Path Analysis on Determinants of Childhood Obesity and Associated Risk Factors of Cardiovascular, Renal, and Hepatic Diseases: The CASPIAN-V Study

Marjan Mansourian,Roya Riahi,Vahid Mansouri,Roya Kelishadi,Mostafa Qorbani,Ramin Heshmat,Rahele Karimi,Mohammad Esmaeil Motlagh

doi:10.1055/s-0040-1716917

Abstract

AbstractThe interaction between several lifestyle and obesogenic environmental factors is considered as the main underlying factor for the escalating trend of childhood obesity and its adverse consequences. In this study, we assessed the mutual influence of lifestyle habits and body mass index (BMI) as well as risk factors for cardiometabolic, hepatic, and renal disorders to define the causality power of each item. This nationwide cross-sectional study was conducted as the fifth round of a school-based surveillance program. Overall, 14,800 students living in Iran were studied, and blood samples were obtained from 4,200 of them. Demographic factors, anthropometric and biochemical measures were used to define lifestyle-related latent variables as well as cardiac, renal, and hepatic risk indicators. Total, direct, and indirect effects between factors were analyzed using the standardized regression weights for each pathway. Data from 14,274 students (participation rate of 99%) and 3,843 blood samples were included. All of the latent variables had a significant direct effect on BMI, with the most potent effect of unhealthy nutrition (β ≅ 0.63) in boys and girls. BMI has significant direct effects on risk indicators of cardiovascular, renal, and hepatic diseases with the most powerful effect on cardiovascular risk factors (β ≅ − 0.08). The most important predisposing factor for obesity was unhealthy nutrition, whereas increased activity, adequate sleep, and better hygiene had protective roles. BMI shows the strongest association with indicator of cardiovascular diseases. These findings underscore the importance of implementing public health programs for the prevention of chronic noncommunicable diseases.

Highlights

The prevalence of obesity is globally emerging at an alarming rate, with a more rapid increase in developing than in developed countries.[1,2,3] According to the World Health Organization (WHO) estimates, in 2016, there were more than 330 million overweight or obese children and adolescents aged 5 to 19 years.[4]Factors that predispose children to excess weight are complex, needing a greater attempt to recognize for implementing preventative strategies
body mass index (BMI) shows the strongest association with indicator of cardiovascular diseases. These findings underscore the importance of implementing public health programs for the prevention of chronic noncommunicable diseases
The path analysis of a previous phase of this study indicated that body mass index (BMI) is the strongest determinant for cardiovascular risk factors; other variables such as unhealthy diet and low physical activity impressed their indirect effects through BMI

Summary

Introduction

The prevalence of obesity is globally emerging at an alarming rate, with a more rapid increase in developing than in developed countries.[1,2,3] According to the World Health Organization (WHO) estimates, in 2016, there were more than 330 million overweight or obese children and adolescents aged 5 to 19 years.[4]Factors that predispose children to excess weight are complex, needing a greater attempt to recognize for implementing preventative strategies. The prevalence of obesity is globally emerging at an alarming rate, with a more rapid increase in developing than in developed countries.[1,2,3] According to the World Health Organization (WHO) estimates, in 2016, there were more than 330 million overweight or obese children and adolescents aged 5 to 19 years.[4]. As WHO demonstrated, the interaction between several lifestyle and obesogenic environmental factors is considered as the main reason for the escalating trend of childhood obesity, as comprehensively reviewed by Sahoo et al.[4–7]. Childhood obesity has an essential role in predicting morbidities in adolescence and adulthood. It increases the risk of cardiometabolic disorders, as well as liver and kidney dysfunctions.[8,9]

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