Early maternal perceived stress and children's BMI: longitudinal impact and influencing factors

Maternal stress and early childhood BMI among US children from the Environmental influences on Child Health Outcomes (ECHO) program

BACKGROUND

We aimed to understand the association between maternal stress in the first year of life and childhood body mass index (BMI) from 2 to 4 years of age in a large, prospective United States-based consortium of cohorts.

METHODS

We used data from the Environmental influences on Child Health Outcomes program. The main exposure was maternal stress in the first year of life measured with the Perceived Stress Scale (PSS). The main outcome was the first childhood BMI percentile after age 2 until age 4 years. We used an adjusted linear mixed effects model to examine associations between BMI and PSS quartile.

RESULTS

The mean BMI percentile in children was 59.8 (SD 30) measured at 3.0 years (SD 1) on average. In both crude models and models adjusted for maternal BMI, age, race, ethnicity, infant birthweight, and health insurance status, no linear associations were observed between maternal stress and child BMI.

CONCLUSIONS

Among 1694 maternal-infant dyads, we found no statistically significant relationships between maternal perceived stress in the first year of life and child BMI after 2 through 4 years.

IMPACT

Although existing literature suggests relationships between parental stress and childhood BMI, we found no linear associations between maternal stress in the first year of life and childhood BMI at 2-4 years of age among participants in ECHO cohorts. Higher maternal stress was significantly associated with Hispanic ethnicity, Black race, and public health insurance. Our analysis of a large, nationally representative sample challenges assumptions that maternal stress in the first year of life, as measured by a widely used scale, is associated with offspring BMI.

Long-term effects of child nutritional status on the accumulation of health human capital

Research on the impact of childhood nutrition on adult health and human capital has been extensively studied in developed countries, but research in China on this topic is limited. Nowadays, for children's nutritional status, while significant progress has been made in addressing childhood undernutrition in China, regional disparities persist, conversely, the prevalence of childhood overweight continues to rise. For adults' health human capital, the burden of chronic non-communicable diseases among Chinese residents is gradually increasing, over 50% of Chinese residents are overweight or obese, with obesity being one of the risk factors for other chronic diseases. Therefore, this study uses national representative data from 1991 to 2015 China Health and Nutrition Survey (CHNS), matched with individual information from their childhood, to examine the relationship between childhood nutrition and adult health human capital. Based on the two-way fixed effects models and logit models, the study finds that childhood nutrition status measured by height-for-age z score (HAZ) significantly and continuously has been influencing adult health human capital measured by height, BMI, self-rated health (SRH), whether have been sick in last four weeks (SH). BMI-for-age z score (BMIZ) significantly and continuously influence adult health human capital measured by BMI, blood pressure, and perceived stress (PS). Among that, this study places special emphasis on the long-lasting effects of late childhood and adolescence (ages exceeding 6) on the progressive height accumulation and sustained presence of elevated blood pressure. In conclusion, reducing childhood overweight and promoting linear growth and development throughout the whole childhood can reduce the future burden of disease on the nation.

Postpartum stress in the first 6 months after delivery: a longitudinal study in Nantong, China

OBJECTIVES

The objective is to to explore the longitudinal change trajectories of postpartum stress and its related factors.

DESIGN

A longitudinal study with follow-ups from 42 days to 6 months after delivery.

SETTINGS AND PARTICIPANTS

A total of 406 postpartum women were recruited at baseline (42 days after delivery) from 6 hospitals in Nantong, Jiangsu Province, China, and followed up at 3 and 6 months. After the follow-ups, 358 postpartum women were retained for further analysis.

METHODS

Postpartum stress was evaluated using the Maternal Postpartum Stress Scale (MPSS) at baseline (42 days) and 3 and 6 months after delivery. MPSS has three dimensions, such as: personal needs and fatigue, infant nurturing and body changes and sexuality. Postpartum depression and anxiety were measured using the Edinburgh Postnatal Depression Scale and the short-form Depression, Anxiety and Stress Scale, respectively. The MPSS scores were normalised using a rank-based inverse normal transformation.

