Self-regulation and rapid weight gain in children from age 3 to 12 years

Abstract

Objective: To examine the extent to which self-regulatory capacities, measured behaviorally at ages 3 and 5 years, were linked to rapid weight gain in children from age 3 to 12 years. Self-regulation failure, or the inability to control an impulse or behavior, has been implicated as a mechanism in the development of overweight.

Design: Prospective longitudinal cohort study.

Setting: Home and laboratory-based settings in 10 sites across the United States.

Participants: Data were drawn from 1061 children as part of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Main Exposure Self-regulatory capacity was measured in 2 behavioral protocols; children participated in a self-control procedure at age 3 years and a delay of gratification procedure at age 5 years.

Main outcome measures: Age- and sex-specific body mass index (BMI) z scores were calculated based on measured BMI at 6 points.

Results: Mixed-modeling analyses were used to examine differences in the rate of weight gain over time based on the extent to which children exhibited the ability to self-regulate in the behavioral procedures. Compared with children who showed high self-regulation in both behavioral protocols at ages 3 and 5 years, children who exhibited a compromised ability to self-regulate had the highest BMI z scores at each point and the most rapid gains in BMI z scores over the 9-year period. Effects of pubertal status were also noted for girls.

Conclusion: Self-regulation failure in early childhood may predispose children to excessive weight gain through early adolescence.

Figure 1.

Child body mass index (BMI) z score from age 3 to 12 years by self-regulation group. The BMI z scores are standardized for age and sex and represent deviations from the group median at each point. Age 3 years, n=1090; age 5 years, n=1031; age 7 years, n=991; age 9 years, n=938; age 11 years, n=929; and age 12 years, n=917. Different superscript letters indicate significant differences between groups in the rate of change over time at P<.05.

Figure 2.

Changes in body mass index (BMI) z scores over time based on girls’ pubertal status at age 9 years.