Understanding gender-differences in the association of toddler self-regulation with obesity at kindergarten-age

• In Event: 1-037 - Developmental Influences on Cardiometabolic Risk in the Early Lifespan

Integrative Statement

Introduction: Poor childhood self-regulation is associated with worse health and social outcomes across many domains (Moffitt et al, 2011), including obesity (Schlam et al, 2013; Francis & Susman, 2009). Previous research in a large nationally representative cohort found that the pattern of association between toddler self-regulation and obesity at kindergarten-age differed for boys and girls. In boys, obesity prevalence was similar across low and intermediate quartiles of self-regulation and obesity was lower in the most self-regulated boys; whereas in girls, obesity prevalence was highest for the most and least self-regulated and lowest for those with intermediate levels of self-regulation. The higher prevalence of obesity among the most self-regulated girls was unexpected and warrants further exploration. Maternal education level is related to many aspects of parenting behavior and home environment for young children. Exploring maternal education as one indicator of children’s environment may offer insight into the different patterns of association between self-regulation and obesity previously observed in boys versus girls.

Study Population: The Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) was designed to provide information about the early learning environments of US children (Snow et al, 2007). ECLS-B utilized a nationally representative probability sample of children born in 2001. Assessments of children and families occurred when children were approximately 9mos, 24mos, 4.5yrs, and 5.5yrs. Our analyses use data from 24mos and 5.5yrs.

Methods: In the home at 24mos, an abridged version of the Bayley Scales of Infant Development (Bayley, 1993) was administered. Observers characterized multiple components of the child’s capacity for self-regulation, including adaptability, attention, persistence, and frustration tolerance (each rated on a 5-level scale), from which we constructed an index of self-regulation. Children’s height and weight were measured and obesity defined as a gender-specific body mass index-for-age ≥95th percentile (Kuczmarski et al, 2002) at age 5.5y. Sociodemographic covariates, including maternal education level, were reported during face-to-face interviews with the primary caregiver. Statistical analyses account for the complex sample design.

Results: Analyses include 6400 children with data available at both time points. Overall, 17.8% of children were obese at 5.5yrs, and obesity was more prevalent for boys (19.2%) compared to girls (16.5%). Self-regulation scores were lower for boys compared to girls (mean, 13.7 [95%CI, 13.4-13.9] vs 14.9 [95%CI, 14.7-15.1]), but for both genders the full distribution of self-regulation scores was observed. Higher levels of maternal education were associated with children’s better self-regulation (P<.05), and this was true for boys and girls. Patterns of association between toddler self-regulation and obesity prevalence differed by gender and maternal education (Figure). For girls, the U-shaped pattern of association was observed when maternal education level was intermediate (high school graduate and some college). However, among daughters of highly educated (college degree or more) mothers, obesity prevalence was highest for those girls who were the most self-regulated. Among boys, low maternal education was also associated with a different pattern of association between self-regulation and obesity; with lower obesity prevalence among the least well-regulated boys (Figure).

Authors

• Sarah E Anderson, The Ohio State University
  Presenting Author

• Robert Whitaker, Public Health and Pediatrics, Temple University; Columbia Bassett Program
  Non-Presenting Author