Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Pediatric Original Article
  • Published:

Dietary factors associated with overweight and body adiposity in Finnish children aged 6–8 years: the PANIC Study

Abstract

Objectives:

To investigate the associations of dietary factors with overweight, body fat percentage (BF%), waist circumference (WC) and hip circumference (HC) among children.

Design:

Cross-sectional analysis of the Physical Activity and Nutrition in Children (PANIC) Study among 510 children (263 boys, 247 girls) aged 6–8 years from Kuopio, Finland.

Methods:

The children’s weight, height, WC and HC were measured. Overweight was defined by International Obesity Task Force body mass index cutoffs. The BF% was measured by dual-energy X-ray absorptiometry, nutrient intakes and meal frequency by 4-day food records and eating behaviour by Children’s Eating Behaviour Questionnaire.

Results:

Daily consumption of all the three main meals was inversely associated with overweight (odds ratio (OR) 0.37, 95% confidence interval (CI) 0.18–0.75), BF% (β −0.12, P=0.012), WC (β −0.16, P=0.002) and HC (β −0.15, P=0.002). Enjoyment of food, food responsiveness and emotional overeating were directly associated with overweight (OR 1.57, 95% CI 1.04–2.35; OR 4.68, 95% CI 2.90–7.54; OR 2.60, 95% CI 1.52–4.45, respectively), BF% (β 0.13, P=0.004; β 0.30, P<0.001; β 0.09, P=0.035, respectively), WC (β 0.14, P=0.003; β 0.40, P<0.001; β 0.19, P<0.001, respectively) and HC (β 0.15, P=0.001; β 0.38, P<0.001; β 0.15, P=0.001, respectively). Satiety responsiveness was inversely associated with overweight (OR 0.42, 95% CI 0.26–0.67), BF% (β −0.20, P<0.001), WC (β −0.26, P<0.001) and HC (β −0.26, P<0.001). Slowness in eating was inversely associated with overweight (OR 0.61, 95% CI 0.41–0.92), WC (β −0.16, P=0.001) and HC (β −0.17, P<0.001). Protein intake was directly associated with BF% (β 0.11, P=0.017), WC (β 0.11, P=0.020) and HC (β 0.13, P=0.008).

Conclusions:

Promoting regular consumption of main meals and healthy eating behaviours should be emphasized in the prevention of overweight among children. More research is needed on the association of protein-rich foods with body adiposity in children.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Janssen I, Katzmarzyk PT, Boyce WF, Vereecken C, Mulvihill C, Roberts C et al. Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obes Rev 2005; 6: 123–132.

    Article  CAS  PubMed  Google Scholar 

  2. de Onis M, Blossner M, Borghi E . Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010; 92: 1257–1264.

    Article  CAS  PubMed  Google Scholar 

  3. Kautiainen S, Rimpela A, Vikat A, Virtanen SM . Secular trends in overweight and obesity among Finnish adolescents in 1977-1999. Int J Obes Relat Metab Disord 2002; 26: 544–552.

    Article  CAS  PubMed  Google Scholar 

  4. Vuorela N, Saha MT, Salo M . Prevalence of overweight and obesity in 5- and 12-year-old Finnish children in 1986 and 2006. Acta Paediatr 2009; 98: 507–512.

    Article  PubMed  Google Scholar 

  5. Arenz S, Ruckerl R, Koletzko B, von Kries R . Breast-feeding and childhood obesity--a systematic review. Int J Obes Relat Metab Disord 2004; 28: 1247–1256.

    Article  CAS  PubMed  Google Scholar 

  6. Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I et al. Early life risk factors for obesity in childhood: cohort study. BMJ 2005; 330: 1357.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Danielzik S, Czerwinski-Mast M, Langnase K, Dilba B, Muller MJ . Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7 y-old children: baseline data of the Kiel Obesity Prevention Study (KOPS). Int J Obes Relat Metab Disord 2004; 28: 1494–1502.

    Article  CAS  PubMed  Google Scholar 

  8. Must A, Tybor DJ . Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth. Int J Obes (Lond) 2005; 29 (Suppl 2): S84–S96.

    Article  Google Scholar 

  9. Kleiser C, Schaffrath Rosario A, Mensink GB, Prinz-Langenohl R, Kurth BM . Potential determinants of obesity among children and adolescents in Germany: results from the cross-sectional KiGGS Study. BMC Public Health 2009; 9: 46.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Rodriguez G, Moreno LA . Is dietary intake able to explain differences in body fatness in children and adolescents? Nutr Metab Cardiovasc Dis 2006; 16: 294–301.

