Abstract
OBJECTIVES: To examine the socio-economic, behavioural and Métis-specific factors that predict obesity among Métis children aged 6 to 14 years. Socio-economic factors included household structure and income, parental education and food insecurity. Cultural factors included knowledge of an Aboriginal language, participation in cultural activities, time spent with Elders and parental residential school attendance.
METHODS: The 2006 Aboriginal Peoples Survey, Children and Youth component collected data about Métis children, including child height and weight, reported by the person most knowledgeable about the child (PMK). Multivariate binary logistic regression was used to predict obesity, defined using IOTF BMI cut-offs. After testing for interactions, models were stratified by age (6-10, 11-14) and gender.
RESULTS: An estimated 18.5% of Métis boys and 14.4% of girls were obese. The effects of socio-economic factors and region varied across age and gender groups, although living in a lone-parent family and rural residence had consistent effects. Many effects of cultural variables were unexpected. Although PMK residential schooling was positively associated with obesity generally, the effects were negative among older girls. As expected, children participating in frequent physical activity generally had lower risk, independent of other factors.
CONCLUSIONS: Although socio-economic factors are related to risk of obesity among Métis children, the effects may not be the same across age groups and for boys and girls. There is some evidence of independent effects of Métis-specific cultural factors, including parental residential schooling, on the risk of child obesity, but further investigation and better data are needed to understand these relationships.
Key Words: Obesity, Body Mass Index, indigenous population, children, Canada
Résumé
OBJECTIFS: Examiner les facteurs socioéconomiques, comportementaux et culturels prédisant l’obésité chez les enfants métis de 6 à 14 ans. Les facteurs socioéconomiques étaient la structure et le revenu des ménages, l’instruction parentale et l’insécurité alimentaire. Les facteurs culturels étaient la connaissance d’une langue autochtone, la participation à des activités culturelles, le temps passé avec les Aînés et la fréquentation parentale des pensionnats.
MÉTHODE: Le volet sur les enfants et les jeunes de l’Enquête auprès des peuples autochtones (2006) présente des données sur les enfants métis, y compris leur taille et leur poids, déclarées par la personne connaissant le mieux l’enfant (PCME). Par régression logistique binaire multivariée, nous avons prédit l’obésité (définie selon les points-limites d’IMC de l’IOTF) chez ces enfants. Après évaluation des interactions, les modèles ont été stratifiés par âge (6-10 ans, 11-14 ans) et par sexe.
RÉSULTATS: Environ 18,5 % des garçons métis et 14,4 % des filles étaient obèses. Les effets des facteurs socioéconomiques et régionaux variaient selon les groupes d’âge et de sexe, mais vivre dans une famille monoparentale et résider en milieu rural produisaient des effets uniformes. De nombreux effets des variables culturelles étaient inattendus. Bien que la fréquentation d’un pensionnat par la PCME soit associée positivement à l’obésité en général, son effet était négatif chez les filles de 11 à 14 ans. Comme prévu, les enfants s’adonnant fréquemment à l’activité physique avaient un risque d’obésité inférieur dans l’ensemble, indépendamment des autres facteurs.
CONCLUSIONS: Bien que les facteurs socioéconomiques soient liés au risque d’obésité chez les enfants métis, leurs effets peuvent ne pas être les mêmes dans tous les groupes d’âge ou entre les garçons et les filles. Il semble que les facteurs culturels propres aux Métis, dont la fréquentation parentale des pensionnats, exercent des effets indépendants sur le risque d’obésité chez les enfants, mais il faudrait pousser la recherche et obtenir de meilleures données pour comprendre ces liens.
Mots Clés: obésité, indice de masse corporelle, population d’origine amérindienne, enfant, Canada
Footnotes
Acknowledgements: Funding was provided by an operating grant from the Canadian Institutes of Health Research, Institute for Aboriginal Peoples’ Health.
Conflict of Interest: None to declare.
