Early childhood obesity and childhood development Open Access

Abstract

Because of the high prevalence of childhood obesity a negative effect on childhood development could have a substantial population impact. Studies examining the association between obesity and development have produced inconsistent results and have been conducted primarily in older children. This dissertation explores the association between early childhood obesity and: cognitive ability; adaptive functioning; behavior; and executive functioning.

The first study assessed the extent to which body mass index (BMI), triceps- and subscapular-skinfold-thickness (TST, SST) differed in their classification of obesity status. This analysis used data from the Follow-Up Development and Growth Experiences (FUDGE) Study, a population of preschool-aged Atlanta children born at one of two Atlanta hospitals. Results demonstrated that agreement among obesity metrics was typically poor and the picture of childhood obesity can change depending on the population. The degree to which differences among metrics exists depends on the population.

The second study explored the association of early childhood overweight/obesity and cognitive ability by using data from FUDGE Study participants to assess the relationship of overweight/obesity with scores on the Differential Ability Scales (DAS). The study then used data from participants in the US Collaborative Perinatal Project (CPP) to examine the association between BMI at ages 3, 4, and 7 years and scores on the Stanford-Binet Intelligence Scales and Wechsler Intelligence Scales for Children. Results from the FUDGE Study found that overweight/obesity was associated with declines in nonverbal cognitive ability in preschool-aged boys; though not among girls. Analysis of CPP data indicated no association between either overweight or obesity and cognitive outcomes.

The third study used data from the FUDGE Study to explore the association of early childhood obesity with adaptive functioning, behavior, and executive functioning. Results indicated that overweight/obesity was associated with declines in motor skills scores among boys (with no corresponding association in girls) and in statue scores among girls of higher socioeconomic status.

Taken together, these studies found little evidence for an association between overweight/obesity and development. However, results indicate possible associations of overweight/obesity with nonverbal cognitive ability and motor skills in boys and NEPSY statue score in girls of higher SES.

Table of Contents

Table of Contents

1. INTRODUCTION.. 1

Dissertation Aims. 2

References. 5

2. LITERATURE REVIEW... 9

Childhood Obesity. 9

Risk factors for childhood obesity. 11

Health consequences of childhood obesity. 15

Measurement of childhood obesity. 17

Childhood obesity and childhood development 21

References. 28

Figures. 36

3. COMPARISON OF THREE OBESITY METRICS IN PRESCHOOL-AGED CHILDREN 37

Abstract 37

Introduction. 39

Methods. 42

Study Population. 42

Data Collection. 43

Study Variables/Measures. 44

Analysis. 45

Results. 45

Discussion. 48

References. 54

Tables and Figures. 58

4. THE ASSOCIATION BETWEEN EARLY CHILDHOOD OVERWEIGHT/OBESITY AND COGNITIVE ABILITY.. 62

Abstract 62

Introduction. 64

Methods. 66

Study Populations. 66

Data Collection. 68

Study variables. 69

Analysis. 72

Results. 73

Discussion. 78

References. 88

Tables. 91

5. THE ASSOCIATION BETWEEN EARLY CHILDHOOD OVERWEIGHT/OBESITY AND CHILDHOOD ADAPTIVE FUNCTIONING, BEHAVIOR, AND EXECUTIVE FUNCTIONING IN ATLANTA CHILDREN 98

Abstract 98

Introduction. 100

Methods. 102

Study Population. 102

Data collection. 104

Study variables. 105

Covariates. 106

Analysis. 106

Results. 107

Discussion. 111

References. 119

Tables. 124

6. DISSERTATION CONCLUSIONS AND SIGNIFICANCE.. 130

Dissertation summary. 130

Motivation. 130

Aims. 130

Conclusions. 131

Dissertation strengths and limitations. 132

Contributions of this dissertation and recommendations for the future. 137

References. 140

A1. SUPPLEMENTAL MATERIAL TO CHAPTER 3. 141

A2. SUPPLEMENTAL MATERIAL TO CHAPTER 4. 158

A3. SUPPLEMENTAL MATERIAL TO CHAPTER 5. 226

About this Dissertation

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School	Laney Graduate School
Department	Epidemiology
Degree	PhD
Submission	Dissertation
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	early childhood obesity obesity measurement FUDGE Study childhood development
Committee Chair / Thesis Advisor	Drews-Botsch, Carolyn D, Emory University
Committee Members	Coles, Claire, Emory University Vos, Miriam Benedicta, Emory University Gazmararian, Julie A, Emory University Kramer, Michael R, Emory University

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