ARTICLE
Bidirectional Associations Between Mothers’ and
Fathers’ Parenting Consistency and Child BMI
AUTHORS: Pauline W. Jansen, PhD,a,b Rebecca Giallo, PhD,c
Elizabeth M. Westrupp, PhD,a,c Melissa Wake, MD,a,d,e and
Jan M. Nicholson, PhDa,c
a Murdoch Childrens Research Institute, Melbourne, Australia;
b Department of Child and Adolescent Psychiatry/Psychology,
Erasmus Medical Center, Rotterdam, Netherlands; cParenting
Research Centre, Melbourne, Australia; dDepartment of
Pediatrics, University of Melbourne, Melbourne, Australia; and
e Centre for Community Child Health, Royal Children’s Hospital,
Melbourne, Australia
KEY WORDS
BMI, overweight, child, parent, consistency, epidemiological,
Longitudinal Study of Australian Children
ABBREVIATIONS
BMIz—body mass index z-score
CFI—comparative fit index
CI—confidence interval
LSAC—Longitudinal Study of Australian Children
MLR—maximum likelihood estimation with robust standard
errors
PC—parenting consistency
RMSEA—root mean square error of approximation
Dr Jansen conducted the literature review and analyses and
drafted the manuscript; Dr Giallo contributed to the design, data
analyses, interpretation of results, and drafting of sections of
the Methods and Results; Dr Westrupp contributed to the data
analyses, interpretation of results, and drafting of sections of
the Methods and Results; Dr Wake was co-senior author and
contributed to the design of the study, interpretation of results,
and drafting of the manuscript; Dr Nicholson was senior author
and supervised the design of the study, data analyses; and
drafting of the manuscript; and all authors approved the final
manuscript as submitted.
www.pediatrics.org/cgi/doi/10.1542/peds.2013-1428
doi:10.1542/peds.2013-1428
Accepted for publication Sep 12, 2013
Address correspondence to Pauline Jansen, PhD, Murdoch
Childrens Research Institute, Flemington Rd, Parkville, Victoria
3053, Australia. E-mail: p.w.jansen@erasmusmc.nl
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2013 by the American Academy of Pediatrics
(Continued on last page)
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WHAT’S KNOWN ON THIS SUBJECT: Parents influence their child’s
overweight development through lifestyle-related parenting
practices. Although broader parenting dimensions may also affect
children’s BMI, reverse causality is possible and there have been
calls to examine the possible impacts of fathers.
WHAT THIS STUDY ADDS: More consistent parenting
prospectively predicted lower child BMI with effects equally
strong for fathers and mothers. There was little evidence of child
BMI influencing parenting. Improved child BMI could be among
the benefits of promoting parenting consistency of both parents.
abstract
BACKGROUND: Research suggests that general parenting dimensions
and styles are associated with children’s BMI, but directionality in this
relationship remains unknown. Moreover, there has been little atten-
tion to the influences of both mothers’ and fathers’ parenting. We
aimed to examine reciprocal relationships between maternal and
paternal parenting consistency and child BMI.
METHODS: Participants were 4002 children and their parents in the
population-based Longitudinal Study of Australian Children. Mothers
and fathers self-reported parenting consistency, and children’s BMI
was measured at 4 biennial waves starting at age 4 to 5 years in 2004.
Bidirectionality between parenting and child BMI was examined by
using regression analyses in cross-lagged models.
RESULTS: The best-fitting models indicated a modest influence from
parenting to child BMI, whereas no support was found for
bidirectional influences. For mothers, higher levels of parenting
consistency predicted lower BMI in children from Waves 1 to 2 and
3 to 4; for example, for every SD increase in mothers’ parenting
consistency at Wave 1, child BMIz fell by 0.025 in Wave 2 (95%
confidence interval: 20.05 to 20.003). For fathers, higher levels
of parenting consistency were associated with lower child BMI from
Waves 1 to 2 and 2 to 3.
CONCLUSIONS: Parenting inconsistency of mothers and fathers pro-
spectively predicted small increases in offspring BMI over 2-year peri-
ods across middle childhood. However, child BMI did not appear to
influence parenting behavior. These findings support recent calls
for expanding childhood overweight interventions to address the broad
parenting context while involving both mothers and fathers. Pediatrics
2013;132:e1513–e1520
e1513
Overweight affects ∼25% of children in
Western countries,1,2 tends to be
chronic,3 and conveys an increased risk
to future health and well-being.4 The
rapid increase in rates of childhood
obesity cannot be explained by genetics
and biology alone, focusing attention on
potentially modifiable environmental
factors, including the role of parents
in the development of their children’s
overweight.5,6 The family environment is
the most important context for children,
within which parents influence child
development through providing rules,
experiences, and resources, and by
