Maternal efficacy and sedentary behavior rules predict child obesity resilience

Abstract<br />Background:<br />To identify longitudinal individual, social and environmental predictors of adiposity (BMI z-score),<br />and of resilience to unhealthy weight gain, in healthy weight children and adolescents.<br />Methods:<br />Two hundred healthy weight children aged 5–12 years at baseline and their parents living in socio-economically disadvantaged neighborhoods were surveyed at baseline and three years later. Children’s height and weight were objectively measured, parents completed a detailed questionnaire that examined the home, social and neighborhood environments, and objective measures of the neighborhood environment were assessed using geographic information system data. Ch<br />ildren classified as healthy weight at baseline who had<br />small or medium increases in their BMI z-score between baseline and three year follow up (those in the bottom<br />and middle tertiles) were categorized as‘ resilient to unhealthy weight gain’. Where applicable, fully adjusted<br />multivariable regression models were employed to determine baseline intrapersonal, social and environmental predictors of child BMI z-scores at follow-up, and resilience to unhealthy weight gain at<br />follow-up.<br />Results:<br />Maternal efficacy for preventing their child from engaging in sedentary behaviors (B = − 0.03, 95 % CI: 0.06, 0.00) was associated with lower child BMI z-score at follow up. Rules to limit sedentary behaviors (OR = 1.14, 95 % CI: 1.03, 1.25) was a predictor of being resilient to unhealthy weight gain.<br />Conclusion:<br />The findings suggest that strategies to support parents to limit their children ’s sedentary behavior may be important in preventing unhealthy weight gain in socioeconomically disadvantaged communities.