The influence of immigrant background and parental education on overweight and obesity in 8-year-old children in Norway

Abstract

Background: Little is known about the prevalence of overweight/obesity and socio-economic position (SEP) in children with immigrant background in Scandinavia. The purpose of this study is to examine the prevalence of overweight/obesity by immigrant background among children in Norway and to explore the role of SEP in explaining differences in weight status.

Methods: Anthropometric data from 8,858 children (age 8.3 years) from the population-based Norwegian Childhood Growth Study were used. Information about immigrant background, country of origin, and parental education (used as an indicator of SEP) were provided by Statistics Norway. For children with immigrant background, regional background was determined based on country of origin. Prevalence ratios (PR) were estimated for overweight/obesity and weight-to-height-ratio (WHtR) ≥ 0.5 by immigration and regional background, using generalized estimating equation log-binominal models adjusting for sex, age, survey year (model 1), residential area, population density (model 2) and parental education (model 3).

Results: Children with immigrant background had a higher prevalence of overweight/obesity and WHtR ≥ 0.5 than non-immigrant background children. Adjusted for parental education, children with an immigrant background from Southern and Eastern Europe, Asia except South-Asia, and Africa had a higher prevalence of overweight/obesity [PR: 1.37 (95% confidence interval (CI): 1.10-1.72), 1.28 (1.05-1.57), 1.47 (1.13-1.91), respectively] than children with a non-immigrant background. Children originating from Asia except South-Asia had a higher prevalence of WHtR ≥ 0.5 (PR: 1.64, CI: 1.25-2.15) compared to non-immigrant background children. The adjustment for parental education did not substantially change the results.

Conclusion: Children with immigrant background had higher prevalence of overweight/obesity than non-immigrant background children. The difference varied according to region of origin but not substantially according to parental education. There is a need for culturally acceptable preventative measures targeting the parents of immigrant background children.

Keywords: Children; Immigrant; Obesity; Overweight; Parental education; Prevalence.

Fig. 1

Flow chart of sample in the current study ^a n included in the total sample and descriptives. ^b n included in the main analysis with complete cases on all covariates

Fig. 2

Children with overweight/obesity (top) and WHtR ≥ 0.5 (bottom) by sex within groups Proportion (with 95% confidence intervals) of children with overweight/obesity (top) and WHtR ≥ 0.5 (bottom) by sex within non-immigrant- and immigrant background in total, and groups by region of origin. Asia except S-A: Asia except South-Asia; ov/ob: overweight including obesity; S/E: Southern and Eastern; W/N: Western and Northern; WHtR: waist-to-heigh-ratio

Fig. 3

Children with overweight/obesity (top) and WHtR ≥ 0.5 (bottom) across parental education levels within groups Proportion (with 95% confidence intervals) of children with overweight/obesity (top) and WHtR ≥ 0.5 (bottom) across parental education levels within non-immigrant- and immigrant background in total, and groups by region of origin. Highest parental education level by either mother or father attained the year of measurement. Asia except S-A: Asia except South-Asia; ov/ob: overweight including obesity; S/E: Southern and Eastern; W/N: Western and Northern; WHtR: waist-to-heigh-ratio

Fig. 4

Overweight/obesity and WHtR ≥ 0.5 for immigrant background children (reference: non-immigrant background children) Prevalence ratios (PR) (95% confidence interval) of overweight/obesity (left) and WHtR ≥ 0.5 (right) for 8-year-old children in Norway by immigrant background in total and groups by region of origin with children, with non-immigrant background as the reference. Three sets of GEE log-binominal models were conducted using children with non-immigrant background as the reference category (indicated by black vertical the line). Model 1 with adjustments for age, sex, and survey year; model 2 additionally adjust for residing area and population density; and model 3 additionally adjust for parental education level. The analyses were conducted with complete cases on all covariates. Asia except S-A: Asia except South-Asia; GEE: generalized estimating equation; ov/ob: overweight including obesity; PR: Prevalence ratio; S/E: Southern and Eastern; W/N: Western and Northern; WHtR: waist-to-heigh-ratio