Sevcikova L. 1, Novakova J.2, Hamade J. 2, Jurkovicova J.1, Stefanikova Z.1, Sobotova. L.1,

Aghova L. 1

1Institute of Hygiene, Faculty of Medicine, Comenius University Bratislava

2 Public Health Authority SR, Bratislava

ludmila.sevcikova@fmed.uniba.skInstitute of Hygiene, Comenius University, Spitalska 24, 813 72 Bratislava, Slovak Republic

Background The life conditions, which are closely linked to social position of a family, impact physical development of children and adolescents.The many current studies dealing with the relationship among genetic and socio-economic factors and developmental parameters of children are particularly aimed at obesity risk.

Object The purpose of the study was to evaluate the growth and body proportionality of children and adolescents in relation to parent education and occupation.

Methods Parameters of height, weight and body mass index have been analyzed on the basis of the 6th Slovak nation-wide cross-sectional anthropometric

survey (2001), which was realized on representative samples (17800 boys and 17400 girls) from all ages (0 - 18years). The overweight has been evaluated as BMI over 90th and 97th percentile for the age of 2 - 18.Education and occupation of parents were obtained using the questionnaire. The programs EPI info and S Plus 6.0 were used for analysis.

Groups Changes in growth and development of children and youth

Age group [year]

GenderDifferences in height [cm]

Differences in BMI [kg]/[m]2

1991-1981 2001-1991 p-value 2001-1991 p-value

1Boys -0.32 0.1 n.s. -0.21 *

Girls -0.05 0.18 n.s. 0.03 n.s.

3Boys 0.58 0.83 *** 0.01 n.s.

Girls 0.76 0.17 * 0.25 n.s.

5Boys 0.68 1.09 *** 0.07 n.s.

Girls 0.79 1.29 *** 0.14 n.s.

7Boys 0.95 1.17 *** 0.07 n.s.

Girls 1.4 0.42 ** 0.11 *

9Boys 1 1.05 *** 0.28 **

Girls 1.43 0 * 0.12 **

11Boys 0.91 0.81 *** 0.3 **

Girls 1.38 0.93 *** 0.39 ***

13Boys 1.7 1.84 *** 0.42 ***

Girls 1.84 0.14 * -0.17 *

15Boys 1.45 4.02 *** 0.41 ***

Girls 0.96 2.26 *** -0.27 ***

17Boys 1.46 1.96 *** 0.15 n.s.

Girls 1.88 0.81 *** -0.24 ***

18Boys 2.01 1.48 *** -0.11 n.s.

Girls 1.94 0.31 ** -0.04 n.s.

The trend in growth and body proportionality of children and youth

* p < 0.05 ** p < 0.01 *** p < 0.001 n.s: non-significant

Source: 4th - 6th Nation-wide Anthropological Survey of Children and Adolescents in SR

« The continuing growth acceleration in boys and girls has been confirmed from 2 years of age, but has slown down in the last decade « The positive secular trend in the

age of 18 years continues in boys 2 and 1.5 cm per decade,

in girls it stagnates (1.9; 0.3 cm)« Continuing slimming trend in Slovak adolescent girls and also

less markedly in boys was confirmed« The trend of the body proportionality does not follow the growth acceleration in boys and girls during the last decade.

3. Prevalencia nadváhy + obezity u 14-17 rocných adolescentov v Európe

% adolescentov s nadváhou alebo obezitou

0 5 10 15 20 25

Cyprus

Grécko

Španielsko

Chorvátsko

Srbsko

Bulharsko

Anglicko

Švédsko

Dánsko

Nemecko

Slovensko

Polsko

Holandsko

Rusko

Slovensko 12 %

2. Prevalencia nadváhy + obezity u 7-11 rocných detí v Európe

0 5 10 15 20 25 30 35 40

Taliansko juh

Malta

Španielsko

Kréta

Grécko

Chorvátsko

Taliansko sever

Anglicko

Francúzsko

Belgicko

Poľsko

Švédsko

Česko

Slovensko

Nemecko

Dánsko

Holandsko

Rusko

% detí s nadváhou alebo obezitou

Slovensko (16,5 %)

in 7-11 year old children

Prevalence of overweight and obesity (%) in children and adolescents in Europe

Source: Ginter E.. Havelková B.. Med Monitor 2005; Lobstein T. Frelut M-L: Prevalence of overweight among children in Europe. Obesity Rev 2003

%

%

in adolescents (14-17 year)

Slovakia

Slovakia

Prevalence of overweight and obesity in Slovak girls and boys belong to the lowest in Europe.

