Impact of parental socioeconomic status on childhood and adolescent overweight and underweight in Korea

The relationships between dietary patterns and socioeconomic status with anthropometric and body composition indices in Iranian preschool children: A cross-sectional study

Background

The prevalence of overweight and obesity among Iranian children is on the rise. Dietary patterns (DPs) and socioeconomic status ( socioeconomic status (SES)) may relate to children's excess weight as a predictor of the risk of obesity in adulthood that may vary by geographical regions.

Aim

The relationship between DPs and the development of obesity in preschool children has not been adequately evaluated. The present study evaluates this relationship by considering SES.

Methods

A total of 320 preschool children (4-6 years) were randomly selected from three different areas of Mashhad based on economic status. Dietary intake was evaluated using a semi-quantitative food frequency questionnaire completed by the children's parents. Anthropometric and body composition variables were measured by means of valid tools and standard methods. socioeconomic status data were collected through a researcher-made questionnaire.

Results

Three dominant DPs of 'healthy', 'unhealthy', and 'meat-free' were identified using factor analysis. The prevalence of overweight and obesity among the children who followed meat-free DP was significantly higher than that of other children (p = 0.004). The means and standard deviations of energy intake, body mass index (BMI), waist circumference, fat-free mass, and fat mass were 1187.97 ± 356.87 Kcal/day, 16.23 ± 2.28 kg/m2, 54.28 ± 6.49 cm, 16.24 ± 2.23 kg, and 4.62 ± 2.70 kg respectively. Being in the higher levels of SES was significantly related to height (p = 0.02), energy intake (p < 0.001), BMI (p = 0.003), waist circumference (p = 004), and fat mass (p = 0.002).

Conclusions

Adherence to meat-free DP and being in the highest levels of SES may be associated with a greater chance of developing overweight and obesity. Therefore, meat consumption and SES can be used to predict childhood overweight and obesity.

Family economic trajectories and body mass index in Indonesia: Evidence from the Indonesian Family Life Surveys 2 to 5

Indonesia faces the double burdens of childhood obesity and malnutrition. A family's socioeconomic status has been suggested to be one of the most influential factors contributing to childhood nutritional problems. This study aimed to: 1) identify the distinct trajectories of family economics; and 2) assess whether a family's economic trajectory influences children's body mass index (BMI). We analyzed trajectory patterns of family economic levels from 1997 to 2015 among 846 children aged under 3 years in 1997 using data from Indonesian Family Life Surveys. Trajectory patterns were identified with Group-Based Trajectory Modeling using the traj plug-in in STATA software. The BMI was classified according to 2007 World Health Organization growth standards. Adjusted relative risk ratios (aRRRs) of family economic level trajectories and children's BMI were calculated using multinomial logistic regressions. We identified three distinct trajectories of family economic level: stable poorest, stable middle, and increasing richest. In the total sample, there were no significant relationships between a family's income trajectory and children's BMI in the adjusted models. A significant relationship existed for male children, but not for female children, of compared to the poorest family trajectory group, male children in the increasing richest trajectory group were more likely to be overweight/obese (aRRR 6.1, 95% confidence interval: 1.22-30.62) after adjusting for age and BMI. The present results highlight the importance of early interventions to minimize the potential adverse impacts of excessive BMI later in adulthood.

Prevalence and factors associated with underweight among 15-49-year-old women in Sierra Leone: a secondary data analysis of Sierra Leone demographic health survey of 2019

BACKGROUND

Women are at higher risks of being underweight than men due to biological, socio-economic, and cultural factors. Underweight women have high risks of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with being underweight among women of reproductive age (15-49 years) in Sierra Leone.

METHODS

We used Sierra Leone Demographic and Health Survey (2019-SLDHS) data of 7,514 women aged 15 to 49 years, excluding pregnant, post-natal, lactating, and post-menopausal women. A multistage stratified sampling approach was used to select study participants, and data was collected using validated questionnaires. A multivariable logistic regression analysis was used to determine factors associated with underweight among 15-49-year-old women in Sierra Leone. Ethical approval for the study was obtained.