RESULTS

Postpartum stress decreased significantly after 3 months, and postpartum stress reduced further after 6 months. Additionally, the scores for all three dimensions reduced after 6 months, while infant nurturing reduced after both 3 and 6 months. Older age (β=0.028, p=0.049), higher education level (β=0.153, p=0.005) and higher body mass index (BMI) (β=0.027, p=0.008) of the postpartum women were significantly associated with higher postpartum stress levels in corresponding dimensions at 42 days. Older age was also associated with higher postpartum stress at 3 (β=0.030, p=0.033) and 6 months (β=0.050, p<0.001) in the dimension of personal needs and fatigue. Postpartum stress levels were significantly higher in women with depression or anxiety symptoms.

CONCLUSIONS

Postpartum stress continuously declined from 42 days to 6 months after delivery. Postpartum women with older age, higher education levels, higher BMI and anxiety or depression symptoms should be the target population for early intervention.

Modification and Psychometric Analyses of Stress and Coping Scales for the Extended Postpartum Period

OBJECTIVE

To modify and psychometrically assess two scales that are used to measure stress and coping during the extended postpartum period.

DESIGN

Instrument modification and psychometric assessment.

SETTING

Online, community, and health care settings.

PARTICIPANTS

Mothers with infants who were 2 to 22 months old: 20 in Phase 1 and 373 in Phase 2.

METHODS

In Phase 1, participants from diverse backgrounds served as content experts to recommend modifications of items on two scales: Sources of Stress-Revised (SoS-R) and Postpartum Coping Scale (PCS). The results were 32-item modified versions of each scale. In Phase 2, we conducted a psychometric analysis of both revised scales using principal components analysis to identify dimensionality, Cronbach's alphas to estimate internal consistency reliability, and Pearson correlations to estimate validity of the SoS-R and PCS with the Perceived Stress Scale and the Brief COPE, respectively.

RESULTS

We identified six components for the SoS-R: Overload, Changes After Pregnancy, Baby-Related Concerns, Working Mother Concerns, Low Support Resources, and Isolated Motherhood. The Cronbach's alpha for the SoS-R was .94. The SoS-R subscales demonstrated correlations with the Perceived Stress Scale that ranged from 0.55 to 0.30. We identified six components for the PCS: Self-Regulation, Spiritual Care, Self-Care, Use and Seek Support, Internal and External Resources, and Health Promotion. The Cronbach's alpha coefficients for the PCS ranged from .84 to .66. The highest correlations observed between the PCS subscales and the Brief COPE subscales ranged from 0.67 to 0.26.

CONCLUSION

The SoS-R and PCS each include six components. Internal consistency reliability for all SoS-R subscales and four of six PCS subscales exceeded .70. The dimensions of each scale highlight areas of clinical and research concern.

Segregated by Wealth, Health, and Development: An Analysis of Pre-School Child Health in a Medium-Sized German City

The School Entry Examination (SEE) can be used to identify children with current health issues, developmental delays, and risk factors for later diseases. This study analyzes the health status of preschool children in a German city with considerable socio-economic differences among its quarters. We used secondary data from SEEs 2016-2019 from the entire city (8417 children), which we divided into quarters with low (LSEB), medium (MSEB), and high socioeconomic burden (HSEB). In HSEB quarters, 11.3% of children were overweight as opposed to 5.3% in LSEB quarters. In HSEB quarters, 17.2% of children had sub-par cognitive development in contrast to 1.5% in LSEB quarters. For overall sub-par development, LSEB quarters had a prevalence of 3.3%, whereas, in HSEB quarters, 35.8% of children received this result. Logistic regression was used to determine the influence of the city quarter on the outcome of overall sub-par development. Here, considerable disparities among HSEB and LSEB quarters remained after adjustment for parents' employment status and education. Pre-school children in HSEB quarters showed a higher risk for later disease than children in LSEB quarters. The city quarter had an association with child health and development that should be considered in the formulation of interventions.

