Since we are in between Halloween, when we give our children copious amounts of candy, and Thanksgiving, the national massive feast day in the U.S., childhood obesity comes to mind. This might be an ideal time to review a fascinating study revealing a link between parenting quality and obesity. First, some background on childhood obesity. According to the Centers for Disease Control, the prevalence of obesity has doubled for children, and tripled for adolescents in the last 30 years. Currently, about a third of children are overweight or obese. Obese children have a strong tendency to become obese adults. Obesity has health, economic, and psychosocial consequences. Treating obesity is difficult, with low success rates, so prevention is our best route. Certainly, there is a strong genetic component in obesity. However, the rapid increase in the prevalence of obesity cannot be explained by genetic changes in our population.
There are plenty of proposed explanations for the rapid rise in childhood obesity:
- increased screen time (TV, video games), less active play,
- reduction of physical education in school,
- increased consumption of sugary beverages,
- increase in fast food consumption, and
- substitution of family meals with snacking.
Assessing Parenting’s Role in Obesity
Each of the above may be contributing factors; but, did you ever think that the way families interact and parents respond to their children may play a part in childhood obesity? A study published in Pediatrics, entitled Early Childhood Family Intervention and Long-term Obesity Prevention Among High Risk Minority Youth by Laurie Miller Brotman and coworkers yielded a surprising finding. The authors conducted this study because there is a known correlation between behavioral disorders and obesity. The paper reports results of two studies where 3- to 5-year-old children from low income minority families were randomly assigned into treatment or control groups. The treatment consisted of a 22-session parenting group intervention that was adapted from the strongly evidence-based Incredible Years program. The intervention focused on parenting quality rather than obesity prevention or treatment. After following the children for five years, in both trials the parenting intervention resulted in lower prevalence of obesity than the control group (Body Mass Index >95 percentile: Study 1, 21% vs. 39% and Study 2, 24% vs. 54%). The children in the intervention were physically more active and showed less screen time than the control group. One of the studies also looked at food intake and blood pressure in girls, and found that the intervention group ate a lower percent of their calories as carbohydrates and had lower blood pressure. It is important to note that studies aimed at preventing or treating obesity usually show small long-term effects, if any. These results were remarkably large and long lasting. These results have strong implications for addressing the obesity epidemic. Further research needs to be done to see if such interventions can reduce obesity for children not showing signs of behavior disorders.
The Role of Parenting Assessment in Prevention
Beyond the important implications for the prevention of childhood obesity, here is yet another study showing that intervening early to improve parenting has positive effects for children. In this blog we have previously discussed how promoting parenting quality for low income children can protect brain development, shield from toxic stress, and close the achievement gap. It is results like these that have the Departments of Health and Education in the United Kingdom recommending universal parenting assessments, using tools like the Keys to Interactive Parenting Scale. Universally assessing parenting can identify those parents who need support; we then have the opportunity to intervene early. The earlier we can identify and intervene, the better we can build parenting that supports healthy child development, shield the child against toxic stress and trauma, and promote a healthier, better-adjusted and more productive adult. Research shows that these early interventions more than pay for themselves in the long run. This concept has been nicknamed the Heckman Equation, after James Heckman, a Nobel Laureate in Economics. The shorthand for the equation is I + D + S = G. The I stands for invest early in disadvantaged families. The D represents developing the social and cognitve skills for children early. The S is for sustaining the early investment. The G stands for "Gain a more capable, productive and valuable workforce that pays dividends to America for generations to come." By spending a little early to identify and support parents who need extra help, we can reap large rewards in the future.
Furthermore, Heckman points out the importance of assessments in effectively addressing the factors contributing to disadvantage. This blog explores the many values of assessing parenting for children, families and programs. So you can imagine my delight when a Nobel Prize Winner in Economics wrote:
The proper measure of disadvantage is not necessarily family poverty or parental education. The available evidence suggests that the quality of parenting is the important scarce resource. So we need better measures of risky family environments in order to achieve more accurate targeting.
-James Heckman, Giving Kids a Fair Chance (A Strategy that Works) page 35.
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