Predictors of Severe Obesity in Low-Income, Predominantly Hispanic/Latino Children: The Texas Childhood Obesity Research Demonstration Study

Abstract

Introduction The objective of this study was to identify predictors of severeobesity in a low-income, predominantly Hispanic/Latino sampleof children in Texas.MethodsThis cross-sectional analysis examined baseline data on 517 childrenfrom the secondary prevention component of the TexasChildhood Obesity Research Demonstration (TX CORD) study;data were collected from September 2012 through February 2014.Self-administered surveys were used to collect data from parentsof children who were aged 2 to 12 years, had a body mass index(BMI) in the 85th percentile or higher, and resided in Austin,Texas, or Houston, Texas. Multivariable logistic regression modelsadjusted for sociodemographic covariates were used to examineassociations of children’s early-life and maternal factors(large-for-gestational-age, exclusive breastfeeding for ≥4 months, maternal severe obesity [BMI ≥35.0 kg/m2]) and children’s behavioralfactors (fruit and vegetable consumption, physical activity,screen time) with severe obesity (BMI ≥120% of 95th percentile),by age group (2–5 y, 6–8 y, and 9–12 y).ResultsAcross all ages, 184 (35.6%) children had severe obesity. Amongchildren aged 9 to 12 years, large-for-gestational-age at birth (oddsratio [OR] = 2.31; 95% confidence interval [CI], 1.13–4.73) wassignificantly associated with severe obesity. Maternal severeobesity was significantly associated with severe obesity amongchildren aged 2 to 5 years (OR = 2.67; 95% CI, 1.10–6.47) and 9to 12 years (OR = 4.12; 95% CI, 1.84–9.23). No significant associationwas observed between behavioral factors and severeobesity in any age group.ConclusionIn this low-income, predominantly Hispanic/Latino sample ofchildren, large-for-gestational-age and maternal severe obesitywere risk factors for severe obesity among children in certain agegroups. Promoting healthy lifestyle practices during preconceptionand prenatal periods could be an important interventionstrategy for addressing childhood obesity