Protective factors, not only risk factors for child obesity among low socio-economic populations

Abstract

Background: Scientific evidence about protective factors that contribute to a healthy weight is limited.This study aimed to examine protective and risk factors for obesity among children of low socio-economic status in the Jewish and Arab sectors in Israel. Methods: Children aged five years were randomly selected from 20 Mother and Child clinics in towns of low socioeconomic ranking in Israel. Children and mothers were invited for special “One Stop Shop - Preparation for School†physical examinations, including weight and height. Mothers were interviewed using a questionnaire on psychosocial, behavioral and environmental factors. 371 Jewish and 575 Arab children participated. Multivariate analyses using logistic regression models predicting obesity were conducted in each population group. Findings: Obesity rates (BMI≥85%) were higher in Jewish than Arab children (25% vs 19%). In both sectors, after controlling for maternal BMI and child birth-weight as risk factors for obesity, Jewish and Arab mothers’ reported self-efficacy regarding the child’s health behaviors was significantly protective (OR=0.52 and 0.60, respectively). Additional protective and risk factors were identified but differed for each sector. In the Jewish sector only, the association between maternal BMI and child BMI was moderated by maternal education. Discussion: Protective factors contribute to healthy child weight alongside risk factors for obesity but differ across the sectors. Maternal education is a significant moderator among Jewish children. Early childhood programs to reduce childhood obesity in disadvantaged populations would be strengthened through a focus on protective factors but needs to be culturally adapted.