Less obesity but higher inequalities in Portuguese children: Trends of childhood obesity between 2002–2016

Abstract

Aim To observe the trends of overweight and obesity among Portuguese children from 2002 to 2016, before and during the years of the economic crisis, and compare these trends according to family's socio‐economic position (SEP). Methods Prevalence rates were calculated using data from six studies providing comparable estimates from 2002, 2009, 2011, 2013 and 2016 for children aged 6–10‐years living in the Portuguese Midlands (n = 7192; 50.2% girls). Height and weight were objectively measured; children and family characteristics were collected by standard questionnaires. A logistic regression was used to test the association between variables. Results Between 2002 and 2016, there was a decrease in the prevalence of overweight and obesity, which reached a statistical significance for girls. The prevalence of overweight, including obesity, was high (low‐SEP = 30.5%; high‐SEP = 20.5%) and a widening of socio‐economic inequalities was found. Socio‐economically disadvantaged children had more than 2 times the odds of having obesity than children from higher‐SEP, even after adjusting for sex, physical activity and screen‐time. Conclusion While a decrease in overall rates of overweight and obesity was observed from 2002 to 2016, the social inequalities have been widened which suggest the need for public efforts to promote healthy weight at a population level, especially in lower socio‐economic classes.

Weight status in the 6- to 9-year-old school population in Spain: results of the ALADINO 2019 Study

“…Destacan las diferencias por sexos, siendo más frecuente el sobrepeso en las niñas y tanto la obesidad como la obesidad severa en los niños. Estos resultados, similares a los del estudio ALADINO 2015 (5) y a los de otro estudio reciente en España ( 24), muestran un cambio de patrón del sobrepeso respecto al ALADINO 2011 (11), donde el sobrepeso era ligeramente superior en los niños, acorde con la evolución observada de disminución del exceso de peso únicamente en los niños a expensas del sobrepeso, similar a lo ocurrido en Italia ( 22) aunque en Portugal el descenso ha sido significativo solo en las niñas (23). En una cohorte de Cataluña se ha observado un descenso significativo del sobrepeso y la obesidad en ambos sexos entre los escolares de 6 a 11 años durante el periodo 2006-2016 (24).…”

The Great Recession weighted on Portuguese children: A structural equation modeling approach considering eating patterns

“…Education was categorized in three levels, according to the years of school completed, as follows: low (≤9 years), medium (10-12 years), and high (university degree). It has been previously done in the Portuguese context (Machado- Rodrigues et al, 2018;Rodrigues et al, 2020), since the country does not have an official measure of this variable, and because it is known that education is positively associated with more health-related knowledge (Tur et al, 2005) and a higher capacity to put it into practice (Ball & Crawford, 2006). In pediatric ages, the more educated the parents, the more likely they will promote adequate dietary practices with their children (Kant & Graubard, 2013).…”

“…Obesity can lead to adverse health outcomes (Global BMI Mortality Collaboration, 2016). In Portugal, the rates of children with overweight and obesity significantly increased between 1970 and 2002 (Padez et al, 2004) reaching a prevalence of 31.5%, but recent data suggest that in the last two decades, the prevalence decreased from 22.9% to 19.6% among boys and from 29.1% to 24.4% among girls (Rodrigues et al, 2020). A similar tendency has been reported in previous Portuguese studies (COSI, 2019) and in other developed countries (Jaacks et al, 2019; NCD‐RisC, 2017).…”

“…In the USA, children from low‐income families were 0.68 times as likely to have excess weight or obesity compared with children from low‐income households (Weaver et al, 2019). In Portugal, the prevalence of overweight, including obesity, was significantly higher in children from low‐educated parents (31.2%) compared with their counterparts from high‐educated families (16.5%; Rodrigues et al, 2021), and those inequalities have been widening (Rodrigues et al, 2020).…”

Repeated cross‐sectional studies found sex inequalities in childhood obesity by socio‐economic vulnerability

“…Childhood obesity is one of the largest global health challenges, 1 but a comprehensive approach to the multiple inter-related inequalities in childhood obesity and how they vary overtime is lacking. 2 We previously published data on the prevalence of obesity among Portuguese children 3 ; this study focuses on sex inequalities by socio-economic status (SES) among children aged 3-5 and 6-10 at three different time points.…”