Biobehavioral Determinants of Energy Intake and Childhood Obesity

Background: Obesity amongst the children is increasing worldwide at an alarming rate in both developed and developing countries. Obese children are at higher risk of developing coronary heart disease, non-insulin dependent diabetes, respiratory disease etc. Methods: A case-control study, preceded by a cross sectional survey was conducted, aimed to estimate the prevalence rate and to identify the factors associated with the development of childhood obesity in Dhaka city. A multi stage probability proportionate to size (PPS) cluster sampling method was used to obtain the sample. To identify the obese children, a pre-tested questionnaire was used to collect data on age, weight and height among the randomly selected 5000 children of 2-10 years age group from 12 government primary and 23 private elementary schools, 4 hospitals, 8 health centres and 12 immunisation centres (on National Immunisation Days) from all the 12 thanas (civil administrative sub-districts) of Dhaka city. Survey included a medical history and physical examination to assess the eligibility of the subjects for the study. Results: Of 5000 children, 380 (7.6%) were identified as obese using the criterion of weight for height >120% as a cut-off point. Obesity was positively correlated with the increase of age in both sexes (r = 0.76). Of all obese children, 216 (56.8%) were boys and 164 (43.2%) were girls. Prevalence of obesity was significantly higher among the boys than girls (p=0.007). The study was conducted among the 220 cases of 380 obese children (Wt/Ht> 120%) and 220 randomly selected controls, matching age and sex, using a semi-structured questionnaire for identifying the factors associated with the development of childhood obesity. Information also collected from parents of both cases and controls. Family income (p<0.001) and expenditure on food (p<0.001) were significantly higher among the cases. Data showed that parental obesity was significantly associated with the obesity in children. There was an association between obesity of the children and parents’ educational status (p<0.001). There was no difference in the working hours of parents outside households between the cases and controls. Energy balance was significantly higher among the cases. Dose response of energy balance shows, the estimated relative risk of obesity increases with higher levels of energy balance up to a maximum of odds ratio 3.41 (p<0.001). A significant difference (p<0.001) was found in hours of television-video viewing between the cases and controls. Conclusion: Findings of this study show that the obesity among the children is caused by a positive energy balance over a considerable period, is related to environmental factors including energy intake, energy expenditure and other behavioural aspects. Appropriate interventions like behavioural change regarding energy intake and physical activity are thus recommended to address the childhood obesity- an emerging public health problem in Dhaka city. Bangladesh Med Res Counc Bull 2019; 45: 68-80

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Biobehavioral Determinants of Energy Intake and Childhood Obesity

Childhood Obesity ◽

10.1201/9781420038071-8 ◽

2005 ◽

pp. 101-118

Author(s):

M. B. E. Livingstone ◽

K. L. Rennie

Keyword(s):

Childhood Obesity ◽

Energy Intake

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Correlates of childhood obesity in Athens, Greece

Public Health Nutrition ◽

10.1017/s1368980008002462 ◽

2008 ◽

Vol 11 (9) ◽

pp. 940-945 ◽

Cited By ~ 13

Author(s):

Areti Lagiou ◽

Maria Parava

Keyword(s):

Physical Activity ◽

Childhood Obesity ◽

Energy Intake ◽

Primary Schools ◽

Activity Patterns ◽

Public Health Problem ◽

School Students ◽

Cross Sectional ◽

Physical Activity Patterns ◽

Eating Occasions

AbstractObjectiveChildhood obesity is a growing public health problem. We have examined the association between sociodemographic profile and eating and physical activity patterns with overweight among primary-school students in Athens, Greece.DesignCross-sectional study.SettingEleven primary schools in the greater Athens area, Greece.SubjectsA total of 633 children aged 10–12 years (50 % boys, 50 % girls) were interviewed in person during spring 2003. Multivariate logistic regression was used to investigate the association between eating and physical activity patterns and overweight (≥85th sex- and age-specific BMI centile). Results are presented as odds ratios and 95 % confidence intervals.ResultsOverweight was more common among girls than among boys (OR=1·73; 95% CI 1·11, 2·69) and substantially less common among children born outside Greece (OR=0·46; CI 0·22, 0·95). Reported physical activity (per 1·5 h per day) was unrelated to overweight (OR=0·97; CI 0·85, 1·12) but patent physical inactivity, operationalised as time spent watching television or working/playing with the computer (per 1·5 h per day) was a highly significant predictor of overweight (OR=1·20; CI 1·05, 1·36). Composition of diet was unrelated to overweight but the daily number of eating occasions, controlling for total energy intake, was significantly inversely associated with overweight (OR=0·61; CI 0·48, 0·76).ConclusionsThe principal factor underlying overweight among children in Athens appears to be the extended inactivity imposed by modern childhood lifestyles. An intriguing finding is that spreading a given energy intake over several eating occasions was inversely associated with the likelihood of childhood obesity.

