Factors associated with childhood obesity in Spain. The OBICE study: a case-control study based on sentinel networks

Centro Superior de Investigacion enSalud Publica, Avenida de Catalunya 21, 46020-Valencia, SpainSubmitted 3 July 2010: Accepted 8 December 2010: First published online 7 February 2011AbstractObjective: To estimate the association strength of dietary behaviour and sedentaryhabits in relation to childhood obesity in Spain.Design: A matched case–control study was carried out using data collected bysentinel network paediatricians in general practices.Setting: Five Spanish autonomous communities.Subjects: Cases were 437 children (2–14 years old) with BMI .95th percentileaccordingtoSpanish referencetables.Controls were 751children (2–14 yearsold;two paired per case) with BMI ,84th percentile. Data were collected in twophases: individual (questionnaires filled in by sentinel paediatricians) and family(self-administered questionnaires filled in a family environment). Crude OR andadjusted OR (ORc and adj OR) for the given variables were calculated using asimple and multiple conditional logistic regression analysis.Results: The factors with the greatest effect on obesity were family history ofobesity: both parents (adj OR511?2), mother but not father (adj OR59?1), fatherbut not mother (adj OR56?1), siblings (adj OR52?7); and eating between meals(adj OR52?5) and consumption of sweets and soft drinks .2 times/week(adj OR52?0). The highest protection effect was found for five meals per day(adjOR50?5), theregularconsumption ofbreakfast(adjOR50?5)and foreatingfruit for dessert (adj OR50?6). Factors related to sedentary habits did not appearas noteworthy.Conclusions: We have determined the association between certain dietary beha-viour and family history with childhood obesity in several Spanish regions.KeywordsChildhood obesityCase–control studySentinel networkChildhood obesity is determined by a complex interplayof genetic, environmental, behavioural and cultural factors,which lead to an energy imbalance. Social and cultural fac-tors appear to play an important role in shaping the closestbehavioural patterns that give rise to body weight gain