RESULTS

The prevalence of underweight was 6.7% (502/7,514). Underweight was likely among age-group of 15-24 years, AOR = 2.50,95%CI:2.39-2.60;p < 0.001 compared to 25-34 year age-group and likely among women with parity of one to four, AOR = 1.48,95%CI:1.08-2.03;p = 0.015 compared to women who never gave birth. Underweight was unlikely among women who did not listen to radios AOR = 0.67,95%CI:0.55-0.83;p < 0.001 compared to those who did; women from the north AOR = 0.73,95%CI:0.56-0.96;p = 0.026 compared to the east, and not married women AOR = 0.59,95%CI:0.47-0.76;p < 0.001 compared to married. All household wealth indices were not significantly associated with underweight.

CONCLUSION

The prevalence of underweight among women in the reproductive age (15-49 years) in Sierra Leone was 6.7% and it is lower compared to global and most sub-Saharan African data. Factors associated with underweight were 15-24-year age-group, and parity of one to four. Being underweight was unlikely among women who did not listen to radios, women from the north and not married. All household wealth indices were not significantly associated with underweight. Even though household wealth indices were not significantly associated with being underweight, most underweight women 68.7% (345/502) were in the poorest, poorer, and middle household wealth indices. The need to address socio-economic determinants of underweight among women (aged 15-49 years) due to household poverty is a priority in Sierra Leone.

Determinants of Weight Disorders in Two- Year- Old Children in Isfahan, Iran

Background

Considering the importance of weight disorders in childhood and its impact until adulthood, this study was conducted to assess the determinants of weight disorders in 2-year-old Iranian children.

Materials and Methods

This cross-sectional study was conducted in 2020 among on 2300 children registered in Comprehensive Health Centers of Isfahan, Iran. Weight disorders, including underweight and overweight were defined according to the standardized National Center for Health Statistics (NCHS)/Centers for Disease Control (CDC) growth charts. Demographic data including gender, birth weight, maternal educational levels and occupation, duration of breastfeeding and the age of beginning complementary food were gathered.

Results

In the present study, 750 children (i.e., 32.6%) had weight disorders. Among them, 53.6% were underweight, 26.3% were overweight, and 12.9% were obese, 7.2%had severe underweight. Female gender, university education of mothers and higher levels of socio-economic status significantly increased the chance of overweight by 14.79%, 22.28%, 27.33% and 24.48%, respectively. Although with the increase in the duration of breastfeeding and the increase of family members, overweight, respectively, decreased by 0.86 and 0.93 fold, but it was not statistically significant. There was an inverse, significant relationship between the duration of breastfeeding with overweight versus underweight.

Conclusion

Underweight and overweight were the two most common weight disorders among 2-year- children, respectively. Control of modifiable risk factors for weight disorders in early life should be underscored in the primary health care system.

Association between subjective degree of influence in class and thinness among adolescents in Japan

Social status in school, measured by subjective degree of influence in class (DOI), may influence thinness among adolescents. This study examined the association between subjective degree of influence in class and thinness among Japanese adolescents. Data were obtained from the Kochi Child Health Impact of Living Difficulty (K-CHILD) study in 2016, which Was a population-based study targeting 5th, 8th and 11th grade adolescents living in Kochi Prefecture, Japan (N = 9,998). DOI was assessed by adolescents via questionnaire. Weight and height were given by caregivers for 5th grade adolescents, whilst they were self-reported for 8th and 11th grade adolescents. Collected data on weight and height were used to calculate body mass index z-scores of WHO standards. Models included grade, gender, number of friends, household income, location of school and depressive symptoms as covariates. The results showed that both high and low DOI were positively associated with thinness after adjustment for other individual covariates (high DOI, OR = 1.59, 95% CI 1.05-2.43; low DOI, OR = 2.04, 95% CI 1.36-3.06). Further stratification by gender revealed that low DOI was positively associated with thinness (OR = 2.14, 95% CI 1.34-3.44) among boys, but there was no association among girls. Both high and low DOI were associated with the risk of being thin in adolescents. Focusing on DOI for adolescents may be important to address thinness among adolescents. Further studies are needed to examine the causality between DOI and thinness in adolescents.

