Troubled Homes May Fuel Obesity in Girls

MONDAY, April 16 (HealthDay News) — Little girls from troubled
homes are more likely to be obese at age 5 than girls from happier ones,
new research shows.

However, researchers did not find that same association between boys’
weight and difficult family situations.

In the study, researchers looked at data on more than 1,600
preschoolers from the Fragile Families and Child Wellbeing Study, which
tracks the health and well-being of children born to mostly low-income,
single-mother families. About half were black, 27 percent were Hispanic
and 22 percent were white.

When their children were aged 1 and 3 years, mothers were asked about
six stressors: domestic violence, depression, drug abuse, housing
insecurity, food insecurity (meaning that their household didn’t always
have enough nutritious food to eat) and whether the child’s father was in
prison. Children’s height and weight were measured at age 5.

At 5 years old, 17 percent of the children were obese, defined as
having a body-mass index in the 95th percentile or above, or being heavier
than 95 percent of their peers for their height.

Girls whose mothers reported experiencing two or more stressors when
their daughter was age 1 were twice as likely to be obese at age 5. If the
mother reported experiencing two or more stressors when the daughter was
age 3, the girl was also about twice as likely to be obese.

Researchers found a trend toward a similarly high risk of obesity if
the mothers reported experiencing stressors when their daughter was aged 1
and 3, however the results were not statistically significant. Researchers
believe that doesn’t mean there isn’t a link, just that this sample wasn’t
big enough to show it.

The results suggest that pediatricians and others trying to stem the
childhood obesity epidemic need to consider the family dynamics and home
environment, rather than just the girl’s weight.

“For families who are experiencing all these stresses, obesity is one
more thing and may not be as high a priority as other things,” said study
author Shakira Suglia, an assistant professor in the department of
epidemiology at Columbia University, in New York City. “Particularly for
girls, when you’re seeing these patients coming in as obese children at
age 5, there is probably more going on than what they’re eating and what
their physical activity is. … There are other things going on in the
family environment that need to be addressed to improve the health of the
child.”

The study is published in the May issue of Pediatrics.

There are several explanations thought to be behind the stress-obesity
connection, said Christina Bethell, a professor in the pediatrics
department at Oregon Health Science University and director of the
Child and Adolescent Health Measurement Initiative.

“The connection between stress, health behaviors and obesity is
profound and many say that to deal with obesity, first we have to deal
with psychosocial issues and stress,” said Bethell.

There may be a direct relationship, in that kids who are stressed
because of difficult home life may be more prone to eat highly caloric
foods. Studies have suggested in adults that stress prompts people to
reach for “comfort foods,” Suglia said.

But there may be indirect effects as well. Mothers who are stressed, or
who are dealing with worries such as violence or serious economic
instability, may not be as emotionally available to their kids, Suglia
said, and may put kids in front of the TV or feed them junk food to keep
them occupied as they try to deal with their own problems.

Economic instability may mean families can’t afford or believe they
can’t afford to buy fresh produce, lean cuts of meat and other nutritious
foods, she added.

Prior research has found stress caused by domestic violence and poverty
is associated with greater risks of cardiovascular disease in adults.

An open question, however, is why there wasn’t an association with
obesity and troubled homes in boys. There are several possible
explanations, Suglia said.

“It’s possible that girls internalize things differently. Other studies
have shown they do act differently in being exposed to stress. Girls tend
to internalize more, and to have more depressive behaviors,” Suglia
said.

Boys are generally more physically active than girls even at a young
age, so all of their running and jumping may help ward off obesity longer.
Boys and girls also develop differently, so it’s possible that girls are
picking up more on maternal worries while boys are paying less attention,
making them less vulnerable to it, Suglia said.

“In the domestic violence literature, we’ve found that girls identify
more with the mom more than the boys,” Suglia said.

But none of these are proven explanations. Indeed, researchers found
that girls who grew up with these psychosocial risk factors were more
likely to be obese than kids from more peaceful homes, but not that a
difficult home life caused the obesity.

More information

The Annie E. Casey Foundation has more on kids and well-being.

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