Drastic increases in overweight and obesity from 1981 to 2010 and related risk factors: results from the Barbados Children’s Health and Nutrition Study

Abstract

Objective: To examine overweight and obesity (OWOB), changes in prevalence and potential risk factors in Barbadian children. Design: A cross-section of students were weighed and measured. The WHO BMIfor-age growth references (BAZ), the International Obesity Task Force cut-offs and the US Centers for Disease Control and Prevention growth percentiles were used to determine OWOB prevalence. Harvard weight-for-height-for-age growth standards were used to estimate differences in OWOB prevalence from 1981 to 2010. Samples of parents and students were interviewed to describe correlates of OWOB. Setting: Barbados. Subjects: Public-school students (n 580) in class 3. Results: Based on WHO BAZ, the overall prevalence of OWOB was 34·8 % (95 % CI 30·9, 38·7 %). A trend of higher OWOB prevalence was seen for girls across cutoffs, with significant sex differences noted using the International Obesity Task Force cut-offs. According to Harvard growth standards, OWOB has increased dramatically, from 8·52 % to 32·5 %. Children were more likely to be OWOB when annual household income was below BBD 9000 (OR = 2·69; 95 % CI 1·21, 5·99). Eating dinner with the family every night was associated with a lower prevalence of OWOB (OR = 0·56; 95 % CI 0·36, 0·87). Conclusions: The sharp increase of OWOB rates in Barbados warrants attention. Sex disparities in OWOB prevalence may emerge at a young age. Promoting family meals may be a feasible option for OWOB prevention. Understanding familial and sociodemographic factors influencing OWOB will be useful in planning successful intervention or prevention programmes in Barbados. Keywords Child obesity Risk factors Sex differences Family mealsOverweight and obesity (OWOB) are major health concerns in contemporary society leading to rises in noncommunicable diseases, decreased quality of life (1) and increased health-care costs (2) . Excess weight early in life increases the risk of a child becoming an obese adult (3) . The rates of OWOB in adults have been increasing globally over the last several decades in both developed and developing nations (4) . The rate of the increase in OWOB is expected to be greater in middle-income nations and emerging economies (5) such as Barbados (6) . These changes have created an environment which has potentially put Barbadian children at risk for OWOB. The last nationally representative data collected on child weight status in Barbados date from 1981 and estimated that 10·5 % of children were underweight and 8·52 % were OWOB. Countries such as Barbados that have undergone significant economic development over the last 30-40 years (7) may be at risk for high levels of child OWOB. It is therefore important to identify risk factors relevant to the Barbadian context of child obesity. Few research or surveillance activities examining weight status have taken place with regard to Barbadian primary-school children. The present study was part of the Barbados Children's Health and Nutrition Study (BCHNS) and proposed to obtain a baseline measure of the prevalence ...

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