Parental Weight Status Research Articles

Multi-level influences on childhood obesity in Sweden: societal factors, parental determinants and child’s lifestyle

Swedish school children living in rural areas and in areas with low education are at excess risk of becoming overweight. This study examines influences of societal and individual characteristics (children and their parents) on prevalence of overweight and obesity, in a national sample of 7-9-year-old children. Anthropometric and lifestyle data were collected in a nationally representative sample of 3636 Swedish children. Overweight and obesity (International Obesity Task Force (IOTF)) data were analyzed in relation to lifestyle factors, parental weight, education and breast-feeding. The prevalence of overweight was 15.6% including 2.6% obese. Urbanization level and parental characteristics (weight status and education) were related to risk of overweight. Overall less favorable lifestyle characteristics were observed in rural areas and for children of low/medium educated mothers. Boys had greater risk of obesity in semi-urban and rural areas but this was not true for girls. For children's overweight, the living area effect was attenuated in multivariate analysis, while there was an association with origin of parents, high parental weight and medium maternal education. For obesity, the living area effect remained in boys while having two non-Nordic parents predicted obesity in girls. Parental weight status was associated with obesity in both girls and boys. Individual and societal factors influence children's weight status, and parental weight status is a strong determinant. Including overweight and obese parents in future health promoting interventions could be a strategy to prevent children from becoming overweight, but identifying those parents may prove difficult. To ensure reaching children with the greatest needs, targeting high risk areas might be a more effective approach.

Familial determinants of body mass index in Colombian 5–18 year old children

Family socioeconomic status (SES), structure, and parental behaviors have been identified as important determinants of children's body mass index (BMI) in developed countries; however the role of these factors in other settings is not clear. We examined the role of family and household characteristics on BMI among 4,484 children 5 to 18 years measured in the 2005 Colombian Nutrition Survey 2005. We used 2‐ level hierarchical linear models with family as level 2, child as level 1, and BMI (continuous) as outcome. The family level explained 20% of variability in BMI. SES (difference 0.4 kg/m2in highest WI quintile vs. lowest), and caregiver education (0.02 kg/m2 per year of schooling) and overweight (0.5 kg/m2vs. normal) and obesity (1.3 kg/m2vs. normal) were positively associated with child BMI (all p<0.01). While living in an extended family was associated with 0.3 kg/m2increase in BMI, the number of family members was inversely associated with BMI (−0.1 kg/m2 per member). The association between parental weight status and child BMI is similar to that described in developed countries; however, the positive relationship between SES (WI and education) and BMI differs from developed country settings. This study identified important family and household predictors of BMI in Colombian children.

Associations Among Parent Acculturation, Child BMI, and Child Fruit and Vegetable Consumption in a Hispanic Sample

The objective of this study was to investigate the association of parent acculturation with child fruit and vegetable consumption and obesity, as measured by body mass index (BMI). Participants included 250 Mexican-American and other Hispanic families living within San Diego County. Height and weight measurements were collected to calculate the age- and sex-specific BMI for each child and parent, and parents completed self-administered surveys. Child BMI z-score was significantly related to parent BMI after controlling for parent acculturation and parent birth place (β = 0.05, p < 0.01). Child fruit consumption was significantly associated with parent acculturation (β = -0.02, p = 0.01) and parent BMI (β = 0.02, p = 0.04) after adjusting for the other variables in the model. Child vegetable consumption was not significantly related to parent acculturation. Findings suggest that parental weight status may be more predictive of child obesity than acculturation, and highlight the need to examine culturally relevant behavioral and psychosocial factors related to childhood obesity and dietary behaviors.

American Indian Parents’ Assessment of and Concern About Their Kindergarten Child’s Weight Status, South Dakota, 2005-2006

Obesity is highly prevalent among American Indians, and effective prevention efforts require caregiver involvement. We examined American Indian (AI) parents' assessment of and level of concern about their kindergarten child's weight status. We collected baseline data (fall of 2005 and fall of 2006) on children and their parents or caregivers for a school-based obesity prevention trial (Bright Start) on an AI reservation in South Dakota. The current study uses 413 parent-child pairs. Age- and sex-adjusted body mass index percentiles were categorized as very underweight (<5th percentile), slightly underweight (5th to <15th percentile), normal weight (15th to <85th percentile), overweight (85th to <95th percentile), and obese (≥ 95th percentile). Parents or caregivers reported their assessment of and concerns about their child's weight status as well as sociodemographic characteristics. We used mixed-model multivariable analysis to examine associations between sociodemographic characteristics and the probability of parents underclassifying or overclassifying their child's weight status; analyses were adjusted for school as a random effect. Children were evenly divided by sex and had a mean age of 5.8 years. Twenty-nine percent of children and 86% of parents were overweight or obese. Approximately 33% (n = 138) of parents underclassified and 7% (n = 29) of parents overclassified their child's weight status. Higher parental weight status and higher concern about their child's weight status increased the probability of underclassification (P for trend = .02 for both). In this sample of at-risk children, one-third of parents underclassified their child's weight status. Childhood obesity prevention programs need to increase awareness and recognition of childhood obesity and address parental weight issues.

