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Individual and family characteristics associated with health indicators at entry into multidisciplinary pediatric weight management: findings from the CANadian Pediatric Weight management Registry (CANPWR)

International Journal of Obesity volume 46, pages 85–94 (2022)Cite this article

Subjects

Abstract

Objectives

(1) To explore individual and family characteristics related to anthropometric and cardiometabolic health indicators and (2) examine whether characteristics that correlate with cardiometabolic health indicators differ across severity of obesity at time of entry to Canadian pediatric weight management clinics.

Methods

We conducted a cross-sectional analysis of 2–17 year olds with overweight or obesity who registered in the CANadian Pediatric Weight Management Registry (CANPWR) between May 2013 and October 2017 prior to their first clinic visit. Individual modifiable health behaviors included dietary intake, physical activity, screen time, and sleep. Family characteristics included parental BMI, family medical history, socioeconomic status and family structure. Linear mixed effects stepwise regression analysis was performed to determine which characteristics were related to each health indicator: BMI z-score; waist circumference; waist to height ratio; blood pressure; glycemia; HDL cholesterol; non-HDL cholesterol; triglycerides.

Results

This study included 1296 children (mean age ± standard deviation: 12.1 ± 3.5 years; BMI z-score: 3.55 ± 1.29; 95.3% with obesity). Hours spent sleeping (estimated β = −0.10; 95% CI [−0.15, −0.05], p = 0.0001), hours per week of organized physical activity (estimated β = −0.32; 95% CI [−0.53, −0.11], p = 0.0026), daily sugared drink intake (estimated β = 0.06; 95% CI [0.01, 0.10], p = 0.0136) and maternal BMI (estimated β = 0.03; 95% CI [0.02, 0.04], p < 0.0001) were associated with BMI z-score (adj. R2 = 0.2084), independent of other individual and family characteristics. Physical activity, total sugared drink intake and sleep duration were associated with glycemia and non-HDL cholesterol, independent of child BMI z-score. However, irrespective of obesity severity, little of the variance (0.86–11.1%) in cardiometabolic health indicators was explained by individual modifiable health behaviors.

Conclusions

Physical activity, total sugared drink intake and hours spent sleeping were related to anthropometric and some cardiometabolic health indicators in children entering pediatric weight management programs. This highlights the importance of these modifiable health behaviors on multiple health indicators in children with obesity.

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Acknowledgements

The CANPWR study received funding support from the Canadian Institutes of Health Research (CIHR), the Population Health Research Institute (PHRI), McMaster Children’s Hospital, and McMaster University. PGM was funded by a CIHR Fellowship FRN 164649. JKH is supported with unrestricted research funds by the University of Toronto Mead Johnson Chair in Child Nutrition. GDCB was supported by an Alberta Health Services Chair in Obesity Research. AML was supported by a FRQS Clinical Research Scholar – Junior 2 Award. The CANPWR investigators would like to acknowledge the exceptional support of the research teams at each clinic and at the central coordinating site (PHRI) as well as all of the children and their families for participating in this study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    Patrick G. McPhee, Lehana Thabane & Katherine M. Morrison

  2. Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, ON, Canada

    Patrick G. McPhee & Katherine M. Morrison

  3. Trillium Health Partners, Mississauga, ON, Canada

    Ian Zenlea

  4. Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    Jill K. Hamilton

  5. Department of Pediatrics, University of Calgary, Calgary, AB, Canada

    Josephine Ho

  6. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada

    Geoff D. C. Ball

  7. Population Health Research Institute, Hamilton, ON, Canada

    Rajibul Mian, Lehana Thabane & Katherine M. Morrison

  8. Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada

    Annick Buchholz & Mark S. Tremblay

  9. Department of Pediatrics, CHU Sainte-Justine and Université de Montréal, Montreal, QC, Canada

    Anne-Marie Laberge

  10. Department of Pediatrics, McGill University, Montreal, QC, Canada

    Laurent Legault

  11. Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada

    Jean-Pierre Chanoine

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Contributions

PGM wrote the first draft of this manuscript supported by the writing group comprised of IZ, JKH, JH, GDCB, and KMM. IZ, JKH, JH, GDCB, AB, AML, LL, JPC, MST, LT, KMM contributed to study design, study conduct, data collection and interpretation of findings. KMM also oversaw the acquisition of funding and study design. RM conducted the analysis, LT contributed to analytical review. All authors edited the manuscript and approved the final version.

Corresponding author

Correspondence to Katherine M. Morrison.

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Competing interests

PGM, IZ, RM, AB, AL, LL, MST, and JPC have no competing interests. IZ is an advisory board member for Novo Nordisk, Canada and Abbot Diabetes. JH is a site investigator for a study sponsored by Levo Therapeutics, Canada, and an advisory board member for Novo Nordisk. GDCB and LL are advisory board members for Novo Nordisk. KMM is an advisory board member for Novo Nordisk and Akcea Therpaeutics, Canada.

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McPhee, P.G., Zenlea, I., Hamilton, J.K. et al. Individual and family characteristics associated with health indicators at entry into multidisciplinary pediatric weight management: findings from the CANadian Pediatric Weight management Registry (CANPWR). Int J Obes 46, 85–94 (2022). https://doi.org/10.1038/s41366-021-00959-3

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