HEALTH NEWS

Study Title:

Stress, Adolescents, and Obesity

Study Abstract

Purpose
A high proportion of adolescents living in low-income households in the United States are overweight or obese, food insecure, or exposed to high levels of individual, maternal, and family stressors. The aim of this paper was to identify the associations of food insecurity and the aforementioned stressors with an adolescent's propensity to be overweight or obese. We hypothesized that individual, maternal, and family stressors may exacerbate the relationship between food insecurity and adolescent overweight/obesity.

Methods
The sample included 1011 adolescents aged 10 to 15 years and their mothers in families with incomes below 200% of the poverty line from Wave 1 of the Welfare, Children, and Families: A Three-City Study (Three-City Study).

Results
A series of logistic regressions predicted the probability of an adolescent being overweight or obese. Overall, higher levels of individual stressors increased the probability of being overweight or obese for adolescents, whereas there was no direct association between food insecurity, maternal, or family stressors and overweight or obesity. The interaction of food insecurity and maternal stressors was significantly linked to the probability of being overweight or obese; more specifically, an increase in maternal stressors amplified a food insecure adolescent's probability of being overweight or obese.

Conclusions
Policies addressing adolescent obesity should consider the benefits to reducing the individual stressors facing low-income adolescents and, for food insecure adolescents, the benefits to reducing their mothers’ stressors.

From press release:

Stress may indeed be a direct contributor to childhood obesity. That's according to a new Iowa State University study finding that increased levels of stress in adolescents are associated with a greater likelihood of them being overweight or obese.

The study of 1,011 adolescents (aged 10-15) and their mothers from low income families living in three cities -- Boston, Chicago and San Antonio -- was posted on the Web site of the Journal of Adolescent Health, which will publish it in the August issue. Forty-seven percent of the teens in the sample were overweight or obese, but that percentage increased to 56.2 percent among those who were impacted by four or more stressors.

"We found that an adolescent or youth who's more stressed -- caused by such things as having poor grades, mental health problems, more aggressive behavior, or doing more drugs and alcohol -- is also more likely to be overweight or obese," said lead author Brenda Lohman, an Iowa State assistant professor of human development and family studies (HDFS).

Susan Stewart, an ISU associate professor of sociology; and Steven Garasky, a professor of HDFS at Iowa State; joined Lohman on the research team. Former ISU faculty members Craig Gundersen, a member of the agricultural and consumer economics faculty at the University of Illinois; and Joey Eisenmann, a member of the kinesiology and pediatrics faculty at Michigan State University; also contributed to the study.

Data collected from noted three-city study

The study analyzes data obtained from the "Welfare, Children and Families: A Three-City Study" -- a six-year longitudinal investigation. Researchers measured the height and weight of the adolescents to determine their body mass index, which was subsequently used to determine weight status based on two widely used classification systems. Adolescent food insecurity status and individual, maternal and family stressors were also determined through interviews.

The five factors used to determine the individual stressor index for the adolescents were:

Academic problems
Consumption of drugs and alcohol
Depression or poor mental health levels
Acting out or aggressive behaviors
Lack of future orientation
The researchers wrote that the adolescents' relationship with stress and becoming overweight may be a result of biological (perturbed hypothalamic-pituitary-adrenal glands) as well as behavioral responses to stress, such as overeating and lack of exercise.

"It could possibly be that the obesity is leading to these stressors too," Lohman said. "And so the work that we're doing right now looks at which one of these is really coming first: the stressors or the obesity. We know that it is cyclical and that all of these factors just compound on each other."

The study also found that a mother's stress, coupled with food insecurity in the household -- a situation in which an individual cannot access enough food to sustain active, healthy living -- contributes to a child's chances of becoming overweight or obese.

"In our past research, we did not find this association for older youth (ages 11-17), we only found it for young children (ages 3-10) who were in a house that had enough food or were food-secure," Lohman said. "But it may be that the adolescents are more cognitively aware of what's going on in the household and they take on their mothers' stress as well. This may be exacerbated in houses where there's not enough food."

Mothers receive the initial focus

While this study singles out mothers, fathers aren't immune to their child's weight status either.

"My own research focuses on fathers and shows that fathers, too, have an effect on children's eating habits and obesity," said Stewart, author of the book "Brave New Stepfamilies," who had another study posted by the Journal of Adolescent Health last month on nonresident father involvement and adolescent eating patterns.

"In our latest study, we found that kids who are involved with nonresident dads eat better -- more vegetables, less fast food," she said. "However, similar to the Lohman study, living with a single mom was associated with worse eating habits."

Lohman says the new research should emphasize the need for healthcare professionals to take a more holistic approach in their treatment of obese teens.

"We absolutely have to focus on their (teens) health, well-being, nutrition and exercise -- and education of these things for them," she said. "But we really need to also look holistically at their life and work towards reducing stress and rates of food insecurity for those adolescents as well."

Gunderson, Garasky and Lohman also published a study out today on the relationship between food insecurity and adolescent obesity. Among 2,516 participants (1,239 girls, 1,277 boys) drawn from the 2001-2004 National Health and Nutrition Examination Survey, 37 percent of families were considered food insecure. Using five different measures of obesity -- BMI, waist circumference, triceps skinfold thickness, trunk fat mass, and percent body fat -- the researchers determined that 15 to 45 percent of children were classified as obese. Yet they found no statistically significant relationship between food insecurity and obesity, regardless of which indicator was used. The study was posted online today and will be published in the June 2009 issue of the Journal of Nutrition.

Lohman is part of another team of ISU researchers that just submitted a new grant proposal to develop family intervention strategies to reduce childhood obesity.

Study Information

Brenda J., Lohman , Susan, Stewart , Craig, Gundersen , Steven, Garasky , Joey C., Eisenmann.
Adolescent Overweight and Obesity: Links to Food Insecurity and Individual, Maternal, and Family Stressors
Journal of Adolescent Health.
2009 April
Iowa State University.