Article

Risk factors for childhood overweight: A prospective study from birth to 9.5 years

Department of Pediatrics , Stanford University, Palo Alto, California, United States
Journal of Pediatrics (Impact Factor: 3.74). 08/2004; 145(1):20-5. DOI: 10.1016/j.jpeds.2004.03.023
Source: PubMed

ABSTRACT To ascertain risk factors for the development of overweight in children at 9.5 years of age.
This was a prospective study of 150 children from birth to 9.5 years of age, with assessment of multiple hypothesized risk factors drawn from research reports.
Five independent risk factors for childhood overweight were found. The strongest was parent overweight, which was mediated by child temperament. The remaining risk factors were low parent concerns about their child's thinness, persistent child tantrums over food, and less sleep time in childhood. Possible mechanisms by which each of these factors influence weight gain are outlined. Two different pathways to childhood overweight/obesity were found, depending on degree of parental overweight.
There is evidence of considerable interaction between parent and child characteristics in the development of overweight. Several of the identified risk factors are amenable to intervention possibly leading to the development of early prevention programs.

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    • "The causal development of childhood obesity is very complex (Agras, Hammer, McNicholas, & Kraemer, 2004; Kipping, Jago, & Lawlor, 2008; Snethen, Hewitt, & Goretzke, 2007). In this context, parental overweight in particular has been identified as a basic risk factor for childhood overweight (Agras et al., 2004; Kimbro, Brooks-Gunn, & McLanahan, 2007; Linabery et al., 2013). For example, if the child has an obese mother there is a 1.5 times higher probability of the child becoming overweight in the first three years of life compared to a child of a normal weight mother (Kimbro et al., 2007). "
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    ABSTRACT: Childhood obesity has become a rising health problem, and because parental obesity is a basic risk factor for childhood obesity, biological factors have been especially considered in the complex etiology. Aspects of the family interaction, e.g., mother–child attachment, have not been the main focus. Our study tried to fill this gap by investigating whether there is a difference between children of obese and normal weight mothers in terms of mother–child attachment, and whether mother–child attachment predicts child’s weight, in a sample of 31 obese and 31 normal weight mothers with children aged 19 to 58 months. Mother–child attachment was measured with the Attachment Q-Set. We found that (1) children of obese mothers showed a lower quality of mother–child attachment than children of normal weight mothers, which indicates that they are less likely to use their mothers as a secure base; (2) the attachment quality predicted child`s BMI percentile; and (3) the mother–child attachment adds incremental validity to the prediction of child’s BMI beyond biological parameters (child’s BMI birth percentile, BMI of the parents) and mother’s relationship status. Implications of our findings are discussed.
    Attachment & Human Development 07/2015; DOI:10.1080/14616734.2015.1067823 · 2.38 Impact Factor
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    • "Surprising was the lack of significant pre-to posttreatment differences between a 10-session Stage 3 clinic-only model compared with a Stage 1 intervention, given the greater number of treatment sessions, structure, and support of LAUNCH-clinic. Barriers to promoting healthy weight gain in early childhood include greater availability and accessibility of unhealthy compared with healthy food options within the home food environment (Wyse, Campbell, Nathan, & Wolfenden, 2011), child resistance to trying new foods (Osborne & Forestell, 2012), and child tantrums over food (Agras et al., 2004). We hypothesize that the in-person guidance and support that parents received from the home therapists' in removing high-calorie low-nutrient foods to improve the home food environment and generalization of clinic-taught child behavioral management strategies to the family's natural environment through modeling, behavioral rehearsal, and coaching of parents in reinforcing positive food choices and managing child resistance to trying new foods, were key to better weight outcomes among children in LAUNCH-HV compared with PC. "
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    ABSTRACT: Objective Tested two family-based behavioral treatments for obesity in preschool children, one meeting the Expert Committee guidelines for Stage 3 obesity intervention criteria (LAUNCH-clinic) and one exceeding Stage 3 (LAUNCH with home visit [LAUNCH-HV]), compared with a Stage 1 intervention, pediatrician counseling (PC). Methods In all, 42 children aged 2–5 years with a body mass index (BMI) percentile of ≥95th were randomized. A total of 33 met intent-to-treat criteria. Assessments were conducted at baseline, Month 6 (posttreatment), and Month 12 (6-month follow-up). Results LAUNCH-HV demonstrated a significantly greater decrease on the primary outcome of change in BMI z-score (BMIz) pre- to posttreatment compared with PC (p = .007), whereas LAUNCH-clinic was not significantly different from PC (p = .08). Similar results were found for secondary outcomes. Conclusions LAUNCH-HV, but not LAUNCH-clinic, significantly reduced BMIz compared with PC by posttreatment, indicating the need for intensive behavioral intervention, including home visitation, to address weight management in obese preschool children.
    Journal of Pediatric Psychology 07/2014; 39(9). DOI:10.1093/jpepsy/jsu059 · 2.91 Impact Factor
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    • "Our data are similar to those reported in New Zealand children, in which the average amount of sleep was 11 hours (Carter et al., 2011). Both high TV exposure and short sleep duration individually have been linked with obesity, even in young children (Agras et al., 2004; Jago et al., 2005; Jiang et al., 2009). Further, short sleep duration (59 hours) was independently associated with hypertension among Chinese boys age 11–14 years old (Guo et al., 2011); in pre-school ages the data so far showed that total ST was correlated with SBP (Sampei et al., 2006), as found in our study. "
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    ABSTRACT: Abstract Aim: The aim of this study was to examine the association between sleeping time (SLT), time spent using screen (ST) and weight status with Systolic Blood Pressure (SBP) among pre-school children. Subjects and methods: The sample comprised 628 pre-school children (50% female), aged 3-6 years-old. SLT and ST were reported by parents. BMI values were categorized according to IOTF. SBP cut points were based on SBP percentiles for age, sex and height. ST was dichotomized according to the following criteria: ≤1 hour vs >1 hour and SLT: ≤10.5 hours vs >10.5 hours. Participants were then categorized into one of four category profiles: Low ST/High SLT; High ST/Low SLT; Low ST/Low SLT and High ST/High SLT. Results: Children assigned to the High ST/Low SLT group were 2-times more likely to have high SBP values compared to those who were assigned to the Low ST/High SLT group (OR = 2.4; 95% CI = 1.1-5.1). Furthermore, those who were assigned as overweight and obese were more likely to be classified as having elevated BP (OR = 1.8; 95% CI = 1.1-3.2 for overweight and OR = 3.1; 95% CI = 1.6-5.8 for obese, respectively). Conclusion: The data showed that high ST exposure time and low SLT are associated with enhanced blood pressure in children at pre-school.
    Annals of Human Biology 05/2014; 41(6):1-5. DOI:10.3109/03014460.2014.909884 · 1.15 Impact Factor
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