Pre- and early postpartum psychosocial stress trajectories in mothers and child body mass index at 3 years: a birth cohort study

BACKGROUND

Child overweight remains a prevalent public health concern, but the impact of maternal psychosocial stress and related constructs, the timing, and possible trajectories on child body mass index (BMI) is controversial. We aimed to investigate the association of maternal stress, depression and anxiety symptoms, and maternal hair cortisol concentrations (HCC) at delivery, 6, and 12 months postpartum with child BMI and age- and sex-standardized BMI (BMI-SDS) at age 3 years.

METHODS

Data were derived from the Ulm SPATZ Health Study with a baseline examination between 04/2012 and 05/2013 at the University Medical Centre Ulm, Germany, the only maternity clinic in Ulm, with a good representation of the source population. Adjusted regression analyses based on BMI/BMI-SDS (dependent) and trajectories of stress, depression, and anxiety (independent variables) were investigated in 596 mothers and children. Multiple imputation of missing covariates was performed.

RESULTS

Various trajectories in independent variables were identified, trajectories of maternal anxiety symptom differed between child sexes. We did not find an association between trajectories of maternal chronic stress, depression symptoms, or HCC and child BMI/BMI-SDS. However, trajectories of low-increasing maternal anxiety symptoms were linked to higher child BMI compared to a low-stable trajectory group (b = 0.58 kg/m², 95% Confidence Interval: 0.11; 1.04) in girls.

CONCLUSIONS

Trajectories of maternal anxiety symptoms were associated with the child's BMI/BMI-SDS in girls at age 3 years. However, further large scale studies should include variables to determine the causal pathway and enlighten sex-specific differences.

Exposure to Obesogenic Environments during Perinatal Development Modulates Offspring Energy Balance Pathways in Adipose Tissue and Liver of Rodent Models

Obesogenic environments such as Westernized diets, overnutrition, and exposure to glycation during gestation and lactation can alter peripheral neuroendocrine factors in offspring, predisposing for metabolic diseases in adulthood. Thus, we hypothesized that exposure to obesogenic environments during the perinatal period reprograms offspring energy balance mechanisms. Four rat obesogenic models were studied: maternal diet-induced obesity (DIO); early-life obesity induced by postnatal overfeeding; maternal glycation; and postnatal overfeeding combined with maternal glycation. Metabolic parameters, energy expenditure, and storage pathways in visceral adipose tissue (VAT) and the liver were analyzed. Maternal DIO increased VAT lipogenic [NPY receptor-1 (NPY1R), NPY receptor-2 (NPY2R), and ghrelin receptor], but also lipolytic/catabolic mechanisms [dopamine-1 receptor (D1R) and p-AMP-activated protein kinase (AMPK)] in male offspring, while reducing NPY1R in females. Postnatally overfed male animals only exhibited higher NPY2R levels in VAT, while females also presented NPY1R and NPY2R downregulation. Maternal glycation reduces VAT expandability by decreasing NPY2R in overfed animals. Regarding the liver, D1R was decreased in all obesogenic models, while overfeeding induced fat accumulation in both sexes and glycation the inflammatory infiltration. The VAT response to maternal DIO and overfeeding showed a sexual dysmorphism, and exposure to glycotoxins led to a thin-outside-fat-inside phenotype in overfeeding conditions and impaired energy balance, increasing the metabolic risk in adulthood.

A Web-Based, Mindful, and Compassionate Parenting Training for Mothers Experiencing Parenting Stress: Results from a Pilot Randomized Controlled Trial of the Mindful Moment Program

Objectives

Mindful Moment is a self-guided, web-based, mindful, and compassionate parenting training for postpartum mothers who experience parenting stress. We aimed to assess Mindful Moment’s feasibility, acceptability, and usability, and to gather preliminary evidence of its effectiveness in reducing parenting stress and outcomes such as mindful parenting, self-compassion, depressive symptoms, anxious symptoms, dispositional mindfulness, mother’s perception of infant temperament, and mother-infant bonding.

