Prevalencia y factores asociados a la sobrecarga ponderal en población de 6 a 12 años de edadPlan "alimenta tu salud"

Abstract

Obesity is the most prevalent nutritional disorder among children and adolescents throughout the world. Particularly, Spain shows alarming rates at younger ages, which is an additional burden for diverse adulthood diseases. Thus, monitoring and early interventions are needed to reverse anticipated trends. The aetiology of obesity is multifactorial and involves complex interactions among genetic, epigenetic, environmental and behavioural factors, although the observed increase in the prevalence of childhood obesity during the past decades is probably the result of obesogenic lifestyles. Overall, there is controversial evidence regarding risk factors for childhood obesity, including combined or confounding effects and differences in exposure and vulnerability to obesogenic environment. During middle childhood, children become more independent and are also highly susceptible to environmental factors, which brings a great opportunity to prevent excess weight gain. However, much more investigation is needed in order to develop specific interventions at regional level according to dietary habits and physical activity patterns. In this context, ¿Alimenta su salud¿ is a childhood obesity prevention programme carried out in Castilla-La Mancha during 2008 with the collaboration of the University of Navarra and supported by the Pharmacists Council and Regional Council of Health and Social Welfare. Therefore, the aims of this thesis were to assess the prevalence of overweight (including obesity), dietary habits and physical activity in 3,061 participants of Plan ¿Alimenta su salud¿ taking into account differences by age group and sex, and to analyse the association between prevalence of overweight (including obesity) and perinatal, familiar and lifestyle factors, focusing on gender differences. One out of four children was overweight or obese in the studied population. The intake of fruits and vegetables was insufficient whereas there was overconsumption of sausages, pastries, salted snacks, sweets and fast food. Mid-morning and supplements consumption were more frequent among girls. Physical inactivity was higher during weekends, in girls and in younger children (6-9 years). P Parental obesity was associated with prevalence of childhood overweight in both sexes, being stronger the father-daughter association. In girls, the likelihood of being overweight was significantly lower in girls aged 10-12 years (OR 0.7, 95% CI 0.5-0.9) comparing to 6-9 years group, whereas those girls with a birth weight over 3,500 g and with a daily consumption of pastries were 1.8 (95% CI 1.3-2.3) and 1.3 (95% CI 1.1-1.7) times more likely to be overweight, respectively. In boys, having one or more siblings (OR 0.7, 95% CI 0.5-0.9), higher paternal education (OR 0.8, 95% CI 0.6-0.9), engaging ≥3 h/week in sports activities (OR 0.7, 95% CI 0.5-0.9), eating daily breakfast (OR 0.6, 95% CI 0.4-0.9) and consuming ≥2 fruits/day (OR 0.8, 95% CI 0.6-0.9) were independent protective factors against overweight, whereas those consuming weekly fast food and daily sweets were estimated to be 30% and 40%, respectively, more likely to be overweight. Finally, these results highlight that differences in modifiable risk factors such as physical activity and eating patterns should be assessed and recognized in order to formulate more effective local health promotion interventions programs, stressing the importance of targeting obese parents, particularly when father education level is low, promoting extracurricular sports since the beginning of primary school and involving families in promoting healthy eating habits. Furthermore, early detection of childhood obesity should extreme vigilance of girls with high birth weight and boys without siblings.