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Brian K Lo, Augustine W Kang, Sebastien Haneuse, Xinting Yu, Tayla von Ash, Susan Redline, Elsie M Taveras, Kirsten K Davison, Changes in Fathers’ Body Mass Index, Sleep, and Diet From Prebirth to 12 Months Postbirth: Exploring the Moderating Roles of Parenthood Experience and Coparenting Support, Annals of Behavioral Medicine, Volume 55, Issue 12, December 2021, Pages 1211–1219, https://doi.org/10.1093/abm/kaab013
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Abstract
While research has examined prenatal to postnatal changes in women’s weight, sleep, and diet, much less is known about these changes among fathers.
This study aimed to (a) examine changes in fathers’ body mass index (BMI), sleep, and diet from 1 month before birth to 5–6 months following birth, and from 5–6 months to 11–12 months following birth and (b) explore the moderating roles of parenthood experience and coparenting support.
169 fathers (mean age 35.5 years, 58.9% White) participated. Fathers completed an intake survey shortly after their infant’s birth to recall their height and weight, nighttime sleep hours, fruit and vegetable intake, soda intake, and fast food intake for the month prior to birth. When their child was 6 and 12 months old, fathers reported their weight, sleep, and diet again for the past 4 weeks (i.e., 4 week periods spanning 5–6 months and 11–12 months following birth). Generalized estimating equations were used to answer our research questions.
Fathers reported higher BMI (Δ = 0.22 kg/m2; 95% confidence interval [CI] = 0.06, 0.38; p = .008) and less nighttime sleep duration (Δ = −0.21 hr; 95% CI = −0.38, −0.05; p = .012) at 5–6 months following birth compared to 1 month prior to birth. Fathers’ diet remained stable over the three timepoints. No evidence was found to support the moderating roles of parenthood experience and coparenting support on fathers’ weight and behavior changes.
5–6 months following birth may be an important point of intervention for fathers to promote a return to prebirth BMI and sleep levels.
Introduction
The life course perspective views significant life events as important intervening points for health promotion [1]. The transition to parenthood is a major, discrete life event that requires substantial social, behavioral, psychological, and physiological changes as parents face new roles and responsibilities [2, 3]. These changes may have long-lasting impacts on parents’ health outcomes. Recent reviews have found that the entry to parenthood can be an inflection point for long-term weight gain carrying into midlife among mothers [4, 5]. Emerging literature also suggests that entering parenthood can lead to long-term weight gain among fathers. For example, among 10,253 men from the National Longitudinal Study of Adolescent Health, Garfield et al. found that both resident and nonresident fathers increased their body mass index (BMI) over a 10 year period while nonfathers decreased their BMI over the same period [6]. Similarly, Laroche et al. found that young Black fathers gained more weight than their childless young Black counterparts over a 7 year period [7] and Umberson et al. found that men who were fathers gained weight more rapidly than nonfathers over a 15 year period [8].
Although these studies provide critical information on the impact of fatherhood on men’s long-term weight gain, more work is needed to understand when fathers start gaining weight and how fathers’ weight-related behaviors may change in the immediate period after birth, which could inform the development of interventions to prevent the onset of weight gain. From a child development perspective, helping fathers to maintain a healthy lifestyle within the first 1,000 days of the baby’s life (i.e., from conception through 2 years of age) may play an important role in preventing childhood obesity [9] because emerging evidence has found that fathers’ weight and weight-related behaviors are associated with their children’s weight and weight-related behaviors [10–14].
The present study, therefore, aims to use a life course perspective to examine fathers’ changes in weight, sleep, and their intake of fruit, vegetables, soda, and fast food between 1 month prior to their child’s birth (i.e., prebirth) and 1 year following their child’s birth. The life course perspective has been utilized to understand women’s pregnancy experiences and postpartum weight changes [15], and it is a useful framework to study fathers’ weight and weight-related behaviors after the birth of a new baby because it focuses on the process of adjustments and adaptations with consideration of life history, current situations, and future aspirations [1, 15]. Specifically, we will use three key concepts in the life course perspective to guide our analysis: “trajectories,” “transitions,” and “linked lives.”
First, trajectories refer to a person’s health behavior patterns over a period of time [1]. The first year of fatherhood can be seen as a critical life event as fathers make adjustments and adapt to parenthood. While some fathers state that fatherhood motivates them to improve their health behaviors [16], fathers may face challenges in improving their health behaviors and experience disruption of behavioral routines in the first few months of parenthood due to unsettled infant behaviors, such as frequent nighttime waking, prolonged crying episodes, and resistance to soothing [17]. In later months, when infant behaviors are more stable and predictable, fathers’ health routines may recover; however, it remains unknown if this is the case. Thus, the first aim of the present study was to examine the trajectories of fathers’ BMI, sleep, and diet from 1 month before birth to 1 year following their child’s birth.