References
- 1.Schell LM, Gallo MV. Overweight and obesity among North American Indian infants, children, and youth. Am J Hum Biol. 2012;24(3):302–13. doi: 10.1002/ajhb.22257. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Willows ND. Overweight in First Nations children: Prevalence, implications, and solutions. J Aboriginal Health. 2005;2:76–86. [Google Scholar]
- 3.Statistics Canada. Aboriginal Peoples in Canada in 2006: Inuit, Métis and First Nations, 2006 Census, Catalogue, no. 97-558-XIE. Ottawa, ON: Minister of Industry; 2008. [Google Scholar]
- 4.Kumar MB, Wesche S, McGuire C. Trends in Métis-related health research (1980- 2009): Identification of research gaps. Can J Public Health. 2012;103(1):23–28. doi: 10.1007/BF03404064. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Veugelers PJ, Fitzgerald AL. Prevalence of and risk factors for childhood overweight and obesity. CMAJ. 2005;173(6):607–13. doi: 10.1503/cmaj.050445. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Janz T, Seto J, Turner A. Aboriginal Peoples Survey, 2006. An Overview of the Health of the Métis Population. Ottawa: Statistics Canada; 2009. [Google Scholar]
- 7.Willows ND, Veugelers P, Raine K, Kuhle S. Prevalence and sociodemographic risk factors related to household food security in Aboriginal peoples in Canada. Public Health Nutr. 2009;12(8):1150–56. doi: 10.1017/S1368980008004345. [DOI] [PubMed] [Google Scholar]
- 8.Willows ND, Hanley AJ, Delormier T. A socioecological framework to understand weight-related issues in Aboriginal children in Canada. Appl Physiol Nutr Metab. 2012;37(1):1–13. doi: 10.1139/h11-128. [DOI] [PubMed] [Google Scholar]
- 9.Lobstein T, Baur L, Uauy R. Obesity in children and young people: A crisis in public health. Obes Rev. 2004;5:4–85. doi: 10.1111/j.1467-789X.2004.00133.x. [DOI] [PubMed] [Google Scholar]
- 10.Richmond CA, Ross NA. The determinants of First Nation and Inuit health: A critical population health approach. Health Place. 2009;15(2):403–11. doi: 10.1016/j.healthplace.2008.07.004. [DOI] [PubMed] [Google Scholar]
- 11.King M, Smith A, Gracey M. Lancet. 2009. Indigenous health part 2: The underlying causes of the health gap; pp. 76–85. [DOI] [PubMed] [Google Scholar]
- 12.Loppie Reading C, Wein F. Health Inequalities and Social Determinants of Aboriginal Peoples’ Health. Vancouver, BC: National Collaborating Centre for Aboriginal Health; 2009. [Google Scholar]
- 13.Dyck M. Social Determinants of Métis health. Ottawa: National Aboriginal Health Organization; 2009. [Google Scholar]
- 14.National Collaborating Centre for Aboriginal Health. Culture and Language as Social Determinants of First Nations, Inuit and Métis Health. Vancouver: National Collaborating Centre for Aboriginal Health; 2009. [Google Scholar]
- 15.Statistics Canada. Aborginal Peoples Survey, 2006: Concepts and Methods Guide. Ottawa: Minister of Industry; 2009. [Google Scholar]
- 16.Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000;320(7244):1240–45. doi: 10.1136/bmj.320.7244.1240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Statistics Canada. Families Reference Guide, 2006. Census. 2011. [Google Scholar]
- 18.Statistics Canada. Bootvar Click-Wrap Licence. 2011. [Google Scholar]
- 19.Shields M. Measured obesity and overweight Canadian children and adolescents, in Nutrition: Findings from the Canadian Community Health Survey. Ottawa: Statistics Canada; 2005. [Google Scholar]
- 20.Can J Public Health. 2010.
- 21.Kuhle S, Allen AC, Veugelers PJ. Prevention potential of risk factors for childhood overweight. Can J Public Health. 2010;101(5):365–68. doi: 10.1007/BF03404854. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Gorden-Larsen P, Adair LS, Popkin BM. The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents. Obes Res. 2003;11(1):121–29. doi: 10.1038/oby.2003.20. [DOI] [PubMed] [Google Scholar]
- 23.Wang Y, Zhang Q. Are American children and adolescents of low socioeconomic status at increased risk of obesity? Changes in the association between overweight and family income between 1971 and 2002. Am J Clin Nutr. 2006;84(4):707–16. doi: 10.1093/ajcn/84.4.707. [DOI] [PubMed] [Google Scholar]
- 24.World Health Organization. Food Security. 2013. [Google Scholar]
- 25.Doolen J, Alpert PT, Miller SK. Parental disconnect between perceived and actual weight status of children: A metasynthesis of the current research. J Am Acad Nurse Pract. 2009;21:160–66. doi: 10.1111/j.1745-7599.2008.00382.x. [DOI] [PubMed] [Google Scholar]