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.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
from$1.95
to$39.95
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet. 2017;390:2627–42.
Statistics Canada. Overweight and obesity based on measured body mass index, by age group and sex, Table 13-10-0373-01. 2017. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310037301.
Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic risks and severity of obesity in children and young adults. N Engl J Med. 2015;373:1307–17.
Sutaria S, Devakumar D, Yasuda SS, Das S, Saxena S. Is obesity associated with depression in children? Systematic review and meta-analysis. Arch Dis Child. 2019;104:64–74.
Friedlander SL, Larkin EK, Rosen CL, Palermo TM, Redline S. Decreased quality of life associated with obesity in school-aged children. Arch Pediatr Adolesc Med. 2003;157:1206–11.
Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92:251–65.
Davison KK, Birch LL. Childhood overweight: a contextual model and recommendations for future research. Obesity Rev. 2001;2:159–71.
Halliday JA, Palma CL, Mellor D, Green J, Renzaho AMN. The relationship between family functioning and child and adolescent overweight and obesity: a systematic review. Int J Obes. 2014;38:480–93.
Pratt KJ, Skelton JA. Family functioning and childhood obesity treatment: a family systems theory-Informed approach. Acad Pediatr. 2018;18:620–7.
Alderfer MA, Fiese BH, Gold JI, Cutuli J, Holmbeck GN, Goldbeck L, et al. Evidence-based assessment in pediatric psychology: family measures. J Pediatr Psychol. 2008;33:1046–61.
Pratt KJ, Van Fossen CA, Berge JM, Murray R, Skelton JA. Youth weight status and family functioning in paediatric primary care. Clin Obes. 2019;9:e12314.
McConley RL, Mrug S, Gilliland MJ, Lowry R, Elliott MN, Schuster MA, et al. Mediators of maternal depression and family structure on child BMI: parenting quality and risk factors for child overweight. Obesity. 2011;19:345–52.
Haines J, Rifas-Shiman SL, Horton NJ, Kleinman K, Bauer KW, Davison KK, et al. Family functioning and quality of parent-adolescent relationship: cross-sectional associations with adolescent weight-related behaviors and weight status. Int J Behav Nutr Phys Act. 2016;13:68.
Berge JM, Telke S, Tate A, Trofholz A. Utilizing a board game to measure family/parenting factors and childhood obesity risk. J Nutr Educ Behav. 2019;51:419–31.
Warnick JL, Stromberg SE, Krietsch KM, Janicke DM. Family functioning mediates the relationship between child behavior problems and parent feeding practices in youth with overweight or obesity. Transl Behav Med. 2019;9:431–9.
Gibson LY, Byrne SM, Davis EA, Blair E, Jacoby P, Zubrick SR. The role of family and maternal factors in childhood obesity. Med J Aust. 2007;186:591–5.
Stradmeijer M, Bosch J, Koops W, Seidell J. Family functioning and psychosocial adjustment in overweight youngsters. Int J Eat Disord. 2000;27:110–4.
de Sousa PML. Body-image and obesity in adolescence: a comparative study of social-demographic, psychological, and behavioral aspects. Span J Psychol. 2008;11:551–63.
Gibson LY, Allen KL, Byrne SM, Clark K, Blair E, Davis E, et al. Childhood overweight and obesity: maternal and family factors. J Child Fam Stud. 2016;25:3236–46.
Mellor D, Renzaho A, Swinburn B, Green J, Richardson B. Aspects of parenting and family functioning associated with obesity in adolescent refugees and migrants from African backgrounds living in Australia. Aust N Z J Public Health. 2012;36:317–24.
Heredia NI, Wilkinson AV, Forman MR, Christie IC, Wang J, Daniel CR, et al. Longitudinal associations of family functioning with body mass index in Mexican-origin adolescents living in the US. Prev Med. 2019;118:309–16.
Jetté M, Desgroseillers L. Survey description and methodology in the Longitudinal Study of Child Development in Québec (QLSCD 1998–2002). Quebec City, Quebec Canada: Institut de la Statistique du Québec. 2000;1.
Miller IW, Bishop DS, Epstein NB, Keitner GI. The McMaster family assessment device: reliability and validity. J Marital Fam Ther. 1985;11:345–56.
Hamilton E, Carr A. Systematic review of self-report family assessment measures. Fam Process. 2016;55:16–30.
Mansfield AK, Keitner GI, Dealy J. The family assessment device: an update. Fam Process. 2015;54:82–93.
Boterhoven de Haan KL, Hafekost J, Lawrence D, Sawyer MG, Zubrick SR. Reliability and validity of a short version of the general functioning subscale of the McMaster Family Assessment Device. Fam Process. 2015;54:116–23.
