Shift‐and‐persist: A protective factor for elevated BMI among low‐socioeconomic‐status children

Objective Low socioeconomic status (SES) is associated with many adverse health outcomes, including childhood overweight and obesity. However, little is understood about why some children defy this trend by maintaining a healthy weight despite living in obesogenic environments. The objective of this...

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Published in:Obesity (Silver Spring, Md.) Md.), 2013-09, Vol.21 (9), p.1759-1763
Main Authors: Kallem, Stacey, Carroll‐Scott, Amy, Rosenthal, Lisa, Chen, Edith, Peters, Susan M., McCaslin, Catherine, Ickovics, Jeannette R.
Format: Article
Language:English
Subjects:
Adolescent
Alliances
Asthma
Behavior
Body Mass Index
Body Weight
Child
Children & youth
Chronic illnesses
Families & family life
Female
Health Surveys
Humans
Insulin resistance
Linear Models
Male
Metabolism
Nervous system
Obesity
Pediatric Obesity - prevention & control
Pediatric Obesity - psychology
Poverty
Preschool education
School boards
School districts
Schools
Social Class
Socioeconomic factors
Stress, Psychological
Students
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Summary:Objective Low socioeconomic status (SES) is associated with many adverse health outcomes, including childhood overweight and obesity. However, little is understood about why some children defy this trend by maintaining a healthy weight despite living in obesogenic environments. The objective of this study is to test the hypothesis that the psychological strategy of “shift‐and‐persist” protects low‐SES children from overweight and obesity. Shift‐and‐persist involves dealing with stressors by reframing them more positively while at the same time persisting in optimistic thoughts about the future. Design and Methods Middle school children (N = 1,523, ages 9‐15) enrolled in a school‐based obesity prevention trial completed health surveys and physical assessments. Multiple linear regression analysis was used to examine the role of SES, shift‐and‐persist strategies, and their interaction on BMI z‐scores, while controlling for student race/ethnicity, gender, and reported diet and physical activity. Results Among children reporting engaging in less frequent shift‐and‐persist strategies, lower SES was associated with significantly higher BMI z‐scores (P < 0.05). However, among children reporting engaging in more frequent shift‐and‐persist strategies, there was no association of SES with BMI z‐score (P = 0.16), suggesting that shift‐and‐persist strategies may be protective against the association between SES and BMI. Conclusions Interventions aimed at improving psychological resilience among children of low SES may provide a complementary approach to prevent childhood overweight and obesity among at‐risk populations.
ISSN:1930-7381
1930-739X
DOI:10.1002/oby.20195