Research On The Relationship And Risk Factors Of Childhood Obesity And Appetite

[Objective]The aim of the study is to investigate the relationship and risk factors of childhood obesity and appetite.[Methods]Chinese CEBQ (Children Eating Behavior Questionnaire) was worked out and validated after reviewing, collecting and screening literatures and tools related to measurement of appetite.About1500elementary school children in Shanghai elementary school were involved in the study and had their heights, weights and waist circumferences measured and blood test for metabolic profile examination and DNA extracting.The children were divided into overweight/obesity group or normal weight group to compare the physical or biochemical parameters mentioned above, appetite traits as well. Non-conditional Logistic regression model was applied for comprehensive analysis of the effects of environmental and genetic factors on obesity development and appetite traits.[Results]The Cronbach’s aof the Localized Chinese CEBQ fell in the rang of0.571to0.822and the retest scores were correlated significantly with the Pearson correlative coefficients mostly near or more than0.5. The correlative coefficients of CEBQ scores before or after a year were ranged from0.163to0.649in7to10years old Chinese children and there was no significant difference found with paired T test.For the whole study population the overweight and obesity prevalence is 18.6%(95%CI:16.7%to20.5%), and there was a higher ratio in boys than in girls, in urban than in suburban. Compared with children of normal weight, the overweight or obesity children have elevated levels of waist circumference, waist to height ratio (WHtR), blood pressure, blood sugar, triglycerides, insulin, IR, but lower Hdl-C, ISI and QUICKI significantly. There is no statistically significant difference in serum total cholesterol, leptin or soluble Lp-R. Overweight or obesity children have lower scores in SE(slowness in eating) and SR(satiety responsiveness) but higher scores in FR(food responsiveness) and EF(enjoyment of food).One way ANOVA and Multi-factors Logistic regression analysis showed that the risk factors of childhood obesity are male, school located in urban areas, parental overweight or obesity, sleeping too long or too short, preferring to fast food, high EF score, low SR score, while the protective factors are having more vegetables and fruits, increasing physical activities, adaptive sleep time, low EF score and high SR score. Factors those related to children’s appetite traits are including parental BMI, parental educational level, sleeping time, eating more vegetable and fruits, nutrition and obesity related knowledge, self-body assessment.No significant associations between LEPR SNP rs1137101and BMI, WHtR, obesity prevalence or appetite traits (CEBQ scores) was found by general linear model, non-conditional logistic regression or Chi-square test. The odds ratio of high WHtR(more than the median) was1.31(95%CI:1.02-1.69) in children with AA/AG alleles (OR=1in children with GG alleles).[Conclusions]The Chinese CEBQ can be applied in the study for appetite measurement with acceptable inner consistency and retest reliability. Chinese elementary school children’s appetite traits are stable and continuous, without significant variation in a year.Overweight or obesity children had already begun to subject the potential risks of metabolic syndrome and show somewhat insulin resistant. They also represented typical appetite traits, including higher food tendency and lower food-avoidness.Parental overweight or obesity, sleeping too long or too short, often eating fast food are all among the risk factors to develop obesity, while the protective factors are increasing physical activities, eating more vegetable and fruits, more nutrition and obesity related knowledge, higher parental educational levels, adaptive sleeping time and appetite traits and so on.Appetite traits showed weak correlations to parental BMI, parental educational levels, sleeping time, eating more vegetable and fruits, more nutrition and obesity related knowledge, but strong correlation to self-body assessment, which suggested that appetite traits were influenced by psychology factors to a large extent.The associations between Obesity, appetite and Polymorphism in a single gene or a single locus are always too weak to observe.