Preschool Obesity Research Articles

Socio-demographic and economic determinants of overweight and obesity in preschool children in Palestine: analysis of data from the Palestinian Multiple Indicator Cluster Survey

BackgroundObesity is a global public health issue and worldwide rates of childhood obesity are ten times higher than 40 years ago. A limited number of studies have been conducted to determine the prevalence of preschool obesity and overweight and associated factors in Palestinian children. The aim of this study was to examine sociodemographic and economic factors associated with preschool overweight and obesity in Palestinian children younger than 5 years of age. MethodsWe used data from the fifth Palestinian Multiple Indicator Cluster Survey (MICS5), a cross-sectional survey of a representative sample of Palestinian households in 2014. The analysis was based on 6853 children (after excluding children whose z-score was out of range or not measured) below 5 years of age (46% [3152 out of 6853] in the Gaza Strip and 54% [3701 out of 6853] in the West Bank), drawn from 7816 completed surveys of a multi-stage cluster sample (99% response rate). The z-scores for BMI-for-age of children were used to evaluate weight status. Underweight, overweight, and obesity were defined as the proportion of preschool children with z-score values of 2 SDs or less, greater than 2 SDs, and greater than 3 SDs, respectively, from the WHO Child Growth Standards. Covariates included gender, age, area and region, number of children per household, mother's level of education, marital status of the mother, mother's age at birth, and wealth quantile (which we used as a composite indicator of wealth, with the first quintile representing the poorest households, and the fifth quintile representing the wealthiest households). We used multiple logistic regression analysis to estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). FindingsThe overall prevalence of overweight and obesity in Palestinian children (birth to 5 years) was 8·8% (95% CI 8·1–9·4); 7·3% were overweight and 1·5% were obese. The prevalence of underweight was 1·4%. The odds of overweight and obesity were lower among children in the Gaza Strip than in the West Bank (AOR=0·74; 95% CI 0·61–0·90). Girls were less likely to be obese and overweight than boys (AOR=0·75; 95% CI 0·63–0·89). Children under 4 years of age had a higher risk of being obese and overweight than children aged 4–5 years. Children who lived in the wealthiest households (fifth quintile) were more likely to be overweight and obese than children in the poorest (first) quintile (AOR=1·36; 95% CI 1·09–1·71). InterpretationThe prevalence of obesity and overweight among preschool children in Palestine (8·8%) is higher than the global prevalence (6·7%; derived using the same standardised method as in this study, and using the WHO Child Growth Standards to assess the nutritional status of children). Obesity and overweight were more likely to affect children from wealthier households, children from the West Bank, boys, and younger children. Excessive weight gain in early childhood is a strong predictor of adulthood obesity. Routine assessment of all children needs to become standard clinical practice from very early childhood. Effective management and preventive interventions are needed to tackle the increasing obesity problem in preschool children. FundingNone.

Adapting the ToyBox obesity prevention intervention for use in Scottish preschools: protocol for a feasibility cluster randomised controlled trial

IntroductionThere is an increasing need for the adoption of effective preschool obesity prevention interventions to combat the high levels of early-childhood obesity in the UK. This study will examine the...

Formative Evaluation of the Impact of a Preschool Obesity Prevention (I-POP!) Curriculum: Focus Group Findings

Formative Evaluation of the Impact of a Preschool Obesity Prevention (I-POP!) Curriculum: Focus Group Findings

NP5 - School Readiness, Obesity, and Inflammation-Related Biomarkers in Low-Income Preschoolers Within the Healthy Kids Study

NP5 - School Readiness, Obesity, and Inflammation-Related Biomarkers in Low-Income Preschoolers Within the Healthy Kids Study

Level of Overweight, Obesity and Associated Factors Among Preschool Children in Dire Dawa City, Eastern Ethiopia, 2016

