Examining the relationship between maternal employment and health behaviours in 5-year-old British children

Lifestyle patterns in European preschoolers: Associations with socio-demographic factors and body mass index

BACKGROUND

Energy balance-related behaviours (EBRBs), that is, dietary intake, screen, outdoor play and sleep, tend to combine into 'lifestyle patterns', with potential synergistic influences on health. To date, studies addressing this theme mainly focused on school children and rarely accounted for sleep, with a cross-country perspective.

OBJECTIVES

We aimed at comparing lifestyle patterns among preschool-aged children across Europe, their associations with socio-demographic factors and their links with body mass index (BMI).

METHODS

Harmonized data on 2-5-year-olds participating in nine European birth cohorts from the EU Child Cohort Network were used (EBRBs, socio-demographics and anthropometrics). Principal component analysis and multivariable linear and logistic regressions were performed.

RESULTS

The most consistent pattern identified across cohorts was defined by at least three of the following EBRBs: discretionary consumption, high screen time, low outdoor play time and low sleep duration. Consistently, children from low-income households and born to mothers with low education level had higher scores on this pattern compared to their socioeconomically advantaged counterparts. Furthermore, it was associated with higher BMI z-scores in the Spanish and Italian cohorts (β = 0.06, 95% CI = [0.02; 0.10], both studies).

CONCLUSION

These findings may be valuable in informing early multi-behavioural interventions aimed at reducing social inequalities in health at a European scale.

Impact of Household Economic and Mothers' Time Affluence on Obesity in Japanese Preschool Children: A Cross-sectional Study

Although the association between household economic affluence and children's obesity has been reported, the association between mothers' time affluence and obesity remains unclear. We conducted a cross-sectional study using Japanese national survey data (2015). The target population was 2-6-year-old preschool children and their mothers. Subjective household economic affluence and mothers' time affluence were divided into "affluent," "neither," "less affluent," and "non-affluent" groups. Obesity was defined based on the International Obesity Task Force. A logistic regression model was conducted to examine the association between household economic affluence, mothers' time affluence, and children's obesity. A total of 2254 respondents were included in the present analysis. The lower household economic affluence was not significantly associated with higher rates of children's obesity (odds ratio (OR) for the "non-affluent" compared with the "affluent" group was 1.68 (95% CI, 0.93-3.03)). A lower mothers' time affluence was not significantly associated with higher rates of children's obesity (OR for the "non-affluent" compared with the "affluent" group was 1.67 (95% CI, 0.92-3.03)). The prevalence of obesity was not synergistically higher when lower household economic affluence and lower mothers' time affluence were combined.

Maternal employment and childhood obesity in Russia

Existing research on childhood obesity shows that rising maternal employment is associated with increases in child weight. This paper aims to estimate the effect of maternal employment on childhood obesity in Russia, where obesity has been spreading quickly over the last 20 years. To address the endogeneity of maternal employment and estimate its effect on the weight outcomes of older siblings, I use plausibly exogenous variation in childcare enrolment for the youngest child in the household as an instrumental variable for maternal employment. Based on the Russian Longitudinal Monitoring Survey (RLMS-HSE), the results show that maternal employment leads to an increase in children's BMI and in their probabilities of becoming overweight and obese. In exploring the potential underlying mechanisms, I find that maternal employment is related to less physical activity, to a higher probability of either watching TV or playing video games, and to poorer dietary habits among children.

Dietary habits, physical activity, and sedentary behaviour of children of employed mothers: A systematic review

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Dietary pattern is poorer among children of employed mothers.

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Children of employed mothers are more physically active.

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Children of employed mothers experience greater prevalence of sedentary activity.

Since approximately 40% of the global workforce are women, a comprehensive understanding of association of maternal employment with child dietary patterns, physical activity and sedentary behaviour needs more focus. This systematic review aims to identify the association between maternal employment and dietary patterns (DP), physical activity (PA) and sedentary behaviour (SB) of children and adolescents (6 to 18 years). Searches were performed using electronic databases and manual searches. Peer reviewed journal articles, conference papers, theses at masters/doctoral levels in English were included. A total 42 studies met selection criteria, which indicated associations between maternal employment and at least one of the domains of interest: DP, PA and/or SB. Using individual samples of analysis, it was found that, 9 samples of DP, 11 samples of PA and 12 samples of SB were positively correlated with maternal employment, whereas 25 samples of DP, 5 samples of PA and 5 samples of SB showed an opposite association. Results suggest that PA and SB were positively related with maternal employment, whereas DP had an inverse relationship. Findings from this review provide evidence that children of employed mothers had poorer DP and greater prevalence of SB, however, their children are more physically active. Future interventions need to create a positive environment at the workplace and for families to support employed mothers and improve children’s dietary patterns and decrease sedentary behaviours. Future studies should prioritise the domains of DP, PA and SB that have been studied inadequately and have inconsistent results.