    Article  PubMed  Google Scholar 

  11. Moreno LA, Rodriguez G . Dietary risk factors for development of childhood obesity. Curr Opin Clin Nutr Metab Care 2007; 10: 336–341.

    Article  PubMed  Google Scholar 

  12. Maffeis C, Provera S, Filippi L, Sidoti G, Schena S, Pinelli L et al. Distribution of food intake as a risk factor for childhood obesity. Int J Obes Relat Metab Disord 2000; 24: 75–80.

    Article  CAS  PubMed  Google Scholar 

  13. Maillard G, Charles MA, Lafay L, Thibult N, Vray M, Borys JM et al. Macronutrient energy intake and adiposity in non obese prepubertal children aged 5-11 y (the Fleurbaix Laventie Ville Sante Study). Int J Obes Relat Metab Disord 2000; 24: 1608–1617.

    Article  CAS  PubMed  Google Scholar 

  14. Johnson L, Mander AP, Jones LR, Emmett PM, Jebb SA . Energy-dense low-fiber, high-fat dietary pattern is associated with increased fatness in childhood. Am J Clin Nutr 2008; 87: 846–854.

    Article  CAS  PubMed  Google Scholar 

  15. Wilson TA, Adolph AL, Butte NF . Nutrient adequacy and diet quality in non-overweight and overweight Hispanic children of low socioeconomic status: the Viva la Familia Study. J Am Diet Assoc 2009; 109: 1012–1021.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Elliott SA, Truby H, Lee A, Harper C, Abbott RA, Davies PS . Associations of body mass index and waist circumference with: energy intake and percentage energy from macronutrients, in a cohort of Australian children. Nutr J 2011; 10: 58.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Nicklas TA, Yang SJ, Baranowski T, Zakeri I, Berenson G . Eating patterns and obesity in children. The Bogalusa Heart Study. Am J Prev Med 2003; 25: 9–16.

    Article  PubMed  Google Scholar 

  18. Toschke AM, Thorsteinsdottir KH, von Kries R . GME Study Group. Meal frequency, breakfast consumption and childhood obesity. Int J Pediatr Obes 2009; 4: 242–248.

    Article  PubMed  Google Scholar 

  19. Sandercock GR, Voss C, Dye L . Associations between habitual school-day breakfast consumption, body mass index, physical activity and cardiorespiratory fitness in English schoolchildren. Eur J Clin Nutr 2010; 64: 1086–1092.

    Article  CAS  PubMed  Google Scholar 

  20. Sleddens EF, Kremers SP, Thijs C . The Children's Eating Behaviour Questionnaire: factorial validity and association with Body Mass Index in Dutch children aged 6-7. Int J Behav Nutr Phys Act 2008; 5: 49.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Viana V, Sinde S, Saxton JC . Children's Eating Behaviour Questionnaire: associations with BMI in Portuguese children. Br J Nutr 2008; 100: 445–450.

    Article  CAS  PubMed  Google Scholar 

  22. Webber L, Hill C, Saxton J, Van Jaarsveld CH, Wardle J . Eating behaviour and weight in children. Int J Obes (Lond) 2009; 33: 21–28.

    Article  CAS  Google Scholar 

  23. Spence JC, Carson V, Casey L, Boule N . Examining behavioural susceptibility to obesity among Canadian pre-school children: the role of eating behaviours. Int J Pediatr Obes 2011; 6: e501–e507.

    Article  PubMed  Google Scholar 

  24. Cole TJ, Freeman JV, Preece MA . Body mass index reference curves for the UK, 1990. Arch Dis Child 1995; 73: 25–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA . Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 1995; 73: 17–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Rastas M, Seppänen R, Knuts LR, Hakala P, Karttila V (eds) Nutrient Composition of Foods. The Social Insurance Institution: Helsinki, France, 1997.

    Google Scholar 

  28. Wardle J, Guthrie CA, Sanderson S, Rapoport L . Development of the Children's Eating Behaviour Questionnaire. J Child Psychol Psychiatry 2001; 42: 963–970.

    Article  CAS  PubMed  Google Scholar 

  29. de Gouw L, Klepp KI, Vignerova J, Lien N, Steenhuis IH, Wind M . Associations between diet and (in) activity behaviours with overweight and obesity among 10-18-year-old Czech Republic adolescents. Public Health Nutr 2010; 13: 1701–1707.

    Article  PubMed  Google Scholar 

  30. Lehto R, Ray C, Lahti-Koski M, Roos E . Meal pattern and BMI in 9-11-year-old children in Finland. Public Health Nutr 2011; 14: 1245–1250.

