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FOLKEHELSE-Folkehelse

Explaining Overweight and Physical Activity in Young Children: A Bio-Psycho-Social and Ecological Model

Awarded: NOK 6.0 mill.

Project Number:

213793

Application Type:

Project Period:

2012 - 2015

Funding received from:

Subject Fields:

There has been a definite increase in overweight and obesity among Norwegian children during the latter decades. Overweight children are in excess risk of becoming overweight as adults. Likewise, there is continuity in physical activity from childhood to adulthood. Alas, treatment of obesity has limited success. Thus preventive efforts should be prioritized, and especially so among young children. Such interventions should be informed by knowledge on the driving forces between obesity and physical inactivity. Such knowledge is scare with respect to young children. Because existing research strongly suggest that both weight and activity are multidetermined we examine the influence from a range of sources including the family, neighborhood, school, parents, and children themselves. Data stem from the Trondheim Early Secure Study (TESS) which follows a community sample of 1,000 children and their parents with bi-annual assessments from age 4 and onwards into adolescence. Physical activity is measured by means of an accelerometer worn on 7 consecutive days. Body composition is measured by bioimpedance. Family factors include housing, demographic factors, parent-child interaction, parenting styles. Neighborhood factors comprise access to leisure areas, playgrounds, ballparks, traffic safety. Parent factors include parental physical activity, transporting the child, mental health, eating problems, SES, BMI, and feeding styles. Child factors include self-esteem, sports participation, time outdoors, screen time, temperament, personality, mental health, social competence, cognition and intelligence. The third and fourth data collection rounds have been conducted during the study period, when the children were 8 and 10 years, respectively. The retention rates were 88% at 8 years (of those who participated when they were 6 years) and we had almost no loss of participants from 8 to 10 years (i.e. 699 families at 8 years and 704 families at 10 years of age). Preliminary findings have been presented at conferences and results have been submitted scientific journals. Broadly speaking, these findings show that Norwegian 1st graders spend on average slightly more 1 hour on moderate to vigorous physical activity (MVPA), objectively measured. Much time in MVPA is predicted by being a boy and temperamental surgency. Structural aspects of the neighborhood and active versus passive transportation of the child did not matter; neither did other child, parental, family and neighborhood characteristics. No change in MVPA occurred from 1st to 3rd grade, but a slight decrease was evident in 5th grade. Childhood obesity is determined by two factors, energy intake and energy expenditure. Intake is to a high degree determined eating patterns, i.e. stable traits such as being cue-dependent, emotional overeating, satiety responsiveness. Expenditure is due to the relative weight of activity and inactivity. Our results show, however, that physical activity and sedentary activity (i.e. screen time) do not predict BMI. Child eating patterns do predict changes in BMI, specifically traits labelled 'appetitive traits', i.e. satiety responsiveness, emotional overeating and food responsiveness (cue-dependency). We pursued this line of reasoning, if child eating traits are important in the development of obesity, what then determines such eating traits? Focusing on parental behavior vis a vis their child's eating we discovered that parents who to a greater degree relied on instrumental feeding, e.g. using food as a reward, had children who later on developed a tendency to eating more in response to food cues, i.e. the sight and smell of food, and also used food as a means of emotion regulation, e.g. eating more when feeling sad or upset. It is viable that parental feeding practices comes about as a response to their children's eating behavior or weight, e.g. trying to restrict the food intake of an already heavy and food-loving child. However, we observed no such child effects.

Preventative intervention to ameliorate risk for childhood obesity is critical to population health. The obesity epidemic is now reaching down to younger ages. Body mass in childhood exhibits strong continuity through adulthood and early obesity is likely to persist for a lifetime. Furthermore, interventions are likely to be most effective if they are implemented early in the life course when patterns of behavior and of development are more plastic. Research on the determinants of young children's physica l activity (PA) and eating habits is needed to inform prevention science and guide intervention design. We propose a model of PA and overweight (OW) development in children which accounts for interplay between three levels: community, family, and child. Community level factors afford or limit physical activity at the family and child levels, and thereby structure child behavior and OW. Family-level structural (e.g. socio-economic position) and behavioral (e.g. parenting practices) factors influence chil dren's PA and eating, and thereby OW. Child-level physical, behavioral and psychological factors directly impact children's PA/OW. Data collection on a probability sample of 1000 children (initially aged 4 years) and their families began in 2007 with bi ennial follow-up since. Children's PA is measured by accelerometry; children are interviewed concerning self-concept and social inclusion; body composition is measured by bio-impedance and anthropometry; resting heart rate is recorded; parenting practice s are measured by coded observation of family interaction; parents report their own PA and mental health and child feeding practices, temperament, conduct problems, mental health, social competence, eating habits, PA, transport habits, screen use, access to leisure time PA facilities, outdoor activities, organized sports; GIS data and parent report characterize the geographic area; self-report and national registers are used to derive socioeconomic information.

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Funding scheme:

FOLKEHELSE-Folkehelse