Associations between parental BMI, socioeconomic factors, family structure and overweight in Finnish children: a path model approach

BMC Public Health

Tiina Laatikainen³  Tuija Martelin¹  Susanna Lehtinen-Jacks²  Esko Levälahti⁴  Päivi Mäki⁴  Suvi Parikka¹ 

[1] National Institute for Health and Welfare, Department of Welfare, Helsinki, 00271, Finland;University of Tampere, School of Health Sciences, Tampere, Finland;Hospital District of North Karelia, Joensuu, Finland;National Institute for Health and Welfare, Department of Health, Helsinki, Finland

关键词: Path model;    Parental overweight;    Family structure;    Family socioeconomic factors;    Childhood overweight;   

Others  :  1159556
DOI  :  10.1186/s12889-015-1548-1

 received in 2014-09-23, accepted in 2015-02-16,  发布年份 2015

【 摘 要 】

Background

The aim of this study was to assess the less studied interrelationships and pathways between parental BMI, socioeconomic factors, family structure and childhood overweight.

Methods

The cross-sectional LATE-study was carried out in Finland in 2007–2009. The data for the analyses was classified into four categories: younger boys and girls (ca 3–8 years) (n = 2573) and older boys and girls (ca 11–16 years) (n = 1836). Associations between parental BMI, education, labor market status, self-perceived income sufficiency, family structure and childhood overweight were first examined by logistic regression analyses. As parental BMI and education had the most consistent associations with childhood overweight, the direct and indirect (mediated by parental BMI) associations of maternal and paternal education with childhood overweight were further assessed using a path model.

Results

Parental BMI and education were the strongest determinants of childhood overweight. Children of overweight parents had an increased risk of being overweight. In younger boys, maternal and paternal education had both direct (b-coefficient paternal −0.21, 95% CI −0.34 to −0.09; maternal −0.17, 95% CI −0.28 to −0.07) and indirect (b-coefficient paternal −0.04, 95% CI −0.07 to −0.02; maternal −0.04, 95% CI −0.06 to −0.02) inverse associations with overweight. Among the older boys, paternal education had both direct (b-coefficient −0.12, 95% CI −0.24 to −0.01) and indirect (b-coefficient −0.03, 95% CI −0.06 to −0.01) inverse associations with overweight, but maternal education had only an indirect association (b-coefficient −0.04, 95% CI −0.07 to −0.02). Among older girls, only an indirect association of maternal education with childhood overweight was found (b-coefficient −0.03, 95% CI −0.06 to −0.01). In younger girls, parental education was not associated with childhood overweight.

Conclusion

The observed pathways between parental BMI and education and childhood overweight emphasize a need for evidence-based health promotion interventions tailored for families identified with parental overweight and low level of education.