Socioeconomic disparities in physical activity, sedentary behavior and sleep patterns among 6- to 9-year-old children from 24 countries in the WHO European region

Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross-sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94-2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country-specific, targeted public health interventions.

Relationship between maternal employment status and children's food intake in Japan

Background

Although long maternal working hours are reported to have a negative effect on children’s dietary habits, few studies have investigated this issue in Japan. Healthy dietary habits in childhood are important because they may reduce the risk of future disease. Here, we examined the relationship between maternal employment status and children’s dietary intake in 1693 pairs of Japanese primary school 5th and 6th graders and their mothers.

Methods

The survey was conducted using two questionnaires, a brief-type self-administered diet history questionnaire and a lifestyle questionnaire. The analysis also considered mothers’ and children’s nutrition knowledge, attitudes toward diet, and some aspects of family environment.

Results

Longer maternal working hours were associated with children’s higher intake of white rice (g/1000kcal) (β 11.4, 95%CI [1.0, 21.9]; working ≥8h vs. not working), lower intake of confectioneries (g/1000kcal) (β −4.0 [−7.6, −0.4]), and higher body mass index (BMI) (kg/m²) (β 0.62 [0.2, 1.0]). Although maternal employment status was not significantly associated with lower intake of healthy food (e.g., vegetables) or higher intake of unhealthy food (e.g., sweetened beverages) in the children, in contrast with previous studies, it may have affected children’s energy intake through their higher intake of white rice. Further, children’s nutrition knowledge and attitudes toward diet, mothers’ food intake, and some family environment factors were significantly associated with intakes of vegetables and sweetened beverages in the children.

Conclusions

Longer maternal working hours were significantly associated with higher intake of white rice and lower intake of confectioneries, as well as higher BMI among children. Even when a mother works, however, it may be possible to improve her child’s dietary intake by other means such as nutrition education for children or enhancement of food environment.

Long work hours of mothers and fathers are linked to increased risk for overweight and obesity among preschool children: longitudinal evidence from Germany

BACKGROUND

Most existing studies on maternal employment and childhood overweight/obesity are from the USA. They are predominantly cross-sectional and show a consistent linear association between the two. Less is known about the joint impact of fathers' and mothers' work hours on childhood overweight and obesity.

OBJECTIVES

To examine the impact of maternal and paternal work hours on overweight/obesity among children aged 1-6 years in Germany using longitudinal data.

METHODS

Child body weight and height and their parents' work hours were collected for 2413 children at ages 0-1, ages 2-3 and ages 5-6. Overweight and obesity was defined using the body mass index percentiles based on the Cole LMS-Method. Random effects model was conducted, adjusting for demographic, socioeconomic and health characteristics of parents and children.

RESULTS

Compared with non-employment, when mothers worked 35 or more hours per week, the risk for child overweight and obesity increased among preschool children. When fathers worked 55 or more hours per week, this effect was strengthened and maternal part-time hours (24-34 per week) also became a risk for child overweight and obesity. The effect was mainly found in high-income families.

CONCLUSIONS

Both mothers' and fathers' long work hours matter to young children's overweight status. Employment protection and work time regulation for both working parents during the first 6 years of the child's life should be considered in future policy.

"If my family is happy, then I am happy": Quality-of-life determinants of parents of school-age children

OBJECTIVE

Obesity is a public health concern for children and adults and effective obesity prevention programming is needed urgently. The effectiveness of health-related messaging and interventions is influenced by the way content is framed. HomeStyles is an obesity prevention program, which aims to promote health through the frame of improved quality of life.

METHODS

Thus, focus groups were conducted with English- and Spanish-speaking parents of school-aged children (ages 6-11) to identify key quality-of-life determinants as described by parents.

RESULTS

Parents (n = 158) reported that their quality of life was influenced by family happiness and parent and child health (e.g. adequate sleep, exercise, healthy diet). Many parents expressed that their busy schedules and lack of family time were detrimental to their quality of life. Work-life balance and financial stability were other factors commonly noted to impact quality of life. Spanish-speaking parents also reported being undocumented and feeling a lack of a sense of community negatively influenced their quality of life.

