Str e ss & Child obe sity: Die tar y pathways in the c onte xt of str e ss E le a no r T a te Sho nko ff, PhD Ca ndida te 8t 8th B h Bienni ennial al C Chi hildhood dhood O Obes besity Conf onferenc nce July 2, 2015
What is str e ss? A stre sso r disrupts ho me o sta sis a nd re q uire s a n o rg a nism to adapt a nd re sto re e q uilib rium I nte rna l vs. E xte rna l Ac ute vs. Chro nic Me a sure me nt: Sub je c tive , Ob je c tive , Bio lo g ic a l Selye, H. (1950). Stress and the general adaptation syndrome. British medical journal, 1 (4667), 1383. Ursin, H., & Eriksen, H. R. (2004). The cognitive activation theory of stress. Psychoneuroendocrinology, 29 (5), 567-592. Wilson, S. M., & Sato, A. F. (2014). Stress and Paediatric Obesity: What We Know and Where To Go. Chemphyschem, 15 (5), 91-102.
Ar e c hildr e n str e sse d? 8.3% o f 12–17 ye a r o lds ha d “me nta lly unhe a lthy da ys” o n a lmo st ha lf o f the da ys in the la st mo nth 5% o f 13-18 ye a r o lds ha d e ve r e xpe rie nc e d Po st- tra uma tic Stre ss Diso rde r Perou, R., Bitsko, R. H., Blumberg, S. J., Pastor, P., Ghandour, R. M., Gfroerer, J. C., . . . Schieve, L. A. (2013). Mental health surveillance among children— United States, 2005–2011.
T r ansac tional Mode l of Str e ss and Coping Coping Appraisal outcomes: Obesity Stressor & coping Health risk efforts behaviors Lazarus, R. S., & Cohen, J. B. (1977). Environmental stress Human behavior and environment (pp. 89-127): Springer.
Could str e ss affe c t c hildr e n’s we ight- r e late d be havior s? Coping Appraisal outcomes: Obesity Stressor & coping Health risk efforts behaviors E E a ting b e ha vio r a ting b e ha vio r Physic a l a c tivity He a lth b e ha vio r le a rne d in c hildho o d te nds to tra c k to a dultho o d Craigie, A. M., Lake, A. A., Kelly, S. A., Adamson, A. J., & Mathers, J. C. (2011). Tracking of obesity-related behaviours from childhood to adulthood: A systematic review. Maturitas, 70(3), 266-284. Lazarus, R. S., & Cohen, J. B. (1977). Environmental stress Human behavior and environment (pp. 89-127): Springer.
Stre ss ma y c ha ng e e a ting be ha vior • Stre ss ma y le a d to : – hig he r swe e ts c o nsumptio n (o lde r a g e ; g irls) – e mo tio n-drive n e a ting & hig h-c a lo rie / lo w- nutrie nt fo o ds • E mo tio n-fo c use d c o ping & unhe a lthy sna c ks • Hig h-re a c tive / hig h-re stra int: – mo re c a lo rie s (≈173 kcals) – e a t fo r lo ng e r (> 3 mins) Balantekin, & Roemmich, (2012). Children’s coping after psychological stress. Choices among food, physical activity, and television. Appetite, 59 (2), 298-304. Michels N. et al. (2015). Longitudinal Association Between Child Stress and Lifestyle. Health Psychology, 34 (1), 40-50. Shimai, S., et al. (2000). Snacking behavior among elementary and junior high school students and its relationship to stress-coping. Jap. jrnl pub. hlth, 47 (1) Tate et al. (2015). Two facets of stress and indirect effects on child diet through emotion-driven eating. Eating Behavior.
