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Maternal BMI and Migration Status As Predictors of Childhood Obesity in Mexico

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Maternal BMI and Migration Status As Predictors of Childhood Obesity in Mexico Nutr Hosp. 2011;26(1):187-193 ISSN 0212-1611 • CODEN NUHOEQ S.V.R. 318 Original Maternal BMI and migration status as predictors of childhood obesity in Mexico A. Jiménez-Cruz1, J. M. Wojcicki2, M. Bacardí-Gascón1, A. Castellón-Zaragoza1, J. L. García-Gallardo1, N. Schwartz3 and M. B. Heyman2 1Nutrition. Universidad Autónoma de Baja California. Tijuana. Mexico. 2Department of Pediatics. University of California. San Francisco. San Francisco, CA. United States. 3Anthropology. COLEF. Tijuana. Mexico. Abstract IMC MATERNO Y MIGRACIÓN COMO PREDICTOR DE OBESIDAD INFANTIL Objective: To assess the association of maternal migra- DE MÉXICO tion to Baja California, body mass index (BMI) status, children’s perceived food insecurity, and childhood lifestyle behaviors with overweight (BMI > 85% ile), obe- Resumen sity (BMI > 95% ile) and abdominal obesity (Waist Cir- cumference > 90% ile). Objetivo: Determinar la asociación entre la inmigra- Methods: Convenience sampling methods were used to ción materna a Baja California, el índice de masa corpo- recruit a cross-sectional sample of 4th, 5th and 6th grade ral (IMC), la percepción de inseguridad alimentaria de children and their parents at Tijuana and Tecate Public los niños, y los estilos de vida y el sobrepeso, (BMI > 85% Schools. Children‘s and parents’ weights and heights were ila), la obesidad (BMI > 95% ila) y la obesidad abdominal measured. Children were considered to have migrant par- (Circunferencia de Cintura > 90% ila). ents if parents were not born in Baja California. Métodos: Se realizó una muestra por conveniencia, en Results: One hundred and twenty-two children and la que se reclutaron niños de 4.º a 6.º grado de primaria y their parents were recruited. The mean age of the chil- a sus padres, de escuelas públicas de Tijuana y Tecate. Se dren was 10.1 ± 1.0 years. Forty nine per cent of children midió el peso y la estatura de los niños. Los padres que no were overweight or obese. Children with obese parents nacieron en el estado de Baja California se consideraron (BMI > 30) had greater odds of being obese, Odds Ratio inmigrantes. (OR) 4.9 (95% Confidence Interval (CI), 1.2-19, p = 0.03). Resultados: Fueron reclutados 122 pares de padres y Children with migrant parents had greater odds of being niños. La edad media de los niños fue de 10,1 ± 1,0 años. obese, OR= 3.7 (95% CI, 1.6-8.3), p = 0.01) and of having Cuarenta y nueve por ciento de los niños presentaron abdominal obesity, OR = 3.2 (95% CI, 1.4-7.1, p = 0.01). sobrepeso u obesidad. Los niños con padres obesos (BMI Children from migrant parents have greater risk of > 30) presentaron mayor riesgo de obesidad, Razón de higher consumption of potato chips, OR = 8.0 (95% CI, Momios (RM) 4,9 (95% Intervalo de confianza (IC) 1,2- 2.1 -29.1, p = 0.01). Children from non-migrant parents 19, p = 0,03). Los niños con padres inmigrantes presenta- had greater odds of being at risk of hunger. ron mayor riesgo de tener obesidad, RM = 3,7 (95% IC, Conclusions: Parental obesity and migration are asso- 1,6-8,3, p = 0,01) y obesidad abdominal, RM = 3,2 (95% ciated with increased risk of obesity among Mexican chil- IC, 1,4-7,1, p = 0,01). Los niños con padres inmigrantes dren. Children whose parents were born in Baja Califor- presentaron mayor riesgo de consumo de patatas fritas, nia have greater odds of being at risk of hunger. Further RM = 8,0 (95% CI, 2,1-29,1, p = 0,01). Los niños de padres studies should evaluate the role of migration on risk for no inmigrantes presentaron mayor riesgo de hambre. childhood obesity. Conclusiones: La obesidad paterna y la inmigración (Nutr Hosp. 2011;26:187-193) estuvieron asociadas con el aumento de obesidad infantil. Los niños de padres nacidos en Baja California presenta- DOI:10.3305/nh.2011.26.1.4592 ron mayor riesgo de hambre. Se requieren más estudios Key words: Childhood. Obesity. Migratio. Food intake. Hun- que valoren el papel de la inmigración sobre el riesgo de ger. obesidad. (Nutr Hosp. 2011;26:187-193) DOI:10.3305/nh.2011.26.1.4592 Correspondence: Arturo Jiménez-Cruz. Universidad Autónoma de Baja California. Palabras clave: Obesidad infatil. Inmigración. Ingesta de ali- Calzada Tecnológico. mentos. Hambre. 14418 Tijuana. BC. Mexico. E-mail: [email protected] Recibido: 18-IX-2009. 1.ª Revisión: 12-XI-2009. Aceptado: 22-IX-2009. 