Risk Factors for Obesity in Five-Year-Old Children: Based on Korean National Health Insurance Service (NHIS) Data.

Mi Jin Choi,Hyunju Kang,Jimi Choi

doi:10.3390/children9030314

Abstract

This study aimed to identify the risk factors for obesity in five-year-old children using data from the database of the Korean National Health Insurance Service. We identified 26,047 children who underwent the sixth screening (at age 5) from the 2017 National Health Screening Program for Infant and Children and for whom data from the fourth screening (at age 3) database and the mothers’ health screening and eligibility database were available. To identify the risk factors of obesity, odds ratios and 95% confidence intervals were calculated by a hierarchical multiple logistic regression. Female sex, a birth weight of over 4 kg, the “caution/refer” remark during developmental screening at ages three and five, maternal obesity, and a middle-level income were risk factors for obesity in the subjects. Good appetite, high consumption of milk, heavy intake of sweet food at age three, speedy eating, irregular meals and snack times, large single-meal quantities, heavy intake of oily and salty food, and not performing physical exercise at age five were also considered significant risk factors. For early intervention efforts to prevent childhood obesity, modifiable behavioral factors and other obesity risk factors identified in this study could be used to target high-risk children and dietary behaviors.

Highlights

Childhood obesity is a global health challenge [1]
Since obesity is difficult to reverse, prevention is important [16], with early childhood being important in this regard; this is because an early intervention approach can be used for long-lasting obesity prevention, owing to the biological and behavioral plasticity during that developmental period [15,17]
Data collected in the process of managing qualifications for insurance premium collection, payment of claim data for medical services, and implementation of health screening services for adults and infants are built into the National Health Insurance Database (NHID)

Summary

Introduction

Childhood obesity is a global health challenge [1]. There are two reasons that render tackling obesity in early childhood important. Rapid early growth becomes a risk factor for subsequent childhood obesity [10]. The early body mass index (BMI) trajectory confirmed an obesity risk of over 50% in children 5–8 years of age who showed a rapid increase in BMI around the age of 3.5 [11]. Children’s dietary habits are established around the age of three [12,13], and early childhood is a time when a healthy lifestyle that lowers the risk of obesity can be established through parents’ influence and the creation of a favorable environment [14,15]. Since obesity is difficult to reverse, prevention is important [16], with early childhood being important in this regard; this is because an early intervention approach can be used for long-lasting obesity prevention, owing to the biological and behavioral plasticity during that developmental period [15,17]

Objectives

Methods

Results

Discussion

Conclusion