Home Environment Characteristics and BMI Z-Score Among Saudi Preschool Children: A Feasibility Study

Authors

  • Rana H. Mosli Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah 21589, KSA

DOI:

https://doi.org/10.6000/1929-4247.2017.06.04.1

Keywords:

Saudi, Feasibility, Preschool, BMI, Home environment, Family

Abstract

Objective: To assess feasibility of using preschools in Saudi Arabia as a source for collecting nutrition-related data; To examine associations among home environment characteristics and child BMI z-score (BMIz).

Methods: Fifty-three (3-5 years old) children and their mothers were recruited from two preschools in Jeddah, Saudi Arabia. Mothers completed a self-administered questionnaire. Child anthropometry was completed using standardized procedures. BMIz was calculated using the WHO growth standards and reference data. Associations between child and home environment variables were tested using Pearson correlation, t-tests and ANOVA.

Results: Participation rate in the middle-to high-income preschool was higher compared to the low- to middle-income preschool (27.3% vs. 17.4%, respectively). Increase in child age and maternal BMI were associated with lower maternal playtime with the child (r= -0.31, p= 0.02, and r= -0.38, p= 0.006, respectively). Increase in child age was also associated with lower paternal playtime with the child (r= -0.26, p= 0.05). Paternal playtime with the child was positively associated with both paternal involvement in feeding (r= 0.30, p= 0.03) and regular family mealtimes (r= 0.26, p=0.05). There was a trend of positive association between paternal involvement in feeding and higher child BMIz (r= 0.26, p=0.08). Mean child BMIz was lower when mothers had ³ a college education vs. not (p= 0.04). Greater child screen time was associated with fewer family mealtimes (p= 0.01).

Conclusion: Increasing awareness is needed in order to improve feasibility of studies conducted in Saudi preschools; Future work is needed to further establish the associations of home environment characteristics and child obesity.

References

[1] Deckelbaum RJ, Williams CL. Childhood obesity: The health issue. Obes Res 2001; 9(S11): 239S-43S.
https://doi.org/10.1038/oby.2001.125
[2] Birch LL, Fisher JO. Development of eating behaviors among children and adolescents. Pediatrics 1998; 101(2): 539-49.
https://doi.org/10.1016/S0031-3955(05)70347-3
[3] Birch LL, Davison KK. Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatric Clinics of North America 2001; 48(4): 893-907.
[4] Cunningham SA, Kramer MR, Narayan KMV. Incidence of childhood obesity in the United States N Engl J Med 2014; 370(5): 403-11.
[5] Dietz WH. Critical periods in childhood for the development of obesity. American Journal of Clinical Nutrition 1994; 59(5): 955-9.
[6] Epstein LH, Myers MD, Raynor HA, Saelens BE. Treatment of pediatric obesity. Pediatrics 1998; 101(1): 554-70.
[7] Evans GW. The environment of childhood poverty Am Psychol 2004; 59(2): 77.
https://doi.org/10.1037/0003-066X.59.2.77
[8] Suglia SF, Duarte CS, Chambers EC, Boynton-Jarrett R. Cumulative social risk and obesity in early childhood. Pediatrics 2012; 129(5): e1173-9.
https://doi.org/10.1542/peds.2011-2456
[9] Hesketh k, Crawford D, Salmon J, Jackson M, Campbell K. Associations between family circumstance and weight status

