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Can J Public Health. 2018 Aug;109(4):489-497. doi: 10.17269/s41997-018-0065-2. Epub 2018 May 30.

Severe obesity in children 17 to 24 months of age: a cross-sectional study of TARGet Kids! and Better Outcomes Registry & Network (BORN) Ontario.

Author information

1
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
2
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
3
Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
4
The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
5
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.
6
Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
7
Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Room 109801, 10th Floor - Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
8
Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada.
9
Faculty of Medicine and Dentistry, Department of Pediatrics, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada.
10
Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. catherine.birken@sickkids.ca.
11
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada. catherine.birken@sickkids.ca.
12
Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. catherine.birken@sickkids.ca.
13
Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Room 109801, 10th Floor - Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, M5G 0A4, Canada. catherine.birken@sickkids.ca.

Abstract

OBJECTIVES:

International data suggest the prevalence of severe obesity in young children may be increasing, yet no Canadian data are available. The objectives of this study were to examine definitions of severe obesity and to evaluate associated risk factors among young children in Ontario.

METHODS:

A cross-sectional study was conducted in children 17 to 24 months of age using two Ontario data sources: TARGet Kids! (n = 3713) and BORN Ontario (n = 768). Body mass index z score (zBMI) definitions were adapted from the World Health Organization (WHO) (z score > 3) and the US Centers for Disease Control (CDC) (> 120% of the 95th percentile) and applied to define severe obesity in young children. Multinomial logistic regression was used to evaluate associations between demographic and pregnancy risk factors and zBMI categories.

RESULTS:

A total of 1.1% (95% CI, 0.8-1.4) of children met the adapted WHO definition of severe obesity compared to 0.3% (95% CI, 0.2-0.6) using the CDC definition. Median neighbourhood household income (OR = 0.80, 95% CI, 0.69-0.93) and maternal pre-pregnancy BMI (OR = 1.08, 95% CI, 1.01-1.15) were associated with severe obesity in unadjusted analyses. After adjustment for potential confounders, the OR for the association between maternal pre-pregnancy BMI and severe obesity was 1.04 (95% CI, 0.94-1.15).

CONCLUSION:

More than 1% of Ontario children met the adapted WHO definition of severe obesity in very early childhood. Modifiable risk factors were identified. Future studies are needed to understand the terminology, prevalence, and risk factors for severe obesity in young children across Canada.

KEYWORDS:

Body mass index; Obesity; Obesity, childhood onset; Obesity, morbid; Obesity, pediatric

PMID:
29981101
PMCID:
PMC6964366
DOI:
10.17269/s41997-018-0065-2
[Indexed for MEDLINE]
Free PMC Article

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