Parental Weight Status Research Articles

Preferences and emotional response to weight-related terminology used by healthcare professionals to describe body weight in people living with overweight and obesity.

Previous studies have explored people's perceptions of weight-related terminology; however, to date, limited data has explored the emotional response to weight-related terms used by healthcare professionals (HCPs). This study explored the preferences and emotional responses of terms used by HCPs to describe body weight and of parents to describe their children's weight. A total of 2911 adults completed an online cross-sectional survey, with 1693 living with overweight or obesity (mean age 49.2 years [SD 12.5], female (96%), median body mass index (BMI) 31.4kg/m2 [28.1, 36.5]). The survey explored preferences of 22 weight-related terms using a 5-point Likert scale and their emotional response to these terms (using 7-core emotions). Parents also indicated preferences and emotional responses to terms used to describe their children's weight. Respondents completed the modified weight bias internalization scale to examine how this may impacted preferences. 'Weight', "unhealthy weight" and "overweight" were the three preferred terms, while "super obese", "chubby", and "extra-large" were least preferred in people living with overweight and obesity. Parents preferred 'weight', "unhealthy weight" and "body mass index", and least preferred "fat", "extra-large" and "extremely obese" when describing their children's weight. All terms elicited a negative emotional response. The most commonly emotion was sadness for terms to describe adult's bodyweight, and anger for terms used to describe children's weight. All BMI categories reported disgust with terms incorporating "obese". Our results offer novel insight into the preferred terminology and emotional responses to terminology used by HCPs for both adults and parents to describe their children's weight.

Association Between State-Based and Trait-Based Responsiveness to Satiety Cues Differs by Child Risk for Overweight/Obesity

ObjectivesThe relationship between parentally reported satiety responsiveness (i.e., trait) and laboratory-assessed satiety responsiveness (i.e., state) in children is not known, making it difficult to interpret and generalize lab-based findings. In addition, while many studies have shown weight-related differences in children’s eating behaviors, less is known about appetitive traits that are present before obesity develops. Therefore, we examined associations between trait- and state-based satiety responsiveness among children with healthy weight who differed by familial risk for obesity. MethodsData from an ongoing longitudinal study were analyzed for 59 healthy-weight, 7–8 year-old children (BMI-for-age% < 85). Familial risk for obesity was determined by parental weight status as low-risk (N = 34, both parents’ BMIs < 25 kg/m2) or high-risk (N = 25, mothers’ BMI ≥ 30 kg/m2; fathers’ BMI ≥ 25 kg/m2). Parents completed the Children’s Eating Behavior Questionnaire to assess satiety responsiveness (SR), a measure of children’s tendency to stop eating once sated (trait). To assess state-based satiety, the Satiety Quotient (SQ) was calculated from an ad-libitum laboratory meal [(Pre-meal hunger – post-meal hunger)/meal intake in grams]. A higher SQ indicates a greater reduction in hunger per gram (i.e., better satiety responsiveness). ResultsOverall, SR and SQ were not correlated (P = 0.57). However, a linear regression controlling for pre-meal hunger and child BMI percentile revealed a risk status-by-SR interaction (β = 0.804, P = 0.04) such that SR was positively associated with SQ in high-risk children (95% CI [0.003, 0.430]), but there was no relationship between SR and SQ in low-risk children (95% CI [–0.203, 0.085]). No differences in SR, SQ, pre-meal hunger, or post-meal hunger were observed between risk groups. ConclusionsParentally reported (trait-based) satiety was positively associated with laboratory-assessed satiety, but only among healthy weight children at high-familial risk for obesity. Parents of children who are at high-risk for developing obesity may be more observant of children’s appetitive traits compared to parents of low-risk children, and this may be helpful in the prevention of obesity. Funding SourcesNIH RO1: DK110060.

Underestimation of overweight weight status in children and adolescents aged 0-19 years: A systematic review and meta-analysis.

