title: Individual, family and environmental factors associated with pediatric excess weight in Spain: a cross-sectional study.
abstract: BACKGROUND
  There is a growing worldwide trend of obesity in children. Identifying the causes and modifiable factors associated with child obesity is important in order to design effective public health strategies.Our objective was to provide empirical evidence of the association that some individual and environmental factors may have with child excess weight.
  
  
  METHODS
  A cross-sectional study was performed using multi-stage probability sampling of 978 Spanish children aged between 8 and 17 years, with objectively measured height and weight, along with other individual, family and neighborhood variables. Crude and adjusted odds ratios were calculated.
  
  
  RESULTS
  In 2012, 4 in 10 children were either overweight or obese with a higher prevalence amongst males and in the 8-12 year age group. Child obesity was associated negatively with the socio-economic status of the adult responsible for the child's diet, OR 0.78 (CI95% 0.59-1.00), girls OR 0.75 (CI95% 0.57-0.99), older age of the child (0.41; CI95% 0.31-0.55), daily breakfast (OR 0.59; p = 0.028) and half an hour or more of physical activity every day. No association was found for neighborhood variables relating to perceived neighborhood quality and safety.
  
  
  CONCLUSIONS
  This study identifies potential modifiable factors such as physical activity, daily breakfast and caregiver education as areas for public health policies. To be successful, an intervention should take into account both individual and family factors when designing prevention strategies to combat the worldwide epidemic of child excess weight.
authors.affiliation: Andalusian School of Public Health (EASP), Granada, Spain. josejuan.obesidad@gmail.com.
authors.forename: José-Juan
authors.initials: JJ
authors.lastname: Sánchez-Cruz
authors.forename: Ingrid
authors.initials: I
authors.lastname: de Ruiter
authors.forename: José J
authors.initials: JJ
authors.lastname: Jiménez-Moleón
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D004777:Environment; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology*; D012111:Residence Characteristics; D012307:Risk Factors; D013030:Spain