Racial Variation in the Association between Positive Urgency and Body Mass Index among American Children

Abstract

Background: Positive urgency reflects a specific facet of impulsivity and correlates with several health-related risk behaviors such as obesity, food addiction, and substance use. However, less is known about whether positive urgency is similarly or differently associated with high body mass index (BMI) across diverse racial groups. Aim: The aim of this study was to investigate racial differences in the associations between positive urgency and BMI in 9-10-year-old children in the US. Materials and Methods: This cross-sectional study used the Adolescent Brain Cognitive Development (ABCD) study. Participants were 11590 American children between ages 9 and 10 years old. The independent variable was positive urgency measured by the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency, Impulsive Behavior Scale (UPPS-SS). The primary outcome was BMI. Race was the moderator. Demographic variables (age and sex) were covariates. Mixed-effects regression models were used for data analysis to adjust for the nested nature of the ABCD data. We also used weights (propensity score) to generate nationally representative results. Results: In the pooled sample, race showed a statistically significant interaction with positive urgency on children’s BMI, indicating a stronger effect of positive urgency on BMI for White children, compared to African American children. Conclusion: The association between positive urgency and BMI seems to be weaker in African American children than in White American children. The role of individual-level risk factors such as impulsive traits may be smaller for African American than White American children. Future research should study the role of obesogenic environments and other area level indicators in altering the effects of individual-level risk factors on BMI and obesity.