A novel hypothesis on the relationship between maternal education and obesity in children; the mediating role of maternal and child self-control—ABIS a population-based cohort study

Figure 1. Diagram of pathways between maternal education and child obesity in Sweden. Dashed lines represent pathways interrupted by social and economic policies in Sweden. BVC: Barnavårdcentral = Children’s healthcare centers including dietary recommendation and follow-up of height and weight development; MVC: Mödravårdcentral = Maternal health services including dietary recommendations; School nurses: follows BMI during school years with dietary recommendations.

Figure 2. Hypothetic pathways from low maternal education to child obesity. Low maternal education reduces maternal self-control directly and leads to low social stratification that feeds back through risk of negative peer pressure and stress, further reducing self-control. Low maternal self-control decreases the ability to control child’s diet and behaviors and increases risk of unhealthy diet in the mother. Low maternal education increases the risk of other negative self-control-related behaviors like parental conflicts, lone parenthood, and addiction that increases maternal and child stress leading to reduced self-control. Note that self-control-related variables like smoking, breastfeeding, and maternal BMI do not act as mediators on the pathway from maternal education – maternal self-control – child’s behaviors to child obesity.

Figure 3. Direct and indirect pathways between maternal education and child BMI/obesity at age 19. (a) Shows the results from model 1 (maternal self-control is a latent variable constructed using four variables: smoking during pregnancy, smoking during the child’s first year of life, breastfeeding duration, and participation with biological samples) with BMI as an outcome. (b) Shows the result of model 2 (adding maternal BMI to the maternal self-control variable) with BMI as an outcome. (c) Shows the results of model 1 and (d) results of model 2 with obesity as an outcome.