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Li K, Yan N. Body mass index, internalizing behavior and executive function: examining trait-state effects from age 2 to 15. Eur Child Adolesc Psychiatry 2024; 33:2629-2636. [PMID: 38170284 DOI: 10.1007/s00787-023-02349-8] [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: 12/06/2022] [Accepted: 12/03/2023] [Indexed: 01/05/2024]
Abstract
This study aimed to examine the reciprocal relation between body mass index and internalizing behavior from age 2 to 15, and also the predictive role of executive function. This study included a subset sample of 640 children (47% were male) from the National Institute of Child Health and Development Study of Early Child Care and Youth Development. A refined random-intercept cross-lagged model was employed to analyze: (1) the reciprocal relation between children's body mass index and internalizing behavior assessed in eight waves from age 2 to 15; (2) the predictive role of executive functioning in both children's body mass index and internalizing behavior. Trait-level body mass index-to-internalizing behavior association was not found; a significant state-level prediction from body mass index in 5th grade to internalizing behavior in 6th grade was found. Executive function was significantly associated with trait-level body mass index, trait-level internalizing behaviors, and state-level internalizing behaviors. The findings suggest that deficits in children's executive functioning may be a shared risk associated with both high body mass index and internalizing behaviors. From an intervention perspective, this study highlighted the importance of targeting executive function to intervene in children's obesity or internalizing behaviors.
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Affiliation(s)
- Keman Li
- Faculty of Psychology, Southwest University, 2 Tiansheng Str., Beibei, Chongqing, 400715, China
- Institute of Developmental Psychology, Beijing Normal University, Beijing, 100875, China
| | - Ni Yan
- Faculty of Psychology, Southwest University, 2 Tiansheng Str., Beibei, Chongqing, 400715, China.
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2
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Rezaeizadeh G, Mansournia MA, Keshtkar A, Farahani Z, Zarepour F, Sharafkhah M, Kelishadi R, Poustchi H. Maternal education and its influence on child growth and nutritional status during the first two years of life: a systematic review and meta-analysis. EClinicalMedicine 2024; 71:102574. [PMID: 38596614 PMCID: PMC11001623 DOI: 10.1016/j.eclinm.2024.102574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/11/2024] Open
Abstract
Background The first 1000 days of life are critical for a child's health and development. Impaired growth during this period is linked to increased child morbidity, mortality, and long-term consequences. Undernutrition is the main cause, and addressing it within the first 1000 days of life is vital. Maternal education is consistently identified as a significant predictor of child undernutrition, but its specific impact remains to be determined. This study presents a systematic review and meta-analysis investigating the influence of high versus low maternal education levels on child growth from birth to age two, using population-based cohort studies. Methods Databases including PubMed, Scopus, EMBASE, Web of Science, ERIC, and Google Scholar were searched from January 1990 to January 2024 using appropriate search terms. We included population-based cohort studies of healthy children aged two years and under and their mothers, categorizing maternal education levels. Child growth and nutritional outcomes were assessed using various indicators. Two reviewers independently conducted data extraction and assessed study quality. The Newcastle Ottawa scale was utilized for quality assessment. Random-effects models were used for meta-analysis, and heterogeneity was assessed using the Cochrane Q and I2 statistic. Subgroup and sensitivity analyses were performed, and publication bias was evaluated. Findings The literature search retrieved 14,295 titles, and after full-text screening of 639 reports, 35 studies were included, covering eight outcomes: weight for age z-score (WAZ), height for age z-score (HAZ), BMI for age z-scores (BMIZ), overweight, underweight, stunting, wasting, and rapid weight gain. In middle-income countries, higher maternal education is significantly associated with elevated WAZ (MD 0.398, 95% CI 0.301-0.496) and HAZ (MD 0.388, 95% CI 0.102-0.673) in children. Similarly, in studies with low-educated population, higher maternal education is significantly linked to increased WAZ (MD 0.186, 95% CI 0.078-0.294) and HAZ (0.200, 95% CI 0.036-0.365). However, in high-income and highly educated population, this association is either absent or reversed. In high-income countries, higher maternal education is associated with a non-significant lower BMI-Z (MD -0.028, 95% CI -0.061 to 0.006). Notably, this inverse association is statistically significant in low-educated populations (MD -0.045, 95% CI -0.079 to -0.011) but not in highly educated populations (MD 0.003, 95% CI -0.093 to 0.098). Interpretation Maternal education's association with child growth varies based on country income and education levels. Further research is needed to understand this relationship better. Funding This study was a student thesis supported financially by Tehran University of Medical Sciences (TUMS).
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Affiliation(s)
- Golnaz Rezaeizadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Keshtkar
- Department of Disaster and Emergency Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Farahani
- Maternal, Fetal, and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Zarepour
- School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Paediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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3
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Graves SL, Wang Y. It’s Not That They Are Big, It’s Just That They Are Black: The Impact of Body Mass Index, School Belonging, and Self Esteem on Black Boys’ School Suspension. SCHOOL PSYCHOLOGY REVIEW 2022. [DOI: 10.1080/2372966x.2022.2072693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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4
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Walton K, McGee M, Sato J, Law N, Hopperton KE, Bando N, Kiss A, Unger S, O'Connor DL. Social-Emotional Functioning and Dietary Intake among Children Born with a Very Low Birth Weight. Appl Physiol Nutr Metab 2022; 47:737-748. [PMID: 35196153 DOI: 10.1139/apnm-2021-0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Very low birth weight infants (VLBW, <1500g) are at elevated risk of neurodevelopmental disorders, later obesity and cardiometabolic disease; if and how neurodevelopmental disorders impact chronic disease risk is poorly understood. The most common neurodevelopmental disorders experienced by VLBW children are those of social-emotional functioning. We compared dietary patterns and body composition between VLBW children with poor vs. typical social-emotional functioning using linear mixed models adjusted for sex, gestational age, cognitive impairment, parental education and BMI. VLBW children (n=158) attending the Donor Milk for Improved Neurodevelopmental Outcomes trial 5.5-year follow-up participated. Poor social-emotional functioning was based on standardized parent-rated questionnaires and/or parent-reported physician diagnosis of autism spectrum or attention-deficit/hyperactivity disorders. Most children had diets categorized as 'needs improvement' (67%) or 'poor' (27%) and 29% of children exhibited poor social-emotional functioning. Poor social-emotional functioning was positively associated with 100% fruit juice (β=0.3 cup equivalents/day; 95% CI 0.1, 0.5) and energy intake (β=118.1 kcals/day; 95% CI 0.9, 235.2). Children with poor social-emotional functioning were more likely to have a limited food repertoire (p=0.02), but less likely to exceed dietary fat recommendations (p=0.04). No differences in overall diet quality or body composition were observed. Diet counselling and research are essential to improving the nutrition of VLBW children to mitigate chronic disease risk. Novelty: • Overall diet quality and body composition did not differ between VLBW children with poor vs. typical social-emotional functioning. • Most had diets "needing improvement" or "poor" according to the HEI 2010. • Diet counselling may help mitigate chronic disease risk in this vulnerable population.