CONCLUSION

Considering parent-defined quality-of-life determinants when framing health-related messaging and developing interventions may increase participant interest and ultimately improve health-related behaviors. Next steps in the HomeStyles project include using parent-reported quality-of-life determinants to guide the development of intervention materials.

The impact of maternal employment on children's weight: Evidence from the UK

Previous research shows that maternal employment is associated with higher children’s body mass index (BMI). Using a large UK longitudinal birth cohort study of almost 20,000 children, we examine the effect of maternal employment during childhood (to age 14) on children’s weight. We address the endogeneity of maternal employment by estimating household fixed effects models. We find that maternal employment has a positive effect on children’s BMI and therefore on excess weight, and this is particularly the case for single mothers. We investigate potential pathways, including children’s sedentary behavior and healthy eating behaviors, and find evidence of more sedentary behavior and poorer eating habits amongst children whose mothers are in employment. This is consistent with higher BMI levels amongst these children.

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First paper providing causal evidence on the effect of maternal employment on children’s weight in a UK context, for a large contemporaneous cohort of children through childhood and early adolescence, one that has grown up in the midst of the childhood ‘obesity epidemic’.

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Maternal employment has a positive effect on children’s BMI and therefore on excess weight, and this is particularly the case for single mothers.

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Consistent with higher levels of excess weight, children of working mothers are more likely to be sedentary and less likely to eat breakfast regularly.

Parental work characteristics and diet quality among pre-school children in dual-parent households: results from a population-based cohort in Taiwan

Objective

To examine the relationship between parental work characteristics and diet quality among pre-school children in dual-parent households.

Design

Cross-sectional study. Parental work characteristics were measured by the types of combined parental work schedules and work hours. The main outcome variables included meal eating habits as well as ‘health-conscious food’ and ‘unhealthy non-core food’ dietary patterns derived by using principal component analysis. Sociodemographic covariates were considered to reduce confounding and selection biases.

Setting

The Taiwan Birth Cohort Study, Taiwan.

Subjects

A population-based sample of 18 046 children.

Results

Multiple regression analyses indicated that compared with having both parents working standard schedules, having at least one parent who worked non-standard schedules was significantly associated with a lower likelihood of a child eating breakfast every day and a higher consumption of unhealthy non-core foods. If only one parent was employed and worked standard schedules, the children demonstrated greater odds of having home-prepared dinner most of the time. The mother’s working long hours was associated with lower odds of eating breakfast every day, more frequent consumption of unhealthy non-core foods and a lower frequency of healthy food consumption.

Conclusions

The findings raise concern that parents’ non-standard work schedules and mother’s long working hours have negative effects on diet quality of pre-school children. Policy implications include the need for a multifaceted approach to supporting working parents so as to create healthier food environments.

Social vulnerability as a predictor of physical activity and screen time in European children

OBJECTIVES

To examine associations between social vulnerabilities and meeting physical activity (PA) and screen time (ST) recommendations during a 2-year follow-up.

METHODS

13,891 children aged 2.0 to  < 9.9 from eight European countries were assessed at baseline and 8482 children at follow-up. Children's sports club membership, PA and ST were collected via parental questionnaires. Moderate-to-vigorous physical activity (MVPA) was objectively assessed with accelerometers. Performing at least 1 h of MVPA daily and spending less than 2 h of ST defined physically active and non-sedentary children, respectively. Vulnerable groups were defined at baseline as children whose parents had minimal social networks, from non-traditional families, with migrant origin or with unemployed parents. Logistic mixed-effects analyses were performed adjusting for classical socioeconomic indicators.

RESULTS

Children whose parents had minimal social networks had a higher risk of non-compliance with PA recommendations (subjectively assessed) at baseline. Migrants and children with unemployed parents had longer ST. All vulnerable groups were less likely to be sports club members.

CONCLUSIONS

Migrants and children with unemployed parents are at risk for excessive ST and all vulnerable groups have lower odds of being sports club members.

