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Influence of the home environment on the development of obesity in children
1Division of Pediatric Gastroenterology and Nutrition, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson School of Medicine, New Brunswick, New Jersey 08903, USA. strausrs@rwja.umdnj.edu
Insights
Maternal obesity, low family income, and reduced cognitive stimulation are key predictors of childhood obesity. These factors significantly increase a child's risk, independent of other socioeconomic influences.
Area of Science:
- Pediatrics
- Public Health
- Child Development
Background:
- Childhood obesity is a prevalent health issue, with significant percentages of children being overweight or obese.
- Understanding the environmental and socioeconomic determinants of childhood obesity is crucial for effective prevention strategies.
Purpose of the Study:
- To prospectively examine the association between home environment and socioeconomic factors with the development of childhood obesity.
- To identify key predictors of obesity in children aged 0-8 years.
Main Methods:
- A prospective cohort study involving 2913 normal-weight children followed for 6 years.
- Data collected included maternal obesity, socioeconomic status (income, education, occupation), and home environment measures (HOME-Short Form).
- Obesity was defined as a body mass index (BMI) above the 95th percentile for age and gender at follow-up.
Main Results:
- Maternal obesity was the strongest predictor of childhood obesity (OR: 3.62).
- Lower cognitive stimulation scores (HOME-Short Form) and lower family income were also significant predictors.
- After controlling for covariates, cognitive stimulation and family income remained significant predictors of obesity development.
Conclusions:
- Children of obese mothers, from low-income families, or with lower cognitive stimulation face elevated obesity risks.
- Socioeconomic factors like low income and cognitive stimulation appear to mediate obesity risk in certain demographic groups, including Black children and those with less educated parents.
Context:
Obesity is the most common health problem facing children. The most recent data from the National Health and Nutrition Examination Survey III suggest that 22% of children and adolescents are overweight and that 11% are obese.
Objective:
To investigate prospectively the association between the home environment and socioeconomic factors and the development of obesity in children.
Design:
Prospective cohort study.
Setting:
The National Longitudinal Survey of Youth. Population. A total of 2913 normal weight children between the ages of 0 and 8 years were followed over a 6-year period. We examined the roles of race, marital status, maternal education, family income, and parental occupation, as well as standardized measures of the home environment (The Home Observation for Measurement of the Environment [HOME]-Short Form) on the development of childhood obesity.
Primary Outcome Measure:
Incidence of obesity. Obesity was defined as a body mass index >95th percentile for age and gender at the 6-year follow-up.
Results:
Maternal obesity was the most significant predictor of childhood obesity (OR: 3.62 [2. 65-4.96]). The HOME-Short Form cognitive scores and household income were also significant predictors of childhood obesity (OR, low HOME-cognitive: 2.64 [1.48-4.70], medium HOME-cognitive: 2.32 [1. 39-3.88]; low income: 2.91 [1.66-5.08], medium income: 2.04 [1.21-3. 44]). Children who lived with single mothers were also significantly more likely to become obese by the 6-year follow-up, as were black children, children with nonworking parents, children with nonprofessional parents, and children whose mothers did not complete high school. Neither the child's gender nor the HOME-emotional scores contributed to the development of obesity. After controlling for the child's initial weight-for-height z-score, maternal body mass index, race, marital status, occupation, education, and HOME emotional scores, only the HOME cognitive score and family income remained significant predictors of childhood obesity.
Conclusion:
Children with obese mothers, low family incomes, and lower cognitive stimulation have significantly elevated risks of developing obesity, independent of other demographic and socioeconomic factors. In contrast, increased rates of obesity in black children, children with lower family education, and nonprofessional parents may be mediated through the confounding effects of low income and lower levels of cognitive stimulation.