Parents’ stress may be quietly driving childhood obesity, Yale study finds

Preventing obesity in children is not simple. For many years, the main approaches have focused on encouraging healthy eating and regular physical activity. Researchers at Yale now suggest that another important factor should be added to that list: reducing stress in parents.

A research team led by Yale psychologist Rajita Sinha found evidence that lowering parental stress may help reduce the risk of obesity in young children.

"It's the third leg of the stool," said Sinha. "We already knew that stress can be a big contributor in the development of childhood obesity. The surprise was that when parents handled stress better, their parenting improved, and their young child's obesity risk went down."

The findings were published in the journal Pediatrics.

Parent Stress May Influence Children's Eating and Health

Earlier studies have shown that children are more likely to develop obesity if their parents are obese. Researchers have also suspected that parental stress may be another hidden contributor to obesity in early childhood.

Previous work has shown that stressed parents are more likely to depend on fast food and less healthy eating habits. These choices can influence children's behavior and food preferences. When parents feel overwhelmed, family routines can break down, unhealthy food choices may become more common, and positive parenting behaviors can decline.

Still, most current childhood obesity prevention programs focus mainly on nutrition education and physical activity. According to Sinha, these efforts often fail to create lasting improvements.

Sinha is the Foundations Fund Professor in Psychiatry and a professor in neuroscience and child study at Yale School of Medicine.

Testing a Stress Reduction Program for Parents

To explore the role of parental stress, researchers conducted a 12 week randomized prevention trial involving 114 parents from diverse ethnic and socioeconomic backgrounds. All participants had children between two and five years old who were overweight or obese.

Parents were assigned to one of two groups. One group participated in a stress focused program called Parenting Mindfully for Health (PMH). This program taught mindfulness techniques and behavioral self regulation skills while also providing guidance on healthy nutrition and physical activity.

The other group served as a comparison group and received only counseling about nutrition and physical activity.

Both groups met once a week for sessions lasting up to two hours. During the 12 week program, researchers measured parent stress levels and tracked the children's weight. Children's weight was also measured three months after the program ended.

Researchers also monitored parenting behaviors such as warmth, listening, patience, and positive emotional interactions, along with children's healthy and unhealthy food intake before and after the intervention.

Results Show Improvements When Parent Stress Drops

By the end of the study, only the PMH group experienced lower levels of parent stress, improved parenting behaviors, and a reduction in unhealthy eating among their children. Importantly, the children in this group did not show significant weight gain three months after the program ended.

The control group showed a different pattern. Parents in that group did not experience improvements in stress levels, parenting behaviors, or children's unhealthy food intake. Their children gained significantly more weight and were six times more likely to move into the overweight or obesity risk category at the three month follow up.

Researchers also observed that the link between high parent stress, weaker parenting behaviors, and lower healthy food intake in children remained in the control group after three months. In contrast, this connection was no longer significant in the PMH group.

"The combination of mindfulness with behavioral self-regulation to manage stress, integrated with healthy nutrition and physical activity, seemed to protect the young children from some of the negative effects of stress on weight gain," Sinha said.

Building on Research Into Stress and Health

This work builds on ongoing research at the Yale Stress Center. The center is an interdisciplinary consortium created with support from a 2007 National Institutes of Health Common Fund initiative that studies the biology of stress, health behaviors, and their effects on chronic mental and physical illness.

"Childhood obesity is such a major issue right now, and the results of this study are highly relevant to the current administration's priority of reducing childhood chronic diseases," said Sinha. "When people start moving up the weight scale, their risk of obesity-related illnesses, even in children, is increased."

The findings suggest that long term studies of Parenting Mindfully for Health could provide further insight into reducing childhood obesity risk. According to Sinha, results from a larger group of families followed for two years are expected in the future.

Research Team and Support

The study was co led by Wendy Silverman, the Alfred A. Professor in the Child Study Center and professor of psychology, and Ania Jastreboff, the Harvey and Kate Cushing Professor of Medicine and professor of pediatrics. Additional authors came from the Yale School of Medicine departments of pediatrics and neuroscience and the Yale Child Study Center.

Researchers from the Bethesda Group, the Chicago School of Professional Psychology, the University of New Mexico, and George Mason University also contributed to the study.

The research was supported by the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).