Observed parenting practices in early childhood as predictors of child weight status and behavioral problems at age 10

Pediatric obesity is a public health concern due to its elevated prevalence rates and its relation to concurrent and long-term physical and psychosocial consequences. Pediatric obesity has been found to be associated with problem behaviors, albeit with inconsistent findings. The mechanism of this relation is unclear. It is possible that they have a shared etiology. Self-regulation and parenting practices are two factors that have been implicated in the development of problem behaviors and are garnering evidence for their relation with pediatric obesity. The goal of the present study was to examine whether self-regulation (SREC), positive behavior support (PBSEC), and coercive limit-setting (CLSEC) in early childhood are shared etiological factors of pediatric obesity and problem behaviors. Using multinomial logistic regression the likelihood of belonging to four outcome groups (Comorbid, Problem behavior only, Overweight only, and Typically developing) at age 10 based on these factors was assessed. Analyses controlled for intervention group assignment, child gender, child African-American or Bi-racial, child Hispanic, cumulative risk, child body size impression at age 2, and parent body size impression at baseline. In the models examining SREC alone, for every 1 standard deviation increase in SREC, there was a reliable reduction in the odds of the child belonging to the comorbid and problem behavior only groups at age 10, compared to the typically developing group (OR = 0.386, 95% CI [0.237, 0.628], OR = 0.281, 95% CI [0.157, 0.503], respectively). This relation was maintained when SREC was in the same model as PBSEC and CLSEC. PBSEC and CLSEC alone did not impact the likelihood of belonging to any of the outcome groups. A significant interaction was found between SREC and CLSEC, such that at high levels of both SREC and CLSEC the odds of a child belonging to the overweight only group at age 10 increased, compared to the typically developing group. Results highlight CLSEC as a parenting practice that may place a highly regulated child at risk for becoming overweight. Overall, the findings suggest that problem behaviors and pediatric obesity do not have a shared etiology.