Reversal of the Upward Trend of Obesity in Boys, but Not in Girls, in Spain

(1) Background: To compare the prevalence of overweight and obesity in boys and girls and to estimate socioeconomic differences associated with obesity in Spain in 1997, 2007, and 2017. (2) Methods: Data were drawn from national health interview surveys. For each year of study, the prevalence of overweight and obesity was measured, and these results were compared by gender (boy/girl) and socioeconomic status (low/high education). (3) Results: The prevalence of overweight and obesity rose from 1997 to 2007 but then fell in 2017 in all subgroups except in girls aged 10 to 15 years. In this group, there was a steady increase in the prevalence of both overweight (1997, 14.6%; 2007, 17.7%; 2017, 19.6%) and obesity (1.1, 3.2, and 3.7%, respectively). The decrease in prevalence of overweight in both sexes and of obesity in boys, along with the increase in prevalence of obesity in girls, was of a higher magnitude in children whose parents had a lower educational level. (4) Conclusions: The apparent turnaround in the obesity epidemic in Spain should be interpreted with caution. Children’s body weight is influenced by both gender and socioeconomic status—considerations that should be kept in mind when designing health promotion interventions.

Prevalence of Underweight and Its Associated Factors among Reproductive Age Group Women in Ethiopia: Analysis of the 2016 Ethiopian Demographic and Health Survey Data

Background

Underweight is defined as being below the healthy weight range. Underweight in reproductive age group women not only affects women but also increases the risk of an intergenerational cycle of malnutrition and child mortality. Various factors are linked with underweight among women. However, studies on the prevalence of underweight and its associated factors among women are limited in Ethiopia. Hence, this study aimed to assess the prevalence of underweight and its associated factors among reproductive age group women in Ethiopia.

Methods

For this study, data were drawn from the 2016 Ethiopian demographic and health survey (EDHS). From the total, 15,683 women participants of the 2016 EDHS; a subsample of 2,848 participants aged 15-49 years who had a complete response to all variables of interest were selected and utilized for analysis. Data were analyzed using SPSS version 20 software program. Pearson's chi-squared test was used to assess the frequency distribution of underweight and is presented with different sociodemographic characteristics. Logistic regression models were applied for analysis. A two-sided p value of less than 0.05 was used to declare a statistically significant association between the independent variables and underweight among women.

Results

The prevalence of underweight among reproductive age group women in Ethiopia was 17.6%. The majority, 78.3% of underweight women, were rural dwellers. The odds of being underweight was higher among the young aged women, among those residing in rural areas, in those with higher educational status, and in those who have one or more children. On the other hand, the odds of underweight among respondents living in Benishangul, SNNPR, and Addis Ababa were less compared to those living in Dire Dawa. Similarly, the odds of underweight among participants with a higher level of husband or partner educational status and among those who chew Khat were less compared to their counterparts.

Conclusion

Underweight among reproductive age group women in Ethiopia is still a major public health problem, particularly among rural dwellers. Underweight was significantly associated with different sociodemographic variables. Hence, context-based awareness creation programs need to be designed on the prevention methods of underweight in Ethiopia, giving especial emphasis to those residing in rural areas.

Household socioeconomic status in relation to childhood general and central obesity in Farrokhshahr, Iran

BACKGROUND

Although the association between socioeconomic status (SES) and general/central obesity has extensively been examined, limited data are available in this regard among children. The aim of this study was to examine the association between household SES and obesity among children.

METHODS

This cross-sectional study was done in Farrokhshahr, Iran, among primary school children aged 6-12 years in 2009. SES was examined using participants' and their parents' oral responses to a pretested questionnaire. In the current study, participants were classified based on tertiles of SES score to low, medium, and high SES categories. General as well as central obesity was defined based on age- and sex-specific national cut-off points.

RESULTS

Comparing individuals in the highest versus lowest tertile of SES, there was no significant difference in mean waist circumference (WC), but those in the middle tertile of SES had greater means of body mass index (BMI) than those in the lowest tertile after controlling for potential confounders (16.19 ± 0.27 vs. 15.27 ± 0.27 kg/m2, P = 0.002). We observed a greater chance of general obesity for those in the highest tertile of SES compared with those in the lowest tertile [odds ratio (OR): 4.00, 95% confidence interval (CI): 1.53-10.59, Ptrend = 0.004]. No significant association was seen between SES and central obesity, either before or after controlling for potential confounders.

CONCLUSION

We found that children in the highest SES class had a greater chance of general obesity than those in the lowest SES class. There was no significant association between SES and central obesity.

Diet, Physical Activity, and Screen Time among School Students in Manipur

Context:

Adolescence is a critical time in the development of lifelong healthy eating and exercise habits. The high prevalence of adolescents exposed to excessive screen time is a matter of concern because of its association with several health problems, such as overweight and obesity, alterations in blood glucose and cholesterol, poor school performance, decreased social interaction, and lower levels of physical activity.

