title: Association between peer relationship problems and childhood overweight/obesity.
abstract: OBJECTIVE
  To assess the association between peer relationship problems and childhood overweight and obesity.
  
  
  METHODS
  Data on 4718 preschool children were obtained at the obligatory school entry health examination in Bavaria. Parentally reported peer relationship problems ('normal', 'borderline' or 'abnormal') were assessed from the Strengths and Difficulties Questionnaire. Overweight and obesity were defined according to age- and gender-specific BMI cut-off points. Multivariate logistic regression analysis was performed to control potential confounders.
  
  
  RESULTS
  The prevalence of overweight and obesity was higher among children with 'borderline' or 'abnormal' peer relationship problems compared to 'normal' children. The association of 'abnormal' peer relationship problems was still significant in the final logistic regression model for girls [odds ratio (OR) for overweight 2.0; 95% confidence interval (CI): 1.4-3.0; OR for obesity 2.6; 95% CI: 1.3-5.0]. Among boys the adjusted odds ratio were lower and no longer significant.
  
  
  CONCLUSIONS
  The significantly increased prevalence of overweight and obesity among preschool children with peer relationship problems could not be explained by confounding. It seems evident that there is a relevant co-morbidity of peer relationship problems and obesity in pre-school children pointing to the need of interventions focusing on both physical as well as psychosocial health.
authors.affiliation: Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilian-University of Munich, Munich, Germany. anja.boneberger@med.uni-muenchen.de
authors.forename: Anja
authors.initials: A
authors.lastname: Boneberger
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.forename: Astrid
authors.initials: A
authors.lastname: Milde-Busch
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bolte
authors.forename: Mascha K
authors.initials: MK
authors.lastname: Rochat
authors.forename: Simon
authors.initials: S
authors.lastname: Rückinger
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000150:complications*; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000209:etiology / Q000523:psychology; D016017:Odds Ratio; D050177:Overweight / Q000209:etiology / Q000523:psychology*; D010379:Peer Group; D015995:Prevalence; D012307:Risk Factors; D012920:Social Behavior Disorders / Q000150:complications*; D011795:Surveys and Questionnaires