Skip to main content
×
Home

Direct and indirect effects of parent stress on child obesity risk and added sugar intake in a sample of Southern California adolescents

  • Eleanor T Shonkoff (a1), Genevieve F Dunton (a2), Chih-Ping Chou (a2), Adam M Leventhal (a2), Ricky Bluthenthal (a2) and Mary Ann Pentz (a2)...
Abstract
Abstract Objective

Research indicates that children are at higher risk for obesity if their parents have been exposed to a larger number of stressors, yet little is known about effects of parents’ subjective, perceived experience of stress on children’s eating behaviours and adiposity and whether weight-related parenting practices (i.e. parent rules and positive family meal practices) mediate this relationship. The present study evaluated the direct and mediated relationship between parent perceived stress and child waist circumference and parent stress and child consumption of added sugars one year later.

Design

Longitudinal panel data.

Setting

Eleven communities in Southern California, USA.

Subjects

Data were collected over two waves from parent–child dyads (n 599). Most parents were female (81 %) and Hispanic (51 %); children were 11 years old on average (sd 1·53; range 7–15 years) and 31 % received free school lunch.

Results

Perceived parent stress was not significantly associated with child waist circumference or consumption of added sugars one year later, and mediating pathways through parenting practices were not significant. However, parent rules were significantly associated with lower child consumption of added sugars (β=−0·14, P<0·001).

Conclusions

Results suggest that parent rules about the types of foods children can eat, clearly explained to children, may decrease child consumption of added sugars but not necessarily lead to changes in obesity risk. Parent- and family-based interventions that support development of healthy rules about child eating have the potential to improve child dietary nutrient intake.