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Affiliation(s)
- Kathryn Walton
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada;
| | - Meghan McGee
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada.,University of Toronto Dalla Lana School of Public Health, 274071, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Nutritional Sciences, Toronto, Ontario, Canada;
| | - Julie Sato
- The Hospital for Sick Children, 7979, Neurosciences & Mental Health, Toronto, Ontario, Canada.,The Hospital for Sick Children, 7979, Diagnostic Imaging , Toronto, Ontario, Canada.,University of Toronto, 7938, Psychology, Toronto, Ontario, Canada;
| | - Nicole Law
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada;
| | - Kathryn E Hopperton
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada;
| | - Nicole Bando
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Nutritional Sciences, Toronto, Ontario, Canada;
| | - Alex Kiss
- University of Toronto Institute of Health Policy Management and Evaluation, 206712, Toronto, Ontario, Canada.,Sunnybrook Research Institute, 282299, Evaluative and Clinical Sciences, Toronto, Ontario, Canada;
| | - Sharon Unger
- Sinai Health System, 518775, Department of Paediatrics, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Department of Pediatrics, Toronto, Ontario, Canada.,The Hospital for Sick Children, 7979, Neonatology, Toronto, Ontario, Canada;
| | - Deborah L O'Connor
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Nutritional Sciences, Toronto, Ontario, Canada.,Sinai Health System, 518775, Paediatrics, Toronto, Ontario, Canada;
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Mustillo SA, Li M, Morton P, Ferraro KF. Early Origins of Body Mass in Later Life: Examining Childhood Risks and Adult Pathways. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:152-169. [PMID: 33856951 PMCID: PMC8187323 DOI: 10.1177/00221465211005419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Prior research reveals that negative early-life experiences play a major role in the development of obesity in later life, but few studies identify mechanisms that alter the lifetime risk of obesity. This study examines the influence of negative childhood experiences on body mass index (BMI) and obesity (BMI ≥30) during older adulthood and the psychosocial and behavioral pathways involved. Using a nationally representative sample, we examine the influence of cumulative misfortune as well as five separate domains of misfortune on BMI and obesity. Results show that four of the five domains are associated with BMI and obesity either directly, indirectly, or both. The influence of cumulative misfortune on the outcomes is mediated by three adult factors: socioeconomic status, depressive symptoms, and physical activity. The mediators identified here provide targets for intervention among older adults to help offset the health risks of excess BMI attributable of early-life exposure to misfortune.
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Affiliation(s)
| | - Miao Li
- Clemson University, Clemson, SC, USA
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Nujić D, Musić Milanović S, Milas V, Miškulin I, Ivić V, Milas J. Association between child/adolescent overweight/obesity and conduct disorder: A systematic review and meta-analysis. Pediatr Obes 2021; 16:e12742. [PMID: 33348469 DOI: 10.1111/ijpo.12742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 09/12/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research findings of the association and its pattern between obesity and psychiatric/psychological comorbidities are not consistent across the types of comorbidities or the study subgroups. OBJECTIVES We aimed to perform meta-analysis of cross-sectional studies and longitudinal studies analysing obesity as a risk factor for conduct disorder in order to assess the association between child/adolescent overweight/obesity and conduct disorder. METHODS Systematic literature search, study selection and data extraction were performed independently by the two authors. Data were analysed by Comprehensive Meta-analysis software. RESULTS Analysis of 13 high-quality cross-sectional studies including 79 027 children and adolescents indicated a significant association between overweight/obesity and conduct disorder among children and adolescents (OR 1.32 [95% CI, 1.18-1.49], I2 = 86.68), with no publication bias. Subgroup analyses yielded a significant difference (P < .01) between boys and girls. Analysis of four low- to moderate-quality longitudinal studies (OR 1.11 [95% CI, 0.89-1.38], I2 = 57.69) showed no prospective association between overweight/obesity and conduct disorder. Subgroup analysis according to gender revealed a significant positive association for boys and negative association for girls. CONCLUSIONS Based on the high-quality cross-sectional data, overweight and obesity are associated with conduct disorder among children and adolescents, affecting boys more frequently than girls. Results of the longitudinal analysis indicated possible association in boys, while girls seem to be protected from conduct disorder. However, these results are very unreliable, indicating the need of well-designed longitudinal studies to elucidate the pattern of association between these disorders.
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Affiliation(s)
- Danijela Nujić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Sanja Musić Milanović
- Division for Health Promotion, Croatian Institute of Public Health, Zagreb, Croatia.,School of Medicine, Andrija Štampar School of Public Health, University of Zagreb, Zagreb, Croatia
| | - Vesna Milas
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Department of Pediatrics, Osijek University Hospital Centre, Osijek, Croatia
| | - Ivan Miškulin
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Vedrana Ivić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Josip Milas
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Department of Epidemiology, Institute of Public Health of Osijek-Baranja County, Osijek, Croatia
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Marttila-Tornio K, Ruotsalainen H, Miettunen J, Männikkö N, Kääriäinen M. Association Between Psychosocial Problems and Unhealthy Health Behavior Patterns Among Finnish Adolescents. Child Psychiatry Hum Dev 2020; 51:699-708. [PMID: 32052232 PMCID: PMC7518991 DOI: 10.1007/s10578-020-00967-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the study was to investigate how psychosocial problems in childhood and adolescence associate with an unhealthy health behavior pattern among adolescents in Northern Finland. The study population consisted of 4350 participants, drawn from the Northern Finland Birth Cohort 1986 Study. Health behavior patterns were assessed in adolescence and psychosocial problems in childhood and adolescence. Logistic regression analyses were performed to determine the associations. Several psychosocial problems predicted greater likelihood of engaging in unhealthy health behavior pattern. Externalizing problems in childhood predicted greater likelihood of engaging in unhealthy behavior patterns for girls. For both genders, externalizing problems and inattention in adolescence were associated with unhealthy health behavior patterns. Boys and girls with externalizing problems both in childhood and adolescence had an increased risk of unhealthy patterns. Psychosocial problems contribute to unhealthy lifestyles and should therefore be acknowledged when designing and targeting health promotion strategies aimed at adolescents.
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Affiliation(s)
- Kaisa Marttila-Tornio
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Heidi Ruotsalainen
- grid.10858.340000 0001 0941 4873Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- grid.10858.340000 0001 0941 4873Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Niko Männikkö
- grid.10858.340000 0001 0941 4873Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- grid.10858.340000 0001 0941 4873Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
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Eiffener E, Eli K, Ek A, Sandvik P, Somaraki M, Kremers S, Sleddens E, Nowicka P. The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial. Pediatr Obes 2019; 14:e12556. [PMID: 31290278 DOI: 10.1111/ijpo.12556] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/13/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Few studies have explored the influence of preschoolers' behavioural problems on obesity treatment. OBJECTIVES To assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status. METHOD The study included 77 children (4-6 years old, 53% girls, mean body mass index [BMI] z-score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z-score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions. RESULTS Child emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z-scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z-scores. CONCLUSIONS Child behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.
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Affiliation(s)
- Elodie Eiffener
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Karin Eli
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK.,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Anna Ek
- Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Stef Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Ester Sleddens
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Paulina Nowicka
- Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.,Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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9
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A 9-year longitudinal study on trajectories of aggressive and depressive symptoms in male and female children with overweight. BMC Res Notes 2019; 12:710. [PMID: 31666127 PMCID: PMC6820918 DOI: 10.1186/s13104-019-4734-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 10/15/2019] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES The aim of this four waves 9-year longitudinal study was to examine aggressive/depressive symptoms trajectories in a sample of N = 90 children with overweight and a matched group of children with normal weight (subjects balanced by sex and sociodemographic characteristics). Weight and height were measured by pediatricians to calculate body mass index (BMI). Aggressive/depressive symptoms were measured through the Child Behavior Check-List filled out by children's parents. Multilevel modeling was used to obtain the best fitting curves describing the change over time in aggression and depression scores. These analyses were performed by sex and group. RESULTS Children with overweight showed a general increase of aggressive symptoms over time, with a peak at 8 years of age in males, whereas scores of the control group decreased over time both in males and in females. Female children with overweight showed increasing levels of depressive symptoms, with a peak at 8 years of age; children with normal weight, instead, showed low scores at all assessment points. The results highlight the importance of considering the developmental trajectories of aggression and depression in children of different weight status.