Breakfast habits, dairy product consumption, physical activity, and their associations with body mass index in children aged 6-18

The purpose of this study was to determine breakfast habits, dairy product consumption, and physical activity and their relations with body mass index (BMI) in schoolchildren and adolescents. This cross-sectional, school-based study was performed with children aged 6-18 years. Height and weight were measured, and a BMI z-score was calculated for each child. Breakfast consumption frequency, intake of milk and other dairy products, physical activity habits, and mothers' employment status were assessed via a self-report questionnaire. Multiple linear regression analysis was used to estimate the association between these habits and BMI z-scores. Seven thousand one hundred sixteen children were included, 3445 (48.4%) female, with a mean age of 11.7 ± 2.7 years (5.8-18.9). Of these, 62.6% had breakfast every day. Boys ate breakfast daily significantly more often than girls (64.5 and 60.7%, respectively; p < 0.001). The percentage of children eating breakfast daily decreased with age (79.1% at 6-11 vs. 52.1% at 12-18 years, p < 0.001). Sixty-four (0.9%) children consumed no dairy products. Milk intake was negatively and significantly associated with BMI z-score (β = - 0.103, p < 0.001). Cheese consumption and the mother being employed were positively and significantly associated with BMI z-score (β = 0.517, p < 0.001, and β = 0.172, p < 0.001, respectively). Children engaging in physical activity had higher BMI z-score values than others (0.22 ± 0.01 vs. 0.12 ± 0.02, p < 0.001). Prevalence of overweight/obese was higher among children of working mothers compared to those of unemployed mothers (respectively, 29.3, 23.3%, p < 0.001).

CONCLUSIONS

Skipping breakfast was associated with overweight/obesity in schoolchildren and adolescents, while milk consumption exhibited a protective effect. What is known? • Dietary interventions should be incorporated into a multidisciplinary strategy for obesity prevention. • Most studies of habitual physical activity in children suggest that the overweight and obese children are less active. What is new? • Milk consumption seems to have a protective effect against overweight/obesity, irrespective of yogurt or cheese consumption. • Children engaging in greater physical activity had higher body mass index values than others.

Non-linear relationship between maternal work hours and child body weight: Evidence from the Western Australian Pregnancy Cohort (Raine) Study

Using longitudinal data from the Western Australia Pregnancy Cohort (Raine) Study and both random-effects and fixed-effects models, this study examined the connection between maternal work hours and child overweight or obesity. Following children in two-parent families from early childhood to early adolescence, multivariate analyses revealed a non-linear and developmentally dynamic relationship. Among preschool children (ages 2 to 5), we found lower likelihood of child overweight and obesity when mothers worked 24 h or less per week, compared to when mothers worked 35 or more hours. This effect was stronger in low-to-medium income families. For older children (ages 8 to 14), compared to working 35-40 h a week, working shorter hours (1-24, 25-34) or longer hours (41 or more) was both associated with increases in child overweight and obesity. These non-linear effects were more pronounced in low-to-medium income families, particularly when fathers also worked long hours.

Clustering patterns of obesity-related multiple lifestyle behaviours and their associations with overweight and family environments: a cross-sectional study in Japanese preschool children

OBJECTIVES

The purpose of this study is (1) to identify obesity-related lifestyle behaviour patterns of diet, physical activity, sedentary and sleep behaviours in preschool children, (2) to examine the association between identified behaviour clusters and overweight/obesity and (3) to investigate differences in children's family environments according to clusters.

DESIGN SETTING AND PARTICIPANTS

A cross-sectional study on 2114 preschool children aged 3-6 years who attended childcare facilities (24 nursery schools and 10 kindergartens) in Tsuruoka city, Japan in April 2003 was conducted.

MAIN OUTCOME MEASURES

Children's principal caregivers completed a questionnaire on children's lifestyle behaviours (dinner timing, outside playtime, screen time and night-time sleep duration), family environment (family members, maternal employment, mealtime regularity and parents' habitual exercise and screen time) and measurements of weight and height. Cluster analysis was performed using children's 4 lifestyle behaviours based on those non-missing values (n=1545). The χ² tests and analysis of variance (ANOVA) estimated cluster differences in overweight/obesity and family environments.

RESULTS

6 clusters were identified. Children's overweight/obesity varied across clusters (p=0.007). The cluster with the most screen time, shorter night-time sleep duration, average dinner timing and outside playtime had the highest overweight/obesity prevalence (15.1%), while the cluster with the least screen time, the longest sleep duration, the earliest dinner timing and average outside playtime had the lowest prevalence (4.0%). Family environments regarding mealtime regularity and both parents' screen time also significantly varied across clusters. The cluster having the highest overweight/obesity prevalence had the highest proportion of irregular mealtimes and the most screen time for both parents.