BackgroundPerceptions of children's weight status may be important in obesity prevention and treatment.AimsThis review identifies the prevalence of the underestimation of overweight status in children by parents/main carers, children, and healthcare professionals (HCP). The review critically synthesized both quantitative and qualitative evidence to explore the factors associated with this underestimation. The diverse methods used to assess this phenomenon are reported.MethodsPooled effect sizes were calculated using random‐effects model. Published studies, up to 2020, were accessed using the following search engines: CINAHL, EMBASE, PUBMED, and Psych‐Info and including the “Cited by” and “Related Articles” functions. Hand‐searching was used to retrieve further articles. Publication language and location had no bearing on the nature of the included studies.ResultsA total of 91 articles were included. In the quantitative studies, 55% (95% CI 49%–61%) of caregivers underestimated their child's level of overweight and obesity using a verbal scale and 47% (95% CI 36%–55%) using visual scales. Of the children studied, 34% (95% CI 25%–43%) underestimated their own level of overweight and obesity using both scales. In (n = 3) articles, HCPs reflected this misperception, but limited studies prevented meta‐analysis. Underestimation was associated with the child's age, gender, BMI and parental weight status, ethnicity and education. In the qualitative studies, parents/main carers of children with overweight and obesity described their child's weight in terms other than overweight, for example, “big boned,” “thick,” and “solid.”ConclusionThe results confirm the prevalence of underestimation of child overweight status across international studies. Understanding the factors which lead to this inaccuracy may help to improve communication within the therapeutic triad and facilitate the recognition and management of children's overweight status.

And yet Again: Having Breakfast Is Positively Associated with Lower BMI and Healthier General Eating Behavior in Schoolchildren.

Given the high prevalence of childhood overweight, school-based programs aiming at nutritional behavior may be a good starting point for community-based interventions. Therefore, we investigated associations between school-related meal patterns and weight status in 1215 schoolchildren. Anthropometry was performed on-site in schools. Children reported their meal habits, and parents provided family-related information via questionnaires. Associations between nutritional behavior and weight status were estimated using hierarchical linear and logistic regression. Analyses were adjusted for age, socio–economic status, school type, migration background, and parental weight status. Having breakfast was associated with a lower BMI-SDS (βadj = −0.51, p = 0.004) and a lower risk of being overweight (ORadj = 0.30, p = 0.009), while having two breakfasts resulting in stronger associations (BMI-SDS: βadj = −0.66, p < 0.001; risk of overweight: ORadj = 0.22, p = 0.001). Likewise, children who regularly skipped breakfast on school days showed stronger associations (BMI-SDS: β = 0.49, p < 0.001; risk of overweight: OR = 3.29, p < 0.001) than children who skipped breakfast only occasionally (BMI-SDS: β = 0.43, p < 0.001; risk of overweight: OR = 2.72, p = 0.032). The associations persisted after controlling for parental SES and weight status. Therefore, our data confirm the school setting as a suitable starting point for community-based interventions and may underline the necessity of national programs providing free breakfast and lunch to children.

Parental Perception of Weight and Feeding Practices in SchoolChildren: A Cross-Sectional Study

Childhood obesity has become a public health problem. Parents play an important role in the transmission of feeding habits and the detection of their child′s weight status. The aim was to analyse the prevalence of overweight/obesity and to determine the relationship between children′s weight status, different feeding practices and weight misperception. A cross-sectional study was conducted in randomly selected schools. The children’s weight status was measured, and a questionnaire was used to identify the feeding practices applied by parents and their perception of their children′s weight. The sample comprised 127 children aged 4 and 5 years and 189 aged 10 and 11. Differences were observed between parental feeding practices and weight status, monitoring being the most used practice. Parents use less pressure to eat and more restriction if their children have overweight or obesity. Misperception of weight was 39.6%, being higher in overweight children, who were perceived as normal weight in 53.19%. Children classified as obese were perceived as overweight in 88.23%. The use of inappropriate eating practices shows a need for health education in parents according to weight status. In addition, the parents’ perception should be improved to increase early detection of overweight and start actions or seek professional help.

Maternal overweight but not paternal overweight before pregnancy is associated with shorter newborn telomere length: evidence from Guangxi Zhuang birth cohort in China

