Relations Between Child Obesity and Executive Functions Among Low-income Latinx Families Participating in an Obesity Intervention: A Secondary Analysis

Amber Shriver

Major Professor: Adam Winsler, PhD, Department of Psychology

Committee Members: Sina Gallo, Robyn Mehlenbeck

Online Location, #2084
July 29, 2020, 02:00 PM to 04:00 PM

Abstract:

Rates of obesity have tripled worldwide since 1975 (WHO, 2017), with the epidemic affecting both pediatric and adult populations.  Many causes for obesity exist including genetics; the child’s immediate and community environment; a lack of nutritional resources; and a lack of motivation and resources to engage in physical activity.  Given the increasingly widespread prevalence of childhood obesity, research has focused on how childhood obesity affects long-term physical and mental health outcomes.  This research robustly supports a bidirectional relationship between childhood obesity and executive functioning.  The term executive functioning describes the cognitive capabilities necessary for an individual to engage in goal-directed behavior (Miyake and Friedman, 2012).  It includes constructs such as cognitive flexibility, working memory, and inhibition (Miyake and Friedman, 2012).  Executive functions influence the individual’s ability to initiate in healthy activities and to inhibit consumption of unhealthy food (Gettens and Gorin, 2017).  This pattern of behaviors results in weight gain over time.  Conversely, obesity changes the physical structure of the brain through decreased blood flow to the pre-frontal cortex (Fitzpatrick et al., 2013), which could result in the development of executive functioning deficits over time.  Based on this relationship, executive functioning deficits could be used to predict weight loss success in obesity interventions.  Despite, the large body of research supporting these relationships, few studies have examined if they generalize within Latinx communities and with young children receiving obesity treatment.

This dissertation explored relationships between childhood obesity, executive functioning, and English language proficiency in a sample (n=44) of low-income Latino immigrant elementary school students.  Childhood obesity was assessed through Body Mass Index (BMI), waist circumference, and blood sample measures.  Executive functioning skills were assessed through the parent-report Spanish version of the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2015), the Child Behavior Checklist (CBCL; Achenback & Rescorla, 2011), and a computerized go-no-go task (Fillmore, Rush, & Hays, 2006).  English language proficiency was assessed via the English version of the Picture Vocabulary Test-III (PPVT-III; Dunn & Dunn, 1997) and parental reports of the child’s language competence.

All participants were recruited through their participation in a community-based childhood obesity intervention (Gallo et al., 2019).  The participants were assessed twice - the first time at baseline (before the intervention began) and the second time directly after the intervention was completed (10-12 weeks after baseline).  Following baseline testing, parents and children participated in a ten-week multi-modal family obesity intervention.  The intervention was designed to improve nutritional knowledge; improve child physical fitness; improve parent and child mental health; and help families set goals for sustainable child weight maintenance.

Concurrent correlational analyses at baseline indicated that child obesity was generally not associated with the executive function measures.  Although small negative correlations (i.e., .11 to .30) were generally in the hypothesized direction, they were typically not significant given the small sample sizes, except for triglyceride counts which (.27 to .38) were positively related to parent-reported EF and behavior problems.  Although unrelated to direct English vocabulary assessment, obesity was positively associated with parent report of child English language proficiency and English use in the home, suggesting that acculturation (more use of English) may be a risk marker for childhood obesity.  Parent report of child’s English proficiency was negatively related to parent-reported EF and behavior problems, but PPVT scores were generally unrelated to the EF measures.  Baseline measures of EF were inconsistently related to obesity intervention gains.  However, children whose blood markers of obesity increased over time also showed worse behavior and EF problems over time as reported by parents.

This study, although hampered by a small sample and attrition of participants over time, demonstrates some evidence that child EF is related to obesity measures in the context of intervention with Latino immigrant families, and suggests that additional research is needed.