Abstract
Background/Objective:
Family relationships have been linked to obesity and related disorders in youth, but few studies have provided causal evidence of this association. This study tested the impact of a family psychosocial intervention on components of metabolic syndrome—a condition driven largely by abdominal obesity—in African American youth. In particular, the study tested whether effects were strongest among those who started at highest risk, that is, with high levels of unsupportive parenting at baseline.
Subjects/Methods:
Randomized clinical trial of a community sample of 391 African American youth (mean age=11.2 years) conducted in 2001–2002, with follow-up metabolic syndrome assessment in 2014–2015. Participants were assigned either to receive a weekly family intervention or to a control group. The primary study outcome was the number of components of metabolic syndrome that were clinically elevated at age 25, including central adiposity, blood pressure, triglycerides, glucose and low high-density lipoproteins. Unsupportive parenting was measured by questionnaires at baseline.
Results:
Significant interaction effects were found between group assignment and baseline unsupportive parenting on counts of metabolic syndrome components in youth (beta=−0.17, P=0.03). Among those who started with higher levels of unsupportive parenting at age 11, participation in the family intervention reduced the number of clinically elevated components of the metabolic syndrome at age 25 relative to the control group. No such effect was seen among those who started with good parenting. Mediation analyses suggested that changes in the psychosocial targets of the parenting intervention partially accounted for the effects amongst those high in unsupportive parenting at baseline (effect size=−0.350, s.e.=0.178).
Conclusions:
These findings suggest that efforts to improve family relationships may be able to ameliorate the detrimental effects that harsh and unsupportive parenting have on obesity-related outcomes such as metabolic syndrome in youth.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Zimmet P, KGMM Alberti, Kaufman F, Tajima N, Silink M, Arslanian S et al. The metabolic syndrome in children and adolescents: an IDF consensus report. Pediatr Diabetes 2007; 8: 299–306.
Cornier MA, Dabelea D, Hernandez TL, Lindstrom RC, Steig AJ, Stob NR et al. The metabolic syndrome. Endocr Rev 2008; 29: 777–822.
American Diabetes Association. The cost of diabetes 2013, http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html.
Miller GE, Chen E, Parker KJ . Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms. Psychol Bull 2011; 137: 959–997.
Wegman HL, Stetler C . A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood. Psychosom Med 2009; 71: 805–812.
Repetti RL, Taylor SE, Seeman T . Risky families: family social environments and the mental and physical health of offspring. Psychol Bull 2002; 128: 330–366.
Ehrlich KB, Hoyt LT, Sumner JA, McDade TW, Adam EK . Quality of relationships with parents and friends in adolescence predicts metabolic risk in young adulthood. Health Psychol 2015; 34: 896–904.
Drew LM, Berg C, King P, Verdant C, Griffith K, Butler J et al. Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control. J Fam Psychol 2011; 25: 751–758.
Evans GW, Kim P, Ting AH, Tesher HB, Shannis D . Cumulative risk, maternal responsiveness, and allostatic load among young adolescents. Dev Psychol 2007; 43: 341–351.
Miller GE, Lachman ME, Chen E, Gruenewald TL, Seeman TE . Pathways to resilience: maternal nurturance as a buffer against childhood poverty’s effects on metabolic syndrome at midlife. Psychol Sci 2011; 22: 1591–1599.
Chen E, Miller GE, Kobor MS, Cole SW . Maternal warmth buffers the effects of low early-life socioeconomic status on pro-inflammatory signaling in adulthood. Mol Psychiatry 2011; 16: 729–737.
Carroll JE, Gruenewald TL, Taylor SE, Janicki-Deverts D, Matthews KA, Seeman TE . Childhood abuse, parental warmth, and adult multisystem biological risk in the Coronary Artery Risk Development in Young Adults study. Proc Natl Acad Sci USA 2013; 110: 17149–17153.