Aims:

The aim of this study is to identify the lifestyle behaviors of young adolescents focusing on physical activity, diet, and screen time.

Settings and Design:

A cross-sectional study was conducted among 929 students of Class VII and VIII in schools in Imphal West and Kangpokpi districts of Manipur.

Subjects and Methods:

Data collection was done by questionnaire method.

Statistical Analysis Used:

The data were analyzed using IBM SPSS for Windows, Version 21.0. Armonk, NY, USA.

Results:

Seven in 10 of the students had inadequate physical activity at school and inadequate physical activity outside school. About 56.9% of the students have a smartphone, whereas one-third of them have Facebook and WhatsApp accounts. Only 5.8% were eating a healthy diet. Females and day scholars were less physically active. Males those staying in a nuclear family, less family income, and more number of siblings were found to have unhealthy dietary habits.

Conclusions:

Less than half of the students were physically active and only six out of 100 the students were eating a healthy diet.

Double burden of malnutrition among school-going adolescent girls in North India: A cross-sectional study

CONTEXT

Double burden of malnutrition comprising both undernutrition and overnutrition is nowadays emerging as a major public health concern among adolescent girls in India.

AIM

The present study was conducted to determine the prevalence of underweight, overweight, and obesity among school-going adolescent girls along with dietary and physical activity-related factors associated with them.

SETTINGS AND DESIGN

The present cross-sectional survey was conducted among 2400 school-going adolescent girls (10-19 years) in Barabanki district of Uttar Pradesh.

SUBJECTS AND METHODS

Multistage sampling technique was used for enrolment of the study subjects. Data were collected on sociodemographic profile, physical activity, dietary intake, and anthropometry. WHO body mass index (BMI)-for-age cutoff classification of girls was used for assessment of underweight, overweight, and obesity.

STATISTICAL ANALYSIS USED

Statistical analysis was done with the Epi Info software. Multinomial logistic regression analysis was used to ascertain various predictors of underweight, overweight, and obesity among adolescent females (P < 0.05 was considered as significant).

RESULTS

The proportion of underweight, overweight, and obese students were 47.0%, 5.9%, and 2.7%, respectively. The girls in mid and late adolescent age group were significantly less susceptible for being underweight for age (odds ratio [OR] 0.28; 95% confidence interval [CI] 0.22-0.36; P = 0.00). The girls belonging to middle and upper socioeconomic strata were about 35 times more susceptible toward obesity (OR 35.12; 95% CI 13.33-92.49; P = 0.00) and 12 times more susceptible toward being overweight (OR 12.46; 95% CI 13.33-92.49; P = 0.00) as compared to those in lower income groups. The probability of overweight and obesity were about 3 times (OR 3.13; 95% CI 1.76-5.55; P = 0.00) and 10 times (OR 9.66; 95% CI 4.00-23.35; P = 0.00) higher among adolescent girls who reside in urban areas as compared to rural one. Apart from these, non-Hindu religion, nuclear type of family, parent's education profile of middle school and above, and engagement in physical activities more than 2 h a day were other factors found to be directly associated with increased chances of overweight/obesity (OR > 1; P < 0.05).

CONCLUSIONS

The high prevalence of the double burden of malnutrition revealed the need of the hour to modify and strengthen the existing adolescent health programs of India so as to deal with both the facets of nutrition spectrum substantially.

Associations of gestational weight gain with offspring thinness and obesity: by prepregnancy body mass index

Background

Previous studies indicated that excessive gestational weight gain (GWG) was positively associated with offspring obesity. Nevertheless, little is known about the effect of GWG on offspring thinness. This study aimed to assess the association of GWG with childhood weight status across the full range of weight status by prepregnancy body mass index (BMI).

Methods

We used data from a retrospective study of 33,828 Chinese children aged 6–18 years and their mothers. Children’s weight and height were objectively measured. Maternal GWG and other information were collected by using self-reported questionnaires. Multivariate linear regressions and logistic regressions were applied.

Results

Overall, the prevalence of thinness and overweight/obesity in children were 12.9 and 17.3% respectively (p < 0.05). Children’s BMI z-score was on average 0.021 higher for every 1-kg greater GWG. For mothers who were underweight or normal weight before pregnancy, excessive GWG was positively associated with offspring overweight/obesity [OR (95% CI): 1.51 (1.21, 1.90) and 1.30 (1.17, 1.45)], whereas inadequate GWG was associated with increased risk of offspring thinness [OR (95% CI): 1.24 (1.05, 1.46) and 1.17 (1.04, 1.32)]. Similar but non-significant associations were found in prepregnancy overweight mothers. Notably, there was a very high prevalence of child overweight/obesity (30.2%) in prepregnancy overweight subgroup regardless of GWG status.

