Changes in Early Childhood Obesity from 2016 to 2019 and Effective Factors

Abstract

Objective: Aim of our study is showing the changes of factors that affecting early childhood obesity from 2016 to 2019 and to ensure that necessary measures are taken about this regard.

Method: 3 years follow-up information of 388 babies whom born in 2013 and 2016 and registered at the Family Health Centers of Rize (Turkey) included to our study. The family doctors participating in this study examined these babies who were registered to them during their 1st, 3rd, 7th, 9th, 12th, 18th, 24th, 30th, 36th months at the family health centers in accordance with Turkish Health Ministry protocols and recorded their height, weight, head circumference, and BMI (Body Mass Index).

Results: 388 babies included in study, 177 of them were born in 2013 and 211 of them were born in 2016. Percentage of being overweight or obese was 19.2% in babies born in 2013 and this rate decreased to 18.2% in babies born in 2016. Percentage of being overweight or obese was 16% in girls and 21.2% in boys. We observed that high birth weight (>4000 gr) and excess gestational weight gain are risk factors for being overweight or obese at the age of three. (p=0,048)

Conclusion: Result of our study showed us that although prevalence of early childhood obesity decreased, but prevalence is still at critical level. We found that gestational weight gain and high birth weight are risk factors for early childhood obesity. In future obesity prevention studies, taking these risk factors into account will be beneficial.

Keywords

• Obesity
• Overweight
• BMI
• Child

Erken Çocukluk Çağı Obezitesinde 2016'dan 2019'a Değişiklikler ve Etkili Faktörler

Abstract

Amaç: Çalışmamızın amacı 2016 yılından 2019 yılına erken çocukluk çağı obezitesine etkili faktörlerin değişimini göstererek bu konuda gerekli önlemlerin alınmasını sağlamaktır.

Yöntem: Retrospektif kohort tipindeki çalışmamıza 2013 ve2016 yılı doğumlu olan ve Rize ili Aile sağlığı merkezlerine kayıtlı 388 çocuğun 3 yaş izlem bilgileri dahil edilmiştir. Çalışmaya katılan Aile Hekimleri kendilerine kayıtlı olan çocukları Türkiye Cumhuriyeti Sağlık Bakanlığı’nın bebek ve çocuk izlem protokolüne uygun olarak 1, 3, 7, 9, 12, 18, 24, 30 ve 36. aylarında aile sağlığı merkezlerinde izleyerek boy-kilo-baş çevresi ve vücut kitle indekslerini (VKI) kaydetmişlerdir. Elde edilen verilerin değerlendirilmesinde tanımlayıcı istatistiksel yöntemler kullanıldı.

Bulgular: Çalışmaya 177’si 2013 doğumlu, 211’i 2016 doğumlu toplam 388 çocuk dahil edilmiştir. Fazla kilolu ya da obez olma durumu 2013 yılı doğumlularda %19.2 iken bu oran 2016 doğumlularda %18.2’ye gerilemiştir. Çalışmaya alınan çocuklarda obezite ya da fazla kilolu olma durumu kızlarda %16 iken erkeklerde %21.2 idi. Yüksek doğum ağırlığının(>4000 gr) ve fazla gestasyonel kilo alımının 3 yaş fazla kilolu ya da obez olma durumu için bir risk olduğunu gözlemledik. (p=0,048)

Sonuç: Çalışmamızın sonucu bize erken çocukluk çağı obezitesi prevalansının alınan son önlemlerle bir miktar gerilese de hala ciddi seviyede olduğunu gösterdi. Gestasyonel kilo alımı ve yüksek doğum ağırlığının erken çocukluk çağı obezitesi için bir risk olduğunu bulduğumuz çalışmamızdan yola çıkarak ileriye yönelik obezite önleme çalışmalarında bu risklerin göz önüne alınması konusunda faydalı olacaktır.

Keywords

• Obezite
• Fazlakiloluk
• VKI
• Çocuk

References

1. 1. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980‐2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766‐781.
2. 2. Global BMIMC, Di Angelantonio E, Bhupathiraju Sh N, et al. Body‐mass index and all cause mortality: individual‐participant‐data meta‐analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776‐786.
3. 3. Evensen E, Wilsgaard T, Furberg AS, Skeie G. Tracking of overweight and obesity from early childhood to adolescence in a populationbased cohort—the Tromso study, Fit Futures. BMC Pediatr. 2016;16(1):64.
4. 4. Aarestrup J, Bjerregaard LG, Gamborg M, et al. Tracking of body mass index from 7 to 69 years of age. Int J Obes (Lond). 2016;40(9):1376‐1383.
5. 5. World Health Organization: Childhood Overweight and Obesity. www.who.int/dietphysicalactivity/childhood/ en/ (last accessed September 30, 2015)
6. 6. GAZIANO, Thomas A. et al. Growing epidemic of coronary heart disease in low-and middle-income countries. Current problems in cardiology. 2010;35.2:72-115.
7. 7. Olaya B, Moneta MV, Pez O, et al. Country-level and individual correlates of overweight and obesity among primary school children: a cross-sectional study in seven European countries. BMC Public Health. 2015;15(1):475. http:// dx.doi.org/10.1186/s12889-015-1809-z.
8. 8. Fraser, A., Tilling, K., Macdonald-Wallis, C., Sattar, N., Brion,M. J., Benfield, L., et al. Association of maternal weight gain in pregnancy with offspring obesity and metabolic and vascular traits in childhood. Circulation. 2010;121(23), 2557–2564.