BackgroundTelomere length (TL) is variable at birth and is inversely associated with body mass index (BMI) in adulthood. A growing number of evidences suggested that a higher maternal pre-pregnancy BMI results in adverse offspring health outcomes, especially shorter newborn TL. However, a newborn’s genetic endowment is equally derived from both parents, the association between parental pre-pregnancy BMI and newborn TL has been rarely discussed. We aimed to determine the association between parental pre-pregnancy BMI and newborn TL.MethodsA total of 1082 parent-newborn pairs were recruited from the Guangxi Zhuang Birth Cohort (GZBC). TL in cord blood was measured using quantitative real-time polymerase chain reaction (qPCR) and expressed as the ratio of telomere copy number to single-copy gene number (T/S). A series of linear regressions were performed to assess the associations between parental pre-pregnancy BMI and newborn TL.ResultsMothers who were overweight before pregnancy had significantly shorter cord blood telomere length in their newborns than those who were normal weight before pregnancy [percentage change: − 7.96% (95% CI: − 14.49 to − 0.69%; P = 0.032)]. Further analysis of the combined effects of parental weight status on newborn TL showed that TL was significantly shortened among newborns whose mothers were overweight and fathers were of healthy weight when compared with those whose mothers and fathers were both of normal weight [percentage change: − 8.38% (95% CI: − 15.47 to − 0.92%; P = 0.028)]. Subgroup analysis indicated these effects were more pronounced among male newborns and those whose paternal age < 31 years or maternal age ≥ 28 years at delivery.ConclusionsMaternal pre-pregnancy overweight, but not paternal pre-pregnancy overweight is associated with shorter newborn TL. Weight control in reproductive women and effective healthy weight management before pregnancy may be of particular benefit for improving longevity and life quality of offspring.

Global relationship between parent and child obesity: a systematic review and meta-analysis.

BackgroundThe growing prevalence of overweight and/or obese children is an important public health problem in both developed and developing countries. Although the association of obesity between parents and their children is well known, its underlying mechanisms are not well established.PurposeThis meta-analysis examined parent-child (PC) relationships in obesity and identified factors such as world region and country income level that may influence this relationship.MethodsWe identified all related studies published between January 1, 2015 and May 31, 2020 by conducting a literature search using the MeSH terms “obesity,” “overweight,” “body mass index,” “parent,” “child,” “associate,” and “relate” in the PubMed database in English.ResultsThe meta-analysis of 23 studies that reported an odds ratio (OR) for parent and child obesity associations found a significant association between parents and children who were overweight or obese (pooled OR, 1.97; 95% confidence interval, 1.85–2.10). A meta-regression analysis was used to examine the sources of interstudy heterogeneity. The association between parent and child obesity was higher in Asia than in Europe and the Middle East and higher in high-income countries than in middle-or low-income countries. In addition, a higher association between parent and child obesity was found when both parents were obese than when only the father or mother was obese. This study from multiple countries indicates a significant PC relationship in weight status that varies according to PC pair type, parent and child weight statuses, world region, and country income level.ConclusionThese results demonstrate that the risk of childhood obesity is greatly influenced by parental weight status and indicate that parents could play an important role in preventing child obesity.

Addressing obesity in the first 1000 days in high risk infants: Systematic review.

Early intervention is critical for addressing the challenge of childhood obesity. Yet many preventive interventions do not target infants most at risk of future overweight or obesity. This systematic review examines interventions delivered before 2 years that aim to ameliorate excess weight gain among infants at high risk of overweight or obesity, due to sociodemographic characteristics, parental weight or health status, infant feeding or health behaviours. We searched six databases for interventions: (a) delivered before age two, (b) specifically aimed at infants at high risk of childhood obesity and (c) that reported outcomes by weight status beyond 28 days. The search identified over 27,000 titles, and 49 papers from 38 studies met inclusion criteria: 10 antenatal interventions, 16 postnatal and 12 conducted both before and after birth. Nearly all targeted infant and/or maternal nutrition. Studies varied widely in design, obesity risk factors, outcomes and quality. Overall, nine interventions of varying quality reported some evidence of significantly improved child weight trajectory, although effects tended to diminish over time. Interventions that improved weight outcomes tended to engage parents for a longer period, and most offered health professional input and support. Two studies of limited quality reported significantly worse weight outcomes in the intervention group.

Brief parental self-efficacy scales for promoting healthy eating and physical activity in children: a validation study

BackgroundBrief scales to measure parental self-efficacy (PSE) in relation to children’s obesogenic behaviours have not been developed and validated using more rigorous methodology such as invariance testing, limiting their generalisability to sub-groups.This study aimed to assess the construct validity and measurement invariance of brief PSE scales for children’s intake of vegetables, soft drinks, and sweets, and physical activity.MethodsParents (n = 242) of five-to-seven-year-old children in disadvantaged and culturally diverse settings in Sweden responded to a questionnaire in Swedish with 12 items assessing PSE in relation to healthy and unhealthy behaviours. Construct validity was assessed with confirmatory factor analysis, invariance testing compared the scales by groups of parental sex, education, and child weight status. Criterion validity was evaluated using objective measures of children’s physical activity and semi-objective measures of diet.ResultsTwo-factor models showed moderate to excellent fit to the data. Invariance was supported across all groups for healthy behaviour scales. Unhealthy behaviour scales were invariant for all groups except parental education where partial metric invariance was supported. Scales were significantly correlated with physical activity and diet.ConclusionThis study provides preliminary evidence for the validity of brief PSE scales and invariance across groups suggesting their utility for research and clinical management of weight-related behaviours.

