Anderson SE, et al. - Using data from the Early Childhood Longitudinal Study, Birth Cohort, researchers investigated how different levels of toddler self-regulation were correlated with the prevalence of obesity at kindergarten age as well as investigated whether patterns of relationships differed between boys and girls. They found differences between boys and girls in the pattern of the relationship between self-regulation at 24 months and obesity at 5.5 years of age in a large national cohort of US children. These findings suggest the possibility that interventions to increase self-regulation in young children might have different results with respect to obesity for girls and boys.

Methods

•  This was a prospective cohort study.
• Participants in the study were 10,700 US children born in 2001 and followed up through kindergarten entry (2006-2007).
• The analytic sample involved 6400 children with observed toddler self-regulation.
• Information gathering occurred in children’s homes and consisted of a parent interview and direct assessment of the child.
• Between May 2016 and March 2018, data analysis took place.
• Observers scored 4 dimensions of children’s self-regulation: adaptability, attention, persistence, and frustration tolerance during a standardized, in-home, developmental assessment at 24 months of age.
• After that, self-regulation scores ranging from a low of 4 to a high of 20 were grouped into quartiles.
• Obesity was defined as a body mass index for age in the 95th percentile or greater with use of measured heights and weights at 5.5 years.

Results

• According to the findings obtained, the analytic sample comprised of 6400 children (3250 boys [50.6%, weighted]), with a median age of 24.1 months (interquartile range, 23.4-24.7 months) and 64.5 months (interquartile range, 61.7-67.6 months) at the self-regulation and body mass index assessments, respectively.
• The outcomes revealed that self-regulation scores were lower for boys than for girls (mean, 13.7 [95% CI, 13.4-13.9] vs 14.9 [95% CI, 14.7-15.1]), and the lowest self-regulation quartile comprised more boys than girls (weighted percentages, 66.5% vs 33.5%).
• It was observed that the prevalence of obesity at 5.5 years was 19.2% among boys and 16.5% among girls.
• Researchers found that the pattern of relationship between toddler self-regulation and obesity at 5.5 years was different for boys and girls (P=.008 for interaction).
• It was noted that the adjusted prevalence of obesity was 19.7%, 18.3%, 20.3%, and 15.9% from lowest to highest quartile of self-regulation among boys whereas there was a U-shaped association (adjusted prevalence of obesity from lowest to highest self-regulation quartile, 17.0%, 10.3%, 10.7%, and 15.0%) among girls.