Methods

This pilot randomized controlled trial (RCT) was a two-arm trial and followed the CONSORT 2010, CONSORT-EHEALTH, and CONSORT-SPI 2018 extension guidelines. A total of 292 Portuguese mothers were randomly assigned to the intervention group (n = 146) or to the waiting list control group (n = 146) and completed baseline (T1) and postintervention (T2) self-reported assessments.

Results

A total of 31 mothers (21.23%) completed the Mindful Moment intervention. Most mothers evaluated the program as good or excellent (90%), considered that Mindful Moment provided them the kind of help they expected or wanted (61%), were satisfied with the help provided by the program (74.6%), would recommend it to a friend in a similar situation (86.4%), and would use it again if needed (81.4%). Regarding the program’s preliminary effectiveness, mothers in the intervention group presented a greater decrease in parenting stress, a greater increase in dispositional mindfulness, and a greater decrease in their perception of the difficult temperament of their infants from T1 to T2.

Conclusions

This study provides preliminary evidence of the Mindful Moment’s effectiveness and suggests that it is a feasible and acceptable program for postpartum mothers experiencing parenting stress. Further research is needed to confirm these results in a larger RCT.

Trial Registration

ClinicalTrials.gov (NCT04892082).

Maternal Stress and Excessive Weight Gain in Infancy

Rapid weight gain in infancy increases the risk of developing obesity early in life and contributes significantly to racial and ethnic disparities in childhood obesity. While maternal perceived stress is associated with childhood obesity, little is known about the impact it has on infant weight gain. Therefore, this study explores the impact of maternal perceived stress on change in weight-for-length (WFL) z-scores and the risk of rapid weight gain in infancy. We conducted a secondary data analysis of the longitudinal Nurture birth cohort (n = 666). Most mothers in the cohort were non-Hispanic/Latinx Black (71.6%). About one-half of mothers had a body mass index (BMI) greater than 25 prior to pregnancy, were unemployed, and had a low income. Most infants in the cohort were born full-term and were of normal weight. Data were collected at 3-, 6-, 9-, and 12-months postpartum. At each assessment, mothers completed the Cohen’s Perceived Stress Scale (PSS), and research assistants weighed and measured each infant. Tertiles were used to compare mothers with high and low perceived stress. A mixed model analysis of repeated measures assessed the associations between baseline perceived stress and the change in infant WFL z-scores over time. Log-binomial models assessed the association between baseline perceived stress and rapid weight gain, defined as a change in WFL z-score > 0.67 standard deviations from three to twelve months. Just under one-half of the infants (47%) experienced rapid weight gain between three and twelve months of age. Birthweight for gestational age (RR = 1.18, 95% CI = 1.08−1.29, p-value = 0.004), gestational age at birth (RR = 1.07, 95% CI = 1.01−1.14, p-value = 0.031), and weeks breastfed (0.99, 95% CI 0.99−1.00, p-value 0.044) were associated with risk of rapid weight gain in unadjusted analyses. WFL z-scores increased significantly over time, with no effect of perceived stress on change in WFL z-score or risk of rapid weight gain. Rapid weight gain in infancy was prevalent in this sample of predominately Black infants in the Southeastern US. We did not find evidence to support the hypothesis that maternal perceived stress influenced the risk of rapid weight gain. More work is needed to identify and assess the risk factors for rapid weight gain in infancy and to understand the role that maternal stress plays in the risk of childhood obesity so that prevention efforts can be targeted.

Higher Consumption of Fruit and Vegetables Is Associated With Lower Worries, Tension and Lack of Joy Across the Lifespan

Background and Aims

Higher total fruit and vegetable (FV) intakes have been associated with lower perceived stress. However, the relationship of FV intake with domains of perceived stress is unclear. The aim of this cross-sectional study was to explore the relationship between consumption of FV and four perceived stress domains (worries, tension, lack of joy and demands) in a population-based cohort of Australian adults.