RussiaNetherlands

DenmarkGermanySlovakiaCzech R.SwedenPoland

BelgiumFrance

EnglandItaly North

CroatiaGreece

CreteSpainMalta

Italy South

Russia

NetherlandsPoland

Slovakia GermanyDenmarkSwedenEngland

BulgariaSerbia

Croatia Spain

Greece

Cyprus

Girls (0 - 6 years / 5783)

Height Weight BMI

0.054 0.060 0.024

0.099 0.122 0.047

0.075 0.087 0.029

0.053 0.092 0.084

-0.075 -0.082 -0.019

-0.005 -0.010 -0.013

0.061 0.059 0.004

0.085 0.089 0.015

0.042 0.042 0.006

0.078 0.079 0.002

Genetic and SES factors

Boys (0 - 6 years/ 5997)

Height Weight BMI

Father's height 0.056 0.060 0.010

Father's weight 0.080 0.114 0.069

Mother's height 0.043 0.055 0.032

Mother's weight 0.024 0.060 0.071

Nationality / Ethnic g. -0.065 -0.071 -0.010

Family (completeness) 0.005 0.000 -0.003

Father's education 0.033 0.038 0.003

Father's employment 0.085 0.090 0.014

Mother's education 0.043 0.045 0.001

Mother's employment 0.083 0.086 0.004

Correlation analysisCorrelation coefficients r

r0.05= 0.0621r0.01= 0.0816

Genetic determination of growth has been confirmed only in some relations between somatic indicators of little children and parents as well as ethnicity. Romany children were the smallest in the followed sample.

Genetic and SES factors

Boys (7 - 18 years / 9808)

Height Weight BMI

Father's height 0.142 0.111 0.037

Father's weight 0.175 0.222 0.223

Mother's height 0.148 0.117 0.037

Mother's weight 0.163 0.219 0.242

Nationality / Ethnic g. -0.061 -0.038 -0.001

Father's education 0.197 0.175 0.096

Father's employment 0.089 0.078 0.053

Mother's education 0.182 0.166 0.099

Mother's employment 0.148 0.135 0.089

Girls (7 - 18 years / 10787)

Height Weight BMI

0.141 0.095 0.009

0.152 0.197 0.190

0.121 0.072 -0.008

0.197 0.277 0.287

-0.063 -0.032 0.007

0.135 0.100 0.034

0.086 0.070 0.038

0.127 0.089 0.025

0.134 0.123 0.083

r0.05= 0.0621r0.01= 0.0816

Correlation analysisCorrelation coefficients r

Associations between SES factors of family and height, weight and BMI in children and adolescents of the age 7 - 18 year have revealed mostly significantly positive with the exception of association between education of parents and BMI of girls.

Prevalence of overweight and obesity in boys (7-18 y, n= 9808) in relation to mother’s education

Prevalence of overweight and obesity in girls (7-18 y, n= 10787) in relation to mother’s education

Mother’s education level

Overweight Obesity

P -valuen % n %

Basic 474 4.8 308 3.1

0.0542High school 619 6.3 380 3.8

University 167 1.7 94 1.0

Mother’s education level

Overweight Obesity

P -valuen % n %

Basic 510 4.7 314 2.9

0.0025High school 565 5.2 316 2.9

University 104 1.0 49 0.5

The results have shown significant negative relationship between incidence of overweight (BMI over 90th percentile) and obesity (BMI over 97th percentile) and educational level of mother particularly in girls.

Conclusions

The continuing growth acceleration has been confirmed in Slovak boys and girls with slowing down in the last decade particularly in girls. Also slimming trend in adolescent girls and less markedly in boys has continued.

The results have shown significant relationship between anthropometric parameters in children and adolescents and socioeconomic / psycho- social factors of family.

... The results of study have confirmed, that many factors have impacted anthropometric indicators in their mutual condition, but the leading role has been played by age-developmental period, as was shown by the ethnicity and parent education.

Although family social level particularly educational level of mother is related to children overweight, the associations vary according age and gender.

Followed socio-economic factors act together with other habits in the family (nutritional, physical activities, etc.).

...

Obesity prediction connected with parent obesity occurrence requires the more complex analysis.

Primary prevention regarding healthy somatic and psychical development of children has to be family oriented. Health education concentrated on family and systematic preventive healthcare during childhood and adolescence belong to fundamental aspects of health policy.

This work was supported in part by Grant 1/3433/06 from the Scientific Grant Agency of Ministry of Education of the Slovak Republic and the Slovak Academy of Sciences.