The relationship between socioeconomic status and childhood overweight/obesity is linked through paternal obesity and dietary intake: a cross-sectional study in Chongqing, China

BACKGROUND@#The prevalence of obesity and overweight in childhood has increased dramatically over the past decades globally. Thus, the risk factors of overweight and obesity in children and adolescents must be studied.@*OBJECTIVES@#This study aimed to reveal the prevalence of childhood obesity and examine the relationship between socioeconomic status (SES) and z-body mass index (z-BMI) via parental obesity and dietary intake using path analysis.@*METHODS@#Stratified cluster sampling was used to select 17,007 participants aged 6-12 years on two avenues per region in urban, suburban, and rural areas. Path analysis was conducted to examine the mediators between SES and z-BMI.@*RESULTS@#The prevalence rates of overweight and obesity were 13.36% and 8.60%, respectively, and were positively correlated with the father's education level, family income, a birth weight > 3000g, a parental obesity history, vegetable intake and red meat intake (all P < 0.05). Four mediators (paternal obesity history, red meat intake, vegetable intake, and nutritional supplements) were observed, and the four path analyses were significant (all P < 0.05). The adjusted total effects on z-BMI were significant for income (β@*CONCLUSIONS@#The prevalence of overweight/obesity in children was notable, and the relationship between SES and z-BMI was mediated by paternal obesity history and dietary intake.

Clinical Decision Supports in Electronic Health Records to Promote Childhood Obesity-Related Care: Results from a 2015 Survey of Healthcare Providers

Obesity-related clinical decision support tools in electronic health records (EHRs) can improve pediatric care, but the degree of adoption of these tools is unknown. DocStyles 2015 survey data from US pediatric healthcare providers (n = 1,156) were analyzed. Multivariable logistic regression identified provider characteristics associated with three EHR functionalities: automatically calculating body mass index (BMI) percentile (AUTO), displaying BMI trajectory (DISPLAY), and flagging abnormal BMIs (FLAG). Most providers had EHRs (88%). Of those with EHRs, 90% reporting having AUTO, 62% DISPLAY, and 54% FLAG functionalities. Only provider age was associated with all three functionalities. Compared to providers aged > 54 years, providers < 40 years had greater odds for: AUTO (adjusted odds ratio [aOR], 3.0; 95% confidence interval [CI], 1.58–5.70), DISPLAY (aOR, 2.07; 95% CI, 1.38–3.12), and FLAG (aOR, 1.67; 95% CI, 1.14–2.44). Future investigations can elucidate causes of lower adoption of EHR functions that display growth trajectories and flag abnormal BMIs.

Protective Effect of Breastfeeding against Overweight Can Be Detected as Early as the Second Year of Life: A Study of Children from One of the Most Socially-deprived Areas of Brazil.

Millions of children live in Brazil’s semi-arid region, one of the most socially-deprived areas of the country, where undernutrition co-exists with obesity as a consequence of the nutrition transition. There is evidence that childhood obesity predisposes adult obesity and, thus, that obesity should be prevented as early as possible. Some studies have shown that breastfeeding is a protective factor against overweight and obesity while other studies have not found this association. There have been few studies on this association in developing countries and of children below two years of age. The present study aimed to investigate whether children exposed to exclusive breastfeeding for ≥6 months showed a lower prevalence of overweight in the second year of life, based on a probability sample of 2,209 children (aged 12 to 24 months). The dependent variable was overweight, defined as weight-for-length z-scores of >2, based on the WHO 2006 standard while the independent variable was exclusive breastfeeding (≥6 months). The prevalence ratio (PR) and its 95% CI were estimated using Poisson regression with robust adjustment of variance. After adjusting for potential confounding factors (socioeconomic, demographic and health-related variables), children on exclusive breastfeeding for ≥6 months showed a lower prevalence of overweight (5.7% vs 9.1%, PR 0.62, 95% CI 0.45-0.89). It was found that exclusive breastfeeding for six months or more is a protective factor against overweight in children in the second year of life living in the Brazilian semi-arid region.

Evaluación del Estado Nutricional de los niños que participaron en el Programa “Activarse” durante el 2011 / Assessment of the Nutritional Status of Children Participating in the Program "Activarse" in 2011 / Avaliação do Estado Nutricional das crianças que participaram do Programa “Activarse” durante 2011

Introducción: Conocer el estado nutricional de los niños que participan del Programa Activarse es de suma importancia para evaluar y caracterizar a la población destinataria y poder optimizar las actividades y contenidos implementados. Material y Método: Estudio descriptivo y transversal. Se realizó una valoración antropométrica de 534 niños, de entre 5 y 10 años de edad, de 3 colegios ubicados en la Provincia de Buenos Aires que participan del programa Activarse desarrollado por Asociación Conciencia y Fundación PepsiCo. Se calculó la puntuación Z de los indicadores Talla/Edad y IMC/Edad. Para establecer el diagnóstico, se utilizó el software Anthro Plus1, al igual que los puntos de corte, salvo en el indicador Talla/Edad que se consideró como riesgo o alerta de baja talla a los niños que presentaban una puntuación Z entre -1,5 y 2. Resultados: La muestra total estuvo compuesta por un 55.4% (n=296) de niñas y un 44.6% (n=238) de niños. Elíndice Talla/Edad arrojó que el 6,5 % de la población tiene un diagnóstico de alerta o baja talla, distribuidos en forma pareja entre niños y niñas. A través del indicador IMC/Edad, se obtuvo que el 47,4% de los niños estudiados se encontraba en el binomio sobrepeso-obesidad. Los niños que presentaron exceso de peso, en su mayoría pertenecen al sexo masculino (52,5% vs 43,2% de sexo femenino). Conclusión: Se debe prestar especial atención al exceso de peso encontrado en la población evaluada, debiendo ser el foco prioritario en las intervenciones planificadas.

