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Obesity among children attending elementary public schools in São Paulo, Brazil: a case–control study

Published online by Cambridge University Press:  22 December 2006

Isabela da Costa Ribeiro ,
José Augusto AC Taddei  and
Fernando Colugnatti
Isabela da Costa Ribeiro*
Affiliation:
Curso de Nutrição da Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155 – Prado Velho, Caixa Postal 16.210, Curitiba, PR, CEP 80215-901, Brazil
José Augusto AC Taddei
Affiliation:
Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brazil
Fernando Colugnatti
Affiliation:
Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brazil
*
*Corresponding author: Email [email protected] or [email protected]
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Abstract

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Objective:

To describe obesity among students of public schools in São Paulo and to identify risk factors for this nutritional and physical activity disorder.

Design:

Case– control study of obese and non-obese schoolchildren to study risk factors for obesity.

Setting:

Anthropometric survey including 2519 children attending eight elementary public schools in Sã o Paulo, Brazil.

Subjects:

Schoolchildren aged 7–10 years, of whom 223 were obese (cases; weight-for-height greater than or equal to two standard deviations(≥2SD) above the median of the National Center for Health Statistics (NCHS) reference population) and 223 were eutrophic (controls; weight-for-height ±1SD from NCHS median).

Measurements:

Parents or guardians of the 446 cases and controls were interviewed about the children's eating behaviours and habits.

Results:

The prevalence of obesity (weight-for-height ≥2SD) in the surveyed population was 10.5%. A logistic regression model fitted to the case–control dataset showed that obesity was positively associated with the following factors: birth weight ≥3500 g (odds ratio (OR) 1.83, 95% confidence interval (CI) 1.21–2.78), child's appetite at meals (OR 3.81, 95% CI 2.49–5.83), watching television for 4h per day or longer (OR 2.07, 95% CI 1.32–3.24), mother's schooling>4 years (OR 1.85, 95% CI 1.25–2.75) and parents' body mass index ≥ 30 kgm−2(OR 2.50, 95% CI 1.43–4.37).

Conclusion:

The explanatory multivariate model points to preventive measures that would encourage knowledge of the children and their guardians in relation to a balanced diet and a less sedentary lifestyle, such as reducing television viewing. Schoolchildren with a birth weight of 3500g or more or whose parents are obese should receive special attention in the prevention of obesity.

Keywords

ObesityRisk factorsSchoolchildrenMaternal obesityTelevision viewing
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 7 , October 2003 , pp. 659 - 663
Copyright
Copyright © CABI Publishing 2003

