Different types of parental stress and childhood obesity: A systematic review of observational studies

Abstract

Different types of parental stress may influence children's health behaviors and weight. The aim of this review was to systematically examine the relationships between parental stress and child obesity. We reviewed 27 studies published through December 2018 and classified parental stress as parents' general stress, parenting role stress, and life event stress. There were positive relationships of parents' general stress and parenting role stress with child obesity among families with younger children and in longitudinal studies. The relationship between life event stress and child obesity differed by measures. We found that parenting role stress may be associated with unhealthy parenting practices. Contextual factors such as children's and parents' sex, race or ethnicity, socioeconomic status, and family structure appeared to play a moderating role in the relationship between parents' stress and child obesity, which warrant cautious interpretation. Our recommendations for future research include clarifying further the types of parental stress that influence child obesity, evaluating long-term relationship between parental stress and child obesity, and identifying possible mediating factors to support the relationship between parents' stress and child obesity. Researchers may also consider developing stress management programs for parents to address child obesity. KEYWORDS child health behaviors, child obesity, parental stress Child obesity is a health threat despite much effort to decrease the rate of obesity in children. In the United States, 18.5% of children between 2 and 19 years were affected by obesity (body mass index [BMI] ≥ age-specific 95th percentile of the Centers for Disease Prevention and Control [CDC] growth charts) in 2015 to 2016. 1 Children with obesity are more likely to be adults with obesity, which increases the risk of developing cardiovascular diseases, cancer, and type 2 diabetes. 2 The epidemic of child obesity and subsequent health issues highlight the importance of early identification of obesity risk factors in children to promote risk reduction. Among the multifactorial influences on child obesity, parents can impact their child's health behaviors regarding diet (eg, fruit and vegetable consumption), physical activity, and sedentary behavior (eg, screen time). 3 Family-based interventions targeting parents to improve child obesity have reported mixed outcomes: some have been effective, while others have not. 4,5 Such interventions have focused primarily on improving parenting skills, parenting practices, or knowledge of healthy lifestyles. 3,6 The risks for developing child obesity are not limited to behavioral factors. Other risks could include parents' psychological factors, especially parental stress, and these factors may be important in the relationship between parents and their child's obesity risk factors.Stress is defined as physiological and psychological responses to stressors that are actual events or perceived threats to an individual. 7Stress is based on individuals' perc...

Maternal Stress, Depressive Symptoms and Body Mass Index of Adolescents: A Prospective Study

“…Socioeconomic factors are also known to be of speci c interest in weight development of children and adolescents. We found that maternal nancial stress was associated with higher baseline zBMI scores among adolescents, a nding in line with previous ones [23,24,61]. More remarkably, a lower educational level among adolescents was consistently associated with a higher zBMI at T2 (β = .16, p = .001) in all our models.…”

“…Because women experience greater levels of psychological stress than men [15,16], maternal psychological wellbeing and subsequent parenting behaviors may therefore have important implications for children's development. To date, growing evidence suggests that maternal psychological stress and depressive symptoms are associated with increased risk rates of obesity in children [17][18][19][20][21][22][23], children's decreased consumption of fruits and vegetables, higher child sedentary behavior [24][25][26] and breakfast skipping and children's high consumption of sweetened drinks, less sleep and less outdoor play [27][28][29].…”

“Food” and “non-food” self-regulation in childhood: a review and reciprocal analysis

“…This means that ASR involves not only the regulation of energy intake, but also the choice of foods, especially with respect to "healthy" and "unhealthy" diet and food choices [34,35,[158][159][160][161][162]. Finally, in the case of ASR, bottom-up processes can arise in different ways, such as from hunger (and the food could be healthy or unhealthy) versus from the attraction of palatable food, or the sweet taste [136,151], from attraction arising from food having been restricted [163,164], especially for children lower in inhibitory control [121], the desire to eat to regulate emotions [29,118,165,166], and in response to stress [167][168][169][170]. This means that what is being responded to and what or how top-down processes might be drawn on seems variable and uncertain in the case of food and eating: is the same top-down process required in relation to self-regulating responses to foods of large portion size and foods higher in energy density, for example?…”

Maternal stress and depressive symptoms and adolescents’ body mass index: a prospective study

“…They are considered to be the primary gatekeeper of the home food environment [27]. To date, growing evidence suggests that maternal mental health issues (i.e., psychological stress and depressive symptoms) are associated with increased risk rates of weight gain, obesity and related weight-related behaviors (i.e., eating, physical activity and sleep patterns) in children and adolescents [28][29][30][31][32][33][34][35][36][37][38]. However, most studies have been limited by cross-sectional designs and have been aimed at (younger) children.…”