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Derks IPM, Bolhuis K, Yalcin Z, Gaillard R, Hillegers MHJ, Larsson H, Lundström S, Lichtenstein P, van Beijsterveldt CEM, Bartels M, Boomsma DI, Tiemeier H, Jansen PW. Testing Bidirectional Associations Between Childhood Aggression and BMI: Results from Three Cohorts. Obesity (Silver Spring) 2019; 27:822-829. [PMID: 30957987 PMCID: PMC6594099 DOI: 10.1002/oby.22419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/21/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study examined the prospective, potentially bidirectional association of aggressive behavior with BMI and body composition across childhood in three population-based cohorts. METHODS Repeated measures of aggression and BMI were available from the Generation R Study between ages 6 and 10 years (N = 3,974), the Netherlands Twin Register (NTR) between ages 7 and 10 years (N = 10,328), and the Swedish Twin Study of Child and Adolescent Development (TCHAD) between ages 9 and 14 years (N = 1,462). In all samples, aggression was assessed with the Child Behavior Checklist. Fat mass and fat-free mass were available in the Generation R Study. Associations were examined with cross-lagged modeling. RESULTS Aggressive behavior at baseline was associated with higher BMI at follow-up in the Generation R Study (β = 0.02, 95% CI: 0.00 to 0.04), in NTR (β = 0.04, 95% CI: 0.02 to 0.06), and in TCHAD (β = 0.03, 95% CI: -0.02 to 0.07). Aggressive behavior was prospectively associated with higher fat mass (β = 0.03, 95% CI: 0.01 to 0.05) but not fat-free mass. There was no evidence that BMI or body composition preceded aggressive behavior. CONCLUSIONS More aggressive behavior was prospectively associated with higher BMI and fat mass. This suggests that aggression contributes to the obesity problem, and future research should study whether these behavioral pathways to childhood obesity are modifiable.
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Affiliation(s)
- Ivonne P. M. Derks
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Generation R Study GroupErasmus Medical CenterRotterdamthe Netherlands
| | - Koen Bolhuis
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Generation R Study GroupErasmus Medical CenterRotterdamthe Netherlands
| | - Zeynep Yalcin
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
| | - Romy Gaillard
- Department of PediatricsErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of EpidemiologyErasmus Medical CenterRotterdamthe Netherlands
| | - Manon H. J. Hillegers
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of PsychiatryRudolf Magnus Brain Center, Utrecht University Medical CenterUtrechtthe Netherlands
| | - Henrik Larsson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
- School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Sebastian Lundström
- Center for Ethics, Law and Mental HealthUniversity of GothenborgGothenborgSweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
| | | | - Meike Bartels
- Department of Biological PsychologyVrije UniversityAmsterdamthe Netherlands
| | - Dorret I. Boomsma
- Department of Biological PsychologyVrije UniversityAmsterdamthe Netherlands
| | - Henning Tiemeier
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of Social and Behavioral SciencesHarvard T. H. Chan School of Public Health, Harvard UniversityBostonMassachusettsUSA
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/PsychologyErasmus Medical Center–Sophia Children's HospitalRotterdamthe Netherlands
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamthe Netherlands
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11
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Matheson BE, Eichen DM. A Review of Childhood Behavioral Problems and Disorders in the Development of Obesity: Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Beyond. Curr Obes Rep 2018; 7:19-26. [PMID: 29411333 DOI: 10.1007/s13679-018-0293-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE OF REVIEW Given the high rates of pediatric and adult obesity, it is imperative to identify early risk factors that might contribute to excess weight gain. This review aims to investigate the relationship between childhood behavioral problems with the development and persistence of obesity. Specifically, this review highlights the association of obesity with (1) neurocognitive constructs, such as executive functioning and inhibition/impulsivity, and (2) disorders commonly diagnosed in childhood, including attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). RECENT FINDINGS Consistent evidence supports a relationship between childhood behavioral problems, executive functioning, inhibition/impulsivity, ADHD, and ASD with obesity across the lifespan. Longitudinal studies suggest behavior problems, neurocognitive functioning deficits, and ADHD symptoms in childhood predict weight gain over time. Identifying risk factors in childhood that promote obesity may help develop targeted intervention and prevention programs. Additional research should elucidate mechanisms that account for these relationships.
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Affiliation(s)
- Brittany E Matheson
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, 6363 Alvarado Court, San Diego, CA, 92120, USA.
- Department of Psychiatry, University of California, San Diego, 8950 Villa La Jolla Dr. Suite C-203, San Diego, CA, 92037, USA.
| | - Dawn M Eichen
- Department of Pediatrics, University of California, San Diego, 8950 Villa La Jolla Dr. Suite C-203, San Diego, CA, 92037, USA
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12
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Cerniglia L, Cimino S, Erriu M, Jezek S, Almenara CA, Tambelli R. Trajectories of aggressive and depressive symptoms in male and female overweight children: Do they share a common path or do they follow different routes? PLoS One 2018; 13:e0190731. [PMID: 29304081 PMCID: PMC5755891 DOI: 10.1371/journal.pone.0190731] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 12/19/2017] [Indexed: 01/18/2023] Open
Abstract
The prevalence of childhood overweight is a major social and public health issue, and primary assessment should focus on early and middle childhood, because weight gain in these phases constitutes a strong predictor of subsequent negative outcomes. Studies on community samples have shown that growth curves may follow linear or non-linear trajectories from early to middle childhood, and can differ based on sex. Overweight children may exhibit a combination of physiological and psychosocial issues, and several studies have demonstrated an association between overweight and internalizing/externalizing behavior. Nevertheless, there is a dearth of longitudinal studies on depressive and aggressive symptoms in children with high BMI. This study adopted a growth curve modeling over three phases to: (1) describe BMI trajectories in two groups of children aged 2–8 (overweight and normal weight) from a community sample; (2) describe the developmental trajectories of children’s aggressive and depressive symptoms from 2 to 8 years of age. Results indicate higher BMI in 2-year-old girls, with males catching up with them by age 8. While overweight females’ BMIs were consistently high, males’ increased at 5 and 8 years. The mean scores for aggressive symptoms at T1 (2 years of age) were the same in all subjects, but a significant deviation occurred from T1 to T2 in both samples, in divergent directions. With regards to children’s depressive symptoms, the two groups had different starting points, with normal weight children scoring lower than overweight youths. Overweight females showed lower depressive scores than overweight males at T1, but they surpassed boys before T2, and showed more maladaptive symptoms at T3. This study solicits professionals working in pediatric settings to consider overweight children’s psychopathological risk, and to be aware that even when children’s BMI does not increase from 2 to 8 years, their psychopathological symptoms may grow in intensity.
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Affiliation(s)
- Luca Cerniglia
- International Telematic University Uninettuno, Psychology Faculty, Department of Psychology, Rome, Italy
- * E-mail:
| | - Silvia Cimino
- Sapienza, University of Rome, Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Rome, Italy
| | - Michela Erriu
- Sapienza, University of Rome, Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Rome, Italy
| | - Stanislav Jezek
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Carlos A. Almenara
- Institute for Research on Children, Youth and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
- Universidad Peruana de Ciencias Aplicadas, Faculty of Psychology, Chorrillos, Lima, Perú
| | - Renata Tambelli
- Sapienza, University of Rome, Psychology and Medicine Faculty, Department of Dynamic and Clinical Psychology, Rome, Italy
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Pittman DW, Bland IR, Cabrera ID, Franck KE, Perkins EL, Schmidt NA, Allen HN, Atkins SR, Pittman SB. The Boss' Healthy Buddies Nutrition Resource Is Effective for Elementary School Students. J Obes 2018; 2018:4659874. [PMID: 29854438 PMCID: PMC5954886 DOI: 10.1155/2018/4659874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/27/2018] [Accepted: 04/12/2018] [Indexed: 12/02/2022] Open
Abstract
Previously we have shown that our Healthy Eating Decisions school-based intervention can influence students' selections of the healthiest foods available in their elementary school cafeterias through positive reinforcement techniques. Although effective, we recognized that students were missing fundamental nutrition knowledge necessary to understand why the Healthy Eating Decisions program identified particular beverages and foods as the healthiest in the cafeteria. Therefore, we developed the Boss' Healthy Buddies nutrition education resource as a freely available curriculum matched with South Carolina education standards and designed for elementary school students from kindergarten through fourth grade. The current study implemented Boss' Healthy Buddies and compared its efficacy to a commercially available nutrition program, CATCH. Elementary school students in Spartanburg, South Carolina, received weekly twenty-minute Boss' Healthy Buddies lessons for eight weeks. Results from preassessment and postassessment surveys were compared with a positive control elementary school using the CATCH program and a negative control school receiving no nutrition education. Results show that Boss' Healthy Buddies was equally effective as the CATCH program in improving the nutrition attitudes regarding healthiest beverages and food selections with the advantage of being freely available and minimizing the impact on classroom instruction time. In order to reduce most effectively the high prevalence of childhood overweight and obesity, it is crucial that children are taught nutrition education to support healthy eating habits at an early age. Both the Healthy Eating Decisions school-based intervention and the Boss' Healthy Buddies nutrition education program are available online for use as free resources to aid in reducing childhood overweight and obesity within elementary schools.
