Prevalence of childhood obesity in Spain and its relation with socioeconomic status and health behaviors: Population-based cross-sectional study

OBJECTIVES

This study aims to assess the current state of childhood overweight and obesity in Spain, and its relationship with socioeconomic status and health-related behaviors.

METHODS

Population-based cross-sectional observational study, based on the 2017 National Health Survey in minors in Spain. This study included all children surveyed who were aged 1-14 years. Childhood obesity was estimated from the z-score of the body mass index.

RESULTS

The study included 4882 children aged 1-14 years (mean 7.5). The prevalence of obesity was 18.6% (95% confidence interval [CI] 18.5-18.7), while 13.5% (95% CI 13.4-13.6) were overweight. These figures represent over a million children in Spain who are obese and nearly 750,000 who are overweight. A north-south geographic gradient was apparent, with higher prevalence of unhealthy body weight in southern Spain. Factors associated with childhood obesity were low socioeconomic status, poor diet and sedentarism, among others.

CONCLUSIONS

Childhood overweight in Spain is strongly associated with socioeconomic status and other factors such as diet and sedentarism. Multidisciplinary public health interventions are needed to reduce this serious health problem in children.

Triponderal mass index and markers of metabolic risk in children and adolescents with obesity

BACKGROUND AND OBJECTIVE

Triponderal mass index (TMI) would estimate excess adiposity better than body mass index (BMI), maintaining stable values during childhood. This work aims to determine the correlation between TMI and markers of metabolic risk as well as set values of TMI that are related to an increase of metabolic risk.

MATERIAL AND METHODS

Multicenter, observational, cross-sectional and prospective study in children under 14 years of age with obesity.

VARIABLES

age, sex, pubertal stage, weight, height, abdominal circumference, BMI, TMI, basal glucose and insulin, HOMA index, blood pressure, lipoprotein profile, transaminases and uric acid. BMI and TMI were expressed according to the values of the Barcelona longitudinal study. Statistical analysis was performed with the SPSS* program.

RESULTS

One hundred and ninety-nine patients (50.3% male), age 11.08 (2.48) years, TMI 19.68 (2.36)kg/m³. Correlation between TMI and abdominal circumference (r=0.571; p=0), insulin (r=0.198; p=0.005), HOMA index (r=0.189; p=0.008) and HDL-c (r=-0.188; p=0.008) was observed. IMT>20.15kg/m³ was associated with insulin≥15mIU/ml (p=0.029) and IMT>20.36kg/m³ with HDL-c<40mg/dl (p=0.023).

CONCLUSIONS

TMI was correlated with increase of abdominal circumference, insulin and HOMA index and decrease of HDL-c. IMT>20kg/m³ can be associated with increased insulin and decreased HDL-c. Therefore, the IMT seems to be a useful parameter in the assessment of pediatric patients with obesity.

Ecological determinants of obesity risk in Mexican infants: a scoping review

BACKGROUND

Childhood obesity is a multifactorial disease. Most of these factors start to develop before birth and worsen throughout life. Therefore, prevention efforts should begin in the first 1000 days of life. This study aimed to quantify published studies on risk factors according to the Six-Cs model of childhood obesity (cell, child, clan, culture, community, and country) and determine which of them have been related to anthropometric indicators of overweight or obesity in children under 2 years of age in Mexico.

METHODS

A systematic scoping review (PRISMA-ScR) was performed. PubMed, Scopus, and EBSCOhost databases were reviewed.

RESULTS

We found that 88% of the studies were observational. The child and family spheres were the most studied, individually and as a whole. The least studied were community, culture, and country. The main risk factors related to obesity indicators were high birth weight, birth by cesarean section, and inadequate feeding practices, in addition to mothers with obesity and those who underestimate their child's weight, stressful parenting style, and food insecurity in the home, together with living in urban areas, family income, and beliefs about preference for ultra-processed products.

CONCLUSION

In Mexico, the study of obesity in early childhood is emerging at the research level. However, further efforts are required to close the knowledge gap at the socioecological level to design evidence-based interventions and reduce early obesity.

[Family functioning, parental rearing and its relationship to nutritional status in preschoolers]

Objetivo

Analizar la asociación entre funcionalidad familiar, crianza parental y estado nutricional en preescolares.

Diseño

Estudio cuantitativo, descriptivo correlacional y transversal.

Emplazamiento

Instituciones públicas de educación preescolar en el estado de Nuevo León, México. Atención Primaria.

Participantes

Muestra compuesta por 228 diadas (madre o padre y preescolar); se tomó como único criterio de inclusión ser el responsable principal de la crianza del preescolar.

Mediciones principales

Se empleó un cuaderno de recogida datos sociodemográficos, el estado nutricional se determinó basándose en recomendaciones de la Organización Mundial de la Salud, se utilizaron la Escala de Evaluación de la Cohesión y la Adaptabilidad Familiar y el cuestionario de Estilos de Crianza Parental. Se obtuvo estadística descriptiva y el coeficiente de correlación de Spearman.