Maternal feeding style and child weight status among Hispanic families with low-income levels: a longitudinal study of the direction of effects

BackgroundThe home environment is a central and modifiable influence on the development of childhood obesity. Evidence supports the central role of parents in shaping problematic child eating behaviors and excess weight. Most studies of feeding emphasize parent-driven influences without taking into account the child’s role in eating interactions. Few studies have addressed the bi-directional nature of feeding dynamics in studies of young children.MethodsThe goals of this study were: 1) to examine if parental feeding styles during preschool (4–5 years) predict child weight status at 7–9 years, and 2) to examine the direction of effects between parental feeding styles and child weight status over time. Participants were part of a larger longitudinal study of Hispanic Head Start families living in the West South Central United States. Data from mother/child dyads were collected at three time points: Time 1 (ages 4–5), Time 2 (ages 5 ½-6 ½), and at Time 3 (ages 7–9). Only data from the Times 1 and 3 were used in the current analyses. A total of 128 mothers and their children had data on all variables needed for the analyses. Assessments included parent-reported feeding styles, feeding practices, acculturation, child eating behaviors, and child height and weight. Hierarchical regression was used to examine the first aim; a cross-lagged panel analysis examined the second aim.ResultsAn indulgent parental feeding style at ages 4–5 was associated with increased child BMI z-score at ages 7–9. Indulgent feeding significantly contributed to child BMI z-score beyond demographics, baseline child BMI z-score, parental acculturation, and child eating behaviors. Regarding the direction of effects in parental feeding interactions, the cross-lagged analyses showed that both indulgent feeding style and authoritative feeding style at Time 1 positively predicted child BMI z-scores at Time 3. Child effects were significant as well. Child BMI z-score at Time 1 positively predicted indulgent feeding and negatively predicted authoritarian feeding at Time 3.ConclusionsIndulgent feeding should be addressed in future family-focused childhood obesity initiatives focused on young children and their parents.

Parental feeding practices and child weight status in Bahraini families

Background: Home environment shapes the eating behavior of children thus their weight status. Parental feeding practices (restriction, pressure to eat, and monitoring) are behaviors taken by parents to manage a child’s dietary intake. Objectives: Raising awareness on the role of parental feeding practices in childhood obesity to allow for early parental intervention. Materials and Methods: In this cross-sectional study, a sample size of 332 children (6–11 years old) was chosen conveniently form eight health centers in Bahrain in August–September 2018. A translated Arabic version of the Child Feeding Questionnaire (CFQ) was filled by parents. Anthropometric measurements of children were conducted. Descriptive statistics were used to describe mean item scores of the CFQ. Correlation tests determined relationships between parental feeding practices and body mass index (BMI)-for-age Z-scores. Chi-square statistics and independent sample t-tests compared parental perception of child weight and feeding practices. Results: The prevalence of obesity among Bahraini children aged 6–11 years was estimated to be 16.87% and overweight was 14.46%. Obesity was more prevalent among males, while overweight in females. The predominant feeding practice was monitoring followed by restriction. Child BMI was negatively correlated with pressure to eat and positively correlated with restriction in males. No significant correlation was found with monitoring. About 56.0% of parents were found to misperceive their child weight status, 50.9% underestimated the weight status. Conclusion: Childhood obesity has reached alarming levels, which may persist due to the parental misperception of child weight status. Avoiding restrictive feeding could limit this problem.

Associations Between Food Insecurity and Parental Feeding Behaviors of Toddlers.