acting as role models.7
To date, parenting research in the
childhood obesity field has primarily
focused on behaviors of mothers only,
and predominantly in the context of
children’s feeding and physical activ-
ity.6 There is now a small body of re-
search suggesting that parents may
influence their children’s BMI through
their broader approaches to parenting.6
In a recent cross-sectional analysis of
4- to 5-year-old children participating in
the Longitudinal Study of Australian
Children (LSAC), Wake et al8 reported
that low parental consistency was as-
sociated with higher BMI in children.
Intriguingly, this association held only
for paternal (and not maternal) parent-
ing consistency once accounting for
possible confounding factors. The par-
enting dimensions of warmth and irri-
tability were unrelated to child weight.
Wake et al8 also examined Baumrind’s
widely used typology of 4 parenting
styles,9 and found that paternal per-
missive and disengaged parenting
styles (both characterized by low levels
of consistency) were associated with
higher odds for children to be over-
weight as compared with authorita-
tive parenting. However, inference on
causality and direction of these associ-
ations was restricted owing to the
cross-sectional data available at that
time, a limitation shared by the majority
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of research in this area.6 Despite recent
calls to examine the possible impacts of
fathers as well as mothers,6,10 the few
longitudinal studies conducted on this
topic have only examined whether ma-
ternal parenting predicted subsequent
child weight, and none have investigated
the possibility of reverse causation.11–14
Parenting consistency reflects the degree
to which parents set and ensure
compliance with age-appropriate in-
structions, rules, and expectations.15
Inconsistent parenting negatively affects
children’s general behavior,16,17 and
potentially their lifestyle behaviors.
Children whose parents are high in
consistency may be more likely to live in
households where there are clear ex-
pectations in general, and also around
healthy behaviors (eg, rules regarding
television viewing, screen time, and
physical activity, bed-time routines, and
the timing and type of foods consumed).
These influences could be expected to
support healthy weight patterns.
Alternatively, this relationship may flow
in the opposite direction with children’s
lifestyle behaviors and weight influ-
encing parenting consistency. Chil-
dren’s unhealthy lifestyle behaviors and
overweight could contribute to parents’
stress, undermining their capacity for
maintaining parenting consistency. Per-
haps more plausibly, child overweight
could increase parenting consistency,
with some parents responding by set-
ting rules and becoming more control-
ling and consistent around diet and
activity. This might be particularly true
for girls, whose parents have been
shown to be more aware of a high BMI in
their child than parents of boys.18 In
contrast, parents who are overweight
themselves may underestimate their
child’s overweight and may be less likely
than normal-weight parents to adjust
their parenting in response to child
overweight.19,20
Disentangling associations between par-
enting and child BMI, and understanding
how these develop over time, requires
repeated measures of parenting and
child BMI. With 4 waves of data now
available, the nationally representative
LSAC21 provides an ideal opportunity to
address these questions, building on
our previous cross-sectional research
from the first wave only. Therefore, our
first aim was to explore the mutual
influences of maternal and paternal
parenting consistency and child BMI
across the pre- and primary school
years, using a cross-lagged modeling
approach.22 We hypothesized that par-
enting consistency not only predicts but
is also a consequence of child BMI.
A second aim was to assess the mod-
erating influence of child gender and
parental weight status on these associ-
ations. We hypothesized that a higher
child BMI would be prospectively asso-
ciated with more parenting consistency
among girls and normal-weight parents.
METHODS
Design and Study Population
This study was conducted by using data
from Waves 1 to 4 of the nationally
representative Growing up in Australia:
Longitudinal Study of Australian Chil-
dren. The LSAC sampling design and
field methods have been described
extensively elsewhere.21 Participants
(n = 4983) were aged 4 to 5 years when
recruited in 2004 and 10 to 11 years
(n = 4169, 84% retention) at Wave 4 data
collection. Data were collected every 2
years via interviews, questionnaires,
and direct anthropometric measure-
ments. Written informed consent was
obtained, and the Australian Institute of
Family Studies Ethics Committee ap-
proved the study.
Of the 4983 participating children, we
excluded those whose BMI data were
missing at all 4 waves (n = 16) and
without any responses to the parenting
consistency items from both mothers
and fathers (n = 965), resulting in
a sample of 4002 child-parent triads.