Methods

Participants (n = 8,640) were men and women aged ≥25 years from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. Dietary intake was assessed using a 74-item validated Food Frequency Questionnaire. Perceived stress domains were determined using a validated 20-item version of the Perceived Stress Questionnaire, with higher scores representing higher perceived stress. Cut-offs for high perceived stress domains were obtained from the highest quartiles of each domain for each sex. Multivariable-adjusted logistic regression was performed to investigate cross-sectional associations.

Results

The mean age of participants (50.1% females) was 47.8 (SD 15) years. Those with higher intakes of FV, combined and separately, had a significantly lower odds (16–36%) for higher worries, tension and lack of joy, independent of other lifestyle factors.

Conclusion

In Australian adults, higher consumption of FV was associated with lower odds of worries, tension and lack of joy. Following the dietary guidelines for the recommended intake of FV may help improve feelings of worries, tension and lack of joy, which are linked to mental health problems.

A Randomized Control Trial of Using Baby Books to Reduce New Mothers' Feelings of Stress and Depression

OBJECTIVE

To determine whether embedding educational information about child development and optimal parenting practices from the Bright Futures Guidelines for Health Supervision into baby books can reduce women's depressive symptoms and parenting stress during the first 18 months of motherhood.

METHODS

A sample of 167 low-income, primarily African-American, first-time mothers were randomized into three conditions while pregnant: an educational book group, a non-educational book group, or a no-book group. Depressive symptoms and parenting stress were assessed using two questionnaires during home visits when women were in their third trimester of pregnancy (baseline) and when their child was 2, 4, 6, 9, 12, and 18 months of age.

RESULTS

Hierarchical Linear Models showed that women who received books with educational information shed depressive symptoms and parenting stress at a faster rate than women who received similar books without educational information and women who did not receive books.

CONCLUSIONS

These findings indicate that providing women with child development and parenting information via baby books can be an effective strategy for promoting new mothers' emotional wellbeing. Since feelings of sadness and stress are risky for both mothers and their infants, this easy to implement intervention holds great promise.

Is the Prospective Link between Parental Stress and Adolescent Snack Intake or Weight Outcome Mediated by Food Parenting Practices?

Parental stress may influence adolescents’ food intake and weight development over time, however, it is largely unknown why this is the case. This study examines whether the link between parental stress and adolescents’ snack intake and weight outcome is mediated by food parenting practices (FPPs). Participants included 400 parents and their adolescent children (aged 12–16) who completed questionnaires. The Perceived Stress Scale (PSS) was used to assess parental general stress levels and the Adolescent Food Parenting Questionnaire (AFPQ) to assess FPPs. Multiple mediation analyses with parallel mediators were performed, with parental general stress as an independent variable and adolescent snack intake and zBMI as dependent variables. FPPs (autonomy support, coercive control, modeling, healthy structure, snack structure) were entered as mediators in the model, adjusted for covariates. Autonomy support mediated the link between parental general stress and adolescent savory snack and sweet snack intake at follow-up. Parents who reported higher stress levels provided less autonomy support, which resulted in more adolescent snacking. None of the other FPPs mediated any link between parental stress and intake or weight outcome, and no significant indirect effects were observed with zBMI as an outcome variable. Further research should replicate this finding and may further examine underlying mechanisms.

The new kids on the block: Emerging obesogens

The current obesity epidemic is calling for action in the determination of contributing factors. Although social and life-style factors have been traditionally associated with metabolic disruption, a subset of endocrine-disrupting chemicals (EDCs), called obesogens are garnering increasing attention for their ability to promote adipose tissue differentiation and accumulation. For some chemicals, such as tributyltin, there is conclusive evidence regarding their ability to promote adipogenesis and their mechanism of action. In recent years, the list of chemicals that exert obesogenic potential is increasing. In this chapter, we review current knowledge of the most recent developments in the field of emerging obesogens with a specific focus on food additives, surfactants, and sunscreens, for which the mechanism of action remains unclear. We also review new evidence relative to the obesogenic potential of environmentally relevant chemical mixtures and point to potential therapeutic approaches to minimize the detrimental effects of obesogens. We conclude by discussing the available tools to investigate new obesogenic chemicals, strategies to maximize reproducibility in adipogenic studies, and future directions that will help propel the field forward.