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Affiliation(s)
- David W. Pittman
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Ida R. Bland
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Isai D. Cabrera
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Kassie E. Franck
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Emily L. Perkins
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Nicole A. Schmidt
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Heather N. Allen
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Savanah R. Atkins
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
| | - Sharyn B. Pittman
- Department of Psychology, Wofford College, 429 North Church Street, Spartanburg, SC 29303, USA
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Lin YC, Su CT, Shiue HS, Chen WJ, Chen YH, Choy CS, Chiou HY, Han BC, Hsueh YM. The Methylation Capacity of Arsenic and Insulin Resistance are Associated with Psychological Characteristics in Children and Adolescents. Sci Rep 2017; 7:3094. [PMID: 28596567 PMCID: PMC5465070 DOI: 10.1038/s41598-017-03084-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/24/2017] [Indexed: 11/25/2022] Open
Abstract
The goal of the present study was to compare the influence of the methylation capacity of arsenic, as well as insulin resistance on psychological characteristics of school students from elementary and junior high school. 296 elementary and 318 junior high school students participated in health examinations, completed questionnaires and determined their concentrations of urinary arsenic species and psychological characteristics. Insulin resistance was determined by means of the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). We found that HOMA-IR values were significantly related to increased score of the depression and anger after adjusted for age, gender, schools, father’s educational levels, mother’s educational levels, BMI, body fat, and urinary creatinine in all students. Anxiety scores and depression scores of junior high school children were significantly higher compared to elementary school children, but lower in disruptive behavior scores. HOMA-IR levels were significantly inversely related to self-concept scores in junior high school students. A greater urinary inorganic arsenic percentage (iAs%) was marginally significantly related to a higher depression score in junior high school students. This is the first study to show a relationship between HOMA-IR levels or urinary arsenic profiles and psychological distress in school students from elementary and junior high school.
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Affiliation(s)
- Ying-Chin Lin
- Department of Family Medicine, Shung Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Health Examination, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Tien Su
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Horng-Sheng Shiue
- Department of Chinese Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wei-Jen Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Cheuk-Sing Choy
- Emergency Department, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.,Department of Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Chiou
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Bor-Cheng Han
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
| | - Yu-Mei Hsueh
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan. .,Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Rankin J, Matthews L, Cobley S, Han A, Sanders R, Wiltshire HD, Baker JS. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolesc Health Med Ther 2016; 7:125-146. [PMID: 27881930 PMCID: PMC5115694 DOI: 10.2147/ahmt.s101631] [Citation(s) in RCA: 295] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Childhood obesity is one of the most serious public health challenges of the 21st century with far-reaching and enduring adverse consequences for health outcomes. Over 42 million children <5 years worldwide are estimated to be overweight (OW) or obese (OB), and if current trends continue, then an estimated 70 million children will be OW or OB by 2025. The purpose of this review was to focus on psychiatric, psychological, and psychosocial consequences of childhood obesity (OBy) to include a broad range of international studies. The aim was to establish what has recently changed in relation to the common psychological consequences associated with childhood OBy. A systematic search was conducted in MEDLINE, Web of Science, and the Cochrane Library for articles presenting information on the identification or prevention of psychiatric morbidity in childhood obesity. Relevant data were extracted and narratively reviewed. Findings established childhood OW/OBy was negatively associated with psychological comorbidities, such as depression, poorer perceived lower scores on health-related quality of life, emotional and behavioral disorders, and self-esteem during childhood. Evidence related to the association between attention-deficit/hyperactivity disorder (ADHD) and OBy remains unconvincing because of various findings from studies. OW children were more likely to experience multiple associated psychosocial problems than their healthy-weight peers, which may be adversely influenced by OBy stigma, teasing, and bullying. OBy stigma, teasing, and bullying are pervasive and can have serious consequences for emotional and physical health and performance. It remains unclear as to whether psychiatric disorders and psychological problems are a cause or a consequence of childhood obesity or whether common factors promote both obesity and psychiatric disturbances in susceptible children and adolescents. A cohesive and strategic approach to tackle this current obesity epidemic is necessary to combat this increasing trend which is compromising the health and well-being of the young generation and seriously impinging on resources and economic costs.
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Affiliation(s)
- Jean Rankin
- Department of Maternal and Child Health, University of the West of Scotland, Paisley
| | - Lynsay Matthews
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Stephen Cobley
- Department of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Ahreum Han
- Department of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Ross Sanders
- Department of Exercise and Sport Science, University of Sydney, Sydney, Australia
| | - Huw D Wiltshire
- Cardiff School of Sport/Ysgol Chwaraeon Caerdydd, Cardiff Metropolitan University, Cardiff, UK
| | - Julien S Baker
- School of Science and Sport, Institute of Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, Scotland
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16
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The association between overweight and internalizing and externalizing behavior in early childhood. Soc Sci Med 2016; 168:35-42. [DOI: 10.1016/j.socscimed.2016.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/30/2016] [Accepted: 09/02/2016] [Indexed: 12/20/2022]
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Kagawa RMC, Fernald LCH, Behrman JR. Weight Status and Behavioral Problems among Very Young Children in Chile. PLoS One 2016; 11:e0161380. [PMID: 27583678 PMCID: PMC5008787 DOI: 10.1371/journal.pone.0161380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 08/04/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/OBJECTIVES Our objective was to explore the association between weight status and behavioral problems in children before school age. We examined whether the association between weight status and behavioral problems varied by age and sex. SUBJECTS/METHODS This study used cross-sectional data from a nationally-representative sample of children and their families in Chile (N = 11,207). These children were selected using a cluster-stratified random sampling strategy. Data collection for this study took place in 2012 when the children were 1.5-6 years of age. We used multivariable analyses to examine the association between weight status and behavioral problems (assessed using the Child Behavior Checklist), while controlling for child's sex, indigenous status, birth weight, and months breastfed; primary caregiver's BMI and education level; and household wealth. RESULTS Approximately 24% of our sample was overweight or obese. Overweight or obese girls showed more behavioral problems than normal weight girls at age 6 (β = 0.270 SD, 95% CI = 0.047, 0.493, P = 0.018). Among boys age 1 to 5 years, overweight/obesity was associated with a small reduction in internalizing behaviors (β = -0.09 SD, 95% CI = -0.163, -0.006, P = 0.034). CONCLUSIONS Our data suggest that the associations between weight status and behavioral problems vary across age and sex.