Excluded children (n = 981) had a sim-
ilar BMI at baseline (P = .09), but were
more likely to be in the lowest tertile of
socioeconomic position, or to have
a non-English speaking or Indigenous
background (P , .001), than children
without missing data (n = 4002).
Measures
Parenting Consistency
In each biennial wave of data collec-
tion, parents gave detailed information
about various aspects of their parent-
ing behaviors. To assess the frequency
with which parents set and enforced
clear expectations and limits, LSAC’s 5-
item measure of parenting consistency
was used.23 The items are: 1) How often
does your child get away with things
that you feel should have been pun-
ished? 2) How often is your child able to
get out of punishment when she(/he)
really sets her mind to it? 3) When you
discipline your child, how often does
she ignore the punishment? 4) When
you give your child an instruction or
make a request to do something, how
often do you make sure that she does
it? and 5) If you tell your child she will
get punished if she doesn’t stop doing
something, but she keeps doing it, how
often will you punish her? Responses
were on 5-point Likert scales (0 =
never/almost never to 4 = all the time)
and reverse coded where appropriate
to indicate higher consistency, with
sum scores ranging from 0 to 20. In-
ternal consistency was acceptable for
mothers and fathers at all 4 waves
(a 0.68–0.72). Previous validations have
demonstrated the expected relation-
ships with other constructs (eg, lower
scores associated with socioeconomic
disadvantage and poorer child de-
velopment).23
Child BMI
At each wave, study staff measured
children’s weight and height (dressed
in light clothing) using standardized
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equipment and procedures. BMI was
calculated as kg/m2 and converted into
age- and gender-specific z-scores (BMIz)
based on the 2000 Centers for Disease
Control growth charts.24
Covariates included child gender, in-
digenous status, language other than
English spoken at home, family socio-
economic position (composite variable
based on annual family income and
parental education and occupational
status),25 and parental BMI derived
from self-reported height and weight.
For the moderation analyses, parental
BMI was categorized as non-overweight
(,25 kg/m2) and overweight/obese
($25 kg/m2).
Analyses
Analyses were performed by using
SPSS version 17.0 and Mplus version
6.0. For Aim 1, cross-sectional and
longitudinal correlations between
maternal/paternal parenting consis-
tency and child BMIz were estimated
with Pearson’s correlation coefficients
(r), while bidirectional influences were
examined by using a cross-lagged
modeling approach.22 Models were
estimated by using maximum likeli-
hood estimation with robust standard
errors (MLR) to account for non-
normality of the data.26 Survey weights
were applied to account for differential
non-response at Wave 1.27 Missing val-
ues in child BMI, parenting consistency
and covariates were accounted for by
full information maximum likelihood
procedures available in Mplus. This
method estimates model parameters
and standard errors using all available
data while adjusting for the uncertainty
associated with missing data.28 Of the
4002 included children, 3312 children
(82.8%) had complete BMI data across
all 4 waves, and 419 (10.5%), 154 (3.8%),
and 117 (2.9%) children had missing
BMI data in 1, 2, or 3 waves, respectively.
Across all waves, parenting consistency
scores were complete for 2964 mothers
ARTICLE
(74.1%) and 1788 fathers (44.7%); 638,
238, and 162 mothers, and 834, 668, and
712 fathers had missing scores in 1, 2,
and 3 waves respectively.
For mothers and fathers separately, 4
competing models were tested, each
assuming different associations be-
tween parenting consistency and BMI
(Fig 1). In all models, covariates were
regressed on the continuous variables
of child BMI and parenting consistency
at Wave 1, a correlation was included
between child BMI and parenting con-
sistency at Wave 1, as well as cross-
sectional residual correlations be-
tween these 2 measures for Waves 2 to
4. Model 1 was the stability model,
which only allowed associations be-
tween child BMI across waves and be-
tween parenting consistency across
waves. In Model 2, lagged effects of
child BMI at each wave on parenting
consistency at each subsequent wave
were added to Model 1. In Model 3,
lagged effects of parenting consistency
on child BMI in the subsequent wave
were added to Model 1. Finally, in Model
4 the cross-lagged effects of BMI on
parenting and of parenting on BMI
were simultaneously added to Model 1.
Acceptable-to-good fit was determined
by a comparative fit index (CFI) .0.90,
and a root mean square error of ap-
proximation (RMSEA) ,0.08.29 Model
improvement was tested using the
Satorra-Bentler x2-difference test for
MLR estimation methods30 with signif-
icance set at P , .05. We tested
whether Models 2 and 3 were a signifi-
cant improvement to Model 1. To for-
mally test for bidirectional associations,
we examined whether Model 4 was
a significant improvement over the best
fitting of Models 1 to 3. The standardized
regression coefficients of the best-
fitting model are presented.
For Aim 2, for the best fitting mothers’
and fathers’ models, we tested mod-
eration by child gender and parental
weight status. We examined whether
e1515

FIGURE 1
Hypothesized models for relationship between parenting consistency (PC) and child BMI. Cross-sectional
correlations between error terms of BMI and PC within waves 2 to 4 not depicted but included in all
models. Covariates: child gender, indigenous or non-English speaking background, family socioeco-
nomic position, and maternal (for models with mothers’ consistency) or paternal (fathers’ consistency)
BMI.
cross-lagged paths differed between
boys and girls, and between normal
weight and overweight parents. Using
multiple group analyses, a model with
all parameters free to vary between the
2 groups (boys and girls; normal weight
and overweight parents) was compared
with a model in which lagged paths
were constrained to be equal for the 2
groups, with a lack of significant im-
provement indicating equivalence in the
model parameters for the 2 groups.
RESULTS
Mean age of children at Wave 1 (n =
4002) was 4.2 years, and 51% were
boys (see Table 1). Forty-two percent of
mothers and 66.8% of fathers were
overweight. Correlations between ma-
ternal and paternal parenting consis-
tency within each wave were modest
(r 0.22–0.36).
Table 2 shows that maternal and pa-
ternal parenting consistency were neg-
atively correlated with child BMI, both
within and between waves, indicating
that higher levels of parenting consis-
tency were associated with slightly
lower child BMI. In all but 2 instances,
correlations were larger for fathers
than for mothers.
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Table 3 gives an overview of the model
fit indices for the alternative cross-
lagged models. Patterns of results
were similar for mothers and fathers.
The stability models (Model 1) were
a good fit to the data for both maternal
and paternal parenting consistency.
The addition of lagged pathways from
child BMI to parenting consistency
(Model 2) did not improve model fit. In
contrast, the models with lagged path-
ways from parenting consistency to
child BMI (Model 3) had a significantly
better fit to the data than the stability
models. The final models including bi-
directional influences (Model 4) were
not a significant improvement over
Model 3, indicating the addition of bi-
directional paths was not an improve-
ment to the unidirectional model.
The lagged parenting to child BMI
models (Model 3) were thus accepted
as the best-fitting and most parsimo-
nious models for mothers and fathers.
Figure 2 shows that the strongest
associations were between BMI across
waves (eg, standardized b Wave 1 to 2
for maternal and paternal models =
0.77, 95% confidence interval [CI]: 0.75
to 0.79) and between parenting con-
sistency across waves (eg, standardized
b Wave 1 to 2 for maternal parenting =
0.60, 95% CI: 0.58 to 0.63). In addition,
higher levels of parenting consistency
predicted lower child BMI in the next
wave at most points. For mothers, this
held from Waves 1 to 2 and 3 to 4, and
for fathers from Waves 1 to 2 and 2 to
3. However, associations were small;
for example, each 1.0 SD increase in
mothers’ parenting consistency at
Wave 1 was associated with a 0.025
reduction in child BMIz at Wave 2 (95%
CI: 20.05 to 20.003).
For Aim 2, we conducted multi-group
analyses on the best-fitting mothers’
and fathers’ models (Model 3) to exam-
ine moderation by gender and parental
weight. Again results were similar for both
parents and indicated that the cross-
lagged paths from parenting consistency
to child BMI did not differ in strength and
direction between boys and girls (mothers:
x2-difference = 0.1, P = .99; fathers: x 2
-difference = 3.1, P = .38), or between
parents who were normal weight ver-
sus overweight (mothers: x2-difference
= 4.9, P = .18; fathers: x 2-difference = 0.8,
P = .84).
DISCUSSION
Findings from this large contemporary
cohort of Australian children suggest
that higher levels of parenting consis-
tency precede slightly lower BMI in
children across a 6-year period from
ages 4–5 to 10–11 years. Unlike the
earlier cross-sectional findings at age
4 to 5 years in this same cohort (which
implicated only fathers),8 effects of
parenting consistency were very simi-
lar for mothers and fathers. Contrary
to our hypothesis, child BMI did not
appear to influence parenting behavior,
nor were associations influenced by
child gender or parent weight status.
Associations of parenting consistency
predicting lower child BMI were small
and, although evident between every
wave, these were not always statis-
tically significant. This may reflect

TABLE 1 Characteristics of the Study Sample (n = 4002)
Child characteristics
Boys, %
Indigenous background, %
Age in years, mean (SD)
BMIz, mean (SD)
Family and parental characteristics
Language other than English spoken at home, %
Maternal BMI (kg/m2), mean (SD)
Paternal BMI (kg/m2), mean (SD)
Parenting consistency score
Mothers, mean (SD)
Fathers, mean (SD)
a Data reported for the wave sourced for the analyses.
difficulty in achieving statistical signif-
icance when assessing a modest as-
sociation over a 2-year time interval,
coupled with high short-term stability in
children’s BMI and in parenting consis-
tency, suggesting that both are largely
set early in life. In the context of the array
of factors known to influence children’s
weight (including genetic inheritance
and the energy intake-expenditure bal-
ance),5 the findings indicate that the
broader parenting environment may
also contribute. As parenting incon-
sistency is quite a distal factor from child
BMI, relationships were expected to be
weak. Nevertheless, both mothers’ and
fathers’ inconsistency in parenting may
generalize to greater difficulty in in-
stituting and enforcing rules, household
organization, and mealtime routines that
could be protective against children’s
weight gain.
TABLE 2 Correlations Between Parenting Consistency and Child BMI
Consistency variable Wave 1
Maternal consistency Wave 1 20.011a
Maternal consistency Wave 2 20.008
Maternal consistency Wave 3 20.008
Maternal consistency Wave 4 0.010
Paternal consistency Wave 1 20.047a,**
Paternal consistency Wave 2 20.012
Paternal consistency Wave 3 20.061**
Paternal consistency Wave 4 20.034
* P , .05; **P , .01; ***P , .001.
a Cross-sectional correlations.
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ARTICLE
BMI at age 9 years. Similar to our study,
Mean (SD) or % per Wavea effects were small. Interesting next steps
Wave 1 Wave 2 Wave 3 Wave 4 in this field would be to examine whether
effects of mothers’ and fathers’ parent-
50.9 – – – ing on child BMI vary across countries
2.6 – – –
4.2 (0.4) 6.3 (0.5) 8.3 (0.4) 10.3 (0.5) that differ in terms of social norms re-
0.54 (1.0) 0.36 (1.0) 0.37 (1.0) 0.34 (1.0) garding mothers’ and fathers’ involve-
ment in child rearing.
10.1 – – –
25.3 (5.2) – – – Contrary to our hypothesis, no evidence
26.9 (4.1) – – – was found for child BMI predicting
15.5 (3.3) 15.9 (3.0) 16.1 (3.0) 16.0 (3.1) parenting consistency. This contrasts
14.9 (3.4) 15.5 (3.2) 15.6 (3.1) 15.4 (3.2) with research on children’s psychoso-
cial well-being, showing bidirectional
associations between parenting and