Feeding a Family in a Recession: Food Insecurity Among Minnesota Parents

We assessed current levels of food insecurity among a large, diverse sample of parents and examined associations between food insecurity and parental weight status, eating patterns, and the home food environment. Project F-EAT (Families and Eating and Activity Among Teens) examined the home food environments of adolescents. Parents and caregivers (n = 2095) living with adolescents from the Minneapolis-St. Paul, Minnesota school districts completed mailed surveys during a 12-month period in 2009-2010. We performed our assessments using multivariate regressions. Almost 39% of the parents and caregivers experienced household food insecurity, whereas 13% experienced very low food security. Food insecurity was significantly associated with poorer nutrition-related variables such as higher rates of parental overweight and obesity, less healthy foods served at meals, and higher rates of binge eating. Food-insecure parents were 2 to 4 times more likely to report barriers to accessing fruits and vegetables. Food insecurity was highly prevalent. Environmental interventions are needed to protect vulnerable families against food insecurity and to improve access to affordable, healthy foods.

Stressed Out and Overcommitted! The Relationships Between Time Demands and Family Rules and Parents’ and Their Child’s Weight Status

This study aimed to determine the relationship between parent time demands and presence and enforcement of family rules and parent/child dyad weight status. In dyads of one child/parent per family (N = 681 dyads) in Twin Cities, Minnesota, 2007-2008, height and weight were measured, and a survey of demographics, time demands, and family rules-related questions was taken. Parent/child dyads were classified into four healthy weight/overweight categories. Multivariate linear associations were analyzed with SAS, testing for interaction by work status and family composition (p < .10). In adjusted models, lack of family rules and difficulty with rule enforcement were statistically lower in dyads in which the parent or child was healthy weight compared with dyads in which the parent and child were both overweight (difference in family rules scores = 0.49, p = .03; difference in rule enforcement scores = 1.09, p ≤ .01). Of parents who worked full-time, healthy weight dyads reported lower time demands than other dyads (difference in time demands scores = 1.44, p = .01). Family experiences of time demands and use of family rules are related to the weight status of parents and children within families.

Predictors of Maternal Perceptions of Their Offspring’s Weight Status:Evidence from a Birth Cohort Study

We examined the predictors of maternal perceptions on their adolescent offspring’s weight status. A mother-child linked analysis was carried out using 14 years follow-up data from a population-based prospective birth cohort of 3721 children (52% males) who born in Brisbane, Australia, between 1981 and 1983. Maternal perception of offspring weight was reported when the offspring were 14 years old and predictors were prospectively. We found that mothers perceived their adolescents’ sons were more underweight and less overweight than their daughters. The independent predictors of maternal perceptions of child overweight status were gender, maternal perceived child dissatisfaction of appearance, shape, size and weight, adolescent dieting to lose weight, their general health status, sports and maternal BMI. Mainly two factors- child health and dieting predict maternal perception of offspring underweight. This study found more child factors than family or maternal factors predict maternal perceptions of their offspring weight status. The finding that child factors are related to maternal perception should be helpful to clinicians as it suggests understanding adolescent and maternal perceptions of weight will best be achieved by a focus on current adolescent body image, dieting, behavioural problems, and parental weight status.

Parental Weight (Mis)Perceptions: Factors Influencing Parents’ Ability to Correctly Categorise Their Child’s Weight Status

This study investigates parents' ability to correctly classify their child's weight status. The influence of parent and child socio-demographic and lifestyle factors on parental misclassification of their child's weight status is explored. A representative sample of Irish children (aged 5-12 (n = 596) years, aged 13-17 years (n = 441)) and their parents (n = 1885) were recruited to participate in a national dietary survey. Parental perceptions of their child's weight and their own weight were measured. Anthropometric measurements (weight and height) were objectively measured for parents and children. Body Mass Index (BMI) scores were derived and categorised as normal, overweight or obese using standard references. Over 80% of parents of overweight boys and 79.3% of parents of overweight girls reported their child's weight was fine for his/her height and age. Furthermore, 44.4% of parents of obese boys and 45.3% of parents of obese girls felt their child's weight was fine for their height and age. Parents were significantly less likely to be correct about their sons' weight status and more likely to be correct the older the child. Parents were over 86% less likely to be correct about their child's weight if their child was overweight and approximately 59% less likely to be correct if the child was obese, compared to parents of normal weight children. This research suggests that parents are failing to recognise overweight and obesity in their children with factors such as parental weight status, child's age and gender influencing this.