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Affiliation(s)
- Rose M. C. Kagawa
- School of Public Health, University of California, Berkeley, CA, United States of America
| | - Lia C. H. Fernald
- School of Public Health, University of California, Berkeley, CA, United States of America
| | - Jere R. Behrman
- Department of Economics, University of Pennsylvania, Philadelphia, PA, United States of America
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Stavrou S, Nicolaides NC, Papageorgiou I, Papadopoulou P, Terzioglou E, Chrousos GP, Darviri C, Charmandari E. The effectiveness of a stress-management intervention program in the management of overweight and obesity in childhood and adolescence. JOURNAL OF MOLECULAR BIOCHEMISTRY 2016; 5:63-70. [PMID: 27570747 PMCID: PMC4996635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Obesity in childhood and adolescence represents a major health problem of our century, and accounts for a significant increase in morbidity and mortality in adulthood. In addition to the increased consumption of calories and lack of exercise, accumulating evidence suggests that childhood obesity is strongly associated with prolonged and excessive activation of the stress system. AIM The aim of our study was to assess the effectiveness of a stress-management intervention program, which included progressive muscle relaxation, diaphragmatic breathing, guided imagery and cognitive restructuring, in overweight and obese children and adolescents. METHODS Forty-nine children and adolescents (mean age ± SEM: 11.15 ± 1.48 years) were prospectively recruited to participate in this randomized controlled study. Of those, 23 participants were assigned into the intervention group, while 26 participants represented the control group. Anthropometric measurements were recorded at the beginning and at the end of the study, and participants were asked to complete the Screen for Child Anxiety Related Disorders (S.C.A.R.E.D.), the Child Depression Inventory (C.D.I.), the Child Behavior Checklist (C.B.C.L.) and the Youth Self Report (Y.S.R.). RESULTS The applied stress-management methods resulted in a significant reduction in the body mass index (BMI) in the intervention group compared with the control group [ΔBMI=1.18 vs 0.10 kg/m2 (p<0.001)]. In addition to BMI, these methods ameliorated depression and anxiety, and reduced the internalizing and externalizing problems in the intervention group. CONCLUSIONS Our study demonstrated that the application of an 8-week stress management program could facilitate weight loss in Greek overweight and obese children and adolescents. Further larger studies are required to evaluate the effectiveness of stress-management methods in overweight and obese subjects.
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Affiliation(s)
- Stavroula Stavrou
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, 11527, Greece
| | - Nicolas C. Nicolaides
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, 11527, Greece
| | - Ifigenia Papageorgiou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
| | - Pinelopi Papadopoulou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
| | - Elena Terzioglou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
| | - George P Chrousos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, 11527, Greece
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, 11527, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, 11527, Greece
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
- Division of Endocrinology and Metabolism, Clinical Research Center, Biomedical Research Foundation of the Academy of Athens, Athens, 11527, Greece
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19
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Psychological and physiological correlates of childhood obesity in Taiwan. Sci Rep 2015; 5:17439. [PMID: 26612264 PMCID: PMC4661724 DOI: 10.1038/srep17439] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/29/2015] [Indexed: 11/08/2022] Open
Abstract
Evidence of associations between psychopathology and obesity in childhood remains inconsistent, and most studies have been conducted in Western countries. This study investigated psychological and physiological correlates of obesity in a community sample of children in Taiwan. In total, 302 children (157 overweight/obese and 145 healthy-weight children) were selected from first- and fourth-grade schoolchildren in eight elementary schools in 2009. These children participated in a comprehensive health examination, including a physical examination, blood sample analysis, and questionnaire administration. We found that regarding physiological characteristics, compared with the healthy-weight children, the overweight/obese children had significantly higher values for body fat estimated using the bioelectrical impedance method (p < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p = 0.001); lower values for high-density lipoprotein (p < 0.001); and worse values for glutamic-pyruvic transaminase (p < 0.001), triglycerides (p < 0.001), and fasting blood glucose (p = 0.049). In logistic models adjusted for parental and child traits and physiological characteristics, children’s overweight/obesity was significantly associated with lower self-concept (odds ratio [OR] = 0.96, 95% confidence interval [CI] = 0.93–0.99) and less disruptive behavior (OR = 0.96, 95% CI = 0.92–0.99). Less disruptive behavior and the lack of a higher prevalence of anxiety and depression in childhood obesity appear to be a unique pattern in Taiwan that warrants further investigation.
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Frenssen F, Croonenberghs J, Van den Steene H, Maes M. Prolyl endopeptidase and dipeptidyl peptidase IV are associated with externalizing and aggressive behaviors in normal and autistic adolescents. Life Sci 2015; 136:157-62. [PMID: 26165750 DOI: 10.1016/j.lfs.2015.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/02/2015] [Indexed: 01/03/2023]
Abstract
AIMS Peptides and a dysregulated immune system play a role in the pathophysiology of autism. Dysfunctions in prolyl endopeptidase (PEP) and dipeptidyl peptidase IV (DPP-IV) may underpin both the peptidergic and immune alterations in autism. The aims of this study are to: (i) delineate serum PEP and DPP-IV enzyme activities in autism, and (ii) examine the associations between both peptidases and behavioral characteristics or immune variables. MAIN METHODS We included 18 autistic patients and 22 healthy controls and measured the Child Behavior Checklist (CBCL), serum PEP and DPP-IV and immune biomarkers, i.e. the serum protein fractions α1, α2 and γ, and immunoglobulins, i.e. IgG1, IgG2, IgG3 and IgG4. Results were adjusted for possible effects of age and body mass index (BMI). KEY FINDINGS There were no significant differences in PEP or DPP-IV between the autistic patients and controls. DPP-IV was significantly and positively associated with the CBCL attention problems, aggressive and externalizing behavior subscales. PEP was significantly and positively associated with the CBCL delinquent, aggressive, externalizing and internalizing behavior subscales. There was a negative correlation between both peptidases and age and Tanner stage. DPP-IV was associated with α2-globulin (positively) and IgG3 (inversely) levels, while PEP activity was correlated with IgG2 levels (inversely). BMI was significantly associated with aggressive and externalizing behaviors. SIGNIFICANCE These findings demonstrate an association between peptidases and aggressive and externalizing behaviors, which may be explained by effects of these peptidases cleaving behavioral neuropeptides. Both peptidases are associated with immune biomarkers suggesting multiple bidirectional effects.
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Affiliation(s)
- Floris Frenssen
- University Center of Child & Adolescent Psychiatry (ZNA-UKJA), University of Antwerp, Antwerp, Belgium; CAPRI-Youth, University of Antwerp, Antwerp, Belgium.
| | - Jan Croonenberghs
- University Center of Child & Adolescent Psychiatry (ZNA-UKJA), University of Antwerp, Antwerp, Belgium; CAPRI-Youth, University of Antwerp, Antwerp, Belgium
| | - Helena Van den Steene
- University Center of Child & Adolescent Psychiatry (ZNA-UKJA), University of Antwerp, Antwerp, Belgium; CAPRI-Youth, University of Antwerp, Antwerp, Belgium
| | - Michael Maes
- IMPACT Strategic Research Centre, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand; Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Londrina, Brazil
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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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Baughcum AE, Gramling K, Eneli I. Severely obese preschoolers in a tertiary care obesity program: characteristics and management. Clin Pediatr (Phila) 2015; 54:346-52. [PMID: 25404751 DOI: 10.1177/0009922814555975] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe the characteristics and management of severely obese 2- to 5-year-olds children referred to a tertiary care multidisciplinary obesity center. METHODS A retrospective chart review was conducted of children 2 to 5 years old evaluated at the center from January 2009 to February 2011. Referral eligibility was a body mass index (BMI) ≥95th percentile. RESULTS Of the 2- to 5-year-olds seen at the center, 140 (94%) had a BMI >99th percentile. Of these children with severe obesity, 54% were female, 48% were Caucasian, and mean age was 4.60 years (SD = 1.00). Mean BMI and BMI z-score at initial visit was 26.5 kg/m(2) (SD = 4.12) and 3.59 (SD = 0.95), respectively. BMI z-scores varied significantly by age-χ(2)(3, N = 140) = 54.44, P < .001-and gender-χ(2)(1, N = 140) = -5.31, P < .001-with males and younger children presenting at much higher BMI z-scores. Most of the children had a family history of obesity, (85%), type 2 diabetes (74%), and hypertension (74%). Nearly one third of families reported history of mental health or substance abuse problems. Comorbidities were prevalent, particularly dyslipidemia and problematic eating behaviors. For the 53% of children who returned for at least one follow-up visit, mean BMI z-score decreased significantly by 0.15-t(79) = 5.31, P < .001. CONCLUSIONS Our findings underscore the severity of the condition facing these children and their families. With improved retention, the tertiary care multidisciplinary program may be a viable option for successful intervention for these children.
