Are all risks equal? Understanding the differential mechanism linking early environmental risk and obesity via the interplay of mental health and lifestyle factors.

The structural equation model examining pathways from early environmental risk to obesity via mental health and lifestyle factors showed acceptable fit.

• Model fit indices: Comparative Fit Index=0.926, Tucker-Lewis Index=0.875, root mean square error of approximation=0.034, standardised root mean square residual=0.046
• Data drawn from the Millennium Cohort Study with a valid sample of n=5401
• Structural equation modelling was used to test proposed pathways

Early environmental risk (EER) was significantly associated with later mental health problems, lifestyle factors (diet, exercise, smoking), and obesity.

• EER was measured from 9 months to age 3 years and included prenatal risks, neonatal risks, low socioeconomic status, maternal psychological problems, and harsh parenting
• Mental health problems were assessed at age 7 years (internalising and externalising problems)
• Lifestyle factors were assessed at age 11 years; obesity was measured at age 14-17 years

Higher EER was modestly associated with higher obesity risk via the interplay of externalising problems and drinking.

• The indirect pathway coefficient was β=0.01, p=0.036
• The pathway specifically implicated externalising (not internalising) problems as the mental health mediator
• Drinking in early adolescence (age 11 years) was the lifestyle factor involved in this mediation pathway

Sex-stratified model results indicated differences between males and females in the pathways linking EER, mental health, lifestyle, and obesity.

• The paper reports that sex-stratified model results indicated differences between males and females
• Specific sex-stratified coefficients are not detailed in the abstract
• Structural equation modelling was applied separately by sex to examine these differences

The study employed a longitudinal design spanning early infancy to late adolescence using data from the Millennium Cohort Study.

• EER was assessed from 9 months to age 3 years
• Mental health problems were measured at age 7 years
• Lifestyle factors (diet, exercise, smoking, and drinking) were measured at age 11 years
• Obesity outcome was measured at age 14-17 years
• Valid sample size was n=5401