Copyright
Corresponding author
* Corresponding author: Email eleanor.shonkoff@tufts.edu
References
Hide All
1. McPhie S, Skouteris H, McCabe M et al. (2011) Maternal correlates of preschool child eating behaviours and body mass index: a cross-sectional study. Int J Pediatr Obes 6, 476480.
2. Gundersen C, Lohman BJ, Garasky S et al. (2008) Food security, maternal stressors, and overweight among low-income US children: results from the National Health and Nutrition Examination Survey (1999–2002). Pediatrics 122, e529e540.
3. Kozyrskyj AL, Zeng Y, Colman I et al. (2011) Maternal distress in early life predicts the waist-to-hip ratio in schoolchildren. J Dev Orig Health Dis 2, 7280.
4. Lohman BJ, Stewart S, Gundersen C et al. (2009) Adolescent overweight and obesity: links to food insecurity and individual, maternal, and family stressors. J Adolesc Health 45, 230237.
5. Stenhammar C, Olsson GM, Bahmanyar S et al. (2010) Family stress and BMI in young children. Acta Paediatr 99, 12051212.
6. Suglia SF, Duarte CS, Chambers EC et al. (2012) Cumulative social risk and obesity in early childhood. Pediatrics 129, e1173e1179.
7. Tate EB, Wood W, Liao Y et al. (2015) Do stressed mothers have heavier children? A meta‐analysis on the relationship between maternal stress and child body mass index. Obes Rev 16, 351361.
8. Lundahl A, Nelson TD, Van Dyk TR et al. (2013) Psychosocial stressors and health behaviors: examining sleep, sedentary behaviors, and physical activity in a low-income pediatric sample. Clin Pediatr 52, 721729.
9. Park H & Walton-Moss B (2012) Parenting style, parenting stress, and children’s health-related behaviors. J Dev Behav Pediatr 33, 495503.
10. Conger KJ, Rueter MA & Conger RD (2000) The role of economic pressure in the lives of parents and their adolescents: the Family Stress Model. In Negotiating Adolescence in Times of Social Change, pp. 201223 [LJ Crockett and RK Silberiesen, editors]. Cambridge: Cambridge University Press.
11. McCurdy K, Gorman KS & Metallinos-Katsaras E (2010) From poverty to food insecurity and child overweight: a family stress approach. Child Dev Perspect 4, 144151.
12. Cohen S, Kessler RC & Underwood Gordon L (editors) (1995) Strategies for measuring stress in studies of psychiatric and physical disorders. In Measuring Stress: A Guide for Health and Social Scientists, pp. 326. New York: Oxford University Press.
13. Parks EP, Kumanyika S, Moore RH et al. (2012) Influence of stress in parents on child obesity and related behaviors. Pediatrics 130, e1096e1104.
14. Walton K, Simpson JR, Darlington G et al. (2014) Parenting stress: a cross-sectional analysis of associations with childhood obesity, physical activity, and TV viewing. BMC Pediatr 14, 244.
15. Hurley KM, Black MM, Papas MA et al. (2008) Maternal symptoms of stress, depression, and anxiety are related to nonresponsive feeding styles in a statewide sample of WIC participants. J Nutr 138, 799805.
16. Mitchell S, Brennan L, Hayes L et al. (2009) Maternal psychosocial predictors of controlling parental feeding styles and practices. Appetite 53, 384389.
17. Eisenberg CM, Ayala GX, Crespo NC et al. (2012) Examining multiple parenting behaviors on young children’s dietary fat consumption. J Nutr Educ Behav 44, 302309.
18. Gubbels JS, Kremers SPJ, Stafleu A et al. (2009) Diet-related restrictive parenting practices. Impact on dietary intake of 2-year-old children and interactions with child characteristics. Appetite 52, 423429.
19. Hauser SI, Economos CD, Nelson ME et al. (2014) Household and family factors related to weight status in first through third graders: a cross-sectional study in Eastern Massachusetts. BMC Pediatr 14, 167.
20. Liem DG, Mars M & De Graaf C (2004) Sweet preferences and sugar consumption of 4- and 5-year-old children: role of parents. Appetite 43, 235245.
21. Verzeletti C, Maes L, Santinello M et al. (2010) Soft drink consumption in adolescence: associations with food-related lifestyles and family rules in Belgium Flanders and the Veneto Region of Italy. Eur J Public Health 20, 312317.
22. Rodriguez LA, Madsen KA, Cotterman C et al. (2016) Added sugar intake and metabolic syndrome in US adolescents: cross-sectional analysis of the National Health and Nutrition Examination Survey 2005–2012. Public Health Nutr 19, 24242434.
23. Della Torre SB, Keller A, Depeyre JL et al. (2016) Sugar-sweetened beverages and obesity risk in children and adolescents: a systematic analysis on how methodological quality may influence conclusions. J Acad Nutr Diet 116, 638659.