We examined associations between household food insecurity status and parental feeding behavior, weight perception, and child weight status in a diverse sample of young children. Cross-sectional analysis of 2-year-old children in Greenlight, a cluster randomized trial to prevent childhood obesity. The exposure was food insecurity, defined as a positive response to a validated screen. Outcomes were parent feeding behaviors/beliefs measured by the Child Feeding Questionnaire and child weight status. t tests and linear regression were used to assess associations between food insecurity and each outcome. We adjusted for child sex, race/ethnicity, parent education, employment, site, number of children in the home, and Special Supplemental Nutrition Program for Women, Infants, and Children status. Five hundred three households (37%) were food insecure. After adjusting for covariates, parents from insecure households reported more pressuring feeding behaviors (mean factor score 3.2 compared to food secure parents mean factor score 2.9, P=.01) and were more worried about their child becoming overweight (mean factor score 2.3 vs 2.0; P=.02). No differences were observed in monitoring or restrictive feeding behaviors. After adjusting for covariates, there was no difference in weight status or prevalence of overweight/obesity of children or parents based on household food insecurity status. Parents from food insecure households reported more pressuring feeding behaviors. This finding underscores the need to address food insecurity and potentially prevent harmful effects on child feeding. Parents in food insecure households might benefit from linkage with resources and education to develop healthier feeding behaviors.

Parent’s Health Behaviors Predict Weight Status of the Child

Abstract Objectives The objective of this study was to determine whether and how a parent's own weight and their lifestyle choices impact the weight of their children. Methods Data were collected for 383 participants, 244 children (48.77% male, mean age 11.87 years) and one or both parents (24.82% male, mean age 41.38 years) via anthropometric measures and a questionnaire. Participants described factors related to their lifestyle and household environment including smoking status, sedentary behavior, and sleep duration. BMI-for-Age percentile (BfaP) was calculated for all children. These data were used to explore how parental and environmental factors relate to a child's weight status via correlation and regression analyses. Results Parents who were overweight or obese were more likely to have children with higher weight status; the relationship between a mother and child's weight status remains similar throughout adolescence (r = 0.26, P &amp;lt; 0.001), but a father's weight status is more reflective of the weight status of older children (r = 0.46, P = 0.015) rather than younger (r = 0.25, P = 0.10). Children were more likely to be overweight or obese if they lived in smoking households (non-smoking mean BfAP 57.29 (SE 2.6) vs. smoking BfAP 67.1 (SE4.9)). Fathers (r = 0.09, P = 0.5) and mothers (r = 0.06, P = 0.4) who spent more time on sedentary activities had children with higher BfAP. Children with parents who ate fast food more often were more likely to carry excess weight (r = 0.15, P = 0.03 for mothers, r = 0.10, P = 0.4 for fathers). Children with fathers who slept fewer than eight hours per day were more likely to be overweight or obese (r = −0.21, P = 0.05); a mother who engaged in very little or in large amounts of sleep was more likely to have offspring who were overweight or obese (P = 0.01). Conclusions Within this cohort, parental weight status predicts a child's weight status. Parents making healthier lifestyle choices for themselves will likely impact their child's weight in a desirable manner, providing guidance for future child obesity prevention and intervention programs. Funding Sources Funding for this research was provided by NIDDK.

Patterns and correlates of objectively measured physical activity in 3-year-old children

BackgroundTo increase the knowledge about physical activity (PA) patterns and correlates among children under the age of 4, there is a need for study’s using objective measurements. The aim of this study was therefore to investigate if objectively measured PA among 3-year-old children differed between day of week and time of day and whether it correlated to child weight status and sex as well as parental weight status and education.MethodsTotally 61 children (51% girls) aged 3, participating in Early Stockholm Obesity Prevention Project were included. PA was measured with a tri-axial accelerometer (ActiGraph GT3X+) worn on the non-dominant wrist for one week. The main outcome was average PA expressed as counts per minute from the vector magnitude. PA and demographics/family-related factors were collected at baseline and at age 3. To analyze the results simple linear regression, ANOVA and paired t-tests were performed.ResultsThe mean number of valid days was 6.7 per child. The children were more active on weekdays than weekends (p < 0.01) and the hourly pattern differed over the day with children being most active midmorning and midafternoon (p = 0.0001). Children to parents with low education were more active (p = 0.01) than those with highly educated parents. No differences in PA by child weight status, sex nor parental weight status were found.ConclusionsPA in 3-year-old children was lower during weekends than weekdays and varied over the day. Boys and girls had similar PA patterns, these patterns were independent of child or parental weight status. Children to parents with low education were more active than their counterparts. The fact that PA differed between weekdays and weekends indicates that PA might be affectable in 3-year-old children.