CONCLUSIONS

This study suggests that public health approaches to prevent children's overweight/obesity should focus on decreasing screen time and increasing night-time sleep duration. To shape those behaviours, regular mealtimes and decreasing parents' screen time within family environments need to be targeted among family members.

Parental employment during early childhood and overweight at 7-years: findings from the UK Millennium Cohort Study

BACKGROUND

There are increasing numbers of families with both parents (or a lone parent) employed, which may impact on the ability of families to support healthy lifestyles for their children. Some studies have linked maternal, but not paternal, employment with childhood overweight, although most have been cross-sectional or reported over short periods. We investigated the relationship between parental employment since infancy and overweight in children at 7-years. We differentiated employment by intensity (hours worked), and examined mutually adjusted associations of cumulative maternal and paternal employment with childhood overweight.

METHODS

Data on parental employment at 9 months, 3, 5 and 7-years were used to create cumulative measures of maternal, paternal and family employment in the UK Millennium Cohort Study (MCS). Risk ratios (RR) and 95 % confidence intervals (CI) for childhood overweight (including obesity) at age 7 were estimated according to employment, before and after adjustment for potential confounders.

RESULTS

Compared to continuous non-employment within the family since infancy, any employment of a parent was associated with lower risks of child overweight (e.g. one survey sweep in employment, adjusted RR: 0.71 [0.56-0.90]). Prolonged maternal full-time employment, however, was associated with elevated risks (four sweeps in full-time employment versus never, adjusted RR: 1.46 [1.20-1.78]). There was no equivalent association with paternal full-time employment. When limited to couple families, and adjusting for cumulative full-time employment of both parents and confounders, the risk of overweight at 7-years associated with continuous maternal full-time employment was not attenuated (adjusted RR: 1.71 [1.38-2.11]), and the association with paternal employment remained non-significant.

CONCLUSIONS

Children living in workless households or where two parents are full-time employed have increased risks of overweight. These findings may imply the need for changes to enable parents to maintain healthy lifestyles for their children in the face of wider obesogenic influences.

Parents' daily time with their children: a workplace intervention

OBJECTIVES

In the context of a group randomized field trial, we evaluated whether parents who participated in a workplace intervention, designed to increase supervisor support for personal and family life and schedule control, reported significantly more daily time with their children at the 12-month follow-up compared with parents assigned to the Usual Practice group. We also tested whether the intervention effect was moderated by parent gender, child gender, or child age.

METHODS

The Support-Transform-Achieve-Results Intervention was delivered in an information technology division of a US Fortune 500 company. Participants included 93 parents (45% mothers) of a randomly selected focal child aged 9 to 17 years (49% daughters) who completed daily telephone diaries at baseline and 12 months after intervention. During evening telephone calls on 8 consecutive days, parents reported how much time they spent with their child that day.

RESULTS

Parents in the intervention group exhibited a significant increase in parent-child shared time, 39 minutes per day on average, between baseline and the 12-month follow-up. By contrast, parents in the Usual Practice group averaged 24 fewer minutes with their child per day at the 12-month follow-up. Intervention effects were evident for mothers but not for fathers and for daughters but not sons.

CONCLUSIONS

The hypothesis that the intervention would improve parents' daily time with their children was supported. Future studies should examine how redesigning work can change the quality of parent-child interactions and activities known to be important for youth health and development.

Parental readiness to implement life-style behaviour changes in relation to children's excess weight

AIM

The aim if this study is to evaluate parental readiness to implement changes in specific life-style behaviours for preventing or reducing obesity in children.

METHODS

Eighty-seven parents of overweight or obese children participated in this cross-sectional study. Parents completed a questionnaire for the assessment of their perceptions about their children's weight and their readiness to take action in general, as well as in relation to ten obesogenic life-style behaviours. The transtheoretical model with the five stages of change (precontemplation, contemplation, preparation, action and maintenance) was used for this assessment. A total readiness score was calculated for the 10 behaviours.

RESULTS

A total of 4.6% of parents were in the precontemplation-contemplation stage for overall weight management. However, this percentage was greater for particular behaviours, such as allowing children to self-regulate their food intake, having family meals, reducing screen time and increasing physical activity. Child's body mass index, paternal education level and parental perception about child's excessive weight being attributed to over-consumption of sweets and salty snacks were significantly associated with total readiness score.

CONCLUSIONS

The results of the present study indicate that the high readiness for general action reported by parents of overweight/obese children does not necessarily imply their readiness to engage in changes in specific life-style behaviours.

