Maternal efficacy and sedentary behavior rules predict child obesity resilience

Background: To identify longitudinal individual, social and environmental predictors of adiposity (BMI z-score), and of resilience to unhealthy weight gain, in healthy weight children and adolescents.

Methods: Two hundred healthy weight children aged 5-12 years at baseline and their parents living in socio-economically disadvantaged neighborhoods were surveyed at baseline and three years later. Children's height and weight were objectively measured, parents completed a detailed questionnaire that examined the home, social and neighborhood environments, and objective measures of the neighborhood environment were assessed using geographic information system data. Children classified as healthy weight at baseline who had small or medium increases in their BMI z-score between baseline and three year follow up (those in the bottom and middle tertiles) were categorized as 'resilient to unhealthy weight gain'. Where applicable, fully adjusted multivariable regression models were employed to determine baseline intrapersonal, social and environmental predictors of child BMI z-scores at follow-up, and resilience to unhealthy weight gain at follow-up.

Results: Maternal efficacy for preventing their child from engaging in sedentary behaviors (B = -0.03, 95 % CI: -0.06, 0.00) was associated with lower child BMI z-score at follow up. Rules to limit sedentary behaviors (OR = 1.14, 95 % CI: 1.03, 1.25) was a predictor of being resilient to unhealthy weight gain.

Conclusion: The findings suggest that strategies to support parents to limit their children's sedentary behavior may be important in preventing unhealthy weight gain in socioeconomically disadvantaged communities.