Abstract
BackgroundChildhood overweight/obesity is a major public health problem worldwide which disproportionally affects specific ethnic groups. Little is known about whether such differences already exist at an early age and which factors contribute to these ethnic differences. Therefore, the present study assessed possible ethnic differences in overweight at age 2 years, and the potential explanatory role of prenatal factors, birth outcomes and postnatal factors.MethodsData were derived from a multi-ethnic cohort in the Netherlands (the ABCD study). Weight and height data of 3,156 singleton infants at age 2 years were used. Five ethnic populations were distinguished: Dutch native (n = 1,718), African descent (n = 238), Turkish (n = 162), Moroccan (n = 245) and other non-Dutch (n = 793). Overweight status was defined by the International Obesity Task Force guidelines. The explanatory role of prenatal factors, birth outcomes and postnatal factors in ethnic disparities in overweight (including obesity) was assessed by logistic regression analysis.ResultsCompared to the native Dutch (7.1%), prevalence of overweight was higher in the Turkish (19.8%) and Moroccan (16.7%) group, whereas the prevalence was not increased in the African descent (9.2%) and other non-Dutch (8.8%) group. Although maternal pre-pregnancy body mass index partly explained the ethnic differences, the odds ratio (OR) of being overweight remained higher in the Turkish (OR: 2.66; 95%CI: 1.56-4.53) and Moroccan (OR: 2.11; 95%CI: 1.31-3.38) groups after adjusting for prenatal factors. The remaining differences were largely accounted for by weight gain during the first 6 months of life (postnatal factor). Maternal height, birth weight and gender were independent predictors for overweight at age 2 years, but did not explain the ethnic differences.ConclusionTurkish and Moroccan children in the Netherlands have 2- to 3-fold higher odds for being overweight at age 2 years, which is largely attributed to maternal pre-pregnancy BMI and weight gain during the first 6 months of life. Further study on the underlying factors of this early weight gain is required to tackle ethnic differences in overweight among these children.
Highlights
Childhood overweight/obesity is a major public health problem worldwide which disproportionally affects specific ethnic groups
The present study explores ethnic disparities in overweight of children at age 2 years, and identifies and quantifies the prenatal factors, birth outcomes and postnatal factors that contribute to the explanation of these differences
Corresponding with the prevalence rates, the odds ratio (OR) for overweight was increased in the Turkish (OR: 3.23; 95%confidence intervals (CI): 2.11-4.96) and Moroccan (OR: 2.61; 95%CI: 1.77-3.84) group compared to the ethnic Dutch group
Summary
Childhood overweight/obesity is a major public health problem worldwide which disproportionally affects specific ethnic groups. In the Netherlands, trends over time show the prevalence of overweight and obesity in school-aged children increasing at an even a faster rate, and at earlier ages, than two decades ago [3,4]. Overweight/obese children are at increased risk of developing obesity at adult age which, in turn, is associated with various comorbidities, de Hoog et al BMC Public Health 2011, 11:611 http://www.biomedcentral.com/1471-2458/11/611 such as type II diabetes, cardiovascular disease, osteoporosis and depression [8,9,10]. Childhood overweight disproportionally affects some ethnic minority populations [11,12], which is consistently reported in American and European studies [5,13,14,15,16]. Fredriks et al found that overweight and obesity were much more prevalent in Turkish and Moroccan children compared to Dutch children, from age 2 years onwards [13]
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