of Australian children. Journal of Pediatric Obesity 2007; 2(2): 86-96.
https://doi.org/10.1080/17477160601148554
[10] Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology 1994; 13(5): 373-83.
https://doi.org/10.1037/0278-6133.13.5.373
[11] Golan M, Crow S. Targeting parents exclusively in the treatment of childhood obesity: Long?Term results. Obesity 2004; 12(2): 357-61.
https://doi.org/10.1038/oby.2004.45
[12] Anderson PM, Butcher KF, Levine PB. Maternal employment and overweight children 31 2003; 22(3): 477-504.
[13] Gubbels JS, Kremers SP, Stafleu A, de Vries SI, Goldbohm RA, Dagnelie PC, et al. Association between parenting practices and children's dietary intake, activity behavior and development of body mass index: the KOALA Birth Cohort Study. International Journal of Behavioral Nutrition and Physical Activity 2011; 8(1): 18.
https://doi.org/10.1186/1479-5868-8-18
[14] Guerrero AD, Chu L, Franke T, Kuo AA. Father involvement in feeding interactions with their young children. American Journal of Health Behavior 2016; 40(2): 221-30.
https://doi.org/10.5993/AJHB.40.2.7
[15] Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics 2011: peds-2010.
[16] Al-Othaimeen AI, M Al-Nozha M, Osman AK. Obesity: an emerging problem in Saudi Arabia. Analysis of data from the National Nutrition Survey. Eastern Mediterranean Health Journal 2007; 13(2): 441-8.
[17] El-Mouzan M, Foster P, Al-Herbish A, Al-Salloum A, A Al-Omer A, Qurachi M, et al. Prevalence of overweight and obesity in Saudi children and adolescents. Annals of Saudi Medicine 2010; 30(3): p.203.
https://doi.org/10.4103/0256-4947.62833
[18] Sibai SM, Nasreddine L, Mokdad AH, Adra N, Tabet M, Hwalla N. Nutrition transition and cardiovascular disease risk factors in Middle East and North Africa countries: reviewing the evidence. Annals of Nutrition and Metabolism 2010; 57(3-4): 193-203.
https://doi.org/10.1159/000321527
[19] Ng SW, Zaghloul S, Ali H, Harrison G, Yeatts K, El-Sadig M, et al. Nutrition transition in the United Arab Emirates. European Journal of Clinical Nutrition 2011; 65(12): 328-1337.
https://doi.org/10.1038/ejcn.2011.135
[20] Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases The American Journal of Clinical Nutrition 2006; 84(2): 289-98.
[21] Al-Muhaimeed AA, Dandash K, Ismail MS, Saquibc N. Prevalence and correlates of overweight status among Saudi school children. Annals of Saudi Medicine 2015; 35(4): 275.
https://doi.org/10.5144/0256-4947.2015.275
[22] Amin TT, Al-Sultan AL, Ali A. Overweight and obesity and their relation to dietary habits and socio-demographic characteristics among male primary school children in Al-Hassa, Kingdom of Saudi Arabia. European Journal of Nutrition 2008; 47(6): 310.
https://doi.org/10.1007/s00394-008-0727-6
[23] Mahfouz AA, Abdelmoneim I, Khan MY, Daffalla AA, Diab MM, Al-Gelban KS, et al. Obesity and related behaviors among adolescent school boys in Abha City, Southwestern Saudi Arabia. Journal of Tropical Pediatrics 2007; 54(2): 120-4.
https://doi.org/10.1093/tropej/fmm089
[24] Al-Hazzaa HM. Pedometer-determined physical activity among obese and non-obese 8-to 12-year-old Saudi schoolboys. Journal of Physiological Anthropology 2007; 26(4): 459-65.
https://doi.org/10.2114/jpa2.26.459
[25] Al-Hazzaa HM, Al-Rasheedi AA. Adiposity and physical activity levels among preschool children in Jeddah, Saudi Arabia Saudi Medical Journal 2007; 28(5): 766.
[26] Chen AY, Escarce JJ. Peer reviewed: Family structure and childhood obesity, early childhood longitudinal study—kindergarten cohort. Preventing Chronic Disease 2010; 7(3).
[27] Maher EJ, Li G, Carter L, Johnson DB. Preschool child care participation and obesity at the start of kindergarten. Pediatrics 2008; 22(2): 322-30.
https://doi.org/10.1542/peds.2007-2233
[28] Lumeng JC, Kaciroti N, Sturza J, Krusky AM, Miller AL, Peterson KE, et al. Changes in body mass index associated with Head Start participation. Pediatrics 2015; 135(2): e449-56.
https://doi.org/10.1542/peds.2014-1725
[29] Spurrier NJ, Magarey AA, Golley R, Curnow F, Sawyer MG. Relationships between the home environment and physical activity and dietary patterns of preschool children: A cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity 2008; 5(1): 31.
https://doi.org/10.1186/1479-5868-5-31
[30] Wen LM, Van-der-Ploeg HP, Kite J, Cashmore A, Rissel C. A validation study of assessing physical activity and sedentary behavior in children aged 3 to 5 years. Pediatric Exercise Science 2010; 22(3): 408-20.
https://doi.org/10.1123/pes.22.3.408
[31] McGarvey E, Keller A, Forrester M, Williams E, Seward D, Suttle DE. Feasibility and benefits of a parent-focused preschool child obesity intervention. American Journal of Public Health 2004; 94(4): 1490-5.
https://doi.org/10.2105/AJPH.94.9.1490
[32] Li B, Adab P, Cheng KK. The role of grandparents in childhood obesity in China - evidence from a mixed methods study. International Journal of Behavioral Nutrition and Physical Activity 2015; 12(1): 91.
https://doi.org/10.1186/s12966-015-0251-z
[33] Mosli RH, Miller AL, Peterson KE, Kaciroti N, Rosenblum K, Baylin A, et al. Birth order and sibship composition as predictors of overweight or obesity among low-income 4- to 8-year-old children. Pediatric Obesity 2016; 11(1): 40-6.
https://doi.org/10.1111/ijpo.12018
[34] Onis MD, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for

