Abstract
Objective. To identify risk factors associated with changes in BMI and sum of skinfold thickness (SSF) in a cohort of preschool children in Ho Chi Minh City (HCMC), Vietnam. Methods. This one year follow-up study, using multi-stage cluster sampling, was conducted from 2005–2006 with 526 children aged 4–5 years in preschools in urban HCMC. Information on neighborhood, preschool and home environments, socio-economic status, the child and parental characteristics were collected using interview-administered questionnaires. Dietary intake and physical activity were measured using modified, validated questionnaires. Weight, height, and triceps, subscapular and suprailiac skinfold thickness were measured. Generalized estimating equations (GEEs) were used to assess the longitudinal relationships between the risk factors and the development of adiposity. Results. A variety of factors at different levels were associated with changes in BMI and SSFs. As safety of the neighborhood increased, BMI and SSFs decreased (coefficients for BMI: −0.59; 95% CI: −1.16 to −0.01 for girls and −0.80; 95% CI: −1.53, −0.08 for boys, and coefficients for SSFs: −2.71; 95% CI: −5.07, −0.35 for girls and −4.16, 95% CI: −8.28, −0.05). Having both parents overweight was strongly predictive of an increase in BMI (1.18, 0.21–2.16). Maternal pre-pregnant BMI status, breast-feeding, and high birth weight were also related to change in adiposity. Conclusion. Contextual variables in the community and home environment, and parental characteristics appeared to be more important than individual factors for explaining on changes in adiposity in this child population.
Acknowledgements
This research was supported by Wellcome Trust Health Consequence of Population Change, Research Training Fellowship (073153/Z/03/Z). We are grateful to the subjects who participated in this study. We gratefully acknowledge the assistance of the staff of the Nutrition Centre of Ho Chi Minh City and school collaborators of the 20 kindergartens in Ho Chi Minh City. We thank Hidde P. van der Ploeg, Centre for Physical Activity and Health, School of Public Health, University of Sydney, Australia, for his advice on evaluating physical activity data.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.