Maternal depression, family food behavior, and child nutritional health

描述(申请人提供)：粮食不安全和超重对低收入儿童的最佳发展构成重大风险。虽然对高质量营养食品的消费不足和/或对劣质食品的过度消费是这些行为的直接原因，但母亲的行为在决定幼儿家庭获得和获得食物方面尤为关键。低收入妇女患抑郁症的风险增加，母亲抑郁对育儿行为(即管教策略、温暖)的影响是众所周知的。反过来，这些同样的母性行为与广泛的儿童行为结果有关。这项研究进一步探讨了母亲抑郁如何影响家庭食物行为，包括食物获取和消费策略，以及这些行为又如何与学龄前儿童的食物安全状况和体重有关。将从罗德岛州贫困城市地区的5个学龄前项目中招募150名低收入、种族多样化的母亲和她们的学龄前儿童作为样本。这项横断面的对比研究将检验以下假设：1)母亲抑郁症状越严重，儿童BMI越高，儿童食物不安全越严重；2)更积极和参与的家庭食物行为将与更健康的儿童体重和更大的食物安全相关；3)包括获取策略(例如，借款、替代食物来源)和食物消费策略(例如，与孩子一起吃饭、吃饭时看电视)在内的家庭食物行为将中介母亲抑郁和儿童营养健康之间的关联。将收集母亲自我报告数据，以评估抑郁症、家庭食品行为、家庭和儿童食品安全状况。儿童的身高和体重将使用标准的人体测量方法收集。将利用OLS回归和逻辑回归模型来检验抑郁和儿童营养健康之间的直接影响(例如，体重状况和食品安全状况的连续和明确的指标)，以及家庭饮食行为和儿童营养健康之间的直接影响。索贝尔系数乘积检验将被用来评估家庭饮食行为是否在母亲抑郁和儿童营养健康之间起中介作用。这项研究的结果将扩大目前在低收入妇女中治疗抑郁症的考虑因素，包括对食物不安全、营养和她们孩子的食物行为的担忧。此外，这项研究的结果将更好地了解家庭食物行为对儿童营养健康的影响，并为更深入、更纵向地研究低收入人群中食物不安全与超重之间的竞争机制奠定基础。 公共卫生相关性：这项研究的结果将进一步加深我们对母亲抑郁在低收入儿童中食物不安全和超重状况发生中可能起到的作用的理解。通过确定抑郁症母亲用来获取食物和养活家人的特定行为和策略，我们将能够建议针对幼儿的食物不安全、营养和食物行为的治疗干预措施。此外，更深入地了解产妇获得食物的战略，将为深入研究造成低收入儿童粮食不安全和超重之间关系的相互竞争的机制奠定基础。

DESCRIPTION (provided by applicant): Food insecurity and overweight pose significant risks to the optimal development of low income children. While insufficient consumption of high-quality nutritious food and/or excessive consumption of poor quality foods are the proximal causes of these behaviors, maternal behavior is particularly critical in determining access and availability of the food in a young child's household. Low-income women are at increased risk for depression and the effects of maternal depression on parenting behaviors (i.e., discipline strategies, warmth) are well established. In turn, these same maternal behaviors have been linked to a wide range of child behavioral outcomes. This study expands on this research to examine how maternal depression affects family food behaviors, including food acquisition and consumption strategies, and how these in turn are related to food security status and weight among preschool-aged children. A sample of 150 low-income, ethnically diverse mothers and their preschool age children will be recruited from 5 preschool programs located in poor, urban areas of Rhode Island. This comparative, cross-sectional study will test the following hypotheses: 1) greater maternal depressive symptomatology will correspond to higher child BMIs and more severe child food insecurity; 2) more active and involved family food behaviors will be associated with healthier child weight and greater food security; and 3) family food behaviors including acquisition strategies (e.g., borrowing, alternative food sources) and food consumption strategies (e.g., eating with child, watching TV during meals) will mediate the association between maternal depression and child nutritional health. Maternal self-report data will be collected to assess depression, family food behaviors, household and child food security status. Children's height and weight will be collected using standard anthropometric methods. OLS regression and logistical regression models will be utilized to test the direct effects between depression and child nutritional health (e.g., continuous and categorical indicators of weight status and food security status), and between family food behaviors and child nutritional health. The Sobel product of coefficients test will be used to assess whether family food behaviors mediate the pathway between maternal depression and child nutritional health. Results from this study will expand current considerations in the treatment of depression among low-income women to include concerns about food insecurity, nutrition and food behaviors for their children. In addition, the results of this study will provide a greater understanding of the effect of family food behaviors on child nutritional health and lay the groundwork for a more intensive, longitudinal study of competing mechanisms that account for the associations between food insecurity and overweight among low-income populations. PUBLIC HEALTH RELEVANCE: The results of this research will further our understanding of the role that maternal depression may have in the incidence of food insecurity and development of overweight status among low-income children. By identifying the particular behaviors and strategies that depressed mothers use to acquire food and feed their families, we will be able to recommend treatment interventions that address food insecurity, nutrition and food behaviors of young children. In addition, a more in-depth understanding of maternal food acquisition strategies will lay the groundwork for an intensive study of competing mechanisms that account for the associations between food insecurity and overweight among low-income children.