Describing socioeconomic gradients in children's diets - does the socioeconomic indicator used matter?

BACKGROUND

Children of low socioeconomic position (SEP) generally have poorer diets than children of high SEP. However there is no consensus on which SEP variable is most indicative of SEP differences in children's diets. This study investigated associations between diet and various SEP indicators among children aged 9-13 years.

METHOD

Families (n=625) were recruited from 27 Adelaide primary schools in 2010. Children completed semi-quantitative food frequency questionnaires providing intake scores for fruit, vegetables, non-core foods, sweetened drinks, and healthy and unhealthy eating behaviours. Parents reported demographic information by telephone interview. Differences in dietary intake scores were compared across parental education, income, occupation, employment status and home postcode.

RESULTS

Across most SEP indicators, lower SEP was associated with poorer dietary outcomes, including higher intake of non-core foods and sweetened drinks, and more unhealthy behaviours; and lower intake of fruit and vegetables, and fewer healthy behaviours. The number and type of significant SEP-diet associations differed across SEP indicators and dietary outcomes. Mother's education appeared most frequently as a predictor of children's dietary intake, and postcode was the least frequent predictor of children's dietary intake.

CONCLUSION

Socioeconomic gradients in children's dietary intake varied according to the SEP indicator used, suggesting indicator-specific pathways of influence on children's dietary intake. Researchers should consider multiple indicators when defining SEP in relation to children's eating.

Ethnic and socio-economic disparities in oral health outcomes and quality of life among Sri Lankan preschoolers: a cross-sectional study

Introduction

The distribution and severity of dental caries among preschool children vary according to the socio-economic and ethnic differences within and between countries. Understanding socio-economic influences on child oral health could inform early interventions to reduce the oral health burden throughout the life-cycle. The aim of this study is to examine the socio-economic and ethnic influences on oral health among preschoolers in Kegalle, Sri Lanka.

Methods

The study involved 784 children aged between 48–72 months recruited from 84 pre-schools in the Kegalle district in Sri Lanka. Cross-sectional data were collected by means of an oral examination of the children and a self-administered questionnaire to their parents/caregivers. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess Oral Health related Quality of Life (OHQoL). Univariate and multivariate models of Poisson regression were used to investigate the associations between the variables.

Results

Compared to children whose fathers had tertiary education, those whose fathers did not study beyond grade 5, had more caries measured in terms of decayed, missing and filled surfaces (dmfs) (IRR = 2.30; 95% CI: 1.30, 4.06; p < 0.01) and experienced poor OHQoL at child (IRR = 2.52; 95% CI: 1.20, 5.31; p < 0.05) and family (IRR = 1.59; 95% CI: 1.11, 2.27; p < 0.05) levels. However, lower educational attainment among mothers was associated with better OHQoL among children. Compared to the Sinhalese ethnic group, Tamils had more gingival bleeding (bleeding surfaces) (IRR = 3.04; 95% CI: 1.92, 4.81; p < 0.001) and poor OHQoL at child level (IRR = 2.07; 95% CI: 1.19, 3.60; p < 0.01), whereas Muslims had poor OHQoL at family level (IRR = 1.42; 95% CI: 1.10, 1.84; p < 0.01). Children of low-income families had more gum bleeding (IRR = 1.00; 95% CI: 0.99, 1.00; p < 0.05) compared to children of high-income families.

Conclusions

Socio-economic and ethnic differences in oral health outcomes exist among this population of preschoolers. Interventions targeting children of fathers with low educational levels and ethnic minority groups are required to reduce inequalities in oral health in Sri Lanka and other similar countries.

Effects of parents' employment status on changes in body mass index and percent body fat in adolescent girls

BACKGROUND

Parents' employment status is frequently cited as a possible predictor of child weight status. Despite the importance of the topic, only a few studies have been conducted. No longitudinal studies have been conducted in the United States.

METHODS

A cohort of 1201 girls from the Trial of Activity for Adolescent Girls was used. Height, weight, and percent body fat (PBF) were measured at the 6th and 8th grades. Parents' employment status (measured at 6th grade) was categorized into working full time (reference), part time, unemployed, working or staying at home, and don't know. Mixed-model regression was used to reflect the hierarchical design of our study and adjusted for age, race, parents' education level, free or reduced-price school lunch status, and living arrangement.