Introduction: Knowing the nutritional status of children participating in the program /"Activarse/" is extremely important in order to assess and characterise the target population and be able to optimize the activities and contents implemented. Materials and Methods: Cross-sectional descriptive study. An anthropometric assessment of 534 children aged 5-10 years, from 3 schools located in the province ofBuenos Aires which participate in the program"Activarse" developed by the Conciencia Association andthe PepsiCo Foundation. The z-score was calculated forthe height/age and BMI/age indicators. In order to establish the diagnosis, the Anthro Plus®1 software was used, as well as the cut-off points, but not in the height/age indicator wich was considered a sign of risk or alert of low height in children with a z-score between -1,5 and 2. Results: The overall sample was 55.4% (n=296) girls and 44.6% (n=238) boys. The height/age index showed that 6.5% of the population has an alert diagnosis or low height, distributed equally among boys and girls.Through the BMI/age indicator we could see that 47.4% of te evaluated children were overweight or obese; these were mostly boys (52,5% versus 43,2% girls). Conclusion: Special attention should be paid to the excessive weight found in the population evaluated, which must be a priority for future planned interventions.

Introdução: Conhecer o estado nutricional das crianças que participam do Programa “ActivaRSE” é fundamental para avaliar e caracterizar a população destinatária e poder otimizar as atividades e conteúdos implantados. Material e Método: Estudo descritivo e transversal. Foi realizada uma valorização antropométrica de 534 crianças entre 5 e 10 anos de idade, de 3 colégios localizados na Província de Buenos Aires que participam do programa “ActivaRSE” desenvolvido pela Associação Consciência e Fundação PepsiCo. Calculou-se a pontuação Z dos indicadores Estatura/Idade e IMC/Idade. Para estabelecer o diagnóstico, foi utilizado o software Anthro Plus, assim como os pontos de corte, salvo no indicador Estatura/Idade que foi considerado como risco ou alerta de baixa estatura em crianças que apresentavam uma pontuação Z -1,5 y 2. Resultados: A amostra total esteve composta por 55.4% (n=296) de meninas e 44.6% (n=238) de meninos. O índice Estatura/Idade indicou que 6,5% da população tem um diagnóstico de alerta ou baixa estatura, distribuídos de forma similar entre meninos e meninas. Através do indicador IMC/Idade, constatou-se que 47,4% das crianças estudadas encontravam-se no binômio sobre peso-obesidade. As crianças que apresentaram excesso de peso, na maioria pertenciam ao sexo masculino 52,5% vs 43,2% de sexo feminino). Conclusão: É preciso prestar uma atenção especial no excesso de peso encontrado na população avaliada, devendo ser o foco prioritário nas intervenções planejadas.

Television Watching, Family Social Class, Parental Overweight, and Parental Physical Activity Levels in Relation to Childhood Overweight / 대한지역사회영양학회지

This study was done to determine the factors associated with childhood overweight in 721 sixth grade elementary school students, in Busan. The students' heights, weights, waist circumferences and triceps-skinfold thicknesses were measured using standard techniques. Other data were collected using a questionnaire that included information about physical activity, television watching, and the amount of exorcise taken during leisure times, family history of diseases related to obesity: social data including family income, parents' education and occupations, eating behaviors; parental weights and heights; and parental activity levels. Childhood overweight was defined as a body mass index at or above the 85th percentile for age and sex. The prevalence of overweight revealed no significant difference between sexes, (24.2% in boys and 22.03% in girls). The risk of childhood overweight was significantly greater if either the mother or the father were overweight. The odds ratio for childhood overweight associated with maternal overweight was 5.045 (94% CI : 3.262-7.801), and 2.727 (95% CI : 1.764-4.218) was the case for parental overweight. Children having a history of hear diseases had higher odds ratios than those who did not. The odds ratios for overweight associated with income were not different. However, a higher odds ratio for overweight was observed in children whose fathers had only an elementary or middle school education than those whore fathers had a high school or college education. Children whose fathers' occupations were service workers or shopkeepers (OR : 3.314, 95% C = 1.851-5.934) or had no occupation (OR = 3.756, 95% CI : 1.898-7.430) had a treater risk of overweight than those whose fathers' were professionals or once workers. The risk of overweight increased in children having more irregular meal times and faster eating times, rather than those having an intake pattern of high energy and sugar containing floods. The amount of exercise taken during leisure times, and daily physical activity showed no difference between overweight and non-overweight children. However, television watching time, especially on weekends, was greater in overweight children than in non-overweight children. Television watching time was positively correlated with BMI, triceps-skin(31d thickness, waist circumference and waist/height ratio. Therefore, television watching was found to be a useful predictor of overweight in children. Television watching in children was negatively related to paternal activity levels, and positively related to parental television watching time. In fact, fathers whose children were overweight were physically less active than fathers whose children were non-overweight. Parents appeared to be a strong influence on their children's physical activity levels. In conclusion, a low family social class, defined on the basis of the father's occupation or education, parental overweight, increased television watching, and unhealthy physical activity levels in parents were all considered risk factors for childhood overweight. Among these, television watching time and lack of physical activity were considered to be the most important risk factors that could be easily modified for the prevention of and intervention in, overweight in children.