Preventing Chronic Disease | Individual, Family, and Community Predictors of Overweight and Obesity Among Colombian Children and Adolescents - CDC
Individual, Family, and Community Predictors of Overweight and Obesity Among Colombian Children and Adolescents
Ines Gonzalez-Casanova, PhD; Olga Lucia Sarmiento, PhD; Michael Pratt, MD, PhD; Julie A. Gazmararian, PhD; Reynaldo Martorell, PhD; Solveig A. Cunningham, PhD; Aryeh Stein, PhD
Suggested citation for this article: Gonzalez-Casanova I, Sarmiento OL, Pratt M, Gazmararian JA, Martorell R, Cunningham SA, et al. Individual, Family, and Community Predictors of Overweight and Obesity Among Colombian Children and Adolescents. Prev Chronic Dis 2014;11:140065. DOI: http://dx.doi.org/10.5888/pcd11.140065
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Abstract
Introduction
Information from high-income countries is often used to design childhood obesity prevention interventions in low- and middle-income countries, even though determinants may differ greatly between settings.
Information from high-income countries is often used to design childhood obesity prevention interventions in low- and middle-income countries, even though determinants may differ greatly between settings.
Methods
We examined the associations of individual, family (household), and community (municipality) characteristics with body mass index (BMI) z scores and likelihood of overweight among children aged 5 to 18 years measured for the Colombian National Nutrition surveys of 2005 (n = 9,119) and 2010 (n = 21,520). We used 3-level hierarchical linear models with child as level 1, household as level 2, and municipality as level 3.
We examined the associations of individual, family (household), and community (municipality) characteristics with body mass index (BMI) z scores and likelihood of overweight among children aged 5 to 18 years measured for the Colombian National Nutrition surveys of 2005 (n = 9,119) and 2010 (n = 21,520). We used 3-level hierarchical linear models with child as level 1, household as level 2, and municipality as level 3.
Results
The prevalence of combined overweight and obesity among Colombian children and adolescents was 15.7% in 2005 and 16.6% in 2010. The household level explained 40% in 2005 and 31% in 2010 of the variability in BMI z scores. Wealth was positively associated with BMI in 2005 (0.09 increase in z score per wealth quintile) and 2010 (0.13 increase in zscore per wealth quintile) (P < .01). Children and adolescents from extended families had higher BMI z scores than those from nuclear families; BMI z scores were inversely associated with the number of family members living in the same household. The municipality level explained only between 2% and 3% of the variability in BMI. Income inequality was positively associated with BMI z scores in 2010.
The prevalence of combined overweight and obesity among Colombian children and adolescents was 15.7% in 2005 and 16.6% in 2010. The household level explained 40% in 2005 and 31% in 2010 of the variability in BMI z scores. Wealth was positively associated with BMI in 2005 (0.09 increase in z score per wealth quintile) and 2010 (0.13 increase in zscore per wealth quintile) (P < .01). Children and adolescents from extended families had higher BMI z scores than those from nuclear families; BMI z scores were inversely associated with the number of family members living in the same household. The municipality level explained only between 2% and 3% of the variability in BMI. Income inequality was positively associated with BMI z scores in 2010.
Conclusion
These patterns differ from those commonly described in high-income countries and suggest more appropriate opportunities for interventions to prevent child and adolescent obesity in Colombia and other Latin American settings and populations.
These patterns differ from those commonly described in high-income countries and suggest more appropriate opportunities for interventions to prevent child and adolescent obesity in Colombia and other Latin American settings and populations.
Acknowledgments
The Demographic and Health Survey of Colombia 2005 was funded by the US Agency for International Development, the United Nations Population Fund, the Colombian Institute of Family Welfare, and Colombia’s Ministry of Social Protection. Support for Ines Gonzalez Casanova’s doctoral studies at Emory University was partially provided by the Consejo Nacional de Ciencia y Tecnología of Mexico, by the Coca-Cola Company via an unrestricted training grant to the CDC Foundation, and the Center for Community Partnerships from Emory University.
Author Information
Corresponding Author: Ines Gonzalez-Casanova, PhD, Hubert Department of Global Health, Rollins School of Public Health, Nutrition and Health Sciences Program, Emory University, 1518 Clifton Rd NE, 7000H, Atlanta, GA 30322. Telephone: 404-727-7568. E-mail: igonza2@emory.edu.
Author Affiliations: Olga Lucia Sarmiento, Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia; Michael Pratt, Rollins School of Public Health, Emory University, Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia, and Centers for Disease Control and Prevention, Atlanta, Georgia; Julie A. Gazmararian, Reynaldo Martorell, Solveig A. Cunningham, Aryeh Stein, Rollins School of Public Health, Emory University, Atlanta, Georgia.
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