Article

Obesity in Preschoolers: Behavioral Correlates and Directions for Treatment

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Obesity (Impact Factor: 4.39). 07/2011; 20(1):3-29. DOI: 10.1038/oby.2011.201
Source: PubMed

ABSTRACT Nearly 14% of American preschoolers (ages 2-5) are obese (BMI ≥ 95th percentile for age and gender), yet this group has received little attention in the obesity intervention literature. This review examines what is known about behavioral correlates of obesity in preschoolers and the developmental context for lifestyle modification in this age group. Information was used to critically evaluate existing weight management prevention and intervention programs for preschoolers and formulate suggestions for future intervention research development. A systematic search of the medical and psychological/behavioral literatures was conducted with no date restrictions, using PubMed, PsycInfo, and MEDLINE electronic databases and bibliographies of relevant manuscripts. Evidence suggests several modifiable behaviors, such as sugar sweetened beverage intake, television use, and inadequate sleep, may differentiate obese and healthy weight preschoolers. Developmental barriers, such as food neophobia, food preferences, and tantrums challenge caregiver efforts to modify preschoolers' diet and activity and parental feeding approaches, and family routines appear related to the negative eating and activity patterns observed in obese preschoolers. Prevention programs yield modest success in slowing weight gain, but their effect on already obese preschoolers is unclear. Multi-component, family-based, behavioral interventions show initial promise in positive weight management for already obese preschoolers. Given that obesity intervention research for preschoolers is in its infancy, and the multitude of modifiable behavioral correlates for obesity in this age group, we discuss the use of an innovative and efficient research paradigm (Multiphase Optimization Strategy; MOST) to develop an optimized intervention that includes only treatment components that are found to empirically reduce obesity in preschoolers.

Full-text

Available from: Lori J Stark, Nov 08, 2014
0 Followers
 · 
123 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examined whether young children include eating in their cognitive scripts for various events, and whether food-related scripts are associated with body mass index (BMI) percentile. Data were collected in a structured interview format. Participants, recruited from area preschools and day cares, provided a four-activity sequence for each of three events, and responses were recorded verbatim. Forty-four children (45% female) participated, with an average BMI percentile of 73.3% (SD = 25.9). Data were binarily coded to indicate whether each response was food-related. Frequencies were obtained, and responses were correlated with BMI percentile. Over 22% of the activities in the children's scripts involved food. The number of food-related activities reported was positively correlated with children's BMI percentile (r = 0.53, p = 0.03). Results provide preliminary evidence that food features prominently in young children's event scripts and that children with higher BMI percentiles may possess scripts that feature more food-related themes. Future researchers should investigate the causal nature of this relationship. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Appetite 11/2014; 85C:66-69. DOI:10.1016/j.appet.2014.11.013 · 2.52 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to investigate Korean preschoolers' obesity-related factors through an ecological approach and to identify Korean preschoolers' obesity-related factors and the different effects of ecological variables on body mass index and its quantiles through an ecological approach. The study design was cross-sectional. Through convenience sampling, 241 cases were collected from three kindergartens and seven nurseries in the Seoul metropolitan area and Kyunggi Province in April 2013 using self-administered questionnaires from preschoolers' mothers and homeroom teachers. Results of ordinary least square regression analysis show that mother's sedentary behavior (p < .001), sedentary behavior parenting (p = .039), healthy eating parenting (p = .027), physical activity-related social capital (p = .029) were significant factors of preschoolers' body mass index. While in the 5% body mass index distribution group, gender (p = .031), preference for physical activity (p = .015), mother's sedentary behavior parenting (p = .032), healthy eating parenting (p = .005), and teacher's sedentary behavior (p = .037) showed significant influences. In the 25% group, the effects of gender and preference for physical activity were no longer significant. In the 75% and 95% group, only mother's sedentary behavior showed a statistically significant influence (p < .001, p = .012 respectively). Efforts to lower the obesity rate of preschoolers should focus on their environment, especially on the sedentary behavior of mothers, as mothers are the main nurturers of this age group. Copyright © 2014. Published by Elsevier B.V.
    Asian Nursing Research 11/2014; 8(4). DOI:10.1016/j.anr.2014.07.005 · 0.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In this study, we investigated the interplay between screen time, sleep duration, outdoor play, having a television in the bedroom and the number of televisions at home and their association with body mass index (BMI) in preschool children. All participants, 3-4 years of age (n = 759), were part of the Groningen expert center for kids with obesity (GECKO) Drenthe birth cohort. Weight and height were measured. Total screen time, number of televisions at home, a television in the bedroom, sleep duration and time of outdoor play were self-reported by parents in a questionnaire. Ordinary least square (OLS) regression-based path analysis was used to estimate direct and indirect effects on BMI in mediation models. A television in the bedroom or more televisions at home gave a higher screen time, which were associated with decreased sleep duration and resulted in higher BMI (indirect effect = 0.0115, 95 % bootstrap interval = 0.0016; 0.0368 and indirect effect = 0.0026, 95 % bootstrap interval = 0.0004; 0.0078, respectively). In contrast to the direct effect of screen time, sleep duration and a television in the bedroom on BMI, no direct effect was found for outdoor play and number or televisions at home on BMI. Conclusions: Short sleep duration, long screen time and a television in the bedroom were associated with the presence of overweight in preschool children.
    European Journal of Pediatrics 11/2014; 174(5). DOI:10.1007/s00431-014-2443-y · 1.98 Impact Factor