Background:
One-quarter of children are already overweight or obese when they enter preschool, underscoring a critical need to improve our understanding of childhood determinants of health, including both sociodemographic (such as poverty) and social-familial influences (such as parenting style), as well as how these determinants may interact with one another.
Objective:
To examine the effects of parenting style on the risk of obesity in youth and determine if poverty is a mediator or moderator for this association.
Methods:
Participants (age 0-11) were from the National Longitudinal Survey of Children and Youth (NLSCY), a representative cross-sectional survey of youth collected bi-annually (1994-2008) throughout Canada. Factor analysis identified 4 parenting styles consistent with Baumrind’s theory of authoritative (demanding and responsive), authoritarian (demanding but not responsive), permissive (responsive but not demanding), and negligent (not demanding and not responsive) parenting control prototypes. Multivariable logistic regression assessed the risk of a child being obese (BMI percentile ≥ 97.7
th
compared to age- and sex-specific WHO growth curves) based on parenting style after adjusting for age, sex, parental education, immigration status, family functioning score, birth order, and maternal age. Analyses were stratified by age (younger: 2-5 years of age, n=19,026; school-age: 6-11 years of age, n=18,551) due to age-related differences in parenting styles. Mediation or moderation by poverty (household income < low income cut-offs adjusted for household size and geographic region) was assessed. Analyses used sampling and bootstrap weights.
Results:
Younger children’s parents were primarily authoritative (42%, n=7357), followed by negligent (22%, n=3763), permissive (20%, n=3436), and authoritarian (16%, n=4470). Parenting styles in school-age children were similar (authoritative: 32%, n=7195, negligent: 31%, n=5586, permissive: 22%, n=3850, authoritarian: 15%, n=1920). In multivariable analyses, compared to authoritative parenting, younger and school-age children with authoritarian parents were 30% (95% CI: 1.1-1.5, p=0.0002) and 37% (CI: 1.1-1.7, p=0.006) more likely to be obese, respectively. In younger children, poverty moderated this association: authoritarian and negligent parenting was associated with 39% (CI: 1.2-1.6, p<0.0001) and 28% (CI: 1.1-1.5, p=0.002) increased risk of obesity, respectively, only among the children not living in poverty. In school-age children, poverty was not a mediator or moderator.
Conclusions:
Parenting style is associated with a child’s risk of obesity but is moderated by poverty in younger children. Successful strategies to combat childhood obesity need to reflect the independent and interactive effects of sociodemographic and social-familial influences on health especially in early childhood.
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