    Article  PubMed  Google Scholar 

  31. Berkowitz RI, Moore RH, Faith MS, Stallings VA, Kral TV, Stunkard AJ . Identification of an obese eating style in 4-year-old children born at high and low risk for obesity. Obesity (Silver Spring) 2010; 18: 505–512.

    Article  Google Scholar 

  32. Ashcroft J, Semmler C, Carnell S, van Jaarsveld CH, Wardle J . Continuity and stability of eating behaviour traits in children. Eur J Clin Nutr 2008; 62: 985–990.

    Article  CAS  PubMed  Google Scholar 

  33. Carnell S, Wardle J . Appetitive traits in children. New evidence for associations with weight and a common, obesity-associated genetic variant. Appetite 2009; 53: 260–263.

    Article  PubMed  Google Scholar 

  34. Rolland-Cachera MF, Deheeger M, Akrout M, Bellisle F . Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age. Int J Obes Relat Metab Disord 1995; 19: 573–578.

    CAS  PubMed  Google Scholar 

  35. Gunnarsdottir I, Thorsdottir I . Relationship between growth and feeding in infancy and body mass index at the age of 6 years. Int J Obes Relat Metab Disord 2003; 27: 1523–1527.

    Article  CAS  PubMed  Google Scholar 

  36. Gunther AL, Buyken AE, Kroke A . Protein intake during the period of complementary feeding and early childhood and the association with body mass index and percentage body fat at 7 y of age. Am J Clin Nutr 2007; 85: 1626–1633.

    Article  PubMed  Google Scholar 

  37. Newby PK . Are dietary intakes and eating behaviors related to childhood obesity? A comprehensive review of the evidence. J Law Med Ethics 2007; 35: 35–60.

    Article  CAS  PubMed  Google Scholar 

  38. Ruottinen S, Niinikoski H, Lagstrom H, Ronnemaa T, Hakanen M, Viikari J et al. High sucrose intake is associated with poor quality of diet and growth between 13 months and 9 years of age: the special Turku Coronary Risk Factor Intervention Project. Pediatrics 2008; 121: e1676–e1685.

    Article  PubMed  Google Scholar 

  39. Buzzard M . 24-h dietary recall and food record methods. In: Willett W (ed.) Nutritional Epidemiology. Oxford University Press: New York, 1998. pp 50.

    Google Scholar 

  40. Sopher AB, Thornton JC, Wang J, Pierson RN, Heymsfield SB, Horlick M . Measurement of percentage of body fat in 411 children and adolescents: a comparison of dual-energy X-ray absorptiometry with a four-compartment model. Pediatrics 2004; 113: 1285–1290.

    Article  PubMed  Google Scholar 

  41. Carnell S, Wardle J . Measuring behavioural susceptibility to obesity: validation of the child eating behaviour questionnaire. Appetite 2007; 48: 104–113.

    Article  PubMed  Google Scholar 

  42. Mäki P, Hakulinen-Viitanen T, Kaikkonen R, Koponen P, Ovaskainen M-L, Sippola R et al. (eds) [Child Health—Results of the LATE-study on growth, development, health, health behavior and growth environment]. In Finnish. National Institute for Health and Welfare (THL): Helsinki, 2010.

    Google Scholar 

Download references

Acknowledgements

We thank all voluntary subjects and their families for participating in the PANIC Study. We are also gratefully indebted to the PANIC Study research team members for their skillful contribution in conducting the study. We gratefully acknowledge MD, PhD David Laaksonen for editing the language of the manuscript, Eila Koski for DXA scans and PhD Marja Kalavainen and PhD Outi Nuutinen for the translation of the Children’s Eating Behaviour Questionnaire into Finnish language. This work has been financially supported by grants from the Ministry of Social Affairs and Health of Finland, the Ministry of Education and Culture of Finland, the University of Eastern Finland, the Finnish Innovation Fund Sitra, the Social Insurance Institution of Finland, the Finnish Cultural Foundation, the Juho Vainio Foundation, the Foundation for Pediatric Research and the Kuopio University Hospital (EVO-funding number 5031343).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T A Lakka.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Eloranta, AM., Lindi, V., Schwab, U. et al. Dietary factors associated with overweight and body adiposity in Finnish children aged 6–8 years: the PANIC Study. Int J Obes 36, 950–955 (2012). https://doi.org/10.1038/ijo.2012.89

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2012.89

Keywords

This article is cited by

Search

Quick links