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Social and behavioral risk factors for obesity in early childhood
Shakira F Suglia1, Cristiane S Duarte, Earle C Chambers
1*Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; †Division of Child and Adolescent Psychiatry, Columbia University, New York, NY; ‡Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY; §Division of General Pediatrics, Boston University School of Medicine, Boston, MA.
Insights
Multiple social and behavioral risk factors are linked to childhood obesity. These combined risks, including externalizing behaviors and short sleep duration, significantly impact obesity rates in young children.
Area of Science:
- Pediatric Health
- Child Psychology
- Public Health
Background:
- Childhood obesity is a growing concern with multiple contributing factors.
- Previous research often studied social and behavioral risk factors for obesity in isolation.
- Understanding the interplay of these factors is crucial for effective interventions.
Purpose of the Study:
- To investigate the relationship between cumulative social risk factors, behavioral problems, health behaviors, and obesity in preschoolers.
- To analyze how co-occurring risks influence obesity development in early childhood.
Main Methods:
- Utilized data from the Fragile Families and Child Wellbeing Study (N = 1589).
- Created a cumulative social risk score based on maternal reports (intimate partner violence, food/housing insecurity, maternal depression/substance use, father's incarceration).
- Assessed child behaviors (Child Behavior Checklist), health behaviors (TV watching, sleep, soda consumption), and measured obesity (BMI ≥ 95th percentile) at age 5.
Main Results:
- Cumulative social risk was associated with obesity in girls.
- Externalizing behavioral problems were linked to obesity in both boys and girls.
- Short sleep duration was associated with obesity in both genders.
- Excessive television viewing (>2 hours/day) was linked to obesity in boys.
Conclusions:
- Co-occurring social and behavioral risk factors are significantly associated with obesity in 5-year-old children.
- This highlights the need for comprehensive approaches addressing multiple risk factors simultaneously.
- Findings underscore the importance of considering social determinants and behavioral patterns in pediatric obesity prevention.
Objective:
Although multiple social and behavioral risk factors associated with obesity co-occur among young children, most studies have examined them separately. The purpose of this study was to examine the relationship between social risk factors, behavioral problems, health behaviors, and obesity among preschoolers in the Fragile Families and Child Wellbeing Study (N = 1589).
Methods:
A cumulative social risk score was created by summing maternal reports of intimate partner violence, food insecurity, housing insecurity, maternal depressive symptoms, maternal substance use, and father's incarceration, obtained when the child was 3 years old. Mothers reported on the child's internalizing and externalizing behaviors with the Child Behavior Checklist at age 5 years. Mothers also reported on hours the child spent watching television and sleeping as well as servings of soda or juice drinks the child consumed per day. Child height and weight were measured at age 5 years. Obesity was defined as body mass index ≥ 95th percentile.
Results:
In regression analyses adjusted for health behaviors, behavioral problems, and sociodemographic factors, cumulative social risk was associated with obesity among girls. Externalizing behavioral problems were associated with obesity among girls (prevalence ratios [PRs], 1.5; 95% confidence interval [CI], 1.2-1.7) and boys (PR, 1.3; 95% CI, 1.1-1.6). Short sleep duration was also associated with obesity among girls (PR, 1.2; 95% CI, 1.0-1.4) and boys (PR, 1.3; 95% CI, 1.1-1.5) even after adjusting for behavioral problems and social risk factors. Watching more than 2 hours of television per day was associated with obesity among boys (PR 1.5; 95% CI, 1.2 to 1.9) but not girls.
Conclusion:
Co-occurring social and behavioral risk factors are associated with obesity among 5-year-old children.
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