![]() To measure unhealthy weight, we evaluated children’s weight status using the WHO growth reference for school-aged children, which estimates BMI z-scores relating a child’s weight and height to children of the same age and sex from a reference population. Many questions draw from well-established surveys of child wellbeing such as ECLS-K, Add Health, or The Fragile Families and Child Wellbeing Study. The present study uses data from interviews with the parents of school-aged children (ages 5–10 years) who participated in a 62-item parent questionnaire (n = 844) (Additional file 1). According to ethical assessment in Spain, no ethical assessment was necessary. Data were collected with the previous verbal informed consent of the participants and researchers had only access to deidentified data, guaranteeing their anonymity and privacy. Interviews were conducted over the phone in Spanish using computer-assisted telephone interviewing (CATI) software. Sampling was done through a proportionate-to-population cluster design using regions as clusters and households with children within regions stratified by size of the municipality, child’s sex and age. The response rate was 33.4%, which is similar to published studies employing these methods. Dataĭata are from Encuesta de Relaciones Inter e Intrageneracionales en la Infancia, a nationally representative survey of households with children ages 0–10 years in Spain fielded in 2010 (n = 2206). We present estimates of the prevalence of unhealthy weight-underweight, overweight, and obesity-among elementary school-aged children in Spain and explore associations with the home environment. In light of recent economic crises in high-income countries, including Spain, it is important to consider both underweight and overweight. Previous studies of unhealthy weight in Europe have focused on obesity, but do not examine under-nutrition. Even in higher-income countries, economic crises can lead to malnutrition, both underweight and obesity. Parents’ socioeconomic status and employment, particularly mothers’ employment, are associated with higher obesity risks among children and youth, though these associations have not been observed in other European countries. In Spain, children whose parents have obesity have higher odds of overweight. The associations between these factors and weight sometimes differ across countries for example, parents’ marital status has been associated with obesity in the US, but not in Norway. The family environment may be linked with child nutrition through child’s age, gender, and daycare attendance mother’s age at childbirth parents’ weight, marital status, employment, and education co-residence of grandparents and siblings family income and activities. Ĭhildren’s weight is thought to be heavily influenced by family environment through quality and quantity of food, eating patterns, and distribution of resources among family members. Disparities in unhealthy weight across Europe have been attributed to differences in consumption patterns, levels of physical activity and inactivity, and childcare practices. Underweight among school-aged children in Europe is estimated to range between 3.3% in Greece to 11.7% in Lithuania. ![]() According to the Childhood Obesity Surveillance Initiative (COSI) (2008–2009), Spain has the second highest prevalence of obesity in Europe among primary school age children (22% in children age 9 years), just behind Greece (31%). Spain experienced an economic crisis starting in 2008, followed by a slow recovery, leading to concerns about healthy growth in children.
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