Girls who face multiple social stressors at home as toddlers are more likely to be obese by age 5, researchers found.
Among girls from mostly disadvantaged families, those who were exposed to at least two social stressors at age 1 or age 3 were more likely to become obese than were girls with no such exposure (ORs 2.1 and 2.2, respectively), according to Shakira Suglia, ScD, of Columbia University’s Mailman School of Public Health in New York City, and colleagues.
There were no significant associations observed for boys, the researchers reported online ahead of the May issue of Pediatrics.
“Identifying modifiable mediators of these associations can better inform intervention and prevention efforts to curb childhood obesity,” they wrote.
Single psychosocial stressors in childhood - such as violence in the home and child neglect - have been associated with obesity in both childhood and adulthood, but the relationship between exposure to multiple stressors and obesity in early life has not been well studied.
“Kids are just getting overweight at a much younger age. We’re noticing that infants are off the chart for height and weight,” said Maryanne Lewis, nurse practitioner at the Children’s Hospital Boston’s Optimal Weight Life Program. “Toddlers are having … difficulty on normal equipment that they have outside in nursery school because they are just so overweight. It is a drastic change from what we’ve seen in the last 25 years, and it’s affecting younger and younger children.”
Obesity rates among children younger then 5 have doubled over the last two decades, according to the Centers for Disease Control and Prevention. The prevalence of childhood obesity has prompted pediatricians to encourage parents to start monitoring their children’s weight.
“This is not something, ‘Oh, my kid looks cute at 2 or 3. They’re a little bit heavy, but they just look cute,’” said Carolyn Landis, assistant professor of pediatrics at Case Western Reserve University and a licensed clinical psychologist in Cleveland. “People don’t realize it, but even preschool age kids can have high blood pressure, they can have type 2 diabetes.”
Conditions like High cholesterol and high blood pressure, which were once seen as only affecting adults, have reached a much younger age group.
To explore the issue, Suglia and colleagues examined data from the Fragile Families and Child Well-being Study, a birth cohort study that follows mother-child pairs from 20 large U.S. cities. The current analysis included 1,605 children.
The researchers created two cumulative social risk scores using the mothers’ reports of intimate partner violence, food insecurity, depression, substance use, and whether the child’s father was incarcerated.
According to objective measurements obtained at an in-home visit, 17% of the children were obese at age 5. In addition, 57% of the children had been exposed to at least one social stressor during their early life.
The most common exposures at age 1 were housing insecurity (22%), maternal depression (12%), and intimate partner violence (10%). The patterns at age 3 were similar.
After adjustment for sociodemographic factors, girls who were exposed to at least two social stressors either at age 1 or at age 3 had about double the likelihood of being obese by age 5.