Psychosocial, Socioeconomic, Behavioral, and Environmental Risk Factors for BMI and Overweight Among 9-to-11-Year Old Children

Abstract

This study explored the risk factors for higher BMI and overweight in 9- to 11-year-old children using the 2007 California Children’s Healthy Eating and Exercise Practices Survey. A total of 741 children completed a two-day food and activity diary. Of these, 299 children participated in the follow-up telephone interview, reporting attitudes and beliefs. Linear regressions identified risk factors related to BMI z-scores; logistic regressions were used for binomial overweight status. Independent variables included children’s diet, activity, screen time, food modeling, family norms/rules, home environment, poverty, and parent education, adjusting for race/ethnicity. Parent education was the strongest risk factor with a clear gradient towards reduced risk as parent education improved. Children were .3 BMI z points lower and one-third less likely to be overweight as education level rose. Each serving of fried vegetables consumed was related to .3 point increase in BMI z. Children were 1.2-1.3 times more likely to be overweight with each increase in school lunch participation. Low-cost overweight prevention efforts targeting children with less parent education, school lunches, and consumption of fried vegetables may reduce BMI and help prevent childhood overweight. Additional investigation should determine the underlying factors contributing to the relationship between eating school lunch and overweight.

The relationship between the home environment and child adiposity: a systematic review

“…No association with adiposity in fully adjusted models. Keihner et al 2009 [ 69 ] Cross USA 299 (47.8%), 9–11 y Media: Physical - TV in bedroom. Social – caregiver limit setting around screen-time Food: Social - Caregiver modelling of energy-dense foods Food and activity diary, FMTS; 4 items; CR and PR.…”

“…A study of children aged 9–11 ( n = 502) reported that those with multiple devices (2–3 or more) in their bedroom had higher body fat percentage than children with no devices in their bedroom [ 29 ]. The remaining studies (8/29; 27.6%) reported null associations between availability of media equipment and child adiposity [ 33 , 42 , 45 , 63 , 64 , 69 , 70 ].…”

“…Sixteen studies examined relationships between social aspects of the home media environment and child adiposity [ 15 , 24 , 34 , 41 – 43 , 63 – 66 , 68 , 69 , 76 , 79 – 81 ]. Of these, five studies measured caregiver modelling of media use [ 43 , 64 , 65 , 77 , 80 ].…”

“…The remaining three studies, involving children aged 2–6 years [ 64 ], and 7–12 years from Australia [ 65 ] and Taiwan [ 43 ], found no associations between caregiver modelling of media use and child adiposity. Sixteen studies examined relationships between caregiver rules and limit setting around media use and child adiposity, with inconsistent findings [ 15 , 24 , 34 , 41 – 43 , 63 – 66 , 68 , 69 , 76 , 79 – 81 ]. Four cross-sectional studies reported associations between fewer caregiver limits and less monitoring of media use with higher risk for abdominal obesity in Australian primary school aged children (aged 6–10 years, n = 3884) [ 68 ] and higher BMI scores in Malaysian children aged 10–12 ( n = 802) [ 66 ], and preschool aged children from the US ( n = 8550) [ 24 ] and South Korea ( n = 241) [ 80 ].…”

“…However, two prospective studies from the Netherlands which pooled data from the Dutch KOALA birth cohort ( n = 1694 and n = 1819) found the reverse relationship, with limits on electronic media use associated with greater increases in child BMI z-scores from ages 5 to 7 [ 15 , 81 ]. Nine studies (56.3%) reported no relationships between caregiver rules and limits around media use and child weight [ 34 , 42 , 43 , 56 , 65 , 69 , 76 , 79 , 84 ]. Findings are summarised visually in Additional file 4 .…”