Childhood obesity and prevention in different socio-economic contexts

ObjectiveTo assess recent trends in obesity, health beliefs, and lifestyles in Swedish schoolchildren, with focus on socioeconomic disparities.MethodThe study was conducted in two areas with high and low socioeconomic status (SES). 340 11–12 year olds participated in three cross-sectional surveys assessing food-related behaviours, physical activity and health beliefs, together with anthropometric examinations. Comparisons were made before and after a community-based intervention (2003 versus 2008) within the low-SES school, and between the low and high-SES school (2008 only).ResultsIn the low-SES school BMI z-score decreased over 5 years (0.80 vs 0.46) as did the percentage of children frequently consuming sweet drinks (43.5 vs 26.8%), statistically significant in girls only (p < 0.05). Children increasingly perceived benefits of healthy life-styles (37 vs 55%). In 2008, consumption of breakfast, vegetables, sweets and sweet drinks differed between schools, as did screen-time and physical activity, all in favour of the high SES-school where the obesity-prevalence was significantly lower (0.8 vs 6.7%).ConclusionPositive changes in diet and weight status were observed, especially in girls, within a low-income multi-ethnic community undergoing a health promotion intervention. Our results underscore the multifactorial etiology of childhood obesity and the importance of continuing tailored, gender-sensitive prevention efforts.

► A community based public health intervention was conducted in a low income area.
► Among 5th and 6th graders, perceived benefit of a healthy life-style increased.
► We observed a shift downwards in BMI z-score for girls.
► Positive changes in girl's BMI-status were paralleled by a decreased intake of sugar.
► For boys, consumption of fruit and vegetables increased.