Overweight in Childhood: The Role of Resilient Parenting in African-American Households

Abstract

Some low-income minority children in the U.S. remain at normal weight throughout their childhood despite high risk of obesity. This study examined whether resilient caregiving accounted for children's healthy weight maintenance and dietary compliance over a 4-year period among poverty-stricken African-American families. A representative sample of 317 African-American caregiver-children (aged 3-5 years) pairs from low-income areas of Detroit MI was examined in 2002-2003 with a follow-up assessment in 2007. Capacity for resilience among caregivers was defined using five individual and environmental protective factors. A BMI score for the children was computed from recorded height and weight, and converted into one of three categories (normal weight, overweight, obese) using age- and gender-specific national references. Dietary information was collected using the Block Food Frequency Questionnaire (FFQ) and Block Kids FFQ. Data were analyzed in 2010 to test whether children's weight transition and dietary compliance varied according to their caregivers' capacity for resilience. In all, 95 caregivers (29%) were identified as having capacity for resilience. They were younger, had higher levels of educational attainment, and had lower levels of daily soda consumption. The children of these caregivers had a lower likelihood of remaining overweight or obese than being of normal weight (relative risk ratio=0.5, 95% CI=0.2, 0.9) and had persistently lower soda consumption over 4 years compared with other children. This finding demonstrates that some caregivers positively influence children's health weight management and dietary compliance despite material deprivation. Interventions to initiate and promote resilient caregiving could benefit the health and health-related behaviors of low-income African-American children.