Wysocki T, Harris MA, Buckloh LM, Mertlich D, Lochrie AS, Taylor A et al. Effects of behavioral family systems therapy for diabetes on adolescents’ family relationships, treatment adherence, and metabolic control. J Pediatr Psychol 2006; 31: 928–938.
Wysocki T, Harris MA, Buckloh LM, Mertlich D, Lochrie AS, Mauras N et al. Randomized trial of behavioral family systems therapy for diabetes. Diabetes Care 2007; 30: 555–560.
Fisher PA, Gunnar MR, Chamberlain P, Reid JB . Preventive intervention for maltreated preschool children: impact on children’s behavior, neuroendocrine activity, and foster parent functioning. J Am Acad Child Adolesc Psychiatry 2000; 39: 1356–1364.
Miller GE, Brody GH, Yu T, Chen E . A family-oriented psychosocial intervention reduces inflammation in low-SES African American youth. Proc Natl Acad Sci USA 2014; 111: 11287–11292.
Brody GH, Yu T, Chen E, Miller GE . Prevention moderates associations between family risks and youth catecholamine levels. Health Psychol 2014; 33: 1435–1439.
Brody GH, Yu T, Beach SR, Philibert RA . Prevention effects ameliorate the prospective association between nonsupportive parenting and diminished telomere length. Prev Sci 2015; 16: 171–180.
Brody GH, Murry VM, Gerrard M, Gibbons FX, Molgaard V, McNair L et al. The Strong African American Families Program: translating research into prevention programming. Child Dev 2004; 75: 900–917.
Brody GH, Kogan SM, Grange CM . Translating longitudinal, developmental research with rural African American families into prevention programs for rural African American youth. In: King RB, Maholmes V (eds). The Oxford Handbook of Poverty and Child Development. Oxford University Press: New York, NY, USA, 2012, pp 553–570.
Brody GH, Murry VM, Kogan SM, Gerrard M, Gibbons FX, Molgaard V et al. The Strong African American Families Program: a cluster-randomized prevention trial of long-term effects and a mediational model. J Consult Clin Psychol. 2006; 74: 356–366.
Brody GH, Murray VM, Gerrard M, Gibbons FX, McNair L, Brown AC et al. The Strong African American Families Program: prevention of youths’ high-risk behavior and a test of a model of change. J Fam Psychol 2006; 20: 1–11.
Brody GH, Ge XJ, Conger R, Gibbons FX, Murry VM, Gerrard M et al. The influence of neighborhood disadvantage, collective socialization, and parenting on African American children’s affiliation with deviant peers. Child Dev 2001; 72: 1231–1246.
Prinz RJ, Foster S, Kent RN, O’Leary KD . Multivariate assessment of conflict in distressed and nondistressed mother-adolescent dyads. J Appl Behav Anal 1979; 12: 691–700.
Brody GH, Flor DL, Hollett-Wright N, McCoy JK . Children’s development of alcohol use norms: Contributions of parent and sibling norms, children’s temperaments, and parent-child discussion. J Fam Psychol 1998; 12: 209–219.
Conger RD . Iowa Youth and Families Project, Wave A. Center for Family Research in Rural Mental Health: Ames, IA, USA, 1989.
Kahn R . Metabolic syndrome: Is it a syndrome? Does it matter? Circulation 2007; 115: 1806–1811.
Kahn R . Metabolic syndrome—what is the clinical usefulness? Lancet 2008; 371: 1892–1893.
Ford ES . Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005; 28: 2745–2749.
Brody GH, Yu T, Chen E, Miller GE, Kogan SM, Beach SRH . Is resilience only skin deep? Rural African Americans’ preadolescent socioeconomic status-related risk and competence and age 19 psychological adjustment and allostatic load. Psychol Sci 2013; 24: 1285–1293.
Brody GH, Yu T, Chen YF, Kogan SM, Evans GW, Beach SR et al. Cumulative socioeconomic status risk, allostatic load, and adjustment: a prospective latent profile analysis with contextual and genetic protective factors. Dev Psychol 2013; 49: 913–927.