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Affiliation(s)
- Amy E Baughcum
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Kerri Gramling
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
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Beal SJ, Hillman J, Dorn LD, Out D, Pabst S. Associations between the prenatal environment and cardiovascular risk factors in adolescent girls: Internalizing and externalizing behavior symptoms as mediators. CHILDRENS HEALTH CARE 2015; 44:17-39. [PMID: 25750471 PMCID: PMC4350244 DOI: 10.1080/02739615.2013.876537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This longitudinal study examines links among adolescent internalizing and externalizing symptoms, the prenatal environment (e.g., nicotine exposure) and pre/perinatal maternal health, and cardiovascular risk factors. Girls (N=262) ages 11-17 reported internalizing and externalizing behaviors and mothers reported about the prenatal environment and maternal health during and 3 months post-pregnancy. Adolescent cardiovascular risk included adiposity, smoking, blood pressure, and salivary C-reactive protein. Internalizing symptoms mediated relations between prenatal exposures/maternal health and adiposity; externalizing symptoms mediated relations between prenatal exposures and adolescent smoking. Healthcare providers who attend to internalizing and externalizing symptoms in girls may ultimately influence cardiovascular health, especially among those with pre/perinatal risk factors.
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Cadieux A, Getzoff Testa E, Baughcum A, Shaffer LA, Santos M, Sallinen Gaffka BJ, Gray J, Burton ET, Ward WL. Recommendations for psychologists in Stage III pediatric obesity program. CHILDRENS HEALTH CARE 2015. [DOI: 10.1080/02739615.2014.979919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Biological correlates of psychological states among young children: a cross-sectional examination of roles of aspartate transaminase/alanine aminotransferase, insulin, and cytokines. CHINESE SCIENCE BULLETIN-CHINESE 2014. [DOI: 10.1007/s11434-014-0617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Oh SY, Ahn H, Chang N, Kang MH, V Oh J. Dietary patterns and weight status associated with behavioural problems in young children. Public Health Nutr 2014; 17:2563-9. [PMID: 24182449 PMCID: PMC10282324 DOI: 10.1017/s1368980013002917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 09/06/2013] [Accepted: 09/17/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the associations of behavioural problems with dietary patterns and weight status in young children. DESIGN We assessed poor social skills and behavioural problems with a seventy-six-item Preschool and Kindergarten Behavior Scale (PKBS) and found three dietary patterns ('Korean healthy', 'animal foods' and 'sweets') in food/food group intake data assessed by an FFQ and analysed using factor analysis. Multiple logistic regression analyses were used to assess the association of diet and weight status with behaviour. SETTING Pre-schools in the metropolitan areas of Korea. SUBJECTS A total of 1458 children (mean age 5·2 (sd 0·9) years) from the Practical Approach for Better Maternal and Child Nutrition and Health Study conducted from 2001 to 2005. RESULTS The 'Korean healthy' pattern showed a significant inverse association with poor social skills in the second highest quartile group (OR = 0·42; 95 % CI 0·21, 0·82) compared with the lowest quartile group for boys. For girls, the 'sweets' pattern was associated with a greater risk of poor social skills (OR = 3·41; 95 % CI 1·29, 9·01 at Q4 v. Q1) and problem behaviours (OR = 2·80; 95 % CI 1·05, 7·43 at Q4 v. Q1). Regarding weight status, both underweight and overweight boys had a higher risk of poor social skills than normal-weight boys. CONCLUSIONS Dietary patterns and weight status are important indicators for the behaviour of young children. Healthy and unhealthy dietary patterns, underweight and overweight status, and gender differences should thus be considered for further studies.
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Affiliation(s)
- Se-Young Oh
- Department of Food and Nutrition, Research Institute of Human Ecology, Kyung Hee University, 1 Hoigi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea
| | - Hyojin Ahn
- Department of Food and Nutrition, Research Institute of Human Ecology, Kyung Hee University, 1 Hoigi-dong, Dongdaemun-gu, Seoul 130-701, Republic of Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea
| | - Myung-Hee Kang
- Department of Food and Nutrition, Hannam University, Daejeon, Republic of Korea
| | - Jiyoung V Oh
- Program of Women's Studies, Iona College, New Rochelle, NY, USA
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Holm-Denoma JM, Smith A, Lewinsohn PM, Pettit JW. Psychosocial predictors of body mass index at late childhood: a longitudinal investigation. J Health Psychol 2014; 19:754-64. [PMID: 23520345 PMCID: PMC4097952 DOI: 10.1177/1359105313479626] [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: 01/18/2023] Open
Abstract
Little is known about the psychosocial circumstances under which children develop excessive body mass. A community sample was followed up from age 2-10 years to determine which early problems were predictive of increased body mass index. Hypothesized mediators (i.e. eating habits, physical activity, and "screen time") were also examined. After controlling for parental psychopathology, family income, child's gender, and child's body mass index, externalizing behaviors, aggressive behaviors, and anger predicted a relatively high body mass index. Exploratory analyses did not support hypothesized mediators, although low power was an issue.
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Xie B, Ishibashi K, Lin C, Peterson DV, Susman EJ. Overweight trajectories and psychosocial adjustment among adolescents. Prev Med 2013; 57:837-43. [PMID: 24075819 PMCID: PMC3903344 DOI: 10.1016/j.ypmed.2013.09.008] [Citation(s) in RCA: 19] [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: 12/19/2012] [Revised: 09/11/2013] [Accepted: 09/17/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Few studies have investigated overweight trajectories and psychosocial adjustment among adolescents. We conducted analyses with data from the multisite Study of Early Child Care and Youth Development (SECCYD). METHODS The sample included 1350 youths born in 1991. Data consisted of repeated measures of weight, height, and multiple subscales of internalizing and externalizing behavioral problems measured by the Child Behavior Checklist (CBCL) from age 9 to age 15. RESULTS Three trajectory patterns were identified: never/rarely overweight/obese (59.5%), late start/light overweight/obese (12.1%), and chronically/heavy overweight/obese (28.4%). Youths with chronically/heavy overweight/obese trajectory pattern had significantly higher scores of internalizing problems over time, as well as syndrome subscales of somatic complaints, social problems and social withdrawal over time than youths with the never/rare overweight/obese trajectory pattern. There was no significant difference in either broad-band behavioral problems or narrow-band syndrome subscales between youths with the never/rare overweight/obese trajectory pattern and those with the late start/light overweight/obesity trajectory pattern. CONCLUSIONS Study findings may advance knowledge on the distinct developmental trajectory patterns of overweight youth and their linkages to the psychosocial adjustment during the period of pubertal transition. The results highlight the need for future prevention research to improve the physical development and mental well-being of adolescents.
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Affiliation(s)
- Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, CA 91711, USA.
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Abstract
OBJECTIVE The objective of this study was to examine the associations between 2 types of emotion regulation (reactivity and inhibition) and 2 types of non-hunger-based eating (emotional eating and external eating). Although emotion regulation and eating regulation problems have both been linked to obesity in previous studies, there is little research examining the link between the two, particularly among children. METHODS A total of 782 rural second graders (49% girls, 20% American Indian) were followed longitudinally through third grade. During both data collection points, children participated in face-to-face interviews at school using the Children's Emotion Management Scales and the revised Dutch Eating Behavior Questionnaire. RESULTS Correlational analyses revealed that children's emotion regulation was significantly related to both external and emotional eating within and across grades, with reactivity appearing to be more consistently related to eating regulation than was inhibition. Regression analyses showed that second to third grade increases in external and emotional eating were predicted by increases in reactivity to anger and reactivity to worry. CONCLUSIONS Given the established link in previous research between poor behavioral regulation and obesity in children, findings from this study linking child emotional reactivity and emotional and external eating (both forms of behavior dysregulation) are important in informing prevention and treatment programs. Based on these findings, targeting child emotion regulation in addition to behavior regulation skills as part of prevention and intervention programs may improve program effectiveness.