References

1World Health Organization (WHO). Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation on Obesity. Geneva: WHO/NUT/NCD, 1998.Google Scholar
2Bellizzi, MC, Dietz, WH. Workshop on childhood obesity: summary of the discussion. American Journal of Clinical Nutrition 1999; 70(Suppl.): 173S–5S.CrossRefGoogle ScholarPubMed
3Shetty, PS. Obesity in children in developing societies: indicator of economic progress or a prelude to a health disaster? Indian Pediatrics 1999; 36(1): 11–5.Google ScholarPubMed
4Jebb, SA. Aetiology of obesity. British Medical Bulletin 1997; 53(2): 264–85.CrossRefGoogle ScholarPubMed
5Guillaume, M, Lapidus, L, Beckers, F, Lambert, A, Björntorp, P. Familial trends of obesity through three generations: the Belgian–Luxembourg child study. International Journal of Obesity 1995; 19(Suppl.3): S5–9.Google ScholarPubMed
6Gortmaker, SL, Must, A, Sobol, AM, Peterson, K, Colditz, GA, Dietz, WH. Television viewing as a cause of increasing obesity among children in the United States, 1986–1990. Archives of Pediatrics & Adolescent Medicine 1996; 150: 356–62.CrossRefGoogle ScholarPubMed
7Cutting, TM, Fisher, JO, Grimm-Thomas, K, Birch, LL. Like mother, like daughter: familial patterns of overweight are mediated by mothers' dietary disinhibition. American Journal of Clinical Nutrition 1999; 69: 608–13.CrossRefGoogle ScholarPubMed
8Maffeis, C, Provera, S, Filippi, L, Sidoti, G, Schena, S, Pinelli, L, et al. Distribution of food intake as a risk factor for childhood obesity. International Journal of Obesity 2000; 24: 75–80.CrossRefGoogle ScholarPubMed
9Parsons, TI, Power, C, Logan, S, Summerbell, CD. Childhood predictors of adult obesity: a systematic review. International Journal of Obesity 1999; 23(Suppl.8): S1–107.Google ScholarPubMed
10Hill, JO, Wyatt, HR, Melanson, EL. Genetic and environmental contributions to obesity. Medical Clinics of North America 2000; 84(2): 333–46.CrossRefGoogle ScholarPubMed
11Engstrom, EM, Anjos, LA. Relationship between maternal nutritional status and obesity in Brazilian children. Revista de Saú de Pública 1996; 30(3): 233–9.CrossRefGoogle ScholarPubMed
12Parizkova, J, Hills, A. Childhood Obesity – Prevention and Treatment. Boca Raton, FL:CRC Press, 2001.Google Scholar
13Burrows, RA. Prevención y tratamiento de la obesidad desde la niñez: la estrategia para disminuir las enfermidades crónicas no transmisibles del adulto. Revista Medica de Chile 2000; 128: 105–10.Google Scholar
14Bernard, L, Lavallée, C, Gray-Donald, K, Delisle, H. Over Weight in Cree schoolchildren and adolescents associated with diet, low physical activity and high television viewing. Journal of the American Dietetic Association 1995; 95(7): 800–2.CrossRefGoogle ScholarPubMed
15Durant, RH, Thompson, WO, Johnson, M, Baranowski, T. The relationship among television watching, physical activity, and body composition of 5- or 6-year-old children. Pediatric Exercise Science 1996; 8: 15–26.CrossRefGoogle Scholar
16Andersen, RE, Crespo, CJ, Bartlett, SJ, Cheskin, LI, Pratt, M. Relationship of physical activity and television watching with body weight and level of fatness among children –results from the Third National Health and Nutrition Examination Survey. Journal of the American Medical Association 1998; 279(12): 938–42.CrossRefGoogle ScholarPubMed
17Neutzling, MB, Taddei, JAAC, Rodrigues, EM, Sigulem, DM. Overweight and obesity in Brazilian adolescents. International Journal of Obesity 2000; 24: 1–7.CrossRefGoogle ScholarPubMed
18Taddei, JAAC. Epidemiologia da obesidade na infância e In: Fisberg, M. Obesidade na Infância e Adolescência. São Paulo: Fundação BYK, 1995.Google Scholar
19Taddei, JAAC. Desvios nutricionais em menores de cinco anos: evidências dos inquéritos antropométricos nacionais. Tese de Livre-Docência, Universidade Federal de São Paulo/Escola Paulista de Medicina, São Paulo, 2000.Google Scholar
20Dietz, WH. Childhood obesity: susceptibility, cause and management. Journal of Pediatrics 1983; 103: 676–86.CrossRefGoogle ScholarPubMed
21Brasil Ministério da Saúde. Plano Nacional Para a Promoç ão da Alimentação Adequada e do Peso Saudável. Brasilia: Brasil Ministério da Saúde, 1999.Google Scholar
22Must, A, Jacques, PF, Dallal, GE, Bajema, CJ, Dietz, WH. Long term morbidity and mortality of overweight adolescents: a follow-up of the Harvard Growth Study of 1922 to 1935. New England Journal of Medicine 1992; 327(19): 1350–5.CrossRefGoogle ScholarPubMed
23Freedman, DS, Dietz, WH, Srinivasan, SR, Berenson, GS. The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics 1999; 103(6): 1175–82.CrossRefGoogle ScholarPubMed
24Taddei, JAAC, Ancona, FL. Reduction Risks of Illness and Death in Adulthood [online]. Available at http://www.unifesp.br/dped/disciplinas/nutricao/rram.html. São Paulo, Brazil, 12 2001.Google Scholar
25World Health Organization (WHO). Physical Status: The Use and Interpretation of Anthropometry. Geneva: WHO, 1995.Google Scholar
26Habicht, JP. Estandarización de métodos epidemiológicos cuantitativos sobre el terreno. Boletín de la Oficina Sanitária Panamericana 1974; 76(5): 375–84.Google Scholar
27Jelliffe, DB. Evaluación del Estado de Nutrición de la Comunidad. Geneva: Organización Mundial de la Salud, 1968.Google Scholar
28Schlesselman, JJ. Case–Control Studies – Design, Conduct, Analysis. Oxford: Oxford University Press, 1982.Google Scholar
29Lebart, L, Morineau, A, Piron, M. Statistique Exploratoire Multidimensionelle. Paris: Dunod, 1995.Google Scholar
30Hosmer, DW, Lemeshow, S. Applied Logistic Regression. New York: Wiley, 1989.Google Scholar
31Stunkard, AJ. Factores determinantes de la obesidad: opinión actual. In: Organización Panamericana de la Salud (OPS)/Organizació n Mundial de la Salud (OMS), ed. La Obesidad en la Pobreza: Un Nuevo Reto para la Salud Pública. Washington DC/Geneva: OPS/OMS, 2000.Google Scholar
32Whitaker, RC, Dietz, WH. Role of the prenatal environment in the development of obesity. Journal of Pediatrics 1998; 132: 768–76.CrossRefGoogle ScholarPubMed
33Maffeis, C, Micciolo, R, Must, A, Zaffanello, M, Pinelli, L. Parental and perinatal factors associated with childhood obesity in north-east Italy. International Journal of Obesity 1994; 18: 301–5.Google ScholarPubMed
34Hanley, AIG, Harris, SB, Gittelsohn, J, Wolever, TMS, Saksvig, B, Zinman, B. Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors. American Journal of Clinical Nutrition 2000; 71: 693–700.CrossRefGoogle Scholar