Conclusions

Inadequate GWG was associated with an increased risk of offspring thinness, whereas excessive GWG was associated with an increased risk of offspring overweight and obesity among prepregnancy underweight and normal weight mothers only.

Subjective Household Economic Status and Obesity in Toddlers: A Cross-Sectional Study of Daycare Centers in Japan

Background

Although lower household economic status is known to be a risk factor for obesity among school-age children, such an association among toddlers remains unclear. The present study investigated the association between household economic status and obesity in toddlers.

Design

We conducted a cross-sectional study of children aged 4 years attending daycare centers in Japan. Information on subjective household economic status [“affluent”, “neither”, “less affluent”, or “non-affluent”] was collected via questionnaire from the children’s guardians in 2015. Based on measured values of height and weight, obesity was defined using the International Obesity Task Force cut-offs of overweight (BMI ≥17.47 for boys and ≥17.19 for girls). We used the logistic regression model to investigate the association between household economic status and obesity.

Results

Among 1,848 respondents, the prevalence of obesity was 6.8%. Non-affluent household economic status was associated with a significantly higher probability of obesity in toddlers; the multivariate adjusted odds ratio for “non-affluent” households was 2.31 (95% confidence interval, 1.23–4.33) compared with “affluent” households.

Conclusion

Perception of non-affluent economic status by the guardian was associated with a higher probability of toddler obesity. This result suggests that non-affluent household economic status is associated with obesity in toddlers.

Association of Weight Control Behaviors with Body Mass Index in Korean Adolescents: A Quantile Regression Approach

PURPOSE

Adolescents are interested in weight control but likely practice unhealthy weight control behaviors. This study aimed to examine weight control behaviors associated with body mass index (BMI) in Korean adolescents.

DESIGN AND METHODS

In this descriptive cross-sectional study of 16- to 19-year-old adolescents (97 girls and 90 boys), analyses were conducted of physical activity, sedentary behaviors, dietary behaviors, and self-efficacy for physical activity and diet. Daily steps were measured using pedometers. Height and weight were self-reported. We conducted descriptive statistics and quantile regression analysis using STATA 14.0.

RESULTS

About 10% were underweight, and 8.6% overweight and obese. Average weekday and weekend steps/day were <10,000. Only 4.3% reported performing moderate-to-vigorous physical activity (MVPA) daily. Less than half (42.5%) reported that they had three meals/day every day. Most (89.3%) had milk less than once/day. Quantile regression showed that, for the 5th BMI percentile group, (1) age (β = 0.941) and milk consumption (β = 2.148) were significantly positively associated with BMI, whereas (2) dietary self-efficacy (β = -0.083) was significantly negatively associated with BMI. For the 95th percentile group, having three meals/day (β = 2.558) was significantly positively associated with BMI, whereas MVPA (β = -5.440) and muscle-strengthening exercise (β = -3.392) were significantly negatively associated with BMI.

CONCLUSIONS

Milk consumption was positively associated with BMI of underweight adolescents, whereas physical activities were negatively associated with BMI of overweight and obese adolescents.

PRACTICE IMPLICATION

Weight control programs for adolescents may need to be tailored for differing BMI levels.

Association of Picky Eating With Weight Status and Dietary Quality Among Low-Income Preschoolers

BACKGROUND

Picky eating is common in children. Few studies have examined predictors of picky eating, and the association of picky eating with weight status and dietary quality is inconsistent in the literature. We aimed to identify predictors of picky eating and to test the association of picky eating with child body mass index z-score (BMIz), dietary quality, and micronutrient intake.

METHODS

This was a cross-sectional analysis of baseline data from a randomized controlled trial to prevent obesity among 506 preschoolers attending Head Start. Parents completed questionnaires to assess picky eating and child temperament. Three 24-hour dietary recalls were collected to assess dietary intake. Multivariate regression models assessed child, parent, and family predictors of picky eating; additional models tested adjusted associations of picky eating with child BMIz, dietary quality (measured using the Healthy Eating Index-2010), and micronutrient intake.

