title: Influence of stress in parents on child obesity and related behaviors.
abstract: OBJECTIVE
  To assess associations of the number of parent stressors and parent-perceived stress with obesity and related behaviors in their children.
  
  
  METHODS
  This cross-sectional analysis used data from the 2006 Southeastern Pennsylvania Household Health Survey in which 2119 parents/caregivers answered questions about themselves and their children (ages 3-17 years). Survey data were used to assess the main exposure variables: the number of stressors (measured using a stressor index) and parent-perceived stress (the response to a general stress question); child covariates (age, race/ethnicity, health quality, and gender); adult covariates (education, BMI, gender, poor sleep quality) and study outcomes (child obesity, fast-food consumption, fruit and vegetable consumption, and physical activity). To account for developmental differences, analyses were also stratified by age group (3-5, 6-8, 9-12, and 13-17 years). Analyses used multiple logistic regression, with results expressed as odds ratios and 95% confidence intervals.
  
  
  RESULTS
  The number of parent stressors was related to child obesity in unadjusted (1.12, 1.03-1.22, P = .007) and adjusted models (1.12, 1.03-1.23, P = .010). Parent-perceived stress was related to fast-food consumption in unadjusted (1.07, 1.03-1.10, P < .001) and adjusted (1.06, 1.02-1.10, P < .001) models.
  
  
  CONCLUSIONS
  The number of parent stressors was directly related to child obesity. Parent-perceived stress was directly related to child fast-food consumption, an important behavioral indicator of obesity risk. Clinical care models and future research that address child obesity should explore the potential benefits of addressing parent stressors and parent-perceived stress.
authors.affiliation: Division of Gastroenterology, The Children's Hospital of Philadelphia, The Children's Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA. proute@email.chop.edu
authors.forename: Elizabeth P
authors.initials: EP
authors.lastname: Parks
authors.forename: Shiriki
authors.initials: S
authors.lastname: Kumanyika
authors.forename: Reneé H
authors.initials: RH
authors.lastname: Moore
authors.forename: Nicolas
authors.initials: N
authors.lastname: Stettler
authors.forename: Brian H
authors.initials: BH
authors.lastname: Wrotniak
authors.forename: Anne
authors.initials: A
authors.lastname: Kazak
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D010290:Parents / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology*