Digital disputation
/Summary of research
The development of childhood obesity starts before conception. Health professionals may find communication with parents of children with overweight challenging.
The aims of this thesis was to explore ethnic differences in thinness and overweight in preschool children, and the effects of mother’s prepregnant weight, gestational weight gain and gestational diabetes on children’s body mass index (BMI) growth trajectories from birth to 4-5 years. We also aimed to explore parent’s views and experiences when health professionals identify their preschool child as overweight.
In a multi-ethnic cohort of healthy pregnant women and their children, we found striking ethnic differences in overweight and thinness in children at age 4-5 years. Logistic regression analyses showed that children with origin in Middle East and North Africa had twice the risk of overweight, compared with children with European origin, while children with South Asian origin had twice the risk of thinness.
Using mixed models analyses, we found that maternal prepregnant obesity was associated with high BMI from birth to 4-5 yeas, while high maternal gestational weight gain was associated with a faster BMI growth form age 6 months. Children exposed to gestational diabetes had a fall in BMI during first 6 months, followed by a rise in BMI.
Systematic text condensation analyses of in-depth interviews with parents of preschool children recently identified with overweight revealed that parents felt vulnerable. They feared eating disorders and preferred conversation without the child present. They considered kindergartens as helpful, and their own weight- and dieting experiences acted as both motivation and barrier to deal with their toddlers overweight.
The thesis provides new knowledge important for identification of families at risk and improvement of communication with parents. It emphasizes the importance of a transgenerational perspective on childhood obesity, as well as cooperation across professions.