Second, transitions refer to major changes in life that require changes in roles and/or responsibilities, such as the birth of the first child [1]. While having a child could bring joy and excitement, becoming a father for the first time can be stressful and result in some escape behaviors, such as gambling, drinking, and overwork to manage the stress [3]. Furthermore, experienced parents with an additional child might experience extra stress and demand to meet family needs, which might compromise their well-being [18, 19]. Prior studies have primarily focused on comparing health outcomes between adults with versus without children [6–8]. Little is known about differences in the health behavior trajectories of first-time and experienced fathers. Hence, the second aim of our study was exploratory in nature that we aimed to explore the moderating role of prior parenthood experience on fathers’ BMI, sleep, and diet changes.
Third, linked lives suggest that one’s health habits and behaviors are modeled by individuals in key relationships [1]. We know that fathers’ parenting support is beneficial to mothers’ well-being [20–22], but we have little understanding of the impact of coparenting support on fathers. Prior studies reported mixed findings for the influence of coparenting support on fathers’ perceived childcare roles and demands. While inadequate coparenting support from mothers may lead fathers to be less involved in caregiving [23, 24], some fathers might perceive coparents’ excessive parenting encouragement as demanding and this might discourage fathers from being more involved in parenting [25]. To our knowledge, although some evidence exist linking coparenting support with fathers’ mental health [26, 27], limited studies have linked coparenting support with fathers’ weight, sleep, and diet. Therefore, the third aim of this study was also exploratory in nature that we aimed to explore the moderating role of coparenting support on fathers’ BMI, sleep, and diet changes.
Methods
Setting and Procedures
This study included fathers who participated in the Rise and SHINE (Sleep Health in INfancy and Early childhood) study. Rise and SHINE is a longitudinal observational study examining associations between infant sleep patterns and growth from birth to 24 months. Details of the Rise and SHINE cohort have been published elsewhere [28]. Briefly, 448 mother–infant dyads were recruited between May 2016 and June 2018 after delivery at Massachusetts General Hospital in Boston, MA. The current study is a substudy of the original Rise and SHINE cohort (referred to as the fathers’ substudy). Beginning in October 2016, fathers were recruited along with mothers and infants from the delivery ward. All fathers who were present were approached. Fathers who were not present in the delivery ward at recruitment received recruitment materials through email. Eligible fathers were biological fathers of the infants and lived in the same household as the mothers and infants. To remain eligible in the study, fathers had to sleep in the same home as the study infant at least one night per week.
Our analytical sample (n = 169) included fathers who completed at least two surveys (i.e., those who only completed the intake and six months surveys [n = 26; 15.4%] and those who completed all the intake, six months, and 12 months surveys [n = 143; 84.6%]). Study activities were reviewed and approved by Partners Health Care Institutional Review Board. Informed consent was obtained from all individual participants included in the study.
Measures
Fathers completed an online intake survey shortly after their infant’s birth, in which they were asked to recall their height, weight, sleep, and diet for the month prior to their infant’s birth. On average, fathers completed the intake survey within 7.9 days (standard deviation [SD] = 7.0) after the birth of their infant. Follow-up assessments took place when their child was 6 and 12 months old. In the follow-up surveys, fathers were asked to self-report their weight, sleep, and diet again for the past 4 weeks. As fathers could fill out the follow-up surveys at any time when their child was 6 and 12 months old, our data captured fathers’ weight and weight-related behaviors over 4 week periods spanning 5–6 months following birth and 11–12 months following birth. While objective measurements are considered the gold standard, we elected to utilize self-reported data to minimize participant burden and maximize the recruitment and retention of fathers. Prior research by our research team shows that fathers are more likely to participate in studies when the time commitment is relatively low [29]. Fathers’ parenthood experience was measured at intake and their coparenting support was measured in the 6 months survey. The measures utilized to assess each construct are outlined below.
Body mass index
Fathers self-reported their weight to the nearest pound and height to the nearest foot and inch. These measures were used to calculate BMI (kilograms per square meter).
Sleep
To assess nighttime sleep duration, fathers responded to the following question, which was asked separately for weekdays/workdays and weekends/days off: “Thinking back on the last four weeks, how many hours of sleep per night did you usually get?” Average daily nighttime sleep duration was calculated by dividing the total number of weekly nighttime sleep hours by seven: ([hours of nighttime sleep per weekday × 5] + [hours of nighttime sleep per weekend day × 2])/7.
