Overweight/Obesity Among Preschoolers Is Associated with Caregiver Overweight/Obesity, Not with Neophobia

Abstract

Abstract Objectives Overweight/obesity (OO) among preschoolers is a major public health issue that has been linked to many factors. Food neophobia is an important factor in children's diet but has inconsistent associations with obesity. Intersectionality affects the outcome of any childhood events. This study examines: 1) direct association of FN and preschooler OO, 2) whether FN moderates or mediates the caregiver OO-preschooler OO association, and 3) intersectionality of sex and race and preschooler OO. Methods Baseline data were gathered from 52 childcare centers participating in a randomized controlled trial to promote healthy dietary habits. The sample included 500 preschoolers and caregivers. Children were weighed and measured; we calculated body mass index percentile (BMIp) and categorized them as OO vs. healthy based on CDC criteria. Caregivers reported their weight, family demographics, and completed the 2-item Household Food Security Scale and the Child Food Neophobia Scale. Logistic Mixed Models (LMM) were used with childcare centers as random effects, adjusting for child age, sex, race, and sociodemographic. Model 1 examined the association between FN and OO. Model 2 added the caregiver OO*FN interaction, and Model 3 examined FN as a mediator in the caregiver OO-preschooler OO association. Model 4 tested the sex*race interaction with preschooler OO. Results Children's mean age was 48 months (SD = 7.5), 55% boys, and 25.4% OO. Caregiver mean age was 36 years (SD = 5.7), 90% women, 67% educated at bachelor's or higher, 84% employed full-time, 13% food insecure, and 58% OO. In multivariable LMM, compared to normal weight, overweight and obese caregivers were 2.6 (95% CI: 1.6–4.3) and 3.9 (95% CI: 2.1–7.3) times, respectively, more likely to have OO child. FN was not associated with preschoolers’ OO directly or through moderation or mediation. The intersectionality of child race and sex was significant (P = 0.01) in predicting child obesity. Non-White girls had the highest mean BMIp, 69.3. Conclusions OO among preschoolers and caregivers was related. FN was not associated with preschooler OO either directly or indirectly. Research into the mechanisms linking caregiver and preschooler OO is needed. The elevated BMIp among non-white preschool girls calls for research focused on this population. Funding Sources National Institute Diabetes and Digestive and Kidney Diseases.