Background : Obesity is accumulation of excess fat that have negative consequences on health. In 21 st century overweight and obesity of children is becoming burning issue. About 42 million under five children are overweight and obese in 2013. Close to 31 million of these are living in developing countries. The objective of this study was to assess the level of overweight and obesity and associated factors among preschool children aged 3-5years in Dire Dawa city, Ethiopia, 2016. Methodology: A community based cross sectional study design was used from March 1-15 2016. Simple random sampling followed by systematic random sampling technique was used to select study participants. A pretested structured questionnaire was used to collect data from total samples of 627 preschool age children with their respective mothers or caretakers. Weight and height were measured using standardized and calibrated equipment. Finally Binary logistic regression analysis was done to identify factors associated with overweight and obesity. Level of statistical significance was declared at p- value less than 0.05. Results : The magnitude of overweight and obesity in the study area were 11.4% and 5.5% respectively. Female sex (AOR = 2.67, 95% CI: 1.13 - 6.32), Mother BMI (AOR = 16.5, 95% CI: 6.80 - 40.29, p value < 0.001) and Father Education (AOR =7.179, 95% CI: 1.06-48.6, p value <0.05) were among factors associated with preschool children overweight and obesity. Conclusion and Recommendation : The combined prevalence of overweight and obesity seen in this city is 16.9%. So as Government of Ethiopia continues in its fight towards reducing under nutrition, it should also expand or modify these efforts to include ways that may help prevent and reduce prevalence of overweight within the community. Keywords: Overweight, Obesity, preschool children, Dire Dawa, Ethiopia. DOI : 10.7176/JMPB/52-06

Overweight and Obesity in Early Childhood A Systematic Review of Individual, Family, and Peer Risk Factors

Purpose: The prevalence of children who are overweight or obese has been increasing worldwide. While a variety of biological as well as sociodemographic correlates have been identified and reviewed, a systematic review of psychosocial factors, particularly among preschool aged children, is lacking. This systematic review synthesizes the research on individual, family and peer risk factors for overweight and obesity in preschool aged children. Method: A systematic review of the recent literature on psychosocial factors and overweight or rather obesity in the early stages of childhood was conducted. Results: A total of 27 studies from 2011-2016 were identified that examined individual, family and social risk factors for obesity in children. Results indicate the importance of eating regulation as well as family factors in understanding early childhood risk for obesity. There was mixed support for associations between behavioral and emotional symptoms and obesity among this age group. For other risk factors examined, too few studies exist to be able to make strong conclusions about their relevance for understanding preschool obesity risk. Conclusions: Psychosocial factors are associated with overweight and obesity among preschool aged children. However, this review also highlights the dearth of research on several potentially important risk factors for childhood obesity in this age group (such as family violence, parental and peer relationships). Longitudinal studies, which examine multiple risk factors simultaneously over this important developmental period, are sorely needed.

Early excessive growth with distinct seasonality in preschool obesity

ObjectivesHealthy-weight children tend to gain weight during winter but lose weight during summer. However, overweight elementary school children have shown accelerated summertime weight gain. Whether this seasonal growth variation occurs...

Habit formation intervention to prevent obesity in low-income preschoolers and their mothers: A randomized controlled trial protocol

BackgroundLow-income and racial/ethnic minority mothers and their young children are at increased risk for obesity. Lack of access to evidence-based obesity prevention and treatment services further contributes to these disparities. MethodsThis two-arm, parallel, randomized controlled trial (RCT) tests the effectiveness of a simple obesity intervention (HABITS) delivered as part of ongoing home visitation services, compared to the existing home visitation services without obesity-related content on mothers' and children's obesity risks. HABITS focuses on habit formation and modifications of food and activity cues in the home to support habit formation. Habit formation is focused on improving five behaviors: 1) fruits/vegetables, 2) fried foods, 3) sugar-sweetened beverages, 4) physical activity and 5) self-monitoring. Participants will be 298 mothers (>50% African American; 100% low income) and their children (3-5yo at baseline) enrolled in a home visitation program in central Alabama. Home visitors will be randomly assigned to deliver the home visitation curriculum with or without HABITS as part of their weekly home visits for 9 months. Assessments of mothers (weight, waist circumference, and habit strength of targeted behaviors), children (rate of weight gain), and the food/activity household environment will be conducted at enrollment, post-intervention (9 month), and one year post-intervention follow-up. DiscussionThis research is poised to have a substantial impact because the delivery modalities of current obesity efforts disproportionally restrict the reach and engagement of underserved, low-income children and their caregivers who are most at-risk for health and obesity disparities.

