Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

(SDAS) Exposure to stress as a mediator of disparities in childhood obesity

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Project Number: R40 MC 08965-01
Grantee: University of Washington
Department/Center: Health Services/Public Health
Project Date: 2/1/2008

Final Report

(SDAS) Exposure to stress as a mediator of disparities in childhood obesity Final Report (PDF) Exit Disclaimer

Principal Investigator

Janice F. Bell, Ph.D.
Senior Fellow
6200 NE 74th Street Bldg #29, CHI STE 210
Seattle, WA  98115
Phone: (206) 616-2895


  • Perinatal/Infancy (0-12 months)
  • Toddlerhood (13-35 months)
  • Early Childhood (3-5 years)
  • Middle Childhood (6-11 years)


  • African American
  • Hispanic/Latino


Recent research using animal models highlights the potential importance of stress in the development of obesity. Mice exposed to chronic stress developed abdominal fat over time. No study to date has explored whether similar relations might operate in humans. Exploring this possibility is important, because results could point to novel obesity-prevention programs and explain some of the associated disparities by race/ethnicity and socio-economic status (SES). This analysis of secondary data employs a national sample of approximately 8,000 children in the National Longitudinal Surveys of Youth - Child Young Adult cohort (NLSY-CYA), linked to data collected for their mothers followed since 1979 (NLSY79). NLSY data are collected via during in-person, in-home interviews conducted by experienced, trained field staff using computer assisted personal interviewing and valid survey instruments. The study includes three specific aims: 1) To test prospective associations between exposure to stress in early childhood (0 - 6 years) and body mass index (BMI) in later childhood (age 10 - 11 years); 3) To investigate, using a causal step approach, whether exposure to stress in early childhood mediates relations between race/ethnicity or family SES and BMI; 3) To test prospective associations between early childhood SES and later childhood BMI. Dependent variables include age- and sex-specific BMI z-scores derived from measured height and weight modeled continuously and as a polychotomous variable (normal weight/overweight/ obese). Key independent variables are early childhood exposure to acute (i.e. one-time stressful life events) and chronic stress (i.e. ongoing, day-to-day experiences). Hypotheses are tested with a series of linear and multinomial logistic regression models that control for important covariates (e.g. age, sex, race/ethnicity, SES, maternal BMI, family structure) and account for the longitudinal design and family-level clustering. The project addresses MCHB Strategic Issues #2 (MCH services and systems of care efforts to eliminate health disparities) and #4 (Promoting the healthy development of MCH populations). Findings will be used to inform future research and novel MCH approaches to intervention that could be executed in clinical or home visiting contexts. Such intervention might teach children stress coping and simultaneously help parents to mitigate the stress to which children are exposed.


Listed is descending order by year published.

Bell JF, Zimmerman FJ. Shortened nighttime sleep duration in early life and subsequent childhood obesity. Arch Pediatr Adolesc Med. 2010 Sept;164(9):840-5.

Zimmerman FJ, Bell JF. Associations of television content type and obesity in children. Am J Public Health. 2010 Feb;100(2):334-40. Epub 2009 Dec 17.


Obesity & Weight, Stress

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