Early Risk Factors for Obesity: Parenting, Child Behavior, and Attachment

肥胖的早期危险因素：养育方式、儿童行为和依恋

• 批准号: 8291413
• 负责人: Sarah E Anderson
• 金额: $ 26.51万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8291413
• 关键词: Adolescence; Adult; Affect; Age; Age-Months; Behavior; Birth; Brain; Characteristics; Child; Child Behavior; Child Care; Child Development; Child Nutrition; Childhood; Cohort Studies; Data; Desire for food; Development; Diet; Eating; Economics; Emotional; Emotional Bonds; Emotions; Epidemic; Epidemiologic Studies; Epidemiology; Etiology; Evaluation; Expenditure; Goals; Healthcare; Height; Intervention; Learning; Life; Life Expectancy; Logistic Regressions; Longitudinal Studies; Measures; Modeling; Modification; Moods; Mothers; National Institute of Child Health and Human Development; Nursery Schools; Obesity; Outcome; Parent-Child Relations; Parenting behavior; Parents; Patient Self-Report; Pattern; Pediatrics; Physical activity; Play; Prevention strategy; Primary Prevention; Productivity; Psychologist; Public Health; Reporting; Research; Risk; Risk Factors; Role; Secure; Security; Shapes; Sleep; Stress; System; Testing; Weight; Weight Gain; Work; Youth; base; biological adaptation to stress; cohort; developmental psychology; early childhood; elementary school; emotion regulation; energy balance; experience; feeding; improved; innovation; kindergarten; mind control; multidisciplinary; novel; obesity in children; obesity prevention; obesity risk; parental influence; prevent; psychosocial; public health relevance; response; skills; social; statistics; trend

DESCRIPTION (provided by applicant): Parents play a central role in efforts to prevent obesity in early childhood. Despite what is known about how stress affects obesity and about how parenting shapes children's stress response, no studies have examined how the emotional quality of observed parent-child interaction and children's attachment security are related to obesity. The epidemiologic research proposed in this application utilizes data from two large national studies, the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) and the NICHD Study of Early Child Care and Youth Development (SECCYD). The objective of the research is to determine how the emotional quality of early parent-child relationships affects risk for childhood obesity. The central hypothesis is that low levels of maternal sensitivity and responsiveness, children's observed negative behavior and lack of engagement with their mother, and insecure attachment, will increase children's risk for obesity before they enter elementary school, and be associated with higher weight gain into adolescence. The rationale for this research is that it will support development of new strategies to prevent obesity in early childhood. These strategies would move beyond the usual focus on diet and physical activity to target the quality of the early parent-child relationship, affecting energy balance by improving children's ability to respond to stress. Three specific aims will be pursued corresponding to three key predictors of children's weight: 1) maternal sensitivity and responsiveness, 2) child engagement and behavior, and 3) attachment security. These aspects of parenting, child behavior, and attachment were assessed in both studies at 24 months of age using validated measures based on direct observations of parent-child interaction. Children's heights and weights were also measured repeatedly in both studies. Levels of these predictors will be examined in relation to two outcomes: 1) risk of obesity at kindergarten (in ECLS-B using logistic regression), and 2) BMI trajectory through adolescence (in SECCYD using hierarchical linear mixed effects models). A component of each aim is assessment of effect modification to investigate the extent to which associations differ by sociodemographic characteristics. The project is innovative because it applies concepts established in the field of developmental psychology to the public health challenge of childhood obesity and moves the research field beyond its current examination of obesity and parenting, which is largely focused on parenting practices that are directly related to children's food intake and activity, or parenting styles that are based on self-report. This project will identify and characterize new risk factors for early childhood obesity that focus on the emotional quality of the parent-child relationship. The proposed epidemiologic research is significant because the results can be used to improve existing obesity prevention strategies for preventing obesity before children enter elementary school. These new strategies can be expected to have an important positive impact on children's weight and energy balance while also benefiting their social and emotional development. PUBLIC HEALTH RELEVANCE: The proposed research will identify new risk factors for early childhood obesity. It will provide evidence that childhood obesity is associated with the emotional quality of the relationship between the parent and the child and whether the child has secure emotional attachment to the parent. The work focuses on aspects of positive parenting that are already known from other research to produce desirable outcomes in children's social and emotional development, and adding healthy weight to these outcomes could reinforce the importance of interventions to improve parenting skills, aligning efforts in the fields of pediatrics, nutrition, child development, and public health.

描述（由申请人提供）：父母在预防幼儿肥胖的努力中发挥着核心作用。尽管压力如何影响肥胖以及父母如何塑造儿童的压力反应是已知的，但没有研究探讨观察到的亲子互动的情感质量和儿童的依恋安全与肥胖有关。本申请中提出的流行病学研究利用了两项大型国家研究的数据，即儿童早期纵向研究，出生队列（ECLS-B）和NICHD早期儿童护理和青年发展研究（SECCYD）。这项研究的目的是确定早期亲子关系的情感质量如何影响儿童肥胖的风险。核心假设是，母亲的敏感性和反应性水平低，儿童观察到的负面行为和缺乏与母亲的接触，以及不安全的依恋，将增加儿童在进入小学之前患肥胖症的风险，并与青春期体重增加有关。这项研究的基本原理是，它将支持制定新的战略，以防止儿童早期肥胖。这些战略将超越通常对饮食和体育活动的关注，以早期亲子关系的质量为目标，通过提高儿童应对压力的能力来影响能量平衡。三个具体的目标将追求对应的三个关键预测儿童的体重：1）母亲的敏感性和反应，2）儿童的参与和行为，和3）附件安全。这些方面的养育，儿童行为和附件进行了评估，在24个月大的研究使用验证措施的基础上直接观察亲子互动。在这两项研究中，儿童的身高和体重也被反复测量。这些预测因子的水平将与两个结果相关：1）幼儿园肥胖风险（ECLS-B中使用逻辑回归），以及2）青春期BMI轨迹（SECCYD中使用分层线性混合效应模型）。每个目标的一个组成部分是评估影响的修改，以调查在何种程度上协会不同的社会人口特征。该项目具有创新性，因为它将发展心理学领域建立的概念应用于儿童肥胖症的公共卫生挑战，并将研究领域超越了目前对肥胖症和养育的研究，目前的研究主要集中在与儿童的食物摄入和活动直接相关的养育做法，或基于自我报告的养育方式。该项目将确定和表征幼儿肥胖的新风险因素，重点是亲子关系的情感质量。这项流行病学研究意义重大，因为研究结果可用于改善现有的肥胖预防策略，以预防儿童进入小学之前的肥胖。这些新的策略有望对儿童的体重和能量平衡产生重要的积极影响，同时也有利于他们的社会和情感发展。 公共卫生相关性：拟议的研究将确定儿童早期肥胖的新风险因素。它将提供证据表明，儿童肥胖与父母和孩子之间关系的情感质量以及孩子是否对父母有安全的情感依恋有关。这项工作的重点是积极育儿的方面，这些方面已经从其他研究中了解到，可以在儿童的社会和情感发展中产生理想的结果，并为这些结果增加健康的体重可以加强干预措施的重要性，以提高育儿技能，调整儿科，营养，儿童发展和公共卫生领域的努力。