Dietary and physical activity assessment in 5-6-year-old Maltese children

Abstract

Background: Most countries worldwide, including Malta, have increasing prevalence of childhood obesity. The most recent local prevalence data available for 6-year-old children was in 2007-2008, however, possible underlying causes of obesity related to food intake and activity levels have not yet been investigated in this age group. Aims: The aim of this study was to explore potential links between obesity and dietary intake and activity levels in a sample of 5-6-year-old Maltese children and possible associations with parental body mass index (BMI). Method: Stratified sampling from 15 schools (state, church and independent), conducted between March-June 2015, yielded a sample of 66 participants. Child and parent anthropometric data was collected and parents completed food, physical activity and sedentary behaviour diaries. The BMI-for-age was classified using International Obesity Task Force, World Health Organization and Centers for Disease Control criteria. The diaries were coded for energy intake, macronutrients and activity. Multiple regression related BMI and waist circumference (WC) with the diaries and Spearman correlation associated parental and child BMI. Results: A significant positive correlation (p < 0.001) was found between the children’s BMI and WC. Mean WC (p < 0.05) differed significantly between schools. Mean BMI (p > 0.05) and mean WC (p > 0.05) varied between genders. WC in girls was higher than the 90th percentile of British and European children (p > 0.05). Protein, saturated fats and non-milk extrinsic sugars (NMES) were significantly higher (p < 0.001) than the UK and Italian recommended values regardless of gender and socio-economic status. NMES were significantly higher in girls than in boys (p < 0.05). Physical activity and screen time were higher in boys than in girls (p > 0.05). Energy and macronutrient intake, activity and screen time varied between districts (p > 0.05). Multiple regression, showed a positive relationship between NMES and both BMI and WC and a negative relationship between physical activity and both BMI and WC. Paternal and child BMI were positively significantly correlated (p < 0.01). Conclusion: The results of this preliminary study suggest that this age group is a relevant group for monitoring obesity onset and prevalence, specific macronutrient and physical activity association and parental BMI association in Maltese children. This warrants further investigations using a larger sample size so as to work towards developing nutritional recommendations on a national basis.