Postpartum Stress and Neural Regulation of Emotion among First-Time Mothers

Early parenting relies on emotion regulation capabilities, as mothers are responsible for regulating both their own emotional state and that of their infant during a time of new parenting-related neural plasticity and potentially increased stress. Previous research highlights the importance of frontal cortical regions in facilitating effective emotion regulation, but few studies have investigated the neural regulation of emotion among postpartum women. The current study employed a functional neuroimaging (fMRI) approach to explore the association between perceived stress, depressive symptoms, and the neural regulation of emotion in first-time mothers. Among 59 postpartum mothers, higher perceived stress during the postpartum period was associated with less self-reported use of cognitive reappraisal in everyday life, and greater use of emotion suppression. While viewing standardized aversive images during the Emotion Regulation Task (ERT), mothers were instructed to experience their natural emotional state (Maintain) or to decrease the intensity of their negative emotion by using cognitive reappraisal (Reappraise). Whole-brain analysis revealed a two-way interaction of perceived stress x condition in the right dorsolateral prefrontal cortex (DLPFC) at p < .05 cluster-wise corrected, controlling for postpartum months and scanner type. Higher levels of perceived stress were associated with heightened right DLPFC activity while engaging in cognitive reappraisal versus naturally responding to negative stimuli. Higher right DLPFC activity during Reappraise versus Maintain was further associated with elevated parenting stress. Findings suggest that stress and everyday reappraisal use is reflected in mothers' neural regulation of emotion and may have important implications for their adaptation to parenthood.

Maternal feeding stress during mealtimes as a mediator between child food fussiness and maladaptive feeding behaviors among mothers of preschoolers

Parenting stress has been linked to maladaptive feeding behaviors and adverse child outcomes. Maternal stress that is specific to child feeding during mealtimes has not been previously explored. We sought to examine our hypothesis that maternal feeding stress during mealtimes (MFS-mealtimes) mediates the association of child food fussiness and concern about child's diet with maladaptive feeding behaviors. Mothers (n = 100) were recruited through different preschoolers around the city of Jeddah, Saudi Arabia. Participants completed an online questionnaire, which included a newly developed MFS-mealtimes index (Cronbach's α = 0.89), the Child Feeding Questionnaire- Arabic (CFQ-A), and the child food fussiness scale. We conducted path analysis to test our hypothesis, and we used bivariate analyses to inform our path model. Mean child age was 4.76 years (SD = 0.62), and 62% of children were female. Mean maternal age was 33.9 years (SD = 5.83). Results from path analysis showed that concern about child's diet and child food fussiness were each associated with higher MFS-mealtimes (B = 0.11, 95% confidence interval (CI) = 0.01, 0.20, p < 0.05, and B = 0.29, 95% CI = 0.05, 0.53, p < 0.01, respectively). MFS-mealtimes was in turn associated with higher pressure to eat (B = 0.45, 95% CI = 0.18, 0.71, p < 0.05). Goodness of fit indices showed good model fit (p > X² = 0.83, SRMR = 0.005, and CFI = 1.00). Our findings suggest a novel approach for promoting a favorable mealtime environment. Parenting stress reduction interventions have been shown to be successful in reducing stress levels and may be utilized for minimizing feeding stress during mealtimes. Mothers of picky eaters may be specifically targeted for intervention programs. Long term consequences of excessive MFS-mealtimes, as well as variations between cultures need further evaluation.

Maternal and Paternal Distress in Early Childhood and Child Adiposity Trajectories: Evidence from the Millennium Cohort Study

OBJECTIVE

The current study investigated associations between mothers' and fathers' distress reported in early childhood (at ages 9 months and 3 years) and childhood adiposity trajectories from ages 5 to 14 years.

