Child behavior, feeding practices, and health in the context of obesity

Abstract

[eng] Childhood obesity is a global public health problem with aggravating consequences during adulthood, including cardiovascular disease, type 2 diabetes, musculoskeletal disorders, and some types of cancers. The reason is that obesity is a complex disease with multiple risk factors at play, at the individual, family, and community levels. The objectives of the thesis were to study several obesity-related factors including children’s diet, sedentary behaviors, physical activity, and health-related quality of life as well as maternal diet, education, parental feeding practices and perception of child´s weight. This thesis regrouped a prospective and a cross-sectional study. The POIBC prospective study was carried out in children aged 8 to 10 and the PERCEPS cross-sectional study was conducted in children aged 5 to 9. Findings from the POIBC prospective study showed that maternal diet and TV time was positively associated with child´s diet and TV viewing. On the other hand, maternal physical activity was not predictive of children´s physical activity. Low maternal education was associated with higher consumption of baked goods, sweets and fast-food and predicted longer screen time in children. Children´s adherence to the Mediterranean diet was positively associated with children´s health-related quality of life. From the PERCEPS cross-sectional study, we observed that children perceived as underweight were applied more pressure-to-eat whereas children with overweight perceived as such or as normal weight experienced less pressure-to-eat. Children accurately identified as overweight presented higher restriction scores. Monitoring and restriction were positively associated with higher BMI z-scores in children while pressure-to-eat presented the inverse association. However, monitoring was positively associated with child’s adherence to the Mediterranean diet whereas restriction and pressure-to-eat were negatively associated. Results from this thesis provide evidence on the impact of several lifestyle factors on childhood obesity. This evidence was drawn from observational studies and therefore lacks causality.