Maternal Stress and Children's Obesity Risk

描述（由申请人提供）：儿童期超重和肥胖是整个生命过程中胆固醇升高、血压升高和心血管疾病的重要风险因素。虽然父母对儿童健康的影响最大，但以父母为中心的预防和治疗儿童肥胖的计划取得了一定的成功。父母的压力是一个未充分研究的因素，可能会损害与儿童的饮食摄入量和体育活动有关的父母的做法。然而，连接父母的压力和儿童的肥胖风险的研究已经遭受的弱点，包括横截面设计，回顾性措施的压力，未能考虑在一天内的过程，并缺乏重点的调解机制，留下很少的信息，以指导预防和治疗计划的发展，减少父母的压力对儿童的肥胖风险的影响。为了解决这一差距，我们提出了一个纵向研究测试一个新的概念模型，声称父母压力对儿童的身体活动和饮食行为的影响，通过一天内的过程，有助于儿童的长期肥胖风险，随着时间的推移，在一个积累的方式。在这项拟议的研究中，200名职业母亲及其9至11岁的子女（N = 400）将在3年内参加6次半年一次的评估。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。每个评估波将包括EMA、唾液皮质醇采样、加速度计和7天内的24小时食物摄入回忆，并结合回顾性纸笔调查;以及母亲和儿童的身高、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，预示着孩子在一天中的后续时间点的身体活动水平越低，健康饮食越少;这些一天内的影响将（2）由与体重相关的育儿实践（例如，建模，鼓励和限制儿童的身体活动和饮食）和儿童的压力，以及（3）在有儿童饮食和身体活动规则的家庭中较弱，而在经历粮食不安全的家庭中较强;（4）更大的个体内变异性（即，在每一个7天的波动中，母亲压力的人内波动）将与同一个7天的波动中儿童的整体体力活动水平较低和健康饮食较少相关;（5）基线时母亲压力较大将与儿童体力活动和健康饮食的较大减少相关，并且在未来3年内肥胖风险增加较大;母亲压力的变化轨迹与儿童肥胖风险在3年内呈负相关。研究结果将为开发新的干预措施提供信息，帮助职业母亲减少压力对体重相关的育儿实践的负面影响，并培养可以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.