The Mediator and/or Moderator Role of Complexity of Knowledge about Healthy Eating and Self-Regulated Behavior on the Relation between Family’s Income and Children’s Obesity

Abstract

Childhood obesity rates have been increasing over the years and is considered one of the most serious public health problems of the century. Low socioeconomic status has been associated with a higher body mass index. However, the pathways underlying this complex relationship are poorly understood. This study aimed to evaluate the possible mediation and/or moderation effects of complexity of knowledge about healthy eating, and self-regulation processes towards healthy eating, in the association between family’s income and weight of elementary school age children. The results showed that complexity of knowledge does not mediate the relationship between socioeconomic status and weight. Still, whenever the levels of complexity of knowledge and self-regulation are high, there is a moderation effect of complexity of knowledge on the relationship between family’s income and weight, conditioned by self-regulation scores. These promising findings support the idea that knowledge about healthy eating in isolation could be insufficient for practicing a healthy diet and underline the relevance of combining transmission of knowledge with training in specific competences (e.g., self-regulation strategies). Considering that complexity of knowledge about healthy eating and self-regulation strategies are interrelated and can be both improved, future preventive interventions could consider incorporating both in their design to mitigate childhood obesity.

Health-Related Behaviors Among School-Aged Children and Adolescents During the Spanish Covid-19 Confinement

“…In contrast, a recent survey among 600 Spanish adults reported that most of the participants maintained vegetable and fruit consumption during the first 5 confinement weeks, although these results might have changed after the whole confinement period ( 50 ). Also, lower food away from home consumption was linked to changes in diet quality (i.e., less added sugars and added fats, and more fiber consumption) ( 51 ), although, for this specific and unprecedented context differences regarding usual eating habits and socioeconomic family status (i.e., higher family socioeconomic status usually lead to healthier eating habits), self-regulating behaviors and knowledge might play an important role ( 52 ). Also, school canteen deprivation could influence the fruit and vegetable consumption since that has observed to worsen healthy habits concerning diet ( 53 ).…”

“…Overall, both parental guidance and example can strongly influence children's and adolescent behaviors regarding diet, screen, and physical activity habits ( 55 , 56 ), which, in turn, could be also influenced by socioeconomic variables such as education and income (i.e., higher education or higher income may lead to healthier HRB) ( 52 , 57 ). Health complications for children and adolescents derived from prolonged confinement or repeated viruses' outbreaks might comprise a higher fat percentage, lower bone mineral density, lower motor competence, higher blood pressure, and higher socio-emotional behavior problems later, among others ( 58 – 63 ).…”

“…Besides, since the likelihood of eating at convenience during Covid-19 confinement might have increased, that could have contributed to maintaining similar levels of fruit and vegetable consumption during this period as the active choice could benefit this behavior among children (54). Overall, both parental guidance and example can strongly influence children's and adolescent behaviors regarding diet, screen, and physical activity habits (55,56), which, in turn, could be also influenced by socioeconomic variables such as education and income (i.e., higher education or higher income may lead to healthier HRB) (52,57). Health complications for children and adolescents derived from prolonged confinement or repeated viruses' outbreaks might comprise a higher fat percentage, lower bone mineral density, lower motor competence, higher blood pressure, and higher socio-emotional behavior problems later, among others (58)(59)(60)(61)(62)(63).…”

An online-based intervention to promote healthy eating through self-regulation among children: study protocol for a randomized controlled trial

“…The majority of these interventions focused on transmitting nutritional knowledge about healthy food, especially emphasizing on increased consumption of fruits and vegetables, and targeting specific behaviors, such as unhealthy eating habits and lack of physical activity (e.g., [ 14 ]). However, research shows that beliefs about healthy eating have a stronger influence on eating behavior than factual knowledge about food [ 17 ] and that providing knowledge about healthy eating only has influence on weight when combined with the promotion of self-regulation competences [ 18 ]. This suggests that the traditional approach of simply conveying knowledge on healthy eating may not be the optimal one.…”

“…In recent years, SR has started to receive attention as a key predictor of a variety health-related and wellbeing outcomes. For instance, poor SR appears to be a predictor of weight gain, especially in adolescence [ 18 , 20 , 31 ]. Several studies have successfully implemented self-management programs among individuals with various health conditions, such as heart disease [ 20 ].…”