Children’s weight status and maternal and paternal feeding practices

Child obesity has become a major concern of health researchers. This study explores the association between parental feeding practices and children's weight status. The study also examines whether maternal and paternal feeding practices lead to significantly different children's weight outcomes. By analyzing samples of 312 children (aged 9-11 and 13-15) and their parents, randomly selected from the Houston Metropolitan Statistical Area, the results show that parental feeding practices are linked to children's weight status. The finding that maternal and paternal feeding practices do not have significantly different effects on children's weight highlights an equivalent role of maternal and paternal feeding practices in shaping children's weight status.

Preventing and treating childhood obesity: time to target fathers

To examine the long-term effects of having one overweight or obese parent on child weight status and determine whether these effects vary according to parent sex. Prospective study: Longitudinal Study of Australian Children (LSAC). Two-parent families (N=3285) from the LSAC were included if height and weight data were available for both parents and their child at the 2004 and 2008 time points. Child weight status category (healthy, overweight, obese) in 2008 when the child was aged 8-9 years. Regression modelling was used to investigate how self-reported parent weight status in 2004 influenced measured child weight status 4 years later. Parent body mass index (BMI) was significantly correlated with child BMI, but there was no evidence of sex-specific associations between parent and child BMI correlations. The results from the regression analysis showed that having an overweight or obese father, but a healthy weight mother, significantly increased the odds of child obesity (odds ratio: 4.18, 95% confidence interval (CI): 1.01-17.33 and odds ratio: 14.88, 95% CI: 2.61-84.77, respectively), but the reverse scenario (overweight or obese mother with a healthy weight father) was not a significant predictor of child overweight or obesity (odds ratio: 2.52, 95% CI: 0.38-16.71 and odds ratio: 2.56, 95% CI: 0.31-21.26, respectively). Children with overweight or obese fathers are at a higher risk of becoming obese. This suggests that interventions are urgently required to test the efficacy of treating overweight fathers as a key strategy for childhood obesity prevention and/or treatment.

Health Measures and Diet in Mexican American Adolescents in Chicago

Recent trends in health patterns place Mexican American (MA) youth at risk for future problems. The purpose of this study was to describe the prevalence of risk factors for chronic disease, characterize nutrient intake, and explore their relationships in MA adolescents. A total of 50 adolescent-parent pairs were recruited from a predominantly MA high school in Chicago. Student data included information on glucose, lipids, blood pressure, anthropometrics, and diet recalls. Family history and anthropometric measures were obtained from a parent. Prevalence of overweight (OW) and obesity were 18% and 26%, respectively. Body mass index was positively associated with systolic blood pressure, LDL, waist circumference, and parental weight status and inversely related to intake of calories, carbohydrate, folate, grains, and the healthy eating index. Prevalence of undesirable fasting glucose was 28%, undesirable total cholesterol was 33%, undesirable LDL was 22%, and undesirable HDL was 24.5%. The metabolic syndrome was more prevalent in men than women. All correlations noted are significant (P &lt; .05).

Influence de la générosité parentale et contrôle alimentaire sur l'obésité pédiatrique

Résumé Cette étude utilise l’économie expérimentale pour mesurer l’effet de la générosité parentale et la réponse de l’enfant surèobésité pédiatrique. L’expérience consiste en un système d’incitation de type « carotte-bâton », dans une variante du jeu du dictateur dans laquelle le répondant (l’enfant) peut punir ou récompenser le dictateur (le parent) en fonction de la générosité du dictateur. Deux traitements ont été conduits dans lesquels l’enfant a dépensé sa dotation en biens alimentaires ou non alimentaires. Notre étude expérimentale met en évidence des rapports significatifs entre l’obésité des parents et leur niveau de générosité quant aux aliments. Nous concluons que le comportement de réponse de l’enfant, les facteurs de prédisposition à l’obésité dans la famille et la tendance de l’enfant au surpoids ou à l’obésité, sont significativement liés.