RESULTS

Girls whose mothers worked part time or stayed at home had a decreased risk of excess weight gain [relative risk (RR) = 0.94, 95% confidence interval (CI) 0.88, 1.00; RR = 0.89, 95% CI 0.79, 1.00, respectively] compared to girls whose mothers worked full time. Girls whose fathers were unemployed had a moderately increased risk of excess weight gain (RR = 1.13, 95% CI 1.00, 1.26) compared to girls whose fathers worked full time. Having an unemployed mother or part-time or stay-at-home father was not associated with excess weight gain. Parents' employment status was not associated with excess PBF gain.

CONCLUSIONS

Our findings suggest that the availability of the mother has a greater influence on the weight of the daughter than the availability of the father. There is a need for a better understanding of how parents' employment status influences excess weight gain in adolescent girls.

Parental employment and work-family stress: associations with family food environments

Parental employment provides many benefits to children's health. However, an increasing number of studies have observed associations between mothers' full-time employment and less healthful family food environments. Few studies have examined other ways in which parental employment may be associated with the family food environment, including the role of fathers' employment and parents' stress balancing work and home obligations. This study utilized data from Project F-EAT, a population-based study of a socio-demographically diverse sample of 3709 parents of adolescents living in a metropolitan area in the Midwestern United States, to examine cross-sectional associations between mothers' and fathers' employment status and parents' work-life stress with multiple aspects of the family food environment. Among parents participating in Project F-EAT, 64% of fathers and 46% of mothers were full-time employed, while 25% of fathers and 37% of mothers were not employed. Results showed that full-time employed mothers reported fewer family meals, less frequent encouragement of their adolescents' healthful eating, lower fruit and vegetable intake, and less time spent on food preparation, compared to part-time and not-employed mothers, after adjusting for socio-demographics. Full-time employed fathers reported significantly fewer hours of food preparation; no other associations were seen between fathers' employment status and characteristics of the family food environment. In contrast, higher work-life stress among both parents was associated with less healthful family food environment characteristics including less frequent family meals and more frequent sugar-sweetened beverage and fast food consumption by parents. Among dual-parent families, taking into account the employment characteristics of the other parent did not substantially alter the relationships between work-life stress and family food environment characteristics. While parental employment is beneficial for many families, identifying policy and programmatic strategies to reduce parents' work-life stress may have positive implications for the family food environment and for the eating patterns and related health outcomes of children and parents.

Trajectories of growth in body mass index across childhood: Associations with maternal and paternal employment

Research links mothers' employment to higher body mass index (BMI), a measure of weight-for-height, among their children. However, how maternal employment patterns relate to their children's BMI trajectories, and the role that fathers' employment plays in when and at what rate children grow, remain unclear. With data on children from 2 to 15 years of age living in two-parent families from the U.S. NICHD's Study of Early Child Care and Youth Development (N = 1107), individual growth models are used to describe American children's BMI trajectories as predicted by maternal and paternal employment characteristics. Results indicate that, by age 15, children's BMIs are, on average, nearly one-half of a standard deviation above recommended levels, and the majority of growth occurs during the preschool period. The duration of maternal employment, and combined measures of maternal and paternal employment duration, are both associated with higher child BMI across childhood. Associations are small but cumulative. Notably, the association between the duration of time children lived in dual-earner families and child BMI is larger than that between maternal employment duration alone and children's BMI, which is strongest during the preschool period. Combined measures of maternal and paternal employment intensity, defined as the number of periods both parents worked 35 or more hours per week, are associated with higher child BMI during the preschool period only. Findings highlight the importance of taking into account both parents' employment characteristics in investigating children's physical development.

An observational study on socio-economic and ethnic differences in indicators of sedentary behavior and physical activity in preschool children

OBJECTIVE

We studied associations between social disadvantage and indicators of sedentary behavior and physical activity at preschool age.

METHODS

Data from 4688 children enrolled in a birth cohort in Rotterdam, the Netherlands, between 2002 and 2006 were analyzed. Indicators of sedentary behavior (watching television ≥ 2 h/day and sitting in a buggy ≥ 0.5 h/day) and physical inactivity (playing outside < 3 h/day) were measured by a parent-reported questionnaire at age 3. Adjustments were made for social circumstances and indicators of health behaviors. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CI).

RESULTS

Children with low-educated mothers (OR: 3.27, 95% CI 2.12-5.05) and non-Dutch children (OR(nonWestern): 2.67, 95% CI 2.04-3.49, OR(Western): 2.09, 95% CI 1.42-3.0) were more likely to watch television for at least 2 h/day. Similar results were seen for sitting in a buggy for at least 0.5h/day. Non western children were more likely to play outside for less than 3 h/day (OR: 1.95, 95% CI: 1.39-2.73) than native Dutch children, while no differences were seen for other western children or children from mothers with a low educational level.