Secondary impact of a behavioral intervention on dietary quality in preschoolers with obesity

ABSTRACTDietary habits and obesity are established in early childhood. This secondary data analysis examined changes in dietary quality among treatment-seeking preschoolers with obesity(n=13). 24-hour dietary recall data collected at baseline, post-treatment(6 months), and 6-months post-treatment follow-up(12 months) were analyzed using the Healthy Eating Index(HEI)-2010. Repeated-measures analyses of variance revealed significant improvements in overall dietary quality and reductions in empty calories from baseline to 12 months. Change in overall dietary quality was not associated with change in BMI z-score at either time point. Identifying effective strategies to increase nutrient-dense food groups(e.g., vegetables) is important for maximizing the health impact of preschool obesity interventions.

Facebook: The Use of Social Media to Engage Parents in a Preschool Obesity Prevention Curriculum

ObjectiveThis study investigated the use of Facebook to deliver health-related education materials to augment a preschool classroom-based obesity prevention curriculum. DesignCross-sectional, mixed methods (descriptive and interviews). SettingHead Start classrooms administered by 2 large agencies (1 rural and 1 urban). ParticipantsConvenience sample of parents in 13 classrooms (cohort 1, 3 classrooms; cohort 2, 10 classrooms). InterventionDelivery of nutrition education curriculum content using social media (Facebook). Variables MeasuredQualitative interviews assessed barriers and facilitators to Facebook use. Parent views, likes, and comments were measured to reflect parent engagement with Facebook. AnalysisContent analyses (qualitative data) and descriptive statistics (quantitative data). ResultsFamily access (views) and interaction (comments and likes) with the posts varied based on type and content of posts. Rural families were more active. Barriers to parental Facebook engagement included a desire to see more posts from classroom teachers, lack of time, and misunderstanding about privacy protections. Facilitators of parental Facebook engagement included perceived utility of the content and social support. Conclusions and ImplicationsFacebook was found to be a feasible platform to provide nutrition education and facilitated varying levels of parental engagement. Lessons learned and implications for prevention and intervention programming are offered.

Clinic and Home-Based Behavioral Intervention for Obesity in Preschoolers: A Randomized Trial

To test the hypotheses that an innovative skills-based behavioral family clinic and home-based intervention (LAUNCH) would reduce body mass index z score (BMIz) compared with motivational interviewing and to standard care in preschool-aged children with obesity. Randomized controlled trial with children between the ages of 2 and 5 years above the 95th percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012 and June 8, 2015. Children were randomized to LAUNCH (an 18-session clinic and home-based behavioral intervention), motivational interviewing (delivered at the same frequency as LAUNCH), or standard care (no formal intervention). Weight and height were measured by assessors blinded to participant assignment. The primary outcome, BMIz at month 6 after adjusting for baseline BMIz, was tested separately comparing LAUNCH with motivational interviewing and LAUNCH with standard care using regression-based analysis of covariance models. A total of 151 of the 167 children randomized met intent-to-treat criteria and 92% completed the study. Children were 76% White and 57% female, with an average age of 55 months and BMI percentile of 98.57, with no demographic differences between the groups. LAUNCH participants demonstrated a significantly greater decrease in BMIz (mean = -0.32, SD = ±0.33) compared with motivational interviewing (mean = -0.05, SD = ±0.27), P < .001, ω2 = 0.74 and compared with standard care (mean = -0.13, SD = ±0.31), P < .004, ω2 = 0.75. In preschool-age children, an intensive 6-month behavioral skills-based intervention is necessary to reduce obesity. Clinicaltrials.gov NCT01546727.

