Abstract
Background and Aims: Scientific evidence regarding protective factors that contribute to healthy weight in childhood is limited and is particularly scarce in lower socio-economic populations in different ethnic groups. This study aimed to assess the prevalence of biological, behavioral and psychosocial factors for child overweight/obesity in Jewish and Arab population groups in Israel, and to compare their associations with child overweight/obesity in the two groups.Methods: Children aged 5–6 years were randomly selected from 20 Mother and Child Health clinics in towns and villages of lowest socio-economic ranking in Northern Israel. Children and mothers were invited for a special “One Stop Shop–Preparation for School” visit which included growth measurements. Questionnaires were distributed to mothers for self-report on biological, SES, psychological and lifestyle factors. Perinatal and early nutritional data were retrieved from clinic records. Multivariate analyses using logistic regression models predicting child overweight/obesity were conducted separately for Jewish (N = 371) and Arab (N = 575) children.Results: Overweight/obesity (BMI ≥85th centile) rates were higher in Jewish (25%) than Arab (19%) children. In both Jewish and Arab groups, respectively, maternal BMI (OR = 1.10 [95%CI = 1.04, 1.17]; OR = 1.08 [95%CI = 1.04, 1.13]), and child birthweight (OR = 1.33 [95%CI = 1.04, 1.71]; OR = 1.39 [95%CI = 1.11, 1.73]) were significant risk factors for overweight/obesity, and maternal self-efficacy regarding child's lifestyle was significantly protective (OR = 0.49 [95%CI = 0.28, 0.85]; OR = 0.54 [95%CI = 0.34, 0.85]). Additionally, four other maternal psychological and child behaviors were significantly associated with overweight/obesity in the Jewish group and two child lifestyle behavior factors in the Arab group. Moreover, significant interactions indicating moderation effects were found only in the Jewish group: maternal education and maternal age moderated the effect of maternal BMI on child overweight/obesity. No other moderation of risk factors was found.Discussion: In this study of children from low SES families, protective factors contributed to healthy child weight alongside risk factors for overweight/obesity. They differed between the population groups, and fewer variables explained overweight/obesity in Arab children. Although further expansion of these findings is required they point at the relevance of protective factors, maternal self-efficacy in particular, for understanding childhood obesity in specific ethnic contexts and for planning culturally adapted prevention programs in disadvantaged populations.
Highlights
The increase in levels of overweight and obesity from a young age poses a challenge for public health throughout the world [1]
It is evident that complications previously occurring only in older age appear in childhood [6], and that disparities in child obesity between population groups, such as between race/ethnic majority and minorities, and by socio-economic status (SES) are already manifest [4, 7, 8]
The current study aimed to extend our understanding of risk and protective factors for child overweight and obesity taking a comprehensive biopsychosocial approach within each population group and focusing on children from low socio-economic backgrounds
Summary
The increase in levels of overweight and obesity from a young age poses a challenge for public health throughout the world [1]. It is evident that complications previously occurring only in older age appear in childhood [6], and that disparities in child obesity between population groups, such as between race/ethnic majority and minorities, and by socio-economic status (SES) are already manifest [4, 7, 8]. Within the Israeli context, child overweight and obesity has increased in the past 12 years, and inequalities exist between Jewish and Arab children [9]. Scientific evidence regarding protective factors that contribute to healthy weight in childhood is limited and is scarce in lower socio-economic populations in different ethnic groups. This study aimed to assess the prevalence of biological, behavioral and psychosocial factors for child overweight/obesity in Jewish and Arab population groups in Israel, and to compare their associations with child overweight/obesity in the two groups
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