Parental Weight Status and Offspring Behavioral Problems and Psychiatric Symptoms

To assess relations of prepregnancy maternal and paternal obesity with offspring behavioral problems and psychiatric symptoms at 7-8years in the Upstate KIDS study, a prospective cohort study. Maternal body mass index (BMI) was calculated from prepregnancy height and weight provided in vital records or self-report at 4months postpartum. Mothers reported paternal height and weight. At 7-8years, mothers indicated if their children had been diagnosed with ADHD or anxiety (n=1915). Additionally, children's behavior was measured with the Strengths and Difficulties Questionnaire at 7years of age (n=1386) and the Vanderbilt ADHD Diagnostic Parent Rating Scale at 8years of age (n=1484). Based on Strengths and Difficulties Questionnaire scores, we identified children with borderline behavioral problems. Adjusted risk ratios (aRR) and 95% CIs were estimated with robust multivariable Poisson regression. Compared with children of mothers with a BMI of <25, children whose mothers had BMI 25-30, 30-35, and ≥35kg/m2 had higher risks of reported ADHD (aRR, 1.14, 95% CI, 0.78-1.69; aRR, 1.96, 95% CI, 1.29-2.98; and aRR, 1.82, 95% CI,1.21-2.74, respectively). Risks of hyperactivity problems identified by the Strengths and Difficulties Questionnaire and a positive screen for inattentive or hyperactive/impulsive behavior with the Vanderbilt ADHD Diagnostic Parent Rating Scale were also higher with increasing maternal prepregnancy BMI. Paternal BMI was not associated with child outcomes. Our findings suggest that maternal, rather than paternal, obesity is associated with maternal report of child ADHD diagnosis and inattentive or hyperactivity problems. Further research is needed to understand how maternal obesity might influence these behavioral changes during or after pregnancy.

Fast food intake and excess weight gain over a 1-year period among preschool-age children.

Fast food is cross-sectionally associated with having overweight and obesity in young children. To examine whether fast food intake independently contributes to the development of overweight and obesity among preschool-age children. Prospective cohort of 3- to 5-year-old children (n = 541) followed for 1 year. Children's height and weight were objectively measured at baseline and study end. Parents reported their child's fast food intake frequency in the past week from 11 chain fast food restaurants in six online follow-up surveys, completed approximately 8 weeks apart. Poisson regression with robust standard errors modelled the risk of a child increasing in weight status (ie, transitioning from a having a healthy weight to having overweight or from having overweight to having obesity) over the study period in relation to their average weekly fast food intake, adjusted for sociodemographics, child obesogenic behaviours, and parent weight status. At baseline, 18.1% of children had overweight and 9.8% had obesity; 8.1% of children transitioned to a greater weight status over the 1-year period. Mean fast food intake frequency among consumers was 2.1 (SD: 1.4) times per week. The risk of increasing in weight status increased linearly with each additional time fast food was consumed in an average week over the study year (RR: 1.38; 95% CI, 1.13-1.67; P < .01). Greater fast food intake over 1 year was associated with increasing weight status during that time in this preschool-age cohort.

Family and Lifestyle Factors Mediate the Relationship between Socioeconomic Status and Fat Mass in Children and Adolescents

Socioeconomic status (SES) is strongly associated with childhood overweight. The underlying mechanism and the role of family and lifestyle factors as potential mediators of this relationship remain, however, unclear. Cross-sectional data of 4,772 girls and boys aged 5–16 years from the Kiel Obesity Prevention Study were considered in mediation analyses. Fat mass (FM) was assessed by bioelectrical impedance analysis and converted into a percent FM SD score (FM%-SDS). SES was defined by the parental educational level, classified as low, middle, or high. Characteristics of family and lifestyle factors were obtained via validated questionnaires and considered as mediators. In 3 different age groups, the product-of-coefficients method was used to examine age-specific mediator effects on the relationship between SES and FM%-SDS (c = total effects) and their ratio to total effects, adjusted for age, sex, puberty, and nationality. The prevalence of overweight was 6.9%. In all age groups, SES was inversely associated with FM%-SDS as follows: 5–7 years, c₁ = –0.11 (95% CI –0.19 to –0.03); 9–11 years, c₂ = –0.21 (95% CI –0.27 to –0.14); and 13–16 years, c₃ = –0.23 (95% CI –0.28 to –0.17). The relationship between SES and FM%-SDS was fully (5–7 and 9–11 years) and partly (13–16 years) mediated by similar and age-specific mediators, including parental BMI, parental smoking habits, media consumption, physical activity, and shared meals. Overall, these variables resulted in a total mediating effect of 77.8% (5–7 years), 82.4% (9–11 years), and 70.6% (13–16 years). Consistent for both sexes, the relationship between SES and FM%-SDS was therefore mediated by parental weight status, risk-related behavior within families, and children’s and adolescents’ lifestyle factors. Strategies for obesity prevention, which are predominantly targeted at socially disadvantaged groups, should therefore address the family environment and lifestyle factors.