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Effect of Attendance of the Child on Body Weight, Energy Intake, and Physical Activity in Childhood Obesity Treatment

JAMA Pediatrics ◽

10.1001/jamapediatrics.2017.0651 ◽

2017 ◽

Vol 171 (7) ◽

pp. 622 ◽

Cited By ~ 28

Author(s):

Kerri N. Boutelle ◽

Kyung E. Rhee ◽

June Liang ◽

Abby Braden ◽

Jennifer Douglas ◽

...

Keyword(s):

Physical Activity ◽

Body Weight ◽

Childhood Obesity ◽

Energy Intake ◽

Obesity Treatment

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Dietary Patterns and Association with Obesity of Children Aged 6–17 Years in Medium and Small Cities in China: Findings from the CNHS 2010–2012

Nutrients ◽

10.3390/nu11010003 ◽

2018 ◽

Vol 11 (1) ◽

pp. 3 ◽

Cited By ~ 2

Author(s):

Dan Liu ◽

Li-Yun Zhao ◽

Dong-Mei Yu ◽

La-Hong Ju ◽

Jian Zhang ◽

...

Keyword(s):

Childhood Obesity ◽

Energy Intake ◽

Dietary Patterns ◽

Household Income ◽

Cross Sectional Study ◽

Chinese Children ◽

Small Cities ◽

Cross Sectional ◽

Housework Time ◽

Increased Risk

Childhood obesity is associated with both near- and longer-term health implications. Few studies have been conducted to explore the associations between dietary patterns and obesity among Chinese children and adolescents. The present study was designed to identify dietary patterns and their relationships with childhood obesity in medium and small cities. This is a cross-sectional study of children participants aged 6–17 years old in the 2010–2012 China Nutrition and Health Survey (CNHS). Socio-demographics, life-style, physical activity, anthropometric variables, and hundred-item food frequency questionnaires (FFQs) were collected. Household income was classified as low, middle, and high. Traffic tools, from non-advanced to advanced, included walking, biking, bus, and car. Dietary patterns were identified using factor analysis of data from FFQs. Two dietary patterns were identified: a Westernized pattern (i.e., high cakes, snacks, sugary beverages, aquatic products, red meat, fruits, and nuts) and a Traditional Chinese pattern (i.e., high cereals, tubers, legumes, fried cereal food, and vegetables). The Westernized pattern was positively correlated with energy intake, household income, traffic tools, and negative correlated with age and housework time. The Traditional Chinese pattern was positively correlated with age, energy intake, and housework time, and negatively correlated with household income and traffic tools. After adjusting for confounding factors, the Westernized pattern was found to be associated with BMI increment, yielding β coefficients (95% confidence interval, 95% CI) of 0.57 (0.40, 0.85) for the fourth quartile. In addition, the Westernized pattern was also found to be significantly associated with an increased risk of obesity, yielding an odds ratio (OR, 95% CI) of 1.49 (1.21, 1.84) from fully-adjusted confounders. Promoting healthier eating patterns could help to prevent obesity in Chinese children. The findings of this study could be used to guide the development of evidence-based preventive nutrition interventions to curb childhood obesity epidemic in small–medium cities in China.

