Risk factors for overweight and obesity in children aged 2–6 years
-
Meda Kondolot
and Selim Kurtoğlu
Abstract
Background:
Understanding risk factors that may vary culturally can help improve preventive strategies for obesity. This is the first cross-sectional study aimed to determine the risk factors for overweight/obesity in children aged 2–6 years in a central Anatolian city in Turkey.
Methods:
A total of 1582 children (1351 healthy, 231 overweight/obese) aged 2–6 years were included from the Anthropometry of Turkish Children aged 0–6 years database. Age, gender, birth weight, birth order, mother’s age, mother’s body mass index (BMI), weight gain of mothers during pregnancy, presence of gestational diabetes, breastfeeding duration, history of formula feeding, mother’s and father’s education, mother’s job, monthly income, smoking at home and physical activity, sleep duration and duration of television (TV) watching of the children were evaluated as independent risk factors. Logistic regression analyses were performed to investigate risk factors for overweight/obesity.
Results:
Having a high family income compared to bad [odds ratio (OR)=1.96; 95% confidence interval (CI): 1.237–3.106], increased the time of watching TV during the weekend (OR=1.094; 95% CI: 1.032–1.159), and similar physical activity level according to their peers compared to less (OR=2.957; 95% CI: 1.056–8.282) were found to be significantly associated with a higher risk of overweight/obesity in children aged 2–6 years old.
Conclusions:
The early childhood period seems to be important in the establishment of healthy behavioral patterns, especially limitation of TV watching and encouragement of physical activity. Obesogenic environment in families with high incomes need to be revealed.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, et al. Child and adolescent obesity: part of a bigger picture. Lancet 2015;385:2510–20.10.1016/S0140-6736(14)61746-3Search in Google Scholar
2. World Health Organization. Report of the commission on ending childhood obesity, WHO 2016. Available at: http://www.who.int/end-childhood-obesity/publications/echo-report/en/.Search in Google Scholar
3. Lo JC, Maring B, Chandra M, Daniels SR, Sinaiko A, et al. Prevalence of obesity and extreme obesity in children aged 3–5 years. Pediatr Obes 2014;9:167–75.10.1111/j.2047-6310.2013.00154.xSearch in Google Scholar PubMed PubMed Central
4. Kondolot M, Balci E, Ozturk A, Mazicioglu MM, Hatipoglu N, et al. Body mass index percentiles for Turkish children aged 0–84 months. Ann Hum Biol 2011;38:676–80.10.3109/03014460.2011.605800Search in Google Scholar PubMed
5. Dixon B, Peña MM, Taveras EM. Lifecourse approach to racial/ethnic disparities in childhood obesity. Adv Nutr 2012;3: 73–82.10.3945/an.111.000919Search in Google Scholar PubMed PubMed Central
6. Taveras EM, Gillman MW, Kleinman K, Rich-Edwards JW, Rifas-Shiman SL. Racial/ethnic differences in early-life risk factors for childhood obesity. Pediatrics 2010;125:686–95.10.1542/peds.2009-2100Search in Google Scholar PubMed PubMed Central
7. Khanolkar AR, Sovio U, Bartlett JW, Wallby T, Koupil I. Socioeconomic and early-life factors and risk of being overweight or obese in children of Swedish-born and foreign-born parents. Pediatr Res 2013;74:356–63.10.1038/pr.2013.108Search in Google Scholar PubMed
8. Lipek T, Igel U, Gausche R, Kiess W, Grande G. Obesogenic environments: environmental approaches to obesity prevention. J Pediatr Endocrinol Metab 2015;28:485–95.10.1515/jpem-2015-0127Search in Google Scholar PubMed
9. Friedman RR, Schwartz MB. Public policy to prevent childhood obesity, and the role of pediatric endocrinologists. J Pediatr Endocrinol Metab 2008;21:717–25.10.1515/JPEM.2008.21.8.717Search in Google Scholar PubMed
10. Janjua NZ, Mahmood B, Islam MA, Goldenberg RL. Maternal and early childhood risk factors for overweight and obesity among low-income predominantly Black children at age five years: A prospective cohort study. J Obes 2012;2012:457173.10.1155/2012/457173Search in Google Scholar PubMed PubMed Central
11. Lamb MM, Dabelea D, Yin X, Ogden LG, Klingensmith GJ, et al. Early-life predictors of higher body mass index in healthy children. Ann Nutr Metab 2010;56:16–22.10.1159/000261899Search in Google Scholar PubMed PubMed Central
12. Tchoubi S, Sobngwi-Tambekou J, Noubiap JJ, Asangbeh SL, Nkoum BA, et al. Prevalence and risk factors of overweight and obesity among children aged 6–59 months in Cameroon: a multistage, stratified cluster sampling nationwide survey. PLoS One 2015;10:e0143215.10.1371/journal.pone.0143215Search in Google Scholar PubMed PubMed Central
13. Pryor LE, Tremblay RE, Boivin M, Touchette E, Dubois L, et al. Developmental trajectories of body mass index in early childhood and their risk factors: an 8-year longitudinal study. Arch Pediatr Adolesc Med 2011;165:906–12.10.1001/archpediatrics.2011.153Search in Google Scholar PubMed
14. Rooney BL, Mathiason MA, Schauberger CW. Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort. Matern Child Health J 2010;15:1166–75.10.1007/s10995-010-0689-1Search in Google Scholar PubMed
15. Yücel O, Kinik ST, Aka S. Diagnosis of a trend towards obesity in preschool children: a longitudinal study. Eur J Pediatr 2011;170:751–6.10.1007/s00431-010-1343-zSearch in Google Scholar PubMed
16. Govindan M, Gurm R, Mohan S, Kline-Rogers E, Corriveau N, et al; University of Michigan Health System. Gender differences in physiologic markers and health behaviors associated with childhood obesity. Pediatrics 2013;132:468–74.10.1542/peds.2012-2994Search in Google Scholar PubMed
17. Dubois L, Girard M. Early determinants of overweight at 4.5 years in a population-based longitudinal study. Int J Obes 2006;30:610–7.10.1038/sj.ijo.0803141Search in Google Scholar PubMed
18. Hassanzadeh-Rostami Z, Kavosi E, Nasihatkon A. Overweight and obesity among preschool children from Fars province of Iran: prevalence and associated factors. J Res Health Sci 2016;16:26–30.Search in Google Scholar
19. Mosli RH, Miller AL, Peterson KE, Kaciroti N, Rosenblum K, et al. Birth order and sibship composition as predictors of overweight or obesity among low-income 4-year-old to 8-year-old children. Pediatr Obes 2016;11:40–6.10.1111/ijpo.12018Search in Google Scholar PubMed PubMed Central
20. Kitsantas P, Gaffney KF. Risk profiles for overweight/obesity among preschoolers. Early Hum Dev 2010;86:563–8.10.1016/j.earlhumdev.2010.07.006Search in Google Scholar PubMed
21. Parsons TJ, Power C, Manor O. Fetal and early life growth and body mass index from birth to early adulthood in 1958 British cohort: longitudinal study. Br Med J 2001;323:1331–5.10.1136/bmj.323.7325.1331Search in Google Scholar PubMed PubMed Central
22. Olson CM, Strawderman MS, Dennison BA. Maternal weight gain during pregnancy and child weight at age 3 years. Matern Child Health J 2009;13:839–46.10.1007/s10995-008-0413-6Search in Google Scholar PubMed
23. Baker JL, Michaelsen KF, Rasmussen KM, Sørensen TI. Maternal prepregnant body mass index, duration of breastfeeding, and timing of complementary food introduction are associated with infant weight gain. Am J Clin Nutr 2004;80:1579–88.10.1093/ajcn/80.6.1579Search in Google Scholar PubMed
24. Owen CG, Martin RM, Whincup PH, Davey-Smith G, Gillman MW, et al. The effect of breastfeeding on mean body mass index throughout life: a quantitative review of published and unpublished observational evidence. Am J Clin Nutr 2005;82:1298–307.10.1093/ajcn/82.6.1298Search in Google Scholar PubMed
25. Harder T, Bergmann R, Kallischnigg G, Plagemann A. Duration of breastfeeding and risk of overweight: a meta-analysis. Am J Epidemiol 2005;162:397–403.10.1093/aje/kwi222Search in Google Scholar PubMed
26. van Stralen MM, te Velde SJ, van Nassau F, Brug J, Grammatikaki E, et al. Weight status of European preschool children and associations with family demographics and energy balance-related behaviours: a pooled analysis of six European studies. Obes Rev 2012;13:29–41.10.1111/j.1467-789X.2011.00959.xSearch in Google Scholar PubMed
27. Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev 2012;33:48–70.10.1210/er.2010-0028Search in Google Scholar PubMed
28. Taveras EM, Rifas-Shiman SL, Oken E, Gunderson EP, Gillman MW. Short sleep duration in infancy and risk of childhood overweight. Arch Pediatr Adolesc Med 2008;162:305–11.10.1001/archpedi.162.4.305Search in Google Scholar PubMed PubMed Central
29. Bell JF, Zimmerman FJ. Shortened nighttime sleep duration in early life and subsequent childhood obesity. Arch Pediatr Adolesc Med 2010;164:840–5.10.1001/archpediatrics.2010.143Search in Google Scholar PubMed
30. Steinsbekk S, Wichstrøm L. Predictors of change in BMI from the age of 4 to 8. J Pediatr Psychol 2015;40:1056–64.10.1093/jpepsy/jsv052Search in Google Scholar PubMed
31. Do LM, Tran TK, Eriksson B, Petzold M, Nguyen CT, et al. Preschool overweight and obesity in urban and rural Vietnam: differences in prevalence and associated factors. Glob Health Action 2015;8:28615.10.3402/gha.v8.28615Search in Google Scholar PubMed PubMed Central
32. Dennison BA, Erb TA, Jenkins PL. Television viewing and television in bedroom associated with overweight risk among low-income preschool children. Pediatrics 2002;109: 1028–35.10.1542/peds.109.6.1028Search in Google Scholar PubMed
33. Lumeng JC, Rahnama S, Appugliese D, Kaciroti N, Bradley RH. Television exposure and overweight risk in preschoolers. Arch Pediatr Adolesc Med 2006;160:417–22.10.1001/archpedi.160.4.417Search in Google Scholar PubMed
34. Peck T, Scharf RJ, Conaway MR, DeBoer MD. Viewing as little as 1 hour of TV daily is associated with higher change in BMI between kindergarten and first grade. Obesity (Silver Spring) 2015;23:1680–6.10.1002/oby.21132Search in Google Scholar PubMed
35. Klesges RC, Shelton ML, Klesges LM. Effects of television on metabolic rate: Potential implications for childhood obesity. Pediatrics 1993;91:281–6.10.1542/peds.91.2.281Search in Google Scholar
36. Marinelli M, Sunyer J, Alvarez-Pedrerol M, Iñiguez C, Torrent M, et al. Hours of television viewing and sleep duration in children: A multicenter birth cohort study. JAMA Pediatr 2014;168:458–64.10.1001/jamapediatrics.2013.3861Search in Google Scholar PubMed
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- Imaging methods for bone mass evaluation during childhood and adolescence: an update
- Original Articles
- Risk factors for overweight and obesity in children aged 2–6 years
- Copy number variations in “classical” obesity candidate genes are not frequently associated with severe early-onset obesity in children
- Trends in the prevalence of extreme obesity among Korean children and adolescents from 2001 to 2014
- Plasma but not serum brain-derived neurotrophic factor concentration is decreased by oral glucose tolerance test-induced hyperglycemia in children
- Environmental and genetic determinants of two vitamin D metabolites in healthy Australian children
- Evaluation of vitamin D prophylaxis in 3–36-month-old infants and children
- Possible effects of neonatal vitamin B12 status on TSH-screening program: a cross-sectional study from Turkey
- Effects of L-thyroxine treatment on heart functions in infants with congenital hypothyroidism
- Hyperandrogenism in adolescent girls: relationship with the somatotrophic axis
- Plasma kisspeptin and ghrelin levels in puberty variant cases
- Genotype-phenotype correlation in paediatric pheochromocytoma and paraganglioma: a single centre experience from India
- Short Communication
- Provider variability in the initial diagnosis and treatment of congenital hypothyroidism
- Case Reports
- Giant parathyroid adenoma associated with severe hypercalcemia in an adolescent patient
- Personalized precision medicine in extreme preterm infants with transient neonatal diabetes mellitus
- Pseudohypoaldosteronism types I and II: little more than a name in common
- Primary pigmented nodular adrenocortical disease: literature review and case report of a 6-year-old boy
Articles in the same Issue
- Frontmatter
- Review
- Imaging methods for bone mass evaluation during childhood and adolescence: an update
- Original Articles
- Risk factors for overweight and obesity in children aged 2–6 years
- Copy number variations in “classical” obesity candidate genes are not frequently associated with severe early-onset obesity in children
- Trends in the prevalence of extreme obesity among Korean children and adolescents from 2001 to 2014
- Plasma but not serum brain-derived neurotrophic factor concentration is decreased by oral glucose tolerance test-induced hyperglycemia in children
- Environmental and genetic determinants of two vitamin D metabolites in healthy Australian children
- Evaluation of vitamin D prophylaxis in 3–36-month-old infants and children
- Possible effects of neonatal vitamin B12 status on TSH-screening program: a cross-sectional study from Turkey
- Effects of L-thyroxine treatment on heart functions in infants with congenital hypothyroidism
- Hyperandrogenism in adolescent girls: relationship with the somatotrophic axis
- Plasma kisspeptin and ghrelin levels in puberty variant cases
- Genotype-phenotype correlation in paediatric pheochromocytoma and paraganglioma: a single centre experience from India
- Short Communication
- Provider variability in the initial diagnosis and treatment of congenital hypothyroidism
- Case Reports
- Giant parathyroid adenoma associated with severe hypercalcemia in an adolescent patient
- Personalized precision medicine in extreme preterm infants with transient neonatal diabetes mellitus
- Pseudohypoaldosteronism types I and II: little more than a name in common
- Primary pigmented nodular adrenocortical disease: literature review and case report of a 6-year-old boy