Brief CommunicationSleep, but not other daily routines, mediates the association between maternal employment and BMI for preschool children
Introduction
In the USA, 23% of 2–5-year-old children are overweight or obese [1]. Overweight during the preschool years is of concern because it is related to overweight in later life [2], poor health [3], and stigmatization [4]. Childhood obesity is multi-determined with biological, familial, and social determinants [5]. Maternal employment is one familial factor associated with childhood obesity. The more time mothers spend working, the more likely their preschool-aged children are to be overweight [6].
Several mechanisms may explain the relationship between maternal employment and child overweight. One that has been relatively unexplored is child sleep [7]. Parents' long work hours increased the odds of shortened child sleep for 6–7-year-old children in the Longitudinal Study of Australian Children [8]; and associations between shortened nighttime sleep and childhood obesity are well established in meta-analyses [9] and population-level studies [10].
Other daily routines (e.g., mealtime routines, frequency of family meals, time spent watching television (TV), dietary habits, and amount of physical activity) have also been suggested as mechanisms between maternal work hours and childhood obesity [11], [12]. However, empirical studies testing these potential mediators are limited; only one study focused on preschool children [12]. Using two waves of data from the Longitudinal Study of Australian Children (n = 4464), Brown et al. [12] found that TV time partially mediated the relationship between maternal employment and child weight status among preschoolers. Among school-aged children, time spent watching TV may act as a mediator [13], [14]. However, one study using a nationally representative sample found no evidence that TV viewing, bedtime, mealtime, dietary habits, or physical activity routines mediated the relationship between maternal employment and childhood obesity for US schoolchildren [11].
The present study adds to the literature by using two waves of panel data to examine associations between maternal employment, sleep, and other daily routines measured at wave 1 (W1), and child body mass index (BMI) measured at wave 2 (W2). We then examined total nighttime sleep, dietary habits, TV time, and family mealtimes as mediators of the relationship between maternal employment and preschooler's BMI.
Section snippets
Data and participants
Data were drawn from W1 and W2 of STRONG Kids [5], a three-wave prospective panel study on childhood obesity among preschoolers. W1 and W2 were collected 1 year apart. Parent–child dyads were recruited from 32 licensed childcare centers within a 65-mile radius of the research site and with registered capacity to serve ≥ 24 children aged 2–3 years. The response rate was 91% among centers and 60–95% among parent–child dyads within centers. Parents completed a comprehensive survey covering
Results
Most mothers in the analytic sample were employed full time (66%) or part time (18%). On average, children were reported to sleep 9.6 h per night (SD = 1.14). At W2, 17% of children were overweight and 12% were obese. On average, mothers were 32.4 years old (SD = 5.43) and had a BMI of 27.0 (SD = 6.85) at W1, and children were an average of 38.0 months old (SD = 7.4) with mean BMI percentile of 61.0 (SD = 26.1). Sixty-six percent of the sample had a college degree. Seventy-three percent were
Discussion
Using a panel study of preschool children and their parents, we found that hours of nighttime sleep, but not other daily routines, mediated the relationship between full-time maternal employment measured at W1 and child BMI at W2. This suggests that mothers who are employed full time may have to wake their children earlier and/or put them to bed later than mothers who work less than full-time schedules [8]. Each additional hour of sleep was associated with a decrease of 6.4 BMI percentage
Conflict of interest
The ICMJE Uniform Disclosure Form for Potential Conflicts of Interest associated with this article can be viewed by clicking on the following link: http://dx.doi.org/10.1016/j.sleep.2014.08.006.
Acknowledgments
This research was funded, in part, by grants from the Illinois Council for Agriculture Research to Kristen Harrison (PI), the University of Illinois Health and Wellness Initiative to Barbara Fiese and Sharon Donovan (Co-PIs), and the United States Department of Agriculture (Hatch 793-328) to Barbara Fiese (PI). The STRONG Kids Team includes Kristen Harrison, Kelly Bost, Brent McBride, Sharon Donovan, Diana Grigsby-Toussaint, Juhee Kim, Janet Liechty, Angela Wiley, Margarita Teran-Garcia, and
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