Child behaviour and subsequent changes in body weight, composition and shape.

Sidse G. Nielsen,Berit L. Heitmann,Sarah E. Jackson,Christine Dalgård,Nanna J. Olsen,Katrine G. Christensen,Sofus C. Larsen

doi:10.1371/journal.pone.0226003

Abstract

ObjectiveStudies have found an association between child behavioural problems and overweight, but the existing evidence for this relationship is inconsistent, and results from longitudinal studies are sparse. Thus, we examined the association between behavioural problems and subsequent changes in body mass index (BMI) and anthropometry over a follow-up period of 1.3 years among children aged 2–6 years.DesignThe study was based on a total of 345 children from The Healthy Start Study; all children were healthy weight but predisposed to develop overweight. The Danish version of the Strengths and Difficulties Questionnaire (SDQ), classified as SDQ Total Difficulties (SDQ-TD) and SDQ Prosocial Behaviour (SDQ-PSB), was used to assess child behaviour. Linear regression analyses were used to examine associations between SDQ scores and subsequent change in BMI z-score, body fat percentage, waist circumference and waist-hip ratio, while taking possible confounding factors into account.ResultsWe found an association between SDQ-PSB and subsequent change in BMI z-score (β: 0.040 [95% CI: 0.010; 0.071, p = 0.009]). However, there was no evidence of an association between SDQ-PSB and measures of body composition or body shape.ConclusionsAmong 2 to 6 years old children predisposed to overweight, the association between SDQ-scores and weight gain is either absent or marginal. The SDQ-PSB score may be associated with subsequent increases in BMI z-score, but this association does not seem driven by an increased relative fat accumulation.

Highlights

Overweight in childhood is a strong independent risk factor for overweight and obesity in adulthood, which can lead to mental health problems, lifestyle diseases and premature death [1–3]
We found an association between Strengths and Difficulties Questionnaire (SDQ)-PSB and subsequent change in body mass index (BMI) z-score (β: 0.040 [95% CI: 0.010; 0.071, p = 0.009])
The SDQ Prosocial Behaviour (SDQ-PSB) score may be associated with subsequent increases in BMI z-score, but this association does not seem driven by an increased relative fat accumulation

Summary

Introduction

Overweight in childhood is a strong independent risk factor for overweight and obesity in adulthood, which can lead to mental health problems, lifestyle diseases and premature death [1–3]. A possible association between the SDQ and body weight has been suggested in several studies. Cross-sectional studies have found a direct association between peer problems and overweight or obesity in children aged 5–6 and 12–18 years [8–10]. Among children aged 2–6 years from the Healthy Start Study, we previously found higher body mass index (BMI) z-scores among those children with behavioural difficulties above the 90th percentile [11]. Sawyer et al found that children with overweight aged 4–5 years had slightly higher rates of mental health problems than children with normal weight [12]. Tiffin et al found an association between obesity and externalizing and internalizing behaviour [13] These studies suggest an association between SDQ and body weight, a direction of the association could not be established as all studies were cross sectional

Methods

Discussion

Conclusion