title: Influence of contextual and individual level risk factors on adiposity in a preschool child cohort in Ho Chi Minh City, Vietnam.
abstract: OBJECTIVE
  To identify risk factors associated with changes in BMI and sum of skinfold thickness (SSF) in a cohort of preschool children in Ho Chi Minh City (HCMC), Vietnam.
  
  
  METHODS
  This one year follow-up study, using multi-stage cluster sampling, was conducted from 2005-2006 with 526 children aged 4-5 years in preschools in urban HCMC. Information on neighborhood, preschool and home environments, socio-economic status, the child and parental characteristics were collected using interview-administered questionnaires. Dietary intake and physical activity were measured using modified, validated questionnaires. Weight, height, and triceps, subscapular and suprailiac skinfold thickness were measured. Generalized estimating equations (GEEs) were used to assess the longitudinal relationships between the risk factors and the development of adiposity.
  
  
  RESULTS
  A variety of factors at different levels were associated with changes in BMI and SSFs. As safety of the neighborhood increased, BMI and SSFs decreased (coefficients for BMI: -0.59; 95% CI: -1.16 to -0.01 for girls and -0.80; 95% CI: -1.53, -0.08 for boys, and coefficients for SSFs: -2.71; 95% CI: -5.07, -0.35 for girls and -4.16, 95% CI: -8.28, -0.05). Having both parents overweight was strongly predictive of an increase in BMI (1.18, 0.21-2.16). Maternal pre-pregnant BMI status, breast-feeding, and high birth weight were also related to change in adiposity.
  
  
  CONCLUSIONS
  Contextual variables in the community and home environment, and parental characteristics appeared to be more important than individual factors for explaining on changes in adiposity in this child population.
authors.affiliation: Nutrition Centre of Ho Chi Minh City, Ho Chi Minh City, Vietnam. thudieuhuynh@yahoo.com
authors.forename: Dieu T T
authors.initials: DT
authors.lastname: Huynh
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dibley
authors.forename: David
authors.initials: D
authors.lastname: Sibbritt
authors.forename: Hanh T M
authors.initials: HT
authors.lastname: Tran
authors.forename: Qui T K
authors.initials: QT
authors.lastname: Le
mesh_terms: D050154:Adiposity; D000367:Age Factors; D001724:Birth Weight; D015992:Body Mass Index; D001942:Breast Feeding; D002675:Child, Preschool; D004032:Diet; D004777:Environment; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D010290:Parents; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012885:Skinfold Thickness; D011795:Surveys and Questionnaires; D014504:Urban Health; D014744:Vietnam / Q000453:epidemiology