Abstract
BackgroundEthnic differences in childhood and adulthood are known, but ethnic differences in preschool overweight and associated factors are less studied. We assessed ethnic differences in pre-school age overweight, and studied the mediating role of early life factors in this association. Furthermore, we assessed body mass index (BMI) z-score development from birth to age 4 years to study ethnic-specific differences in BMI z-score trajectory.MethodsWe used data on 4581 children participating in a birth cohort who were born between 2002 and 2006 in Rotterdam, the Netherlands. Child’s ethnicity was defined according to country of birth of the parents. Weight and length/height was repeatedly measured between 1 and 45 months of age. Overweight at age 4 years was defined according to cut-off points for BMI from the international obesity task force. We performed logistic regression to obtain independent estimates of the association between ethnicity and preschool-age overweight, and to assess the mediating role of early life risk factors. Mixed models were used to describe BMI-z development for each ethnic group from birth to preschool age.ResultsRelative to native Dutch children, non-Dutch children were more likely to be overweight at age 4 years, except for Surinamese-Hindustani children. Socio-demographic factors, parental BMI, and infant weight change in the first 6 months after birth reduced associations. After full adjustment, Turkish (OR: 2.02, 95% CI: 1.34-3.04) and Antillean/Surinamese Creole (OR: 1.78, 95% CI: 1.06-3.02) children were still more likely to be overweight at age 4 years.ConclusionEthnic differences on the prevalence of overweight in preschool children can be partially explained by maternal educational level, parental overweight and early infant weight change. These may be possible targets to reduce ethnic inequalities in preschool age overweight.
Highlights
Ethnic differences in childhood and adulthood are known, but ethnic differences in preschool overweight and associated factors are less studied
The direction of differences in father’s body mass index (BMI), smoking during pregnancy, breastfeeding, birth weight and gestational age varied according to ethnic subgroup (Table 1)
In contrast to the results of Whitaker and Orzol, who concluded that the higher prevalence of overweight in Hispanic children could not be explained by maternal education, household income or food security, our study showed a large contribution of maternal educational level [16]
Summary
Ethnic differences in childhood and adulthood are known, but ethnic differences in preschool overweight and associated factors are less studied. We assessed ethnic differences in pre-school age overweight, and studied the mediating role of early life factors in this association. We assessed ethnic differences in pre-school age overweight, and studied the mediating role of risk factors that were present before overweight was developed (‘early life factors’) in this association. We distinguished these early life factors into parental, prenatal, and postnatal factors in order to get clues which of these factors can be targets for preventive interventions. We assessed body mass index (BMI) z-score development from birth to age 4 years to study ethnic-specific differences in BMI z-score trajectory
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