Diet
Fathers’ consumption of fruit, vegetables, soda, and fast foods were measured using validated questions from the National Health and Nutrition Examination Survey (NHANES) Dietary Screener Questionnaire (DSQ) [30, 31]. Fathers indicated how often, on average, in the past 4 weeks they: (a) ate fruit, including fresh, frozen, or canned fruit; (b) ate vegetables, including raw, cooked, canned, or frozen vegetables; (c) drank any regular sodas or soft drinks, including Manzanita, Penafiel, Coke, Pepsi, Dr. Pepper, or Mountain Dew (excluding diet sodas); and (d) ate something from a fast food restaurant, such as McDonald’s, Burger King, Taco Bell, Dunkin Donuts, Chipotle, and Dominoes. Response options included “never,” “less than once per week,” “once per week,” “2–4 times per week,” “nearly daily or daily,” “2–4 times per day,” and “5 or more times per day.” We transformed all the diet variables into the frequency of intake per day suggested by the National Cancer Institute [32].
Parenthood experience
Information on the number of living children was collected at intake. We used this information to classify fathers as first time (i.e., no living children prior to the recent birth) versus experienced (i.e., at least one living child prior to the recent birth) fathers.
Fathers’ coparenting support
Fathers’ coparenting support was measured using the brief version (six-item) of the Coparenting Relationship Scale (CRS) [33]. The CRS demonstrates moderate to good reliability, stability, and construct validity [33]. Fathers indicated whether six statements regarding coparenting support were applicable to them on a seven-point scale (e.g., “My partner asks my opinion on issues related to parenting” and “My partner appreciates how hard I work at being a good parent”). Responses ranged from “not true of us” (0 point) to “very true of us” (6 points). A coparenting support score was calculated by summing scores for the six items (Cronbach α = 0.93). Higher scores indicated greater coparenting support.
Sociodemographic information
At intake, fathers reported their age, race, ethnicity, educational attainment, employment status, annual household income, and whether they planned to take parental leave.
Statistical Analysis
Descriptive statistics (means/SDs and counts/percentages) were used to characterize fathers’ demographics, parenthood experience, coparenting support, and their BMI and weight-related behaviors at each timepoint.
To address our research questions, we used generalized estimating equations (GEEs) to examine the changes in the outcomes over time (i.e., 1 month prior to birth, 5–6 months following birth, and 11–12 months following birth) [34]. Each dependent variable, including BMI, sleep, fruit intake, vegetable intake, soda intake, and fast food intake, was analyzed separately as a continuous outcome variable. Regression coefficients are interpreted as differences in the mean outcome. To ensure valid inference that accounts for dependence among the repeated measures within participants, we report results based on the robust sandwich estimator following the use of a working independence correlation structure [34].
To test if changes in fathers’ BMI, sleep, and diet were moderated by parenthood experience and/or coparenting support (Research Questions 2 and 3), we added an interaction term between time (i.e., a three-level categorical variable: 1 month prior to birth, 5–6 months following birth, and 11–12 months following birth) and one of the proposed moderators (first-time fatherhood status; coparenting support) into the previously mentioned models. Because fathers’ coparenting support scores were left skewed (median score 33 out of 36), we used fathers’ log-transformed coparenting support scores in our analyses.
All models adjusted for fathers’ age, education, and race/ethnicity. Analyses were conducted using SAS version 9.4 software (SAS Institute Inc., Cary, NC). The Type I error rate was set at 0.05.
Results
Table 1 summarizes the characteristics of the participant fathers. The mean age of fathers was 35.5 (SD 4.7) with a mean number of living children 1.5 (SD 0.7). Slightly more than half of fathers were non-Hispanic White (58.9%), 19.1% were Hispanic or Latino, 16.7% were Asian, and 5.4% were Black/African American. Most fathers completed a bachelor’s degree or beyond (79.0%), had an annual household income of at least $80,000 (75.9%), and had taken parental leave (74.7%). About half of the fathers were first-time parents (59.2%). Fathers’ mean coparenting support score was 30.0 out of 36 (SD 7.6). Prior to birth, 44.6% of fathers had overweight and 20.2% had obesity.
