Abstract
Objective. To identify neighbourhoods with increased prevalence of overweight children and to examine whether the association between neighbourhood and overweight can be explained by demographic characteristics and energy-related behaviours. Method. This cross-sectional study was carried out among 4,072 primary schoolchildren in the city of Zwolle, The Netherlands. Data collection consisted of measured height, weight and waist circumference, and a parental questionnaire on socio-demographic characteristics, dietary and (in)activity behaviour of their child. With Multivariate Logistic regressions, associations between unhealthy behaviours and neighbourhoods (defined by postal code) with high and low prevalence of childhood overweight were investigated. Results. In three neighbourhoods the prevalence of overweight was significantly higher (16.5% vs. 10.6%, p < 0.05). The odds of living in these neighbourhoods were higher among children watching >2 h television/day (OR: 1.57; 95% CI: 1.15–2.14), not eating breakfast daily (OR: 2.86; 95% CI: 1.93–4.23), drinking >3 glasses/day sugared drinks (OR: 1.23; 95% CI: 1.01–1.50) on weekdays and not participating in organized sports (OR: 1.32; 95% CI: 1.09–1.59). This odds was however lower among children eating <2 fruit/day (OR: 0.83; 95% CI: 0.69–1.00) on weekends. The association between neighbourhood and overweight altered slightly after adjustment for socio-demographic and behavioural characteristics during weekdays (OR: 1.42; 95% CI: 1.05–1.92) and weekends (OR: 1.50; 95% CI; 1.11–2.02). Conclusion. Three neighbourhoods with higher prevalence of overweight were identified. A small part of the association between overweight and neighbourhood is explained by socio-demographic factors and unhealthy behaviours measured in this study. Neighbourhoods with higher overweight prevalence are a priority setting for targeted interventions to prevent overweight. The association between neighbourhood and overweight needs to be explored further to understand the role the neighbourhood can play in tackling overweight.
Acknowledgements
We would like to thank our partners in this monitoring study: the Zwolle city council, the local health services and several welfare organizations in the city. We also would like to thank Sandra Bleeker and Hilly Langewen for the help in setting up the study. We are thankful for the help of all the students who performed the measurements, the participating schools and for sponsorships we received. Maaike Koning's corrections in this article are gratefully acknowledged.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.