METHODS

Linear mixed-effects models were undertaken in the Millennium Cohort Study. Self-reported maternal and paternal distress was measured at ages 9 months and 3 years. BMI and fat mass index (FMI) were modeled from ages 5 to 14 years, adjusting for socioeconomic and child characteristics and stratifying by child sex.

RESULTS

Maternal distress reported at 9 months was associated with steeper increases in BMI and FMI trajectories for girls (BMI: β = 0.06; 95% CI: 0.01 to 0.11; FMI: β = 0.04; 95% CI: 0.00 to 0.08). Paternal distress reported at 9 months was associated with steeper increases in BMI and FMI for both girls (BMI: β = 0.06; 95% CI: 0.00 to 0.12, FMI: β = 0.05; 95% CI: -0.02 to 0.10) and boys (BMI: β = 0.09; 95% CI:  0.03 to 0.15, FMI: β = 0.06; 95% CI: 0.01 to 0.10). Maternal "moderate" distress at 3 years was associated with steeper BMI and FMI trajectories for girls only (BMI: β = 0.08; 95% CI: 0.03 to 0.12, FMI; β = 0.06; 95% CI: 0.02 to 0.10).

CONCLUSIONS

Maternal and paternal distress experienced in early childhood, particularly during infancy, was associated with steeper adiposity trajectories for children from ages 5 to 14 years.

Associations of Mothers' and Children's Stress With Children's Device-Measured Physical Activity and Sedentary Behavior Trajectories Across 3 Years

BACKGROUND

Psychological stress has adverse effects on health-related behaviors, yet longitudinal research is lacking. Research examined how children's and mothers' perceived stress are associated with children's physical activity and sedentary behavior trajectories across 3 years.

METHODS

Mothers and their children (N = 186 dyads; 8-12 y at baseline, 57% Hispanic) completed 6 assessments across 3 years. Children and mothers self-reported perceived stress using the Stress in Children Scale and Perceived Stress Scale, respectively. Children's moderate to vigorous physical activity (MVPA) and sedentary behavior were assessed using accelerometers. Mixed models examined interactions of mothers' and children's perceived stress by time elapsed in the study on children's MVPA and sedentary behavior.

RESULTS

The perceived stress × time elapsed interactions were significant for children's MVPA and sedentary behavior (Ps < .05). Higher average perceived stress in mothers was associated with greater decreases in children's MVPA and increases in children's sedentary behavior. The child stress × time elapsed interactions was significant for children's MVPA (P < .05) but not sedentary behavior. Higher average perceived stress in children was associated with smaller decreases in children's MVPA.

CONCLUSION

Interventions to promote physical activity and reduce screen time in children should mitigate the effects of psychological stress, especially among mothers, on these behaviors.

Maternal stress and depressive symptoms and adolescents' body mass index: a prospective study

Background

Growing evidence suggests that maternal mental health issues are associated with (young) children’s weight outcomes. However, most studies have been limited by cross-sectional designs and have been aimed at (younger) children. The current prospective study focuses on the link between maternal mental health (i.e., psychological stress and depressive symptoms) and adolescents’ zBMI development.

Methods

The participants in the present study were part of wave 1 and 2 of a longitudinal study on Dutch adolescents’ and their parents’ health behavior. Adolescents (aged 10–14) and their parents were recruited through six secondary schools in the South and the East of the Netherlands. For this study, we only included biological mothers and their adolescent children who participated in both waves, with data on the main measures in both waves, leaving a final sample of 336 biological mother-child dyads. Adolescents height and weight were measured, and both parents and adolescents filled in validated questionnaires on perceived stress and depressive symptoms and answered additional questions concerning domain-specific stress. Regression analyses were performed in R to examine longitudinal links between maternal stress and depressive symptoms at baseline (T1) and adolescents’ BMI standard deviation scores (zBMI) 6 months later (T2), corrected for baseline zBMI and covariates.