24. Keller A & Della Torre SB (2015) Sugar-sweetened beverages and obesity among children and adolescents: a review of systematic literature reviews. Child Obes 11, 338346.
25. Gubbels JS, Kremers SPJ, Stafleu A et al. (2011) Association between parenting practices and children’s dietary intake, activity behavior and development of body mass index: the KOALA Birth Cohort Study. Int J Behav Nutr Phys Act 8, 18.
26. Lytle LA, Hearst MO, Fulkerson J et al. (2011) Examining the relationships between family meal practices, family stressors, and the weight of youth in the family. Ann Behav Med 41, 353362.
27. Li C, Ford ES, Mokdad AH et al. (2006) Recent trends in waist circumference and waist-height ratio among US children and adolescents. Pediatrics 118, e1390e1398.
28. Spolidoro JV, Pitrez ML, Vargas LT et al. (2013) Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults. Clin Nutr 32, 9397.
29. Shearrer GE, Daniels MJ, Toledo-Corral CM et al. (2016) Associations among sugar sweetened beverage intake, visceral fat, and cortisol awakening response in minority youth. Physiol Behav 167, 188193.
30. Bigornia SJ, LaValley MP, Noel SE et al. (2015) Sugar-sweetened beverage consumption and central and total adiposity in older children: a prospective study accounting for dietary reporting errors. Public Health Nutr 18, 11551163.
31. Pentz MA, Dunton G, Huh J et al. (2010) Effects of living in a smart growth community on social and environmental connectivity, and physical activity: the Healthy Places Trial. Obesity 18, S58.
32. Pentz MA, Dunton G, Wolch J et al. (2010) Design and methods of the healthy places trial: a study of the effects of smart growth planning principles on family obesity prevention. Ann Behav Med 39, 42.
33. Almanza E, Jerrett M, Dunton G et al. (2012) A study of community design, greenness, and physical activity in children using satellite, GPS and accelerometer data. Health Place 18, 4654.
34. Dunton GF, Intille SS, Wolch J et al. (2012) Investigating the impact of a smart growth community on the contexts of children’s physical activity using ecological momentary assessment. Health Place 18, 7684.
35. Dunton GF, Liao Y, Kawabata K et al. (2012) Momentary assessment of adults’ physical activity and sedentary behavior: feasibility and validity. Front Psychol 3, 260.
36. Perez-Pastor EM, Metcalf BS, Hosking J et al. (2009) Assortative weight gain in mother – daughter and father – son pairs: an emerging source of childhood obesity. Longitudinal study of trios (EarlyBird 43). Int J Obes (Lond) 33, 727735.
37. Cullen KW, Baranowski T, Rittenberry L et al. (2000) Social-environmental influences on children’s diets: results from focus groups with African-, Euro- and Mexican-American children and their parents. Health Educ Res 15, 581590.
38. US Department of Agriculture (2009) Child Nutrition Programs: Income Eligibility Guidelines (July 1, 2009–June 30, 2010). https://www.gpo.gov/fdsys/pkg/FR-2009-03-27/pdf/E9-6806.pdf (accessed August 2017).
39. Moens E, Braet C, Bosnians G et al. (2009) Unfavourable family characteristics and their associations with childhood obesity: a cross-sectional study. Eur Eat Disord Rev 17, 315323.
40. Santiago S, Zazpe I, Cuervo M et al. (2012) Perinatal and parental determinants of childhood overweight in 6–12 years old children. Nutr Hosp 27, 599605.
41. Hunsberger M, O’Malley J, Block T et al. (2012) Relative validation of Block Kids Food Screener for dietary assessment in children and adolescents. Matern Child Nutr 11, 260270.
42. Comstock EM St Pierre RG & Mackiernan YD (1981) Measuring individual plate waste in school lunches. Visual estimation and children’s ratings vs. actual weighing of plate waste. J Am Diet Assoc 79, 290296.
43. Bowman SA, Friday JE & Moshfegh AJ (2008) MyPyramid Equivalents Database, 2.0 for USDA Survey Foods, 2003–2004: Documentation and User Guide. Beltsville, MD: Food Surveys Research Group, Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture.
44. Cohen S, Kamarck T & Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24, 385396.
45. Lee E-H (2012) Review of the psychometric evidence of the Perceived Stress Scale. Asian Nurs Res 6, 121127.
46. Nast I, Bolten M, Meinlschmidt G et al. (2013) How to measure prenatal stress? A systematic review of psychometric instruments to assess psychosocial stress during pregnancy. Paediatr Perinat Epidemiol 27, 313322.
