The Role of Parental Employment in Childhood Obesity

Childhood obesity is a major public health concern, as it has been shown to lead to increased health care costs, reduced quality of life and significant morbidity and mortality. Childhood obesity has been linked to numerous environmental, genetic, and behavioral risk factors. Maternal employment has been shown to exert considerable influence on childhood obesity, however little is known about the role of paternal behaviors in children's overweight and obesity. The current study addresses this important knowledge gap by examining the joint impact of parental influences on children's overweight and obesity as measured by body mass index (BMI). The Child Development Supplement (CDS) of the Panel Study of Income Dynamics (PSID) was used to explore the potential pathways by which maternal and paternal behaviors impact children's health. In particular, this study investigated whether father involvement as measured by paternal weekly work hours plays a significant role in the onset of childhood obesity, while taking into account the influence of maternal weekly work hours on child weight. This study found a significant relationship between maternal employment and child BMI, but found that paternal employment plays a significant role as well. The relative importance of parents' work hours on child body mass outcomes varied with child age, younger children being more affected by maternal work hours and older children impacted more by paternal work hours. This investigation revealed that parental work hours may impact both the quantity and quality of time spent with one's child. Shared parent-child activities found to have an impact on childhood obesity included yard work, laundry, shopping, building or repair work, food preparation, talking and reading. Additionally, this study found that the relative influence of maternal and paternal employment hours on child BMI differed, with paternal work hours associated with lower child body mass outcomes, and maternal employment predictive of increased risk of childhood obesity. These findings point to a complex dynamic between parental employment and child weight. This study's finding that the impact of father's hours of work on childhood obesity is significant indicates that ignoring this factor may potentially lead to biased and inconsistent findings. Thus, results of studies that omit paternal employment hours from their modeling, estimation, and inference must be interpreted with a degree of caution. Given parents' mutual interest in efficiently providing for the health and well-being of their children in terms of relative investments of time and other resources, the findings of this research provide theoretical support for the observed asymmetries in parental contributions to child health production. The results of this study point to the need for programs and policies that support parents in their individual and shared contributions to maintaining healthy weight outcomes in children

Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes

BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo