Risk of obesity in youths with functional limitations and the potentially mediating effect of youth lifestyle, parenting experience, neighborhood social capital and social participation

Purpose: The purpose of this study was twofold, to determine (1) if obesity is more prevalent among youths with functional limitations than among youths without special needs; and (2) to determine if variables related to the domains of youth lifestyle, parenting experience, perceived social capital, and youth social participation mediate the relationship between youths with functional limitations and obesity.;Design: This study is a secondary analysis of cross-sectional data from the nationally representative dataset, the National Survey of Children's Health.;Exposure: Youths between the ages of 10 and 17 with functional limitations or no special healthcare needs.;Outcome: Sex-specific body mass index ≥ 95th for age percentile values using 2000 Center of Disease Control growth charts.;Variables of interest: Potential mediators were examined in four domains: (1) youth lifestyle, defined as participation in after-school sports, physical activities, hours spent watching television, having a television set in the youth's bedroom, eating family meals together, and getting enough sleep; (2) parenting experience, defined as parental aggravation, coping, and emotional support; (3) perceived neighborhood social capital; and (4) youth social participation, defined as participation in after-school club activities.;Results: Gender was an effect modifier, with 27.7% of females with functional limitations being obese, as compared to 12.9% of females with no special needs. There was no statistically significant difference between the prevalence of obesity in male youths with functional limitations and in those with no special needs. The association between female youths with functional limitations and obesity was partly mediated by participation in after-school sports and participation in physical activities.;Conclusion/Implications: The findings from this study suggest that lack of female participation in after-school sports and physical activities is partly responsible for the increased prevalence of obesity in those with functional limitations compared to those with no special needs. Future interventions that reduce barriers to and increase facilitators of after-school sports and physical activities could reduce the difference in obesity prevalences between females with functional limitations and those with no special needs.