title: Risk factors for overweight/obesity in preschool children: an ecological approach.
abstract: BACKGROUND
  Identification of risk factors is critical to preventing the childhood obesity epidemic. Risk factors that contribute to obesity are multifactorial. However, limited research has focused on identifying obesity risk factors using an ecological approach.
  
  
  METHODS
  Baseline self-report survey data from the STRONG Kids program were used. The sample consisted of 329 parent-child dyads recruited from childcare programs in east-central Illinois. Child height and weight were measured and converted to age- and sex-specific z-scores using standard growth charts. An ecological model provided the theoretical framework for the selection of 22 previously reported childhood obesity risk factors. Multiple logistic regression analyses were used to identify risk factors.
  
  
  RESULTS
  Of 22 potential risk factors, three were found to be significantly associated with child overweight/obesity. These included child nighttime sleep duration (χ(2)=8.56; p=0.003), parent BMI (χ(2)=5.62; p=0.01), and parental restrictive feeding for weight control (χ(2)=4.77; p=0.02). Children who slept for 8 hours and less were 2.2 times more likely to be overweight/obese [95% confidence interval (CI): 1.3-3.7), whereas children with an overweight/obese parent were 1.9 times more likely to be overweight/obese (95% CI: 1.12-3.2). Finally, children whose parents used restrictive feeding practices were 1.75 times more likely to be overweight/obese (95% CI: 1.06-2.9).
  
  
  CONCLUSIONS
  Using an ecological approach, we conclude that childhood obesity prevention efforts may benefit from targeting the key risk factors of child sleep duration, parent BMI, and parental restrictive feeding practices as focus areas for obesity prevention.
authors.affiliation: 1 Division of Nutritional Sciences, University of Illinois Urbana-Champaign , Urbana, IL.
authors.forename: Dipti A
authors.initials: DA
authors.lastname: Dev
authors.forename: Brent A
authors.initials: BA
authors.lastname: McBride
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Fiese
authors.forename: Blake L
authors.initials: BL
authors.lastname: Jones
authors.forename: Hyunkeun
authors.initials: H
authors.lastname: Cho
mesh_terms: D015992:Body Mass Index; D002675:Child, Preschool; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D010290:Parents; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D012892:Sleep Deprivation / Q000150:complications / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
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