| . | Mean ± SD or n (%) . |
|---|---|
| Age (years) | 35.5 ± 4.7 |
| Number of living children | 1.5 ± 0.7 |
| Race/ethnicity | |
| White | 99 (58.9) |
| Black/African American | 9 (5.4) |
| Asian | 28 (16.7) |
| Hispanic or Latino | 32 (19.1) |
| Education | |
| Less than 12th grade | 6 (3.6) |
| High school or GED | 17 (10.2) |
| Some college or an associate’s degree | 12 (7.2) |
| Bachelor’s degree | 47 (28.1) |
| Graduate degree or higher | 85 (50.9) |
| Annual household income | |
| ≤ $39,999 | 16 (9.6) |
| $40,000–$59,999 | 14 (8.4) |
| $60,000–$79,999 | 10 (6.0) |
| $80,000–$99,999 | 10 (6.0) |
| $100,000–&199,999 | 52 (31.3) |
| ≥$200,000 | 64 (38.6) |
| Employment status | |
| Employed | 162 (95.9) |
| Unemployed | 5 (2.9) |
| Students | 2 (1.2) |
| Prebirth weight status | |
| Overweight | 75 (44.6) |
| Obese | 34 (20.2) |
| Parental leave | |
| Yes | 121 (74.7) |
| No | 41 (25.3) |
| First-time parenthood | |
| Yes | 100 (59.2) |
| No | 69 (40.8) |
| Coparenting support score (out of 36) | 30.0 (7.6) |
| . | Mean ± SD or n (%) . |
|---|---|
| Age (years) | 35.5 ± 4.7 |
| Number of living children | 1.5 ± 0.7 |
| Race/ethnicity | |
| White | 99 (58.9) |
| Black/African American | 9 (5.4) |
| Asian | 28 (16.7) |
| Hispanic or Latino | 32 (19.1) |
| Education | |
| Less than 12th grade | 6 (3.6) |
| High school or GED | 17 (10.2) |
| Some college or an associate’s degree | 12 (7.2) |
| Bachelor’s degree | 47 (28.1) |
| Graduate degree or higher | 85 (50.9) |
| Annual household income | |
| ≤ $39,999 | 16 (9.6) |
| $40,000–$59,999 | 14 (8.4) |
| $60,000–$79,999 | 10 (6.0) |
| $80,000–$99,999 | 10 (6.0) |
| $100,000–&199,999 | 52 (31.3) |
| ≥$200,000 | 64 (38.6) |
| Employment status | |
| Employed | 162 (95.9) |
| Unemployed | 5 (2.9) |
| Students | 2 (1.2) |
| Prebirth weight status | |
| Overweight | 75 (44.6) |
| Obese | 34 (20.2) |
| Parental leave | |
| Yes | 121 (74.7) |
| No | 41 (25.3) |
| First-time parenthood | |
| Yes | 100 (59.2) |
| No | 69 (40.8) |
| Coparenting support score (out of 36) | 30.0 (7.6) |
GED general education development, SD standard deviation.
If ns in each category do not add to the total N, the difference is due to missing data.
| . | Mean ± SD or n (%) . |
|---|---|
| Age (years) | 35.5 ± 4.7 |
| Number of living children | 1.5 ± 0.7 |
| Race/ethnicity | |
| White | 99 (58.9) |
| Black/African American | 9 (5.4) |
| Asian | 28 (16.7) |
| Hispanic or Latino | 32 (19.1) |
| Education | |
| Less than 12th grade | 6 (3.6) |
| High school or GED | 17 (10.2) |
| Some college or an associate’s degree | 12 (7.2) |
| Bachelor’s degree | 47 (28.1) |
| Graduate degree or higher | 85 (50.9) |
| Annual household income | |
| ≤ $39,999 | 16 (9.6) |
| $40,000–$59,999 | 14 (8.4) |
| $60,000–$79,999 | 10 (6.0) |
| $80,000–$99,999 | 10 (6.0) |
| $100,000–&199,999 | 52 (31.3) |
| ≥$200,000 | 64 (38.6) |
| Employment status | |
| Employed | 162 (95.9) |
| Unemployed | 5 (2.9) |
| Students | 2 (1.2) |
| Prebirth weight status | |
| Overweight | 75 (44.6) |
| Obese | 34 (20.2) |
| Parental leave | |
| Yes | 121 (74.7) |
| No | 41 (25.3) |
| First-time parenthood | |
| Yes | 100 (59.2) |
| No | 69 (40.8) |
| Coparenting support score (out of 36) | 30.0 (7.6) |
| . | Mean ± SD or n (%) . |
|---|---|
| Age (years) | 35.5 ± 4.7 |
| Number of living children | 1.5 ± 0.7 |
| Race/ethnicity | |
| White | 99 (58.9) |
| Black/African American | 9 (5.4) |
| Asian | 28 (16.7) |
| Hispanic or Latino | 32 (19.1) |
| Education | |
| Less than 12th grade | 6 (3.6) |
| High school or GED | 17 (10.2) |
| Some college or an associate’s degree | 12 (7.2) |
| Bachelor’s degree | 47 (28.1) |
| Graduate degree or higher | 85 (50.9) |
| Annual household income | |
| ≤ $39,999 | 16 (9.6) |
| $40,000–$59,999 | 14 (8.4) |
| $60,000–$79,999 | 10 (6.0) |
| $80,000–$99,999 | 10 (6.0) |
| $100,000–&199,999 | 52 (31.3) |
| ≥$200,000 | 64 (38.6) |
| Employment status | |
| Employed | 162 (95.9) |
| Unemployed | 5 (2.9) |
| Students | 2 (1.2) |
| Prebirth weight status | |
| Overweight | 75 (44.6) |
| Obese | 34 (20.2) |
| Parental leave | |
| Yes | 121 (74.7) |
| No | 41 (25.3) |
| First-time parenthood | |
| Yes | 100 (59.2) |
| No | 69 (40.8) |
| Coparenting support score (out of 36) | 30.0 (7.6) |
GED general education development, SD standard deviation.
