Positive parenting during early childhood may prevent obesity

Today, one out of five American children is obese. Young children who are overweight are five times more likely than their peers of normal weight to be obese by adolescence. Obese children and adolescents, especially low-income and minority youth, are at increased risk for a range of medical, social and academic problems.

The new study led by Laurie Miller Brotman, PhD, professor of Child and Adolescent Psychiatry and Director of the Center for Early Childhood Health and Development at the NYU Child Study Center investigated whether early family intervention that was effective for parents of children with behavior problems, resulted in lower rates of obesity. This innovative study took advantage of two long-term follow up studies of high-risk children who had participated in evaluations of either ParentCorps or another effective parenting intervention, the "Incredible Years," during early childhood. The study involved 186 children from low-income, minority families at high risk for obesity who were randomly assigned to family intervention or a control group when the children were approximately four years old. Behavioral family intervention in early childhood included a series of weekly 2-hour parent and child groups over a 6-month period. The interventions did not address nutrition, activity, or weight.

"Children who enter school with behavior problems are at very high risk for academic underachievement and school dropout, antisocial behavior, delinquency, obesity and other health problems. ParentCorps engages parents of high-risk children, reduces harsh and ineffective parenting and prevents early behavior problems from escalating into more serious and intractable problems," said Dr. Brotman.

For more than a decade, Dr. Brotman and her colleagues have developed and evaluated programs for parents and young children living in urban poverty. ParentCorps, a culturally-informed family program for young children, helps parents to be more responsive and nurturing as well as more effective in their approach to discipline. ParentCorps graduates are more attentive and attuned to their children, spend more time playing and reading with their children and praise positive behaviors such as sharing with peers. After participating in ParentCorps groups, parents replace physical punishment with more effective strategies such as time out. ParentCorps has benefits for ethnically and socioeconomically diverse families, and is especially helpful for parents of children with behavior problems.

In both follow-up studies, children who were assigned to the intervention and children in the control condition were evaluated from three to five years later. The evaluation of children as they approached adolescence included examination of body mass index, sedentary activity and physical activity. In one of the studies, blood pressure and nutritional intake were also measured.

Children who received family intervention during early childhood had significantly lower rates of obesity compared to children in the control group. In the larger study, without intervention, more than half of the children with early behavior problems were obese by second grade. In contrast, among children with behavior problems who received ParentCorps in early childhood, only 24% were obese. Similarly positive effects were found across the two studies on sedentary behavior and physical activity. The one study that examined blood pressure and diet showed lower rates of blood pressure and relatively lower consumption of carbohydrates in adolescents who received early childhood intervention.

ParentCorps and other programs that promote effective parenting and prevent behavior problems at a young age may contribute to a reduction of obesity among low-income, minority youth.

Dr. Brotman's co-authors include Spring Dawson-McClure, PhD, Keng-Yen Huang, PhD, Rachelle Theise, PsyD, Dimitra Kamboukos, PhD, Jing Wang, MA, Eva Petkova, PhD, of the Department of Child and Adolescent Psychiatry and Gbenga Ogedegbe, MD, of the Department of Medicine, Division of General Internal Medicine, NYU School of Medicine.

This study of health outcomes was supported by the J. Ira and Nicki Harris Family Foundation. The original randomized controlled trials were supported by grants from the National Institute of Mental Health and the Institute for Education Sciences to Dr. Brotman.