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Pediatrics

Associations between family functioning during early to mid-childhood and weight status in childhood and adolescence: findings from a Quebec birth cohort

Abstract

Background

Impaired family functioning has been associated with obesity in children and adolescents, but few longitudinal studies exist. We examined whether family functioning from early to mid-childhood is associated with overweight and obesity in later childhood and adolescence.

Methods

We examined data from the Quebec Longitudinal Study of Child Development (QLSCD), a birth cohort (N = 2120), collected between 1998 and 2011. Parent-reported family functioning was assessed at 4 time points between ages 0.5 and 8 years using the McMaster Family Assessment Device with established cut-offs for impaired family functioning. Participants were classified as having experienced: 1) early-childhood impaired functioning, 2) mid-childhood impaired functioning, 3) both early and mid-childhood impaired functioning, or 4) always healthy family functioning. Overweight and obesity were determined at 10- and 13-years using WHO criteria. Covariate adjusted multinomial logistic regressions were fitted to the data to examine associations between longitudinal family functioning groups (using the always healthy functioning as reference category) and the likelihood of having overweight and obesity (vs normal weight) at ages 10 (n = 1251) and 13 years (n = 1226).

Results

In the 10- and 13-year sub-samples, respectively 10.2% and 12.5% of participants had experienced both early and mid-childhood impaired family functioning. Participants in this group had an increased likelihood of having obesity (vs normal weight) at age 10 years [OR = 2.63 (95% CI: 1.36; 5.08)] and at age 13 years [OR = 1.94 (95% CI: 0.99; 3.80] compared to those in the always healthy functioning group. No associations were found for other family functioning categories or for overweight status.

Conclusion

Approximately one in ten children experienced impaired family functioning throughout early and mid-childhood. Findings suggest a link between impaired functioning across childhood and the development of obesity at 10 years of age and possibly at 13 years of age.

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Acknowledgements

The Québec Longitudinal Study of Child Development was supported by funding from the ministère de la Santé et des Services sociaux, le ministère de la Famille, le ministère de l’Éducation et de l’Enseignement supérieur, the Lucie and André Chagnon Foundation, the Institut de recherche Robert-Sauvé en santé et en sécurité du travail, the Research Centre of the Sainte-Justine University Hospital, the ministère du Travail, de l’Emploi et de la Solidarité sociale and the Institut de la statistique du Québec. Additional funding was received by the Fonds de Recherche du Québec - Santé (FRQS). Natasha Wills-Ibarra received a Summer Research Bursary from the Ingram School of Nursing Programme, McGill University. Andraea Van Hulst and Lisa Kakinami hold a FRQS Junior 1 salary award. Geoff DC Ball is supported by an Alberta Health Services Chair in Obesity Research.

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AVH and NWI conceptualised and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. AVH additionally designed the data analysis plan and oversaw statistical analyses. BN conducted the data analysis and contributed to the interpretation of the results. LK provided methodological expertise for the QLSCD cohort and contributed to the interpretation of study findings. KP and GDB contributed to the conceptualisation of the study, the measurement of family functioning, and the interpretation of study findings. All authors critically reviewed the manuscript for important intellectual content and approved submission of its final version.

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Correspondence to Andraea Van Hulst.

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Van Hulst, A., Wills-Ibarra, N., Nikiéma, B. et al. Associations between family functioning during early to mid-childhood and weight status in childhood and adolescence: findings from a Quebec birth cohort. Int J Obes 46, 986–991 (2022). https://doi.org/10.1038/s41366-021-01041-8

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