Matthew Thorpe and Dr. Randal Day, Marriage, Family and Human Development

Obesity is increasing in all age groups in the developed world. This trend is considered by many to be a public health emergency. Obesity is a well established risk factor for cardiovascular disease, some types of cancers, and diabetes. Diabetes itself is an independent risk factor for several serious conditions, including heart attack, stroke and kidney disease. The Centers for Disease Control and Prevention (CDC) attribute 34.3% of 2003 deaths to heart disease and stroke, diseases that are frequently tied to obesity and are often preventable with healthy weight and lifestyle.

Obesity is more easily prevented than treated, making the incidence of obesity among children and adolescents a crucial leverage point in obesity management. Obesity in youth promotes obesity in adulthood. Furthermore, we are beginning to see increasing frequency of diseases affect children and teens that are traditionally considered adult diseases. These include diabetes and various cardiovascular risk factors.

Many studies have investigated the role of parenting in child and adolescent obesity, noting important relationships between parenting practices and child lifestyle including eating and exercise behavior. More often than not these studies exclusively or predominantly include mothers, to the neglect of the fathering relationship. A few studies note important roles of fathers in the unrolling of child obesity that are distinct from maternal influence.

This study sought to identify some ways in which fathers and mothers might be involved in child eating and activity patterns, using a large existing collection of survey data from U.S. adolescents: the National Longitudinal Study of Adolescent Health (Add Health). Using research support from the Office of Research and Creative Activities and the University Honors Program, I obtained the public-use version of Add Health and screened the data for family and especially parenting variables considered relevant to child eating and activity behavior. I also identified survey items important to statistical control, such as socioeconomic status.

Each adolescent responding to the Add Health survey was asked to provide age, weight, height, age and gender. With the counsel of Dr. Allison Campbell of the Nutrition, Dietetics and Food Science department I used statistical programming developed by the CDC to calculate a comparative percentile of weight adjusted for height, age and gender for each responding adolescent. These percentiles are the recommended epidemiological standard for defining overweight status.

With the help of Justin Dyer, a BYU graduate and current doctoral candidate at the University of Illinois, I computed the Income-to-Needs ratio for responding adolescent’s households. This ratio is a measure of socioeconomic status that takes into account the number of adults and children in the home, and describes income controlled for estimated cost of living for a given family structure using U.S. census data.
Finally I created an index of the quality and the quantity of parent involvement for both the father and the mother of two-parent homes in the study. I used structural equation modeling with the AMOS program to test the Add Health data for relationships between father and mother involvement and adolescent obesity, reported levels of physical activity and the frequency of family meals while controlling for the influence of parental education and the income to needs ratio. My mentor, Dr. Day, guided me to the appropriate statistical tests for presenting these relationships.

I found that improved father involvement was associated with adolescent physical activity more strongly than mother involvement, and that father and mother involvement were both associated with the frequency of family meals. No direct association between parent involvement and child obese status was discovered, however other research has demonstrated that more frequent family meals are related to healthier child eating practices, and that physical activity levels predict obese status. The results also highlighted that these relationships differ across ethnic background and between genders.

The results are important because they broaden the concept of how family might influence an adolescent’s weight. Because the influence of fathers is different from the influence of mothers, a study that narrowly defines parent involvement or that does not assess father involvement may be missing out on an important part of the family system.

These results and a review of family influence in adolescent obesity were the basis for my honors thesis, and will be presented at the 2007 national conference of the American College of Sports Medicine in May. They will also be submitted to an as yet unidentified exercise science journal to answer noted limitations in the literature on parent influence on child physical activity. Specifically several studies on this topic have not included a well accepted measure of socioeconomic status or assessment of ethnic differences.

The mentored learning program at BYU offered me an opportunity to perform undergraduate research at the level of a graduate student. I am currently enrolled in the Medical Scholars Program at the University of Illinois, where I will graduate with a PhD in nutritional sciences as well as an MD degree. My undergraduate research training helped me gain admission to this competitive program, as well as a research fellowship from the U.S. Department of Agriculture for research in nutrition and health. With this graduate training and my undergraduate background in the behavioral sciences, I hope to conduct medical research that incorporates biomedical, lifestyle and behavioral components.