187 Introduction Data collection Prevention of pediatric overweight (OW) has Two graduate research assistants in Tijuana and become a public health priority in the USA.1 In several Tecate conducted all interviews. They were trained at European countries, childhood OW and obesity espe- one central location by two of the authors of this study cially among migrant children has also become an (AJC, MBG) in taking anthropometric measurements important health concern.2 In Austria, the prevalence of for children and adults and in conducting interviews. OW and obesity was found to be significantly higher Children’s and parents’ weights and heights and waist among children whose families migrated from Turkey circumferences (WC) were measured as part of the and former Yugoslavia.2 In Mexico, higher prevalence interview process. of childhood OW associated with food insecurity has been found in the Mexico-US border and among chil- dren from Central or Southern Mexican migrant par- Anthropometric measurements ents compared with the Mexican national prevalence.3,4 While these reports document the association of migra- Height was measured to the nearest millimeter with tion with higher prevalence of childhood obesity, data a portable stadiometer (model 214 Rodad Rod, Seca are lacking that show evidence that parental migration Corp, Hanover, MD, USA). Weight was measured and food insecurity are risk factors for child OW with electronic scales (model 2001, Tanita Corp, among population groups of the same genetic origin. In Tokyo, Japan) to the nearest 0.1 kg. Body mass index this study we evaluated maternal migration, parental (BMI; in kg/m2) was subsequently calculated. WC was BMI, children’s food insecurity, and children’s measured at the minimum circumference between the lifestyle behaviors and the associations of these factors iliac crest and the rib cage. BMI values were compared with OW and obesity in children. with age/gender BMI percentiles from the Centers for Disease Control and Prevention Growth Charts (National Center for Health Statistics and National Methodology Center for Chronic Disease Prevention).7 Cutoff points were the 85th and 95th percentiles for OW, 95th per- Settings centile for obesity and 99th percentile for extreme obesity. WC measurements were compared to CDC In 2006, Baja California, which shares a strong eco- growth charts defining > 90th percentile for abdominal nomic and cultural relationship with the United States, obesity for children,8 and 85 to 95th percentiles for OW had approximately 3,460,000 residents. Tijuana and and 95th percentile for obesity in adults. Waist cir- Tecate are the most northwestern border Mexican cities. cumference cut points for abdominal obesity in adults Tijuana had approximately 1,795 000 and Tecate was > 35 inches for women and 40 inches for males.9 118,000 residents, accounting for about 55% of the total population of the state of Baja California.5 In the 2005- 2006 academic years, Tijuana had 563 public elemen- Questionnaires tary schools with 193,600 students, and Tecate had 66 public elementary schools with 13,958 students.5 Stu- We developed two questionnaires to measure child dents attending public schools in Mexico are usually intake, food insecurity, migration and health history, from middle to low socioeconomic status (SES).6 parental stress and physical and leisure time activities. One questionnaire was designed for children and the other for parents or the child’s primary caregiver. For Subjects and recruitment procedures some sections of the questionnaire we used previously validated instruments as referenced below.10,11,12 The Two public elementary schools from Tijuana and parent questionnaire included questions on sociodemo- three from Tecate, where interviewers had previous graphic information, health history, food consump- collaborations, were chosen to participate in the study tion,10 food insecurity10 physical activity, stress and by convenience sampling at schools. School principals, family support,12 and migration history. The children’s teachers and parents were contacted and told about the questionnaire contained questions pertaining to food purpose of the study. Parents were asked to participate consumption, food security using the food insecurity before or after school hours. Every child in the 4th, 5th, questionnaire,11 physical activity, food and nutrition and 6th grades at these two schools was recruited (n = knowledge, family environment, migration and psy- 512). All parents of these children were asked to partic- chosocial issues. Food security refers to the availability ipate in the study; 25% (129) parents or relatives of food and one’s access to it. A household is consid- agreed to participate. The Human Subjects Committee ered food insecure when its occupants perceive hunger of the University Autonomous of Baja California or fear of starvation. The Food insecurity questions approved the study. Written informed consent was were: Did your household ever run out of money to buy obtained from all parents. food to make a meal?, Did you ever eat less tant you felt 188 Nutr Hosp. 2011;26(1):187-193 A. Jiménez-Cruz et al. you should because there was not enough money to buy who was not born in the state of Baja California. We food?, Did you ever tell your parent (s) that you were assessed the associations between parental migration, hunger because there was not enough food in the child food consumption, OW status, and hunger.
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