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Association of overweight with academic performance and social and behavioral problems: an update from the early childhood longitudinal study.

Article Excerpt
Children in the United States are becoming more overweight. Numerous studies have documented the alarming increases in obesity and overweight in both adults and children. (1-3) Among children aged 6-11 years, 37.2% are either overweight or at risk of becoming overweight, with 18.8% already overweight, according to the 2003-2004 National Health and Nutrition Examination Survey, (1) compared to less than 5% in the late 1970s. (2)

Childhood overweight involves significant risks to physical and emotional health. Excess body weight in children is associated with a plethora of type 2 diabetes and cardiovascular disease (CVD) risk factors. (4,5) In a population-based sample, approximately 60% of overweight children aged 5-10 years had at least 1 CVD risk factor--such as elevated total cholesterol, triglycerides, insulin, or blood pressure--and 25% had 2 or more CVD risk factors. (6) In addition, childhood overweight has been associated with several immediate health risk factors such as orthopedic, neurological, pulmonary, gastroenterological, and endocrine conditions. (7,8) Overweight during childhood and particularly during adolescence is related to increased morbidity and mortality in later life, as overweight children and adolescents tend to become overweight adults. (9)

Of equal importance are the negative social and psychological ramifications of childhood overweight, including a lower self-esteem and poor relationships with peers. (10,12) It is possible that the social and psychological problems are even more significant than the health consequences of being overweight in children. Overweight school-age children are more likely to be the victims and perpetrators of bullying behaviors than their normal-weight peers. (12) In addition, overweight children often experience higher rates of stigmatization and social isolation than leaner children. (12)

More recent research indicates a relationship between overweight status; gender; and social, behavioral, and psychological problems. (13) Using a sample of kindergarten-age children, Datar and Sturm (14) found that childhood overweight was already associated with behavior problems when girls, but not boys, begin school. Other studies report a significant association between overweight status and psychosocial distress among girls but not among boys. (12,15,16) These findings are inconsistent with the body of research indicating gender differences in classroom behavior: boys are more likely to exhibit disruptive and unfocused behavior. (17) These findings do, however, reinforce research that girls are more likely to internalize emotional distress. (18)

With regards to academic success, 1 study of youth in Thailand demonstrated that overweight adolescents, but not children, on average had a significantly lower grade point average than their non-overweight peers. (19) Datar and Sturm also indicated lower academic performance among overweight kindergartners and first grade children. (20) Overweight children had significantly lower test scores in math and reading compared with nonoverweight children.

Data on childhood overweight and academic achievement and children's classroom behaviors in population-based samples of elementary school--age children are limited, despite growing concerns regarding increasing overweight and its likely effect on school performance. The current study focuses on academic achievement and social skills in a population-based sample of third grade girls and boys, building upon previous research. More specifically, we examined if there are differences between third grade overweight and nonoverweight girls and boys in academic achievement and classroom social and behavioral problems.

METHODS

Data for the present study were derived from the Early Childhood Longitudinal Study-Kindergarten Class (ECLS-K), a nationally representative cohort of kindergartners attending public and private schools in 1998-1999. Sponsored by the National Center for Education Statistics, the ECLS-K is designed to document the educational status and progress of a nationally representative sample of children from kindergarten through 12th grade. (21) The ECLS-K study used a multistage probability sample design. The primary sampling units were geographic areas consisting of counties or groups of counties from which 1280 public and private schools offering kindergarten programs were selected. From each of these schools, a target sample of approximately 24 children was selected. The study collected detailed information on children, parent, teacher, and school characteristics. We conducted our cross-sectional analyses on data from the spring...

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