Psychosocial stress and obesity among children residing in Kaunas City.

INTRODUCTION: An unfavorable psychosocial environment has been associated with an increased prevalence of obesity among children. However, the available evidence on the association of low socioeconomic status and parent-child relationships with childhood obesity is scarce. The aim of our study was to conduct a simultaneous evaluation of the risks associated with pathological mother-child relationships, education level, and overweight/obesity among 4-6 year-old children. METHODS: This cross-sectional study included 1489 mother-child pairs living in Kaunas city, Lithuania. The Parenting Stress Index was measured using the Parent-Child Dysfunctional Interaction subscale. Children's overweight/obesity was defined as the body mass index ≥18kg/m2. Logistic regression models as well as crude and adjusted odds ratios (OR) and their 95% confidence intervals (CI) were used to indicate the strength of the associations between childhood overweight/obesity, maternal education level, and psychosocial stress. RESULTS: The percentage of children with overweight/obesity rose with an increasing Parenting Stress Index score. The percentage of children with overweight/obesity in the group of parents with better education and normal mother-child relations was 6.0%, while in the group of less educated parents and pathological mother-child relations, this percentage reached 13.9%. The stratified multivariable model showed that, with reference to the group of better educated parents and normal mother-child relations, lower education level and pathological mother-child relations were statistically significant risk factors for overweight/obesity in 4-6 year-old children, increasing the OR of overweight/obesity (aOR: 2.43; 95% CI: 1.31-4.51). Pathological mother-child relations and maternal smoking mediated the effect of low maternal education level on children's BMI z-scores. CONCLUSION: Pathological mother-child relations, lower parental education levels, and smoking may be predictors of children's overweight/obesity. Measures oriented towards health behavior and psychosocial stress management should be encouraged among parents in order to decrease the risk of overweight/obesity in their children.

The effect of residential greenness and city park visiting habits on preschool Children's mental and general health in Lithuania: A cross-sectional study.

AIM: The aim of this study was to determine the association between levels of residential surrounding greenness, preschool children's park use, sedentary behaviour, and mental and general health. METHODS: This cross-sectional study included 1489 4-6-year-old children - residents of Kaunas city, Lithuania. Responses to the questionnaires completed by parents were used to ascertain children's general and mental health. We estimated exposure to greenness by the normalised difference vegetation index (NDVI), and time spent in a park (i.e. park use). We used multivariate logistic regression models to explore the independent associations between health outcomes and surrounding greenness and time spent in the nearest city park, controlling for potential confounders. RESULTS: Of all the studied children, 14% had poor perceived general health, and 44.7% spent 5 or more hours per week in city parks. A significant increase in sedentary behaviour was observed in children with poor health. Every additional hour of time spent in parks was associated with decreased sedentary behaviour and a lower risk of poor health; meanwhile, lower residential greenness was associated with poorer mental and general health. Compared with NDVI-100 m > median and park use exceeding 5 h per week, lower greenness exposure and shorter park usage were associated with the risk of poor health (adjusted odds ratio 2.32 (95% CI: 1.43, 3.78) and the general risk of mental difficulties (adjusted odds ratio 1.43 (95% CI: 1.03, 2.18) in 4-6-year-old children. CONCLUSIONS: Lower residential greenness levels and less time spent in a park were associated with poorer general and mental health among 4-6-year-old children. Physical activity in green spaces is recommended as a measure to prevent poor general and mental health among children.

Impact of Psychosocial Environment on Young Children's Emotional and Behavioral Difficulties.

Objective: The impact of maternal psychosocial stress on young children's mental difficulties is unclear. This study investigated the joint effects of the socioeconomic status and parent-child relationships on emotional and behavioral difficulties in preschool children. Methods: The case-control study included 1416 mothers and their 4-6 year-old children pairs, living in Kaunas city, Lithuania. The parent-child relationships were measured using the Parent-Child Dysfunctional Interaction subscale. Children's mental health difficulties were assessed by the Strengths and Difficulties Questionnaire. We used logistic regression models to indicate the strength of the associations. Results: Lower socioeconomic status women more often than higher ones reported pathological mother-child relations. Low education level was associated with statistically significant increase adjusted odds ratios for emotional symptoms and total behavioral difficulties. With reference to the group of better-educated mothers and normal mother-child relations, low education and pathological mother-child relations statistically significantly increased the risk of total difficulties in 4-6 year-old children; the adjusted odds ratios were 2.45; 95% CI 1.51-3.99. Conclusions: Pathological mother-child relations strengthened the effect of lower education on the increased risk of emotional and behavioral difficulties in preschool-age children. Measures oriented towards health behavior and psychosocial difficulties management may decrease children's emotional and behavioral difficulties.

Visiting green space is associated with mental health and vitality: A cross-sectional study in four european cities.

Many epidemiological studies have found that people living in environments with more green space report better physical and mental health than those with less green space. However, the association between visits to green space and mental health has seldom been studied. The current study explored the associations between time spent in green spaces by purposeful visits and perceived mental health and vitality in four different European cities, and to what extent gender, age, level of education, attitude towards nature and childhood nature experience moderate these associations. Data was gathered using a questionnaire administered in four European cities (total n=3748). Multilevel analyses showed significant positive associations between time spent visiting green spaces and mental health and vitality in the pooled data, as well as across the four cities. Significant effect modification was found for level of education and childhood nature experience. The findings confirm the hypothesis that more time spent in green space is associated with higher scores on mental health and vitality scales, independent of cultural and climatic contexts.

Impact of residential greenness on preschool children's emotional and behavioral problems.

This study investigated the effects of the proximity to city parks and the influence of residential greenness on children's emotional and behavioral problems. This cross-sectional study included 1,468 mothers of children (ages 4 to 6) who were residents of the city of Kaunas, Lithuania. The mothers and their children were enrolled in the FP7 PHENOTYPE project study. The mothers reported on their parenting stress and their children's mental health. Residential greenness was characterized as an average of the satellite-derived normalized difference vegetation index (NDVI) in a 300 m buffer around each home address, and the proximity to city parks was defined as the distance from the subject's residence to the nearest park. Linear regression models were used to investigate the association among the residence distances from city parks, greenness and children's mental health problems. Farther residential distance from city parks was associated with worse mental health (except for the emotional problems subscale) in children whose mothers had a lower education level. More residential greenness was associated with worse mental health (more conditional problems and less prosocial behavior) in children whose mothers had a higher education level. These relationships have important implications for the prevention of emotional and behavioral problems in children.