Self-regulation and rapid weight gain in children from age 3 to 12 years

Objective: To examine the extent to which self-regulatory capacities, measured behaviorally at ages 3 and 5 years, were linked to rapid weight gain in children from age 3 to 12 years. Self-regulation failure, or the inability to control an impulse or behavior, has been implicated as a mechanism in the development of overweight. Design: Prospective longitudinal cohort study. Setting: Home and laboratory-based settings in 10 sites across the United States. Participants: Data were drawn from 1061 children as part of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Main Exposure: Self-regulatory capacity was measured in 2 behavioral protocols; children participated in a self-control procedure at age 3 years and a delay of gratification procedure at age 5 years. Main Outcome Measures: Age-and sex-specific body mass index (BMI) z scores were calculated based on measured BMI at 6 points. Results: Mixed-modeling analyses were used to examine differences in the rate of weight gain over time based on the extent to which children exhibited the ability to self-regulate in the behavioral procedures. Compared with children who showed high self-regulation in both behavioral protocols at ages 3 and 5 years, children who exhibited a compromised ability to self-regulate had the highest BMI z scores at each point and the most rapid gains in BMI z scores over the 9-year period. Effects of pubertal status were also noted for girls. Conclusion: Self-regulation failure in early childhood may predispose children to excessive weight gain through early adolescence.