Breakfast consumption and obesity among preadolescents: An epidemiological study.

This study aimed to examine the association between breakfast consumption and childhood weight status, in relation to various socioeconomic and lifestyle factors. A cross-sectional survey was conducted including 1,728 children aged 10-12years and their parents, during the school years 2014-2016. Primary schools from five Greek counties (including the Athens metropolitan area) were randomly selected. Parental and child data were collected through self-administered, anonymous questionnaires. Children's weight status was based on gender- and age-specific tables derived from the International Obesity Task Force body mass index cutoffs. Logistic regression was used to determine the association between frequency and type of breakfast consumption and children's weight status. The frequency of breakfast consumption was not associated with childhood overweight or obesity, even when other factors were included in the analysis like sex, age, physical activity, meals / day, family annual income, parental weight status, parental physical activity level, parental educational level and parental employment status. From the nine foods that were included only the consumption of bread or rusks and chocolate milk were found to have a negative association with childhood overweight or obesity (odds ratio: 0.51; 95% CI: 0.34, 0.79 and OR: 0.50; 95% CI: 0.28, 0.87, respectively). The result that frequency of breakfast consumption was not associated with children's overweight / obesity may lead to a deeper investigation of the foods consumed during breakfast. Bread or rusks and chocolate milk seemed to have a protective effect; further nutritional analysis is needed to explore the potential mechanisms of this observation.

Weight status, eating and sedentary behaviours in Maltese pre-school children living in a high-risk poverty area

AbstractIntroductionEarly eating behavioural traits could contribute to development of weight problems later in life. Evidence suggests children living in higher-poverty areas are at higher risk of overweight and obesity. The main objective was to investigate possible associations between weight status, eating and sedentary behaviours in pre-school children living in an area of high-poverty risk.Materials and MethodsThe children (3–4 years) and their parents living in a school district which is classified as being at a high risk of poverty were invited to participate for the study. Following consent, they were interviewed by telephone using The Child Eating Behaviours Questionnaire (CEBQ) in 2018. The CEBQ utilises a five-point Likert scale with scores computed for different eating behaviours. Anthropometric measures on the children were carried out in the schools.ResultsResponse rate was 63.3% (n = 71), with 54.8% of parents possessing a secondary school education There was no significant association between parental education level and weight status using World Health Organisation (WHO), International Obesity Task Force (IOTF) and Center for Disease Control (CDC) criteria (p = 0.227, 0.373, 0,213 respectively). No significant relationship was found between children's weight status and gender (WHO; p = 0.800 &amp; CDC; p = 0.655; IOTF; p = 0.804). 71.8 % of the children exceeded the 1-hour screen time daily recommended guidelines (National Institute for Health and Care Excellence, 2015) during weekdays while 47.9% exceeded the recommendations during weekends. Main sedentary behaviours were the use of smartphones/tablets (mean 72 min/day; 64 min/day; weekend, weekdays respectively) with a significant association found across this behaviour and all weight standard criteria (p = 0.013, 0.016 and 0.015 for WHO, CDC and IOTF respectively).Food enjoyment varied significantly according to weight status (WHO: p = 0.001; CDC; 0.010; IOTF: p = 0.028). Lowest food fussiness scores were observed in normal weight children using WHO and CDC weight standard criteria and in the underweight category when using IOTF criteria and was significant across all weight criteria (p = WHO; 0.013/ CDC; 0.047/ IOTF; 0.024). Children with mean high food avoidance scores scored in a higher weight category (WHO: p = 0.003; IOTF: p = 0.013).DiscussionIn this small study, some eating behaviours were found to be linked to weight status suggesting further work required. Public health initiatives to reduce sedentary behaviours should also be targeted at younger age children. Larger studies comparing children in different socio economic regions and targeting the family and obesogenic environment are recommended for targeted early intervention.

Unfavourable sleep characteristics and adiposity in children: does parental weight status make a difference?

Unfavourable sleep characteristics and adiposity in children: does parental weight status make a difference?