Abstract
OBJECTIVE: This study was conducted to determine the prevalence of overweight and obesity in preschool-aged (42-66 months) children in Newfoundland and Labrador in 2009/10. Second, 2009/10 rates were compared to those reported for 2001/02 and 1988/89 to ascertain whether the previous rising trend had continued, stabilized or decreased while public health prevention and intervention efforts increased.
METHODS: Heights and weights of children measured in clinics in 2009/10, 2001/02 and 1988/89 were sampled, representing 29%, 77% and 45% of provincial births in 2005, 1997 and 1984, respectively. Body mass indices were calculated and classified as overweight, obese or neither, using World Health Organization (WHO) growth charts. ANOVA and regression procedures were used to compare cohorts.
RESULTS: Combined overweight and obesity was significantly lower in 2009/10 (35.7%) than in 2001/02 (38.9%), (OR 0.87, 95% CI 0.76-0.99). Considered separately, both overweight and obesity rates stabilized. Boys were 1.4 times more likely to be overweight or obese than girls in all samples. In 2009/10, combined overweight and obesity was higher in rural areas (OR 1.67, 95% CI 1.28-2.18). In three of four public health jurisdictions, prevalence in 2009/10 remained significantly higher than 20 years earlier. In one region, rates returned to 1988/89 levels.
CONCLUSION: Progress has been made in stabilizing, even reversing, overweight and obesity in the Newfoundland and Labrador preschool population, however, prevalence rates remain high. Surveillance and intervention efforts must continue. Given the jurisdictional and regional differences found, further research should compare ecological contexts and thus attempt to isolate and identify important contributing factors and effective interventions.
Key Words: Preschool children, overweight, obesity, prevalence, rural, urban
Résumé
OBJECTIF: Déterminer la prévalence du surpoids et de l’obésité chez les enfants d’âge préscolaire (42-66 mois) de Terre-Neuve-et-Labrador en 2009–2010. Nous avons ensuite comparé les taux de 2009-2010 aux taux déclarés en 2001–2002 et en 1988-1989 pour vérifier si la tendance haussière antérieure s’est maintenue, s’est stabilisée ou a diminué, alors que la santé publique a accru ses efforts de prévention et d’intervention.
MÉTHODE: Nous avons échantillonné la taille et le poids d’enfants mesurés en clinique en 2009-2010, 2001-2002 et 1988-1989; ces enfants représentaient respectivement 29 %, 77 % et 45 % des naissances dans la province en 2005, 1997 et 1984. Les indices de masse corporelle ont été calculés et classés dans trois catégories (en surpoids, obèse ou ni l’un ni l’autre) selon les fiches de croissance de l’Organisation mondiale de la santé (OMS). Nous avons comparé les cohortes au moyen d’analyses de la variance et d’analyses de régression.
RÉSULTATS: Le surpoids et l’obésité combinés étaient significativement plus faibles en 2009-2010 (35,7 %) qu’en 2001-2002 (38,9 %) (RC 0,87, IC de 95 % 0,76-0,99). Pris séparément, les taux de surpoids et d’obésité se sont stabilisés. Les garçons étaient 1,4 fois plus susceptibles d’être en surpoids ou obèses que les filles dans tous les échantillons. En 2009-2010, le surpoids et l’obésité combinés étaient plus élevés en milieu rural (RC 1,67, IC de 95 % 1,28-2,18). Dans trois régions sanitaires sur quatre, leur prévalence en 2009-2010 était encore sensiblement plus élevée que 20 ans plus tôt. Dans une des régions, les taux étaient revenus à ceux de 1988–1989.
CONCLUSIONS: On a fait des progrès pour stabiliser, et même inverser, le surpoids et l’obésité dans la population préscolaire de Terre-Neuve-et- Labrador, mais les taux de prévalence demeurent élevés. Les efforts de surveillance et d’intervention doivent se poursuivre. À la lumière des écarts provinciaux et régionaux constatés, il faudrait pousser la recherche pour comparer les contextes écologiques afin de tenter d’isoler et d’identifier les facteurs qui contribuent à la situation et les interventions efficaces.
Mots Clés: enfant d’âge préscolaire, surpoids, obésité, prévalence, population rurale, population urbaine
Footnotes
Acknowledgements: This work was supported by a grant from the Health Promotion and Wellness Division of the Department of Health and Community Services, Government of Newfoundland and Labrador. The authors thank the managers, nurses and other personnel of the four Regional Health Authorities who provided data for this study. We thank Dr. Tim Seifert for assistance with statistical analysis and the research assistants for many hours of data entry.
Conflict of Interest: None to declare.
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