9. 9. Oken, E., Kleinman, K. P., Belfort, et al. Associations of gestational weight gain with short- and longer-term maternal and child health outcomes. American Journal of Epidemiology. 2009; 170(2), 173–180.
10. 10. Koren, A., Kahn-D'angelo, L., et al. Examining Childhood Obesity From Infancy: The Relationship Between Tummy Time, Infant BMI-z, Weight Gain, and Motor Development—An Exploratory Study. Journal of Pediatric Health Care. 2019;33(1), 80-91.
11. 11. Peirson L, Fitzpatrick-Lewis D, Morrison K, et al. Treatment of overweight and obesity in children and youth: a systematic review and meta-analysis. CMAJ Open. 2015;3(1): E35-E46.
12. 12. Ng SK, Olog A, Spinks AB, et al. Risk factors and obstetric complications of large for gestational age births with adjustments for community effects: results from a new cohort study. BMC Public Health 2010;(6)10:460.
13. 13. Freedman DS, Khan LK, Serdula MK, et al. Racial differences in the tracking of childhood BMI to adulthood. Obes Res. 2005;13(5):928‐935.
14. 14. https://www.who.int/end-childhood-obesity/facts/en/
15. 15. Understanding recent trends in childhood obesity in the United States makaleye atıf yap.
16. 16.http://www.istanbulsaglik.gov.tr/w/sb/halksag/belge/mevzuat/turkiye_obezite_mucadele_kontrol_prg.pdf
17. 17. Bider‐Canfield, Z. Martinez, M. P. Wang, et al. Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years. Pediatric obesity 2017;12(2), 171-178.
18. 18. Heslehurst, N. , Vieira, R. , Akhter, Z. , et al. The association between maternal body mass index and child obesity: A systematic review and meta-analysis. PLoS medicine. 2019;16(6).
19. 19. Zheng, Z. , Yang, T. , Chen, L., et al. Increased maternal Body Mass Index is associated with congenital heart defects: An updated meta-analysis of observational studies. International journal of cardiology. 2018; 273, 112-120.
20. 20. Werneck, A. O., Silva, D. R. P., Collings, P. J., et al. Birth weight, biological maturation and obesity in adolescents: a mediation analysis. Journal of developmental origins of health and disease. 2017;8(4), 502-507.
21. 21. Qiao, Y., Zhang, T., Liu, H., Katzmarzyk, P. T., et al. Joint association of birth weight and physical activity/sedentary behavior with obesity in children ages 9‐11 years from 12 countries. Obesity. 2017; 25(6), 1091-1097.
22. 22. Zhao, P., Liu, E., Qiao, Y., et al. Maternal gestational diabetes and childhood obesity at age 9–11: results of a multinational study. Diabetologia. 2016; 59(11), 2339-2348.
23. 23. Hu, Z., Tylavsky, F. A., Han, J. C., et al Maternal metabolic factors during pregnancy predict early childhood growth trajectories and obesity risk: the CANDLE Study. International journal of obesity. 2019;43(10),1914-1922.
24. 24. Wang, J., Wang, L., Liu, H., et al. Maternal gestational diabetes and different indicators of childhood obesity: a large study. Endocrine connections, 2018;7(12), 1464-1471.
25. 25. Pitkin RM. Nutritional support in obstetrics and gynecology. Clin Obstet Gynecol. 1976;19:489–513.
26. 26. Nelson SM, Matthews P, Poston L. Maternal metabolism and obesity: modifiable determinants of pregnancy outcome. Hum Reprod Update. 2010;16:255–75.
27. 27. Karachaliou M, Georgiou V, Roumeliotaki T, et al. Association of trimester-specific gestational weight gain with fetal growth, offspring obesity, and cardiometabolic traits in early childhood. Am J Obstet Gynecol. 2015;212:502.e501–14.
28. 28. Alfaradhi MZ, Ozanne SE. Developmental programming in response to maternal overnutrition. Front Genet. 2011;2:27.
29. 29. Gibbs, B. G., & Forste, R. Socioeconomic status, infant feeding practices and early childhood obesity. Pediatric obesity. 2014;9(2), 135-146.
30. 30-.Kramer, M. S., Matush, L., Vanilovich, I., et al. Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 years: Evidence from a large ran- domized trial. The American Journal of Clinical Nutrition. 2007; 86(6), 1717–1721.
31. 31. Gillman, M. W., Rifas-Shiman, S. L., Camargo, C. A, et al. Risk of overweight among adolescents who were breastfed as infants. The Journal of the American Medical Association. 2001;285(19), 2461–2467.
32. 32. Grummer-Strawn, L. M., & Mei, Z. Does breastfeeding protect against pediatric overweight? Analysis of longitudinal data from the Centers for Disease Control and Prevention Pediatric Nutrition Surveillance System. Pediatrics. 2004; 113(2), e81–e86.
33. 33. Fisher, J. O., Birch, L. L., Smiciklas-Wright, H., & Picciano, M.F. Breast-feeding through the first year predicts maternal control in feeding and subsequent toddler energy intake. Journal of the American Dietetic Association. 2000;100, 641–646.
34. 34. Li R, Magadia J, Fein SB, Grummer-Strawn LM. Risk of bottlefeeding for rapid weight gain during the first year of life. Arch Pediatr Adolesc Med. 2012;155:431–436