Influential Factors of School-Aged Childhood Obesity and Normal-Weighted Children; A Case-Control Study

Abstract

Objective: To find influential factors of obesity in terms of eating behavior, daily activities, and family factors of school-aged childhood obesity compared to healthy and normal-weighted children.
Material and Method: The case-control study of 112 participants (56 from the obesity cases in Childhood obesity Clinic, Phra Nakhon Si Ayutthaya Hospital, compared with 56 control from normal-weighted children from Anuban Phra Nakhon Si Ayutthaya Elementary school, matched age and gender in a ratio of 1: 1.  The participants had completed the questionnaire survey. The data was analyzed in the domains of patient factors, nutritional factors, physical activity, and parent-child relationships such as encouragement of eating and preparing and cooking among caregivers.
Results: The obesity ages started from an average of 2.32 years old, with no statistically significant difference between gender (2.16 + 1.1 v.s 2.66 + 1.0 years old, p-value < 0.054), male and female respectively. Domain of nutritional status/diets, the obese children group (case) overall average food intake consumed more than normal-weight children group (control), 3.15+0.19 v.s.2.31+0.14, respectively ( p-value < 0.001). Most obese cases ate more vegetables on average than the normal-weight group, 2.55.+0.19 v.s. 2.08 +0.21, p-value=0.038). The physical activities had at least one active physical exercise; significantly fewer sports were played in the obesity group than in the normal-weight group (2.10+1.08 vs. 2.69+1.00, p-value= 0.003). But, the other physical activities had not shown significance, jogging (2.13+0.75 vs. 2.28+0.8 and swimming (1.28+0.49 vs.1.31+0.46), with p-values of 0.308 and 0.739 respectively. TV watching and time-screen showed statistically significantly higher in the case group than in the control group. The results showed 4.95+2.10 vs. 3.40+1.30 in TV watching (p-value < 0.001), and 4.25+1.08 vs. 3.70+1.43 in time-screen playing (p-value=0.023). Related genetic factors (obesity/metabolic syndrome, Diabetes Mellitus, and abnormal cholesterol in family members), We found only Family DM was statistically more significant in the obese group than in normal-weight children (OR: 2.68,95 % CI 1.09-6.61, p-value = 0.03).
Conclusion: Obesity is significantly present in pre-school and school-age children. We found multifactorial problems are causes, combined with nutrition factors and genetics vulnerable to metabolic disease and encouragement of eating, preparing, and cooking. The key to successfully treating and preventing childhood obesity lies in two main factors: patient and family/or caregivers; coordinate and synchronize among these factors to prevention.

Keywords: Childhood obesity, Overweight, Family factor, Diet therapy, Physical activity