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Suglia SF, Duarte CS, Chambers EC, Boynton-Jarrett R. Social and behavioral risk factors for obesity in early childhood. J Dev Behav Pediatr 2013; 34:549-56. [PMID: 24131877 PMCID: PMC3960979 DOI: 10.1097/dbp.0b013e3182a509c0] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Although multiple social and behavioral risk factors associated with obesity co-occur among young children, most studies have examined them separately. The purpose of this study was to examine the relationship between social risk factors, behavioral problems, health behaviors, and obesity among preschoolers in the Fragile Families and Child Wellbeing Study (N = 1589). METHODS A cumulative social risk score was created by summing maternal reports of intimate partner violence, food insecurity, housing insecurity, maternal depressive symptoms, maternal substance use, and father's incarceration, obtained when the child was 3 years old. Mothers reported on the child's internalizing and externalizing behaviors with the Child Behavior Checklist at age 5 years. Mothers also reported on hours the child spent watching television and sleeping as well as servings of soda or juice drinks the child consumed per day. Child height and weight were measured at age 5 years. Obesity was defined as body mass index ≥ 95th percentile. RESULTS In regression analyses adjusted for health behaviors, behavioral problems, and sociodemographic factors, cumulative social risk was associated with obesity among girls. Externalizing behavioral problems were associated with obesity among girls (prevalence ratios [PRs], 1.5; 95% confidence interval [CI], 1.2-1.7) and boys (PR, 1.3; 95% CI, 1.1-1.6). Short sleep duration was also associated with obesity among girls (PR, 1.2; 95% CI, 1.0-1.4) and boys (PR, 1.3; 95% CI, 1.1-1.5) even after adjusting for behavioral problems and social risk factors. Watching more than 2 hours of television per day was associated with obesity among boys (PR 1.5; 95% CI, 1.2 to 1.9) but not girls. CONCLUSION Co-occurring social and behavioral risk factors are associated with obesity among 5-year-old children.
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Affiliation(s)
- Shakira F Suglia
- *Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; †Division of Child and Adolescent Psychiatry, Columbia University, New York, NY; ‡Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY; §Division of General Pediatrics, Boston University School of Medicine, Boston, MA
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Jansen PW, Mensah FK, Clifford SA, Tiemeier H, Nicholson JM, Wake M. Development of mental health problems and overweight between ages 4 and 11 years: a population-based longitudinal study of Australian children. Acad Pediatr 2013; 13:159-67. [PMID: 23356960 DOI: 10.1016/j.acap.2012.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 11/27/2012] [Accepted: 12/04/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate timing and strength of associations between mental health and overweight in childhood; to investigate how the cumulative burden of each of these problems affects the other. METHODS Participants were 3197 children in the population-based Longitudinal Study of Australian Children. At 4 biennial waves spanning ages 4-5 to 10-11 years, parents and teachers reported child mental health on the Strengths and Difficulties Questionnaire, and researchers measured body mass index (BMI). Outcomes were analyzed both continuously and dichotomized (clinical vs no mental health problems; overweight vs not overweight). RESULTS Approximately 30% of participants had overweight and/or mental health problems at some point between ages 4-5 and 10-11 years. Small positive cross-sectional mental health-BMI associations emerged at 8-9 years and strengthened by 10-11 years. In longitudinal analyses, more episodes of overweight predicted higher Total Difficulties scores by 10-11 years, mainly reflecting greater Peer Problems and, to a lesser degree, Emotional Symptoms than never-overweight children; though modest, these associations were robust to a range of sensitivity analyses. In post hoc analyses, overweight in late childhood was more strongly associated with poorer mental health at 10-11 years than early and fluctuating childhood overweight. Associations were smaller and less robust for mental health problems prospectively predicting higher BMI. CONCLUSIONS Relationships between poorer mental health and higher BMI emerged then strengthened in middle to late childhood. In childhood, it appears that overweight precedes mental health problems, particularly peer problems and-on a lower level-emotional problems, rather than the reverse.
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Relation of emotional and behavioral problems with body mass index in preschool children: the Generation R study. J Dev Behav Pediatr 2012; 33:641-8. [PMID: 23027138 DOI: 10.1097/dbp.0b013e31826419b8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Although problem behavior in children and adolescents has frequently been associated with overweight, it is unclear whether this relationship is already present in early childhood. We hypothesized that problem behavior is positively related to body mass index (BMI) in children of preschool age and that eating behavior explains part of this relation. METHODS The study was embedded in the Generation R Study, a population-based cohort with data available on BMI and problem behavior for 3137 children aged 3 to 4 years. Problem behavior was measured with the child behavior checklist (CBCI), and eating behavior was assessed using the child eating behaviour questionnaire (CEBQ). Linear regression analyses were conducted to assess the association between the CBCI (expressed as z-scores). CEBQ, and BMI standard deviation scores (BMI-SDS), Bootstrapping was used to formally test mediation. RESULTS Children with higher levels of emotional problems had a lower BMI-SDS after adjustment for relevant covariates (e.g., β [95% confidence interval {Cl}] for mother report of emotional problems = -0.04 [-0.07, -0.001], father report = -0.04 [-0.08, -0.001]). Behavioral problems were not associated with BMI. Emotional and behavioral problems were not associated with underweight or overweight if studied categorically. The effect estimate for the relation of emotional problems with BMI-SDS attenuated to nonsignificance after adjustment for specific eating behaviors, i.e., they were accounted for by satiety responsiveness, fussiness, and emotional undereating. CONCLUSION In this population-based study, emotional problems in preschoolers were negatively related to BMI, and this relation was fully explained by food avoidant eating behaviors.
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Gonzalez A, Boyle MH, Georgiades K, Duncan L, Atkinson LR, MacMillan HL. Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study. BMC Public Health 2012; 12:755. [PMID: 22958463 PMCID: PMC3490808 DOI: 10.1186/1471-2458-12-755] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 09/03/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood. METHODS We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4-16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21-35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. RESULTS At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. CONCLUSION Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.
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Affiliation(s)
- Andrea Gonzalez
- McMaster University, Department of Psychiatry and Behavioral Neuroscience, Offord Centre for Child Studies, 1280 Main Street West, Chedoke Site, Patterson Building, Hamilton, ON L8S 3K1, Canada.
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Seyedamini B, Malek A, Ebrahimi-Mameghani M, Tajik A. Correlation of obesity and overweight with emotional-behavioral problems in primary school age girls in tabriz, iran. IRANIAN JOURNAL OF PEDIATRICS 2012; 22:15-22. [PMID: 23056854 PMCID: PMC3448210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 10/01/2011] [Accepted: 11/01/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Obesity and overweight have shown an increasing trend in most developing countries. Childhood obesity would impose numerous health-related problems. This study was conducted to determine the correlation of obesity and overweight with emotional-behavioral problems in primary school age girls. METHODS In a cross-sectional study, 300 primary school girls (aged 7-11 years) were selected using a multi-staged sampling method, including randomized cluster and stratified method. For all students body mass index was measured and then based on BMI for age and sex, from each grade (1-5), 20 students were selected for each group of normal weight, overweight and obese. The emotional-behavioral problems were evaluated using child behavior checklist that consists of 113 items for childhood behavioral problems. FINDINGS Total behavioral problems were seen in 17%, 27%, and 2% in obese, overweight, and normal weight children, respectively. Internalizing problems (including Anxious/Depressed, Withdrawn, and Somatic Complaints) were seen in 11%, 15%, and 2% and externalizing problems (including Aggressive and Delinquent Behaviors) were observed in 8%, 17%, and 2% in obese, overweight, and normal weight children, respectively. The mean scores in all scales were higher in obese and overweight children in comparison with normal weight children and the emotional-behavioral problems had significant positive correlation with obesity and overweight (P<0.01). CONCLUSION Despite the cultural differences between east and west, yet there are similarities in the most of the emotional-behavioral problems related to overweight and obesity. Also, it seems that the risk of behavioral-emotional problems in overweight girls is more than in obese girls. Overweight and Obesity prevention may be a primary preventive step for these problems in children.
