Project Details

How and For Whom Does Adversity Lead to Childhood Obesity: A Mediated Moderation Analysis

Lindsay Huffhines, PhD

Summary

BACKGROUND: Despite dedication of significant resources to prevention and intervention of childhood obesity, obesity rates remain historically high among children living in disadvantaged environments, which includes more than 15 million children in the U.S. One-third of children are overweight or obese in the U.S., and aside from being harmful in and of itself, obesity is also associated with chronic comorbidities, increased health care expenditures, and reduced quality of life. GAP: To date, childhood obesity interventions have largely focused on promoting healthy eating, reducing screen time, and increasing exercise. Although this approach is effective for children without significant adversities, obesity will continue unabated in children living in disadvantaged environments unless underlying individual and family factors that are salient for this population and undermine healthy weight-related behaviors, such as emotion dysregulation, are addressed. HYPOTHESIS: More work is needed to test the potential pathway of risk from adversity to obesity through emotion dysregulation (moderated by parent-child physiological synchrony), given the potential for physiological synchrony to serve as a modifiable intervention target, either through improvement of parent emotion dysregulation, or increasing the child’s ability to maintain their own regulation when faced with parent emotion dysregulation. Hypothesis 1a: High levels of physiological synchrony will amplify associations between adversity and emotion dysregulation; Hypothesis 1b: Emotion dysregulation, in turn, will be linked to higher levels of overweight/obesity over time. METHODS: This is a longitudinal study including 100 children (46% Hispanic) with and without documented maltreatment that were followed from early (3-5 years) to middle childhood (9-11 years). RESULTS: Path analyses indicated that children who had experienced greater adversity had higher levels of both observed and parent-reported emotion dysregulation, which was in turn associated with change in overweight/obesity as indicated by higher body mass index z-scores and higher waist-to-hip ratio scores over time. Moderation analyses revealed that these indirect effects varied as a function of parent-child physiological synchrony, with the link between adversity and emotion dysregulation only present for children who had high levels of physiological synchrony with their parent. IMPACT: Knowledge gained will inform development of an innovative family-based treatment to tackle pediatric obesity among children exposed to adversity. Website Link: https://vivo.brown.edu/display/lhuffhin