Canadian Pediatric Endocrine Group. WHO Growth Charts for Canada 2014. https://cpeg-gcep.net/content/who-growth-charts-canada.
Séguin L, Nikiéma B, Gauvin L, Lambert M, Tu MT, Kakinami L, et al. Tracking exposure to child poverty during the first 10 years of life in a Quebec birth cohort. Can J Public Health. 2012;103:e270–e6.
Berge JM, Wall M, Larson N, Loth KA, Neumark-Sztainer D. Family functioning: associations with weight status, eating behaviors, and physical activity in adolescents. J Adolesc Health. 2013;52:351–7.
Park SH, Kim MJ, Park CG, McCreary L, Patil C, Norr KF. Family factors and body mass index among Korean-American preschoolers. J Pediatr Nurs. 2015;30:e101–e11.
Pulkki-Råback L, Elovainio M, Hakulinen C, Lipsanen J, Hintsanen M, Jokela M, et al. Cumulative effect of psychosocial factors in youth on ideal cardiovascular health in adulthood: the Cardiovascular Risk in Young Finns Study. Circulation. 2015;131:245–53.
Pulkki-Råback L, Elovainio M, Hakulinen C, Lipsanen J, Kubzansky LD, Hintsanen M, et al. Positive psychosocial factors in childhood predicting lower risk for adult type 2 diabetes: the cardiovascular risk in Young Finns Study, 1980–2012. Am J Prev Med. 2017;52:e157–e64.
Salvy S-J, de la Haye K, Bowker JC, Hermans RC. Influence of peers and friends on children’s and adolescents’ eating and activity behaviors. Physiol Behav. 2012;106:369–78.
Chung SJ, Ersig AL, McCarthy AM. The influence of peers on diet and exercise among adolescents: a systematic review. J Pediatr Nurs. 2017;36:44–56.
Poulsen PH, Biering K, Winding TN, Nohr EA, Andersen JH. How does childhood socioeconomic position affect overweight and obesity in adolescence and early adulthood: a longitudinal study. BMC obesity. 2018;5:1–14.
Pratt KJ, Van Fossen CA, Kiser HM, Whiting R, Spees C, Taylor CA, et al. Dyadic reports of weight control practices, sedentary behaviors, and family functioning and communication between adult weight management patients and their children. Obes Sci Pract. 2021;7:326–36.
Dalton WT 3rd, Kitzmann KM, Burghen GA, Mallare JT, Stender SS. Family functioning and children’s response to primary care treatment for overweight: a preliminary study. J Pediatr Nurs. 2010;25:282–8.
Taylor JH, Xu Y, Li F, Shaw M, Dziura J, Caprio S, et al. Psychosocial predictors and moderators of weight management programme outcomes in ethnically diverse obese youth. Pediatr Obes. 2017;12:453–61.
Bates CR, Buscemi J, Nicholson LM, Cory M, Jagpal A, Bohnert AM. Links between the organization of the family home environment and child obesity: a systematic review. Obesity Rev. 2018;19:716–27.
Rhodes RE, Guerrero MD, Vanderloo LM, Barbeau K, Birken CS, Chaput J-P, et al. Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth. Int J Behav Nutr Phys Act. 2020;17:1–31.
Carbert NS, Brussoni M, Geller J, Mâsse LC. Moderating effects of family environment on overweight/obese adolescents’ dietary behaviours. Appetite. 2019;134:69–77.
Guerrero MD, Barnes JD, Tremblay MS, Pulkki-Råback L. Typologies of family functioning and 24-h movement behaviors. Int J Environ Res Public Health. 2021;18:699.
Pratt KJ, Ferriby M, Noria S, Skelton J, Taylor C, Needleman B. Perceived child weight status, family structure and functioning, and support for health behaviors in a sample of bariatric surgery patients. Fam Syst Health. 2020;38:300–9.
Park J, Woo S, Ju Y-S, Seo Y-G, Lim H-J, Kim Y-M, et al. Factors associated with dropout in a lifestyle modification program for weight management in children and adolescents. Obes Res Clin Pract. 2020;14:566–72.
Smith JD, Montaño Z, Maynard A, Miloh T. Family functioning predicts body mass index and biochemical levels of youths with nonalcoholic fatty liver disease. J Dev Behav Pediatr. 2017;38:155–60.
Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, et al. Pediatric obesity-assessment, treatment, and prevention: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2017;102:709–57.
Skelton JA, Van Fossen C, Harry O, Pratt KJ. Family dynamics and pediatric weight management: putting the family into family-based treatment. Curr Obes Rep. 2020;9:424–41.
White IR, Royston P, Wood AM. Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011;30:377–99.
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.
Author information
Authors and Affiliations
Contributions
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.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
About this article
Cite this article
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
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41366-021-01041-8