Although the findings for fathers are children’s behavior or temperamen-
entirely novel, these modest pro- tal characteristics.32 Unlike behavioral
spective consistency-BMI associations problems, child overweight appears
are in line with previous longitudinal to have little direct impact on chil-
studies. Most have examined parenting dren’s health,33 family activities and rou-
styles (ie, authoritarian, permissive, or tines, and objective health care costs
neglectful) and showed that children (S. Clifford, personal communication,
raised by authoritative mothers (char- 2013) in the first decade of life at the
acterized by warmth as well as consis- population level. Thus, the only real
tency) had lower mean BMIs than driver to change parenting would be
children who were raised with other recognition that their child is at risk for
styles.6,11–14 Maternal parenting consis- future poor health, yet it is well docu-
tency as a stand-alone construct has mented that most parents do not con-
been investigated less often and, to our sider their overweight children to be
knowledge, only once using a longitudi- overweight.34,35 This study does not
nal design. In an unpublished thesis, rule out the possibility that child BMI
Hejazi31 showed that lower parental could affect more specific parenting
consistency (assessed for the parent dimensions or practices related to
most knowledgeable about the child, lifestyle behaviors like physical activity
probably often the mother) among 2.5- and eating behavior. In fact, some re-
year-old Canadian children predicted cent studies found that children’s
a trajectory leading to a relatively high weight status acts as an antecedent to
parent’s food-related restrictions.36,37
Together, our and previous findings
suggest that domain-specific parent-
Pearson Correlation Coefficients (r)
ing may be partly context driven,
Child BMIz whereas more general parenting is
Wave 2 Wave 3 Wave 4 a quite stable construct that typically
20.035* 20.050** 20.045** influences child development, but not
20.030a 20.034* 20.035* the reverse.
20.048** 20.042a,* 20.066***
20.022 20.034* 20.034a,* A key strength of the current study was
20.056** 20.082*** 20.076*** our longitudinal examination of both
20.022a 20.042* 20.057** mothers’ and fathers’ parenting in re-
20.056** 20.066a,** 20.063**
20.061** 20.045* 20.059a,**
lation to child BMI. Despite our initial
report of a cross-sectional association
between fathers’ parenting consistency
e1517
TABLE 3 Models for Parenting Consistency and Child BMI
Model fit indices Fit Indices for Different Models

