Original ReportPrevalence and Correlates of Overweight among Elementary Schoolchildren in Multiethnic, Low Income, Inner-City Neighbourhoods in Montreal, Canada
Introduction
Overweight and obesity are rapidly emerging public health priorities in many industrialized countries, because of the well-demonstrated impact of overweight and obesity on health 1, 2, 3, and because population-based surveys have documented dramatic rises in weight for height indices among both adults and children over the past 30 years 4, 5, 6, 7, 8. Among children, elevated body weight has been associated with increases in low and very low density lipoprotein cholesterol, decreases in high density lipoprotein cholesterol, increases in blood pressure and clustering of ischemic heart disease risk factors 9, 10, 11, 12, 13. Excessive weight during late childhood and adolescence has been associated with higher morbidity and mortality in adulthood, as well as poverty and a lower likelihood of being married 14, 15, 16, 17.
Although the majority of overweight adults were not overweight as children, 26–41% of obese preschool children, and 42–63% of obese schoolchildren become obese adults (18). Given the low success in treating adult obesity, increased understanding of the early determinants of obesity is needed to support the development of effective preventive strategies, especially in low socioeconomic status (SES) populations where the prevalence of adult obesity is particularly high 19, 20.
As part of the evaluation of the impact of a school-based heart health promotion program, we collected anthropometric data from children attending inner-city elementary schools in multiethnic, low income neighbourhoods in Montreal, Canada. This report describes the prevalence and correlates of overweight in this population.
Section snippets
Materials and methods
Coeur en santé St. Louis du Parc is a school-based heart health promotion program in St-Louis du Parc, a multiethnic, low income, inner-city neighbourhood in Montreal. This five-year research and demonstration project is conducted by a local public health department, as part of the Canadian Heart Health Initiative (21). All eight elementary schools in St-Louis du Parc were designated intervention schools. Over the five-year implementation period, all children in grades 4 to 6 in these schools
Results
Data were collected from 2285 of 2840 eligible students (80.5%); 143 (5.0%) were absent on the day of the in-class questionnaire administration and 411 (14.5%) did not participate because their parents did not provide informed consent. We excluded all 177 children aged 13 years old who normally would have been in grade seven rather than grade six, because their distribution by family origin was significantly different from other ages, potentially introducing a selection bias if family origin
Discussion
Although our definitions of overweight and obesity were conservative compared to others 4, 34, we observed a very high prevalence of excessive weight in this population—approximately one-third of boys and girls were overweight. By contrast, Troiano and colleagues (7) reported that 22.7% of boys and 21.4% of girls aged 9 to 11 years from NHANES III were overweight. These investigators used BMI as the only indicator of obesity and they compared their results to an earlier and lower BMI standard.
Acknowledgements
This research was conducted as part of the Projet Québécois de Démonstration en Santé du Coeur, which is funded by the National Health Research and Development Program, Health Canada (grant no. 66053754-H), the Quebec Ministry of Health and Social Services, and the Quebec Heart and Stroke Foundation. Dr. J. O’Loughlin is a National Health Research Scholar. Dr. L. Renaud is a Chercheur-Boursier of the Conseil Québécois de la Recherche Sociale.
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