RESULTS

Picky eating was predicted by male sex, older child age, and more difficult temperament but not race/ethnicity, maternal body mass index, maternal depressive symptoms, household food insecurity, or single parent home. Picky eating was not associated with child BMIz or micronutrient deficiencies; it was inversely associated with total Healthy Eating Index-2010 score and servings of whole fruit, total vegetables, greens and beans, and total protein foods.

CONCLUSIONS

Pediatric providers should support parents in expanding the number of healthy foods the child eats to improve dietary quality, but reassure parents that picky eating is not associated with children's weight status or micronutrient deficiencies.

Lifestyle factors associated with underweight among Japanese adolescents: a cross-sectional study

Background

Because underweight in adolescents poses several health problems, it is important to prevent it in adolescence. For the prevention of underweight, it is necessary to investigate risk factors, especially lifestyles, because these can be modified. However, a limited number of studies exist regarding lifestyle factors associated with underweight among adolescents. The present study aimed to investigate the relationship between lifestyle factors and underweight among Japanese adolescents.

Methods

Study subjects comprised 2641 seventh-grade school children (age 12 or 13 years) from the town of Ina, Saitama Prefecture, Japan. Measurements of height and weight were made for each subject, while information regarding lifestyles of each subject was obtained using a self-administered questionnaire. Underweight was determined by the age- and sex-specific body mass index cut-off points. A logistic regression model was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for underweight.

Results

Adolescents who ate slowly were more likely to be underweight than those who did not eat slowly; the OR (95% CI) was 2.78 (1.77–4.39) in boys and 2.69 (1.81–3.98) in girls. Girls who did not exercise were more likely than those who exercised to be underweight (OR: 1.64, 95% CI: 1.07–2.51).

Conclusions

The present study showed that eating slowly and exercise were associated with underweight among Japanese adolescents. These results suggest that eating speed and exercise need to be considered in school health programs for healthy body weight.

Socioeconomic Inequality in Childhood Obesity

Background: The aim of this study was to assess the socioeconomic inequalities in obesity and overweight in children aged 10 to 12 yr old.

Study design: A cross-sectional study.

Methods: This study was conducted on 2506 children aged 10 to 12 yr old in the city of Sanandaj, western Iran in 2015. Body mass index (BMI) was calculated. Considering household situation and assets, socioeconomic status (SES) of the subjects was determined using Principal Component Analysis (PCA). Concentration Index was used to measure inequality and Oaxaca decomposition was used to determine the share of different determinants of inequality.

Results: The prevalence of overweight was 24.1% (95% CI: 22.4, 25.7). 11.5% (95% CI: 10.0, 12.0) were obese. The concentration index for overweight and obesity, respectively, was 0.10 (95% CI: 0.05, 0.15), and 0.07 (95% CI: 0.00, 0.14) which indicated inequality and a higher prevalence of obesity and overweight in higher SES. The results of Oaxaca decomposition suggested that socioeconomic factors accounted for 75.8% of existing inequalities. Residential area and mother education were the most important causes of inequality.

Conclusions: To reduce inequalities in childhood obesity, mother education must be promoted and special attention must be paid to residential areas and children gender.

Developmental trajectories of body mass index and emotional-behavioral functioning of underweight children: A longitudinal study

Although several studies have addressed developmental trajectories from childhood to adolescence of internalizing/externalizing problems, limited attention has been given to underweight children. Two groups were recruited for this study from a community sample: underweight (Ug, N = 80, 50% female) and normal weight (NWg, N = 80, 50% female) to examine the developmental trajectories of body mass index and emotional-behavioral functioning of underweight children from the age two years, and their risk of eating disorder at early adolescence. The study was organized over four waves, each of three years. Pediatricians measured BMI, parents completed the Child Behavior Checklist (CBCL) and the Eating Disorders Inventory-Referral Form (EDI-3-RF). Our results showed that children in the two groups recorded different BMI trajectories over time. In NWg, male and female subjects started from a higher BMI at T1 than their peers. In Ug, internalizing and externalizing problems in males and females remained higher than their peers at all points of assessment. Males and females in Ug scored higher than those in NWg on EDI-3-RF total score. Our results indicate a need for effective physical and psychological assessment of underweight children in community samples to prevent psychological difficulties and eating disorders in adolescence.

The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan

Background:

We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn.

Methods:

Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight.

Results:

Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02–1.24); girls=1.35 (1.23–1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09–1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group.

Conclusions:

Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence.