Researchers find mental health of parents matters when it comes to child obesity; study also examined role of income and rurality

As more of the nation’s children become overweight or obese, especially in rural areas, researchers are beginning to look beyond some of the known causes, like inactivity and a poor diet, to other contributors, like the mental health of their parents.

One such study, using data from 14,733 children between the ages of 10 and 17 in the 2016 National Survey of Children’s Health, found that both the mother and father’s mental health were associated with their child’s weight, but only the mother’s association remained significant after the data were adjusted for children’s food security, physical activity and screen time.

More than one in five Kentucky children between 10 and 17 are obese, ranking the state third in the nation, according to a new report from the Robert Wood Johnson Foundation.

The study, published in The Journal of Rural Health, also found that children were more likely to be overweight or obese in homes with household incomes that were double the federal poverty level or less, and less likely in other households. This comparison found little rural and urban differences.

Among rural families, 44.1% of children in low-income families were either overweight or obese, compared to 32.9% of those in high-income families. Among urban families, 40.4% of children in low-income families were either overweight or obese, compared to 28.3% in high-income families.

The study also found that among higher-income families, positive mental health of either parent was associated with lower odds that the child would be overweight or obese, but those odds persisted only in regard to the mother’s mental health after adjusting for other possible causes such as food insecurity, physical activity and screen time.

The mental health status of the parent was determined by this question: “In general, how is your mental or emotional health?” Those who answered “excellent” or “very good” were placed in the “positive mental health” category and those who answered “good,” “fair” or “poor” were not.

“Our findings highlight the need to address maternal mental health in rural settings in order to address the physical health of the child,” the researchers wrote. “We show that mothers’ mental health (in rural settings) remains associated with child weight among high‐income rural families despite adjustment for known individual, child‐level risk factors for obesity.”

The report also points to the “novel association” between a father’s mental health and a child’s weight, noting that the lack of association after the data were adjusted could reflect a more “transactional relationship” that often exists between fathers and children, compared to mothers’ supportive.

“This might explain why the variables of family food security, child physical activity, and child screen time moderated the association between paternal mental health and child weight,” the researchers write.

The report notes that the study only looked at data at one point in time, which leads to the potential for “reverse causality.” For example, overweight and obese children may experience more stress at school, which could have an affect on their parent’s mental health instead of the parent’s mental health instead of vice-versa. The report acknowledges that the mental-health data is self-reported.

“Despite these limitations, we found associations between mental health and child overweight/obesity,” the researchers write. “In addition, these national‐level data provide evidence that the rural–urban differences in obesity prevalence among children may be secondary to distributions of income, as we observed no difference in the rural prevalence of overweight/obesity after stratifying by income.”