Results

Maternal general perceived stress (β = .20, p = .002) at T1 preceded higher adolescents’ zBMI at T2, after controlling for baseline zBMI and other covariates, whereas maternal depressive symptoms at T1 (β = −.05, p = .44) and other domain-specific stress did not (maternal financial stress, maternal stress at work, maternal stress at home). Additionally, lower educational level among adolescents (β = .16, p = .001) and adolescent depressive symptoms (β = .16, p = .001) was associated with a higher zBMI at T2.

Conclusions

Results suggest that maternal general stress, but not depressive symptoms, may influence adolescents’ weight development. Our findings warrant future investigation on whether and how general stress among mothers may predict weight increases of their adolescent offspring.

Longitudinal associations of maternal stress and child stress with child body mass index trajectory

BACKGROUND

Although exposure to stress is common among children and their parents, longitudinal research on the effects of perceived stress on child obesity risk is lacking. This study examined the 3-year longitudinal associations of children and mothers' perceived stress with children's body mass index (BMI).

METHODS

A sample of 199 mothers and their children (8-12 years at baseline, 56% Hispanic) completed six semi-annual assessments across 3 years with questionnaire-based self-report measures of perceived stress and measured height/weight. Parallel process latent growth curve modelling specified regressions of latent intercept and slope of children's BMI on latent intercepts and slopes for mothers' and children's perceived stress.

RESULTS

Greater child self-reported perceived stress at baseline predicted greater increase in children's BMI across the six assessments whereas mother self-reported perceived stress at baseline was unrelated to change in child BMI. Baseline child BMI was unrelated to change in children or mothers' perceived stress across the six assessment waves.

CONCLUSION

Children's own perceptions of stress may play a larger contributing role in BMI progression during middle childhood than their mother's perceived stress levels. These findings underscore the importance of focusing on children's stress-coping strategies for promoting a healthy weight.

Amidst the COVID-19 pandemic childhood obesity is still an epidemic-spotlight on obesity's multifactorial determinants

PURPOSE

Childhood obesity is a global epidemic and a chronic disease. Multifactorial determinants have long been linked with childhood obesity. These have been challenged with the onset of COVID-19 and the associated mitigation measures. The study aimed to re-highlight these determinants while exploring the effects of the ongoing COVID-19 pandemic on these pre-existing childhood obesity determinants, while providing evidence that may be beneficial for the post-COVID-19 recovery plan.

METHODS

A PubMed literature search (2016-2021) using the keywords, "childhood obesity", "gender", "sex", "obesity in youth", "obesity in adolescents", "COVID-19″ and "SARS-CoV2" was performed.

RESULTS

Genetic predisposition, biologically low leptin levels, certain cultural beliefs and socio-economic statuses, as well as exposure to an "obesogenic" environment were found to have a positive association with childhood obesity. Additionally, the onset of COVID-19 further aggravates the childhood obesity epidemic, increasing childrens' susceptibility to obesity and all associated consequential diseases.

DISCUSSION

A possible key to the control and prevention of the burden of childhood obesity, lies in dealing with its precursors and risk factors. Certain factors, including socio-cultural norms, cultural beliefs and geographical factors are amenable. COVID-19 further challenged these and it is evident that the childhood obesity epidemic is still a critical one. Encouraging preventative interventions, such as screening programs, public awareness and policies targeting the environment, amongst others, are recommended.

Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities

Childhood obesity has become a global pandemic in developed countries, leading to a host of medical conditions that contribute to increased morbidity and premature death. The causes of obesity in childhood and adolescence are complex and multifaceted, presenting researchers and clinicians with myriad challenges in preventing and managing the problem. This article reviews the state of the science for understanding the etiology of childhood obesity, the preventive interventions and treatment options for overweight and obesity, and the medical complications and co-occurring psychological conditions that result from excess adiposity, such as hypertension, nonalcoholic fatty liver disease, and depression. Interventions across the developmental span, varying risk levels, and service contexts (e.g.,community, school, home, health care systems) are reviewed. Future directions for research are offered with an emphasis on translational issues for taking evidence-based interventions to scale in a manner that will reduce the public health burden of the childhood obesity pandemic.