Maternal distress and body mass index in preschoolers living in families experiencing low-income

Health disparities among children living in poverty underscore the importance of identifying risk and protective factors for childhood obesity. By applying a family stress framework with an equity lens, this study aimed to test the differential associations between maternal distress and child body mass index (BMI) in preschool-age children living in low-income families. Pre-intervention data from an obesity prevention randomized controlled trial were used to assess mother-reported parental distress and anthropometry collected from children and mothers in a diverse sample of 450 families enrolled in Head Start. Analyses examined associations between maternal distress and child BMI z-score (BMIz) and moderation by child sex. The sample of children was 49% female, 42% White, 25% Black, 11% Hispanic and 33% had overweight status or obesity. Results indicated higher BMIz for girls compared to boys (beta = 0.10, p = 0.03). Child sex modified the association between maternal distress and child BMIz (beta = 0.12, p = 0.01). Greater maternal distress was associated with higher BMIz among girls but not boys. Among preschoolers, the maternal distress-BMIz association differed by child sex. Understanding individual differences in how maternal distress relates to childhood obesity may have important implications for obesity prevention efforts.