The Intergenerational Transmission of Thinness

To examine intergenerational associations for thinness and to compare maternal and paternal effects. Population-based, cross-sectional design using data from the Health Survey for England from January 1, 2001, through December 31, 2006. The Health Survey for England, an annual, national survey representative of the population living in private households in England. Families with children and adolescents aged 2 to 15 years with anthropometric data available for children and adolescents and 2 parents (N = 4423 families, N = 7078 children and adolescents). Trained interviewers collected height and weight measurements. Child/adolescent thinness, categorized using International Obesity Task Force criteria. Of 7078 children and adolescents, 402 (5.7%) were categorized as being thin. Thinness was more common in 2- to 5-year-olds (odds ratio, 1.61; 95% confidence interval, 1.22-2.13) than in 11- to 15-year-olds and in children and adolescents from ethnic minority (black: 2.28; 1.22-4.26; and Asian: 3.65; 2.76-4.83) than white backgrounds, but no differences were observed by sex or socioeconomic status. The strongest predictor of child/adolescent thinness was parental weight status. The prevalence of thinness was highest (16.2%) when both parents were thinner and progressively lower when both parents were in the upper half of the healthy-weight range (7.8%) or were overweight (5.3%) or obese (2.5%), with no differences in the magnitude of maternal and paternal influences. These results are consistent with the idea that many cases of thinness are likely to represent the low end of the healthy distribution of weight and, as such, are likely to have a primarily genetic origin.

Eating behaviour and its association with social living conditions and weight status among adolescent girls: results of the cross-sectional Berlin School Children's Cohort study

To capture a more holistic picture of eating behaviour by investigating the impact of the social living conditions and weight status of parents and daughters on food consumption frequency, the context of meals and daily portion sizes. Cross-sectional Berlin School Children's Cohort study. A total of sixty-nine schools in Berlin (3 400 000 inhabitants, eastern Germany) participated in the present study. A total of 1519 girls aged 11-14 years were selected. Bi- and multivariate analyses were performed to examine the impact of age, migration background, socio-economic status (SES), parental education, family situation and the weight status of parents and daughters on three different eating behaviour scores according to nutritional recommendations. For the three dependent eating behaviour variables, different patterns of influencing factors emerged. Multivariate regression (model 1) revealed that low and middle SES, two-parent migration background and older age were significant risk factors. Meal context was also significantly influenced by living with a single parent. Similar results were obtained for the daily portion size scores and maternal overweight status was the most influential. Model 2 succeeded in showing that, within the composite variable of family SES, mothers' level of education was the dominant component. SES as a whole, and especially the component of mothers' level of education and two-parent migration background, was the strongest risk factor for an unfavourable eating pattern among adolescent girls. The results clearly indicated preventive potential. Using three different measures of eating behaviour simultaneously provided an in-depth understanding of general patterns and potential risk factors.

Home food availability, dietary intake and child weight status

Background The home is a primary food environment for children. Therefore, it is important to study how home food availability (HFA) may influence dietary intake and weight status. Objective This study examined HFA of fruits, vegetables, and milk and its association with children's weight status and dietary intake of these foods. Methods This was a cross-sectional study based on surveys from 489 students in grades 3–12 and their parents in 2009. Descriptive statistics were conducted and multiple linear regression was used to ascertain if a relationship existed between HFA, child weight status, and dietary intake of fruits, vegetables, and milk. Results Overall, 12.5% of participants were overweight and 6.7% were obese. About 26% of participants reported that they consumed 5 or more servings of fruits and vegetables per day and 17% consumed 3 or more glasses of milk per day. No relationship was found between HFA of fruits, vegetables, and milk and reported intake of these foods. Although a significant association was found between parent and child weight status, no association was found between HFA and child weight status. Conclusions Although the home is a primary food environment for children, this study did not find an association between HFA, weight status, and dietary intake. In addition to HFA, future research should include measures of foods eaten away from home, such as at school or in restaurants. Grant Funding Source: USDA National Research Initiative Grant 55215-18799

178 - The effect of growth between zero and two years of age on cardiometabolic risk factors at eight to10 years: Is there a modifying influence of parental metabolic syndrome and parental weight status?

178 - The effect of growth between zero and two years of age on cardiometabolic risk factors at eight to10 years: Is there a modifying influence of parental metabolic syndrome and parental weight status?