If ns in each category do not add to the total N, the difference is due to missing data.
Table 2 presents fathers’ BMI, average daily nighttime sleep hours, and diet outcomes 1 month prior to birth, at 5–6 months following birth, and at 11–12 months following birth. The results from analyses testing changes in fathers’ BMI, sleep hours, and diet from 1 month prior to birth to 5–6 months following birth, and from 5–6 months to 11–12 months following birth are displayed in Table 3. Interaction test results are summarized in Supplementary Tables S1 and S2.
Father’s BMI, nighttime sleep hours, and diet 1 month prior to birth and at 5–6 months and 11–12 months following birth
| . | BMIa . | Sleepb . | Fruitc . | Vegetablesc . | Sodac . | Fast foodc . |
|---|---|---|---|---|---|---|
| . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . |
| 1 month prior to birth | 26.8 (3.9) | 7.0 (1.0) | 1.0 (1.0) | 1.5 (1.3) | 0.2 (0.3) | 0.1 (0.2) |
| 5–6 months | 27.0 (4.2) | 6.7 (1.0) | 1.0 (1.1) | 1.4 (1.2) | 0.2 (0.5) | 0.1 (0.2) |
| 11–12 months | 26.8 (4.1) | 6.8 (1.0) | 1.1 (1.1) | 1.4 (1.1) | 0.2 (0.6) | 0.1 (0.3) |
| . | BMIa . | Sleepb . | Fruitc . | Vegetablesc . | Sodac . | Fast foodc . |
|---|---|---|---|---|---|---|
| . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . |
| 1 month prior to birth | 26.8 (3.9) | 7.0 (1.0) | 1.0 (1.0) | 1.5 (1.3) | 0.2 (0.3) | 0.1 (0.2) |
| 5–6 months | 27.0 (4.2) | 6.7 (1.0) | 1.0 (1.1) | 1.4 (1.2) | 0.2 (0.5) | 0.1 (0.2) |
| 11–12 months | 26.8 (4.1) | 6.8 (1.0) | 1.1 (1.1) | 1.4 (1.1) | 0.2 (0.6) | 0.1 (0.3) |
BMI body mass index; SD standard deviation.
aKilograms per square meter.
bAverage daily nighttime sleep duration in hours.
cNumber of times of intake per day.
Father’s BMI, nighttime sleep hours, and diet 1 month prior to birth and at 5–6 months and 11–12 months following birth
| . | BMIa . | Sleepb . | Fruitc . | Vegetablesc . | Sodac . | Fast foodc . |
|---|---|---|---|---|---|---|
| . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . |
| 1 month prior to birth | 26.8 (3.9) | 7.0 (1.0) | 1.0 (1.0) | 1.5 (1.3) | 0.2 (0.3) | 0.1 (0.2) |
| 5–6 months | 27.0 (4.2) | 6.7 (1.0) | 1.0 (1.1) | 1.4 (1.2) | 0.2 (0.5) | 0.1 (0.2) |
| 11–12 months | 26.8 (4.1) | 6.8 (1.0) | 1.1 (1.1) | 1.4 (1.1) | 0.2 (0.6) | 0.1 (0.3) |
| . | BMIa . | Sleepb . | Fruitc . | Vegetablesc . | Sodac . | Fast foodc . |
|---|---|---|---|---|---|---|
| . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . | Mean (SD) . |
| 1 month prior to birth | 26.8 (3.9) | 7.0 (1.0) | 1.0 (1.0) | 1.5 (1.3) | 0.2 (0.3) | 0.1 (0.2) |
| 5–6 months | 27.0 (4.2) | 6.7 (1.0) | 1.0 (1.1) | 1.4 (1.2) | 0.2 (0.5) | 0.1 (0.2) |
| 11–12 months | 26.8 (4.1) | 6.8 (1.0) | 1.1 (1.1) | 1.4 (1.1) | 0.2 (0.6) | 0.1 (0.3) |
BMI body mass index; SD standard deviation.
aKilograms per square meter.
bAverage daily nighttime sleep duration in hours.
cNumber of times of intake per day.
