Household and family factors related to weight status in first through third graders: a cross-sectional study in Eastern Massachusetts

Abstract

BackgroundEarly environmental influences have been linked to child weight status, however further understanding of associations in diverse populations is needed.MethodsA cross-sectional analysis of household and family factors associated with overweight was conducted on a culturally diverse, urban dwelling sample of 820 first through third graders (mean age 7.6 ± 1.0 years) residing in three eastern Massachusetts cities. Overweight was defined as BMI > 85th percentile, based on measured height and weight, and the CDC growth reference. Multivariate logistic regression was used to identify demographic, behavioral, and social environmental variables significantly related to weight status. Independent variables included race-ethnicity, age, sex, servings of sugar-sweetened beverages/week, hours of screen time/week, parent overweight, (calculated from self-reported weight/height), parent education, household food restriction rules regarding snacking and/or kitchen access, frequency of having dinner as a family (reported as “a lot” vs. “sometimes/rarely/never”) and child vitamin/mineral supplement use. Selected interactions were explored based on prior studies.ResultsPrevalence of overweight was 35.5% in girls and 40.8% in boys. In the final, adjusted model, compared to white children, the odds of overweight were higher in children of Hispanic race-ethnicity (odds ratio (OR) = 2.4, 95% CI = 1.4 - 4.1). In the same adjusted model, compared to children with no household food restriction rules, the odds of overweight were 2.6 (95% CI = 1.3-5.1) times higher and 3.5 (95% CI = 1.9-6.4) times higher for children having one rule or two rules, respectively. Parent report of frequent family dinner and child vitamin use were protective, with a halving of risk for overweight for each behavior (OR = 0.47, 95% CI = 0.31-0.71 and OR = 0.54, 95% CI = 0.37-0.78, respectively).ConclusionsIn the presence of other factors, frequent family dinner and vitamin use were associated with lower risk of overweight and household food restriction rules with higher risk. Although such relationships have previously been reported, this investigation is among the first to demonstrate these associations in a low-income, racially-diverse early elementary school population, and suggest potential targets of opportunity within the family context that could reduce child overweight risk in a subgroup of children at elevated risk of obesity.

Links between the organization of the family home environment and child obesity: a systematic review

“…Papoutsou and colleagues studied family mealtime routines among 5,099 European children (ages 6–10) and found that low frequency of eating breakfast at home (≤2 times/week) was associated with overweight or obese status in boys and >90% waist circumference in girls, even when adjusting for demographic characteristics, blood pressure and lipid variables. In a sample of 820 US children (grades 1–3), Hauser and colleagues additionally found that frequent family mealtimes were protective against child overweight even after controlling for sex, age, consumption of sugar‐sweetened beverages and parent education. Hauser and colleagues also assessed family limitations around screen time and found that households allowing more screen time were more likely to have an overweight child.…”

“…Studies also examined the broad home environment and household crowding . Lumeng and colleagues used the full 55‐item Home Observation for Measurement of the Environment (HOME)‐Middle Childhood scale and found that the home environments of normal weight children were rated to be of a higher overall quality than those of overweight or obese children.…”

“…Fifteen studies examined relations between the organization of the family home environment and child weight in elementary school-age children ((31,51,55-67); Table S2). Thirteen studies in the school-age group were rated as low risk for bias (31,(55)(56)(57)(58)(59)(61)(62)(63)(64)(65)67,69), and two studies were rated as unclear (60) or high risk (66). Twelve of the 14 studies found evidence for significant relations between the organization of the family home environment and child weight (31,51,55,56,59,60,(62)(63)(64)(65)(66)(67).…”

“…Two of the significant studies examined sleep routines (56,66), four examined meal routines (31,51,58,63,64), five examined family limit setting around screen time (55,56,59,60,63), two examined household crowding (65,67) and two examined the broad home environment (62,66). Lumeng and colleagues (66) examined sleep routines in a sample of 785 US children (ages 9-12) and uncovered direct relations between sleep duration and sleep problems and overweight.…”

Health issues in Hispanic/Latino youth.

“…Studies report that parental support in associated with less consumption of sugary beverages, but parent-mediated behaviors like eating at fast food restaurants and having meals while watching TV were associated with higher consumption of sugary beverages (Lopez et al, 2012). On the other hand, higher frequency of family dinners and having rules about snacking were inversely associated with overweight and obesity (Hauser et al, 2014). Food and physical activity environments also play an important role in obesity.…”