CONCLUSIONS

Socio-economic status and ethnicity are already associated with indicators of sedentary lifestyles at preschool age.

Maternal work hours in early to middle childhood link to later adolescent diet quality

Objective

Previous studies on maternal work hours and child diet quality have reported conflicting findings possibly due to differences in study design, lack of a comprehensive measure of diet quality and differing ages of the children under investigation. The present study aimed to prospectively examine the impact of parental work hours from age 1 year to age 14 years on adolescent diet quality.

Design

Multivariate linear regression models were used to examine independent associations between parents’ work hours at each follow-up and across 14 years and adolescent diet quality at age 14 years. A diet quality index was based on the international literature and Australian recommendations, consisting of six food groups and nine nutrients.

Setting

Perth, Western Australia.

Subjects

Children (n 1629) participating in the Western Australian Pregnancy Cohort (Raine) Study.

Results

Compared with children of mothers in full-time employment, children of mothers who were not employed in early childhood up to age 5 years had a higher average diet quality score at age 14 years, independent of maternal and family socio-economic status. Across 14 years the number of years the mother worked full time and increasing average weekly hours were associated with lower diet quality. Father's work hours had little association with adolescent diet quality.

Conclusions

Having a mother stay at home in early to middle childhood is associated with better diet quality in adolescence. Support may be beneficial for families where the mother returns to full-time employment before the child reaches 8 years of age.

Changing influences on childhood obesity: a study of 2 generations of the 1958 British birth cohort

Explanations for the trend of increasing childhood obesity have yet to be identified. The authors examined members of the 1958 British birth cohort (age 7 years, n = 8,552) and offspring (ages 4-9 years, n = 1,889) born to mothers under age 30 years to establish whether risk factors for childhood obesity have changed over time (1965-1991). The authors applied multilevel linear and logistic models that account for within-family correlations in order to examine associations between risk factors and childhood body mass index (BMI; weight (kg)/height (m)(2)) (age- and sex-specific standard deviation scores and overweight/obesity) in the 2 populations. The authors found that the prevalence of overweight/obesity had increased by more than 50% between generations. Parental BMI and full-time maternal employment were both positively associated with offspring BMI in childhood (e.g., an increase of 0.4-0.5 units for maternal employment); these associations had strengthened between generations. There was evidence of a widening social gap in childhood obesity: Indicators of lower socioeconomic position showed either no association or a protective effect in cohort members but were associated with increased BMI in offspring. Prevalences of parental obesity and maternal employment had increased. Socioeconomic factors had improved across generations. Parental obesity, maternal employment, and socioeconomic factors may play an increasing role in the childhood obesity epidemic.

Social and dental status along the life course and oral health impacts in adolescents: a population-based birth cohort

Background

Harmful social conditions in early life might predispose individuals to dental status which in turn may impact on adolescents' quality of life.

Aims

To estimate the prevalence of oral health impacts among 12 yr-old Brazilian adolescents (n = 359) and its association with life course socioeconomic variables, dental status and dental services utilization in a population-based birth cohort in Southern Brazil.

Methods

Exploratory variables were collected at birth, at 6 and 12 yr of age. The Oral Impacts on Daily Performances index (OIDP) was collected in adolescence and it was analyzed as a ranked outcome (OIDP from 0 to 9). Unadjusted and adjusted multivariable Poisson regression with robust variance was performed guided by a theoretical determination model.

Results

The response rate was of 94.4% (n = 339). The prevalence of OIDP = 1 was 30.1% (CI95%25.2;35.0) and OIDP ≥ 2 was 28.0% (CI95%23.2;32.8). The most common daily activity affected was eating (44.8%), follow by cleaning the mouth and smiling (15.6%, and 15.0%, respectively). In the final model mother schooling and mother employment status in early cohort participant's life were associated with OIDP in adolescence. As higher untreated dental caries at age 6 and 12 years, and the presence of dental pain, gingival bleeding and incisal crowing in adolescence as higher the OIDP score. On the other hand, dental fluorosis was associated with low OIDP score.

Conclusion

Our findings highlight the importance of adolescent's early life social environmental as mother schooling and mother employment status and the early and later dental status on the adolescent's quality of life regardless family income and use of dental services.