Effects Of Different Parental Weight Status On Eating Behaviors And Physical Development Of Preschool Children

Objective: To assess different parental weight status that may influence the eating behaviors and BMI z scores(BMI_Z)of preschool children by prospective cohort study,and to provide evidence for overweight and obesity prevention in early childhood.Methods: Participants were recruited from the Wuhan Maternal and Child Health Care System from November 2010 to October 2013 before children's one year old for those who were Wuhan residents and agreed to participate in the cohort.The baseline survey was conducted when children was 1 years old and families were defined as high risk group when father's BMI?24 kg/m2;the control group was defined as father's BMI<24.0 kg/m2 depended on data collected at baseline survey.And families were followed up within 2 weeks around children's 4 years old birthday.The study contained both anthropometric measurements and questionnaires fulfilling.In the questionnaires,parental social-economic status and other basic information,child eating behavior and feeding pattern were included.Chi square test were used to compare two sets of frequencies;t test and variance analysis are used to estimate whether data were significantly different from each other for continuous variables(obeying normal distribution or approximate normal distribution,such as age,height,weight,BMI,BMI_Z etc.).Cronbach's alpha coefficient and confirmatory factor analysis(CFA)was used in reliability and validity evaluation of Child Eating Behavior Questionnaire.Multiple regression models were adopted to evaluate the association between children's BMI_Z,children's eating behavior and parental weight status,adjusted with confounding factors.Results:(1)General: A total of 299 families included in the analysis,follow-ups of 176 were carried out which represent a follow-up rate of 58.86%,no significant difference was detected for basic characteristics between 4th years and the baseline population(P>0.05).114 of families were in the high risk group and 62 in the control group,no significant difference was found in the basic variables(P>0.05)expect paternal BMI.(2)Growth: high risk group had significant greater value than control group in weight,BMI,BMI_Z and overweight and obesity rates of children.Among them,the boys in high-risk group had significantly higher BMI and BMI_Z than those in the control group at age 1 to 4 years(P<0.05).Girls in high-risk group had significantly higher BMI and BMI_Z than those in the control group at age 0,2 and 4 years(P<0.05).Girls and boys in high-risk group had significantly greater weight than those in the control group at one years old(P<0.05),and for boys in high-risk group there were greater weight than those in the control group at age 2 to 4 years(P<0.05).Compare with control group,boys in high-risk group at age 2 to 4 years and girls at age 0 to 1 years had significant higher overweight/obesity rates(P<0.05).(3)Child Eating Behavior Questionnaire has good faith validity in the population of this study.Cronbach's a coefficient were between 0.63~0.84,CFA results show that the approximate error mean square root(RMSEA)is 0.069,the remaining indicators are reached or close to the reference value.(4)Results from multiple regression models indicated that paternal weight status and children 4-year-old BMI_Z value were positive correlated,after adjusted children gender,family income,maternal education level and breastfeeding duration(BMI_Z for boys in high-risk groups is 0.70 while those in control group is 0.20,BMI_Z for girls in high-risk groups is 0.81 while those in control group is 0.24).In unadjusted model(Model 1),"Emotional Under-eating" had a negative effect on children 4-year-old BMI_Z(?=-0.27,P<0.05),while "Fastness in Eating" had a positive effect on children 4-year-old BMI_Z(?= 0.34,P<0.05).Added parental weight status before pregnancy(Model 2)and adjusted for children gender,family income,maternal education level,and breastfeeding duration(Model 3)," Fastness in Eating" presented positive stable and significant correlation with child 4-year-old BMI_Z(?=0.35 and0.36,P<0.05).Conclusions: Parental weight status had significant impacts on child BMI_Z at 4 years old,maternal weight status should be concerned while paternal weight statue should also be take into consideration when making policies for children obesity prevention,as well as promoting children to form healthy eating behavior in early childhood.