Predictors of obesity and overweight in preschoolers: The role of parenting styles and feeding practices

Childhood obesity/overweight (OB/OW) displayed a rapid increase and high prevalence in the last few decades in preschool-aged children, which raised health concerns across the world and motivated researchers to investigate the factors that underlie childhood obesity. The current study examined parenting styles and child-feeding practices as potential predictors for OB/OW in preschool children, controlling for child's temperament, which has been shown to be linked with OB/OW. The sample included 61 normal weight (NW) and 61 obese/overweight (OB/OW) Turkish pre-schoolers (M age = 62.2 months; SD = 7.64, range = 45–80 months). Parenting styles (authoritarian, authoritative), child-feeding practices (restriction, pressure to eat, monitoring), and child's temperament (negative affectivity) were measured with mothers' reports. Results showed that authoritarian parenting and maternal pressure to eat were the two parenting variables that significantly predicted child's weight status; the odds of being OB/OW was 4.71 times higher in children whose mothers used higher authoritarian parenting style, and was 0.44 times lower when mothers pressured their child to eat. These findings suggest that understanding the unique role of different aspects of parenting in the risk of early OB/OW status of children would be important in developing more effective interventions from early years in life.

Temperament Is Associated With Outdoor Free Play in Young Children: A TARGet Kids! Study

ObjectiveOutdoor free play is important for preschoolers' physical activity, health, and development. Certain temperamental characteristics are associated with obesity, nutrition, and sedentary behaviors in preschoolers, but the relationship between temperament and outdoor play has not been examined. This study examined whether there is an association between temperament and outdoor play in young children. MethodsHealthy children aged 1 to 5 years recruited to The Applied Research Group for Kids (TARGet Kids!), a community-based primary care research network, from July 2008 to September 2013 were included. Parent-reported child temperament was assessed using the Childhood Behavior Questionnaire. Outdoor free play and other potential confounding variables were assessed through validated questionnaires. Multivariable linear regression was used to determine the association between temperament and outdoor play, adjusted for potential confounders. ResultsThere were 3393 children with data on outdoor play. The association between negative affectivity and outdoor play was moderated by sex; in boys, for every 1-point increase in negative affectivity score, mean outdoor play decreased by 4.7 minutes per day. There was no significant association in girls. Surgency was associated with outdoor play; for every 1-point increase in surgency/extraversion, outdoor play increased by 4.6 minutes per day. ConclusionsYoung children's temperamental characteristics were associated with their participation in outdoor free play. Consideration of temperament could enhance interventions and strategies to increase outdoor play in young children. Longitudinal studies are needed to elucidate the relationship between children's early temperament and physical activity.

Improving Self-Regulation for Obesity Prevention in Head Start: A Randomized Controlled Trial.

To determine the effect of an intervention to improve emotional and behavioral self-regulation in combination with an obesity-prevention program on the prevalence of obesity and obesity-related behaviors in preschoolers. This was a cluster-randomized intervention trial in Head Start (HS) classrooms conducted in each of 4 academic years from 2011 to 2015. Participants (697 children; 49% boys; mean age: 4.1 ± 0.5 years; 48% white, 30% African American, 12% Hispanic) were randomly assigned by classroom to 1 of 3 intervention arms: (1) HS + Preschool Obesity Prevention Series (POPS) + Incredible Years Series (IYS) (HS enhanced by the POPS [program targeting evidence-based obesity-prevention behaviors] and the IYS [program to improve children's self-regulation]), (2) HS+POPS, or (3) HS. Primary outcomes were changes in prevalence of obesity, overweight/obesity, BMI z score, and teacher-reported child emotional and behavioral self-regulation; secondary outcomes were dietary intake, outdoor play, screen time, and parent nutrition knowledge and nutrition self-efficacy. HS+POPS+IYS improved teacher-reported self-regulation compared with HS+POPS (P < .001) and HS (P < .001), but there was no effect on the prevalence of obesity (16.4% preintervention to 14.3% postintervention in HS+POPS+IYS versus 17.3% to 14.4% in HS+POPS [P = .54] versus 12.2% to 13.0% in HS [P = .33]). There was no effect of HS+POPS compared with HS alone (P = .16). There was no effect on other outcomes except for sugar-sweetened beverage intake (HS+POPS+IYS resulted in a greater decline than HS; P = .005). An intervention for parents and children to improve HS preschoolers' emotional and behavioral self-regulation in combination with an obesity-prevention curriculum did not reduce obesity prevalence or most obesity-related behaviors.

