Maternal Stress and Children's Obesity Risk

描述(由申请人提供)：儿童超重和肥胖是一生中胆固醇升高、血压升高和心血管疾病的重要危险因素。尽管父母对儿童健康的影响最大，但以父母为重点的预防和治疗儿童肥胖症的计划取得了一定的成功。父母的压力是一个未被充分研究的因素，它可能会损害与孩子的饮食摄入和体育活动有关的育儿实践。然而，将父母压力与儿童肥胖风险联系起来的研究一直存在缺陷，包括横断面设计、压力的回溯性测量、未能考虑日内过程，以及缺乏对调节机制的关注--几乎没有信息来指导预防和治疗计划的发展，以减少父母压力对儿童肥胖风险的影响。为了解决这一差距，我们建议进行一项纵向研究，测试一个新的概念模型，该模型声称，父母压力对儿童身体活动和饮食行为的影响是通过一天内的过程进行的，这些过程会随着时间的推移而累积，从而导致儿童长期肥胖的风险。在这项拟议的研究中，200名职业母亲和她们9至11岁的孩子(N=400)将参加为期3年的6次半年度评估。生态瞬时评估(EMA)和唾液皮质醇采样方法将捕捉一天内的压力过程。每个评估浪潮将包括EMA、唾液皮质醇采样、加速计量法和24小时食物摄入量回忆，结合回溯性的纸和铅笔调查；以及对母亲和儿童的身高、体重和腰围评估。主要目的是检验以下假设：(1)在一天中的任何给定时间点，母亲的压力越大，孩子们在一天中随后的时间点的体力活动水平和健康饮食就会越少；这些一天内的影响将通过与体重相关的育儿做法(例如，建模、鼓励和限制儿童的体力活动和饮食)和儿童压力来调节，(3)在有关于儿童饮食和体力活动的规定的家庭中较弱，在食物不安全的家庭中较强；(4)在每7天的波动中，母亲压力的个体内变异性(即人内波动)更大，将与同一7天波动中儿童的总体体力活动水平和较差的健康饮食相关；(5)基线水平的母亲压力更大，将与未来3年儿童体力活动和健康饮食的更大减少，以及肥胖风险的更大增加相关；以及(6)在这3年中，母亲压力和儿童肥胖风险的变化轨迹将呈负相关。研究结果将有助于开发新的干预措施，帮助职业母亲减少压力对与体重相关的育儿实践的负面影响，并培养能够缓冲母亲压力对儿童肥胖风险影响的家庭环境。鉴于儿童肥胖对健康的有害影响，这些信息可能具有重大的公共卫生价值。

DESCRIPTION (provided by applicant): Childhood overweight and obesity are significant risk factors for elevated cholesterol, blood pressure, and cardiovascular disease throughout the life course. Although parents exert one of the strongest influences on children's health, parent-focused programs to prevent and treat child obesity have had modest success. Parental stress is an understudied factor that may compromise parenting practices related to children's dietary intake and physical activity. However, research linking parental stress and children's obesity risks has suffered from weaknesses including cross-sectional designs, retrospective measures of stress, the failure to consider within-day processes, and a lack of focus on mediating mechanisms-leaving little information to guide the development of prevention and treatment programs that reduce the effects of parental stress on children's obesity risk. To address this gap, we propose a longitudinal study testing a novel conceptual model purporting that the effects of parental stress on children's physical activity and eating behaviors operate through within- day processes that contribute to children's long-term obesity risk in an accumulated manner over time. In the proposed study, 200 working mothers and their 9 to 11 year-old children (N = 400 total) will participate in 6 semi-annual assessments waves across 3 years. Ecological momentary assessment (EMA) and salivary cortisol sampling methods will capture within-day stress processes. Each assessment wave will consist of EMA, salivary cortisol sampling, accelerometry, and 24-hour food intake recalls across 7 days in combination with retrospective paper-and-pencil surveys; and height, weight, and waist circumference assessments in mothers and children. The primary aims are to test hypotheses that (1) greater maternal stress at any given point in the day will predict lower physical activity levels and less healthy eating by children at subsequent points in the day; these within-day effects will be (2) mediated by weight-related parenting practices (e.g., modeling, encouraging, and limiting of children's physical activity and eating) and children's stress, and (3) weaker in households that have rules about children's eating and physical activity, and stronger in households experiencing food insecurity; (4) greater intra-individual variability (i.e., within-person fluctuations) in maternal stress across each 7-day wave will be associated with lower overall physical activity levels and less healthy eating in children across that same 7-day wave; (5) greater maternal stress at baseline will be associated with greater decreases in children's physical activity and health eating, and greater increases in obesity risk over the next 3 years; and (6) change trajectories of maternal stress and children's obesity risk will be inversely relate over the 3 years. The results will inform the development of novel interventions that help working mothers to reduce the negative effects of stress on weight-related parenting practices, and foster family environments that can buffer the effects of maternal stress on children's obesity risk. Given the detrimental health effects of childhood obesity, such information could have significant public health value.