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Affiliation(s)
- Bayanah Seyedamini
- Department of Nursing, Islamic Azad University, Mahabad branch, Mahabad, Iran
| | - Ayyoub Malek
- Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding Author:Address: Child and Adolescent Psychiatric Ward, Department of Psychiatry, Razi Mental Hospital, El-Goli Blvd, POB: 5456, Tabriz, Iran. E-mail:
| | - Mehrangiz Ebrahimi-Mameghani
- Department of Nutrition, School of Public Health & Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Tajik
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Psychological complications associated with pediatric obesity include low self-esteem, depression, body dissatisfaction, loss-of-control eating, unhealthy and extreme weight control behaviors, impaired social relationships, obesity stigma, and decreased health-related quality of life. Bioecological models offer a framework for understanding the interaction between pediatric obesity and psychological complications and illustrate system-level approaches for prevention and intervention. As the medical setting is often the first point of contact for families, pediatricians are instrumental in the identification and referral of children with psychological complications. Motivational interviewing, patient talking points, brief screening measures, and referral resources are important tools in this process.
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Affiliation(s)
- Jillon S Vander Wal
- Department of Psychology, Saint Louis University, 221 North Grand Boulevard, St Louis, MO 63103, USA.
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Tiffin PA, Arnott B, Moore HJ, Summerbell CD. Modelling the relationship between obesity and mental health in children and adolescents: findings from the Health Survey for England 2007. Child Adolesc Psychiatry Ment Health 2011; 5:31. [PMID: 21982578 PMCID: PMC3213165 DOI: 10.1186/1753-2000-5-31] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 10/07/2011] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED A number of studies have reported significant associations between obesity and poor psychological wellbeing in children but findings have been inconsistent. METHODS This study utilised data from 3,898 children aged 5-16 years obtained from the Health Survey for England 2007. Information was available on Body Mass Index (BMI), parental ratings of child emotional and behavioural health (Strengths and Difficulties Questionnaire), self-reported physical activity levels and sociodemographic variables. A multilevel modelling approach was used to allow for the clustering of children within households. RESULTS Curvilinear relationships between both internalising (emotional) and externalising (behavioural) symptoms and adjusted BMI were observed. After adjusting for potential confounders the relationships between obesity and psychological adjustment (reported externalising and internalising symptoms) remained statistically significant. Being overweight, rather than obese, had no impact on overall reported mental health. 17% of children with obesity were above the suggested screening threshold for emotional problems, compared to 9% of non-obese children. Allowing for clustering and potential confounding variables children classified as obese had an odds ratio (OR) of 2.13 (95% CI 1.39 to 3.26) for being above the screening threshold for an emotional disorder compared to non-obese young people. No cross-level interactions between household income and the relationships between obesity and internalising or externalising symptoms were observed. CONCLUSIONS In this large, representative, UK-based community sample a curvilinear association with emotional wellbeing was observed for adjusted BMI suggesting the possibility of a threshold effect. Further research could focus on exploring causal relationships and developing targeted interventions.
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Affiliation(s)
- Paul A Tiffin
- School of Medicine and Health, Wolfson Research Institute, Durham University Queen's Campus, University Boulevard, Stockton-on-Tees, TS17 6BH, UK
| | - Bronia Arnott
- Child Development Unit, Wolfson Research Institute, Durham University Queen's Campus, University Boulevard, Stockton-on-Tees, TS17 6BH, UK
| | - Helen J Moore
- School of Medicine and Health, Wolfson Research Institute, Durham University Queen's Campus, University Boulevard, Stockton-on-Tees, TS17 6BH, UK
| | - Carolyn D Summerbell
- School of Medicine and Health, Wolfson Research Institute, Durham University Queen's Campus, University Boulevard, Stockton-on-Tees, TS17 6BH, UK
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Anderson SE, Whitaker RC. Attachment security and obesity in US preschool-aged children. ACTA ACUST UNITED AC 2011; 165:235-42. [PMID: 21383273 DOI: 10.1001/archpediatrics.2010.292] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To estimate the association between attachment security in children aged 24 months and their risk for obesity at 4½ years of age. Insecure attachment is associated with unhealthy physiologic and behavioral responses to stress, which could lead to development of obesity. DESIGN Cohort study. SETTING National sample of US children born in 2001. PARTICIPANTS Children and mothers participating in the 2003 and 2005-2006 waves of the Early Childhood Longitudinal Study, Birth Cohort, conducted by the National Center for Education Statistics. Our analytic sample included 6650 children (76.0% of children assessed in both waves). MAIN EXPOSURE Attachment security at 24 months was assessed by trained interviewers during observation in the child's home. Insecure attachment was defined as lowest quartile of attachment security, based on the security score from the Toddler Attachment Sort-45 Item. OUTCOME MEASURE Obesity at 4½ years of age (sex-specific body mass index ≥95th percentile for age). RESULTS The prevalence of obesity was 23.1% in children with insecure attachment and 16.6% in those with secure attachment. For children with insecure attachment, the odds of obesity were 1.30 (95% confidence interval, 1.05-1.62) times higher than for children with secure attachment after controlling for the quality of mother-child interaction during play, parenting practices related to obesity, maternal body mass index, and sociodemographic characteristics. CONCLUSIONS Insecure attachment in early childhood may be a risk factor for obesity. Interventions to increase children's attachment security should examine the effects on children's weight.
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Affiliation(s)
- Sarah E Anderson
- Division of Epidemiology, College of Public Health, The Ohio State University, 320 West 10th Avenue, Columbus, OH 43210, USA.
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Garthus-Niegel S, Hagtvet KA, Vollrath ME. A prospective study of weight development and behavior problems in toddlers: the Norwegian Mother and Child Cohort Study. BMC Public Health 2010; 10:626. [PMID: 20961446 PMCID: PMC2972243 DOI: 10.1186/1471-2458-10-626] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 10/20/2010] [Indexed: 12/03/2022] Open
Abstract
Background Previous research has suggested that overweight children have a higher risk of behavior problems, but the causal direction of this relationship remains unclear. In a large prospective population study, we investigated whether child behavior problems and body mass index are associated in toddlers and whether overweight is a risk for behavior problems or vice versa. Methods The study was part of the Norwegian Mother and Child Cohort Study. The sample consisted of 10 860 toddlers, followed up to age 36 months. We used data from maternal questionnaires from gestation week 17 and at child ages 18 and 36 months, and data from the Medical Birth Registry of Norway. Child height and weight were assessed at child health stations and recorded by mothers. Behavior problems were assessed using shortened subscales from the Child Behavior Checklist. Statistical analyses were conducted using structural equation modeling. Results Behavior problems in toddlers were not associated with higher body mass index cross-sectionally at either age 18 or 36 months, and there was no indication that behavior problems caused increasing body mass index over time or vice versa. Conclusions The association between behavior problems and body mass index found in older children did not appear in toddlers up to age 36 months. Future studies should focus on the age span from 3 to 6 years, which includes the period of adiposity rebound.
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Affiliation(s)
- Susan Garthus-Niegel
- Department of Psychosomatics and Health Behavior, Norwegian Institute of Public Health, Postbox 4404, Nydalen, 0403 Oslo, Norway.
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