title: Effects of social and environmental determinants on overweight and obesity among Brazilian schoolchildren from a developing region.
abstract: OBJECTIVE
  To identify the social and environmental determinants most strongly associated with overweight and obesity in Brazilian schoolchildren from a developing region.
  
  
  METHODS
  Data were collected from a community-based survey of schoolchildren from the Valley of Jequitinhonha, Minas Gerais, Brazil. The sample was composed of 5 100 school children aged 6-18 years. Overweight and obesity were defined by body mass index based on the current method recommended by the World Health Organization in 2007. Social and environmental determinants were collected by using a structured questionnaire.
  
  
  RESULTS
  The prevalence of overweight and obesity was 11.1% and 2.7% in girls and 8.2% and 1.5% in boys, respectively. The chance of overweight was higher in schoolchildren who engaged in remunerated work (odds ratio [OR] = 2.19, 95% confidence interval [CI] 1.30- 3.26), whose parents had higher education levels (OR = 1.52, 95% CI 1.12-2.07), who had two or fewer siblings (OR = 1.74, 95% CI 1.21-2.49), and who were in a high economic class (OR = 1.93, 95% CI 1.32-2.85). Schoolchildren who traveled by car to school (OR = 1.50, 95% CI 1.14-1.91), lived < 5 km from school (OR = 1.64, 95% CI 1.06-2.39), and consumed foods sold in the school cafeteria (OR = 1.56, 95% CI 1.19-2.16) presented high odds of being overweight.
  
  
  CONCLUSIONS
  The background from a particular region of a country should be considered when implementing preventive measures regarding overweight and obesity, especially for very poor, developing regions like the Valley of Jequitinhonha. Measures taken should consider a multilevel intervention that includes the family, school, and physical environment.
authors: Department of Physical Education and Sport, State University of Londrina, Paraná, Brazil. darta@sercomtel.com.br
authors: Dartagnan Pinto
authors: DP
authors: Guedes
authors: Giselle Divino
authors: GD
authors: Rocha
authors: António José Rocha Martins
authors: AJ
authors: Silva
authors: Isabel Mourão
authors: IM
authors: Carvalhal
authors: Eduarda Maria
authors: EM
authors: Coelho
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003906:Developing Countries; D015981:Epidemiologic Factors; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D009752:Nutritional Status; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology*; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D012931:Social Environment; D012959:Socioeconomic Factors; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D014944:World Health Organization