Fathers’ adjusted BMI, sleep, and diet changes from 1 month prior to birth to 5–6 months following birth and from 5–6 months to 11–12 months following birth
| . | 5–6 months vs. 1 month prior to birth . | 11–12 months vs. 5–6 months . | ||
|---|---|---|---|---|
| . | Δ Estimated . | 95% CI . | Δ Estimated . | 95% CI . |
| BMIa | 0.22 | (0.06, 0.38) | −0.19 | (−0.51, 0.13) |
| Sleepb | −0.21 | (−0.38, −0.05) | 0.03 | (−0.11, 0.18) |
| Fruitc | 0.04 | (−0.12, 0.20) | 0.06 | (−0.12, 0.24) |
| Vegetablesc | −0.11 | (−0.31, 0.08) | −0.06 | (−0.25, 0.12) |
| Sodac | 0.03 | (−0.04, 0.10) | −0.004 | (−0.10, 0.09) |
| Fast foodc | 0.005 | (−0.02, 0.03) | 0.05 | (−0.0009, 0.11) |
| . | 5–6 months vs. 1 month prior to birth . | 11–12 months vs. 5–6 months . | ||
|---|---|---|---|---|
| . | Δ Estimated . | 95% CI . | Δ Estimated . | 95% CI . |
| BMIa | 0.22 | (0.06, 0.38) | −0.19 | (−0.51, 0.13) |
| Sleepb | −0.21 | (−0.38, −0.05) | 0.03 | (−0.11, 0.18) |
| Fruitc | 0.04 | (−0.12, 0.20) | 0.06 | (−0.12, 0.24) |
| Vegetablesc | −0.11 | (−0.31, 0.08) | −0.06 | (−0.25, 0.12) |
| Sodac | 0.03 | (−0.04, 0.10) | −0.004 | (−0.10, 0.09) |
| Fast foodc | 0.005 | (−0.02, 0.03) | 0.05 | (−0.0009, 0.11) |
All models controlled for fathers’ age, education, and race/ethnicity. For analysis, education was dichotomized into “some college or below” and “bachelor’s degree or higher.”
BMI body mass index; CI confidence interval.
aKilograms per square meter.
bAverage daily nighttime sleep hours.
cNumber of times of intake per day.
dDifferences in means.
Fathers’ adjusted BMI, sleep, and diet changes from 1 month prior to birth to 5–6 months following birth and from 5–6 months to 11–12 months following birth
| . | 5–6 months vs. 1 month prior to birth . | 11–12 months vs. 5–6 months . | ||
|---|---|---|---|---|
| . | Δ Estimated . | 95% CI . | Δ Estimated . | 95% CI . |
| BMIa | 0.22 | (0.06, 0.38) | −0.19 | (−0.51, 0.13) |
| Sleepb | −0.21 | (−0.38, −0.05) | 0.03 | (−0.11, 0.18) |
| Fruitc | 0.04 | (−0.12, 0.20) | 0.06 | (−0.12, 0.24) |
| Vegetablesc | −0.11 | (−0.31, 0.08) | −0.06 | (−0.25, 0.12) |
| Sodac | 0.03 | (−0.04, 0.10) | −0.004 | (−0.10, 0.09) |
| Fast foodc | 0.005 | (−0.02, 0.03) | 0.05 | (−0.0009, 0.11) |
| . | 5–6 months vs. 1 month prior to birth . | 11–12 months vs. 5–6 months . | ||
|---|---|---|---|---|
| . | Δ Estimated . | 95% CI . | Δ Estimated . | 95% CI . |
| BMIa | 0.22 | (0.06, 0.38) | −0.19 | (−0.51, 0.13) |
| Sleepb | −0.21 | (−0.38, −0.05) | 0.03 | (−0.11, 0.18) |
| Fruitc | 0.04 | (−0.12, 0.20) | 0.06 | (−0.12, 0.24) |
| Vegetablesc | −0.11 | (−0.31, 0.08) | −0.06 | (−0.25, 0.12) |
| Sodac | 0.03 | (−0.04, 0.10) | −0.004 | (−0.10, 0.09) |
| Fast foodc | 0.005 | (−0.02, 0.03) | 0.05 | (−0.0009, 0.11) |
All models controlled for fathers’ age, education, and race/ethnicity. For analysis, education was dichotomized into “some college or below” and “bachelor’s degree or higher.”
BMI body mass index; CI confidence interval.
aKilograms per square meter.
bAverage daily nighttime sleep hours.
cNumber of times of intake per day.
dDifferences in means.
BMI Changes
Fathers’ BMI increased significantly from 1 month prior to birth to 5–6 months following birth (Δ = 0.22 kg/m2; 95% confidence interval [CI] = 0.06, 0.38; p = .008; % of Δ = 0.43%; SD = 3.32) and declined from 5–6 months to 11–12 months following birth, although this change was not statistically significant (Δ = −0.19 kg/m2; 95% CI = −0.51, 0.13; p = .251; % of Δ = −0.19%; SD = 3.34). From 1 month prior to birth to 5–6 months following birth, 59.6% of fathers lost or maintained weight, 13.3% of fathers gained less than 5 pounds, and 27.1% of fathers gained 5 pounds or more. From 5−6 months to 11–12 months following birth, 68.1% of fathers lost or maintained weight, 11.4% of fathers gained less than 5 pounds, and 20.6% of fathers gained 5 pounds or more. The interaction effects for parenthood experience (χ 2[2] = 3.15, p = .207) and coparenting support (χ 2[2] = 2.80, p = .246) were not significant.
