How invested fathers lead to healthier children

Michelle S. Wong, PhD

The more fathers took part in some aspects of raising their 2- to 4-year-old children, the less likely it was that their children were obese, according to a study published in Obesity (Silver Spring).¹

“For pediatricians, this provides evidence that having fathers involved with caring for their children may potentially have positive benefits for the child’s health,” says study author Michelle S. Wong, PhD, research fellow in Health Services Research at the US Department of Veterans’ Affairs (VA) Center for the Study of Healthcare Innovation, Implementation, and Policy, Greater Los Angeles Healthcare System.

It's important to find ways to curb childhood obesity because it is a growing problem. Researchers reported in 2018 that despite research suggesting that childhood obesity rates have stabilized or decreased, they found no evidence of declining obesity rates at any age. Rather, they found, among other things, that children aged 2 to 5 years had a sharp increase in obesity prevalence from 2015 to 2016 compared with the previous cycle.²

Parents greatly influence their children’s dietary preferences, activity levels, and, ultimately, weight during early childhood, according to studies, but most of the research so far has focused on mothers’ influence.¹

Fathers are now more into childcare

Fathers have taken a greater role in child caregiving in recent decades. Although most of fathers’ time is dedicated to playtime, they’ve increased the time in general that they spend caring for their children. A study by the Pew Research Center found fathers increased the time they spent caring for their children by nearly 3-fold-from about 2.5 hours to 7 hours a week-between 1965 and 2011.³

To study fathers’ potential impact on young children’s weight, Wong and colleagues referred to the Early Childhood Longitudinal Study-Birth Cohort. They looked at associations among fathers’ involvement and childhood obesity-related outcomes-‚sugar-sweetened beverage consumption, screen time, body mass index z score, overweight/obesity, and obesity. Researchers focused on 2 domains of involvement: fathers’ child caregiving, including meal preparation, play or exercise, child supervision and physical care, such as grooming. The other domain was fathers’ influences on child-related decision-making regarding nutrition, healthcare, discipline, and childcare.

Finally, the researchers studied how child age, maternal and paternal employment, and family poverty status might impact the weight status of children aged 2 to 4 years. “We looked specifically within heterosexual 2-parent households,” Wong says.

They reported on about 3900 children-a weighted sample representing 2,603,286 US children.

Paternal caregiving matters

Childhood obesity decreased as fathers’ caregiving increased. For example, increasing their frequency of taking their child out for walks or play from a few times a month to a few times a week or from a few times a week to once a day on average was associated with a 30% drop in childhood obesity.

Increases in fathers’ involvement in physical childcare, including bathing and dressing children, was associated with lower childhood obesity rates.

Also, while fathers’ influence on decision-making didn’t appear to be associated with childhood weight, increases in fathers’ influence on childcare decisions approached statistical significance in decreasing some toddlers’ sugar-sweetened beverage consumption and obesity.

“When we looked at whether this relationship between father involvement and various types of child caregiving activities and childhood obesity outcomes varied by father education level, whether mothers were employed, and whether families were above or below the poverty line, we actually did not find any evidence that these relationships differed by these characteristics,” Wong says. “This suggests that there is a pretty consistent relationship of fathers’ involvement potentially being beneficial for childhood obesity across all families, regardless of father education, maternal employment, and family poverty status.”

Pediatricians: Involve dads

Pediatricians play an important role in getting fathers more involved in their children’s weight and health, and in educating fathers that their involvement matters.

Fathers feel neglected during their children’s visits to pediatricians, according to one study. Researchers reported in Childhood Obesity in April 2013 that fathers generally felt “left out” during clinic appointments. The quality of the relationships between fathers and their children's providers impacted how receptive fathers were to talking about their children's weight, diet, and physical activity behaviors. Among the suggestions fathers made in this study to improve communication between providers and fathers: personalizing the discussion.⁴

“One of our specific findings was that greater frequency of fathers taking their children outside to walk or play was associated with decreases in the odds of obesity. I think this is a message that pediatricians could try to incorporate, emphasizing to both parents the importance of an active lifestyle for their kids-taking their kids for walks, taking their kids outside to play-and maybe this message could be directed to fathers as well,” Wong says.

Parenting childhood obesity interventions tend to focus on mothers’ involvement. The authors suggest that making more of an effort to involve fathers in these interventions might help.

Among the study’s limitations was that fathers self-reported the data and their responses weren’t externally validated.

Follow Michelle S. Wong, PHD, on Twitter: @mychellss

References:

1. Wong MS, Jones-Smith JC, Colantuoni E, Thorpe RJ Jr, Bleich SN, Chan KS. The longitudinal association between early childhood obesity and fathers' involvement in caregiving and decision-making. Obesity (Silver Spring). 2017;25(10):1754-1761.

2. Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of obesity and severe obesity in US children, 1999-2016. Pediatrics. 2018;141(3):e20173459. Erratum in: Pediatrics. 2018;142(3):20181916.

3. Parker K, Wang W. Modern parenthood: Roles of moms and dads converge as they balance work and family. Washington, DC: Pew Research Center; 2013. Available at: https://www.pewsocialtrends.org/2013/03/14/modern-parenthood-roles-of-moms-and-dads-converge-as-they-balance-work-and-family/. Accessed May 13, 2019.

4. Lowenstein LM, Perrin EM, Berry D, et al. Childhood obesity prevention: fathers’ reflections with healthcare providers. Child Obes. 2013;9(2):137-143.