title: Trimming the fat: identification of risk factors associated with obesity in a pediatric emergency department.
abstract: OBJECTIVE
  The purpose of this study was to assess which knowledge deficits and dietary habits in an urban pediatric emergency department (ED) population are risk factors for obesity.
  
  
  METHODS
  This cross-sectional study in an urban pediatric ED used a modified version of the Diet and Health Knowledge Survey, an in-person interview questionnaire, to collect data on demographics, dietary knowledge, and practices. All patients aged 2 to 17 years were enrolled in the study over a 4-month period. Subjects were excluded if they were in extremis, pregnant, incarcerated, institutionalized, considered an emancipated minor, or consumed only a modified consistency diet.
  
  
  RESULTS
  One hundred seventy-nine subjects were enrolled in this study. Based on body mass index, the prevalence of obesity in our study population was 24%. Parents with obese children answered a mean of 62.9% (95% confidence interval, 60.4%-65.5%) of knowledge questions correctly, whereas all others scored 60.3% (95% confidence interval, 58.3%-62.3%) correctly. Based on the univariate analysis, 10 predictors met inclusion criteria into logistic regression analysis: screen time (P = 0.03), race (P = 0.08), sex (P = 0.04), parental education (P = 0.08), parental estimation that child is overweight (P < 0.0001), parental estimation that child is underweight (P = 0.003), trimming fat from meat (P = 0.06), soft-drink consumption (P = 0.03), exercise (P = 0.07), and chip consumption (P = 0.04). In a multivariate analysis, only male sex, regularly trimming fat from meat, and parental assessment of obesity were independently associated with obesity.
  
  
  CONCLUSIONS
  Knowledge deficiencies regarding healthy nutrition among parents in an urban pediatric ED population were not significantly associated with having obese children; however, specific habits were. Emergency physicians may provide a valuable role in identification and brief behavioral intervention in high-risk populations during the current epidemic of childhood obesity.
authors.affiliation: Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, FL, USA. joseft@mindspring.com
authors.forename: Josef G
authors.initials: JG
authors.lastname: Thundiyil
authors.forename: Danielle
authors.initials: D
authors.lastname: Christiano-Smith
authors.forename: Sarah
authors.initials: S
authors.lastname: Greenberger
authors.forename: Kelly
authors.initials: K
authors.lastname: Cramm
authors.forename: Janese
authors.initials: J
authors.lastname: Latimer-Pierson
authors.forename: Renee F
authors.initials: RF
authors.lastname: Modica
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D017028:Caregivers / Q000523:psychology*; D002648:Child; D002668:Child Rearing; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection; D004041:Dietary Fats; D004636:Emergency Service, Hospital; D005247:Feeding Behavior; D005260:Female; D005431:Florida / Q000453:epidemiology; D006184:Habits; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008460:Meat; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D010290:Parents / Q000523:psychology*; D010372:Pediatrics; D012307:Risk Factors; D012959:Socioeconomic Factors; D014505:Urban Population
chemical_list: D004041:Dietary Fats