Model 1: Model 2: Lagged BMI to Model 3: Lagged Parenting to Model 4: Lagged

Stability Parenting BMI Bidirectionala
Maternal parenting consistency
x 2 (df) 1061 (52)*** 1049 (49)*** 1039 (49)*** 1026 (46)***
x 2 Δ test indicating difference from Model 1 — 4.2 (3) 15.8 (3)** 21.3 (6)**
(df)b
CFI 0.91 0.91 0.91 0.91
RMSEA 0.070 0.071 0.071 0.071
Paternal parenting consistency
x 2 (df)b 793 (52)*** 50.0 (11)*** 37.6 (11)*** 33.3 (8)***
x 2 Δ test (df)b — 6.2 (3) 8.8 (3)* 15.0 (6)*
CFI 0.93 0.93 0.93 0.93
RMSEA 0.060 0.061 0.061 0.063
CFI, comparative fit index; df, degrees of freedom; RMSEA, root mean square error of approximation. *P , .05; **P , .01; ***P , .001.
a Model 4 was not an improvement over best fitting Model 3: mothers, x 2-difference = 5.6, P = .13; fathers, x 2-difference = 6.2, P = .10.
b Based on Satorra-Bentler scaled x 2-difference test.

and child BMI in 2007,8 research re-
garding fathers’ influences on children’s
overweight has remained sparse.6,10
In keeping with our earlier analyses,
fathers’ parenting consistency pro-
spectively predicted small decreases
in offspring BMI over 2-year periods
across middle childhood. Other strengths
FIGURE 2
Lagged model for relationship between parenting consistency of mothers (A) and fathers (B) and child
BMI. PC, parenting consistency. Coefficients are standardized estimates. *P , .05, **P , .01, ***P , .001.
of the current study were its large,
population-based sample and repeated
assessments of both parenting consis-
tency and objective BMI. Our study
also had some limitations. While ac-
counting for selective participation by
using sampling weights, we did not
account for selective loss to follow-up.
Data were more often missing in chil-
dren from disadvantaged families. Al-
though we recently showed that such
children have a particularly high risk
for overweight,38 children excluded
from the present analyses because of
missing data did not have a higher BMI
than included children. Furthermore,
given the availability of data from 4
waves only, it was not possible to
identify age trends in the parenting-
BMI relationship. Associations may
change in adolescence, a period char-
acterized by changes in parenting and
other environmental influences on
eating and activity.
This study is unique in exploring dy-
namics between child BMI and parent-
ing behavior of both parents. Findings
supported a protective influence of
parenting consistency on child BMI,
with no evidence of an influence from
child BMI to parenting. Although not
large, these associations were only
slightly smaller than the effects of other
factors repeatedly cited as contributing
to or being protective for children’s
overweight development, like breast
feeding.39,40 Thus, our results support
recent calls for expanding childhood
overweight interventions to address
the broad parenting context41; these
should involve both mothers and
fathers.

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ACKNOWLEDGMENTS
This paper uses confidentialized unit re-
cord files from Growing Up in Australia,
the Longitudinal Study of Australian
Children (LSAC). The study is conducted
in partnership between the Depart-
ment of Families, Housing, Community
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(Continued from first page)

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: Dr Jansen was supported by a Rubicon grant 446-11-010 from the Netherlands Organisation for Scientific Research (NWO) and the Marie Cofund Action.
Dr Wake and Dr Nicholson were supported by National Health and Medical Research Council Career Development Awards (Dr Wake: 546405; Dr Nicholson: 390136)
and Research Fellowships (Dr Wake: 1046518). Murdoch Childrens Research Institute research is supported by the Victorian Government’s Operational
Infrastructure Support Program, and the Parenting Research Centre receives funding from the Victorian Government Department of Education and Early Child
Development.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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Bidirectional Associations Between Mothers' and Fathers' Parenting Consistency
and Child BMI
Pauline W. Jansen, Rebecca Giallo, Elizabeth M. Westrupp, Melissa Wake and Jan M.
Nicholson
Pediatrics 2013;132;e1513; originally published online November 25, 2013;
DOI: 10.1542/peds.2013-1428
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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly

publication, it has been published continuously since 1948. PEDIATRICS is owned, published,
and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk
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Bidirectional Associations Between Mothers' and Fathers' Parenting Consistency
and Child BMI
Pauline W. Jansen, Rebecca Giallo, Elizabeth M. Westrupp, Melissa Wake and Jan M.
Nicholson
Pediatrics 2013;132;e1513; originally published online November 25, 2013;
DOI: 10.1542/peds.2013-1428

The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/132/6/e1513.full.html

PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly

publication, it has been published continuously since 1948. PEDIATRICS is owned,
published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point
Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2013 by the American Academy
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.

Downloaded from pediatrics.aappublications.org at Indonesia:AAP Sponsored on January 11, 2015