August 05, 2019
3 min read

Parental education levels, BMI influence childhood obesity risk

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact

Children with obesity are more likely to be boys, be physically inactive and have parents with some combination of elevated BMI and lower levels of education, according to findings published in Diabetes/Metabolism Research and Reviews.

“There is evidence supporting a potential contribution of various [energy balance-related behaviors] and parental features on childhood obesity, but evidence on the synergetic effect of [energy balance-related behaviors] on obesity onset are few and often inconclusive,” Lucia Frittitta, MD, of the department of clinical and experimental medicine at the University of Catania and the unit of endocrinology at Garibaldi Hospital in Catania, Italy, and colleagues wrote.

Frittitta and colleagues measured weight, height and waist circumference of 1,702 children (mean age, 10.7 years; 49.6% girls) from Catania, Italy, and used these measures to calculate BMI, BMI z score and waist-to-height ratio. Questionnaires were completed by parents of these children and provided information on how often children engaged in physical activity, spent time in front of a screen or drank sugary beverages. The parents also self-reported their own height, weight and education levels.

Overweight or obesity was confirmed in 41.9% of the children, including 57% of the boys and 43% of the girls (P < .0001). Boys were 1.65 times more likely to have obesity than girls (95% CI, 1.34-2.04), according to researchers.

Doctor and tape measure 2019 
Children with obesity are more likely to be boys, be physically inactive and have parents with some combination of elevated BMI and lower levels of education.
Source: Adobe Stock

Physical activity

Lower scores on the physical activity questionnaire indicated a child was less physically active. The average BMI z score for children who were considered less physically active was 0.42 compared with a score of 0.27 for those who were considered more active (P < .05). Less physically active children had an average waist circumference of 74.43 cm vs. an average circumference of 71.95 cm for those who were more active (P < .05). The researchers also noted that the waist-to-height ratio was 0.507 for less active children compared with 0.496 for more active children (P < .05) and that less active children had 27.36% fat mass vs. 24.79% fat mass in more active children (P < .05). Children who were physically inactive were 40% more likely to have overweight or obesity in comparison with those who were more active (OR = 1.4; 95% CI, 1.11-1.77).

“[Physical activity] appears to have major importance, while other aspects of unhealthy behavior such as [sugar-sweetened beverage consumption] and [screen time] seem to be less important, probably because they only partially represent the role of diet and sedentary behavior, which are also determined by other unhealthy eating and lifestyle habits,” the researchers wrote.


Parental influences

The mothers of children who were less physically active had an average BMI of 26.5 kg/m2 and the average BMI of fathers of these children was 26.9 kg/m2, which compared with measures of 23.8 kg/m2 and 24.3 kg/m2 in mothers and fathers of children who were more active, respectively (P < .05).

Children who spent more than 2 hours in front of a screen each day had an average waist circumference of 75.88 cm and an average waist-to-height ratio of 0.51, whereas those who spent less time on screens had measures of 72.32 cm and 0.498, respectively (P < .05 for both). However, the researchers noted that more time in front of screens did not significantly affect the risk for overweight and obesity. Fathers of children who utilized screens more often had a mean BMI of 27.2 kg/m2 vs. a mean BMI of 26.6 kg/m2 for fathers of children who spent less time with screens (P < .05). There was no significant difference between the mothers of these children.

In addition, BMI z score, waist circumference, waist-to-height ratio and fat mass percentage were not drastically different between those who drank at least five sugary drinks or more per week and those who drink fewer than that. However, 89.2% of the mothers and 90.8% of the fathers of children who consumed sugary drinks more frequently did not have more than a high school education vs. 81.6% of the mothers and 83.1% of the fathers of those who drank those types of beverages more frequently (P < .001).

Overall, children who had a parent with a high school education or less and either overweight or obesity were 80% more likely to develop overweight or obesity compared with children whose parents did not meet these criteria (OR = 1.8; 95% CI, 1.37-2.37).

“Our data suggest that parental characteristics play a predominant role in determining children's overweight/obesity status, possibly due to lifestyle factors,” the researchers wrote. “Our efforts should be directed to prevention strategies focused on the importance of the healthy lifestyles that involve children and their families.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.