school-aged children and adolescents. Bulletin of the World health Organization 2007; 85(9): 660-7.
https://doi.org/10.2471/BLT.07.043497
[35] World Health Organization. WHO child growth standards: length/height for age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age, methods and development. World Health Organization; 2006.
[36] World Data on Education (6th ed.). UNESCO IBE 2006/2007. Available from: http://www.ibe.unesco.org/en/resources? search_api_views_fulltext=%22WDE%202006%20index.
[37] Allqassem R, Dashash D, Alzahrani A. Early Childhood Education in Saudi Arabia: Report. World Journal of Education 2016; 6(5).
[38] Ministry of Education Statistical Information. Kingdom of Saudi Arabia. Statistics on General Education by Year. Available from: https://www.moe.gov.sa/ar/Pages/Statistical-Information.aspx.
[39] Federal Education Budget Project. New America Foundation. Retrieved May 21, 2013.
[40] Education Commission of the States. 50-state comparison: State kindergarten Policies (2014), Accesed on August 28, 2017: https://www.ecs.org/kindergarten-policies/.
[41] Wong MS, Jones?Smith JC, Colantuoni E, Thorpe RJ, Bleich SN, Chan KS. The longitudinal association between early childhood obesity and fathers' involvement in caregiving and decision?making. Obesity 2017.
https://doi.org/10.1002/oby.21902
[42] Benson L, Mokhtari M. Parental employment, shared parent–child activities and childhood obesity. Journal of Family and Economic Issues 2011; 32(2): 233-44.
https://doi.org/10.1007/s10834-011-9249-0
[43] Buswell L, Zabriskie RB, Lundberg N, Hawkins AJ. The relationship between father involvement in family leisure and family functioning: The importance of daily family leisure. Leisure Sciences 2012; 34(2): 172-90.
https://doi.org/10.1080/01490400.2012.652510
[44] Li B, Adab P, Cheng KK. The role of grandparents in childhood obesity in China-evidence from a mixed methods study. International Journal of Behavioral Nutrition and Physical Activity 2015; 12(1): 91.
https://doi.org/10.1186/s12966-015-0251-z
[45] Boone JE, Gordon-Larsen P, Adair LS, Popkin BM. Screen time and physical activity during adolescence: longitudinal effects on obesity in young adulthood. International Journal of Behavioral Nutrition and Physical Activity 2007; 4(1): 26.
https://doi.org/10.1186/1479-5868-4-26

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2017-11-08

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