Str e ss may inc r e ase obe sity r isk • Chro nic stre ss ha s b e e n a sso c ia te d with hig he r o b e sity risk • Mo re like ly fo r g irls • Stre ss-e a ting & hig he r o dds o f o b e sity De Vriendt et al. (2012). European adolescents' level of perceived stress and its relationship with body adiposity-The HELENA Study. European Journal of Public Health, 22 (4), 519-524. Jaaskelainen et al. (2014). Stress-related eating, obesity and associated behavioural traits in adolescents: a prospective population-based cohort study. Bmc Public Health, 14 . Wilson & Sato, 2014
Could obe sity a lso a ffe c t stre ss re a c tivity a nd e a ting be ha vior? Eating Stress Obesity behavior
Obe sity ma y a ffe c t stre ss re sponse s a nd e a ting be ha vior • Ove rwe ig ht/ o b e se yo uth: – hig he r c o rtiso l re spo nse to so c ia l stre sso rs – mo re hig h-de nsity sa lty fo o ds fo llo wing so c ia l stre ss Horsch et al. (2015). Impact of physical activity on energy balance, food intake and choice in normal weight and obese children in the setting of acute social stress: a randomized controlled trial. Bmc Pediatrics, 15 . Verdejo-Garcia et al. (2015). Social Stress Increases Cortisol and Hampers Attention in Adolescents with Excess Weight. Plos One, 10 (4).
Bauer et al. (2012). Parental employment and work-family stress: Associations with family food environments. Social Science & Medicine, 75(3), 496-504 Hurley et al. (2008). Maternal symptoms of stress, depression, and anxiety are related to nonresponsive feeding styles in a statewide sample of WIC participants. Journal of Nutrition, 138 (4), 799-805. Parks et al. (2012). Influence of Stress in Parents on Child Obesity and Related Behaviors. Pediatrics, 130 (5), E1096-E1104.
Me thods • Ma te rna l stre ss a fte r the c hild’ s b irth • 17 studie s; 19 inde pe nde nt e ffe c t size s • Mo the r-c hild dya ds – M = 2,462 • Child a g e a t ma te rna l stre ss me a sure – c ro ss-se c tio na l ( M = 6.36 yrs., SD = 3.23) – lo ng itudina l ( M = 1.68 yrs., SD = 1.38)
Positive e ffe c t size be twe e n ma te rna l stre ss &c hild obe sity risk Cro ss-se c tio na l d = .20, p < .01 L o ng itudina l d = .18, p =.05 Mo de ra to rs in lo ng itudina l studie s: Child stre ss Study q ua lity Child a g e
Child Age at Mate r nal Str e ss Me asur e R e g re s s io n o f tim e _ s tre s s o n P o in t e s tim a te 0 .6 0 0 .5 3 L ong itudina l 0 .4 6 Effect size 0 .3 9 Point estimate 0 .3 2 0 .2 5 0 .1 8 0 .1 1 0 .0 4 -0 .0 3 -0 .1 0 -0 .3 0 0 .0 6 0 .4 2 0 .7 8 1 .1 4 1 .5 0 1 .8 6 2 .2 2 2 .5 8 2 .9 4 3 .3 0 Child age R e g re s s io n o f a v g _ a g e o n P o in t e s tim a te 1 .0 0 0 .8 9 Cross- se c tiona l 0 .7 8 Effect size 0 .6 7 Point estimate 0 .5 6 0 .4 5 0 .3 4 0 .2 3 0 .1 2 0 .0 1 -0 .1 0 1 .8 5 3 .0 3 4 .2 0 5 .3 7 6 .5 4 7 .7 1 8 .8 8 1 0 .0 5 1 1 .2 2 1 2 .3 9 1 3 .5 7 Child age
Ma te rna l stre ss is a ssoc ia te d with hig he r c hild obe sity risk ffe c t size d ≈ . 19 E E ffe c t ma y b e stro ng e r fo r to ddle rs tha n infa nts
Child eating Child stress Child obesity behavior Eating context Parent stress
Conc lusions & Implic ations • He lping fa milie s a nd c hildre n c o pe with stre ss ma y he lp pre ve nt o b e sity – E duc a tio n in stre ss-ma na g e me nt te c hniq ue s – Be a ttune d to e a ting ha b its fo r c hildre n in hig h-stre ss e nviro nme nts • F uture re se a rc h: – F a mily/ e xte rna l stre sso rs vs. pe rc e ive d stre ss vs. stre ss re a c tivity (e x. c o rtiso l) – I nte rve ntio ns
T hank you! Advisors and co-authors Dr. Genevieve F. Dunton, chair Dr. Yue Liao Support University of Southern California National Cancer Institute Training Fellowship Dairy Council of California 1 9
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