Resultados

El promedio de edad de los padres fue de 32,09 años, el 60,5% de las madres se dedican al hogar y el 100% de los padres trabaja; la media de escolaridad en años fue de 12,16; el 68,9% de los participantes son casados; referente a los preescolares, el 29,4% presentó sobrepeso u obesidad. En cuanto a la funcionalidad familiar, se identificó que en la dimensión de cohesión es semirrelacionada el 44,3%. El estilo de crianza parental que predominó en los padres fue el permisivo con el 62,3%.

Conclusiones

La mayoría de los padres de familia presentaron desequilibrio en la funcionalidad familiar. No se encontró significación estadística entre funcionalidad familiar y crianza parental con estado nutricional en preescolares (p < 0,05).

[Which variables influence compliance with physical activity recommendations in young children?]

INTRODUCTION

There are established European guidelines for physical activity in childhood. The main goal of our study was to determine the factors that may influence compliance with European recommendations for physical activity in young children.

METHODS

We included 136 children (aged 2-8 years) classified by weight status, calculated based on the body mass index z-score using the growth standards of the World Health Organization. We measured physical activity over 5 consecutive days with accelerometers and recorded the food intake.

RESULTS

A greater level of physical activity was associated with a lower weight status category (B=-1.55; 95% CI: -2.02 to -1.08; P<.001), lower age (B=-1.33; 95% CI: -1.72 to -0.93; P<.001) and greater energy expenditure (B=0.02; 95% CI: 0.02 to 0.03; P<.001). The overall physical activity in the sample was light (mean=589 cpm/day). Children with overweight and obesity spent less time engaged in moderate to vigorous physical activity (P=.005) and more time engaged in sedentary activities (P=.005) compared to children with normal weight. All groups spent between 90 and 130minutes a day in sedentary activities, with a mean time spent that amounted to 15.5% of their time (excluding time spent sleeping). The adherence to European recommendations varied in association with sex (P=.010) and weight status (P=.038).

CONCLUSION

Young children spent more than 100minutes a day engaged in sedentary activities. Most of the sample met the European recommendations for daily moderate to vigorous physical activity. However, the degree of adherence depended on sex and weight status.

Comparing disordered eating and feeding practices in African American and Caucasian treatment-seeking youth with obesity

OBJECTIVES

Examine racial differences in disordered eating and parental feeding in youth with obesity.

METHODS

A diverse sample of 131 treatment-seeking youth (M_age = 12.84 years; Range_age = 8-18 years; 65.6% African American, 34.4% Caucasian) with obesity (M_BMIz = 2.60) completed a disordered eating questionnaire; parents completed a questionnaire about feeding practices.

RESULTS

No significant differences in disordered eating between African American and Caucasian youth emerged. Significant differences were found on parent feeding where parents of African American children endorsed more frequent use of pressure to eat, including ensuring and monitoring enough is eaten.

CONCLUSIONS

Generally, comparisons of disordered eating and parent feeding practices between African American and Caucasian youth with obesity were not significant. Racial differences on some aspects of parental feeding practices were found. Future research should identify cultural factors impacting these differences. Clinical implications include providing culturally sensitive psychoeducation and interventions to address unhealthy feeding practices in diverse families.

[Parental obesity is associated with the severity of childhood obesity and its comorbidities]

INTRODUCTION

The influence of parental obesity on their obese offsprings is acknowledged but insufficiently characterised.

PATIENTS AND METHODS

Retrospective study of 800 obese patients (45.2% girls; age: 10.35±3.40 years, body mass index [BMI]:+4.22±1.68 standard deviation score [SDS]). Group comparison according to the presence of obesity in none (n=347) or any of the parents (n=453), and then whether the obese parent was the father (n=185), the mother (n=151), or both parents (n=117) were performed. The parameters analysed were: Age at the onset of the obesity and at their first visit, birth weight (BW), BMI-SDS, blood glucose, insulin level, homeostatic model assessment (HOMA) index, total cholesterol (TC), HDL, LDL, triglycerides, 25-OH-vitamin-D, area under the curve (AUC) for insulin in the oral glucose tolerance test (OGTT), whole body insulin sensitivity index (WBISI), LDL/HDL and TC/HDL ratios, and weight loss after 12 month follow-up.

RESULTS

No differences were observed between groups as regarding gender, ethnic background, or pubertal stage. Patients with one obese parent showed higher BW-SDS and BMI-SDS (P<.01), more severe impairment of carbohydrate metabolism (blood insulin, insulin-AUC, HOMA, HbA1c [P<.01] and lower WBISI [P<.05]) than those with no obese parent. Among those patients with a single obese parent, higher BW-SDS, insulin, HOMA, and lower 25-OH-vitamin D (P<.05) was observed when obesity was present in the mother. There was a higher prevalence of metabolic syndrome when both parents were obese (χ²=5.96, P<.05). A total of 132 patients reduced their BMI by ≥1.5SDS, or their weight by ≥10%, with no influence of the background of parental obesity.

CONCLUSIONS

Obesity in any parent determines a higher severity of their offspring obesity and metabolic comorbidities, more importantly when obesity is present in the mother or in both parents, but without interference in the options of therapeutic success.