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Anthropometric, lifestyle and parental characteristics associated with the prevalence of energy intake misreporting in children: the GRECO (Greek Childhood Obesity) study

British Journal Of Nutrition ◽

10.1017/s0007114515000458 ◽

2015 ◽

Vol 113 (7) ◽

pp. 1120-1128 ◽

Cited By ~ 6

Author(s):

Paul Farajian ◽

Vassiliki Bountziouka ◽

Grigoris Risvas ◽

Demosthenes B. Panagiotakos ◽

Antonis Zampelas

Keyword(s):

Childhood Obesity ◽

Energy Intake ◽

Maternal Education ◽

Multinomial Logistic Regression ◽

Study Data ◽

The Body ◽

Cross Sectional ◽

Multinomial Logistic Regression Analysis ◽

Weight Satisfaction ◽

Parental Characteristics

The objectives of the present study were to identify childhood energy misreporting, and evaluate characteristics that are associated with its prevalence in a nationwide cross-sectional sample of Greek schoolchildren. Under the context of the GRECO (Greek Childhood Obesity) study, data from a total of 4547 children aged 10–12 years and 2318 parents were included in the analysis. Anthropometric, lifestyle and parental characteristics plus psychological concerns were investigated in relation to the prevalence of energy misreporting. Of the included children, 36 % were classified as energy under-reporters and 16 % as over-reporters. Multinomial logistic regression analysis revealed that the most important predictors of energy under-reporting (URP) were children's BMI (OR 1·11, 95 % CI 1·09, 1·14) and weight satisfaction (OR 0·87, 95 % CI 0·78, 0·97). In the case of energy over-reporting (ORP), children's BMI (OR 0·87, 95 % CI 0·84, 0·90), meal and snack consumption frequency (OR 1·52, 95 % CI 1·32, 1·75), female sex (OR 0·65, 95 % CI 0·45, 0·90), and maternal education (OR 0·95, 95 % CI 0·91, 0·99) remained as significant predictors. Additionally, parental perception that the body weight of their children was normal reduced the odds of URP (OR 0·69, 95 % CI 0·48, 0·99) and ORP (OR 0·53, 95 % CI 0·31, 0·93). In conclusion, the present study confirms that the issue of URP and ORP in childhood populations is evident and quite serious. Although there are no definite guidelines on how to use data obtained from misreporters in an epidemiological dataset, validity of reported energy intake seems to be influenced by children's BMI and weight satisfaction, as well as by parental perceptions regarding their children's weight.

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Food sources of free sugars in children’s diet and identification of lifestyle patterns associated with free sugars intake: the GRECO (Greek Childhood Obesity) study

Public Health Nutrition ◽

10.1017/s1368980015003146 ◽

2015 ◽

Vol 19 (13) ◽

pp. 2326-2335 ◽

Cited By ~ 8

Author(s):

Paul Farajian ◽

Grigoris Risvas ◽

Demosthenes B Panagiotakos ◽

Antonis Zampelas

Keyword(s):

Childhood Obesity ◽

Energy Intake ◽

Dietary Patterns ◽

Dietary Habits ◽

Linear Regression Analysis ◽

Food Sources ◽

Cross Sectional ◽

Free Sugars ◽

Major Food ◽

Lifestyle Patterns

AbstractObjectiveExcessive free sugars consumption has a possible role in health issues, diet quality and obesity development. The present cross-sectional study aimed to identify the major food sources of free sugars in Greek children’s diet and investigate possible associations of dietary patterns with free sugars intake.DesignAnthropometric measurements and information on dietary and physical activity habits were obtained. Energy and free sugars intake coming from foods were estimated and principal components analysis was applied to identify dietary patterns.SettingThe GRECO (Greek Childhood Obesity) study.SubjectsNationwide sample of 3089 children (aged 10–12 years).ResultsAdopting WHO criteria, 44·2 % of participants were categorized as having free sugars intake above 10 % of total energy intake. Mean contribution of free sugars to energy intake was 11·2 %, and the major food sources of free sugars differed from those of other childhood populations. Free sugars intake was not associated with overweight/obesity. Multiple linear regression analysis revealed that two lifestyle and dietary patterns, characterized by higher consumption of sweets, fast foods, fries, sugared drinks, frequently ordering/eating outside home and having meals in front of a screen (pattern 1) and higher consumption of whole fruits, 100 % fruit juices, vegetables, legumes and honey/jam (pattern 2), were positively associated with free sugars intake.ConclusionsA large proportion of children exceeded the recommended cut-off and free sugars intake was associated with lifestyle patterns rather than single foods. Public health programmes aiming to reduce free sugars consumption should be tailored on promoting the correct dietary habits of specific childhood populations.

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