Associations Among Measures of Weight Status, Energy Balance Related Behaviors, and Psychosocial Mediators in Urban Upper Elementary School Children

Childhood obesity is a serious public health concern, yet evidence linking childhood obesity and related modifiable behaviors is lacking. This study examines cross-sectional associations among two measures of weight status, energy balance related behaviors (EBRB), and psychosocial mediators. Participants included children (N=1382) who participated in baseline assessments for the Food, Health and Choices childhood obesity study during Spring and Fall 2012. Participants were mostly low-income Hispanic and Black children, ages 9-13, from New York City public elementary schools in upper Manhattan and the Bronx. Body mass index percentile for age (BMI) and percent body fat (%BF) were calculated using a Tanita body composition analyzer and stadiometer. The Food, Health and Choices Questionnaire (FHC-Q), administered in participating classrooms, measured self-reported EBRB, such as sweetened beverage intake and physical activity frequency, as well as psychosocial mediators, such as outcome expectations and autonomy. Statistical analyses included Pearson correlations, regression analyses, one-way ANOVA, ANCOVA, and descriptive statistics. Despite a high correlation between BMI and %BF, a wide range of %BF was observed for each category of weight status determined by BMI: underweight, normal weight, overweight, and obese. Unexpectedly, slight but significant inverse correlations were observed between BMI/%BF and processed packaged snack and sweetened beverage intake. Overweight and obese children reported healthier EBRB than normal weight children. Mediator analyses identified habit strength as a predictive variable for most EBRB. Means for mediator scales indicated healthier levels of autonomous motivation, competence, goal setting skills, behavioral intentions, and outcome expectations among overweight and obese children compared to normal weight children. Results suggest more healthful behaviors and mediators may already be in place in overweight/obese children compared to normal weight children. However, EBRB for all children was far removed from current dietary and activity recommendations indicating room for improvement in this population. Further investigation of associations among childhood obesity, EBRB, and psychosocial mediators is warranted, as is the development of %BF standards for children.