Alison L Miller1, Ashley N Gearhardt2, Lauren Retzloff3, Julie Sturza3, Niko Kaciroti4, Julie C Lumeng5. 1. Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Mich. Electronic address: alimill@umich.edu. 2. Department of Psychology, University of Michigan, Ann Arbor, Mich. 3. Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich. 4. Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Mich. 5. Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich; Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Mich; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Mich.
Abstract
OBJECTIVE: To identify whether psychosocial stress exposure during early childhood predicts subsequent increased eating in the absence of hunger (EAH), emotional overeating, food responsiveness, and enjoyment of food. METHODS: This was an observational longitudinal study. Among 207 low-income children (54.6% non-Hispanic white, 46.9% girls), early childhood stress exposure was measured by parent report and a stress exposure index calculated, with higher scores indicating more stress exposure. Eating behaviors were measured in early (mean, 4.3; standard deviation, 0.5 years) and middle (mean, 7.9; standard deviation, 0.7 years) childhood. Observed EAH was assessed by measuring kilocalories of palatable food the child consumed after a meal. Parents reported on child eating behaviors on the Child Eating Behavior Questionnaire. Child weight and height were measured and body mass index z score (BMIz) calculated. Multivariable linear regression, adjusting for child sex, race/ethnicity, and BMIz, was used to examine the association of stress exposure with rate of change per year in each child eating behavior. RESULTS: Early childhood stress exposure predicted yearly increases in EAH (β = 0.14; 95% confidence interval, 0.002, 0.27) and Emotional Overeating (β = 0.14; 95% confidence interval, 0.008, 0.27). Stress exposure was not associated with Food Responsiveness (trend for decreased Enjoyment of Food; β = -0.13; 95% confidence interval, 0.002, -0.26). All child obesogenic eating behaviors increased with age (P < .05). CONCLUSIONS: Early stress exposure predicted increases in child eating behaviors known to associate with overweight/obesity. Psychosocial stress may confer overweight/obesity risk through eating behavior pathways. Targeting eating behaviors may be an important prevention strategy for children exposed to stress.
OBJECTIVE: To identify whether psychosocial stress exposure during early childhood predicts subsequent increased eating in the absence of hunger (EAH), emotional overeating, food responsiveness, and enjoyment of food. METHODS: This was an observational longitudinal study. Among 207 low-income children (54.6% non-Hispanic white, 46.9% girls), early childhood stress exposure was measured by parent report and a stress exposure index calculated, with higher scores indicating more stress exposure. Eating behaviors were measured in early (mean, 4.3; standard deviation, 0.5 years) and middle (mean, 7.9; standard deviation, 0.7 years) childhood. Observed EAH was assessed by measuring kilocalories of palatable food the child consumed after a meal. Parents reported on child eating behaviors on the Child Eating Behavior Questionnaire. Child weight and height were measured and body mass index z score (BMIz) calculated. Multivariable linear regression, adjusting for child sex, race/ethnicity, and BMIz, was used to examine the association of stress exposure with rate of change per year in each child eating behavior. RESULTS: Early childhood stress exposure predicted yearly increases in EAH (β = 0.14; 95% confidence interval, 0.002, 0.27) and Emotional Overeating (β = 0.14; 95% confidence interval, 0.008, 0.27). Stress exposure was not associated with Food Responsiveness (trend for decreased Enjoyment of Food; β = -0.13; 95% confidence interval, 0.002, -0.26). All childobesogenic eating behaviors increased with age (P < .05). CONCLUSIONS: Early stress exposure predicted increases in child eating behaviors known to associate with overweight/obesity. Psychosocial stress may confer overweight/obesity risk through eating behavior pathways. Targeting eating behaviors may be an important prevention strategy for children exposed to stress.
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