Longitudinal associations of family functioning with body mass index in Mexican-origin adolescents living in the U.S.

Abstract

Mexican-origin adolescents have a high prevalence of obesity. Research is needed to understand how family context may shape adolescent BMI. This study examined longitudinal associations of family functioning variables with the Centers for Disease Control and Prevention’s modified BMI z-score (BMIaz) in 1,175 Mexican-origin adolescents, and explored interactions with acculturation. Adolescents (50% female, aged 11–13 y in 2005–06) were identified from an ongoing cohort study of Mexican-origin adults in Houston, TX, and were assessed three times from 2005–06 to 2010–11. In multivariate linear mixed models stratified by gender, we assessed longitudinal associations of family cohesion and family conflict with adolescent BMIaz and explored interactions with language acculturation. We disaggregated the between- (mean) and within-person (individual deviation) components of family cohesion and family conflict to assess the effects on BMIaz. Approximately one-third of adolescents were obese at baseline, and BMIaz declined during the study. In girls, higher mean family cohesion and conflict were associated with steeper declines in BMIaz. Parental linguistic acculturation modified the relationship between within-person deviation in family cohesion and BMIaz in girls, such that high parental U.S. acculturation was associated with a stronger inverse association. There were no significant associations in boys. These findings highlight the potential importance of the family context to female adolescent BMI and the promise of addressing family context in obesity-related interventions.

Understanding family functioning in mothers and daughters with obesity

“…Receiving emotional support in the form of compliments was previously associated with increased physical activity in Latinas (Marquez, Norman, Fowler, Gans, & Marcus, 2018 ). Moreover, verbal encouragement by family has been identified as a facilitator of physical activity with parent-child dyads describing more support from each other than spousal dyads (Heredia et al, 2019 ). In our study, mothers viewed directives and daughters identified praise as forms of encouragement.…”

“…Thus, family functioning may serve an important focus of intervention for conditions such as obesity (Halliday et al, 2014 ). For example, high family functioning predicts greater decrease in body mass index in adolescent Mexican American girls (Heredia et al, 2019 ). The relationship between family functioning and obesity is likely bidirectional but longitudinal data suggests that poor family functioning in childhood is associated with obesity later in adolescence and early adulthood among females (Poulsen et al, 2018 ).…”

Family Dynamics in Sleep Health and Hypertension

“…In contrast, sensitive parenting (involving support and low hostility) in early childhood predicted lower BMI during adolescence [50,56]. Finally, in a large, longitudinal study on family cohesion and conflict, Heredia and colleagues found that less family cohesion and more conflict predict steeper weight loss declines in Mexican-American girls from age 12 to 17 [59].…”

Validation of the Childhood Family Mealtime Questionnaire in Mexican Adolescents with Obesity and Their Caregivers

“…In 2007, Barlow et al [7] proposed that comprehensive strategies incorporating family-based interventions, as well as changes in weight-related behaviors rather than weight loss goals, can lead to sustained improvements in medical and psychosocial outcomes for children and adolescents living with obesity. Numerous studies have delved into how family behaviors associated with lifestyle, such as diet, physical activity, feeding practices, parental roles, health care support, and parenting style, may influence the weight of adolescents [4,5,[8][9][10][11]. However, only a limited number of studies have explored the impact of broader family environmental factors, such as family functioning during mealtimes or the quality of the relationship between parents and adolescents, on the body composition and lifestyle of adolescents [6,12,13].…”