The Promise of Early Childhood Self-Regulation for Obesity Prevention.

* Abbreviations: IYS — : Incredible Years intervention POPS — : Preschool Obesity Prevention Series We live in an obesity-promoting environment, with ubiquitous highly palatable, energy-dense foods and easy access to reinforcing sedentary activities. To navigate through the environment unscathed by these dual threats, children need adult supervision and guidance and an ability to control temptations. The latter can be a challenge for young children, who have fully developed brain reward systems combined with still-emerging executive functions that facilitate resisting immediate temptations and focusing on longer-term goals. There is a burgeoning literature on how poor self-control in young children predicts excess growth and overweight/obesity in later childhood and into adulthood,1–3 with causal pathways supported by obesity treatment studies with older children4 and the demonstration of self-regulation–related interventions’ collateral benefits on weight.5,6 Early childhood is a sensitive period for the development of self-regulation,7 highlighting an opportunity for obesity prevention research. To date, the literature had not addressed the potential of enhancing self-regulation skills in young children with the specific goal of preventing excess weight gain. Thus, the study by Lumeng et al,8 in this issue of Pediatrics , implemented in Head Start centers … Address correspondence to Leonard H. Epstein, PhD, SUNY Distinguished Professor of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Farber Hall, G-56, 3435 Main St, Buffalo, NY 14214. E-mail: lhenet{at}buffalo.edu

Overweight and obesity in preschoolers: Prevalence and relation to food consumption.

To determine overweight and obesity prevalence in preschool children from public education, and to determine their relation to food consumption. Cross-sectional study with children aged between 2 and 5 years, of both sexes, enrolled at municipal day care centers. Socioeconomic, demographic and anthropometric data were collected, in order to calculate the body mass index (BMI) for age. Data on food consumption were assessed using a Food Frequency Questionnaire. χ2 test, Kruskal-Wallis test, Student's t-test and Pearson's correlation were used at a significance level of 5%. Of 548 children, 52% were male, with mean age of 4.2 years old. Most families had incomes between 1 and 2 minimum wages (59.7%), in addition to 10 years (mothers) of education. Anthropometric parameters did not differ significantly between sexes. According to the BMI-for-age, it was found that most of children were well-nourished (85.2%), 8.2% had the risk of becoming overweight, and 4.2% were overweight. The most consumed foods were: rice (100%), beans (99.4%), bread (98.5%), fruit (98.5%), red meat (97.1%), butter and margarine (95.4%), biscuits, cakes and sweet pies (94.1%), dairy products (94.1%), chocolate milk (91.7%), and soft drinks (90.2%). Consumed foods that were strongly correlated (r > 0.7) to the risk of/excess weight were, as follows: bread; biscuits, cakes, sweet pies; dairy products; chocolate milk; sausages. There was low prevalence of overweight and absence of obesity among the population assessed. The risk of overweight was greater among girls. Data from the study showed deviations in food consumption.

