Abstract

Abstract Background One of the current public health problems in Bulgaria is the high prevalence of overweight and obesity in childhood. The family environment affects many aspects of children’s health and well-being. The unfavourable socio-economic characteristics of the family environment might be a risk for overweight and obesity in childhood. Methods A national representative survey was conducted in Bulgaria in 2016 as part of the WHO European Childhood Obesity Surveillance Initiative (COSI). 3379 schoolchildren were recruited. The average age of the sample was 7.7 years, equally distributed by gender - girls 50.11% (n = 1693) and boys 49.89% (n = 1686). The data from the filled in Family form was analysed with SPSS using descriptive statistical methods. Results The study identified the following risk factors of the family environment for the development of overweight in childhood: the proportion of parents with elementary or primary education was significant - about a quarter, nearly one third of the surveyed households were experiencing financial difficulties, 14.1% of the women and 11.6% of the men were unemployed in the last 1 year. There was a high incidence of co-morbidity among family members: hypertension - 27.7%, diabetes mellitus - 14.4% and hypercholesterolemia - 13.6%. Among the surveyed parents 28.4% of the women and 68% of the men were overweight. Only 13.5% of the parents estimated the weight status of their child as overweight (with objectively measured overweight among 29.2% of the recruited children). A significant proportion of the children were not breastfed (17.3%) or the duration of exclusive breastfeeding was not optimal for 67.8% of the exclusively breastfed children. Conclusions Identifying family risk factors associated with overweight in childhood is important for the public health and provides opportunities to develop policies for improvement of the nutritional and health status of children. Key messages To tackle the childhood obesity epidemic the family risk factors should be addressed. The awareness of the children and parents should be raised through targeted information materials and campaigns.

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