47. Hearst MO, Sevcik S, Fulkerson JA et al. (2012) Stressed out and overcommitted! The relationships between time demands and family rules and parents’ and their child’s weight status. Health Educ Behav 39, 446454.
48. Gattshall ML, Shoup JA, Marshall JA et al. (2008) Validation of a survey instrument to assess home environments for physical activity and healthy eating in overweight children. Int J Behav Nutr Phys Act 5, 3.
49. Pentz MA, Mihalic SF & Grotpeter JK (1997) The Midwestern Prevention Project. Boulder, CO: Center for the Study and Prevention of Violence, Institute of Behavioral Science, University of Colorado.
50. Leventhal AM (2012) Relations between anhedonia and physical activity. Am J Health Behav 36, 860872.
51. Ramasubramanian L, Lane S & Rahman A (2013) The association between maternal serious psychological distress and child obesity at 3 years: a cross-sectional analysis of the UK Millennium Cohort Data. Child Care Health Dev 39, 134140.
52. Topham GL, Page MC, Hubbs-Tait L et al. (2010) Maternal depression and socio-economic status moderate the parenting style/child obesity association. Public Health Nutr 13, 12371244.
53. Hughes SO, Power TG, Fisher JO et al. (2005) Revisiting a neglected construct: parenting styles in a child-feeding context. Appetite 44, 8392.
54. Keranen AM, Rasinaho E, Hakko H et al. (2010) Eating behavior in obese and overweight persons with and without anhedonia. Appetite 55, 726729.
55. Komulainen T, Keranen AM, Rasinaho E et al. (2011) Quitting a weight loss program is associated with anhedonia: preliminary findings of the Lifestyle Intervention Treatment Evaluation Study in northern Finland. Int J Circumpolar Health 70, 7278.
56. Radloff LS (1991) The use of the center for epidemiologic studies depression scale in adolescents and young-adults. J Youth Adolesc 20, 149166.
57. Willett W (2012) Nutritional Epidemiology, 3rd ed. New York: Oxford University Press.
58. Muthén LK & Muthén BO (1998–2011) Mplus User’s Guide, 6th ed. Los Angeles, CA: Muthén & Muthén.
59. Kline RB (2011) Principles and Practice of Structural Equation Modeling. New York: Guilford Press.
60. Muthén BO & Muthén LK (2012) Mplus Version 7: User’s Guide. Los Angeles, CA: Muthén & Muthén.
61. Cole DA & Maxwell SE (2003) Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling. J Abnorm Psychol 112, 558577.
62. Preacher KJ & Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40, 879891.
63. Fryar GU, Carroll MD & Ogden CL (2012) Prevalence of obesity among children and adolescents: United States, trends 1963–1965 through 2009–2010. National Center for Health Statistics, Health E-Stats. https://www.cdc.gov/nchs/data/hestat/obesity_child_09_10/obesity_child_09_10.pdf (accessed September 2017).
64. Curran PJ, West SG & Finch JF (1996) The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychol Methods 1, 1629.
65. Bauer KW, Hearst MO, Escoto K et al. (2012) Parental employment and work – family stress: associations with family food environments. Soc Sci Med 75, 496504.
66. Ogden CL, Carroll MD, Kit BK et al. (2012) Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA 307, 483490.
67. Ervin RB, Kit BK, Carroll MD et al. (2012) Consumption of added sugar among US children and adolescents, 2005–2008. NCHS Data Brief issue 87, 18; available at http://www.cdc.gov/nchs/data/databriefs/db87.pdf
68. US Department of Health and Human Services (2010) Parent Tips: Calories Needed Each Day. https://www.nhlbi.nih.gov/health/educational/wecan/downloads/calreqtips.pdf (accessed January 2017).
69. Vos MB, Kaar JL, Welsh JA et al. (2016) Added sugars and cardiovascular disease risk in children. Circulation 135, e1017e1034.
70. Clark HR, Goyder E, Bissell P et al. (2007) How do parents’ child-feeding behaviours influence child weight? Implications for childhood obesity policy. J Public Health 29, 132141.
71. Birch LL & Fisher JO (2000) Mothers’ child-feeding practices influence daughters’ eating and weight. Am J Clin Nutr 71, 10541061.
72. Birch LL, Fisher JO, Grimm-Thomas K et al. (2001) Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 36, 201210.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 14
Total number of PDF views: 55 *
Loading metrics...

Abstract views

Total abstract views: 330 *
Loading metrics...

* Views captured on Cambridge Core between 5th October 2017 - 25th November 2017. This data will be updated every 24 hours.