【 授权许可】

   
2015 Parikka et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]de Onis M, Blossner M, Borghi E: Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010, 92(5):1257-64.
• [2]Wang Y, Lim H: The global childhood obesity epidemic and the association between socio-economic status and childhood obesity. Int Rev Psychiatry 2012, 24(3):176-88.
• [3]Kautiainen S, Koivisto AM, Koivusilta L, Lintonen T, Virtanen SM, Rimpelä A: Sociodemographic factors and a secular trend of adolescent overweight in Finland. Int. J. Pediatr. Obes. 2009, 4(4):360-370.
• [4]Knai C, Lobstein T, Darmon N, Rutter H, McKee M: Socioeconomic patterning of childhood overweight status in Europe. Int. J. Environ. Res. Public. Health. 2012, 9(4):1472-1489.
• [5]Laitinen J, Power C, Jarvelin MR: Family social class, maternal body mass index, childhood body mass index, and age at menarche as predictors of adult obesity. Am J Clin Nutr 2001, 74(3):287-94.
• [6]Keane E, Layte R, Harrington J, Kearney PM, Perry IJ: Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9. PLoS One 2012, 7(8):e43503.
• [7]Hendrie GA, Coveney J, Cox DN: Defining the complexity of childhood obesity and related behaviours within the family environment using structural equation modelling. Public Health Nutr 2012, 15(1):48-57.
• [8]Lajunen HR, Kaprio J, Rose RJ, Pulkkinen L, Silventoinen K: Genetic and environmental influences on BMI from late childhood to adolescence are modified by parental education. Obesity (Silver Spring) 2012, 20(3):583-589.
• [9]Jaaskelainen A, Pussinen J, Nuutinen O, Schwab U, Pirkola J, Kolehmainen M, et al.: Intergenerational transmission of overweight among Finnish adolescents and their parents: a 16-year follow-up study. Int.J.Obes.(Lond) 2011, 35(10):1289-1294.
• [10]Shrewsbury V, Wardle J: Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990–2005. Obesity (Silver Spring) 2008, 16(2):275-84.
• [11]Bammann K, Gwozdz W, Lanfer A, Barba G, De Henauw S, Eiben G, et al.: Socioeconomic factors and childhood overweight in Europe: results from the multi-centre IDEFICS study. Pediatr. Obes. 2013, 8(1):1-12.
• [12]De Spiegelaere M, Dramaix M, Hennart P: The influence of socioeconomic status on the incidence and evolution of obesity during early adolescence. Int J Obes Relat Metab Disord 1998, 22(3):268-74.
• [13]Schmeer KK: Family structure and obesity in early childhood. Soc Sci Res 2012, 41(4):820-32.
• [14]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320(7244):1240-3.
• [15]WHO Consultation on Obesity: Obesity: preventing and managing the global epidemic. Report of a WHO consultation World Health.Organ.Tech.Rep.Ser 2000, 894:i-xii. 1–253
• [16]Muthén B, du Toit SHC, Spisic D: Robust inference using weighted least squares and quadratic estimating equations in latent variable modeling with categorical and continuous outcomes. Unpublished technical report. 1997.
• [17]Asparouhov TM, B. Robust Chi Square Difference Testing with Mean and Variance Adjusted Test Statistics. Mplus Web Notes May 6, 2006;10.
• [18]Mackinnon DP, Lockwood CM, Williams J: Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods. Multivariate Behav Res 2004, 39(1):99.
• [19]Muthén LK, Muthén BO editors. Mplus User’s Guide. Fifth edition. Los Angeles, CA: Muthén & Muthén; 1998–2007
• [20]Xu L, Dubois L, Burnier D, Girard M, Prud'homme D: Parental overweight/obesity, social factors, and child overweight/obesity at 7 years of age. Pediatr Int 2011, 53(6):826-31.
• [21]Freeman E, Fletcher R, Collins CE, Morgan PJ, Burrows T, Callister R: Preventing and treating childhood obesity: time to target fathers. IntJObes(Lond) 2012, 36(1):12-5.
• [22]Moraeus L, Lissner L, Yngve A, Poortvliet E, Al-Ansari U, Sjöberg A: Multi-level influences on childhood obesity in Sweden: societal factors, parental determinants and child’s lifestyle. Int J Obes (Lond) 2012, 36(7):969-76.
• [23]Fernandez-Alvira JM, te Velde SJ, De Bourdeaudhuij I, Bere E, Manios Y, Kovacs E, et al. Parental education associations with children’s body composition: mediation effects of energy balance-related behaviors within the ENERGY-project. Int.J.Behav.Nutr.Phys.Act. 2013 Jun 21;10:80-5868-10-80.
• [24]Lehto R, Ray C, Roos E: Longitudinal associations between family characteristics and measures of childhood obesity. Int J Public Health 2012, 57(3):495-503.
• [25]Mikkila V, Rasanen L, Raitakari OT, Pietinen P, Viikari J: Consistent dietary patterns identified from childhood to adulthood: the cardiovascular risk in Young Finns Study. Br J Nutr 2005, 93(6):923-31.
• [26]Masse LC, Blanck HM, Valente M, Atienza AA, Agurs-Collins T, Weber D, et al.: Association between self-reported household practices and body mass index of US children and adolescents, 2005. Prev Chronic Dis 2012, 9:E174.
• [27]Wikstrom K, Lindstrom J, Tuomilehto J, Saaristo TE, Korpi-Hyövälti E, Oksa H, et al.: Socio-economic differences in dysglycemia and lifestyle-related risk factors in the Finnish middle-aged population. Eur J Public Health 2011, 21(6):768-74.
• [28]Giskes K, Avendano M, Brug J, Kunst AE: A systematic review of studies on socioeconomic inequalities in dietary intakes associated with weight gain and overweight/obesity conducted among European adults. Obes Rev 2010, 11(6):413-29.
• [29]Tandon PS, Zhou C, Sallis JF, Cain KL, Frank LD, Saelens BE. Home environment relationships with children’s physical activity, sedentary time, and screen time by socioeconomic status. Int.J.Behav.Nutr.Phys.Act. 2012 Jul 26;9:88-5868-9-88.
• [30]Pearson N, Biddle SJ, Gorely T: Family correlates of fruit and vegetable consumption in children and adolescents: a systematic review. Public Health Nutr 2009, 12(2):267-83.
• [31]Kantomaa MT, Tammelin TH, Nayha S, Taanila AM: Adolescents’ physical activity in relation to family income and parents’ education. Prev Med 2007, 44(5):410-5.
• [32]Lynch J, Kaplan G. Socioeconomic position. In: Berkman L, Kawachi I, eds. Social Epidemiology Oxford: Oxford Univesity Press 2000:13–35.
• [33]Leino T, Koskenniemi E, Saranpää PR, Strömberg N, Kilpi T: Rokotuskattavuus edelleen huippuluokkaa. Suomen Lääkärilehti 2007, 62(8):739-43.
• [34]Hankonen N, Absetz P, Haukkala A, Uutela A: Socioeconomic status and psychosocial mechanisms of lifestyle change in a type 2 diabetes prevention trial. Ann Behav Med 2009, 38(2):160-5.