Excess weight in preschool children: The role of food intake

SANTOS, Dayse Rafaele Lima dos; LIRA, Pedro Israel Cabral de; SILVA, Giselia Alves Pontes da

doi:10.1590/1678-98652017000100005

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Original Articles • Rev. Nutr. 30 (1) • Jan-Feb 2017 • https://doi.org/10.1590/1678-98652017000100005 copy

Excess weight in preschool children: The role of food intake

Excesso de peso em pré-escolares: o papel do consumo alimentar

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

The study aimed to compare the food intake of overweight/obese and normal weight preschoolers and to verify whether excess weight is associated with low birth weight, catch-up growth, early weaning, and physical activity/inactivity

Methods:

This case-control study was conducted in family healthcare units of the city of Olinda, Pernambuco, from May to August 2014

Results:

A total of 253 children were studied, 84 with 'excess weight' and 164 with 'normal weight'. In the 'overweight/obese' and 'normal weight' groups, 77% and 43% of the children, respectively, had high calorie intake. The 'overweight/obese' group had lower fruit intake, higher maternal education level, higher family income, higher maternal excess weight, and presence of catch-up growth and inactivity

Conclusion:

The results suggest that food intake has an important role, but that other variables contribute to excess weight in children. Recognition of the problem's many causes should guide the public policies directed at this age group to prevent this nutritional disorder.

Keywords:
Child; preschool. Food consumption. Obesity. Overweight

Variables	Total		Preschoolers (24 to 59 months)
	Total		Normal weight	Excess weight	OR (95%CI)	p
	n	%	n	n	OR (95%CI)	p
Maternal age (years)
≥20	241	95.3	163	78	2.09 (0.65-6.68)	0.21
<20	12	4.7	6	6
Maternal education (years)
≥8	126	49.8	76	50	1.80 (1.06-3.06)	0.03
<8	127	50.2	93	34
Maternal nutritional status
Excess weight	165	65.2	90	75	7.30 (3.44-15.55)	<0.001
Normal weight/underweight	88	34.8	79	9
Maternal occupation
Homemaker/unemployed	163	64.4	109	54	1.00 (0.58-1.74)	0.97
Employed	90	35.6	60	30
Per capita family income
≥P₂₅	190	75.1	120	70	1.49 (0.72-2.95)	0.03
<P₂₅	63	24.9	49	14
Cash transfer program
No	72	28.5	49	23	1.08 (0.60-1.94)	0.79
Yes	181	71.5	120	61
Maternal fruit intake
No	134	52.9	84	50	1.48 (0.87-2.52)	0.14
Yes	119	47.1	85	34
Maternal vegetable intake
No	168	66.4	110	58	1.19 (0.68-2.09)	0.53
Yes	85	33.6	59	26

Child’s variables	Total		Preschoolers (24 to 59 months)
	Total		Normal weight	Excess weight	OR (95%CI)	p
	n	%	n	n	OR (95%CI)	p
Sex
Male	147	58.1	92	55	1.58 (0.92-2.73)	0.09
Female	106	41.9	77	29
Birth weight (g)
≤2,999 and ≥4,000	95	38.0	55	40	1.89 (1.10-3.24)	0.02
3,000-3,999	155	62.0	112	43
Exclusive breastfeeding duration
<4 months	172	67.9	107	65	1.98 (1.08-3.60)	0.02
≥4 months	81	32.1	62	19
Weight gain in the first three months of life
≥0.67 Z-score	58	77.1	33	25	1.74 (0.31-1.04)	0.04
<0.67 Z-score	195	22.9	136	59
Level of physical activity
Little active	191	75.5	117	74	3.28 (1.57-6.87)	0.001
Active	62	24.5	52	10
Sedentary behavior
Yes	120	47.4	65	55	3.03 (1.91-5.69)	<0.001
No	133	52.6	104	29

Child’s variables	Total		Preschoolers (24 to 59 months)
	Total		Normal weight	Excess weight	OR (95%CI)	p
	n	%	n	n	OR (95%CI)	p
Fruit intake
No	119	47.0	67	52	2.47 (1.44-4.23)	0.001
Yes	134	53.0	102	32
Non-starchy vegetable intake
No	199	78.7	129	70	1.55 (0.79-3.04)	0.20
Yes	54	21.3	40	14
Superfluous food intake*
Yes	221	87.4	154	67	0.38 (0.18-0.81)	0.01
No	32	12.6	15	17
Excess calorie intake
Yes	138	54.5	73	65	4.49 (2.48-8.15)	<0.001
No	115	45.5	96	19

Variables	Preschoolers (24 to 59 months)
	Excess weight (n=84)		Normal weight (n=169)		p
	Median	Minimum-Maximum	Median	Minimum-Maximum	p
Calorie intake (kcal)	1589.6	342.0-3017.0	1321.4	716.0-4527.0	<0.01
Protein intake (g)	52.8	9.9-109.0	40.8	4.1-235.2	<0.01
% of total calorie intake	13.1	5.6-20.0	12.1	5.3-56.8	<0.01
Carbohydrate intake (g)	217.6	48.5-424.0	183.6	43.6-627.9	<0.01
% total calorie intake	55.3	39.2-71.4	54.5	19.4-78.4	0.19
Total lipid intake (g)	56.0	6.5-117.0	49.5	11.3-184.1	0.10
% total calorie intake	31.8	17.1-49.8	33.6	13.7-45.5	<0.01

Variables	Excess weight in preschoolers
Variables	Crude OR	P	Adjusted OR	95%CI	p
Model 1
Maternal education (years)
≥8	1.80	0.03	1.82	0.99-3.33	0.05
<8
Maternal nutritional status
Excess weight	7.30	<0.001	7.74	3.57-16.77	<0.001
Normal weight/underweight
Family per capita income
≥P₂₅	1.49	0.03	1.90	0.91-3.98	0.08
<P₂₅
Model 2*
Exclusive breastfeeding duration
<4 months	1.98	0.02	2.12	1.01-4.46	0.05
≥4 months
Weight gain in the first three months of life
≥0.67 Z-score	1.74	0.04	3.40	1.46-7.96	0.005
<0.67 Z-score
Level of physical activity
Little active	3.28	0.001	2.62	0.94-7.32	0.07
Active
Sedentary behavior
Yes	3.03	<0.001	2.36	1.09-5.11	0.03
No
Model 3**
Fruit intake
No	2.47	0.001	2.86	1.35-6.06	0.006
Yes
Non-starchy vegetable intake
No	1.55	0.20	1.45	0.57-3.66	0.42
Yes
Superfluous food intake***
Yes	0.38	0.01	0.08	0.03-0.31	<0.001
No
Excess calorie intake
Yes	4.49	<0.001	3.04	1.52-6.07	0.002
No

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[1] Correspondência para/Correspondence to: DRL SANTOS. E-mail: <dayselima.nutri@ymail.com>.