Social and somatic determinants of underweight, overweight and obesity at 5 years of age: a Norwegian regional cohort study

Abstract

ObjectiveTo identify associations between the weight groups underweight (UW), overweight (OW) and obesity (OB) at 5 years of age and exposures related to pregnancy, anthropometric measures at birth, sociodemographic factors, and family health, anthropometric measures and habits.DesignRegional cohort study.SettingOppland County, Norway.MethodsPregnancy data were obtained from a prospective perinatal register for children born in the county, and weight and height were measured by midwives at birth and by public health nurses at 5 years. Other information was obtained from questionnaires completed by parents.ParticipantsOf 1895 eligible children, current weight and height were obtained for all, weight and length at birth and information from parents for 1119 (59%) and pregnancy register data for 749 (40%) of the children. The significance of potential explanatory variables from descriptive statistics was tested in multinomial logistic regression analysis.ResultsThe prevalence of UW, OW and OB among participants was 7.8%, 10.6% and 3.5%, respectively. UW was associated with anthropometric measures at birth and those of parents, but not with sociodemographic or behavioural characteristics. OW and OB were associated with anthropometric measures of parents and siblings and with a variety of unfavourable social characteristics, lack of prolonged breast feeding, sedentary behaviour and dental caries, but not with current dietary habits. After adjustments, OW and OB were marginally related to birth parameters and diet and unrelated to physical activity, but significantly related to parental body mass index, low parental education and maternal smoking.ConclusionThe strong associations between sociodemographic and behavioural factors and OW and OB, but not with UW, may suggest that environmental factors are major contributing causes of OW and particularly OB at 5 years. These results may be helpful in targeting preventive measures against OW and OB.

Environmental risk factors and nonpharmacological and nonsurgical interventions for obesity: An umbrella review of meta‐analyses of cohort studies and randomized controlled trials

“…Notably, a recent large cohort study (not yet included in any of the meta-analyses) showed that after adjustment for several confounding factors, obesity was only marginally related to dietary patterns and unrelated to physical activity, while low parental education was associated with childhood obesity. 22 Large-scale epidemiological data also seem to support this finding. Although it is presumed that the urbanization of society has significantly contributed to the emergence of the obesity epidemic, for example, due to a lack of opportunities for the practice of physical activity, a large-scale analysis of the health effects of obesity in 195 countries over 25 years noted that alarming rates of obesity took place well before urbanization across several cultures.…”

“…To the best of our knowledge, no other umbrella review has graded evidence from meta‐analyses of putative environmental risk factors for obesity as well as evidence from randomized controlled nonpharmacological and nonsurgical interventions both in adults and children, including only patients affected by obesity and excluding overweight participants. Notably, a recent large cohort study (not yet included in any of the meta‐analyses) showed that after adjustment for several confounding factors, obesity was only marginally related to dietary patterns and unrelated to physical activity, while low parental education was associated with childhood obesity . Large‐scale epidemiological data also seem to support this finding.…”

No significant associations between breastfeeding practices and overweight in 8‐year‐old children

“…From this cohort, we have previously reported that exclusive breastfeeding for at least 4 months was not significantly associated with a risk of overweight and obesity at pre‐school age . The present study adds that there were no significant effects on BMI or risk of overweight or obesity in the third grade, an age at which children are becoming more independent.…”

Obesity and associated risk factors in adolescents in rural areas of Buryatia, Russia

“…Наличие такой связи сложно опосредуется взаимодействием генетических факторов с факторами семейного окружения, формирующими так называемое обесогенное поведение ребенка: низкая физическая активность, длительное экранное время, нездоровые паттерны питания, короткая продолжительность сна. Как интересную находку нашего исследования следует отметить то, что мы, в отличие от большинства других исследователей, показавших связь избыточного веса детей с весом обоих родителей [10,11], обнаружили, что ожирение у сельских подростков связано с ИМТ их матерей, но не отцов. Результаты, сходные с полученными нами, были получены еще в двух исследованиях, в которых, к сожалению, не приведены данные о территории проживания включенных в выборку детей [7,9].…”

“…Результаты, сходные с полученными нами, были получены еще в двух исследованиях, в которых, к сожалению, не приведены данные о территории проживания включенных в выборку детей [7,9]. И еще в одном исследовании, хотя и была установлена связь ожирения ребенка с ИМТ отца, подчеркивалось, что ИМТ матери влияет на вес ребенка значительно сильнее [11]. Можно предположить, что показанная нами ассоциация во многом реализуется через преимущественную роль матери в формировании семейной среды в сельских общинах, которая, в свою очередь, определяет паттерны питания и образа жизни ребенка.…”