Sleep Changes
Fathers’ average daily nighttime sleep duration significantly decreased from 1 month prior to birth to 5–6 months following birth (Δ = −0.21 hr; 95% CI = −0.38, −0.05; p = .012; % of Δ = −1.55; SD = 19.16) but did not change from 5−6 months to 11–12 months following birth (Δ = 0.03 hr; 95% CI = −0.11, 0.18; p = .658; % of Δ = 1.05; SD = 13.18). From 1 month prior to birth to 5–6 months following birth, 41.3% of fathers increased or maintained their average nighttime sleep, 35.9% of fathers reported up to an hour less nighttime sleep, and 22.8% reported an hour or more decrease in nighttime sleep. From 5−6 months to 11–12 months following birth, 53.9% of fathers increased or maintained their average nighttime sleep, 38.5% of fathers reported up to an hour less nighttime sleep, and 7.7% reported an hour or more decrease in nighttime sleep. The interaction effects for parenthood experience (χ 2[2] = 0.24, p = .889) and coparenting support (χ 2[2] = 5.01, p = .082) were not significant.
Diet Changes
No significant changes in fathers’ fruit, vegetable, soda, or fast food consumption were reported from 1 month prior to birth to 5–6 months following birth or from 5−6 months to 11–12 months following birth. In addition, the interaction effects for parenthood experience and coparenting support for each dietary outcome were not significant.
Discussion
In this study, we found that fathers gained weight and lost nighttime sleep from 1 month prior to birth to 5–6 months following birth. We identified no changes, however, in fathers’ diet from 1 month prior to birth to 11–12 months following birth. Additionally, there was no evidence that parenthood experience or coparenting support moderated changes in BMI, sleep, or diet. In short, our findings document weight gain and nighttime sleep loss during the first 5–6 months of fatherhood.
In prior research, Garfield et al. found that resident fathers gained an average BMI of 0.59 kg/m2 after 10 years of becoming fathers, while nonfathers decreased their BMI over the same period [6]. Laroche et al. found that, while all men tended to gain weight over time, among young Black men, those who became fathers gained an average BMI of 0.68 kg/m2 more than their nonfather counterparts over 7 years [7]. In addition, Umberson et al. found that fathers gained an average BMI of 2.00 kg/m2 more than nonfathers over 15 years [8]. In our study, fathers increased their BMI by 0.22 kg/m2 during the first 5–6 month period following birth followed by a similar magnitude of BMI decrease between 5−6 months and 11–12 months following birth. Our findings suggest that fathers may start gaining weight as early as the first few months of fatherhood but that weight gain may be fluctuating over the first year after birth. Proposed by others, potential mechanisms that contribute to fathers’ weight gain over the parenthood transition period might include hormonal changes (e.g., a reduction in testosterone and an increase in prolactin) [35, 36] and disruptions of health behaviors, such as those related to sleep, diet, and physical activity [2]. In comparison to prior studies, fathers in our study were older, had a higher baseline BMI, and had higher levels of education and income. Further investigations using a larger sample with a diverse background and following fathers beyond 1 year postbirth are needed to better understand patterns of change in fathers’ weight over time.
The loss in average daily nighttime sleep duration among fathers in early parenthood may be associated with infants’ frequent night waking [37, 38]. Fathers in our study lost about 12.6 min of sleep, nightly, in the first 5–6 months of fatherhood. This sleep loss is consistent with a prior nationally representative cross-sectional study, which reported that fathers with a young child reported 13 fewer minutes of sleep than men without a young child [39]. Additionally, using wrist actigraphs, Gay et al. examined changes in couples’ objective sleep from prebirth to 1 month postpartum and found that fathers lost 15.8 min of nightly sleep in the first month after birth [40]. Prior research suggests that 13 min less sleep per day may be clinically significant. An experimental study examining sleep disruption found that even 10 min of uninterrupted sleep can trigger its restorative effect [41] and a study of driving performance reported measurable improvements in driving with an increase of 30 min of habitual sleep [42]. It is also important to note that fathers’ nighttime sleep hours did not recover from 5−6 months to 11–12 months following birth in the present study. In other words, fathers in our study lost about a total of 76.6 nighttime sleep hours in their first year of fatherhood.
We did not observe any changes in fathers’ fruit, vegetables, soda, and fast food intakes from 1 month prior to birth to 11–12 months following birth. While some may argue that the lack of change in fathers’ diet is at odds with increases in their BMI, we do not think these findings are contradictory. We measured a limited number of diet indicators, which together cannot provide a measure of fathers’ total energy expenditure. Furthermore, changes in fathers’ BMI could be explained by reductions in nighttime sleep hours and other factors that were not examined in the present study, such as physical activity, psychological well-being, and hormonal functions. Needless to say, a more comprehensive assessment of fathers’ diet (including their total energy intake) in future research would be beneficial. Future studies should also look at the interrelationships between change in BMI and weight-related behaviors using mediation models.