Radloff LS . The CES-D scale: a self-report depression scale for research in the general population. J Appl Psychol Measurement 1977; 1: 385–401.
Brody GH, Chen YF, Kogan SM, Smith K, Brown AC . Buffering effects of a family-based intervention for African American emerging adults. J Marriage Fam 2010; 72: 1426–1435.
System YRBS Youth Risk Behavior Survey. Centers for Disease Control and Prevention, US Department of Health and Human Services: Atlanta, GA, USA, 2009.
Valente MJ, MacKinnon DP . Comparing models of change to estimate the mediated effect in the pretest-posttest control group design. Struct Equ Modeling 2017; 24: 428–445.
Preacher KJ, Hayes AF . SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behav Res Methods Instrum Comput 2004; 36: 717–731.
Menke A, Casagrande S, Geiss LS, Cowie CC . Prevalence of and trends in diabetes among adults in the United States, 1988-2012. J Am Med Assoc 2015; 314: 1021–1029.
Brody GH, Chen YF, Kogan SM, Murry VM, Brown AC . Long-term effects of the Strong African American Families program on youths’ alcohol use. J Consult Clin Psychol 2010; 78: 281–285.
Brody GH, Kogan SM, Chen YF, Murry VM . Long-term effects of the Strong African American Families program on youths’ conduct problems. J Adolesc Health 2008; 43: 474–481.
Beach SRH, Kogan SM, Brody GH, Chen YF, Lei MK, Murry VM . Changes in caregiver depression as a function of the Strong African American Families program. J Fam Psychol 2008; 22: 241–252.
Brody GH, Murry VM, Chen YF, Kogan SM, Brown AC . Effects of family risk factors on dosage and efficacy of a family-centered preventive intervention for rural African Americans. Prev Sci 2006; 7: 281–291.
Abraham NG, Brunner EJ, Eriksson JW . Metabolic syndrome: psychosocial, neuroendocrine, and classical risk factors in type 2 diabetes. Ann N Y Acad Sci 2007; 275: 256–275.
Charmandari E, Tsigos C, Chrousos G . Endocrinology of the stress response. Annu Rev Physiol 2005; 67: 259–284.
Brunner EJ, Hemingway H, Walker BR, Page M, Clarke P, Juneja M et al. Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study. Circulation 2002; 106: 2659–2665.
Hotamisligil GS . Inflammation and metabolic disorders. Nature 2006; 444: 860–867.
Chen E, Miller GE . ‘Shift-and-persist’ strategies: why being low in socioeconomic status isn’t always bad for health. Perspect Psychol Sci 2012; 7: 135–158.
Cummings EM, Miller-Graf LE . Emotional Security Theory: an emerging theoretical model for youths’ psychological and physiological responses across multiple developmental contexts. Curr Dir Psychol Sci 2015; 24: 208–213.
Chen E, Brody GH, Miller GE . Childhood close family relationships and health. Am Psychol 2017; 72: 555–566.
Acknowledgements
The research reported in this article was supported by grants from the National Institute of Child Health and Human Development (R01 HD030588) and National Institute on Drug Abuse (P30 DA027827).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Additional information
Supplementary Information accompanies this paper on International Journal of Obesity website
Supplementary information
Rights and permissions
About this article
Cite this article
Chen, E., Miller, G., Yu, T. et al. Unsupportive parenting moderates the effects of family psychosocial intervention on metabolic syndrome in African American youth. Int J Obes 42, 634–640 (2018). https://doi.org/10.1038/ijo.2017.246
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/ijo.2017.246
This article is cited by
-
Reviewing the Literature on the Impact of Gun Violence on Early Childhood Development
Current Psychiatry Reports (2023)
-
BARBQTCM Survey: Einfluss von Schlafstörungen auf die TCM-Akzeptanz bei Übergewicht und Adipositas
Deutsche Zeitschrift für Akupunktur (2021)