Epidemiology of Parenting and Childhood Obesity

描述(由申请者提供)：肥胖预防工作越来越侧重于儿童早期。大量证据表明，支持家庭用餐和充足睡眠的儿童家庭日常生活有助于预防肥胖。新出现的证据表明，有反应的父母教育和孩子的自我调节也可能降低肥胖的风险。然而，没有一项基于人群的研究调查了家庭惯例、父母的反应能力和孩子的自我调节如何共同影响未来的体重状况。目前尚不清楚，如果在父母反应的背景下实施家庭例行公事，在预防肥胖方面是否更有效，或者日常例行公事对预防肥胖症的影响是否归因于儿童更大的自我调节。这项应用的目的是利用对两项队列研究--幼儿纵向研究、出生队列研究(ECLS-B)和NICHD早期儿童保育和青年发展研究(SECCYD)--的现有数据进行流行病学分析，以调查父母的反应在多大程度上改变了家庭常规对儿童肥胖风险的影响，以及自我调节是否提供了一种解释机制。核心假设是，如果在父母的反应范围内，围绕睡眠和饮食的家庭日常活动将增加孩子的自我调节能力，从而降低他们患肥胖症的风险。这项研究的基本原理是为改善儿童肥胖症预防战略提供基础，方法是解决实施家庭例行公事的情感背景，并将自我调节确定为一种潜在的机制。该提案有两个具体目标：1)确定父母在幼儿时期的反应在多大程度上改变了家庭日常生活的影响，以防止后来的肥胖；2)确定自我调节作为一种机制，解释日常生活和反应与肥胖之间的联系。ECLS-B和SECCYD都包括对父母反应和儿童自我调节的结构化观察，对儿童身高和体重的连续测量，以及对儿童早期家庭日常生活的评估。拟议的流行病学分析将重点放在ECLS-B中5.5岁的肥胖和SECCYD中的青少年肥胖，并评估ECLS-B中24个月和SECCYD中24个月和54个月时的日常生活、反应和自我调节。这种方法是创新的，因为它利用发展科学提供的信息，对现有数据进行创造性和成本效益的分析，为儿童早期更有效的新的肥胖预防干预措施提供基础。这项拟议的研究意义重大，因为所获得的知识有望刺激预防儿童肥胖的努力的创新。根据这项拟议的研究，肥胖干预措施增加了家庭日常生活、响应性父母教育和儿童自我调节，预计将对儿童的行为、认知发展和社会情绪功能产生额外的积极影响。提供非肥胖益处的儿童肥胖预防干预措施可能会有效地激励和吸引父母。

DESCRIPTION (provided by applicant): Obesity prevention efforts are increasingly focused on early childhood. Substantial evidence indicates that household routines for children that support having family meals and obtaining adequate sleep can help prevent obesity. Emerging evidence suggests that responsive parenting and children's self-regulation may also reduce risk for obesity. However, no population-based studies have investigated how household routines, parental responsiveness, and child self-regulation work together to influence future weight status. It is unknown whether household routines are more effective in preventing obesity when they are implemented in the context of parental responsiveness or if the impact of routines on obesity prevention is due to children's greater self- regulation. The objective of this applicationis to use epidemiologic analyses of existing data from two cohort studies-the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), and the NICHD Study of Early Child Care and Youth Development (SECCYD)-to investigate the extent to which parental responsiveness modifies the impact of household routines on children's risk for obesity and whether self-regulation offers an explanatory mechanism. The central hypothesis is that household routines around sleep and meals, when practiced in the context of parental responsiveness, will reduce children's risk for obesity by increasing their capacity for self- regulation. The rationale for this research is to provide the basis for improving childhood obesity prevention strategies by addressing the emotional context in which household routines are implemented and identifying self-regulation as a potential mechanism. The proposal has two specific aims: 1) to determine the extent to which parental responsiveness in early childhood modifies the impact of household routines to protect against later obesity, and 2) to identify self-regulation as a mechanism explaining how routines and responsiveness are associated with obesity. Both ECLS-B and SECCYD include structured observations of parental responsiveness and children's self-regulation, serial measurements of children's height and weight, and assessment of household routines in early childhood. The proposed epidemiologic analyses will focus on obesity at age 5.5 years in ECLS-B and adolescent obesity in SECCYD, with assessment of routines, responsiveness, and self-regulation at age 24 months in ECLS-B and 54 months in SECCYD. The approach is innovative because it uses creative and cost-efficient analyses of existing data, informed by developmental science, to provide the basis for new and more effective obesity prevention interventions in early childhood. The proposed research is significant because the knowledge gained can be expected to stimulate innovation in efforts to prevent childhood obesity. Obesity interventions, informed by the proposed research, that increase household routines, responsive parenting, and children's self-regulation can be expected to have additional positive impacts on children's behavior, cognitive development, and social-emotional functioning. Childhood obesity prevention interventions that offer non-obesity benefits may effectively motivate and engage parents.