Examining the Relationships Between Family Meal Practices, Family Stressors, and the Weight of Youth in the Family

Research is limited on how the social environment of the home is related to childhood obesity. The purpose of this research was to examine the relationships between positive family meal practices, family stressors, and the weight of youth and to examine parental weight status as a moderator of these relationships. The study enrolled 368 parent/child dyads from a Minnesota sample. We used mediation analysis to examine the associations Families represented by an overweight parent reported fewer positive family meal practices (p < 0.001), higher levels of depression (p = 0.01), and fewer family rules (p = 0.02) as compared to families represented by a healthy weight parent. For overweight parents, positive family meal practices mediated the relationship between some family stressors and child weight. This research suggests that the home environment may affect the weight of children in the family, and the effect is more pronounced in families with at least one overweight parent.

Longer Breastfeeding Is Associated with Increased Lower Body Explosive Strength during Adolescence

Our aim in this study was to examine the association between breastfeeding duration and cardiorespiratory fitness, isometric strength, and explosive strength during adolescence. A total of 2567 adolescents (1426 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study aged 12.5–17.5 y were included. Information about duration of any and exclusive breastfeeding was obtained retrospectively by means of a parental questionnaire. The 20-m shuttle run, handgrip strength, and standing long jump tests were used to assess physical fitness. Significant differences among the categories of breastfeeding duration were tested using ANCOVA after adjusting for a set of potential confounders: gestational and current age, birth weight, sexual maturation, fat mass, fat-free mass, maternal education, parental weight status, country, smoking behavior, and days of vigorous physical activity. Longer breastfeeding (either any or exclusive) was associated with a higher performance in the standing long jump test in both boys and girls (P < 0.001), regardless of fat mass, fat-free mass, and the rest of potential confounders. In adolescents who were breastfed for 3–5 mo or ≥6 mo, the risk of having a standing long jump performance below the 5th percentile was reduced by half compared with those who were never breastfed [odds ratio (OR) = 0.54, 95% CI = 0.30–0.96, P < 0.05; and OR = 0.40, 95% CI = 0.22–0.74, P < 0.01, respectively). These findings suggest a role of breastfeeding in determining lower body explosive strength during adolescence.

Comparing maternal and paternal intergenerational transmission of obesity risk in a large population-based sample

Previous research showed childhood obesity to be more strongly associated with maternal weight than with paternal weight. However, confidence in this finding is limited by the lack of objectively measured data from both parents. We quantified the individual and combined effects of maternal and paternal overweight/obesity on obesity risk in children. Data were pooled from the annual Health Surveys for England carried out between 2001 and 2006. Families with < or =2 children aged 2-15 y with anthropometric data available for both parents and children were included (n = 4432 families, n = 7078 children). Weights and heights were measured by a trained nurse. Having 2 overweight parents was associated with an increased risk of child obesity [odds ratio (OR): 2.2; 95% CI: 1.3, 3.7; P < 0.001] compared with having 2 normal-weight parents. Having 2 obese (including severely obese) parents was associated with a higher risk of child obesity (OR: 12.0; 95% CI: 7.2, 20.1; P < 0.01), and having 2 severely obese parents was associated with an even higher risk of child obesity (OR: 22.3; 95% CI: 10.3, 48.4; P < 0.01) independent of age, sex, socioeconomic status, and ethnicity. Mother-child associations (r = 0.27) for body mass index were significantly stronger than father-child associations (r = 0.23), even after adjustment for plausible levels (< or =4%) of undisclosed nonpaternity. Associations were the same for sons and daughters but increased with age. There is a strong and graded association between parental weight status and risk of childhood obesity, which is significantly stronger for maternal weight. Parental obesity could be used to target preventive interventions in the preschool years to avoid serious adverse effects on the future health of children.

Relationships between child, parent and community characteristics and weight status among young children

To examine the relationship between weight status and child, parent and community characteristics among young boys and girls. Cross-sectional data were collected from 1 299 5-7-year-old children and their parents from 20 government primary schools in New South Wales, Australia. Measures included parental report of time spent in physical and sedentary activities, time spent with parents, parental working hours, parental perceptions of their child's physical competence and children's actual physical competence. Overweight boys spent more time watching television (p = 0.001 for weekday) and in quiet play (p = 0.007 for weekdays and p = 0.006 for weekends) and less time away from their parents (p = 0.01) than their lean counterparts. Parents of overweight boys perceived them to be less competent in the skill of running than parents of non-overweight boys (p = 0.001). Overweight girls spent more time watching television on weekends compared with their non-overweight peers (p = 0.008), and were less proficient in overall actual competence (p = 0.008), particularly overall locomotor skill proficiency (p = 0.001). Several modifiable relationships between weight status and child, parental and community characteristics were identified. Importantly these relationships differed between boys and girls. We suggest that early school years may be an appropriate time to intervene through targeting the identified characteristics.