Nutritional counselling and risk factors for obesity: an observational study in toddlers.

Abstract

Background Nutrition exerts a fundamental role in the prevention of pediatric obesity (OB). The effect of a strict nutritional counselling on the prevalence of overweight (OW) or OB according to the association with potential risk factors has never been explored in toddlers. Methods The eligible population was represented by 676 toddlers aged 24–36 months, assigned to 18 primary care pediatricians specifically trained on nutritional issues in the Campania region. Six-hundred-twenty-nine children (333 boys, 296 girls), mean age 27.8 ± 4.2 months were effectively included in this observational study. Specifically, children received nutritional advice with particular emphasis to proteins and sugar composition supported by leaflets and reinforced at each visit. Weight, height and body mass index were assessed at the last control visit, at the age of 24–36 months. The following individual and family risk factors were considered: gestational age, birth weight, eutocic/caesarean delivery, milk feeding history, household smoking or antibiotics exposure, parents’ weight, height and educational level. Results Twenty-two% children were classified as OW and 6% as OB. High birth weight, parental OW/OB, and caesarean delivery were significant risk factors for OW/OB. In adjusted models, cesarean versus vaginal delivery was independently associated with a more than 70% risk of OW/OB, while paternal OW/OB vs normal-weight was associated with a nearly twofold increase of OW/OB in toddlers. Conclusions The high prevalence of OW/OB in toddlers underlines that a strict nutritional counseling should be implemented in a primary care setting. Toddlers with high parental BMI or born by cesarean delivery represent a category at particular risk for OW/OB, and may require a more intensive surveillance.