Causes of childhood obesity complex, but families, media play key roles

Although the causes of obesity are complex, families have significant influence on children's dietary habits and weight, and should be involved in planning healthy living campaigns and efforts to curb food marketing that targets children, suggest the study's authors, Barbara H. Fiese and Kelly K. Bost, both with the University of Illinois.

"The family system plays an important role in understanding childhood obesity -- not as a source of blame but as part of a larger ecology that may support or derail children's health," wrote Fiese and Bost, who are scholars with the U. of I.'s Family Resiliency Center and its Synergistic Theory and Research on Obesity and Nutrition Group, better known as the STRONG Kids program.

While researchers have identified about 20 genes that heighten people's risk for obesity, a recent large study with 10-year-old children found that children's awareness of and response to feelings of fullness or hunger mediated the relation between their genetic risk for obesity and their body mass index, Fiese and Bost wrote.

Published recently in the journal Family Relations, the paper by Fiese and Bost indicated that shared family meals provide powerful opportunities to promote and model healthy eating behaviors and reduce children's likelihood of developing eating disorders or weight problems.

"Family communication is key to the developmental processes that promote -- or disrupt -- healthy eating habits, physical activity and internal cues to satiety," said Fiese, who is the center's director as well as a professor of human development and family studies. "Families who routinely engage in positive forms of direct communication and show genuine concern about each other's activities also have children who are less likely to be overweight or obese, or engage in unhealthy eating habits."

In a recent study of 200 families, Fiese's research team found that children whose family members shared meals that lasted at least 20 minutes each a minimum of four times a week weighed significantly less than peers whose family dinners were three or four minutes shorter.

Parenting styles, parent-child attachment relationships and feeding practices all have been found to be reliable indicators of children's food consumption, eating behaviors and risks for obesity. However, experts often don't involve parents when planning healthy-living campaigns for fear that parents will feel they are being blamed for their children's weight problems, according to the study.

Parents who are indulgent -- those who are not very demanding and are highly responsive to their children's desires -- tend to have children who eat fewer fruits and vegetables and more foods with high levels of sugar and fat, Fiese and Bost report.

"Several studies have indicated that parental responsiveness to young children's distress, including early hunger cues, contain some of the first learning experiences of dyadic stress coping and the resulting regulation of internal states, including emotions," said Bost, a professor of child development.

Researchers have found that using electronic media while dining increases children's risks for obesity as well, and Fiese and Bost hypothesize that there may be several reasons for this effect. Focusing on TV shows, text messages or other media may impede the positive communication and social interaction that promote healthy dietary habits. Adults may forego opportunities to model healthy eating habits such as portion control and be less attentive to what their children are consuming, the researchers said.

Studies also have found that people who are engrossed in watching TV or using their computers tend to eat mindlessly, consuming greater amounts of unhealthy foods and ignoring feelings of fullness, Fiese and Bost report.

Another hazard associated with electronic media usage during meals is that it increases children's exposure to food commercials and advergames -- video games created as product-marketing vehicles, oftentimes to whet young viewers' appetites for unhealthy foods such as sugary snacks, cereals or soda, Fiese and Bost wrote.

Both the Institute of Medicine and World Health Organization have identified the marketing of foods high in fat, sugar and salt as an important causal factor in childhood obesity, Fiese and Bost report.

Children between the ages of 2 and 11 view more than 10 food advertisements on TV daily, and although most 5-year-olds can name common food brands, they tend to recall more of the unhealthy products, researchers have found. Even worse, when children see an advertisement multiple times or in various forms, such as on billboards and on the Web, they perceive that food as nutritious, Fiese and Bost wrote.

Although the researchers support greater collaboration of experts with families, educating parents about the need to eat healthy and increase physical activity may not be enough, the researchers wrote: Parents also need the social tools to put concepts into action.

Toward that end, researchers at the Family Resiliency Center developed a series of educational videos called Mealtime Minutes, which address common problems such as sibling conflict, picky eaters and electronic device usage during meals. The videos are available on the center's website, on Youtube and Vimeo.