Cumulative Risk Exposure and Waist Circumference in Preschool-Aged Children: the Mediating Role of Television and Modera
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ORIGINAL ARTICLE
Cumulative Risk Exposure and Waist Circumference in Preschool-Aged Children: the Mediating Role of Television and Moderating Role of Sex Anna H. Grummon, BA, MSPH 1 & Amber Vaughn, MPH, RD 2 & Deborah J. Jones, PhD 3 & Dianne S. Ward, EdD 2,4
# The Society of Behavioral Medicine 2017
Abstract Background Children exposed to multiple stressors are more likely to be overweight, but little is known about the mechanisms explaining this association. Purpose This cross-sectional study examined whether children exposed to multiple stressors had higher waist circumference, and whether this association was mediated through children’s television time. Methods Participants were 319 parent–child dyads. Children were 2–5 years old and had at least one overweight parent (BMI ≥ 25 kg/m2). Data were collected at baseline of a larger childhood obesity prevention study and included information on psychosocial stressors (e.g., parenting stress), demographic stressors (e.g., low income), children’s television time, and children’s waist circumference. Two cumulative risk scores were created by summing stressors in each domain
Electronic supplementary material The online version of this article (doi:10.1007/s12160-016-9872-y) contains supplementary material, which is available to authorized users. * Dianne S. Ward [email protected] 1
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
2
Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
3
Department of Psychology, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
4
Department of Nutrition, Gillings School of Global Public Health, and Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, 135 Dauer Drive, 2200 McGavran-Greenberg Hall, CB no. 7461, Chapel Hill, NC 27599-7461, USA
(demographic and psychosocial). Mediation and moderated mediation analyses were conducted. Results Indirect effects of both cumulative risk scores on waist circumference through television time were not significant; however, moderated mediation analyses found significant moderation by gender. The indirect effects of both risk scores on waist circumference through television time were significant and positive for girls, but near-zero for boys. Conclusions Reducing television time should be explored as a strategy for buffering against the negative health effects of exposure to multiple stressors among girls. Longitudinal and intervention research is needed to confirm these results and to identify mediating factors between cumulative risk and body weight among boys. Keywords Cumulative risk . Stressors . Family stress . Environmental factors . Childhood overweight . Childhood obesity . Body weight . Waist circumference . Television viewing . Mediation . Moderation . Sex differences More than 20 % of children ages two to five in the USA are overweight or obese [1]. Increasing attention
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