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Determinants of Childhood Obesity and Association with Maternal Perceptions of Their Children's Weight Status: The “GENESIS” Study

https://doi.org/10.1016/j.jada.2010.07.004Get rights and content

Abstract

Prevention of early childhood obesity requires a clear understanding of its determinants. This study examined perinatal, parental, and lifestyle determinants of childhood obesity and how these factors are associated with maternal misperceptions of their children's weight status. The current work presents a cross-sectional analysis of 2,374 children, age 1 to 5 years, living in Greece (April 2003 to July 2004). The 2000 Centers for Disease Control and Prevention growth charts were used to classify children as overweight (≥85th and <95th body mass index [BMI]–for-age percentile for children older than 24 months) and obese (≥95th weight-for-length percentile for children younger than 24 months and ≥95th BMI–for-age percentile for children older than 24 months). Maternal perceptions about their children's weight status were assessed via interviews with the mothers. Early infancy growth data were obtained from pediatric medical records. The present study showed that the prevalence of overweight and obesity was 16.2% and 17.5%, respectively. Each unit increase of maternal and paternal BMI significantly increased the likelihood of childhood obesity by a factor of 1.03 (95% confidence interval [CI]: 1.01 to 1.07) and 1.15 (95% CI: 1.10 to 1.20), respectively. Furthermore, children with a rapid weight gain in infancy were 1.9 (95% CI: 1.3 to 2.7) times more likely to be overweight and 1.5 (95% CI: 1.2 to 1.9) times more likely to have their weight status underestimated by their mother. In conclusion, rapid infancy weight gain and higher parental BMI were the main determinants of obesity in preschool years. Maternal underestimation of children's weight status was more likely for children with rapid weight gain in infancy.

Section snippets

Methods

The “Growth, Exercise, and Nutrition Epidemiological Study in preSchoolers” (GENESIS study) was conducted from April 2003 to July 2004. A representative sample of randomly selected public and private child day-care centers within municipalities of urban, semiurban, and rural locality in five Greek counties was invited to participate in the study. An extended letter explaining the aims of the current study and a consent form was given to parents of children at these day-care centers. Signed

Results and Discussion

The prevalence of overweight and obesity observed in the present study was 17.5% and 16.2%, respectively. These rates reveal that preschool obesity in Greece is among the highest in the world, comparable or even higher to the United States, where the rates reported for preschool population range from 11.6% at 6 to 23 months to 12.4% at 2 to 5 years of age (30, 31). However, none of the public health initiatives attempted so far has prevented the problem from expanding; in both countries

Conclusion

The current study showed that rapid weight gain during infancy, children's lower physical activity levels, and higher parental BMIs were the most important factors that significantly increased the likelihood for obesity in preschool children. In addition, among all determinants of early childhood overweight and obesity presented in Table 1, specific maternal characteristics (ie, higher BMI, lower educational level), children's behaviors leading to a positive energy balance (ie, higher energy

Y. Manios is an assistant professor, Department of Nutrition and Dietetics, Harokopio University of Athens, Greece.

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    Y. Manios is an assistant professor, Department of Nutrition and Dietetics, Harokopio University of Athens, Greece.

    G. Moschonis is a dietitian-clinical nutritionist, Department of Nutrition and Dietetics, Harokopio University of Athens, Greece.

    E. Grammatikaki is a dietitian-public health nutritionist, Department of Nutrition and Dietetics, Harokopio University of Athens, Greece.

    A. Anastasiadou is a clinical dietitian, Department of Nutrition and Dietetics, Harokopio University of Athens, Greece.

    T. Liarigkovinos is a clinical dietitian, Department of Nutrition and Dietetics, Harokopio University of Athens, Greece.

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