Factors Affecting Obesity and Overweight in Korean Preschool Children: Based on the Korea National Health and Nutrition Examination Survey 2013-2014

Purpose: The aim of the study was to assess the prevalence of preschooler obesity/overweight and to identify associated factors. Methods: This study was a cross-sectional study. Data for 591 preschoolers, 432 fathers and 538 mothers from the Korea National Health and Nutrition Examination Survey 2013-2014 were included. Obesity/overweight was defined by 2007 Korean National Growth Charts. T-test, Rao-Scott χ²2, multivariate logistic regression was used for the analysis. Results: Prevalence rates for preschooler obesity/overweight were 14.9% (obesity, 5.4%; overweight, 9.5%). The preschoolers with atopic dermatitis or allergic rhinitis or asthma (OR=2.78, 95% CI [1.27-6.09], p=.011) and eating more thiamine per day (OR=1.01, 95% CI [1.00-1.02], p=.001) showed higher obesity/overweight development. The only parental factor affecting preschooler obesity/overweight was parental body mass index (father, OR=1.18, 95% CI [1.09-1.28], p＜.001; mother, OR=1.09, 95% CI [1.04-1.15], p＜.001). Conclusion: Interventions on preventing preschooler obesity should be introduced much earlier for children with risk factors. Results from this study can be used as preliminary data to develop effective strategies to prevent obesity in Korean preschoolers.

Emotion regulation strategies and childhood obesity in high risk preschoolers

The current study examined the relationships between the specific strategies that preschool children use to regulate their emotions and childhood weight status to see if emotion regulation strategies would predict childhood weight status over and above measures of eating self-regulation. 185 4- to 5-year-old Latino children were recruited through Head Start centers in a large city in the southeastern U.S. Children completed both a delay of gratification task (emotion regulation) and an eating in the absence of hunger task (eating regulation). Eating regulation also was assessed by maternal reports. Four emotion regulation strategies were examined in the delay of gratification task: shut out stimuli, prevent movement, distraction, and attention to reward. Hierarchical linear regressions predicting children's weight status showed that both measures of eating regulation negatively predicted child obesity, and the use of prevent movement negatively predicted child obesity. Total wait time during the delay of gratification tasks was not a significant predictor. The current findings are consistent with studies showing that for preschool children, summary measures of emotion regulation (e.g., wait time) are not concurrently associated with child obesity. In contrast, the use of emotion regulation strategies was a significant predictor of lower child weight status. These findings help identify emotion regulation strategies that prevention programs can target for helping children regulate their emotions and decrease their obesity risk.

A feasibility study of group caregiver training for the prevention of obesity (GCT-O) in African American preschoolers.

A feasibility study of group caregiver training for the prevention of obesity (GCT-O) in African American preschoolers.

Associations of Fat Mass and Fat-Free Mass with Physical Fitness in 4-Year-Old Children: Results from the MINISTOP Trial.

Physical fitness is a powerful marker of health in youth. Studies in adolescents and adults suggest that higher fat mass is related to worse physical fitness. However, there is limited knowledge whether fat mass and fat-free mass are associated with physical fitness already in preschoolers. Baseline data from the MINISTOP (Mobile-based INtervention Intended to STop Obesity in Preschoolers) trial was utilized for this cross-sectional analysis. Body composition was assessed using air-displacement plethysmography. Fat mass index [fat mass (kg)/height2 (m)] and fat-free mass index [fat-free mass (kg)/height2 (m)] were used to provide height-adjusted measures of body composition. Physical fitness was measured using the PREFIT (FITness testing in PREschool children) battery, which assesses cardiorespiratory fitness, upper-body and lower-body muscular strength as well as motor fitness. In total, this study included 303 children (168 boys and 135 girls), who were on average 4.48 ± 0.15 years old. Higher fat mass index was associated with worse cardiorespiratory fitness (standardized β = −0.17, p = 0.002), lower-body muscular strength (β = −0.17, p = 0.003) and motor fitness (β = −0.21, p < 0.001) in regression analyses adjusted for age, sex and mutually adjusted for fat-mass index and fat-free mass index. Conversely, higher fat-free mass index was associated with better cardiorespiratory fitness (β = 0.18, p = 0.002), upper-body muscular strength (β = 0.39, p < 0.001), lower-body muscular strength (β = 0.22, p < 0.001) and motor fitness (β = 0.17, p = 0.004). Thus, fat mass and fat-free mass in preschoolers appear to have joint but opposite associations with physical fitness, an important marker for current and future health.