescence: using behavioral and neural measures to investigate obesity risk. Physiol Behav 2013; 121:79-88. [PMID: 23458627 PMCID: PMC3725261 DOI: 10.1016/j.physbeh.2013.02.015] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 10/27/2022]
Abstract
We come into the world with enduring predispositions towards food, which interact with environmental factors to influence our eating behaviors and weight trajectories. But our fates are not sealed - by learning more about this process we can identify ways to intervene. To advance this goal this we need to be able to assess appetitive traits such as food cue responsiveness and satiety sensitivity at different developmental stages. Assessment methods might include behavioral measures (e.g. eating behavior tests, psychometric questionnaires), but also biomarkers such as brain responses to food cues measured using fMRI. Evidence from infants, children and adolescents suggests that these indices of appetite differ not only with body weight, but also with familial obesity risk as assessed by parent weight, which reflects both genetic and environmental influences, and may provide a useful predictor of obesity development. Behavioral and neural approaches have great potential to inform each other: examining eating behavior can help us identify meaningful appetitive endophenotypes whose neural bases can be probed, while increasing knowledge of the shared neurobiology underlying appetite, obesity, and related behaviors and disorders may ultimately lead to innovative generalized interventions. Another challenge will be to combine comprehensive behavioral and neural assessments of appetitive traits with measures of relevant genetic and environmental factors within long-term prospective studies. This approach may help to identify the biobehavioral precursors of obesity, and lay the foundations for targeted neurobehavioral interventions that can interrupt the pathway to excess weight.
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Affiliation(s)
- Susan Carnell
- New York Obesity Nutrition Research Center, St Luke's-Roosevelt Hospital, Columbia University College of Physicians & Surgeons, Babcock Building, Suite 10A, 1111 Amsterdam Avenue, New York, NY 10025, USA.
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Hafstad GS, Abebe DS, Torgersen L, von Soest T. Picky eating in preschool children: the predictive role of the child's temperament and mother's negative affectivity. Eat Behav 2013; 14:274-7. [PMID: 23910765 DOI: 10.1016/j.eatbeh.2013.04.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 02/06/2013] [Accepted: 04/03/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The objective of this study is to describe the development and examine predictors of picky eating from 1.5 to 4.5 years of age in a community sample of children. METHODS Mothers completed a questionnaire, assessing picky eating and a range of child and maternal factors, when their children were aged 1.5 (n = 913), 2.5 (n = 777), and 4.5 (n = 727) years. RESULTS Picky eating increased significantly from 1.5 to 4.5 years. Lower maternal age, higher levels of child emotionality, and maternal negative affectivity at the child's age 1.5 predicted an increase in picky eating from 1.5 years to 2.5 and 4.5 years. Having siblings protected against the development of picky eating. CONCLUSION Child and maternal temperament at a very early stage in the child's life increase the risk for picky eating later on.
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Affiliation(s)
- Gertrud Sofie Hafstad
- Division of Mental Health, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, 0403 Oslo, Norway.
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Gittner LS, Ludington-Hoe SM, Haller HS. Utilising infant growth to predict obesity status at 5 years. J Paediatr Child Health 2013; 49:564-74. [PMID: 23773259 DOI: 10.1111/jpc.12283] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2013] [Indexed: 01/19/2023]
Abstract
AIM This study determines if an early life growth pattern in healthy infants can predict obesity at age 5. METHODS Randomly selected from all healthy children born from 1997 to 2001 in a Midwestern US Health Maintenance Organization; growth patterns from birth to 5 years were described for children who were categorised by obesity classification at 5 years into normal weight (n = 61), overweight (n = 47), obese (n = 41) and morbidly obese (n = 72) cohorts using World Health Organization body mass index (BMI) criteria. A retrospective longitudinal analysis based on weighted least squares was performed on BMI by age (1 week; 2, 4, 6, 9, 12, 15 and 18 months; and 2, 3, 4 and 5 years). Graphs of the longitudinal repeated measures analysis of variance of means allowed identification of the earliest significant divergence of a cohort's average BMI pattern from other cohorts' patterns. RESULTS Distinctions in growth patterns and BMIs were evident before 1-year post-birth. Children who were obese or morbidly obese at 5 years demonstrated a BMI pattern that differed from children who were normal weight at 5 years. CONCLUSIONS Identifying obesity development in early life may assist with prevention of later obesity. The results merit future study. An early life BMI growth pattern is clinically important because it permits discrimination of those who do and do not fit a normal weight pattern, guiding individualised interventions in the first year of life while precursors of later health are still forming.
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Affiliation(s)
- Lisaann S Gittner
- Frances Payne Bolton School of Nursing and Case Statistical Computing Center, Case Western Reserve University, Cleveland, Ohio, United States.
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