Too indulgent or not sensitive enough: mothering in the current historical era and its relevance to childhood obesity.
Too indulgent or not sensitive enough: mothering in the current historical era and its relevance to childhood obesity.
复制标题
过于纵容或不够敏感：当前历史时代的母亲及其与儿童肥胖的相关性。
DOI：
10.1038/ijo.2017.117
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Lumeng,JC
中科院分区：
文献类型：
--
作者：
Lumeng,JC
In this issue of the International Journal of Obesity, Anderson and colleagues 1 describe results of their analysis testing a popular conceptual model for the prevention of childhood obesity: more structured home routines will lead to better self-regulation, which will prevent childhood obesity. There is a strong theoretical foundation for this model. Obesity-related hormones are entrained by daily routines, 2 basic behavior theory suggests that routines increase child compliance 3 and poor self-regulation has been repeatedly linked to childhood obesity. Unfortunately, the authors found that while some household routines were associated with some aspects of children’s self-regulation, and some routines were associated with lower obesity risk, the child’s self-regulation was not the mechanism of association. We likewise found that although a behavioral intervention improved children’s self-regulation, these improvements did not reduce childhood obesity. 4 A plethora of interventions seeking to improve parenting to prevent childhood obesity have now reported modest effects. 5 Why might parenting interventions to prevent childhood obesity not be as effective as expected?The lay press abounds with advice to parents to promote routines but the research evidence that doing so improves child outcomes is remarkably sparse. 3 A potential explanation for modest effects of parenting interventions on child obesity may be that child characteristics moderate the effects of parenting on child outcomes in a transactional manner. For example, households with more routines have children with easier temperaments. 6, 7 These associations may be due to shared genetics between parents and child (both of whom may have rhythmic temperaments that easily adapt to routines) as opposed to parenting that causes children to have easier temperaments. Parenting routines are also more strongly associated with children’s outcomes when the child is at biobehavioral risk. 7, 8 These observations align with the fact that most research on the effects of routines on children’s outcomes has been among children at risk. 9 The intervention potential of routines for typically developing, healthy children may be modest. The current framing of parenting as a contributor to childhood obesity may also be a function of the era in history. The first half of the twentieth century saw the emergence of the ‘parenting expert’in the form of pediatricians or scientists publishing treatises on how women should most competently raise children. During this era, great emphasis was placed on structure, obedience and discipline. In the 1950’s, there was an increased emphasis on sensitivity, responsiveness and attachment. The advent of the childhood obesity epidemic began introducing uncertainty about whether permissiveness, indulgence or lack of sensitivity could cause childhood obesity. 10 There has therefore been increasing emphasis on teaching mothers to accurately read children’s hunger and satiety cues based on the premise that if mothers accurately identified children’s needs in a sensitive and responsive manner, children would not become obese. In direct contrast to this conceptual model, however, is emerging work that children’s hunger and satiety cues cannot be accurately and reliably identified (by mothers or researchers). While early
