Toddler self-regulation skills predict risk for pediatric obesity

Abstract

Objective To investigate the role of early self-regulation skills, including emotion regulation, sustained attention, and inhibitory control/reward sensitivity, in predicting pediatric obesity in early childhood. Method Participants for this study included 57 children (25 girls) obtained from three different cohorts participating in a larger ongoing longitudinal study. At 2 years of age, participants participated in several laboratory tasks designed to assess their self-regulation abilities. Height and weight measures were collected when children were 2 and 5.5 years of age. Results Self-regulation skills in toddlerhood were predictive of both normal variations in BMI development and pediatric obesity. Specifically, emotion regulation was the primary self-regulation skill involved in predicting normative changes in BMI as no effects were found for sustained attention or inhibitory control/reward sensitivity. However, both emotion regulation and inhibitory control/reward sensitivity predicted more extreme weight problems (i.e., pediatric obesity), even after controlling for 2yr BMI. Thus, toddlers with poorer emotion regulation skills and lower inhibitory control skills/higher reward sensitivity were more likely to be classified as overweight/at risk at 5.5 years of age. Conclusion Early self-regulation difficulties across domains (i.e., behavioral, and emotional) represent significant individual risk factors for the development of pediatric obesity. Mechanisms by which early self-regulation skills may contribute to the development of pediatric obesity are discussed.

Co-occurring weight problems among children with attention deficit/hyperactivity disorder: the role of executive functioning

“…The cross-sectional aspect of the current study limits our ability to infer not only the temporal association between EF deficits and weight problems among children with ADHD but also its directionality. Although past longitudinal research has shown that other self-regulation deficits (for example, emotion regulation) during the toddlerhood period predict future weight problems in early childhood, 32 we must recognize the possibility that EF deficits may have emerged after children with ADHD gained weight, although we are not aware of any current findings showing such an effect. In addition, it is important to recognize that self-regulation skills entail control efforts across not only EF but also other domains (for example, emotion regulation and behavioral inhibition) that have a role in the development of both ADHD and pediatric obesity.…”

“…31 Similarly, toddlers with difficulties regulating emotion and delaying gratification during laboratory tasks were also more likely to be classified as overweight or obese at 5 1 2 years. 32 These self-regulation deficits across behavioral and emotional domains are also common in youth with ADHD. 33,34 Even more prominent among current theoretical and neurobiological notions of the etiology of ADHD is neurocognitive or executive functioning (EF) deficits.…”

Dietary restraint and self-regulation in eating behavior

“…109,110 Greater capacity to delay gratification is associated with lower levels of overweight and a slower rate of weight gain in childhood, [111][112][113] and better self-regulation skills at the age of 2 years predicted lower BMI and lower risk of obesity by the age of 5 years. 114 The literature on executive function provides a neuropsychological perspective on self-regulation. Studies suggest that individuals who have difficulty controlling their weight also show executive function deficits, including poorer performance on tasks involving inhibition, flexibility and decision making.…”

Association of symptoms of attention-deficit/hyperactivity disorder with childhood overweight adjusted for confounding parental variables

“…14 The few longitudinal studies are also not conclusive. [17][18][19] One reported prediction of obesity at 5.5 years by low self-regulation skills at 2 years of age (emotion regulation, sustained attention and inhibitory control/reward sensitivity), 17 while another reported no prediction of weight standard deviation score by ADHD over a 10-year follow-up. 19 A third study also did not report a prediction of obesity by ADHD over an 8-year follow-up period.…”