Overall, there was no support for the moderators examined. We found no differences in change in fathers’ weight, sleep, or diet for first-time versus experienced fathers. This finding suggests that experienced fathers might not be better off than first-time fathers. Prior studies found that not-first-time parents may experience higher stress and challenges to meet family needs than first-time parents [18, 19]. In other words, both first-time and experienced fathers face challenges in early fatherhood, but the sources of challenges may be different. Our findings suggest that interventions to ease fathers’ burdens during the first year of parenthood should target both first-time and experienced fathers.
Similarly, coparenting support did not modify fathers’ weight, sleep, and diet trajectories in the first year following birth. This suggests that coparenting support may not influence fathers’ weight and weight-related behaviors. However, both the mean and median coparenting scores in this sample were high, which may have limited our ability to see an effect. As a result, there may have been insufficient fathers with low coparenting support. Existing evidence suggests that the influence of coparenting support on fathers’ health outcomes and related behaviors might be mediated by the amount of fathers’ involvement in caregiving [23–25]. Future studies, with more heterogeneous samples in terms of coparenting support, should examine the interplay between coparenting support, childcare workload, and fathers’ health behaviors and outcomes.
Our study has two main strengths. First, the examination of fathers’ weight and weight-related behavior changes in the first year of fatherhood is novel. It contributes to the limited knowledge base on the impact of early parenthood on fathers’ weight and health behaviors. Second, we measured fathers’ weight and weight-related behaviors at three time points between 1 month prior to birth and 11–12 months following birth, addressing recent calls for more longitudinal studies on fathers [2, 5].
Our study also has some limitations. First, fathers self-reported their height, weight, sleep, and diet. Therefore, our findings may have been subject to measurement error and should be interpreted with caution. Future studies should consider using objective measurements, such as height and weight measured by trained personnel and sleep measured by actigraphs, to collect more precise measurements of BMI and sleep; strategies to minimize participant burden, however, will be needed. In our study, we used NHANES DSQ to capture a small set of food items [31]; future studies should consider using 24 hr recalls to capture more comprehensive dietary measurements. Even though self-reported dietary data are subject to recall bias, they provide unique information, such as eating patterns and food intake, that cannot be obtained from biomarkers; experts have recommended the continued use of self-reported dietary data as they provide critical information about foods consumed, informing nutrition policy and diet-disease associations [43]. Second, our findings may not be generalizable to the general population of fathers of young children. More than half of the fathers surveyed were White and the majority of them had received postsecondary education, a pattern that was likely exacerbated over time due to selective attrition. Given that weight-related chronic conditions disproportionally affect people with lower socioeconomic status [44], further examination is needed among more diverse samples before more targeted strategies can be developed to alleviate health disparities among disadvantaged populations. Furthermore, only fathers living in the same household as mothers and infants were recruited in this study. Thus, it remains unclear how the weight and weight-related behaviors of single fathers and those who do not live with their infant, but may still be active in caring for them, may change following the birth of a child. Third, our exploratory assessment of parenthood experience and coparenting support as effect modifiers may have been limited by the small sample size. Further examinations with a larger sample size are needed to examine the effects of parenthood experience and coparenting support on fathers’ behaviors during parenthood. Lastly, future studies could measure fathers’ weight and weight-related behaviors during (their partner’s) pregnancy to provide a more comprehensive assessment of fathers’ behavior change trajectories prior to and following childbirth.
Conclusion
Findings from this study contribute to the limited research on fathers’ weight, sleep, and diet changes between 1 month prior to birth and 11–12 months following birth. Among fathers in the Rise and SHINE study, regardless of their parenthood experience and coparenting support, fathers, in general, gained weight and lost sleep in the first 5–6 months following birth. Our results suggest that men’s health over the transition to parenthood, and for a number of years beyond, should be a focus of research and possible intervention efforts by health and social work professionals.
Acknowledgments
We are grateful to the fathers who participated in our study and Melissa McTernan at Boston College for her statistical support.
Funding
This research was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK107972). S.R. was partly funded by the National Heart, Lung, and Blood Institute (R35 HL135818). The funders had no role in the study design, data collection, data analysis, data interpretation, writing of the article, or the decision to submit it for publication.
Compliance With Ethical Standards
Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards The authors declare that they have no conflict of interest.
Authors’ Contributions B.K.L.: conceptualization, methodology, formal analysis, writing—original draft preparation. A.W.K.: conceptualization, methodology, writing—review & editing. S.H.: methodology, formal analysis, writing—review & editing. X.Y.: methodology, data curation, writing—review & editing. T.A.: conceptualization, methodology, writing—review & editing. S.R.: conceptualization , methodology, writing—review & editing, funding acquisition. E.M.T.: conceptualization, methodology, writing—review & editing, funding acquisition. K.K.D.: conceptualization, methodology, writing—review & editing, funding acquisition, supervision.
Ethical Approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the Partners Health Care Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent Informed consent was obtained from all individual participants included in the study.
